생명과학회지 (Journal of Life Science)

  • 제23권5호
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  • Pages.703-709
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  • 2013
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  • 1225-9918(pISSN)
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  • 2287-3406(eISSN)
한국생명과학회 (Korean Society of Life Science)
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임상검체로부터 분리된 Escherichia coli 의 Extended-spectrum β-lactamase와 퀴놀론 내성 유전자의 출현빈도 및 항생제 내성

Prevalence of Extended-spectrum β-Lactamase and Quinolone Resistance Genes in Escherichia coli Clinical Isolates and their Antibiotic Resistance

  • Lee, Min Hyeok (Department of Biology, College of Life Science and Natural Resources, Sunchon National University) ;
  • Hwang, Yeoung Min (Department of Biology, College of Life Science and Natural Resources, Sunchon National University) ;
  • Baik, Keun Sik (Department of Biology, College of Life Science and Natural Resources, Sunchon National University) ;
  • Cho, Hyun Wook (Department of Biology, College of Life Science and Natural Resources, Sunchon National University) ;
  • Seong, Chi Nam (Department of Biology, College of Life Science and Natural Resources, Sunchon National University)
  • 투고 : 2013.03.07
  • 심사 : 2013.05.22
  • 발행 : 2013.05.30
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초록

본 연구에서는 ESBL을 생성하는 Escherichia coli의 Extended-spectrum ${\beta}$-lactamase (ESBL) 유전자와 퀴놀론 내성결정부위(qnr)의 유전자형과 항생제 내성 양상을 규명하고자 하였다. 임상검체에서 분리 된 E. coli 274개 균주를 대상으로 double-disk synergy test 검사를 실시하여 42개의 ESBL 생성 균주를 분리하였다. 검체별로는 소변에서 28균주가 분리되었으며, 객담에서 6균주, 농에서 3균주, 상처에서 2균주, 혈액에서 2균주 그리고 조직에서 1균주가 분리되었다. 이 균주들을 대상으로 ESBL 유전자와 퀴놀론 내성 유전자를 PCR을 이용하여 검색하였다. 35개의 균주가 1개 혹은 2개의 ESBL 유전자를 보유하고 있었다. ESBL 유전자의 분포는 CTX-M-1이 가장 많았으며, CTX-M-9과 TEM 유전자 순이었다. SHV, CTX-M-2와 CTX-M-8는 검출되지 않았다. qnr 유전자는 10개 균주에서 검출되었으며 유전형별로는 qnrB4, qnrB1, qnrS 1 순이었다. 2가지 이상의 ESBL 유전자를 동시에 보유한 균주와 ESBL과 qnr 유전자를 동시에 보유한 균주가 검출되었다. ESBL 유전자 보유균주는 cefotaxmie (80.0%), levofloxacin (82.9%)과 ampicillin (100%)에 고도내성을 보였다. qnr 유전자 보유 균주의 cefotaxmie, levofloxacin과 ampicillin에 대한 내성율은 각각 70%, 70%, 100%였다. ESBL 유전자들간의 그리고 qnr 유전자와의 동시 보유가 항생제 내성에 미치는 상승효과는 없었다. qnr 유전자 보유와 퀴놀론에 대한 내성 사이의 상관관계도 없었다.

The aim of this study was to investigate the prevalence of Extended-spectrum ${\beta}$-lactamase (ESBL) gene and quinolone resistance determinant (qnr) and the pattern of antibiotic resistance in the ESBL-producing Escherichia coli clinical isolates. The 42 ESBL-producing strains from total 274 isolates were detected using a double disk synergy test. They were isolated from various specimens, such as urine (28 strains), sputum (6 strains), pus (3 strains), wound (2 strains), blood (2 strains), and tissue (1 strain). Using the PCR with the specific primers ESBL, ESBL and qnr gene types were determined. Thirty-five strains possessed one or two ESBL genes. CTX-M-1 type was the most abundant followed by CTX-M-9 type and TEM, but SHV, CTX-M-2, and CTX-M-8 gene types were not detected. qnr gene types were detected from ten isolates in the order of qnrB4, qnrB1, and qnrS. Coexistence of ESBL and qnr genes was found. ESBL-producing isolates showed high resistance against some antibiotics, such as cefotaxmie (80.0%), levofloxacin (82.9%), and ampicillin (100%). Neither a synergy effect from the coexistence of ESBL and qnr genes on antibiotic resistance nor a correlation between the production of qnr gene and quinolone resistance were found.

