CAJ | 학술논문

目的：了解临床收集的多重耐药大肠埃希菌克隆播散状况及质粒介导耐药性的特性。方法通过K- B纸片法明确细菌耐药谱，脉冲场凝胶电泳（PFGE）进行耐药菌株的克隆分型，了解其克隆播散情况，通过质粒接合实验获得耐药性质粒的接合菌，用PCR方法筛选接合菌株的常见耐药基因，并利用S1酶切质粒再进行PFGE的方法判读分析质粒的分子大小，分析菌株间的质粒水平迁移状况。结果临床分离95株大肠埃希菌均为多重耐药菌，对青霉素类、头孢菌素类、喹诺酮类、四环素类等药物显示出广泛耐药性，PFGE分型显示克隆传播趋势不明显。耐药菌株常携带可接合性耐药质粒，质粒分子量大小分布在40~330kb，编码多种对青霉素类、头孢菌素类等药物耐药的耐药基因，包括CTX- M型、TEM型β-内酰胺酶基因，以及质粒介导喹诺酮耐药基因qnr等等。结论临床大肠埃希菌多重耐药性严重，耐药性的快速传播已非同源克隆细菌的简单播散，可接合质粒造成的耐药基因水平转移可能起到了相当重要的作用。
목적：료해림상수집적다중내약대장애희균극륭파산상황급질립개도내약성적특성。방법통과K- B지편법명학세균내약보，맥충장응효전영（PFGE）진행내약균주적극륭분형，료해기극륭파산정황，통과질립접합실험획득내약성질립적접합균，용PCR방법사선접합균주적상견내약기인，병이용S1매절질립재진행PFGE적방법판독분석질립적분자대소，분석균주간적질립수평천이상황。결과림상분리95주대장애희균균위다중내약균，대청매소류、두포균소류、규낙동류、사배소류등약물현시출엄범내약성，PFGE분형현시극륭전파추세불명현。내약균주상휴대가접합성내약질립，질립분자량대소분포재40~330kb，편마다충대청매소류、두포균소류등약물내약적내약기인，포괄CTX- M형、TEM형β-내선알매기인，이급질립개도규낙동내약기인qnr등등。결론림상대장애희균다중내약성엄중，내약성적쾌속전파이비동원극륭세균적간단파산，가접합질립조성적내약기인수평전이가능기도료상당중요적작용。
Objective To investigate the plasmid- mediated multidrug resistance in Escherichia coli. Methods Ninety five clinical isolates of multidrug resistant Escherichia coli were col ected. Antimicrobial susceptibility was determined by K- B method. PFGE was used to investigate the clonality of clinical isolates. Plasmid conjugation assay was used by filter mating. An S1- PFGE assay on plasmid was performed to determine the plasmid molecular size. PCR amplification and sequencing were used to screen common antimicrobial resistance genes. Results Ninety- five clinical isolates of Escherichia coli exhibited mul-tidrug resistance to penicil in, cephalosporins, quinolones and tetracycline. PFGE result did not support the evidence of clone dissemination. Resistant isolates harbored conjugant plasmid with 40kb- 330kb size, which encoded penicil in, cephalosporins or quinolones resistant determinants, including CTX- M, TEM typeβ- lactamase genes and gene. Conclusion Clinical isolates of Escherichia coli present severe problem of multidrug resistance. The rapid prevalence of resistance may be mainly determined by conjugant plasmid or horizontal gene transfer instead of simple clone dissemination.