产AmpC酶大肠埃希菌和肺炎克雷伯菌中整合子与多重耐药的研究

目的探讨整合子介导的耐药机制在产AmpC酶大肠埃希菌和肺炎克雷伯菌多重耐药中的作用.方法5株产AmpC酶大肠埃希菌和肺炎克雷伯菌分离自2002年1月-2004年5月间我院呼吸科住院的患者,采用E-test试验条进行药敏试验、电转化试验,筛选、分离耐药质粒.PCR扩增Ⅰ型整合子基因盒插入序列,分子克隆和序列分析.结果所有产酶菌株通过电转化试验可将头孢西丁耐药性传递给受体菌,5个产AmpC酶耐药质粒中,有4个检出整合酶序列,其中3个携带2种抗药性基因盒,包括氨基糖苷乙酰转移酶基因aacA4;氨基糖苷腺苷转移酶基因aadA5;二氢叶酸还原酶基因dfrA17;氯霉素外排蛋白编码基因cmL44.结论整合子介导的抗药性基因盒参与了产质粒AmpC酶大肠埃希菌和肺炎克雷伯菌多重耐药的形成,应引起高度重视.     

一株铜绿假单胞菌中检出两种新的整合子

目的研究铜绿假单胞菌多重耐药的临床分离株RJ217中发现的两个新整合子的结构，并分析其在多重耐药性中的作用。方法用改良三相试验分析RJ217产β-内酰胺酶的情况，用常规和长片段PCR法扩增耐药基因和整合子，并对PCR产物进行序列分析。结果发现铜绿假单胞菌RJ217携带两个新的整合子，其中一个携带veb-I型超广谱β-内酰胺酶(ESBL)基因，这两个整合子的结构分别为IS10-like-veb-I-aadB-oxa10／aadA1和aadB-oxa10／aadA1。结论整合子介导的耐药基因在RJ217的多重耐药性中发挥了重要的作用。     

第1类整合子中aadA2基因翻译起始位点的确定

目的 确定第1类整合子中aadA2基因能否从上游无核糖体结合位点的密码子ATG起始翻译并合成有功能的蛋白.方法 定点突变含有不同翻译起始密码子的aadA2基因盒,并连同上游的可变区启动子分别克隆入质粒pACYC184中,转化大肠埃希菌JM109,免疫印迹检测含有不同翻译起始密码子的aadA2基因的翻译产物,用微量肉汤稀释法检测链霉素对含有不同翻译起始密码子aadA2基因的大肠埃希菌JM109的最小抑菌浓度.结果 aadA2基因可从上游无核糖体结合位点的密码子ATG及上游具有核糖体结合位点的密码子GTG起始翻译,同时在GTG密码子下游还存在着起始翻译密码子,其翻译产物在免疫印迹中均可与抗氨基糖苷-3″-腺苷酰基转移酶多克隆抗体产生特异性杂交条带,并赋予宿主细菌对链霉素不同水平的耐药.结论 当位于第1类整合子第1位基因盒中,aadA2基因可从上游无核糖体结合位点的密码子ATG起始翻译并合成有功能的蛋白,这一结构特点使得整合入第1类整合子的基因盒,不需带有核糖体结合位点即可起始基因盒中相应读码框的翻译,从而有利于第1类整合子表达从外界环境中捕获的基因.     

