Korean J Clin Microbiol.  2010 Mar;13(1):19-26. 10.5145/KJCM.2010.13.1.19.

Molecular and Phenotypic Characteristics of 16S rRNA Methylase-producing Gram-negative Bacilli

Affiliations
  • 1Department of Laboratory Medicine, Kwandong University College of Medicine, Goyang, Korea.
  • 2Incheon Blood Center, Korean Red Cross, Incheon, Korea.
  • 3Korean Institute of Tuberculosis, Seoul, Korea.
  • 4Department of Clinical Laboratory Science, Dongeui University, Busan, Korea.
  • 5Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea. leekcp@yuhs.ac

Abstract

BACKGROUND
Recently a novel plasmid-mediated resistant mechanism that conferred high-level resistance to aminoglycoside via methylation of 16S rRNA was reported. The aims of this study were to determine the prevalence of the 16S rRNA methylase genes and to characterize the coresistance to other antibiotics in Gram-negative bacilli.
METHODS
Consecutive non-duplicate Gram-negative bacilli were isolated from clinical specimens at a Korean secondary- and tertiary-care hospital from July 2006 to June 2007. The antimicrobial susceptibility was tested by the CLSI agar dilution method,and PCR was performed to detect the 16S rRNA methylase genes in the arbekacin-resistant isolates.
RESULTS
In Gram-negative bacilli, the proportions of 16S rRNA methylase gene-positive isolates were 5% (75/1,471) in the secondary-carehospital and 4% (48/1,251) in the tertiary-care hospital, and the positive rates by species were 1% Escherichiae coli 16% (10/1,062), Klebsiella pneumoniae 16% (75/460), K. oxytoca 2% (1/44), Citrobacter spp. 9% (7/82), Enterobacter spp. 2% (4/181), Serratia marcescens 6% (6/100), Proteus miriabilis 4% (2/57), Achromobacter xylosoxidans 20% (1/5), Pseudomonas aeruginosa < 1% (1/505), Acinetobacter spp. 10% (11/112), and Stenotrophomonas maltophilia 2% (1/66), respectively. Among 16S rRNA methylase-positive isolates from secondary- and tertiary-care hospitals, 93% (70/75) and 90% (43/48), respectively, were armA positive, and others, except one rmtA positive isolate, were positive for the rmtB gene, according to PCR results. The rates of ESBL-positive and cefoxitin-resistant K. pneumoniae were 59% and 92%,s respectively. In addition, 91% of 16S rRNA methylase-producing K. pneumoniae were positive for qnrB. There were no MBL producers among 16S rRNA methylase-producing Pseudomonas and Acinetobacter species.
CONCLUSION
The novel aminoglycoside-resistant mechanisms involving16S rRNA methylase were prevalent and widely distributed among Gram-negative bacilli in Korea, and other resistance mechanisms were commonly associated with 16S rRNA methylase-mediated resistance in Korea.

Keyword

16S rRNA dimethylase; armA; qnrB; Aminoglycoside; Gram-negative bacilli

MeSH Terms

Achromobacter denitrificans
Acinetobacter
Agar
Anti-Bacterial Agents
Citrobacter
Enterobacter
Escherichia
Klebsiella pneumoniae
Korea
Methylation
Methyltransferases
Pneumonia
Polymerase Chain Reaction
Prevalence
Proteus
Pseudomonas
Pseudomonas aeruginosa
Serratia marcescens
Stenotrophomonas maltophilia
Agar
Anti-Bacterial Agents
Methyltransferases

Cited by  1 articles

The Genetic Characteristics of Multidrug-resistant Acinetobacter baumannii Coproducing 16S rRNA Methylase armA and Carbapenemase OXA-23
Jinsook Lim, Hye Hyun Cho, Semi Kim, Jimyung Kim, Kye Chul Kwon, Jong Woo Park, Sun Hoe Koo
J Bacteriol Virol. 2013;43(1):27-36.    doi: 10.4167/jbv.2013.43.1.27.


