整合子与多重耐药大肠埃希菌相关性研究

目的探讨整合子在多重耐药大肠埃希菌耐药性中的作用。方法对临床分离的93株多重耐药大肠埃希菌的I、Ⅱ型整合酶基因进行检测,并分析药敏结果。结果多重耐药临床分离株中Ⅰ型整合子阳性率为60.2%。所检出整合子共有3种长度即1000、1600和2000 bp;主要携带aadA和dfrA类基因盒;未检出Ⅱ型整合子。结论整合子形成是细菌产生多重耐药的重要原因。     

细菌多重耐药性的转移与基因盒-整合子系统

细菌的多重耐药已成为临床治疗的难题,近年来耐药基因转移的新机制与基因盒-整合子系统密切相关。本文就该系统的发展历史、整合子的结构与分类、基因盒的种类与表达、基因盒．整合子的检测方法及其多重耐药性传递的相关性作一全面阐述。     

产ESBLs肺炎克雷伯菌Ⅰ类整合子基因盒的研究

目的探讨整合子参与产ESBLs肺炎克雷伯菌多重耐药的分子机制。方法整合酶基因扩增法检测Ⅰ类整合子;整合子可变区扩增并测序。结果8株产ESBLs肺炎克雷伯菌中有7株Ⅰ类整合子检测阳性,其中4株耐药基因盒为dfrA12-orfF—aadA2,2株为dfrA17-aadA4／aadA5,I株为aadA2,1株未检测到耐药基因盒。结论整合子介导的耐药基因盒参与了产ESBLs肺炎克雷伯菌多重耐药的形成,应引起高度重视。     

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。     

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。     

整合子与细菌耐药性

整合子是由1个编码整合酶的intI基因、2个基因重组位点、启动子和耐药基因盒组成,根据整合酶的DNA碱基序列的不同分为4类,它能通过位点的基因重组机制使耐药基因移动,传递细菌耐药性,并与多重耐药性相关。     

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。     

ESBLs大肠埃希菌和肺炎克雷伯杆菌整合子分布及其与ESBLs基因关系研究

目的研究整合子在院内感染ESBLs大肠埃希菌和肺炎克雷伯杆菌中的分布及其与细菌耐药的相关性,探讨Ⅰ类整合子在ESBLs基因水平转移中的作用及其与ESBLs基因型的关系。方法运用K-B法,纸片扩散法,PCR,接合传递试验、套式PCR、质粒谱分析及DNA测序研究携带耐药基因的Ⅰ类整合子与耐药播散的关系。结果产ESBLs和非产ESBLs菌株中Ⅰ类整合酶扩增阳性例数分别是70例（占66.7%）和22例（占22.4%）,2组整合子阳性率差异有统计学意义（P〈0.01）。整合子阳性组中ESBLs、多重耐药菌均明显高于阴性组。产ESBLs菌株中blaSHV、blaCTX和blaTEM基因与整合子经质粒共同转移的频率分别是79.3%、58.5%和45.1%。结论整合子在产ESBLs大肠埃希菌和肺炎克雷伯杆菌中的分布明显高于非产ESBLs菌株,主要为Ⅰ类整合子,并参与产ESBLs菌株多重耐药性的形成,其中blaSHV基因型与整合子经质粒共同转移的频率高于其他两类基因,提示SHV型酶在浙南地区具有更强的扩散优势。     

临床分离肺炎克雷伯菌Ⅰ类整合子的结构与功能

为了探索细菌多重耐药性的产生和播散的分子机制, 文章对2002～2007年间179株临床分离的肺炎克雷伯菌进行耐药性、I类整合子可变区基因盒结构以及基因盒携带的耐药性基因进行分段克隆和耐药性功能测定。结果显示：65.9%(118/179)的肺炎克雷伯菌表现出对至少两种以上的抗生素(主要为β-内酰胺类、氨基糖苷类和喹诺酮类抗菌药物)的耐药性; 36.3%(65/179)的菌株检出单条或者双条I类整合子基因盒条带; 对整合子阳性组与阴性组的耐药率进行比较发现, 除氨基糖苷类、喹诺酮类和复方新诺明等药物的耐药性存在显著性差异(P<0.01)外, 其余药物的差异不显著; 共发现15种耐药基因构成形式的整合子基因盒, 其中以dfrA17-aadA5最为多见, 实验证明整合子可由接合转移耐药性质粒携带; 对整合子基因盒(dhfr17-orfF-aadA2)分段克隆的耐药性功能研究发现, 3个克隆重组子(pET28a-dhfr17、pET28a-dhfr17-orfF和pET28a-dhfr17-orfF-aadA2)对复方新诺明的抗性(MIC值)均为256 µg/mL, 重组子pET28a-dhfr17-orfF与重组子pET28a-dhfr17对链霉素的抗性无明显区别, 和受体菌一样MIC值均为8 µg/mL, 而pET28a-dhfr17-orfF-aadA2对链霉素的抗性则明显提高, MIC值为256 µg/mL。结果表明, I类整合子在肺炎克雷伯菌中较常见, 携带氨基糖苷类和甲氧苄啶类的耐药基因盒在数量上占优势, 且整合子携带的耐药基因具有耐药性功能, 位于可水平转移耐药性质粒的耐药性基因相关的整合子对病原菌耐药性播散具有重要意义。 目的基因     

