Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/81169
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dc.contributor溫福賢zh_TW
dc.contributorFu-Shyan Wenen_US
dc.contributor.author童耀申zh_TW
dc.contributor.authorTong, Yao-Shenen_US
dc.contributor.other生命科學院碩士在職專班zh_TW
dc.date2013en_US
dc.date.accessioned2014-06-13T08:11:08Z-
dc.date.available2014-06-13T08:11:08Z-
dc.identifierU0005-2208201301175400en_US
dc.identifier.citation陳昶華.2007. Integron與抗生素抗藥性與院內感染的探討.感染控制雜誌 17: 250-253. 陳婉雯 .2005. Class 1 integron在鮑氏不動桿菌臨床分離株中的盛行率與 VIM-11之分子特性分析. 國立中興大學生命科學系研究所碩士論文 Bergogne-Berezin, E. and K. J. Towner. 1996. Acinetobacter spp. as nosocomial pathogens: microbiological, clinical, and epidemiological features. Clin. Microbiol. Rev. 9:148-165. Bush, K., G. A. Jacoby, and A. A. Medeiros. 1995. A functional classification scheme for beta-lactamases and its correlation with molecular structure. Antimicrob. Agents Chemother. 39:1211-1233. Collis, C. M. and R. M. Hall. 1995. Expression of antibiotic resistance genes in the integrated cassettes of integrons. Antimicrob. Agents Chemother. 39:155-162. Collis, C. M., M. J. Kim, S. R. Partridge, H. W. Stokes, and R. M. Hall. 2002. Characterization of the class 3 integron and the site-specific recombination system it determines. J. Bacteriol. 184:3017-3026. Fluit, A. C. and F. J. Schmitz. 1999. Class 1 integrons, gene cassettes, mobility, and epidemiology. Eur. J. Clin. Microbiol. Infect. Dis. 18:761-770. Fournier, P. E., D. Vallenet, V. Barbe, S. Audic, H. Ogata, L. Poirel, H. Richet, C. Robert, S. Mangenot, C. Abergel, P. Nordmann, J. Weissenbach, D. Raoult, and J. M. Claverie. 2006. Comparative genomics of multidrug resistance in Acinetobacter baumannii. PLoS. Genet. 2:e7. Hall, R. M. and C. M. Collis. 1995. Mobile gene cassettes and integrons: capture and spread of genes by site-specific recombination. Mol. Microbiol. 15:593-600. Hancock, R. E. 1998. Resistance mechanisms in Pseudomonas aeruginosa and other nonfermentative gram-negative bacteria. Clin. Infect. Dis. 27 Suppl 1:S93-S99. Huang L.-Y. and Chen T.-L. 2008. Dissemination of multidrug-resistant, class 1 integron-carrying Acinetobacter baumannii isolates in Taiwan. Clin Microbiol Infect . 14: 1010–1019. Levesque, C., L. Piche, C. Larose, and P. H. Roy. 1995. PCR mapping of integrons reveals several novel combinations of resistance genes. Antimicrob. Agents Chemother. 39:185-191. Liebert, C. A., R. M. Hall, and A. O. Summers. 1999. Transposon Tn21, flagship of the floating genome. Microbiol. Mol. Biol. Rev. 63:507-522. Livermore, D. M. 1995. Beta-lactamases in laboratory and clinical resistance. Clin. Microbiol. Rev. 8:557-584. Mazel, D., B. Dychinco, V. A. Webb, and J. Davies. 1998. A distinctive class of integron in the Vibrio cholerae genome. Science 280:605-608. Mussi, M. A., A. S. Limansky, and A. M. Viale. 2005. Acquisition of resistance to carbapenems in multidrug-resistant clinical strains of Acinetobacter baumannii: natural insertional inactivation of a gene encoding a member of a novel family of beta-barrel outer membrane proteins. Antimicrob. Agents Chemother. 49:1432-1440. Recchia, G. D. and R. M. Hall. 1995. Gene cassettes: a new class of mobile element. Microbiology 141 ( Pt 12):3015-3027. Siu, L. K. 2002. Antibiotics: action and resistance in gram-negative bacteria. J. Microbiol. Immunol. Infect. 35:1-11. Stokes, H. W. and R. M. Hall. 1989. A novel family of potentially mobile DNA elements encoding site-specific gene-integration functions: integrons. Mol. Microbiol. 