Młynarczyk A, Młynarczyk G, Pupek J, Bilewska A, Kawecki D, Łuczak M, Gozdowska J, Durlik M, Paczek L, Chmura A, Rowińnski W
Department of Medical Microbiology, Warsaw Medical University, Warsaw, Poland.
Transplant Proc. 2007 Nov;39(9):2879-82. doi: 10.1016/j.transproceed.2007.08.046.
Serratia marcescens is an important agent in hospital infections. The aim of this paper was to compare the resistance patterns of S. marcescens strains isolated during 1 year from patients of various wards of the Institute of Transplantology. The mechanisms of beta-lactam antibiotic resistance were of especial interest. We investigated the 81 strains of S. marcescens, isolated during 2005 from patients on 3 wards and 1 clinic of the Transplantation Institute. An unusually high resistance to most antibiotics was observed among S. marcescens strains. Extended spectrum beta-lactamases (ESBLs) were probably produced by 63.2% to 84.6% of strains, depending on the ward. Additionally, about 30% of them were probably derepressed AmpC producers. The patterns of resistance indicated that at least 2 resistant clones of S. marcescens spread among the patients. One of the clones demonstrated both ESBL and derepressed AmpC production and was susceptible only to carbapenems. The second, producing ESBL, was susceptible to piperacillin/tazobactam and carbapenems. All investigated strains were resistant to nitrofurantoin. Strains of the second group were rarely susceptible to other antibiotics: aminoglycosides, ciprofloxacin, cotrimoxazole, or fosfomycin.
粘质沙雷氏菌是医院感染中的一种重要病原体。本文旨在比较从移植研究所各病房患者中分离出的粘质沙雷氏菌菌株在1年期间的耐药模式。β-内酰胺类抗生素耐药机制尤其令人关注。我们调查了2005年从移植研究所3个病房和1个门诊的患者中分离出的81株粘质沙雷氏菌。在粘质沙雷氏菌菌株中观察到对大多数抗生素具有异常高的耐药性。根据病房不同，63.2%至84.6%的菌株可能产生超广谱β-内酰胺酶（ESBLs）。此外，其中约30%可能是去阻遏AmpC产生菌。耐药模式表明，至少有2个粘质沙雷氏菌耐药克隆在患者中传播。其中一个克隆既产生ESBL又产生去阻遏AmpC，仅对碳青霉烯类敏感。第二个产生ESBL的克隆对哌拉西林/他唑巴坦和碳青霉烯类敏感。所有调查菌株对呋喃妥因耐药。第二组菌株很少对其他抗生素敏感：氨基糖苷类、环丙沙星、复方新诺明或磷霉素。
