한 대학병원에서 다년간 수집된 Imipenem 내성 Acinetobacterbaumannii와 Pseudomonas aeruginosa의 Carbapenemase와Integrase 내성유전자 보유율
Prevalence of Carbapenemase and Integrase Genes inImipenem-resistant Acinetobacter baumannii andPseudomonas aeruginosa Collected over Several Yearsin a University Hospital
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배경: Imipenem 내성 Acinetobacter baumannii (IRAB)와 imipenem 내성 Pseudomonas aeruginosa (IRPA)가 전세계적으로 증가하고 있다. 최근 분자생물학적 연구에 의하면 carbapenemase의 보유율도 증가하고 있다. 그러나, 국내에서 carbapenemase와 integrase 유전자를 가진 IRAB와 IRPA의 빈도에 대해 한 병원에서 다년간 조사한 보고는 드물기 때문에 본 연구를 시행하였다. 방법: 2003년부터 2006년까지 4년간 조선대학교병원 진단검사의학과에서 수집한 IRAB 46주와 IRPA 51주에 대해서 carbapenemase 유전자(blaOXA-23, blaOXA-24, blaOXA-58, blaIMP-1, blaVIM-2, blaSIM-1, blaSPM-1)와 integrase 유전자(intI1, intI2, intI3)를 PCR법으로 조사하였다. 결과: Integrase 유전자는 모두 class 1이었고, 보유율은 IRPA보다 IRAB가 더 높았는데 두 균종에서 모두 매년 증가하여 2006년에는 100%에 달했다. IRAB는 2003년에 blaIMP-1과 blaVIM-2의 보유율이 각각 57%와 64%로 다른 연도에 비해 높았으나, 2004년과 2005년에는 각각 1주에서만 blaVIM-2와 blaIMP-1이 양성이었다. IRPA는 2005년과 2006년에 각각 blaVIM-2와 blaOXA-23 1주씩만 양성으로 carbapenemase 보유율이 매우 낮았다. 그 밖에 다른 carbapenemase 유전자는 IRAB와 IRPA 모두에서 음성이었다. Rep-PCR 결과는 서로 패턴이 다르게 나타났다. 결론: Carbapenemase 유전자 보유율은 2003년을 제외하고는 비교적 낮았으며 연도별 차이를 보였다. IRAB와 IRPA의 class 1 integrase의 보유율은 매우 높았고 해가 갈수록 증가하였다. 2003년에 blaIMP-1, blaVIM-2의 보유율이 매우 높은 이유를 알 수 없었지만, rep-PCR을 시행한 결과 서로 패턴이 달랐기 때문에blaIMP-1이나 blaVIM-2을 보유한 동일한 클론이 퍼진 결과는 아님을 알 수 있었다.
Abstract
Background: The incidence of infections with imipenem- resistant Acinetobacter baumannii (IRAB) and Pseudomonas aeruginosa (IRPA) is increasing worldwide, and recent molecular studies indicate that the prevalence of carbapenemases is increasing in various parts of the world. However, few long-term longitudinal studies have assessed the prevalence of IRAB- and IRPA-derived carbapenemases and integrases in a hospital setting in Korea. Methods: The carbapenemase genes (blaOXA-23, blaOXA-24, blaOXA-58, blaIMP-1, blaVIM-2, blaSIM-1, blaSPM-1) and integrase genes (intI1, intI2, intI3) produced by 46 IRAB strains and 51 IRPA strains collected at Chosun University Hospital between 2003 and 2006 were determined by PCR. Results: The IRAB strains produced class 1 integrases more often than did the IRPA strains. However, the incidence increased steadily in both strains, reaching 100% in 2006. Carbapenemases of blaIMP-1 and blaVIM-2 types were found in 57% and 64% of the IRAB strains, respectively, in 2003. However, only one strain with blaVIM-2 was found in 2004 and another one with blaIMP-1 in 2005. The prevalence of carbapenemases was very low in the IRPA strains, just one strain with blaVIM-2 in 2005 and another one with blaoxa-23 in 2006. No other types of carbapenemase genes were detected in both strains. Rep-PCR of IRAB strains in 2003 showed different patterns. Conclusion: The incidence of carbapenemase varied by year but was generally low, except in 2003. The prevalence of class 1 integrases was consistently high and increased every year. The reason for the high prevalence of carbapenemases in 2003 is still unknown, but we assumed that it was not from the spread of a clone containing either blaIMP-1 or blaVIM-2 because the strains exhibited different rep-PCR patterns.