产ESBL肺炎克雷伯菌中16S rRNA甲基化酶的分布与相关耐药性的研究

目的 调查我院产ESBL肺炎克雷伯菌临床分离株16S rRNA甲基化酶基因的分布以及与耐药谱的关系,并初步探讨其在分子流行病学分析中的作用.方法 收集我院临床2010年3月至9月分离出69株非重复产ESBL肺炎克雷伯菌,采用PCR法检测16S rRNA 甲基化酶基因,并对阳性菌株进行ESBL基因及整合子基因分析,通过DNA直接测序确定.质粒接合试验和质粒消除试验确定16S rRNA甲基化酶基因的传播途径,利用ERIC-PCR技术进行基因分型.结果 69株产ESBL肺炎克雷伯菌中有rmtB阳性菌株20株(28.9％),其中2株同时携带有rmtB和armA.在20株产16SrRNA甲基化酶菌株中,均携带有CTX-M基因,测序显示14株CTX-M-14基因,6株CTX-M-15基因;14株携带有TEM-1基因;8株携带有SHV基因,测序显示5株SHV-12基因,3株SHV-11基因;3株携带有OXA-10基因;3株携带有VBE-1基因.另有12株携带有int1阳性,含有5种不同的耐药基因盒,分别携带drfA25、drfA1、drfA12、aadA1、aadA2、sat和blaVEB-1基因.ERIC-PCR法显示20株16SrRNA甲基化酶基因阳性的肺炎克雷伯菌主要分为5型,A型为优势流行克隆株.质粒接合和消除试验发现A型克隆株KP5和KP16 rmtB均位于一质粒上并通过接合传播.结论 本院产ESBL肺炎克雷伯菌临床分离株中存在16S rRNA甲基化酶基因rmtB的普遍流行,导致对多种氨基糖苷类抗生素高水平耐药.rmtB可通过水平基因传播和克隆传播的两种方式进行播散,并且存在同时产ESBLs、16S rRNA甲基化酶和Ⅰ类整合子的肺炎克雷伯菌的传播.     

医院泛耐药鲍曼不动杆菌对碳青霉烯抗生素的耐药机制

目的 探讨医院泛耐药鲍曼不动杆菌对碳青霉烯抗生素的耐药机制.方法 应用PCR方法对2010年12月至2012年3月期间本院从临床痰标本中分离的36株泛耐药鲍曼不动杆菌进行碳青霉烯酶IMP、OXA23基因和整合子基因检测;提取细菌膜蛋白行SDS-PAGE电泳分析其组成.结果 36株泛耐药鲍曼不动杆菌碳青霉烯酶OXA23基因扩增均为阳性;14株碳青霉烯酶IMP基因扩增阳性,22株阴性.12株整合子PCR产物约1200 bp,10株约3000 bp,14株整合子PCR产物约3500 bp.与碳青霉烯抗生素敏感鲍曼不动杆菌膜蛋白比较,22株泛耐药鲍曼不动杆菌存在相对分子质量为25 000、36 000的膜蛋白缺失.结论 医院泛耐药鲍曼不动杆菌耐碳青霉烯抗生素机制与产IMP、OXA23碳青霉烯酶及膜蛋白缺失有关.     

养殖动物及人分离大肠埃希菌染色体和质粒介导氟喹诺酮耐药机制的研究

目的 探讨从养殖动物及周围人群分离的大肠埃希菌染色体和质粒介导氟喹诺酮耐药机制. 方法 纸片扩散法和肉汤稀释法检测氟喹诺酮抗菌药物及其他抗生素的耐药性表型.PCR扩增DNA解旋酶(gyrA和gyrB)和拓扑异构酶IV(parC和parE)基因的喹诺酮耐药决定区、导致喹诺酮类抗生素耐药质粒的部分基因(qnr)以及氨基糖苷类抗生素乙酰转移酶Ib亚型cr变异体编码基因[aac(6')-I b-or],PCR产物进行直接测序.接合试验确定aac(6')-I b-cr酶的可转移性以及在氟喹诺酮耐药中的作用. 结果 鸡来源的大肠埃希菌对常用抗生素的耐药率明显高于猪和周围人群来源菌株.在PCR检测的64株大肠埃希菌中,环丙沙星MIC值大于1μg/ml以上的53株均存在gyrA和/或/parC基因上出现两个位点突变和氨基酸替代,环丙沙星的MIC>16μg/ml的菌株parE基因也发生了点突变及相应氨基酸替代.未发现gyrB亚单位有氨基酸替代.鸡来源28株菌和猪来源9株菌中分别有7株(25.O%)和1株(11.1%)携带有aac(6')-I b-cr基因;aac(6')-I b-cr基因可使环丙沙星、诺氟沙星乙酰化而降低药物抗菌活性. 结论 gyrA、parC和parE碱基突变导致氨基酸置换的数量与菌株对氟喹诺酮类耐药水平呈正相关,携带aac(6')-I b-cr基因的质粒在细菌氟喹诺酮耐药上也具有一定作用.     

