Department of Microbiology, prof. F. Łukaszczyk Centre of Oncology in Bydgoszcz, Bydgoszcz, Poland.
Department of Antibiotics and Microbiology, National Medicines Institute, Warsaw, Poland.
Microb Drug Resist. 2021 Nov;27(11):1470-1481. doi: 10.1089/mdr.2020.0530. Epub 2021 Jul 14.
Infectious complications caused by multidrug-resistant bacteria are a serious clinical and therapeutic problem. Our study aimed to analyze the genetic characteristics of extended-spectrum β-lactamase-producing (ESBL-E) that cause multidrug-resistant infections in patients with solid tumors. Identification of ESBL-encoding genes was performed by polymerase chain reaction (PCR) and sequencing. The clonal relationship of the isolates was evaluated by pulsed-field gel electrophoresis. Multilocus sequence typing (MLST) was carried out for selected and isolates. All strains were classified into phylogenetic groups using the PCR-based approach. There were 735 patients with clinical symptoms of infections tested, of which 44 (6.0%) were positive for ESBL-E on genotypic testing. The most frequent organism was ( = 24, 54.5%), followed by ( = 13, 29.5%), ( = 3, 6.8%), cplx ( = 2, 4.5%), and ( = 2, 4.5%). Overall, 31 (70.5%) of the ESBL-E isolates carried only -like genes, and the genes were found to be ( = 30, 68.2%) or ( = 1, 2.3%). Eleven strains (25%) had -like genes, mostly ( = 10, 22.7%) and unique ( = 1, 2.3%). One isolate possessed both and genes, and another one produced TEM-12 ESBL. MLST analysis revealed sequence type (ST) 131 and ST361, and ST16, ST307, and ST437. Among isolates, the B2 phylogenetic group was predominant. Most of the strains showed resistance to third-generation cephalosporins and fluoroquinolones, and susceptibility to aminoglycosides and carbapenems. Patients with solid cancer and ESBL-E infections require special management since they are a population with a high threat of antibiotic-resistant infections. Carbapenems and aminoglycosides remain active antibiotics against these infections.
耐多药细菌引起的感染性并发症是一个严重的临床和治疗问题。我们的研究旨在分析引起实体瘤患者多重耐药感染的产超广谱β-内酰胺酶（ESBL-E）的遗传特征。通过聚合酶链反应（PCR）和测序来鉴定 ESBL 编码基因。通过脉冲场凝胶电泳评估分离株的克隆关系。对选定的 和 分离株进行多位点序列分型（MLST）。所有 菌株均采用基于 PCR 的方法进行种系发生分组。在有临床感染症状的 735 名患者中，经基因检测有 44 名（6.0%）为 ESBL-E 阳性。最常见的病原体是 （ = 24，54.5%），其次是 （ = 13，29.5%）、 （ = 3，6.8%）、 cplx（ = 2，4.5%）和 （ = 2，4.5%）。总体而言，31 株（70.5%）ESBL-E 分离株仅携带 -like 基因，发现这些基因是 （ = 30，68.2%）或 （ = 1，2.3%）。11 株（25%）具有 -like 基因，主要是 （ = 10，22.7%）和独特的 （ = 1，2.3%）。一株分离株同时携带 和 基因，另一株产生 TEM-12 ESBL。MLST 分析显示 ST131 和 ST361 序列类型，以及 ST16、ST307 和 ST437。在 分离株中，B2 种系发生群占优势。大多数菌株对第三代头孢菌素和氟喹诺酮类药物表现出耐药性，对氨基糖苷类和碳青霉烯类药物敏感。患有实体瘤和 ESBL-E 感染的患者需要特殊管理，因为他们是抗生素耐药感染威胁较高的人群。碳青霉烯类和氨基糖苷类药物仍然是治疗这些感染的有效抗生素。
