Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Medical Microbiology and Immunology Department, Faculty of Medicine, New Giza University, Giza, Egypt.
Am J Trop Med Hyg. 2019 Mar;100(3):522-528. doi: 10.4269/ajtmh.18-0396.
Extended-spectrum β-lactamases (ESβLs) pose a serious problem in the treatment of urinary tract infections (UTIs). The ESβL-producing organism is an expanding global health problem. Therefore, screening for ESβL, detection of their drug-resistance pattern, and molecular characterization should be a continuous process. The present study was performed to determine the antibiotic resistance profile and the genetic characterization of ESβL isolates from hospital- and community-acquired UTIs. Two hundred fifty isolates were obtained from urine samples of outpatient clinic attendants and hospitalized patients at Kasr Al-Aini Hospital. By phenotypic screening tests, 100 ESβL isolates were detected among the studied groups. Furthermore, detection of beta-lactamase () cefotaxime (CTX)-M, sulfhydryl variable, and temoneira ESβL genes was investigated by polymerase chain reaction. A subset of 25 CTX-M-positive isolates was further identified by gene sequencing technology. Among the 100 ESβL isolates, 66% were and 34% were spp. There was no statistical difference in the prevalence of ESβL in community-acquired versus hospital-acquired UTIs. The susceptibility of all ESβL isolates to carbapenems was the most prevalent finding. In addition, all ESβL isolates were susceptible to fosfomycin, whereas all community-acquired ESβL isolates were susceptible to nitrofurantoin. A total of 98% of the ESβL isolates harbored -CTX-M genes, with CTX-M-15 being the most prevalent. It could be concluded that ESβL production is present at a high rate among Egyptian patients with hospital- and community-acquired UTI. The high prevalence of CTX-M may suggest it as a candidate for molecular screening of ESβL.
扩展谱β-内酰胺酶（ESβLs）在治疗尿路感染（UTIs）方面构成了严重的问题。产生 ESβL 的生物体是一个不断扩大的全球健康问题。因此，筛查 ESβL、检测其耐药模式和分子特征应该是一个持续的过程。本研究旨在确定来自医院和社区获得性 UTIs 的 ESβL 分离株的抗生素耐药谱和遗传特征。从 Kasr Al-Aini 医院的门诊病人和住院病人的尿液样本中获得了 250 株分离株。通过表型筛选试验，在研究组中检测到 100 株 ESβL 分离株。此外，通过聚合酶链反应检测了β-内酰胺酶（）头孢噻肟（CTX）-M、巯基变量和替莫那 ESβL 基因。通过基因测序技术进一步鉴定了 25 株 CTX-M 阳性分离株的一个亚组。在 100 株 ESβL 分离株中，66%为 ，34%为 。社区获得性与医院获得性 UTIs 中 ESβL 的流行率没有统计学差异。所有 ESβL 分离株对碳青霉烯类药物的敏感性是最常见的发现。此外，所有 ESβL 分离株均对磷霉素敏感，而所有社区获得性 ESβL 分离株均对呋喃妥因敏感。98%的 ESβL 分离株携带 -CTX-M 基因，CTX-M-15 最为常见。可以得出结论，埃及医院和社区获得性 UTI 患者中 ESβL 的产生率很高。CTX-M 的高流行率可能表明其适合作为 ESβL 分子筛查的候选物。
