革兰阴性菌中16SrRNA甲基化酶基因的检测

目的 了解大连2所医院临床分离革兰阴性菌中介导高水平氨基糖苷类抗生素耐药的16S rRNA甲基化酶基因armA、rmtB的流行情况,并研究其耐药机制.方法 收集临床分离的耐阿米卡星的革兰阴性杆菌134株.PCR法筛选2种甲基化酶基因armA及rmtB;PCR产物进行测序.质粒提取、接合试验及转化试验确定armA及rmtB基因定位.琼脂稀释法测定阳性菌株、结合子和转化产物对阿米卡星、庆大霉素、妥布霉素3种氨基糖苷抗生素的MIC值.结果 134株耐药菌株中,21株鲍曼不动杆菌检出armA基因,5株大肠埃希菌和5株肺炎克雷伯菌检出rmtB基因.质粒抽提试验及接合试验rmtB阳性菌获得成功.接合子及转化产物DH5a(pMDarmA)均获得高水平耐氨基糖苷类抗生素的特性. 结论 大连2所医院检测到16S rRNA甲基化酶基因armA和rmtB阳性菌株.armA基因存在于鲍曼不动杆菌中;rmtB基因位于大肠埃希菌及肺炎克雷伯菌的质粒上.armA和rmtB可以导致细菌对氨基糖苷类抗生素的高水平耐药.     

氨基糖苷类耐药的肠杆菌科细菌16S rRNA甲基化酶基因研究

目的探讨临床分离的对氨基糖苷类耐药的肠杆菌科细菌产16S rRNA甲基化酶状况,分析其分子流行趋势及其耐药性形成和传播的机制。方法采用纸片扩散法筛选庆大霉素和/或阿米卡星耐药的肠杆菌科细菌;采用聚合酶链反应(PCR)扩增16S rRNA甲基化酶基因、氨基糖苷修饰酶基因、β-内酰胺酶基因;采用质粒接合试验验证16S rRNA甲基化酶的转移性;应用脉冲场凝胶电泳(PFGE)对16S rRNA甲基化酶基因阳性菌株进行分型。结果 201株对庆大霉素和/或阿米卡星耐药的肠杆菌科细菌中共检出38株16S rRNA甲基化酶阳性株(armA基因16株,rmtB基因22株)。其中30株可通过接合试验将耐药质粒转移至受体菌。blaCTX-M-14、blaTEM-1和blaSHV-12可连同armA或rmtB分别转移到11、20和7个接合子中。肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌分别被PFGE分为4、21和1个型别。结论本研究分离的肠杆菌科细菌16S rRNA甲基化酶以armA和rmtB为主要流行型别,且后者分离率较高。该甲基化酶可导致氨基糖苷类高水平耐药,而且酶编码基因位于质粒上,具有转移性,β-内酰胺酶基因和氟喹诺酮耐药决定因子可随之一同转移。     

革兰阴性杆菌16S rRNA甲基化酶基因检测及作用研究

目的分析上海中医药大学附属普陀医院临床分离的革兰阴性杆菌中16S rRNA甲基化酶基因的流行情况及革兰阴性杆菌的氨基糖苷类耐药机制。方法收集临床分离的对阿米卡星和/或庆大霉素耐药的革兰阴性杆菌53株。采用聚合酶链反应（PCR）法检测16S rRNA甲基化酶基因：armA、rmtA、rmtB、rmtC、rmtD、npmA;PCR阳性产物测序分析。构建PET32-armA和PET32-rmtB的重组质粒并转化入宿主菌BL21中。纸片扩散法（K-B）检测临床分离16S rRNA甲基化酶基因阳性菌株和重组菌对5种氨基糖苷类药物的敏感性。结果 53株耐药菌中5株鲍曼不动杆菌、2株肺炎克雷伯和1株阴沟肠杆菌检出armA基因,2株大肠埃希菌检出rmtB基因。获得PET32-armA和PET32-rmtB的重组BL21菌株。PET32-armA和PET32-rmtB的重组菌均获得氨基糖苷类抗菌药物耐药性。结论本院临床样本检测到16S rRNA甲基化酶基因armA和rmtB阳性菌株,armA基因存在于鲍曼不动杆菌、肺炎克雷伯菌和阴沟肠杆菌中;rmtB基因位于大肠埃希菌中。将armA和rmtB基因转入非耐药的宿主菌中可以诱导其对氨基糖苷类抗菌药物的耐药。     

