بررسی الگوی مقاومت آنتی بیوتیکی جدایه های بالینی باکتری استافیلوکوکوس اورئوس جدا شده از بیمارستان‌های شهر بروجرد

محورهای موضوعی : میکروبیولوژی

سجاد سلمانی ^{1 *} , محسن میرزایی ²

1 - دانش‌آموخته کارشناسی ارشد میکروبیولوژی، دبیر زیست‌شناسی اداره آموزش و پرورش ناحیه 2، کرمانشاه، ایران
2 - استادیار ، گروه زیست‌شناسی، دانشگاه آزاد اسلامی واحد بروجرد، بروجرد، ایران

تاریخ دریافت : 1403/05/24 تاریخ پذیرش : 1403/07/12 تاریخ انتشار : 1403/11/28

کلید واژه: الگوی مقاومت آنتی بیوتیکی, کووید-19, استافیلوکوکوس اورئوس, متی سیلین,

چکیده مقاله :

استافيلوکوکوس اورئوس يکي از عوامل عفوني بيمارستاني است که نسبت به بسياري از آنتي بيوتيک‌هاي رايج مقاوم شده و امروزه سويه‌هاي مقاوم به متي سيلين اين باکتري يکي از عوامل اصلي عفونت‌هاي بيمارستاني به شمار مي‌رود. هدف اين مطالعه شناسايي الگوهاي مقاومت آنتي بيوتيکي در سويه‌هاي مقاوم و حساس به متي سيلين در بیمارستان امام خمینی و کوثر واقع در شهر بروجرد است. در اين مطالعه توصيفي- مقطعي 100 نمونه باليني مشکوک به استافيلوکوکوس اورئوس طي 12 ماه جمع‌آوري و با استفاده از تست‌هاي بيوشيميايي استاندارد از قبيل کاتالاز، تخمير مانيتول، کواگولاز و DNase بررسي شدند. حساسيت سويه‌هاي تأييد شده با روش ديسک ديفيوژن نسبت به آنتي بيوتيک‌هاي رايج ارزيابي شدند. داده‌ها با آزمون‌هاي آمار توصيفي تجزيه و تحليل شدند. در مجموع ۵۹ سويه (59 درصد) نسبت به متي سيلين مقاوم بودند. مقاومت در سويه‌هاي استافيلوکوکوس اورئوس مقاوم به متي‌سيلين شامل: 59 ایزوله (100%) به پنی سیلین، 57 ایزوله (6/96%) به اریترومایسین، 46 ایزوله (9/77%) به کلیندامایسین، 43 ایزوله (8/72%) به جنتامایسین، 38 ایزوله (4/64%) به سیپروفلوکساسین، 28 ایزوله (4/47%) به تتراسیکلین، 22 ایزوله (2/37%) به آمیکاسین و 18 ایزوله (5/30%) به کوتریموکسازول مقاوم بودند و تمام سويه‌ها نسبت به ونکومايسين حساس بودند. در مجموع 8 الگوي مقاومت آنتي بيوتيکي متفاوت در سويه‌هاي استافيلوکوکوس اورئوس مقاوم به متي‌سيلين شناسايي شد. نتایج اين مطالعه نشان داد مقاومت بالايي نسبت به گروهي از آنتي بيوتيک‌هاي بررسي شده در سويه‌هاي استافيلوکوکوس اورئوس مقاوم به متي‌سيلين در بيمارستان امام خميني (ره) و کوثر بروجرد وجود دارد.

چکیده انگلیسی:

Introduction: Ppatients with COVID-19 admitted to the intensive care unit and requiring mechanical ventilation are at risk for ventilator-associated bacterial infections secondary to SARS-CoV-2 infection: Staphylococcus aureus is one of the most important nosocomial infecting agents resistant to commonly used antibiotics. Nowadays, methicillin-resistant S. aureus (MRSA) is considered one of the main causes of nosocomial infections. Aim: The aim of this study was to identify the antibiotic resistance pattern of methicicllin- resistant and susceptible strains in Borujerd, Iran. Material and methods: In the present cross - sectional study, a number of 100 clinically suspected cases of Staphylococcus aureus were collected during a 12 month period. The bacteria were investigated using standard biochemical tests such as catalase, mannitol fermentation, coagulase and DNase. Sensitive strains were confirmed by disk diffusion method compared to commonly used antibiotics. The collected data were analyzed using descriptive statistical tests. Results: A total of 59 strains of S. aureus (59 percent) were resistant to methicillin. Resistance to S. aureus strains resistant to methicillin included: Penicillin (100%), Erythromycin (96.6%), Clindamycin (77.9%), Gentamicin (72.8%), Ciprofloxacin (64.4%), Tetracycline (47.4%), Amikacin (37.2%) and all isolates strains were sensitive to Vancomycin. A total of 8 different patterns of antibiotic resistance in methicillin-resistant Staphylococcus aureus strains were identified. Conclusion: Expression of new resistance factor in nosocomial infection is one of the major challenges in treating these infections. This study showed a high prevalence of resistance against some class of antibiotics in MRSA isolated from Imam Khomeini and Kosar hospital of Borujerd, Iran.

