Regional variation in the prevalence of extended-spectrum β-lactamase-producing clinical isolates in the Asia-Pacific region (SENTRY 1998-2002)
Regional variation in the prevalence of extended-spectrum β-lactamase-producing clinical isolates in the Asia-Pacific region (SENTRY 1998-2002)
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DOI：
10.1016/j.diagmicrobio.2005.04.004
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发表时间：
2005-08-01
影响因子：
2.9
通讯作者：
Kohno, S
中科院分区：
文献类型：
--
作者：
Hirakata, Y;Matsuda, J;Kohno, S
我们检查了肺炎克雷伯菌、产酸克雷伯菌、大肠杆菌、奇异变形杆菌、科塞柠檬酸杆菌和沙门氏菌的产超广谱 β-内酰胺酶 (ESBL) 菌株的流行情况。 1998 年至 2002 年间，作为 SENTRY 亚太监测计划的一部分，分离出这些菌株。在研究期间，从 7 个国家的 17 个医疗中心收集了总共 6388 个菌株，并检查了 ESBL 的产生和产酸克雷伯菌染色体 K1 β-内酰胺酶的过量产生。新加坡肺炎克雷伯菌菌株中产ESBL的确诊率较高（35.6%），其次是中国大陆（30.7%）、南非（28.1%）和菲律宾（21.9%），而日本和澳大利亚的产ESBL率低于10%。产ESBL的大肠杆菌菌株在中国大陆（24.5%）、香港（14.3%）和新加坡（11.3%）也很常见。产 ESBL 的催产克雷伯菌在菲律宾（38.5%）、新加坡（33.3%）和中国（30.0%）很常见。产酸克雷伯氏菌染色体 K1 β-内酰胺酶的过量生产在澳大利亚和日本很常见。来自新加坡的奇异果菌株产生 ESBL（17.9%），尽管其他国家的流行率较低（0-8.1%）。很少有产 ESBL 的 C. koseri 和沙门氏菌属。在日本、新加坡、台湾和南非发现了菌株。尽管各国之间的底物偏好存在差异，但头孢他啶更有可能在肺炎克雷伯菌中检测到推定的 ESBL 表型，氨曲南更有可能在大肠杆菌中检测到，而头孢曲松是确认 ESBL 产生的最佳底物。产ESBL菌株对氨基糖苷类、四环素、甲氧苄啶-磺胺甲恶唑和环丙沙星表现出高水平的共耐药性。亚胺培南保留了针对所有产 ESBL 菌株的活性。表达 ESBL 的生物广泛分布于亚太地区，但患病率差异很大。 (c) 2005 Elsevier Inc. 保留所有权利。
We examined the prevalence of extended-spectrum beta-lactamase (ESBL)-producing strains of Klebsiella pneumoniae, Klebsiella oxytoca, Escherichia coli, Proteus mirabilis, Citrobacter koseri, and Salmonella spp. that were isolated as part of the SENTRY Asia-Pacific Surveillance Program between 1998 and 2002. During the study period, a total of 6388 strains were gathered from 17 medical centers in 7 countries and examined for ESBL production and hyperproduction of K. oxytoca chromosomal K1 beta-lactamase enzyme. High rates of confirmed ESBL-producing isolates were found in K. pneumoniae strains from Singapore (35.6%), followed by those from mainland China (30.7%), South Africa (28.1%), and the Philippines (21.9%), whereas the rates were less than 10% in Japan and Australia. ESBL-producing E. coli strains were also prominent in mainland China (24.5%), Hong Kong (14.3%), and Singapore (11.3%). ESBL-producing K. oxytoca were common in the Philippines (38.5%), Singapore (33.3%), and China (30.0%). Hyperproduction of K. oxytoca chromosomal K1 beta-lactamase enzyme was common in Australia and Japan. P. mirabilis strains from Singapore produced ESBL (17.9%) despite the low prevalence (0-8.1%) in other countries. Few ESBL-producing C. koseri and Salmonella spp. strains were found in Japan, Singapore, Taiwan, and South Africa. Although there was variation among countries in substrate preference, ceftazidime was more likely to detect presumptive ESBL phenotype in K. pneumoniae and aztreonam more likely in E. coli, whereas ceftriaxone was the best substrate for the confirmation of ESBL production. ESBL-producing strains showed high levels of coresistance to aminoglycosides, tetracycline, trimethoprim-sulfamethoxazole, and ciprofloxacin. Imipenem retained activity against all ESBL-producing strains. Organisms expressing ESBLs are widely distributed in the Asia-Pacific region, although prevalence rates vary significantly. (c) 2005 Elsevier Inc. All rights reserved.