Reuland E Ascelijn, Halaby Teysir, Hays John P, de Jongh Denise M C, Snetselaar Henrieke D R, van Keulen Marte, Elders Petra J M, Savelkoul Paul H M, Vandenbroucke-Grauls Christina M J E, Al Naiemi Nashwan
Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands.
Laboratory for Medical Microbiology and Public Health, Hengelo, The Netherlands.
PLoS One. 2015 Jan 14;10(1):e0113033. doi: 10.1371/journal.pone.0113033. eCollection 2015.
The objective of this study was to determine the prevalence of pAmpC beta-lactamases in community-acquired Gram negative bacteria in the Netherlands, and to identify possible risk factors for carriage of these strains.
Fecal samples were obtained from community-dwelling volunteers. Participants also returned a questionnaire for analysis of risk factors. Screening for pAmpC was performed with selective enrichment broth and a selective screening agar. Confirmation of AmpC-production was performed with two double disc combination tests: cefotaxime and ceftazidime with either boronic acid or cloxacillin as inhibitor. Multiplex PCR was used as gold standard for detection of pAmpC. 16S rRNA PCR and AFLP were performed as required, plasmids were identified by PCR-based replicon typing. Questionnaire results were analyzed with SPSS, version 20.0.
Fecal samples were obtained from 550 volunteers; mean age 51 years (range: 18-91), 61% were females. pAmpC was present in seven E. coli isolates (7/550, 1.3%, 0.6-2.7 95% CI): six CMY-2-like pAmpC and one DHA. ESBL-encoding genes were found in 52/550 (9.5%, 7.3-12.2 95% CI) isolates; these were predominantly blaCTX-M genes. Two isolates had both ESBL and pAmpC. Admission to a hospital in the previous year was the only risk factor we identified.
Our data indicate that the prevalence of pAmpC in the community seems still low. However, since pAmpC-producing isolates were not identified as ESBL producers by routine algorithms, there is consistent risk that further increase of their prevalence might go undetected.
本研究的目的是确定荷兰社区获得性革兰氏阴性菌中pAmpCβ-内酰胺酶的流行情况，并确定这些菌株携带的可能风险因素。
从社区居住的志愿者中获取粪便样本。参与者还返回一份问卷以分析风险因素。使用选择性富集肉汤和选择性筛选琼脂进行pAmpC筛选。使用两种双盘联合试验确认AmpC的产生：以硼酸或氯唑西林作为抑制剂的头孢噻肟和头孢他啶。多重PCR用作检测pAmpC的金标准。根据需要进行16S rRNA PCR和AFLP，通过基于PCR的复制子分型鉴定质粒。问卷结果用SPSS 20.0版进行分析。
从550名志愿者中获取粪便样本；平均年龄51岁（范围：18 - 91岁），61%为女性。7株大肠杆菌分离株中存在pAmpC（7/550，1.3%，0.6 - 2.7 95% CI）：6株CMY - 2样pAmpC和1株DHA。在52/550（9.5%，7.3 - 12.2 95% CI）株分离株中发现了ESBL编码基因；这些主要是blaCTX - M基因。2株分离株同时具有ESBL和pAmpC。前一年住院是我们确定的唯一风险因素。
我们的数据表明社区中pAmpC的流行率似乎仍然较低。然而，由于产生pAmpC的分离株未通过常规算法被鉴定为ESBL产生菌，存在其流行率进一步增加可能未被发现的持续风险。
