ﺑﺮرﺳﯽ ﻓﺮاواﻧﯽ و اﻟﮕﻮي ﻣﻘﺎوﻣﺖ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ ﻋﻔﻮﻧﺖ ﻫﺎي .Acinetobacter spp در ﻣﺮاﮐﺰ درﻣﺎﻧﯽ ﺷﻬﺮﮐﺮد

Prevalence and antibiotic resistance pattern of Acinetobacter spp. infections in Shahrekord medical centers

ﮔﻮﻧﻪ ﻫﺎي Acinetobacter ﺑﻪ ﻃﻮر ﻓﺰاﯾﻨﺪه اي در ﺣﺎل ﺗﺒﺪﯾﻞ ﺑﻪ ﺟﻨﺲ ﻣﻘﺎوم ﺑﻪ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮏ ﻣﯽﺑﺎﺷﻨﺪ. داﻧﺶ ﺷﯿﻮع و اﻟﮕﻮي ﻣﻘﺎوﻣﺖ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ .Acinetobacter spp ﻣﻬﻢ اﺳﺖ. از اﯾﻦ رو، ﻣﻄﺎﻟﻌﻪ اﻧﺠﺎم ﺷﺪه ﺑﻪ ﺑﺮآورد ﻣﯿﺰان ﺷﯿﻮع و اﻟﮕﻮي ﻣﻘﺎوﻣﺖ ﺿﺪ ﻣﯿﮑﺮوﺑﯽ اﯾﺰوﻟﻪ ﻫﺎي .Acinetobacter spp از ﻧﻤﻮﻧﻪ ﻫﺎي ﻣﺨﺘﻠﻒ ﺑﺎﻟﯿﻨﯽ ﭘﺮداﺧﺘﻪ اﺳﺖ. ﺑﺎ ﻧﺮم اﻓﺰارﻫﺎي ﺑﯿﻮاﻧﻔﻮرﻣﺎﺗﯿﮑﯽ Primer Express و Gene Runner ﻃﺮاﺣﯽ ﭘﺮاﯾﻤﺮ ﺑﺮاي ﺟﻨﺲ .Acinetobacter spp اﻧﺠﺎم ﺷﺪ. ﺗﺎﯾﯿﺪ ﺻﺤﺖ ﭘﺮاﯾﻤﺮ ﺗﻮﺳﻂ اﺑﺰار آﻧﻼﯾﻦ BLASTn و ﺑﺮﻧﺎﻣﻪ Sequence Match اﻧﺠﺎم ﺷﺪ. اﯾﺰوﻟﻪ ﻫﺎي Acinetobacterاز ﻧﻤﻮﻧﻪﻫﺎي ﻣﺨﺘﻠﻒ ﺑﺎﻟﯿﻨﯽ ﺑﺎ روشﻫﺎي اﺳﺘﺎﻧﺪارد ﺑﯿﻮﺷﯿﻤﯿﺎﯾﯽ و ﺗﺴﺖ PCR ﺷﻨﺎﺳﺎﯾﯽ ﺷﺪﻧﺪ. آزﻣﺎﯾﺸﺎت ﺣﺴﺎﺳﯿﺖ ﺿﺪﻣﯿﮑﺮوﺑﯽ و ﺗﺸﺨﯿﺺ ﺑﯿﻮﻓﯿﻠﻢ ﺑﺮاي اﯾﺰوﻟﻪﻫﺎي ﺷﻨﺎﺳﺎﯾﯽ ﺷﺪه ﺑﻪ روش اﺳﺘﺎﻧﺪارد دﯾﺴﮏدﯾﻔﯿﻮژن ﻣﻄﺎﺑﻖ ﭘﺮوﺗﮑﻞ CLSI و ﻣﯿﮑﺮوﺗﯿﺘﺮﭘﻠﯿﺖ اﻧﺠﺎم ﺷﺪ. ﭘﺮاﯾﻤﺮ ﻃﺮاﺣﯽ ﺷﺪه Acinetobacter spp را ﺑﺎ Query Cover و ﻧﻤﺮه Per. Ident ﺑﺮاﺑﺮ ﺑﺎ 100% ﺷﻨﺎﺳﺎﯾﯽ ﮐﺮد. از 60 ﻧﻤﻮﻧﻪ ﺑﺎﻟﯿﻨﯽ، 243 اﯾﺰوﻟﻪ ﺑﺎﮐﺘﺮﯾﺎﯾﯽ ﺑﻪ دﺳﺖ آﻣﺪ. 112 اﯾﺰوﻟﻪ )46/09 %( ﻣﺮﺑﻮط ﺑﻪ ﺑﺎﮐﺘﺮيﻫﺎي ﮔﺮم ﻣﻨﻔﯽ ﺑﻮد ﮐﻪ 43 اﯾﺰوﻟﻪ )17/69 %( ﺑﻪ ﻋﻨﻮان Acinetobacter ، ﺷﻨﺎﺳﺎﯾﯽ ﺷﺪ. ﻣﻄﺎﺑﻖ آزﻣﻮن PCR 31 ﺳﻮﯾﻪ )77/5 %( ﺑﻪ ﻋﻨﻮان Acinetobacter baumannii، 7 ﺳﻮﯾﻪ )17/5 %( ﺑﻪ ﻋﻨﻮانAcinetobacter lwoffii ، 2 ﺳﻮﯾﻪ )5%( ﺑﻪ ﻋﻨﻮان junii Acinetobacter ﺷﻨﺎﺳﺎﯾﯽ ﺷﺪ. ﻣﻄﺎﻟﻌﻪ ﺣﺴﺎﺳﯿﺖ آﻧﺘﯽ ﺑﯿﻮﺗﯿﮑﯽ ﻧﺸﺎن داد ﮐﻪ ﺗﻤﺎم ﺳﻮﯾﻪ ﻫﺎي ﺟﺪاﺷﺪه MDR ﺑﻮده و 87/5 % اﯾﺰوﻟﻪ ﻫﺎ XDR ﺑﻮدﻧﺪ. اﯾﻦ در ﺣﺎﻟﯿﺴﺖ ﮐﻪ ﺗﻨﻬﺎ 12/5 % از اﯾﺰوﻟﻪ ﻫﺎ ﻧﺴﺒﺖ ﺑﻪ ﮐﺎرﺑﺎﭘﻨﻢ ﻫﺎ ﺣﺴﺎﺳﯿﺖ ﻧﺸﺎن دادﻧﺪ ﮐﻪ ﺗﻤﺎﻣﺎ ﻣﺮﺑﻮط ﺑﻪ ﺳﻮﯾﻪ ﻫﺎﯾﯽ ﻏﯿﺮ از Acinetobacter baumannii ﺑﻮدﻧﺪ. ﺗﻤﺎم اﯾﺰوﻟﻪ ﻫﺎي Acinetobacter ﺑﯿﻮﻓﯿﻠﻢ ﻣﺜﺒﺖ ﺑﻮده و ﺑﺎ ﻣﯿﺎﻧﮕﯿﻦ ﮐﻞ 0/213 ﺑﻪ ﻋﻨﻮان ﺑﯿﻮﻓﯿﻠﻢ ﻗﻮي ﺷﻨﺎﺧﺘﻪ ﺷﺪﻧﺪ. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺑﺮرﺳﯽ اﻧﺠﺎم ﺷﺪه ﻣﺸﺨﺺ ﻣﯽ ﺷﻮد ﮐﻪ آﻟﻮدﮔﯽ ﺑﺎ ﺑﺎﮐﺘﺮي Acinetobacter اﺣﺘﻤﺎﻻ در آﯾﻨﺪه ﻣﯽ ﺗﻮاﻧﺪ ﻣﻨﺠﺮ ﺑﻪ ﭼﺎﻟﺶ ﻫﺎي ﻣﻬﻢ در ﺳﯿﺴﺘﻢ درﻣﺎﻧﯽ ﮐﺸﻮر ﮔﺮدد. ﺑﻪ اﯾﻦ ﻣﻨﻈﻮر ﯾﺎﻓﺘﻦ راه ﺣﻞ ﻫﺎﯾﯽ ﺑﺮاي ﭘﯿﺸﮕﯿﺮي و ﺟﻠﻮﮔﯿﺮي از ﻋﻔﻮﻧﺖ اﯾﻦ ﺟﻨﺲ ﺑﺎﮐﺘﺮﯾﺎﯾﯽ ﺧﺼﻮﺻﺎ Acinetobacter baumannii ﺑﺴﯿﺎر ﻣﻬﻢ و ﺿﺮوري ﻣﯽ ﺑﺎﺷﺪ.

