Araque María, Labrador Indira
Laboratory of Molecular Microbiology, Department of Microbiology and Parasitology, University of The Andes, Mérida, Venezuela.
Osong Public Health Res Perspect. 2018 Jan;9(1):9-15. doi: 10.24171/j.phrp.2018.9.1.03.
Antimicrobial resistant extended-spectrum-β-lactamase-producing (ESBL-PE) have been shown to be present in healthy communities. This study examined healthy children from the rural Andean village of Llano del Hato, Mérida, Venezuela, who have had little or no antibiotic exposure to determine the prevalence of fecal carriage of ESBL-producing (ESBL-EC).
A total of 78 fecal samples were collected in healthy children aged from 1 to 5 years. ESBL-EC were selected in MacConkey agar plates with cefotaxime and further confirmed by the VITEK 2 system. ESBL were phenotypically detected and presence of genes and their variants were confirmed by molecular assays. Determination of phylogenetic groups was performed by PCR amplification. Risk factors associated with fecal carriage of ESBL-EC-positive isolates were analyzed using standard statistical methods.
Of the 78 children studied, 27 (34.6%) carried ESBL-EC. All strains harbored the allele. Of these, 8 were co-producers of , , or . Co-resistance to aminoglycosides and/or fluoroquinolones was observed in 9 strains. 51.9% of ESBL-EC isolates were classified within phylogroup A. A significant, positive correlation was found between age (≥2.5 - ≤5 years), food consumption patterns and ESBL-EC fecal carriage.
This is the first study describing the high prevalence of fecal carriage of ESBL-EC expressing CTX-M-15- among very young, healthy children from a rural Andean village in Venezuela with scarce antibiotic exposure, underlining the importance of this population as a reservoir.
已证明产超广谱β-内酰胺酶(ESBL-PE)的耐药菌存在于健康社区。本研究对委内瑞拉梅里达州拉诺德尔阿托农村安第斯村庄的健康儿童进行了调查,这些儿童很少或几乎没有接触过抗生素,以确定产ESBL大肠埃希菌(ESBL-EC)的粪便携带率。
共收集了78名1至5岁健康儿童的粪便样本。在含头孢噻肟的麦康凯琼脂平板上筛选ESBL-EC,并通过VITEK 2系统进一步确认。通过表型检测ESBL,并通过分子检测确认基因及其变体的存在。通过PCR扩增进行系统发育组的测定。使用标准统计方法分析与ESBL-EC阳性分离株粪便携带相关的危险因素。
在研究的78名儿童中,27名(34.6%)携带ESBL-EC。所有菌株均携带该等位基因。其中,8株为、、或的共同产生菌。在9株菌株中观察到对氨基糖苷类和/或氟喹诺酮类的共同耐药。51.9%的ESBL-EC分离株属于A系统发育组。发现年龄(≥2.5 - ≤5岁)、食物消费模式与ESBL-EC粪便携带之间存在显著的正相关。
这是第一项描述委内瑞拉农村安第斯村庄极少接触抗生素的非常年幼健康儿童中产CTX-M-15的ESBL-EC粪便携带率很高的研究,强调了这一人群作为储存宿主的重要性。