‫ﺳﻨﺔ ‪2017‬‬ ‫ﺍﻟﻌﺪﺩ ‪3‬‬ ‫ﺍ‪‬ﻠﺪ ‪22‬‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

‫*ﺗﺸﺨﻴﺺ ﺑﻜﺘﺮﻳﺎ ‪ Proteus mirabilis‬ﺑﺄﺳﺘﺨﺪام ﺗﻘﻨﻴﺔ اﻟــ‪ PCR‬وﺗﺤﺪﻳﺪ ﺣﺴﺎﺳﻴﺘﻬﺎ‬

‫ﻟﺒﻌﺾ اﻟﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ‪.‬‬

‫ﺳﻴﻮف ﺧﻮﻣﺎن اﻟﺮﻣﺎﺣﻲ‬ ‫ﻧﻬﻰ ﺟﻮاد اﻟﺴﻌﻴﺪي‬

‫ﻗﺴﻢ ﻋﻠﻮم ﺣﻴﺎة‪-‬ﻛﻠﻴﺔ اﻟﻌﻠﻮم‪-‬ﺟﺎﻣﻌﺔ اﻟﻘﺎدﺳﻴﺔ‬ ‫ﻗﺴﻢ ﻋﻠﻮم ﺣﻴﺎة‪ -‬ﻛﻠﻴﺔ اﻟﻌﻠﻮم‪-‬ﺟﺎﻣﻌﺔ اﻟﻘﺎدﺳﻴﺔ‬

‫‪Syoof.alramahi@qu.edu.iq‬‬ ‫‪njnjnj.hu4@gmail.com‬‬

‫اﻟﺨﻼﺻﺔ‬
‫ﺗﻨﺎوﻟﺖ اﻟﺪراﺳﺔ ﺟﻤﻊ ﻋﻴﻨﺎت ﻣﻦ اﻟﺤﺎﻻت اﻟﺴﺮﻳﺮﻳﺔ اﻟﻤﺨﺘﻠﻔﺔ ﺑﻮاﻗﻊ ‪ 185‬ﻋﺰﻟﺔ ﻣﻦ ﻣﺴﺘﺸﻔﻴﺎت ﻣﺪﻳﻨﺔ اﻟﺪﻳﻮاﻧﻴﺔ‬
‫ﺧﻼل اﻟﻤﺪة ﻣﻦ ﺗﺸﺮﻳﻦ اﻻول ‪ 2015‬ﻟﻐﺎﻳﺔ ﻧﻴﺴﺎن ‪ 2016‬وﻗﺴﻤﺖ اﻟﻌﻴﻨﺎت ﺑﺤﺴﺐ ﻣﺼﺎدر ﺟﻤﻌﻬﺎ اﻟﻰ ﺧﻤﺲ‬
‫ﻣﺠﻤﻮﻋﺎت )‪ 46‬ﻣﺴﺤﺔ أذن‪ 42 ,‬ﻣﺴﺤﺔ ﺣﺮوق ‪ 37 ,‬ﻋﻴﻨﺔ اﻟﺒﺮاز‪ ,‬و‪ 59‬ﻋﻴﻨﺔ ادرار‪ 1 ,‬ﻋﻴﻨﺔ دم ( ‪ ,‬اذ اﻇﻬﺮت‬
‫ﻧﺘﺎﺋﺞ اﻟﻔﺤﻮﺻﺎت اﻟﺰرﻋﻴﺔ واﻟﻜﻴﻤﻮﺣﻴﻮﻳﺔ ﻋﺎﺋﺪﻳﺔ ‪69‬ﻋﺰﻟﺔ ﻟﺒﻜﺘﻴﺮﻳﺎ ‪ , P.mirabilis‬وﺗﻢ ﺗﺄﻛﻴﺪ ﺗﺸﺨﻴﺼﻬﺎ ﺑﻮﺳﺎﻃﺔ‬
‫‪ api 20E‬واﺳﺘﺨﺪام ﺗﻔﺎﻋﻞ اﻟﺒﻠﻤﺮة اﻟﻤﺘﺴﻠﺴﻞ ‪.PCR‬اﺧﺘﺒﺮت ﺣﺴﺎﺳﻴﺔ ﻋﺰﻻت ‪ P.mirabilis‬ﺗﺠﺎه ‪ 15‬ﻧﻮﻋﺎً ﻣﻦ‬
‫اﻟﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ ﺑﻄﺮﻳﻘﺔ اﻧﺘﺸﺎر اﻻﻗﺮص‪ ,‬واﻟﻌﺎﺋﺪة ﻟﻌﺸﺮة اﺻﻨﺎف ﻣﻦ اﻟﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ ‪ ,‬اذ ﺑﻴﻨﺖ ﻧﺘﺎﺋﺞ‬
‫اﺧﺘﺒﺎر اﻟﺤﺴﺎﺳﻴﺔ اﻻوﻟﻲ ﻟﻌﺰﻻت ﻟﺒﻜﺘﻴﺮﻳﺎ ‪ , P.mirabilis‬أن ﻧﺴﺒﺔ اﻟﻤﻘﺎوﻣﺔ ﺑﻜﺘﺮﻳﺎ ‪ P.mirabils‬ﻟﻤﻀﺎدات‬
‫اﻟﺒﻴﺘﺎﻻﻛﺘﻢ اﻟﻤﺘﻤﺜﻠﺔ ﺑﻤﻀﺎد اﻻﻣﻮﻛﺴﻴﻠﻴﻦ ‪Amoxicillin‬ﻧﺴﺒﺔ اﻟﻤﻘﺎوﻣﺔ ‪ , %84.05‬اﻣﺎ ﻣﻘﺎوﻣﺔ اﻟﺒﻜﺘﺮﻳﺎ ﻟﻤﻀﺎد‬
‫اﻻﻣﺒﺴﻠﻴﻦ ‪ Ampicillin‬ﺑﻨﺴﺒﺔ‪ ,%84.05‬أﻣﺎ اﻻﻣﻮﻛﺴﻴﻠﻴﻦ‪ -‬ﻛﻼﻓﻴﻮﻻﻧﻚ أﺳﺪ ‪Amoxicillin/cluvanic acid‬‬
‫ﺑﻨﺴﺒﺔ‪, % 47.82‬أﻣﺎ اﻟﺘﻴﻜﺮاﺳﻴﻠﻴﻦ ‪ Ticarcillin‬وﻣﻀﺎد اﻟﺴﻴﻔﺘﺎزﻳﺪﻳﻢ ‪ Cefatozidime‬ﻛﺎﻧﺖ ﻧﺴﺒﺔ اﻟﻤﻘﺎوﻣﺔ‬
‫ﻟﻬﻤﺎ ‪ , %66.66‬اﻟﺴﻴﻔﻮﺗﺎﻛﺴﻴﻢ ‪ Cefotaxim‬ﺑﻨﺴﺒﺔ ‪,%53.62‬اﻟﻤﻴﺮوﺑﻨﻴﻢ ‪ Meropenem‬ﺑﻨﺴﺒﺔ ‪ .,%5.6‬أﻣﺎ‬
‫ﻧﺴﺒﺔ اﻟﻤﻘﺎوﻣﺔ ﻟﻤﻀﺎدات اﻷﻣﻴﻨﻮﻛﻼﻳﻜﻮﺳﻴﺪات اﻟﻤﺘﻤﺜﻠﺔ ﺑﻤﻀﺎداﻷﻣﻴﻜﺎﺳﻴﻦ ‪Amikacin‬ﺑﻨﺴﺒﺔ ‪ ,%17.39‬ﻣﻀﺎد‬
‫اﻟﺠﻨﺘﺎﻣﺎﻳﺴﻴﻦ ‪ Gentamicin‬ﺑﻠﻐﺖ ‪ ,%33.33‬ﻣﻀﺎدات اﻟﻜﻮﻳﻨﻮﻟﻴﻨﺎت ‪ Quinolones‬اﻟﻤﺘﻤﺜﻠﺔ ﺑﺤﺎﻣﺾ‬
‫اﻟﻨﺎﻟﺪﻳﻜﺴﻴﻚ ‪ Nalidic acid‬ﺑﻨﺴﺒﺔ ‪ ,%75.36‬اﻣﺎ ﻣﻀﺎد اﻟﺴﺒﺮوﻓﻠﻮﻛﺴﺎﺳﻴﻦ ‪ Ciprofloxacin‬ﻓﺴﺠﻞ اﻗﻞ ﻧﺴﺒﺔ‬
‫ﻣﻘﺎوﻣﺔ ‪ ,%4.34‬ﺳﺠﻞ ﻣﻀﺎد اﻟﺘﺮاﻳﻤﻴﺜﻮﺑﺮﻳﻢ ‪ Trimethoprim‬ﻧﺴﺒﺔ ﻣﻘﺎوﻣﺔ ‪ , %75.36‬أﻣﺎ اﻟﻜﻠﻮراﻣﻔﻴﻨﻴﻜﻮل‬
‫‪ ,%82.60‬وﻛﺬﻟﻚ ﻛﻞ ﻣﻦ ﻣﻀﺎد اﻟﺘﺘﺮاﺳﺎﻳﻜﻠﻴﻦ‬ ‫‪ Chloramphenicol‬ﺳﺠﻞ ﻧﺴﺒﺔ ﻣﻘﺎوﻣﺔ ﻋﺎﻟﻴﺔ‬
‫‪ Tetracycline‬ﺑﻨﺴﺒﺔ ‪ ,%82.60‬وﻣﻀﺎد اﻟﺮﻳﻔﺎﻣﺒﻴﻦ ‪ Rifampin‬ﺑﻨﺴﺒﺔ ‪.%91.30‬‬

