Increasing secondary bacterial infections with Enterobacteriaceae harboring bla_(CTX-M-15) and bla_(CMY-6) in patients with bronchogenic carcinoma:an emerging point of concern

作     者：Mohammed Shahid Abida Malik Rakesh Bhargava 

作者机构：Section of Bacteriology & Molecular BiologyDepartment of Medical MicrobiologyJN Medical College & HospitalAligarh Muslim UniversityAligarh-202 002U.P.India T.B.& Chest DiseasesJawaharlal Nehru Medical College & HospitalAligarh Muslim UniversityAligarh-202002Uttar PradeshIndia 

出 版 物：《Asian Pacific Journal of Tropical Medicine》 (亚太热带医药杂志（英文版）)

年 卷 期：2011年第4卷第1期

页      面：5-12页

核心收录：

学科分类：100208[医学-临床检验诊断学] 1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Department of Science & Technology Ministry of Science & Technology Government of India for awarding "Young Scientist Project Award"(FT/SR-L-111/2006) 

主　　题：Bronchogenic carcinoma Secondary bacterial infections CTX-M AmpC Enterobacteriaceae 

摘      要：Objective:To look for secondary bacterial infections in bronchogenic carcinoma（BCA） with resistant organisms harboring bla genes considering the paucity of relevant studies.Methods: A total of 137 confirmed cases of BCA and 34 healthy volunteers were studied for the occurrence and prevalence of blaCTX-M and and blaAmpC harboring-enterobacteriaceae.A subset of these patients（n=69） was previously reported for the secondary infection with the Aspergillus species. Bronchoalveolar lavages（BAL） were subjected for bacterial and fungal cultures and the bacterial isolates were screened by multiplex PCRs for the presence of blaCTX-M and blaAmpC.The isolates were also screened for the association of insertion sequence（IS26） by PCR and characterized by RAPD for any clonal relatedness.Results:A total of 143 bacterial isolates were obtained from 137 BAL specimens of BC,patients.The Enterobacteriaceae-isolates were multidrug-resistant showing concomitant resistance to fluoroquinolones and aminoglycosides.Both blaCTX-M and blaAmpC of CIT family were detected in 77.4%and 27.4%isolates,respectively.Sequencing revealed the presence of blaCTX-M-15 and blaCMY-6.Twenty one percent of the isolates were simultaneously harboring blaampC and blaCTX-M-15.IS26 PCR and RAPD typing revealed the presence of diverse bacterial population but no predominant clone was identified.The present study also suggests strong association of aspergillosis with lung cancer and further strengthens the potential use of non-validated serological tests suggested earlier.Conclusions:We emphasize that all patients of bronchogenic carcinoma should also be screened for secondary bacterial infections,along with secondary fungal infections,so as to introduce early and specific antimicrobial therapy and to prevent unwanted deaths.