利用表型筛选法测定整合子对耐药性基因盒的整合频率

目的 建立一种利用表型筛选的方法来测定整合子对耐药性基因盒的整合频率. 方法 将整合子和aadA2耐药性基因盒克隆到同一质粒pACYCl84的不同位点,该重组质粒和高表达整合酶的重组质粒分别转化大肠杆菌BL21(DE3),挑选阳性克隆过夜培养后,取适量菌液涂布含有链霉素的LB琼脂平板,同时取适量菌液涂布不含链霉素的LB琼脂平板,过夜培养后计数菌落个数,用以计算整合频率.同时以链霉素平板上的阳性克隆为模板,进行PCR扩增.对扩增产物切胶回收纯化,然后进行测序,以确定aadA2耐药性基因盒整合位点. 结果 在大肠杆菌BL21(DE3)宿主中,整合子对aadA2耐药性基因盒的整合频率为1.1×103,主要的整合位点为attI. 结论 该系统可以用于整合子对基因盒捕获频率的测定.     

泛耐药鲍曼不动杆菌整合子Ⅰ和ISCR1结构及基因分型研究

目的研究从临床分离的鲍曼不动杆菌的整合子Ⅰ和ISCR1的分布及结构情况,并对其进行基因分型。方法分离自临床的57株鲍曼不动杆菌,PCR检测整合酶Ⅰ、整合子Ⅰ、ISCR1以及ISCR1可变区,PCR产物进行限制性片段长度多态性（RFLP）分型并进行测序分析可变区携带的耐药基因盒,ERIC-PCR进行基因分型。结果 49株整合酶I阳性,其中47株整合子I扩增阳性,RFLP分为2型,测序结果为aacA4-catB8-aadA1和drf17-aadA5。3株ISCR1以及ISCR1可变区扩增均阳性,可变区经RFLP分为1型,测序结果为orf513-qnrA1-ampR-qacEdeltal,ISCR1阳性菌整合子I均阳性,经ERIC-PCR检测将57株鲍曼不动杆菌分为27个基因型。结论Ⅰ类整合子广泛存在于鲍曼不动杆菌中,ISCRI携带率较低,氨基糖苷类、甲氧苄啶类和β-内酰胺类耐药基因盒较常见,ERIC-PCR可用于临床鲍曼不动杆菌的分子流行病学研究。     

铜绿假单胞菌氨基糖苷类耐药性及其修饰酶基因的研究

铜绿假单胞菌是院内感染最常见的细菌之一,因其外膜通透性极低的特异性,表现出对多种抗生素的天然耐药.以往的研究多侧重于对β-内酰胺类和喹诺酮类抗生素的耐药机制,而临床工作中发现,铜绿假单胞菌对氨基糖苷类抗生素耐药现象亦非常严重.细菌对氨基糖苷类抗生素耐药主要是由于细菌产生的氨基糖苷类修饰酶（aminoglycosides-modifying enzymes,AME）对进入细胞内的药物分子进行修饰使之失去生物活性而耐药.AME基因型的分布带有明显的地区性和菌株差异,且不同基因型的细菌耐药和流行特征也不同.我们对2003年6月-2004年3月的26株铜绿假单胞菌进行AME基因型分布研究.     

