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印度查谟和克什米尔一家三级护理医院中ESKAPE病原体的基因分型及抗菌药物耐药性概况。

Genotyping and antimicrobial resistance profile of ESKAPE pathogens from a tertiary care hospital in Jammu & Kashmir, India.

作者信息

Qureshi Sabia, Din Faheem U, Banday Muddasir S, Farhana Anjum, Nehvi Nahid, Kashoo Zahid, Bashir Leenah, Hassan Mir Nadeem, Badroo Gulzar, Bhat M Altaf, Nabi Mansoor, Farooq Shaheen, Hussain Md Isfaqul, Dar Pervaiz, Gulzar Maliha, Mehraj Junaid

机构信息

Division of Veterinary Microbiology & Immunology, FVSc &A.H, Shuhama (Aulesteng), SKUAST-K, 19006, India.

Division of Veterinary Microbiology & Immunology, FVSc &A.H, Shuhama (Aulesteng), SKUAST-K, 19006, India.

出版信息

Diagn Microbiol Infect Dis. 2025 Mar;111(3):116714. doi: 10.1016/j.diagmicrobio.2025.116714. Epub 2025 Jan 25.

Abstract

The rise of MDR (multi drug resistant) ESKAPE pathogens in hospitals is a pressing global healthcare crisis, demanding urgent attention and action. The current study investigates the prevalence and antimicrobial resistance patterns of ESKAPE pathogens in a tertiary care hospital in the union territory of Jammu and Kashmir, India. Out of 244 ESKAPE pathogens isolated in present study from patients of a tertiary care hospital, 84 (34.4 %) isolates were identified as Staphylococcus aureus, of which 59.52 % were identified as methicillin resistant S. aureus (MRSA), 4.76 % were methicillin sensitive S. aureus (MSSA) and 35.71 % were methicillin resistant coagulase negative staphylococci (MR-CoNS). The mecA gene (methicillin resistant staphylococcal cassette chromosome) was detected in 61.9 % of the S. aureus isolates of the present study. Klebsiella pneumoniae was the second most prevalent (28.75 %) pathogen, followed by Pseudomonas aeruginosa and Escherichia coli (27.5 % each), Acinetobacter baumannii (11.87 %), and others. A higher number of isolates were recovered from male patients (61 %) than from female patients (39 %). Screening for β-lactamase genes (bla, bla, bla) revealed that 32.5 % of isolates carried the TEM gene (Temoniera), 36.87 % had the CTX-M-15 gene (CefoTaXimase-Munich), and 20.62 % harboured SHV variants (Sulfhydryl Variable). Notably, 23 isolates, predominantly K. pneumoniae, were positive for all three β-lactamase genes, highlighting the significant prevalence of multidrug resistance among ESKAPE pathogens in the region. This study provides epidemiological data on the prevalence of ESKAPE isolates in tertiary care hospital in the union territory of Jammu and Kashmir, India. To our knowledge, this is the first comprehensive report on the prevalence of ESBL genes in ESKAPE pathogens of this region. Further, this study underscores the critical need for enhanced surveillance and targeted antimicrobial stewardship programs to address the growing challenge of antimicrobial resistance in hospital settings.

摘要

医院中多重耐药(MDR)的ESKAPE病原体的出现是一个紧迫的全球医疗危机,需要紧急关注和采取行动。当前的研究调查了印度查谟和克什米尔联合属地一家三级护理医院中ESKAPE病原体的流行情况和抗菌药物耐药模式。在本研究中从一家三级护理医院的患者中分离出的244株ESKAPE病原体中,84株(34.4%)分离株被鉴定为金黄色葡萄球菌,其中59.52%被鉴定为耐甲氧西林金黄色葡萄球菌(MRSA),4.76%为甲氧西林敏感金黄色葡萄球菌(MSSA),35.71%为耐甲氧西林凝固酶阴性葡萄球菌(MR-CoNS)。在本研究的61.9%的金黄色葡萄球菌分离株中检测到了mecA基因(耐甲氧西林葡萄球菌盒式染色体)。肺炎克雷伯菌是第二常见(28.75%)的病原体,其次是铜绿假单胞菌和大肠埃希菌(各占27.5%)、鲍曼不动杆菌(11.87%)及其他。从男性患者中分离出的菌株数量(61%)高于女性患者(39%)。对β-内酰胺酶基因(bla、bla、bla)的筛查显示,32.5%的分离株携带TEM基因(Temoniera),36.87%具有CTX-M-15基因(头孢他美酯酶-慕尼黑),20.62%含有SHV变体(巯基可变)。值得注意的是,23株分离株,主要是肺炎克雷伯菌,对所有三种β-内酰胺酶基因均呈阳性,突出了该地区ESKAPE病原体中多重耐药的显著流行情况。本研究提供了关于印度查谟和克什米尔联合属地三级护理医院中ESKAPE分离株流行情况的流行病学数据。据我们所知,这是该地区ESKAPE病原体中ESBL基因流行情况的第一份全面报告。此外,本研究强调了加强监测和有针对性的抗菌药物管理计划以应对医院环境中日益增长的抗菌药物耐药挑战的迫切需求。

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