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首页> 外文期刊>Advances in Microbiology >Detection of the Production of Klebsiella Pneumoniae Carbapenemase, New Delhi Metallo-Beta-Lactamase and Oxacillinase-48-Type Carbapenemases by Gram-Negative Bacilli in Resource-Limited Setting
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Detection of the Production of Klebsiella Pneumoniae Carbapenemase, New Delhi Metallo-Beta-Lactamase and Oxacillinase-48-Type Carbapenemases by Gram-Negative Bacilli in Resource-Limited Setting

机译：检测通过革兰氏阴性杆菌在资源限制设定中，通过革兰氏阴性杆菌检测克雷布氏菌肺癌蛋白酶，新德里金属β-内酰胺酶和牛奶酶-48型碳结构酶

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Background: The increasing resistance of bacteria to various antibiotics is a worldwide public health issue. Carbapenems that have elicited great hope in treating infections caused by multidrug-resistant germs have seen their efficacy narrowed over time with the emergence of other novel resistance mechanisms, notably the production of Carbapenemases. Methods: A prospective cross-sectional study was conducted from May 2017 to May 2018 in Douala (Cameroon) to detect carbapenemase-producing Gram-negative bacilli. Isolated strains were identified using the Vitek2~(TM) system. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on agar plates with 20 selected commercially available antibiotic discs. The bacterial strains were tested for the production of three Carbapenemases (OXA-48, NDM, KPC), using an immuno-chromatographic technique, with the “RESIST-3 O.K.N. K-SeT” rapid detection kit. Results: During the study period, 1687 strains of Gram-negative bacilli were isolated in selected laboratories with a total of 200 multi-resistant strains identified (11.9%). Among the multi-resistant strains, E. coli was the species most represented in Enterobacteriaceae (27.5%) followed by K. pneumoniae (15.5%) and the non-fermenting Gram-negative bacilli were predominantly P. aeruginosa (20.5%). These strains mainly came from urine and pus, i.e. 41% and 32% respectively. Thirty-two (16%) strains produced one of the Carbapenemases with a higher frequency at the General Hospital (84%). NDM-type carbapenemase was the most frequently identified (8.5%), OXA-48 type 7.5%, and no KPC production was observed. Among the Enterobacteriaceae 22.9% produced Carbapenemases and only 5.1% of the non-fermenting bacilli produced these enzymes. The isolates strains were completely resistant to all antibiotics except Amikacin and Fosfomycin. The strains producing the NDM-type carbapenemase showed higher rates of resistance to almost all of the antibiotics tested. Conclusion: Multidrug-resistant strains are experiencing an increase in evolution. The apparition of strains producing Carbapenemases prominently, the NDM and OXA-48 favor this increase. The activities of antibiotics with high efficacies on these strains are low.
机译：背景：细菌对各种抗生素的耐药性是全球公共卫生问题。在治疗多药物抗性毒性引起的感染方面引起了巨大希望的Carbapenems已经看到它们的疗效随着时间的推移而狭隘地缩小了其他新的抵抗机制的出现，特别是生产碳结构酶的产生。 方法：从2017年5月至2018年5月在Douara（喀麦隆）中进行了前瞻性横截面研究，以检测产生碳丙胺酶的革兰阴性杆菌。使用Vitek2〜（TM）系统鉴定分离的菌株。使用琼脂平板上的Kirby-Bauer盘扩散方法进行抗微生物易感性测试，其中20种选择的商用抗生素盘。使用免疫色谱技术测试三种碳结构酶（OXA-48，NDM，KPC）的细菌菌株用“抗蚀剂-3 o.k.n.”进行测试。 K-Set“快速检测套件。 结果：在研究期间，在选定的实验室中分离了1687株革兰氏阴性杆菌，鉴定了200多种多种多种多种抗性菌株（11.9％）。在多抗性菌株中， e。 Coli是最多代表的物种在肠杆菌痤疮（27.5％），然后是 k。肺炎（15.5％）和非发酵革兰阴性杆菌主要是 p。铜绿假单胞菌（20.5％）。这些菌株主要来自尿液和脓液， i.e。 41％和32％。三十二（16％）菌株在综合医院（84％）产生了较高频率的碳结甲酶。 NDM型Carbapenemase是最常鉴定的（8.5％），Oxa-48型7.5％，并且没有观察到KPC生产。在肠杆菌菌中22.9％产生的碳基氨酸酶，只有5.1％的非发酵杆菌产生这些酶。分离株菌株与Amikacin和Fosfomcin以外的所有抗生素完全抵抗。产生Ndm型碳结构酶的菌株显示出对测试的几乎所有抗生素的抗性率较高。 结论：多药抗性菌株正在经历进化的增加。菌株突出产生碳结构酶突出，NDM和Oxa-48赞成这种增加。这些菌株高效具有高效率的抗生素的活性较低。

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