Hernández Erick, Araque María, Millán Ysheth, Millán Beatriz, Vielma Silvana
Invest Clin. 2014 Mar;55(1):32-43.
In this study we determined the prevalence of extended-spectrum beta-lactamases (ESBLs) in phylogenetic groups of uropathogenic E. coli (UPEC) isolated from patients in the community. Twenty one UPEC strains with reduced susceptibility to broad-spectrum cephalosporins were collected between January 2009 and July 2010, from patients with urinary tract infection who attended the Public Health Laboratory in Mérida, Venezuela. Genotypic characterization determined that all UPEC strains harbored blaBLEEs genes: 76.2% of the strains showed the presence of a single ESBL-producer gene, represented by blaCTX-M-15, whereas 23.8% of UPEC showed various combinations of bla genes (blacCTX-M-15 + blaTEM-1, blaCTX-M-15 + blaSHV and blaSHV + blaTEM-1). In this study, 61.9% of the isolates were placed in phylogroup A and the remaining strains were assigned to group B2 (38.1%). There was no evidence of spread of a particular UPEC clone; only seven strains belonged to a clonal group with an index of similarity greater than 85%. To our knowledge, this is the first description of blxCTX-M-15 in UPEC from patients with community-acquired urinary tract infections, which shows that Venezuela is also part of the so-called CTX-M-15 pandemic. The findings in this study, as well as its clinical and epidemiological implications, lead to the need for monitoring and controlling the spread of CTX-M-15 producing UPECs, not only regionally, but also nationwide.
在本研究中,我们测定了从社区患者中分离出的尿路致病性大肠杆菌(UPEC)系统发育群中广谱β-内酰胺酶(ESBLs)的流行情况。2009年1月至2010年7月期间,从委内瑞拉梅里达公共卫生实验室就诊的尿路感染患者中收集了21株对广谱头孢菌素敏感性降低的UPEC菌株。基因分型鉴定确定所有UPEC菌株都携带blaBLEEs基因:76.2%的菌株显示存在单个ESBL产生基因,以blaCTX-M-15为代表,而23.8%的UPEC显示bla基因的各种组合(blaCTX-M-15 + blaTEM-1、blaCTX-M-15 + blaSHV和blaSHV + blaTEM-1)。在本研究中,61.9%的分离株属于A系统发育群,其余菌株被归为B2群(38.1%)。没有证据表明存在特定的UPEC克隆传播;只有7株属于相似性指数大于85%的克隆群。据我们所知,这是首次对社区获得性尿路感染患者的UPEC中blxCTX-M-15进行描述,这表明委内瑞拉也是所谓CTX-M-15大流行的一部分。本研究的结果及其临床和流行病学意义表明,不仅需要在区域内,而且需要在全国范围内监测和控制产CTX-M-15的UPEC的传播。