Antibiotic resistance and genotypic detection of extended spectrum beta-lactamase producing pathogens in catheter associated urinary tract infection at a teaching facility in Kumasi, Ghana.
Antibiotic resistance and genotypic detection of extended spectrum beta-lactamase producing pathogens in catheter associated urinary tract infection at a teaching facility in Kumasi, Ghana.
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DOI：
10.5897/ajmr2020.9374
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发表时间：
2020-01-01
影响因子：
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通讯作者：
Addo, Matthew Glover
中科院分区：
文献类型：
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作者：
Bekoe, Alexander;Azorliade, Roland;Addo, Matthew Glover
本研究确定了广谱β -内酰胺酶（ESBL）产生的导管相关性尿路感染（CAUTI）病原体的抗生素耐药模式以及与耐药相关的基因。该研究使用了从2018年6月至2018年11月在CAUTI发现的尿液和生物膜中分离出的35种产生esbl的病原体。用头孢多肟联合光盘试剂盒证实病原菌产生ESBL的表型。采用Kirby-Baurer圆盘扩散法在Muller Hinton琼脂上检测抗生素耐药性。用PCR方法鉴定ESBL基因型。尿分离株对环丙沙星（94.11%）、头孢呋辛和头孢他啶（82.35%）耐药率较高，对厄替培南（0.0%）无耐药率。生物膜分离株的平均耐药率为0.0%（厄替培南）~ 88.89%（头孢呋辛、头孢多辛、环丙沙星和甲氧苄啶）。所有靶基因均鉴定出CTX-M（40%）为最显性基因。产生esbl的病原菌对Ertepenem的耐药性为零。环丙沙星和其他常用于CAUTI治疗的头孢类药物效果较差。高耐药性是由于生物膜中存在的细菌细胞，肺炎克雷伯菌比产生esbl的大肠杆菌表现出更强的耐药性，并且在鉴定的基因型中，CTX-M-1被鉴定为最普遍的基因。因此，应推荐使用厄替培南治疗导管相关性尿路感染。
This study determines the antibiotic resistance pattern of extended spectrum beta-lactamase (ESBL) producing pathogens responsible for catheter associated urinary tract infection (CAUTI) and the genes associated with the resistance. The study used 35 ESBL-producing pathogens isolated from urine and biofilm found in CAUTI from June 2018 to November 2018. Pathogens were confirmed phenotypically for ESBL production with cefpodoxime combination disc kits. Antibiotic resistance was tested using the Kirby-Baurer disc diffusion method on Muller Hinton Agar. ESBL genotypes were identified with PCR. Urine isolates showed higher frequency of resistance against ciprofloxacin (94.11%), cefuroxime and ceftazidime (82.35%) and with no recorded resistance against Ertepenem (0.0%). The average resistance of the biofilm isolates ranged from 0.0% (Ertepenem) to 88.89% (Cefuroxime, Cefpodoxime, Ciprofloxacin and Trimethoprim). All the targeted genes were identified with CTX-M (40%) being the most dominant among them. The ESBL-producing pathogens showed zero resistance against Ertepenem. Ciprofloxacin and other Cephems commonly used in CAUTI treatment were shown to be less effective. The high resistance is as a result of the bacterial cells present in the biofilm with Klebsiella pneumoniae exhibiting more resistance than the ESBL-producing E. coli and CTX-M-1 was identified as the most prevalent gene among the identified genotypes. Ertepenem should therefore be recommended for treatment of Catheter associated urinary tract infection.