Prevalence of the Extended-Spectrum β-Lactamase and qnr Genes in Clinical Isolates of Escherichia coli
Escherichia coli 의 Extended-Spectrum β-Lactamase 및 qnr 유전자 보유 현황
2
조회
0
다운로드
8
인용
0
참고문헌
키워드
초록
Background : This study was performed to investigate the prevalence of qnr genes in clinical isolates of Escherichia coli from Korea that produce extended-spectrum β-lactamases (ESBLs). Methods : During the period of May to June 2005, we collected clinical isolates of E. coli that were intermediate or resistant to ceftazidime and/or cefotaxime from 11 Korean hospitals. Antimicrobial susceptibility was determined by the disk diffusion and agar dilution methods. ESBL production was confirmed phenotypically by the double-disk synergy test. ESBL and qnr genes were searched for by PCR amplification, and the PCR products were then subjected to direct sequencing. Results : Double-disk synergy tests were positive in 84.3% (118/140) of ceftazidime- and/or cefotaxime-nonsusceptible E. coli isolates. The most prevalent types of ESBL in E. coli isolates were CTXM-14 (N=41) and CTX-M-15 (N=58). Other ESBLs were also identified, including CTX-M-3 (N=7), CTX-M-9 (N=8), CTX-M-12 (N=1), CTX-M-57 (N=1), SHV-2a (N=2), SHV-12 (N=17) and TEM-52 (N=4). The qnrA1 and qnrB4 genes were identified in 4 and 7 ESBL-producing isolates, respectively. Conclusions : CTX-M-type enzymes were the most common type of ESBL in E. coli isolates from Korea, and the qnr genes were not uncommon in ESBL-producing E. coli isolates. Dissemination of E. coli containing both ESBL and qnr genes could compromise the future usefulness of the expanded- spectrum antibiotics for the treatment of infections.
Abstract
Background : This study was performed to investigate the prevalence of qnr genes in clinical isolates of Escherichia coli from Korea that produce extended-spectrum β-lactamases (ESBLs). Methods : During the period of May to June 2005, we collected clinical isolates of E. coli that were intermediate or resistant to ceftazidime and/or cefotaxime from 11 Korean hospitals. Antimicrobial susceptibility was determined by the disk diffusion and agar dilution methods. ESBL production was confirmed phenotypically by the double-disk synergy test. ESBL and qnr genes were searched for by PCR amplification, and the PCR products were then subjected to direct sequencing. Results : Double-disk synergy tests were positive in 84.3% (118/140) of ceftazidime- and/or cefotaxime-nonsusceptible E. coli isolates. The most prevalent types of ESBL in E. coli isolates were CTXM-14 (N=41) and CTX-M-15 (N=58). Other ESBLs were also identified, including CTX-M-3 (N=7), CTX-M-9 (N=8), CTX-M-12 (N=1), CTX-M-57 (N=1), SHV-2a (N=2), SHV-12 (N=17) and TEM-52 (N=4). The qnrA1 and qnrB4 genes were identified in 4 and 7 ESBL-producing isolates, respectively. Conclusions : CTX-M-type enzymes were the most common type of ESBL in E. coli isolates from Korea, and the qnr genes were not uncommon in ESBL-producing E. coli isolates. Dissemination of E. coli containing both ESBL and qnr genes could compromise the future usefulness of the expanded- spectrum antibiotics for the treatment of infections.
