Drug Resistance and Molecular Epidemiology of Aerobic Bacteria Isolated from Puerperal Infections in Bangladesh
Drug Resistance and Molecular Epidemiology of Aerobic Bacteria Isolated from Puerperal Infections in Bangladesh
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DOI：
10.1089/mdr.2014.0219
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发表时间：
2015-06-01
影响因子：
2.6
通讯作者：
Kobayashi, Nobumichi
中科院分区：
文献类型：
--
作者：
Ahmed, Salma;Kawaguchiya, Mitsuyo;Kobayashi, Nobumichi
产褥感染是发展中国家产后常见的并发症。对孟加拉国2年（2010-2012年）产褥感染的470株分离株的细菌种类、耐药性和遗传特征进行了研究。最常见的菌种为大肠埃希菌（n=98），其次为粪肠球菌（n=54）、溶血葡萄球菌（n=33）、奇异变形杆菌（n=32）、金黄色葡萄球菌（n=27）、克雷伯氏杆菌（n=22）和阴沟肠杆菌（n=21）。S.金黄色葡萄球菌和鲍曼不动杆菌在剖宫产术后伤口感染中的分离率较高，而E. coli、E. cloxacin和K.肺炎分离自社区获得性尿道炎和尿路感染。对第三代头孢菌素的耐药是肠杆菌属常见的，主要由bla（CTX-M-1）组β-内酰胺酶介导。CTX-M基因在E. B2群分离株属于ST 131，携带O25 b等位基因，携带aac（6）-Ib-cr和多种毒力因子。在大肠杆菌A群和E群各分离到1株碳青霉烯酶基因bla（NDM-1）和bla（NDM-7）。杆菌耐甲氧西林表皮葡萄金黄色葡萄球菌分离株具有IV型或V型SCCmec，包括ST 361（CC 672）分离株，其与印度次大陆出现的ST 672克隆相关。这项研究揭示了孟加拉国产褥感染需氧菌的流行病学现状，为改善临床实践和感染控制提供了有用的信息。
Puerperal infection is a common complication during postnatal period in developing countries. Bacterial species, drug resistance, and genetic characteristics were investigated for a total of 470 isolates from puerperal infections in Bangladesh for a 2-year period (2010-2012). The most common species was Escherichia coli (n=98), followed by Enterococcus faecalis (n=54), Staphylococcus haemolyticus (n=33), Proteus mirabilis (n=32), Staphylococcus aureus (n=27), Klebsiellapneumoniae (n=22), and Enterobacter cloacae (n=21). S. aureus and Acinetobacter baumannii were isolated at a higher frequency from wound infections after cesarean section, while E. coli, E. cloacae, and K. pneumoniae were isolated from community-acquired endometritis and urinary tract infections. Resistance to third-generation cephalosporins was frequent for Enterobacteriacae, and was mainly mediated by bla(CTX-M-1) group beta-lactamases. The CTX-M gene in E. coli from the four phylogroups was identified as bla(CTX-M-15), and phylogroup B2 isolates with bla(CTX-M-15) were classified into ST131 with O25b allele, harboring aac(6)-Ib-cr and various virulence factors. Carbapenemase genes bla(NDM-1) and bla(NDM-7) were identified in one isolate each of phylogroup A E. coli. Methicillin-resistant S. aureus isolates had type IV or V SCCmec, including isolates of ST361 (CC672), which is related to an emerging ST672 clone in the Indian subcontinent. This study revealed the recent epidemiological status of aerobic bacteria causing puerperal infections in Bangladesh, providing useful information to improve clinical practice and infection control.