ESBL-producing Escherichia coli and Its Rapid Rise among Healthy People.
ESBL-producing Escherichia coli
and Its Rapid Rise among Healthy People.
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DOI：
10.14252/foodsafetyfscj.2017011
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发表时间：
2017-12-01
期刊：
影响因子：
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通讯作者：
Arakawa, Yoshichika
中科院分区：
文献类型：
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作者：
Kawamura, Kumiko;Nagano, Noriyuki;Arakawa, Yoshichika
自2000年代以来，大肠杆菌（E.大肠杆菌）对氧亚氨基头孢菌素和氟喹诺酮类的耐药性在世界范围内的临床环境中显著增加。E.大肠杆菌也在患有社区发病的传染病如尿路感染的患者中被鉴定。此外，多药耐药E.近年来，从健康人粪便中分离大肠杆菌的报道越来越多，尽管实际情况仍不确定。这些E.大肠杆菌分离株通常产生超广谱β-内酰胺酶（ESBL），以及获得GyrA和/或ParC的喹诺酮类耐药决定区（QRDRs）中的氨基酸取代，以及质粒介导的喹诺酮类耐药决定簇如Qnr、AAC（6 '）-Ib-cr和QepA。产ESBL大肠杆菌的现状。大肠埃希菌在住院患者中的感染情况已在许多国家进行了仔细的调查，而在健康人群中的感染情况仍不确定，尽管在亚洲和南美国家，健康人群中ESBL产生者的粪便携带率很高。由于ESBL变异株和质粒的迅速增加，以及各种流行株和国际克隆的出现，使得ESBL产生菌的问题变得非常复杂和混乱。大肠杆菌和肺炎克雷伯菌携带携带多个抗菌素耐药基因的可转移质粒。因此，从分子流行病学的角度概述了医院外ESBL产生者的现状，以及从牲畜、食品、宠物、环境和野生动物中回收的ESBL之间的关系。这篇简短的综述可能有助于人们更好地了解ESBL生产者，他们不熟悉全球范围内威胁上升的抗菌素耐药性（AMR）。
Since around the 2000s, Escherichia coli (E. coli) resistant to both oxyimino-cephalosporins and fluoroquinolones has remarkably increased worldwide in clinical settings. The kind of E. coli is also identified in patients suffering from community-onset infectious diseases such as urinary tract infections. Moreover, recoveries of multi-drug resistant E. coli from the feces of healthy people have been increasingly documented in recent years, although the actual state remains uncertain. These E. coli isolates usually produce extended-spectrum beta-lactamase (ESBL), as well as acquisition of amino acid substitutions in the quinolone-resistance determining regions (QRDRs) of GyrA and/or ParC, together with plasmid-mediated quinolone resistance determinants such as Qnr, AAC(6')-Ib-cr, and QepA. The actual state of ESBL-producing E. coli in hospitalized patients has been carefully investigated in many countries, while that in healthy people still remains uncertain, although high fecal carriage rates of ESBL producers in healthy people have been reported especially in Asian and South American countries. The issues regarding the ESBL producers have become very complicated and chaotic due to rapid increase of both ESBL variants and plasmids mediating ESBL genes, together with the emergence of various "epidemic strains" or "international clones" of E. coli and Klebsiella pneumoniae harboring transferable-plasmids carrying multiple antimicrobial resistance genes. Thus, the current state of ESBL producers outside hospital settings was overviewed together with the relation among those recovered from livestock, foods, pets, environments and wildlife from the viewpoint of molecular epidemiology. This mini review may contribute to better understanding about ESBL producers among people who are not familiar with the antimicrobial resistance (AMR) threatening rising globally.