de Champs C, Sirot D, Chanal C, Poupart M C, Dumas M P, Sirot J
Service de Bactériologie-Virologie, Faculté Médecine, Clermont Ferrand, France.
J Antimicrob Chemother. 1991 Apr;27(4):441-57. doi: 10.1093/jac/27.4.441.
From January 1988 to August 1989, 267 non-repetitive strains of Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBla) derived from TEM (CTX-1/TEM-3, CAZ-6) or SHV (CAZ-5) were isolated from 219 colonized or infected patients. ESBlas were characterized by analytical isoelectric focusing. Biotypes, resistance phenotypes and plasmid patterns were determined in order to differentiate the isolates in each species. Among the 116 CTX-1-producing Enterobacteriaceae, 48 strains were differentiated: 27 from 74 Klebsiella pneumoniae isolates, seven from 22 Enterobacter aerogenes isolates, and 14 from a combined total of seven K. oxytoca, five Serratia marcescens, six Escherichia coli, 1 Enterobacter cloacae and 1 Citrobacter freundii. CAZ-5 has been isolated since January 1988 in 16 different strains among 101 K. pneumoniae isolates. CAZ-6 was first identified in K. pneumoniae (January 1988). Among the 48 Enterobacteriaceae producing CAZ-6, 12 strains were differentiated: four from 39 E. aerogenes isolates, three from four K. pneumoniae, and five from a combined total of two S. marcescens, two E. coli and one E. cloacae. During this outbreak, CTX-1 was found to be encoded by 85 kb (Inc 7/M) or greater than or equal to 150 kb (Inc 6/C) plasmids. CAZ-6 was always encoded by an 85 kb (Inc 7/M) plasmid and CAZ-5 by a greater than 150 kb plasmid. These results show that strain epidemics and plasmid dissemination occurred mainly in K. pneumoniae and E. aerogenes for CTX-1, in E. aerogenes for CAZ-6, and in K. pneumoniae for CAZ-5. They also suggest that the bla(tem) gene (CTX-1) has spread between different plasmids present in the same ecosystem.
1988年1月至1989年8月，从219例定植或感染患者中分离出267株非重复性产超广谱β-内酰胺酶（ESBla）的肠杆菌科细菌，这些酶源自TEM（CTX-1/TEM-3、CAZ-6）或SHV（CAZ-5）。通过分析等电聚焦对ESBla进行表征。确定生物型、耐药表型和质粒图谱，以便区分每个菌种中的分离株。在116株产CTX-1的肠杆菌科细菌中，48株得以区分：27株来自74株肺炎克雷伯菌分离株，7株来自22株产气肠杆菌分离株，14株来自总共7株产酸克雷伯菌、5株粘质沙雷氏菌、6株大肠埃希菌、1株阴沟肠杆菌和1株弗氏柠檬酸杆菌。自1988年1月以来，在101株肺炎克雷伯菌分离株中的16株不同菌株中分离出了CAZ-5。CAZ-6于1988年1月首次在肺炎克雷伯菌中被鉴定出来。在48株产CAZ-6的肠杆菌科细菌中，12株得以区分：4株来自39株产气肠杆菌分离株，3株来自4株肺炎克雷伯菌，5株来自总共2株粘质沙雷氏菌、2株大肠埃希菌和1株阴沟肠杆菌。在此次暴发期间，发现CTX-1由85 kb（Inc 7/M）或大于或等于150 kb（Inc 6/C）的质粒编码。CAZ-6始终由85 kb（Inc 7/M）质粒编码，CAZ-5由大于150 kb的质粒编码。这些结果表明，CTX-1的菌株流行和质粒传播主要发生在肺炎克雷伯菌和产气肠杆菌中，CAZ-6的传播发生在产气肠杆菌中，CAZ-5的传播发生在肺炎克雷伯菌中。它们还表明bla(tem)基因（CTX-1）已在同一生态系统中存在的不同质粒之间传播。