‫*اﻟﻜﻠﻤﺎت اﻟﻤﻔﺘﺎﺣﻴﺔ ‪:‬ﻣﻘﺎوﻣﺔ ‪,‬اﻟﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ ‪,‬اﻟﻤﺘﻘﻠﺒﺎت‪.‬‬

‫*اﻟﺒﺤﺚ ﻣﺴﺘﻞ ﻣﻦ رﺳﺎﻟﺔ ﻣﺎﺟﺴﺘﻴﺮ اﻟﺒﺎﺣﺚ اﻟﺜﺎﻧﻲ ‪.‬‬

‫اﻟﻤﻘﺪﻣﺔ‬

‫وﻟﻬﺬه اﻟﺒﻜﺘﺮﻳﺎ اﻫﻤﻴﺔ ﻛﺒﻴﺮة ﻓﻲ‬ ‫ﻟﻠﻌﺎﺋﻠﺔ اﻟﻤﻌﻮﻳﺔ‬ ‫ﺗﻌﺪ ﺑﻜﺘﻴﺮﻳﺎ ‪ Proteus mirabilis‬واﺣﺪة ﻣﻦ اﻫﻢ‬
‫اﻟﻤﺴﺘﺸﻔﻴﺎت‬ ‫ﻣﻦ‬ ‫اﻟﻤﻜﺘﺴﺒﺔ‬ ‫اﻟﻌﺪوى‬ ‫ﺗﻔﺸﻲ‬ ‫اﻻﻧﻮاع اﻟﺒﻜﺘﻴﺮﻳﺔ اﻟﺴﺎﻟﺒﺔ ﻟﺼﺒﻐﺔ ﮔرام اﻟﺘﻲ ﺗﻨﺘﻤﻲ‬
 ‫ﺳﻨﺔ ‪2017‬‬ ‫ﺍﻟﻌﺪﺩ ‪3‬‬ ‫ﺍ‪‬ﻠﺪ ‪22‬‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

‫ﻣﺘﺰاﻣﻨﺎً ﻣﻊ اﻟﻤﻘﺎوﻣﺔ اﻟﻤﺘﻌﺪدة ﻟﻠﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ‬ ‫‪ .‬ﻛﻤﺎ وﺗﻌﺪ‬ ‫)‪(1,2‬‬

‫‪Nosocomial infections‬‬
‫)‪ .(4‬إن إﻧﺰﻳﻤﺎت اﻟﺒﻴﺘﺎﻻﻛﺘﺎﻣﻴﺰ اﻟﻮاﺳﻌﺔ اﻟﻄﻴﻒ ﺗﻨﺘﺞ‬ ‫ﻣﻦ اﻟﻤﻤﺮﺿﺎت اﻻﻛﺜﺮ ﺷﻴﻮﻋﺎً اﻟﺘﻲ ﺗﺴﺒﺐ اﻻﺧﻤﺎج‬
‫ﻣﻦ ﻗﺒﻞ اﻟﺒﻜﺘﺮﻳﺎ اﻟﺴﺎﻟﺒﺔ ﻟﺼﺒﻐﺔ ﻛَﺮام أذ ﺗﻤﻨﺢ‬ ‫‪Community acquird‬‬ ‫اﻟﻤﻜﺘﺴﺒﺔ ﻣﻦ اﻟﻤﺠﺘﻤﻊ‬
‫اﻟﺒﻜﺘﺮﻳﺎ اﻟﺘﻲ ﺗﻨﺘﺠﻬﺎ زﻳﺎدة ﻓﻲ ﻣﻘﺎوﻣﺔ اﻟﻤﻀﺎدات‬ ‫اﻧﺘﻬﺎزﻳﺔ‬ ‫ﺑﻜﺘﺮﻳﺎ‬ ‫وﻟﻜﻮﻧﻬﺎ‬ ‫‪,‬‬ ‫‪infections‬‬
‫اﻟﺤﻴﺎﺗﻴﺔ ﺷﺎﺋﻌﺔ اﻻﺳﺘﺨﺪام وﻣﻨﻬﺎ ﻣﻀﺎدات اﻟﺒﻴﺘﺎﻻﻛﺘﻢ‬ ‫‪ Opportunistic‬ﻟﺬا ﻓﻬﻲ ﺗﺴﺒﺐ اﻟﻜﺜﻴﺮ ﻣﻦ‬
‫‪.‬وﺑﺎﻟﻨﻈﺮ ﻻﻫﻤﻴﺔ اﻟﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ وﺗﻔﺸﻲ‬ ‫)‪(5‬‬
‫اﻻﺻﺎﺑﺎت اﻟﻤﺮﺿﻴﺔ ﻋﻨﺪﻣﺎ ﺗﺘﻮاﺟﺪ ﻓﻲ ﻏﻴﺮ ﺑﻴﺌﺎﺗﻬﺎ‬
‫ﻣﻘﺎوﻣﺔ اﻟﺒﻜﺘﺮﻳﺎ ﻟﻠﻤﻀﺎدات وﺧﺼﻮﺻﺎ اﻟﺸﺎﺋﻌﺔ‬ ‫‪.‬ان ﻣﻘﺎوﻣﺔ اﻟﻌﺰﻻت ﺑﻜﺘﺮﻳﺎ‬ ‫)‪(2,3‬‬
‫اﻟﻄﺒﻴﻌﻴﺔ‬
‫اﻻﺳﺘﺨﺪام وﻋﻠﻴﺔ ﺗﻨﺎوﻟﺖ اﻟﺪراﺳﺔ ﻣﻘﺎوﻣﺔ اﻟﻤﻀﺎدات‬ ‫اﻟﻤﺘﻌﺪدة‬ ‫اﻟﻤﻘﺎوﻣﺔ‬ ‫وﻻﺳﻴﻤﺎ‬ ‫‪P.mirabilis‬‬
‫اﻟﻤﻌﺰوﻟﺔ ﻣﻦ‬ ‫اﻟﺤﻴﺎﺗﻴﺔ ﻟﺒﻜﺘﺮﻳﺎ ‪P.mirabilis‬‬ ‫ﻟﻠﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ ‪multi drug rsistance‬‬
‫ﻣﺴﺘﺸﻔﻴﺎت ﻣﺪﻳﻨﺔ اﻟﺪﻳﻮاﻧﻴﺔ ﻟﺘﻔﺎدي ﻣﻘﺎوﻣﺔ اﻟﺒﻜﺘﺮﻳﺎ‬ ‫اﺻﺒﺤﺖ ﻣﺸﻜﻠﺔ ﻣﺘﺰاﻳﺪة ﻣﻊ اﻟﺰﻣﻦ ﺑﺎﻻﺿﺎﻓﺔ اﻟﻰ ان‬
‫ﻟﻠﻤﻀﺎدات اﻟﺸﺎﺋﻌﺔ واﺳﺘﺨﺪام اﻟﻌﻼج اﻟﻤﻨﺎﺳﺐ‪.‬‬ ‫اﻧﺘﺎج اﻧﺰﻳﻤﺎت اﻟﺒﻴﺘﺎﻻﻛﺘﺎﻣﻴﺰ واﺳﻌﺔ اﻟﻄﻴﻒ ﻳﻜﻮن‬

