Chen Chih-Ming, Lai Chih-Ho, Wu Hwa-Jene, Wu Lii-Tzu
Division of Infectious Disease, Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung 433, Taiwan - Department of Health Food, Chung Chou University of Science and Technology, Changhua 510, Taiwan.
Graduate Institute of Biomedical Sciences, Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan - Molecular Infectious Disease Research Center, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Taoyuan 333, Taiwan - Graduate Institute of Basic Medical Science, School of Medicine, China Medical University, Taichung 404, Taiwan - Department of Medical Research and Department of Laboratory Medicine, China Medical University Hospital, Taichung 404, Taiwan - Department of Nursing, Asia University, Taichung 413, Taiwan.
Biomedicine (Taipei). 2017 Jun;7(2):9. doi: 10.1051/bmdcn/2017070202. Epub 2017 Jun 14.
Proteus mirabilis is an opportunistic pathogen, commonly associated with complicated urinary tract infections (UTIs). UTIs caused by multidrug-resistant Proteus mirabilis have increased worldwide. Multidrug-resistance of Gram-negative enteric bacteria is usually associated with class 1 integrons.
To investigate the prevalence and characterize gene cassettes of class 1 integrons in multidrug-resistant P. mirabilis Methods: From 2006 to 2008, 314 P. mirabilis isolates from urine were collected from a regional teaching hospital. Antimicrobial resistance of the isolates was determined by disk diffusion methods. The phenotypic confirmatory test of extended-spectrum β-lactamase (ESBL) production was performed as described in the Clinical and Laboratory Standards Institute (CLSI) guideline. The genetic organization of the class 1 integron cassettes was investigated by PCR, cloning, and sequencing of the regions surrounding these genes.
Seventy-nine (25%, 79/314) P. mirabilis isolates were ESBL-producing and most ESBL-producing P. mirabilis were positive for bla. Class 1 integrons were presented in 76 isolates (24.2%, 76/314), and were more frequently found in ESBL-positive (55/79, 70%) than ESBL-negative (21/235, 8.9%) P. mirabilis isolates. The most prevalence of the cassettes encoded resistance genes were aminoglycoside (aac(6')-Ib, aacA7, aadAl, aadA2, and aadAla), trimethoprim (dfrAl and dfrA12) and chloramphenicol (catB3 and cmlA6). The most prevalent cassette of dfr12-orfF-aadA2 was found in 49 isolates. The cassette array aadB-catB3-oxa10-aadA1 was first found in P. mirabilis. The enterobacterial repetitive intergenic consensus (ERIC)-PCR fingerprinting patterns were detected in these 76 integron positive P. mirabilis isolates and belonged to 8 profiles.
This study investigated the prevalence and characterized gene cassettes of class 1 integrons in MDR P. mirabilis isolates from urine samples. The frequency of gene cassettes in P. mirabilis were partially by clonal spread of the carriers and the results could provide information for effective antimicrobial therapy and infection control.
奇异变形杆菌是一种机会致病菌，通常与复杂性尿路感染（UTIs）相关。由多重耐药奇异变形杆菌引起的UTIs在全球范围内有所增加。革兰氏阴性肠道细菌的多重耐药性通常与1类整合子有关。
调查多重耐药奇异变形杆菌中1类整合子的流行情况并对其基因盒进行特征分析。方法：2006年至2008年，从一家地区教学医院收集了314株尿液来源的奇异变形杆菌分离株。采用纸片扩散法测定分离株的抗菌药物耐药性。按照临床和实验室标准协会（CLSI）指南所述进行超广谱β-内酰胺酶（ESBL）产生的表型确证试验。通过PCR、克隆以及对这些基因周围区域进行测序来研究1类整合子基因盒的基因结构。
79株（25%，79/314）奇异变形杆菌分离株产ESBL，且大多数产ESBL的奇异变形杆菌bla呈阳性。76株（24.2%，76/314）分离株中存在1类整合子，在产ESBL的奇异变形杆菌（55/79，70%）中比在不产ESBL的奇异变形杆菌（21/235，8.9%）中更常见。编码耐药基因的基因盒最常见的是氨基糖苷类（aac(6')-Ib、aacA7、aadAl、aadA2和aadAla）、甲氧苄啶（dfrAl和dfrA12）和氯霉素（catB3和cmlA6）。在49株分离株中发现最常见的基因盒dfr12-orfF-aadA2。基因盒阵列aadB-catB3-oxa10-aadA1首次在奇异变形杆菌中发现。在这76株整合子阳性的奇异变形杆菌分离株中检测到肠杆菌重复基因间共有序列（ERIC）-PCR指纹图谱模式，共属于8种图谱。
本研究调查了尿液样本中多重耐药奇异变形杆菌分离株中1类整合子的流行情况并对其基因盒进行了特征分析。奇异变形杆菌中基因盒的频率部分是由携带者的克隆传播所致，研究结果可为有效的抗菌治疗和感染控制提供信息。
