Fecal carriage of CTX-M β-lactamase-producing Enterobacteriaceae in nursing homes in the Kinki region of Japan.
Fecal carriage of CTX-M β-lactamase-producing Enterobacteriaceae in nursing homes in the Kinki region of Japan.
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DOI：
10.2147/idr.s43868
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发表时间：
2013
影响因子：
3.9
通讯作者：
Yamamoto Y
中科院分区：
文献类型：
--
作者：
Luvsansharav UO;Hirai I;Niki M;Nakata A;Yoshinaga A;Yamamoto A;Yamamoto M;Toyoshima H;Kawakami F;Matsuura N;Yamamoto Y
日本产CTX-M型β-内酰胺酶肠杆菌科细菌检出率明显上升。养老院可能是耐药细菌的储存库。因此，我们确定了养老院居民粪便携带产CTX-M型β-内酰胺酶肠杆菌科细菌的患病率及其相关危险因素。共采集225份粪便样本进行产超广谱β-内酰胺酶（ESBL）肠杆菌科细菌的表型和基因型鉴定。进行多变量分析，以确定与CTX-M生产者粪便携带相关的风险因素。CTX-M型产ESBL肠杆菌科细菌的流行率为19.6%（44/225份样本），经表型和基因型方法证实。产CTX-M型ESBL菌以大肠埃希菌为主（41/44）。44份阳性标本中，CTX-M-9、CTX-M-1和CTX-M-2分别占68.2%、29.5%和2.3%。在养老院检出的产CTX-M型ESBL肠杆菌科细菌中，95.5%（42/44株）对喹诺酮类抗生素同时耐药。在多变量logistic回归分析中，过去2年内无法在床上翻身、糖尿病和侵入性操作是与粪便携带CTX-M型ESBL生产者独立相关的唯一变量。日本养老院居民中CTX-M型产ESBL肠杆菌携带率较高，对喹诺酮类药物具有较高的共耐药性。
The detection rate of CTX-M-type β-lactamase-producing Enterobacteriaceae in Japan has significantly increased. Nursing homes may be a reservoir of antibiotic-resistant bacteria. Therefore, we determined the prevalence of, and risk factors associated with, fecal carriage of CTX-M-type β-lactamase-producing Enterobacteriaceae among nursing home residents. A total of 225 stool samples were collected for phenotypic and genotypic identification of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Multivariate analysis was performed to identify the risk factors associated with fecal carriage of CTX-M producers. The prevalence of CTX-M-type ESBL-producing Enterobacteriaceae, as confirmed by phenotypic and genotypic methods, was 19.6% (44 of 225 samples). Escherichia coli was the predominant CTX-M-type ESBL-producing bacterium among these isolates (41 of 44 isolates). Genotyping of blaCTX-M gene-positive isolates showed that 30 (68.2%), 13 (29.5%), and 1 (2.3%) of 44 samples belonged to groups CTX-M-9, CTX-M-1 and CTX-M-2, respectively. Among the CTX-M-type ESBL-producing Enterobacteriaceae found in nursing homes, 95.5% (42 of 44 isolates) were co-resistant to quinolone antibiotics. In multivariate logistic regression analysis, inability to turn over in bed, diabetes, and invasive procedures within the last 2 years were the only variables independently associated with fecal carriage of CTX-M-type ESBL producers. Nursing home residents in Japan exhibit a high prevalence of CTX-M-type ESBL-producing Enterobacteriaceae carriage, with a high level of co-resistance to quinolones.