참고문헌 (26)
- "Rapidly rising prevalence of nosocomial multidrugresistant,Gram-negative bacilli: a 9-year surveillance study", 25, pp.842~846 (2004)
- "Surveillance for antimicrobial susceptibility among clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii from hospitalized patients in the United States, 1998 to 2001", 47, pp.1681~1688 (2003)
- "Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features", 9, pp.148~165 (1996)
- "In-vitro activity ofampicillin", sulbactam against multiresistant Acinetobacter calcoaceticusvar, 298~300
- "Genotypic and phenotypic similarity of multiresistant Acinetobacter baumanniiisolates in the Czech Republic", 48, pp.287~296 (1999)
- "Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa", 43, pp.S49~S56 (2006)
- "Typing and characterization of carbapenem-resistant Acinetobacter calcoaceticus-baumannii complex in a Chinese hospital", 53, pp.653~656 (2004)
- "Molecular characterization of an enterobacterial metallo β-lactamase found in a clinical isolate of Serratia marcescens thatshows imipenem resistance", osa(e), pp.71~8
- "Nosocomial outbreak of carbapenem-resistant Pseudomonas aeruginosa with a new blaIMP allele, blaIMP-7", 46, pp.255~258 (2002)
- Lauretti L, "Cloning and characterization of blaVIM a new integron-borne metallo-β-lactamase gene from a Pseudomonasaeruginosa clinical isolate", 43, pp.1584~1590 (1999)
- Kim IS, "Screening and identification of metallo-β-lactamase gene in clinical isolates of imipenem-resistantPseudomonas aeruginosa", 24, pp.177~182 (2004)
- "Characterization of VIM-2 a carbapenem-hydrolyzing metallo-β-lactamase and its plasmid- and integron-borne gene from aPseudomonas aeruginosaclinical isolate in France", 44, pp.891~897 (2000)
- "Identification of epidemic strains of Acinetobacterbaumannii by integrase gene PCR", 39, pp.8~13 (2001)
- "Class I integrons in Gram-negative isolates fromdifferent European hospitals and association with decreased susceptibilityto multiple antibiotic compounds", 42, pp.689~696 (1998)
- "Gene cassettes: a new class of mobile element", 141, pp.3015~3027 (1995)
- "Building communication networks: international network for the study and prevention of emerging antimicrobial resistance", 7, pp.319~322 (2001)
- "Prevalence of metallo-β-lactamase among Pseudomonas aeruginosa and Acinetobacter baumannii in a Korean university hospital and comparisonof screening methods for detecting metallo-β-lactamase", 54, pp.411~418 (2003)
- "Novel acquired metallo-β-lactamase gene, blaSIM-1, in a class 1 integron from Acinetobacter baumannii clinical isolates from Korea", 49, pp.4485~4491 (2005)
- "Outbreaks of imipenem-resistant Acinetobacter baumannii producing carbapenemases in Korea", 44, pp.423~431 (2006)
- "Evaluation of typing of Vibrio parahaemolyticus by three PCR methods using specific primers", 39, pp.4233~4240 (2001)
- "PCR detection of metallo-β-lactamase gene (blaIMP) in gram-negative rods resistant to broad-spectrum β-lactams", 34, pp.2909~2913 (1996)
- "Outbreak of multiple clones ofimipenem-resistant Acinetobacter baumannii isolates expressing OXA-58 carbapenemase in an intensive care unit", 57, pp.557~561 (2006)
- "VIM- and IMP-type metallo-β-lactamase-producing Pseudomonas spp. and Acinetobacter spp. in Korean hospitals", 9, pp.868~871 (2003)
- "Increasing prevalence and diversity of metallo-β-lactamases inPseudomonas spp., and Enterobacteriaceae from Korea", 50, pp.1884~1886 (2006)
- "Metallo-β-lactamase-producing gram-negative bacilli in Korean Nationwide Surveillance of Antimicrobial Resistance group hospitals in 2003: continued prevalence of VIM-producing Pseudomonas spp. and increase of IMP-producing Acinetobacter spp", 50, pp.51~58 (2004)
- "Dissemination of imipenem-resistant Acinetobacter baumanniistrains carrying the ISAba1 blaOXA-23 genes in a Chinese hospital", 56, pp.1076~1080 (2007)