Bagus Wasito Eddy, Shigemura Katsumi, Osawa Kayo, Fardah Alpha, Kanaida Akiho, Raharjo Dadik, Kuntaman K, Hadi Usman, Harijono Sugeng, Marto Sudarmo Subijanto, Nakamura Tatsuya, Shibayama Keigo, Fujisawa Masato, Shirakawa Toshiro
Department of Microbiology, Faculty of Medicine, Airlangga University/Dr. Soetomo Hospital.
Institute of Tropical Disease, Airlangga University.
Jpn J Infect Dis. 2017 Jul 24;70(4):378-382. doi: 10.7883/yoken.JJID.2016.234. Epub 2016 Dec 22.
The purpose of this study was to investigate extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates from pediatric (aged 0 to 3 years) diarrhea patients in Surabaya, Indonesia, where this kind of survey is rare; our study included assessment of their antibiotic susceptibilities, as well as ESBL typing, multilocus sequence typing (MLST), and diarrheagenic E. coli (DEC)-typing. ESBL-producing E. coli were detected in 18.8% of all the samples. Many ESBL-producing E. coli had significantly lower susceptibility to gentamicin (p ＜ 0.0001) and the quinolones nalidixic acid (p＝0.004) and ciprofloxacin (p ＜ 0.0001) than non-producers. In ESBL-producing E. coli, 84.0% of strains expressed CTX-M-15 alone or in combination with other ESBL types. MLST revealed that 24.0% of ESBL-producers had sequence type 617, all of which expressed the CTX-M-15 gene; we also detected expression of 3 DEC-related genes: 2 enteroaggregative E. coli genes and 1 enteropathogenic E. coli gene. In conclusion, CTX-M-15-type ESBL-producing E. coli ST617 appear to have spread to Indonesia.
本研究的目的是调查印度尼西亚泗水地区0至3岁小儿腹泻患者中产生超广谱β-内酰胺酶（ESBL）的大肠杆菌分离株，该地区此类调查较为罕见；我们的研究包括评估它们的抗生素敏感性，以及ESBL分型、多位点序列分型（MLST）和致泻性大肠杆菌（DEC）分型。在所有样本中，18.8%检测到产ESBL的大肠杆菌。许多产ESBL的大肠杆菌对庆大霉素（p＜0.0001）、喹诺酮类药物萘啶酸（p＝0.004）和环丙沙星（p＜0.0001）的敏感性显著低于非产ESBL的大肠杆菌。在产ESBL的大肠杆菌中，84.0%的菌株单独表达CTX-M-15或与其他ESBL类型联合表达。MLST显示，24.0%的产ESBL菌株序列型为617，所有这些菌株均表达CTX-M-15基因；我们还检测到3个DEC相关基因的表达：2个肠聚集性大肠杆菌基因和1个肠致病性大肠杆菌基因。总之，产CTX-M-15型ESBL的大肠杆菌ST617似乎已传播到印度尼西亚。
