产ESBLs大肠埃希菌整合子及其相关基因盒的研究

目的检测产超广谱β-内酰胺酶（ESBLs）大肠埃希菌中整合子的整合酶及插入的相关基因盒情况,分析整合子对细菌耐药性的影响。方法采用K-B琼脂扩散法对45株临床分离的产ESBLs大肠埃希菌进行药敏试验;应用PCR法检测45株产ESBLs大肠埃希菌Ⅰ类、Ⅱ类和Ⅲ类整合子;对Ⅰ类整合子阳性菌进行整合子相关基因盒检测。结果45株菌中有27株（60．0％）含有Ⅰ类整合子,没有检测到Ⅱ类和Ⅲ类整合子阳性菌。在Ⅰ类整合子阳性菌中,有23株携带Ⅰ类整合子相关基因盒（85．2％）,5种不同的基因盒图谱,片段大小在600～2322bp,分离自同一科室的部分菌株携带大小相同的基因盒;Ⅰ类整合子阳性菌株的耐药率高于整合子阴性的菌株。结论Ⅰ类整合子及整合子相关基因盒在产ESBLs大肠埃希菌株中分布广泛,整合子在细菌耐药中发挥作用。     

大肠埃希菌耐药性水平传播实验研究

目的研究重症监护病房（ICU）患者标本中分离的大肠埃希菌的耐药情况以及耐药性水平传播的实验研究。方法采取双纸片法（K-B）检测细菌的耐药性;产超广谱β-内酰胺酶（ESBLs）大肠埃希菌为供体菌,耐利福平大肠埃希菌（对其他抗生素敏感）作为受体菌进行接合实验;采用聚合酶链反应（PCR）技术扩增整合子和耐药基因。结果30株大肠埃希菌中产ESBLs菌株检出率为46．7％;接合培养后,接合菌携带23kb和25kb大质粒,而无供体菌中一系列小质粒;供体菌和接合菌均携带I型整合子。结论大肠埃希菌耐药性严重,且呈多重耐药性;产ESBLs菌株可通过质粒和整合子将耐药基因转移给敏感菌,导致耐药性传播。     

临床产ESBLs大肠埃希菌整合子检测及基因型分析

了解临床分离的产ESBLs大肠埃希菌(ESBLs-producing Escherichia coli,ESBL-EC)中Ⅰ、Ⅱ、Ⅲ类整合子及ESBL-EC基因型的分布。收集2014年1月至12月某三甲医院住院患者分离的大肠埃希菌,经全自动细菌分析系统鉴定并检测其对临床常用抗菌药物的耐药性,双纸片协同试验确定ESBL-EC,采用聚合酶链反应(PCR)对整合子基因和ESBLs基因进行检测。K-B法比较整合子阳性菌株与阴性菌株的耐药率。结果发现,98株临床非重复ESBL-EC对青霉素类、头孢菌素类、喹诺酮类、单环酰胺类和庆大霉素耐药率均大于50%,对妥布霉素耐药率为31.62%,对呋喃妥因、阿莫西林/克拉维酸和阿米卡星较敏感,分别为11.11%、13.4%和6.12%;对碳青霉烯类抗菌素、替加环素和哌拉西林/他唑巴坦敏感率为100%。98株菌中检出47株含Ⅰ类整合子(47.96%),3株含Ⅱ类整合子(3.06%),所有菌株中有1株同时含Ⅰ类和Ⅱ类整合子,未检出Ⅲ类整合子。整合子阳性菌株对四环素和复方新诺明的耐药率高于整合子阴性菌株(P0.05)。98株菌中β-内酰胺酶基因TEM、CTX-M-9、CTX-M-1、CTX-M-2和SHV阳性率分别为62.24%、53.06%、32.65%、4.08%和3.06%,ESBL-EC基因分型分布以TEM合并CTX-M-9型(共30株)最多见,占30.61%。结果表明,Ⅰ类整合子在产ESBLs大肠埃希菌中分布广泛,本研究尚不足以证明整合子的存在可影响ESBL-EC菌株抗生素耐药水平。同时携带TEM和CTX-M-9基因是安徽医科大学解放军174临床学院产ESBLs大肠埃希菌临床耐药菌株产生的主要原因。     

新生儿病区产ESBLs大肠埃希菌整合子及其耐药性分析

目的 了解新生儿病区产ESBLs大肠埃希菌整合子的携带情况及其耐药性.方法 采用K-B琼脂扩散法对56株产ESBLs大肠埃希菌进行药敏试验;应用PCR法检测Ⅰ类、Ⅱ类和Ⅲ类整合子;以肠杆菌科重复序列-聚合酶链式反应(ERIC-PCR)进行基因分型.结果 56株产ESBLs大肠埃希菌的Ⅰ类整合子检出率为60.7％,未检出Ⅱ类和Ⅲ类整合子;菌株对庆大霉素、环丙沙星、左氧氟沙星、复方新诺明、头孢唑林、氨曲南、头孢他啶的耐药率差异有统计学意义(P＜0.05),阳性菌株的耐药率高于阴性菌株;56株大肠埃希菌分为45种基因型.结论 Ⅰ类整合子广泛存在于新生儿病区产ESBLs大肠埃希菌并与其耐药性相关.     

