Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de República, Alfredo Navarro 3051, CP: 11600 Montevideo, Uruguay.
J Antimicrob Chemother. 2011 Aug;66(8):1725-9. doi: 10.1093/jac/dkr222. Epub 2011 Jun 17.
To analyse the prevalence of resistance to β-lactams and plasmid-mediated quinolone resistance in Enterobacteriaceae in the paediatric hospital of Uruguay.
A total of 368 enterobacterial isolates collected between 1 May and 30 November 2009 were studied for the presence of extended-spectrum β-lactamases (ESBLs), qnr alleles and aac(6')Ib by phenotypic and molecular methods. The genomic context and transferability of β-lactamase and qnr genes were examined by PCR and conjugation, respectively.
The proportion of inpatients having an infection caused by ESBL-producing enterobacteria was 0.23% (16/7073) in paediatrics wards, 0.64‰ (3/4696) in the neonatology department and 0.03‰ (1/32 557) in the emergency department. ESBL-carrying enterobacteria constituted a total of 21.6% (16/74), 13% (3/23) and 0.37% (1/271) when samples were obtained from paediatrics wards, the neonatology department and the emergency department, respectively. Overall, CTX-M-2 (n = 7), CTX-M-9 (n = 3), CTX-M-8 (n = 2), CTX-M-15 (n = 1), SHV-5 (n = 5) and SHV-2 (n = 2) β-lactamases were detected. Thirteen out of 20 ESBL-producing isolates also carried the aac(6')Ib gene, and the cr variant was detected in one of them. qnr alleles were detected in four isolates comprising two qnrA1 genes, a qnrB8-like variant and a new qnrB gene showing 26 amino acid differences from QnrB1.
The proportion of ESBL-producing enterobacteria in Uruguay's paediatric hospital during the study period was 2.3 per 1000 hospitalized patients. The number of different microorganisms detected, as well as the various EBSLs, suggests the occurrence of sporadic episodes instead of nosocomial outbreaks. Nevertheless, the presence of new resistance genes reinforces the necessity for permanent surveillance programmes.
分析乌拉圭儿科医院肠杆菌科中β-内酰胺类和质粒介导的喹诺酮耐药的流行情况。
2009 年 5 月 1 日至 11 月 30 日期间共收集了 368 株肠杆菌，通过表型和分子方法检测超广谱β-内酰胺酶（ESBLs）、qnr 等位基因和 aac(6')Ib 的存在。通过 PCR 和接合分别检测β-内酰胺酶和 qnr 基因的基因组背景和可转移性。
在儿科病房、新生儿科和急诊科，产 ESBL 肠杆菌引起感染的住院患者比例分别为 0.23%（16/7073）、0.64‰（3/4696）和 0.03‰（1/32557）。当从儿科病房、新生儿科和急诊科获得样本时，携带 ESBL 的肠杆菌分别占总数的 21.6%（16/74）、13%（3/23）和 0.37%（1/271）。共检测到 CTX-M-2（n=7）、CTX-M-9（n=3）、CTX-M-8（n=2）、CTX-M-15（n=1）、SHV-5（n=5）和 SHV-2（n=2）β-内酰胺酶。20 株产 ESBL 的分离株中有 13 株还携带 aac(6')Ib 基因，其中一株检测到 cr 变异。4 株分离株中检测到 qnr 基因，包括 2 个 qnrA1 基因、1 个 qnrB8 样变体和 1 个新的 qnrB 基因，与 QnrB1 相比有 26 个氨基酸差异。
研究期间，乌拉圭儿科医院产 ESBL 的肠杆菌占住院患者的 2.3/1000。检测到的不同微生物数量以及各种 EBSLs 表明，这是散发性事件而不是医院爆发。然而，新的耐药基因的存在加强了对持续监测计划的必要性。