키워드

참고문헌

  1. Antimicrobial resistance newsletter. 2006. Antimicrobial resistance of clinical isolates of bacteria in 2005. Ser. No.52.
  2. Bae, I. K., Woo, G. J., Jeong, S. H., Park, K. O., Cho, B. K., Kim, D. M., Kwon, S. B., Kim, H. J. and Kang, H. K. 2004. Prevalence of CTX-M-type extended-spectrum $\beta$-lactamase producing Esherichia coli and Klebsiella pneumoniae isolates in Korea. Korean J Clin Microbiol 7, 48-54.
  3. Bush, K., Jacoby, G. A. and Medeiros, A. A. 1995. A functional classification scheme for $\beta$-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 39, 1211-1233. https://doi.org/10.1128/AAC.39.6.1211
  4. Canton, R. and Coque, T. M. 2006. The CTX-M beta-lactamase pandemic. Curr Opin Microbiol 9, 466-475. https://doi.org/10.1016/j.mib.2006.08.011
  5. Garau, J., Xercavins, M., Rodriguez-Carballeira, M., Gomez-Vera, J. R., Coll, I., Vidal, D., Llovet, T. and Ruiz-Bremon, A. 1999. Emergence and dissemination of quinolone- resistance Escherichia coli in the community. Antimicrob Agents Chemother 43, 2736-2741.
  6. Hassan, W. M., Hashim, A. and Domany, R. 2012. Plasmid mediated quinolone resistance determinants qnr, aac(6')-Ib-cr, and qep in ESBL-producing Escherichia coli clinical isolates from Egypt. Indian J Med Microbiol 30, 442-447. https://doi.org/10.4103/0255-0857.103766
  7. Hong, J. S., Bae, I. K., Song, E. H., Jeong, S. H., Lee, K. W., Yong, D. E., Lee, J. W., Lee, W. G., Kang, J. O., Ahn, J. Y., Hong, S. K., Shin, J. H., Uh, Y., Park, Y. J., Kim, E. C., Kwak, H. S. and Woo, G. J. 2005. Dissemination of CTX-M type extended-spectrum $\beta$-lactamases and emergence of CTX-M-12 in Escherichia coli. Korean J Lab Med 25, 252-258.
  8. Hwang, H. Y., Park, J. S., Bae, I. K., Lee, Y. N. and Jeong, S. H. 2007. Escherichia coli producing CTX-M extended- spectrum $\beta$-lactamase. Kosin Med J 22, 58-67.
  9. Jacoby, G. A. and Medeiros, A. A. 1991. More extended- spectrum $\beta$-lactamases. Antimicrob Agents Chemother 35, 1697-1704. https://doi.org/10.1128/AAC.35.9.1697
  10. Jacoby, G. A., Chow, N. and Waites, K. B. 2003. Prevalence of plasmid-mediated quinolone resistance. Antimicrob Agents Chemother 47, 559-562. https://doi.org/10.1128/AAC.47.2.559-562.2003
  11. Jacoby, G. A. 2006. $\beta$-Lactamase nomenclature. Antimicrob Agents Chemother 50, 1123-1129. https://doi.org/10.1128/AAC.50.4.1123-1129.2006
  12. Jeong, H. S., Bae, I. K., Shin, J. H., Jung, H. J., Kim, S. H., Lee, J. Y., Oh, S. H., Kim, H. R., Chang, C. L., Kho, W. G. and Lee, J. N. 2011. Prevalence of plasmid-mediated quinolone resistance and its association with extended- spectrum beta-lactamase and AmpC beta-lactamase in Enterobacteriaceae Korean J Lab Med 31, 257-264. https://doi.org/10.3343/kjlm.2011.31.4.257
  13. Jeong, S. H., Bae, I. K., Kwon, S. B., Lee, J. H., Song, J. S., Jung, H. I., Sung, K. H., Jang, S. J. and Lee, S. H. 2005. Dissemination of transferable CTX-M-type extended- spectrum $\beta$-lactamase-producing Escherichia coli in Korea. J Appl Microbiol 98, 921-927. https://doi.org/10.1111/j.1365-2672.2004.02526.x
  14. Kang, H. K. 2008. Prevalence of qnr genes among clinical isolates of Escherichia coli producing extended-spectrum $\beta$ -lactamase from Korea. Ph.D. Thesis. Kosin University. Korea.
  15. Kim, Y. J., Seo, M. R., Kim, J., Choi, E. H., Lee, H. J. and Pai, H. J. 2009. Prevalence and characterization of plasmid- mediated quinolone resistance genes among clinical isolates of extended-spectrum cephalosporin resistant Enterobacter cloacae. Infec Chemother 41, 279-285. https://doi.org/10.3947/ic.2009.41.5.279
