Nemec Alexandr, Krízová Lenka, Maixnerová Martina, Diancourt Laure, van der Reijden Tanny J K, Brisse Sylvain, van den Broek Peterhans, Dijkshoorn Lenie
Centre of Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic.
J Antimicrob Chemother. 2008 Sep;62(3):484-9. doi: 10.1093/jac/dkn205. Epub 2008 May 13.
The aim of this study was to analyse the emergence of carbapenem resistance among hospital strains of Acinetobacter in the Czech Republic.
Acinetobacter isolates were collected prospectively in 2005-06 from 19 diagnostic laboratories. They were identified to species level by AFLP, typed using AFLP, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing, and tested for susceptibility to 14 antimicrobials and for the presence of 20 genes associated with antimicrobial resistance.
A total of 150 Acinetobacter isolates were obtained from 56 intensive care units of 20 hospitals in 15 cities. They were identified as Acinetobacter baumannii (n = 108) or other species. A. baumannii isolates were allocated to EU clone I (n = 5), EU clone II (n = 66) or other, mostly unique genotypes. Two-thirds of the clone II isolates had nearly identical AFLP and PFGE fingerprints. As many as 85% and 88% isolates were susceptible to meropenem and imipenem (<or=4 mg/L), respectively. Carbapenem MICs of >or=8 mg/L were found in 23 A. baumannii isolates, of which 20 belonged to clone II. Isolates with bla(OXA-58-like) (n = 3)(,) bla(OXA-24-like) (n = 1) or ISAba1 adjacent to bla(OXA-51-like) (n = 34) had carbapenem MICs of 2 to >16 mg/L, while those without these elements showed MICs of <or=0.5-4 mg/L. Clone II isolates varied in susceptibility to some antibiotics including carbapenems and carried 6-12 resistance genes in 17 combinations.
The emergence of Acinetobacter carbapenem resistance in the Czech Republic is associated with the spread of A. baumannii strains of EU clone II. The variation in susceptibility in these strains is likely to result from both the horizontal spread of resistance genes and differential expression of intrinsic genes.
本研究旨在分析捷克共和国医院分离的不动杆菌菌株中碳青霉烯类耐药性的出现情况。
2005 - 2006年前瞻性收集来自19个诊断实验室的不动杆菌分离株。通过扩增片段长度多态性（AFLP）鉴定到种水平，使用AFLP、脉冲场凝胶电泳（PFGE）和多位点序列分型进行分型，并检测对14种抗菌药物的敏感性以及20个与抗菌药物耐药性相关基因的存在情况。
从15个城市20家医院的56个重症监护病房共获得150株不动杆菌分离株。它们被鉴定为鲍曼不动杆菌（n = 108）或其他种。鲍曼不动杆菌分离株被分为欧盟克隆I（n = 5）、欧盟克隆II（n = 66）或其他，大多为独特基因型。三分之二的克隆II分离株具有几乎相同的AFLP和PFGE指纹图谱。分别有多达85%和88%的分离株对美罗培南和亚胺培南敏感（≤4mg/L）。在23株鲍曼不动杆菌分离株中发现碳青霉烯类最低抑菌浓度（MIC）≥8mg/L，其中20株属于克隆II。携带bla(OXA - 58 - like)（n = 3）、bla(OXA - 24 - like)（n = 1）或与bla(OXA - 51 - like)相邻的ISAba1（n = 34）的分离株碳青霉烯类MIC为2至＞16mg/L，而没有这些元件的分离株MIC≤0.5 - 4mg/L。克隆II分离株对包括碳青霉烯类在内的一些抗生素的敏感性存在差异，并以17种组合携带6 - 12个耐药基因。
捷克共和国不动杆菌碳青霉烯类耐药性的出现与欧盟克隆II的鲍曼不动杆菌菌株传播有关。这些菌株敏感性的差异可能是由于耐药基因的水平传播和固有基因差异表达共同导致的。
