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대한임상미생물학회

   접수번호

  20180014

   접수일

  2018-06-28

   구분

  원저

   교신저자

  윤은정        (ejyoon : 윤은정)

   소속

  연세대학교 의과대학 진단검사의학교실 및 세균내성연구소

   이메일

  ejyoon@yuhs.ac

   제목

  CTX-M 광범위 베타락탐 분해효소의 그룹별 내성표현형 차이

   Running Title

  

   영문초록

  Background: Enterobacteriaceae clinical isolates producing CTX-M extended-spectrum beta-lactamases (ESBLs) were assessed for the antimicrobial resistance phenotypes varied by group of enzymes.
Methods: A total of 1,338 Enterobacteriaceae blood isolates, including 959 Escherichia coli and 379 Klebsiella pneumoniae, was studied. All the strains were collected between January and July 2017 from eight general hospitals in South Korea. The species were identified by matrix assisted laser desorption ionization-time of flight mass spectrometry. Antimicrobial susceptibilities were determined by disk diffusion methods and ESBL phenotypes by double-disk synergy tests using disks containing cefotaxime, ceftazidime, cefepime, aztreonam, and clavulanic acid (CA). The genes for bate-lactamases were identified by PCR and sequencing.
Results: Of total, 31.6% (303/959) E. coli and 24.0% (91/379) K. pneumoniae were resistant to cefotaxime and 28.1% (269/959) E. coli and 20.1% (76/379) K. pneumoniae were CTX-M-type ESBL producers. Among the detected CTX-M ESBLs, 58.0% (156/269) in E. coli and 86.8% (66/76) in K. pneumoniae belonged to group 1, 46.8% (126/269) in E. coli and 14.5% (11/76) in K. pneumoniae were group 9. Ten E. coli and one K. pneumoniae isolates co-produced both groups of CTX-M ESBL. The group 1 CTX-M producers had higher level of resistance to cefotaxime, ceftazidime, cefepime, and aztreonam and exhibited stronger synergistic activities by combination with CA compared to the group 9.
Conclusion: ESBL phenotypes were differed by group of CTX-M ESBL and phenotype testing with drugs including 4th generation cephalosporins and monobactams is critical for screening the CTX-M-producers with better sensitivity.

   Key Words

  CTX-M, extended-spectrum beta-lactama, Enterobacteriaceae, resistance phenotype

   논문파일

1 . 표지(Title Page) A-20180014-1-00.docx 32 Kbytes 2018-06-28
2 . 본문(Main Body) A-20180014-2-00.docx 398 Kbytes 2018-06-28
3 . 국문초록 A-20180014-4-00.docx 18 Kbytes 2018-06-28
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1 김현수 comichaha@gmail.com Y 010-3048-1015 N 2018-07-23
1 송원근 swonkeun@hallym.or.kr Y 010-4051-9205 Y 2018-07-23 2018-07-24 수정후 편집위 결정
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