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从两家希腊医院的人类和厨房环境中分离出的产超广谱β-内酰胺酶(ESBL)和碳青霉烯酶的大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌之间的流行率、特征及流行病学关系

Prevalence, Characterization, and Epidemiological Relationships between ESBL and Carbapenemase-Producing , and spp. Isolated from Humans and the Kitchen Environment of Two Greek Hospitals.

作者信息

Tsitsos Anestis, Damianos Alexandros, Boutel Maria, Gousia Panagiota, Soultos Nikolaos, Papa Anna, Tirodimos Ilias, Economou Vangelis

机构信息

Laboratory of Animal Food Products Hygiene and Veterinary Public Health, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.

Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece.

出版信息

Antibiotics (Basel). 2024 Oct 2;13(10):934. doi: 10.3390/antibiotics13100934.

Abstract

BACKGROUND

Extended-spectrum-β-lactamase (ESBL) and carbapenemase-producing Enterobacterales and spp. pose significant challenges as nosocomial pathogens, demonstrating resistance against various antimicrobials. Their presence in food suggests that hospital kitchens could serve as antibiotic resistance reservoirs leading to patients' infection.

OBJECTIVES

The aim of this study was to assess the prevalence and characteristics of β-lactam-resistant strains of , , and spp. isolated from the kitchen environment and from the staff of two Greek hospitals.

METHODS

Strains were recovered after selective isolation with β-lactams and were identified with MALDI-TOF MS. Antimicrobial susceptibility and presence of common β-lactamase genes were evaluated. Protein profiles were examined to analyze potential relationships of the strain with those from hospital patients. strains were further categorized into phylogenetic groups.

RESULTS

The overall prevalence in the kitchen environment was 4.5%, 1.5%, and 15.0% for , and spp., respectively, whereas the prevalence of spp. in human skin was 4.0%. Almost all strains were multidrug-resistant. All strains were ESBL producers and belonged to phylogroups A and B1. All and seven strains were carbapenemase-producers. A protein profile analysis showed relatedness between chicken and kitchen environment strains, as well as between kitchen environment and patient strains originated either from the same or from different hospitals.

CONCLUSIONS

The results suggest that hospital kitchens may act as important pathogen hotspots contributing to the circulation of resistant strains in the hospital environment.

摘要

背景

产超广谱β-内酰胺酶(ESBL)和碳青霉烯酶的肠杆菌科细菌及其他菌种作为医院病原体构成了重大挑战,对多种抗菌药物表现出耐药性。它们在食物中的存在表明医院厨房可能成为导致患者感染的抗生素耐药菌库。

目的

本研究旨在评估从两家希腊医院的厨房环境和工作人员中分离出的β-内酰胺耐药的肠杆菌科细菌、克雷伯菌属和沙雷菌属菌株的流行情况及特征。

方法

用β-内酰胺类药物进行选择性分离后回收菌株,并用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)进行鉴定。评估抗菌药物敏感性和常见β-内酰胺酶基因的存在情况。检查蛋白质谱以分析菌株与医院患者菌株之间的潜在关系。将肠杆菌科细菌菌株进一步分类到系统发育组。

结果

厨房环境中肠杆菌科细菌、克雷伯菌属和沙雷菌属的总体流行率分别为4.5%、1.5%和15.0%,而人皮肤中沙雷菌属的流行率为4.0%。几乎所有菌株都是多重耐药的。所有肠杆菌科细菌菌株都是ESBL产生菌,属于A和B1系统发育组。所有克雷伯菌属和7株沙雷菌属菌株都是碳青霉烯酶产生菌。蛋白质谱分析显示鸡肉和厨房环境菌株之间以及厨房环境与来自同一或不同医院的患者菌株之间存在相关性。

结论

结果表明医院厨房可能是重要的病原体热点,有助于耐药菌株在医院环境中的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a056/11504295/7f316e492ad2/antibiotics-13-00934-g001.jpg

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