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Metallo-β-lactamase 생성 녹농균에서 Class 1 Integron의 유전형 분석

Characterization of Class 1 Integrons in Metallo-β- lactamase-producing Pseudomonas aeruginosa

박종우|신소연|송정훈|구선회|성지연|권계철|고지선
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2009.03|Annals of Clinical Microbiology|제12권 제1호|pp. 17-23

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키워드

Class 1 integronMetallo-β-lactamase (MBL)Multidrug resistance Pseudomonas aeruginosa

초록

배경: 강력한 carbapenemase인 metallo-β-lactamase (MBL) 유전자는 세균간의 내성유전자 확산에 중요한 역할을 하는 integron에 존재하는 경우가 많다. 본 연구에서는 imipenem 비감수성 녹농균을 대상으로 carbaepenmase의 유전형을 분석하 고 이 유전자들이 class 1 integron에 위치하는지를 확인하였다. 방법: 2006년 7월부터 2008년 3월까지 충남대학교병원에서 분리된 imipenem 비감수성 녹농균 81주를 대상으로 하였다. Hodge 변법과 double disk synergy 시험을 이용하여 각각 carbapenemase와 MBL의 생성여부를 결정하였고 PCR과 염기서 열 분석을 통하여 carbapenemase 유전자와 class 1 integron의 유전형을 분석하였다. 역학연구는 repetitive element sequence- based (Rep)-PCR로 하였다. 결과: Imipenem 비감수성 녹농균 81주 중 13.6%에 해당하는 11주가 MBL을 생성하는 것으로 나타났다. 이들 중 10주가 blaIMP-1을 가지고 있던 반면 blaVIM-2를 가지고 있던 균주는 단 한 주 뿐이었다. IMP-1 생성주의 경우 모두 4.0 kb의 integron을 가지고 있는 것으로 나타났으며 이 integron에는 chloramphenicol, aminoglycoside 및 β-lactam 항균제 내성유전자 가 위치해 있었다. 그러나 blaIMP-1은 integron 상에 위치해 있지 않았다. 반면 VIM-2 생성균주에서는 blaVIM-2가 2.5 kb의 integron 상에 위치해 있었다. 10주의 IMP-1 생성균주는 Rep-PCR에서 한 가지의 동일한 밴드패턴을 보였다. 결론: IMP-1 β-lactamase를 생성하는 녹농균이 충청지역에 확산되어 있으며 특히 이 균주들은 모두 다양한 항균제 내성 유전자 카세트가 포함된 class 1 integron을 가지고 있었다.

Abstract

Background: The genes of metallo-β-lactamase (MBL), a powerful carbapenemase, are carried as a part of the mobile gene cassettes inserted into integrons playing an important role in rapid dissemination of antibiotic resistance genes among bacterial isolates. In this study, we investigated carbapenemase genes and class 1 integrons integrated into the gene cassettes in imipenem-non susceptible P. aeruginosa. Methods: From July 2006 to March 2008, 81 consecutive, non-duplicate, imipenem-non susceptible P. aeruginosa were isolated at Chungnam National University Hospital in Chungcheong province of Korea. The modified Hodge and double disk synergy tests were conducted for the screening of carbapenemase and MBL production, respectively, and PCR and DNA sequencing were performed for the detection of carbapenemase genes and class 1 integron gene cassettes. We also employed the repetitive element sequence- based (Rep)-PCR method for an epidemiologic study. Results: MBLs were detected in 13.6% (11/81) of imipenem-non susceptible P. aeruginosa. Ten isolates were found to carry blaIMP-1, whereas 1 isolate was found to carry a blaVIM-2. All of the IMP-1-producing strains harbored 4.0 kb class 1 integron containing chloramphenicol, aminoglycoside, and β-lactamresistant genes. However, blaIMP-1 was not detected at class 1 integron. A 2.5 kb class 1 integron harboring blaVIM-2 was detected in a VIIM-2- producing strain. One identical pattern was observed in ten IMP-1 producing strains. Conclusion: IMP-1 producing P. aeruginosa strains are currently distributed throughout Chungcheong province of Korea. In particular, all of the strains harbored class 1 integrons containing variant antibiotic resistance gene cassettes.

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