동물및환경에서분리된 항생제내성균및내성유전자kfem.or.kr/wp-content/uploads/2005/04/data_envinfo_epds... · 2014-12-23 · Companion Animals 1,000,000 2.8% Total

동물 및 환경에서 분리된

항생제 내성균 및 내성 유전자

경북 의대 미생물학 조동택

The antibiotic paradox :

How miracle drugs are destroying the miracle?

In Humans

In Fish

In Other Animals

In Plants

Non-Human Antimicrobial Use in USATotal Percent Pounds Total Use

Livestock Uses

Non-therapeutic (3 species*) 24,600,000 70.0%

Non-therapeutic (other) 3,000,000 8.5%

Therapeutic (all species) 2,000,000 5.7%

Pesticide Uses 50,000 0.1%

Companion Animals 1,000,000 2.8%

Total Non-Human Uses 30,600,000 87.0%

Human Use 4,500,000 13.0%

Total Use 35,100,000

101st Annual Meeting, American Society for MicrobiologyMay 22, 2001, Charles M. Benbrook

* 3 species: cattle, swine, poultry

Usage of antimicrobial agents for food animals in Europe

Basic & Clinical Pharmacology & Toxicology96:271-334

Relative distribution of usage of antimicrobial agents for treatment of infections in pigs and

humans in Denmark (from DANMAP 2004)


Changes in occurrence of resistance in E. faecium and E. faecalis isolated from Danish pigs or broilers from 1995 to 2003 following withdrawing of antimicrobial agents for growth promotion(Aarestrup et al. 2001; DANMAP 2004)


Agricultural Use of Antibiotics

significant source of antibiotic resistance

among foodborne pathogens

Consumers risk exposure to disease-carrying bacteria during food preparation and consumption. If serious food-borne illnesses occur, antibiotics used for treatment may not be effective if the bacteria have become resistant.

A Dangerous Cycle

Many of the same antibiotics humans are regularly added to livestock feed to promote rapid growth.

Slaughter and processing may result in bacterial contamination of retail foods.

Because of routine antibiotic use, strains of bacteria can form that are resistant to the drugs.

New Drug-Resistant SalmonellaS. typhimurium DT104

살모넬라 균주중 S. typhimurium DT104 균주는 최근에 전세계적으

로 유행하고 있는 대표적인 균주로 ampicillin, chloramphenicol, streptomycin, sulfonamide 및 tetracycline 등 5종의 항생제에 내

성을 나타내며 다른 살모넬라균에 비하여 질병의 이환률과 사망률이 높

은 것으로 알려져 있다.

Swine Herd

Swine Herd

Slaughter-house

PorkProducts

Consumers Hospital

Two herds were identified as sources of Salmonella DT104. Piglets were moved between farms and the farms shared machinery.

Eighteen people became ill after eating contaminated fork and seven were hospitalized; half ate meat confirmed coming from the incriminated slaughter house. A slaughterhouse worker also fell ill.

Two additional people – a nurse and a fellow patient who shared a hospital room – were infected after contact with one of the hospitalized patients. The fellow patient died.

Nurse

Fellow patient

Worker

The Community

Outbreak of a Resistant Foodborne IllnessOutbreak in Denmark of Salmonella DT104

Using molecular “fingerprinting” technique, researchers in Denmark were able to reconstruct the course of the 1998 Salmonella DT104 outbreak from the farm through the community.

