巴林产超广谱β-内酰胺酶肠杆菌科的流行情况。

Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in Bahrain.

机构信息

Department of Microbiology, Immunology and Infectious Diseases, Arabian Gulf University, Manama, Bahrain.

出版信息

J Infect Public Health. 2009;2(3):129-35. doi: 10.1016/j.jiph.2009.04.005. Epub 2009 Sep 18.

DOI:10.1016/j.jiph.2009.04.005

PMID:20701872

Abstract

OBJECTIVES

To determine the occurrence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in Bahrain.

METHODS

Retrospective analysis of records (January 2005-December 2006) at the Microbiology Laboratory of the Salmaniya Medical Complex, Bahrain which is the major national diagnostic laboratory.

RESULTS

Out of a total of 11,886 member of family of Enterobacteriaceae isolated, 2695 (22.6%) were ESBL producers. Majority of ESBL isolates were from inpatients (n=2363; 87.7%). Escherichia coli (52.2%) and Klebsiella pneumoniae (24.3%) were predominant and distributed comparatively in the hospital wards while Proteus spp. (17.6%) was predominant in medical wards. Urine was the major source (52.2%) with low occurrence in blood cultures. No carbapenem resistant isolates was identified but resistance to three classes of antibiotics was exhibited by >25% of the isolated ESBL strains. Nitrofurantoin resistance was identified in 38.2% of urinary isolates.

CONCLUSION

This is the first report from Bahrain and it indicates that the prevalence of ESBL-producing isolates is high. Carbapenems were the most active drug against the ESBL-producing isolates. We recommend strict infection control to prevent trafficking into the community.

摘要

目的

确定巴林产肠杆菌科中是否存在产超广谱β-内酰胺酶（ESBL）的细菌。

方法

对巴林 Salmaniya 医疗综合体微生物实验室（主要国家诊断实验室）的记录（2005 年 1 月至 2006 年 12 月）进行回顾性分析。

结果

在所分离的 11886 个肠杆菌科成员中，有 2695 个（22.6%）为 ESBL 产菌。大多数 ESBL 分离株来自住院患者（n=2363；87.7%）。大肠埃希菌（52.2%）和肺炎克雷伯菌（24.3%）是主要的，在医院病房中分布较为均匀，而普通变形杆菌（17.6%）在医学病房中更为常见。尿液是主要的来源（52.2%），血液培养中出现的情况较少。未发现耐碳青霉烯类的分离株，但>25%的分离 ESBL 菌株对三类抗生素表现出耐药性。在尿分离株中，有 38.2%对呋喃妥因耐药。