第21届欧洲临床微生物学与感染病大会在意大利召开
作者：刘玉华
2011年5月7日-10日，全球最大的感染病会议——欧洲临床微生物学与感染病大会（ECCMID）在意大利米兰召开，来自世界各地的8500余名专家相聚一起，共同分享了欧洲和全球各地关于如何改善感染病防治的最新知识和实践经验。
本届ECCMID的首要议程是：遏制几乎对所有抗生素和治疗耐药的“超级细菌”的迅速蔓延；疫苗的新技术变革；新技术如何改变感染的诊断方式和速度，从而改善患者的治疗和护理。
欧洲临床微生物学与感染病学会(ESCMID)主席Giuseppe Cornaglia教授在开幕式上说道：“我们从来没有像今天这样面临着如此令人堪忧的抗生素耐药水平和新的几乎无法医治的细菌的出现，如近期所观察到的来自印度次大陆和巴尔干半岛的携Ⅰ型新德里β-内酰胺酶（NDM-1）基因的细菌。我们必须将我们的经验汇集起来，必须将我们的行动协调好。”
大会还特别强调了当前和今后的疫苗研发，今年ECCMID优秀奖颁发给了世界顶级疫苗开发的领军人物——Rino Rappuoli博士，他是诺华全球疫苗研发主管。Rino Rappuoli博士在会上说道：“今天，由于技术革命，我们正在开发安全的疫苗以解决21世纪全球需要。若没有现在我们使用的研发技术，这些新的开发就无从谈起。“他还解释说：“诺华疫苗与诊断试剂研究中心正在利用反向疫苗学（reverse vaccinology）、结构疫苗学和开发新的佐剂（激发对疫苗产生免疫反应的成分），来推动20多种潜在的、疫苗可预防疾病的新疗法的发展。”
“ECCMID同样也重点关注了新技术及感染病诊断的最新进展，这是影响患者医疗的一个重要领域。每年新鉴定的细菌和病毒量急剧增加，这将改善患者的医疗，帮助医生选择最合适的抗生素，避免无效或危险的治疗。”ESCMID官方杂志——《临床微生物学与感染》（CMI）杂志主编Didier Raoult教授说道。
来源：医学论坛网 日期：2011-05-20
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第21届欧洲临床微生物学与感染病大会（ECCMID)报道 根据希腊雅典一儿童医院的7年研究，细菌性胃肠炎致病菌对抗生素的耐药性不断增加。令人担忧的是，一些最常见的致病菌在短时间内（2003年年初至2009年年底）由完全不耐药变成了高度耐药。
沙门菌和空肠弯曲菌是最常见的胃部细菌，目前两细菌耐药性正在不断增加。如沙门菌对氨苄西林的耐药率从2.5%上升到了23.9%，对克霉唑的耐药率由1.7%升到了10.9%。最初，空肠弯曲菌对环丙沙星和四环素均不耐药，现在对两药的耐药率分别上升到了63%和45.7%。研究人员还发现，所有的沙门菌分离株对头孢噻肟敏感，所有的空肠弯曲菌均对红霉素敏感。
详情点击：Epidemiologic study of bacterial gastroenteritis in Greek children (2003-2009)
原文摘要：
G. Kalogeras, N. Palaiologou, K. Giannakopoulou, F. Antonopoulou, P. Xenos, M. Papadimitriou, D. Hatzaki, E. Vetouli, E. Lebessi* (Athens, GR)
Objectives: Bacterial gastroenteritis is a common illness worldwide. A seven-year study was conducted in a pediatric hospital in Athens, in order to assess the isolation incidence and antimicrobial resistance of pathogens involved in acute diarrhea in children younger than 14 years.
Methods: We retrospectively reviewed a total of 9,667 stool cultures performed in our lab from children with acute gastroenteritis from Jan 2003 to Dec 2009.