‫اﻟﻤﻮاد وﻃﺮق اﻟﻌﻤﻞ ‪:‬‬

‫ﺷُﺨﺼﺖ ﻣﺴﺘﻌﻤﺮات ﺑﻜﺘﺮﻳﺎ ‪ P.mirabilis‬ﻣﺒﺪﺋﻴﺎً‬ ‫ﺟﻤـــــــــﻊ اﻟﻌﻴﻨــــــــــﺎت‬

‫اﻋﺘﻤﺎداً ﻋﻠﻰ اﻟﺼﻔﺎت اﻟﻤﻈﻬﺮﻳﺔ ﻟﻬﺎ ﻣﻦ ﺣﻴﺚ ﺷﻜﻞ‬
‫وﻟﻮن اﻟﻤﺴﺘﻌﻤﺮات‪ .‬إذ ﺗﻢ اﻟﺘﺮﻛﻴﺰ ﻋﻠﻰ‬
‫اﻟﻤﺴﺘﻌﻤﺮات اﻟﺘﻲ ﺗﻤﻴﺰت ﺑﻈﺎﻫﺮة اﻻﻧﺜﻴﺎل ﻟﺒﻜﺘﺮﻳﺎ‬
‫‪ P.mirabilis‬ﻋﻠﻰ وﺳﻂ اﻛﺎر اﻟﺪم‪ .‬ﻛﺬﻟﻚ ﻇﻬﺮت‬
‫ﺑﻤﺴﺘﻌﻤﺮات ﺷﺎﺣﺒﺔ ﻏﻴﺮ ﻣﺨﻤﺮة ﻟﺴﻜﺮ اﻟﻼﻛﺘﻮز‬
‫ﻋﻠﻰ وﺳﻂ اﻛﺎر اﻟﻤﺎﻛﻮﻧﻜﻲ‪.‬أذ ﺗﻢ دراﺳﺔ اﺷﻜﺎل‬
‫اﻟﻤﺴﺘﻌﻤﺮات اﻟﻨﺎﻣﻴﺔ وﺧﺼﺎﺋﺼﻬﺎ اﻟﻤﺰرﻋﻴﺔ واﻟﻨﻤﻮ‬
‫‪ .‬ﻛﻤﺎ‬ ‫أو ﻋﺪم اﻟﻨﻤﻮ ﻋﻠﻰ اﻷوﺳﺎط اﻟﺘﻔﺮﻳﻘﻴﺔ‬
‫وﺷﺨﺼﺖ ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﺤﻮﺻﺎت اﻟﻜﻴﻤﻮﺣﻴﻮﻳﺔ‬
‫اﻧﺘﺎج‬ ‫‪,‬اﻟﻴﻮرﻳﺰ‪,‬‬ ‫‪,‬اﻻوﻛﺴﺪﻳﺰ‬ ‫اﻟﻜﺘﺎﻟﻴﺰ‬
‫اﻟﻐﺎز‪,‬ﺗﺨﻤﺮ اﻟﺴﻜﺮﻳﺎت ‪,‬واﺧﺘﺒﺎر اﻟﺠﻴﻼﺗﻴﻨﻴﺰ ‪,‬‬
‫واﺧﺘﺒﺎرات ‪.(6) . IMViC‬‬
‫إﺧﺘﺒﺎر ﻓﺤﺺ اﻟﺤﺴﺎﺳﻴﺔ‬
‫ﺑﻜﺘﻴﺮﻳﺎ‬ ‫ﻣﻦ‬ ‫ﻣﺴﺘﻌﻤﺮات‬ ‫‪4-2‬‬
‫‪P.mirabilis‬إﻟﻰ أﻧﺒﻮب إﺧﺘﺒﺎر ﻳﺤﻮي ‪5‬ﻣﻞ ﻣﻦ‬
‫ﻣﻦ ﻣﺮق ﻧﻘﻴﻊ اﻟﻘﻠﺐ واﻟﺪﻣﺎغ وﺣﻀﻨﺖ ﺑﺪرﺟﺔ ‪37‬‬
‫مْ ﻟﻤﺪة ‪ 8‬ﺳﺎﻋﺎت‪ .‬ﺧﻔﻒ اﻟﻨﻤﻮ اﻟﺤﺎﺻﻞ ﺑﺎﺳﺘﻌﻤﺎل‬
‫ﺗﻀﻤﻨﺖ اﻟﺪراﺳﺔ اﻟﺤﺎﻟﻴﺔ ﺟﻤﻊ ‪185‬ﻋﻴﻨﺔ ﻣﻦ‬
‫وﺣﺠﻢ‬
‫اﻟﺤﺎﻻت اﻟﺴﺮﻳﺮﻳﺔ ﺧﻼل ﻓﺘﺮة ﻣﻦ ﺗﺸﺮﻳﻦ اﻻول‬
‫‪2015‬اﻟﻰ ﻧﻴﺴﺎن ‪2016‬ﻣﻦ اﻟﻤﺮﺿﻰ اﻟﻤﺼﺎﺑﻴﻦ‬
‫ﺑﺄﻋﻤﺎر ﻣﺨﺘﻠﻔﺔ ﻟِﻜِﻼ اﻟﺠﻨﺴﻴﻦ ﻣﻦ ﻣﺴﺘﺸﻔﻴﺎت ﻓﻲ‬
‫ﺷﻤﻠﺖ ﻣﺴﺘﺸﻔﻰ اﻟﺪﻳﻮاﻧﻴﻪ‬ ‫ﻣﺤﺎﻓﻈﺔ اﻟﺪﻳﻮاﻧﻴﺔ‬
‫اﻟﺘﻌﻠﻴﻤﻲ ‪,‬ﻣﺨﺘﺒﺮ اﻟﺼﺤﻪ اﻟﻌﺎﻣﻪ ‪,‬ﻣﺴﺘﺸﻔﻰ اﻟﻨﺴﺎﺋﻴﻪ‬
‫واﻟﺘﻮﻟﻴﺪ ‪ ,‬ﻣﺮﻛﺰ اﻟﺤﺮوق اﻟﺘﺨﺼﺼﻲ ﻓﻲ اﻟﺪﻳﻮاﻧﻴﻪ‬
‫‪,‬ﻛﻤﺎ وﺣﺮص اﺛﻨﺎء ﺟﻤﻊ اﻟﻌﻴﻨﺎت ﻋﻠﻰ اﺳﺘﺨﺪام‬
‫اﻟﻤﺴﺤﺎت اﻟﻘﻄﻨﻴﺔ اﻟﺤﺎوﻳﺔ ﻋﻠﻰ وﺳﻂ ﻧﺎﻗﻞ‬
‫وﻣﻨﻬﺎ‬
‫‪ Transport media swabs‬ﻓﻲ ﻋﻤﻠﻴﺔ ﺟﻤﻊ‬
‫اﻟﻌﻴﻨﺎت ﻟﻀﻤﺎن ﺣﻴﻮﻳﺔ اﻟﻌﺰﻟﺔ‪.‬وﺑﻌﺪ ذﻟﻚ اﺟﺮﻳﺖ‬
‫اﻻﺧﺘﺒﺎرات اﻟﻜﻴﻤﻮﺣﻴﻮﻳﺔ ﺑﺬﻟﻚ ﺷﺨﺼﺖ ‪69‬ﻋﺰﻟﺔ‬
‫ﺗﻌﻮد ﻟﺒﻜﺘﺮﻳﺎ ‪ P. mirabilis‬وﺗﻢ ﺗﺄﻛﻴﺪﻫﺎ ب‬
‫ﺑﺄﺳﺘﺨﺪام ‪ API-20A‬وﺛﻢ ﺷﺨﺼﺖ ﺑﻮاﺳﻄﺔ ﺗﻘﻨﻴﺔ‬
‫اﺧﺬت‬
‫‪. PCR‬‬
‫ﺗﺸﺨﻴﺺ اﻟﺒﻜﺘﺮﻳﺎ اﻟﻤﻌﺰوﻟﺔ‬
 ‫ﺳﻨﺔ ‪2017‬‬ ‫ﺍﻟﻌﺪﺩ ‪3‬‬ ‫ﺍ‪‬ﻠﺪ ‪22‬‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

