Mesa Raúl Jesús, Blanc Vanessa, Blanch Anicet R, Cortés Pilar, González Juan José, Lavilla Susana, Miró Elisenda, Muniesa Maite, Saco Montserrat, Tórtola Ma Teresa, Mirelis Beatriz, Coll Pere, Llagostera Montserrat, Prats Guillem, Navarro Ferran
Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau Barcelona, Spain.
J Antimicrob Chemother. 2006 Jul;58(1):211-5. doi: 10.1093/jac/dkl211. Epub 2006 May 23.
This study aimed to determine the presence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in different environments.
Clinical samples and stool samples from animal farms, sewage, human faecal carriers attending the emergency room and faecal carriers in the context of food-borne disease outbreaks were subcultured onto MacConkey agar supplemented with cefotaxime for the detection of ESBL-producing Enterobacteriaceae. Identification, susceptibility pattern and ERIC-PCR were used for clone delineation in each sample. Community consumption of antibiotics was also recorded.
An ESBL-producing Enterobacteriaceae prevalence of 1.9% was observed in human infections. A cross-sectional survey of human faecal carriers in the community showed a general prevalence of 6.6% with a temporal distribution. High use of antibiotics in winter coincided with a lower prevalence in carriers. ESBL-producing Enterobacteriaceae were detected in the five samples of human sewage, in samples from 8 of 10 pig farms, 2 of 10 rabbit farms, from all 10 poultry farms and in 3 of 738 food samples studied. Faecal carriage of ESBL-producing Enterobacteriaceae was detected in samples from 19 of 61 food-borne outbreaks evaluated. All food-borne outbreaks were due to enteropathogens. The prevalence of carriers in these outbreaks ranged from 4.4% to 66.6%.
This widespread occurrence of ESBL-producing Enterobacteriaceae suggests that the community could act as a reservoir and that food could contribute to the spread of these strains.
本研究旨在确定不同环境中产超广谱β-内酰胺酶（ESBL）的肠杆菌科细菌的存在情况。
将来自动物养殖场的临床样本和粪便样本、污水、急诊室就诊的人类粪便携带者以及食源性疾病暴发中的粪便携带者接种于添加头孢噻肟的麦康凯琼脂上，以检测产ESBL的肠杆菌科细菌。对每个样本进行鉴定、药敏试验和ERIC-PCR以进行克隆分型。还记录了社区抗生素的使用情况。
在人类感染中观察到产ESBL的肠杆菌科细菌的患病率为1.9%。对社区人类粪便携带者的横断面调查显示总体患病率为6.6%，且存在时间分布。冬季抗生素的高使用量与携带者中较低的患病率相吻合。在5份人类污水样本、10个猪场中的8个样本、10个兔场中的2个样本、所有10个家禽场的样本以及738份研究的食品样本中的3份中检测到了产ESBL的肠杆菌科细菌。在评估的61起食源性疾病暴发中的19份样本中检测到了产ESBL的肠杆菌科细菌的粪便携带情况。所有食源性疾病暴发均由肠道病原体引起。这些暴发中携带者的患病率在4.4%至66.6%之间。
产ESBL的肠杆菌科细菌的广泛存在表明社区可能是一个储存库，并且食物可能有助于这些菌株的传播。