Results: In total, 1783 samples from an equal number of children yielded one or more enteropathogenic bacteria. During a seven - year period, from 2003 to 2009, on a sequential, yearly basis starting in 2003, the following bacteria, associated with acute diarrhea, were isolated: Salmonella spp n=708 (119;48.3% - 177;50.5% - 117;40.4% - 100;36.7% - 82;31.2% - 67;29.5% - 46;23.8%), Campylobacter jejuni n=435 (17;6.9% - 62;17.7% - 42;14.5% - 58;21.3% - 81;30.9% - 82;36.1% - 93;48.1%), enteropathogenic Escherichia coli n=449 (69;28.1% - 76;21.7% - 71;24.5% - 80;29.4% - 67;25.5% - 52;22.9% - 34;17.6%), Aeromonas hydrophila n=95 (16;6.5% - 13;3.7% - 16;5.5% - 12;4.4% - 17;6.5% - 14;6.2% - 7;3.6%), Shigella spp n=74 (18;7.3% - 15;4.3% - 7;2.4% - 12;4.4% - 10;3.8% - 7;3.1% - 5;6.7%), Yersinia enterocolitica n=53 (7;2.8% - 7;2.0% - 11;3.8% - 10;3.7% - 5;1.9% - 5;2.2% - 8;4.1%). The predominant serovars among Salmonella isolates were: Enteritidis (n=525, 74.1%) and Typhimurium (n=111, 15.8%). Among Shigella isolates, the majority were S. sonnei (n=32, 43.2%) and S. flexneri (n=31, 41.9%). All but one, Y. enterocolitica isolates belonged to O:3 (n=52, 98.1%). A significant increase was observed in the resistance rates for Salmonella isolates to ampicillin (2.5% to 23.9%) and to cotrimoxazole (1.7% to 10.9%), as well as a dramatic increase in the resistance for C.jejuni to ciprofloxacin (0% to 63%) and to tetracycline (0% to 45.7%). All Salmonella isolates were found susceptible to cefotaxime, and all C.jejuni strains were found susceptible to erythromycin.
Conclusion: Salmonella spp and C.jejuni remain the most frequent enteropathogens among children in Greece. It is of concern, that their isolation rates have been reversed since 2008. A worrisome increase in drug resistance was found for Salmonella spp and C.jejuni. This phenomenon emphasize the need for a more restrictive policy on the use of antibiotics in humans and animals.
葡萄牙公交车流行MRSA 提示有必要进行社区控制
第21届欧洲临床微生物学与感染病大会（ECCMID)报道 在欧洲，葡萄牙的医院获得性耐甲氧西林金黄色葡萄球菌（MRSA）流行率最高，超过50%。MRSA常通过直接的人与人之间的皮肤接触传播，但金黄色葡萄球菌能在非生命物体如扶手中存活很长一段时间，扶手也能传播感染。
一项对葡萄牙波尔图85辆市区公交车进行的研究显示，22辆公交车存在MRSA污染。其中，流行性EMRSA-15菌株（目前流行于波尔图医院的主要菌株）最常见，这提示菌株从医院“流窜”到了社区环境中。因此，当前迫切需要采取感染控制措施，限制EMRSA-15传播给普通人群，避免葡萄牙社区中MRSA的大幅增加。目前葡萄牙社区中的MRSA流行率还很低。
详情点击：High prevalence of EMRSA-15 in Portuguese public buses: a worrisome finding
原文摘要：
High prevalence of EMRSA-15 in Portuguese public buses: a worrisome finding
Objectives: The nosocomial prevalence of methicillin resistant Staphylococcus aureus (MRSA) in Portugal remains one of the highest in Europe and is currently over 50%. Transmission of S. aureus, including MRSA, occurs principally by direct human-to-human skin contact. However, S. aureus can survive for long periods on inanimate objects, which may represent an important reservoir for dissemination as well. The aim of the present study was to explore the role of hand-touch surfaces in Portuguese public buses as a reservoir of MRSA and provide insights into the genetic background of the isolates.
Methods: Between May 2009 and February 2010, handrails of 85 public urban buses circulating in Oporto, Portugal, were screened for the occurrence of MRSA. All isolates were tested for antimicrobial susceptibility and for the presence of mecA and Panton-Valentine leukocidin (PVL) genes. Moreover, the isolates were characterized by pulsed-field gel electrophoresis (PFGE), staphylococcal cassette chromosome (SCC) mec typing, spa typing, and multilocus sequence typing (MLST).
