Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
권호 표지
DOI QR코드

DOI QR Code

The Prevalence of Plasmid-Mediated Quinolone Resistance Genes among CTX-M-14 Producing Escherichia coli Strains Isolated from a University Hospital in the Chungcheong Province

충청지역에 위치한 일개의 대학병원에서 분리된 CTX-M-14형 ESBL 생성 대장균을 대상으로 PMQR 유전자 빈도조사

  • Sung, Ji Youn (Department of Biomedical Laboratory Science, Far East University)
  • 성지연 (극동대학교 임상병리학과)
  • Received : 2016.07.30
  • Accepted : 2016.09.05
  • Published : 2016.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Recently, there has been a considerable increase in the prevalence of CTX-M type extended-spectrum ${\beta}$-lactamase (ESBL)-producing E. coli isolates worldwide, including Korea. To investigate the ESBL genes in the E. coli strains isolated from a university hospital in the Chungcheong area, a study was conducted using PCR amplification and nucleotide sequence analysis of the amplified products to detect the plasmid mediated quinolone resistance (PMQR) genes in ESBL producing E. coli isolates. The number of CTX-M-14 producing isolates was 25 (16.0%) isolates, and of them, 9 (5.8%) isolates also produced CTX-M-15. All CTX-M type ESBL producing E. coli isolates showed resistance to cefotaxime. Twelve (48%) CTX-M type ESBL producing E. coli isolates contained the PMQR genes, 8 contained qnrS1, and 8 contained aac(6')-Ib-cr. Four isolates harbored both qnrS1 and aac(6')-Ib-cr genes. In our study, we confirmed that the plasmid mediated antimicrobial resistant determinants-the ESBL and PMQR genes-were distributed in the E. coli isolates. To prevent further spreading of the resistant genes among the E. coli isolates, consistent effort is required to investigate and monitor the resistant genes.

최근 들어 CTX-M형 extended-spectrum ${\beta}$-lactamase(ESBL) 생성 대장균이 국내는 물론 전세계적으로 빠르게 증가하고 있다. 본 연구에서는 충청지역에 위치한 일개의 대학병원에서 분리된 대장균을 대상으로 ESBL 유전자를 중합효소연쇄반응 및 염기서열 분석방법을 통해 확인하였으며, 같은 방법으로 ESBL 생성 대장균으로부터 plasmid mediated quinolone resistance (PMQR) 유전자의 빈도를 조사하였다. 16.0%에 해당하는 25균주가 CTX-M-14를 생성하였으며 이중 9균주는 CTX-M-15도 동시에 생성하는 것으로 나타났다. 항균제 감수성 시험결과 CTX-M형 ESBL을 생성하는 대장균은 모두 cefotaxime에 내성을 보였다. 한편 CTX-M형 ESBL을 생성하는 대장균의 48% (12균주)가 PMQR 유전자를 포함하고 있음이 확인되었는데 8균주가 qnrS1유전자를 그리고 8균주가 aac(6')-Ib-cr 유전자를 포함하고 있었다. 그 중 4균주는 두 개의 유전자를 모두 가지고 있는 것으로 나타났다. 본 연구에서는 플라스미드를 통해 확산될 수 있는 ESBL 및 PMQR 유전자가 대장균 사이에 확산되어 있음을 확인하였다. 항균제 내성유전자들의 확산을 막기 위해서는 지속적인 내성유전자의 모니터링과 감시가 필요할 것으로 사료된다.

