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Brenciani A, Cinthi M, Coccitto SN, Massacci FR, Albini E, Cucco L, Paniccià M, Freitas AR, Schwarz S, Giovanetti E, Magistrali CF. Global spread of the linezolid-resistant Enterococcus faecalis ST476 clonal lineage carrying optrA. J Antimicrob Chemother 2024; 79:846-850. [PMID: 38366373 DOI: 10.1093/jac/dkae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/30/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVES To investigate the global distribution of an optrA-harbouring linezolid-resistant Enterococcus faecalis ST476 clonal lineage. METHODS Comprehensive searches of the NCBI database were performed to identify published peer-reviewed articles and genomes of E. faecalis ST476. Each genome was analysed for resistome, virulome, OptrA variant and optrA genetic contexts. A phylogenetic comparison of ST476 genomes with publicly available genomes of other STs was also performed. RESULTS Sixty-six E. faecalis ST476 isolates from 15 countries (China, Japan, South Korea, Austria, Denmark, Spain, Czech Republic, Colombia, Tunisia, Italy, Malaysia, Belgium, Germany, United Arab Emirates and Switzerland) mainly of human and animal origin were identified. Thirty available ST476 genomes compared with genomes of 591 STs indicated a progressive radiation of E. faecalis STs starting from ST21. The closest ancestral node for ST476 was ST1238. Thirty E. faecalis ST476 genomes exhibited 3-916 SNP differences. Several antimicrobial resistance and virulence genes were conserved among the ST476 genomes. The optrA genetic context exhibited a high degree of or complete identity to the chromosomal transposon Tn6674. Only three isolates displayed an optrA-carrying plasmid with complete or partial Tn6674. The WT OptrA protein was most widespread in the ST476 lineage. CONCLUSIONS Linezolid-resistant optrA-carrying E. faecalis of the clonal lineage ST476 is globally distributed in human, animal and environmental settings. The presence of such an emerging clone can be of great concern for public health. Thus, a One Health approach is needed to counteract the spread and the evolution of this enterococcal clonal lineage.
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Affiliation(s)
- Andrea Brenciani
- Department of Biomedical Sciences and Public Health, Unit of Microbiology, Polytechnic University of Marche Medical School, Ancona, Italy
| | - Marzia Cinthi
- Department of Life and Environmental Sciences, Unit of Microbiology, Polytechnic University of Marche, Ancona, Italy
| | - Sonia Nina Coccitto
- Department of Biomedical Sciences and Public Health, Unit of Microbiology, Polytechnic University of Marche Medical School, Ancona, Italy
| | - Francesca Romana Massacci
- Department of Research and Development, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche 'Togo Rosati', Perugia, Italy
| | - Elisa Albini
- Department of Research and Development, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche 'Togo Rosati', Perugia, Italy
| | - Lucilla Cucco
- Department of Research and Development, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche 'Togo Rosati', Perugia, Italy
| | - Marta Paniccià
- Department of Research and Development, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche 'Togo Rosati', Perugia, Italy
| | - Ana R Freitas
- UCIBIO, Departamento de Ciências Biológicas, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
- Associate Laboratory i4HB, Faculty of Pharmacy, Institute for Health and Bioeconomy, University of Porto, Porto, Portugal
- 1H-TOXRUN-One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra 4585-116, Portugal
| | - Stefan Schwarz
- Institute of Microbiology and Epizootics, Centre for Infection Medicine, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Key Laboratory of Animal Antimicrobial Resistance Surveillance, MARA, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Eleonora Giovanetti
- Department of Life and Environmental Sciences, Unit of Microbiology, Polytechnic University of Marche, Ancona, Italy
| | - Chiara Francesca Magistrali
- Department of Research and Development, Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche 'Togo Rosati', Perugia, Italy
