Antimicrobial resistance profile of Enterococcus species isolated from intestinal tracts of hospitalized patients in Jimma, Ethiopia.
Antimicrobial resistance profile of Enterococcus species isolated from intestinal tracts of hospitalized patients in Jimma, Ethiopia.
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DOI：
10.1186/s13104-015-1200-2
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发表时间：
2015-06-03
影响因子：
1.8
通讯作者：
Abdissa A
中科院分区：
文献类型：
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作者：
Abamecha A;Wondafrash B;Abdissa A
在住院患者肠道内定植的多重耐药肠球菌是医院内感染和传播的主要来源。尽管全球多药耐药肠球菌在住院患者中的定植和感染率不断上升，但资源有限的环境下的数据仍然很匮乏。本研究旨在确定埃塞俄比亚吉马住院患者肠道中肠球菌的耐药性。这项研究于2013年1月至7月在吉马大学专科医院的住院患者中进行。采集粪便样本，进行细菌分离和抗菌剂敏感性试验。将粪便标本接种于肠球菌选择性培养基(胆汁七叶皂苷叠氮琼脂平板)上，加入和不加入6 mg/ml万古霉素。通过培养特性、革兰氏染色、过氧化氢酶试验、在6.5%氯化钠肉汤中的生长、45℃下的生长、运动试验和API 20链球菌系统的鉴定，对分离到的菌株进行了属和种水平的鉴定。药敏试验采用Kirby-Bauer纸片扩散法。用E-test试纸法测定万古霉素的最低抑菌浓度。总体而言，从114名(76%)研究对象中分离出肠球菌。分离菌株依次为屎肠球菌(35.1%)、粪肠球菌(29.8%)、鸡肠球菌(17.5%)、酪黄色肠球菌(8.8%)和硬肠球菌(8.8%)。114株肠球菌对氨苄西林耐药41株(36%)，链霉素62株(54.4%)，庆大霉素39株(34.2%)。用于治疗肠球菌医院内混合感染的其他替代抗生素在体外也显示出较高的耐药率：环丙沙星(50%)、诺氟沙星(49.1%)、红霉素(63.2%)、四环素(64.9%)、氯霉素(34.2%)和硝基呋喃妥因(32.4%)。89.5%的粪肠球菌对多重耐药。5%的粪肠球菌对万古霉素耐药。本研究揭示了多重耐药肠球菌的高粪便定植率和万古霉素耐药菌株的流行。因此，建议定期监测抗菌药物敏感性，以发现新出现的耐药性，防止耐药菌株的传播。
Multi-drug-resistant Enterococci colonizing the intestinal tract of hospitalized patients are the major source of infection as well as nosocomial spread. Despite worldwide increasing rate of multidrug resistant Enterococci colonization and infection among hospitalized patients, there is scarcity of data from resource limited setting. The present study aimed at determining the antimicrobial resistance profile of Enterococcus species from intestinal tracts of hospitalized patients in Jimma, Ethiopia. The study was conducted among hospitalized patients at Jimma University Specialized Hospital, from January to July 2013. Fecal samples were collected and processed for bacterial isolation and susceptibility testing to antimicrobial agents. Stool samples were inoculated onto enterococcus selective media (Bile Esculin azide agar plate) with and without 6 µg/ml of vancomycin. The isolates were identified to genus and species level by cultural characteristics, Gram’s stain, catalase test, growth in 6.5% NaCl broth, growth at 45°C, motility test and by using API 20 Streptococcus system. Sensitivity testing was done using Kirby–Bauer disk diffusion method. Minimum inhibitory concentrations for vancomycin were determined using E-test strips. Overall, Enterococci were isolated from 114 (76%) of the study subjects. The isolates were Enterococcus faecium (35.1%) followed by Enterococcusfaecalis (29.8%), Enterococcus gallinarum (17.5%), Enterococcuscasseliflavus (8.8%) and Enterococcusdurans (8.8%). Among 114 tested Enterococci isolates, 41 (36%) were resistant to ampicillin, 62 (54.4%) to streptomycin and 39 (34.2%) to gentamycin. Other alternative antibiotics to treat mixed nosocomial infection caused by Enterococci also showed high rate of resistance in vitro: ciprofloxacin (50% of resistance), norfloxacin (49.1%), erythromycin (63.2%), tetracycline (64.9%), chloramphenicol (34.2%), and nitrofrantoin (32.4%). Multiple drug resistance was observed among 89.5% of E. faecium and E. faecalis. Vancomycin resistant Enterococci were observed in 5% of E. faecium isolates. This study reveals high rate of fecal colonization by multidrug-resistant Enterococci and prevalence of vancomycin resistance strains. Thus periodic surveillance of antibacterial susceptibilities is recommended to detect emerging resistance and to prevent the spread of antibacterial-resistant strains.