Prevalence, microbiology, and clinical characteristics of extended-spectrum β-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii in Korea
Prevalence, microbiology, and clinical characteristics of extended-spectrum β-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii in Korea
复制标题
DOI：
10.1007/s10096-007-0308-2
复制
发表时间：
2007-08-01
影响因子：
4.5
通讯作者：
Kim, Y. S.
中科院分区：
文献类型：
--
作者：
Choi, S.-H.;Lee, J. E.;Kim, Y. S.
我们研究了肠杆菌属中产超广谱β-内酰胺酶（ESBL）临床分离株的流行率和特征，粘质沙雷氏菌、弗氏柠檬酸杆菌和摩氏摩根菌，并评价产ESBL微生物引起感染的筛选标准、临床特征和结局。2005年1月至6月，在韩国首尔一家拥有2，300张床位的三级医院牙山医疗中心，共收集了493株非重复的连续分离株。ESBL试验阳性50株（10.1%）。肠杆菌属ESBL表型试验阳性率，S.粘质C. freundii和M. Morgannii分别为12.8%、12.4%、4.9%和0%。SHV-12（18株）、CTX-M-9（17株）和TEM-52（5株）是最常见的ESBL类型。17株菌株未检出ESBL。以头孢吡肟MIC ≥ 1 μ g/ml作为ESBL筛选标准，敏感性最高（0.84），特异性最高（0.87）。半数产ESBL菌株（25/50）被判定为病原菌。最常见的感染是胆管炎（10例）和肺炎（6例）。总死亡率为12.0%。
We examined the prevalence and characteristics of extended-spectrum beta-lactamase (ESBL)-producing clinical isolates among Enterobacter spp., Serratia marcescens, Citrobacter freundii, and Morganella morganii, and evaluated screening criteria, clinical characteristics and outcomes of infections caused by ESBL-producing organisms. Between January and June 2005, a total of 493 nonduplicate consecutive isolates were collected at Asan Medical Center, a 2,300-bed tertiary hospital in Seoul, Republic of Korea. Fifty isolates (10.1%) were positive for phenotypical ESBL-test. The positive rate of phenotypical ESBL-test in Enterobacter spp., S. marcescens, C. freundii, and M. morgannii was 12.8%, 12.4%, 4.9%, and 0% respectively. SHV-12 (18 isolates), CTX-M-9 (17 isolates), and TEM-52 (five isolates) were the most prevalent ESBL types. The ESBL in 17 strains could not be identified. As an ESBL screening criterion, the cefepime MIC >= 1 mu g/ml had the highest sensitivity (0.84) and specificity (0.87). Half of the ESBL-producing isolates (25/50) were judged as pathogens. Cholangitis (ten cases), and pneumonia (six cases) were the most common infections. The overall mortality was 12.0%.