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Liu P, Zeng B, Wu X, Zheng F, Zhang Y, Liao X. Risk exploration and prediction model construction for linezolid-resistant Enterococcus faecalis based on big data in a province in southern China. Eur J Clin Microbiol Infect Dis 2024; 43:259-268. [PMID: 38032514 PMCID: PMC10821975 DOI: 10.1007/s10096-023-04717-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Enterococcus faecalis is a common cause of healthcare-associated infections. Its resistance to linezolid, the antibiotic of last resort for vancomycin-resistant enterococci, has become a growing threat in healthcare settings. METHODS We analyzed the data of E. faecalis isolates from 26 medical institutions between 2018 and 2020 and performed univariate and multivariate logistic regression analyses to determine the independent predictors for linezolid-resistant E. faecalis (LREFs). Then, we used the artificial neural network (ANN) and logistic regression (LR) to build a prediction model for linezolid resistance and performed a performance evaluation and comparison. RESULTS Of 12,089 E. faecalis strains, 755 (6.25%) were resistant to linezolid. Among vancomycin-resistant E. faecalis, the linezolid-resistant rate was 24.44%, higher than that of vancomycin-susceptible E. faecalis (p < 0.0001). Univariate and multivariate regression analyses showed that gender, age, specimen type, length of stay before culture, season, region, GDP (gross domestic product), number of beds, and hospital level were predictors of linezolid resistance. Both the ANN and LR models constructed in the study performed well in predicting linezolid resistance in E. faecalis, with AUCs of 0.754 and 0.741 in the validation set, respectively. However, synthetic minority oversampling technique (SMOTE) did not improve the prediction ability of the models. CONCLUSION E. faecalis linezolid-resistant rates varied by specimen site, geographic region, GDP level, facility level, and the number of beds. At the same time, community-acquired E. faecalis with linezolid resistance should be monitored closely. We can use the prediction model to guide clinical medication and take timely prevention and control measures.
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Affiliation(s)
- Peijun Liu
- Administration Department of Nosocomial Infection, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Bangwei Zeng
- Administration Department of Nosocomial Infection, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China.
| | - Xiaoyan Wu
- Administration Department of Nosocomial Infection, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Feng Zheng
- Information Department, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Yangmei Zhang
- Administration Department of Nosocomial Infection, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
| | - Xiaohua Liao
- Administration Department of Nosocomial Infection, Fujian Medical University Union Hospital, Fuzhou, 350001, Fujian Province, China
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Ha HTA, Nguyen PTL, Hung TTM, Tuan LA, Thuy BT, Lien THM, Thai PD, Thanh NH, Bich VTN, Anh TH, Hanh NTH, Minh NT, Thanh DP, Mai SNT, The HC, Trung NV, Thu NH, Duong TN, Anh DD, Ngoc PT, Bañuls AL, Choisy M, van Doorn HR, Suzuki M, Hoang TH. Prevalence and Associated Factors of optrA-Positive- Enterococcus faecalis in Different Reservoirs around Farms in Vietnam. Antibiotics (Basel) 2023; 12:954. [PMID: 37370273 PMCID: PMC10294904 DOI: 10.3390/antibiotics12060954] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Linezolid is an antibiotic of last resort for the treatment of infections caused by Gram-positive bacteria, including vancomycin-resistant enterococci. Enterococcus faecalis, a member of enterococci, is a significant pathogen in nosocomial infections. E. faecalis resistance to linezolid is frequently related to the presence of optrA, which is often co-carried with fex, phenicol exporter genes, and erm genes encoding macrolide resistance. Therefore, the common use of antibiotics in veterinary might promote the occurrence of optrA in livestock settings. This is a cross-sectional study aiming to investigate the prevalence of optrA positive E. faecalis (OPEfs) in 6 reservoirs in farms in Ha Nam province, Vietnam, and its associated factors and to explore genetic relationships of OPEfs isolates. Among 639 collected samples, the prevalence of OPEfs was highest in flies, 46.8% (51/109), followed by chickens 37.3% (72/193), dogs 33.3% (17/51), humans 18.7% (26/139), wastewater 16.4% (11/67) and pigs 11.3%, (14/80). The total feeding area and total livestock unit of the farm were associated with the presence of OPEfs in chickens, flies, and wastewater. Among 186 OPEfs strains, 86% were resistant to linezolid. The presence of optrA was also related to the resistant phenotype against linezolid and levofloxacin of E. faecalis isolates. Close genotypic relationships identified by Pulsed Field Gel Electrophoresis between OPEfs isolates recovered from flies and other reservoirs including chickens, pigs, dogs, and wastewater suggested the role of flies in the transmission of antibiotic-resistant pathogens. These results provided warnings of linezolid resistance although it is not used in livestock.
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Affiliation(s)
- Hoang Thi An Ha
- Hanoi Medical University, Hanoi 100000, Vietnam; (H.T.A.H.); (T.H.A.)
- Department of Microbiology, Vinh Medical University, Vinh 431000, Vietnam
| | - Phuong Thi Lan Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Tran Thi Mai Hung
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Le Anh Tuan
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Bui Thanh Thuy
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Tran Hoang My Lien
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Pham Duy Thai
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Nguyen Ha Thanh
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Vu Thi Ngoc Bich
- Oxford University Clinical Research Unit, Hanoi 100000, Vietnam; (V.T.N.B.); (H.R.v.D.)
| | - Tran Hai Anh
- Hanoi Medical University, Hanoi 100000, Vietnam; (H.T.A.H.); (T.H.A.)
| | - Ngo Thi Hong Hanh
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Nguyen Thi Minh
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Duy Pham Thanh
- Oxford University Clinical Research Unit, Ho Chi Minh City 700000, Vietnam; (D.P.T.); (S.-N.T.M.); (H.C.T.)
| | - Si-Nguyen T. Mai
- Oxford University Clinical Research Unit, Ho Chi Minh City 700000, Vietnam; (D.P.T.); (S.-N.T.M.); (H.C.T.)
| | - Hao Chung The
- Oxford University Clinical Research Unit, Ho Chi Minh City 700000, Vietnam; (D.P.T.); (S.-N.T.M.); (H.C.T.)
| | - Nguyen Vu Trung
- Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam;
| | | | - Tran Nhu Duong
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
| | - Pham Thi Ngoc
- National Institute of Veterinary Research, Hanoi 100000, Vietnam;
| | - Anne-Laure Bañuls
- MIVEGEC (IRD-CNRS-Université de Montpellier), LMI DRISA, Centre IRD, 34394 Montpellier, France;
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City 700000, Vietnam; (D.P.T.); (S.-N.T.M.); (H.C.T.)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 4BH, UK
| | - H. Rogier van Doorn
- Oxford University Clinical Research Unit, Hanoi 100000, Vietnam; (V.T.N.B.); (H.R.v.D.)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 4BH, UK
| | - Masato Suzuki
- National Institute of Infectious Diseases, Tokyo 162-0052, Japan;
| | - Tran Huy Hoang
- Hanoi Medical University, Hanoi 100000, Vietnam; (H.T.A.H.); (T.H.A.)
- National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam; (P.T.L.N.); (T.T.M.H.); (L.A.T.); (B.T.T.); (T.H.M.L.); (P.D.T.); (N.H.T.); (N.T.H.H.); (N.T.M.); (T.N.D.); (D.D.A.)
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Prevalence of Class 1 Integron and In Vitro Effect of Antibiotic Combinations of Multidrug-Resistant Enterococcus Species Recovered from the Aquatic Environment in the Eastern Cape Province, South Africa. Int J Mol Sci 2023; 24:ijms24032993. [PMID: 36769316 PMCID: PMC9917988 DOI: 10.3390/ijms24032993] [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: 01/12/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Enterococci are regarded as a better indication of faecal pollution in freshwater and marine waters. Their levels in seawater are positively connected with swimming-related gastrointestinal disorders. This study used an Enterococcus-specific polymerase chain reaction (PCR) to characterize the isolates. Classes 1 and 2 integrons were examined for environmental Enterococcus isolates using a standard biological procedure. All strains were assessed against a panel of 12 antibiotics from various classes using disc diffusion methods. The microdilution method was used to work out the minimum inhibitory concentration (MIC) according to the CLSI guiding principles. The combination therapy of the resistant drugs was evaluated using a checkerboard assay and a time-dependent test for assessing their bactericidal or bacteriostatic activity. The gene diversity of the tested organisms was analyzed with the aid of Enterobacterial Repetitive Intergenic Consensus (ERIC) PCR. In total, 57 Enterococcus spp. environmental samples were recovered, in which Enterococcus faecalis (33.33%) and Enterococcus faecium (59.65%) were the dominant species. Resistance to linezolid, ciprofloxacin, erythromycin, gentamicin, vancomycin, rifampicin, and tetracycline was prevalent. Fifty (50) strains tested positive for class 1 integron, more frequent in Enterococcus faecium and Enterococcus faecalis isolates, with no gene cassette array discovered. A combination of gentamicin (MIC 4 µg/mL) with vancomycin (MIC 256 µg/mL) antibiotics against Enterococcus faecalis showed antibacterial activity. In contrast, the combination of ciprofloxacin (1 µg/mL) with Ampicillin (16 µg/mL) antibiotics against Enterococcus faecalis showed a bacteriostatic effect. The ERIC-PCR analysis pointed out that most of the assessed isolates have close genetic similarities.
