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产超广谱β-内酰胺酶大肠埃希菌作为社区获得性尿路感染病因的分子特征及药敏模式

[Molecular characterization and antimicrobial susceptibility pattern of extended-spectrum β-lactamase-producing Escherichia coli as cause of community acquired urinary tract infection].

作者信息

Galindo-Méndez Mario

机构信息

Laboratorios Galindo SC, Universidad Anáhuac Oaxaca, México.

出版信息

Rev Chilena Infectol. 2018;35(1):29-35. doi: 10.4067/s0716-10182018000100029.

Abstract

Background Community acquired urinary tract infections (CaUTI) caused by strains of extended-spectrum β-lactamases (ESBL) - producing Escherichia coli, mainly by strains carrying the blaCTX-M-15 gene, is a growing phenomenon worldwide. Aim To determine the antibiotic susceptibility pattern of ESBL-producing E. coli as cause of CaUTI and to identify their molecular pattern. Methods A descriptive study was performed in the city of Oaxaca, Mexico, from where 288 strains of CaUTI-producing strains of E. coli in adults with possible UTI were isolated. The CLSI criteria was followed to determine the antimicrobial susceptibility patterns, and their molecular characterization was performed by using PCR. Results 31.3% of E. coli strains isolated in our population were ESBL producers, which presented higher levels of antibiotic resistance than those of non-producers of these enzymes. 95.6% of the studied strains were carriers of the blaCTX-M gene. Conclusions One-third of the Ca-UTI caused by E. coli in our population are caused by ESBL-producing strains, which present high levels of resistance to the antibiotics widely used in our community. This situation considerably decreases the number of antibiotics available for an empiric treatment against these infections.

摘要

背景 由产超广谱β-内酰胺酶(ESBL)的大肠埃希菌菌株引起的社区获得性尿路感染(CaUTI),主要是携带blaCTX-M-15基因的菌株,在全球范围内呈增长趋势。目的 确定作为CaUTI病因的产ESBL大肠埃希菌的抗生素敏感性模式,并鉴定其分子模式。方法 在墨西哥瓦哈卡市进行了一项描述性研究,从可能患有尿路感染的成年人中分离出288株产CaUTI的大肠埃希菌菌株。遵循CLSI标准确定抗菌药物敏感性模式,并通过PCR进行分子特征分析。结果 在我们的研究人群中分离出的大肠埃希菌菌株中有31.3%是ESBL生产者,其抗生素耐药水平高于非这些酶生产者。95.6%的研究菌株携带blaCTX-M基因。结论 在我们的研究人群中,由大肠埃希菌引起的Ca-UTI中有三分之一是由产ESBL菌株引起的,这些菌株对我们社区广泛使用的抗生素呈现高水平耐药。这种情况大大减少了可用于针对这些感染进行经验性治疗的抗生素数量。

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