충청지역의 임상검체로부터 분리된 대장균에 Aminoglycoside-Modifying Enzymes 확산
Spreading of Aminoglycoside-Modifying Enzymes among Escherichia coli Isolated from Clinical Specimens in Chungcheong Province
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초록
세균의 항균제 내성율은 지난 몇십년 동안 지속적으로 상승하였으며 mobile genetic elements를 통한 항균제내성인자들의 전파는 다제내성세균의 출현 및 확산을 가중시켰다. 본연구에서는 임상검체에서 분리된 aminoglycoside에 비감수성 대장균 33주를 대상으로 mobile genetic elements를 통해 전파될 수 있는 aminoglycoside 내성인자를 조사하였다. 16S ribosomal RNA methyltransferases (RMTases)와 amino-glycoside-modifying enzyme (AME)유전자가 PCR과 DNA 염기서열분석을 통해 검출되었다. 그 결과 aac(3′)-II 유전자(54.5%)를 포함하고 있는 균주가 제일 많았으며 그 다음으로 aph(3′)-Ia 유전자(18.2%)가 많았고 aac(6′)-Ib 유전자(15.2%)를 포함하는 균주도 있었다. RMTase 유전자는 본 연구에서는 검출되지 않았다. aac(3′)-II 유전자를 포함하고 있는 18균주 중 17균주가 gentamicin에 내성을 보였으며 이중 16균주는 tobramycin에도 내성을 보였다. aac(6′)-Ib 유전자를 포함하고 있는 5균주는 모두 tobramycin에 내성을 보였다. 본 연구에서 AME 유전자를 획득하는 것은 사람에서 분리된 대장균이 aminoglycoside에 내성을 나타내는 중요한 기전 중 하나임이 확인되었다. 사람으로부터 분리된 세균을 대상으로 지속적으로 항균제 내성인자를 조사하는 것은 내성세균의 확산을 막는데 필요할 것으로 사료된다.
Abstract
The antimicrobial resistance rate in bacteria has increased over the last several decades. The transfer of antimicrobial resistant determinants on mobile genetic elements could cause the accelerated emergence and spread of multidrug resistant bacteria. This study investigated the aminoglycoside resistance determinants transferred by mobile genetic elements in a total of 33 aminoglycoside non-susceptible E. coli isolated from clinical specimens in Chungcheong province. 16S ribosomal RNA methyl-transferases (RMTases) and aminoglycoside-modifying enzyme (AME) genes were detected via PCR and DNA sequencing. The most common AME genes were aac(3′)-II gene (54.5%), followed by aph(3′)-Ia (18.2%) and aac(6′)-Ib (15.2%). None of the evaluated RMTase genes were detected in the 33 isolates. Seventeen of the 18 isolates harboring aac(3′)-II gene were resistant to gentamicin, and 16 of them were resistant to tobramycin. The 5 isolates harboring aac(6′)-Ib gene were all resistant to tobramycin. In this study, we confirmed that one of the important mechanisms of aminoglycoside resistance in E. coli isolated from human is the acquisition of AME genes. Continuing investigations of antimicrobial resistant determinants in bacteria isolated from human may be required to prevent dissemination of antimicrobial resistant bacteria.
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