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Aung MS, Urushibara N, Kawaguchiya M, Ohashi N, Hirose M, Kudo K, Tsukamoto N, Ito M, Kobayashi N. Antimicrobial Resistance, Virulence Factors, and Genotypes of Enterococcus faecalis and Enterococcus faecium Clinical Isolates in Northern Japan: Identification of optrA in ST480 E. faecalis. Antibiotics (Basel) 2023; 12:antibiotics12010108. [PMID: 36671309 PMCID: PMC9855154 DOI: 10.3390/antibiotics12010108] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/10/2023] Open
Abstract
Enterococcus faecalis and E. faecium are the major pathogens causing community- and healthcare-associated infections, with an ability to acquire resistance to multiple antimicrobials. The present study was conducted to determine the prevalence of virulence factors, drug resistance and its genetic determinants, and clonal lineages of E. faecalis and E. faecium clinical isolates in northern Japan. A total of 480 (426 E. faecalis and 54 E. faecium) isolates collected over a four-month period were analyzed. Three virulence factors promoting bacterial colonization (asa1, efaA, and ace) were more prevalent among E. faecalis (46-59%) than E. faecium, while a similar prevalence of enterococcal surface protein gene (esp) was found in these species. Between E. faecalis and E. faecium, an evident difference was noted for resistance to erythromycin, gentamicin, and levofloxacin and its responsible resistance determinants. Oxazolidinone resistance gene optrA and phenicol exporter gene fexA were identified in an isolate of E. faecalis belonging to ST480 and revealed to be located on a cluster similar to those of isolates reported in other Asian countries. The E. faecalis isolates analyzed were differentiated into 12 STs, among which ST179 and ST16 of clonal complex (CC) 16 were the major lineage. Nearly all the E. faecium isolates were assigned into CC17, which consisted of 10 different sequence types (STs), including a dominant ST17 containing multidrug resistant isolates and ST78 with isolates harboring the hyaluronidase gene (hyl). The present study revealed the genetic profiles of E. faecalis and E. faecium clinical isolates, with the first identification of optrA in ST480 E. faecalis in Japan.
