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자료유형
학술저널
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대한진단검사의학회 Annals of Laboratory Medicine Annals of Laboratory Medicine 제34권 제4호
발행연도
2014.1
수록면
286 - 292 (7page)

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Background: Pseudomonas aeruginosa is a clinically important pathogen that causes op- portunistic infections and nosocomial outbreaks. Recently, the type III secretion system (TTSS) has been shown to play an important role in the virulence of P. aeruginosa . ExoU, in particular, has the greatest impact on disease severity. We examined the relationship among the TTSS effector genotype ( exoS and exoU ), fluoroquinolone resistance, and tar- get site mutations in 66 carbapenem-resistant P. aeruginosa strains. Methods: Sixty-six carbapenem-resistant P. aeruginosa strains were collected from pa- tients in a university hospital in Daejeon, Korea, from January 2008 to May 2012. Mini- mum inhibitory concentrations (MICs) of fluoroquinolones (ciprofloxacin and levofloxacin) were determined by using the agar dilution method. We used PCR and sequencing to de- termine the TTSS effector genotype and quinolone resistance-determining regions (QR- DRs) of the respective target genes gyrA, gyrB, parC , and parE . Results: A higher proportion of exoU+ strains were fluoroquinolone-resistant than exoS+ strains (93.2%, 41/44 vs. 45.0%, 9/20; P ≤0.0001). Additionally, exoU + strains were more likely to carry combined mutations than exoS + strains (97.6%, 40/41 vs. 70%, 7/10; P =0.021), and MIC increased as the number of active mutations increased. Conclusions: The recent overuse of fluoroquinolone has led to both increased resistance and enhanced virulence of carbapenem-resistant P. aeruginosa . These data indicate a specific relationship among exoU genotype, fluoroquinolone resistance, and resistance- conferring mutations.

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