Kamei Jun, Yagihara Yuka, Kume Haruki, Horiuchi Takamasa, Sato Tomoaki, Nakagawa Tohru, Fujimura Tetsuya, Fukuhara Hiroshi, Moriya Kyoji, Homma Yukio
Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan.
Int J Urol. 2017 Apr;24(4):295-300. doi: 10.1111/iju.13308. Epub 2017 Feb 21.
To examine resistant Escherichia coli in rectal swab culture of Japanese men undergoing prostate biopsy, and to determine its prevalence, genotypic characteristics and carriage risk factors.
Rectal swabs of consecutive men undergoing transrectal ultrasound-guided prostate biopsy from April 2013 to March 2015 were cultured to isolate fluoroquinolone-resistant and extended-spectrum β-lactamase-producing E. coli. The prevalence and antimicrobial susceptibility of these resistant E. coli strains and extended-spectrum β-lactamase genotyping were examined. The risk factors of antimicrobial resistance carriage were also examined.
The cohort was 376 men with a mean age of 67.8 years. Fluoroquinolone-resistant E. coli and extended-spectrum β-lactamase-producing E. coli were detected in 37 men (9.8%) and 22 men (5.9%), respectively, with fluoroquinolone-resistant and/or extended-spectrum β-lactamase-producing E. coli in 48 men (13.0%). All 49 antimicrobial-resistant strains were susceptible to tazobactam/piperacillin, amikacin, fosfomycin, meropenem and faropenem. CTX-M-9 and CTX-M-1 group were detected in 14 (63.6%) and eight (36.4%) men, respectively. CTX-M-9 showed relatively higher susceptibility to LVFX and minocycline compared with CTX-M-1. Diabetes mellitus was a significant factor for carriage of resistance by multivariate analysis (odds ratio 2.12, P = 0.039).
The present study showed the fecal carriage of fluoroquinolone-resistant E. coli and extended-spectrum β-lactamase-producing E. coli at 9.8% and 5.9%, respectively, with CTX-M-9 group of extended-spectrum β-lactamase-producing E. coli comprising 63.6%, in Japanese men receiving prostate biopsy. The carriage of fluoroquinolone-resistant and/or extended-spectrum β-lactamase-producing E. coli was significantly related to diabetes.
检测接受前列腺活检的日本男性直肠拭子培养中的耐药大肠杆菌，确定其患病率、基因型特征及携带风险因素。
对2013年4月至2015年3月期间连续接受经直肠超声引导下前列腺活检的男性的直肠拭子进行培养，以分离耐氟喹诺酮和产超广谱β-内酰胺酶的大肠杆菌。检测这些耐药大肠杆菌菌株的患病率和抗菌药物敏感性以及超广谱β-内酰胺酶基因分型。还检测了抗菌药物耐药性携带的风险因素。
该队列包括376名男性，平均年龄67.8岁。分别在37名男性（9.8%）和22名男性（5.9%）中检测到耐氟喹诺酮大肠杆菌和产超广谱β-内酰胺酶大肠杆菌，48名男性（13.0%）中检测到耐氟喹诺酮和/或产超广谱β-内酰胺酶大肠杆菌。所有49株耐药菌株对他唑巴坦/哌拉西林、阿米卡星、磷霉素、美罗培南和法罗培南敏感。分别在14名（63.6%）和8名（36.4%）男性中检测到CTX-M-9和CTX-M-1组。与CTX-M-1相比，CTX-M-9对左氧氟沙星和米诺环素的敏感性相对较高。多因素分析显示，糖尿病是耐药性携带的一个重要因素（比值比2.12，P = 0.039）。
本研究显示，在接受前列腺活检的日本男性中，耐氟喹诺酮大肠杆菌和产超广谱β-内酰胺酶大肠杆菌的粪便携带率分别为9.8%和5.9%，其中产超广谱β-内酰胺酶大肠杆菌的CTX-M-9组占63.6%。耐氟喹诺酮和/或产超广谱β-内酰胺酶大肠杆菌的携带与糖尿病显著相关。