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。     

整合子系统介导沙门菌耐药性的研究进展

沙门菌（Salmonella spp.）是公共卫生学上具有重要意义的人畜共患病病原菌。人、畜感染沙门菌后会引起伤寒、副伤寒、胃肠炎、败血症和肠外局灶性感染等疾病。抗生素是治疗沙门菌严重感染的有效手段,随着临床和畜牧业中抗生素的大量使用,使得沙门菌的耐药情况日益严重。整合子是普遍存在于细菌中的一种可移动基因元件,可有效捕获外源基因确保其表达,并复合于转座子、质粒等,使多种耐药基因在细菌种内或者种间进行传播。在过去的二十年中,随着新基因盒和复杂整合子的不断出现,导致整合子系统迅速进化。整合子在沙门菌耐药性传播过程中具有非常重要的作用,因此,本文对整合子系统的分子结构、分类、作用机制,以及沙门菌中存在的Ⅰ、Ⅱ、Ⅲ类整合子介导的耐药性及现有检测方法的研究进展进行综述,以期为沙门菌耐药性研究提供参考。     

Increased levels of sigJ mRNA in late stationary phase cultures of Mycobacterium tuberculosis detected by DNA array hybridisation

Integrons are genetic elements known for their role in the acquisition and expression of genes conferring antibiotic resistance. Such acquisition is mediated by an integron-encoded integrase, which captures genes that are part of gene cassettes. To test whether integrons occur in environments with no known history of antibiotic exposure, PCR primers were designed to conserved regions of the integrase gene and the gene cassette recombination site. Amplicons generated from four environmental DNA samples contained features typical of the integrons found in antibiotic-resistant and pathogenic bacteria. The sequence diversity of the integrase genes in these clones was sufficient to classify them within three new classes of integron. Since they are derived from environments not associated with antibiotic use, integrons appear to be more prevalent in bacteria than previously observed.     

Class I integrons containing a dhfrI trimethoprim resistance gene cassette in aquatic Acinetobacter spp

The presence of antibiotic resistance gene cassettes in class I integrons was investigated in 24 sulfamethoxazole-resistant and -sensitive Acinetobacter isolates derived from two Danish freshwater trout farms. Integrons were detected in five isolates from one of the fish farms, and their inserts were characterised by DNA sequencing. Each isolate contained a dhfrI gene cassette encoding resistance to trimethoprim and an open reading frame orfC of unknown function identical to the content of an integron previously found in a clinical enterobacterial isolate. Among the five isolates, at least two different strains were differentiated based on phenotypic tests and randomly amplified polymorphic DNA analysis. To our knowledge, this is the first report and characterisation of an integron in environmental bacteria.     

Epidemiology and molecular mechanism of integron-mediated antibiotic resistance in <Emphasis Type="Italic">Shigella</Emphasis>

Integrons are gene capture and expression systems that are characterized by the presence of an integrase gene. This encodes an integrase, a recombined site, and a promoter. They are able to capture gene cassettes from the environment and incorporate them using site-specific recombination. The role of integrons and gene cassettes in the dissemination of multidrug resistance in Gram-negative bacteria is significant. In Shigella species, antimicrobial resistance is often associated with the presence of class 1 and class 2 integrons that contain resistance gene cassettes. Multiple and complex expression regulation mechanisms involving mobile genetic elements in integrons have been developed in the evolution of Shigella strains. Knowledge of the epidemiology and molecular mechanisms of antimicrobial resistance in this important pathogen is essential for the implementation of intervention strategies. This review was conducted to introduce the structures and functions of integrons in Shigella species and mechanisms that control integron-mediated events linked to antibiotic resistance.     

Evidence for dynamic exchange of qac gene cassettes between class 1 integrons and other integrons in freshwater biofilms

Class 1 integrons carried by pathogens have acquired over 100 different gene cassettes encoding resistance to antimicrobial compounds, helping to generate a crisis in the management of infectious disease. It is presumed that these cassettes originated from environmental bacteria, but exchange of gene cassettes has surprisingly never been demonstrated outside laboratory or clinical contexts. We aimed to identify a natural environment where such exchanges might occur, and determine the phylogenetic range of participating integrons. Here we examine freshwater biofilms and show that families of cassettes conferring resistance to quaternary ammonium compounds ( qac ) are found on class 1 integrons identical to those from clinical contexts, on sequence variants of class 1 integrons only known from natural environments, and on other diverse classes of integrons only known from the chromosomes of soil and freshwater Proteobacteria . We conclude that gene cassettes might be readily shared between different integron classes found in environmental, commensal and pathogenic bacteria. This suggests that class 1 integrons in pathogens have access to a vast pool of gene cassettes, any of which could confer a phenotype of clinical relevance. Exploration of this resource might allow identification of resistance or virulence genes before they become part of multi-drug-resistant human pathogens.     