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Affiliation(s)
- Meiji Soe Aung
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
- Correspondence: ; Tel.: +81-11-611-2111
| | - Noriko Urushibara
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
| | - Mitsuyo Kawaguchiya
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
| | - Nobuhide Ohashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
| | - Mina Hirose
- Division of Pediatric Dentistry, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu 061-0293, Japan
| | - Kenji Kudo
- Sapporo Mirai Laboratory, Co., Ltd., Sapporo 060-0003, Japan
| | | | - Masahiko Ito
- Sapporo Mirai Laboratory, Co., Ltd., Sapporo 060-0003, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan
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Kim E, Shin SW, Kwak HS, Cha MH, Yang SM, Gwak YS, Woo GJ, Kim HY. Prevalence and Characteristics of Phenicol-Oxazolidinone Resistance Genes in Enterococcus Faecalis and Enterococcus Faecium Isolated from Food-Producing Animals and Meat in Korea. Int J Mol Sci 2021; 22:ijms222111335. [PMID: 34768762 PMCID: PMC8583520 DOI: 10.3390/ijms222111335] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 01/27/2023] Open
Abstract
The use of phenicol antibiotics in animals has increased. In recent years, it has been reported that the transferable gene mediates phenicol-oxazolidinone resistance. This study analyzed the prevalence and characteristics of phenicol-oxazolidinone resistance genes in Enterococcus faecalis and Enterococcus faecium isolated from food-producing animals and meat in Korea in 2018. Furthermore, for the first time, we reported the genome sequence of E. faecalis strain, which possesses the phenicol-oxazolidinone resistance gene on both the chromosome and plasmid. Among the 327 isolates, optrA, poxtA, and fexA genes were found in 15 (4.6%), 8 (2.5%), and 17 isolates (5.2%), respectively. Twenty E. faecalis strains carrying resistance genes belonged to eight sequence types (STs), and transferability was found in 17 isolates. The genome sequences revealed that resistant genes were present in the chromosome or plasmid, or both. In strains EFS17 and EFS108, optrA was located downstream of the ermA and ant(9)-1 genes. The strains EFS36 and EFS108 harboring poxtA-encoding plasmid cocarried fexA and cfr(D). These islands also contained IS1216E or the transposon Tn554, enabling the horizontal transfer of the phenicol-oxazolidinone resistance with other antimicrobial-resistant genes. Our results suggest that it is necessary to promote the prudent use of antibiotics through continuous monitoring and reevaluation.
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Affiliation(s)
- Eiseul Kim
- Institute of Life Sciences & Resources and Department of Food Science and Biotechnology, Kyung Hee University, Yongin 17104, Korea; (E.K.); (S.-W.S.); (H.-S.K.); (S.-M.Y.); (Y.-S.G.)
| | - So-Won Shin
- Institute of Life Sciences & Resources and Department of Food Science and Biotechnology, Kyung Hee University, Yongin 17104, Korea; (E.K.); (S.-W.S.); (H.-S.K.); (S.-M.Y.); (Y.-S.G.)
| | - Hyo-Sun Kwak
- Institute of Life Sciences & Resources and Department of Food Science and Biotechnology, Kyung Hee University, Yongin 17104, Korea; (E.K.); (S.-W.S.); (H.-S.K.); (S.-M.Y.); (Y.-S.G.)
| | - Min-Hyeok Cha
- Laboratory of Food Safety and Evaluation, Department of Biotechnology, Korea University Graduate School, Seoul 02841, Korea;
| | - Seung-Min Yang
- Institute of Life Sciences & Resources and Department of Food Science and Biotechnology, Kyung Hee University, Yongin 17104, Korea; (E.K.); (S.-W.S.); (H.-S.K.); (S.-M.Y.); (Y.-S.G.)
| | - Yoon-Soo Gwak
- Institute of Life Sciences & Resources and Department of Food Science and Biotechnology, Kyung Hee University, Yongin 17104, Korea; (E.K.); (S.-W.S.); (H.-S.K.); (S.-M.Y.); (Y.-S.G.)
| | - Gun-Jo Woo
- Laboratory of Food Safety and Evaluation, Department of Biotechnology, Korea University Graduate School, Seoul 02841, Korea;
- Correspondence: (G.-J.W.); (H.-Y.K.); Tel.: +82-2-3290-3021 (G.-J.W.); +82-31-201-2123 (H.-Y.K.); Fax: +82-2-3290-3581 (G.-J.W.); +82-31-204-8116 (H.-Y.K.)
| | - Hae-Yeong Kim
- Institute of Life Sciences & Resources and Department of Food Science and Biotechnology, Kyung Hee University, Yongin 17104, Korea; (E.K.); (S.-W.S.); (H.-S.K.); (S.-M.Y.); (Y.-S.G.)
- Correspondence: (G.-J.W.); (H.-Y.K.); Tel.: +82-2-3290-3021 (G.-J.W.); +82-31-201-2123 (H.-Y.K.); Fax: +82-2-3290-3581 (G.-J.W.); +82-31-204-8116 (H.-Y.K.)