‫اﻟﻐﺮﻓﺔ ﻟﻀﻤﺎن إﻣﺘﺼﺎص اﻟﺮﻃﻮﺑﺔ‪ ،‬ﺛﻢ وُﺿﻌﺖ‬
‫أﻗﺮاص اﻟﻤﻀﺎدات اﻟﺤﻴﻮﻳﺔ ‪ ،‬ﺣُﻀﻨﺖ اﻷﻃﺒﺎق ﻓﻲ‬
‫‪ 35‬مْ ﻟﻤﺪة ‪ 18‬ﺳﺎﻋﺔ ﻟﺠﻤﻴﻊ أﻧﻮاع اﻟﻤﻀﺎدات‬
‫اﻟﺤﻴﺎﺗﻴﺔ‪ ،‬ﻗﺮُأت اﻟﻨﺘﺎﺋﺞ ﺑﻘﻴﺎس أﻗﻄﺎر اﻟﺘﺜﺒﻴﻂ ﺑﺄﺧﺬ‬
‫ﻗﻄﺮﻳﻦ ﻣﺘﻌﺎﻣﺪﻳﻦ وﻗﻮرﻧﺖ اﻟﻨﺘﺎﺋﺞ ﻣﻊ ﻗﻴﺎﺳﺎت‬
‫ﻋﺎﻟﻤﻴﺔ ﺑﺤﺴﺐ ﻣﺎ ﺟﺎء ﻓﻲ)‪.(7‬‬
‫ﻣﺤﻠﻮل اﻟﻤﻠﺢ اﻟﻔﺴﻠﺠﻲ ﺣﺼﻮل ﻋﻠﻰ درﺟﺔ ﻋﻜﻮره‬
‫ﻣﻤﺎﺛﻠﺔ إﻟﻰ ﻋﻜﻮرة أﻧﺒﻮﺑﺔ ﻟــ ﻣﺎﻛﻔﺮﻻﻧﺪ ‪ 0.5‬اﻟﻘﻴﺎﺳﻴﺔ‬
‫‪ ،‬وﻏﻤﺴﺖ اﻟﻤﺴﺤﺔ اﻟﻘﻄﻨﻴﺔ ﺑﺎﻟﻮﺳﻂ اﻟﺰرﻋﻲ‬
‫اﻟﻤﺨﻔﻒ وﻧﺸﺮت اﻟﺒﻜﺘﻴﺮﻳﺎ ﻋﻠﻰ وﺳﻂ ﻣﻮﻟﺮ‪ -‬ﻫﻨﺘﻮن‬
‫اﻟﺼﻠﺐ ﺑﻄﺮﻳﻘﺔ اﻟﺘﺨﻄﻴﻂ ﻷﻛﺜﺮ ﻣﻦ ﻣﺮة وﺑﺎﺗﺠﺎﻫﺎت‬
‫ﻣﺨﺘﻠﻔﺔ ‪ ،‬وﺗُﺮﻛﺖ اﻷﻃﺒﺎق ‪ 5‬ﻗﺎﺋﻖ ﻓﻲ درﺟﺔ ﺣﺮارة‬

