Medboua-Benbalagh Chafiaa, Touati Abdelaziz, Kermas Rachida, Gharout-Sait Alima, Brasme Lucien, Mezhoud Halima, Touati Djamila, Guillard Thomas, de Champs Christophe
1 Laboratoire d'Ecologie Microbienne , FSNV, Université de Bejaia, Bejaia, Algérie.
2 Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière , CHU Reims, Hôpital Robert DEBRE, Reims, France .
Microb Drug Resist. 2017 Sep;23(6):757-763. doi: 10.1089/mdr.2016.0153. Epub 2017 Jan 17.
The current study aimed to investigate extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) fecal carriage in children with different cancers admitted in the pediatric oncology unit of Beni-Messous Hospital (Algiers, Algeria).
Rectal swabs from children with cancer were sampled from February 2012 to May 2013 within 48 hours following their admission. After species identification and detection of ESBL production by double-disk synergy test (DD test), antibiotic susceptibility was determined by the standard disk diffusion method. Antibiotic resistance genes, including bla genes and plasmid-mediated quinolone resistance (PMQR) genes, were investigated by polymerase chain reaction (PCR). The phylogenetic grouping of Escherichia coli strains was determined by PCR.
Of the 171 children studied, 93 (54%) were ESBL carriers. An antibiotic treatment for the last 3 months before admission (p = 0.01), hematological malignancies (p = 0.003), and death (p = 0.0003) were more frequent in the ESBL-E group than in the non-ESBL group. Multivariate analysis showed that hematological malignancies (odds ratio [OR]: 3.9; confidence interval [CI]: 1.1-14.1; p = 0.04) and ESBL-E carriage (OR: 6.2; CI: 1.7-22.00; p = 0.005) were two independent factors associated with increased risk of death. A total of 103 ESBL-E isolates were obtained. Klebsiella pneumoniae and E. coli isolates were the most frequently isolated. PCR amplification showed that all the isolates produced a CTX-M ESBL (CTX-M-15, CTX-M-14, and CTX-M-3). The PMQR genes detected were qnrB, qnrS, and aac(6')-Ib-cr. E. coli isolates were assigned to four major extraintestinal pathogenic E. coli phylogroups, including B2 and D.
This study provides, for the first time, insight into epidemiology of the ESBL-E fecal carriage among children with cancer in Algeria.
本研究旨在调查在贝尼-梅苏斯医院（阿尔及尔，阿尔及利亚）儿科肿瘤科住院的不同癌症患儿中产超广谱β-内酰胺酶肠杆菌科细菌（ESBL-E）的粪便携带情况。
2012年2月至2013年5月期间，在癌症患儿入院后48小时内采集直肠拭子。通过双纸片协同试验（DD试验）进行菌种鉴定和ESBL产生检测后，采用标准纸片扩散法测定抗生素敏感性。通过聚合酶链反应（PCR）研究包括bla基因和质粒介导喹诺酮耐药（PMQR）基因在内的抗生素耐药基因。通过PCR确定大肠杆菌菌株的系统发育分组。
在171名研究儿童中，93名（54%）为ESBL携带者。ESBL-E组入院前最后3个月接受抗生素治疗的情况（p = 0.01）、血液系统恶性肿瘤（p = 0.003）和死亡情况（p = 0.0003）比非ESBL组更常见。多因素分析显示，血液系统恶性肿瘤（优势比[OR]：3.9；置信区间[CI]：1.1 - 14.1；p = 0.04）和ESBL-E携带（OR：6.2；CI：1.7 - 22.00；p = 0.005）是与死亡风险增加相关的两个独立因素。共获得103株ESBL-E分离株。肺炎克雷伯菌和大肠杆菌分离株是最常分离到的。PCR扩增显示所有分离株均产生CTX-M型ESBL（CTX-M-15、CTX-M-14和CTX-M-3）。检测到的PMQR基因有qnrB、qnrS和aac(6')-Ib-cr。大肠杆菌分离株被归入四个主要的肠道外致病性大肠杆菌系统发育组，包括B2和D组。
本研究首次深入了解了阿尔及利亚癌症患儿中ESBL-E粪便携带的流行病学情况。
