Zhang Hongna, Zhou Yufa, Guo Shuyuan, Chang Weishan
College of Animal Science and Technology, Shandong Agricultural University Taian, China.
College of Animal Science and Technology, Shanxi Agricultural University Taigu, China ; Animal Husbandry Bureau of Daiyue Taian, China.
Front Microbiol. 2015 Mar 27;6:239. doi: 10.3389/fmicb.2015.00239. eCollection 2015.
The study was carried out to understand the prevalence of CTX-M type extended-spectrum beta-lactamase (ESBL)-harboring Enterobacteriaceae and to analyze risk factors related with fecal carriage in healthy rural residents in Taian, China. A total of 620 stool samples were collected from rural residents. The ESBL-positive Enterobacteriaceae was screened using ChromID ESBL agar, and then further confirmed by double-disk diffusion. The CTX-M genes were determined using polymerase chain reaction. The risk factors associated with fecal carriage of CTX-M-positive isolates were analyzed using the standard statistic methods. 458 isolates carrying CTX-M gene (458/620, 73.9%) were obtained from different individuals, and the most dominant genotype was CTX-M-9 group (303/458, 66.2%). The dominant species were Escherichia coli (E. coli; 403/458, 88.0%) and Klebsiella pneumoniae (K. pneumoniae; 26/458, 5.7%) among the isolates carrying CTX-M genes. All the CTX-M producers were resistant to ampicillin, cefazolin, cefuroxime, and ceftriaxone, but were all susceptible to biapenem, imipenem, and meropenem. The results of multivariate logistic regression model identified the enrollment in formal education (OR 2.321; 95% CI 1.302-3.768; P= 0.039), the hospitalization history within the last 6 months (OR 1.753; 95% CI 1.127-2.584; P= 0.031) and the antibiotics use within the last 6 months (OR 1.892; 95% CI 1.242-2.903; P= 0.034). The three variables were significantly associated with carriage of CTX-M ESBL producers (x (2) = 21.21; df = 3; P< 0.001). The prevalence of fecal carriage of CTX-M ESBL-producing Enterobacteriaceae among healthy rural humans in Taian was high, and the recent antibiotic use and hospitalization history may be the important contributors.
开展本研究是为了了解携带CTX-M型超广谱β-内酰胺酶（ESBL）的肠杆菌科细菌的流行情况，并分析中国泰安农村健康居民粪便携带相关的危险因素。共从农村居民中收集了620份粪便样本。使用ChromID ESBL琼脂筛选ESBL阳性肠杆菌科细菌，然后通过双纸片扩散法进一步确认。使用聚合酶链反应确定CTX-M基因。采用标准统计方法分析与CTX-M阳性分离株粪便携带相关的危险因素。从不同个体中获得了458株携带CTX-M基因的分离株（458/620，73.9%），最主要的基因型是CTX-M-9组（303/458，66.2%）。在携带CTX-M基因的分离株中，优势菌种是大肠埃希菌（大肠杆菌；403/458，88.0%）和肺炎克雷伯菌（肺炎克雷伯菌；26/458，5.7%）。所有CTX-M产生菌对氨苄西林、头孢唑林、头孢呋辛和头孢曲松耐药，但对比阿培南、亚胺培南和美罗培南均敏感。多因素logistic回归模型结果确定了接受正规教育（比值比2.321；95%置信区间1.302 - 3.768；P = 0.039）、过去6个月内的住院史（比值比1.753；95%置信区间1.127 - 2.584；P = 0.031）和过去6个月内使用抗生素（比值比1.892；95%置信区间1.242 - 2.903；P = 0.034）。这三个变量与CTX-M ESBL产生菌的携带显著相关（χ(2)=21.21；自由度=3；P<0.001）。泰安农村健康人群中携带CTX-M ESBL的肠杆菌科细菌粪便携带率较高，近期使用抗生素和住院史可能是重要因素。