  16. Kjerulf, A., Hansen, D. S., Sandvang, D., Hansen, F. and Frimodt-Møller, N. 2008. The prevalence of ESBL-producing E. coli and Klebsiella strains in the Copenhagen area of Denmark. APMIS 116, 118-124. https://doi.org/10.1111/j.1600-0463.2008.00777.x
  17. Lee, C. C., Lui, G., Ip, M., Ling, T. K. and Lee, N. 2012. Frequent detection of plasmid-mediated quinolone resistance (qnr) genes in multidrug-resistant Enterobacteriaceae blood isolates, Hong Kong. Eur J Clin Microbiol Infect Dis 31, 3183-3189. https://doi.org/10.1007/s10096-012-1683-x
  18. Lee, G. S. 2004. Patterns of antimicrobial resistance and genotyping of extended spectrum $\beta$-Lactamase (ESBL) producing clinical isolates in Korea. M.Sc. Thesis. Yonsei University, Korea.
  19. Munshi, M. H., Sack, D. A., Haider, K., Ahmed, Z. U., Rahaman, M. M. and Morshed, M. G. 1987. Plasmid-mediated resistance to nalidixic acid in Shigella dysenteriae type 1. Lancet 2, 419-421. 1. Lancet 2, 419-421.
  20. National Committee for Clinical Laboratory Standards. 1993. Performance standards for antimicrobial disk susceptibility tests. Approved standard M2- A5. National Committee for Clinical Laboratory Standards, Villanova, Pa.
  21. Pai, H., Choi, E. H., Lee, H. J., Hong, J. Y. and Jacoby, G. A. 2001. Identification of CTX-M-14 extended-spectrum $\beta$ -lactamase in clinical isolates of Shigella sonnei, Escherichia coli, Klebsiella pneumoniae in Korea. J Clin Microbiol 39, 3747-3749. https://doi.org/10.1128/JCM.39.10.3747-3749.2001
  22. Park, J. H., Lee, S. H., Jeong, S. H., Kim, B. N., Kim, K. B., Yoon, J. D. and Jeon, B. C. 2003. Characterization and prevalence of Escherichia coli and Klebsiella pneumoniae isolates producing an extended-spectrum $\beta$-lactamase from Korean hospitals. Korean J Lab Med 23, 18-24.
  23. Park, J. H., Lee, S. H., Jeong, S. H., Kim, K. B., Yoon, J. D. and Jeon, B. C. 2003. Charaterization and prevalence of Escherichia coli and Klebsiela pneumoniae isolate producing an extended-spectrum $\beta$-lactamase from Korea hospital. Korea J Med 23, 18-20.
  24. Philippon, A., Labia, R. and Jacoby, G. A. 1989. Extended-spectrum $\beta$-lactamases. Antimicrob Agents Chemother 33, 1131-1136. https://doi.org/10.1128/AAC.33.8.1131
  25. Robicsek, A., Jacoby, G. A. and Hooper, D. C. 2006. The worldwide emergence of plasmid-mediated quinolone resistance. Lancet Infect Dis 6, 629-640. https://doi.org/10.1016/S1473-3099(06)70599-0
  26. Sanders, C. C., Barry, A. L., Washington, J. A., Shubert, C., Moland, E. S., Traczewski, M. M., Knapp, C. and Mulder, R. 1996. Detection of extended-spectrum-$\beta$-lactamase-producing members of the family Enterobacteriaceae with Vitek ESBL test. J Clin Microbiol 34, 2997-3001.
  27. Sanders, C. C. and Sanders, W. E. Jr. 1992. $\beta$-Lactam resistance in Gram negative bacteria: global trends and clinical impact. Clin Infect Dis 15, 824-839. https://doi.org/10.1093/clind/15.5.824
  28. Scheutz, F. and Strockbine, N. A. 2005. Genus I. Escherichia Castellani and Chalmers 1919, $941^{AL}$. In Bergey's Manual of Systematic Bacteriology, The Proteobacteria, Part B: The Gammaproteobacteria, 2nd eds., vol. 2, pp. 607-625. In: Garrity, G., Brenner, D. J., Krieg, N. R. and Staley, J. R. (eds.), New York: Springer.
  29. Wu, J. J., Ko, W. C., Tsai, S. H. and Yan, J. J. 2007. Prevalence of plasmid-mediated quinolone resistance determinants qnrA, qnrB, and qnrS among clinical isolates of Enterobacter cloacae in a Taiwanese hospital. Antimicrob Agents Chemother 51, 1223-1227. https://doi.org/10.1128/AAC.01195-06
  30. Yoo, Y. 2008. In vitro susceptibility against piperacillin/ tazobactam and ESBL genotypes of Escherichia coli and Klebsiella pneumonia producing extended-spectrum $\beta$- lactamase. M.Sc. Thesis. Konkuk University, Korea.