广泛耐药铜绿假单胞菌甲基化酶基因的检测和基因周边结构分析

目的了解16S rRNA甲基化酶基因在广泛耐药(XDR)铜绿假单胞菌临床株中的分布及此类耐药基因周边结构。方法收集XDR铜绿假单胞菌59株,琼脂稀释法测定MIC,PCR方法检测16S rRNA甲基化酶基因(armA,rmt A,rmtB,rmtC,rmtD,rmtE,npmA),ERIC-PCR方法进行同源性分析,并对检出的16S rRNA甲基化酶基因armA和rmtB进行周边序列分析。结果 59株XDR铜绿假单胞菌临床分离株中,16S rRNA甲基化酶基因总检出率62.7%(37/59),rmtB的检出率略高于armA,未检出其他甲基化酶基因。根据ERIC-PCR结果受试临床株可分为19个型别。17株检出armA基因菌株分布在3个克隆,其中15株(88.2%)集中在一个克隆(克隆D);而rmtB基因散布于9个克隆。基因周边序列分析显示,armA基因位于一个含多种转座酶的移动元件上,其与大肠埃希菌和鲍曼不动杆菌携带的armA阳性质粒序列一致性达99%;rmtB基因也位于一个含转座酶的移动元件上,其与大肠埃希菌和肺炎克雷伯菌携带的rmtB质粒序列高度一致。结论 16S rRNA甲基化酶基因在XDR铜绿假单胞菌分离株中分布广泛,均在对庆大霉素高度耐药的菌株中检出。armA在铜绿假单胞菌中存在克隆传播。     

多重耐药不动杆菌16S rRNA甲基化酶和同源性研究

目的 调查2007年7月-2008年5月山西医科大学第二附属医院临床分离的61株多重耐药不动杆菌中介导氨基糖苷类抗生素高水平耐药的16S rRNA甲基化酶基因和Ⅰ类整合子携带耐药基因的分布.方法 利用blaOXA-51基因及16S rRNA-23S rRNA序列进行菌株鉴定,琼脂稀释法测定12种抗菌药物对61株不动杆菌的MIC,PCR筛选6种16S rRNA甲基化酶基因以及整合子基因盒,脉冲场凝胶电泳(PFGE)分析菌株同源性.结果 61株临床分离不动杆菌中55株为鲍曼不动杆菌、3株为3TU不动杆菌、l株13TU不动杆菌、1株醋酸钙不动杆菌、l株溶血不动杆菌.48株不动杆菌对阿米卡星、庆大霉素、妥布霉素均耐药,其中有47株检出armA基因;未检出rmtA、rmtB、rmtC、mad和npmA基因.armA基因阳性的菌株中Ⅰ类整合子阳性27株,分别携带arr-3、accA4、aacCl、catB8、aadA1和dfrA12基因.PFGE条带分析发现47株armA阳性菌株分为5个克隆,其中A、B为主要克隆,分布在我院多个科室中.结论 16S rRNA甲基化酶基因armA在多重耐药不动杆菌中广泛存在,armA基因不位于Ⅰ类整合子中,不动杆菌Ⅰ类整合子携带耐药基因主要介导对氨基糖苷类及氯霉素的耐药性.PFGE结果显示armA基因阳性菌株在我院呈克隆播散,必须采取有效的措施来控制耐药菌的传播.     

