Dataset Information

Characterization of resistance mechanisms of Enterobacter cloacae Complex co-resistant to carbapenem and colistin.

ABSTRACT:

Background

The emergence of carbapenem-resistant and colistin-resistant ECC pose a huge challenge to infection control. The purpose of this study was to clarify the mechanism of the carbapenems and colistin co-resistance in Enterobacter cloacae Complex (ECC) strains.

Results

This study showed that the mechanisms of carbapenem resistance in this study are: 1. Generating carbapenemase (7 of 19); 2. The production of AmpC or ESBLs combined with decreased expression of out membrane protein (12 of 19). hsp60 sequence analysis suggested 10 of 19 the strains belong to colistin hetero-resistant clusters and the mechanism of colistin resistance is increasing expression of acrA in the efflux pump AcrAB-TolC alone (18 of 19) or accompanied by a decrease of affinity between colistin and outer membrane caused by the modification of lipid A (14 of 19). Moreover, an ECC strain co-harboring plasmid-mediated mcr-4.3 and blaNDM-1 has been found.

Conclusions

This study suggested that there is no overlap between the resistance mechanism of co-resistant ECC strains to carbapenem and colistin. However, the emergence of strain co-harboring plasmid-mediated resistance genes indicated that ECC is a potential carrier for the horizontal spread of carbapenems and colistin resistance.

SUBMITTER: Liu S

PROVIDER: S-EPMC8268410 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Publications

Characterization of resistance mechanisms of Enterobacter cloacae Complex co-resistant to carbapenem and colistin.

Liu Shixing S Fang Renchi R Zhang Ying Y Chen Lijiang L Huang Na N Yu Kaihang K Zhou Cui C Cao Jianming J Zhou Tieli T

BMC microbiology 20210708 1

<h4>Background</h4>The emergence of carbapenem-resistant and colistin-resistant ECC pose a huge challenge to infection control. The purpose of this study was to clarify the mechanism of the carbapenems and colistin co-resistance in Enterobacter cloacae Complex (ECC) strains.<h4>Results</h4>This study showed that the mechanisms of carbapenem resistance in this study are: 1. Generating carbapenemase (7 of 19); 2. The production of AmpC or ESBLs combined with decreased expression of out membrane pr ...[more]

PMID: 34238225

Similar Datasets

Project description:Carbapenem-resistant Enterobacter cloacae complex (CR-ECC), which is rapidly increasing as the cause of nosocomial infections, has limited treatment options. The aim of this study is to investigate the microbiological and clinical traits and molecular epidemiology of isolates of CR-ECC and provide guidance for antibiotic selection in clinical practice. Clinical CR-ECC isolates (ertapenem MIC ≥ 2 mg/L) were collected from 2021 to 2022. Species identification was performed using hsp60 gene analysis, and antibiotic susceptibility tests were conducted by broth microdilution. The clinical characteristics of patients with CR-ECC isolates were retrospectively analyzed. Among the 108 CR-ECC isolates, 25 (23.2%) were non-susceptible to colistin, with colistin susceptibility being higher in Enterobacter hormaechei compared to non-E. hormaechei isolates (P < 0.0001). Of the 108 CR-ECC isolates, 9 (8.3%) produced carbapenemases, and only 6 of the 22 colistin-resistant CR-ECC isolates (27.3%) harbored the mcr gene. A total of 73 sequence types (STs), including 28 newly identified STs, were detected, demonstrating significant clonal diversity. The most common ST was ST74, known for its high prevalence and association with carbapenem resistance, with 77.8% identified as E. hormaechei subsp. hoffmannii. E. hormaechei was more common in the colistin-susceptible group than in the non-susceptible group (88.0% vs 37.5%, P < 0.0001), and E. hormaechei was the only protective factor for colistin resistance (HR 0.089, CI 0.030-0.261, P < 0.001). Although colistin resistance of CR-ECC is high, colistin could be administered safely to E. hormaechei. It is imperative to maintain ongoing surveillance and to further research on CR-ECC.IMPORTANCEAlthough new antibiotics are being developed, there are still limited options for treating carbapenem-resistant Enterobacter cloacae complex (CR-ECC) in regions where their use is restricted. The resistance level to one of these options, colistin, was investigated using bacteria isolated from clinical samples. In clinical practice, colistin is frequently administered empirically without susceptibility testing. However, this study suggests that colistin can be safely administered to certain species such as Enterobacter hormaechei within the CR-ECC.

Dataset Information

Characterization of resistance mechanisms of Enterobacter cloacae Complex co-resistant to carbapenem and colistin.

Background

Results

Conclusions

Publications

Characterization of resistance mechanisms of Enterobacter cloacae Complex co-resistant to carbapenem and colistin.

Similar Datasets

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