3:1669-1683. Turton, J. F., M. E. Kaufmann, J. Glover, J. M. Coelho, M. Warner, R. Pike, and T. L. Pitt. 2005. Detection and typing of integrons in epidemic strains of Acinetobacter baumannii found in the United Kingdom. J. Clin. Microbiol. 43:3074-3082. Walsh, T. R., M. A. Toleman, L. Poirel, and P. Nordmann. 2005. Metallo-beta-lactamases: the quiet before the storm? Clin. Microbiol. Rev. 18:306-325. Wolter, D. J., N. D. Hanson, and P. D. Lister. 2004. Insertional inactivation of oprD in clinical isolates of Pseudomonas aeruginosa leading to carbapenem resistance. FEMS Microbiol. Lett. 236:137-143. Zarrilli, R., M. Crispino, M. Bagattini, E. Barretta, P. A. Di, M. Triassi, and P. Villari. 2004. Molecular epidemiology of sequential outbreaks of Acinetobacter baumannii in an intensive care unit shows the emergence of carbapenem resistance. J. Clin. Microbiol. 42:946-953.en_US
dc.identifier.urihttp://hdl.handle.net/11455/81169-
dc.description.abstract抗藥性鮑氏不動桿菌( Acinetobacter baumannii)是引起醫療照護相關感染非常重要的原因,除高致病性與致死率外,也是醫療照護相關感染主要病原菌之ㄧ,而Integron是除了質體與轉位子之外,細菌獲得新抗藥基因有關的水平傳播單位。本研究在2008~2010年共收集彰化秀傳醫院100株鮑氏不動桿菌臨床血液培養菌株,針對14種抗生素進行抗藥性的測試。並運用CS-PCR技術來分析Class 1 integrons的分布與其所攜帶抗藥基因卡匣種類。分析後發現,鮑氏不動桿菌對cephalosporins類藥物的抗藥性明顯上升(由54%上升為66%),且對PIP、TZP、SXT、SAM類抗生素的抗藥性也都有上升的趨勢,但同時發現對Aminoglycosides的抗藥性則有下降的趨勢(由60%降為48%)。 約有61.8%的鮑氏不動桿菌臨床分離株可增幅出Class 1 integron的cassette array;增幅出的cassette array有3.0 kb, 2.5 kb, 1.5 kb和1.0 kb四種大小,其中以帶有2.5 kb cassette array所佔的比率最高,為所有帶integron的菌株之87.3%。經對照抗生素的抗性測試可以發現,帶有Class 1 integron的菌株,其具有的抗生素抗性比不具有Class 1 integron的菌株較為多樣化。可是發現頻率最高的2.5 kb的cassette array,在其他國家的報告卻極少;推測可能因素為經由醫院內長期抗生素壓力的篩選,使得帶有2.5 kb integron的鮑氏不動桿菌,形成了台灣地區特有的臨床優勢菌株,而這種趨勢的產生應該是與醫師在治療上使用的抗生素有關。zh_TW
dc.description.abstractAntibiotics-resisant Acinetobacter baumannii is a very important cause of healthcare-associated infections, in addition to the highly pathogenic and mortality, it is one of major healthcare-associated infecting pathogens. Integrons are the genetic unit that confer antibiotic resistance to bacteria besides plasmid and transposon.In this study, 100 A. baumannii clinical blood culture isolates were collected from Show Chwan Memorial Hospital from 2008 to 2010 .When their drug susceptibility against 14 kinds of antibiotics were tested,it was found that the drug resistance of A. baumannii to cephalosporins increased significantly (54% up to 66%), and the resistance to PIP, TZP, SXT, SAM also have an upward trend , but the drug resistance to aminoglycosides decreased (60% down to 48%). The CS-PCR method was used to detect the existence of class 1 integron , in these isolates. It was found that 61.8% of these isolates carried the class 1 integron, and the cassette arrays they carried were only in 4 different sizes: 3.0 kb, 2.5 kb, 1.5 kb and 1.0 kb,among them the isolates carrying 2.5 kb cassette array were at the highest percentage, 87.3%.This study also showed that A. baumannii isolates carrying integron were more resistant to various antibiotics tested than non-integron-carrying isolates. The widespread occurrence of 2.5 kb cassette array in A. baumannii isolates from Show Chwan Memorial Hospital was rarely reported in other countries.It is speculating that this phenomenon may be linked to the preference of hospital to certain particular antibiotics, so that the A. baumannii strains carrying 2.5-kb cassette array became dominant under antibiotic selection pressure.  en_US
