Evidence of extensive interspecies transfer of integron-mediated antimicrobial resistance genes among multidrug-resistant Enterobacteriaceae in a clinical setting
Evidence of extensive interspecies transfer of integron-mediated antimicrobial resistance genes among multidrug-resistant Enterobacteriaceae in a clinical setting
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DOI：
10.1086/341078
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发表时间：
2002-07-01
影响因子：
6.4
通讯作者：
Verhoef, J
中科院分区：
文献类型：
--
作者：
Leverstein-van Hall, MA;Box, ATA;Verhoef, J
革兰氏阴性菌的多药耐药性似乎主要是通过水平转移获得耐药基因的结果。然而，在临床环境中，水平转移在多大程度上可能导致多药耐药的出现，却很少有人研究。因此，整合子的内容收集在医院暴发的基因型无关的多重耐药肠杆菌科的特点。由于整合子与多重耐药相关，因此选择其作为转移标记。一些基因型相同的分离株携带不同的整合子。携带相同整合子的10例患者产生6个流行病学连锁簇，每个簇代表不同的整合子。几个病人携带多个物种窝藏同一整合子。用这些菌株进行的接合实验导致以高频率（10（-2）至10（-4））转移完整的抗性模式。这些发现提供了强有力的证据，耐药基因的水平转移在很大程度上促成了多重耐药肠杆菌科在这种临床环境中的出现。
Multidrug resistance in gram-negative bacteria appears to be primarily the result of the acquisition of resistance genes by horizontal transfer. To what extent horizontal transfer may be responsible for the emergence of multidrug resistance in a clinical setting, however, has rarely been investigated. Therefore, the integron contents of isolates collected during a nosocomial outbreak of genotypically unrelated multidrug-resistant Enterobacteriaceae were characterized. The integron was chosen as a marker of transfer because of its association with multiresistance. Some genotypically identical isolates harbored different integrons. Grouping patients carrying the same integron yielded 6 epidemiologically linked clusters, with each cluster representing a different integron. Several patients carried multiple species harboring the same integron. Conjugation experiments with these strains resulted in the transfer of complete resistance patterns at high frequencies (10(-2) to 10(-4)). These findings provide strong evidence that the horizontal transfer of resistance genes contributed largely to the emergence of multidrug-resistant Enterobacteriaceae in this clinical setting.