본문 바로가기
KERD
논문KCI 등재

한 대학병원에서 분리된 blaOXA-23을 생성하는 Acinetobacter baumannii의 분자생물학적 특성

Molecular Characteristics of blaOXA-23-Producing Acinetobacter baumannii Isolated from a University Hospital

이규상|김종배|어영|박순덕|장인호|최일
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2013.09|Annals of Clinical Microbiology|제16권 제3호|pp. 126-133

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

Multidrug resistanceBeta-lactamasesGenesAcinetobacter baumanniiImipenem

초록

배경: 다제내성 Acinetobacter baumannii는 전 세계적으로 병원 내 감염의 중요한 원인균으로 증가하고 있다. 본 연구의 목적은 최근 임상검체에서 분리된 다제내성 A. baumannii의 분자유전학적 특성을 파악하고자 하였다. 방법: 2011년 3월에서 11월까지 강원도 원주시 소재의 한 대학병원에서 분리된 중복분리를 제외한 285주의 imipenem 내성 A. baumannii를 대상으로 다제내성 유전자를 분석하였다. 결과: 285주의 imipenem 내성 A. baumannii 모두에서 blaOXA-23-like와 blaOXA-51-like가 검출되었고, blaOXA-23-like 유전자의 upstream에 ISAba1이 존재하였다. 16S rRNA methylase인 armA 유전자가 153주(50.2%)에서 확인되었으나, rmtA, rmtB, rmtC, rmtD과 npmA 유전자는 검출되지 않았다. Aminoglycoside 변경 효소에 관여하는 유전자 중에서는 aac(6')-Ib가 가장 높은 빈도를 나타내었다. gyrA와 parC의 quinolone resistance determining regions에서 염기서열분석에서는 Ser (TCA) 83이 Leu (TTA)으로, Ser (TCG) 80이 Leu (TTG)로 아미노산이 각각 치환되었다. 대상 균주의 근연도에서는 한 주를 제외한 모든 균주에서 유사한 repetitive extragenic palindromic-PCR profiles이 관찰되었다. 결론: 강원도 원주 지역에서 분리된 다제내성 A. baumannii의 내성 유전자의 특성은 국내 다른 지역과 유사하였다.

Abstract

Background: Multi-drug resistant (MDR) Acinetobacter baumannii has emerged as a significant infectious agent in hospitals worldwide. The purpose of this study was to determine the molecular characterization of MDR A. baumannii clinical isolates. Methods: Two hundred eighty-five strains of non-duplicated A. baumannii collected from March to November 2011 from a university hospital laboratory located in the Wonju area of the Gangwon province of Korea were analyzed for MDR genes. Results: All of the 285 imipenem-resistant A. baumannii isolates were encoded by a blaOXA-23-like gene, and all isolates with the blaOXA-23-like gene had the upstream element ISAba1. The 16S rRNA methylase gene armA was detected in 153 (50.2%) clinical isolates, but rmtA, rmtB, rmtC, rmtD and npmA were not detected in any isolates in the present study. The gene encoding aac(6')-Ib was the most prevalent aminoglycoside-modifying enzyme. The sequencing data for the quinolone resistance-determining region of gyrA and parC revealed the presence of Ser (TCA) 83 to Leu (TTA) and Ser (TCG) 80 to Leu (TTG) substitutions. All but one of the 285 A. baumannii isolates showed similar band patterns on repetitive extragenic palindromic-PCR profiles. Conclusion: The molecular characteristics of the resistance genes of MDR A. baumannii isolates obtained from the Wonju area of Gangwon province were similar to those of other areas in Korea.

참고문헌 (36)

