1887

Journal of Medical Microbiology logo

Volume 70, Issue 3

Co-infections of two carbapenemase-producing clinical strains isolated from the same diabetes individual in China Free

Abstract

Since was first reported in China, there have been ten variants of MCR appearing nationwide so far. Multidrug-resistant bacteria carrying both NDM and MCR have become a serious threat to global public health.

The genetic structure of needs to be better understood in order to better prevent and control the transmission of drug-resistant genes.

The aim of this study was to characterize the presence of two isolates, which carries CME2 and the coexistence of and strain CMD2, which were isolated from a patient with diabetes in Sichuan, China.

The microbroth dilution method was used for antibiotic susceptibility. Conjugation experiment was used to investigate the transferability of , and . Whole-genome sequencing was performed on Illumina HiSeq platform. The ability of biofilm formation was detected by crystal-violet staining, the virulence of the bacteria was measured by killing assay.

carrier CME2 and CMD2 with and were resistant to carbapenems, β-lactam, aminoglycoside, quinolone and tetracycline, while CMD2 was also resistant to colistin. Conjugation assay and plasmid replicon typing further demonstrated that both and were respectively present on the self-transferrable IncX3 plasmid, was located on the self-transferrable IncHI2 plasmid. Through the analysis of gene context, the structure was -IS-Δ-IS, context was IS-ΔIS-IS --ΔIS structure, structure was IS --ΔIS-IS. Biofilm formation of CME2 was stronger than CMD2. There was no significant difference in virulence between the two strains.

This study reveals two multiple drug-resistant isolates from diabetes patient samples. carrying two NDM-resistant genes is already a serious threat, where MCR is an important cause of treatment failure in bacterial infections. This study is a reminder not only to prevent infection in patients with diabetes, but also to constantly monitor the epidemic and spread of the drug-resistant gene.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): diabetes , Enterobacter hormaechei , mcr-9 and Whole-genome sequencing
Funding
This study was supported by the:
  • United Funds of Luzhou and Southwest Medical University (Award 2018LZXNYD-ZK51)
    • Principle Award Recipient: ManlinDing
  • the Application Technology Research and Development of Sichuan Science and Technology (Award 20YYJC0952)
    • Principle Award Recipient: NotApplicable
© 2021 The Authors
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001316
2021-02-02
2024-04-20
Loading full text...

Full text loading...

/deliver/fulltext/jmm/70/3/jmm001316.html?itemId=/content/journal/jmm/10.1099/jmm.0.001316&mimeType=html&fmt=ahah

