台湾多重耐药的携带1型整合子的鲍曼不动杆菌的扩散

David

Clinical Microbiology and InfectionVolume 14 Issue 11, Pages 1010 - 1019
Published Online: 22 Oct 2008
ORIGINAL ARTICLE
Dissemination of multidrug-resistant, class 1 integron-carrying Acinetobacter baumannii isolates in Taiwan
台湾多重耐药的携带1型整合子的鲍曼不动杆菌的扩散

L.-Y. Huang 1 , T.-L.Chen 2,3 , P.-L. Lu 4 , C.-A. Tsai 5 , W.-L. Cho 3 , F.-Y. Chang 6 , C.-P. Fung 2,3 and L. K. Siu 6,7 [url=] [/url] 1 Graduate Institute of Medical Sciences , [url=] [/url] 2 Section of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital , [url=] [/url] 3 Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei , [url=] [/url] 4 Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung , [url=] [/url] 5 Section of Infectious Diseases, Department of Medicine, Taichung Veterans General Hospital, Taichung , [url=] [/url] 6 Department of Medicine, Tri-Service General Hospital, National Defence Medical Centre and [url=] [/url] 7 Division of Clinical Research, National Health Research Institutes, Taiwan
Corresponding author and reprint requests: L. K. Siu, Division of Clinical Research, National Health Research Institutes, Room 7118, 7/F, No. 161, Min-Chuan East Rd., NDMC, 114, Taipei, Taiwan
E-mail: klksiu@gmail.com

Copyright Journal compilation © 2008 European Society of Clinical Microbiology and Infectious Diseases

KEYWORDS
Acinetobacter baumannii • epidemic clone • integron-associated • multidrug-resistant • ribotype

ABSTRACT
In this study, 283 multidrug-resistant Acinetobacter baumannii (MDR-AB) bloodstream isolates were collected between 1996 and 2004, from three teaching hospitals located in different regions of Taiwan. Susceptibility data showed that strains carrying class 1 integrons were significantly more resistant (p <0.01) to all tested antibiotics (except aztreonam and chloramphenicol) than strains lacking integrons, Seven types of gene cassette were identified among these strains, including two that have not been previously reported. The vast majority of the cassettes encoded aminoglycoside resistance genes, including aacA4, aacC1, aac(6')-II, aadA1, aadA2, aadA4 and aadDA1. Sixteen distinct ribotypes were identified in MDR-AB isolates carrying class 1 integrons. Only one strain was found to produce an extended-spectrum β-lactamase, i.e. VEB-3. In the 18 imipenem-resistant strains, two carbapenenmase genes, blaVIM-11 and blaOXA-58, were found concomitantly in one isolate. An island-wide epidemic clone and an endemic clone from a hospital located in the northern region were identified by ribotyping. On the basis of the susceptibility data among the different ribogroups, the epidemic clone was associated more significantly with resistance to cefepime and ampicillin–sulbactam than was the endemic clone. In conclusion, the presence of class 1 integrons was significantly associated with resistance in MDR-AB, and the epidemic, class 1 integron-carrying MDR-AB clone was found to be widespread in Taiwan.


Original Submission: 21 October 2007;  Revised Submission: 23 May 2008;  Accepted: 27 May 2008 Edited by L. Poirel