腸内細菌に由来する抗菌薬耐性プラスミドの分子疫学的解析と抗菌薬使用に関する研究

肠道细菌耐药质粒的分子流行病学分析及抗菌药物使用研究

• 批准号: 24931032
• 负责人: 日暮 芳己
• 金额: $ 0.13万
• 依托单位: The University of Tokyo
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Scientists
• 财政年份: 2012
• 资助国家: 日本
• 起止时间: 2012 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-24931032/
• 关键词: plasmid-mediated AmpC βラクタマーゼ; replicon type; 腸内細菌

<目的>plasmid-mediated AmpCβラクタマーゼ(pAmpC)産生腸内細菌を対象に,プラスミドのinc/repタイプと分離患者の抗菌薬投与歴をレトロスペクティブに調査し,pAmpC産生株のinc/repタイプと抗菌薬投与歴との関連を調査した.<方法>当施設にて2005年から2012年に分離・同定された腸内細菌のうち,第3世代セフェム系抗菌薬およびセブメタゾールまたはセフォキシチンに耐性をしめし,さらにβラクタマーゼ阻害剤に無効であった保存菌株119株を対象とした.薬剤耐性遺伝子の検出として,pAmpCはPerezらの方法,ESBLはYagiら,Shibataらの方法を用いた.inc/rep型はJohnsonらの方法,プラスミドの有無は,Kadoらの方法を用いた.抗菌薬投与歴は,患者記録を当院の個人情報規定に従い,調査を行った.<結果>pAmpC産生株は25%で確認され, E. coliとC. freundiiが過半数を占めた.それらの遺伝子型はCIT型,EBC型,DHA型及びACC型であった.また,pAmpC産生と同時にTEM型ESBL,SHV型ESBLおよびCTX-M型ESBLを産生する菌株も確認された.これらの多くは,約90kbのプラスミドをもち,inc/rep型は,N型,I1型,Frep型,FIA型,FIB型で,同時に複数のinc/rep型を保有する菌株もあった.E. coliでは,分離時期が異なるが,同一のpAmpC遺伝子型とinc/rep型を保有するE.coliもみられた.また,各分離患者は,カルバペネム系抗菌薬を含むβラクタム系抗菌薬が投与されていたが,inc/rep型と抗菌薬投与歴との関連は,明らかにできなかった.<まとめ>inc/rep型の結果より,E.coliでは同型のプラスミドを有する株を認め,当施設内外でのプラスミド伝播が示唆された。

Objective: To investigate the relationship between the inc/rep profile of plasmid-mediated AmpC beta (pAmpC)-producing strains and the isolation of patients 'antimicrobial agents. <Method> When the experiment was conducted from 2005 to 2012, the intestinal bacteria were isolated and identified, and the third generation strains were selected as antibacterial agents and resistant strains, and 119 strains were preserved. PAmpC is Perez's method,ESBL is Yagi's method,Shibata's method, inc/rep is Johnson's method, and Kado's method is used. Antimicrobial agents and patients were recorded in the hospital's personal information regulations, and investigations were conducted. <Results> 25% of pAmpC-producing strains were confirmed, E. coliとC. freundii CIT type,EBC type,DHA type and ACC type. pAmpC was produced and TEM type ESBL,SHV type ESBL and CTX-M type ESBL were produced. The strains are of the type: inc/rep type,N type,I1 type,Frep type,FIA type,FIB type, etc. E.coli, the isolation period is different, the same pAmpC gene type and inc/rep type remain. In each case, the isolated patient had a relationship between the administration of the antibiotic agent and that of the inc/rep type, which indicated that the antibiotic agent had a relationship between the administration of the antibiotic agent and that of the beta type. The results showed that E.coli strains with different isotypes were identified, and the expression of isotypes was detected when the cells were cultured inside and outside the plant.