肠杆菌科细菌致恶性肿瘤患者肺部感染的临床特点与耐药性分析

目的探讨肠杆菌科细菌致恶性肿瘤患者肺部感染的临床特点、病原学构成和耐药特征,为今后的临床治疗提供参考。方法收集2009年7月至2014年6月本院住院恶性肿瘤患者下呼吸道标本,应用BD Phoenix100全自动微生物鉴定仪鉴定菌种,药敏试验采用纸片法(K-B)进行,并进行ESBLs检测,按CLSI标准判定药敏结果,用WHONET 5.6软件分析数据。结果从恶性肿瘤患者下呼吸道标本中共分离肠杆科细菌256株,主要为肺炎克雷伯菌和大肠埃希菌,分别占39.5%和33.2%;药敏试验表明常见肠杆菌科细菌除对碳青霉烯类、含酶抑制剂抗菌素耐药率较低外,对其余抗菌药物均为中高度耐药;肺炎克雷伯菌的ESBLs检出率最高为60.4%。结论从本院恶性肿瘤合并下呼吸道感染患者中分离出的肠杆菌科细菌多重耐药现象严重,产酶率高,治疗该类细菌感染,首选碳青霉烯类、含酶抑制剂抗菌素,临床应加强ESBLs检测和耐药性监测,防止多重耐药菌的产生。     

Dissemination of IncF-type plasmids in multiresistant CTX-M-15-producing Enterobacteriaceae isolates from surgical-site infections in Bangui,Central African Republic

Background

Surgical-site infection is the most frequent health care-associated infection in the developing world, with a strikingly higher prevalence than in developed countries We studied the prevalence of resistance to antibiotics in Enterobacteriaceae isolates from surgical-site infections collected in three major tertiary care centres in Bangui, Central African Republic. We also studied the genetic basis for antibiotic resistance and the genetic background of third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae.

Results

Between April 2011 and April 2012, 195 patients with nosocomial surgical-site infections were consecutively recruited into the study at five surgical departments in three major tertiary care centres. Of the 165 bacterial isolates collected, most were Enterobacteriaceae (102/165, 61.8%). Of these, 65/102 (63.7%) were 3GC-R, which were characterized for resistance gene determinants and genetic background. The bla_CTX-M-15 and aac(6′)-Ib-cr genes were detected in all strains, usually associated with qnr genes (98.5%). Escherichia coli, the most commonly recovered species (33/65, 50.8%), occurred in six different sequence types, including the pandemic B2-O25b-ST131 group (12/33, 36.4%). Resistance transfer was studied in one representative strain of the resistance gene content in each repetitive extragenic palindromic and enterobacterial repetitive intergenic consensus sequence-PCR banding pattern. Plasmids were characterized by PCR-based replicon typing and sub-typing schemes. In most isolates (18/27, 66.7%), bla_CTX-M-15 genes were found in incompatibility groups F/F31:A4:B1 and F/F36:A4:B1 conjugative plasmids. Horizontal transfer of both plasmids is probably an important mechanism for the spread of bla_CTX-M-15 among Enterobacteriaceae species and hospitals. The presence of sets of antibiotic resistance genes in these two plasmids indicates their capacity for gene rearrangement and their evolution into new variants.

Conclusions

Diverse modes are involved in transmission of resistance, plasmid dissemination probably playing a major role.     

Relationships between the density of different indicator organisms on sheep and beef carcasses and in frozen beef and sheep meat

AIM: To describe the relationship between the concentration of different indicator bacteria in red meat. METHODS AND RESULTS: Enumeration data for aerobic plate count (APC), Enterobacteriaceae, coliforms and Escherichia coli biotype I were analysed from an Australia-wide survey of beef carcasses, sheep carcasses, frozen beef and frozen sheep meat. In all commodities, there was only low-to-moderate rank correlation (0.16-0.47) between concentration of APC and concentration of each Gram-negative indicator. Rank correlations between counts of Gram-negative indicators were much higher (0.47-0.92) especially when nondetections were excluded from analysis (0.78-0.94). Receiver-operator characteristics analysis showed that detection of coliforms can predict the presence of E. coli biotype I with almost 100% sensitivity but fails to predict absence in 2.7-8.5% of samples not containing E. coli biotype I. CONCLUSIONS: Enumeration of coliforms is a useful adjunct to enumeration of E. coli biotype I or Enterobacteriaceae in red meat. The density of coliforms or Enterobacteriaceae can be used to predict the presence or absence of E. coli biotype I, although when the latter is at low prevalence errors in positive test prediction can be large. SIGNIFICANCE AND IMPACT OF THE STUDY: A quantitative basis is provided for comparing the concentration of different indicator bacteria measured in the production, regulation and trade of red meat.     

