Bartoloni Alessandro, Pallecchi Lucia, Benedetti Marta, Fernandez Connie, Vallejos Yolanda, Guzman Elisa, Villagran Ana Liz, Mantella Antonia, Lucchetti Chiara, Bartalesi Filippo, Strohmeyer Marianne, Bechini Angela, Gamboa Herlan, Rodríguez Hugo, Falkenberg Torkel, Kronvall Göran, Gotuzzo Eduardo, Paradisi Franco, Rossolini Gian Maria
Clinica Malattie Infettive, Dipartimento Area Critica Medico Chirurgica, Universitá di Firenze, Florence, Italy.
Emerg Infect Dis. 2006 Jun;12(6):907-13. doi: 10.3201/eid1206.051258.
Using a rapid screening method, we investigated the prevalence of fecal carriage of antimicrobial drug-resistant Escherichia coli in 3,174 healthy children from 4 urban settings in Peru and Bolivia. High resistance rates were observed for ampicillin (95%), trimethoprim-sulfamethoxazole (94%), tetracycline (93%), streptomycin (82%), and chloramphenicol (70%). Lower resistance rates were observed for nalidixic acid (35%), kanamycin (28%), gentamicin (21%), and ciprofloxacin (18%); resistance to ceftriaxone and amikacin was uncommon (<0.5%). In a random sample of 1,080 resistant E. coli isolates, 90% exhibited a multidrug-resistance (MDR) phenotype. The 2 most common MDR phenotypes (ampicillin/tetracycline/trimethoprim-sulfamethoxazole and ampicillin/tetracycline/trimethoprim-sulfamethoxazole/chloramphenicol) could be transferred en bloc in conjugation experiments. The most common acquired resistance genes were blaTEM, tet(A), tet(B), drfA8, sul1, sul2, and catI. These findings underscore the magnitude of the problem of antimicrobial drug resistance in low-resource settings and the urgent need for surveillance and control of this phenomenon.
我们采用一种快速筛查方法，对来自秘鲁和玻利维亚4个城市地区的3174名健康儿童粪便中携带耐抗菌药物大肠杆菌的情况进行了调查。氨苄西林（95%）、甲氧苄啶-磺胺甲恶唑（94%）、四环素（93%）、链霉素（82%）和氯霉素（70%）的耐药率较高。萘啶酸（35%）、卡那霉素（28%）、庆大霉素（21%）和环丙沙星（18%）的耐药率较低；对头孢曲松和阿米卡星的耐药情况不常见（<0.5%）。在1080株耐药大肠杆菌分离株的随机样本中，90%表现出多重耐药（MDR）表型。两种最常见的MDR表型（氨苄西林/四环素/甲氧苄啶-磺胺甲恶唑和氨苄西林/四环素/甲氧苄啶-磺胺甲恶唑/氯霉素）在接合实验中可作为一个整体进行转移。最常见的获得性耐药基因是blaTEM、tet(A)、tet(B)、drfA8、sul1、sul2和catI。这些发现凸显了资源匮乏地区抗菌药物耐药问题的严重性，以及对这一现象进行监测和控制的迫切需求。
