충청지역에 위치한 일개의 대학병원에서 분리된 CTX-M-14형 ESBL 생성 대장균을 대상으로 PMQR 유전자 빈도조사
The Prevalence of Plasmid-Mediated Quinolone Resistance Genes among CTX-M-14 Producing Escherichia coli Strains Isolated from a University Hospital in the Chungcheong Province
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초록
최근 들어 CTX-M형 extended-spectrum -lactamase (ESBL) 생성 대장균이 국내는 물론 전세계적으로 빠르게 증가하고있다. 본 연구에서는 충청지역에 위치한 일개의 대학병원에서 분리된 대장균을 대상으로 ESBL 유전자를 중합효소연쇄반응 및 염기서열 분석방법을 통해 확인하였으며, 같은 방법으로 ESBL 생성 대장균으로부터 plasmid mediated quinolone resistance (PMQR) 유전자의 빈도를 조사하였다. 16.0%에 해당하는 25균주가 CTX-M-14 를 생성하였으며 이중 9균주는 CTX-M-15도 동시에 생성하는 것으로 나타났다. 항균제 감수성 시험결과 CTX-M형 ESBL을 생성하는 대장균은 모두 cefotaxime에 내성을 보였다. 한편 CTX-M형ESBL을 생성하는 대장균의 48% (12균주)가 PMQR 유전자를 포함하고 있음이 확인되었는데 8균주가 qnrS1유전자를 그리고 8균주가 aac(6 ’)-Ib-cr 유전자를 포함하고 있었다. 그 중 4균주는 두 개의 유전자를 모두 가지고 있는 것으로 나타났다. 본 연구에서는 플라스미드를 통해 확산될 수 있는 ESBL 및 PMQR 유전자가 대장균사이에 확산되어 있음을 확인하였다. 항균제 내성유전자들의 확산을 막기 위해서는 지속적인 내성유전자의 모니터링과 감시가 필요할 것으로 사료된다.
Abstract
Recently, there has been a considerable increase in the prevalence of CTX-M type exten-ded-spectrum β-lactamase (ESBL)-producing E. coli isolates worldwide, including Korea. To investigate the ESBL genes in the E. coli strains isolated from a university hospital in the Chungcheong area, a study was conducted using PCR amplification and nucleotide sequence analysis of the amplified products to detect the plasmid mediated quinolone resistance (PMQR) genes in ESBL producing E. coli isolates. The number of CTX-M-14 producing isolates was 25 (16.0%) isolates, and of them, 9 (5.8%) isolates also produced CTX-M-15. All CTX-M type ESBL producing E. coli isolates showed resistance to cefotaxime. Twelve (48%) CTX-M type ESBL producing E. coli isolates contained the PMQR genes, 8 contained qnrS1, and 8 contained aac(6’)-Ib-cr. Four isolates harbored both qnrS1 and aac(6’)-Ib-cr genes. In our study, we confirmed that the plasmid mediated antimicrobial resistant determinants—the ESBL and PMQR genes—were distributed in the E. coli isolates. To prevent further spreading of the resistant genes among the E. coli isolates, consistent effort is required to investigate and monitor the resistant genes.
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