منابع و مأخذ:

1.
World Health Organization. 2021. COVID-19 Weekly Epidemiological Update 22. World Heal Organ;1–3. 2. Saadat S, Solhjoo K, Kazemi A, Mradaneh J. Antibiotic Resistance Pattern of Staphylococcus aureus Strains Isolated from Personnel of Jahrom Hospitals in 2012. Yasuj University of Medical Sciences Journal (YUMSJ). 2013;18(10): 826-835
. 3. Murray PR., Rosenthal KS., Pfaller MA. (2013).Medical microbiology. 7th Edition ed. Philadelphia: Elsevier/Saunders; 874 pages
. 4. Versalovic J. American Society for Microbiology.(2011). Manual of clinical microbiology. 10th ed. Washington, DC: ASM Press; 2011
. 5. Brooks GF., Jawetz E., Melnick JL., Adelberg EA., Jawetz, Melnick., & Adelberg's medical microbiology. 25th ed. ed. New York, N.Y.: McGraw-Hill Medical; 2010
. 6. Parhizgari N, Moosavian S, Sharifi A. Antibiotic resistant pattern of methicillin resistant and sensitive Staphylococcus aureus isolated from patients durining 2009-2010, Ahvaz, Iran. Armaghane danesh 2013; 18 (9):757-76
. 7.
Melter O, Radojevic B. Small colony variants of Staphylococcus aureus--review. Folia microbiologica 2010; 55:548-58. 8. Noorbakhsh F. Antibiotic resistance to beta-lactams in bacteria: Beta- Lactamases. Iranian Journal of Biological Sciences 2022; 17(2):67-80
. 9. Zheng Y, Wan Y, Zhou L, Ye M, Liu S, Xu C, et al. Risk factors and mortality of patients with nosocomial carbapenem-resistant Acinetobacter baumannii pneumonia. Am J Infect Control 2013; 41: 59-63
. 10. Kreitmann L, Monard C, Dauwalder O, Simon M, Argaud L. Early bacterial co-infection in ARDS related to COVID-19. Intensive Care Med 2020;46:1787–9
. 11. Stapleton PD, Taylor PW. Methicillin resistance in Staphylococcus aureus: mechanisms and modulation. Science progress 2002; 85 (1): 57-72. DOI: https://doi.org/10.3184/003685002783238870
12. Ansari S, Gautam R, Shrestha S, Ansari SR, Subedi SN, Chhetri MR. Risk factors assessment for nasal colonization of Staphylococcus aureus and its methicillin resistant strains among pre-clinical medical students of Nepal. BMC Researc Notes 2016; 9 (1): 214. DOI: https://doi.org/10.1186/s13104-016-2021-7
13. Lu P-L, Tsai J-C, Chiu Y-W, Chang F-Y, Chen Y-W, Hsiao C-F, Siu L. Methicillin-resistant Staphylococcus aureus carriage, infection and transmission in dialysis patients, healthcare workers and their family members. Nephrology Dialysis Transplantation 2008; 23 (5): 1659-1665. DOI: https://doi.org/10.1093/ndt/gfm806
14. Coia JE, Duckworth GJ, Edwards DI, Farrington M, Fry C, Humphreys H, Mallaghan C, Tucker DR. Guidelines for the control and prevention of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. Journal of Hospital Infection 2006; 63: S1-S44. DOI: https://doi.org/10.1016/j.jhin.2006.01.001
15. Mousavi M, Fallah M, Jafari Jushqhan N. Isolation and identification of gram-negative bacteria from patients with urinary tract infections referred to Savadkooh laboratory and determination of their drug resistance pattern from the beginning of October 2021 to the end of December 2021. Iranian Journal of Biological Sciences 2022;16(3):33-39. DOR 20.1001.1.17354226.1400.16.3.3.0
. 16. Yousefi A, Eslami G, Zandi H, Vakili M.Frequency of methicillin- resistance among clinical isolates of staphylococcus aureus by phenotypic and molecular methods in Yazd. J Shahid Sadoughi Univ Med Sci 2015; 23(1): 1826-37
. 17. Tabaei S, Noghondar MK, Mohammadzadeh M, Ataei L, Jamehdar SA. Pattern of antibiotic resistance in methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from clinical specimens: Imam Reza hospital in Mashhad. Med J Mashad Univ Med Sci. 2016; 59(2): 64-70
