The role of horizontal gene transfer in the spread of trimethoprim-sulfamethoxazole resistance among uropathogenic Escherichia coli in Europe and Canada
The role of horizontal gene transfer in the spread of trimethoprim-sulfamethoxazole resistance among uropathogenic Escherichia coli in Europe and Canada
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DOI：
10.1093/jac/dkl020
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发表时间：
2006-04-01
影响因子：
5.2
通讯作者：
Marrs, CF
中科院分区：
文献类型：
--
作者：
Blahna, MT;Zalewski, CA;Marrs, CF
目的：了解欧洲和加拿大地区尿路致病性大肠埃希菌对甲氧苄氨嘧啶-磺胺甲恶唑耐药基因的分布及水平基因转移和克隆扩增在其耐药率上升中的作用。方法：对西欧16个国家和加拿大(ECO.SENS)350株尿路感染的急性、非并发症、社区获得性尿路感染进行横断面研究，确定耐药等位基因sul1、sul2、sul3、dfr和1型、2型整合子。甲氧苄氨嘧啶耐药基因最常见的是dfrA1，在含有DfR的菌株中占37.9%。同样，磺胺甲恶唑耐药基因在不同地区的分布也没有显著差异(P=0.20)。最常见的磺胺甲恶唑耐药基因sul2存在于77.9%的磺胺甲恶唑耐药株中。1型和2型整合子的分布因地区而略有差异(P=0.04)，其中以1型整合子最为常见(85.9%)。我们观察到了sul基因、Dfr基因和整合子类型的34种组合；最常见的组合广泛分布于所研究的每个地区。结论：在欧洲和加拿大，水平基因转移比克隆扩张在提高甲氧苄氨嘧磺胺甲恶唑耐药水平方面发挥着更大的作用。
Objectives: To describe the distribution of trimethoprim-sulfamethoxazole resistance genes and the role of horizontal gene transfer and clonal expansion in recent increases of antibiotic resistance rates among uropathogenic Escherichia coli in Europe and Canada.Methods: We identified antibiotic resistance alleles sul1, sul2, sul3 and dfr along with type 1 and type 2 integrons among 350 uropathogenic E. coli isolates from a cross-sectional study of acute, uncomplicated, community-acquired urinary tract infections in 16 western European countries and Canada (ECO.SENS).Results: Trimethoprim resistance gene distributions showed no regional dependency (P = 0.84). The most common trimethoprim resistance gene was dfrA1, which occurred in 37.9% of dfr containing isolates. Similarly, the sulfamethoxazole resistance gene distributions did not vary significantly by region (P = 0.20). sul2, the most common sulfamethoxazole resistance gene, was found in 77.9% of sulfamethoxazole-resistant isolates. The distribution of type 1 and type 2 integrons varied slightly by region (P = 0.04) with type 1 integrons being the more common (85.9%). We observed 34 combinations of the sul genes, dfr genes and integron types; the most common combinations were broadly disseminated across every region examined.Conclusions: Horizontal gene transfer plays a larger role than clonal expansion in the increase of trimethoprim-sulfamethoxazole resistance levels in Europe and Canada.