Molecular Epidemiology of Integron-Associated Antimicrobial Gene Cassettes in the Clinical Isolates of Acinetobacter baumannii from Northern Taiwan
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Background: The aims of this study were to understand the molecular epidemiology of integron-associated gene cassettes in Acinetobacter baumannii across four hospitals in northern Taiwan and to clarify the relationship between the presence of integrons and antibiotic-resistant phenotypes. Methods: Sixty-five A. baumannii isolates, collected from the patients of four regional hospitals in northern Taiwan in 2009, were tested for the presence of integrons and their associated gene cassettes. The susceptibility difference between integron-positive and integron-negative A. baumannii strains was analyzed. Antibiotic-resistant phenotypes among A. baumannii with different types of gene cassette array combinations were also compared. Results: Around 72% of the A. baumannii isolates carried class 1 integrase genes. Despite this, only three gene cassette arrays were found in the integrons. Integron-positive strains were significantly more resistant to all the tested antibiotics than the integrase-negative strains. All the four types of A. baumannii with different gene cassette array combinations were multidrug-resistant in nature. Gene cassette array aacA4-catB8-aadA1 existed in all the integron-positive A. baumannii isolates. Repetitive-sequence-based PCR (rep-PCR)results revealed the prevalence of one major cluster of imipenem-resistant A. baumannii strains (84%) in the four regional hospitals. Conclusions: The presence of integrons with associated antimicrobial resistance gene cassettes can be used as a representative marker of multidrug resistance in A. baumannii. Some prevalent gene cassette arrays may exist among epidemiologically unrelated A. baumannii strains.
Abstract
Background: The aims of this study were to understand the molecular epidemiology of integron-associated gene cassettes in Acinetobacter baumannii across four hospitals in northern Taiwan and to clarify the relationship between the presence of integrons and antibiotic-resistant phenotypes. Methods: Sixty-five A. baumannii isolates, collected from the patients of four regional hospitals in northern Taiwan in 2009, were tested for the presence of integrons and their associated gene cassettes. The susceptibility difference between integron-positive and integron-negative A. baumannii strains was analyzed. Antibiotic-resistant phenotypes among A. baumannii with different types of gene cassette array combinations were also compared. Results: Around 72% of the A. baumannii isolates carried class 1 integrase genes. Despite this, only three gene cassette arrays were found in the integrons. Integron-positive strains were significantly more resistant to all the tested antibiotics than the integrase-negative strains. All the four types of A. baumannii with different gene cassette array combinations were multidrug-resistant in nature. Gene cassette array aacA4-catB8-aadA1 existed in all the integron-positive A. baumannii isolates. Repetitive-sequence-based PCR (rep-PCR)results revealed the prevalence of one major cluster of imipenem-resistant A. baumannii strains (84%) in the four regional hospitals. Conclusions: The presence of integrons with associated antimicrobial resistance gene cassettes can be used as a representative marker of multidrug resistance in A. baumannii. Some prevalent gene cassette arrays may exist among epidemiologically unrelated A. baumannii strains.
참고문헌 (29)
- Perez F, "Global challenge of multidrug-resistant Acinetobacter baumannii", Antimicrob Agents Chemother, 51, pp.3471~3484 (2007)
- Peleg AY, "Acinetobacter baumannii: emergence of a successful pathogen", Clin Microbiol Rev, 21, pp.538~582 (2008)
- Valenzuela JK, "Horizontal gene transfer in a polyclonal outbreak of carbapenem- resistant Acinetobacter baumannii", J Clin Microbiol, 45, pp.453~460 (2007)
- Carattoli A, "Importance of integrons in the diffusion of resistance", Vet Res, 32, pp.243~259 (2001)
- Mazel D, "Integrons: agents of bacterial evolution", Nat Rev Microbiol, 4, pp.608~620 (2006)
- Gu B, "Prevalence and characterization of class I integrons among Pseudomonas aeruginosa and Acinetobacter baumannii isolates from patients in Nanjing, China", J Clin Microbiol, 45, pp.241~243 (2007)
