期刊
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
卷 67, 期 4, 页码 376-379出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2010.03.012
关键词
ESBL; Fecal carrier; Chromogenic medium; CTX-M; Community
资金
- CIBERESP (Network Center for Biomedical Research in Epidemiology and Public Health) of Institut Carlos III, Ministerio de Ciencia e Innovacion of Spain
- European Commission [LSHM-CT-2005-018705, LSHM-CT-2008-223031]
- CIBERESP research networks, Institut de Salud Carlos III, Spanish Ministry of Health (CIBERESP)
Five hundred fecal samples from 462 patients (68.4% ambulatory) (February April, 2007) from Madrid (Spain) were screened for extended-spectrum beta-lactamase (ESBL) producers using ceftazidime and cefotaxime (1 mg/L) MacConkey (MAC) agar plates and a chromogenic media (chromwID ESBL; bioMerieux, Marcy-l'Etoile, France). bla(ESBL), qnr, aac(6')Ib-cr, and 16S rRNA methylase genes were assessed. A prevalence of 8.2% of ESBL fecal carriers was observed (8.9% hospitalized, 7.9% nonhospitalized patients), higher than that previously observed (1991, 0.6%; 2003, 7.0%). Sensitivity, specificity, and positive and negative predicted values were 100%, 94.8%, 63%, and 100% for chromID ESBL and 87.8%, 89.8%, 43.4%, and 98.9% for MAC, respectively. ESBL distribution was as follows: CTX-M-9-group, 40% (mainly CTX-M-14); CTX-M-1-group, 26.6% (mainly CTX-M-15); SHV-type, 29% (mainly SHV-12); and TEM-type, 4.4%. These enzymes were found in pulsed-field gel electrophoresis nonclonally related Escherichia coli and Klebsiella pneumoniae isolates. Transferable quinolone resistance was confirmed in CTX-M-9 (qnrS1), CTX-M-15 [aac(6')Ib-cr, gnrS1], and SHV-12 (qnrB7, qnrS1) producers but not 16S rRNA methylase genes. The chromID ESBL medium was reliable to screen ESBL fecal carriers with a general decrease in the laboratory workload. Time-to-time monitoring of ESBL fecal carriers is useful to ascertain current trend of ESBL epidemiology. (C) 2010 Elsevier Inc. All rights reserved.
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