대한임상검사과학회지 (Korean Journal of Clinical Laboratory Science)

  • 제52권2호
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  • Pages.136-142
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  • 2020
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  • 1738-3544(pISSN)
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  • 2288-1662(eISSN)
대한임상검사과학회 (Korean Society for Clinical Laboratory Science)
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충청지역의 임상검체로부터 분리된 대장균에 Aminoglycoside-Modifying Enzymes 확산

Spreading of Aminoglycoside-Modifying Enzymes among Escherichia coli Isolated from Clinical Specimens in Chungcheong Province

  • 성지연 (극동대학교 임상병리학과) ;
  • 권필승 (원광보건대학교 임상병리과)
  • Sung, Ji Youn (Department of Biomedical Laboratory Science, Far East University) ;
  • Kwon, Pil Seung (Department of Clinical Laboratory Science, Wonkwang Health Science University)
  • Received : 2020.04.07
  • Accepted : 2020.04.29
  • Published : 2020.06.30
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Abstract

세균의 항균제 내성율은 지난 몇십년 동안 지속적으로 상승하였으며 mobile genetic elements를 통한 항균제내성인자들의 전파는 다제내성세균의 출현 및 확산을 가중시켰다. 본연구에서는 임상검체에서 분리된 aminoglycoside에 비감수성 대장균 33주를 대상으로 mobile genetic elements를 통해 전파될 수 있는 aminoglycoside 내성인자를 조사하였다. 16S ribosomal RNA methyltransferases (RMTases)와 aminoglycoside-modifying enzyme (AME)유전자가 PCR과 DNA 염기서열분석을 통해 검출되었다. 그 결과 aac(3')-II 유전자(54.5%)를 포함하고 있는 균주가 제일 많았으며 그 다음으로 aph(3')-Ia 유전자(18.2%)가 많았고 aac(6')-Ib 유전자(15.2%)를 포함하는 균주도 있었다. RMTase 유전자는 본 연구에서는 검출되지 않았다. aac(3')-II 유전자를 포함하고 있는 18균주 중 17균주가 gentamicin에 내성을 보였으며 이중 16균주는 tobramycin에도 내성을 보였다. aac(6')-Ib 유전자를 포함하고 있는 5균주는 모두 tobramycin에 내성을 보였다. 본 연구에서 AME 유전자를 획득하는 것은 사람에서 분리된 대장균이 aminoglycoside에 내성을 나타내는 중요한 기전 중 하나임이 확인되었다. 사람으로부터 분리된 세균을 대상으로 지속적으로 항균제 내성인자를 조사하는 것은 내성세균의 확산을 막는데 필요할 것으로 사료된다.

The antimicrobial resistance rate in bacteria has increased over the last several decades. The transfer of antimicrobial resistant determinants on mobile genetic elements could cause the accelerated emergence and spread of multidrug resistant bacteria. This study investigated the aminoglycoside resistance determinants transferred by mobile genetic elements in a total of 33 aminoglycoside non-susceptible E. coli isolated from clinical specimens in Chungcheong province. 16S ribosomal RNA methyl-transferases (RMTases) and aminoglycoside-modifying enzyme (AME) genes were detected via PCR and DNA sequencing. The most common AME genes were aac(3')-II gene (54.5%), followed by aph(3')-Ia (18.2%) and aac(6')-Ib (15.2%). None of the evaluated RMTase genes were detected in the 33 isolates. Seventeen of the 18 isolates harboring aac(3')-II gene were resistant to gentamicin, and 16 of them were resistant to tobramycin. The 5 isolates harboring aac(6')-Ib gene were all resistant to tobramycin. In this study, we confirmed that one of the important mechanisms of aminoglycoside resistance in E. coli isolated from human is the acquisition of AME genes. Continuing investigations of antimicrobial resistant determinants in bacteria isolated from human may be required to prevent dissemination of antimicrobial resistant bacteria.

