فراوانی ژن‌های متالوبتالاکتاماز و بتالاکتامازهای طیف گسترده در باکتری‌های گرم منفی جدا شده از پنومونی وابسته به ونتیلاتور در بخش مراقبت‌های ویژه بیمارستان امام رضا(ع) شهر کرمانشاه

نوع مقاله : Original Article(s)

نویسندگان

1 کارشناسی ارشد میکروب‌شناسی، کمیته‌ی تحقیقات دانشجویی، گروه میکروب‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران

2 استادیار باکتری‌شناسی پزشکی، گروه میکروب‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران

3 کارشناسی ارشد، کمیته‌ی تحقیقات دانشجویی، گروه میکروب شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران

4 استاد، مرکز تحقیقات باروری و ناباروری، گروه میکروبیولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران

5 استادیار باکتری‌شناسی پزشکی، دانشکده‌ی علوم پزشکی بهبهان، بهبهان، ایران

6 دانشیار، مرکز تحقیقات فناوری پزشکی، گروه میکروبیولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران

چکیده

مقاله پژوهشی




مقدمه: پنومونی وابسته به ونتیلاتور، شایع‌ترین عفونت اکتسابی بیمارستانی است که مسؤول افزایش مرگ و میر بیماران بستری در بخش مراقبت‌های ویژه است. مطالعه‌ی حاضر، با هدف بررسی فراوانی ژن‌های MBL و ESBL و تعیین الگوهای مقاومت آنتی‌بیوتیکی در باسیل‌های گرم منفی جدا شده از ونتیلاتور در بخش (Intensive care unit) ICU بیمارستان امام رضا(ع) شهر کرمانشاه طراحی شد.
روش‌ها: پس از جمع‌آوری نمونه‌ها و تعیین هویت باکتری‌ها به وسیله‌ی روش‌های استاندارد بیوشیمیایی و کشت میکروبی، 152 ایزوله‌ی باکتریایی شناسایی شد. شناسایی ژن‌های ESBL و MBL با روش فنوتیپی DDCT و روش مولکولی PCR با استفاده از پرایمرهای اختصاصی انجام شد.
یافته‌ها: شایع‌ترین میکروارگانیسم جداسازی شده از بیماران (Ventilator-associated pneumonia) VAP، کلبسیلا پنومونیه (56/2 درصد) بود. در مجموع، فراوانی ژن‌های ESBL و MBL (74/34 درصد) 113 و (5/26 درصد) 8 بود. الگوی مقاومت آنتی‌بیوتیکی نشان داد که 53/36 درصد ایزوله‌ها به سفتازیدیم، سفوتاکسیم و ایمی‌پنم مقاوم هستند. ژن blaSHVOS با فراوانی (49/34 درصد) 75، بیشترین فراوانی ژنوتیپی را داشت. ژن blaVIM در هیچ کدام از ایزوله‌ها یافت نشد.
نتیجه‌گیری: مقاومت بالای ایزوله‌های اسینتوباکتر بومانی و کلبسیلا پنومونیه نسبت به آنتی‌بیوتیک‌های مذکور و شیوع بالای ژن‌های مولد ESBL در ایزوله‌های کلبسیلا پنومونیه، زنگ هشدار قابل توجهی در ICU بخش‌های مختلف بیمارستان امام رضا(ع) است. ظهور ژن blaPER-1 در بیماران مبتلا به VAP نگرانی دیگری در بیماران مبتلا به VAP در بخش مراقبت‌های ویژه ایجاد کرده است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Frequency of Metallo-Beta-Lactamase and Extended- Spectrum Beta-Lactamase genes in Gram-Negative Bacteria Isolated from Ventilator- Associated Pneumonia in the Intensive Care Unit of Imam Reza Hospital in Kermanshah

نویسندگان [English]

  • Sepide Kadivarian 1
  • Jale Moradi 2
  • Mohsen Najafi 3
  • Mohsen Azizi 3
  • Ramin Abiri 4
  • Sara Kooti 5
  • Amirhooshang Alvandi 6
1 MSc, Student Research Committee, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Assistant Professor of Medical Bacteriology, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
3 MSc, Student Research Committee, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
4 Professor, Fertility and Sterility Research Center, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
5 Assistant Professor of Medical Bacteriology, Behbahan Faculty of Medical Sciences, Behbahan, Iran
6 Associate Professor, Medical Technology Research Center, and Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
چکیده [English]

Background: Ventilator-associated pneumonia is the most common nosocomial infection that is responsible for increasing the mortality of patients admitted to the intensive care unit. The aim of this study was to evaluate the frequency of MBL and ESBL genes and to determine the patterns of antibiotic resistance in gram-negative bacilli isolated from ventilators in the ICU of Imam Reza Hospital in Kermanshah.
Methods: After collecting samples and identifying the bacteria by standard biochemical and microbial culture methods, 152 bacterial isolates were identified. ESBL and MBL genes were identified by phenotypic DDCT method and molecular PCR method using specific primers.
Findings: The most common microorganism isolated from ventilator-associated pneumonia (VAP) patients was Klebsiella pneumoniae (2.56%). In total, the frequency of ESBL and MBL genes was 113 (74.34%) and
8 (5.26%). The antibiotic resistance pattern showed that 36.53% of the isolates were resistant to ceftazidime, cefotaxime and imipenem. The blaSHVOS gene with a frequency of 75 (49.34%) had the highest genotypic frequency. The blaVIM gene was not found in any of the isolates.
Conclusion: The high resistance of Acinetobacter baumannii and Klebsiella pneumoniae isolates to the mentioned antibiotics and the high prevalence of ESBL-producing genes in Klebsiella pneumoniae isolates is a significant alarm in the ICU of different wards of Imam Reza Hospital. The emergence of the blaPER-1 gene in patients with VAP has raised another worry in patients with VAP in the intensive care unit.

کلیدواژه‌ها [English]

  • Ventilator-associated pneumonia
  • Extended Spectrum Beta-Lactamase
  • Metallo-Beta-Lactamase
  • Intensive care unit

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مجله دانشکده پزشکی اصفهان
دوره 40، شماره 702
هفته 2 اسفندماه
بهمن و اسفند 1401
صفحه 1085-1095

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  • تاریخ دریافت: 10 مرداد 1401
  • تاریخ پذیرش: 03 اسفند 1401

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