Surveillance of extended-spectrum β-lactamases from clinical samples and faecal carriers in Barcelona, Spain
Surveillance of extended-spectrum β-lactamases from clinical samples and faecal carriers in Barcelona, Spain
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DOI：
10.1093/jac/dki395
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发表时间：
2005-12-01
影响因子：
5.2
通讯作者：
Coll, P
中科院分区：
文献类型：
--
作者：
Miró, E;Mirelis, B;Coll, P
目的：本研究的目的是表征和比较2001年和2002年从临床样本和粪便携带者中分离出的广谱β -内酰胺酶（ESBL）产生生物。方法：对临床分离的5251株肠杆菌科细菌和1321株粪便样本进行ESBLs检测。将粪便样本铺于含有2 mg/L头孢噻肟的麦康基琼脂平板上，筛选产esbl菌株。这些菌株被定义为阿莫西林/克拉维酸与第三代头孢菌素之间表现出协同作用的菌株。所涉及的β -内酰胺酶通过等电聚焦、PCR检测和DNA测序进行了表征。结果：临床肠杆菌科产esbl菌株的感染率为1.7%。其中产生CTX-M的占87.6%，产生SHV的占25.8%，产生tem型的占2.2%。除4株肺炎克雷伯菌和1株弗伦地柠檬酸杆菌外，所有临床产esbl菌株均为大肠杆菌。产esbl微生物粪便携带率为3.3%。其中75%产生ctx - m型酶，其次是22.7%产生shv的菌株。除1株阴沟肠杆菌和1株奇迹变形杆菌外，粪便中产生esbl的菌株均为大肠杆菌。后一株在西班牙首次报道产生PER-1酶。结论：粪便样本中产esbl菌株的流行率高于同期临床样本。在这两种情况下发现的不同类型的esbl是相似的。最常见的ESBLs是ctx - m相关酶，有9种不同的类型，其次是SHV-12。
Objectives: The aim of the present study was to characterize and compare the extended-spectrum beta-lactamase (ESBL)-producing organisms isolated from clinical samples and faecal carriers in 2001 and 2002.Methods: A total of 5251 Enterobacteriaceae isolated from clinical samples and 1321 stool samples were evaluated for the presence of ESBLs. The stool samples were spread onto plates of MacConkey agar containing 2 mg/L cefotaxime for selection of ESBL-producing strains. These strains were defined as those showing synergism between amoxicillin/clavulanic acid and third-generation cephalosporins. The beta-lactamases involved were characterized by isoelectric focusing, PCR assays and DNA sequencing.Results: The prevalence of ESBL-producing strains among clinical Enterobacteriaceae was 1.7%. Of these, 87.6% produced CTX-M, 25.8% produced SHV and 2.2% were TEM-type-producing strains. All clinical ESBL-producing strains were Escherichia coli, with the exception of four Klebsiella pneumoniae and one Citrobacter freundii. The prevalence of faecal carriage of ESBL-producing organisms was 3.3%. Of these, 75% produced CTX-M-type enzymes followed by 22.7% SHV-producing strains. All faecal ESBL-producing strains were E. coli except for one Enterobacter cloacae and one Proteus mirabilis. This latter strain produced the PER-1 enzyme reported for the first time in Spain.Conclusions: The prevalence of ESBL-producing strains in stool samples was higher than that observed in clinical samples from the same period. The different types of ESBLs found were similar in both contexts. The most prevalent ESBLs were the CTX-M-related enzymes, with nine different types, followed by SHV-12.