Clinical and molecular characteristics of Chryseobacterium indologenes isolates at a teaching hospital in Shanghai, China

Abstract

Background: Chryseobacterium indologenes (C. indologenes) has recently emerged as a cause of life-threatening nosocomial infections in humans. This study aims to investigate the clinical characteristics, homology, and antimicrobial patterns of C. indologenes clinical isolates at a teaching hospital in Shanghai, China.Methods: A total of 135 consecutive non-replicate clinical C. indologenes isolates from January 2010 to December 2018 were collected at a tertiary care university hospital in Shanghai, China. Genetic relatedness of the isolates was performed by pulsed-field gel electrophoresis (PFGE). The antimicrobial susceptibility of these isolates was measured by the microdilution broth method. The prevalence of β-lactamase genes was investigated by polymerase chain reaction (PCR), while the quinolone resistance-determining regions (QRDRs) were sequenced.Results: All 135 C. indologenes isolates were collected from hospitalized patients with an average age of 55 years. Most of these clinical isolates were derived from ascites (59.3%) or urine (23.7%) specimens. Eighty (80/135) of the strains were classified as clone D by PFGE. In vitro drug susceptibility tests showed that minocycline and trimethoprim-sulfamethoxazole had sound antibacterial effects. However, more than 86% of the tested strains were resistant to cephalosporins (ceftazidime, cefotaxime), β-lactamase/β-lactamase inhibitors (cefoperazone-sulbactam), and carbapenems (meropenem, imipenem). Metallo-β-lactamase bla IND and type A broad-spectrum β-lactamase genes bla CIA were present in 135 and 103 isolates, respectively. The clinical strains in our hospital mainly carried bla IND-2 (89.6%, 121/135). Compared with previous studies, these strains had a high rate of resistance to quinolones. The resistance rates to levofloxacin, ciprofloxacin, norfloxacin, gatifloxacin, and nemonoxacin were as high as 83.7-94.8%. The mutations at Ser83Val, Ser83Tyr, and Asp87Gly in the QRDRs of GyrA were significantly related to the resistance of C. indologenes to levofloxacin. All but one quinolone-resistant strain contained at least one significant mutation.Conclusions: This study showed a clonal dissemination of C. indologenes isolates in infections at a tertiary care university hospital in Shanghai, China. Minocycline and trimethoprim-sulfamethoxazole had favorable in vitro antibacterial effects. However, the high resistance rate to β-lactams and quinolones was due to carrying β-lactamase (bla IND , bla CIA ), and mutations in the QRDRs of GyrA.

The Hyperbilirubinemia and Potential Predictors Influence on Long-Term Outcomes in Sepsis: A Population-Based Propensity Score-Matched Study

“…Our results are consistent with previous basic research, which shows that the liver plays an important role in endotoxin-induced acute lung injury (30). Moreover, Zhang et al (31) have proposed a Cox regression model with time-varying covariates, which is useful for evaluating the dynamic change of hyperbilirubinemia on clinical outcomes and can be used in further analysis. The liver is the key detoxification organ and the critical site to clear invasive pathogens and alleviate inflammation reaction by exerting innate immune system function (6,7).…”

Whole genome sequencing of the multidrug-resistant Chryseobacterium indologenes isolated from a patient in Brazil

“…Considering the pediatric population can present significant morbidity and immune dysfunction, we postulate that the relevance of C. indologenes isolated from clinical samples of infants can be challenging since novel molecular and phenotypic tests are providing rapid and accurate identification of many bacterial species, including glucose non-fermenting gram-negative bacilli (78, 79) such as C. indologenes. Chryseobacterium indologenes often exhibit resistance to a wide variety of broad-spectrum antibiotics, including aminoglycosides, tetracyclines, chloramphenicol, macrolides, clindamycin, and teicoplanin; extended-spectrum penicillins; and first-, second-and third-generation cephalosporin, aztreonam, ticarcillin-clavulanate and the carbapenems (19,23,80). According to our phenotypic results, our C. indologenes strain was resistant to most of these antibiotics.…”

“…Since the identification of the tet(X) gene from the obligately anaerobic Bacteroides spp. (108,109), it has been reported among strains of Enterobacteriaceae, Comamonadaceae, Flavobacteriaceae, and Moraxellaceae (23,110,111). Resistance to quinolones can be conferred by mutations in quinolone-resistance-determining region (QRDRs) (gyrA, gyrB, parC, and parE subunits), efflux pumps (QepA and OqxAB), DNA topoisomerase protection protein Qnr, and quinolone acetyltransferase Aac (6 )-Ib-cr (23,112,113).…”

“…Although the clinical significance and pathogenicity of C. indologenes are not well established (17,18), C. indologenes is known to be naturally resistant to a wide variety of antibiotics including not only aminoglycosides, tetracyclines, chloramphenicol, macrolides, aminopenicillins, clindamycin, teicoplanin but also first-generation cephalosporins, aztreonam, ticarcillin-clavulanate, and carbapenems (10,(19)(20)(21). The most potent drugs reported against C. indologenes are quinolones (gatifloxacin and levofloxacin), minocycline, and trimethoprimsulfamethoxazole (18,22,23); however, many studies show an alarming trend in resistance to those antibiotics (3,9,24).…”

COVID-19 Associated Bacteremia with Chryseobacterium indologenes Co-Harboring blaIND-2, blaCIA and blaCcrA

“…The bla IND and bla CIA were the predominant AMR gene in C. indologenes and the bla IND and bla CIA co-harboring C. indologenes were also reported. 6 Although C. indologenes has become one of healthcare-associated infections (HAI) pathogen, there are few reports about C. indologenes infection associated with COVID-19. Here, we reported a COVID-19 patient with superimposed C. indologenes bloodstream infection.…”