Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Spanish hospitals: 2nd multicenter study (GEIH-BLEE project, 2006)
Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Spanish hospitals: 2nd multicenter study (GEIH-BLEE project, 2006)
复制标题
DOI：
10.1016/j.eimc.2008.09.006
复制
发表时间：
2009-11-01
影响因子：
2.5
通讯作者：
Pascual, Alvaro
中科院分区：
文献类型：
--
作者：
Angel Diaz, Miguel;Ramon Hernandez, Jose;Pascual, Alvaro
2000年，在西班牙开展了第一个关于产生广谱β -内酰胺酶（ESBL）的大肠杆菌和肺炎克雷伯菌的全国项目（GEIH-BLEE项目2000）。第二项全国性的研究是在2006年开展的，目的是调查这一问题的演变。方法：设计了一项前瞻性多中心研究，包括2006年2月至3月在西班牙44家医院分离的所有产esbl的大肠杆菌和肺炎克雷伯菌菌株。鉴定在协调中心进行了验证，ESBL的生产按照CLSI的指导方针进行了确认。结果：共检出大肠杆菌1021株，肺炎K菌162株。所有参与研究的医院均分离出产esbl的大肠杆菌菌株，而34家医院分离出产esbl的肺炎克雷伯菌。大肠杆菌和肺炎克雷伯菌产生ESBL的总百分比（范围）分别为4.04%（0.4- 20.3%）和5.04%（0- 30%）。在ESBL大肠杆菌（Ec）病例中，32%的感染被认为是社区感染，36%的感染与卫生保健有关，30%的感染是医院感染；在ESBL肺炎克雷伯菌（Kp）病例中，通过这些途径感染的比例分别为10%、18%和68%。最常显示这些微生物的样本是尿液（77% Ec和48.2% Kp）和伤口渗出液（8.6% Ec和14.8% Kp）。结论：自2000年以来，西班牙大肠杆菌和肺炎克雷伯菌分离株中产esbl的比例分别增加了8倍和2倍。产esbl大肠杆菌的增加主要发生在门诊患者的分离株中，最常见的是尿液样本。(C) 2008 Elsevier Espana， S.L.版权所有
Introduction: During the year 2000, the 1st nationwide project (GEIH-BLEE Project 2000) on Escherichia coli and Klebsiella pneumoniae producing extended-spectrum beta-lactamases (ESBL) was carried out in Spain. The 2nd nationwide study was developed in 2006 to investigate the evolution of this problem.Methods: A prospective multicenter study was designed, including all ESBL-producing E. coli and K. pneumoniae strains isolated at 44 Spanish hospitals between February and March 2006. Identification was verified at the coordinating centre and ESBL production was confirmed following CLSI guidelines.Results: A total of 1021 E. coli and 162 K pneumoniae strains were collected. ESBL-producing E. coli strains were isolated in all the participating hospitals, whereas ESBL-producing K. pneumoniae were isolated in 34. The overall percentage (range) of ESBL production among E. coli and K. pneumoniae was 4.04% (0.4-20.3) and 5.04% (0-30), respectively. In ESBL E. coli (Ec) cases, acquisition was considered community-acquired in 32%, related to health care in 36%, and nosocomial in 30%; and in ESBL K. pneumoniae (Kp) cases, acquisitionby these routes was 10%, 18%, and 68% respectively. The samples most commonly showing these microorganisms were urine (77% Ec and 48.2% Kp) and wound exudate (8.6% Ec and 14.8% Kp).Conclusions: Since 2000, the percentage of ESBL-producing strains among E. coli and K. pneumoniae isolates in Spain has increased 8-fold and 2-fold, respectively. The increase in ESBL-producing E. coli mainly occurred in isolates from outpatients, and most commonly in urine samples. (C) 2008 Elsevier Espana, S.L. All rights reserved.