Molecular Epidemiology and Major Mechanisms of Carbapenem and Fluoroquinolone Resistance of Elizabethkingia Anophelis

• Main Authors: JIAN, MING-JR, 簡明志
• Other Authors: SHANG, HUNG-SHENG
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/g9mpnc

博士 === 國防醫學院 === 醫學科學研究所 === 107 === Elizabethkingia anophelis is a genus of bacteria commonly found in natural environments, and can cause opportunistic infections in immunocompromised individuals or newborn infants. An E. anopheles outbreak has previously been reported in Wisconsin, USA, between 2015 and 2016, which involved at least 65 cases with 20 deaths. In addition, another outbreak involving 10 cases with 6 deaths has also been reported in Illinois. Therefore, E. anophelis is opportunistic pathogens with high mortality rates. This project aims to explore the clinical symptoms and characteristics of Elizabethkingia infections with the following three objectives: (1) Establishment of rapid molecular typing: pulsed-field gel electrophoresis is the golden standard for molecular typing, but this method is time-consuming. In this study, we will employ random-amplified polymorphic DNA (RAPD) coupled with capillary electrophoresis in order to establish a rapid, sensitive, and highly reproducible molecular typing method for epidemiological investigation. (2) Analysis of the development of carbapenem resistance: we tried to investigate the presence or absence of the MBL gene in the E. anophelis clinical strain of carbapenem antibiotic-resistant patients in our hospital. We used PCR-based methods to detect E. anophelis strains. The carbapenemase gene is carried and the MBL phenotyping method is evaluated by utilizing the ability of a metal chelator such as EDTA to inhibit MBL activity. (3) Determine mechanisms of antibiotic resistance: the resistance of E. anophelis to ciprofloxacin/levofloxacin will be explored, and potentially mutated genes will be sequenced to investigate the underlying mechanisms of antibiotic resistance. In addition, we also hope to establish a rapid detection methodology through High-resolution Melting (HRM) technology to confirm whether E. anophelis has a single amino acid mutation in gyrase.