Extended Spectrum β-Lactamases among Gram-negative bacteria of nosocomial origin from an Intensive Care Unit of a tertiary health facility in Tanzania -: art. no. 86
Extended Spectrum β-Lactamases among Gram-negative bacteria of nosocomial origin from an Intensive Care Unit of a tertiary health facility in Tanzania -: art. no. 86
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DOI：
10.1186/1471-2334-5-86
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发表时间：
2005-10-15
影响因子：
3.7
通讯作者：
Langeland, N
中科院分区：
文献类型：
--
作者：
Ndugulile, F;Jureen, R;Langeland, N
背景资料：革兰氏阴性菌中由于超广谱β-内酰胺酶（ESBL）的获得和表达而对第三代头孢菌素的耐药性正在增加。据报道，产ESBL微生物的存在显著影响感染的过程和结果。因此，ESBL分离株引起的感染继续对全球感染管理构成挑战。本研究的目的是确定是否存在，并描述ESBLs的表型和基因型特征，在重症监护病房（ICU）设置在Tanzana.Methods：2002年10月至2003年4月，临床信息和样本收集怀疑有医院感染的患者在重症监护病房的三级医院在坦桑尼亚。结果：39例患者的临床标本中分离出39株革兰阴性菌。其中大肠埃希菌13株，肠杆菌属12株，假单胞菌属5株，变形杆菌属4株，克雷伯菌属2株。肺炎克雷伯氏菌2株，弗氏柠檬酸杆菌2株，黄黄金单胞菌1株。产ESBL菌株11株（28.2%）。表征的ESBL基因为SHV-12、SHV-28和CTX-M-15。产ESBL菌株对庆大霉素和环丙沙星的耐药性高于非产ESBL菌株。结论：本研究表明，在坦桑尼亚ICU环境中革兰氏阴性菌中存在ESBL基因。有必要制定严格的医院感染控制政策，并定期监测抗菌药物的耐药性。
Background: Resistance to third generation cephalosporins due to acquisition and expression of extended spectrum beta-lactamase (ESBL) enzymes among Gram-negative bacteria is on the increase. Presence of ESBL producing organisms has been reported to significantly affect the course and outcome of an infection. Therefore infections due to ESBL isolates continue to pose a challenge to infection management worldwide. The aim of this study was to determine the existence and to describe phenotypic and genotypic characteristics of ESBLs in an Intensive Care Unit (ICU) setting in Tanzania.Methods: Between October 2002 and April 2003, clinical information and samples were collected from patients suspected to have nosocomial infections in an Intensive Care Unit of a tertiary hospital in Tanzania. The isolates were identified, tested for antimicrobial susceptibility and analysed for presence of ESBL genes.Results: Thirty-nine Gram-negative bacteria were isolated from clinical samples of 39 patients. These isolates included 13 Escherichia coli, 12 Enterobacter spp, 5 Pseudomonas spp, 4 Proteus spp, 2 Klebsiella. pneumoniae, 2 Citrobacter freundii and 1 Chryseomonas luteola. Eleven (28.2%) of these isolates were ESBL producing. The ESBL genes characterised were SHV-12, SHV-28 and CTX-M-15. The ESBL producing isolates were more resistant to gentamicin and ciprofloxacin than non-ESBL producing isolates.Conclusion: This study shows the presence of ESBL genes among Gram-negative bacteria in the ICU setting in Tanzania. There is a need to institute strict hospital infection control policy and a regular surveillance of resistance to antimicrobial agents.