. 18. Rahimi F, Bouzari M, Katouli M, Pourshafie MR. Antibiotic resistance pattern of methicillin resistant and methicillin sensitive staphylococcus aureus isolates in Tehran, Iran. Jundishapur J Microbiol 2013; 6:144-149
. 19. Parhizgari N, Moosavian S, Sharifi A. Antibiotic resistant pattern of methicillin resistant and sensitive Staphylococcus aureus isolated from patients durining 2009-2010, Ahvaz, Iran. Armaghane danesh. 2013; 18 (9) :757-76. 20. Yousefi A, Eslami G, Zandi H, Vakili M.Frequency of methicillin- resistance among clinical isolates of staphylococcus aureus by phenotypic and molecular methods in Yazd. J Shahid Sadoughi Univ Med Sci 2015; 23(1): 1826-37
. 21. Nourbakhsh F, Momtaz H. Detection of antibiotic resistance patterns in Staphylococcus aureus strains isolated from patients admitted to Isfahan hospitals during 2014-2015. Feyz 2015; 19(4): 356-63
. 22. Ghasemian R, Najafi N, Shojai Far A. The survey frequency of Staphylococcus aureus nasal careers in staff of Ghaem educational hospital and determination antibiotic resistance patterns of isolated strains. Medical Journal of Mazandaran University 2005; 14(44): 79-86
. 23. Vaez H, Ghazi Saeidi K, Moradi A, Tabaraei A, Khodabakhshi B, Bazouri M, et al . Antibiotic resistance pattern of methicillin resistant Staphylococcus aureus isolated from Health-educational centers of Gorgan, Iran, 2008-2009 . Iran J Med Microbiol. 2010; 3 (4) :31-36
. 24. Hsueh PR, Teng LG, Chen WH, Pan HJ, Chen Ml, Chang S, et al. Increasing prevalence of Methicillin Resistant Staphylococcus aureus causing nosocomial infections at a university hospital in Taiwan from 1986to 2001. J Antimicrob Chemother 2004; 48(4): 1361-4
. 25. Rahimi F, Bouzari M, Katouli M, Pourshafie MR. Antibiotic resistance pattern of methicillin resistant and methicillin sensitive staphylococcus aureus isolates in Tehran, Iran. Jundishapur J Microbiol 2013; 6:144-149
. 26. Ghasemian R, Najafi N, Shojai Far A. The survey frequency of Staphylococcus aureus nasal careers in staff of Ghaem educational hospital and determination antibiotic resistance patterns of isolated strains. Medical Journal of Mazandaran University 2005; 14(44): 79-86
. 27. Shittu AO, Lin J. Antimicrobial susceptibility patterns and characterization of clinical isolates of Staphylococcus aureus in KwaZulu-Natal province, South Africa. BMC Infectious Diseases . BMC Infectious Diseases 2006; 6: 125
. 28. Tiwari HK, Sapkota D, Sen MR. High prevalence of multidrugresistant MRSA in a tertiary care hospital of northern India. Infect Drug Resist 2008; 1: 57-61. 29. Ranjan KP, Arora R, Ranjan N. An approach to linezolid and vancomycin against methicillin resistant Staphylococcus aureus. Webmed Central Microbiology. 2010; 1: WMC00590
30. Askari A, Tabatabai SM, Arianpoor A, Naderi Nasab M. VanA-Positive Vancomycin Resistant Staphylococcus aureus. Infectious Diseases in Clinical Practice 2013; 21(2); 91-3
. 31. Arzu T,Serhat U,Akalin E.risk factors influencing clinical outcome in Staphylococcus aureus bacteraemia in a Turkish university hospital. J Antimicrob Agent 2000;14:57-63
. 32. Oliveria L,Wey S,Castelo A.risk factor for mortality in Staphylococcus aureus bacteraemia .Infect Control Hos Epidemiol 1998;19:32-37
. 33. Ronald C.A Comparison of clinical virulence of nosocomially acquired methicillin resistant and methicillin sensitive Staphylococcus aureus infection in a university hospital. Infect Control Hosp Epidemiol1992;13:587-593