De Gheldre Y, Struelens M J, Glupczynski Y, De Mol P, Maes N, Nonhoff C, Chetoui H, Sion C, Ronveaux O, Vaneechoutte M
Service de Microbiologie, Laboratoire de Bacteriologie, Université Libre de Bruxelles-Hôpital Erasme, 808 route de Lennik, 1070 Brussels, Belgium.
J Clin Microbiol. 2001 Mar;39(3):889-96. doi: 10.1128/JCM.39.3.889-896.2001.
Two national surveys were conducted to describe the incidence and prevalence of Enterobacter aerogenes in 21 Belgian hospitals in 1996 and 1997 and to characterize the genotypic diversity and the antimicrobial resistance profiles of clinical strains of E. aerogenes isolated from hospitalized patients in Belgium in 1997 and 1998. Twenty-nine hospitals collected 10 isolates of E. aerogenes, which were typed by arbitrarily primed PCR (AP-PCR) using two primers and pulsed-field gel electrophoresis. MICs of 10 antimicrobial agents were determined by the agar dilution method. Beta-lactamases were detected by the double-disk diffusion test and characterized by isoelectric point. The median incidence of E. aerogenes colonization or infection increased from 3.3 per 1,000 admissions in 1996 to 4.2 per 1000 admissions in the first half of 1997 (P < 0.01). E. aerogenes strains (n = 260) clustered in 25 AP-PCR types. Two major types, BE1 and BE2, included 36 and 38% of strains and were found in 21 and 25 hospitals, respectively. The BE1 type was indistinguishable from a previously described epidemic strain in France. Half of the strains produced an extended-spectrum beta-lactamase, either TEM-24 (in 86% of the strains) or TEM-3 (in 14% of the strains). Over 75% of the isolates were resistant to ceftazidime, piperacillin-tazobactam, and ciprofloxacin. Over 90% of the strains were susceptible to cefepime, carbapenems, and aminoglycosides. In conclusion, these data suggest a nationwide dissemination of two epidemic multiresistant E. aerogenes strains in Belgian hospitals. TEM-24 beta-lactamase was frequently harbored by one of these epidemic strains, which appeared to be genotypically related to a TEM-24-producing epidemic strain from France, suggesting international dissemination.
开展了两项全国性调查，以描述1996年和1997年21家比利时医院中产气肠杆菌的发病率和流行率，并对1997年和1998年从比利时住院患者中分离出的产气肠杆菌临床菌株的基因型多样性和抗菌药物耐药谱进行特征分析。29家医院收集了10株产气肠杆菌，使用两种引物通过任意引物PCR（AP-PCR）和脉冲场凝胶电泳对其进行分型。采用琼脂稀释法测定10种抗菌药物的最低抑菌浓度（MIC）。通过双纸片扩散试验检测β-内酰胺酶，并通过等电点对其进行特征分析。产气肠杆菌定植或感染的发病率中位数从1996年的每1000例入院患者3.3例增加到1997年上半年的每1000例入院患者4.2例（P < 0.01）。产气肠杆菌菌株（n = 260）聚为25种AP-PCR型。两种主要类型BE1和BE2分别包含36%和38%的菌株，分别在21家和25家医院中发现。BE1型与法国先前描述的一株流行菌株无法区分。一半的菌株产生超广谱β-内酰胺酶，其中86%的菌株为TEM-24，14%的菌株为TEM-3。超过75%的分离株对头孢他啶、哌拉西林-他唑巴坦和环丙沙星耐药。超过90%的菌株对头孢吡肟、碳青霉烯类和氨基糖苷类敏感。总之，这些数据表明两种具有多重耐药性的产气肠杆菌流行菌株在比利时医院中出现了全国性传播。其中一种流行菌株经常携带TEM-24β-内酰胺酶，该菌株在基因型上似乎与法国一株产TEM-24的流行菌株相关，提示存在国际传播。
