Bertrand Xavier, Hocquet D, Boisson K, Siebor E, Plésiat P, Talon D
Service d'Hygiène Hospitalière et d'Epidémiologie moléculaire, CHU Jean Minjoz, 25030 Besançon, France.
Int J Antimicrob Agents. 2003 Aug;22(2):128-33. doi: 10.1016/s0924-8579(03)00098-0.
We conducted a retrospective study to investigate the epidemiology of Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBLE) in our hospital. We determined the occurrence of extended-spectrum beta-lactamase (ESBL) in Enterobacteriaceae over a 2-year period. We also characterised ESBLs by isoelectric focusing (IEF) and investigated the epidemiological relatedness of EBLSE by pulsed field gel electrophoresis (PFGE). During this period, 70 patients were colonised/infected with one or several strains of EBLSE, giving a crude incidence of 0.095 per 1000 patient-days. We found that ESBL-producing Enterobacter aerogenes were the main source of ESBLE dissemination. Indeed, 59.5% of ESBLE were E. aerogenes and 21.9% of the other ESBLE resulted from a plasmid transfer originating from E. aerogenes. IEF and PFGE analysis demonstrated that the dissemination of ESBL from E. aerogenes in our hospital was due to a single clone that always harbours TEM-24. This emphasises the importance of standard contact isolation precautions and the early detection of ESBLE-colonised patients in high risk departments like intensive care units.
我们进行了一项回顾性研究，以调查我院产超广谱β-内酰胺酶（ESBLE）肠杆菌科细菌的流行病学情况。我们确定了两年期间肠杆菌科细菌中超广谱β-内酰胺酶（ESBL）的发生率。我们还通过等电聚焦（IEF）对ESBL进行了表征，并通过脉冲场凝胶电泳（PFGE）研究了产ESBL肠杆菌科细菌的流行病学相关性。在此期间，70例患者被一株或几株产ESBL肠杆菌科细菌定植/感染，粗发病率为每1000患者日0.095例。我们发现产ESBL的产气肠杆菌是ESBLE传播的主要来源。事实上，59.5%的ESBLE是产气肠杆菌，另外21.9%的ESBLE是由源自产气肠杆菌的质粒转移导致的。IEF和PFGE分析表明，我院产气肠杆菌ESBL的传播是由一个始终携带TEM-24的单一克隆引起的。这强调了标准接触隔离预防措施以及在重症监护病房等高风险科室早期检测产ESBLE定植患者的重要性。