64株大肠埃希菌对氨基糖苷类抗生素的耐药表型与钝化酶基因型的分析

目的 调查2004年北京地区临床收集的耐庆大霉素大肠埃希菌对氨基糖苷类抗生素的敏感性和氨基糖苷类钝化酶基因的流行状况.方法 采用微量肉汤稀释法检测64株大肠埃希菌对16种氨基糖苷类抗生素的最低抑菌浓度（MIC）值;利用巢式PCR方法对其可能含有的7种氨基糖苷类钝化酶基因进行检测和确证.结果 临床大肠埃希菌的耐药表型较为复杂,与钝化酶基因表达有关.测试菌株中存在aac（3）-Ⅱc、aac（6＇）-Ⅰ b、ant（2＂）-Ⅰ a和ant（3＂）-Ⅰ a 4种耐药基因,aac（3）-Ⅱc和aac（6′）-Ⅰ b是主要的产酶基因.约40%的耐药菌中存在2种或2种以上的钝化酶基因.结论 产生氨基糖苷类钝化酶是临床分离的大肠埃希菌对氨基糖苷类抗生素主要的耐药机制.采用巢式PCR方法检测耐药基因,特别是在缺少阳性对照菌株的情况下,可以保障检测结果的特异性和准确性.临床菌的耐药表型和钝化酶基因关系较为复杂,这可能与耐药菌中尚存在其他耐药基因有关.     

Diagnostic accuracy of class 1 integron PCR method in detection of antibiotic resistance in Salmonella isolates from swine production systems

The diagnostic accuracy of an integron PCR method (Int-PCR) for detecting class 1 integrons (1,000, 1,200, and 1,600 bp) in the identification of antibiotic-resistant Salmonella strains was evaluated using 730 Salmonella isolates from pen floor samples collected from four swine production systems in Illinois. Three integron groupings were detected: 1,000 bp only, 1,600 bp only, and both 1,000 and 1,200 bp. The presence of any of the three class 1 integron groupings was associated with four-drug resistance (streptomycin, spectinomycin, sulfisoxazole, and tetracycline [St Spc Su Tet]). In addition, the presence of both the 1,000- and 1,200-bp integrons added resistance to ampicillin (Amp) and chloramphenicol (Cm), and the 1,600-bp integron added resistance to gentamicin (Gen) and kanamycin (Kan). DNA sequencing of integrons confirmed the presence of the aminoglycoside adenyl transferase (aadA) gene, conferring St Spc resistance in the 1,000-bp integron; the beta-lactamase gene, conferring Amp resistance in the 1,200-bp integron; and the aadA and aadB genes, conferring St Spc Gen Kan resistance in the 1,600-bp integron. The 1,600-bp integron appears to have the 1,000-bp intergron as its core, with additional genetic material conferring additional antibiotic resistance. The diagnostic accuracy of Int-PCR in detecting resistance to individual antibiotics was limited by the presence of phenotypic resistance in isolates without integrons. However, Int-PCR had high diagnostic accuracy (sensitivity and specificity) in detecting multidrug resistance: 0.98 and 0.92, respectively, for St Spc Su Tet; 0.95 and 1.0 for Amp Cm St Spc Su Tet; and 1.0 and 0.99 for Gen Kan St Spc Su Tet. Thus, Int-PCR can be valuable in epidemiological surveys as a screening tool for the detection of multidrug-resistant Salmonella strains.     

Class 1 integrons and Salmonella genomic island 1 among Salmonella enterica isolated from poultry and swine

Two hundred eleven Salmonella enterica strains representing 35 serotypes isolated from healthy poultry (n=103) and swine (n=108) were used in this study. The occurrence and characteristics of class 1 integrons were investigated. Salmonella genomic islands (SGIs) and the horizontal transfer of integrons were assessed. One hundred eighty-six isolates (88%) were resistant to at least one antimicrobial and 140 isolates (66%) were multidrug resistant. The intI1 gene was present in 54 isolates (25.6%), of which 33 (15.6%) carried gene cassettes with sizes ranging from 0.7 to 2.3 kb. Sequence analysis revealed 11 distinct integron profiles in which resistance genes bla(PSE-1), dfrA1, dfrA12, aadA2, aadA4a, and silB were present. The gene cassette array dfrA12-aadA2 was the most prevalent among the isolates whereas most integrons were located on conjugative plasmids. SGI1 variants (SGI1-A and -F) were present in nine isolates belonging to serovars Albany, Emek, Kedougou, and Kingston.     

