High Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Isolated from Clinical Settings in Egypt: Recalling for Judicious Use of Conventional Antimicrobials in Developing Nations
High Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Isolated from Clinical Settings in Egypt: Recalling for Judicious Use of Conventional Antimicrobials in Developing Nations
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DOI：
10.1089/mdr.2018.0380
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发表时间：
2019-04-01
影响因子：
2.6
通讯作者：
Shimamoto, Tadashi
中科院分区：
文献类型：
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作者：
Khalifa, Hazim O.;Soliman, Ahmed M.;Shimamoto, Tadashi
本研究的目的是调查，在分子水平上，不同的抗菌药物耐药基因，包括，超广谱β-内酰胺酶，AmpC β-内酰胺酶，第1类和第2类整合子，质粒介导的喹诺酮类耐药基因的革兰氏阴性菌从埃及的临床环境中分离的抗菌药物耐药机制。2014年，从埃及住院患者的不同临床样本中回收了总共126株非重复的革兰氏阴性分离株。药敏试验结果显示，93.6%（118/126）的菌株具有多重耐药表型。有趣的是，我们报告了几乎所有测试抗生素的高水平抗菌素耐药性;据我们所知，这是埃及的第一份报告，表明埃及的抗生素耐药性非常高。聚合酶链反应和DNA测序结果显示，75.4%（95/126）的分离株携带至少一种超广谱β-内酰胺酶编码基因，其中以bla（CTX-M）最常见（65.9%），其次为bla（SHV）（46.8%）。AmpC β-内酰胺酶bla（CMY）在7.1%（9/126）的细菌分离株中被检测到，其中bla（CMY-42）是最普遍的。在50.8%（64/126）的分离株中检测到1类整合子，在2.4%（3/126）的分离株中检测到2类整合子。质粒介导的喹诺酮类耐药基因qnr的检出率为58.7%（74/126），其中qnrS最为常见。在埃及首次鉴定了几种抗菌素耐药性决定簇，如SHV-27、SHV-28、SHV-33、SHV-63、SHV-71、SHV-82、SHV-142、CMY-42、CMY-6和新的CMY-72样。这项研究强调了有意识地使用常规抗菌药物以克服多药耐药问题的重要性。
This study was designed to investigate, at the molecular level, the antimicrobial resistance mechanisms of different antimicrobial resistance genes, including, extended-spectrum beta-lactamases, AmpC beta-lactamases, class 1 and 2 integrons, and plasmid-mediated quinolone resistance genes of Gram-negative bacteria isolated from clinical settings in Egypt. A total of 126 nonduplicate Gram-negative isolates were recovered from different clinical samples taken from hospitalized patients in Egypt in 2014. Antimicrobial susceptibility testing showed that, 93.6% (118/126) of the isolates had a multidrug-resistant phenotype. Interestingly, we reported a high level of antimicrobial resistance nearly for all tested antibiotics; to our knowledge, this is the first report from Egypt indicating very high level of antibiotic resistance in Egypt. Polymerase chain reaction screening and DNA sequencing revealed that, 75.4% (95/126) of the isolates harbored at least one extended-spectrum beta-lactamase-encoding gene, with bla(CTX-M) being the most prevalent (65.9%), followed by bla(SHV) (46.8%). The AmpC beta-lactamase, bla(CMY), was detected in 7.1% (9/126) of bacterial isolates, with bla(CMY-42) being the most prevalent. Class 1 integrons were detected in 50.8% (64/126) of the isolates, and class 2 integrons were detected in 2.4% (3/126) of the isolates. The plasmid-mediated quinolone resistance gene, qnr, was detected in 58.7% (74/126) of the tested isolates, with qnrS being the most prevalent. Several antimicrobial resistance determinants were identified in Egypt for the first time, such as SHV-27, SHV-28, SHV-33, SHV-63, SHV-71, SHV-82, SHV-142, CMY-42, CMY-6, and the new CMY-72 like. This study highlights the importance of the conscious use of conventional antimicrobials to overcome the multidrug resistance problem.