Fosfomycin resistance determinants in Escherichia coli isolates of human and animal origin from Iran.

BACKGROUND

Fosfomycin has regained clinical interest over the last years due to its superior activity against multidrug-resistant bacterial pathogens. In the current study we aimed to characterize genotypic and phenotypic features of fosfomycin resistant (FosR) Escherichia coli isolates originating from human and animal.

METHODS AND RESULTS

Five FosR bacteria were selected from a population of 150 E. coli isolates of human and broiler chickens. The sequence types of isolates were determined by multi-locus sequencing typing. Fosfomycin MICs were determined by agar dilution and gradient diffusion methods. Molecular detection of plasmid encoded fosfomycin resistance genes, fosA, fosA3, fosA4, fosA5 and fosC2 was performed by PCR. The modifications of fosfomycin target (MurA), transporters (GlpT, UhpT), and transporter regulator (PtsI) were investigated by gene sequencing. The MICs of fosfomycin were found to be ≥ 128 mg/L according to agar dilution and > 1024 mg/L according to gradient diffusion method. FosR isolates belonged to sequence types ST10 (n = 2), ST361, ST209 and ST1158 (n = 1). While all FosR isolates carried fos genes (fosA3 (n = 2), fosA5 (n = 2) and fosA4(n = 1)), only three isolates revealed amino acid substations in MurA, PtsI and GlpT with MurA P99S change being predicted to have deleterious impact on the function of protein.

CONCLUSIONS

Emergence of fosfomycin resistance among studied isolates was mainly attributed to plasmid genes coding for fosfomycin modifying enzymes. The similarity in fosfomycin resistance determinants among clonally diverse E. coli isolates of human and animals indicates a possible cross-sectoral dissemination of fos genes by epidemic plasmids between bacterial isolates of clinical settings and those from animals.