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Co-Occurrence of mcr-9 and bla NDM-1 in Enterobacter cloacae Isolated from a Patient with Bloodstream Infection.


ABSTRACT: 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.

SUBMITTER: Lin M 

PROVIDER: S-EPMC7229791 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Co-Occurrence of <i>mcr-9</i> and <i>bla</i> <sub>NDM-1</sub> in <i>Enterobacter cloacae</i> Isolated from a Patient with Bloodstream Infection.

Lin Minmin M   Yang Yongqiang Y   Yang Yanxian Y   Chen Guanping G   He Ruowen R   Wu Yiping Y   Zhong Lan-Lan LL   El-Sayed Ahmed Mohamed Abd El-Gawad MAE   Feng Siyuan S   Shen Cong C   Wen Xin X   Huang Jin J   Li Hongyu H   Zheng Xiaobin X   Tian Guo-Bao GB  

Infection and drug resistance 20200512


<h4>Background</h4>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 <i>mcr</i> and carbapenem resistance genes were considered as a serious problem.<h4>Purpose</h4>In this study, two <i>mcr-9</i>-harbori  ...[more]

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