Extended-Spectrum -lactamase를 생성하는 Klebsiella pneumoniae 에서의 qnrB와 armA 유전자의 동시생성 = Coproduction of qnrB and armA from Extended-Spectrum -lactamase-producing Klebsiella pneumoniae

국문 초록 (Abstract)

배경 : 전세계적으로 다제 내성 장내 세균이 문제로 대두되고있고 여러 가지 항균제에 대한 내성률이 증가하고 있으나 extend-ed-spectrum -lactamase (ESBL) 생성 Klebsiella pneumo-niae에서의 ESBL, quinolone 및 aminoglycoside 제에 대한삼중 내성에 대한 보고가 없다. 이에 ESBL 생성 K. pneumoni-ae에서의 quinolone 및 aminoglycoside 제에 대한 다제 내성빈도를 알아보고자 하였다.방법 : 2006년 3월부터 9월까지 충남대학교병원에서 분리된Isolates qnr16S rRNAmethylase-lactamaseMIC of agents ( g/mL)AMK GEN CAZ CTX CIPDonors (state of origin)K-3 ≥64 ≥16 ≥64 8 ≥4 S H V qnrB armAK-4 4 1 ≥64 8 ≥4 S H V qnrB armAK-12 16 2 ≥64 4 0.25 SHV qnrB armAK-17 ≥64 8 ≥64 ≥64 ≥4 S H V qnrB armAK-20 ≥64 8 ≥64 ≥64 ≥4 S H V qnrB armAK-24 ≥64 ≥16 ≥64 16 ≥4 S H V qnrB armAK-100 ≥64 ≥16 ≥64 8 ≥4 S H V qnrB armAK-102 ≥64 ≥16 ≥64 8 ≥4 S H V qnrB armAK-159 ≥64 ≥16 ≥64 8 ≥4 S H V qnrB armAK-160 ≥64 ≥16 ≥64 4 ≥4 S H V qnrB armAJ53 transconjugantsK-3′ ≥64 8 ≥64 4 ≥4 S H V qnrB armAK-4′ 2 1 ≥64 1 0.25 SHV qnrB armAK-12′ 4 2 16 2 0.01 SHV qnrBK-17′ 4 2 16 1 0.25 SHV qnrB armAK-20′ 4 2 16 1 0.25 SHV qnrB armAK-24′ 2 2 1 6 1 2 S H V qnrB armAK-100′ 8 0.1 ≥64 16 0.01 SHV qnrB armAK-102′ 2 0.1 ≥64 32 0.01 SHV qnrB armAK-159′ 1 0.1 16 1 0.1 SHV qnrB armAK-160′ 2 2 1 6 1 0 S H V qnrB armAE. coli J53 0.25 0.1 0.15 0.06 0.01434 김문희성지연박종우 외 2인ESBL유전형을 가진 K. pneumoniae 4주를 대상으로 -lac-tam 항생제의 최소 억제 농도를 액체 배지 미량 희석법으로 측정하였다. Azide에 내성을 갖는 E. coli J53을 이용하여 피전달접합균주에 대한 시험을 하였다. PCR을 시행하였고 그 증폭 산물로직접 염기 서열 분석을 시행하여 quin olone 및 aminoglycoside제제에 대한 내성 유전형을 결정하였다. 역학연구는 Enterobacte-rial repetitive intergenic consensus-PCR (ERIC-PCR)로 하였다.

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