The revolving door between hospital and community: extended-spectrum beta-lactamase-producing Escherichia coli in Dublin
The revolving door between hospital and community: extended-spectrum beta-lactamase-producing Escherichia coli in Dublin
复制标题
DOI：
10.1016/j.jhin.2012.04.021
复制
发表时间：
2012-07-01
影响因子：
6.9
通讯作者：
Fitzgerald-Hughes, D.
中科院分区：
文献类型：
--
作者：
Burke, L.;Humphreys, H.;Fitzgerald-Hughes, D.
背景：产生超广谱 β-内酰胺酶 (ESBL) 的大肠杆菌是导致医疗保健相关感染的一个日益增加的原因，社区医疗机构可能是重要流行性克隆的储存库。目的：回顾性地描述和调查 2009 年和 2010 年在都柏林一家医院收集的产 ESBL 大肠杆菌的流行病学特征，并调查特定克隆在医院和社区医疗机构内的传播情况。方法：使用脉冲场凝胶电泳 (PFGE) 确定 100 个产 ESBL 大肠杆菌分离株的遗传相关性。确定了系统发育组并在集合中鉴定了 O25b-ST131 克隆。将遗传数据与抗菌药物敏感性、临床和人口统计数据相关联，以探索特定克隆的流行病学。结果：系统发育组 B2 (62%) 和 D (18%) 最常见，并且与非尿液分离株相关（Fisher 精确检验 P < 0.0001）。 PFGE 揭示了 12 个簇（>= 80% 相似性），其中最大的簇与流行的英国菌株 A 簇在一起。社区中长期护理机构 (LTCF) 的居民专门携带 O25b-ST131 克隆和系统发育群 B2 和 D。结论：大肠杆菌 O25b-ST131 是都柏林 LTCF 中产生 ESBL 的大肠杆菌的主要原因。产 ESBL 大肠杆菌在我们医院和社区的分布凸显了这些耐药细菌传播和传播的“旋转门”。 (C) 2012 年医疗保健感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Escherichia coli that produce extended-spectrum beta-lactamases (ESBLs) are an increasing cause of healthcare-associated infection, and community healthcare facilities may be a reservoir for important epidemic clones.Aim: To characterize retrospectively and investigate the epidemiology of ESBL-producing E. coli collected in a Dublin hospital, during 2009 and 2010, and to investigate the dissemination of specific clones within hospital and community healthcare facilities.Methods: Pulsed-field gel electrophoresis (PFGE) was used to determine the genetic relatedness of 100 ESBL-producing E. coli isolates. Phylogenetic groups were determined and the O25b-ST131 clone identified in the collection. The genetic data were correlated with antimicrobial susceptibility, clinical and demographic data to explore the epidemiology of specific clones.Findings: Phylogenetic groups B2 (62%) and D (18%) were the most common and were associated with non-urinary isolates (P < 0.0001 by Fisher's exact test). PFGE revealed 12 clusters (>= 80% similarity), the largest of which clustered with the epidemic UK strain A. Residents of long-term care facilities (LTCFs) in the community exclusively carried the O25b-ST131 clone and phylogenetic groups B2 and D.Conclusions: E. coli O25b-ST131 is largely responsible for ESBL-producing E. coli in LTCFs in Dublin. The distribution of ESBL-producing E. coli in our hospital and community highlights a 'revolving door' through which these resistant bacteria spread and disseminate. (C) 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.