1887

Abstract

Members of the genus are facultative anaerobic Gram-negative bacilli belonging to the [Janda 1994; 32(8):1850–1854; Arens 1997;3(1):53–57]. Formerly, were occasionally reported as nosocomial pathogens with low virulence [Pepperell 2002;46(11):3555–60]. Now, they are consistently reported to cause nosocomial infections of the urinary tract, respiratory tract, bone, peritoneum, endocardium, meninges, intestines, bloodstream and central nervous system. Among species, the most common isolates are and , while has seldom been isolated [Janda 1994; 32(8):1850–1854; Marak 2017;49(7):532–9]. Further, spp. are usually susceptible to carbapenems, aminoglycosides, tetracyclines and colistin [Marak 2017;49(7):532–9].

As is rare, only one clinical isolate, coharbouring carbapenem resistance gene and quinolone resistance gene , has been reported.

To characterize a carbapenem-resistant strain from PR China coharbouring and .

Three hundred and forty nonrepetitive carbapenem-resistant (CRE) strains were collected during 2011–2018. A carbapenem-resistant strain was detected and confirmed using a VITEK mass spectrometry-based microbial identification system and 16S rRNA sequencing. Minimum inhibitory concentrations (MICs) for clinical antimicrobials were obtained by the broth microdilution method. Whole-genome sequencing (WGS) was performed for antibiotic resistance gene analysis, and a phylogenetic tree of strains was constructed using the Bacterial Pan Genome Analysis (BPGA) tool. The transferability of the resistance plasmid was verified by conjugal transfer.

A rare carbapenem-resistant strain (CA71) was recovered from a patient with cerebral obstruction and the sequences of 16S rRNA gene shared more than 99 % similarity with CITRO86, FDAARGOS 165. CA71 is resistant to β-lactam, quinolone and aminoglycoside antibiotics, and even imipenem and meropenem (MICs of 2 and 4 mg l respectively), and is only sensitive to polymyxin B and tigecycline. Six antibiotic resistance genes were detected via WGS, including the β-lactam genes , and , the quinolone gene , and the aminoglycoside genes . Interestingly, and coexist on an IncN1-type plasmid (pCA71-IMP) and successfully transferred to J53 via conjugal transfer. Phylogenetic analysis showed that CA71 is most similar to strain CJ25 and belongs to the same evolutionary cluster along with seven other strains.

To the best of our knowledge, this is the first report of a carbapenem-resistant isolate coharbouring and .

Funding
This study was supported by the:
  • Technology Planning Project for Medicine and Healthcare of Zhejiang Province (Award 2021KY1237)
    • Principle Award Recipient: ZhigangZhao
  • the Major Research and Development Project of Lishui City of China (Award 2020ZDYF11)
    • Principle Award Recipient: ZhigangZhao
  • the Major Research and Development Project of Lishui City of China (Award 2017ZDYF13)
    • Principle Award Recipient: JianshengHuang
  • National Natural Science Foundation of China (Award 81802044)
    • Principle Award Recipient: JianshengHuang
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2021-06-25
2021-07-29
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