the study estimated the prevalence and pattern of antimicrobial resistance of Acinetobacter spp. isolate from different clinical specimens. Primer design for Acinetobacter spp. was performed with Bioinformatics software Primer Express and Gene Runner. Primer authentication was performed by BLASTn online tool and Sequence Match program. Acinetobacter isolates were identified from different clinical specimens by standard biochemical methods and PCR tests. Antimicrobial susceptibility tests and biofilm detection were performed for isolates identified by standard disk diffusion method according to CLSI‌ protocol and Microtiter plate. Acinetobacter spp. were identified by designed primer with Query Cover and Per. Ident 100%. From 60 clinical samples, 243 bacterial isolates were obtained. 131 isolates (53.9%) were related to gram-positive bacteria and 112 isolates (46.09%) were gram-negative bacteria, of which 43 isolates (17.69%) Were identified as Acinetobacter spp. According to the PCR test, 31 strains (77.5%) were identified as Acinetobacter baumannii, 7 strains (17.5%) as Acinetobacter lwoffii, 2 strains (5%) as Acinetobacter junii. Antibiotic susceptibility study showed that all isolated strains were MDR and 87.5% of isolates were XDR. However, only 12.5% of the isolates were sensitive to carbapenems, All Acinetobacter isolates were biofilm positive and were identified as strong biofilms with a total mean of 0.213. According to the study, it is clear that infection with Acinetobacter can lead to significant challenges in the country's health care system in the future. To this end, finding solutions to prevent infection of this bacterial genus, especially Acinetobacter baumannii, is very important and necessary.