Journal of Ilam University of Medical Sciences
مجله دانشگاه علوم پزشکی ایلام
J. Ilam Uni. Med. Sci.
Medical Sciences
http://sjimu.medilam.ac.ir
96
journal96
1563-4728
2588-3135
doi
fa
jalali
1393
6
1
gregorian
2014
9
1
22
4
online
1
fulltext
fa
بررسی میزان مقاومت آنتی بیوتیکی و ردیابی بتالاکتاماز طیف وسیع TEM در جدایه های بالینی اشریشیا کلای مولد ESBL در شهر رشت
Surveying of antibiotic resistance pattern and frequency rate of blaTEM in the ESBLs producing E. coli isolated in Rasht
باکتری شناسی
Bacteriology
كاربردي
Applicable
<div style="text-align: right direction: rtl"><p class="MsoNormal" dir="RTL" style="margin-bottom: 0.0001pt text-align: justify line-height: 120% direction: rtl unicode-bidi: embed"><b><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">مقدمه:</span></b><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"> </span><i><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">E. coli</span></i><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">یکی از عوامل شایع در عفونتهای بیمارستانی محسوب می گردد<i>. </i>مقاومت آنتی
بیوتیکی منجر به شکست درمانعفونتهای
ناشی از </span><i><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">E.coli</span></i><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> می شود. تولید بتالاکتامازهای وسیع الطیف (</span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">ESBLs</span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span>) </span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">توسط این باکتری از علل مقاومت آنتی بیوتیکی
است. این آنزیمها منشا پلاسمیدی داشته و اکثر آنها مشتقاتی از آنزیمهای </span><span dir="LTR"></span><i><span lang="FA" dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif"><span dir="LTR"></span> </span></i><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">TEM</span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">و</span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">SHV<sub> </sub></span><span dir="RTL"></span><sub><span style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> </span></sub><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">میباشند.</span><span dir="LTR"></span><span lang="FA" dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif"><span dir="LTR"></span> </span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">هدف از این مطالعه تعیین میزان فراوانی ژن</span><span dir="LTR"></span><i><span lang="FA" dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif"><span dir="LTR"></span> </span></i><i><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">bla</span></i><sub><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">TEM</span></sub><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span>
در سویه های </span><i><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">E. coli</span></i><span dir="RTL"></span><i><span style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> </span></i><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">مولد </span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">ESBLs</span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> جدا شده از
بیماران بستری در 6 بیمارستان</span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif"></span><span dir="RTL"></span><span style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> <span lang="FA">شهر رشت بود.<b><o:p /></b></span></span></p><p class="MsoNormal" dir="RTL" style="margin-bottom: 0.0001pt text-align: justify line-height: 120% direction: rtl unicode-bidi: embed"><b><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">مواد و روشها: </span></b><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">از نمونه های مختلف بیماران بستری شده</span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'Times New Roman', serif">ِ</span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">،</span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"> 160 مورد
اشریشیا کلای جدا گردید. تست حساسیت آنتی بیوتیکی به روش </span><span dir="LTR"></span><span class="apple-converted-space"><span dir="LTR" style="font-family: Arial, sans-serif background-color: white background-position: initial initial background-repeat: initial initial"><span dir="LTR"></span> </span><span dir="LTR" style="background-color: white background-position: initial initial background-repeat: initial initial">kirby</span></span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif background-color: white background-position: initial initial background-repeat: initial initial">-<em><span style="font-style: normal">Bauer</span></em></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">ارزیابی گردید </span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">و برای ایزوله های مقاوم، تست دابل دیسک به منظور شناسایی سویه های مولد </span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">ESBL</span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> انجام گرفت. سپس از سویه های مولد </span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">ESBL</span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span>، </span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">DNA</span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> پلاسمیدی استخراج و با استفاده از</span><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">PCR </span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> ژن </span><i><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">bla</span></i><sub><span dir="LTR" style="font-size: 10pt line-height: 120% font-family: 'Times New Roman', serif">TEM </span></sub><span dir="RTL"></span><sub><span style="font-size: 12pt line-height: 120% font-family: 'B Mitra'"><span dir="RTL"></span> </span></sub><span lang="FA" style="font-size: 12pt line-height: 120% font-family: 'B Mitra'">شناسایی<sub> </sub>شد.<b><o:p /></b></span></p><p class="MsoNormal" dir="RTL" style="text-align: justify direction: rtl unicode-bidi: embed"><b><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">یافته های پژوهش:</span></b><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"> </span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">از بین 160 ایزوله </span><i><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">E. coli</span></i><span dir="RTL"></span><i><span style="font-size: 10pt line-height: 115% font-family: 'B Mitra'"><span dir="RTL"></span> </span></i><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">جدا شده، بیشترین مقاومت سویه</span><span dir="LTR" style="font-size: 12pt line-height: 115% font-family: 'Times New Roman', serif"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">ها در برابر
