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从眼部感染分离的细菌中发现的超广谱β-内酰胺酶介导的耐药性。

Extended-spectrum beta-lactamase-mediated resistance among bacterial isolates recovered from ocular infections.

机构信息

Department of Microbiology and Molecular Biology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.

出版信息

Ophthalmic Res. 2012;47(1):52-6. doi: 10.1159/000322807. Epub 2011 Jun 29.

Abstract

PURPOSE

To evaluate resistances mediated by extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases among Gram-negative bacteria recovered from ocular infections.

METHODS

As per the Clinical Laboratory Standards Institute M100-S-16 document, a total of 135 Gram-negative bacilli were recovered from ocular specimens and were subjected to phenotypic confirmation for ESBL production by the double-disc synergy test, cephalosporin and clavulanate combination disc test and E test, and, for AmpC β-lactamase, the modified double-disc approximation method and AmpC disc test.

RESULTS

In the double-disc synergy test, 21 (15.5%) isolates showed positive results against the cefpodoxime disc, 19 (14%) against cefpodoxime and cefotaxime, 15 (11%) against cefpodoxime, cefotaxime and ceftriaxone and 10 (7%) isolates were against cefpodoxime, cefotaxime, ceftriaxone and ceftazidime discs. In the cephalosporin/clavulanate combination disc test, 19 (14%) isolates showed positive results against cefotaxime with clavulanic acid and 10 (7%) isolates against ceftazidime with clavulanic acid. In the E test, 10 (7%) isolates displayed positive results against ceftazidime and 19 (14%) against cefotaxime. In the AmpC disc test for phenotypic confirmation, indentations were observed in 15 (11%) isolates with flattening also occurring in 10 (7%) isolates.

CONCLUSION

The incidences of ESBL- and AmpC β-lactamase-mediated resistances are found to be 7 and 18.5% among ocular isolates, respectively, and are more prevalent among the strains of Escherichia coli and Klebsiella pneumoniae.

摘要

目的

评估从眼部感染中分离的革兰氏阴性菌产生的超广谱β-内酰胺酶(ESBL)和 AmpC β-内酰胺酶的耐药性。

方法

根据临床实验室标准化协会 M100-S-16 文件,从眼部标本中分离出 135 株革兰氏阴性杆菌,通过双碟协同试验、头孢菌素和克拉维酸联合碟试验和 E 试验进行 ESBL 产生的表型确认,以及改良的双碟近似法和 AmpC 碟试验进行 AmpC β-内酰胺酶的表型确认。

结果

在双碟协同试验中,21 株(15.5%)分离株对头孢泊肟碟片呈阳性反应,19 株(14%)对头孢泊肟和头孢噻肟呈阳性反应,15 株(11%)对头孢泊肟、头孢噻肟和头孢曲松呈阳性反应,10 株(7%)分离株对头孢泊肟、头孢噻肟、头孢曲松和头孢他啶碟片呈阳性反应。在头孢菌素/克拉维酸联合碟片试验中,19 株(14%)分离株对头孢噻肟加克拉维酸呈阳性反应,10 株(7%)分离株对头孢他啶加克拉维酸呈阳性反应。在 E 试验中,10 株(7%)分离株对头孢他啶呈阳性反应,19 株(14%)分离株对头孢噻肟呈阳性反应。在 AmpC 碟片试验中,15 株(11%)分离株出现凹陷,10 株(7%)分离株出现平坦。

结论

眼部分离株中 ESBL 和 AmpC β-内酰胺酶介导的耐药率分别为 7%和 18.5%,在大肠杆菌和肺炎克雷伯菌中更为普遍。

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