A study of Molecular Epidemiology of ESBL Clinical Isolates in Taiwan

• Main Authors: Yu-Hsin Liu, 劉育歆
• Other Authors: Jui-Yu Wu
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/82751516255335299195

碩士 === 臺北醫學大學 === 醫學科學研究所 === 98 === ESBL (extended-spectrum β-lactamase) is originally generated through clinical administration of the third-generation cephalosporins on bacterial pathogen, those ESBL-classified clinical isolates are able to expressed various β-lactamase to inactive β-lactam antibiotics by hydrolysis mechanism. ESBL is forward primarity in Klebsiella pneumoniae and Escherichia coli, however other Gram-negative pathogens also have been identified to carry with ESBL, such as Salmonella enteric, Proteus spp. In recent years, the prevalence rate of clinical drug-resistant ESBLhave dramatically increased in Taiwan. In the study, 572 clinical ESBL isolates were collected from many major medical centers and regional hospitals of north-, mid-, south-, and east- Taiwan, several aspects of molecular epidemiology in these ESBL isolates will be investigated: (1)the genotyping distribution and dissemination of ESBL isolates, and (2)molecular classification of common antibiotic resistance genes. First, ERIC-PCR typing technical was used to build up fingerprinting database, the genetic similarity of dendrogram can be generated to easily classify clinical isolates. The diversification of resistance gene cassettes of integron has shown high percentage of existence rate and critical contribution to cause various ESBL among these clinical isolates. Interestingly, results also demonstrated that several integron cassette can be found in different pathogens. Finally, the three most common resistance gene of ESBL: TEM, SHV, CTX-M were analyzed by PCR typing and DNA sequencing to obtain the complete information of genetic composition and variants. With all results from ERIC-PCR fingerprinting, integron, TEM, SHV, CTX-M, integrated information can be obtained as valuable database for clinical diagnosis.