Whole-Genome Sequencing Identifies In Vivo Acquisition of a blaCTX-M-27-Carrying IncFII Transmissible Plasmid as the Cause of Ceftriaxone Treatment Failure for an Invasive Salmonella enterica Serovar Typhimurium Infection
Whole-Genome Sequencing Identifies In Vivo Acquisition of a blaCTX-M-27-Carrying IncFII Transmissible Plasmid as the Cause of Ceftriaxone Treatment Failure for an Invasive Salmonella enterica Serovar Typhimurium Infection
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DOI：
10.1128/aac.01649-16
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发表时间：
2016-12-01
影响因子：
4.9
通讯作者：
Jobling, Michael G.
中科院分区：
文献类型：
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作者：
McCollister, Bruce;Kotter, Cassandra V.;Jobling, Michael G.
我们报告一例头孢曲松治疗失败的菌血症所造成的沙门氏菌肠亚种。肠道血清型鼠伤寒沙门氏菌，由于体内获得bla（CTX-M-27）编码的IncFII组可传递质粒。在头孢曲松治疗期间，原始β-内酰胺酶敏感分离株ST 882 S被耐药分离株ST 931 R取代。复发后，改为环丙沙星治疗，患者痊愈。菌株ST 931R在37 ℃下可将抗性传递给大肠杆菌。我们利用ST882S和ST931R的全基因组测序，对E.大肠杆菌转接合子，并分离质粒DNA，明确表明ST 882 S和ST 931 R具有相同的染色体，都具有206个相同的单核苷酸多态性（SNP）相对于S。鼠伤寒14028s。我们为ST931R组装了一个完整的环状基因组，ST882S读段与之映射，没有SNP。ST 882 S和ST 931 R是等基因的，除了在ST 931 R中存在三个额外的质粒。ST931R和E.由于存在60.5-kb的IS26侧翼的bla（CTX-M-27）编码IncFII质粒，与14082s相比，ST931R具有几乎相同的Giffsy-1，Giffsy-2和ST64B前噬菌体，缺乏Giffsy-3，而是携带与LT 2中发现的相关的独特的Fels-2前噬菌体。ST 882 S和ST 931 R均具有与pSLT 14028 s具有> 99%同一性的94-kb毒力质粒和隐蔽的3，904-bp复制子; ST 931 R还具有隐蔽的93-kb IncI 1和62-kb IncI 2组质粒。据我们所知，在体内获得超广谱β-内酰胺酶耐药的S。美国沙门氏菌分离株中的鼠伤寒沙门氏菌和bla（CTX-M-27）基因此前尚未报道。
We report a case of ceftriaxone treatment failure for bacteremia caused by Salmonella enterica subsp. enterica serovar Typhimurium, due to the in vivo acquisition of a bla(CTX-M-27)-encoding IncFII group transmissible plasmid. The original beta-lactamasesusceptible isolate ST882S was replaced by the resistant isolate ST931R during ceftriaxone treatment. After relapse, treatment was changed to ciprofloxacin, and the patient recovered. Isolate ST931R could transfer resistance to Escherichia coli at 37 degrees C. We used whole-genome sequencing of ST882S and ST931R, the E. coli transconjugant, and isolated plasmid DNA to unequivocally show that ST882S and ST931R had identical chromosomes, both having 206 identical single-nucleotide polymorphisms (SNPs) versus S. Typhimurium 14028s. We assembled a complete circular genome for ST931R, to which ST882S reads mapped with no SNPs. ST882S and ST931R were isogenic except for the presence of three additional plasmids in ST931R. ST931R and the E. coli transconjugant were ceftriaxone resistant due to the presence of a 60.5-kb IS26-flanked, bla(CTX-M-27)-encoding IncFII plasmid. Compared to 14082s, ST931R has almost identical Gifsy-1, Gifsy-2, and ST64B prophages, lacks Gifsy-3, and instead carries a unique Fels-2 prophage related to that found in LT2. ST882S and ST931R both had a 94-kb virulence plasmid showing > 99% identity with pSLT14028s and a cryptic 3,904-bp replicon; ST931R also has cryptic 93-kb IncI1 and 62-kb IncI2 group plasmids. To the best of our knowledge, in vivo acquisition of extended-spectrum beta-lactamase resistance by S. Typhimurium and bla(CTX-M-27) genes in U.S. isolates of Salmonella have not previously been reported.