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Brown-Elliott BA, Wallace RJ, Wengenack NL, Workman SD, Cameron ADS, Bush G, Hughes MD, Melton S, Gonzalez-Ramirez B, Rodriguez E, Somayaji K, Klapperich C, Viers M, Bolaji AJ, Rempel E, Alexander DC. Erratum for Brown-Elliott et al., "Emergence of Inducible Macrolide Resistance in Mycobacterium chelonae Due to Broad-Host-Range Plasmid and Chromosomal Variants of the Novel 23S rRNA Methylase Gene, erm(55)". J Clin Microbiol 2024; 62:e0041524. [PMID: 38572983 PMCID: PMC11077984 DOI: 10.1128/jcm.00415-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
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Brown-Elliott BA, Wallace RJ, Wengenack NL, Workman SD, Cameron ADS, Bush G, Hughes MD, Melton S, Gonzalez-Ramirez B, Rodriguez E, Somayaji K, Klapperich C, Viers M, Bolaji AJ, Rempel E, Alexander DC. Emergence of Inducible Macrolide Resistance in Mycobacterium chelonae Due to Broad-Host-Range Plasmid and Chromosomal Variants of the Novel 23S rRNA Methylase Gene, erm(55). J Clin Microbiol 2023; 61:e0042823. [PMID: 37347171 PMCID: PMC10358161 DOI: 10.1128/jcm.00428-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/31/2023] [Indexed: 06/23/2023] Open
Abstract
Macrolides are a mainstay of therapy for infections due to nontuberculous mycobacteria (NTM). Among rapidly growing mycobacteria (RGM), inducible macrolide resistance is associated with four chromosomal 23S rRNA methylase (erm) genes. Beginning in 2018, we detected high-level inducible clarithromycin resistance (MICs of ≥16μg/mL) in clinical isolates of Mycobacterium chelonae, an RGM species not previously known to contain erm genes. Using whole-genome sequencing, we identified a novel plasmid-mediated erm gene. This gene, designated erm(55)P, exhibits <65% amino acid identity to previously described RGM erm genes. Two additional chromosomal erm(55) alleles, with sequence identities of 81% to 86% to erm(55)P, were also identified and designated erm(55)C and erm(55)T. The erm(55)T is part of a transposon. The erm(55)P allele variant is located on a putative 137-kb conjugative plasmid, pMchErm55. Evaluation of 133 consecutive isolates from 2020 to 2022 revealed 5 (3.8%) with erm(55). The erm(55)P gene was also identified in public data sets of two emerging pathogenic pigmented RGM species: Mycobacterium iranicum and Mycobacterium obuense, dating back to 2008. In both species, the gene appeared to be present on plasmids homologous to pMchErm55. Plasmid-mediated macrolide resistance, not described previously for any NTM species, appears to have spread to multiple RGM species. This has important implications for antimicrobial susceptibility guidelines and treatment of RGM infections. Further spread could present serious consequences for treatment of other macrolide-susceptible RGM. Additional studies are needed to determine the transmissibility of pMchErm55 and the distribution of erm(55) among other RGM species.
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Affiliation(s)
- Barbara A. Brown-Elliott
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | - Richard J. Wallace
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | - Nancy L. Wengenack
- Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sean D. Workman
- Department of Biology, University of Regina, Regina, Saskatchewan, Canada
| | | | - Georgie Bush
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | - M. Dolores Hughes
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | - Stephanie Melton
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | - Bibiana Gonzalez-Ramirez
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | - Eliana Rodriguez
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | - Kavya Somayaji
- Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
| | | | - Mary Viers
- Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ayooluwa J. Bolaji
- Cadham Provincial Laboratory, Diagnostic Services, Shared Health, Winnipeg, Manitoba, Canada
| | - Emma Rempel
- Cadham Provincial Laboratory, Diagnostic Services, Shared Health, Winnipeg, Manitoba, Canada
| | - David C. Alexander
- Cadham Provincial Laboratory, Diagnostic Services, Shared Health, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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