整合子介导的肠致病性大肠埃希菌多重耐药研究

目的了解肠致病性大肠埃希菌（EPEC）多重耐药菌株中整合酶基因的携带情况,研究整合子与抗生素多重耐药的相关性。方法使用血清学的方法对EPEC进行初筛,用PCR扩增EPEC毒力基因（eae,EAF,bfpA）进行确证。对确证为EPEC的细菌DNA进行提取,使用PCR方法对整合酶基因及在整合子中插入的基因盒进行扩增。EPEC药敏试验采用K-B琼脂扩散法。结果在34株EPEC中,ESBL为14株,其中在lI株ESBL阳性细菌中扩增出整合子I整合酶片段,在20株ESBL阴性细菌中,有7株扩增出相应的片段。在这所有的34株细菌中未检出整合子Ⅱ和Ⅲ。结论I类整合子在肠致病性大肠埃希菌多重耐药菌株中最常见,是导致细菌多重耐药的一个重要因素,合理用药,控制耐药基因的传播是当前医学面临的一个重要问题     

大肠埃希菌连续分离株氨基糖苷类修饰酶基因研究

目的了解临床分离的大肠埃希菌耐药性及氨基糖苷类修饰酶（AMEs）基因的存在状况。方法测定临床分离的60株大肠埃希菌对19种抗菌药物的敏感性,采用PCR技术检测氨基糖苷类修饰酶基因。结果60株大肠埃希菌呈现多重耐药,氨基糖苷类修饰酶基因aac（3）-Ⅱ、aac（6′）-Ⅰb、aac（6′）-Ⅱ、ant（3′′）-Ⅰ、ant（2′′）-Ⅰ的阳性率分别为36.7%、18.3%、0%、10%、1.6%。携带1种或1种以上基因的菌株有33株（55%）。结论临床分离的大肠埃希菌多重耐药严重,氨基糖苷类修饰酶基因携带率较高。     

山东省某地区奶牛源大肠埃希菌的血清型、耐药特性及分子特性

【目的】旨在对从山东省某地区4个健康奶牛养殖场分离到的大肠埃希菌进行优势血清型、耐药特性、Ⅰ类整合子基因盒携带情况以及系统进化群分析。【方法】采集194份来自山东省某地区4个规模化奶牛场奶牛新鲜粪便样品,进行大肠埃希菌分离和鉴定,利用常用大肠埃希菌诊断血清进行血清型鉴定;利用10%的绵羊血平板检测溶血性;利用K-B法检测对14种常规抗菌药物的敏感性;利用聚合酶链式反应(PCR)检测革兰阴性菌常见的6大类24种耐药基因、Ⅰ类整合子基因盒结构并对目的条带测序分析;利用细菌多位点序列分型(Multilocus sequence typing,MLST)技术分析大肠埃希菌的ST型并使用eBURST v3软件分析菌株之间的克隆关系。【结果】从194份新鲜粪便样品中分离到171株大肠埃希菌,其中主要为致病性(19.9%)和侵袭性大肠埃希菌(17.0%),优势血清型分别为O128:K67(12/171)和O143:K7(12/171)。另外,具有溶血性的大肠埃希菌阳性率为9.4%(16/171);药敏试验结果显示多重耐药菌株的比率为22.2%,其中对氨苄西林耐药率最高为33.9%,四环素次之,为24.0%;PCR检测耐药基因和整合子结果显示,59.1%的菌株携带β-内酰胺类耐药基因blaTEM,59.1%的菌株携带氨基糖苷类耐药基因ant(2′),未检测到四环素耐药基因tetA和tetB;Ⅰ类整合子的阳性率为4.1%(7/171),dfrA12-aadA2-sul1为优势基因盒结构(4/171);MLST将大肠埃希菌分为8种ST型,其中,ST155(10/171)和ST58(45/171)形成一个克隆复合物且没有发现新的ST型。【结论】本研究证实,从该地区规模化健康奶牛场新鲜粪便中分离到的大肠埃希菌优势血清型为O128:K67和O143:K7;少部分大肠埃希菌具有溶血性;仅对氨苄西林、四环素等具有较高的耐药率;优势基因盒结构为dfrA12-aadA2-sul1;MLST分型显示不同奶牛场分离出亲缘关系较近的菌株,其分布具有多态性,血清型与ST型之间无相关性。本研究表明源自表观健康的奶牛的大肠埃希菌存在多重耐药现象,具有食品公共卫生安全隐患,该研究对于提升规模化奶牛场奶制品的安全生产与质量评估具有一定的理论指导意义。     

