High frequency of virulence genes among Escherichia coli with the bla CTX-M genotype from diarrheic piglets in China

Genetic diversity and virulence gene profiles of Escherichia coli from diarrhoeal rabbits in Sichuan Province, China

Escherichia coli (E. coli) can cause diarrhoea in a wide range of hosts. Moreover, some trains with high virulence and drug resistance pose a serious threat to public health and livestock products. Diarrhoea caused by E. coli outbreaks in rabbitries result in serious economic losses. The aim of this study was to investigate the distribution of virulence genes and molecular genetic characteristics of E. coli from diarrhoeal rabbits in the main rearing areas of Sichuan province, China in 2015-2017. In total, 39 E. coli isolates were identified and undivided divided into 17 sequence types by multilocus sequence typing (MLST) and grouped in 22 clusters by pulsed-field gel electrophoresis. Polymerase chain reaction tests detected 6 virulence genes: eae (41.0%), ler (41.0%), ral (33.3%), afr2 (10.3%), irp2 (15.4%) and astA (7.7%) of the tested 17 virulence genes identifying 16 enteropathogenic E. coli (EPEC) isolates. The main sequence types U328, ST328 and ST20 carried rabbit EPEC associated virulence genes (eae, ler, ral and afr2). The results showed that the distribution of virulence genes varied by year and area; genotype had major types in local rearing areas but was of high diversity in Sichuan province.

Epidemiology of blaCTX-M-Positive Salmonella Typhimurium From Diarrhoeal Outpatients in Guangdong, China, 2010–2017

Salmonella enterica can lead to intestinal diarrhea, and the emergence and spread of cephalosporin-resistant Salmonella have brought great challenges to clinical treatment. Therefore, this study investigated the prevalence and transmission of bla_CTX-M genes among S. Typhimurium from diarrhoeal outpatients in Guangdong, China, from 2010 to 2017. A total of 221 bla_CTX-M-positive isolates were recovered from 1,263 S. Typhimurium isolates from the facal samples of diarrhoea patients in 45 general hospitals from 11 cities. The most popular CTX-M gene was bla_CTX-M-55 (39.6%, 72/182) in the CTX-M-1 group, followed by bla_CTX-M-14 (22.5%, 41/182) and bla_CTX-M-65 (19.2%, 35/182) in the CTX-M-9 group. The isolates that carried bla_CTX-M-9G had significantly higher resistance rates to multiple antibacterials compared with bla_CTX-M-1G (p < 0.01). Meanwhile, PFGE analysis not only showed the clonal transmission of bla_{CTX-M-55/14/65}-positve isolates of diarrhoeal outpatients’ origins from different hospitals in Guangdong province, but also the characteristic of bla_{CTX-M-55/14/65}-positve isolates’ bacterial persistence. Multilocus sequence typing (MLST) analysis indicated that these S. Typhimurium isolates possessed ST34 and ST19. Furthermore, genomic Beast phylogenomic analysis provided the evidence of a close relationship of bla_CTX-M-positive S. Typhimurium isolates between the outpatients and pork. Most bla_{CTX-M-55/14/65} genes were transmitted by non-typeable or IncI1/IncFII/IncHI2 plasmids with the size of ranging from ~80 to ~280 kb. Moreover, whole-genome sequencing (WGS) analysis further revealed that bla_{CTX-M-55/14/65} coexisted with other 25 types of ARGs, of which 11 ARGs were highly prevalent with the detection rates >50%, and it first reported the emergence of bla_TEM-141 in S. Typhimurium. This study underscores the importance of surveillance for bla_CTX-M-positive microbes in diarrhea patients.

Clinical Characteristics of Patients and Whole Genome Sequencing-Based Surveillance of Escherichia coli Community-Onset Bloodstream Infections at a Non-tertiary Hospital in CHINA

Background:Escherichia coli is the most common pathogens in patients with community-onset blood stream infections (COBSI). Knowledge of the epidemiology of this disease is crucial to improve allocation of health resources, formulate isolation strategies that prevent transmission, and guide empirical antibiotic therapy.

Methods: This retrospective observational study examined patients with E. coli COBSI (EC-COBSI) at a non-tertiary hospital in China. Whole-genome sequencing and analysis of the isolates was performed. The relationships of clinical variables with antimicrobial resistance and the genetic background of the isolates were examined.

Results: There were 148 isolates in patients with EC-COBSI. All isolates were susceptible to ceftazidime/avibactam, carbapenems, and tigecycline; 35.1% were positive for extended spectrum β-lactamase (ESBL+); and bla_CTX–M–14 was the most common ESBL gene. Patients with ESBL- isolates were more likely to receive appropriate empiric treatment than those with ESBL+ isolates (61.5% vs. 91.4%, p < 0.001), but these two groups had similar mortality rates. The overall 30-day mortality rate was 9.5%. Phylogenetic analysis showed that the isolates were diverse, and that the main sequence types (STs) were ST95, ST131, and ST69. Intra-abdominal infection was the primary source of disease, and isolates from these patients had lower frequencies of virulence genes.