Incidence of Extended-Spectrum β-Lactamases and Characterization of Integrons in Extended-Spectrum β-Lactamase-producing Klebsiella pneumoniae Isolated in Shantou, China

This study is concerned with the level of antibiotic resistance of extended-spectrum β-lactamase （ESBL）-producing Klebsiella pneumoniae, isolated in Shantou, China, and its mechanism. Seventy- four non-repetitive clinical isolates of K. pneumoniae producing ESBLs were isolated over a period of 2 years. Antibiotic susceptibility, carried out by Epsilometer test, showed that most of the isolates were multiresistant. Polymerase chain reaction showed that, among the several types of β-lactamases, SHV was the most prevalent, TEM was the second most prevalent, and CTX-M was the least prevalent. Sixty-nine isolates were positive for integrase gene IntI1, but no IntI2 or IntI3 genes were found. The variable region of class 1 integrons were amplified and further identified by sequencing. Thirteen different gene cassettes and 11 different cassette combinations were detected. Dfr and aadA cassettes were predominant and cassette combinations dfrA12, orfF and aadA2 were most frequently found. No gene cassettes encoding ESBLs were found. Integrons were prevalent and played an important role in multidrug resistance in ESBL-producing K. pneumoniae.     

Mobile gene cassettes and DNA integration elements

Integrons are unique natural systems for capturing and spreading the antibiotic resistance genes among Gram-negative bacteria. Gene transfer into small genomes and into plasmids is via site-specific recombination. Integrons act as receptors of antibiotic resistance cassettes. There are known more than 50 cassettes conferring resistance to beta-lactams, aminoglycosides, trimethoprim, chloramphenicol, streptomycin, and other antibiotics. The structure of integrons and of gene cassettes are described and the mechanisms of capture, mobilization, and expression of cassettes considered.     

Prevalence of class 1 integron among multidrug-resistant Acinetobacter baumannii in Tabriz, northwest of Iran

Integrons are associated with a variety of gene cassettes, which confer resistance to multiple classes of antibacterial drugs. In this study we tested the frequency of class 1 and 2 integrons among multidrug-resistant Acinetobacter baumannii (MDRAB) clinical isolates. One hundred clinical isolates of A. baumannii were screened for carriage of class 1 and 2 integrons by PCR method. Results showed that seventy four (92.5%) of 80 MDRAB carried class 1 integron. Integron-positive isolates were statistically more resistant to aminoglycoside, quinolone and beta-lactam compounds except for cefepime. This is the first report of class 1 integrons in MDRAB isolates in northwest Iran.     

Integrons and gene cassettes: hotspots of diversity in bacterial genomes

Integrons are genetic units found in many bacterial species that are defined by their ability to capture small mobile elements called gene cassettes. Cassettes usually contain only one gene, potentially any gene, and an attC recombination site, and thousands of cassettes have been sequenced. A specialized IntI site-specific recombinase encoded by the integron recognizes attC and incorporates cassettes into an attI site located adjacent to the intI gene. Over 100 types of integrons have been found, most in bacterial chromosomes. They can all potentially share the same cassettes and, as recombination between attC in a cassette and an attI can occur repeatedly, an integron can contain from zero to hundreds of cassettes. Cassette arrays that are not located next to an intI gene, or solo cassettes at apparently random sites, are also seen. Hence, integrons contribute to generation of diversity in bacterial, plasmid, and transposon genomes and facilitate extensive sharing of information among bacteria.     

IntI2 integron integrase in Tn7

Integrons can insert and excise antibiotic resistance genes on plasmids in bacteria by site-specific recombination. Class 1 integrons code for an integrase, IntI1 (337 amino acids in length), and are generally borne on elements derived from Tn5090, such as that found in the central part of Tn21. A second class of integron is found on transposon Tn7 and its relatives. We have completed the sequence of the Tn7 integrase gene, intI2, which contains an internal stop codon. This codon was found to be conserved among intI2 genes on three other Tn7-like transposons harboring different cassettes. The predicted peptide sequence (IntI2*) is 325 amino acids long and is 46% identical to IntI1. In order to detect recombination activity, the internal stop codon at position 179 in the parental allele was changed to a triplet coding for glutamic acid. The sequences flanking the cassette arrays in the class 1 and 2 integrons are not closely related, but a common pool of mobile cassettes is used by the different integron classes; two of the three antibiotic resistance cassettes on Tn7 and its close relatives are also found in various class 1 integrons. We also observed a fourth excisable cassette downstream of those described previously in Tn7. The fourth cassette encodes a 165-amino-acid protein of unknown function with 6.5 contiguous repeats of a sequence coding for 7 amino acids. IntI2*179E promoted site-specific excision of each of the cassettes in Tn7 at different frequencies. The integrases from Tn21 and Tn7 showed limited cross-specificity in that IntI1 could excise all cassettes from both Tn21 and Tn7. However, we did not observe a corresponding excision of the aadA1 cassette from Tn21 by IntI2*179E.