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bla Genotype and Molecular Epidemiological Analysis of Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae in Chungcheong Regional Hospitals

충청지역병원에서 분리된 Extended-Spectrum β-Lactamase 생성 대장균과 폐렴간균의 bla 유전형 및 분자역학적 분석

  • Yook, Keun Dol (Department of Clinical Laboratory Science, Daejeon Health Science College) ;
  • Yang, Byoung Seon (Department of Medical Laboratory Science, Jinju Health College) ;
  • Park, Jin Sook (Department of Biological Sciences and Biotechnology, Hannam University)
  • 육근돌 (대전보건대학교 임상병리과) ;
  • 양병선 (진주보건대학교 임상병리과) ;
  • 박진숙 (한남대학교 생명시스템과학과)
  • Received : 2014.05.21
  • Accepted : 2014.06.26
  • Published : 2014.06.30

Abstract

A total of 122 ESBL-producing intestinal bacteria were collected from regional hospitals in the Chungcheong area. Combination disk test (CDT) was performed for antimaicrobial susceptability using cefotaxime and cefotaxime/clavulanate according to Clinical Laboratory Standard Institute (CLSI). Mutiplex PCR using specific primers was performed for a detection of ESBL-genotypes and enterobacterial repetitive intergenic consensus (ERIC)-PCR was carried out for the tracking of molecular epidemiology. In the confirmation test using CDT, 73 out of 76 (96.1%) ESBL-producing Escherichia coli and 43 out of 46 (93.4%) ESBL-producing Klebsiella pnemoniae were positive. In the multiplex PCR, 60.5% of E. coil were positive for CTX-M-2 type gene and 56.5% of K. pneumoniae were positive for VEB -1 type gene. In the ERIC-PCR, E. coil isolates formed 5 clusters and K. pneumoniae isolates were grouped into 4 clusters depending on region. Genotypes of clinical isolates are useful for detection and differentiation of ESBL producing intestinal bacteria. The ERIC-PCR method is thought to be helpful for establishing a regional surveillance system for infection due to its formation of different clusters depending on region.

충청지역병원에서 ESBL생성 장내세균 122균주를 분리하여 Clinical and Laboratory Standards Institute (CLSI) 방법에 따라 cefotaxime과 cefotaxime/clavulanate를 이용한 combination disk test (CDT)에 의하여 항균제 감수성을 조사하고, 특이 유전자를 대상으로 multiplex PCR을 실시하여 유전형을 검출하였으며 enterobacterial repetitive intergenic consensus (ERIC)-PCR에 의해 분자 역학조사를 실시하였다. ESBL 생성 Escherichia coli 76균주와 Klebsiella pneumoniae 46균주를 CDT로 확인한 결과, ESBL 생성 E. coli의 경우 96.1%가 양성을 나타내었으며 K. pneumoniae의 경우 93.4%가 양성을 나타냈다. Multiplex PCR 결과, E. coli의 경우 CTX-M-2형이 60.5% 양성으로 나타났으며 K. pneumoniae의 경우 VEB-1형이 56.5%가 양성으로 나타났다. ERIC-PCR을 실시한 결과 E coli는 분리지역에 따라 5개의 cluster을 형성하였고 K. pneumoniae는 4개의 cluster을 형성하였다. ESBL생성 장내세균의 유전형은 임상에서 분리한 균주의 감별과 검출에 유용하였으며 ERIC-PCR의 결과는 분리지역에 따라 cluster을 형성하여 지역 간 감염 감시체계 확립에 도움이 될 것으로 사료된다.

Keywords

References

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