Dissemination of multidrug-resistant, class 1 integron-carrying Acinetobacter baumannii isolates in Taiwan
Dissemination of multidrug-resistant, class 1 integron-carrying Acinetobacter baumannii isolates in Taiwan
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DOI：
10.1111/j.1469-0691.2008.02077.x
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发表时间：
2008-11-01
影响因子：
14.2
通讯作者：
Siu, L. K.
中科院分区：
文献类型：
--
作者：
Huang, L. -Y.;Chen, T. -L.;Siu, L. K.
本研究于1996年至2004年间，从台湾不同地区的三所教学医院收集了283株耐多药鲍曼不动杆菌（MDR-AB）血液分离株。药敏数据显示，携带1类整合子的菌株对所有抗生素（除氨曲南和氯霉素外）的耐药性均显著高于缺乏整合子的菌株（p < 0.01）。在这些菌株中鉴定出7种基因盒，其中包括2种未见报道的基因盒。绝大多数卡带编码氨基糖苷抗性基因，包括aacA4、aacC1、aac（6’）-II、aadA1、aadA2、aadA4和aadDA1。在携带1类整合子的MDR-AB分离株中鉴定出16种不同的核糖型。只有一株菌株被发现产生广谱β -内酰胺酶，即VEB-3。在18株亚胺培南耐药菌株中，1株碳青霉烯酶基因bla（VIM-11）和bla（OXA-58）同时存在。通过核型鉴定了一个全岛范围内的流行病克隆和一个北部地区某医院的地方性克隆。根据不同核蛋白群的敏感性数据，流行克隆与头孢吡肟和氨苄西林-舒巴坦耐药的相关性比流行克隆更显著。综上所述，1类整合子的存在与MDR-AB的耐药显著相关，并且发现携带1类整合子的MDR-AB克隆在台湾广泛流行。
In this study, 283 multidrug-resistant Acinetobacter baumannii (MDR-AB) bloodstream isolates were collected between 1996 and 2004, from three teaching hospitals located in different regions of Taiwan. Susceptibility data showed that strains carrying class 1 integrons were significantly more resistant (p < 0.01) to all tested antibiotics (except aztreonam and chloramphenicol) than strains lacking integrons, Seven types of gene cassette were identified among these strains, including two that have not been previously reported. The vast majority of the cassettes encoded aminoglycoside resistance genes, including aacA4, aacC1, aac(6')-II, aadA1, aadA2, aadA4 and aadDA1. Sixteen distinct ribotypes were identified in MDR-AB isolates carrying class 1 integrons. Only one strain was found to produce an extended-spectrum beta-lactamase, i.e. VEB-3. In the 18 imipenem-resistant strains, two carbapenenmase genes, bla(VIM-11) and bla(OXA-58), were found concomitantly in one isolate. An island-wide epidemic clone and an endemic clone from a hospital located in the northern region were identified by ribotyping. On the basis of the susceptibility data among the different ribogroups, the epidemic clone was associated more significantly with resistance to cefepime and ampicillin-sulbactam than was the endemic clone. In conclusion, the presence of class 1 integrons was significantly associated with resistance in MDR-AB, and the epidemic, class 1 integron-carrying MDR-AB clone was found to be widespread in Taiwan.