ザグレブの病院でVIM-1とVIM-4陽性Proteus mirabilisによって発生
Branka Bedenić1,2, Gernot Zarfel3, Josefa Luxner3
1Biomedical Research Institute-BIMIS, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
Pathogens (Basel, Switzerland)
|August 28, 2025
まとめ
クロアチアの精神病院で,カルバペネム耐性プロテウス・ミラビリス (CRPM) が流行しました. これらの広範に薬剤耐性 (XDR) のCRPM分離体はVIM-1およびVIM-4メタロβ- ラクタマスを生成し,治療の選択肢を制限しました.
科学分野:
- 臨床微生物学と感染症
- 抗菌剤耐性
- 分子疫学
背景:
- プロテウス・ミラビリスは 尿路や傷口の感染症の 共通の原因です
- 拡張スペクトルセファロスポリン (ESCs) に対する耐性は,ESBLsまたはp-AmpCsによって媒介される.
- カーバペネーム抵抗性P.ミラビリス (CRPM) の出現は,カーバペネーマースの産生による重大な脅威である.
研究 の 目的:
- クロアチアのザグレブにある 精神病院でのCRPM感染の発生を調査するためです
- 疫病に関連するP.ミラビリスの抗菌剤耐性メカニズムを特徴づける.
主な方法:
- 抗生物質の感受性試験は,ディスク拡散とブローの稀薄法を用いて行われます.
- ESBLs,p-AmpCs,およびカーバペネメーズに対するスクリーニングは,フェノタイプ検査 (DDST,MHT,CIM,eCIM) を使用します.
- 耐性遺伝子 (VIM-1,VIM-4,blaCTX-M-15,blaTEM) の分子識別とプラズミドの特徴づけ (PBRT,WGS) を行う.
主要な成果:
- ESCやカルバペネムを含む複数の抗生物質に対する耐性を示す20のCRPM単離体を分析した.
- フェノタイプ検査では,ESBLの産生とメタロβ- ラクタマース (MBL) の活性が示された.
- PCRとWGSでは,VIM-1とVIM-4カルバペネメーゼと,blaCTX-M-15,blaTEM,および様々なアミノグリコシド,スルフォナミド,トリメトプリム,クロラムフェニコル,およびテトラサイクリン耐性遺伝子を特定しました.
結論:
- 精神病院でCRPMの流行が確認され,その特徴は薬剤耐性 (XDR) フェノタイプである.
- VIM-1およびVIM-4カルバペネメーゼの存在は,限られた治療選択肢に寄与した.
- この研究は,クロアチアでカーバペネメーゼを生成するP.ミラビリスの最初の報告です.
関連する概念動画
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
4.4K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
4.4K
Healthcare Associated Infections II: Preventive Measures
2.8K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.8K
Urinary Tract Infection II: Pathophysiology
43
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
43
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
35
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
35
Urinary Tract Infection I: Introduction
47
Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
47
Development of Antibiotic Resistance
197
Antibiotic resistance is a major public health concern that arises when bacteria evolve mechanisms to withstand the effects of antibiotic treatments. This resistance can be intrinsic, acquired through genetic mutations, or transferred between bacteria via horizontal gene transfer. The development of antibiotic resistance poses significant challenges in treating bacterial infections and necessitates ongoing research to develop new therapeutic strategies.Intrinsic resistance occurs when bacterial...
197


