Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Characteristics of aac(6')-Ib-cr Gene in Extended-Spectrum $\beta$-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolated from Chungnam Area

충남지역에서 분리된 ESBL 생성 Escherichia coli와 Klebsiella pneumoniae에서 검출된 aac(6')-Ib-cr 유전자의 특성

Shin, So-Youn;Kwon, Kye-Chul;Park, Jong-Woo;Song, Jeong-Hoon;Ko, Young-Hyun;Sung, Ji-Youn;Shin, Hae-Won;Koo, Sun-Hoe
신소연;권계철;박종우;송정훈;고영현;성지연;신해원;구선회

  • Published : 20091200
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Abstract

Background : Concomitant quinolone resistance in extended-spectrum $\beta$-lactamase (ESBL)-producing Enterobacteriaceae is a crucial problem in the clinical management of infections. In foreign countries, the fluoroquinolone acetylating aminoglycoside-(6)-N-acetyltransferase (aac[6']-Ib-cr) gene, a novel plasmid-mediated quinolone resistance determinant has been reported to occur in conjunction with qnr. We aim to investigate the prevalence and characteristics of concomitant aac(6')-Ib-cr and qnr expression in ESBL-producing Escherichia coli and Klebsiella pneumoniae in Korea. Methods : Between December 2007 and April 2008, we collected 60 and 69 clonally unrelated non-repetitive clinical isolates of ESBL-producing E. coli and K. pneumoniae, respectively. We studied the expressions of 11 types of ESBL-encoding genes, 4 types of 16s rRNA methylase genes; rmtA, rmtB, rmtC and armA, 3 types of qnr genes; qnrA, qnrB, qnrS and aac(6')-Ib. The presence of aac(6')-Ib-cr variants was detected by sequencing. The involvement of integrons was studied using multiplex PCR and sequencing of gene-cassette arrays. Conjugation experiments were performed to confirm plasmid-mediated resistance and the relationships among coharbored genes. Results : We observed a high prevalence of the cr variant (61.1%) of aac(6')-Ib, and the prevalence of this variant in qnr and aac(6')-Ib-coharboring isolates (67.4%) was higher than in qnr-negative isolates (51.7%). The high prevalence of the cr variant was significantly related to the high minimum inhibitory concentrations (MICs) of ciprofloxacin, tobramycin, and amikacin and indicated the statistically significant roles of qnrB, qnrS, rmtA, and rmtB in quinolone and aminoglycoside resistance. Conclusions : The aac(6')-Ib-cr variants were widespread and showed significant relation to the highlevel quinolone and aminoglycoside resistance in ESBL-producing E. coli and K. pneumoniae.

Keywords

References

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