Medical Biology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
Medical Entomology Platform, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
Int J Infect Dis. 2018 Jan;66:74-79. doi: 10.1016/j.ijid.2017.10.025. Epub 2017 Nov 11.
Although antibiotics are too often used inappropriately in Cambodia, published data on antimicrobial resistance in this country are scarce. Epidemic dissemination and the transfer of resistance genes to other bacterial species put the population at risk. The aim of this study was to evaluate the frequency and characteristics of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) isolated in consecutive samples tested at Institut Pasteur du Cambodge over a 4-year period (2012-2015). Antimicrobial susceptibility testing was performed by disk diffusion on agar technique and the results were read automatically using an OSIRIS system. The Etest was used to determine minimum inhibitory concentrations (MIC) for some resistance phenotypes. The strain most commonly identified was Escherichia coli (63.9%). The proportion of ESBL-E increased gradually over the study period, from 23.8% to 38.4%. ESBL was detected in 42.7% of the E. coli strains and 33.7% of all Klebsiella pneumoniae isolated. The proportion of ESBL-producing E. coli increased significantly from 28.9% in 2012 to 48.2% in 2015, while the increase for K. pneumoniae remained non-significant. Multidrug resistance was high in this Cambodian series, with some strains displaying resistance to all antibiotics available in the country. There is currently no established system for the surveillance of antimicrobial resistance in Cambodia. Collecting samples from clinical settings throughout the country is critical to assess the impact of antimicrobial drug use in patients in Cambodia and in the Mekong Region.
尽管在柬埔寨，抗生素经常被不适当地使用，但有关该国抗菌药物耐药性的已发表数据却很少。耐药基因的流行传播和转移到其他细菌物种会使人群面临风险。本研究的目的是评估在柬埔寨巴斯德研究所连续 4 年（2012-2015 年）检测的连续样本中分离的产超广谱β-内酰胺酶（ESBL）肠杆菌科（ESBL-E）的频率和特征。通过琼脂技术的纸片扩散法进行抗菌药物敏感性测试，结果使用 OSIRIS 系统自动读取。Etest 用于确定某些耐药表型的最小抑菌浓度（MIC）。最常见的菌株是大肠杆菌（63.9%）。在研究期间，ESBL-E 的比例逐渐增加，从 23.8%增加到 38.4%。在 42.7%的大肠杆菌菌株和所有分离的肺炎克雷伯菌中检测到 ESBL。产 ESBL 的大肠杆菌的比例从 2012 年的 28.9%显著增加到 2015 年的 48.2%，而肺炎克雷伯菌的比例增加仍不显著。该柬埔寨系列中存在高度的多药耐药性，一些菌株对该国所有可用的抗生素均有耐药性。目前柬埔寨尚未建立抗菌药物耐药性监测系统。从全国各地的临床环境中收集样本对于评估柬埔寨和湄公河地区患者中抗菌药物使用的影响至关重要。