Assessment of a new technique combining a viability test, whole-cell hybridization and laser-scanning cytometry for the direct counting of viable Enterobacteriaceae cells in drinking water

A new direct approach, called direct viable count (DVC)-FISH-ScanRDI, combining viability measurement, specific detection and sensitive enumeration of highly diluted Enterobacteriaceae cells, was assessed during the summer in water samples from a North American drinking water treatment plant and its distribution system. Major results of this field investigation show a higher sensitivity of the DVC-FISH-ScanRDI approach in enumerating viable Enterobacteriaceae cells in distributed drinking water, relative to a culture-based method, and the increased concentration of viable but non-culturable (VBNC) Enterobacteriaceae cells in distributed water for temperatures above 18 degrees C.     

Microbiological changes in mawè during natural fermentation

Lactic acid bacteria increased from 3.2 × 10⁶ and 1.6 × 10⁷ c.f.u./g (wet wt) to 2 × 10⁹ and 1.6 × 10⁹ c.f.u./g after 12 to 24 h of fermentation of home-produced mawè (a dough produced from dehulled maize) and commercial mawè, respectively. In commercial mawè, the yeast count increased from 1.3 × 10⁵ to 2.5 × 10⁷ c.f.u./g after 48 h of fermentation before decreasing, whereas in the home-produced mawè it increased from 2.5 × 10⁴ to 3.2 × 10⁷ c.f.u./g after 72 h of fermentation; the dominant yeasts were mainly Candida krusei, although C. kefyr, C. glabrata and Saccharomyces cerevisiae were also present. Enterobacteriaceae counts increased slightly during the initial stage ofthe fermentation, but decreased below the detection level after 24 to 48 h. Enterobacter cloacae was mostly found in commercial mawè and Escherichia coli mostly in homeproduced mawè.D.J. Hounhouigan and C.M. Nago are with the Université Nationale du Bénin, Faculté des Sciences Agronomiques, Département de Nutrition et de Sciences Alimentaires, BP 526, Cotonou, Benin; M.J.R. Nout and F.M. Rombouts are with the Agricultural University, Department of Food Science, Bomenweg 2, 6703 HD Wageningen, The Netherlands. J.H. Houben is with Utrecht University, Department of the Science of Foods of Animal Origin, Yalelaan 2, 3508 TD Utrecht, The Netherlands.     

Development and validation of a resistance and virulence gene microarray targeting Escherichia coli and Salmonella enterica

A microarray was developed to simultaneously screen Escherichia coli and Salmonella enterica for multiple genetic traits. The final array included 203 60-mer oligonucleotide probes, including 117 for resistance genes, 16 for virulence genes, 25 for replicon markers, and 45 other markers. Validity of the array was tested by assessing inter-laboratory agreement among four collaborating groups using a blinded study design. Internal validation indicated that the assay was reliable (area under the receiver-operator characteristic curve = 0.97). Inter-laboratory agreement, however, was poor when estimated using the intraclass correlation coefficient, which ranged from 0.27 (95% confidence interval 0.24, 0.29) to 0.29 (0.23, 0.34). These findings suggest that extensive testing and procedure standardization will be needed before bacterial genotyping arrays can be readily shared between laboratories.     

Tatumella ptyseos,an Unrevealed Causative Agent of Pink Disease in Pineapple

Pink disease is a major problem in the pineapple canning industry. Affected fruit acquire a brownish pigment after pasteurization and can contaminate non‐affected fruit before they are released to the consumer. In the last few years, Pantoea citrea has been described as the causative agent of pink disease. In this study, over 300 bacterial isolates from pineapple plants, growing in Mexican commercial fields, and from soil close to plant roots were recovered. Over 250 isolates showed a very high similarity in their phenotypic and genotypic traits with Tatumella ptyseos, a close relative of Pantoea. These isolates exhibited typical pathogenicity reactions in pineapple juice tests, pineapple slices and fruit. On this basis, molecular identification procedures for the Tatumella isolates associated with pink disease were implemented. In affected fruit populations around 10⁶ CFU/g of fresh tissue were recovered. This is first time that T. ptyseos is demonstrated as a causal agent of pink disease.