Co-infections of two carbapenemase-producing Enterobacter hormaechei clinical strains isolated from the same diabetes individual in China

Abstract

Introduction. Since mcr-1 was first reported in China, there have been ten variants of MCR appearing nationwide so far. Multidrug-resistant Enterobacteriaceae bacteria carrying both NDM and MCR have become a serious threat to global public health. Hypothesis/Gap Statement. The genetic structure of mcr-9 needs to be better understood in order to better prevent and control the transmission of drug-resistant genes. Aims. The aim of this study was to characterize the presence of two Enterobacter hormaechei isolates, which carries bla NDM-5 CME2 and the coexistence of mcr-9 and bla NDM-1 strain CMD2, which were isolated from a patient with diabetes in Sichuan, China. Methodology. The microbroth dilution method was used for antibiotic susceptibility. Conjugation experiment was used to investigate the transferability of bla NDM-1, bla NDM-5 and mcr-9. Whole-genome sequencing was performed on Illumina HiSeq platform. The ability of biofilm formation was detected by crystal-violet staining, the virulence of the bacteria was measured by Galleria mellonella killing assay. Results. bla NDM-5 carrier CME2 and CMD2 with bla NDM-1 and mcr-9 were resistant to carbapenems, β-lactam, aminoglycoside, quinolone and tetracycline, while CMD2 was also resistant to colistin. Conjugation assay and plasmid replicon typing further demonstrated that both bla NDM-1 and bla NDM-5 were respectively present on the self-transferrable IncX3 plasmid, mcr-9 was located on the self-transferrable IncHI2 plasmid. Through the analysis of mcr-9 gene context, the structure was DUF4942-rcnR-rcnA-copS-IS903-mcr-9-wbuC-qseC-qseB-IS1R-ΔsilR-IS903, bla NDM-1 context was IS3000-ΔISAba125-IS5-bla NDM-1-ble-trpF-groS-groL-insE-ΔIS26 structure, bla NDM-5 structure was IS3000-bla NDM-5-ble-trpF-dsbC-ΔIS26-umuD-ISKox3-tnpR-parA. Biofilm formation of CME2 was stronger than CMD2. There was no significant difference in virulence between the two strains. Conclusion. This study reveals two multiple drug-resistant E. hormaechei isolates from diabetes patient samples. E. hormaechei carrying two NDM-resistant genes is already a serious threat, where MCR is an important cause of treatment failure in bacterial infections. This study is a reminder not only to prevent infection in patients with diabetes, but also to constantly monitor the epidemic and spread of the drug-resistant gene.

Complete genome sequence and probiotic properties of Lactococcus petauri LZys1 isolated from healthy human gut

“…ml −1 bacterial solution was selected to infect eight Galleria mellonella larvae. Then 10 µl bacterial solution was injected into the body cavity with a 25 µl Hamilton syringe (Hamilton, America) through the left hind foot of the Galleria mellonella larvae, to observe the survival of the Galleria mellonella larvae [17]. Another eight non-infected Galleria mellonella larvae (Galleria mellonella larvae injected with 10 µl PBS) were used as controls.…”

Global Epidemiology and Genetic Environment of mcr genes: A One Health Systematic Review of Current and Emerging Trends

“…It is widely distributed within Enterobacteriaceae , particularly within Enterobacter sp. 129, 130, 132, 133, 135 , Citrobacter telavivum 134 , Salmonella sp. 127, 137, 138 and E. coli 136, 140 .…”

“…The presence of mcr-9 on a plasmid replicon facilitates its dissemination globally and across Enterobacteriaceae 127 . It has thereafter been identified in more clinical settings [128][129][130][131][132][133][134][135] and in food-producing animals 136,137 . Among the 355 genomes, 65 were associated with a plasmid replicon, which may facilitate their dissemination globally 127 .…”

Co-occurrence of Klebsiella variicola and Klebsiella pneumoniae Both Carrying blaKPC from a Respiratory Intensive Care Unit Patient

“…6 The antimicrobial susceptibility of transconjugants was determined by the microbroth dilution method. 14 The replicon F of the transconjugants was determined according to the previous method, based on the whole genome sequencing (WGS) analysis. 26…”

“…[7][8][9][10] These notorious resistance genes are usually carried by various mobile genetic elements, such as plasmids, integrons, and transposons, which can be transmitted between intraspecific or interspecific microorganisms. [11][12][13] In recent years, there has been a high incidence of coinfection with more than two different multi-drug-resistan t bacteria in the same patient, which brings a serious threat to patients [14][15][16][17] because the variety of bacteria in the coinfection can be misdiagnosed or misidentified. 18,19 For example, many types of Klebsiella species or subspecies (eg, Klebsiella variicola, Klebsiella quasipneumoniae subsp.…”