Sangare Samba Adama, Maiga Almoustapha Issiaka, Guindo Ibrehima, Maiga Aminata, Camara Namory, Dicko Oumar Agaly, Diallo Souleymane, Bougoudogo Flabou, Armand-Lefevre Laurence, Andremont Antoine, Maiga Ibrahim Izetiegouma
Gabriel Touré University Teaching Hospital, Bamako, Mali.
J Infect Dev Ctries. 2016 Oct 31;10(10):1059-1064. doi: 10.3855/jidc.7536.
The increasing frequency of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is becoming a serious public health concern. This study sought to determine ESBL frequency in Enterobacteriaceae isolated from patients' blood cultures in two university teaching hospitals of Bamako, Mali.
During a three-month period, the presence of Enterobacteriaceae from blood cultures of patients admitted to the university teaching hospitals of Bamako was evaluated. The microbial identifications were initially performed with an API 20E gallery and VITEK2 locally in Mali, and then confirmation in France was performed with a mass spectrometry MALDI-TOF in the bacteriology laboratory of the university teaching hospital of Bichat. Antibiotic susceptibility profiles were determined by the diffusion method as recommended by the European Committee on Antimicrobial Susceptibility Testing (EUCAST).
The isolated species were K. pneumoniae (14/40; 35.0%), E. coli (11/40; 27.5%), and E. cloacae (9/40; 22.5%). Of the strains isolated, 21/34 (61.8%) had an ESBL phenotype, including 10/14 (71.4%) K. pneumoniae, 8/11 (72.7%) E. coli, and 3/9 (33.3%) E. cloacae. Resistances associated with ESBL strains of K. pneumoniae, E. coli, and E. cloacae were as follows: gentamicin (10/10, 100%; 6/8, 75%; 2/3, 67%, respectively), amikacin (2/10, 20%; 0/8, 0%; 0/3, 0%, respectively), ofloxacin (8/10, 80%; 7/8, 87%; 3/3, 100%, respectively), and cotrimoxazole (10/10, 100%; 6/8, 75%; 3/3, 100%, respectively).
Almost two-thirds (61.8%) of Enterobacteriaceae isolated from our blood cultures were ESBL producers. Only susceptibilities to carbapenems and to amikacin were fully conserved within the strains.
产超广谱β-内酰胺酶（ESBL）肠杆菌科细菌的出现频率不断增加，正成为一个严重的公共卫生问题。本研究旨在确定马里巴马科两家大学教学医院从患者血培养物中分离出的肠杆菌科细菌中ESBL的频率。
在三个月的时间里，对巴马科大学教学医院收治患者血培养物中的肠杆菌科细菌进行了评估。微生物鉴定最初在马里当地使用API 20E鉴定条和VITEK2进行，然后在法国比夏大学教学医院的细菌学实验室用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）进行确认。按照欧洲抗菌药物敏感性试验委员会（EUCAST）的建议，采用扩散法测定抗生素敏感性谱。
分离出的菌种为肺炎克雷伯菌（14/40；35.0%）、大肠埃希菌（11/40；27.5%）和阴沟肠杆菌（9/40；22.5%）。在分离出的菌株中，21/34（61.8%）具有ESBL表型，其中肺炎克雷伯菌10/14（71.4%）、大肠埃希菌8/11（72.7%）、阴沟肠杆菌3/9（33.3%）。肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌的ESBL菌株相关耐药情况如下：庆大霉素（分别为10/10，100%；6/8，75%；2/3，67%）、阿米卡星（分别为2/10，20%；0/8，0%；0/3，0%）、氧氟沙星（分别为8/10，80%；7/8，87%；3/3，100%）和复方新诺明（分别为10/10，100%；6/8，75%；3/3，100%）。
从我们的血培养物中分离出的肠杆菌科细菌中，近三分之二（61.8%）是ESBL产生菌。菌株中仅对碳青霉烯类和阿米卡星的敏感性完全保留。
