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[委内瑞拉一家医院中广谱β-内酰胺酶的肠杆菌生产者]

[Enterobacteria producers of extended-spectrum beta-lactamase in a hospital from Venezuela].

作者信息

Tedesco Maiullari Rosa María, Guevara Armando

机构信息

Postgrado en Ciencias Médicas Fundamentales, Facultad de Medicina, Universidad de Los Andes, Mérida, Venezuela.

出版信息

Infez Med. 2012 Jun;20(2):93-9.

Abstract

The emergence of antimicrobial resistance due to extended-spectrum beta-lactamase (ESBL) has significant clinical impact and is a public health problem. The aim of the present study was to determine the frequency of infections by ESBL-producing enterobacteria in patients hospitalized in the "Ruiz y Paez" Hospital (CHRP) from Cuidad Bolivar, Venezuela, from January to July 2011. We determined the ESBL production from all isolates of E. coli, K. pneumoniae, K. oxytoca and P. mirabilis, using a double disk synergy test and combined disk method. Of the Enterobacteriaceae isolated, 20.3% (53) were ESBL producers, the main ones being K. pneumoniae and E. coli with 56.6% and 43.3% respectively: 15.7% of all E. coli and 47.6% of all K. pneumoniae were ESBL producers, and were more frequent in the purulent samples (43.3%) and blood (30.1%). The service with the greatest number of isolated ESBL-producing enterobacteria was medicine (26.4%) followed by perinatology (24.5%). We concluded that the CHRP has a high rate of ESBL-producing enterobacteria, mainly K. pneumoniae.

摘要

由超广谱β-内酰胺酶(ESBL)导致的抗菌药物耐药性的出现具有重大临床影响,是一个公共卫生问题。本研究的目的是确定2011年1月至7月在委内瑞拉玻利瓦尔城“鲁伊斯·伊·派斯”医院(CHRP)住院患者中产ESBL肠杆菌的感染频率。我们使用双纸片协同试验和复合纸片法,从所有大肠杆菌、肺炎克雷伯菌、产酸克雷伯菌和奇异变形杆菌分离株中检测ESBL的产生情况。在分离出的肠杆菌科细菌中,20.3%(53株)是ESBL产生菌,主要是肺炎克雷伯菌和大肠杆菌,分别占56.6%和43.3%:所有大肠杆菌中有15.7%、所有肺炎克雷伯菌中有47.6%是ESBL产生菌,且在脓性样本(43.3%)和血液样本(30.1%)中更为常见。分离出产ESBL肠杆菌数量最多的科室是内科(26.4%),其次是围产医学科(24.5%)。我们得出结论,CHRP中产ESBL肠杆菌的比例很高,主要是肺炎克雷伯菌。

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