[국내논문]Characterization of Trimethoprim-Sulfamethoxazole Resistance Genes and Their Relatedness to Class 1 Integron and Insertion Sequence Common Region in Gram-Negative Bacilli원문보기
Trimethoprim-sulfamethoxazole (TMP-SMX) has been used for the treatment of urinary tract infections, but increasing resistance to TMP-SMX has been reported. In this study, we analyzed TMP-SMX resistance genes and their relatedness with integrons and insertion sequence common regions (ISCRs) in uropa...
Trimethoprim-sulfamethoxazole (TMP-SMX) has been used for the treatment of urinary tract infections, but increasing resistance to TMP-SMX has been reported. In this study, we analyzed TMP-SMX resistance genes and their relatedness with integrons and insertion sequence common regions (ISCRs) in uropathogenic gram-negative bacilli. Consecutive nonduplicate TMP-SMX nonsusceptible clinical isolates of E. coli, K. pneumoniae, Acinetobacter spp., and P. aeruginosa were collected from urine. The minimal inhibitory concentration was determined by Etest. TMP-SMX resistance genes (sul and dfr), integrons, and ISCRs were analyzed by PCR and sequencing. A total of 45 E. coli (37.8%), 15 K. pneumoniae (18.5%), 12 Acinetobacter spp. (70.6%), and 9 Pseudomonas aeruginosa (30.0%) isolates were found to be resistant to TMP-SMX. Their MICs were all over 640. In E. coli and K. pneumoniae, sul1 and dfr genes were highly prevalent in relation with integron1. The sul3 gene was detected in E. coli. However, in P. aeruginosa and Acinetobacter spp., only sul1 was prevalent in relation with class 1 integron; however, dfr was not detected and sul2 was less prevalent than in Enterobacteriaceae. ISCR1 and/or ISCR2 were detected in E. coli, K. pneumoniae, and Acinetobacter spp. but the relatedness with TMP-SMX resistance genes was not prominent. ISCR14 was detected in six isolates of E. coli. In conclusion, resistance mechanisms for TMP-SMX were different between Enterobacteriaceae and glucose non-fermenting gram-negative bacilli. Class 1 integron was widely disseminated in uropathogenic gram-negative baciili, so the adoption of prudent use of antimicrobial agents and the establishment of a surveillance system are needed.
Trimethoprim-sulfamethoxazole (TMP-SMX) has been used for the treatment of urinary tract infections, but increasing resistance to TMP-SMX has been reported. In this study, we analyzed TMP-SMX resistance genes and their relatedness with integrons and insertion sequence common regions (ISCRs) in uropathogenic gram-negative bacilli. Consecutive nonduplicate TMP-SMX nonsusceptible clinical isolates of E. coli, K. pneumoniae, Acinetobacter spp., and P. aeruginosa were collected from urine. The minimal inhibitory concentration was determined by Etest. TMP-SMX resistance genes (sul and dfr), integrons, and ISCRs were analyzed by PCR and sequencing. A total of 45 E. coli (37.8%), 15 K. pneumoniae (18.5%), 12 Acinetobacter spp. (70.6%), and 9 Pseudomonas aeruginosa (30.0%) isolates were found to be resistant to TMP-SMX. Their MICs were all over 640. In E. coli and K. pneumoniae, sul1 and dfr genes were highly prevalent in relation with integron1. The sul3 gene was detected in E. coli. However, in P. aeruginosa and Acinetobacter spp., only sul1 was prevalent in relation with class 1 integron; however, dfr was not detected and sul2 was less prevalent than in Enterobacteriaceae. ISCR1 and/or ISCR2 were detected in E. coli, K. pneumoniae, and Acinetobacter spp. but the relatedness with TMP-SMX resistance genes was not prominent. ISCR14 was detected in six isolates of E. coli. In conclusion, resistance mechanisms for TMP-SMX were different between Enterobacteriaceae and glucose non-fermenting gram-negative bacilli. Class 1 integron was widely disseminated in uropathogenic gram-negative baciili, so the adoption of prudent use of antimicrobial agents and the establishment of a surveillance system are needed.
Recent rise in TMP-SMX resistance is thought to be due to horizontal gene transfer and clonal expansion [2]. In this study, we evaluated genes related to TMP-SMX resistance and their relatedness with the class 1 integron and ISCR in uropathogenic gram-negative bacilli.
The following primers were used for the PCR and sequencing of sul genes: sul1F (5’-CTTCGATGAGAGCCGGCGGC-3’) and sul1R (5’-GCAAGGCGGAAACCCGCGCC-3’) [1], sul2F (5’-GCGCTCAAGGCAGATGGCATT-3’) and sul2R (5’-GCGTTTGATACCGGCACCCGT-3’) [1], and sul3F (5’-GAGCAAGATTTTTGGAATCG-3’) and sul3R (5’-CTAACCTAGGGCTTTGGATAT-3’) [18]. For detection of all ISCRs, the following primers were used: CRF (5’-CACTWCCACATGCTGTKKC-3’) and CRFF-r (5’-CGCTTGAGSCGTTGCRYCC-3’) [24].
이론/모형
The MIC for trimethoprim-sulfamethoxazole was determined by the Etest, conducted in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines [16]. E.
성능/효과
In conclusion, resistance to TMP-SMX in Enterobacteriaceae, E. coli, and K.
Interestingly, the dfr gene, which was observed in relation to the class 1 integron in Enterobacteriaceae, was not observed in any isolates of glucose non-fermenting gram-negative bacilli. Several ISCRs were observed in Enterobacteriaceae and glucose non-fermenting gram-negative bacilli, but we could not find strong relatedness between TMP-SMX resistance genes.
coli facilitated acquisition of resistance to a broad spectrum of antibiotic agents [23]. Therefore, it was found that the class 1 integron with multiple resistance genes was more widely distributed in Korea, which directly contributed to the resistance not only to trimethoprim and sulfamethoxazole, but also to other antibiotics. The TMP-SMX resistance genes sul1, sul2, and dfr were found to be widely disseminated in E.
후속연구
coli. Consequently, further study is warranted to uncover the possibility of ISCRs for carrier of resistance genes, especially in E. coli and other gram-negative bacilli.
참고문헌 (28)
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