Results: Twenty-two (26%) out of the 85 buses showed MRSA contamination. The molecular characterization of a total of 55 MRSA clustered the isolates into three clonal types. Nevertheless, the overwhelming majority (n=50; 91%) of the isolates belonged to a single non-multidrug resistant clone (PFGE A, spa types t747, t032, t025 or t020, ST22, SCCmec type IVh). This clone exhibits the characteristics of the pandemic EMRSA-15, currently the major lineage circulating in Portuguese hospitals, namely in the Oporto region. Two additional clones were found but in much lower numbers: (i) PFGE B, ST5, spa type t002, SCCmec IVa (n=3), and (ii) PFGE C, spa type t008, ST8, SCCmec IVa (n=2). None of the 55 isolates was PVL positive.
Conclusions: Public buses in Oporto are an important reservoir of MRSA of nosocomial origin, providing evidence that the major hospital-associated MRSA clone in Portugal is escaping from the primary ecological niche of hospitals to the community environment. Infection control measures are urgently warranted to limit the spread of EMRSA-15 to the general population and avoid a massive increase of MRSA in the Portuguese community, which so far remained low.
汲取经验为下一次流感大流行作准备
第21届欧洲临床微生物学与感染病大会（ECCMID)报道 2009H1N1流感大流行期间，设法鼓励公众接种抗H1N1流感疫苗的卫生专家面临一件尴尬的事情：一些医疗专业人员他们本身并不想接种疫苗。其背后原因多种多样，但根据此调查，确保医疗人员接种（疫苗）的两个关键因素，分别是参加所在机构的互动资讯会议，以及国家卫生政策的可靠性。
对一所大学附属医院医生和护士进行的调查采访也显示，前些年接种过季节性流感疫苗及以互联网作为主要信息来源的的医疗工作者也更可能接种H1N1疫苗。
原文摘要：
Vaccination against pandemic influenza A/H1N1(2009) among healthcare workers: lessons for the next pandemic
Objective: To investigate the factors associated with receiving or refusing pandemic influenza vaccines among physicians and nurses of a tertiary care university hospital.
Methods: The study was conducted at a 2000-bed tertiary-care hospital with a health care worker (HCW) population consisted of 1234 physicians, 1125 nurses, 385 nurse-asistants and 549 medical technicians. Only physicians and nurses were included in the study.
After the termination of vaccination campaign, a total of 472 HCWs (236 vaccinated, 236 unvaccinated) were randomly selected from the employee list of human resources and
data about demographics, professional category and work year, history of seasonal influenza vaccine uptake in previous year, reasons for accepting or refusing the pandemic influenza A/H1N1 vaccine, the source of knowledge on pandemic vaccines of these HCWs were collected by a structured survey.
Categorical data were analyzed by chi-square test, whereas Student’s t-test was performed for continuous variables. Bivariate analysis was done to evaluate the effect of each independent variable on pandemic influenza A/H1N1 vaccine uptake. A multivariate logistic regression analysis was performed to determine independent predictors of refusal of the pandemic influenza A/H1N1 vaccine. All statistical analysis was done by a software (STATA-9.0, Tx,USA) and a P-value of <0.05 was considered as statistically significant.
Results: A total of 472 HCWs (236 vaccinated and 236 unvaccinated) were included in the study. Of the 472 HCWs, 333(70.5%) were female, 253 (53.6%) were physicians and 149 (32.6%) were working in the surgical wards. Characteristics of surveyed HCWs and vaccination rates for pandemic influenza A/H1N1 according to demographics and professional variables are summarized in Table 1.
By using a multivariate logistic regression modelling; being a nurse in a surgical department (OR:0.19; 95%CI:0.08-0.45; P<0.001), receiving seasonal influenza vaccine in the previous year (OR:2.59; 95%CI:1.13-5.95; P=0.024), using internet as the main source of information (OR:0.31; 95%CI:0.13-0.74; P=0.009) and being informed by attending the meetings held at the hospital (OR:4.54; 95%CI:1.14-17.9; P<0.031)were found to be independently associated with pandemic vaccine uptake.
Conclusion: interactive informational meetings at institutional level and high credibility of the policies of national health authorities are essential factors for promoting vaccination against influenza.
