본문 바로가기
KERD
논문KCI 등재

Carbapenem 내성 Acinetobacter spp.의 내성 기전

Mechanisms of Acquiring Carbapenem-resistance in Acinetobacter Species

정석훈
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2009.03|Annals of Clinical Microbiology|제12권 제1호|pp. 1-5

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

OXA-23AcinetobacterMetallo-β-lactamaseOXA carbapenemaseOXA- 51Outer membrane proteinAdeABC efflux pump

초록

Carbapenem 내성 Acinetobacter spp.의 빠른 확산은 임상적으로 심각한 위협이 되고 있다. Acinetobacter spp.의 carbapenem 내성 획득에 가장 중요한 기전은 carbapenemase의 생성이며, 세포외막 단백의 변화, penicillin 결합 단백의 친화도 혹은 발현량의 변이, 유출 펌프의 과량 발현 등 비효소적 기전도 carbapenem 내성 획득에 기여한다. 국내 A. baumannii가 carbapenem 내성을 획득하는 주요 기전은 OXA-23 생성인데 반하여 non-baumannii Acinetobacter의 주요 기전은 metallo-β-lactamase 생성이다.

Abstract

A rapid dissemination of carbapenem-resistant Acinetobacter spp. represents a significant clinical threat. Production of OXA carbapenemases and metallo-β- lactamases (MBLs) is the most important mechanism in acquiring carbapenem resistance in Acinetobacter spp. Carbapenem resistance has also ascribed to nonenzymatic mechanisms, including changes in outer membrane proteins, alterations in the affinity or expression of penicillin-binding proteins, and overexpression of efflux pumps. The most important mechanism in A. baumannii isolates from Korea is the production of OXA-23, while that in other species of Acinetobacter is the production of metallo-β-lactamases.

참고문헌 (29)

  1. Peleg AY, "Acinetobacter baumannii: emergence of a successful pathogen", Clin Microbiol Rev, 21, pp.538~582 (2008)
  2. Gerner-Smidt P, "Ribotyping of the Acinetobacter calcoaceticus- Acinetobacter baumannii complex", J Clin Microbiol, 30, pp.2680~2685 (1992)
  3. 이경원, "High Prevalence of Ceftazidime-Resistant Klebsiella pneumoniae and Increase of Imipenem-Resistant", Yonsei Medical Journal, 47(5), pp.634~645 (2006), 연세대학교의과대학
  4. WHO Network on Antimicrobial Resistance Monitoring: Korean focal point and core laboratory, "Antimicrobial resistance of clinical isolates of bacteria in 2007", Antimirobial Resistance Newsletter, 16, pp.1~2 (2008)
  5. Poirel L and Nordmann P, "Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology", Clin Microbiol Infect, 12, pp.826~836 (2006)
  6. Lee K, "VIM- and IMP-type metallo-β-lactamase-producing Pseudomonas spp. and Acinetobacter spp. in Korean hospitals", Emerg Infect Dis, 9, pp.868~871 (2003)
  7. Yum JH, "Molecular characterization of metallo-β-lactamase-producing Acinetobacter baumannii and Acinetobacter genomospecies 3 from Korea: identification of two new integrons carrying the blaVIM-2 gene cassettes", J Antimicrob Chemother, 49, pp.837~840 (2002)
  8. Lee K, "Novel acquired metallo-β-lactamase gene, blaSIM-1, in a class 1 integron from Acinetobacter baumannii clinical isolates from Korea", Antimicrob Agents Chemother, 49, pp.4485~4491 (2005)
  9. Walsh TR, "Metallo-betalactamases: the quiet before the storm?", Clin Microbiol Rev, 18, pp.306~325 (2005)
  10. Walsh TR, "Clinically significant carbapenemases: an update", Curr Opin Infect Dis, 21, pp.367~371 (2008)
  11. Donald HM, "Sequence analysis of ARI-1, a novel OXA β-lactamase, responsible for imipenem resistance in Acinetobacter baumannii 6B92", Antimicrob Agents Chemother, 44, pp.196~199 (2000)
  12. Zhou H, "Dissemination of imipenem-resistant Acinetobacter baumannii strains carrying the ISAba1 blaOXA-23 genes in a Chinese hospital", J Med Microbiol, 56, pp.1076~1080 (2007)
  13. Afzal-Shah M, "Characterization of OXA-25, OXA-26, and OXA-27, molecular class D β-lactamases associated with carbapenem resistance in clinical isolates of Acinetobacter baumannii", Antimicrob Agents Chemother, 45, pp.583~588 (2001)
  14. Seok Hoon Jeong, "Outbreaks of Imipenem-Resistant Acinetobacter baumannii Producing Carbapenemases in Korea", The Journal of Microbiology, 44(4), pp.423~431 (2006), 한국미생물학회
  15. Bou G, "OXA-24, a novel class D β- lactamase with carbapenemase activity in an Acinetobacter baumannii clinical strain", Antimicrob Agents Chemother, 44, pp.1556~1561 (2000)
  16. Poirel L, "OXA-58, a novel class D β-lactamase involved in resistance to carbapenems in Acinetobacter baumannii", Antimicrob Agents Chemother, 49, pp.202~208 (2005)
  17. Marqué S, "Regional occurrence of plasmid-mediated carbapenem-hydrolyzing oxacillinase OXA-58 in Acinetobacter spp. in Europe", J Clin Microbiol, 43, pp.4885~4888 (2005)
  18. Lee K, "Wide dissemination of OXA-type carbapenemases in clinical Acinetobacter spp. isolates from South Korea", Int J Antimicrob Agents (2008)
  19. Turton JF, "The role of ISAba1 in expression of OXA carbapenemase genes in Acinetobacter baumannii", FEMS Microbiol Lett, 258, pp.72~77 (2006)
  20. Limansky AS, "Loss of a 29-kilodalton outer membrane protein in Acinetobacter baumannii is associated with imipenem resistance", Clin Microbiol, 40, pp.4776~4778 (2002)
  21. Mussi MA, "Acquisition of resistance to carbapenems in multidrug-resistant clinical strains of Acinetobacter baumannii: natural insertional inactivation of a gene encoding a member of a novel family of β-barrel outer membrane proteins", Antimicrob Agents Chemother, 49, pp.1432~1440 (2005)
  22. Bou G, "Characterization of a nosocomial outbreak caused by a multiresistant Acinetobacter baumannii strain with a carbapenem-hydro lyzing enzyme: high-level carbapenem resistance in A. baumannii is not due solely to the presence of beta-lactamases", J Clin Microbiol, 38, pp.3299~3305 (2000)
  23. del Mar Tomás M, "Cloning and functional analysis of the gene encoding the 33- to 36-kilodalton outer membrane protein associated with carbapenem resistance in Acinetobacter baumannii", Antimicrob Agents Chemother, 49, pp.5172~5175 (2005)
  24. Dupont M, "Identification of an OprD homologue in Acinetobacter baumannii", J Proteome Res, 4, pp.2386~2390 (2005)
  25. Wieczorek P, "Multidrug resistant Acinetobacter baumannii - the role of AdeABC (RND family) efflux pump in resistance to antibiotics", Histochem Cytobiol, 46, pp.257~267 (2008)
  26. Héritier C, "Contribution of acquired carbapenem-hydrolyzing oxacillinases to carbapenem resistance in Acinetobacter baumannii", Antimicrob Agents Chemother, 49, pp.3198~3202 (2005)
  27. Magnet S, "Resistance-nodulation-cell division-type efflux pump involved in aminoglycoside resistance in Acinetobacter baumannii strain BM4454", Antimicrob Agents Chemother, 45, pp.3375~3380 (2001)
  28. Marchand I, "Expression of the RND-type efflux pump AdeABC in Acinetobacter baumannii is regulated by the AdeRS two-component system", Antimicrob Agents Chemother, 48, pp.3298~3304 (2004)
  29. Lee Y, "Inactivation ofblaOXA-51-like gene expression by a novel insertion sequence in Acinetobacter baumannii", Korean J Lab Med, 28, pp.388S~ (2008)