Conclusion: The mortality rate of patients with EC-COBSI was unrelated to ESBL status of the isolates. Most isolates had low resistance to most of the tested antimicrobial agents. The isolates were diverse, and multiple strains were related. Prevention and control of EC-COBSI should target prevention of patient colonization and the living environment.

High prevalence of multidrug-resistant Escherichia coli and first detection of IncHI2/IncX4-plasmid carrying mcr-1 E. coli in retail ready-to-eat foods in China

Antibiotic-resistant bacteria in food pose an important threat to public health. Multidrug-resistant strains in ready-to-eat (RTE) foods can be transferred to humans through diet, which increases their health risk. This study systematically investigated antibiotic resistance and antibiotic resistance genes in E. coli isolated from retail RTE foods and characterized plasmid-mediated colistin-resistant E. coli strains. A total of 1118 RTE food samples were collected from markets in 39 cities in China, and 126 E. coli strains, >95% of which were multidrug-resistant, were isolated. The isolates showed a high prevalence of resistance to tetracycline (95.24%), ampicillin (82.54%), trimethoprim-sulfamethoxazole (77.78%), nalidixic acid (74.60%), cephalothin (72.22%), chloramphenicol (66.67%), and streptomycin (53.97%). Twenty-two extended-spectrum β-lactamase (ESBL)-producing E. coli and four colistin-resistant E. coli were identified. The resistance genes TEM, CTX-M, tetA, sul2, strA/strB, aadA, and qnrS were the most frequently detected. CTX-M-55 and CTX-M-14 were the predominant CTX-M types. All the four colistin-resistant E. coli isolates were positive for mcr-1. The mcr-1 gene can be transferred to E. coli C600 through conjugation and transformation. Whole-genome sequencing revealed that the mcr-1 genes were found in IncX4 and IncHI2 plasmids. To the best of our knowledge, this is the first report of IncHI2/IncX4 plasmid-bearing mcr-1-positive E. coli strains in RTE foods sold in markets, and the first report of the isolation of the international epidemic E. coli clone ST101 and mcr-1-carrying ESBL-producing E. coli from RTE foods. These results provide valuable information for assessing antibiotic-resistant E. coli infections and controlling antibiotic-resistant E. coli.

Occurrence and Antimicrobial Profile of Bacterial Pathogens in Former Foodstuff Meat Products Used for Pet Diets

European legislation stipulates that food no longer intended for human consumption, due to commercial reasons, manufacturing problems, or some defect, can be used in pet feed. However, the presence of former foodstuffs in pet diets could constitute a public health issue because pets can act as reservoirs of antimicrobial resistance genes. In this study, for the first time, biological hazards due to the presence of Escherichia coli and Salmonella in former foodstuff meat products were evaluated. Among the 112 samples of packaged fresh meat (poultry, pork, and beef) collected from cold storage warehouses of a mass market retailer, the overall prevalence of E. coli and Salmonella, the prevalence of strains with multidrug resistance, the phenotypic and genotypic characteristics of strains that produce extended-spectrum β-lactamase, and the presence of biofilm producers were assessed. A high prevalence of E. coli was observed in former foodstuffs of poultry (100%), pork (100%), and beef (93.3%). Salmonella Derby and Salmonella Typhimurium were found in 11.5% of the poultry samples, and Salmonella Typhimurium was found in 13.3% of the pork samples. Salmonella was not recovered from the beef samples. Multidrug resistance was found in E. coli and Salmonella isolates from poultry, pork, and beef. Overall, 18.2% of E. coli isolates and 20% of Salmonella isolates were resistant to various types of antibiotics with various mechanisms of action. Salmonella isolates from pork are an important source of extended-spectrum β-lactamase production. Both E. coli and Salmonella were carriers of antibiotic resistance marker genes ( bla_TEM, bla_SHV, and bla_CTX-M) associated with β-lactamase production in poultry and pork. Approximately 30% of the E. coli isolates from the various types of meat were phenotypically biofilm producers, and all carried the fimH gene. These findings indicate that the use of former foodstuff meat products in pet diets can represent a risk for public health.

Prevalence and Molecular Characteristics of Extended-Spectrum β-Lactamase Genes in Escherichia coli Isolated from Diarrheic Patients in China

Background: The emergence and spread of antimicrobial resistance has become a major global public health concern. A component element of this is the spread of the plasmid-encoded extended-spectrum b-lactamase (ESBL) genes, conferring resistance to third-generation cephalosporins. The purpose of this study was to investigate the molecular characteristics of ESBL-encoding genes identified in Escherichia coli cultured from diarrheic patients in China from 2013 to 2014.

