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Hatrongjit R, Wongsurawat T, Jenjaroenpun P, Chopjitt P, Boueroy P, Akeda Y, Okada K, Iida T, Hamada S, Kerdsin A. Genomic analysis of carbapenem- and colistin-resistant Klebsiella pneumoniae complex harbouring mcr-8 and mcr-9 from individuals in Thailand. Sci Rep 2024; 14:16836. [PMID: 39039157 PMCID: PMC11263567 DOI: 10.1038/s41598-024-67838-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024] Open
Abstract
The surge in mobile colistin-resistant genes (mcr) has become an increasing public health concern, especially in carbapenem-resistant Enterobacterales (CRE). Prospective surveillance was conducted to explore the genomic characteristics of clinical CRE isolates harbouring mcr in 2015-2020. In this study, we aimed to examine the genomic characteristics and phonotypes of mcr-8 and mcr-9 harbouring carbapenem-resistant K. pneumoniae complex (CRKpnC). Polymerase chain reaction test and genome analysis identified CRKpnC strain AMR20201034 as K. pneumoniae (CRKP) ST147 and strain AMR20200784 as K. quasipneumoniae (CRKQ) ST476, harbouring mcr-8 and mcr-9, respectively. CRKQ exhibited substitutions in chromosomal-mediated colistin resistance genes (pmrB, pmrC, ramA, and lpxM), while CRKP showed two substitutions in crrB, pmrB, pmrC, lpxM and lapB. Both species showed resistance to colistin, with minimal inhibitory concentrations of 8 µg/ml for mcr-8-carrying CRKP isolate and 32 µg/ml for mcr-9-carrying CRKQ isolate. In addition, CRKP harbouring mcr-8 carried blaNDM, while CRKQ harbouring mcr-9 carried blaIMP, conferring carbapenem resistance. Analysis of plasmid replicon types carrying mcr-8 and mcr-9 showed FIA-FII (96,575 bp) and FIB-HI1B (287,118 bp), respectively. In contrast with the plasmid carrying the carbapenemase genes, the CRKQ carried blaIMP-14 on an IncC plasmid, while the CRKP harboured blaNDM-1 on an FIB plasmid. This finding provides a comprehensive insight into another mcr-carrying CRE from patients in Thailand. The other antimicrobial-resistant genes in the CRKP were blaCTX-M-15, blaSHV-11, blaOXA-1, aac(6')-Ib-cr, aph(3')-VI, ARR-3, qnrS1, oqxA, oqxB, sul1, catB3, fosA, and qacE, while those detected in CRKQ were blaOKP-B-15, qnrA1, oqxA, oqxB, sul1, fosA, and qacE. This observation highlights the importance of strengthening official active surveillance efforts to detect, control, and prevent mcr-harbouring CRE and the need for rational drug use in all sectors.
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Affiliation(s)
- Rujirat Hatrongjit
- Department of General Sciences, Faculty of Science and Engineering, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Thidathip Wongsurawat
- Division of Bioinformatics and Data Management for Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Piroon Jenjaroenpun
- Division of Bioinformatics and Data Management for Research, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Peechanika Chopjitt
- Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Parichart Boueroy
- Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | | | - Kazuhisa Okada
- Japan-Thailand Research Collaboration Centre On Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Tetsuya Iida
- Japan-Thailand Research Collaboration Centre On Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Infection Metagenomics, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
- Department of Bacterial Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Shigeyuki Hamada
- Japan-Thailand Research Collaboration Centre On Emerging and Re-emerging Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Anusak Kerdsin
- Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand.