References

  1. Lai C-C, Lee K, Xiao Y, Ahmad N, Veeraraghavan B et al. High burden of antimicrobial drug resistance in Asia. J Glob Antimicrob Resist 2014; 2:141–147 [View Article][PubMed]
     [Google Scholar]
  2. Kazmierczak KM, Rabine S, Hackel M, McLaughlin RE, Biedenbach DJ et al. Multiyear, multinational survey of the incidence and global distribution of metallo-β-lactamase-producing Enterobacteriaceae and Pseudomonas aeruginosa . Antimicrob Agents Chemother 2016; 60:1067–1078 [View Article][PubMed]
     [Google Scholar]
  3. Son SK, Lee NR, Ko J-H, Choi JK, Moon S-Y et al. Clinical effectiveness of carbapenems versus alternative antibiotics for treating ESBL-producing Enterobacteriaceae bacteraemia: a systematic review and meta-analysis. J Antimicrob Chemother 2018; 73:2631–2642 [View Article]
     [Google Scholar]
  4. Pitout JDD. Infections with extended-spectrum β-lactamase-producing Enterobacteriaceae . Drugs 2010; 70:313–333 [View Article]
     [Google Scholar]
  5. van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae . Virulence 2017; 8:460–469 [View Article][PubMed]
     [Google Scholar]
  6. Tängdén T, Giske CG. Global dissemination of extensively drug-resistant carbapenemase-producing Enterobacteriaceae: clinical perspectives on detection, treatment and infection control. J Intern Med 2015; 277:501–512 [View Article][PubMed]
     [Google Scholar]
  7. Kwa A, Kasiakou SK, Tam VH, Falagas ME. Polymyxin B: similarities to and differences from colistin (polymyxin E). Expert Rev Anti Infect Ther 2007; 5:811–821 [View Article][PubMed]
     [Google Scholar]
  8. Rodríguez-Baño J, Cisneros JM, Gudiol C, Martínez JA. Treatment of infections caused by carbapenemase-producing Enterobacteriaceae . Enferm Infecc Microbiol Clin 2014; 32 Suppl 4:49–55 [View Article][PubMed]
     [Google Scholar]
  9. van Duin D, Kaye KS, Neuner EA, Bonomo RA. Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes. Diagn Microbiol Infect Dis 2013; 75:115–120 [View Article][PubMed]
     [Google Scholar]
  10. Quan J, Li X, Chen Y, Jiang Y, Zhou Z et al. Prevalence of mcr-1 in Escherichia coli and Klebsiella pneumoniae recovered from bloodstream infections in China: a multicentre longitudinal study. Lancet Infect Dis 2017; 17:400–410 [View Article][PubMed]
     [Google Scholar]
  11. Bulman ZP, Chen L, Walsh TJ, Satlin MJ, Qian Y et al. Polymyxin combinations combat Escherichia coli harboring mcr-1 and bla NDM-5: preparation for a postantibiotic era. mBio 2017; 8:e00540–17 [View Article][PubMed]
     [Google Scholar]
  12. Shen Z, Hu Y, Sun Q, Hu F, Zhou H et al. Emerging carriage of NDM-5 and MCR-1 in Escherichia coli from healthy people in multiple regions in China: a cross sectional observational study. EClinicalMedicine 2018; 6:11–20 [View Article][PubMed]
     [Google Scholar]
  13. Wang X, Wang Y, Zhou Y, Li J, Yin W et al. Emergence of a novel mobile colistin resistance gene, mcr-8, in NDM-producing Klebsiella pneumoniae . Emerg Microbes Infect 2018; 7:1–9 [View Article]
     [Google Scholar]
  14. Anyanwu MU, Jaja IF, Nwobi OC. Occurrence and characteristics of mobile colistin resistance (mcr) gene-containing isolates from the environment: a review. Int J Environ Res Public Health 2020; 17:1028 [View Article][PubMed]
     [Google Scholar]
  15. Xu T, Zhang C, Ji Y, Song J, Liu Y et al. Identication of mcr-10 carried by self-transmissible plasmids and chromosome in Enterobacter roggenkampii strains isolated from hospital sewage water. Environmental Pollution 2020; 268:
     [Google Scholar]
  16. Liang Q, Yin Z, Zhao Y, Liang L, Feng J et al. Sequencing and comparative genomics analysis of the IncHI2 plasmids pT5282-mphA and p112298-catA and the IncHI5 plasmid pYNKP001-dfrA. Int J Antimicrob Agents 2017; 49:709–718 [View Article][PubMed]
     [Google Scholar]
