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CTX-M 型产超广谱β-内酰胺酶 B2-O25-ST131 R 在日本非急性护理机构居民中的流行情况。

Prevalence of CTX-M-Type Extended-Spectrum β-Lactamase-Producing B2-O25-ST131 R Among Residents in Nonacute Care Facilities in Japan.

机构信息

1Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan.

2Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan.

出版信息

Microb Drug Resist. 2018 Dec;24(10):1513-1520. doi: 10.1089/mdr.2018.0068. Epub 2018 May 23.

Abstract

We investigated the prevalence and characteristics of extended-spectrum β-lactamase (ESBL)-producing among 258 residents of long-term care facilities (LTCFs) in Japan. Out of 258 fecal samples collected from nine LTCFs between November 2015 and March 2017, we recovered 59 ESBL-producing isolates. All isolates carried genes, mainly (42.4%), (23.7%), and (18.6%). The isolates showed 7 serotypes (STs), including ST131 ( = 49, 83.1%) and ST38 ( = 4, 6.8%), and 47 (79.7%) out of 49 isolates belonging to ST131 were identified as R. The 59 ESBL producers were divided into four groups, B2 (86.4%), D (8.5%), A (3.4%), and C (1.7%); 44 (74.6%) were epidemic clone B2-O25-ST131 R, of which 21, 11, and 6 harbored , , and , respectively. Most plasmids were of IncF replicon types ( = 33), and 22 -carrying plasmids showed multiple replicon types, including IncFII, FIA, and FIB. The ESBL producers were susceptible to imipenem, amikacin, and fosfomycin, but resistant to ceftazidime (49.2%), and ciprofloxacin (88.1%); in particular, the isolates harboring the gene showed significantly high resistance rate to ceftazidime ( < 0.01). Our findings indicate that a considerable proportion of the examined LTCF residents carried ESBL-producing isolates in feces and had high prevalence of epidemic clone B2-O25-ST131. Furthermore, continuous investigations would be very necessary to monitor actual carriage states of ESBL-producers among the LTCF residents from the viewpoint of both public health and healthcare viewpoints.

摘要

我们调查了日本 258 名长期护理机构(LTCF)居民中携带产超广谱β-内酰胺酶(ESBL)的 的流行率和特征。在 2015 年 11 月至 2017 年 3 月期间,从 9 家 LTCF 采集的 258 份粪便样本中,我们共分离出 59 株产 ESBL 的 。所有分离株均携带 blaCTX-M 基因,主要为 blaCTX-M-15(42.4%)、blaCTX-M-65(23.7%)和 blaCTX-M-14(18.6%)。分离株显示 7 种血清型(STs),包括 ST131( = 49,83.1%)和 ST38( = 4,6.8%),49 株 ST131 中有 47 株(79.7%)被鉴定为 R 型。59 株 ESBL 产生菌分为 4 组,B2(86.4%)、D(8.5%)、A(3.4%)和 C(1.7%);44 株(74.6%)为流行克隆 B2-O25-ST131 R,其中 21、11 和 6 株分别携带 blaCTX-M-15、blaCTX-M-65 和 blaCTX-M-14。大多数质粒属于 IncF 复制子类型( = 33),22 株携带质粒显示多种复制子类型,包括 IncFII、FIA 和 FIB。ESBL 产生菌对亚胺培南、阿米卡星和磷霉素敏感,但对头孢他啶(49.2%)和环丙沙星(88.1%)耐药;特别是携带 blaCTX-M-15 基因的分离株对头孢他啶的耐药率显著较高( < 0.01)。我们的研究结果表明,在所检查的 LTCF 居民粪便中,相当一部分携带产 ESBL 的 ,且流行克隆 B2-O25-ST131 的检出率较高。此外,从公共卫生和医疗保健的角度来看,有必要对 LTCF 居民的 ESBL 产生菌实际携带状态进行持续监测。

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