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방광암환자에서 방광내 BCG 주입요법 후 발생한 ESBL양성 E.coli감염에서 B-lactamase 유전자의 특성 |
| CHA의과학대학교 분당차병원, 비뇨의학교실 |
| 유영동*, 오태훈, 백종현, 김태진, 김태헌, 이승렬, 홍영권, 박동수 |
Aim: This study evaluated the phenotypic/genotypic characteristics and antibiotics susceptibility of Extended-spectrum β-lactamase (ESBL) producing Escherichia coli (E.coli) isolated from bladder cancer (BC) patients and non-bladder-cancer (NBC) patients.
Methods: From November 2018 to March 2020, urine samples were collected from total of 40 patients (20 BC patients / 20 NBC patients) who were confirmed with ESBL positive E.coli infection by the Double Disk Diffusion Synergy Test (DDST). ESBL isolates were further analyzed for sequencing of β-lactamase genes and antibiotic susceptibility.
Results: All BC patients had T1 stage and 90% of them underwent TUR-BT only once. The mean time from BCG instillation to ESBL positive E.coli infection was 3.8weeks for BC group. PCR analysis for β-lactamase gene showed the greatest prevalence with blaCTX-M-TEM-SHV (40%) and blaCTX-M (35%) among BC and NBC groups, respectively. B2 type was the most frequent phylogenetic type in both groups (BC: 75%, NBC 100%). 2 cases of BC group had severe gross hmeaturia, which required blood transfusion while no transfusion was required among NBC group. All E.coli isoltates were sensitive to ertapenem. NBC group had significantly higher susceptibility (80%) with amikacin than BC group (40%). BC group had higher rates of biofilm formation than NBC group. 3 patients of BC group had tuberculous epididymitis whereas only these 3 cases were classified as phylogenetic type A.
Conclusions: blaCTX-M-TEM-SHV was the most frequent ESBL genotype in BC groups. phylogenetic type A E.coli might be associated with gross hematruia among BC patients. |
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keywords : Extended-spectrum β-lactamase, E.coli, bladder cancer |
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