THE CARRIAGE OF ESCHERICHIA-COLI RESISTANT TO ANTIMICROBIAL AGENTS BY HEALTHY-CHILDREN IN BOSTON, IN CARACAS, VENEZUELA, AND IN QIN-PU, CHINA
THE CARRIAGE OF ESCHERICHIA-COLI RESISTANT TO ANTIMICROBIAL AGENTS BY HEALTHY-CHILDREN IN BOSTON, IN CARACAS, VENEZUELA, AND IN QIN-PU, CHINA
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DOI：
10.1056/nejm199008023230501
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发表时间：
1990-08-02
影响因子：
158.5
通讯作者：
OBRIEN, TF
中科院分区：
文献类型：
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作者：
LESTER, SC;PLA, MD;OBRIEN, TF
背景和方法。一个社区的健康成员代表着其最大的耐药细菌库。我们比较了来自三大洲城市未经治疗的健康儿童粪便样本中大肠杆菌对八种病原体的耐药性。结果当通过选择性方法进行筛查时，在10，000个菌落中检测到1个耐药菌落，波士顿近一半的儿童（39个中的18个）没有耐药菌落-这一发现与在发展中国家进行的其他调查结果一致。然而，在委内瑞拉加拉加斯筛查的41名儿童中，除1名外，其余所有儿童都携带耐药菌株，在中国秦浦筛查的53名儿童中，除2名外，其余所有儿童都携带耐药菌株。波士顿只有1名儿童携带甲氧苄啶耐药菌株，但加拉加斯有25名，秦浦有34名。波士顿和加拉加斯的儿童中没有一个携带对庆大霉素耐药的菌株，但在秦浦有17个。从每份粪便样本中随机抽取10个菌落，加拉加斯的平均耐药频率是波士顿的3.6倍，秦浦的平均耐药频率是波士顿的5.3倍。20%的秦普菌株和6%的加拉加斯菌株对5种或5种以上的抗菌药物耐药，但波士顿菌株均无耐药。结论.除了临床分离株外，如前所述，在社区中健康儿童中定植的细菌在某些地区的耐药性可能远远高于其他地区。社区中抗菌药物耐药性的低携带率应该成为公共卫生目标。
Background and Methods. The healthy members of a community represent its largest resevoir of bacteria resistant to antimicrobial agents. We compared the resistance to eight agents of Escherichia coli in stool samples from untreated, healthy children in cities on three continents. Results. When screened by a selective method that detected 1 resistant colony in 10,000 colonies, nearly half the children in Boston (18 of 39) had no resistant colonies - a finding consistent with the findings of other surveys performed in developing countries. However, all but 1 of 41 children screened in Caracas, Venezuela, and all but 2 of 53 in Qin Pu, China, carried resistant strains. Only 1 child in Boston, but 25 in Caracas and 34 in Qin Pu carried strains resistant to trimethoprim. None of the children in Boston or Caracas but 17 in Qin Pu carried strains resistant to gentamicin. Among 10 colonies selected randomly from each stool sample, the average frequency of resistance in Caracas was 3.6 times greater than in Boston, and that in Qin Pu was 5.3 times greater. There was resistance to five or more antimicrobial agents in 20 percent of the Qin Pu strains and in 6 percent of the Caracas strains but in none of the Boston strains. Conclusions. In addition to clinical isolates, as reported previously, the bacteria that colonize healthy children in the community may be resistant far more often in some regions than in others. A low rate of carriage of antimicrobial resistance in the community should become a public health goal.