Molecular Analysis of Antibiotic Resistance Determinants and Plasmids in Malaysian Isolates of Multidrug Resistant Klebsiella pneumoniae.
Molecular Analysis of Antibiotic Resistance Determinants and Plasmids in Malaysian Isolates of Multidrug Resistant Klebsiella pneumoniae.
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DOI：
10.1371/journal.pone.0133654
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Tay ST
中科院分区：
文献类型：
--
作者：
Al-Marzooq F;Mohd Yusof MY;Tay ST
多重耐药肺炎克雷伯菌引起的感染在世界许多地区的报告越来越多。马来西亚共有93株多重耐药克雷伯菌。研究了2010-2012年从马来西亚吉隆坡马来亚大学医学中心的患者中分离的肺炎克雷伯氏菌的抗生素耐药决定因素，包括超广谱β-内酰胺酶（ESBLs）、氨基糖苷类和甲氧苄啶/磺胺甲恶唑耐药基因和质粒复制子。CTX-M-15（91.3%）是本研究中检测到的主要ESBL基因。aacC 2基因（67.7%）是氨基糖苷类耐药菌株中最常见的基因。对甲氧苄啶/磺胺甲恶唑耐药（90.3%）归因于sul 1（53.8%）和dfrA（59.1%）基因的存在。在95.7%的菌株中检测到多个质粒复制子（1-4）。FIIK是与13种其他类型的质粒复制子一起检测到的优势复制子。从43株K菌中的27株中获得了接合质粒（1-3个~3-100 kb的质粒）。肺炎分离株。从每个接合子中检测到ESBL基因（CTX-M-15、CTX-M-3或SHV-12）。在大多数接合性质粒中发现了与至少一种其他抗生素耐药决定簇[sul 1、dfrA、aacC 2、aac（6 ′）-Ib、aac（6 ′）-Ib-cr和qnrB]的共检测。接合子对β-内酰胺类、庆大霉素、复方新诺明等多种抗生素耐药，但对环丙沙星无耐药。这是第一项描述马来西亚多重耐药克雷伯氏菌中质粒循环特征的研究。肺炎分离株。这项研究的结果表明，马来西亚分离株之间的高度多样化的质粒与多个抗生素耐药决定因素的扩散。应采取有效的感染控制措施和抗生素管理计划，以限制多重耐药细菌在医疗机构中的传播。
Infections caused by multidrug resistant Klebsiella pneumoniae have been increasingly reported in many parts of the world. A total of 93 Malaysian multidrug resistant K. pneumoniae isolated from patients attending to University of Malaya Medical Center, Kuala Lumpur, Malaysia from 2010-2012 were investigated for antibiotic resistance determinants including extended-spectrum beta-lactamases (ESBLs), aminoglycoside and trimethoprim/sulfamethoxazole resistance genes and plasmid replicons. CTX-M-15 (91.3%) was the predominant ESBL gene detected in this study. aacC2 gene (67.7%) was the most common gene detected in aminoglycoside-resistant isolates. Trimethoprim/sulfamethoxazole resistance (90.3%) was attributed to the presence of sul1 (53.8%) and dfrA (59.1%) genes in the isolates. Multiple plasmid replicons (1-4) were detected in 95.7% of the isolates. FIIK was the dominant replicon detected together with 13 other types of plasmid replicons. Conjugative plasmids (1-3 plasmids of ~3-100 kb) were obtained from 27 of 43 K. pneumoniae isolates. An ESBL gene (either CTX-M-15, CTX-M-3 or SHV-12) was detected from each transconjugant. Co-detection with at least one of other antibiotic resistance determinants [sul1, dfrA, aacC2, aac(6ˊ)-Ib, aac(6ˊ)-Ib-cr and qnrB] was noted in most conjugative plasmids. The transconjugants were resistant to multiple antibiotics including β-lactams, gentamicin and cotrimoxazole, but not ciprofloxacin. This is the first study describing the characterization of plasmids circulating in Malaysian multidrug resistant K. pneumoniae isolates. The results of this study suggest the diffusion of highly diverse plasmids with multiple antibiotic resistance determinants among the Malaysian isolates. Effective infection control measures and antibiotic stewardship programs should be adopted to limit the spread of the multidrug resistant bacteria in healthcare settings.