‫ﻟﺼﺒﻐﺔ ﻛَﺮام اﻟﺘﻲ ﻛﺎﻧﺖ ‪ %42.16‬أﻣﺎ ﻋﺪد اﻟﻌﻴﻨﺎت‬ ‫اﻟﻨﺘﺎﺋﺞ واﻟﻤﻨﺎﻗﺸﺔ‪:‬‬

‫اﻟﺨﺎﻟﻴﺔ ﻣﻦ اﻟﻨﻤﻮ ﻓﻜﺎﻧﺖ ﺑﻨﺴﺒﺔ ‪ .%11.89‬اﻛﺪت‬
‫‪ %45.94‬اﻟﺘﻲ ﺗﻢ‬ ‫ﺑﻠﻐﺖ ﻧﺴﺒﺔ ﻋﺰﻻت ﺑﻜﺘﺮﻳﺎ‬
‫اﻟﺪراﺳﺎت ان اﺳﺒﺎب اﻟﺘﻠﻮث اﻟﺒﻜﺘﻴﺮي ﻓﻲ‬
‫‪185‬ﻣﻦ اﻟﻌﻴﻨﺎت‬ ‫ﻣﻦ ﻣﺠﻤﻮع‬ ‫اﻟﺤﺼﻮل ﻋﻠﻴﻬﺎ‬
‫اﻟﻤﺴﺘﺸﻔﻴﺎت إﻣﺎ أن ﻳﻜﻮن ﺑﺸﻜﻞ ذاﺗﻲ ﺣﻴﺚ ﺗﻤﺜﻞ‬
‫ﺑﻨﺴﺒﺔ‬ ‫اﻻدرار‬ ‫ﻋﻴﻨﺎت‬ ‫وﻣﻨﻬﺎ‬ ‫اﻟﺴﺮﻳﺮﻳﺔ‬
‫ﻫﺬه اﻟﺒﻜﺘﺮﻳﺎ ﺟﺰء ﻣﻦ اﻟﻔﻠﻮرا اﻟﻄﺒﻴﻌﻴﺔ أوﻗﺪ ﺗﻜﺘﺴﺐ‬
‫‪,%10.81‬ﻋﻴﻨﺎت اﻻذن اﻟﻮﺳﻄﻰ ﺑﻨﺴﺒﺔ ‪%6.48‬‬
‫ﻣﻦ اﺳﺘﻌﻤﺎل اﻟﻤﺮﺿﻰ ﻟﻠﺼﺤﻴﺎت أو ﻋﻦ ﻃﺮﻳﻖ‬
‫‪,%9.72‬ﻋﻴﻨﺎت‬ ‫اﻟﺤﺮوق‬ ‫اﻟﺘﻬﺎﺑﺎت‬ ‫‪,‬ﻋﻴﻨﺎت‬
‫اﻷﺷﺨﺎص اﻟﻤﺮاﻓﻘﻴﻦ ﻟﻠﻤﺮﻳﺾ وﺑﺸﻜﻞ ﻋﺎم ﻓﺄن‬
‫اﻟﺒﺮاز‪ ,%13.51‬ﺳﺠﻠﺖ ﻋﻴﻨﺎت ﺗﺠﺮﺛﻢ اﻟﺪم اﻗﻞ‬
‫اﻟﻬﻮاء واﻟﻤﻴﺎه واﻷﻃﻌﻤﺔ واﻷﻳﺪي ﺟﻤﻴﻌﻬﺎ ﺗﺴﻬﻢ ﻓﻲ‬
‫ﻧﺴﺒﺔ ﻓﻲ اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﻤﺘﻘﻠﺒﺎت ﻓﻲ اﻟﻌﻴﻨﺎت‬
‫اﻧﺘﻘﺎل اﻟﻌﺪوى ﻣﻦ ﺷﺨﺺ ﻵﺧﺮ وﺳﻮف ﻳﺆدي اﻟﻰ‬
‫اﻟﺴﺮﻳﺮﻳﺔ ﺑﻨﺴﺒﺔ ‪ . %0.54‬ﻛﻤﺎﻫﻮ ﻣﻮﺿﺢ ﺑﺎﻟﺠﺪول‬
‫ﺗﻮﺳﻊ داﺋﺮة اﻧﺘﻘﺎل اﻟﺒﻜﺘﻴﺮﻳﺎ)‪.(8‬‬
‫)‪ (1‬ﻛﻤﺎ وﺑﻴﻦ ﻧﺴﺒﺔ ﻋﺰل اﻟﺒﻜﺘﺮﻳﺎ اﻟﻤﻮﺟﺒﺔ واﻟﺴﺎﻟﺒﺔ‬
‫ﺟﺪول)‪ (1‬اﻟﻨﺴﺐ اﻟﻤﺌﻮﻳﺔ ﻟﻠﺒﻜﺘﺮﻳﺎ اﻟﻤﻌﺰوﻟﺔ ﺣﺴﺐ ﻣﺼﺎدر ﻋﺰﻟﻬﺎ‪.‬‬

‫ﻋﺪدﻋﺰﻻت ﺑﻜﺘﺮﻳﺎ‬ ‫ﻋﺪد اﻟﻌﺰﻻت ﻟﺒﻜﺘﺮﻳﺎ‬ ‫‪No‬‬ ‫اﻟﻌﺪد اﻟﻜﻠﻲ ﻟﻠﻌﻴﻨﺎت‬ ‫ﻣﺼﺪر اﻟﻌﺰﻻت‬
‫‪Proteus‬‬ ‫‪Spp‬‬ ‫اﻟﺴﺎﻟﺒﺔ واﻟﻤﻮﺟﺒﺔ‬ ‫‪growth‬‬ ‫ﺣﺴﺐ ﻣﺼﺪرﻫﺎ‬

‫‪(%10.81)20Aa‬‬ ‫‪(%16.21)30Aa‬‬ ‫‪(%4.86)9‬‬ ‫‪(31.89)59‬‬ ‫اﻻدرار‬

‫‪(%6.48) 21‬‬ ‫‪Aa‬‬
‫‪(%10.8 )20‬‬ ‫‪ABa‬‬
‫‪(%2.70)5‬‬ ‫‪(24.86)46‬‬ ‫اﻻذن‬
‫‪%(9.72)18Aa‬‬ ‫‪(% 9.)18ABa‬‬ ‫‪(%3.24)6‬‬ ‫‪(22.70)42‬‬ ‫اﻟﺤﺮوق‬
‫‪(%13.51)25Aa‬‬ ‫‪(%5.40)10Ba‬‬ ‫‪(%1.08)2‬‬ ‫‪(%20)37‬‬ ‫اﻟﺒﺮاز‬
‫‪(%0.54)1Ba‬‬ ‫‪(%0)0Ca‬‬ ‫‪(%0)0‬‬ ‫‪(%0.54) 1‬‬ ‫دم‬
‫‪(%45.94)85‬‬ ‫‪(%42.16) 78‬‬ ‫‪(11.89)22‬‬ ‫‪(%100)185‬‬ ‫اﻟﻤﺠﻤﻮع‬
‫‪2‬‬ ‫‪2‬‬
‫ان ﻗﻴﻤﺔ ﻣﺮﺑﻊ ﻛﺎي ‪ X‬اﻟﻤﺤﺴﻮﺑﺔ ‪ 29.748‬اﻛﺒﺮ ﻣﻦ اﻟﺠﺪوﻟﻴﺔ ‪ 28.869 X‬إذاَ ﺗﻮﺟﺪ ﻓﺮوق ﻣﻌﻨﻮﻳﺔ ‪.‬‬ ‫‪‬‬

‫اﻟﻌﺰل واﻟﺘﺸﺨﻴﺺ ‪:‬‬

‫‪P.mirabilis‬‬ ‫ﺖ ﺑﻜﺘ‬
‫ﺔ‬
‫‪,P.mirabilis‬‬
 2017 ‫ﺳﻨﺔ‬ 3 ‫ﺍﻟﻌﺪﺩ‬ 22 ‫ﻠﺪ‬‫ﺍ‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

. H2S (Swarrming
DNA ‫إذ‬
P.mirabilis

16S Monoplex PCR

rRNA gene .
IMViC
16S RNA ,‫اﻻﻧﺪول‬
, P.mirabilis -
P.mirabilis
‫( أّذ‬1) 16S rRNA gene
, P.mirabilis
24
. P.miraiblis

16SrRNA gene PCR ‫ اﻟﺘﺮﺣ‬:(1

-1 M: Marker ladder 1500-100bp Proteus mirabilis
100 80 .305bp P.mirabilis 24
.‫ﺳﺎﻋﺔ واﺣﺪة‬

‫اﻻ‬ %37.29
25

‫اﻻ‬ ‫أ‬. 69
.( 9)
ُ‫ﻓ‬
P.mirabilis 8.64
‫ﺖ‬ 12.02 P.mirabilis
(10)

(11)
%20 P.mirabilis ‫أذ‬
 ‫ﺳﻨﺔ ‪2017‬‬ ‫ﺍﻟﻌﺪﺩ ‪3‬‬ ‫ﺍ‪‬ﻠﺪ ‪22‬‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

‫ﺖ اﻟ‬ ‫‪ .%45‬ﻋُ‬ ‫‪%5.9‬‬

‫‪%8.64‬‬ ‫‪P.mirabilis‬‬ ‫‪.‬‬
‫)‪(10‬أذ‬ ‫‪%9.18‬‬
‫‪ P. mirabilis‬و‪.vulgaris‬‬ ‫ﺖ‬ ‫أذ ﻋﺰﻟ‬ ‫)‪(12‬‬

‫)‪(11‬‬
‫‪%13.33‬‬ ‫‪P‬‬ ‫‪, %10.4‬‬
‫‪P.mirabilis‬‬ ‫‪.‬‬ ‫ﻋُ‬ ‫‪%17.6‬‬ ‫اﻻذن‬
‫‪%0.54‬‬ ‫‪P. mirabilis‬‬
‫)‪(15‬‬
‫اﻟﺒﺎ‬ ‫‪% 8.64‬‬
‫)‪(13‬‬
‫‪P.mirabilis‬‬ ‫‪P.mirabilis‬‬
‫)‪(16‬‬
‫‪, %0.58‬‬ ‫‪%12.5‬‬ ‫و ‪P.vulgaris‬‬
‫ﺑﻜﺘﺮﻳﺎ ‪ P.mirabilis‬ﻣﻦ اﻟﺪم ﺑﻨﺴﺒﺔ ‪. %2.5‬‬ ‫ا‬ ‫)‪(14‬‬