  17. Borowiak M, Fischer J, Baumann B, Hammerl JA, Szabo I et al. Complete genome sequence of a VIM-1-producing Salmonella enterica subsp. enterica serovar infantis isolate derived from minced pork meat. Genome Announc 2018; 6:e00327-18 26 04 2018 [View Article][PubMed]
     [Google Scholar]
  18. Krishnaraju M, Kamatchi C, Jha AK, Devasena N, Vennila R et al. Complete sequencing of an IncX3 plasmid carrying blaNDM-5 allele reveals an early stage in the dissemination of the blaNDM gene. Indian J Med Microbiol 2015; 33:30–38 [View Article][PubMed]
     [Google Scholar]
  19. Lazarovitch T, Amity K, Coyle JR, Ackerman B, Tal-Jasper R et al. The complex epidemiology of carbapenem-resistant enterobacter infections: a multicenter descriptive analysis. Infect Control Hosp Epidemiol 2015; 36:1283–1291 [View Article][PubMed]
     [Google Scholar]
  20. Mouftah SF, Pál T, Darwish D, Ghazawi A, Villa L et al. Epidemic IncX3 plasmids spreading carbapenemase genes in the United Arab Emirates and worldwide. Infect Drug Resist 2019; 12:12 [View Article][PubMed]
     [Google Scholar]
  21. Kieffer N, Royer G, Decousser J-W, Bourrel A-S, Palmieri M et al. mcr-9, an inducible gene encoding an acquired phosphoethanolamine transferase in Escherichia coli, and its origin. Antimicrob Agents Chemother 2019; 63:e00965–19 [View Article][PubMed]
     [Google Scholar]
  22. Akajagbor DS, Wilson SL, Shere-Wolfe KD, Dakum P, Charurat ME et al. Higher incidence of acute kidney injury with intravenous colistimethate sodium compared with polymyxin B in critically ill patients at a tertiary care medical center. Clin Infect Dis 2013; 57:1300–1303 [View Article][PubMed]
     [Google Scholar]
  23. Breland EJ, Zhang EW, Bermudez T, Martinez CR, Hadjifrangiskou M. The histidine residue of QseC is required for canonical signaling between QseB and PmrB in uropathogenic Escherichia coli . J Bacteriol 2017; 199:JB.00060–17 [View Article][PubMed]
     [Google Scholar]
  24. Krishnaraju M, Kamatchi C, Jha AK, Devasena N, Vennila R et al. Complete sequencing of an IncX3 plasmid carrying blaNDM-5 allele reveals an early stage in the dissemination of the blaNDM gene; 2015; 3330–38
  25. Yuan Y, Li Y, Wang G, Li C, Chang Y-F et al. blaNDM-5 carried by a hypervirulent Klebsiella pneumoniae with sequence type 29. Antimicrob Resist Infect Control 2019; 8:1–9 [View Article]
     [Google Scholar]
  26. Qin S, Fu Y, Zhang Q, Qi H, Wen JG, Liu H-M et al. High incidence and endemic spread of NDM-1-positive Enterobacteriaceae in Henan Province, China. Antimicrob Agents Chemother 2014; 58:4275–4282 [View Article][PubMed]
     [Google Scholar]
  27. Zogaj X, Bokranz W, Nimtz M, Römling U. Production of cellulose and curli fimbriae by members of the family Enterobacteriaceae isolated from the human gastrointestinal tract. Infect Immun 2003; 71:4151–4158 [View Article][PubMed]
     [Google Scholar]
  28. Khalifa HO, Soliman AM, Ahmed AM, Shimamoto T, Shimamoto T. NDM-4- and NDM-5-producing Klebsiella pneumoniae coinfection in a 6-month-old infant. Antimicrob Agents Chemother 2016; 60:4416–4417 [View Article][PubMed]
     [Google Scholar]
  29. Paul D, Garg A, Bhattacharjee A. Occurrence of blaNDM-1 and blaNDM-5 in a Tertiary Referral Hospital of North India. Microb Drug Resist 2017; 23:815–821 [View Article][PubMed]
     [Google Scholar]
  30. Mezzatesta ML, Gona F, Stefani S. Enterobacter cloacae complex: clinical impact and emerging antibiotic resistance. Future Microbiol 2012; 7:887–902 [View Article][PubMed]
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001316
Loading
Co-infections of two carbapenemase-producing Enterobacter hormaechei clinical strains isolated from the same diabetes individual in China
J. Med. Microbiol. 70, 001316 (2021); https://doi.org/10.1099/jmm.0.001316
/content/journal/jmm/10.1099/jmm.0.001316
/content/journal/jmm/10.1099/jmm.0.001316
Loading

Data & Media loading...

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error