产ESBLs大肠埃希菌和肺炎克雷伯菌呼吸道分离株的基因分型及耐药性分析

目的了解深圳市人民医院大肠埃希菌和肺炎克雷伯菌呼吸道分离株超广谱β-内酰胺酶(ESBLs)的基因型特点及耐药性。方法采用临床实验室标准化协会(CLSI)推荐的表型确证试验筛选出该院呼吸道分离株产ESBLs大肠埃希菌和肺炎克雷伯菌共78株。应用PCR及DNA测序法分析产酶株的TEM、SHV及CTX-M3种β-内酰胺酶基因,用琼脂稀释法测定细菌最低抑菌浓度(MIC)。结果 37株产ESBLs大肠埃希菌中,28株(75.7%)检出CTX-M-14基因,4株(10.8%)检出CTX-M-9基因,其他型较少见。41株肺炎克雷伯菌中,25株(61.0%)检出SHV-12基因,4株(9.8%)检出SHV-11基因,其他SHV型较少。20株(48.8%)检出CTX-M-14基因,5株(12.2%)检出CTX-M-3基因,其他型较少。产ESBL菌株均对亚胺培南敏感,对氨苄西林/舒巴坦的耐药率最高(90%),对其他抗生素有不同程度耐药。结论深圳市人民医院呼吸道分离的产ESBLs大肠埃希菌以CTX-M-14型为主,产酶肺炎克雷伯菌以SHV-12和CTX-M-14型为最常见。     

产超广谱β-内酰胺酶大肠埃希菌Ⅰ类整合子检测与耐药性关系

目的了解I类整合子在产ESBLs和非产ESBLs大肠埃希菌中分布状况,分析I类整合子在细菌多重耐药中的作用。方法用PCR方法扩增I类整合酶基因,经电泳后检测扩增产物。用2χ检验进行统计学分析,P<0.05为差异有显著性。结果105株大肠埃希菌检出I类整合子46株,检出率为43.8%。I类整合子在产ESBLs菌的检出率为53.4%,明显高于非产ESBLs菌(31.9%),2χ检验,P<0.01。I类整合子阳性菌株多重耐药率为68.8%(33/48),明显高于阴性菌株(33.3%),P<0.05。I类整合子阳性菌株和产ESBLs菌均对青霉素类、喹诺酮类、磺胺类抗生素表现出较高的耐药率。所有菌株均对亚胺培南敏感。结论I类整合子携带与产ESBLs菌株耐药有关,I类整合子阳性菌株对多种抗生素的耐药率大于整合子阴性菌株。     

重症监护病房产ESBLs菌的基因分型

目的了解深圳市人民医院重症监护病房分离菌超广谱β-内酰胺酶（ESBLs）的检出率及其基因型分布情况。方法收集来自重症监护病房大肠埃希菌和肺炎克雷伯菌分离株48株,采用CLSI推荐的表型确证方法筛选出ESBLs株,并利用PCR及DNA测序法分析产酶菌株的ESBL基因型。结果（1）48分离株菌中共检出产ESBLs菌24株,阳性率为50.0%。（2）产酶菌中93.8%（15/16）的大肠埃希菌和87.5%（7/8）的肺炎克雷伯菌分别检出CTX-M基因;其中72.7%（16/22）为CTX-M-14。6株肺炎克雷伯菌检出SHV基因,其中3株为SHV-11型,另3株为SHV-12型,6株含SHV基因的肺炎克雷伯菌中5株合并CTX-M基因。而所有大肠埃希菌株均未检出SHV基因。所有产酶菌中,分别有10株大肠埃希菌和2株肺炎克雷伯菌检出TEM-1基因,其中1株大肠埃希菌只检出TEM-1基因,未检出SHV型或CTX-M型基因。结论重症监护病房分离菌ESBLs检出率高,以CTX-M-14为主要基因型。     

