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- Title
Characterization of the population structure, drug resistance mechanisms and plasmids of the community-associated Enterobacter cloacae complex in China.
- Authors
Kai Zhou; Wei Yu; Xiaoli Cao; Ping Shen; Haifeng Lu; Qixia Luo; Rossen, John W. A.; Yonghong Xiao; Zhou, Kai; Yu, Wei; Cao, Xiaoli; Shen, Ping; Lu, Haifeng; Luo, Qixia; Xiao, Yonghong
- Abstract
<bold>Objectives: </bold>To investigate the population structure, drug resistance mechanisms and plasmids of community-associated Enterobacter cloacae complex (CA-ECC) isolates in China.<bold>Methods: </bold>Sixty-two CA-ECC isolates collected from 31 hospitals across China were typed by hsp60 typing and MLST. ESBL and AmpC-overexpression phenotype was determined by double-disc synergy test. Replicon typing and conjugation were performed for plasmid analysis. All ESBL-positive isolates and representative conjugants were subjected to detailed characterization by WGS.<bold>Results: </bold>Enterobacter hormaechei and Enterobacter kobei were predominant in our collections. MLST distinguished 46 STs with a polyclonal structure. ST591 was the most prevalent clone detected in northern China. Twenty-two isolates (35.5%) were ESBL positive and half of them were E. kobei. ESBL positivity was related to ESBL production (15/22) and to AmpC overexpression (18/22). Core-genome phylogenetic analysis identified intra- and inter-regional dissemination of ESBL-producing E. kobei clones. ESBL producers were exclusively classified as E. hormaechei and E. kobei, and blaCTX-M-3 was the most prevalent ESBL genotype (10/15) detected in four different environments. In the ESBL-positive population, the ESBL producers encoded more drug resistance genes (8-24 genes) by carrying more plasmids (1-3 plasmids) than the non-ESBL-producing isolates, resulting in an inter-group difference in drug susceptibilities. IncHI-type plasmids were prevalent in the ESBL producers (12/15). All IncHI2-type plasmids (n = 11) carried ESBL genes and shared a similar backbone to p09-036813-1A_261 recovered from Salmonella enterica in Canada.<bold>Conclusions: </bold>The species-specific distribution, species-dependent ESBL mechanism and endemic plasmids identified in our study highlight the necessity for tailored surveillance of CA-ECC in the future.
- Subjects
CHINA; ENTEROBACTER cloacae; DRUG resistance in bacteria; PLASMIDS; REPLICONS; GENETIC overexpression; PUBLIC health; ANTIBIOTICS; BACTERIAL proteins; DRUG resistance in microorganisms; GENES; GRAM-negative bacteria; HYDROLASES; MICROBIAL sensitivity tests; PROTEINS; ENTEROBACTERIACEAE diseases; SEQUENCE analysis; PHARMACODYNAMICS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2018, Vol 73, Issue 1, p66
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkx361