Mối liên quan giữa mức độ kháng carbapenem và sự xuất hiện gen mã hóa carbapenemase của các chủng Acinetobacter baumannii phân lập tại một số bệnh viện

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Tác giả: Thị Vũ Nga Lưu, Duy Thái Phạm, Hồng Nhung Phạm, Huy Hoàng Trần, Thị Vân Phương Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Khoa học và Công nghệ Việt Nam - B, 2020

Mô tả vật lý: tr.35

Bộ sưu tập: Metadata

ID: 290733

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Bên cạnh các yếu tố độc lực, khả năng đề kháng kháng sinh của các chủng vi khuẩn Acinetobacter baumannii đã khiến chúng trở thành căn nguyên gây nhiễm khuẩn bệnh viện thường gặp nhất. Ở A. baumannii, kháng carbapenem chủ yếu do carbapenemase. Trong nghiên cứu này, 144 chủng A. baumannii phân lập từ 9 bệnh viện thuộc 3 miền ở Việt Nam được nghiên cứu để xác định nồng độ ức chế tối thiểu (MIC) của kháng sinh và tìm mối liên quan giữa mức độ kháng carbapenem và sự xuất hiện một số gen mã hóa carbapenemase. Kết quả nghiên cứu cho thấy, 7/9 kháng sinh bị kháng trên 70,8%
83,3% số chủng kháng cả 3 kháng sinh thuộc nhóm carbapenem với MIC50, MIC90 lần lượt là 32-64 µg/ml và ≥64 µg/ml. 100% số chủng nhạy cảm colistin với MIC50 là 0,25 µg/ml và MIC90 là 0,5 µg/ml. Các chủng chỉ mang gen blaOXA-51 có tỷ lệ đề kháng kháng sinh và MIC thấp hơn nhiều so với các chủng có ≥2 gen mã hóa arbapenemase (với p<
0,01). 100% các chủng có blaOXA-23 và chủng mang blaNDM-1 kháng carbapenem và với MIC rất cao. Kết luận: có mối liên quan giữa mức độ kháng carbapenem và sự xuất hiện của gen blaOXA-23 và blaNDM-1. Colistin trở thành “vũ khí” cuối cùng trong điều trị nhiễm trùng do A. baumannii đa kháng.In addition to virulence factors, antibiotic resistance has helped strains of Acinetobacter baumannii become one of the most common agents of hospital-acquired infections. In A. baumannii, carbapenem resistance is mainly mediated by carbapenemase. In this study, 144 strains of A. baumannii isolated from 9 hospitals in representing 3 regions of Vietnam were studied to detect the minimum inhibitory concentration (MIC) and find an association between carbapenem resistance levels and the appearance of some carbapenemase coding genes. Results: more than 70.8% of the isolated were resistant to 7/9 antibiotics tested
83.3% strains were resistant to 3 carbapenem antibiotics with MIC50, and MIC90 values were 32-64 µg/ml and ≥64 µg/ml, respectively
100% strains were susceptible to colistin (MIC50=0.25 µg/ml and MIC90=0.5 µg/ml). Strains with only blaOXA-51 showed much lower rates of antibiotic resistance and MIC than those with ≥2 carbapenemase genes (p<
0.01). 100% strains carrying blaOXA-23 and blaNDM-1 were resistant to carbapenem with very high MIC values. Conclusion: there is an association between carbapenem resistance and the appearance of gene blaOXA-23 and blaNDM-1. Colistin is the last resort for the treatment of multidrug-resistant A. baumannii.

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