DOI QR코드

DOI QR Code

CTX-M-15형 Extended Spectrum β-lactamase와 ArmA 동시 생성 Enterobacter cloacae의 출현

Emergence of CTX-M-15 Extended Spectrum β-lactamase and ArmA-Producing Enterobacter cloacae

  • 성지연 (극동대학교 임상병리학과)
  • Sung, Ji-Youn (Dept. of Biomedical Laboratory Sciencence, Far East University)
  • 투고 : 2015.10.25
  • 심사 : 2015.12.20
  • 발행 : 2015.12.28

초록

본 연구에서는 세균의 항균제 내성기전을 연구하기 위해 일개의 대학병원에서 분리된 Enterobacter cloacae를 대상으로 extended spectrum ${\beta}$-lactamase (ESBL) 및 16S rRNA methyltransferase 유전자를 검출하고 항균제 감수성 양상을 조사하였다. 대상균주 중 총 8 균주가 CTX-M-15형 ESBL을 생성하는 것으로 확인되었으며 이 균주들 중 3 균주는 16S rRNA methyltransferase의 한 종류인 armA 유전자도 동시에 가지고 있는 것으로 나타났다. CTX-M-15형 ESBL 유전자와 armA 유전자를 동시에 가지고 있는 E. cloacae는 3세대 cephalosporin 계열 및 aminoglycoside 계열의 항균제 뿐 만 아니라 fluoroquinolone 계열의 항균제에도 내성을 보였다. 더구나 이러한 항균제 내성 유전자들은 플라스미드를 통해 다른 세균으로 전달 될 수 있어 다제내성 세균의 출현 및 확산을 촉진 할 수 있다. 따라서 E. cloacae를 대상으로 지속적인 항균제 내성 유전자를 모니터링 하는 것은 항균제 내성 확산방지를 위해 중요할 것으로 사료된다.