  1. Lockhart SR, "Antimicrobial resistance among Gramnegative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004", J Clin Microbiol, 45, pp.3352~3359 (2007)
  2. Higgins PG, "OXA-143, a novel carbapenem-hydrolyzing class D beta-lactamase in Acinetobacter baumannii", Antimicrob Agents Chemother, 53, pp.5035~5038 (2009)
  3. Kim CK, "Prevalence and diversity of carbapenemases among imipenemnonsusceptible Acinetobacter isolates in Korea: emergence of a novel OXA-182", Diagn Microbiol Infect Dis, 68, pp.432~438 (2010)
  4. Bou G, "OXA-24, a novel class D beta-lactamase with carbapenemase activity in an Acinetobacter baumannii clinical strain", Antimicrob Agents Chemother, 44, pp.1556~1561 (2000)
  5. Afzal-Shah M, "Characterization of OXA-25, OXA-26, and OXA-27, molecular class D beta-lactamases associated with carbapenem resistance in clinical isolates of Acinetobacter baumannii", Antimicrob Agents Chemother, 45, pp.583~588 (2001)
  6. Héritier C, "Genetic and functional analysis of the chromosome-encoded carbapenem-hydrolyzing oxacillinase OXA-40 of Acinetobacter baumannii", Antimicrob Agents Chemother, 47, pp.268~273 (2003)
  7. Seok Hoon Jeong, "Outbreaks of Imipenem-Resistant Acinetobacter baumannii Producing Carbapenemases in Korea", The Journal of Microbiology, 44(4), pp.423~431 (2006), 한국미생물학회
  8. 이경원, "2006년 서울과 경기지역 4개 병원에서 분리된 Carbapenem 내성 Acinetobacter spp.의 내성 기전과 분자역학", Annals of Clinical Microbiology, 13(1), pp.27~33 (2010), 대한임상미생물학회
  9. Segal H, "Extended- 10 promoter in ISAba-1 upstream of blaOXA-23 from Acinetobacter baumannii", Antimicrob Agents Chemother, 51, pp.3040~3041 (2007)
  10. Peleg AY, "Acinetobacter baumannii: emergence of a successful pathogen", Clin Microbiol Rev, 21, pp.538~582 (2008)
  11. Turton JF, "The role of ISAba1 in expression of OXA carbapenemase genes in Acinetobacter baumannii", FEMS Microbiol Lett, 258, pp.72~77 (2006)
  12. 배일권, "Carbapenem 내성 Acinetobacter baumannii", Annals of Clinical Microbiology, 15(1), pp.1~8 (2012), 대한임상미생물학회
  13. Yong D, "High prevalence of PER-1 extended-spectrum beta-lactamase-producing Acinetobacter spp. in Korea", Antimicrob Agents Chemother, 47, pp.1749~1751 (2003)
  14. Kim JW, "Characterization of Acinetobacter baumannii carrying blaOXA-23, blaPER-1 and armA in a Korean hospital", Clin Microbiol Infect, 14, pp.716~718 (2008)
  15. Lee G, "Prevalence of multidrug-resistant Acinetobacter baumannii producing OXA-23-like from a healthcare facility of Gangwon Province, South Korea", Int J Antimicrob Agents, 39, pp.452~453 (2012)
  16. Vila J, "Mutation in the gyrA gene of quinolone-resistant clinical isolates of Acinetobacter baumannii", Antimicrob Agents Chemother, 39, pp.1201~1203 (1995)
  17. Vila J, "Quinolone-resistance mutations in the topoisomerase IV parC gene of Acinetobacter baumannii", J Antimicrob Chemother, 39, pp.757~762 (1997)
  18. Wisplinghoff H, "Mutations in gyrA and parC associated with resistance to fluoroquinolones in epidemiologically defined clinical strains of Acinetobacter baumannii", J Antimicrob Chemother, 51, pp.177~180 (2003)
  19. Hamouda A, "Novel gyrA and parC point mutations in two strains of Acinetobacter baumannii resistant to ciprofloxacin", J Antimicrob Chemother, 54, pp.695~696 (2004)
  20. Vakulenko SB, "Versatility of aminoglycosides and prospects for their future", Clin Microbiol Rev, 16, pp.430~450 (2003)
  21. Fritsche TR, "Detection of methyltransferases conferring high-level resistance to aminoglycosides in enterobacteriaceae from Europe, North America, and Latin America", Antimicrob Agents Chemother, 52, pp.1843~1845 (2008)
  22. Galimand M, "Plasmid-mediated high-level resistance to aminoglycosides in Enterobacteriaceae due to 16S rRNA methylation", Antimicrob Agents Chemother, 47, pp.2565~2571 (2003)
  23. Lee H, "Dissemination of 16S rRNA methylase-mediated highly amikacinresistant isolates of Klebsiella pneumoniae and Acinetobacter baumannii in Korea", Diagn Microbiol Infect Dis, 56, pp.305~312 (2006)
  24. Dijkshoorn L, "Evaluation of amplified ribosomal DNA restriction analysis for identification of Acinetobacter genomic species", Syst Appl Microbiol, 21, pp.33~39 (1998)
  25. Clinical and Laboratory Standards Institute, "Performance Standards for Antimicrobial Susceptibility Testing; Twenty-first Informational Supplement. Document M100-S21", Clinical and La-boratory Standards Institute, ~ (2011)
  26. Lee K, "Evaluation of the Hodge test and the imipenem-EDTA double-disk synergy test for differentiating metallo-beta-lactamase-producing isolates of Pseudomonas spp. and Acinetobacter spp", J Clin Microbiol, 41, pp.4623~4629 (2003)
  27. Woodford N, "Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp", Int J Antimicrob Agents, 27, pp.351~353 (2006)
  28. Segal H, "Is ISABA-1 customized for Acinetobacter?", FEMS Microbiol Lett, 243, pp.425~429 (2005)
  29. Hujer KM, "Rapid determination of quinolone resistance in Acinetobacter spp", J Clin Microbiol, 47, pp.1436~1442 (2009)
  30. Akers KS, "Aminoglycoside resistance and susceptibility testing errors in Acinetobacter baumannii-calcoaceticus complex", J Clin Microbiol, 48, pp.1132~1138 (2010)
  31. 이경원, "Further Increases in Carbapenem-, Amikacin-, and Fluoroquinolone-Resistant Isolates of Acinetobacter spp. and P. aeruginosa in Korea: KONSAR Study 2009", Yonsei Medical Journal, 52(5), pp.793~802 (2011), 연세대학교의과대학
  32. Lee K, "Wide dissemination of OXA-type carbapenemases in clinical Acinetobacter spp", Int J Antimicrob Agents, 33, pp.520~524 (2009)
  33. Park YS, "Extensively drug-resistant Acinetobacter baumannii: risk factors for acquisition and prevalent OXA-type carbapenemases--a multicentre study", Int J Antimicrob Agents, 36, pp.430~435 (2010)
  34. Mendes RE, "Emergence and widespread dissemination of OXA-23, -24", 40 and -58 carbapenemases among Acinetobacter spp. in Asia-Pacific nations: report from the SENTRY Surveillance Program, 2009, pp.63, 55~59
  35. 구선회, "Genetic Basis of Multidrug-resistant Acinetobacter baumannii Clinical Isolates from Three University Hospitals in Chungcheong Province, Korea", Annals of Laboratory Medicine, 30(5), pp.498~506 (2010), 대한진단검사의학회
  36. Cho YJ, "Genetic basis of resistance to aminoglycosides in Acinetobacter spp. and spread of armA in Acinetobacter baumannii sequence group 1 in Korean hospitals", Diagn Microbiol Infect Dis, 64, pp.185~190 (2009)

