Clinical and molecular epidemiology of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a long-term study from Japan
Clinical and molecular epidemiology of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a long-term study from Japan
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DOI：
10.1007/s10096-010-1057-1
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发表时间：
2011-01-01
影响因子：
4.5
通讯作者：
Kamimura, T.
中科院分区：
文献类型：
--
作者：
Chong, Y.;Yakushiji, H.;Kamimura, T.
与世界各地相比，日本产超广谱β-内酰胺酶（ESBL）细菌的检出率非常低（约为5%）。此外，这些细菌在日本的当前趋势尚不清楚，很少有纵向观察的研究报告。为了获得日本产ESBL细菌的流行病学数据，其基因型特征及其抗生素耐药模式，我们分析了2003年至2009年7年期间本机构住院患者的细菌分离株。在2，304株分离株中，发现202株（8.8%）产ESBL，包括大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌。产ESBL菌株的检出率逐渐升高，大肠埃希菌和铜绿假单胞菌的检出率分别为17.1%和10.5%。埃希菌和肺炎菌株，分别在2009年。基因分型分析显示，约90%的产ESBL分离株携带CTX-M基因型，其中CTX-M-9组占优势，尽管日本认为CTX-M-2组是主要基因型;此外，许多菌株产生多种β-内酰胺酶。产ESBL细菌的检出率在日本的有限区域内可能趋于较高。需要进行全国范围的调查，以了解全国范围内产ESBL细菌的趋势。此外，我们的研究结果表明，检测到的ESBL生产者的基因型是相似的，那些表现出成功的院内传播世界各地。
The detection rates of extended-spectrum beta-lactamase (ESBL)-producing bacteria in Japan are very low (similar to 5%) compared with those obtained worldwide. Further, the current trend of these bacteria in Japan is not known, and few studies with longitudinal observations have been reported. To obtain epidemiologic data on ESBL-producing bacteria, their genotypic features, and their antibiotic resistance patterns in Japan, we analyzed bacterial isolates from hospitalized patients at our institution over the 7-year period from 2003 to 2009. Of 2,304 isolates, 202 (8.8%) were found to be ESBL producers, including Escherichia coli, Klebsiella pneumonia, and Proteus mirabilis. The detection rates of the ESBL-producing isolates gradually increased and reached 17.1% and 10.5% for the E. coli and K. pneumoniae strains, respectively, in 2009. Genotyping analysis showed that similar to 90% of the ESBL-producing isolates carried the CTX-M genotype, in which the CTX-M-9 group was predominant, although the CTX-M-2 group is considered to be the main genotype in Japan; further, many of the strains produced multiple beta-lactamases. The detection rates of ESBL-producing bacteria may tend to be high within a limited region in Japan. A countrywide survey is required to understand the trend for ESBL-producing bacteria at the national level. In addition, our findings suggest that the genotypes of the detected ESBL producers are similar to those exhibiting a successful nosocomial spread worldwide.