키워드

항균제

참고문헌

  1. S. Abbott, Manual of Clinical Microbiology. p.475-482, American Society for Microbiology, 1999.
  2. D. L. Paterson, and R. A. Bonomo, Extended-spectrum ${\beta}$-lactamases: a clinical update. Clin Microbiol Rev, Vol. 18, pp.657-686, 2005. https://doi.org/10.1128/CMR.18.4.657-686.2005
  3. J. P. Folster, R. Rickert, E. J. Barzilay, and J. M. Whichard, Identification of the Aminoglycoside Resistance Determinants armA and rmtC among Non-Typhi Salmonella Isolates from Humans in the United States. Antimicrob Agents Chemother, Vol. 53, pp.4563-4564, 2009. https://doi.org/10.1128/AAC.00656-09
  4. L. Ma, C. J. Lin, J. H. Chen, C. P. Fung, and F. Y. Chang, Widespread Dissemination of Aminoglycoside Resistance Genes armA and rmtB in Klebsiella pneumoniae Isolates in Taiwan Producing CTX-M-Type Extended-Spectrum ${\beta}$-Lactamases. Antimicrob Agents Chemother, Vol. 53, pp.104- 111, 2009. https://doi.org/10.1128/AAC.00852-08
  5. CLSI. Performance Standards for Antimicrobial Susceptibility Testing; Sixteenth Informational Supplement. CLSI document M100-S20. p.52-53, Clinical and Laboratory Standards Institute, 2010.
  6. L. M. Li, S. J. Jan, I. K. Bae, G. Park, Y. S. Kim, and J. H. Shin, Frequency of Extended-spectrum ${\beta}$-lactamase (ESBL) and AmpC ${\beta}$-lactamase Genes in Escherichia coli and Klebsiella pneumoniae over a Three-year Period in a University Hospital in Korea. Korean J Lab Med, Vol. 30 pp.616-623, 2010. https://doi.org/10.3343/kjlm.2010.30.6.616
  7. P. Bogaerts, M. Galimand, C. Bauraing, A. Deplano, R. Vanhoof, and R. De Mendonca, Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium. J Antimicrob Chemother, Vol. 59, pp.459-464, 2007. https://doi.org/10.1093/jac/dkl527
  8. D. M. Livermore. ${\beta}$-Lactamases in laboratory and clinical? resistance. Clin Microbioal Rev, Vol. 8, pp.557-584, 1995.
  9. S. G. Hong, S. J. Kim, S. H. Jeong, C. H. Chang, S. R. Cho, and J. Y. Ahn, Prevalence and diversity of extened-spectrum ${\beta}$-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in Korea. Korean J Clin Microbiol, Vol. 6, pp149-155, 2003.
  10. J. D. Pitout, and K. B. Laupland. Extended-spectrum beta-lactamase producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect. Dis, Vol. 8 pp.159-166, 2008. https://doi.org/10.1016/S1473-3099(08)70041-0
  11. K. S. Ko, M. Y. Lee, J. H. Song, H. Lee, D. S. Jung, and S. I. Jung, Prevalence and characterization of extended-spectrum ${\beta}$-lactamase-producing Enterobacteriaceae isolated in Korean hospitals. Diagn Microbiol Infect Dis, Vol. 61, pp.453-459, 2008. https://doi.org/10.1016/j.diagmicrobio.2008.03.005
  12. Y. Park, H. K. Kang, I. K. Bae, J. Kim, J. S. Kim, and Y. Uh. Prevalence of the extended-spectrum ${\beta}$-lactamase and qnr genes in clinical isolates of Escherichia coli. Korean J Lab Med, Vol. 29, pp.218-223, 2009. https://doi.org/10.3343/kjlm.2009.29.3.218
  13. W. H. Sheng, R. E. Badal, P. R. Hsueh, and SMART Program. Distribution of Extended-Spectrum ${\beta}$-Lactamases, AmpC-Lactamases, and Carbapenemases among Enterobacteriaceae Isolates Causing Intra-Abdominal Infections in the Asia-Pacific Region: Results of the Study for Monitoring Antimicrobial Resistance Trends (SMART). Antimicrob Agents Chemother, Vol. 57, No. 7, pp. 2981-2988, 2013. https://doi.org/10.1128/AAC.00971-12
  14. H. Lee, E. M. Koh, C. K. Kim, J. H. Yum, K. Lee, and Y. Chong, Molecular and Phenotypic Characteristics of 16S rRNA Methylase-producing Gram-negative Bacilli. Korean J Clin Microbiol, Vol. 13, No. 1, pp.19-26, 2010. https://doi.org/10.5145/KJCM.2010.13.1.19
  15. M. Golebiewski, Kern-Zdanowicz, M. Zienkiewicz, M. Adamczyk, J. Zylinska, A. Baraniak, M. Gniadkowski, J. Bardowski, and P. Ceglowski. Complete nucleotide sequence of the pCTX-M3 plasmid and its involvement in spread of the extended-spectrum beta-lactamase gene $bla_{CTX-M-3}$. Antimicrob Agents Chemother, Vol. 51, No. 11, pp.3789-3795, 2007. https://doi.org/10.1128/AAC.00457-07
  16. J. J. Yan, J. J. Wu, W. C. Ko, S. H. Tsai, C. L. Chuang, and H. M. Wu, Plasmidmediated 16S rRNA methylase conferring high-level aminoglycoside resistance in Escherichia coli and Klebsiella pneumoniae isolates from two Taiwanese hospitals. J Antimicrobial Chemother, Vol. 54 pp.1007-1012, 2004. https://doi.org/10.1093/jac/dkh455
  17. M. H. Kim, J. Y. Sung, J. W. Park, G. C. Kwon, and S. H. Koo. Coproduction of qnrB and armA from Extended-Spectrum ${\beta}$-lactamase-producing Klebsiella pneumoniae. Korean J Lab Med, Vol. 27, pp.428-436, 2007. https://doi.org/10.3343/kjlm.2007.27.6.428