- Huang LY, "Dissemination of multidrug-resistant, class 1 integron-carrying Acinetobacter baumannii isolates in Taiwan", Clin Microbiol Infect, 14, pp.1010~1019 (2008)
- Turton JF, "Detection and typing of integrons in epidemic strains of Acinetobacter baumannii found in the United Kingdom", J Clin Microbiol, 43, pp.3074~3082 (2005)
- Chen TL, "Comparison of one-tube multiplex PCR, automated ribotyping and intergenic spacer (ITS) sequencing for rapid identification of Acinetobacter baumannii", Clin Microbiol Infect, 13, pp.801~806 (2007)
- Clinical and Laboratory Standards Institute, "Performance Standards for Antimicrobial Disk Susceptibility Tests. Approved Standards-Tenth edition, M02-A10" (2009), Clinical and Laboratory Standards Institute
- Koeleman JG, "Identification of epidemic strains of Acinetobacter baumannii by integrase gene PCR", J Clin Microbiol, 39, pp.8~13 (2001)
- Vincze T, "NEBcutter: a program to cleave DNA with restriction enzymes", Nucleic Acids Res, 31, pp.3688~3691 (2003)
- Misbah S, "Antibiotic susceptibility and REP-PCR fingerprints of Acinetobacter spp. isolated from a hospital ten years apart", J Hosp Infect, 58, pp.254~261 (2004)
- Gaur A, "Possible role of integrase gene polymerase chain reaction as an epidemiological marker: study of multidrug-resistant Acinetobacter baumannii isolated from nosocomial infections", Int J Antimicrob Agents, 29, pp.446~450 (2007)
- Gallego L, "Carriage of class 1 integrons and antibiotic resistance in clinical isolates of Acinetobacter baumannii from northern Spain", J Med Microbiol, 50, pp.71~77 (2001)
- Gombac F, "Molecular characterization of integrons in epidemiologically unrelated clinical isolates of Acinetobacter baumannii from Italian hospitals reveals a limited diversity of gene cassette arrays", Antimicrob Agents Chemother, 46, pp.3665~3668 (2002)
- 성지연, "Antimicrobial Resistance Determinants in Imipenem-nonsusceptible Acinetobacter calcoaceticus-baumannii Complex Isolated in Daejeon, Korea", Annals of Laboratory Medicine, 31(4), pp.265~270 (2011), 대한진단검사의학회
- Seifert H, "Standardization and interlaboratory reproducibility assessment of pulsed-field gel electrophoresis-generated fingerprints of Acinetobacter baumannii", J Clin Microbiol, 43, pp.4328~4335 (2005)
- Bartual SG, "Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii", J Clin Microbiol, 43, pp.4382~4390 (2005)
- Higgins PG, "Interlaboratory reproducibility of DiversiLab rep-PCR typing and clustering of Acinetobacter baumannii isolates", J Med Microbiol, 61, pp.137~141 (2012)
- Higgins PG, "Molecular epidemiology of Acinetobacter baumannii bloodstream isolates obtained in the United States from 1995 to 2004 using rep-PCR and multilocus sequence typing", J Clin Microbiol, 50, pp.3493~3500 (2012)
- Lin MF, "Role of integrons in antimicrobial susceptibility patterns of Acinetobacter baumannii", Jpn J Infect Dis, 63, pp.440~443 (2010)
- Qiao Zhong, "Clonal Spread of Carbapenem Non-susceptible Acinetobacter baumannii in an Intensive Care Unit in a Teaching Hospital in China", Annals of Laboratory Medicine, 32(6), pp.413~419 (2012), 대한진단검사의학회
- Nemec A, "Diversity of aminoglycoside-resistance genes and their association with class 1 integrons among strains of pan-European Acinetobacter baumannii clones", J Med Microbiol, 53, pp.1233~1240 (2004)
- Lee YT, "Gene cassette arrays, antibiotic susceptibilities, and clinical characteristics of Acinetobacter baumannii bacteremic strains harboring class 1 integrons", J Microbiol Immunol Infect, 42, pp.210~219 (2009)
- Su CH, "Increase of carbapenem-resistant Acinetobacter baumannii infection in acute care hospitals in Taiwan: association with hospital antimicrobial usage", PLoS One, 7, pp.e37788~ (2012)
- Chen YS, "Colonization of a medical center in Southern Taiwan by epidemic strains of carbapenem- and multidrug-resistant Acinetobacter baumannii and the genetic organization of their integrons", Jpn J Infect Dis, 62, pp.155~157 (2009)
- Lin MF, "Molecular epidemiology and antimicrobial resistance determinants of multidrugresistant Acinetobacter baumannii among five proximal hospitals in Taiwan", Jpn J Infect Dis, 64, pp.222~227 (2011)
- Iacono M, "Wholegenome pyrosequencing of an epidemic multidrug-resistant Acinetobacter baumannii strain belonging to the European clone II group", Antimicrob Agents Chemother, 52, pp.2616~2625 (2008)