Detection and characterization of class 1 integrons in enterohemorrhagic Escherichia coli

Enterohemorrhagic Escherichia coli (EHEC) strains isolated from humans, cattle, and food and belonging to serogroups O26 (7 strains), O111 (19 strains), and O157 (70 strains) were examined for susceptibility to 11 antimicrobial drugs. Fifty-nine strains showing resistance to at least one of the drugs were examined by PCR for the presence of class 1 integrons, which were identified in 17 strains. Integrons were found more frequently in strains belonging to serogroups O111 and O26 than in the O157 isolates. DNA sequence analysis demonstrated that most of the integrons contained the aadA1 gene cassette conferring resistance to streptomycin/ spectinomycin, alone or associated with the drfA1 gene cassette conferring resistance to trimethoprim. One integron, identified in a O157:H7 strain, carried the aadA2 and dfrA12 gene cassettes, conferring resistance to streptomycin/spectinomycin and trimethoprim, and the open reading frame F (OrfF) encoding unknown functions. Most of the integrons were carried by Tn21 derivative transposons and were transferable by conjugation to an E. coli K-12 strain. In conclusion, integrons and antibiotic resistance genes can be frequently found in EHEC strains, particularly E. coli O111 and E. coli O26, and their presence could complicate therapeutic trials.     

Establishing streptomycin epidemiological cut-off values for Salmonella and Escherichia coli

This study was conducted to elucidate the accuracy of the current streptomycin epidemiological cut-off value (ECOFF) for Escherichia coli and Salmonella spp. A total of 236 Salmonella enterica and 208 E. coli isolates exhibiting MICs between 4 and 32 mg/L were selected from 12 countries. Isolates were investigated by polymerase chain reaction for aadA, strA, and strB streptomycin resistance genes. Out of 236 Salmonella isolates, 32 (13.5%) yielded amplicons for aadA (n = 23), strA (n = 9), and strB (n = 11). None of the 60 Salmonella isolates exhibiting MIC 4 mg/L harbored resistance genes. Of the Salmonella isolates exhibiting MICs 8 mg/L, 16 mg/L, and 32 mg/L, 1.6%, 15%, and 39%, respectively, tested positive for one or more genes. For most monitoring programs, the streptomycin ECOFF for Salmonella is wild type (WT) ≤32 or ≤16 mg/L. A cut-off value of WT ≤32 mg/L would have misclassified 13.5% of the strains as belonging to the WT population, since this proportion of strains harbored resistance genes and exhibited MICs ≤32?mg/L. Out of 208 E. coli strains, 80 (38.5%) tested positive for aadA (n = 69), strA (n = 18), and strB (n = 31). Of the E. coli isolates exhibiting MICs of 4 mg/L, 8 mg/L, 16 mg/L, and 32 mg/L, 3.6%, 17.6%, 53%, and 82.3%, respectively, harbored any of the three genes. Based on the European Committee on Antimicrobial Susceptibility Testing guidelines (ECOFF ≤16 mg/L), 25% of the E. coli strains presenting MIC ≤16 mg/L would have been incorrectly categorized as belonging to the WT population. The authors recommend an ECOFF value of WT ≤16 mg/L for Salmonella and WT ≤8 mg/L for E. coli.     

