Blahová J, Králiková K, Krcméry V, Torsová V
Institute of Preventive and Clinical Medicine, Bratislava, Slovak Republic.
Zentralbl Bakteriol. 1997 Nov;286(4):449-55. doi: 10.1016/s0934-8840(97)80045-x.
Six Klebsiella pneumoniae strains were collected from two hospitals in Ostrava, Czech republic. Four strains (Nos. 209, 217, 218, 222) were isolated from sputa of critically ill patients from Municipal Hospital Vítkovice-Ostrava. They were resistant to cephalothin, cefotaxime, and ceftazidime (MIC > 100 mg x l-1). Strain No. 218 was intermediately resistant also to ofloxacin and aztreonam (MIC = 12.5 mg x l-1), strain No. 222 was resistant to aztreonam (MIC = 50 mg x l-1). Determinants of resistance to cephalothin, cefotaxime, aztreonam and ceftazidime were transferred to recipient strains of P. mirabilis P-38 rif+ and E. coli K-12 No. 3110 rif+ by all four strains. Synergy between clavulanate-cefotaxime, clavulanate-ceftazidime and clavulanate-aztreonam indicated production of ESBLs by these strains. Two strains, No. 214 and 224, from patients of the ICU in the University Hospital were resistant to cephalothin, cefotaxime and ceftazidime (MIC > 100 mg x l-1). Strain No. 214 was intermediately resistant to aztreonam and ofloxacin (MIC = 12.5 mg x l-1) and strain No. 224 was highly resistant to aztreonam (MIC = 50 mg x l-1). Synergy between clavulanate and cefotaxime as well as between clavulanate and aztreonam, but not between clavulanate and ceftazidime corresponds with non-transferable ceftazidime resistance in strains No. 214 and 224 and indicates different types of ESBL in strains from each of two hospitals.
从捷克共和国俄斯特拉发的两家医院收集了6株肺炎克雷伯菌。4株（编号209、217、218、222）从俄斯特拉发市维特科维采市立医院重症患者的痰液中分离得到。它们对头孢噻吩、头孢噻肟和头孢他啶耐药（MIC>100mg·L⁻¹）。218号菌株对氧氟沙星和氨曲南也呈中介耐药（MIC=12.5mg·L⁻¹），222号菌株对氨曲南耐药（MIC=50mg·L⁻¹）。这4株菌均将对头孢噻吩、头孢噻肟、氨曲南和头孢他啶的耐药决定簇转移至奇异变形杆菌P-38 rif⁺和大肠杆菌K-12 3110 rif⁺的受体菌株。克拉维酸-头孢噻肟、克拉维酸-头孢他啶和克拉维酸-氨曲南之间的协同作用表明这些菌株产生了超广谱β-内酰胺酶（ESBLs）。来自大学医院重症监护病房患者的2株（编号214和224）对头孢噻吩、头孢噻肟和头孢他啶耐药（MIC>100mg·L⁻¹）。214号菌株对氨曲南和氧氟沙星呈中介耐药（MIC=12.5mg·L⁻¹），224号菌株对氨曲南高度耐药（MIC=50mg·L⁻¹）。克拉维酸与头孢噻肟以及克拉维酸与氨曲南之间存在协同作用，但克拉维酸与头孢他啶之间不存在协同作用，这与214号和224号菌株中不可转移的头孢他啶耐药情况相符，表明来自两家医院的菌株中ESBLs的类型不同。