大肠埃希菌16S rRNA甲基化酶基因的接合传递及其与整合子的相关性

目的 对临床分离的多重耐药（MDR）大肠埃希菌株的16S rRNA甲基化酶基因特征与接合传递效率进行研究,探讨其与整合子的相关性。 方法 136株MDR大肠埃希菌经PCR筛检16S rRNA甲基化酶基因armA、rmtA、rmtB、rmtC、rmtD;对阳性菌株作整合酶基因intI1、intI2和intI3检测,并扩增Ⅰ类整合子可变区插入片段,对扩增产物进行测序与鉴定所含耐药基因盒;以阳性菌株为供体菌,耐叠氮化钠大肠埃希菌J53为受体菌进行接合试验,并结合质粒图谱对16S rRNA甲基化酶基因进行初步定位。 结果 在136株多重耐药大肠埃希菌中,共检出16S rRNA甲基化酶阳性菌12株（8.8%）,其中,armA阳性3株（2.2%）,rmtB阳性10株（7.4%）,未检出rmtA、rmtC、rmtD基因。阳性菌株均只含Ⅰ类整合子,对其可变区扩增片段（1 000～2 300 bp）的测序结果显示,该区域含有多种耐药基因盒,但不含16S rRNA甲基化酶基因。接合试验与质粒图谱结果初步表明armA和rmtB编码基因位于约23 000 bp的质粒上,接合试验的耐药质粒传递率高达83.3%(10/12)。 结论 在MDR大肠埃希菌中,armA和rmtB编码基因位于约23 000 bp质粒上,其中,rmtB为优势基因,接合试验和质粒图谱证明该类耐药质粒很容易在同种菌间传播。Ⅰ类整合子与16S rRNA甲基化酶基因虽然存在于同一菌体内和/或同处于一个质粒上,但整合子基因盒对该类基因的捕获率很低或根本不捕获。     

肺炎克雷伯菌临床分离株aac(6')-Ib-cr基因的检测

目的 调查肺炎克雷伯菌临床分离株aac(6')-Ib-cr基因存在情况.方法 收集2006年1月至2007年9月从临床分离的337株非重复的肺炎克雷伯菌.挑选64株对庆大霉素、阿米卡星和妥布霉素任何一种耐药的肺炎克雷伯菌临床分离株进行aac(6')-Ib-cr基因检测,采用PCR法检测aac(6')-Ib和Ⅰ类整合酶基因(intll),通过DNA直接测序确定aac(6')-Ib-cr.抗生素MIC值测定采用琼脂稀释法.ESBLs检测采用双纸片扩散法,通过接合试验检测质粒是否可以发生转移.结果 337株肺炎克雷伯菌临床分离株中,对庆大霉素、阿米卡星和妥布霉素的耐药率分别为19.0%(64/337)、8.3%(28/337)和16.3%(55/337).共有24株细菌经PCR证实aac(6')-Ib基因阳性,经测序证实全部为aac(6')-Ib-cr基因,阳性率为37.5%(24/64).24株aac(6')-Ib-cr基因阳性株中,有13株对环丙沙星耐药(MIC≥2 mg/L)和11株环丙沙星敏感(MIC≤0.25～1.0 mg/L).aac(6')-Ib-cr基因在环丙沙星耐药菌株和环丙沙星敏感菌株中的检出率分别为54.2%(13/24)和27.5%(11/40),经X2检验,差异具有统计学意义(X2=11.056,P＜0.01).24株aac(6')-Ib-cr基因阳性株中,ESBLs和intl1基因的阳性率分别为79.2%(19/24)和91.7%(22/24).13株aac(6')-Ib-cr基因阳性菌株的质粒成功转移至受体菌,以受体菌质粒DNA为模板进行aac(6')-Ib-cr检测,13株受体菌质粒全部为aac(6')-Ib-cr基因和intl基因阳性,全部为ESBLs阳性株.结论 aac(6')-Ib-cr基因广泛存在于肺炎克雷伯菌临床分离株中,aac(6')-Ib-cr可能通过Ⅰ类整合子和ESBL基因同时位于可转移的质粒上造成传播.     

多耐药肺炎克雷伯菌同时携带16S rRNA甲基化酶和氨基糖苷类修饰酶基因

目的 调查肺炎克雷伯菌中16S rRNA甲基化酶基因和氨基糖苷类修饰酶基因(AMEs)的存在情况.方法 收集绍兴市人民医院2007年10月到2009年6月患者标本中分离的肺炎克雷伯菌共20株,采用聚合酶链反应(PCR)及序列分析的方法分析6种16S rRNA甲基化酶基因 (armA、rmtA、rmtB、rmtC、rmt...     