脸谱等社交网络或有助于监测感染病暴发
第21届欧洲临床微生物学与感染病大会（ECCMID）报道 社交网络如脸谱（Facebook）和Twitter可使流言蜚语不胫而走，但它们也可以传播一些有助于疾病监测的重要信息。
感染病暴发的标准监测意指监测如患者出现的症状等各种指标。一个研究小组对近期在德国大学暴发的诺如病毒感染进行了研究，以确定将新闻和信息发布到脸谱、Twitter和博客上是否较基于特定指标的监测报告更快。他们发现这些社交媒体收集和讨论新闻的速度较其他新闻媒体快。由于社交媒体是互动的，它们便于交流信息。很明确的是，其他监测和报告也很重要，但研究社交媒体或有助于收集潜在的感染病暴发信息。
研究摘要链接：Social media and infectious disease surveillance: tweets indicate norovirus outbreak at a university
荷兰感染病数据库可提供耐药监测网
第21届欧洲临床微生物学与感染病大会（ECCMID）报道 荷兰关于抗生素耐药性的感染病监测信息系统（ISIS-AR）及其交互式数据库（ISISweb），被开发用于监测抗菌剂耐药性趋势。它将27个医学微生物学实验室连接到了一个开放的中央数据库，在这个中央数据库中，每月将上传抗菌剂敏感性检测结果和40个菌种的流行病学数据。这样可以告知专业人员和政策制定者，如2008年-2010年间，MRSA的流行率稳定在1%左右。在ISISweb上，可观察到相关数据，并可根据研究类型、医院科室和年龄组来比较这些数据。该系统的成功经验表明,它可扩展应用于其他细菌或病毒的监测。
研究摘要链接：ISIS-AR and ISISweb: a new surveillance system for antimicrobial resistance surveillance
沿丝绸之路追踪抗生素耐药性
第21届欧洲临床微生物学与感染病大会（ECCMID）报道 根据一项丝绸之路沿线活着的野生动物研究，即使是全球最偏远的地域—从西藏高原至戈壁沙漠，也存在耐药细菌。丝绸之路是古代连接亚洲和欧洲及南非的贸易通道，也是多种哺乳动物的家园，而今很多哺乳动物已濒临灭绝。
科学家分析了5种典型的哺乳动物（蒙古野生驴，普氏野马，灰色土拨鼠，双峰骆驼和豺狗）的粪便，他们发现细菌存在抗生素耐药基因的比率很高。这些耐药性是针对治疗人类疾病的重要抗生素如红霉素、环丙沙星、庆大霉素和氨苄西林。生活在如此偏远区域的动物，其体内细菌的抗生素耐药水平如此惊人，说明了抗生素耐药性的蔓延有多广，因此慎重使用抗生素很重要。
研究摘要链接：Tracking antibiotic resistance along the Silk Road
原文摘要：
Tracking antibiotic resistance along the Silk Road
S. Quinteira, C. Novais*, P. Antunes, J. Campos, A.R. Freitas, A. Abdukadir, N. Monteiro, L. Peixe (Vila Nova de Famalicão, Porto, PT; Urumqi, CN)
Objectives: Information on the occurrence of antibiotic resistance in relatively pristine ecosystems is still scarce. Accordingly, the goal of this study was to evaluate if wild or feral animals, most of which facing extinction, inhabiting remote areas of the globe (from the Tibetan plateau to the Gobi desert), carry bacteria that harbour antibiotic resistance genes.
Methods: During the SilkRoad2010 expedition (CIBIO and Chinese Academy of Sciences), faecal samples were collected from five iconic mammal species (Mongolian wild ass, Przewalski horse, Grey marmot, Bactrian camel and Dhole), most of which endangered or in the verge of extinction. Samples were pre-enriched in peptone water and 0.1ml were plated in Slanetz-Bartley agar without and with antibiotics (vancomycin-4mg/L, ampicillin-16mg/L, ciprofloxacin-4mg/L, gentamicin-125mg/L, streptomycin-1000mg/L, tetracycline-8mg/L, chloramphenicol-8mg/L). Susceptibility to 12 antibiotics was tested by disk diffusion method (CLSI). Species identification (E. faecium-Efm, E. faecalis-Efl), characterization of antibiotic resistance genes (tetM, tetL, tetO, tetK, tetS, ermB) and putative virulence genes (esp, hylEfm, acmEfm) were done by PCR. purK gene was amplified and sequenced for specific Efm-isolates
Results: Enterococci were present in all samples, identified as Efm (14), Efl (3) and Enterococcus sp (3). Overall a high incidence of antibiotic resistance was detected: tetracycline-85% (17/20), minocyclin-45% (9/20), erythromycin-40% (8/20), ciprofloxacin-35% (7/20), High Level of Resistance (HLR) to gentamicin-15% (3/20), HLR-streptomycin-5% (1/20) and ampicillin-10% (2/20). Resistance to tetracyclines was associated to tetM+tetL (13 Efm) or tetM (3 Efl), while erythromycin resistance was linked to ermB (6 Efm). esp and acmEfm genes were detected in 3 Efl from a Przewalski horse and in all Efm, respectively. purK1 was identified in 2 Efm highly resistant to ampicillin and ciprofloxacin, from a Bactrian camel.
