Distribution of adeG, adeB, adeE, adeY, abeM, and adeJ Efflux Pump Genes in Clinical Isolates of Acinetobacter Species from Korea

In-Sun Choi; Ji Ae Choi; Sook Jin Jang; Geon Park; Seok Hoon Jeong; Choon-Mee Kim; O-Jin Lee; Seong-Ho Kang; Dae Soo Moon

doi:10.3343/lmo.2019.9.4.201

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Choi, Choi, Jang, Park, Jeong, Kim, Lee, Kang, and Moon: Distribution of adeG, adeB, adeE, adeY, abeM, and adeJ Efflux Pump Genes in Clinical Isolates of Acinetobacter Species from Korea

Original Article

Laboratory Medicine Online 2019; 9(4): 201-209.

Published online: 1 October 2019

DOI: https://doi.org/10.3343/lmo.2019.9.4.201

Distribution of adeG, adeB, adeE, adeY, abeM, and adeJ Efflux Pump Genes in Clinical Isolates of Acinetobacter Species from Korea

In-Sun Choi, M.D.¹, Ji Ae Choi, M.Sc.², Sook Jin Jang, M.D.³

, Geon Park, M.D.³, Seok Hoon Jeong, M.D.^4,⁵, Choon-Mee Kim, Ph.D.⁶, O-Jin Lee, M.D.³, Seong-Ho Kang, M.D.³, Dae Soo Moon, M.D.³

¹Department of Laboratory Medicine, Sean Hospital, Mokpo, Korea.

²Division of Antimicrobial Resistance, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea.

³Department of Laboratory Medicine, Chosun University College of Medicine, Gwangju, Korea.

⁴Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

⁵Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.

⁶Premedical Science, College of Medicine, Chosun University, Gwangju, Korea.

Corresponding author: Sook Jin Jang, M.D., Ph.D. Department of Laboratory Medicine, Chosun University College of Medicine, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea. Tel: +82-62-220-3259, Fax: +82-62-232-2063, sjbjang@chosun.ac.kr

Received 28 June 2018 Revised 27 August 2018 Accepted 10 September 2018

Laboratory Medicine Online

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The aim of the present study was to determine the frequency of six efflux pump genes in Acinetobacter clinical isolates collected from South Korean hospitals.

Methods

In this study, we used a total of 339 Acinetobacter strains, comprising 279 Acinetobacter calcoaceticus–Acinetobacter baumannii (ACB) complex and 60 non-ACB complex strains. We performed specific PCR assays to detect adeG, adeB, adeE, adeY, abeM, and adeJ, transporter genes of the multidrug efflux pumps AdeFGH, AdeABC, AdeDE, AdeXYZ, AbeM, and AdeIJK, respectively.

Results

Frequencies of six efflux pump genes varied according to the species of Acinetobacter. Frequencies of adeE, abeM, and adeJ between A. baumannii group and A. nosocomialis group were found to be significantly different. Significant differences were found in the frequencies of adeB, adeE, adeY, and adeJ among the susceptible A. baumannii (SAB), multidrug-resistant A. baumannii (MDRAB), and extensively drug-resistant A. baumannii (XDRAB) groups within the 154 strains of A. baumannii. The frequencies of efflux pump genes in imipenem-susceptible and imipenem-nonsusceptible groups were significantly different for adeB, adeY, and adeJ. The frequencies of efflux pump genes in ciprofloxacin-susceptible and ciprofloxacin-nonsusceptible groups were significantly different for adeB and adeY. No significant difference was found in the frequency of efflux pump genes among groups sampled from different regions of Korea, across 86 strains of A. baumannii collected in 2012.

Conclusions

The frequencies of six efflux pump genes obtained in this study demonstrate the fundamental epidemiological feature of efflux pump genes in Korean Acinetobacter clinical isolates.

Keywords: Gene frequency, Multidrug efflux pump genes, Resistance-nodulation-cell division-type efflux pump, Acinetobacter, adeB, abeM

Figures and Tables

Table 1

Frequencies of six efflux pump genes, namely adeG, adeB, adeE, adeY, abeM, and adeJ, according to various species of 339 Acinetobacter clinical isolates

^*Chi-square test performed on two most common species, namely A. baumannii and A. nosocomialis, revealed statistically significant differences for adeE (P<0.0001), abeM (P<0.0001), and adeJ (P<0.0001) efflux pump genes.

Abbreviation: NT, not tested.

Table 2

Distribution of strains containing efflux pump genes adeG, adeB, adeE, adeY, abeM, and adeJ simultaneously among 154 Acinetobacter baumannii and 94 Acinetobacter nosocomialis clinical isolates

Table 3

Frequencies of six efflux pump genes adeG, adeB, adeE, adeY, abeM, and adeJ across three groups: susceptible A. baumannii (SAB), multidrug-resistant A. baumannii (MDRAB), and extensively drug-resistant A. baumannii (XDRAB) groups of 154 Acinetobacter clinical isolates

Statistically significant differences were found among SAB, MDRAB, and XDRAB groups for adeB (P<0.001), adeE (P<0.0001), abeY (P<0.0001), and adeJ (P<0.019) efflux pump genes using Fisher's exact test on 3×2 contingency tables. Among them, statistically significant differences using Mann-Whitney U test were found between the following comparison pairs: ^*SAB vs. MDRAB (P=0.001) in adeB; ^†SAB vs. MDRAB (P=0.005) and MDRAB vs. XDRAB (P=0.0001) in adeE; ^‡SAB vs. MDRAB (P<0.001) and SAB vs. XDRAB (P<0.003) in adeY; ^§SAB vs. MDRAB (P=0.029) and SAB vs. XDRAB (P=0.038) in adeJ. The significant P value cut-off was set at 0.0167 by Bonferroni-correction.

Table 4

Frequency of six efflux pump genes adeG, adeB, adeE, adeY, abeM, and adeJ according to susceptible and non-susceptible groups to imipenem or ciprofloxacin across 154 Acinetobacter baumannii clinical isolates

Comparison pairs showing statistically significant differences by Chi-square test were as follows: ^*IPM-S vs. IPM-NS group for adeB (P=0.002), for adeY (P<0.0001), and for adeJ (P=0.010); ^†CIP-S vs. CIP-NS group for adeB (P=0.003), and for adeY (P<0.0001).

Abbreviations: IPM, imipenem; CIP, ciprofloxacin; NS, non-susceptible; S, susceptible.

Table 5

Frequencies of six efflux pump genes, adeG, adeB, adeE, adeY, abeM, and adeJ, according to the year of isolation across 86 Acinetobacter baumannii clinical strains collected from Chosun University Hospital in Gwangju, South Korea

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ORCID iDs: Sook Jin Jang
https://orcid.org/0000-0003-0286-2483
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