明野教学医院尿路感染患者耐万古霉素粪肠球菌的研究

A. Kumurya, A. Idris, Maryam Ali
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引用次数: 1

摘要

背景:万古霉素耐药肠球菌(VRE)的出现已成为世界范围内医院感染控制的一个严重问题。肠球菌中抗生素耐药性的增加,特别是对万古霉素的耐药性,已成为一个主要的临床和流行病学问题。目的:研究尼日利亚卡诺Aminu Kano教学医院女病房和产后病房住院患者粪肠球菌的鉴定、表型特征及万古霉素对尿路感染(UTI)相关粪肠球菌的敏感性。材料与方法:无菌收集疑似UTI患者114份尿液标本,分别在血琼脂和半胱氨酸-乳糖-电解质缺乏琼脂上培养,37℃厌氧和好氧环境下培养24 h。采用粪肠球菌鉴定标准方法进行细菌生长,并检测其对万古霉素(30 μg)、环丙沙星(10 μg)、链霉素(10 μg)、氯霉素(30 μg)、四环素(10 μg)和复方新诺明(25 μg) (Oxoid, UK)采用圆盘扩散法。测定万古霉素的最小抑菌浓度(MIC)和最小杀菌浓度(MBC)。每次试验均以ATCC粪肠球菌29,212为对照菌。生成的数据使用描述性统计进行分析。结果:114份标本中共分离出粪肠球菌8只(7.0%)。圆盘扩散法和肉汤稀释法的VRE患病率分别为50.0%和25.0%。抗生素药敏分析结果显示,6株(75.0%)粪肠球菌对四环素(30 μg)、复方新诺明(1.25/23.75 μg)和链霉素(10 μg)多重耐药,对环丙沙星(5 μg)和氯霉素(30 μg)较为敏感。MIC结果显示,万古霉素在浓度为4、2 μg/ml时具有较高的抑菌效果,当浓度增加到8、16、32、64 μg/ml时失去抑菌效果;MBC结果显示,万古霉素仅对粪肠杆菌具有抑菌作用。结论:因此,环丙沙星和氯霉素是卡诺地区治疗VRE感染的最佳选择,获得的耐药治疗可能会影响这些药物的特征治疗和感染管理。
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Vancomycin-resistant enterococcus faecalis among patients with urinary tract infection at aminu kano teaching hospital
Background: Emergence of vancomycin-resistant enterococci (VRE) has become a serious issue for nosocomial infection control worldwide. The increase in antibiotic resistance among enterococci, specifically to vancomycin, has become a major clinical and epidemiological problem. Aim: The study aimed at the identification, phenotypic characterization of Enterococcus faecalis, and susceptibility pattern of vancomycin on E. faecalis associated with urinary tract infection (UTI) on patients admitted to the female medical ward and postnatal ward of Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: A total of 114 urine samples were aseptically collected from patients suspected with UTI and cultured on blood agar and cystine–lactose–electrolyte-deficient agar and incubated under anaerobic and aerobic environment, respectively, at 37°C for 24 h. Bacterial growth was subjected to standard methods for the identification of E. faecalis and tested for their antibiotic susceptibility patterns on vancomycin (30 μg), ciprofloxacin (10 μg), streptomycin (10 μg), chloramphenicol (30 μg), tetracycline (10 μg), and co-trimoxazole (25 μg) (Oxoid, UK) using disk diffusion method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of vancomycin were determined. ATCC E. faecalis 29,212 was used as control organism for every test run. Data generated were analyzed using descriptive statistics. Results: A total of 8 (7.0%) E. faecalis were isolated from 114 samples studied. The prevalence of 50.0% and 25.0% VRE was obtained by disk diffusion and broth dilution methods, respectively. The result of antibiotics susceptibility pattern revealed that 6 (75.0%) of the E. faecalis isolates show multiple resistance to tetracycline (30 μg), co-trimoxazole (1.25/23.75 μg), and streptomycin (10 μg), but more sensitive to ciprofloxacin (5 μg) and chloramphenicol (30 μg). The MIC result revealed that vancomycin has high effect at lower concentration of 4 and 2 μg/ml and loses its effect at increase concentration of 8, 16, 32, and 64 μg/ml, and the result obtained from the MBC of vancomycin revealed that it has only a bacteriostatic effect against E. faecalis. Conclusion: Therefore, ciprofloxacin and chloramphenicol are the best therapeutic options to treat infection with VRE in Kano, and treatment with the resistant drugs obtained may affect feature treatment and management of infection with these drugs.
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