Gu Dan-xia, Hu Yun-jian, Zhou Hong-wei, Zhang Rong, Chen Gong-xiang
1Department of Laboratory Medicine, Second Affiliated Hospital of Zhejiang University, Hang Zhou, China.
2Beijing Hospital, Beijing, China.
Microb Drug Resist. 2015 Jun;21(3):345-51. doi: 10.1089/mdr.2014.0057. Epub 2014 Dec 16.
To investigate the prevalence and the mechanism of quinolone-resistant Acinetobacter pittii, 634 Acinetobacter calcoaceticus-Acinetobacter baumannii complex isolates were collected throughout Zhejiang Province. Identification of isolates was conducted by matrix-assisted laser desorption ionization/time of flight mass spectrometry (MALDI-TOF MS), blaOXA-51-like gene, and partial RNA polymerase β-subunit (rpoB) amplification. Twenty-seven isolates of A. pittii were identified. Among the 634 isolates, A. baumannii, A. pittii, Acinetobacter nosocomialis, and A. calcoaceticus counted for 87.22%, 4.26%, 8.20%, and 0.32%, respectively. Antimicrobial susceptibility of nalidixic acid, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, levofloxacin, sparfloxacin, moxifloxacin, and gatifloxacin for 27 A. pittii were determined by the agar dilution method. Detection of quinolone-resistant determining regions of gyrA, gyrB, parC, and parE was performed for the A. pittii isolates. In addition, plasmid-mediated quinolone resistance (PMQR) determinants (qnrA, qnrB, qnrS, qnrC, qnrD, aac(6')-Ib-cr, qepA, oqxA, and oqxB) were investigated. All the 27 isolates demonstrated a higher minimum inhibitory concentration (MIC) to old quinolones than the new fluoroquinolones. No mutation in gyrA, gyrB, parC, or parE was detected in 20 ciprofloxacin-susceptible isolates. Seven ciprofloxacin-resistant A. pittii were identified with a Ser83Leu mutation in GyrA. Among them, six isolates with simultaneous Ser83Leu amino acid substitution in GyrA and Ser80Leu in ParC displayed higher MIC values against ciprofloxacin. Additionally, three were identified with a Met370Ile substitution in ParE, and two were detected with a Tyr317His mutation in ParE, which were reported for the first time. No PMQR determinants were identified in the 27 A. pittii isolates. In conclusion, mutations in chromosome play a major role in quinolone resistance in A. pittii, while resistance mechanisms mediated by plasmid have not been found. Ser83Leu substitution in GyrA and Ser80Leu substitution in ParC are associated with quinolone resistance in A. pittii. Whether Met370Ile and Tyr317His substitutions in ParE play a minor role requires further investigation.
为研究耐喹诺酮类皮氏不动杆菌的流行情况及其机制,在浙江省范围内收集了634株醋酸钙不动杆菌-鲍曼不动杆菌复合菌。采用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)、blaOXA-51样基因及部分RNA聚合酶β亚基(rpoB)扩增对分离株进行鉴定。共鉴定出27株皮氏不动杆菌。在这634株分离株中,鲍曼不动杆菌、皮氏不动杆菌、医院不动杆菌和醋酸钙不动杆菌分别占87.22%、4.26%、8.20%和0.32%。采用琼脂稀释法测定了27株皮氏不动杆菌对萘啶酸、氧氟沙星、依诺沙星、环丙沙星、洛美沙星、左氧氟沙星、司帕沙星、莫西沙星和加替沙星的药敏情况。对皮氏不动杆菌分离株检测gyrA、gyrB、parC和parE的喹诺酮耐药决定区。此外,还研究了质粒介导的喹诺酮耐药(PMQR)决定簇(qnrA、qnrB、qnrS、qnrC、qnrD、aac(6')-Ib-cr、qepA、oqxA和oqxB)。所有27株分离株对老一代喹诺酮类药物的最低抑菌浓度(MIC)均高于新一代氟喹诺酮类药物。在20株环丙沙星敏感分离株中未检测到gyrA、gyrB、parC或parE的突变。鉴定出7株环丙沙星耐药的皮氏不动杆菌,其GyrA存在Ser83Leu突变。其中,6株GyrA同时存在Ser83Leu氨基酸替代和ParC的Ser80Leu,对环丙沙星的MIC值较高。此外,鉴定出3株ParE存在Met370Ile替代,2株ParE存在Tyr317His突变,均为首次报道。在27株皮氏不动杆菌分离株中未鉴定出PMQR决定簇。综上所述,染色体突变在皮氏不动杆菌喹诺酮耐药中起主要作用,而未发现质粒介导的耐药机制。GyrA的Ser83Leu替代和ParC的Ser80Leu替代与皮氏不动杆菌喹诺酮耐药有关。ParE的Met370Ile和Tyr317His替代是否起次要作用有待进一步研究。