‫ﺟﺪول )‪ (2‬اﻟﻨﺴﺐ اﻟﻤﺌﻮﻳﺔ ﻟﻌﺰل اﻧﻮاع ﺑﻜﺘﺮﻳﺎ ‪ Proteus ssp‬ﻣﻦ اﻟﻤﺼﺎدر اﻟﺴﺮﻳﺮﻳﺔ اﻟﻤﺨﺘﻠﻔﺔ‬

‫اﻟﻨﺴﺒﺔ اﻟﻤﺌﻮﻳﺔ‬ ‫اﻟﻤﺼﺪر‬ ‫‪Proteus ssp‬‬

‫اﻟﻜﻠﻴﺔ‬ ‫اﻟﺪم‬ ‫اﻟﺤﺮوق‬ ‫اﻻذن‬ ‫اﻻدرار‬ ‫اﻟﺒﺮاز‬

‫‪(%37.29)69A‬‬ ‫‪(0.54) 1‬‬ ‫‪( 8.64) 16‬‬ ‫‪(9.18) 17‬‬ ‫‪(8.64) 16‬‬ ‫‪(12.02) 19‬‬ ‫‪P. mirabilis‬‬
‫‪(%8.64)16B‬‬ ‫)‪0(0‬‬ ‫‪(1.08)2‬‬ ‫‪(2.16)4‬‬ ‫‪(2.16)4‬‬ ‫‪(3.24)6‬‬ ‫‪Other Proteus‬‬
‫‪2‬‬ ‫‪2‬‬
‫ان ﻗﻴﻤﺔ ﻣﺮﺑﻊ ﻛﺎي ‪ X‬اﻟﻤﺤﺴﻮﺑﺔ‪ 36.129‬اﻛﺒﺮ ﻣﻦ اﻟﺠﺪوﻟﻴﺔ ‪ 15.507 X‬إذاَ ﺗﻮﺟﺪ ﻓﺮوق ﻣﻌﻨﻮﻳﺔ ‪.‬‬ ‫‪‬‬

‫أﻧﺘﺸﺎر وﺗﻮزﻳﻊ ﺑﻜﺘﺮﻳﺎ ‪ Proteus mirabilis‬ﺑﻴﻦ اﻟﻔﺌﺎت اﻟﻌﻤﺮﻳﺔ واﻟﺠﻨﺲ‬

‫‪. %9.2‬‬ ‫‪18‬‬

‫و‬
‫‪51‬‬ ‫‪41-50‬‬
‫)‪. (3‬‬
‫‪ %10.14 P.mirabilis‬و ‪18.84‬‬ ‫‪P.mirabilis‬‬
‫)‪. (4‬‬ ‫‪34.78‬‬ ‫‪30-21‬‬
‫)‪(18‬‬
‫‪31-40‬‬
‫)‪(51-60‬‬ ‫)‪)(15‬ﻟﻠ‬ ‫‪%13.4‬‬
‫‪60‬‬ ‫‪34‬‬ ‫)‪(39-30‬‬ ‫‪, %21.78‬و‬ ‫)‪(29-20‬‬
‫‪%24‬‬ ‫‪.%17.82‬‬
‫‪1-10‬‬
‫‪%11.59‬‬ ‫‪11-20‬‬
‫)‪.(4‬‬
‫ﺚ )‪ (17‬ﻓ‬ ‫ﺖ‬ ‫و‬
 ‫ﺳﻨﺔ ‪2017‬‬ ‫ﺍﻟﻌﺪﺩ ‪3‬‬ ‫ﺍ‪‬ﻠﺪ ‪22‬‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

‫اﻟﻌﻤﺮﻳﺔ اﻻﺧﺮى )‪(19‬‬

‫ﺟﺪول)‪ (3‬ﺗﻮزﻳﻊ ﻋﺰﻻت ‪ P.mirabils‬ﺑﺤﺴﺐ اﻟﻌﻤﺮ ﻣﻦ اﻟﺤﺎﻻت اﻟﺴﺮﻳﺮﻳﺔ اﻟﻤﺨﺘﻠﻔﺔ ‪.‬‬

‫اﻟﻤﺼــﺪر‬
‫ﻣﺠﻤﻮع‬ ‫اﻟﺪم‬ ‫اﻟﺤﺮوق‬ ‫اﻻدرار‬ ‫اﻻذن‬ ‫اﻟﺒﺮاز‬ ‫اﻟﻔﺌﺎت‬
‫اﻟﻌﻤﺮﻳﺔ‬
‫‪(%11.59)8A‬‬ ‫‪0(0)Aa‬‬ ‫‪(2.89)2Aa‬‬ ‫‪(2.89)2Aa‬‬ ‫‪(2.89)2Aa‬‬ ‫‪(2.89)2Aa‬‬ ‫‪1-10‬‬

‫‪(%11.59)8A‬‬ ‫‪(1.44)1Aa‬‬ ‫‪(4.34)3ABa‬‬ ‫‪(1.44)1Aa‬‬ ‫‪(2.89)2Aa‬‬ ‫‪(1.44)1Aa‬‬ ‫‪11-20‬‬

‫‪(%34.78)24B‬‬ ‫‪0(0)Ab‬‬ ‫‪(11.59)8Ba‬‬ ‫‪(5.79)4Aa‬‬ ‫‪(7.24)5Aa‬‬ ‫‪(10.14)7Ba‬‬ ‫‪21-30‬‬
‫‪A‬‬ ‫‪Ab‬‬ ‫‪Aab‬‬ ‫‪Aa‬‬ ‫‪Aa‬‬ ‫‪ABa‬‬
‫‪(%13.04)9‬‬ ‫)‪0(0‬‬ ‫‪(1.44)1‬‬ ‫‪(2.89)2‬‬ ‫‪(4.34)3‬‬ ‫‪(4.34)3‬‬ ‫‪31-40‬‬
‫‪A‬‬ ‫‪Aa‬‬ ‫‪Aa‬‬ ‫‪Aa‬‬ ‫‪Aa‬‬ ‫‪Aa‬‬
‫‪(%10.14)7‬‬ ‫)‪0(0‬‬ ‫‪(1.44)1‬‬ ‫‪(2.89)2‬‬ ‫‪(2.89)2‬‬ ‫‪(2.89)2‬‬ ‫‪41-50‬‬
‫‪(%18.84)13A‬‬ ‫‪0(0)Ab‬‬ ‫‪(1.44)1Aab‬‬ ‫‪(7.24)5Aa‬‬ ‫‪(4.34)3Aa‬‬ ‫‪(5.79)4ABa‬‬ ‫‪>51‬‬
‫‪2‬‬ ‫‪2‬‬
‫ان ﻗﻴﻤﺔ ﻣﺮﺑﻊ ﻛﺎي ‪ X‬اﻟﻤﺤﺴﻮﺑﺔ ‪ 43.228‬اﻛﺒﺮ ﻣﻦ اﻟﺠﺪوﻟﻴﺔ ‪ 41.337 X‬إذاً ﺗﻮﺟﺪ ﻓﺮوق ﻣﻌﻨﻮﻳﺔ ‪.‬‬ ‫‪‬‬

‫‪. %36.4‬‬
‫‪P.mirabilis‬‬
‫‪ P.mirabilis‬ﺑ‬
‫‪P.mirabilis‬‬ ‫‪%42.02‬‬ ‫‪57.97‬‬
‫‪4‬‬ ‫و‬
‫ﻪ )‪ (20‬أذ‬ ‫اﻟﺪر‬

