Žemličková H, Jakubů V, Marejková M, Urbášková P
Epidemiol Mikrobiol Imunol. 2014 Sep;63(3):184-90.
To determine the frequency of Campylobacter spp. isolated from humans in the Czech Republic and to test their susceptibility to antimicrobials commonly used to treat campylobacteriosis by the standard EUCAST method.
Consecutive Campylobacter isolates recovered from clinical specimens in 49 microbiological laboratories within one month in 2013 were identified using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Susceptibility to erythromycin, ciprofloxacin, and tetracycline was tested by the microdilution method and the results were interpreted based on the EUCAST clinical breakpoints to differentiate between susceptible and resistant strains.
Of the study set of 769 Campylobacter spp. strains, 90.1 % were assigned to C. jejuni, 9.8 % to C. coli, and a single strain to C. fetus (0.1 %). Except one blood isolate of C. jejuni, all other isolates were recovered from the stool. Ciprofloxacin resistance (MIC > 0.5 mg/l) was detected in 61.9 % strains of C. jejuni and in 72.0 % strains of C. coli, tetracycline resistance (MIC > 2 mg/l) was detected in 32.0 % of strains of both species, and erythromycin resistance was found in 0.3 % of strains of C. jejuni (MIC > 8 mg/l) and in 2.7 % of strains of C. coli (MIC > 4 mg/l). A C. coli strain was multidrug resistant (i.e. resistant to all three antimicrobials tested).
Despite the fact that most Campylobacter infections in humans cure on their own, the resistance of the causative strains to the antimicrobials of choice and alternative agents needs to be studied because of its relevance to the treatment of severe cases that require antibiotics. Resistance to macrolides was found rather infrequently in this study in both C. jejuni (0.1 %) and C. coli (2.7 %) strains. Nevertheless, alarming is ciprofloxacin resistance confirmed in 61.9 % of C. jejuni strains and 72.0 % C. coli strains. As the species C. coli is more often resistant to antimicrobials than C. jejuni and ciprofloxacin along with other fluoroquinolones is commonly used to treat severe food-borne and generalized infections, it is crucial to identify the Campylobacter strains to the species level and to test their susceptibility to relevant antibiotics by a valid and reproducible method to be able to provide an effective therapy.
确定捷克共和国从人类分离出的弯曲杆菌属的频率，并通过标准的欧洲抗菌药物敏感性试验委员会（EUCAST）方法检测它们对常用于治疗弯曲杆菌病的抗菌药物的敏感性。
2013年，在一个月内从49个微生物实验室的临床标本中连续分离出的弯曲杆菌菌株，使用基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF MS）进行鉴定。通过微量稀释法检测对红霉素、环丙沙星和四环素的敏感性，并根据EUCAST临床断点解释结果，以区分敏感菌株和耐药菌株。
在769株弯曲杆菌属菌株的研究组中，90.1%被鉴定为空肠弯曲菌，9.8%为大肠弯曲菌，1株为胎儿弯曲菌（0.1%）。除1株空肠弯曲菌血液分离株外，所有其他分离株均从粪便中分离得到。在61.9%的空肠弯曲菌菌株和72.0%的大肠弯曲菌菌株中检测到环丙沙星耐药（MIC>0.5mg/l），在这两个菌种的32.0%菌株中检测到四环素耐药（MIC>2mg/l），在0.3%的空肠弯曲菌菌株（MIC>8mg/l）和2.7%的大肠弯曲菌菌株（MIC>4mg/l）中发现红霉素耐药。1株大肠弯曲菌菌株对多种药物耐药（即对所有三种测试抗菌药物均耐药）。
尽管大多数人类弯曲杆菌感染可自行痊愈，但由于其与需要使用抗生素治疗的严重病例的治疗相关，因此需要研究致病菌株对首选抗菌药物和替代药物的耐药性。在本研究中，空肠弯曲菌（0.1%）和大肠弯曲菌（2.7%）菌株中对大环内酯类药物的耐药情况较少见。然而，令人担忧的是，在61.9%的空肠弯曲菌菌株和72.0%的大肠弯曲菌菌株中证实存在环丙沙星耐药。由于大肠弯曲菌比空肠弯曲菌更常对抗菌药物耐药，并且环丙沙星以及其他氟喹诺酮类药物常用于治疗严重的食源性感染和全身性感染，因此至关重要的是将弯曲杆菌菌株鉴定到种水平，并通过有效且可重复的方法检测它们对相关抗生素的敏感性，以便能够提供有效的治疗。
