Garrido Ana, Seral Cristina, Gude María José, Casado Cristina, González-Domínguez María, Sáenz Yolanda, Castillo Francisco Javier
1 Department of Microbiology, Hospital Clínico Universitario "Lozano Blesa," Zaragoza, Spain .
Microb Drug Resist. 2014 Aug;20(4):301-4. doi: 10.1089/mdr.2013.0109. Epub 2013 Dec 13.
Active surveillance of plasmid-mediated β-lactamase-producing Enterobacteriaceae (PMBL-E) in fecal carriers in the hospital and in the community setting in a non-outbreak period of time.
Patients were screened for carriage of Enterobacteriaceae resistant to expanded-spectrum cephalosporins and PMBL-E were characterized (extended-spectrum-β-lactamase [ESBL], plasmid-mediated AmpC β-lactamase [pAmpC], and carbapenemases) by PCR and sequencing.
The prevalence of ESBL and pAmpC carriers was 5.06% and 0.59%, respectively. Overall, CTX-M-like enzymes were the ESBL dominate enzymes (96.15%). The group CTX-M-9 was the most prevalent (81, 54%) [CTX-M-14 (74, 91.35%), CTX-M-9 (5, 6.17%), CTX-M-24 (1, 1.23%), and CTX-M-27 (1, 1.23%)] followed by the group CTX-M-1 (64, 42.67%) [CTX-M-15 (42, 65.63%), CTX-M-1 (13, 20.31%), CTX-M-32 (8, 12.5%), and CTX-M-3 (1, 1.56%)]. One CTX-M-10, one CTX-M-59, and three CTX-M-8 were also found. A very small representation of SHV or TEM ESBL enzymes was found (3.2% and 0.64%, respectively). pAmpC characterization revealed a predominance of CMY-2 (81.25%), followed by DHA-1 (18.75%). We did not detect the presence of carbapenemase producers.
The prevalence of ESBL-producers from fecal carriers is stable in our area, but colonization by pAmpC producers has emerged recently as we have confirmed. Periodic active surveillance is useful to identify these human reservoirs and control the evolution of PMBL carriage in a community over time.
在医院和社区环境中，在非暴发时期对粪便携带者中质粒介导的产β-内酰胺酶肠杆菌科细菌（PMBL-E）进行主动监测。
对患者进行筛选，以检测对广谱头孢菌素耐药的肠杆菌科细菌的携带情况，并通过PCR和测序对PMBL-E进行特征分析（超广谱β-内酰胺酶[ESBL]、质粒介导的AmpCβ-内酰胺酶[pAmpC]和碳青霉烯酶）。
ESBL和pAmpC携带者的患病率分别为5.06%和0.59%。总体而言，CTX-M样酶是ESBL的主要类型（96.15%）。CTX-M-9组最为常见（81株，54%）[CTX-M-14（74株，91.35%）、CTX-M-9（5株，6.17%）、CTX-M-24（1株，1.23%）和CTX-M-27（1株，1.23%）]，其次是CTX-M-1组（64株，42.67%）[CTX-M-15（42株，65.63%）、CTX-M-1（13株，20.31%）、CTX-M-32（8株，12.5%）和CTX-M-3（1株，1.56%）]。还发现了1株CTX-M-10、1株CTX-M-59和3株CTX-M-8。SHV或TEM ESBL酶的比例非常小（分别为3.2%和0.64%）。pAmpC特征分析显示CMY-2占主导地位（81.25%），其次是DHA-1（18.75%）。我们未检测到碳青霉烯酶产生菌的存在。
在我们地区，粪便携带者中产ESBL菌的患病率稳定，但正如我们所证实的，pAmpC产生菌的定植最近有所出现。定期主动监测有助于识别这些人类储存宿主，并随着时间的推移控制社区中PMBL携带情况的演变。
