Overexpression of AdeABC efflux pump associated with tigecycline resistance in clinical Acinetobacter nosocomialis isolates

被引：34

作者：

Yang, Y-S ^{[1
]}

Chen, H-Y ^{[2
]}

Hsu, W. J. ^{[2
]}

Chou, Y-C ^{[3
]}

Perng, C-L ^{[4
]}

Shang, H-S ^{[4
]}

Hsiao, Y-T ^{[2
]}

Sun, J-R ^{[4
,5
]}

Chang, Yea-Yuan ^{[6
]}

Liu, Yuag-Meng ^{[7
]}

Kuo, Shu-Chen ^{[8
]}

Liu, Chang-Pan ^{[9
]}

Chen, Te-Li ^{[10
]}

Lee, Yi-Tzu ^{[11
]}

Yang, Ya-Sung ^{[12
]}

机构：

[1] Natl Def Med Ctr, Triserv Gen Hosp, Dept Internal Med, Div Infect Dis & Trop Med, Taipei, Taiwan

[2] Taipei City Hosp, Dept Med Tech, Ren Ai Branch, Taipei, Taiwan

[3] Natl Def Med Ctr, Sch Publ Hlth, Taipei, Taiwan

[4] Natl Def Med Ctr, Triserv Gen Hosp, Dept Pathol, Div Clin Pathol, Taipei, Taiwan

[5] Natl Def Med Ctr, Inst Prevent Med, Taipei, Taiwan

[6] Natl Yang Ming Univ Hosp, Yilan, Taiwan

[7] Changhua Christian Hosp, Changhua, Taiwan

[8] Natl Hlth Res Inst, Natl Inst Infect Dis & Vaccinol, Zhunan Township, Miaoli County, Taiwan

[9] MacKay Mem Hosp, Taipei, Taiwan

[10] Natl Def Med Ctr, Grad Inst Life Sci, Taipei, Taiwan

[11] Taipei Vet Gen Hosp, Taipei, Taiwan

[12] Natl Def Med Ctr, Taipei, Taiwan

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2019年 / 25卷 / 04期

关键词：

Acinetobacter nosocomialis; Bloodstream infection; Resistance-nodulation-cell; Division efflux pumps; Tigecycline resistant; MOLECULAR EPIDEMIOLOGY; BAUMANNII COMPLEX; SYSTEM; SUSCEPTIBILITY; ADEIJK;

D O I：

10.1016/j.cmi.2018.06.012

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: Tigecycline non-susceptible Acinetobacter nosocomialis (TNAN) has been discovered in clinical isolates. The resistance-nodulation-cell division (RND)-type efflux system plays a major role in tigecycline non-susceptible Acinetobacter baumannii, but the mechanism in A. nosocomialis remains unknown. Our aim was to analyse the contribution of efflux-based tigecycline resistance in clinical A. nosocomialis isolates collected from multiple medical centres in Taiwan. Methods: A total of 57 A. nosocomialis isolates, including 46 TNAN and 11 tigecycline-susceptible A. nosocomialis (TSAN) isolates, were analysed. Of these, 46 TNAN isolates were clustered to ST410 (43 isolates) and ST68 (three isolates) by multi-locus sequence typing. Results: The relationship between the RND efflux pump and tigecycline resistance was indirectly verified by successfully reducing tigecycline resistance with NMP, an efflux pump inhibitor. The three RND efflux systems (AdeABC, AdeIJK and AdeFGH) were detected in all clinical isolates. The transcript level of adeB gene increased significantly and was correlated with tigecycline resistance. Moreover, the AdeRS two-component system was further classified into four different types of AdeRS patterns considering the amino acid sequence. Further analysis showed that tigecycline resistance was related to the transcript level of adeB gene and the AdeRS pattern. Conclusion: This study showed that the dissemination of TNAN isolates in Taiwan is attributable mainly to the spread of ST410. The AdeABC efflux pump appeared to play an important role in the tigecycline resistance of A. nosocomialis. (C) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

引用

页码：512.e1 / 512.e6

页数：6

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