Conclusion: Even though inhabiting remote areas with extremely low human pressure, the critically endangered Silk Road fauna surprisingly harbours bacteria carrying antibiotic resistance and virulence determinants. Moreover, the unexpected detection of genetic traits commonly associated with worldwide nosocomial epidemic strains (purK1, ampicillin and ciprofloxacin resistance, acmEfm and esp) shows that drug resistance, far from limited to hospitals, may be spreading into the most remote areas of the globe
即时诊断使癣患者获得缓解
第21届欧洲临床微生物学与感染病大会(ECCMID)报道 开发出一种致癣真菌的即时分析法，可能意味着患者能在数天而非数周得到诊断和治疗，因而防止疾病扩散。癣或脚癣在一般人群中很常见，估计5人中就有1人感染。现在科学家已发明了一种依靠识别不同种类致癣真菌中的DNA的新技术，该技术已在数千样本中经过了试验。
原文摘要：
A clinical evaluation of two novel PCR-based analyses for the diagnosis of dermatophytosis in skin and hair
Objective: Classic diagnosis of dermatophytosis may require several weeks due to the slow-growing nature of dermatophytes. We implemented a multiplex PCR detecting any dermatophyte and Trichophyton rubrum specifically in 2006 and subsequently developed and evaluated species specific PCRs for the other common human pathogenic species which were implemented in the spring 2010. Here we present the performance of PCR-based analyses of skin and hair specimens compared with traditional diagnostics.
Methods: Positive rates and species distribution were retrospectively evaluated for samples received in the period from July 15th to October 1st in 2009 (before implementation of new PCR tests) and in 2010 (after implementation of new tests). The diagnostic algorithms for PCR tests were based on epidemiological statistics. Thus, skin samples (other than from feet) were channelled to two specific PCR assays detecting all Trichophyton sp., Microsporum canis/audouinii and all species within the T. mentagrophytes complex (T. interdigitale, A. vanbreuseghemii, A. benhamiae and T. erinacei). Hair/scalp samples were subjected to Trichophyton sp., M. canis/audouinii, M. canis and T. violaceum specific PCR assays. Samples negative for T. rubrum but positive in the pan-dermatophyte PCR were subjected to the T. mentagrophytes complex specific PCR.
Results: A total of 3148 and 3266 samples were collected in the 2009 and the 2010 periods respectively (Table). Overall, more than 75 % of the samples were subjected to the previously described PCR analysis detecting all dermatophytes and T. rubrum specifically and no significant changes between 2009 and 2010 in sample number or species distribution were observed. Samples submitted to the two novel PCR assays constituted 6.5 % and a total number of 213 analyses were ordered. Comparing again 2009 and 2010 we demonstrate that except an increase in detected T. rubrum the species distribution statistically was not different indicating that the performances of the novel analyses were as intended.
Conclusion: Dermatophytosis is by far the most prevalent fungal infection and many are affected by a fast and confident diagnosis of such infections. Here we demonstrate that the implementation of two novel PCR-based analyses for diagnosis of dermatophytosis in skin and hair potentially can replace culturing and thereby reducing the diagnosis-time from several weeks to a few days.
