Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Antibiotic Resistance Mechanisms of Escherichia coli Isolates from Urinary Specimens

요 검체에서 분리된 대장균의 항균제 내성 기전

Song, Sung-Wook;Lee, Eun-Young;Koh, Eun-Mi;Ha, Ho-Sung;Jeong, Ho-Joong;Bae, Il-Kwon;Jeong, Seok-Hoon
송성욱;이은영;고은미;하호성;정호중;배일권;정석훈

  • Published : 20090200
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Abstract

Background : This study was designed to characterize urinary isolates of Escherichia coli that produce extended-spectrum $\beta$-lactamases (ESBLs) and to determine the prevalence of other antimicrobial resistance genes. Methods : A total of 264 non-duplicate clinical isolates of E. coli were recovered from urine specimens in a tertiary-care hospital in Busan in 2005. Antimicrobial susceptibility was determined by disk diffusion and agar dilution methods, ESBL production was confirmed using the double-disk synergy (DDS) test, and antimicrobial resistance genes were detected by direct sequencing of PCR amplification products. E. coli isolates were classified into four phylogenetic biotypes according to the presence of chuA, yjaA, and TSPE4. Results : DDS testing detected ESBLs in 27 (10.2%) of the 264 isolates. The most common type of ESBL was CTX-M-15 (N=14), followed by CTX-M-3 (N=8) and CTX-M-14 (N=6). All of the ESBLproducing isolates were resistant to ciprofloxacin. PCR experiments detected genes encoding DHA-1 and CMY-10 AmpC $\beta$-lactamases in one and two isolates, respectively. Also isolated were 5 isolates harboring 16S rRNA methylases, 2 isolates harboring Qnr, and 19 isolates harboring AAC(6')-Ib-cr. Most ESBL-producing isolates clustered within phylogenetic groups B2 (N=14) and D (N=7). Conclusion : CTX-M enzymes were the dominant type of ESBLs in urinary isolates of E. coli, and ESBL-producing isolates frequently contained other antimicrobial resistance genes. More than half of the urinary E. coli isolates harboring CTX-M enzymes were within the phylogenetic group B2.

배경 : 본 연구에서는 요 검체에서 분리된 extended-spectrum $\beta$-lactamase (ESBL) 생성 Escherichia coli의 내성 특성을 조사하고, 이들 ESBL 생성 균주의 다른 항균제 내성 유전자의 보유율을 알아보았다. 방법 : 2005년 국내 3차 병원의 요 검체에서 분리된 E. coli 264주를 대상으로 하였다. 항균제 감수성은 디스크 확산법 및 한천희석법으로 시험하였으며, double-disk synergy (DDS)법을 사용하여 ESBL 생성을 확인하였다. PCR 및 염기서열 분석으로 항균제 내성의 유전형을 분석하였다. 균주의 chuA, yjaA 및 TSPE4 보유 여부에 따라 계통발생학적 분류를 하였다. 결과 : 총 264주 중 27주가 DDS 양성이었으며, CTX-M-15 (N=14), CTX-M-3 (N=8), CTX-M-14 (N=6)의 순으로 ESBL이 검출되었으며, ESBL 생성 균주 모두는 ciprofloxacin에 내성이었다. ESBL 생성 균주 중 각 1주와 2주에서 DHA-1과 CMY-10 AmpC $\beta$-lactamase, 5주에서 16S rRNA methylase, 2주에서 Qnr, 19주에서 AAC(6')-Ib-cr를 생성하였다. ESBL 생성 균주 대부분은 계통발생학적 B2군(N=14, 51.9%) 혹은 D군(N=7, 25.9%)에 속하였다. 결론 : 요 검체에서 분리된 E. coli가 생성하는 ESBL의 다수는 CTX-M형이었으며, ESBL 생성 균주 중 타 계열의 항균제에 내성을 부여하는 유전자를 지닌 경우가 흔하였다. CTX-M형 ESBL 생성 균주의 반 이상이 계통발생학적 B2군에 속하였다.

Keywords

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