CAJ | 학술논문

目的了解CTX-M型超广谱β-内酰胺酶(ESBLs)在大肠埃希菌中的分布及传播的分子机制.方法用Kirby-Bauer(K-B)药敏法分析43株大肠埃希菌的耐药性;用多重聚合酶链式反应(PCR)扩增ESBLs、AmpC、ISEcp1 B、IS903、IS26等插入序列及I类整合子;用套式PCR在I类整合子寻找β-内酰胺酶基因盒,扩增CTX-M型ESBLs全序列并测序.结果大肠埃希菌对以下抗生素的耐药率从高到低分别是:氨苄西林(97.68%)、头孢曲松(67.44%)、哌拉西林(65.12%)、头孢噻肟(62.79%)、头孢他啶(58.14%)、头孢唑啉(55.81%)、头孢吡肟(53.49%)、头孢西丁(51.16%)、环丙沙星(44.19%)、氨曲南(41.86%)、头孢哌酮/舒巴坦(20.93%)、阿米卡星(0%)、亚胺培南(0%).亚胺培南有较好的体外抗菌活性;25株大肠埃希菌中检出CTX-M-G1,其中9株同时检出TEM、SHV、CTX-M-G1、ISEap1 B及I类整合子,ECO 3、5同时检出IS903,ECO 3检出IS26;在EC05中,CTX-M-G1上游是ISEcp1 B,提供-35及-10位点两个启动子.一个右反向重复序列(IRR),下游是插入序列IS903组成复合转座子.结论 LSEcp1 B可能对下游CTX-M型ESBLs的高水平表达和传播起重要的调控作用.
목적 료해CTX-M형초엄보β-내선알매(ESBLs)재대장애희균중적분포급전파적분자궤제.방법 용Kirby-Bauer(K-B)약민법분석43주대장애희균적내약성;용다중취합매련식반응(PCR)확증ESBLs、AmpC、ISEcp1 B、IS903、IS26등삽입서렬급I류정합자;용투식PCR재I류정합자심조β-내선알매기인합,확증CTX-M형ESBLs전서렬병측서.결과 대장애희균대이하항생소적내약솔종고도저분별시:안변서림(97.68%)、두포곡송(67.44%)、고랍서림(65.12%)、두포새우(62.79%)、두포타정(58.14%)、두포서람(55.81%)、두포필우(53.49%)、두포서정(51.16%)、배병사성(44.19%)、안곡남(41.86%)、두포고동/서파탄(20.93%)、아미잡성(0%)、아알배남(0%).아알배남유교호적체외항균활성;25주대장애희균중검출CTX-M-G1,기중9주동시검출TEM、SHV、CTX-M-G1、ISEap1 B급I류정합자,ECO 3、5동시검출IS903,ECO 3검출IS26;재EC05중,CTX-M-G1상유시ISEcp1 B,제공-35급-10위점량개계동자.일개우반향중복서렬(IRR),하유시삽입서렬IS903조성복합전좌자.결론 LSEcp1 B가능대하유CTX-M형ESBLs적고수평표체화전파기중요적조공작용.
Objective To investigate the distribution of the CTX-M- extended spectrum beta-lactamase (ESBLs) producing Esche- richia coli(ECO) and the molecular mechanism of dissemination. Methods To analyze the drug resistance of the 43 isolates, Kirby-Bauer susceptibility method was used. Multiple polymeraso chain reaction (PCR) was used to amplify the gene of ESBLs, AmpC, full length of blaCTX-M-like gene, insertion sequence (IS) ISEcp1B, IS903 , IS26 and integron I. NEST-PCR was used to detect if the beta-lactamase gene lo- cated in the integron I. The product of full length of bla-CTX-M like gone amplified by PCR was sequenced. Results Susceptibility test showed the resistance from high to low in turn was Ampicillin (97.68%), Coftriaxone (67.44 % ), piperacillin(65.12 % ), Cefotaxime (62.79 % ) ,Coftasidime(58.14% ), Cofasolin(55.81% ), Cofepime (53.49%), Cefexitin(51.16%), ciprofloxacin (44. 19% ), Aztreo- nam(41.86% ), Cefoperasone/Sulbactam ( 20.93% ), Amikacin (0% ), Imipenem (0% ), respectively. ECO was susceptive to Imipenem. CTX-M-G1 was found in 25 strains of ECO , TEM, SHV, CTX-M-G1, ISEcp1B, and integron I were found in the nine isolates. IS903 were found in ECO 3 and 5, and IS26 was found in ECO 3. In ECO 3 and 5, blaCTX-M-like was flanked upstream by ISEcp1B element that provided -35 and -10 promoter sequences and a right inverted repeat (IRR) recognized by transposase, downstream by IS903 provided an inverted re- peat, ISEcp1 B and IS903 composed the complex transpeson. Conclusion ISEcplB may drive the expression and dissemination of blaCTX-M-like gene at a high level.