新纳米传感器有助于防止耐药性
第21届欧洲临床微生物学与感染病大会（ECCMID 2011)报道 “超级细菌”如耐甲氧西林金黄色葡萄球菌（MRSA）的出现证明了抗生素耐药性的威胁在不断增加，这大多由抗生素滥用或使用不当所致。面临着药物管道中新抗生素的缺乏，我们需要慎重地使用现有的抗生素，以避免耐药性的增加。要做到这点，一种方法就是确保给予患者的药物剂量精确，但精确剂量的确定在一定程度上依赖于个体对药物的生化过程。
科学家现在已开发出了一种新纳米传感器，它可测定血流中的循环药物浓度，并能观察药物如何作用于细菌。这可能意味着有一天将给予患者个体化的抗生素疗程。
研究摘要链接：Nanosensors for antibiotic discovery and therapeutic drug monitoring in real time
原文摘要：Antibiotic use, stewardship and resistance in the hospital: optimising outcomes
Nanosensors for antibiotic discovery and therapeutic drug monitoring in real time
J. Ndieyira*, N. Kappeler, S. Logan, R. McKendry, G. Aeppli (London, UK)
Today the emergence of new infections and the re-emergence of old enemies, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) is a major global healthcare problem. The frequent use of antimicrobial agents in developing countries where they are readily available without prescription and failure to complete treatment courses have escalated development of resistance to antibiotics. Faced with shortages of new antibiotics in the drug pipeline, prudent use of current antibiotics is necessary to curb the incorrect usage of antibiotics which has contributed to the fuelling of anti-microbial drug resistance. Alternative approach is to focus on precise dosing by employing novel technologies to optimise drug therapy for better disease management.
Here we report the development of a new point-of-care (POC) nanosensor, which in combination with a new model, can be used to probe in real time, the concentrations of active “free drug” circulating in serum as well as directly quantify the drug-target interactions at the receptor site. Using model bacterial cell wall peptides terminating in Lysine D-Alanine D-Alanine (DAla) on the cantilever surface and antibiotics incubated with serum, the surface drug-mucopeptide and solution drug-serum interactions were simultaneously quantified in near-physiological conditions. Thereby, the effect of serum binding on the antibiotic activity is determined, allowing precise tuning by adjusting the antibiotic doses to optimize antimicrobial activity and monitor drug resistance. 1 These findings provide a new paradigm for POC applications in personalised medicine and drug discovery process.
与青霉素耐药相关的肺炎链球菌的特殊变异性
第21届欧洲临床微生物学与感染病大会（ECCMID）报道 肺炎链球菌是造成急性中耳炎和有创性感染如肺炎、血流感染和脑膜炎的主要原因。和所有细菌一样，肺炎链球菌存在不同的变异（或血清型）。了解血清型和疾病之间的联系，有助于开发出新的抗肺炎疫苗和监测细菌对青霉素的耐药性。
最常分离的肺炎链球菌血清型14，在急性中耳炎和有创性感染中均有。与有创性感染相比，从急性中耳炎中分离出的19A，9V，19F和3血清型较常见。14, 19A, 6A,和9V血清型大多与青霉素耐药相关。
详情点击：Serotype distribution of Streptococcus pneumoniae isolated from Argentinian paediatric patients
原文摘要：
Paediatric infections: preclinical and clinical data
Serotype distribution of Streptococcus pneumoniae isolated from Argentinian paediatric patients
V. Reijtman, S. Fossati, C. Hérnandez, P. Sommerfleck, P. Bernaldez, M. Litterio, J. Pinheiro, H. Lopardo* (Buenos Aires, AR)
Introduction: Streptococcus pneumoniae (Spn) is a major cause of acute otitis media (AOM) and invasive infections (INV) such as pneumonia, blood-stream infections and meningitis. Identification of serotypes involved in different pathologies may help in deciding formulations of new anti-pneumococcal vaccines and is directly related to levels of resistance to penicillin.
Objectives: To record the serotype distribution in AOM and INV in pediatric patients. To evaluate the coverage of 7-valent (PCV7), 10-valent (PCV10) and 13-valent (PCV13) pneumococcal protein conjugate vaccines. To evaluate the relationship between serotypes and resistance to penicillin.
Materials and methods: Between May 2009- August 2010 we studied 127 Spn isolated from middle ears of <10 y-o patients by tympanocentesis and 89 Spn isolated from normally sterile fluids in <19 y-o patients with INV. They were identified by optochin susceptibility and bile solubility. Penicillin MICs were determined by the Etest and were interpreted using CLSI guidelines. Serotyping was performed by the quellung reaction.
