TỶ LỆ NHIỄM VÀ GEN KHÁNG THUỐC METALLO-β-LACTAMASE NDM, IMP, VIM CỦA MỘT SỐ TRỰC KHUẨN GRAM ÂM TRÊN BỆNH NHÂN VIÊM PHỔI TẠI BỆNH VIỆN ĐA KHOA THÀNH PHỐ CẦN THƠ NĂM 2022-2023

Abstract

 Background: In recent years, Gram-negative bacteria causing pneumonia have shown an increasing resistance to carbapenem antibiotics due to the rising production of metallo-β-lactamase (MBL) enzymes. Objectives: To determine the prevalence and carriage rate of MBL resistance genes, including the three types of genes: imipenemase (IMP), Verona integron-encoded MBLs (VIM), and New Delhi metallo-β-lactamase (NDM), in gram-negative bacteria Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa, isolated from lower respiratory tract specimens of patients with pneumonia. Materials and methods: A cross-sectional descriptive study was conducted on 92 patients diagnosed with pneumonia caused by A. baumannii, E. coli, P. aeruginosa, and K. pneumoniae from August 2022 to April 2023 at the Can Tho City General Hospital. Bacterial isolates were cultured and identified from lower respiratory tract specimens using an automated system, and a real-time PCR technique was employed to detect MBL resistance genes, including three genotypes: VIM, IMP, and NDM. Result: Among the 92 isolated Gram-negative bacteria, the infection rates of K. pneumoniae, A. baumannii, E. coli, and P. aeruginosa were 34.4%, 29.2%, 20.8%, and 11.5%, respectively. Of these, 62 (67.4%) Gram-negative bacteria carried MBL genes, including 3 genotypes: NDM, IMP, and VIM, with prevalence rates of 96.8%, 32.3%, and 1.6%, respectively. Conclusion: K. pneumoniae and A. baumannii were the most common Gram-negative bacteria found in pneumonia patients. Approximately 70% of the Gramnegative bacteria in this study carried MBL resistance genes, with the NDM genotype appearing in most of these bacteria. K. pneumoniae strains carrying all three MBL genes were observed, and P. aeruginosa in this study consistently carried at least one MBL genotype.