Department of Bioinformatics, Osaka University Graduate School of Medicine, Osaka.
Infect Drug Resist. 2013 Jul 22;6:67-70. doi: 10.2147/IDR.S43868. Print 2013.
The detection rate of CTX-M-type β-lactamase-producing Enterobacteriaceae in Japan has significantly increased. Nursing homes may be a reservoir of antibiotic-resistant bacteria. Therefore, we determined the prevalence of, and risk factors associated with, fecal carriage of CTX-M-type β-lactamase-producing Enterobacteriaceae among nursing home residents. A total of 225 stool samples were collected for phenotypic and genotypic identification of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Multivariate analysis was performed to identify the risk factors associated with fecal carriage of CTX-M producers. The prevalence of CTX-M-type ESBL-producing Enterobacteriaceae, as confirmed by phenotypic and genotypic methods, was 19.6% (44 of 225 samples). Escherichia coli was the predominant CTX-M-type ESBL-producing bacterium among these isolates (41 of 44 isolates). Genotyping of bla CTX-M gene-positive isolates showed that 30 (68.2%), 13 (29.5%), and 1 (2.3%) of 44 samples belonged to groups CTX-M-9, CTX-M-1 and CTX-M-2, respectively. Among the CTX-M-type ESBL-producing Enterobacteriaceae found in nursing homes, 95.5% (42 of 44 isolates) were co-resistant to quinolone antibiotics. In multivariate logistic regression analysis, inability to turn over in bed, diabetes, and invasive procedures within the last 2 years were the only variables independently associated with fecal carriage of CTX-M-type ESBL producers. Nursing home residents in Japan exhibit a high prevalence of CTX-M-type ESBL-producing Enterobacteriaceae carriage, with a high level of co-resistance to quinolones.
日本产 CTX-M 型β-内酰胺酶肠杆菌科的检出率显著增加。养老院可能是抗生素耐药菌的储存库。因此，我们确定了养老院居民粪便中产 CTX-M 型β-内酰胺酶肠杆菌科的流行情况和相关危险因素。共采集 225 份粪便标本，进行表型和基因型鉴定产超广谱β-内酰胺酶（ESBL）肠杆菌科。采用多变量分析确定与 CTX-M 产生菌粪便携带相关的危险因素。通过表型和基因型方法证实，CTX-M 型 ESBL 产肠杆菌科的流行率为 19.6%（225 份样本中的 44 份）。在这些分离株中，大肠埃希菌是主要的 CTX-M 型 ESBL 产细菌（41/44 株）。bla CTX-M 基因阳性分离株的基因分型显示，44 份样本中有 30 份（68.2%）、13 份（29.5%）和 1 份（2.3%）分别属于 CTX-M-9 组、CTX-M-1 组和 CTX-M-2 组。在养老院发现的产 CTX-M 型 ESBL 肠杆菌科中，95.5%（42/44 株）对喹诺酮类抗生素同时耐药。在多变量逻辑回归分析中，无法翻身、糖尿病和过去 2 年内的侵入性操作是与 CTX-M 型 ESBL 产肠杆菌科粪便携带相关的唯一独立变量。日本养老院居民携带 CTX-M 型 ESBL 产肠杆菌科的流行率较高，对喹诺酮类药物的耐药性较高。
