Caubey Mohit, Suchitra M Shenoy
Bokaro General Hospital, Bokaro Steel City, Jharkhand 827004, India.
Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
Infect Disord Drug Targets. 2018;18(1):68-71. doi: 10.2174/1871526517666170425125217.
Extended spectrum beta lactamases (ESBL) are responsible for increased resistance to third generation cephalosporins. Proteus species is an important cause of both community acquired and nosocomial infections. The Proteus species is usually susceptible to beta lactam drugs but there is progressive increase in beta lactam resistance and recently, ESBLs are also fast spreading to this species.
This study was conducted to study ESBL production and occurrence of TEM, SHV and CTX-M beta lactamases in clinical isolates of Proteus species in a tertiary care center.
This prospective hospital based study was carried out in Microbiology, Kasturba Medical College, Mangalore over 9 months. All non-duplicate consecutive Proteus isolates were identified and antibiotic susceptibility testing was done. ESBL detection was done by double disk synergy method and TEM, SHV, CTX-M genes were detected by PCR.
84 Proteus isolates from urine (29), blood (1), respiratory secretions (2), tissue (20) and exudates (47) were included in the study. 20.2% (17) were ESBL positive by disk synergy method. CTX-M was present in 6, TEM in 2 and both in 9 isolates. SHV was not present in any isolate.
Our findings showed that 20% of clinical isolates of Proteus species were ESBL producers. 52% of ESBL positive isolates carried both TEM and CTX-M genes followed by CTX-M alone (35%) and only 11% had TEM alone. This stresses on the fact that ESBL detection should be done routinely in Proteus isolates and the genotype surveyed periodically for better management.
超广谱β-内酰胺酶（ESBL）导致对第三代头孢菌素的耐药性增加。变形杆菌属是社区获得性感染和医院感染的重要原因。变形杆菌属通常对β-内酰胺类药物敏感，但β-内酰胺耐药性呈逐渐上升趋势，最近，ESBL也迅速在该菌属中传播。
本研究旨在研究三级医疗中心临床分离的变形杆菌属菌株中ESBL的产生情况以及TEM、SHV和CTX-Mβ-内酰胺酶的出现情况。
这项基于医院的前瞻性研究在芒格洛尔卡斯图尔巴医学院微生物学系进行，为期9个月。对所有非重复的连续变形杆菌分离株进行鉴定并进行药敏试验。采用双纸片协同法检测ESBL，通过PCR检测TEM、SHV、CTX-M基因。
本研究纳入了84株来自尿液（29株）、血液（1株）、呼吸道分泌物（2株）、组织（20株）和渗出液（47株）的变形杆菌分离株。通过纸片协同法检测，20.2%（17株）为ESBL阳性。6株分离株中存在CTX-M，2株中存在TEM，9株中同时存在CTX-M和TEM。所有分离株中均未检测到SHV。
我们的研究结果表明，20%的变形杆菌属临床分离株为ESBL产生菌。52%的ESBL阳性分离株同时携带TEM和CTX-M基因，其次是单独携带CTX-M基因的分离株（35%），仅11%的分离株单独携带TEM基因。这强调了应常规对变形杆菌分离株进行ESBL检测，并定期调查基因型以进行更好的管理。
