| Project/Area Number |
16K09931
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Infectious disease medicine
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| Research Institution | Nagoya University |
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Principal Investigator |
Yagi Tetsuya 名古屋大学, 医学系研究科, 教授 (70333573)
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| Research Collaborator |
IGUCHI mitsutaka
TOMITA yuuka
KATO daizo
MORIOKA hiroshi
TETSUKA nobuyuki
INAGAKI takayuki
HIRABAYASHI aki
SUZUKI hitoshi
SHIBAYAMA keigo
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Fiscal Year 2016: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | カルバペネマーゼ産生腸内細菌科細菌 / Enterobacter cloace / IMP-1 / インテグロン / IncHI2A / カルバペネム耐性腸内細菌科細菌 / E. cloacae complex / MLST / カルバペネマーゼ / K. pneumoniae / カルバペネム耐性 / Enterobacter cloacae / IMP-60 / 感染症 / 薬剤耐性菌 |
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| Outline of Final Research Achievements |
Thirty-nine carbapenem-resistant Enterobacter cloacae complex (CRECC) isolates recovered in Nagoya University Hospital from 2012 to 2016. Twenty out of 39 CRECC were carbapenemase-producing (CP) ECC. Molecular epidemiologic analysis with MLST and Rep-PCR showed ST53 (6 strains), ST113 (7 strains), ST513 (2 strains) among CPE strains were genetically closely-related. Whole genome sequencing analysis of plasmids from seven representative CPE strains revealed that they all had similar structure of plasmid with class I integron containing IMP-1 gene and IncHI2A replicon type.
Eighty-two ECC isolates, which were suspected to produce carbapenemase, were collected from 24 hospitals participated in an regional network in Aichi prefecture from 2014 to 2016. Eighteen out of 82 isolates, which were recovered from 4 hospitals, were shown to be IMP-1 producers. MLST analysis revealed that CPECC isolates with same ST were identified in the specific hospitals, and rarely seen beyond one hospital.
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| Academic Significance and Societal Importance of the Research Achievements |
我が国でカルバペネム耐性腸内細菌科細菌の中で、最も検出の多いE. cloacae complexでのCPEの疫学を明らかにした。CPEの方が非産生菌より施設内で水平伝播しやすいことが初めて示唆された。分子疫学的解析では、これまでに報告のあるSTとは異なるSTの株も見出され、STが異なっていても、構造が類似したIMP-1遺伝子のあるクラスIインテグロンを持つIncHI2Aプラスミドを持っていることが明らかになった。
愛知県下の多施設連携サーベイランスでもCPEは検出されていたが、施設を超えたクローンの伝播は見られなかった。菌の分子疫学的解析を含めた地域連携サーベイランスの重要性が示された。
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