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在捷克共和国社区获得性感染的产CTX-M型大肠杆菌中,ST131的高流行率。

High prevalence of ST131 among CTX-M-producing Escherichia coli from community-acquired infections, in the Czech Republic.

作者信息

Papagiannitsis Costas C, Študentová Vendula, Jakubů Vladislav, Španělová Petra, Urbášková Pavla, Žemličková Helena, Hrabák Jaroslav

机构信息

1 Department of Microbiology, Faculty of Medicine and University Hospital in Plzen, Charles University in Prague , Plzen, Czech Republic .

出版信息

Microb Drug Resist. 2015 Feb;21(1):74-84. doi: 10.1089/mdr.2014.0070. Epub 2014 Sep 4.

Abstract

A total of 2,683 nonrepetitive Escherichia coli isolates were collected from microbiological laboratories covering all regions of the Czech Republic, during April 2011. Antimicrobial susceptibility patterns of E. coli were assessed. All 38 cefotaxime-resistant (CTX-R) isolates were found to be extended-spectrum β-lactamase (ESBL)-positive by the double-disc synergy test. Thirty-two of those isolates produced enzymes of CTX-M-1 family, five of CTX-M-9 family, and one isolate both CTX-M types. Genotyping by multilocus sequence typing classified all ESBL-producing isolates into 13 sequence types (STs). ST131 was the most prevalent and was exclusively correlated with E. coli belonging to the more-virulent phylogroup B2. blaCTX-M-15 and blaCTX-M-9-like genes were mainly carried by plasmids belonging to the IncF group, while replicon I1 was predominant among CTX-M-1-encoding plasmids. Additionally, 63% of the ESBL-producing isolates were also resistant to ciprofloxacin. Sequence analysis of quinolone resistance-determining regions of gyrA and parC revealed the presence of amino acid substitutions in 22 out of 23 ciprofloxacin-resistant isolates. The acc(6')-Ib-cr and qnrB1 plasmid-mediated quinolone resistance genes were also detected in some of the isolates. This is the first report on the emergence and spread of CTX-M-producing E. coli in the community of the Czech Republic, indicating the high prevalence of ST131 clone among CTX-M producers.

摘要

2011年4月期间,从覆盖捷克共和国所有地区的微生物实验室收集了总共2683株非重复性大肠杆菌分离株。评估了大肠杆菌的抗菌药敏模式。通过双纸片协同试验发现,所有38株对头孢噻肟耐药(CTX-R)的分离株均为超广谱β-内酰胺酶(ESBL)阳性。其中32株分离株产生CTX-M-1家族的酶,5株产生CTX-M-9家族的酶,1株同时产生两种CTX-M类型的酶。通过多位点序列分型进行基因分型,将所有产ESBL的分离株分为13种序列类型(STs)。ST131最为常见,且仅与属于毒力更强的B2系统发育群的大肠杆菌相关。blaCTX-M-15和blaCTX-M-9样基因主要由IncF组质粒携带,而复制子I1在编码CTX-M-1的质粒中占主导地位。此外,63%的产ESBL分离株也对环丙沙星耐药。对gyrA和parC喹诺酮耐药决定区的序列分析显示,在23株环丙沙星耐药分离株中有22株存在氨基酸替换。在一些分离株中还检测到acc(6')-Ib-cr和qnrB1质粒介导的喹诺酮耐药基因。这是关于捷克共和国社区中产CTX-M大肠杆菌出现和传播的首次报告,表明ST131克隆在CTX-M生产者中高度流行。

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