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7
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Schwarz S, Zhang W, Du XD, Krüger H, Feßler AT, Ma S, Zhu Y, Wu C, Shen J, Wang Y. Mobile Oxazolidinone Resistance Genes in Gram-Positive and Gram-Negative Bacteria. Clin Microbiol Rev 2021; 34:e0018820. [PMID: 34076490 PMCID: PMC8262807 DOI: 10.1128/cmr.00188-20] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Seven mobile oxazolidinone resistance genes, including cfr, cfr(B), cfr(C), cfr(D), cfr(E), optrA, and poxtA, have been identified to date. The cfr genes code for 23S rRNA methylases, which confer a multiresistance phenotype that includes resistance to phenicols, lincosamides, oxazolidinones, pleuromutilins, and streptogramin A compounds. The optrA and poxtA genes code for ABC-F proteins that protect the bacterial ribosomes from the inhibitory effects of oxazolidinones. The optrA gene confers resistance to oxazolidinones and phenicols, while the poxtA gene confers elevated MICs or resistance to oxazolidinones, phenicols, and tetracycline. These oxazolidinone resistance genes are most frequently found on plasmids, but they are also located on transposons, integrative and conjugative elements (ICEs), genomic islands, and prophages. In these mobile genetic elements (MGEs), insertion sequences (IS) most often flanked the cfr, optrA, and poxtA genes and were able to generate translocatable units (TUs) that comprise the oxazolidinone resistance genes and occasionally also other genes. MGEs and TUs play an important role in the dissemination of oxazolidinone resistance genes across strain, species, and genus boundaries. Most frequently, these MGEs also harbor genes that mediate resistance not only to antimicrobial agents of other classes, but also to metals and biocides. Direct selection pressure by the use of antimicrobial agents to which the oxazolidinone resistance genes confer resistance, but also indirect selection pressure by the use of antimicrobial agents, metals, or biocides (the respective resistance genes against which are colocated on cfr-, optrA-, or poxtA-carrying MGEs) may play a role in the coselection and persistence of oxazolidinone resistance genes.
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Affiliation(s)
- Stefan Schwarz
- Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Wanjiang Zhang
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin, People’s Republic of China
| | - Xiang-Dang Du
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, People’s Republic of China
| | - Henrike Krüger
- Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Andrea T. Feßler
- Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Shizhen Ma
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Yao Zhu
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin, People’s Republic of China
| | - Congming Wu
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Jianzhong Shen
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
| | - Yang Wang
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing, People’s Republic of China
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Jiang L, Xie N, Chen M, Liu Y, Wang S, Mao J, Li J, Huang X. Synergistic Combination of Linezolid and Fosfomycin Closing Each Other's Mutant Selection Window to Prevent Enterococcal Resistance. Front Microbiol 2021; 11:605962. [PMID: 33633692 PMCID: PMC7899970 DOI: 10.3389/fmicb.2020.605962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/30/2020] [Indexed: 12/21/2022] Open
Abstract
Enterococci, the main pathogens associated with nosocomial infections, are resistant to many common antibacterial drugs including β-lactams, aminoglycosides, etc. Combination therapy is considered an effective way to prevent bacterial resistance. Preliminary studies in our group have shown that linezolid combined with fosfomycin has synergistic or additive antibacterial activity against enterococci, while the ability of the combination to prevent resistance remains unknown. In this study, we determined mutant prevention concentration (MPC) and mutant selection window (MSW) of linezolid, fosfomycin alone and in combination including different proportions for five clinical isolates of Enterococcus and characterized the resistance mechanism for resistant mutants. The results indicated that different proportions of linezolid combined with fosfomycin had presented different MPCs and MSWs. Compared with linezolid or fosfomycin alone, the combination can restrict the enrichment of resistant mutants at a lower concentration. A rough positive correlation between the selection index (SI) of the two agents in combination and the fractional inhibitory concentration index (FICI) of the combination displayed that the smaller FICI of linezolid and fosfomycin, the more probable their MSWs were to close each other. Mutations in ribosomal proteins (L3 and L4) were the mechanisms for linezolid resistant mutants. Among the fosfomycin-resistant mutants, only two strains have detected the MurA gene mutation related to fosfomycin resistance. In conclusion, the synergistic combination of linezolid and fosfomycin closing each other’s MSW could effectively suppress the selection of enterococcus resistant mutants, suggesting that the combination may be an alternative for preventing enterococcal resistance. In this study, the resistance mechanism of fosfomycin remains to be further studied.