آموکسی</span><span dir="LTR"></span><span lang="FA" dir="LTR" style="font-size: 12pt line-height: 115% font-family: 'Times New Roman', serif"><span dir="LTR"></span> </span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">سیلین بود و همه ایزوله</span><span dir="LTR" style="font-size: 12pt line-height: 115% font-family: 'Times New Roman', serif"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">ها به ایمی پنم حساس بودند. در تمامی سویه</span><span dir="LTR" style="font-size: 12pt line-height: 115% font-family: 'Times New Roman', serif"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">ها 9/51 درصد تولید کننده </span><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">ESBL</span><span dir="RTL"></span><span style="font-size: 10pt line-height: 115% font-family: 'B Mitra'"><span dir="RTL"></span>
</span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">بودند و ژن </span><i><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">bla</span></i><sub><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">TEM </span></sub><span dir="RTL"></span><sub><span style="font-size: 10pt line-height: 115% font-family: 'B Mitra'"><span dir="RTL"></span> </span></sub><sub><span style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"> </span></sub><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">در 27 سویه (32/5 درصد) </span><sub><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"> </span></sub><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">توسط روش </span><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">PCR</span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"><span dir="RTL"></span> شناسایی شد</span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">.</span><b><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif"><o:p /></span></b></p><p class="MsoNormal" dir="RTL" style="margin-bottom: 0.0001pt text-align: justify line-height: 120% direction: rtl unicode-bidi: embed">
</p><p class="MsoNormal" dir="RTL" style="text-align: justify direction: rtl unicode-bidi: embed"><b><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">بحث و نتیجه گیری:</span></b><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"> در </span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">این تحقیق</span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">،</span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"> بیش از 50 درصد ایزوله</span><span dir="LTR" style="font-size: 12pt line-height: 115%"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">ها مولد </span><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">ESBL</span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"><span dir="RTL"></span> بودند که بیش از نیمی از آن</span><span dir="LTR" style="font-size: 12pt line-height: 115%"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">ها حامل ژن </span><i><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">bla</span></i><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif"> <sub>TEM</sub></span><span dir="RTL"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"><span dir="RTL"></span> بودند. مقایسه
این نتایج با سایر مطالعات انجام شده در این زمینه نشان میدهد که گسترش مقاومت در
برابر آنتی بیوتیک</span><span dir="LTR" style="font-size: 12pt line-height: 115%"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">های بتالاکتام با انتقال ژن</span><span dir="LTR" style="font-size: 12pt line-height: 115%"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">هایی مانند </span><i><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif">bla</span></i><span dir="LTR" style="font-size: 10pt line-height: 115% font-family: 'Times New Roman', serif"> <sub>TEM</sub></span><span dir="RTL"></span><span style="font-size: 10pt line-height: 115% font-family: 'B Mitra'"><span dir="RTL"></span> </span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">رابطه</span><span dir="LTR" style="font-size: 12pt line-height: 115%"></span><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'">ی مستقیم دارد.</span><b><span lang="FA" style="font-size: 12pt line-height: 115% font-family: 'B Mitra'"><o:p /></span></b></p></div><div style="text-align: right direction: rtl"><br></div>
<i>
Introduction</i>: <i>E. coli</i> is one of the most frequent causes of nosocomial infection .Antimicrobial resistance leads to failure in treatment of hospital infections caused by<i> E. coli</i>. Extended-Spectrum Beta-lactamases (ESBLs) is one of the causes antibiotic resistance in this bacteria. The enzymes are predominantly plasmid mediated and are derived from TEM and SHV type enzymes. The aim of this study was to investigate the frequency of blaTEM genes in ESBL-producing <i>E. coli</i> strains isolated from admitted patients in six hospitals in Rasht, Iran. <div><i>Materials and Methods</i>: All 160 clinical samples have been taken from various samples of hospitalized patients after diagnosis of<i> E. col</i>i, antibiotic resistance was surveyed by Kirby-Bauer method. For resistant isolates, double disk phenotypic confirmatory test was carried out in order to diagnosis ESBL-producing strains. Then from ESBL-producing strains, DNA extracted And <i>bla</i><sub>TEM</sub> genes were detected using PCR. </div><div><i>Finding</i> :Among 160 clinical isolates of <i>E. coli</i> which were collected, the maximum resistance to Amoxicillin has been observed in all strains, and all were susceptible to Imipenem, and 51.9% of strains were ESBL positive, that 27 strains (32.5%) of <i>bla</i><sub>TEM</sub> genes were observed using PCR.</div><div><i> Discussion &Conclusions </i>:In this study, more than 50% were detected as ESBL-producing strains, which More than half of the isolates were <i>bla</i><sub>TEM</sub> positive. Comparing these results with other studies in this field shows a direct relations between development of resistance to beta-lactam antibiotics and genes transfer such as <i>bla </i><sub>TEM.
</sub></div>
اشریشیا کلای, بتالاکتامازهای وسیع الطیف, blaTEM
E. coli, ESBLs, blaTEM
180
189
http://sjimu.medilam.ac.ir/browse.php?a_code=A-10-1222-1&slc_lang=fa&sid=1
m
haghighat panah
مریم
حقیقت پناه
m.haghighatpanah@gmail.com
9600319475328460015976
9600319475328460015976
Yes
Islamic Azad University
دانشگاه ازاد لاهیجان
n
amirmozafari
نور
امیرمظفری
amirmozafari@yahoo.com
9600319475328460015977
9600319475328460015977
No
Iran University of Medical Sciences
دانشکده علوم پزشکی ایران
m
faezi
محمد
فائزی
faezi_m@yahoo.com
9600319475328460015978
9600319475328460015978
No
Islamic Azad University
دانشگاه آزاد اسلامی، واحد لاهیجان
m
shenagari
محمد
شناگری
shenagari@gmail.com
9600319475328460015979
9600319475328460015979
No
Guilan University of Medical Sciences
دانشگاه علوم پزشکی گیلان