Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada.
National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
Microbiol Spectr. 2021 Dec 22;9(3):e0199821. doi: 10.1128/spectrum.01998-21.
In the context of a recent rise in prevalence of NDM-encoding carbapenemase-producing Enterobacterales (CPE) in the province of QC, Canada, the genetic environment of was investigated. Three NDM-producing clinical isolates of Enterobacter hormaechei recovered from hospitalized patients involved in a putative outbreak were further characterized by whole-genome sequencing (WGS). Two isolates were confirmed by pulsed-field gel electrophoresis and WGS to be closely related. In addition to a ∼128 kb IncFII conjugative multidrug-resistance (MDR) plasmid, these isolates possessed a ∼45 kb mobilizable IncR MDR plasmid containing 2 MDR regions: a complex class 1 integron harboring and 7 other AMR genes, and the (A)(A) azithromycin resistance unit. The predicted antimicrobial resistance (AMR) genes correlated with the antimicrobial susceptibility testing results. The multidrug-resistant phenotype in addition to the presence of two important mobile genetic elements, suggest a potent role as a reservoir of antibiotic resistance for such a small IncR plasmid. Analyzing the genetic environment of clinically relevant MDR genes can provide information on the way in which such genes are maintained and disseminated. Understanding this phenomenon is of interest for clinicians as it can also provide insight on where these genes might have been sourced, possibly supporting outbreak investigations.
在加拿大魁北克省最近 NDM 编码碳青霉烯酶产生肠杆菌科 (CPE) 流行率上升的背景下，研究了 的遗传环境。从参与疑似暴发的住院患者中分离出的 3 株产 NDM 的肠杆菌霍氏亚种临床分离株通过全基因组测序 (WGS) 进一步进行了表征。通过脉冲场凝胶电泳和 WGS 确认了两种分离株具有密切的相关性。除了约 128 kb IncFII 可接合的多药耐药 (MDR) 质粒外，这些分离株还含有一个约 45 kb 的可移动 IncR MDR 质粒，其中包含 2 个 MDR 区域：一个复杂的类 1 整合子，携带 和 7 个其他 AMR 基因，以及（A）（A）阿奇霉素耐药单位。预测的抗生素耐药性 (AMR) 基因与抗生素药敏试验结果相关。除了存在两种重要的移动遗传元件外，这种多药耐药表型表明，这种小的 IncR 质粒作为抗生素耐药性的储库具有很强的作用。分析临床相关 MDR 基因的遗传环境可以提供有关这些基因如何维持和传播的信息。了解这种现象对临床医生很重要，因为它还可以提供有关这些基因可能来自何处的信息，可能有助于暴发调查。