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Shahzad S, Willcox MDP, Rayamajhee B. A Review of Resistance to Polymyxins and Evolving Mobile Colistin Resistance Gene ( mcr) among Pathogens of Clinical Significance. Antibiotics (Basel) 2023; 12:1597. [PMID: 37998799 PMCID: PMC10668746 DOI: 10.3390/antibiotics12111597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/26/2023] [Accepted: 11/04/2023] [Indexed: 11/25/2023] Open
Abstract
The global rise in antibiotic resistance in bacteria poses a major challenge in treating infectious diseases. Polymyxins (e.g., polymyxin B and colistin) are last-resort antibiotics against resistant Gram-negative bacteria, but the effectiveness of polymyxins is decreasing due to widespread resistance among clinical isolates. The aim of this literature review was to decipher the evolving mechanisms of resistance to polymyxins among pathogens of clinical significance. We deciphered the molecular determinants of polymyxin resistance, including distinct intrinsic molecular pathways of resistance as well as evolutionary characteristics of mobile colistin resistance. Among clinical isolates, Acinetobacter stains represent a diversified evolution of resistance, with distinct molecular mechanisms of intrinsic resistance including naxD, lpxACD, and stkR gene deletion. On the other hand, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are usually resistant via the PhoP-PhoQ and PmrA-PmrB pathways. Molecular evolutionary analysis of mcr genes was undertaken to show relative relatedness across the ten main lineages. Understanding the molecular determinants of resistance to polymyxins may help develop suitable and effective methods for detecting polymyxin resistance determinants and the development of novel antimicrobial molecules.
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Affiliation(s)
- Shakeel Shahzad
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Mark D. P. Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia;
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Formenti N, Guarneri F, Bertasio C, Parisio G, Romeo C, Scali F, Birbes L, Boniotti MB, Diegoli G, Candela L, Romeo GA, Pasquali P, Alborali GL. Wastewater-based surveillance in Italy leading to the first detection of mcr-10-positive Klebsiella quasipneumoniae. Antimicrob Resist Infect Control 2022; 11:155. [PMID: 36494741 PMCID: PMC9734789 DOI: 10.1186/s13756-022-01194-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
Wastewater-based surveillance enabled the first detection of the mobile colistin resistance gene mcr-10 in Italy. This plasmid-borne resistance gene was found in strains of Klebsiella quasipneumoniae isolated from samples of human raw sewage collected over several months. Although the isolates were phenotypically susceptible to colistin, the emergence of mcr-10 is concerning due to the highly variable expression of the gene and the potential for horizontal transfer to other species. In addition, the strains also carried an extended-spectrum β-lactamase gene and were phenotypically resistant to several beta-lactams. This study highlights the value of wastewater-based surveillance as an effective tool to monitor the emergence of antimicrobial resistance in strains circulating in the community and the environment.
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Affiliation(s)
- Nicoletta Formenti
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Flavia Guarneri
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Cristina Bertasio
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Giovanni Parisio
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Claudia Romeo
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Federico Scali
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Laura Birbes
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Maria Beatrice Boniotti
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
| | - Giuseppe Diegoli
- Regione Emilia Romagna - Settore Prevenzione Collettiva e Sanità Pubblica, Bologna, Italy
| | - Loredana Candela
- grid.415788.70000 0004 1756 9674Ministero della Salute - Direzione Generale della Sanità Animale e dei Farmaci Veterinari, Rome, Italy
| | - Gianluca Antonio Romeo
- grid.415788.70000 0004 1756 9674Ministero della Salute - Direzione Generale della Sanità Animale e dei Farmaci Veterinari, Rome, Italy ,grid.419578.60000 0004 1805 1770Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise “G. Caporale”, Teramo, Italy
| | - Paolo Pasquali
- grid.416651.10000 0000 9120 6856Istituto Superiore di Sanità - Dipartimento di Sicurezza Alimentare, Nutrizione e Sanità Pubblica Veterinaria, Rome, Italy
| | - Giovanni Loris Alborali
- grid.419583.20000 0004 1757 1598Istituto Zooprofilattico Sperimentale Della Lombardia e dell’Emilia Romagna “Bruno Ubertini”, Brescia, Italy
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