1Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan.
2Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan.
Microb Drug Resist. 2018 Dec;24(10):1513-1520. doi: 10.1089/mdr.2018.0068. Epub 2018 May 23.
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.
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。