Keywords

References

  1. Qadri F, Svennerholm AM, Faruque AS, Sack RB. Enterotoxigenic Escherichia coli in developing countries: epidemiology, microbiology, clinical features, treatment, and prevention. Clin Microbiol Rev. 2005;18:465-483. https://doi.org/10.1128/CMR.18.3.465-483.2005
  2. Canton R, Gonzalez-Alba JM, Galan JC. CTX-M enzymes: origin and diffusion. Front Microbiol. 2012;3:110.
  3. Poirel L, Kampfer P, Nordmann P. Chromosome-encoded Ambler class A beta-lactamase of Kluyvera georgiana, a probable progenitor of a subgroup of CTX-M extended-spectrum beta-lactamases. Antimicrob Agents Chemother. 2002;46:4038-4040. https://doi.org/10.1128/AAC.46.12.4038-4040.2002
  4. Song W, Lee H, Lee K, Jeong SH, Bae IK, Kim JS, et al. CTX-M-14 and CTX-M-15 enzymes are the dominant type of extended-spectrum beta-lactamase in clinical isolates of Escherichia coli from Korea. J Med Microbiol. 2009;58:261-266. https://doi.org/10.1099/jmm.0.004507-0
  5. Seo MR, Park YS, Pai H. Characteristics of plasmid mediated quinolone resistance genes in extended-spectrum cephalosporin-resistant isolates of Klebsiella pneumoniae and Escherichia coli in Korea. Chemotherapy. 2010;56:46-53. https://doi.org/10.1159/000290972
  6. Ruiz J. Mechanisms of resistance to quinolones: Target alterations, decreased accumulation and DNA gyrase protection. J Antimicrob Chemother. 2003;51:1109-1117. https://doi.org/10.1093/jac/dkg222
  7. Yang HY, Nam YS, Lee HJ. Prevalence of plasmid-mediated quinolone resistance genes among ciprofloxacin-nonsusceptible Escherichia coli and Klebsiella pneumoniae isolated from blood cultures in Korea. Can J Infect Dis Med Microbiol. 2014;25:163-169. https://doi.org/10.1155/2014/329541
  8. Robicsek A, Strahilevitz J, Jacoby GA. Fluoroquinolone modifying enzyme: A new adaptation of a common aminoglycoside acetyltransferase. Nat Med. 2006;12:83-88. https://doi.org/10.1038/nm1347
  9. Bae IK, Kim J, Sun JY, Jeong SH, Kim YR, Wang KK, et al. Comparison of pulsed-field gel electrophoresis & repetitive sequence-based PCR methods for molecular epidemiological studies of Escherichia coli clinical isolates. Indian J Med Res. 2014;140:679-685.
  10. CLSI. Performance standards for antimicrobial susceptibility testing; sixteenth informational supplement. CLSI document M100-S20. Wayne, PA: Clinical and Laboratory Standards Institute; 2010, p52-53.
  11. Lewis JS, Herrera M, Wickes B, Patterson JE, Jorgensen JH. First report of the emergence of CTX-M-type extended-spectrum beta-lactamases (ESBLs) as the predominant ESBL isolated in a U.S. health care system. Antimicrob Agents Chemother. 2007;51:4015-4021. https://doi.org/10.1128/AAC.00576-07
  12. Cattoir V, Poirel L, Rotimi V, Soussy CJ, Nordmann P. Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates. J Antimicrob Chemother. 2007;60:394-397. https://doi.org/10.1093/jac/dkm204
  13. Song S, Lee EY, Koh EM, Ha HS, Jeong HJ, Bae IK, et al. Antibiotic resistance mechanisms of Escherichia coli isolates from urinary specimens. Korean J Lab Med. 2009;29:17-24. https://doi.org/10.3343/kjlm.2009.29.1.17
  14. Yamane K, Wachino J, Suzuki S, Arakawa Y. Plasmid-mediated qepA gene among Escherichia coli clinical isolates from Japan. Antimicrob Agents Chemother. 2008;52:1564-1566. https://doi.org/10.1128/AAC.01137-07
  15. Bou G, Cervero G, Dominguez MA, Quereda C, Martinez-Beltran J. PCR-based DNA fingerprinting (REP-PCR, AP-PCR) and pulsed-field gel electrophoresis characterization of a nosocomial outbreak caused by imipenem- and meropenem-resistant Acinetobacter baumannii. Clin Microbiol Infect. 2000;6:635-643. https://doi.org/10.1046/j.1469-0691.2000.00181.x
  16. Sung JY, Oh JE, Kim ES, Son JM, Kim HY, Lim DY. Spread of CTX-M Extended-spectrum ${\beta}$-lactamase Producing Escherichia coli in the Community in Chungcheong Area, Korea. Korean J Clin Lab Sci. 2013;45:43-47.
  17. Kim JS, Kim J, Kim SJ, Jeon SE, Oh KH, Cho SH, et al. Characterization of CTX-M-type extended-spectrum beta-lactamase-producing diarrheagenic Escherichia coli isolates in the Republic of Korea during 2008-2011. J Microbiol Biotechnol. 2014;24:421-426. https://doi.org/10.4014/jmb.1401.01023
  18. Nordmann P. In vivo selection of fluoroquinolone-resistant Escherichia coli isolates expressing plasmid-mediated quinolone resistance and expanded-spectrum beta-lactamase. Antimicrob Agents Chemother. 2006;50:1525-1527. https://doi.org/10.1128/AAC.50.4.1525-1527.2006
  19. Kim S, Sung JY, Choi SG. Molecular Characterization of Escherichia coli Isolates from Humans and Chickens in the Chungcheong Area Using MLST Analysis. Korean J Clin Lab Sci. 2015;47:71-77. https://doi.org/10.15324/kjcls.2015.47.2.71

Cited by

  1. 임상검체와 가축으로부터 분리된 대장균을 대상으로 Quinolone계 항균제 내성인자 분석 vol.50, pp.4, 2018, https://doi.org/10.15324/kjcls.2018.50.4.422