Results: Thirty serotypes were identified. The twelve most frequently isolated serotypes were, in decreasing order, 14 (14.2%); 19A (11.8%); 9V (8.7%); 3 and 19F (7.1%); 6A (6.3%); 18C (4.7%); 23F (3.1%); 5, 6B, 7F and 33F (2.4%) in AOM, and 14 (28.1%); 1 (6.7%); 5, 12F and 19A (5.6%); 6B and 18C (4.5%); 3, 6A, 7F, 15A and 19F (3.4%) in INV. Serotypes related to penicillin resistance were: 14; 19A; 6A y 9V. The coverage of different vaccines was 41.7% and 44.9% by PCV7, 48.1% and 60.6% by PCV10, and 73.3% and 73.0% by PCV13; for AOM and INV respectively.
Conclusion: The most frequently isolated serotype was 14 in both cases. Serotypes: 19A, 9V, 19F y 3 were isolated most frequently in AOM that in INV (p>0.05). The highest potential coverage would be obtained with PCV13 (>70%). Non-significant differences between coverage of Spn in OMA and INV were observed with all vaccines.
进口鸡肉的大肠肝菌感染率及耐药性
第21届欧洲临床微生物学与感染病大会（ECCMID）报道 进口肉类是一令人担忧的大肠杆菌感染源，因为出口国对肉类的质量控制可能没有进口国严格。一项对瑞士进口冷冻鸡肉的调查显示，与来自欧洲其他地方的进口鸡肉19%的大肠杆菌感染率相比，来自南美的进口鸡肉的大肠杆菌感染率高达92%。
两个区域的大肠杆菌均有一定的抗生素耐药性，但来自南美的进口鸡肉的细菌相较于来自欧洲的进口鸡肉的细菌对较多的抗生素耐药，并有较多的耐药基因。来自丹麦的进口鸡肉的大肠杆菌对抗生素治疗最敏感。
详情点击：High prevalence of ESBL-producing Escherichia coli in chicken meat imported into Sweden
原文摘要：
Epidemiology of antimicrobial resistance
High prevalence of ESBL-producing Escherichia coli in chicken meat imported into Sweden
S. Börjesson*, M. Egervärn, M. Finn, I. Tillander, C. Wiberg, S. Englund (Uppsala, SE)
Objectives: Investigate if chicken meat imported into Sweden from South America and Europe may be a potential source for extended spectrum β-lactamase (ESBL) producing Escherichia coli.
Methods: In total, 115 samples, 36 South American and 79 European, from imported fresh, tenderized and frozen chicken meat were collected in retail stores and outlets during 2009 and 2010. The meat was subjected to stomaching, put in pre-enrichment broth containing cefotaxime and incubated overnight. Potential ESBL-producing E. coli was isolated using CHROMagar™ ESBL and CHROMagar™ supplemented with cefotaxime. ESBL-producing E. coli was verified by Etest® ESBL. Antibiotic susceptibility to 11 antibiotics, belonging to 7 classes, was assessed using VetMICTM GN-mo microtitre plates. The presence of antibiotic resistance genes, including the ESBL gene groups, was identified using Identibac AMR-ve ArrayTube™. The specific gene variants responsible for ESBL production were determined by sequencing using BigDye® v1.1.
Results: In total 42% of the chicken meat was identified to contain ESBL producing E. coli. The meat from South America was positive in 92% of the cases and in the European meat 19% was positive. The following ESBL gene variants were identified: cmy-2, ctx-m1, ctx-m1 + tem-1, ctx-m2, ctx-m2 + tem1, ctx-m8, ctx-m8 + tem-1, ctx-m14 and tem-135. The ctx-m8 and ctx-m14 were only identified in isolates from South American meat and ctx-m1 and tem-135 were only identified in isolates from European meat. Resistance to chloramphenicol (4 isolates) and florfenicol (1 isolate) were exclusively found among the South American isolates from South American meat. One isolate from Chilean meat was susceptible to colistin only. Overall, isolates from South American meat showed resistance to a wider range of antibiotics and carried more genes encoding antibiotic resistance compared to the isolates from European meat. Isolates from Danish meat were the most susceptible generally showing resistance to beta-lactams only.
Conclusion: ESBL-producing E. coli were frequently identified in chicken meat imported into Sweden, indicating it as a possible source for gut colonization. Chicken meat from South American had a much higher prevalence of ESBL-producing E. coli than chicken meat imported into Sweden from Europe.