참고문헌 (25)
- Rossolini GM, "The spread of CTX-Mtype extended-spectrum beta-lactamases", Clin Microbiol Infect, 14(S1), pp.S33~S41 (2008)
- Bush K, "Extended-spectrum beta-lactamases in North America, 1987-2006", Clin Microbiol Infect, 14(S1), pp.S134~S143 (2008)
- Pai H, "Survey of extended-spectrum beta-lactamases in clinical isolates of Escherichia coli and Klebsiella pneumoniae: prevalence of TEM-52 in Korea", J Clin Microbiol, 37, pp.1758~1763 (1999)
- Ryoo NH, "Dissemination of SHV-12 and CTX-M-type extended-spectrum beta-lactamases among clinical isolates of Escherichia coli and Klebsiella pneumoniae and emergence of GES-3 in Korea", J Antimicrob Chemother, 56, pp.698~702 (2005)
- Neuhauser MM, "Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use", JAMA, 289, pp.885~888 (2003)
- Sheng WH, "Emerging fluoroquinolone-resistance for common clinically important gram-negative bacteria in Taiwan", Diagn Microbiol Infect Dis, 43, pp.141~147 (2002)
- Kahlmeter G, "An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO.SENS Project", J Antimicrob Chemother, 51, pp.69~76 (2003)
- 세브란스병원진단검사의학과, 세균내성연구소, "Network on Antimicrobial Resistance monitoring: Korean Focal Point and Core Laboratory, Focal Point Data", 항균제내성소식, pp.14~ (2006)
- Hooper DC, "Mechanisms of fluoroquinolone resistance", Drug Resist Updat, 2, pp.38~55 (1999)
- Martinez-Martinez L, "Quinolone resistance from a transferable plasmid", Lancet, 351, pp.797~799 (1998)
- Wang M, "Plasmid-mediated quinolone resistance in clinical isolates of Escherichia coli from Shanghai, China", Antimicrob Agents Chemother, 47, pp.2242~2248 (2003)
- Shin JH, "High rates of plasmid-mediated quinolone resistance QnrB variants among ciprofloxacin-resistant Escherichia coli and Klebsiella pneumoniae from urinary tract infections in Korea", Microb Drug Resist, 14, pp.221~226 (2008)
- Clinical and Laboratory Standards Institute, "Performance standards for antimicrobial susceptibility testing. 18th Informational supplement. M100-S18" (2008), Clinical and Laboratory Standards Institute
- Song W, "Emergence of Escherichia coli isolates producing conjugative plasmid-mediated DHA-1 beta-lactamase in a Korean university hospital", J Hosp Infect, 63, pp.459~464 (2006)
- Bae IK, "Emergence of CTX-M-12 extended-spectrum beta-lactamase-producing Escherichia coli in Korea", J Antimicrob Chemother, 58, pp.1257~1259 (2006)
- 배일권, "CTX-M-12와 새로운 CTX-M형 Extended-Spectrum β-Lactamase생성 Klebsiella pneumoniae의 출현", The Korean Journal of Laboratory Medicine, 26(1), pp.21~26 (2006), 대한진단검사의학회
- Karim A, "Plasmid-mediated extended-spectrum β-lactamase (CTX-M-3 like) from India and gene association with insertion sequence ISEcp1", FEMS Microbiol Lett, 201, pp.237~241 (2001)
- Pai H, "Identification of CTXM-14 extended-spectrum β-lactamase in clinical isolates of Shigella sonnei, Escherichia coli, Klebsiella pneumoniae in Korea", J Clin Microbiol, 39, pp.3747~3749 (2001)
- Hopkins KL, "Identification of novel plasmid-mediated extended-spectrum beta-lactamase CTX-M-57 in Salmonella enterica serovar Typhimurium", Int J Antimicrob Agents, 31, pp.85~86 (2008)
- Kariuki S, "Molecular characterization of a novel plasmid-encoded cefotaximase (CTX-M-12) found in clinical Klebsiella pneumoniae isolates from Kenya", Antimicrob Agents Chemother, 45, pp.2141~2143 (2001)
- Villegas MV, "CTX-M-12 β-lactamase in a Klebsiella pneumoniae clinical isolate in Colombia", Antimicrob Agents Chemother, 48, pp.629~631 (2004)
- Munshi MH, "Plasmid-mediated resistance to nalidixic acid in Shigella dysenteriae type 1", Lancet, 2, pp.419~421 (1987)
- Jeong JY, "Detection of qnr in clinical isolates of Escherichia coli from Korea", Antimicrob Agents Chemother, 49, pp.2522~2524 (2005)
- Choi SH, "Increasing incidence of quinolone resistance in human non-typhoid Salmonella enterica isolates in Korea and mechanisms involved in quinolone resistance", J Antimicrob Chemother, 56, pp.1111~1114 (2005)
- Park YJ, "Prevalence and diversity of qnr alleles in AmpC-producing Enterobacter cloacae, Enterobacter aerogenes, Citrobacter freundii and Serratia marcescens: a multicentre study from Korea", J Antimicrob Chemother, 60, pp.868~871 (2007)