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The Resistance Mechanism and Clonal Distribution of Tigecycline-Nonsusceptible Klebsiella pneumoniae Isolates in Korea
Yonsei Medical Journal ; : 641-646, 2016.
Artigo em Inglês | WPRIM | ID: wpr-21851
ABSTRACT

PURPOSE:

Tigecycline is one of the drugs used to treat multi-drug resistant Klebsiella pneumoniae (K. pneumoniae) infections, including complicated skin and soft tissue infections, complicated intra-abdominal infection, and community-acquired pneumonia in the Republic of Korea. However, since its commercial release, K. pneumoniae resistance against tigecycline has been reported, and there is a serious concern about the spread of tigecycline resistant bacteria. MATERIALS AND

METHODS:

In this study, we collected and analyzed 342 isolates from 23 hospitals in the Republic of Korea to determine the mechanisms of tigecycline susceptibility and their clonal types. The hospitals include several from each province in the Republic of Korea, except Jeju, an island province, and nonsusceptibility among the isolates was tested by the disk diffusion method. In our lab, susceptibility was checked again using the broth dilution method, and clonal types were determined using the multilocus sequence typing protocol. Real-time PCR was performed to measure the ramR mutation in the isolates nonsusceptible to tigecycline, which would suggest an increased expression of the AcrAB multidrug pump.

RESULTS:

Fifty-six K. pneumoniae isolates were found to be nonsusceptible, 16% of the 342 collected. Twenty-seven and nine isolates of the tigecycline nonsusceptible isolates had mutations in the ramR and rpsJ genes, respectively; while 18 nonsusceptible isolates harbored the tetA gene. Comparison of isolates with and without ramR mutation showed a significant statistical difference (p<0.05) for expression of AcrAB. Moreover, the most common clonal types, as observed in our study, appear to be ST11 and ST789.

CONCLUSION:

Several dominate clonal types infer tigecycline resistance to K. pneumoniae, including ST11, ST768, ST15, ST23, ST48, and ST307. There does not seem to be a transferrable medium, such as plasmid, for the resistance yet, although mutation of the ramR gene may be a common event, accounting for 48% of the nonsusceptibility in this study.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Plasmídeos / Proteínas de Bactérias / Infecções por Klebsiella / Testes de Sensibilidade Microbiana / Reação em Cadeia da Polimerase / Farmacorresistência Bacteriana / República da Coreia / Tipagem de Sequências Multilocus / Reação em Cadeia da Polimerase em Tempo Real / Klebsiella pneumoniae Limite: Humanos País/Região como assunto: Ásia Idioma: Inglês Revista: Yonsei Medical Journal Ano de publicação: 2016 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Plasmídeos / Proteínas de Bactérias / Infecções por Klebsiella / Testes de Sensibilidade Microbiana / Reação em Cadeia da Polimerase / Farmacorresistência Bacteriana / República da Coreia / Tipagem de Sequências Multilocus / Reação em Cadeia da Polimerase em Tempo Real / Klebsiella pneumoniae Limite: Humanos País/Região como assunto: Ásia Idioma: Inglês Revista: Yonsei Medical Journal Ano de publicação: 2016 Tipo de documento: Artigo