Coexistence of bla (NDM-5) and tet(X4) in international high-risk Escherichia coli clone ST648 of human origin in China.
Coexistence of bla (NDM-5) and tet(X4) in international high-risk Escherichia coli clone ST648 of human origin in China.
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DOI：
10.3389/fmicb.2022.1031688
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发表时间：
2022
影响因子：
5.2
通讯作者：
Jiao, Xiaoyang
中科院分区：
文献类型：
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作者：
Shafiq, Muhammad;Zeng, Mi;Permana, Budi;Bilal, Hazrat;Huang, Jinhu;Yao, Fen;Algammal, Abdelazeem Mohamed;Li, Xin;Yuan, Yumeng;Jiao, Xiaoyang
病原体的出现导致人们对替加环素、粘菌素和碳青霉烯类等最后手段的治疗产生耐药性，限制了治疗选择，并引发了人们对新“超级细菌”出现的担忧。本研究报告了首例 blaNDM-5 和 tet(X4) 共同携带对碳青霉烯和替加环素耐药的大肠杆菌，该大肠杆菌作为一名 94 岁患者尿路感染的病原体而恢复。大肠杆菌菌株 ECCL209 携带多种耐药基因 [即 blaTEM–1B、blaNDM–5、blaCMY–2、aadA22、florR、erm(B)、mph(A)、erm(42)、lnuG、qnrS1 和 sul2]，并对几乎所有临床使用的抗生素表现出耐药性。 MLST分析发现该菌株属于ST648，被认为是全球高风险大流行克隆。此外，还检测到多种质粒不相容类型，即IncHI1A、IncHI1B、IncFII、IncFIA、IncFIB、IncQ1、Col和IncX4。遗传分析显示 blaNDM-5 和 tet(X4) 基因位于两个具有多个复制子的杂交质粒上。建议进行持续监测研究来量化抗菌素耐药性并评估此类超级细菌在人类医疗保健环境中的传播情况。
The emergence of pathogens is conferring resistance to last-resort therapies such as tigecycline, colistin, and carbapenems, limiting the therapeutic options, and raising concerns about the emergence of new “superbugs.” This study reports the first incident of a blaNDM–5 and tet(X4) co-harboring Escherichia coli with resistance to carbapenem and tigecycline recovered as the causative agent of a urinary tract infection in a 94-year-old patient. The E. coli strain ECCL209 carries multiple resistance genes [i.e., blaTEM–1B, blaNDM–5, blaCMY–2, aadA22, florR, erm(B), mph(A), erm(42), lnuG, qnrS1, and sul2] and exhibits resistance to almost all clinically used antibiotics. MLST analysis found that the strain belongs to ST648, considered a worldwide high-risk pandemic clone. Moreover, multiple plasmid incompatibility types were detected, i.e., IncHI1A, IncHI1B, IncFII, IncFIA, IncFIB, IncQ1, Col, and IncX4. Genetic analysis revealed that blaNDM–5 and tet(X4) genes were localized on two hybrid plasmids with multiple replicons. Continuous monitoring studies are suggested to quantify the antimicrobial resistance and assess the dissemination of such superbugs into a human healthcare setting.
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