Yamanaka Takayuki, Funakoshi Hanako, Kinoshita Kazue, Iwashita Chinami, Horikoshi Yuho
Department of Pediatrics Niigata City General Hospital, Niigata, Japan; Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan.
Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan.
J Infect Chemother. 2020 Sep;26(9):1005-1007. doi: 10.1016/j.jiac.2020.05.017. Epub 2020 Jun 23.
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have spread globally as one of the most common multidrug resistant organisms. Although a wide variety of ESBL genes were known in each geographical region, few reports existed on the distribution of ESBL genes in Japanese children. To clarify the distribution of ESBL genes, we investigated the CTX-M type of the ESBL-producing Enterobacteriaceae and patient characteristics among hospital-acquired and community-acquired cases. Total of 253 isolates of ESBL-producing Enterobacteriaceae were recovered from 238 pediatric patients. ESBL-producing Enterobacteriaceae were mostly recovered from children with underlying diseases (76.5%). Ratio of community-acquired and hospital-acquired cases was 58.8% and 41.2%, respectively. Compared to the hospital-acquired cases, community-acquired cases had younger age, fewer underlying diseases, and the dominant detection of Escherichia coli. The most common ESBL-producing Enterobacteriaceae was E. coli (79.8%), followed by Klebsiella pneumoniae (9.1%). CTX-M9 group was the most prevalent CTX-M group gene (63.2%), which was dominantly detected in E. coli (72.7%). This was the largest descriptive study to find CTX-M9 group as the most prevalent ESBL genotype among Enterobacteriaceae isolated from Japanese children in line with adult's epidemiology.
产超广谱β-内酰胺酶（ESBL）的肠杆菌科细菌已作为最常见的多重耐药菌之一在全球范围内传播。尽管每个地理区域都已知多种ESBL基因，但关于日本儿童中ESBL基因分布的报道却很少。为了阐明ESBL基因的分布情况，我们调查了产ESBL肠杆菌科细菌的CTX-M类型以及医院获得性和社区获得性病例中的患者特征。从238名儿科患者中总共分离出253株产ESBL的肠杆菌科细菌。产ESBL的肠杆菌科细菌大多从患有基础疾病的儿童中分离得到（76.5%）。社区获得性病例与医院获得性病例的比例分别为58.8%和41.2%。与医院获得性病例相比，社区获得性病例年龄更小，基础疾病更少，且主要检测到大肠埃希菌。最常见的产ESBL肠杆菌科细菌是大肠埃希菌（79.8%），其次是肺炎克雷伯菌（9.1%）。CTX-M9组是最常见的CTX-M组基因（63.2%），主要在大肠埃希菌中检测到（72.7%）。这是最大规模的描述性研究，发现CTX-M9组是从日本儿童中分离出的肠杆菌科细菌中最常见的ESBL基因型，与成人流行病学情况一致。