痰液中产ESBL肺炎克雷伯菌Ⅰ、Ⅱ类整合子检测及基因分型研究

目的研究临床痰液分离的产ESBLs肺炎克雷伯菌Ⅰ、Ⅱ类整合子分布情况,并进行基因分型。方法分离临床痰液中100株产ESBLs的肺炎克雷伯菌,用WHONET 5.4分析菌株药敏情况,PCR检测整合酶Ⅰ、整合酶Ⅱ,ERIC-PCR进行基因分型。结果 100株菌对碳青霉烯类敏感率100%,对β-内酰胺类、氨基糖苷类、氟喹诺酮类多数耐药。整合酶Ⅰ检出率为60%,未检出整合酶Ⅱ。100株菌分为72个基因型。结论Ⅰ类整合子广泛存在于产ESBLS肺炎克雷伯菌中,与肺炎克雷伯菌的耐药相关,ERIC-PCR可用于临床分离肺炎克雷伯的基因分型。     

I类整合子与产ESBLs肺炎克雷伯菌多重耐药关系的研究

目的了解产ESBLs肺炎克雷伯菌的整合子存在状况。方法用PCR方法扩增Ⅰ类整合酶基因,经电泳后检测扩增产物。结果72株产ESBLs肺炎克雷伯菌中检测出Ⅰ类整合子67株,检出率为93．0％,Ⅰ类整合子阳性菌对氨基糖苷类、喹诺酮类及头孢菌素类药物表现出较高的耐药,其多重耐药率明显高于Ⅰ类整合子阴性菌株（P〈0．05）。结论Ⅰ类整合子广泛地存在产ESBLs肺炎克雷伯菌中,Ⅰ类整合子对细菌多重耐药性的产生和传播起着重要作用。     

上呼吸道分离鲍曼不动杆菌1 型整合子的分离与鉴定

【目的】研究I型整合子的结构特征,探讨其与细菌多重耐药之间的相关性。【方法】收集2008年至2009年广州呼吸疾病研究所上呼吸道分离的187株鲍曼不动杆菌,应用K-B纸片扩散法检测耐药性,采用聚合酶链式反应进行I型整合子整合酶基因的检测;扩增整合子的可变区,应用DNA测序技术分析I型整合子基因结构。【结果】I型整合子的阳性率达53.4%。共七种1型整合子基因盒被鉴定,其中首次发现报道一种新的整合子(GenBank:HQ322622)。可变区主要编码氨基糖苷类药物的耐药基因。20种抗菌素耐药的结果均表明携带Ⅰ型整合子的鲍曼不动杆菌耐药率较不携带I型整合子的鲍曼不动杆菌的耐药率明显增高。整合子与鲍曼不动杆菌的多重耐药表型具有密切相关性。【结论】I类整合子相关耐药基因在本院临床分离鲍曼不动杆菌中分布较广泛。整合子在鲍曼不动杆菌耐药性的形成和播散中具有重要作用。     

Prevalence of antimicrobial resistance in bacteria isolated from central nervous system specimens as reported by U.S. hospital laboratories from 2000 to 2002

Background

Class 1 integrons contain genetic elements for site-specific recombination, capture and mobilization of resistance genes. Studies investigating the prevalence, distribution and types of integron located resistance genes are important for surveillance of antimicrobial resistance and to understand resistance development at the molecular level.

Methods

We determined the prevalence and genetic content of class 1 integrons in Enterobacteriaceae (strain collection 1, n = 192) and E. coli (strain collection 2, n = 53) from bloodstream infections in patients from six Norwegian hospitals by molecular techniques. Class 1 integrons were also characterized in 54 randomly selected multiresistant E. coli isolates from gastrointestinal human infections (strain collection 3).

Results

Class 1 integrons were present in 10.9% of the Enterobacteriaceae blood culture isolates of collection 1, all but one (S. Typhi) being E. coli. Data indicated variations in class 1 integron prevalence between hospitals. Class 1 integrons were present in 37% and 34% of the resistant blood culture isolates (collection 1 and 2, respectively) and in 42% of the resistant gastrointestinal E. coli. We detected a total of 10 distinct integron cassette PCR amplicons that varied in size between 0.15 kb and 2.2 kb and contained between zero and three resistance genes. Cassettes encoding resistance to trimethoprim and aminoglycosides were most common. We identified and characterized a novel plasmid-located integron with a cassette-bound novel gene (linF) located downstream of an aadA2 gene cassette. The linF gene encoded a putative 273 aa lincosamide nucleotidyltransferase resistance protein and conferred resistance to lincomycin and clindamycin. The deduced LinF amino acid sequence displayed approximately 35% identity to the Enterococcus faecium and Enterococcus faecalis nucleotidyl transferases encoded by linB and linB'

Conclusions

The present study demonstrated an overall low and stable prevalence of class 1 integron gene cassettes in clinical Enterobacteriaceae and E. coli isolates in Norway. Characterization of the novel lincosamide resistance gene extends the growing list of class 1 integron gene cassettes that confer resistance to an increasing number of antibiotics.     