dc.description.tableofcontents中文摘要 ………………………………………………………………I 英文摘要………………………………………………………………Ⅱ 目次………………………………………………………………………Ⅲ 圖目次……………………………………………………………………Ⅵ 表目次…………………………………………………………………VII 附錄……………………………………………………………………VII 第一章、前言……………………………………………………………1 1-1 研究背景及動機……………………………………………………1 1-2 鮑氏不動桿菌………………………………………………………1 1-3抗藥機轉……………………………………………………………2 (1)抗生素結合蛋白的改變……………………………………………2 (2)產生抗生素的分解酶………………………………………………3 (3)改變細胞外膜通透性………………………………………………3 1-4 抗藥性基因的水平傳播…………………………………………4 1-5 Integron的簡介…………………………………………………4 (1)基因卡匣的基本結構………………………………………………5 (2)基因卡匣基因的表現………………………………………………6 (3)基因卡匣的移動……………………………………………………6 1-6 Integron的種類…………………………………………………7 (1)Class 1 integron…………………………………………………7 (2)Class 2 integron…………………………………………………8 (3)Class 3 integron…………………………………………………8 (4)Class 4 integron…………………………………………………9 第二章、材料與方法…………………………………………………10 2-1 臨床菌株之分離及收集…………………………………………10 2-2 抗生素感受性試驗………………………………………………10 2-3 Genomic DNA的萃取……………………………………………10 2-4 聚合酶連鎖反應(Polymerase chain reaction) ……………11 2-5核酸膠體電泳分析與紀錄…………………………………………11 2-6 DNA片段回收及純化………………………………………………12 2-7 Cassette array序列分析與比對………………………………12 第三章、結果…………………………………………………………13 3-1臨床菌株收集及抗藥性分析……………………………………13 3-2 Class 1 integron之盛行率……………………………………13 3-3 Cassette array序列分析………………………………………14 (1)3.0 kb cassette array…………………………………………14 (2)2.5 kb cassette array…………………………………………15 (3)1.5 kb cassette array…………………………………………15 (4)1.0 kb cassette array…………………………………………15 第四章、討論…………………………………………………………16 4-1 鮑氏不動桿菌抗藥性的改變……………………………………16 4-2 Integron與鮑氏不動桿菌抗藥性的相關性……………………16 4-3 Cassette array與抗藥性之相關性……………………………17 (1)帶有 2.5 kb cassette array 的菌株…………………………17 (2)帶有 3.0 kb cassette array 的菌株…………………………17 (3)帶有 1.5 kb cassette array 的菌株…………………………17 (4)帶有 1.0 kb cassette array 的菌株…………………………18 (5)不具有任何cassette array的菌株……………………………18 4-4 彰化秀傳醫院鮑氏不動桿菌特有的抗藥性cassette array分布情形………………………………………………………………………18 第五章、結論…………………………………………………………19 參考文獻………………………………………………………………19 表目次 表一、A.baumannii不同分離株之PHOENIX 100藥物敏感試驗結果…24 表一、A.baumannii不同分離株之PHOENIX 100藥物敏感試驗結果(續)……………………………………………………………………………25 表一、A.baumannii不同分離株之PHOENIX 100藥物敏感試驗結果(續)……………………………………………………………………………26 表一、A.baumannii不同分離株之PHOENIX 100藥物敏感試驗結果(續)……………………………………………………………………………27 表二、Class 1 integron 檢測結果…………………………………28 表三、以PCR 從A.baumannii分離株所得之cassette array統計表………………………………………………………………………29 表四、具有 2.5 kb cassette array之菌株的PHOENIX 100藥物敏感試驗測試結果…………………………………………………………30 表五、具有2.5 kb與其他 cassette array之菌株的PHOENIX 100藥物敏感試驗測試結果……………………………………………………31 表六、僅帶有 3.0 kb、 1.5 kb或是1.0 kb cassette array的菌株,藥物敏感試驗結果………………………………………………………………………31 表七、不具Class 1 integron之菌株的PHOENIX 100藥物敏感試驗測試結果…………………………………………………………………32   圖目次 圖一、2007-2008年彰化秀傳醫院鮑氏不動桿菌的藥物敏感性趨勢圖………………………………………………………………………33 圖二、2008-2010年鮑氏不動桿菌抗藥性統計圖…………………34 圖三、以PCR 檢測不同A.baumannii分離株之Class 1 integron的電泳分析(1-48號菌株)…………………………………………………35 圖四、以PCR 檢測不同A.baumannii分離株之Class 1 integron的電泳分析(49-79號菌株)………………………………………………36 圖五、各種 cassette array所帶基因意示圖……………………37 圖六、2008年與2009-2010年鮑氏不動桿菌的抗藥性比較圖……38 附錄 附錄 1 3.0 kb cassette array DNA sequence……………………39 附錄 2 2.5 kb cassette array DNA sequence……………………40 附錄 3 1.5 kb cassette array DNA sequence……………………41 附錄 4 1.0 kb cassette array DNA sequence……………………42zh_TW
dc.language.isozh_TWen_US
dc.publisher生命科學院碩士在職專班zh_TW
dc.relation.urihttp://www.airitilibrary.com/Publication/alDetailedMesh1?DocID=U0005-2208201301175400en_US
dc.subject鮑氏不動桿菌zh_TW
dc.subjectAcinetobacter baumanniien_US
dc.subject整合子zh_TW
dc.subjectClass 1 integronsen_US
dc.title鮑氏不動桿菌藥物敏感試驗與Class 1 integrons之探討zh_TW
dc.titleStudy of variation on drug susceptibility testing and Class 1 integrons of Acinetobacter baumanniien_US
dc.typeThesis and Dissertationzh_TW
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.openairetypeThesis and Dissertation-
item.cerifentitytypePublications-
item.fulltextno fulltext-
item.languageiso639-1zh_TW-
item.grantfulltextnone-
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