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Molecular Characteristics of Extended Spectrum β-Lactamases in Escherichia coli and Klebsiella pneumoniae and the Prevalence of qnr in Extended Spectrum β-Lactamase Isolates in a Tertiary Care Hospital in Korea

김명희|박경선|서진태|이희주
연세대학교의과대학 (Yonsei University College of Medicine)|2010.09|Yonsei Medical Journal|제51권 제5호|pp. 768-774

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키워드

E. coliESBLAntimicrobial resistanceK. pneumoniaeqnr
주제분류의학일반

초록

Purpose: Extended spectrum β-lactamases (ESBLs) are cephalosporinases that confer resistance to a wide variety of oxyimino cephalosporins and create serious therapeutic problems. In addition, the quinolone resistance qnr genes are becoming increasingly prevalent in clinical isolates, some of which also produce ESBL. This study was designed to evaluate the occurrence and genotypic distribution of ESBL producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae)as well as the prevalence and distribution of qnr genes in ESBL-producing isolates in a tertiary care hospital in Korea. Materials and Methods: We tested a total of 111 ESBL-producing isolates of E. coli and K. pneumoniae, which were collected at Kyung Hee Medical Center from November 2006 to June 2008. ESBL production was determined by the Clinical and Laboratory Standards Institute (CLSI) ESBL confirmatory test. The cefotaxime and ceftazidime resistance of the ESBL-producers were transferred to azide-resistant E. coli J53 by conjugation. The presence and identity of ESBL and qnr genes were determined by polymerase chain reaction (PCR) and nucleotide sequencing. Results: The prevalence of ESBLs was 17.7% (297/1,680) of E. coli and 26.5% (240/904) of K. pneumoniae in our hospital during the study periods. Of the 111 collected isolates, 69 isolates were E. coli and 42 isolates were K. pneumoniae. The most prevalent ESBL genotype was CTX-M15. Among the ESBL-producing isolates, 4 E. coli (5.8%)and 17 K. pneumoniae (40.5%) contained qnr genes. qnrB4 was the most frequent type in both E. coli and K. pneumoniae. Conclusion: CTX-M15 was the most frequently encountered ESBL. In addition, a high prevalence of qnr genes among ESBL-producing K. pneumoniae was identified in this study.

Abstract

Purpose: Extended spectrum β-lactamases (ESBLs) are cephalosporinases that confer resistance to a wide variety of oxyimino cephalosporins and create serious therapeutic problems. In addition, the quinolone resistance qnr genes are becoming increasingly prevalent in clinical isolates, some of which also produce ESBL. This study was designed to evaluate the occurrence and genotypic distribution of ESBL producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae)as well as the prevalence and distribution of qnr genes in ESBL-producing isolates in a tertiary care hospital in Korea. Materials and Methods: We tested a total of 111 ESBL-producing isolates of E. coli and K. pneumoniae, which were collected at Kyung Hee Medical Center from November 2006 to June 2008. ESBL production was determined by the Clinical and Laboratory Standards Institute (CLSI) ESBL confirmatory test. The cefotaxime and ceftazidime resistance of the ESBL-producers were transferred to azide-resistant E. coli J53 by conjugation. The presence and identity of ESBL and qnr genes were determined by polymerase chain reaction (PCR) and nucleotide sequencing. Results: The prevalence of ESBLs was 17.7% (297/1,680) of E. coli and 26.5% (240/904) of K. pneumoniae in our hospital during the study periods. Of the 111 collected isolates, 69 isolates were E. coli and 42 isolates were K. pneumoniae. The most prevalent ESBL genotype was CTX-M15. Among the ESBL-producing isolates, 4 E. coli (5.8%)and 17 K. pneumoniae (40.5%) contained qnr genes. qnrB4 was the most frequent type in both E. coli and K. pneumoniae. Conclusion: CTX-M15 was the most frequently encountered ESBL. In addition, a high prevalence of qnr genes among ESBL-producing K. pneumoniae was identified in this study.

참고문헌 (38)

