Pseudomonas aeruginosa 와 Acinetobacter baumannii 에서의 Metallo-β-lactamase의 유병률
Prevalence of Metallo-β-lactamases in Imipenem-nonsusceptible Pseudomonas aeruginosa and Acinetobacter baumannii
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배경: 그람음성막대균에서의 metallo-β-lactamase에 대한 연구가 지속되고 있으며 카바페넴을 포함한 대부분의 β-lactam 제제를 가수분해하므로 임상적 중요성이 점차 증가되고 있다. 본 연구는 일개 대학병원에서 분리된 이미페넴에 비감수성 Pseudomonas aeruginosa와 Acinetobacter baumannii를 대상으로 metallo-β-lactamase의 유병률을 조사하였다. 방법: 임상검체에서 분리된 이미페넴 비감수성인 128주의 P. aeruginosa와 93주의 A. baumannii를 대상으로 Vitek GNI와GNS 카드를 이용하여 균의 동정과 감수성검사를 실시하였다. Hodge 변법과 imipenem-EDTA synergy 검사를 이용하여metallo-β-lactamase의 생성유무를 확인하였다. blaIMP-1, blaVIM-1 그리고 blaVIM-2 유전형검사는 다중분획중합효소연쇄반응법을 이용하였다결과: 총 31주의 P. aeruginosa (24.2%)와 3 A. baumannii (3.2%)에서 metallo-β-lactamase를 생성하였다. P. aeruginosa 31주중 20 (15.6%)주에서 blaIMP-1를 11 (8.6%)주에서는 blaVIM-2를 생성하였으며 A. baumannii에서는 1 (1.0%)주에서 blaIMP-1를,2 (2.2%)주에서 blaVIM-2를 생성하였다. 결론: 본 연구결과, 다른 연구와는 달리 이미페넴 비감수성 P. aeruginosa에서 IMP-1이 VIM-2유전자보다 더 흔한 것으로나타났다. 병원 내 감염관리와 metallo-β-lactamase의 유전형의 지역적 역학분석을 위하여 보다 많은 균주를 대상으로지속적인 연구가 필요할 것으로 생각한다. [대한임상미생물학회지 2010;13:169-172]
Abstract
Background: Metallo-β-lactamases (MBLs) have been reported in gram negative bacilli and are becoming increasingly important clinically because the enzymes hydrolyse almost all β-lactams, including carbapenems. Thus, the present study was conducted to determine the prevalence of MBL types in imipenem-nonsusceptible Pseudomonas aeruginosa and Acinetobacter baumannii isolated from a tertiary teaching hospital. Methods: Imipenem-nonsusceptible strains, 128 P. aeruginosa and 93 A. baumannii, were collected from clinical specimens. Identification and susceptibility tests were determined by Vitek GNI and GNS cards. MBL production was determined by modified Hodge test and imipenem-EDTA synergy test. Multiplex PCR amplification of MBL genes including blaIMP-1, blaVIM-1 and blaVIM-2were performed. Results: Thirty-one P. aeruginosa (24.2%) isolates and 3 A. baumannii (3.2%) were found to be MBL producers. In P. aeruginosa, 20 (15.6%) and 11 (8.6%)isolates were positive for blaIMP-1 and blaVIM-2, respectively whereas 1 (1.0%) and 2 (2.2%) isolates in A. baumannii, respectively. Conclusion: IMP-1 is more prevalent MBL type than VIM-2 among imipenem-nonsusceptible P. aeruginosa unlike in other studies. Larger numbers of isolates and sequential studies are strongly recommended for the useful evaluation and monitoring of MBL production in the hospital setting to infection-control. (Korean J Clin Microbiol 2010;13:169-172)
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