临床分离肺炎克雷伯菌的抗生素谱和生物膜发育

Subash Paudel, Prashanna Adhikari, Sanjay Singh K.C., U. Shrestha, P. K. Shah
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摘要

目的:评价不同临床标本分离的肺炎克雷伯菌的耐药模式和生物膜的形成,探讨耐药模式与生物膜形成的关系。方法:根据标准微生物学程序,对2019年9月至2020年3月在Sahid Gangalal国家心脏中心就诊的患者的944份临床样本进行处理,以鉴定可能的细菌病原体。采用改良Kirby Bauer圆盘扩散法对分离的肺炎克雷伯菌进行药敏试验。采用组织培养平板技术评价生物膜的形成。结果:944份样本中有146份细菌生长,占15.47%,其中肺炎克雷伯菌35份,占23.97%。35株肺炎克雷伯菌分离株中,多重耐药16株(45.71%),广泛耐药15株(42.86%)。60%(21%)的肺炎克雷伯菌无力产生生物膜。生物膜的生成与多药耐药表现有显著相关性(p值<0.05)。结论:医院耐药肺炎克雷伯菌感染率较高,值得警惕。耐药模式与生物膜产生之间的显著关联意味着需要立即采取措施,以限制临床环境中耐药微生物的生长和传播。
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Antibiogram and Biofilm Development among Klebsiella pneumoniae from Clinical Isolates
Objectives: This study was aimed to evaluate antibiotic resistance pattern and biofilm formation in K. pneumoniae strains isolated from different clinical specimens and to study on association of drug resistance pattern with biofilm formation. Methods: A total of 944 clinical samples from patients attending Sahid Gangalal National Heart Center were processed from September 2019 to March 2020 to identify possible bacterial pathogens following standard microbiological procedures. K. pneumonaie isolates were further subjected to antibiotic susceptibility testing using modified Kirby Bauer disc diffusion technique. Biofilm formation was evaluated by tissue culture plate technique. Results: Of the total 944 samples, 15.47% (146) samples showed bacterial growth, among which 23.97% (35) were K. pneumoniae. Out of 35 K. pneumoniae isolates, 45.71% (16) were multidrug-resistant and 42.86% (15) were extensively drug-resistant. Sixty percent (21) of K. pneumoniae feebly produced biofilm. Significant association was observed between biofilm production and exhibition of multidrug resistance (p value<0.05). Conclusion: Prevalence of antibiotics resistant K. pneumoniae in hospital setting is high and alarming. Significant association between drug resistance pattern and biofilm production implicates need of an immediate response to limit growth and spread of drug resistant microbes in clinical settings.
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