Villar Hugo Edgardo, Aubert Victoria, Baserni Marisa Noemí, Jugo Monica Beatriz
J Chemother. 2013 Dec;25(6):324-7. doi: 10.1179/1973947813Y.0000000081. Epub 2013 Dec 6.
The aim of this study was to determine the prevalence of vaginal Escherichia coli colonization and perianal carriage of Enterobacteriaceae resistant to third generation cephalosporins in pregnant women. Vaginal and perianal samples from 259 pregnant women were studied. Vaginal swabs were inoculated onto MacConkey agar plates and perianal swabs were inoculated onto CHROMagar extended-spectrum beta-lactamase (ESBL) plates. The minimal inhibitory concentration of the isolates was determined using the Epsilometer test method. The phenotypic detection of ESBLs was performed by the combined disc method using cefotaxime versus cefotaxime plus clavulanate. The prevalence of vaginal E. coli colonization during pregnancy was 14.3%. The resistance rate to ampicillin, gentamicin, and cefotaxime was 48.6, 10.8, and 0.8%, respectively. Enterobacteriaceae resistant to third generation cephalosporins were recovered in 7.3% of all perianal specimens. Among them, 5.4% of pregnant women were colonized with E. coli ESBL-producer strains. The present study revealed that colonization with Enterobacteriaceae resistant to third generation cephalosporins is significant in pregnancy. ESBL-producing E. coli were the most prevalent organisms. Screening strategies designed to monitor for ESBL-producing E. coli could be useful in endemic areas to prevent perinatal transmission and the introduction of multiresistant strains to the maternity ward.
本研究的目的是确定孕妇阴道大肠杆菌定植情况以及产超广谱β-内酰胺酶（ESBL）肠杆菌科细菌在肛周的携带情况。对259名孕妇的阴道和肛周样本进行了研究。阴道拭子接种于麦康凯琼脂平板，肛周拭子接种于CHROMagar超广谱β-内酰胺酶平板。采用E试验法测定分离株的最低抑菌浓度。ESBLs的表型检测采用头孢噻肟与头孢噻肟加克拉维酸的联合纸片法。孕期阴道大肠杆菌定植率为14.3%。对氨苄西林、庆大霉素和头孢噻肟的耐药率分别为48.6%、10.8%和0.8%。在所有肛周标本中，产超广谱β-内酰胺酶肠杆菌科细菌的检出率为7.3%。其中，5.4%的孕妇感染了产ESBL大肠杆菌菌株。本研究表明，产超广谱β-内酰胺酶肠杆菌科细菌在孕期的定植情况较为显著。产ESBL大肠杆菌是最常见的病原体。旨在监测产ESBL大肠杆菌的筛查策略在流行地区可能有助于预防围产期传播以及多重耐药菌株引入产科病房。
