广谱β -内酰胺酶基因在尼日利亚拉各斯州两家医院的Fomites、医护人员和患者中的分布

T. Egwuatu, O. Ishola, O. Oladele
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摘要

抗生素耐药性是由于滥用抗生素治疗人类和动物相关感染而迅速出现的问题。自发现β -内酰胺以来,对其的使用已大大增加,同时,大多数革兰氏阴性菌中存在blaCTX-M、blaTEM和blaSHV基因介导的广谱β -内酰胺酶(ESBL)的耐药基因也被发现。本研究旨在检测尼日利亚拉各斯州两家医院的污染物、医护人员和尿路感染患者中ESBL基因的广泛分布。共收集了150份拭子样本,分别来自于污染物、卫生保健工作者和尿路感染(UTI)患者的导管。采用Kirby- Bauer技术,按照CLSI指南进行抗生素药敏试验。对ESBL表型阳性的生物体进行PCR进行分子分析。ESBL患病率为21.8%,碳青霉烯酶耐药率为16.7%。产ESBL菌株对头孢曲松的耐药性最高(82.4%),对替加环素的耐药性最低(5.9%)。blaCTX-M和blaTEM分别在76.5%和17.6%的分离株中检测到,bla编码基因在本研究中未被检测到。本研究检测到的blaSHV基因分布值得高度关注,需要在抗生素特别是第三代头孢菌素的使用中严格控制。总之,对拉各斯两家医院内ESBL编码基因的存在和分布进行了检测,记录到blaCTX-M基因的发生率最高,减少并限制了感染的可用治疗选择。
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The distribution of extended-spectrum Beta-Lactamase genes in Fomites, healthcare workers, and patients from two hospitals in Lagos state, Nigeria
Antibiotics resistance is a rapidly emerging issue through the misuse of antibiotics to treat human and animalrelated infections. The use of beta-lactams has increased considerably since its discovery so also resistant genes leading to Extended-Spectrum Beta-Lactamases (ESBL) mediated by the presence of blaCTX-M , blaTEM and blaSHV genes present in most Gram-negative bacteria. This study aimed to detect the widespread distribution of ESBL genes from fomites, healthcare workers, and patients suffering from urinary tract infection in two hospitals in  Lagos state, Nigeria. A total of 150 swab samples were collected from fomites, health care workers, and cathetersof patients suffering from urinary tract infection (UTI). Antibiotics susceptibility test was performed by Kirby- Bauer technique according to CLSI guidelines. Organisms that tested positive phenotypically for ESBL were subjected to PCR for molecular analysis. ESBL prevalence rate of 21.8% and a carbapenemase-resistance rate of 16.7% were recorded. The ESBL producing isolates showed the highest resistance to ceftriaxone (82.4%) and the least resistance to tigecycline (5.9%). The existence of blaCTX-M and blaTEM was detected in 76.5% and 17.6% of the isolates respectively, while bla encoding gene was not detected in this study. The distribution of blaSHV genes detected in this study is of great concern which necessitates strict control measures in the usage of antibiotics especially the third-generation cephalosporin. In summary, the presence and distribution of ESBL encoding genes within two hospitals in Lagos were tested and the highest occurrence was recorded in blaCTX-M gene  reducing and limiting the available treatment option for infections.
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