Characteristics and genomic epidemiology of colistin-resistant Enterobacterales from farmers, swine, and hospitalized patients in Thailand, 2014–2017

BMC Infectious Diseases

Research

Chakkraphong Seenama¹  Teerawit Tangkoskul¹  Visanu Thamlikitkul²  Adhiratha Boonyasiri³  Richard C. White⁴  Kevin Nguyen⁴  Chris Greco⁴  Derrick E. Fouts⁴  Lauren M. Brinkac⁵  Elita Jauneikaite⁶ 

[1] Faculty of Medicine Siriraj Hospital, Mahidol University, Salaya, Thailand;Faculty of Medicine Siriraj Hospital, Mahidol University, Salaya, Thailand;Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;Faculty of Medicine Siriraj Hospital, Mahidol University, Salaya, Thailand;NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK;J. Craig Venter Institute, 20850, Rockville, MD, USA;J. Craig Venter Institute, 20850, Rockville, MD, USA;Noblis, 20191, Reston, VA, USA;NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK;Department of Infectious Disease Epidemiology, School of Public Health, Imperial College, London, UK;

关键词: Carbapenemase-producing Enterobacterales;    Colistin resistance;    Genomic epidemiology;    Swine;   

DOI  :  10.1186/s12879-023-08539-8

 received in 2023-03-23, accepted in 2023-08-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundColistin is one of the last resort therapeutic options for treating carbapenemase-producing Enterobacterales, which are resistant to a broad range of beta-lactam antibiotics. However, the increased use of colistin in clinical and livestock farming settings in Thailand and China, has led to the inevitable emergence of colistin resistance. To better understand the rise of colistin-resistant strains in each of these settings, we characterized colistin-resistant Enterobacterales isolated from farmers, swine, and hospitalized patients in Thailand.MethodsEnterobacterales were isolated from 149 stool samples or rectal swabs collected from farmers, pigs, and hospitalized patients in Thailand between November 2014–December 2017. Confirmed colistin-resistant isolates were sequenced. Genomic analyses included species identification, multilocus sequence typing, and detection of antimicrobial resistance determinants and plasmids.ResultsThe overall colistin-resistant Enterobacterales colonization rate was 26.2% (n = 39/149). The plasmid-mediated colistin-resistance gene (mcr) was detected in all 25 Escherichia coli isolates and 9 of 14 (64.3%) Klebsiella spp. isolates. Five novel mcr allelic variants were also identified: mcr-2.3, mcr-3.21, mcr-3.22, mcr-3.23, and mcr-3.24, that were only detected in E. coli and Klebsiella spp. isolates from farmed pigs.ConclusionOur data confirmed the presence of colistin-resistance genes in combination with extended spectrum beta-lactamase genes in bacterial isolates from farmers, swine, and patients in Thailand. Differences between the colistin-resistance mechanisms of Escherichia coli and Klebsiella pneumoniae in hospitalized patients were observed, as expected. Additionally, we identified mobile colistin-resistance mcr-1.1 genes from swine and patient isolates belonging to plasmids of the same incompatibility group. This supported the possibility that horizontal transmission of bacterial strains or plasmid-mediated colistin-resistance genes occurs between humans and swine.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3

Fig. 2

40517_2023_267_Article_IEq3.gif