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Affiliation(s)
- Lifang Jiang
- Department of Basic and Clinical Pharmacology, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Na Xie
- Department of Basic and Clinical Pharmacology, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Mingtao Chen
- Department of Basic and Clinical Pharmacology, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Yanyan Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shuaishuai Wang
- Department of Basic and Clinical Pharmacology, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Jun Mao
- Department of Basic and Clinical Pharmacology, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
| | - Jiabin Li
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaohui Huang
- Department of Basic and Clinical Pharmacology, School of Pharmacy, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Major Autoimmune Diseases, School of Pharmacy, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei, China
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Enterococcus phage Nonaheksakonda infecting clinical isolates of Enterococcus faecalis represents a new lineage in the family Siphoviridae. Arch Virol 2021; 166:593-599. [PMID: 33392817 DOI: 10.1007/s00705-020-04905-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/15/2020] [Indexed: 01/11/2023]
Abstract
Enterococcus phage Nonaheksakonda was isolated from wastewater, using a vancomycin-resistant strain of the opportunistic pathogen Enterococcus faecalis (VRE) as a host. Nonaheksakonda is a lytic phage infecting E. faecalis V583 and clinical isolates with at least four different multi-locus sequence types (MLSTs). The genome is a 41.9-kb double-stranded DNA molecule (34.6% GC) with 74 coding sequences. Comparative analysis revealed only one close relative, Enterococcus phage heks. All other phages had low protein similarity and shared less than 54% nucleotide sequence identity with phage Nonaheksakonda. The most similar phages were all classified and unclassified efquatroviruses. We propose that the phages Nonaheksakonda and heks represent a novel genus within the family Siphoviridae, order Caudovirales, for which we propose the name "Nonaheksakondavirus".
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Drug Resistance Determinants in Clinical Isolates of Enterococcus faecalis in Bangladesh: Identification of Oxazolidinone Resistance Gene optrA in ST59 and ST902 Lineages. Microorganisms 2020; 8:microorganisms8081240. [PMID: 32824090 PMCID: PMC7463919 DOI: 10.3390/microorganisms8081240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/06/2020] [Accepted: 08/13/2020] [Indexed: 12/11/2022] Open
Abstract
Enterococcus faecalis is one of the major causes of urinary tract infection, showing acquired resistance to various classes of antimicrobials. The objective of this study was to determine the prevalence of drug resistance and its genetic determinants for E. faecalis clinical isolates in north-central Bangladesh. Among a total of 210 E. faecalis isolates, isolated from urine, the resistance rates to erythromycin, levofloxacin, and gentamicin (high level) were 85.2, 45.7, and 11.4%, respectively, while no isolates were resistant to ampicillin, vancomycin and teicoplanin. The most prevalent resistance gene was erm(B) (97%), and any of the four genes encoding aminoglycoside modifying enzyme (AME) were detected in 99 isolates (47%). The AME gene aac(6′)-Ie-aph(2”)-Ia was detected in 46 isolates (21.9%) and was diverse in terms of IS256-flanking patterns, which were associated with resistance level to gentamicin. Tetracycline resistance was ascribable to tet(M) (61%) and tet(L) (38%), and mutations in the quinolone resistance-determining region of both GyrA and ParC were identified in 44% of isolates. Five isolates (2.4%) exhibited non-susceptibility to linezolide (MIC, 4 μg/mL), and harbored the oxazolidinone resistance gene optrA, which was located in a novel genetic cluster containing the phenicol exporter gene fexA. The optrA-positive isolates belonged to ST59, ST902, and ST917 (CC59), while common lineages of other multiple drug-resistant isolates were ST6, ST28, CC16, and CC116. The present study first revealed the prevalence of drug resistance determinants of E. faecalis and their genetic profiles in Bangladesh.
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