Infectious Disease Section, New York Hospital Queens, Flushing, NY 11355, USA.
Diagn Microbiol Infect Dis. 2010 Apr;66(4):402-6. doi: 10.1016/j.diagmicrobio.2009.11.012.
Bacteria harboring CTX-M extended-spectrum beta-lactamases (ESBLs) have been identified worldwide, with most reports coming from regions outside North America. We have identified CTX-M enzymes in 31% of ESBL-positive Escherichia coli isolates from our hospital and more than half (53%) of the isolates from associated long-term care facilities. Approximately 3/4 of all CTX-M-bearing isolates were from urine specimens, with a predominance of CTX-M-15. A large proportion of such isolates were nonsusceptible to levofloxacin, trimethoprim/sulfamethoxazole, and all beta-lactam antimicrobials with the exception of the carbapenems, requiring carbapenem therapy for acute urinary tract infection or urinary tract-related sepsis. CTX-M beta-lactamases have emerged within our location, and detection of bacteria harboring these enzymes in the clinical microbiology laboratory remains problematic because molecular methods are needed for their identification.
细菌携带 CTX-M 型超广谱β-内酰胺酶（ESBLs）已在全球范围内被发现，大多数报告来自北美以外的地区。我们从医院分离的 ESBL 阳性大肠埃希菌中发现了 CTX-M 酶，在相关长期护理机构分离的菌株中有一半以上（53%）携带 CTX-M 酶。所有携带 CTX-M 的分离株中约有 3/4 来自尿液标本，以 CTX-M-15 为主。此类分离株中很大一部分对左氧氟沙星、复方磺胺甲噁唑和除碳青霉烯类以外的所有β-内酰胺类抗菌药物均不敏感，需要碳青霉烯类药物治疗急性尿路感染或尿路感染相关败血症。CTX-M 型β-内酰胺酶已在我们所在地区出现，由于需要分子方法才能对这些酶进行鉴定，因此临床微生物实验室检测携带这些酶的细菌仍然存在问题。
