Ahoyo A T, Baba-Moussa L, Anago A E, Avogbe P, Missihoun T D, Loko F, Prévost G, Sanni A, Dramane K
Laboratoire de biochimie et biologie moléculaire, faculté des sciences et techniques, université d'Abomey-Calavi, 04BP0320 Cotonou, Bénin.
Med Mal Infect. 2007 Nov;37(11):746-52. doi: 10.1016/j.medmal.2007.03.004. Epub 2007 Apr 16.
Over a 6-month period, extended-spectrum betalactamase (ESBL)-producing isolates of Escherichia coli (EC) were collected from in-patients and their environment at the Zou-Collines Hospital Centre (CHDZ/C) in Benin. The aim of this study was to determine the incidence of ESBL and to describe their phenotypic susceptibility to antibiotics in a secondary hospital (500 beds) in Benin.
From 15 May to 15 November 2005, clinical informations and samples were collected from patients suspected to have nosocomial infections. The isolates were identified, tested for antimicrobial susceptibility and analysed for the presence of ESBL genes blaTEM and blaSHV by PCR.
One hundred ninety-seven enterobacteria were isolated from the clinical samples of 342 patients, these isolates included 143 EC and 32/143 (22%) of these isolates produced ESBL. Forty-six EC were isolated from the environment and 7 (15%) of them produced ESBL. Except for Imipenem for which the difference was not significant, the isolates producing ESBL were more resistant to the other antibiotics (especially to third generation cephalosporins: Ceftriaxone, Cefotaxime, Ceftazidime (P<0.00001)) than non-ESBL producing isolates. Both ESBL genes blaSHV and blaTEM were identified in the EC ESBL strains from patient and from the environment.
This study shows the presence of ESBL genes among EC in various wards of the CHDZ/C hospital proving that there is a need to implement a strict hospital infection control program and a regular surveillance of resistance to antimicrobial agents.
在6个月的时间里,从贝宁的邹 - 科利内斯医院中心(CHDZ/C)的住院患者及其环境中收集产超广谱β-内酰胺酶(ESBL)的大肠杆菌(EC)分离株。本研究的目的是确定ESBL的发生率,并描述其在贝宁一家二级医院(500张床位)中对抗生素的表型敏感性。
2005年5月15日至11月15日,从疑似医院感染的患者中收集临床信息和样本。对分离株进行鉴定、检测抗菌药物敏感性,并通过PCR分析ESBL基因blaTEM和blaSHV的存在情况。
从342例患者的临床样本中分离出197株肠杆菌,这些分离株包括143株EC,其中32/143(22%)的分离株产ESBL。从环境中分离出46株EC,其中7株(15%)产ESBL。除亚胺培南差异不显著外,产ESBL的分离株比不产ESBL的分离株对其他抗生素(尤其是第三代头孢菌素:头孢曲松、头孢噻肟、头孢他啶,P<0.00001)耐药性更强。在来自患者和环境的EC ESBL菌株中均鉴定出ESBL基因blaSHV和blaTEM。
本研究表明在CHDZ/C医院各病房的EC中存在ESBL基因,证明有必要实施严格的医院感染控制计划并定期监测抗菌药物耐药性。