بررسی الگوی مقاومت آنتی بیوتیکی و فراوانی بتالاکتامازهای وسیع الطیف در باکتری‌های گرم منفی جدا شده از نمونه‌های ادراری در شهرستان بندر ترکمن

نویسندگان
آنیا آهنی آذری 1
آیدین خواجه 1
احمد دانش 2
1 گروه میکروبیولوژی، دانشکده علوم زیستی، واحد گرگان، دانشگاه آزاد اسلامی، گرگان، ایران
2 مرکز تحقیقات بیماری‌های عفونی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی گلستان، گلستان، ایران
چکیده
مقدمه

مقاومت آنتی بیوتیکی در باکتری­‌های گرم منفی ایجاد کننده عفونت­‌های دستگاه ادراری رو به افزایش است. هدف از این مطالعه، ارزیابی الگوی مقاومت آنتی­‌بیوتیکی و فراوانی بتالاکتامازهای وسیع الطیف (ESBLs) در باکتری­های یوروپاتوژن گرم منفی جدا شده از نمونه‌­های ادراری ارجاع شده به آزمایشگاه­‌های بالینی شهرستان بندر ترکمن بود.

مواد و روش­ها

در این مطالعه 138 نمونه ادرار از بیماران مشکوک به عفونت ادراری جمع­‌آوری شد. در نمونه­‌های مثبت، یوروپاتوژن­های گرم منفی با استفاده از آزمون­‌های میکروب‌­شناسی و بیوشیمیایی استاندارد شناسایی شده و الگوی مقاومتی آنتی بیوتیکی آن­ها به روش انتشار در دیسک تعیین شد. سپس تست تأیید فنوتیپی برای تشخیص تولید ESBL انجام شد.

یافته‎ها

از 96 جدایه گرم منفی، بیشترین موارد جدا شده عبارت بودند از: اشریشیاکلی (88/5 درصد)، کلبسیلا پنومونیه (5/2 درصد)، آنتروباکتر کلوآکه (4/2 درصد) و سودوموناس ائروژینوزا (2/1 درصد). جدایه های اشریشیاکلی بیشترین میزان مقاومت را نسبت به آنتی‌بیوتیک­‌های آمپی سیلین، نیتروفورانتوئین و سفالوتین و کمترین میزان مقاومت را نسبت به آنتی بیوتیک نورفلوکساسین از خود نشان دادند. از 35 جدایه مقاوم به سفوتاکسیم، 29 جدایه ESBL مثبت بودند.

نتیجه‎گیری

در این مطالعه، شایعترین علت عفونت ادراری، اشریشیاکلی بود. فراوانی ESBL ها در جدایه­های اشریشیاکلی مشابه نتایج مطالعات دیگران بود اما در جدایه­های کلبسیلا پنومونیه بسیار بالا بود. نتایج این مطالعه نشان دهنده روند افزایشی مقاومت نسبت به سفالوسپورین­های وسیع الطیف است لذا انجام آزمایش آنتی­بیوگرام قبل از تجویز آنتی‌­بیوتیک و پرهیز از مصرف خودسرانه آن امری اجتناب ناپذیر به نظر می­‌رسد.
کلیدواژه‌ها
مقاومت آنتی بیوتیکی
باکتری های گرم منفی
عفونت های ادراری بتالاکتاماز

عنوان مقاله English

Assessment of Antibiotic Resistance pattern and Frequency of extended spectrum β-lactamases (ESBLs) in Gram Negative Bacteria isolated from Urine samples in Bandar-e Torkaman

نویسندگان English

Ania Ahani Azari 1
Aydin Khajeh 1
Ahmad Danesh 2
1 Department of Microbiology, Gorgan Branch, Islamic Azad University, Gorgan, Iran
2 Infectious Diseases Research Center, Golestan University of Medical Sciences, Gorgan, Iran
چکیده English

Introduction

Antibiotic resistance is increasing in gram-negative bacteria that cause urinary tract infections. The aim of this study was to evaluate antibiotic resistance pattern and frequency of broad-spectrum β-lactamases (ESBLs) among gram-negative bacteria isolated from urine samples referred to clinical laboratories in Bandar Torkaman, Iran.

Materials and Methods

In this study, 138 positive urine samples were collected from patients with suspected urinary tract infection. In positive samples, gram-negative europathogens were identified using standard microbiological and biochemical tests and their antibiotic resistance patterns were determined by propagation in the disk method. Then, a phenotypic confirmatory test was performed for the detection of ESBLs producers.

Results

96 samples were positive for urinary infection due to gram-negative bacteria. The most isolated cases were: Escherichia coli (88.5%), Klebsiella pneumonia (5.2%), Enterobacter cloace (4.2%) and pseudomonas aerouginosa (2.1%). The E. coli isolates showed the highest resistance to ampicillin, nitrofurantoin and cefalotin and the lowest resistance to norfloxacin. Of the 35 isolates resistant to cefotaxime, 29 isolates were positive for ESBLs.

Conclusion

In this study, the most common cause of UTI was E. coli (88.5%). The frequency of ESBLs in E. coli isolates was similar to the results of other studies but it was very high inK. pneumonia isolates. The results of this study indicate an increasing trend of resistance to Extended-Spectrum cephalosporins. Therefore, antibiogram test before the antibiotic prescription could be a retional strategy to avoid further antibiotic resistance.

کلیدواژه‌ها English

Antibiotic resistance
Betalactamase
Gram negative bacteria
Urinary tract infections
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