관련 논문AI추천

다제내성 Acinetobacter baumannii의 항생제 내성 유전자 분석김종배, 이규상, 임진아, 최연임대한임상검사과학회 · 대한임상검사과학회지2016 · 제48권 제3호대전지역 소재 대학병원에 blaOXA-23 유전자를 가지고 있는 다제내성 Acinetobacter baumannii의 확산성지연대한임상검사과학회 · 대한임상검사과학회지2016 · 제48권 제2호Characterization of Acinetobacter baumannii Co-producing Carbapenemases OXA-23 and OXA-66, and armA 16S Ribosomal RNA Methylase at a University Hospital in South Korea류동희, 손보라, 신경섭, 신동익, 정혜원, 한규동, 홍승복대한임상미생물학회 · Annals of Clinical Microbiology2011 · 제14권 제2호OXA-23 혹은 IMP-1 β-Lactamase 생성 Acinetobacter baumannii에 의한 감염의 분자 역학박광옥, 배일권, 손한철, 정석훈대한임상미생물학회 · Annals of Clinical Microbiology2005 · 제8권 제2호Molecular and Epidemiological Characterization of Carbapenem-Resistant Acinetobacter baumannii in Non-Tertiary Korean Hospitals김화수, 박선옥, 유재일, 유정식, 이경민, 이영선, 정경태연세대학교의과대학 · Yonsei Medical Journal2013 · 제54권 제1호Genetic Basis of Multidrug-resistant Acinetobacter baumannii Clinical Isolates from Three University Hospitals in Chungcheong Province, Korea구선회, 권계철, 성지연, 조혜현대한진단검사의학회 · Annals of Laboratory Medicine2010 · 제30권 제5호

이 간행물의 다른 논문 (6건)

Enterobacteriaceae에 대한 β-Lactam제 감수성시험 기준 및 Extended-Spectrum β-Lactamase와 Carbapenemase 검출을 위한 전략박연준, 송원근pp. 111-119그람음성 막대균 보존 중 blaVIM-2 및 blaIMP-1 유전자의 소실, 소실 균주의 항균제 감수성 및 유전자의 위치이양순, 정윤섭, 염종화, 이경원, 서영희, 용동은, 임영식pp. 120-125단일 기관에서 장내 기생충 양성률의 변화(2003-2012년)허희재, 이남용, 김영은, 황유연pp. 134-139인플루엔자 A 및 A/H1N1/2009 균주 검출을 위한 Cepheid Xpert Flu의 평가손지연, 김지연, 박경선, 이남용, 기창석pp. 140-144시흥지역 1차 의료기관의 균종 및 항균제 감수성윤정숙pp. 145-148
원문 보기