論文

国際誌
2021年1月

Genetic analysis of ESBL-producing Klebsiella pneumoniae isolated from UTI patients in Indonesia.

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
  • Saya Yamasaki
  • ,
  • Katsumi Shigemura
  • ,
  • Kayo Osawa
  • ,
  • Koichi Kitagawa
  • ,
  • Aya Ishii
  • ,
  • K Kuntaman
  • ,
  • Toshiro Shirakawa
  • ,
  • Takayuki Miyara
  • ,
  • Masato Fujisawa

27
1
開始ページ
55
終了ページ
61
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jiac.2020.08.007

INTRODUCTION: Extended spectrum beta-lactamase (ESBL)-producing Klebsiellapneumoniae is a serious concern for nosocomial infection and the emergence rate in Indonesia is higher than that in developed countries. The purpose of this study was to investigate the genetic characteristics of ESBL-producing K. pneumoniae isolated from UTI patients in Indonesia. MATERIALS AND METHODS: We collected K. pneumoniae resistant to ceftazidime or cefotaxime isolated from UTI patients in Dr. Soetomo's Academic Hospital in Surabaya, Indonesia in 2015. Ninety-four strains were identified as ESBL-producing bacteria by confirmation tests. The isolates were investigated by antimicrobial susceptibility testing with 20 drugs and ESBL gene detection, plasmid replicon typing and virulence genes as hypermucoviscous (HMV) strains were tested by the string test. RESULTS: High rates of resistance to ciprofloxacin (86.2%), tetracycline (80.9%) and nalidixic acid (78.7%) were observed. CTX-M-15 was the most common ESBL gene (89.4%), 33 of which also carried SHV-type ESBL. IncF was the most prevalent plasmid replicon typing (47.6%). Sixteen (17.0%) strains were judged as HMV, all of which had rmpA and more than half of which had fimH, uge, and wab. IncL/M was the most common replicon plasmid in the HMV strains, and the difference in the positive rate was statistically significant (p = 0.0024). CONCLUSION: This study showed the high prevalence of multiple-drug resistant and predominately CTX-M-15-positive ESBL-producing K. pneumoniae in Indonesia. There was a correlation between IncL/M and the HMV phenotype in this study. As such hypervirulent strains continue to emerge, studying their dissemination with resistance determinants is an urgent priority.

リンク情報
DOI
https://doi.org/10.1016/j.jiac.2020.08.007
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32888833
ID情報
  • DOI : 10.1016/j.jiac.2020.08.007
  • PubMed ID : 32888833

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