Antibiotic Reference Laboratory, Institute of Environmental Science and Research (ESR), Wellington, New Zealand.
Int J Antimicrob Agents. 2009 Dec;34(6):544-9. doi: 10.1016/j.ijantimicag.2009.07.014. Epub 2009 Sep 11.
The aims of this survey were (i) to determine the prevalence of extended-spectrum beta-lactamases (ESBLs) among urinary Escherichia coli and Klebsiella spp. in New Zealand (NZ), (ii) to identify the relative prevalence of ESBL types and (iii) to investigate clonality among ESBL-producing E. coli and Klebsiella spp. During a 4-week period in 2006, 86% of NZ hospital and community diagnostic microbiology laboratories participated in the survey and referred isolates to the national reference laboratory. A total of 86 ESBL-producing isolates were identified, comprising 55 E. coli and 31 Klebsiella spp. (all Klebsiella pneumoniae), equating to prevalence rates of 0.7% and 4.2%, respectively. The majority of the ESBL-producing E. coli (80.0%) and K. pneumoniae (58.6%) were reported to be from community-acquired urinary tract infections. CTX-M-15 and CTX-M-14 accounted for 75.9% and 13.3%, respectively, of the ESBL types identified. A novel ESBL, designated CTX-M-68, was identified. Most CTX-M-15-producing isolates were multiresistant to three or more antibiotic classes. Pulsed-field gel electrophoresis typing identified a wide diversity of strains among the ESBL-producing E. coli, whereas the K. pneumoniae were more clonal. The results of this survey show that the prevalence of ESBLs has increased in recent years in NZ, that CTX-M ESBLs are almost wholly dominant and that ESBL-producing organisms are already established as community-acquired pathogens.
(i) 确定新西兰（NZ）尿型大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶（ESBL）的流行率；(ii) 确定 ESBL 型的相对流行率；(iii) 研究产 ESBL 的大肠埃希菌和肺炎克雷伯菌的克隆性。2006 年的 4 周内，86%的 NZ 医院和社区诊断微生物学实验室参与了该调查，并将分离株转介至国家参考实验室。共鉴定出 86 株产 ESBL 分离株，包括 55 株大肠埃希菌和 31 株肺炎克雷伯菌（均为肺炎克雷伯菌），流行率分别为 0.7%和 4.2%。大多数产 ESBL 的大肠埃希菌（80.0%）和肺炎克雷伯菌（58.6%）报告来自社区获得性尿路感染。CTX-M-15 和 CTX-M-14 分别占鉴定出的 ESBL 型的 75.9%和 13.3%。鉴定出一种新型 ESBL，命名为 CTX-M-68。大多数产 CTX-M-15 的分离株对三种或更多抗生素类别的耐药性很高。脉冲场凝胶电泳分型鉴定出产 ESBL 的大肠埃希菌存在广泛的菌株多样性，而肺炎克雷伯菌则更具克隆性。本调查结果表明，近年来 NZ 的 ESBL 流行率有所增加，CTX-M ESBL 几乎完全占主导地位，产 ESBL 生物已成为社区获得性病原体。