‫‪57.2 P.mirabilis‬‬
‫اﻟﺒﻮﻟﻴﺔ )‪. (21‬‬ ‫)‪( 16‬‬ ‫‪42.8‬‬
‫‪63.6‬‬
‫ﺟﺪول)‪ (4‬ﺗﻮزﻳﻊ ﻋﺰﻻت ‪ P.mirabils‬ﺣﺴﺐ اﻟﺠﻨﺲ ﻣﻦ اﻟﺤﺎﻻت اﻟﺴﺮﻳﺮﻳﺔ اﻟﻤﺨﺘﻠﻔﺔ‪.‬‬

‫ﻣﺼﺪر‬
‫ﻣﺠﻤﻮع‬ ‫اﻟﺪم‬ ‫اﻟﺤﺮوق‬ ‫اﻻدرار‬ ‫اﻻذن‬ ‫اﻟﺒﺮاز‬ ‫ﺟﻨﺲ‬

‫‪(%57.97)40A‬‬ ‫‪--‬‬ ‫‪(15.94)11‬‬ ‫‪(17.39)12‬‬ ‫‪(14.49)10‬‬ ‫‪(10.14)7‬‬ ‫اﻻﻧﺎث‬

‫‪(%42.02)29A‬‬ ‫‪(1.44)1‬‬ ‫‪(7.24)5‬‬ ‫‪(5.79)4‬‬ ‫‪(10.14)7‬‬ ‫‪(17.39)12‬‬ ‫اﻟﺬﻛﻮر‬
‫‪2‬‬ ‫‪2‬‬
‫ان ﻗﻴﻤﺔ ﻣﺮﺑﻊ ﻛﺎي ‪ X‬اﻟﻤﺤﺴﻮﺑﺔ ‪ 2.544‬اﻛﺒﺮ ﻣﻦ اﻟﺠﺪوﻟﻴﺔ ‪ 3.841 X‬اذاً ﺗﻮﺟﺪ ﻓﺮوق ﻣﻌﻨﻮﻳﺔ ‪ .‬ﻛﻤﺎ وﺗﺪل اﻟﺤﺮوف اﻟﻤﺘﺸﺎﺑﻬﺔ‬
‫ﻋﻠﻰ ﻋﺪم وﺟﻮد ﻓﺮوﻗﺎت ﻣﻌﻨﻮﻳﺔ ﻋﻨﺪ ﻣﺴﺘﻮى اﺣﺘﻤﺎﻟﻴﺔ ‪.5%‬‬

‫اﺧﺘﺒﺎر ﻓﺤﺺ اﻟﺤﺴﺎﺳﻴﺔ ﻟﻠﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ‬

 2017 ‫ﺳﻨﺔ‬ 3 ‫ﺍﻟﻌﺪﺩ‬ 22 ‫ﻠﺪ‬‫ﺍ‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

, %48.1
‫ ﻟ‬P.mirabilis ‫ﻴﺎﺗ‬ 15
, %53.62
‫ﺖ‬
(15)
P.mirabils
‫د‬ , % 54 P.mirabilis 5
, %4.34 ‫ﻟ‬
‫ﺖ‬
(25)

.%5.6 P.mirabilis
‫ﻗﺎﺑﻠ ﺔ‬ (7)

P.mirabilis ‫ﻣﻘﺎوﻣ‬

‫ﻟ‬ ‫ ﻟ‬P.mirabils
‫ﺖ‬ ‫ إذ‬%84.05
‫و‬ (17)

P.mirabilis
‫ﻢ‬ 83.6
‫ﺒﻮرﻳﻨﺎت‬ .%12.5 ‫( ﻓ‬13)
P.mirabilis
‫ﺖ‬ 84.05
.(26) (22)
‫ﺚ‬ ‫ﻞ‬
‫د‬ ‫ ﻟ‬P.mirabilis ‫اﻟ‬
P.mirabilis .%86
‫ﺖ‬ 17.39 -
‫أذ‬ (27)
‫ﺖ‬ ‫أذ‬,%47.82
P.mirabilis ‫أذ‬ (23)

. %36.4 ,%50
P.mirabilis
‫ﺖ‬ ‫ أذ‬,%33.33 . %66.66
(16)
P.mirabilis
, %66.66 ‫ﻟ‬
P.mirabilis .%28.9 ‫ﺖ‬
(24)
 2017 ‫ﺳﻨﺔ‬ 3 ‫ﺍﻟﻌﺪﺩ‬ 22 ‫ﻠﺪ‬‫ﺍ‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

P.mirabilis ‫أ‬ ,%75.36

%82.60 Ciprofloxacin
‫ﺖ‬ %4.34
(14)
‫ﺖ‬ ,
62.5 P.mirabilis (22)
‫ﺚ‬
.%
(13)
P.mirabilis .% 88.9
‫ﺖ‬ 82.60
(28)
.% 15.0
. %94.4 P.mirabilis
‫ ﻟ‬P.mirabilis , %75.36 ‫ﻟ‬
‫ﺖ‬ 91.30 ‫ﺖ‬
‫أذ‬ (14) (24)

.% 93.7 ‫ﻣﻘﺎوﻣﺔ اﻟﺒﻜﺘﺮﻳﺎ ﻟﻤﻀﺎد اﻟﺮﻳﻔﺎﻣﺒﻴﻦ‬

.%63.5
.‫ اﻟﻤﻘﺎوﻣﺔ ﻟﻠﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ‬P.mirablis ‫( اﻟﻨﺴﺐ اﻟﻤﺌﻮﻳﺔ ﻟﻌﺰﻻت ﺑﻜﺘﺮﻳﺎ‬5) ‫ﺟﺪول‬
R% I% S% ‫اﻟﺮﻣﺰ‬ ‫اﻧﻮاع اﻟﻤﻀﺎدات اﻟﺤﻴﺎﺗﻴﺔ‬

(84.05)58 (5.79)4 (10.14)7 AMX Amoxicillin

(84.05)58 (8.69)6 (7.24)5 AMP Ampicillin
(47.82)33 (17.39)12 (34.78)24 AMC Amoxicillin/cluvanic
(66.66)46 (11.59)8 (21.73)15 TC Ticarcillin
(53.62)37 (11.59)8 (34.78)24 CTX Cefotaxim
(66.66)46 (18.8)13 (14.49)10 CAZ Cefatozidime
(4.34)3 (4.34)3 (91.30)63 MEM Meropenem
(17.39)12 (1.44)1 (81.15)56 AK Amikacin
(33.33)23 (2.89)2 (63.76)44 CN Gentamicin
(75.36)52 (10.14)7 (14.49)10 NA Nalidic acid
(4.34)3 (2.89)2 (92.75)64 CIP Ciprofloxacin
(75.36)52 (7.24)5 (17.39)12 TS Trimethoprim
(82.60)57 (8.69)6 (8.69)6 C Chloramphenicol
(82.60)57 (13.4)9 (4.34)3 T Tetracycline
(91.30)63 (4.34)3 (4.34)3 RF Rifampin
‫ إذاً ﺗﻮﺟﺪ ﻓﺮوق ﻣﻌﻨﻮﻳﺔ‬67.504 X2 ‫ اﻛﺒﺮ ﻣﻦ اﻟﺠﺪوﻟﻴﺔ‬173.12 ‫ اﻟﻤﺤﺴﻮﺑﺔ‬X2 ‫ان ﻗﻴﻤﺔ ﻣﺮﺑﻊ ﻛﺎي‬ 
Proteus mirabilis. Natu. Revi. Microbio.. ‫اﻟﻤﺼﺎدر‬
10(11), pp: 743-754. 1.Armbruster, C. E. and Mobley, H. L.
2012. Merging mythology and
2-Jacobsen, S. M. & Shirtliff, M. E.
morphology: the multifaceted lifestyle of
(2011). Proteus mirabilis biofilmsand
catheter-associated urinary tract infections.
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Medicine, The University of Sydney, Virulence 2, 460–465.Iran. EMHJ, 18(2).

