Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brasil.
Rev Soc Bras Med Trop. 2011 Jul-Aug;44(4):441-6. doi: 10.1590/s0037-86822011000400008.
Extended spectrum β-lactamases (ESBLs) are enzymes that degrade β-lactam antibiotics and have been reported to be an important cause of nosocomial infection in worldwide.
During 2009, 659 enterobacteria strains were isolated from different clinical specimens and tested for ESBL production. The disk approximation test, combined disk method and addition of clavulanic acid were used for phenotypic detection of the ESBL-producing strains and PCR for detection of the bla(TEM) and bla(CTX-M) genes.
Among the isolates, 125 were ESBL producers. The bla(CTX-M) and bla(TEM) genes were detected in 90.4% and 75% of the strains, respectively. Most strains were isolated from urine. Klebsiella pneumoniae was the most prevalent organism. Microorganisms presented high resistance to the antibiotics.
These results support the need for extending ESBL detection methods to different pathogens of the Enterobacteriaceae family because these methods are only currently standardized by the CLSI for Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. Carbapenems were the antibiotic class of choice for the treatment of infections caused by ESBL-producing Enterobacteriaceae.
扩展谱β-内酰胺酶（ESBLs）是能够降解β-内酰胺类抗生素的酶，已被报道为全球医院感染的重要原因。
在 2009 年，从不同的临床标本中分离了 659 株肠杆菌，并对其产 ESBL 情况进行了检测。采用纸片扩散逼近试验、联合纸片法和添加克拉维酸的方法对产 ESBL 菌株进行表型检测，采用 PCR 法对 bla(TEM)和 bla(CTX-M)基因进行检测。
在所分离的菌株中，有 125 株为 ESBL 产生菌。bla(CTX-M)和 bla(TEM)基因分别在 90.4%和 75%的菌株中被检测到。大多数菌株是从尿液中分离出来的。肺炎克雷伯菌是最常见的病原体。这些微生物对抗生素表现出高度的耐药性。
这些结果支持需要将 ESBL 检测方法扩展到肠杆菌科的不同病原体，因为这些方法目前仅由 CLSI 标准化用于大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌和奇异变形杆菌。碳青霉烯类抗生素是治疗产 ESBL 肠杆菌科感染的首选抗生素。
