Département de Biologie Médicale, Hôpital d'Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon.
Laboratoire de Bactériologie de Recherche, Unité de Recherche et d'Analyses Médicales (URAM), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
Microb Drug Resist. 2021 Nov;27(11):1525-1534. doi: 10.1089/mdr.2020.0497. Epub 2021 May 5.
In Gabon, few data exist on extended-spectrum beta-lactamases-producing Enterobacteriaceae (ESBL-PE). This study investigated ESBL-PE prevalence and the associated resistance genes in clinical samples ( = 5,956) and anal swabs ( = 78) analyzed in eight hospitals and a medical analysis laboratory in Gabon from January 2016 to March 2018. Matrix-Assisted Laser Desorption Ionization-Time Of Flight (MALDI-TOF) mass spectrometry analysis identified 790 Enterobacteriaceae isolates ( = 712 clinical samples and = 78 fecal samples). ESBL-PE prevalence (Müller-Hinton agar disk diffusion method and double-disk synergy test) was 11.8% (84/712) in clinical samples (15.5% from inpatients and 7.1% from outpatients; < 0.05) and 16.7% (13/78) in carriage isolates. Most ESBL-PE were isolated from urine samples (46/84). In clinical and carriage ESBL-PE isolates, was predominant (42.8% and 61.5%; phylogroups A, B1, B2, and D), followed by (41.7% and 23.1%). Multiplex PCR and bi-directional sequencing showed that CTX-M group 1 (blaCTX-M-15) was predominant in clinical and carriage ESBL-PE (94% and 92.3%) among which 85.7% and 92.3% also harbored one to three β-lactamase-encoding genes (blaTEM-1, blaOXA-1, or blaSHV-1). Resistance genes were detected in all hospitals in Gabon. ESBL-PE prevalence in Gabon has not reached alarming levels yet, but corrective and monitoring measures are needed to curb their emergence.
在加蓬，关于产超广谱β-内酰胺酶肠杆菌科（ESBL-PE）的资料很少。本研究调查了 2016 年 1 月至 2018 年 3 月期间，在加蓬的 8 家医院和一个医学分析实验室中，对 5956 份临床样本（712 份临床样本和 78 份粪便样本）和肛拭子（78 份）中 ESBL-PE 的流行率和相关耐药基因。基质辅助激光解吸电离飞行时间（MALDI-TOF）质谱分析鉴定出 790 株肠杆菌科分离株（712 份临床样本和 78 份粪便样本）。临床样本中 ESBL-PE 的流行率（Müller-Hinton 琼脂扩散法和双碟协同试验）为 11.8%（84/712）（住院患者为 15.5%，门诊患者为 7.1%；<0.05），携带分离株为 16.7%（13/78）。大多数 ESBL-PE 分离自尿液样本（46/84）。在临床和携带 ESBL-PE 分离株中，最为常见的是 （42.8%和 61.5%；分为 A、B1、B2 和 D 群），其次是 （41.7%和 23.1%）。多重 PCR 和双向测序显示，CTX-M 组 1（blaCTX-M-15）在临床和携带 ESBL-PE 中最为常见（94%和 92.3%），其中 85.7%和 92.3%还携带 1-3 种β-内酰胺酶编码基因（blaTEM-1、blaOXA-1 或 blaSHV-1）。所有加蓬医院都检测到了耐药基因。加蓬的 ESBL-PE 流行率尚未达到令人担忧的水平，但需要采取纠正和监测措施来遏制其出现。
