تعیین فراوانی سویه‌های MDR اسینتوباکتر بومانی ایزوله شده از بخش مراقبت‌های ویژه (ICU) بیمارستان‌های شهر اصفهان با روش مولکولی و بررسی الگوی مقاومت دارویی آن‌ها

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه میکروب‌شناسی، دانشکده‌ی پزشکی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، گروه میکروب‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: اسینتوباکتر بومانی از مهم‌ترین پاتوژن‌ها در عفونت‌های کسب شده‌ی بیمارستانی به خصوص در بخش مراقبت‌های ویژه است. این پاتوژن فرصت طلب به راحتی از خاک، آب و تجهیزات بیمارستانی جدا می‌شود و به اکثر آنتی‌بیوتیک‌های وسیع‌الطیف مقاومت نشان می‌دهد. هدف از این مطالعه، تعیین فراوانی اسینتوباکتر بومانی ایزوله شده از بخش مراقبت‌های ویژه (ICU یا Intensive care unit) و تعیین الگوی مقاومت آنتی‌بیوتیکی آن‌ها بود.روش‌ها: در طول دوره‌ی یک ساله‌ی 92-1391، تعداد 350 نمونه از بیماران بستری در واحد مراقبت‌های ویژه‌ی بیمارستان‌های شهر اصفهان به دست آمد. تعیین خصوصیات نمونه‌ها به عنوان اسینتوباکتر، با استفاده ازآزمایش‌های فنوتیپی و بیوشیمیایی صورت گرفت و ایزوله‌ها با اثبات وجود ژن like 51-OXA توسط تکنیک PCR (Polymerase chain reaction) تأیید شدند. آزمایش حساسیت آنتی‌بیوتیکی به روش دیسک دیفیوژن طبق دستورالعمل CLSI (Clinical and Laboratory Standards Institute) انجام گرفت.یافته‌ها: از 350 نمونه‌ی جدا شده از بیماران، 43 نمونه‌ی اسینتوباکتر بومانی شناخته شد. میزان فراوانی الگوهای ضد میکروبی جدایه‌ها نشان داد که 5/53 درصد ایزوله‌ها به آمیکاسین، 7/83 درصد به تتراسایکلین، 0/86 درصد به سفتازیدیم، 7/90 درصد به تری‌متوپریم سولفامتوکسازول و 0/93 درصد به ایمی‌پنم، مروپنم، سفیپیم و آمپی‌ سیلین سولباکتام مقاوم بودند و همچنین تمام جدایه‌ها به سیپروفلوکسازین مقاوم بودند. تمامی اسینتوباکترهای جدا شده از ICU بیمارستان‌های شهر اصفهان، مقاوم به چند دارو (MDR یا Multi-drug resistance) بودند.نتیجه‌گیری: این مطالعه مقاومت بالای اسینتوباکتر بومانی به طیف وسیع آنتی‌بیوتیک‌ها را نشان داد. از این رو، استراژی مناسب جهت کنترل انتشار باکتری در بخش مراقبت‌های ویژه و سایر بخش‌ها ضروری به نظر می‌رسد. 

کلیدواژه‌ها

عنوان مقاله [English]

Frequency of Multi-Drug Resistance Acinetobacter Baumannii Isolates in Intensive Care Units (ICU) of Isfahan Hospitals, Iran, via Molecular Method and Their Antimicrobial Resistance Patterns

نویسندگان [English]

  • Hasan Ghajavand 1
  • Asghar Havaei 2
  • Bahram Nasr-Esfahani 2
  • Hossein Fazeli 2
  • Sharareh Moghim 2
1 MSc Student, Department of Microbiology, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Acinetobacter baumannii is one of the most important pathogen in hospital acquired infections, especially in intensive care units (ICUs). This opportunistic pathogen can be easily isolated from water, soil, and hospital facilities. Acinetobacter baumannii, as a nosocomial opportunistic pathogen, is resistant to wide range of antibiotics. The aim of this study was to determine the frequency and resistance patterns of Acinetobacter baumannii isolated from intensive care units of Isfahan Hospitals, Iran.Methods: During one year period (2012-2013), 350 specimens were collected from intensive care units of Isfahan hospitals. The specimens were characterized as Acinetobacter baumannii via conventional phenotypic and biochemical tests. The isolates were confirmed using polymerase chain reaction (PCR) for OXA_51-like gene. Susceptibility of isolates was determined via standard disk diffusion method according to CLSI (Clinical and Laboratory Standards Institute).Findings: From 350 specimens, 43 isolates was Acinetobacter baumannii. 53.5% of isolates were resistant to amikacin, 83.7% to tetracyclin, 86.0% to ceftazidime, 90.7% to trimetoprim sulfametoxazol, 93.0% to imipenem, cefepime, meropenem, and ampicillin-sulbactam. All isolates were resistant to ciprofloxacin. Our findings showed that all of Acinetobacter baumannii, isolated from the intensive care units of Isfahan hospitals were multi-drug resistance (MDR).Conclusion: This study showed a high resistant of Acinetobacter baumannii to a wide range of antimicrobial agent. It is necessary to adopt appropriate strategies to control the spread of the bacteria in care unit centers and wards.

کلیدواژه‌ها [English]

  • Acinetobacter baumannii
  • Polymerase chain reaction (PCR)
  • Antibiotic Resistance
  • Intensive care units (ICU)

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مجله دانشکده پزشکی اصفهان
دوره 32، شماره 295 - شماره پیاپی 295
مرداد و شهریور 1393
صفحه 1175-1185

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سابقه مقاله

  • تاریخ دریافت: 04 اسفند 1392
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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