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越南肠杆菌科临床分离株中广谱β-内酰胺酶的分布情况

Distribution of extended-spectrum beta-lactamases in clinical isolates of Enterobacteriaceae in Vietnam.

作者信息

Cao Van, Lambert Thierry, Nhu Duong Quynh, Loan Huynh Kim, Hoang Nguyen Kim, Arlet Guillaume, Courvalin Patrice

机构信息

Unité des Agents Antibactériens, Institut Pasteur, 75724 Paris Cedex 15, France.

出版信息

Antimicrob Agents Chemother. 2002 Dec;46(12):3739-43. doi: 10.1128/AAC.46.12.3739-3743.2002.

Abstract

Among 730 Escherichia coli, 438 Klebsiella pneumoniae, and 141 Proteus mirabilis isolates obtained between September 2000 and September 2001 in seven hospitals in Ho Chi Minh City, Vietnam, 26.6% were resistant to ceftazidime, 30% were resistant to cefotaxime, 31.5% were resistant to ceftriaxone, 15.9% were resistant to cefoperazone, and 6% were resistant to cefepime. Resistance to imipenem was found in 5.6% of the isolates. In 55 strains producing extended-spectrum beta-lactamases (32 E. coli isolates, 13 K. pneumoniae isolates, and 10 P. mirabilis isolates), structural genes for VEB-1 (25.5%), CTX-M (25.5%), SHV (38.1%), and TEM (76.3%) enzymes were detected alone or in combination. Sequencing of the PCR products obtained from the K. pneumoniae isolates revealed the presence of bla(VEB-1), bla(CTX-M-14), bla(CTX-M-17), bla(SHV-2), and bla(TEM-1). Molecular typing of the strains with a similar resistance phenotype to broad-spectrum cephalosporins indicated polyclonal spread. ISEcp1 was presumably responsible for dissemination of the bla(CTX-M-like) gene.

摘要

2000年9月至2001年9月期间,在越南胡志明市的七家医院采集了730株大肠杆菌、438株肺炎克雷伯菌和141株奇异变形杆菌。其中,26.6%的菌株对头孢他啶耐药,30%对头孢噻肟耐药,31.5%对头孢曲松耐药,15.9%对头孢哌酮耐药,6%对头孢吡肟耐药。5.6%的菌株对亚胺培南耐药。在55株产超广谱β-内酰胺酶的菌株(32株大肠杆菌、13株肺炎克雷伯菌和10株奇异变形杆菌)中,单独或联合检测到了VEB-1(25.5%)、CTX-M(25.5%)、SHV(38.1%)和TEM(76.3%)酶的结构基因。对肺炎克雷伯菌分离株的PCR产物测序显示存在bla(VEB-1)、bla(CTX-M-14)、bla(CTX-M-17)、bla(SHV-2)和bla(TEM-1)。对具有相似耐药表型的广谱头孢菌素菌株进行分子分型表明为多克隆传播。ISEcp1可能是bla(CTX-M样)基因传播的原因。

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