https://scholars.lib.ntu.edu.tw/handle/123456789/163858
標題: | 雞隻與人類鮑氏不動桿菌分離株藥物敏感性之差異 Antimicrobial susceptibility differences of Acinetobacter baumannii between chicken and human isolates |
作者: | 王郁菁 Wang, Yu-Ching |
關鍵字: | 鮑氏不動桿菌;改良LAM 培養基;藥物敏感性;乙內醯胺酶超廣效性乙內醯胺酶脈衝式電泳;Acinetobacter baumannii;Modified Leeds Acinetobacter Medium;Antimicrobial susceptibility;Beta-lactamase;Extended spectrum β-lactamases;Pulsed-field gel electrophoresis | 公開日期: | 2008 | 摘要: | 摘要 鮑氏不動桿菌(Acinetobacter baumannii;AB)為環境中伺機菌,常存在於健康人體皮膚表面,此菌亦為重要的院內病原菌,可造成包括:菌血症、肺炎、腦膜腦炎等具有高度死亡率的數種感染症,且廣泛使用抗生素治療,易使此菌對廣效性抗生素產生抗藥性,主要由於乙內醯胺酶之產生,導致治療上的窘境,也備受重視。在各動物族群中,目前僅於犬、貓與馬見相關報告。本研究自2006年6月至2007年5月由台灣北、中、南及東部地區之雞隻,分別採取810個氣管及共泄腔棉拭子樣本,培養於礦物培養基,再以改良式Leeds Acinetobacter Medium(MLAM)培養基分離目標菌株後;除經16S rRNA聚合酶鏈鎖反應外並利用擴增核糖體DNA限制性分析方法(amplified ribosomal DNA restriction analysis;ARDRA)進行基因型分析與鮑氏不動桿菌標準菌株(ATCC 19606)比對鑑定,結果共分離70/1620株(4.3%)鮑氏不動桿菌。北、中、南、東部地區的分離率分別為5%(15/312)、5.5%(21/384)、4.6%(32/692)及0.9%(2/232),以及至台北某一醫院收集73株病患分離之鮑氏不動桿菌;進行藥物敏感性試驗、偵測抗藥性基因與脈衝式電泳分析(pulsed-field gel electrophoresis;PFGE)。由藥物敏感性試驗結果得知,雞來源鮑氏不動桿菌對安比西林、安默西林、羥四環素均產生高等程度抗藥性(high-level resistance),但對人醫所使用的乙內醯胺類抗生素與乙內醯胺酶抑制劑合併製劑 (例:Unasyn 與Tazocin )、amikacin與carbapenems類藥物仍具有敏感性;而人分離菌株大部分為多重抗藥性菌株,62%(45/73)對胺基醣苷類與乙內醯胺類藥物包括meropenem皆產生抗藥性,除了可利斯汀與Unasyn 為具敏感性。將所分離之143株鮑氏不動桿菌分離株為基礎,根據藥物敏感試驗結果來探討抗藥性基因之相關性。隨即以聚合酶鏈鎖反應進行抗藥性基因之分析,經定序及與國外研究結果比對後,143株鮑氏不動桿菌人源(73株)與雞源(70 株)菌株中,人源菌株具blaTEM-1、blaSHV-18、blaOXA-51-like、blaOXA-58、blaOXA-72及blaAmpC基因,分別為82.3%、50.7%、100%、86.3% 、38.9%與100%;雞源菌株所具有之比例分別為75.7%、47.1%、100%、64.3%、8.6%與100%。因此,抗藥性基因與乙內醯胺類之抗藥性有很大之關係。運用脈衝式電泳分型分析來比較雞與人源菌株兩者間之關係,結果發現兩種來源之菌株間具有相同基因型,但抗藥性之演化應該是獨立發生。人類分離株抗藥性比例明顯比雞隻分離株高,人類分離株具有多重抗藥性,但其抗藥性並不源自雞隻。結果認為人類與雞隻鮑氏不動桿菌具有基因相關性,但是抗藥性之演化是各自獨立的。 Abstract Acinetobacter species is an opportunistic pathogen present in the environment, and also a common part of the normal skin flora in human. Acinetobacter baumannii has emerged as an important pathogen in nosocomial infection. It may cause serious infections such as bacteremia, pneumonia and meningitis that yields high rates of mortality and morbidity. Extensive use of antimicrobial chemotherapy within hospitals has contributed for the selection and the increase in the number of A. baumannii strains resistant to a wide range of antibiotics, mainly due to the products of β-lactamases. A. baumannii become to mutidrug resistant, and difficult to treatment. To date A. baumannii has only been associated with the dog, cat and horse. In this study, eight hundred and ten tracheal and cloaca swabs were collected from poultry farms from June 2006 to May 2007 in district regions of Taiwan. Mineral medium was used for isolation of A. baumanni strains. This Modified Leeds acinetobacter medium (MLAM) was used as the selective medium. The samples were identified not only by polymerase chain reaction but also by amplified ribosomal DNA restriction analysis. Of the sample collected 70/1620 strains (4.3 %) were isolated. The prevalence in the northern, middle, southern and eastern in regions were 5 % (15/312)、5.5 % (21/384)、4.6 % (32/692)and 0.9 % (2/232). A total of 73 Acinetobacter baumannii were consecutively collected from patient in regional hospital. The microdilution method results indicated the A. baumannii isolates were high resistant to ampicillin, amoxicillin and oxytetracycline but were sensitive to unasyn , amikacin and carbapenems of poultry. Most of human A.baumannii isolates had multidrug resistant bacteria . Forty-five isolate (62 %) were resistant to all aminoglycosides and beta-lactam antibiotic (include Meropenem), except susceptible to colistin and unasyn . TEM-, SHV-, and OXA-related enzymes and AmpC beta-lactamase were studied by PCR with 143 A. baumannii isolates recovered from chicken (n=70) and human (n=73) origin. By the results of sequencing and comparing with other previous studies, the percentage of β-lactamase gene in A. baumannii of humans and chickens are 82.3 % and 75.7 % in blaTEM-1, 50.7 % and 47.1 % in blaSHV-18, 100 % and 100 % in blaOXA-51-like, 86.3 % and 64.3 % in blaOXA-58 and 38.9 % and 8.6 % in blaOXA-72, 100 % and 100 % in blaAmpC. To determine the genetic relatedness among human and chicken isolates by pulsed field gel electrophoresis analysis. Clusters containing both human and chicken strains, as well as some strains that were closely related genetically. Human isolates were against more antimicrobials and had higher levels of resistance than chicken isolates. This study demonstrated that the A. baumannii isolates from human and chicken were genetically related, but the drug resistance for the two groups developed independently. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/178917 |
顯示於: | 獸醫學系 |
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