Reference

1. Lee K, Park KH, Jeong SH, Lim HS, Shin JH, Yong D, et al. Further increase of vancomycin-resistant Enterococcus faecium, amikacin- and fluoroquinolone-resistant Klebsiella pneumoniae, and imipenem-resistant Acinetobacter spp. in Korea: 2003 KONSAR surveillance. Yonsei Med J. 2006; 47:43–54.
Article
2. Vakulenko SB and Mobashery S. Versatility of aminoglycosides and prospects for their future. Clin Microbiol Rev. 2003; 16:430–50.
Article
3. Galimand M, Courvalin P, Lambert T. Plasmid-mediated high-level resistance to aminoglycosides in Enterobacteriaceae due to 16S rRNA methylation. Antimicrob Agents Chemother. 2003; 47:2565–71.
4. Yokoyama K, Doi Y, Yamane K, Kurokawa H, Shibata N, Shibayama K, et al. Acquisition of 16S rRNA methylase gene in Pseudomonas aeruginosa. Lancet. 2003; 362:1888–93.
Article
5. Doi Y, Yokoyama K, Yamane K, Wachino J, Shibata N, Yagi T, et al. Plasmid-mediated 16S rRNA methylase in Serratia marcescens conferring high-level resistance to aminoglycosides. Antimicrob Agents Chemother. 2004; 48:491–6.
6. Wachino J, Yamane K, Shibayama K, Kurokawa H, Shibata N, Suzuki S, et al. Novel plasmid-mediated 16S rRNA methylase, RmtC, found in a Proteus mirabilis isolate demonstrating extraordinary high-level resistance against various aminoglycosides. Antimicrob Agents Chemother. 2006; 50:178–84.
7. Doi Y, de Oliveira Garcia D, Adams J, Paterson DL. Coproduction of novel 16S rRNA methylase RmtD and metallo-beta-lactamase SPM-1 in a panresistant Pseudomonas aeruginosa isolate from Brazil. Antimicrob Agents Chemother. 2007; 51:852–6.
8. Yan JJ, Wu JJ, Ko WC, Tsai SH, Chuang CL, Wu HM, et al. Plasmid-mediated 16S rRNA methylases conferring high-level aminoglycoside resistance in Escherichia coli and Klebsiella pneumoniae isolates from two Taiwanese hospitals. J Antimicrob Chemother. 2004; 54:1007–12.
Article
9. Lee H, Yong D, Yum JH, Roh KH, Lee K, Yamane K, et al. Dissemination of 16S rRNA methylase-mediated highly amikacin-resistant isolates of Klebsiella pneumoniae and Acinetobacter baumannii in Korea. Diagn Microbiol Infect Dis. 2006; 56:305–12.
Article
10. Kondo S. Development of arbekacin and synthesis of new derivatives stable to enzymatic modifications by methicillin-resistant Staphylococcus aureus. Jpn J Antibiot. 1994; 47:561–74.
11. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; Seventeenth informational supplement. Wayne, PA, CLSI. 2006.
12. Cattoir V, Poirel L, Rotimi V, Soussy CJ, Nordmann P. Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates. J Antimicrob Chemother. 2007; 60:394–7.
Article
13. Skeggs PA, Thompson J, Cundliffe E. Methylation of 16S ribosomal RNA and resistance to aminoglycoside antibiotics in clones of Streptomyces lividans carrying DNA from Streptomyces ten-jimariensis. Mol Gen Genet. 1985; 200:415–21.
Article
14. Cundliffe E. How antibiotic-producing organisms avoid suicide. Annu Rev Microbiol. 1989; 43:207–33.
Article
15. Bogaerts P, Galimand M, Bauraing C, Deplano A, Vanhoof R, De Mendonca R, et al. Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium. J Antimicrob Chemother. 2007; 59:459–64.
Article
16. Yamane K, Wachino J, Suzuki S, Kato H, Shibayama K, Kimura K, et al. 16S rRNA methylase-producing, gram-negative pathogens, Japan. Emerg Infect Dis. 2007; 13:642–6.
Article
17. Park YJ, Lee S, Yu JK, Woo GJ, Lee K, Arakawa Y. Co-production of 16S rRNA methylases and extended-spectrum beta-lactamases in AmpC-producing Enterobacter cloacae, Citrobacter freundii and Serratia marcescens in Korea. J Antimicrob Chemother. 2006; 58:907–8.
18. Chen L, Chen ZL, Liu JH, Zeng ZL, Ma JY, Jiang HX. Emergence of RmtB methylase-producing Escherichia coli and Enterobacter cloacae isolates from pigs in China. J Antimicrob Chemother. 2007; 59:880–5.
Article
19. Galimand M, Sabtcheva S, Courvalin P, Lambert T. Worldwide disseminated armA aminoglycoside resistance methylase gene is borne by composite transposon Tn1548. Antimicrob Agents Chemother. 2005; 49:2949–53.
20. Golebiewski M, Kern-Zdanowicz I, Zienkiewicz M, Adamczyk M, Zylinska J, Baraniak A, et al. Complete nucleotide sequence of the pCTX-M3 plasmid and its involvement in spread of the extended-spectrum β-lactamase (ESBL) gene blaCTX-M-3. Antimicrob Agents Chemother. 2007 Aug 13. [Epub ahead of print].
21. Bae IK, Lee YN, Jeong SH, Lee K, Yong D, Lee J, et al. Emergence of CTX-M-12, PER-1 and OXA-30 β-lactamase-producing Klebsiella pneumoniae. Korean J Clin Microbiol. 2006; 9:102–9.
22. Yu YS, Zhou H, Yang Q, Chen YG, Li LJ. Widespread occurrence of aminoglycoside resistance due to ArmA methylase in imipenem-resistant Acinetobacter baumannii isolates in China. J Anti-microb Chemother. 2007; 60:454–5.
Article
23. Doi Y, Adams JM, Yamane K, Paterson DL. Identification of 16S Ribosomal RNA Methylase-Producing Acinetobacter baumannii Clinical Strains in North America. Antimicrob Agents Chemother. 2007; 51:4209–10.
24. Doi Y, Ghilardi AC, Adams J, de Oliveira Garcia D, Paterson DL. High prevalence of metallo-beta-lactamase and 16S rRNA methylase coproduction among imipenem-resistant Pseudomonas aeruginosa isolates in Brazil. Antimicrob Agents Chemother. 2007; 51:3388–90.
25. Hooper DC. Mechanisms of Quinolone Resistance. Hooper DC and Rubenstein E, editor. Quinolone Antimicrobial Agents. 3rd ed.Washington DC: American Society for Microbiology Press;2006. p. 41–67.
Article
26. Poole K. Efflux pumps as antimicrobial resistance mechanisms. Ann Med. 2007; 39:162–76.
Article
27. Ruiz J. Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J Antimicrob Chemother. 2003; 51:1109–17.
Article
28. Martínez-Martínez L, Pascula A, Jacoby GA. Quionolone resistance from a transferable plasmid. Lancet. 1998; 351:797–9.
29. Yamane K, Wachino J, Suzuki S, Kimura K, Shibata N, Kato H, et al. New plasmid-mediated fluoroquinolone efflux pump, QepA, found in an Escherichia coli clinical isolate. Antimicrob Agents Chemother. 2007; 51:3354–60.
30. Robicsek A, Jacoby GA, Hooper DC. The worldwide emergence of plasmid-mediated quinolone resistance. Lancet Infect Dis. 2006; 6:629–40.
Article
Full Text Links
  • KJCM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr