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首页> 外文期刊>Journal of Clinical Microbiology >Effects of Phenotype and Genotype on Methods for Detection of Extended-Spectrum-β-Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Norway
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Effects of Phenotype and Genotype on Methods for Detection of Extended-Spectrum-β-Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Norway

机译：表型和基因型对挪威产大范围β-内酰胺酶大肠埃希菌和肺炎克雷伯菌的临床分离株检测方法的影响

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Consecutive clinical isolates of Escherichia coli (n = 87) and Klebsiella pneumoniae (n = 25) with reduced susceptibilities to oxyimino-cephalosporins (MICs > 1 mg/liter) from 18 Norwegian laboratories during March through October 2003 were examined for blaTEM/SHV/CTX-M extended-spectrum-β-lactamase (ESBL) genes, oxyimino-cephalosporin MIC profiles, ESBL phenotypes (determined by the ESBL Etest and the combined disk and double-disk synergy [DDS] methods), and susceptibility to non-β-lactam antibiotics. Multidrug-resistant CTX-M-15-like (n = 23) and CTX-M-9-like (n = 15) ESBLs dominated among the 50 ESBL-positive E. coli isolates. SHV-5-like (n = 9) and SHV-2-like (n = 4) ESBLs were the most prevalent in 19 ESBL-positive K. pneumoniae isolates. Discrepant ESBL phenotype test results were observed for one major (CTX-M-9) and several minor (TEM-128 and SHV-2/-28) ESBL groups and in SHV-1/-11-hyperproducing isolates. Negative or borderline ESBL results were observed when low-MIC oxyimino-cephalosporin substrates were used to detect clavulanic acid (CLA) synergy. CLA synergy was detected by the ESBL Etest and the DDS method but not by the combined disk method in SHV-1/-11-hyperproducing strains. The DDS method revealed unexplained CLA synergy in combination with aztreonam and cefpirome in three E. coli strains. The relatively high proportion of ESBL-producing E. coli organisms with a low ceftazidime MIC in Norway emphasizes that cefpodoxime alone or both cefotaxime and ceftazidime should be used as substrates for ESBL detection.
机译：连续性大肠杆菌（ n = 87）和肺炎克雷伯菌肺炎克雷伯菌（ n = 25）的临床分离株于2003年3月至2003年10月间从挪威18个实验室检测到的亚氨基头孢菌素（MICs> 1 mg / L）的 bla TEM / SHV / CTX-M 扩展光谱- β-内酰胺酶（ESBL）基因，氧亚氨基头孢菌素MIC谱，ESBL表型（通过ESBL Etest以及磁盘和双磁盘协同增效[DDS]方法确定），以及对非β-内酰胺类抗生素的敏感性。 50例ESBL阳性患者中，多重耐药CTX-M-15-like（ n = 23）和CTX-M-9-like（ n = 15）ESBL占主导地位 E。大肠杆菌分离株。在19个ESBL阳性 K中，SHV-5-like（ n = 9）和SHV-2-like（ n = 4）ESBL最普遍。肺炎分离株。观察到一个主要（CTX-M-9）和几个次要（TEM-128和SHV-2 / -28）ESBL组和SHV-1 / -11-高产分离株的ESBL表型测试结果不一致。当使用低MIC的氧亚氨基头孢菌素底物检测棒酸（CLA）协同作用时，ESBL结果为阴性或临界。在SHV-1 / -11-高产菌株中，通过ESBL Etest和DDS方法检测到CLA协同作用，但未通过组合圆盘方法检测到。 DDS方法揭示了在三个E中与氨曲南和头孢哌酮合用无法解释的CLA协同作用。大肠杆菌菌株。产生ESBL的 E的比例相对较高。挪威头孢他啶MIC较低的大肠杆菌强调应单独使用头孢泊肟或头孢噻肟和头孢他啶作为ESBL检测的底物。

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