Detection of PSE in Salmonella entericaserotype Typhimurium DT104 from pig

1. 서울 근교 도축장에서 총 152마리의 돼지에서 10주의 Salmonella 분리

Salmonella enterica serovar TyphimuriumSa 10

Salmonella typhimuriumSa 9

Salmonella typhimurium LT2Sa 8




Salmonella typhimurium LT2Sa 4




동 정 결 과 (by 16S rRNA sequencing)Strains

S. ardwickC1 Sa 10

S. ardwickC1Sa 9

S. muenchenC2Sa 8

DT203S. typhimuriumBSa 7

S. ardwickC1 Sa 6

S. ardwickC1Sa 5

DT104LS. typhimuriumBSa 4

S. bradenburgBSa 3

S. ardwickC1Sa 2

S. ardwickC1 Sa 1

Phage type 균 주 판 정O-serogroup균 주 번 호

2. Phage typing

S19S21S23S26S26CCARM11066

R-S24S17S22S22Sa10

R-S22S17S23S24Sa 9

R-R-R11S26R-Sa 8

R-R-R-R-R-Sa 7

R-S24S18S24S25Sa 6

R-S24S17S25S23Sa 5

R-R-R-R-R-Sa 4

R -S22S17S26S22Sa 3

R-S20S17 S23S24Sa 2

R-S21S17S24S23Sa 1

TetracyclineSulfisoxazolStreptomycinChloram-phenicolAmpicillinStrains

3. Antimicrobial susceptibility by disk diffusion method (지름 mm)

116244E.coli

128128482Sa10

128128482Sa 9

> 128> 1024164> 128Sa 8

> 128> 1024> 128> 128> 128Sa 7

128128482Sa 6

128128482Sa 5

> 128> 102464> 128> 128Sa 4

12864884Sa 3

128128482Sa 2

128128482Sa 1

TetracyclineSulfisoxazoleStreptomycinChloramphenicolAmpicillin

4. Antimicrobial susceptibility test by agar dilution method (MIC)

5. Characterization of β-lactamase

with Isoelectric focusing, PCR, and sequencing

DT104 균주에서 PSE-1 β-lactamase 유전자가 확인

Antibiotic-resistant bacteria and antibiotics are discharged in huge amount in the environment as a result of the increasing and often indiscriminate use of antibiotics in medical, veterinary, and agricultural practices. River waters are the main receptacle for these pollutants, since they receive the sewage of urban effluents. As rivers are one of the major sources of water, directly or indirectly, for human and animal consumption, this pollution may contribute to the maintenance and even the spread of bacterial antibiotic resistance.

River water : main receptacle for pollutants

강물에 존재하는 총 균 수와 장내 세균수

총균수

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

10th

11th

12th

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20th

21st

22nd

23rd

24th

25th

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28th

29th

30th

31st

32nd

log CFU/ml

중랑천

한강

금호강

낙동강

섬진강 지류

섬진강

KONAR, 2005

Norfloxacin 내성 대장균수

0

50

100

150

200

250

300

10th

11th

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CFU

/m

중랑천 NOR내성 장내세균수

중랑천 NOR내성 대장균수

한강 NOR내성 장내세균수

한강 NOR내성 대장균수

금호강 NOR내성 장내세균수

금호강 NOR내성 대장균수

낙동강 NOR내성 장내세균수

낙동강 NOR내성 대장균수

섬진지류 NOR내성 장내세균수

섬진지류 NOR내성 대장균수

섬진강 NOR내성 장내세균수

섬진강 NOR내성 대장균수

항생제 내성 장내 세균 및 대장균 수

KONAR, 2005

Identification of CTX-M-14, TEM-52, and CMY-1 extended-spectrum β-lactamases

in environmental strains of E. coli isolated from Han river in Korea

ApTcSmSuTpKmGm32482512>12810022


ApCmTcSmSuTpKmGmAk32482256>12810019



ApCmTcSmSuTpKmGm>128882512>12810014

ApTcSmSuTpKmGm32>512416256>12810013

ApCmTcSmSuTpKmGm32884256>12810012



ApCmTcSmSuTpKmGmAk>1284162128>12810009

ApCmTcSmSuTpKmGmAk<0.54481612810006

ApCmTcSmSuTpKmGmAk<0.58481612810005

ApCmTcSmSuTpKmGm<0.5448166410004



Antimicrobial resistance patternbnorfloxacincefoxitinaztreonamceftazidimecefotaximecephalothin

Strain No.

MICs (µg/ml)a

Antimicrobial susceptibility of E. coli isolated from Han river

KONAR, 2005

dfrA17-aadA51.6 kbTEM-1, CTX-M145.4, 8.0+10014

dfrA12-orfF-aadA22kbCTX-M148.0+10022





NDdNDdTEM-1, CMY-1, OXA-1-like5.4, 7.4, 8.0+10013




ND2.1kb, 1.4kbTEM-1, CTX-M145.4, 8.0+10009

aadA11kbTEM-1, TEM-52, OXA-1-like5.4, 5.9, 7.4+10006





integrated gene cassettessize of ampliconcβ-lactamase genesIsoelectric point (pI) DDSTaStrain No.

Class I integron

Genotypic characteristics of E. coli isolated from Han river

KONAR, 2005

Documents

동물및환경에서분리된 항생제내성균및내성유전자kfem.or.kr/wp-content/uploads/2005/04/data_envinfo_epds... · 2014-12-23 · Companion Animals 1,000,000 2.8% Total