Abstract：
Extended-spectrum beta-lactamases (ESBLs) and AmpC producing Enterobacteriaceae are public health threats. This study aims to characterize ESBL and AmpC producing Enterobacteriaceae isolated from sepsis patients. A multicenter study was conducted at four hospitals located in central (Tikur Anbessa and Yekatit 12), southern (Hawassa) and northern (Dessie) parts of Ethiopia. Blood culture was performed among 1416 sepsis patients. Enterobacteriaceae (n = 301) were confirmed using MALDI-TOF and subjected for whole genome sequencing using the Illumina (HiSeq 2500) system. The overall genotypic frequencies of ESBL and AmpC producing Enterobacteriaceae were 75.5% and 14%, respectively. The detection of ESBL producing Enterobacteriaceae at Hawassa, Yekatit 12, Tikur Anbessa and Dessie was 95%, 90%, 82% and 55.8%, respectively. The detection frequency of blaCTX-M, blaTEM and blaSHV genes was 73%, 63% and 33%, respectively. The most frequently detected ESBL gene was blaCTX-M-15 (70.4%). The common AmpC genes were blaACT (n = 22) and blaCMY (n = 13). Of Enterobacteriaceae that harbored AmpC (n = 42), 71% were ESBL co-producers. Both blaTEM-1B (61.5%) and blaSHV-187 (27.6%) were the most frequently detected variants of blaTEM and blaSHV, respectively. The molecular epidemiology of ESBL producing Enterobacteriaceae showed high frequencies and several variants of ESBL and AmpC genes. Good antimicrobial stewardship and standard bacteriological laboratory services are necessary for the effective treatment of ESBL producing Enterobacteriaceae.
摘要：
产超广谱β-内酰胺酶(ESBLs)和AmpC肠杆菌科是公共卫生威胁。这项研究旨在表征从脓毒症患者中分离出的产ESBL和AmpC肠杆菌科。在位于中部的四家医院（TikurAnbessa和Yekatit12）进行了一项多中心研究，埃塞俄比亚的南部（Hawassa）和北部（Dessie）部分。对1416例脓毒症患者进行了血培养。使用MALDI-TOF确认肠杆菌科(n=301),并使用Illumina(HiSeq2500)系统进行全基因组测序。产ESBL和AmpC肠杆菌的总体基因型频率分别为75.5％和14％，分别。在Hawassa检测出产ESBL的肠杆菌科细菌，Yekatit12，TikurAnbessa和Dessie是95％，90%,82%和55.8%，分别。BlaCTX-M的检测频率,blaTEM和blaSHV基因为73%,63%和33%，分别。最常见的ESBL基因是blaCTX-M-15(70.4%)。常见的AmpC基因是blaACT(n=22)和blaCMY(n=13)。在含有AmpC的肠杆菌科中（n=42），71%是ESBL联合生产者。blaTEM-1B(61.5%)和blaSHV-187(27.6%)是blaTEM和blaSHV最常见的变异体,分别。产ESBL肠杆菌科的分子流行病学显示出ESBL和AmpC基因的高频率和几种变体。良好的抗菌管理和标准的细菌学实验室服务对于有效治疗产生ESBL的肠杆菌科是必要的。