관련 논문AI추천

Carbapenem 내성 Acinetobacter baumannii배일권, 이경원, 정석훈대한임상미생물학회 · Annals of Clinical Microbiology2012 · 제15권 제1호2006년 서울과 경기지역 4개 병원에서 분리된 Carbapenem 내성 Acinetobacter spp.의 내성 기전과 분자역학김창기, 노경호, 염종화, 용동은, 이경원, 이창규, 임채승, 정석훈, 정윤섭, 조윤정대한임상미생물학회 · Annals of Clinical Microbiology2010 · 제13권 제1호Metallo-β-lactamase 생성 그람음성 간균용동은대한임상미생물학회 · Annals of Clinical Microbiology2009 · 제12권 제3호Multidrug-Resistant Acinetobacter spp.: Increasingly Problematic Nosocomial Pathogens용동은, 이경원, 정석훈, 정윤섭연세대학교의과대학 · Yonsei Medical Journal2011 · 제52권 제6호국내 대학병원에서 분리된 Metallo-β-Lactamase (MBL) 생성 Acinetobacter spp. 분리주의 높은 출현율과 유전형 특징염종화대한임상검사과학회 · 대한임상검사과학회지2019 · 제51권 제4호대전지역 소재 대학병원에 blaOXA-23 유전자를 가지고 있는 다제내성 Acinetobacter baumannii의 확산성지연대한임상검사과학회 · 대한임상검사과학회지2016 · 제48권 제2호

이 간행물의 다른 논문 (8건)

2006년 진주지역 초등학생에서 분리된 Streptococcus pyogenes의 T 항원형과 emm 유전자형 및 항생제 내성고은하, 김인숙, 김선주pp. 6-10Toxigenic Clostridium difficile 배양에서 종동정과 독소확인 다중 PCR 검사의 적용성흥섭, 김미나, 정재우, 박숙자, 백승미, 장윤하pp. 11-16Metallo-β-lactamase 생성 녹농균에서 Class 1 Integron의 유전형 분석구선회, 송정훈, 고지선, 권계철, 성지연, 신소연, 박종우pp. 17-23Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca와 Proteus mirabilis 에서 Boronic Acid Disk를 이용한 Extended-spectrum β-lactamase와 AmpC β-lactamase 검출김효열, 장인호, 어영, 윤갑준, 박순덕, 권오건pp. 24-29디스크확산법에 의한 Helicobacter pylori의 Clarithromycin과 Amoxicillin 항균제감수성 검사이혜경, 임지훈, 김미나, 이미경, 이미애, 강정옥, 성흥섭, Helicobacter 연구회, 이종욱pp. 30-36
원문 보기