Agyekum Alex, Fajardo-Lubián Alicia, Ansong Daniel, Partridge Sally R, Agbenyega Tsiri, Iredell Jonathan R
Centre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia; Malaria Research Centre, Agogo Presbyterian Hospital, Komfo Anokye Teaching Hospital, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Centre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia.
Diagn Microbiol Infect Dis. 2016 Apr;84(4):328-33. doi: 10.1016/j.diagmicrobio.2015.12.010. Epub 2015 Dec 17.
Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases (ESBLs) are among the most multidrug-resistant pathogens in hospitals and are spreading worldwide. Horizontal gene transfer and spread of high-risk clones are involved in ESBL dissemination. Investigation of the resistance phenotypes of 101 consecutive clinical E. coli (n=58) and K. pneumoniae (n=43) isolated at the Komfo Anokye Teaching Hospital in Ghana over 3 months revealed 63 (62%) with an ESBL phenotype. All 63 had a blaCTX-M gene, and sequence analysis showed that 62 of these were blaCTX-M-15. blaCTX-M-15 was linked to ISEcp1 and orf477Δ in all isolates, and most isolates also carried blaTEM, aac(3)-II, aacA4cr, and/or blaOXA-30 genes on IncF plasmids. XbaI/pulsed-field electrophoresis showed heterogeneity among isolates of both species, suggesting that blaCTX-M-15 dissemination is caused by horizontal gene transfer rather than clonal spread of these species in Ghana.
产超广谱β-内酰胺酶（ESBLs）的大肠埃希菌和肺炎克雷伯菌是医院中耐药性最强的病原体之一，且正在全球范围内传播。水平基因转移和高风险克隆的传播与ESBL的传播有关。对加纳Komfo Anokye教学医院在3个月内连续分离出的101株临床大肠埃希菌（n = 58）和肺炎克雷伯菌（n = 43）的耐药表型进行调查，发现63株（62%）具有ESBL表型。所有63株均有blaCTX-M基因，序列分析表明其中62株为blaCTX-M-15。在所有分离株中，blaCTX-M-15均与ISEcp1和orf477Δ相连，且大多数分离株在IncF质粒上还携带blaTEM、aac(3)-II、aacA4cr和/或blaOXA-30基因。XbaI/脉冲场凝胶电泳显示这两个菌种的分离株之间存在异质性，这表明在加纳，blaCTX-M-15的传播是由水平基因转移而非这些菌种的克隆传播引起的。
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