Molecular characterization of invasive Enterobacteriaceae from pediatric patients in Central and Northwestern Nigeria.
Molecular characterization of invasive Enterobacteriaceae from pediatric patients in Central and Northwestern Nigeria.
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尼日利亚中部和西北部的儿科患者的侵入性肠杆菌科的分子表征。
DOI：
10.1371/journal.pone.0230037
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Obaro S
中科院分区：
文献类型：
--
作者：
Duru C;Olanipekun G;Odili V;Kocmich N;Rezac A;Ajose TO;Medugu N;Umoru D;Onuchukwu C;Munir H;Jibir BW;Farouk Z;Gambo S;Hassan-Hanga F;Olaosebikan R;Ebruke B;Esimone C;Obaro S
在发展中国家，菌血症是导致死亡的主要原因，然而，病原学评价不常见，经验性抗生素使用缺乏证据。在此，我们评估了尼日利亚中部和西北部卫生机构社区获得性菌血症综合征监测研究中儿童的ESBL耐药模式。2008年9月至2016年12月，对怀疑患有败血症的5岁以下儿童进行了血培养。使用BACTEC 00 AE系统孵育血液，并使用分析特征指数（API 20 E ®）鉴定肠杆菌科的菌种水平。药敏试验采用纸片扩散法。真实的时间PCR用于表征负责ESBL产生的基因。在2008年9月至2016年12月筛查的21，000名儿童中，2，625名（12.5%）为培养阳性。对413株可用于分析的肠杆菌科细菌进行ESBL筛查。160株产ESBL肠杆菌科细菌对头孢曲松耐药率较高（92.3%），氨曲南（96.8%），头孢泊肟（96.3%），头孢噻肟对亚胺培南的敏感率分别为87.5%、90.7%和91.9%，分别为阿米卡星和美罗培南。常见的耐药基因为blaTEM-83.8%（134/160），blaCTX-M 83.1%（133/160），其次为blaSHV基因66.3%（106/160）。在94/160（58.8%）的受试分离株中观察到blaCTX-M、blaTEM和blaSHV共存，在118/160（73.8%）的受试分离株中观察到blaCTX-M和blaTEM共存，在97/160（60.6%）的受试分离株中观察到blaTEM和blaSHV共存，在100/160（62.5%）的受试分离株中观察到blaCTX-M和blaSHV共存。我们的研究结果表明，高流行率的菌血症ESBL肠杆菌科在这一人口的儿童。它们对常用抗生素具有耐药性，谨慎选择抗生素治疗方案至关重要。进一步的研究，以评估传播动力学的耐药基因可能有助于在这些设置中的ESBL耐药的减少。
Bacteremia is a leading cause of mortality in developing countries, however, etiologic evaluation is infrequent and empiric antibiotic use not evidence-based. Here, we evaluated the patterns of ESBL resistance in children enrolled into a surveillance study for community acquired bacteremic syndromes across health facilities in Central and Northwestern Nigeria. Blood culture was performed for children aged less than 5 years suspected of having sepsis from Sept 2008-Dec 2016. Blood was incubated using the BACTEC00AE system and Enterobacteriacea identified to the species level using Analytical Profile Index (API20E®). Antibiotic susceptibility profile was determined by the disc diffusion method. Real time PCR was used to characterize genes responsible for ESBL production. Of 21,000 children screened from Sept 2008-Dec 2016, 2,625(12.5%) were culture-positive. A total of 413 Enterobacteriaceae available for analysis were screened for ESBL. ESBL production was detected in 160 Enterobacteriaceae, high resistance rates were observed among ESBL-positive isolates for Ceftriaxone (92.3%), Aztreonam (96.8%), Cefpodoxime (96.3%), Cefotaxime (98.8%) and Trimethoprim/sulfamethoxazole (90%), while 87.5%, 90.7%, and 91.9% of the isolates were susceptible to Imipenem, Amikacin and Meropenem respectively. Frequently detected resistance genes were blaTEM—83.8% (134/160), and, blaCTX-M 83.1% (133/160) followed by blaSHVgenes 66.3% (106/160). Co-existence of blaCTX-M, blaTEM and blaSHV was seen in 94/160 (58.8%), blaCTX-M and blaTEM in 118/160 (73.8%), blaTEM and blaSHV in 97/160 (60.6%) and blaCTX-M and blaSHV in 100/160 (62.5%) of isolates tested. Our results indicate a high prevalence of bacteremia from ESBL Enterobacteriaceae in this population of children. These are resistant to commonly used antibiotics and careful choice of antibiotic treatment options is critical. Further studies to evaluate transmission dynamics of resistance genes could help in the reduction of ESBL resistance in these settings.
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影响因子：
0.2
作者：
Mohammed, Yahaya;Gadzama, Galadima Bala;Aboderin, Aaron Oladipo
通讯作者：
Aboderin, Aaron Oladipo
影响因子：
5.2
作者：
McNulty, Cliodna A. M.;Lecky, Donna M.;Hawkey, Peter M.
通讯作者：
Hawkey, Peter M.
影响因子：
5.7
作者：
Kasap, Murat;Fashae, Kayode;Vahaboglu, Haluk
通讯作者：
Vahaboglu, Haluk
影响因子：
--
作者：
Adeyankinnu FA;Motayo BO;Akinduti A;Akinbo J;Ogiogwa JI;Aboderin BW;Agunlejika RA
通讯作者：
Agunlejika RA
DOI：
10.5863/1551-6776-19.2.83
发表时间：
2014-04-01
期刊：
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG
影响因子：
--
作者：
Benner, Kim W;Prabhakaran, Priya;Lowros, Autumn S
通讯作者：
Lowros, Autumn S