Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
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2022
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شناسایی مولکولی بتالاکتامازهای وسیع الطیف blaTEM، blaSHV و blaCTX در بین باکتری های غیرتخمیری جدا شده از
بیماران بستری در استان مازندران
Molecular Identification of ESBLs Genes (blaTEM, blaSHV and blaCTX) among Non-fermenting Gram-negative Bacteria Isolated from Hospitalized Patients in Mazandaran Province, Iran
ميکروبيولوژي
Microbiology
گزارش کوتاه
Brief Report
<span style="font-size:12pt"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:80%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.2pt">سابقه</span></span></span><span lang="AR-SA" style="line-height:80%"><span style="font-family:"B Koodak""><span style="letter-spacing:-.2pt"> و هدف:</span></span></span><span lang="FA" style="font-family:"B Zar""><span style="letter-spacing:-.2pt"> یکی از مکانیسم</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="font-family:"B Zar""><span style="letter-spacing:-.2pt">های </span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">مقاومت در برابر آنتی</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">بیوتیک</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">ها تولید آنزیم</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">های بتالاکتاماز</span></span></span> <span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">توسط باکتری</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">ها است و تولید آن به ویژه نوع</span></span></span> <span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">بتالاکتامازهای وسیع</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">الطیف(</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%"><span style="letter-spacing:-.2pt">ESBL</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">) یکی از مشکلات بهداشتی و درمانی در سطح دنیا می</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">باشد.</span></span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">ESBL</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> ها اغلب بر روی پلاسمید قرار دارند و از جمله شایع ترین آن</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">ها می</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">توان به </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">TEM</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">CTX-M</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">SHV</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> اشاره نمود. هدف از انجام این مطالعه، تعیین توانایی تولید </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">ESBL</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> براساس روش</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">های مولکولی در <span style="letter-spacing:-.1pt">بین باکتری</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">های </span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">غیرتخمیری (<i>سودوموناس آئروژینوزا</i> و <i>آسینتوباکتر بومانی</i>) جدا شده از بیماران در بیمارستان</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">های آموزشی ا<span style="color:black">ستان مازندران بود.</span><span style="color:#0e101a"></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:80%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:80%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">در این مطالعه توصیفی مقطعی، از میان نمونه</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">های بالینی جمع</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">آوری شده، تعداد 81 ایزوله باکتریایی <span style="letter-spacing:-.2pt">غیرتخمیری جداسازی شد. ایزوله</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">ها ازنظر حساسیت به آنتی</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">بیوتیک</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">‎</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">ها مطابق دستورالعمل </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%"><span style="letter-spacing:-.2pt">CLSI</span></span></span><span style="line-height:80%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt"> بررسی شدند. شناسایی مولکولی</span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> ژن</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">های </span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>SHV</sub></span></span></i><i><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">، </span></span></i><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>TEM</sub></span></span></i><span style="line-height:80%"><span style="font-family:"B Zar""> <i>و </i></span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>CTX-M</sub></span></span></i><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> با استفاده از پرایمرهای اختصاصی و تکنیک واکنش زنجیره پلیمراز</span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">(PCR) </span></span><span style="line-height:80%"><span style="font-family:"B Zar""> انجام شد.<span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:80%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:80%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black">از 81 باکتری غیرتخمیری جدا شده، 49</span></span></span> <span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black">ایزوله (5/60 درصد) <i>آسینتوباکتر بومانی </i>و 32 ایزوله (5/39 درصد) به عنوان <i>سودوموناس آئروژینوزا</i> تایید شدند. شیوع ژن</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black">های شناسایی شده به ترتیب در بین ایزوله</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black">های <i>سودوموناس آئروژینوزا</i>، </span></span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>SHV</sub></span></span></i><span style="line-height:80%"><span style="font-family:"B Zar""> <span lang="FA" style="color:black">(26 درصد)، </span></span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>TEM</sub></span></span></i><i> </i><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">(19 درصد) <span style="color:black">و </span></span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>CTX-M</sub></span></span></i><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black"> (12 درصد) و در ایزوله</span></span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black">های <i>آسینتوباکتر بومانی</i> </span></span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>TEM</sub></span></span></i><span style="line-height:80%"><span style="font-family:"B Zar""> (11 درصد)<span style="color:black">، </span></span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>CTX-M</sub></span></span></i><i> </i><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">(8 درصد)<span style="color:black"> و </span></span></span><i><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">bla<sub>SHV</sub></span></span></i><span style="line-height:80%"><span style="font-family:"B Zar""> <span lang="FA" style="color:black">(4 درصد) بود.