충청지역의 임상검체로부터 분리된 Acinetobacter calcoaceticus-baumannii Complex를 대상으로 항균제 내성 유전자 비교분석
Distribution of Antimicrobial Resistant Genes in Acinetobacter calcoaceticus-baumannii Complex Isolated from Clinical Specimens in Chungcheong, Korea
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초록
Acinetobacter calcoaceticus-baumannii (Acb) complex 에 속한 종들은 빈번하게 병원감염 및 기회감염을 일으킨다. 또한 다제내성인 경우가 많아 이 균들의 감염증 치료를 위한 항균제 선택이 매우 제한적이다. 본 연구에서는 ciprofloxacin 내성Acinetobacter species 53균주를 대상으로 fluoroquinolone 내성기전을 조사했다. 항균제 감수성 양상을 조사하기 위해 디스크확산법이 시행되었다. Fluoroquinolone 내성과 관련된 유전자 및 돌연변이 검출을 위해 PCR과 염기서열분석이 이루어졌다. 본 연구에서 수집된 53균주의 ciprofloxacin 내성Acinetobacter 중 47균주가 gyrA 유전자의 83번째 serine 아미노산 잔기와 parC 유전자의 80번째 serine 아미노산 잔기가 leucine 잔기로 치환된 sense mutations 가지고 있는 것으로나타났다. gyrA와 parC 유전자에 sense mutations을 가지고있는 47균주 중 44균주가 A. baumannii 였고 3균주는 A. pittii 였다. 본 연구에서 조사대상이 되었던 Acb complex 균주들 중plasmid-mediated quinolone resistance (PMQR) determinants를가지고 있는 균주는 한나도 없었다. 46 균주의ciprofloxacin 내성 A. baumannii 는 A, B, 또는 F형의banding pattern을 보였는데 이는 충청지역에 위치한 일개의병원에 ciprofloxacin 내성 A. baumannii가 수평확산 되어 있음을 의미한다. Fluoroquinolone 내성 Acb complex 균주의집락화 및 확산을 막기 위해서 다제내성 균주들을 대상으로 항균제 내성인자들을 지속적으로 조사하고 모니터링할 필요가 있을 것으로 사료된다.
Abstract
Species that belong to the Acinetobacter calcoaceticus-baumannii (Acb) complex are major causes of hospital-acquired infections. They are important opportunistic pathogens. These species are usually multidrug resistant (MDR), and the therapeutic options to treat the infections caused by these species are limited. In the present study, we investigated fluoroquinolone resistance mechanisms in 53 ciprofloxacin resistant Acinetobacter species isolates in Chungcheong, Korea. Antimicrobial susceptibilities were determined using the disk-diffusion method. Detections of genes and identification of mutations associated with fluoroquinolone resistance were carried out using PCR and DNA sequencing. In our study, 47 out of 53 ciprofloxacin resistant Acinetobacter isolates harbored sense mutations at the 83rd residue (serine to leucine) in the gyrA gene as well as at the 80th residue (serine to leucine) in the parC gene. Among the 47 isolates harboring sense mutations in gyrA and parC gene, 44 isolates were A. baumannii and 3 isolates were A. pittii. Plasmid-mediated quinolone resistance (PMQR) determinants were detected in isolates in our study. Among the 46 ciprofloxacin resistant A. baumannii isolates, 41 showed type A, B, or F banding patterns on their REP-PCR profiles. This result suggests that clonal relation and horizontal spreading of the bacterial isolates have been around hospitals in Chungcheong area. To prevent colonization and disseminations of fluoroquinolone resistance Acb complex isolates, continuous investigation and monitoring of antimicrobial resistant determinants of MDR isolates are needed.
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