Wystepowanie beta-laktamaz o rozszerzonym spektrum substratowym [ESBL] i beta-laktamz indukowanych [IBL] u klinicznych szczepow paleczek Gram-ujemnych

• Autorzy: Rokosz A. , Sawicka-Grzelak A.
• Języki publikacji: PL

Abstrakty

PL

W ciągu trzech miesięcy (kwiecień-czerwiec 1997) wyhodowano z próbek materiału klinicznego 200 szczepów pałeczek Gram-ujemnych. Próbki pochodziły od pacjentów hospitalizowanych w różnych oddziałach PSK Nr 1 w Warszawie. Najczęściej izolowano szczepy gatunku Pseudomonas aeruginosa. Wśród pałeczek Gram-ujemnych znaleziono 30 szczepów produkujących ß-laktamazy o rozszerzonym spektrum substratowym (ESBL) i 45 szczepów wytwarzających ß-laktamazy indukowane (IBL).

EN

This study was undertaken to check the situation concerning the occurrence of Gram-negative rods producing extended-spectrum ß-lactamases (ESBL) and inducible ß-lactamases (IBI) in clinical specimens from patients hospitalized in National Clinical Hospital No. 1 in Warsaw. Such determinations were not performed in this hospital so far. During three months (April-June, 1997) 200 strains of Gram-negative rods were cultured. The strains were identified in automatic ATB system using strips with biochemical tests: ID 32 E for enteric rods and ID 32 GN for non-fermenting rods. ESBL-producing strains were detected with double disc diffusion test according to Jarlier et al. (1988). Clavulanate was applied as the inhibitor of ß-lactamases (AMO/CLAV disc). Inducible ß-lactamases were determined using double disc method according to Sanders and Sanders (1979). Cefoxitin was the inductor of these ß-lactamases. 82 strains (41% of all strains) belonging to Enterobacteriaceac family, 92 strains (46%) of Pseudomonadaceae rods and 26 strains (13%) of other Grant-negative rods were isolated. 30 ESBL producing strains (15% of all strains) and 45 strains (22,5%) with IBL activity were detected. The obtained results confirm the necessity of continuous and reliable monitoring of ESBL - and IBL - producing strains among Gram-negative rods isolated from clinical materials. The aims of such procedure are the control and prevention of their dissemination within a hospital as well as the avoidance of therapeutic failures.

Słowa kluczowe

PL

Pseudomonas aeruginosa; infekcja bakteryjna; wystepowanie; beta-laktamaza; bakterie Gram-ujemne; antybiotyki beta-laktamowe

• Wydawca: -
• Czasopismo: Medycyna Doświadczalna i Mikrobiologia
• Rocznik: 1998
• Tom: 50
• Numer: 1-2
• Opis fizyczny: s.31-39,tab.,bibliogr.

Twórcy

autor

Rokosz A.

• Akademia Medyczna, 02-004 Warszawa, ul.T.Chalubinskiego 5

autor

Sawicka-Grzelak A.

Bibliografia

• 1. Dzierżanowska D. Przegląd głównych grup antybiotyków. I Antybiotyki ß-laktamowe. W: Antybiotykoterapia praktyczna, α-medica press, Bielsko-Biała, 1994, 59-76.
• 2. Dzierżanowska D. Mechanizmy bakteryjnej oporności na chemioterapeutyki oraz znaczenie kliniczne tego zjawiska. Med. po dyplomie, 1995, wydanie specjalne/wrzesień: 3-15.
• 3. Gniadkowski M. Beta-laktamazy u pałeczek Gram-ujemnych. Nowa Med (Bakteriol) 1997; 4: 20-26.
• 4. Gniadkowski M, Schneider I, Jungwirth R i inni. Three new TEM ß-lactamases expressed by ceftazidime-resistant K. pneumoniae and E. coli isolates from Polish hospitals. Clin Microbiol Infect 1997; 3(Suppl. 2): 301.
• 5. Gniadkowski M, Trzciński K, Pałucha A i inni. Wykrywanie ß-laktamaz o rozszerzonym zakresie działania (ESBL) w izolatach klinicznych Klebsiella pneumoniae: test dwóch krążków i test ATB BLSE. Diag Lab 1996; 32: 697-709.
• 6. Hryniewicz W. Antybiotykoterapia wobec problemu narastającej oporności drobnoustrojów. Mikrobiol Med 1994; 1: 19-23.
• 7. Jarlier V, Nicolas M, Fournier G i inni. Extended broad-spectrum ß-lactamases conferring transferable resistance to newer ß-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility patterns. Rev Infect Dis 1988; 10: 867-78.
• 8. Katsanis GP, Spargo J, Ferraro MJ i inni. Detection of Klebsiella pneumoniae and Escherichia coli strains with extended-spectrum ß-lactamases. J Clin Microbiol 1994; 32: 691-96.
• 9. Livermore D. ß-lactamases in laboratory and clinical resistance. Clin Microbiol Rev 1995; 8: 557-84.
• 10. National Committee for Clinical Laboratory Standards (NCCLS). Performance Standards for Antimicrobial Susceptibility testing - 6th Inform. Suppl., Doc. M100-S6, NCCLS, Villanova, Pa, December, 1995, 15.
• 11. Neu HC. Contributions of ß-lactamases to bacterial resistance and mechanisms to inhibit ß-lactamases. Am J Med 1985; 79(Suppl. 5B): 2-12.
• 12. Pagani L, Micheletti P, Daturi R i inni. Survey of extended-spectrum ß-lactamases (ESBL) in Enterobacteriaceae clinical isolates from North Italian hospital. Clin. Microbiol Infect 1997; 3(Suppl. 2): 302.
• 13. Petit A, Gerbaud G, Sirot D i inni. Molecular epidemiology of TEM-3 (CTX-1) ß-lactamase. Antimicrob Agents Chemother 1990; 34: 219-24.
• 14. Rice LB, Willey SH, Papanicolaou GA i inni. Outbreak of ceftazidime resistance caused by extended-spectrum ß-lactamases at Massachusetts chronic care facility. Antimicrob Agents Chemother 1990; 34: 2193-99.
• 15. Sanders CC, Sanders WE. Emergence of resistance to cefamandole: possible role of cefoxitin- inducible beta-lactamases. Antimicrob Agents Chemother 1979; 15: 792-97.
• 16. Sanders CC, Sanders WE. ß-lactam resistance in Gram-negative bacteria: global trends and clinical impact. Clin Infect Dis 1992; 15: 824-39.
• 17. Sirot D, Sirot J, Labia R i inni. Transferable resistance to third-generation cephalosporins in clinical isolates of Klebsiella pneumoniae: identification of CTX-1, a novel ß-lactamase. J Antimicrob Chemother 1987; 20: 323-24.
• 18. Stratton CW, Cooksey RC. Susceptibility tests: special tests. W: Manual of Clinical Micro¬biology. Red. A. Balows i inni, ASM Washington, D.C., 1991, 115, 1160-65.
• 19. Thompson CJ, Amyes SGB. TRC-1:emergence of a clavulanic acid-resistant TEM ß-lactamases in a clinical strains. FEMS Microbiol Lett 1992; 91: 113-17.
• 20. Vedel G, Belaaouaj A, Gilly L i inni. Clinical isolates of Escherichia coli producing TRI ß-lactamases novel TEM-enzymes conferring resistance to ß-lactamase inhibitors. J Anti¬microb Chemother 1992; 30: 449-62.