Keywords

References

  1. Aarestrup FM, Wegener HC, Collignon P. Resistance in bacteria of the food chain: epidemiology and control strategies. Expert Rev Anti Infect Ther. 2008;6:733-750. https://doi.org/10.1586/14787210.6.5.733
  2. Tadesse DA, Zhao S, Tong E, Ayers S, Singh A, Bartholomew MJ, et al. Antimicrobial drug resistance in Escherichia coli from humans and food animals, United States, 1950-2002. Emerg Infect Dis. 2012;18:741-749. https://doi.org/10.3201/eid1805.111153
  3. Wei Q, Hu Q, Li S, Lu H, Chen G, Shen B, et al. A novel functional class 2 integron in clinical Proteus mirabilis isolates. J Antimicrob Chemother. 2014;69:973-976. https://doi.org/10.1093/jac/dkt456
  4. Garneau-Tsodikova S, Labby KJ. Mechanisms of resistance to aminoglycoside antibiotics: overview and perspectives. Medchemcomm. 2016;7:11-27. https://doi.org/10.1039/c5md00344j
  5. Park YJ. Aminoglycoside resistance in Gram-negative bacilli. Korean J Clin Microbiol. 2009;12:57-61. https://doi.org/10.5145/kjcm.2009.12.2.57
  6. Wachino JI, Arakawa Y. Exogenously acquired 16S rRNA methyl- transferases found in aminoglycoside resistant pathogenic Gram-negative bacteria: an update. Drug Resist Updat. 2012; 15:133-148. https://doi.org/10.1016/j.drup.2012.05.001
  7. Kim HC, Jang J, Kim H, Kim Y, Lee K, Kim Y. Multiplex PCR for simultaneous detection of aminoglycoside resistance genes in Escherichia coli and Klebsiella pneumonia. Korean J Clin Lab Sci 2012;44:155-165.
  8. CLSI. Performance standards for antimicrobial susceptibility testing; sixteenth informational supplement. CLSI document M100-S20. Wayne, Pennsylvania: Clinical and Laboratory Standards Institute; 2010. p52-53.
  9. Hidalgo L, Hopkins KL, Gutierrez B, Ovejero CM, Shukla S, Douthwaite S, et al. Association of the novel aminoglycoside resistance determinant RmtF with NDM carbapenemase in Enterobacteriaceae isolated in India and the UK. J Antimicrob Chemother. 2013;68:1543-1550. https://doi.org/10.1093/jac/dkt078
  10. Akers KS, Chaney C, Barsoumian A, Beskius M, Zera W. Aminoglycoside resistance and susceptibility testing errors in Acinetobacter baumannii - calcoaceticus complex. J Clin Microbiol. 2010;48:1132-1138. https://doi.org/10.1128/JCM.02006-09
  11. Ballaben AS, Andrade LN, Galetti R, Ferreira JC, McElheny CL, Mettus RT, et al. Diversity of high-level aminoglycoside resistance mechanisms among gram-negative nosocomial pathogens in Brazil. Antimicrob Agents Chemother. 2018;62:E01550-18. https://doi.org/10.1128/AAC.01550-18
  12. Shin KA, Hwang SY, Hong SB. Molecular characterization and prevalence of 16S ribosomal RNA methylase producing bacteria in amikacin resistant gram-negative bacilli isolated from clinical specimens. Biomed Sci Let. 2012;18:299-306.
  13. Cirit OS, Fernandez-Martinez M, Yayla B, Martinez-Martinez L. Aminoglycoside resistance determinants in multiresistant Escherichia coli and Klebsiella pneumoniae clinical isolates from Turkish and Syrian patients. Acta Microbiol Immunol Hung. 2019;66:327-335. https://doi.org/10.1556/030.66.2019.005
  14. Abo-State M, Saleh YE, Gharee HM. Prevalence and sequence of aminoglycosides modifying enzymes genes among E.coli and Klebsiella species isolated from Egyptian hospitals. J Radiat Res. 2018;11:408-415. https://doi.org/10.1016/j.jrras.2018.08.005
  15. Fernandez-Martinez M, Miro E, Ortega A, Bou G, Gonzalez-Lopez JJ, Oliver A, et al. Molecular identification of aminoglycoside- modifying enzymes in clinical isolates of Escherichia coli resistant to amoxicillin/clavulanic acid isolated in Spain. Int J Antimicrob Agents. 2015;46:157-163. https://doi.org/10.1016/j.ijantimicag.2015.03.008
  16. Lim J, Lee G, Choi Y, Kim J. An analysis of the antibiotic resistance genes of multi-drug resistant (MDR) Acinetobacter baumannii. Korean J Clin Lab Sci. 2016;48:217-224. http://doi.org/10.15324/kjcls.2016.48.3.217
  17. Belaynehe KM, Shin SW, P HT, Yoo HS. Occurrence of aminoglycoside- modifying enzymes among isolates of Escherichia coli exhibiting high levels of aminoglycoside resistance isolated from Korean cattle farms. FEMS Microbiol Lett. 2017;364:129. https://doi.org/10.1093/femsle/fnx129