Hameed Muhammad Fazal, Chen Yanan, Bilal Hazrat, Khan Sabir, Ge Honghua, Xiaofang Chen, Gu Pengying
Institutes of Physical Science and Information Technology, Anhui University, Hefei, Anhui, China.
Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
J Infect Dev Ctries. 2022 Apr 30;16(4):622-629. doi: 10.3855/jidc.15943.
Plasmid-mediated colistin resistance genes, especially mcr-3 combined with the fosfomycin resistance gene fosA3, are a grave health concern. Our study was designed to determine the epidemiological characteristics of the combination of mcr-3 and fosA3 in Anhui province, China.
A total of 127 multi-drug-resistant (MDR) E. coli strains were assessed for antibiotic resistance/sensitivity to detect mcr-3 and fosA3 using polymerase chain reaction (PCR) and sequencing. The genes of interest were conjugated using EC600, and replicon and sequence types (STs) were identified by PCR-based replicon typing (PBRT) and multilocus sequence typing (MLST). Cluster similarity and genomic relatedness among the positive isolates were confirmed by Xbal PFGE.
The processed E. coli isolates were highly resistant to the tested antibiotics; the prevalence of mcr-3 was 0.78% in the transferable IncP-type plasmid in ST131, whereas fosA3 prevalence was 38.58% among different transferable plasmids, including IncFIIK, IncFII and IncA/C, and in various STs including ST69, ST1193, ST12, ST46, ST57, ST1196, ST38, ST95, ST131, ST7584 and ST10184. Both were successfully transferred to EC600. The Xbal PFGE cluster exposed similarities among the STs.
Our results show that to control the spread of colistin and fosfomycin resistance genes in human pathogens, the ban on colistin must be continued in animal feeding farms not only in China but around the world; additionally, awareness platforms on the use of colistin must be implemented and strict policies in poultry and pig farms must be maintained. Furthermore, fosfomycin misuse by patients and overuse by physicians must be strictly managed to stop the spread of fosfomycin resistance.
质粒介导的黏菌素耐药基因，尤其是mcr - 3与磷霉素耐药基因fosA3的组合，是严重的健康问题。我们的研究旨在确定中国安徽省mcr - 3和fosA3组合的流行病学特征。
共评估了127株多重耐药（MDR）大肠杆菌菌株的抗生素耐药性/敏感性，使用聚合酶链反应（PCR）和测序检测mcr - 3和fosA3。使用EC600对感兴趣的基因进行接合，并通过基于PCR的复制子分型（PBRT）和多位点序列分型（MLST）鉴定复制子和序列类型（STs）。通过Xbal PFGE确认阳性分离株之间的簇相似性和基因组相关性。
处理后的大肠杆菌分离株对测试抗生素具有高度耐药性；mcr - 3在ST131的可转移IncP型质粒中的流行率为0.78%，而fosA3在不同的可转移质粒（包括IncFIIK、IncFII和IncA/C）以及各种STs（包括ST69、ST1193、ST12、ST46、ST57、ST1196、ST38、ST95、ST131、ST7584和ST10184）中的流行率为38.58%。两者均成功转移至EC600。Xbal PFGE簇显示出STs之间的相似性。
我们的结果表明，为了控制黏菌素和磷霉素耐药基因在人类病原体中的传播，不仅在中国而且在全世界的动物饲养场都必须继续禁止使用黏菌素；此外，必须建立关于黏菌素使用的宣传平台，并在禽类和养猪场维持严格的政策。此外，必须严格管理患者对磷霉素的滥用和医生的过度使用，以阻止磷霉素耐药性的传播。