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Umpiérrez, A.; Maskell, D.J.and
9. Shoff, W. H. and Green-McKenzie, J.
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Shukri , M. S. (2015). Molecular
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6.Winn, J. W.; Allen, S.; Janda, W.;
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Koneman, E.; Procop, G.;
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7.CLSI (Clinical and Laboratory

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21.Freedman, A. L. (2005). Urologic
Diseases in North America Project: trends
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173(3):949-954
22.A.Bahashwan,S.(2013).Antimicrobial
resistance patterns of proteus isolates from
clinical specimens. Eur. Sci. Jo, 9(27):
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.(2013).‫ﺻﺒﺤﻲ ﺣﺴﻴﻦ‬,‫ﺧﻠﻒ‬,‫ﻣﺤﻤﻮد زﻛﻲ‬,‫ اﻟﺤﺴﻮ‬.23
‫ﻣﻘﺎوﻣﺔ ﺑﻌﺾ اﻟﻌﺼﻴﺎت اﻟﺴﺎﻟﺒﺔ ﻟﺼﺒﻐﺔ ﻛﺮام ﻣﻦ‬
‫اﺻﺎﺑﺎت اﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ اﻟﺴﻔﻠﻲ ﻟﻤﻀﺎدات اﻟﺒﻴﺘﺎﻻﻛﺘﻢ‬
.(76-66):(6)24, ‫ﻣﺠﻠﺔ ﻋﻠﻮم اﻟﺮاﻓﺪﻳﻦ‬.
24.Hussein ,A .A .(2013) . phenotypic
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25.Perween, N; Prakash.S, K; and
Bharara ,T.(2016). Prevalence of
Multidrug-Resistant and Extensively
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27.Hasanin, A; Eladawy, A; Mohamed
,H; Salah ,Y ; Lotfy ,A; Mostafa ,H;
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Prevalence of extensively drug-resistant
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28.Nahar , A. ; Siddiquee , M.;
Nahar,S.; Anwar2,K . S.; Ali , S .k .
Islam1, I.S.(2014). Multidrug Resistant-
22 ‫ﻠﺪ‬‫ﺍ‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬
mirabilis Isolate and Compared with
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15. Pal, N.; Sharma,N.; Sharma,R.;
Hooja,S.; and K Maheshwari , R .(2014)
. Prevalence of Multidrug (MDR) and
Extensively Drug Resistant (XDR)
Proteus species in a tertiary care hospital,
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243-252.
16.Senthamarai ,S. Sivasankari, S.;
Anitha ,C.; Kumudavathi ,MS.;
Amshavathani ,SK.; Venugopal ,V.; and
Thenmozhi Valli, P R.(2015). A study
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Proteus spp among various samples.
IJAPBC – Vol. 4(2): 2277 – 4688.
17.Wang, J; Chen ,P; Chang ,S ; Shiau,
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; Lauderdale ,T,Y; and Hospitals ,T.(
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Proteus mirabilis: a longitudinal
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18.Adnan,M.; Hussein,I.; and Al-
DeresawiP3 ,A. M.S.(2014). Molecular
detection of Proteus mirabilis using PCR
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19.Brooks , G.F. ; Carroll , K. C. ; Butel
, J.S. and Morse , S. A. (2007) . Jawets,
Melnick, Adelberg's Medical
th
microbiology. 24 ed. McGraw-Hill com.
PP. 174.
‫ﺣﺴﻦ‬,‫ﻧﺎﺟﻲ‬, ‫ﺧﺎﻟﺪ ﻋﺒﺪ اﻟﻜﺎﻇﻢ‬,‫ اﻟﻄﺎﺋﻲ‬.20
‫ﺗﺄﺛﻴﺮ ﺧﻠﻂ ﻣﻀﺎدات اﻟﺒﻴﺘﺎﻻﻛﻨﻢ ﻣﻊ‬.(2013).‫ﻓﺎﺿﻞ‬
‫اﻻﻣﻴﻨﻮ ﻛﻼﻳﻜﻮﺳﻴﺪات ﻋﻠﻰ اﻟﻤﺘﻘﻠﺒﺎت اﻟﻤﺘﻌﺪدة اﻟﻤﻘﺎوﻣﺔ‬
‫ ااﻟﻌﻠﻮم اﻟﺼﺮﻓﺔ‬/‫ﻣﺠﻠﺔ ﺟﺎﻣﻌﺔ ﺑﺎﺑﻞ‬.‫ﻟﻠﻤﻀﺎدات اﻟﺤﻴﻮﻳﺔ‬
.(1299-1293 ):(21)4 . ‫واﻟﺘﻄﺒﻴﻘﻴﺔ‬
2017 ‫ﺳﻨﺔ‬ 3 ‫ﺍﻟﻌﺪﺩ‬ 22 ‫ﻠﺪ‬‫ﺍ‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

Health Educ ,2(2): 2332-0893. Proteus Mirabilis Isolated from Chicken

Droppings in Commercial Poultry Farms:
Bisecurity Concern and Emerging Public
Health Threat in Bangladesh. J Biosafety
 2017 ‫ﺳﻨﺔ‬ 3 ‫ﺍﻟﻌﺪﺩ‬ 22 ‫ﻠﺪ‬‫ﺍ‬ ‫ﳎﻠﺔ ﺍﻟﻘﺎﺩﺳﻴﺔ ﻟﻠﻌﻠﻮﻡ ﺍﻟﺼﺮﻓﺔ‬

Diagnosis of Proteus mirabilis using PCR technique and determining

their sensitivity to some antibiotics.

Nuha Jawad Syoof Khowman. Alramahy

Biology Department - College of Sciences - University of Al-Qadisiyah

njnjnj.hu4@gmail.com Syoof.alramahi@qu.edu.iq

abstract

Proteus mirabilis The samples of the study were collected from different clinical
sources 185 isolates of hospitals, the Diwaniyah city during the period from October
2015 to April and divided the samples, according to sources collected into five groups
(46 swab ear, 42 swab burns, 37 a stool sample, 59 urine sample and 1 blood
sample), as results showed that cultural and biochemical tests 69 isolated belong to
P.mirabilis, diagnosis was confirmed by api 20E and the use of polymerase chain
reaction. Tested the sensitivity of isolates P.mirabilis about 15 types of
antibiotics by disk diffusion method, and belonging to ten classes of antibiotics,That
shown sensitivity first to isolates of P.mirabilis results, the proportion of resistant
P.mirabils antimicrobial β- lactam antibiotic represented in Amoxicillin resistance
and Ampicillin 84.05%, Amoxicillin/cluvanic acid 47.82%, Ticarcillin and ,
Cefatozidime 66.66%, Cefotaxim 53.62%, Meropenem 5.6%. The rate of resistance to
antibiotics aminoglycosides represented in Amikacin resistance 17.36 %, Gentamicin
percentage resistance 33.33%, Quinolones represented in Nalidic acid resistance
75.36%, while the Ciprofloxacin counted lower proportion of resistance 4.34 %,
Trimethoprim resistance75.36 %.Chloramphenicol have high resistance rate of
82.60 %, as well as all of the Tetracycline 82.60%, and Rifampin 91.30% .

Key word: Resistance, Antibiotic,Proteus .mirabilis

*The Reserch is apart of on MSC.thesis in the case of first Reserach