期刊
INFECTION AND DRUG RESISTANCE
卷 13, 期 -, 页码 1397-1402出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/IDR.S248342
关键词
MDR; mcr-9; colistin; virulence genes
资金
- National Natural Science Foundation of China [81830103, 81722030, 81902123]
- National Science and Technology Key Projects for Major Infectious Diseases [2017ZX10302301]
- China Postdoctoral Science Foundation [2019M653192]
- Guangdong Natural Science Foundation [2017A030306012]
- Science and Technology Planning Project of Guangdong [2017A020215017]
- Science, Technology & Innovation Commission of Shenzhen Municipality [JCYJ20190807151601699]
- Open project of Key Laboratory of Tropical Disease Control (Sun Yat-sen University)
- Ministry of Education - 111 Project [B12003]
Background: Bloodstream infection (BSI) caused by carbapenem-resistant Enterobacteriaceae are potentially life-threatening related to poorer outcomes. Colistin is considered one of the last-resort treatments against human infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Therefore, emergence of strains from the blood that co-harboring mcr and carbapenem resistance genes were considered as a serious problem. Purpose: In this study, two mcr-9-harboring MDR Enterobacter cloacae isolates BSI034 and BSI072 recovered from BSI patients were identified, one of which co-harbored mcr-9 and bla(NDM-1). The genetic characteristics of the MDR plasmid needed to be clarified. Methods: S1-PFGE and Southern blotting were conducted to determine the location of mcr-9. Whole-genome sequencing was performed to obtain the complete genome and plasmid sequences. The resistome and virulence genes of the strains, accompanied by the genetic characteristics of mcr-9- and bla(NDM-1)-harboring plasmids, were analyzed. Results: Whole-genome sequencing showed that BSI034 harbored mcr-9-carrying IncHI2-type pBSI034-MCR9 and bla(NDM-1)-carrying IncX3-type pBSI034-NDM1. The 278,517 bp pBSI034-MCR9 carried mcr-9 along with the other 19 resistance genes. mcr-9 was flanked by IS903B (1057 bp) and IS26 (820 bp) in the same orientation. In addition to resistance genes, strain BSI034 also carried a chromosome-located Yersinia high-pathogenicity island, which harbored genes of yersiniabactin biosynthesis operon ybtSXQPAUTE, irp1/2, and fyuA. Conclusion: We described the complete genome and mcr-9/bla(NDM-1)-co-harboring plasmid of E. cloacae from a BSI patient. Notable differences were observed within mosaic modules between pBSI034-MCR9 and other mcr-9-harboring plasmids due to extensive recombination via horizontal gene transfer.
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