1Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Microbiology and Infection Control, Amsterdam Immunity and Infection Institute, Amsterdam, The Netherlands.
2Department of Microbiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
Antimicrob Resist Infect Control. 2019 Feb 26;8:45. doi: 10.1186/s13756-019-0494-6. eCollection 2019.
The objective of this study was to determine the prevalence of plasmid-mediated AmpC (pAmpC) among Enterobacteriaceae isolated from humans and from retail meat in Egypt.
Enterobacteriaceae were isolated from patients with suspected bloodstream infection, human fecal samples, retail chicken meat samples and retail sheep meat samples. All group I Enterobacteriaceae were analyzed for presence of pAmpC genes by PCR. Antibiotic susceptibility testing was performed in all pAmpC positive isolates, followed by phenotypic and genotypic ESBL and carbapenemase testing on indication.
The prevalence of pAmpC among group I Enterobacteriaceae isolated from 225 patients with bloodstream infection was 5.6% [95%CI 2.2-13.4]. Among 100 patients with community-onset gastroenteritis the prevalence in fecal samples was 4.8% [95%CI 2.1-10.7]. The prevalence among 112 chicken carcasses and 100 sheep meat samples was 2.4% [95%CI 0.7-8.4] and 1.1% [95%CI 0.2-5.7], respectively. In half of the AmpC positive isolates we detected an ESBL gene and 2 isolates harbored a carbapenemase gene. In five isolates there was resistance to at least three important alternative antibiotic drugs.
We consider the prevalence of pAmpC in Egypt, as found in our study, moderately low. To follow future trends in prevalence of pAmpC worldwide, a standardized screening algorithm for the detection of pAmpC is needed.
本研究旨在确定埃及分离自人类和零售肉中的肠杆菌科中质粒介导的 AmpC（pAmpC）的流行率。
从疑似血流感染的患者、人类粪便样本、零售鸡肉样本和零售羊肉样本中分离肠杆菌科。通过 PCR 分析所有 I 组肠杆菌科中是否存在 pAmpC 基因。对所有 pAmpC 阳性分离株进行抗生素敏感性测试，然后根据需要进行表型和基因型 ESBL 和碳青霉烯酶测试。
225 例血流感染患者中 I 组肠杆菌科分离株中 pAmpC 的流行率为 5.6%[95%CI 2.2-13.4]。100 例社区获得性胃肠炎患者粪便样本中的流行率为 4.8%[95%CI 2.1-10.7]。112 个鸡胴体和 100 个羊肉样本中的流行率分别为 2.4%[95%CI 0.7-8.4]和 1.1%[95%CI 0.2-5.7]。在一半的 AmpC 阳性分离株中检测到 ESBL 基因，2 株携带碳青霉烯酶基因。在 5 株分离株中至少有 3 种重要的替代抗生素药物耐药。
我们认为在埃及发现的 pAmpC 的流行率，如我们的研究所示，处于中等水平。为了跟踪全球 pAmpC 流行率的未来趋势，需要一种标准化的筛选算法来检测 pAmpC。
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