Villar Hugo Edgardo, Baserni Marisa Noemí, Jugo Monica Beatriz
Department of Clinical Bacteriology, Laboratorio Hidalgo, Buenos Aires, Argentina .
J Infect Dev Ctries. 2013 Aug 15;7(8):630-4. doi: 10.3855/jidc.2900.
The aim of this study was to determine the prevalence of intestinal carriage of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and carbapenem-resistant Gram-negative bacilli in the community in Buenos Aires, Argentina.
Faecal samples from 164 non-hospitalized patients were cultured on CHROMagar KPC and CHROMagar ESBL plates. Isolates resistant to third-generation cephalosporins or carbapenems were selected for further study. The minimal inhibitory concentration (MIC) of the isolates was determined using the E-test method. The phenotypic detection of ESBLs and carbapenemases was performed using the double-disc synergy test.
The rate of faecal carriage of Enterobacteriaceae resistant to third-generation cephalosporins was 26.8%. Escherichia coli represented a large majority (75%) of the isolates recovered. Thirty-three ESBL-producing isolates were detected from 31 faecal samples (18.9% of the collected specimens). Eight carbapenem-resistant Gram-negative bacilli were recovered from eight specimens (4.9%).
This study revealed a high prevalence of faecal carriage of multidrug-resistant Gram-negative bacteria, including ESBLs, in Buenos Aires. Therefore, the use of surveillance cultures will be helpful for tracking and monitoring the spread of ESBL-producing Enterobacteriaceae within community settings.
本研究旨在确定阿根廷布宜诺斯艾利斯社区中产超广谱β-内酰胺酶(ESBL)肠杆菌科细菌和耐碳青霉烯革兰氏阴性杆菌的肠道携带率。
对164名非住院患者的粪便样本在CHROMagar KPC平板和CHROMagar ESBL平板上进行培养。选择对第三代头孢菌素或碳青霉烯类耐药的分离株进行进一步研究。使用E-test法测定分离株的最低抑菌浓度(MIC)。采用双纸片协同试验进行ESBLs和碳青霉烯酶的表型检测。
对第三代头孢菌素耐药的肠杆菌科细菌粪便携带率为26.8%。回收的分离株中,大肠杆菌占绝大多数(75%)。从31份粪便样本中检测到33株产ESBLs分离株(占所收集标本的18.9%)。从8份标本中分离出8株耐碳青霉烯革兰氏阴性杆菌(4.9%)。
本研究显示,在布宜诺斯艾利斯,包括ESBLs在内的多重耐药革兰氏阴性菌粪便携带率很高。因此,采用监测培养有助于追踪和监测产ESBL肠杆菌科细菌在社区环境中的传播。