阿米卡星耐药鲍曼不动杆菌16S rRNA甲基化酶基因的研究

目的了解阿米卡星耐药鲍曼不动杆菌中16S rRNA甲基化酶基因的分布情况。方法收集2010年1月—2012年4月临床标本中分离的阿米卡星耐药鲍曼不动杆菌54株。5种16 S rRNA甲基化酶基因(armA、rmtA、rmtB、rmtC和rmtD)的检测采用聚合酶链反应(PCR)方法,PCR产物采用琼脂糖凝胶电泳分析并将阳性扩增产物进行测序。抗菌药物的药敏试验采用纸片扩散法进行,WHONET5.5软件进行统计分析。结果 54株阿米卡星耐药鲍曼不动杆菌中40株检出16S rRNA甲基化酶基因armA,检出率为74.1%,未检出rmtA、rmtB、rmtC及rmtD基因。54株阿米卡星耐药鲍曼不动杆菌对米诺环素、亚胺培南和美罗培南耐药率分别为38.9%、63.0%和64.8%,对其余14种抗菌药物耐药率均在85.0%以上。结论阿米卡星耐药鲍曼不动杆菌主要携带armA型16S rRNA甲基化酶耐药基因,除米诺环素对该菌有较好的抗菌活性外,该菌对其他16种抗菌药物耐药严重。     

大肠埃希菌临床分离株质粒介导16S rRNA甲基化酶基因的检测及转移机制研究

近年来,发现一类质粒介导的16S rRNA甲基化酶,该酶能够保护细菌的30S核糖体的16s rRNA不与氨基糖苷类药物结合,造成其对包括阿贝卡星在内的所有的氨基糖苷类药物耐药,并且为高水平耐药~[1-4].目前,在革兰阴性杆菌中已发现ArmA、RmtA、RmtB、RmtC、RmtD和NpmA 6种16SrRNA甲基化酶,且该酶通常和ESBL基因共处一个质粒上,通过质粒在不同的菌株之间播散~[2-3,5-6].我们在前期的研究中发现肺炎克雷伯菌临床分离株中存在rmtB和armA两种16S rRNA甲基化酶基因~[7],16S rRNA甲基化酶基因也可能存在于大肠埃希菌临床分离株中.在本研究中,我们对从温州医学院附属第一医院2006年1月至2008年7月临床标本中分离的680株大肠埃希菌进行了16S rRNA甲基化酶基因筛查,并对其转移机制进行了研究.     

Plasmid-mediated 16S rRNA methylases conferring high-level aminoglycoside resistance in Escherichia coli and Klebsiella pneumoniae isolates from two Taiwanese hospitals

OBJECTIVES: This study was conducted to investigate the occurrence of 16S rRNA methylases that confer high-level aminoglycoside resistance in Klebsiella pneumoniae and Escherichia coli isolates from two Taiwanese hospitals and the characteristics of these isolates. METHODS: A total of 1624 K. pneumoniae and 2559 E. coli isolates consecutively collected over an 18 month period from a university hospital and seven E. coli and eight K. pneumoniae isolates that were resistant to amikacin from a district hospital were analysed. Two 16S rRNA methylase genes, armA and rmtB, were detected by PCR-based assays. beta-Lactamase characteristics were determined by phenotypic and genotypic methods. RESULTS: Overall, 28 armA-positive and seven rmtB-positive isolates were identified, and extended-spectrum beta-lactamases (ESBLs) were detected in 33 (94.3%) isolates. The prevalence rates of armA and rmtB at the university hospital were 0.9% (n=15) and 0.3% (n=5) in K. pneumoniae and 0.4% (n=10) and 0.04% (n=1) in E. coli. CTX-M-3, CTX-M-14, SHV-5-like ESBLs, and CMY-2 were detected alone or in combination in 21, 6, 11, and 2, respectively, of the 28 armA-positive isolates. CTX-M-14 was detected in six of the seven rmtB-positive isolates. Fingerprinting of conjugative plasmids revealed the dissemination of closely related plasmids containing both armA and bla(CTX-M-3). PFGE suggests that armA and rmtB spread by both horizontal transfer and clonal spread. CONCLUSIONS: This is the first report of the emergence of 16S rRNA methylases in Enterobacteriaceae in Taiwan. The spread of the multidrug-resistant isolates producing both ESBLs and 16S rRNA methylases may become a clinical problem.     

Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium

OBJECTIVES: 16S rRNA methylase-mediated high-level resistance to aminoglycosides has been reported recently in clinical isolates of Gram-negative bacilli only from a limited number of countries. This study was conducted to investigate the occurrence of this type of resistance in clinical isolates of Enterobacteriaceae from two Belgian hospitals and the characteristics of the strains. METHODS: We screened for high-level gentamicin, tobramycin and amikacin resistance in clinical isolates of Enterobacteriaceae consecutively collected between 2000 and 2005 at two laboratories by PCR for the armA, rmtA and rmtB 16S rRNA methylase genes. The beta-lactamase presence in the strains was also determined by phenotypic and genotypic methods. RESULTS: Overall armA genes were detected in 18 Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae and Citrobacter amalonaticus whereas rmtB was detected in a single E. coli isolate. The rmtA gene was not found. All 16S rRNA methylase-bearing strains produced extended-spectrum beta-lactamases (ESBLs), predominantly type CTX-M-3, as well as various types of beta-lactamases. In the majority of the strains, the armA gene was carried by conjugative plasmids of the IncL/M incompatibility group whereas rmtB was borne by an IncFI plasmid. CONCLUSIONS: This is the first report of the emergence of 16S rRNA methylases in Enterobacteriaceae in Belgium. The rapid spread of multidrug-resistant isolates producing both ESBLs and 16S rRNA methylases raises clinical concern and may become a major therapeutic threat in the future.     

16SrRNA甲基化酶基因在产ESBLs肠杆菌科细菌中的分布

目的了解临床分离的产超广谱β-内酰胺酶（ESBLs）的革兰阴性肠杆菌科细菌中16SrRNA甲基化酶基因的分布情况。方法对临床分离的70株革兰阴性肠杆菌科细菌用VITEK．32型全自动微生物分析系统进行细菌鉴定,用纸片扩散法检测ESBLs,并用聚合酶链反应（PCR）检测armA、rmtA、rmtB、rmtC、rmtD和npmA6种16SrRNA甲基化酶基因,对检测的阳性产物进行测序,并通过GenBank比对DNA序列。结果70株产ESBLs革兰阴性肠杆菌中,9株16SrRNA甲基化酶基因阳性,其中5株检出armA基因,4株检出rmtB基因,2株同时检出armA和rmtB基因,rmtA、rmtC、rmtD、npmA4种基因扩增均为阴性。结论不同地区医院16SrRNA甲基化酶基因的分布情况各不相同。     

Dissemination of 16S rRNA methylase-mediated highly amikacin-resistant isolates of Klebsiella pneumoniae and Acinetobacter baumannii in Korea

Novel 16S rRNA methylase-mediated high-level resistance to amikacin and arbekacin has been reported recently in clinical isolates of Gram-negative bacilli only from several countries. We tested amikacin- or arbekacin-nonsusceptible Gram-negative bacilli isolated in 2003 and 2005 at a tertiary-care hospital in Korea by polymerase chain reaction to detect 16S rRNA methylase genes. armA alleles were detected in 14 isolates of Klebsiella pneumoniae, 10 other species of Enterobacteriaceae, and 16 Acinetobacter baumannii, whereas the rmtB allele was detected in 1 K. pneumoniae isolate. The resistance 1st detected in 2003 persisted in 2005. 16S rRNA methylase-producing isolates were highly resistant to arbekacin and amikacin, and were mostly coresistant to levofloxacin. Most K. pneumoniae isolates also produced extended-spectrum beta-lactamases and plasmid-mediated AmpC beta-lactamases, and most A. baumannii isolates were nonsusceptible to carbapenems.     