  1. Patrick RM EJ, "Manual of Clinical Microbiology 9th ed" (2007), American Society for Microbiology
  2. Bae IK, "Prevalence of CTX-M-type extended-spectrum β-Lactamaseproducing Esherichia coli and Klebsiella pneumoniae isolates in Korea", Korean J Clin Microbiol, 7, pp.48~54 (2004)
  3. Hong SG, "Prevalence & diversity of extended-spectrum beta -Lactamaseproducing Escherichia coli and Klebsiella pneumoniae isolates in Korea", Korean J Clin Microbiol, 6, pp.149~155 (2003)
  4. 강지혜, "Ambler Class A Extended-Spectrum β-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의국내분리현황", 대한임상미생물학회지, 8(1), pp.17~25 (2005), 대한임상미생물학회
  5. Lee JH, "Prevalence of CTX-M-type extended-spectrum beta-Lactamaseproducing Escherichia coli and Klebsiella pneumoniae isolates in Korea, 2003", Korean J Clin Microbiol, 7, pp.111~118 (2004)
  6. 박정호, "전국 주요 병원에서 분리된 Escherichia coli와 Klebsiella pneumoniae의 Extended-Specrum β-Lactamase 생성 현황과 특징", The Korean Journal of Laboratory Medicine, 23(1), pp.18~24 (2003), 대한진단검사의학회
  7. 송원근, "한국에서 분리된 Plasmid-Mediated AmpC ß-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의 빈도와 유전자형의 분포", The Korean Journal of Laboratory Medicine, 22(6), pp.410~416 (2002), 대한진단검사의학회
  8. Jacoby GA, "Prevalence of plasmid-mediated quinolone resistance", Antimicrob Agents Chemother, 47, pp.559~562 (2003)
  9. Wang M, "Emerging plasmidmediated quinolone resistance associated with the qnr gene in Klebsiella pneumoniae clinical isolates in the United States", Antimicrob Agents Chemother, 48, pp.1295~1299 (2004)
  10. Cattoir V, "Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates", J Antimicrob Chemother, 60, pp.394~397 (2007)
  11. Jones GL, "Prevalence and distribution of plasmid-mediated quinolone resistance genes in clinical isolates of Escherichia coli lacking extended-spectrum beta-lactamases", J Antimicrob Chemother, 62, pp.1245~1251 (2008)
  12. 김문희, "Extended-Spectrum -lactamase를 생성하는 Klebsiella pneumoniae 에서의 qnrB와 armA 유전자의 동시생성", The Korean Journal of Laboratory Medicine, 27(6), pp.428~436 (2007), 대한진단검사의학회
  13. 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)
  14. Wang A, "Occurrence of qnr-positive clinical isolates in Klebsiella pneumoniae producing ESBL or AmpC-type beta-lactamase from five pediatric hospitals in China", FEMS Microbiol Lett, 283, pp.112~116 (2008)
  15. Wang A, "Presence of qnr gene in Escherichia coli and Klebsiella pneumoniae resistant to ciprofloxacin isolated from pediatric patients in China", BMC Infect Dis, 8, pp.68~ (2008)
  16. Bassetti M, "Antimicrobial use and resistance among Gram-negative bacilli in an Italian intensive care unit (ICU)", J Chemother, 18, pp.261~267 (2006)
  17. 고지선, "대전지역에서 분리된 Escherichia coli 와 Klebsiella pneumoniae 의Extended-Spectrum -lactamase 생성 현황", The Korean Journal of Laboratory Medicine, 27(5), pp.344~350 (2007), 대한진단검사의학회
  18. CLSI, "Performance standards for antimicrobial susceptibility testing; eighteenth informational supplement, M100-S16", Clinical and Laboratory Standards Institute, ~ (2008)
  19. Jacoby GA, "Detection of extended-spectrum beta-lactamases in clinical isolates of Klebsiella pneumoniae and Escherichia coli", J Clin Microbiol, 34, pp.908~911 (1996)
  20. 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
  21. Livermore DM, "beta-Lactamases in laboratory and clinical resistance", Clin Microbiol Rev, 8, pp.557~584 (1995)
  22. Bradford PA, "Extended-spectrum beta-lactamases in the 21st century:characterization, epidemiology, and detection of this important resistance threat", Clin Microbiol Rev, 14, pp.933~951 (2001)
  23. Jones RN, "Antimicrobial activity and spectrum investigation of eight broad-spectrum beta-lactam drugs: a 1997 surveillance trial in 102 medical centers in the United States. Cefepime Study Group", Diagn Microbiol Infect Dis, 30, pp.215~228 (1998)
  24. Yagi T, "A preliminary survey of extended-spectrum beta-lactamases (ESBLs) in clinical isolates of Klebsiella pneumoniae and Escherichia coli in Japan", FEMS Microbiol Lett, 184, pp.53~56 (2000)
  25. Pai H, "The characteristics of extended-spectrum beta-lactamases in Korean isolates of Enterobacteriaceae", Yonsei Med J, 39, pp.514~519 (1998)
  26. Hong SG, "Molecular characteristics of extended-spectrum beta -Lactamases in clinical isolates of Enterobacteriaceae", Korean J Clin Pathol, 21, pp.495~504 (2001)
  27. Kim J, "CTXM and SHV-12 beta-lactamases are the most common extendedspectrum enzymes in clinical isolates of Escherichia coli and Kleb-siella pneumoniae collected from 3 university hospitals within Korea", FEMS Microbiol Lett, 245, pp.93~98 (2005)
  28. 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)
  29. Kim J, "Survey of Klebsiella pneumoniae strains producing extended-spectrum beta-lactamases:prevalence of SHV-12 and SHV-2a in Korea", J Clin Microbiol, 36, pp.1446~1449 (1998)
  30. Hopkins KL, "Identification of novel plasmid-mediated extended-spectrum beta-lactamase CTXM-57 in Salmonella enterica serovar Typhimurium", Int J Antimicrob Agents, 31, pp.85~86 (2008)
  31. Nordmann P, "Emergence of plasmid-mediated resistance to quinolones in Enterobacteriaceae", J Antimicrob Chemother, 56, pp.463~469 (2005)
  32. Robicsek A, "The worldwide emergence of plasmid-mediated quinolone resistance", Lancet Infect Dis, 6, pp.629~640 (2006)
  33. 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)
  34. Mammeri H, "Emergence of plasmid-mediated quinolone resistance in Escherichia coli in Europe", Antimicrob Agents Chemother, 49, pp.71~76 (2005)
  35. Tran JH, "Mechanism of plasmid-mediated quinolone resistance", Proc Natl Acad Sci U S A, 99, pp.5638~5642 (2002)
  36. Wang M, "Activities of newer quinolones against Escherichia coli and Klebsiella pneumoniae containing the plasmid-mediated quinolone resistance determinant qnr", Antimicrob Agents Chemother, 48, pp.1400~1401 (2004)
  37. 신정환, "3차 병원에 내원한 환자에서 지역사회 요로감염의 원인 균종과 항균제 감수성", 대한임상미생물학회지, 8(2), pp.142~147 (2005), 대한임상미생물학회
  38. Chong Y, "Characteristics of Extended-spectrum beta-lactam hydrolyzing activity of Klebsiella pneumoniae and Escherichia coli strains isolated from clinical specimens", Korean J Infect Dis, 29, pp.477~486 (1997)

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