Materials and Methods: A total of 51 E. coli were confirmed as ESBL producers by double-disk synergy testing of 912 E. coli isolates studied. Polymerase chain reaction (PCR) and DNA sequencing were performed to identify the corresponding ESBL genes. Susceptibility testing was tested by the disk diffusion method. Plasmids were typed by PCR-based replicon typing and their sizes were determined by S1-nuclease pulsed-field gel electrophoresis. Multi-locus sequence typing (MLST) and phylogrouping were also performed. Broth mating assays were carried out for all isolates to determine whether the ESBL marker could be transferred by conjugation.

Results: Of the 51 ESBL-positive isolates identified, bla_CTX-M, bla_TEM, bla_OXA, and bla_SHV were detected in 51, 26, 3, 1 of these isolates, respectively. Sequencing revealed that 7 bla_CTX-M subtypes were detected, with bla_CTX-M-14 being the most common, followed by bla_CTX-M-79 and bla_CTX-M-28. Of the 26 TEM-positive isolates identified, all of these were bla_TEM-1 genotypes. All isolates contained one to three large plasmids and 10 replicon types were detected. Of these, IncFrep (n = 50), IncK/B (n = 31), IncFIB (n = 26), IncB/O (n = 14), and IncI1-Ir (n = 8) replicon types were the predominating incompatibility groups. Twenty-six isolates demonstrated the ability to transfer their cefotaxime resistance marker at high transfer rates. MLST typing identified 31 sequence types and phylogenetic grouping showed that 12 of the 51 donor strains belonged to phylogroup B2.

Conclusion: This study highlights the diversity of the ESBL producing E. coli and also the diversity of ESBL genes and plasmids carrying these genes in China, which poses a threat to public health.

Rapid determination of bacterial aminoglycoside resistance in environmental samples using membrane electrospray ionization mass spectrometry

RATIONALE

Antibiotic resistance in pathogenic bacteria is becoming a global public health problem, such as aminoglycoside resistance encoded by the armA gene. Although many methods have been reported, rapid analysis of environmental samples is still challenging.

METHOD

A rapid analytical method was developed in this study to determine bacterial aminoglycoside resistance using membrane electrospray ionization mass spectrometry (MESI-MS). Precursor/product-ion pairs of ArmA unique peptides were detected with minimal sample preparation. Standard peptides were synthesized and used for developing and validating the methodology, and then the method was verified by both ArmA positive and ArmA negative simulated environmental samples.

RESULTS

A rapid method for determination of bacterial aminoglycoside resistance was developed using MESI-MS/MS. The bacterial cultural time was optimized to 2 hours, and the precision, accuracy and recovery of this method were investigated. The peptide IHSSTNER (IR-8) unique to ArmA in simulated environmental samples can be successfully identified within 3 hours.

CONCLUSIONS

The novel assay offered a rapid method to determine bacterial aminoglycoside resistance with high sensitivity, accuracy and precision in simulated environmental samples. This method could also be applied to identify other drug-resistance proteins in clinical/environmental samples. Copyright © 2016 John Wiley & Sons, Ltd.

Persistent spread of the rmtB 16S rRNA methyltransferase gene among Escherichia coli isolates from diseased food-producing animals in China

A total of 963 non-duplicate Escherichia coli strains isolated from food-producing animals between 2002 and 2012 were screened for the presence of the 16S rRNA methyltransferase genes. Among the positive isolates, resistance determinants to extended spectrum β-lactamases, plasmid-mediated quinolone resistance genes as well as floR and fosA/A3/C2 were detected using PCR analysis. These isolates were further subjected to antimicrobial susceptibility testing, molecular typing, PCR-based plasmid replicon typing and plasmid analysis. Of the 963 E. coli isolates, 173 (18.0%), 3 (0.3%) and 2 (0.2%) were rmtB-, armA- and rmtE-positive strains, respectively. All the 16S rRNA methyltransferase gene-positive isolates were multidrug resistant and over 90% of them carried one or more type of resistance gene. IncF (especially IncFII) and non-typeable plasmids played the main role in the dissemination of rmtB, followed by the IncN plasmids. Plasmids that harbored rmtB ranged in size from 20kb to 340kb EcoRI-RFLP testing of the 109 rmtB-positive plasmids from different years and different origins suggested that horizontal (among diverse animals) and vertical transfer of IncF, non-typeable and IncN-type plasmids were responsible for the spread of rmtB gene. In summary, our findings highlight that rmtB was the most prevalent 16S rRNA methyltransferase gene, which present persistent spread in food-producing animals in China and a diverse group of plasmids was responsible for rmtB dissemination.