Detection and typing of integrons in epidemic strains of Acinetobacter baumannii found in the United Kingdom

Integrons were sought in Acinetobacter isolates from hospitals in the United Kingdom by integrase gene PCR. Isolates were compared by pulsed-field gel electrophoresis, and most belonged to a small number of outbreak strains or clones of A. baumannii, which are highly successful in the United Kingdom. Class 1 integrons were found in all of the outbreak isolates but in none of the sporadic isolates. No class 2 integrons were found. Three integrons were identified among the main outbreak strains and clones. While a particular integron was usually associated with a strain or clone, some members carried a different integron. Some integrons were associated with more than one strain. The cassette arrays of two of the integrons were very similar, both containing gene aacC1, which confers resistance to gentamicin, two open reading frames coding for unknown products (orfX, orfX'), and gene aadA1a, which confers resistance to spectinomycin and streptomycin. The larger of these integrons had two copies of the first (orfX) of the gene cassettes coding for unknown products. The third integron, with a cassette array containing gene aacA4, which codes for amikacin, netilmicin, and tobramycin resistance; a chloramphenicol acetyltransferase, catB8; and gene aadA1, conferring resistance to spectinomycin and streptomycin, was associated with an OXA-23 carbapenemase-producing clone, which has spread rapidly in hospitals in the United Kingdom during 2003 and 2004. These integron cassette arrays have been found in other outbreak strains of A. baumannii from other countries. We conclude that integrons are useful markers for epidemic strains of A. baumannii and that integron typing provides valuable information for epidemiological studies.     

Integron-associated antibiotic resistance in enteroaggregative and enteroinvasive Escherichia coli

Ten enteroinvasive (EIEC) and 25 enteroaggregative (EaggEC) E. coli strains isolated from Senegalese patients were analyzed for their integron content. All strains were resistant to at least two antibiotics. Four EIEC and 15 EaggEC were found to carry a class 1 integron. An identical integron carrying a single dfrA5 cassette, conferring resistance to trimethoprim, was identified in all four EIEC strains. Five EaggEC strains harbored an integron with a single cassette, dfrA7, while the remaining 10 strains carried two integrons, one with a single cassette, aadA1a conferring resistance to streptomycin and spectinomycin, and the second one bearing two cassettes, dfrA13 and oxa5, the later being a beta-lactam resistance cassette. The presence of these integrons is worrying, because trimethoprim is largely used for diarrheal disease therapy in Africa. Thus, the presence of integrons in diarrheagenic strains is of public health importance because a limited number of antibiotics are available in developing countries.     

Characterization of antimicrobial resistance, plasmids, and gene cassettes in Shigella spp. from patients in vietnam

The objective of the study was to investigate antimicrobial resistance, plasmids and class 1 integrons in 150 Shigella strains isolated from patients with diarrhea in Vietnam. Most isolates were resistant to the majority of antimicrobial agents used for treatment in the isolation areas and 90% were resistant to three or more antibiotics. A total of 20 strains yielded class 1 integrons, which harbored oxa1, dfrA, orfF, and aadA gene cassettes. The most common gene cassette, aadA2, was always located closest to the 3' conserved segment of the integrons and oxa1 and dfrA closest to the 5' end. Plasmid profiles of the 20 class 1 integron-positive strains all contained more than one plasmid, and 14 different profiles were found. No correlation was found between species, antibiograms, plasmid profiles, or presence of class 1 integrons. Conjugation resulted in 25 transconjugants, which all were resistant to four or more antimicrobial agents and all harbored at least one plasmid (>60 kb). Class 1 integrons were detected in 64% of the transconjugants. Phenotypic resistance pattern and plasmid profiles of the transconjugants seemed independent of the presence of an integron. Class 1 integrons seemed of less importance in phenotypic antibiograms and in transfer of resistance genes than conjugative plasmids.     