Prevalence of 16S rRNA methylase genes in Klebsiella pneumoniae isolates from a Chinese teaching hospital: coexistence of rmtB and armA genes in the same isolate

16S rRNA methylase-mediated high-level resistance to aminoglycosides has been reported recently in clinical isolates of Gram-negative bacilli from several countries. Twenty-one (6.2%, 21/337) of 337 isolates of Klebsiella pneumoniae from a teaching hospital in Wenzhou, China, were positive for 16S rRNA methylase genes (3 for armA, 13 for rmtB, 5 for both armA and rmtB) and highly resistant to gentamicin, amikacin, and tobramycin (MICs, ≥256 μg/mL). Nineteen of 21 isolates harboring 16S rRNA methyalse genes were extended-spectrum β-lactamase (ESBL) producers. The plasmids harboring 16S rRNA methylase genes from 14 of 21 donors were transferred into the recipients, Escherichia coli J53. The armA and the rmtB usually coexisted with ESBL genes in the same isolate in clinical isolates and cotransferred with ESBL genes on a self-transmissible conjugative plasmid to the recipients. Among 5 isolates harboring both armA and rmtB, the armA genes were located on the chromosomes, and the rmtB genes were located on the plasmids, as determined by Southern hybridization. The result of pulsed-field gel electrophoresis showed that horizontal gene transfer and clonal spread were responsible for the dissemination of the rmtB and the armA genes. 16S rRNA methylase-producing isolates of Klebsiella pneumoniae were commonly identified in the Chinese teaching hospital with coexistence of rmtB and armA genes in the same isolate.     

Emergence of Klebsiella pneumoniae coproducing KPC-2 and 16S rRNA methylase ArmA in Poland

A Klebsiella pneumoniae epidemic strain that coproduced carbapenemase KPC-2 (K. pneumoniae carbapenemase 2) and 16S rRNA methylase ArmA has emerged in Poland. Four nonduplicate isolates from patients in a hospital in Warsaw, Poland, were found to carry the bla(KPC-2) and armA genes on ca. 50-kb and 90-kb plasmids, respectively. Tn4401 with a 100-bp deletion in the variable region was detected in all the isolates. XbaI pulsed-field gel electrophoresis (PFGE) revealed 93.2% similarity of the isolates. All the isolates were resistant to carbapenems and 4,6-disubstituted 2-deoxystreptamines.     

Emergence of RmtB methylase-producing Escherichia coli and Enterobacter cloacae isolates from pigs in China

OBJECTIVES: To investigate the occurrence of 16S rRNA methylases conferring high-level resistance to aminoglycosides in Enterobacteriaceae isolated from two pig farms in China. METHODS: Enterobacteriaceae isolated from 151 pig rectal swab samples and 9 environmental samples were screened for the presence of the rmtA, rmtB, armA and rmtC genes by PCR and sequencing. Conjugation experiments were carried out to study the transferability of the 16S rRNA methylase genes. All isolates and their transconjugants were tested for susceptibility to antimicrobial agents. The clonal relatedness of RmtB-producing Escherichia coli was assessed by PFGE with XbaI. RESULTS: Of 152 Enterobacteriaceae isolates recovered from pigs, 49 (32%) were positive for the rmtB gene, including 48 E. coli and a single isolate of Enterobacter cloacae. Of the nine Enterobacteriaceae isolates from environmental samples, no 16S rRNA methylase gene was identified. The 49 rmtB-positive isolates showed resistance to ampicillin, tetracycline and trimethoprim and also carried a bla(TEM) gene. Transfer of the rmtB and bla(TEM) genes by conjugation experiments of all 49 isolates was successful, suggesting that the rmtB-containing plasmids in the E. coli and E. cloacae isolates were self-transmissible. Conjugative transfer frequencies varied from 2.2 x 10(-10) to 1.3 x 10(-6) transconjugants per recipient. The transfer of non-aminoglycoside antimicrobial resistance traits was also observed in most cases. Forty-four rmtB-positive E. coli showed 30 different PFGE types. CONCLUSIONS: The rmtB gene was detected on conjugative plasmids of porcine E. coli and E. cloacae isolates. Both horizontal gene transfer and clonal spread were responsible for the dissemination of the rmtB gene. The emergence of 16S rRNA methylases in Enterobacteriaceae isolates is described for the first time in China. This is also the first report of rmtB-positive Enterobacteriaceae among healthy food-producing animals.