喀麦隆6个卫生设施中产碳青霉烯酶铜绿假单胞菌分离株的表型特征和流行

SPG biomed Pub Date : 2023-01-12 DOI:10.3390/biomed3010006
Cecile Ingrid Djuikoué, P. D. Djouela Djoulako, Hélène Valérie Same Njanjo, Christiane Possi Kiyang, Feline Leina Djantou Biankeu, C. Guegang, Andrea Sheisley Didi Tchouotou, Kamga Wouambo Rodrigue, Benjamin D. Thumamo Pokam, T. Apalata, K. Jeannot
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引用次数: 3

摘要

铜绿假单胞菌是一种革兰氏阴性条件致病菌,具有很强的适应应激能力,特别是适应医院环境中抗生素的选择压力。这种病原体构成真正的公共卫生问题,特别是在低收入和中等收入国家。在喀麦隆,人们对铜绿假单胞菌的耐药模式知之甚少。本研究旨在确定在喀麦隆中部、沿海和西部地区的六个卫生机构中产生碳青霉烯酶的铜绿假单胞菌菌株的流行情况。在2021年7月至10月的四个月期间进行了一项分析性横断面研究。系统收集了不同卫生机构细菌学实验室从病理产物中分离出的所有铜绿假单胞菌或疑似菌株,并进行了重新鉴定。将菌悬液(0.5McFarland标准)用API 20NE体系进行生化鉴定后,将菌悬液在cetrimide琼脂上生长,在营养琼脂上传代成功,对纯菌落进行氧化酶试验。按照适当的标准程序进行药敏试验,检测过量生产的诱导型头孢菌素酶和碳青霉烯酶的广谱β -内酰胺酶。其中347株(74.14%)为铜绿假单胞菌,产生诱导型头孢菌素酶(CAZR和C/TS)的占34.49%(120/347),产生广谱β -内酰胺酶的占32.26%(112/347)。产碳青霉烯酶P. aeruginosa (imr和C/TR)阳性率为25.07%(87/347),其中A类为17.24% (15/87),b类为82.76%(72/87)。对青霉素的耐药率较高(哌拉西林:70.58%,替卡西林:60.24%)。我们还发现,对头孢他啶的耐药率为34.49%,对亚胺培南的耐药率为30.22%,对美罗培南的耐药率为37.02%,对头孢甲苯/他唑巴坦(C/T)的耐药率为25.1%。对喹诺酮类药物的耐药率为79.57%,对氨基糖苷类药物的耐药率为26%。多因素分析显示,产碳青霉烯酶铜绿假单胞菌相关感染与住院(p = 0.04)、分娩(p = 0.03)、手术(p = 0.04)和重症监护病房(p = 0.04)显著相关。这项研究强调了碳青霉烯酶产生铜绿假单胞菌的高负担耐药菌株。应加强监测,以防止这些毒株的传播和扩散。
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Phenotypic Characterization and Prevalence of Carbapenemase-Producing Pseudomonas aeruginosa Isolates in Six Health Facilities in Cameroon
Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen with a great ability to adapt to stress, in particular, to the selective pressure of antibiotics in the hospital environment. This pathogen constitutes a real public health concern, especially in low- and middle-income countries. In Cameroon, little is known about the drug resistance patterns of Pseudomonas aeruginosa. This study sought to determine the prevalence of Pseudomonas aeruginosa strains producing carbapenemases in six health facilities in the center, littoral, and west regions of Cameroon. An analytical cross-sectional study was conducted over a four-month period from July to October 2021. All Pseudomonas aeruginosa or suspected strains isolated from pathological products at the bacteriology laboratory of different health facilities were systematically collected and underwent a re-identification. After growing on cetrimide agar and successfully subculturing on nutrient agar, an oxidase test was performed on pure colonies, followed by biochemical identification (API 20NE system) of the bacterial suspension (0.5McFarland standard). Drug susceptibility testing for the detection of extended-spectrum beta-lactamases of overproduced inducible cephalosporinases and carbapenemases was performed according to adequate standard procedures. Of the 468 isolates collected, 347 (74.14%) were confirmed Pseudomonas aeruginosa after re-identification, of which 34.49% (120/347) produced inducible cephalosporinases (CAZR and C/TS) and 32.26% (112/347) extended-spectrum beta-lactamases. The prevalence of carbapenemase-producing P. aeruginosa (IMPR and C/TR) was 25.07% (87/347), with 17.24% (15/87) class A and 82.76% (72/87) class B. A high rate of resistance to penicillin (piperacillin: 70.58% and ticarcillin: 60.24%) was observed. We also noted a 34.49% resistance to ceftazidime, 30.22% to imipenem against 37.02% to meropenem, and 25.1% to ceftolozane/tazobactam (C/T). These strains also exhibited 79.57% resistance to quinolones and about 26% to aminoglycoside families. Multivariate analysis revealed that carbapenemase-producing Pseudomonas aeruginosa-related infections were significantly associated with hospitalization (p = 0.04), maternity (p = 0.03), surgery (p = 0.04), and intensive care wards (p = 0.04). This study highlighted a high burden of resistant strains of carbapenemase-producing Pseudomonas aeruginosa. Surveillance should be intensified to prevent the dissemination and spread of these strains.
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