Class 1 Integrons and Antibiotic Resistance of Clinical Acinetobacter calcoaceticus–baumannii Complex in Poznań, Poland

Sixty-three clinical isolates of Acinetobacter calcoaceticus–baumannii complex were analyzed for the presence of integrons and antimicrobial resistance. Class 1 integrons were detected in 40 (63.5 %) isolates. None of them had class 2 or class 3 integrons. The majority of the integrons contained aacC1–orfA–orfB–aadA1 gene cassette array. The presence of integrons was associated with the increased frequency of resistance to 12 of 15 antimicrobials tested, multi-drug resistance phenotype, and the overall resistance ranges of the strains.     

Molecular characterization of antimicrobial resistance in Salmonella isolated from animals in Japan

Aims:  To investigate the prevalence of integrons and antimicrobial resistance genes in Salmonella recovered from animals in Japan.
Methods and Results:  Forty-eight out of ninety-four (51·1%) Salmonella isolates showed multidrug resistance phenotypes and harboured at least one antimicrobial resistance gene. Twenty-two out of forty-seven (46·8%) Salmonella enterica serovar Typhimurium that were multidrug-resistant were of definitive phage type DT104. Class 1 integrons were identified in 34/94 isolates (36·2%): 21 isolates containing two gene cassettes, aadA2 and bla _PSE–1, and 13 containing one gene cassette, aadA1 , aadA2 or bla _PSE–1. Class 2 integrons containing estX - sat2 - aadA1 gene cassettes were only identified in Salmonella Enteritidis. The β-lactamase-encoding gene, bla _TEM, was only detected in S. Typhimurium. The plasmid-mediated quinolone resistance gene, qnrS1 , was identified in S. Typhimurium and Salmonella Thompson.
Conclusions:  Our results characterized integrons and antimicrobial resistance genes in Salmonella of animal origin. To the best of our knowledge, this is the first report of qnrS in Salmonella from Japan and also the first report of qnrS in S . Thompson.
Significance and Impact of the Study:  Little is known about the molecular basis of antimicrobial resistance in Salmonella isolated from animals. This study provides useful data on the incidence of integrons and resistance genes in Salmonella of animal origin.     

Antibiotic-resistant Escherichia coli in karstic systems: a biological indicator of the origin of fecal contamination?

Occurrences of antibiotic-resistant Escherichia coli in two springs of a karstic system (NW France) providing drinking water were determined to study the role of aquifers in the dissemination of the resistance genes. Water samples were collected during wet and dry periods and after a heavy rainfall event to investigate E. coli density, antibiotic resistance patterns, and occurrences of class 1, 2, and 3 integrons. By observing patterns of the resistant isolates (i.e. number and type of resistances) and their occurrences, we were able to define two resistant subpopulations, introduced in the aquifer via surface water: (1) R1-2, characterized by one or two resistance(s), essentially to chloramphenicol and/or tetracycline (96.5%), was always found during the heavy rainfall event; (2) R3-10, characterized by three or more resistances, mostly resistant to tetracycline (94.1%) and beta-lactams (86%), was found transiently. Class 1 and 2 integrons were detected, mostly in the R3-10 subpopulation for class 1 integrons. The characteristics of these two subpopulations strongly suggest that the contamination originates from pasture runoff for the R1-2 subpopulation and from wastewater treatment plant effluents for the R3-10 subpopulation. These two subpopulations of E. coli could be used as biological indicators to determine the origin of groundwater contamination.     

Mechanisms of resistance to quinolones in Salmonella Typhimurium from patients with infectious diarrhea

This study investigated the mechanisms of resistance of 36 quinolone‐resistant Salmonella Typhimurium strains isolated from outpatients with infectious diarrhea in Beijing Tian Tan Hospital between 2013 and 2015. The resistance spectrum of the 36 strains was measured using a broth dilution method. Class 1 integrons harboring the β‐lactamase gene and mutations in quinolone resistance determining regions were also investigated. All 36 quinolone‐resistant Salmonella Typhimurium strains were found to be multidrug‐resistant and the majority of these strains harbored Class 1 integrons. These findings study suggests that strategies for determining resistance spectrums should be implemented with greater urgency.