</span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:80%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:80%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">سویه</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">های تولیدکننده </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:80%">ESBL</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar""> در میان سویه</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">های <i>سودوموناس آئروژینوزا</i> و <i>آسینتوباکتر بومانی</i> جدا شده از بیمارستان در حال افزایش است. توانایی بالای این سویه</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">ها در انتقال ژن</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">های مقاومت به سایر سویه</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">ها، اهمیت شناسایی سریع آن</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">ها در آزمایشگاه را نشان می</span></span><span lang="AR-BH" style="line-height:80%"><span style="font-family:"B Zar"">‎</span></span><span lang="FA" style="line-height:80%"><span style="font-family:"B Zar"">دهد.</span></span><span lang="AR-SA" style="line-height:80%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span><br>
<br>
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<span style="font-size:12pt"><span style="line-height:120%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:120%"><span style="font-family:"Arial","sans-serif""><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:120%">Production of beta-lactamase enzymes by bacteria, especially Extended-spectrum β-lactamases (ESBLs) is one of the major problems worldwide. ESBLs are mostly located on bacterial plasmids and it is recognized that SHV, TEM,<i> </i>and<i> </i>CTX-M are prevailing among them. The aim of this study was to determine the ability to produce ESBLs genes based on molecular method among non-fermenting Gram-negative bacteria (<i>Pseudomonas aeruginosa </i>and<i> Acinetobacter baumannii</i>) isolated from hospitalized patients in Mazandaran province, Iran.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:120%"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:120%"><span style="font-family:"Arial","sans-serif"">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:120%">In this cross-sectional descriptive study, 81 non-fermenting bacterial isolates were collected. The isolates were tested for antibiotic susceptibility according to CLSI guidelines. Molecular identification of <i>bla</i><sub>SHV</sub>, <i>bla</i><sub>TEM</sub>, and <i>bla</i><sub>CTX-M </sub>genes was performed using specific primers and polymerase chain reaction (PCR) method.</span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:120%"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:120%"><span style="font-family:"Arial","sans-serif"">Results:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:120%">Of 81 non-fermentative bacteria isolated, 49 (60.5%) isolates of <i>A. baumannii </i>were detected<i> </i>and 32 (39.5%) isolates were confirmed as <i>P. aeruginosa</i>. The prevalence of identified genes in these isolates was as follows: 26% <i>bla</i><sub>SHV</sub>, 19% <i>bla</i><sub>TEM</sub>, and 12% <i>bla</i><sub>CTX-M </sub>in <i>P. aeruginosa</i> and 11% <i>bla</i><sub>TEM</sub>, 8% <i>bla</i><sub>CTX-M</sub>,<sub> </sub>and 4% <i>bla</i><sub>SHV</sub> in <i>A. baumannii</i>.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:120%"><span style="vertical-align:top"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:10.0pt"><span style="line-height:120%"><span style="font-family:"Arial","sans-serif"">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:120%"> ESBL positive strains of <i>P. aeruginosa</i> and <i>A. baumannii</i> are increasingly found in hospital isolates. Their high ability to pass resistant genes to other clinical strains requires their quick<span style="color:black"> detection in clinical laboratories.<i></i></span></span></span></span></span></span></span><br>
<br>
باکتریهای غیرتخمیری, مقاومت آنتیبیوتیکی, ESBL, PCR
non fermenter bacteria, antibiotic resistance, ESBL, PCR
150
158
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-10690-4&slc_lang=fa&sid=1
Ghazaleh
Elahi
غزاله
الهی
ghazalehelahi@gmail.com
1003194753284600148440
1003194753284600148440
No
MSc Student in Medical Microbiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
دانشجوی کارشناسی ارشد میکروب شناسی، گروه میکروب شناسی و ویروس شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Mohammad
Ahanjan
محمد
آهنجان
ahanjan2007@gmail.com
1003194753284600148441
1003194753284600148441
No
Professor, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
استاد، مرکز تحقیقات مقاومت های میکروبی، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران
Zhara
Rafi Parhizkar
زهرا
رفیع پرهیزکار
zparhizkar@yahoo.com
1003194753284600148442
1003194753284600148442
No
Medical Student, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
دانشجوی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Hamid Reza
Goli
حمیدرضا
گلی
gouli59@gmail.com
1003194753284600148443
1003194753284600148443
No
Assistant Professor, Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، گروه میکروب شناسی و ویروس شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Laleh
Vahedi Larijani
لاله
واحدی لاریجانی
lvahedi23@yahoo.com
1003194753284600148444
1003194753284600148444
No
Associate Professor, Department of Pathology, Immunogenetics Research Center, Mazandaran University of Medical Sciences, Sari, Iran
دانشیار، گروه پاتولوژی، مرکز تحقیقات ایمونوژنتیک، دانشگاه علوم پزشکی مازندران، ساری، ایران
Fatemeh
Bagherzadeh
فاطمه
باقرزاده
fbagherzadeh56@yahoo.com
1003194753284600148445
1003194753284600148445
No
BSc in Laboratory Sciencs, Sari Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
کارشناس آزمایشگاه، بیمارستان امام خمینی، دانشگاه علوم پزشکی مازندران، ساری، ایران
Mehrdad
Gholami
مهرداد
غلامی
mehrdad_gholami90@yahoo.com
1003194753284600148446
1003194753284600148446
Yes
Assistant Professor, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
استادیار، مرکز تحقیقات مقاومت های میکروبی، پژوهشکده بیماری های واگیر، دانشگاه علوم پزشکی مازندران، ساری، ایران