Prevalence and characterization of extended-spectrum beta-lactamases-producing Salmonella enterica isolates in Saragossa, Spain (2001-2008)

We analyzed the prevalence of resistance to extended-spectrum cephalosporins (ESCs) among clinical strains of Salmonella enterica collected by the Laboratory of Clinical Microbiology in the University Clinical Hospital Lozano Blesa in the region of Aragón (Spain), for which very few epidemiological information exists. A total of 2,092 strains of S. enterica were identified in stool samples from patients with gastroenteritis. Five isolates showed an extended-spectrum beta-lactamase (ESBL) phenotype: four isolates of S. enterica serotype Virchow harbored the ESBL-encoding bla(CTX-M-9) gene and an isolate of serotype Enteritidis carried a bla(CTX-M-1) gene, which, to the best of our knowledge, is described here for the first time in this serotype of S. enterica. The five ESC-resistant isolates were also resistant to spectinomycin, streptomycin, kanamycin, sulfonamides, tetracycline, and trimethoprim as well as to nalidixic acid. The ESBL isolate of serotype Enteritidis, however, remained susceptible to kanamycin and nalidixic acid. A class 1 integron of 1.5?kb was detected for the four serotype Virchow isolates with the gene cassette dfrA16-aadA2. The bla(CTX-M-9) gene was carried by an ～300-kb IncHI2 conjugative plasmid in the case of the S. enterica serotype Virchow isolates. The bla(CTX-M-1) gene was carried by an ～100-kb IncI1-N conjugative plasmid for the serotype Enteritidis ESC-resistant isolate. All the four ESC-resistant strains of S. enterica serotype Virchow clustered together in a XbaI pulsed-field gel electrophoresis, which also revealed a strong similarity between them and some pulsotypes of S. enterica serotype Virchow from France.     

Novel gene cassettes and integrons in antibiotic-resistant bacteria isolated from urban wastewaters

In this study, the occurrence and diversity of integrons were evaluated in 697 isolates belonging to Enterobacteriaceae and Aeromonas spp. isolated from urban wastewaters. Screening of integrons was performed by dot blot hybridization and intI-positive strains were further characterized. The global prevalence of integrons was 3.73%. Three new gene cassettes were identified: a novel aadA variant (aadA17), a gene putatively involved in cell signaling (dcyA) and an open reading frame of unknown function interrupted by a novel insertion sequence (orfER.17::ISAs12). In total, thirteen different gene cassette arrays were detected, 4 representing novel integrons: intI1-dcyA-tniC, intI1-orfER.1.7::ISAs12-aadA13-qacEΔ1-sul1, intI1-aacA4-catB3-bla(OxA-10)-aadA1-qacEΔ1-sul1 and intI1-catB8-aadA17-qacEΔ1-sul1. Approximately 80% of strains were resistant to at least 3 antibiotics of different classes. The presence of novel integron structures in treated effluents suggests that domestic wastewaters may favor the formation of novel combinations of gene cassettes. Moreover, the high prevalence of multiresistant strains highlights the urgent need to employ effective means of effluent disinfection to avoid dissemination of antibiotic-resistant bacteria.     

Characterization of antimicrobial resistance and class 1 integrons in Enterobacteriaceae isolated from Mediterranean herring gulls (Larus cachinnans)

Mediterranean herring gulls (Larus cachinnans) were investigated as a possible reservoir of antibiotic resistant bacteria and of cassette-borne resistance genes located in class 1 integrons. Two hundred and fourteen isolates of the family Enterobacteriaceae were collected from cloacal swabs of 92 chicks captured in a natural reserve in the North East of Italy. They showed high percentages of resistance to ampicillin and streptomycin. High percentages of resistance to trimethoprim/sulfamethoxazole were found in Proteus and Citrobacter and to chloramphenicol in Proteus. Twenty-two (10%) isolates carried the intI1 gene. Molecular characterization of the integron variable regions showed a great diversity, with the presence of 11 different cassette arrays and of one integron without integrated cassettes. The dfrA1-aadA1a and aadB-aadA2 cassette arrays were the most frequently detected. Also the estX cassette, alone or in combination with other cassettes, was detected in many isolates. From this study it is concluded that the enteric flora of Mediterranean herring gulls may act as a reservoir of resistant bacteria and of resistance genes. Due to their feeding habits and their ability to fly over long distances, these free-living birds may facilitate the circulation of resistant strains between waste-handling facilities, crops, waters, and urban areas.