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Kamijo T, Horiuchi K, Negishi T, Natori T, Yamane T, Hachiro A, Uehara T, Hayashi W, Nagano N. First Detection of Chimeric β-Lactamase CTX-M-64-Producing Salmonella Typhimurium from a Domestic Source in Japan. Jpn J Infect Dis 2024; 77:47-50. [PMID: 37648488 DOI: 10.7883/yoken.jjid.2023.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Salmonella enterica subsp. enterica serovar Typhimurium has recently emerged worldwide as a producer of extended-spectrum β-lactamase (ESBL). However, drug-resistant clinical isolates are rare in Japan. The common types of ESBLs found are the CTX-M-type β-lactamases, including novel β-lactamases such as CTX-M-64. CTX-M-64 has a chimeric structure comprising a combination of the CTX-M-1 and CTX-M-9 groups. In 2017, S. Typhimurium was isolated from stool, blood, and urine cultures of an 82-year-old man. Herein, we describe the discovery of a clinical isolate of S. Typhimurium in Japan. Antimicrobial susceptibility testing revealed that the isolate was resistant to third- and fourth-generation cephalosporins, including ceftazidime and monobactam. The minimum inhibitory concentrations of ceftazidime and ceftriaxone were restored by administration of clavulanic acid. Whole-genome sequencing analysis revealed that the isolate harbored the blaCTX-M-64 gene on an IncHI2/IncHI2A-type plasmid, with an assembly length of 174,477 bp. The genetic structure of the region surrounding the blaCTX-M-64 gene, ISKpn26-ΔISEcp1-blaCTX-M-64-orf477, was shared only with the chromosome sequence of S. Typhimurium detected in food-producing chickens in Guangdong, China. Although rare, S. Typhimurium can induce bloodstream infections and produce ESBL. To our knowledge, this is the first report of a CTX-M-64-producing Enterobacterales clinical isolate of domestic origin in Japan.
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Affiliation(s)
- Tomu Kamijo
- Department of Laboratory Medicine, Shinshu University Hospital, Japan
- Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University, Japan
| | - Kazuki Horiuchi
- Department of Laboratory Medicine, Shinshu University Hospital, Japan
| | - Tatsuya Negishi
- Department of Laboratory Medicine, Shinshu University Hospital, Japan
| | - Tatsuya Natori
- Department of Laboratory Medicine, Shinshu University Hospital, Japan
| | - Taku Yamane
- Department of Laboratory Medicine, Shinshu University Hospital, Japan
- Department of Medical Sciences, Graduate School of Medicine, Science and Technology, Shinshu University, Japan
| | - Ayaka Hachiro
- Department of Laboratory Medicine, Shinshu University Hospital, Japan
| | - Takeshi Uehara
- Department of Laboratory Medicine, Shinshu University Hospital, Japan
| | - Wataru Hayashi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Japan
| | - Noriyuki Nagano
- Department of Health and Medical Science, Graduate School of Medicine, Shinshu University, Japan
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Chen J, Chen S, Jiang Y, Zhang R, Cai J. Fecal Carriage and Genetic Characterization of CTX-M-1/9/1-Producing Escherichia coli From Healthy Humans in Hangzhou, China. Front Microbiol 2021; 12:616687. [PMID: 33664715 PMCID: PMC7921147 DOI: 10.3389/fmicb.2021.616687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/15/2021] [Indexed: 11/16/2022] Open
Abstract
CTX-M-199, a novel chimeric β-lactamase which mediated resistance to sulbactam and tazobactam, was recently identified in Hangzhou, China. This study investigated the prevalence of fecal carriage of bacteria producing CTX-M-199 and other CTX-M-1/9/1-type enzymes among healthy individuals and characterized the genetic features of blaCTX–M–1/9/1-bearing mobile elements. A total of 74 Enterobacterales strains carrying various blaCTX–M–1/9/1 genes, including blaCTX–M–64 (n = 40, carriage rate of 0.74%), blaCTX–M–199 (n = 23, 0.40%), blaCTX–M–123 (n = 5, 0.10%), novel blaCTX–M–153 (n = 5, 0.10%), and blaCTX–M–132 (n = 2, 0.04%), were isolated from 68 out of 5,000 (1.36%) fecal samples of healthy adults in Hangzhou City. Phylogenetic analysis based on whole-genome sequencing data showed that 72 blaCTX–M–1/9/1-bearing Escherichia coli isolates were clustered into four major clades, three of which included CTX-M-199 producers. Sixty out of 75 blaCTX–M–1/9/1 genes were located on plasmids belonging to four Inc types: IncI2, IncI1, IncFIB, and IncHI2. The blaCTX–M–199 genes were harbored by three of the four types of plasmids except for IncHI2. All these blaCTX–M–1/9/1 genes were carried on an ISEcp1-mediated transposition unit. In conclusion, human fecal carriage of blaCTX–M–1/9/1 was low in healthy populations of China. The ISEcp1 was commonly associated with blaCTX–M–1/9/1 and may mediate its transmission on various mobile elements. Our findings provide insights into the dissemination and the development of further measures for the control of pathogens producing CTX-M-1/9/1-type enzymes.
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Affiliation(s)
- Jiawei Chen
- Clinical Microbiology Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Sheng Chen
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Yin Jiang
- Clinical Laboratory, The First People's Hospital of Fuyang Hangzhou, Hangzhou, China
| | - Rong Zhang
- Clinical Microbiology Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Jiachang Cai
- Clinical Microbiology Laboratory, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
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Tanaka H, Hayashi W, Iimura M, Taniguchi Y, Soga E, Matsuo N, Kawamura K, Arakawa Y, Nagano Y, Nagano N. Wastewater as a Probable Environmental Reservoir of Extended-Spectrum-β-Lactamase Genes: Detection of Chimeric β-Lactamases CTX-M-64 and CTX-M-123. Appl Environ Microbiol 2019; 85:e01740-19. [PMID: 31519655 PMCID: PMC6821968 DOI: 10.1128/aem.01740-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/06/2019] [Indexed: 02/06/2023] Open
Abstract
The presence of antimicrobial-resistant bacteria and resistance genes in aquatic environments is a serious public health concern. This study focused on Escherichia coli possessing blaCTX-M genes in wastewater inflows. Twelve crude inflow water samples from wastewater treatment plant (WWTP) A and two samples each from three other WWTPs were collected in 2017 and 2018. A total of 73 E. coli isolates with 31 different sequence types (STs) harboring distinctive blaCTX-M gene repertoires were detected. In WWTP A influents, blaCTX-M-14 (14 isolates) was dominant, followed by blaCTX-M-15 (12 isolates) and blaCTX-M-27 (10 isolates). The chimeric blaCTX-M-64 and blaCTX-M-123 genes were each identified in one of the E. coli isolates from the same WWTP A inflow port. The blaCTX-M-27 gene was associated with five of seven B2-ST131 isolates, including three isolates of the B2-O25b-ST131-H30R/non-Rx lineage. One of the remaining two isolates belonged to the B2-O25b-ST131-H30R/Rx lineage harboring the blaCTX-M-15 gene. As for the B2-O25b-ST131-H30R/non-Rx lineage, two isolates with blaCTX-M-27 were recovered from each of the WWTP B and D influents, and one isolate with blaCTX-M-174 was also recovered from WWTP B influent. Whole-genome sequencing of chimeric blaCTX-M-harboring E. coli isolates revealed that the blaCTX-M-64 gene was integrated into the chromosome of ST10 E. coli B22 via ISEcp1-mediated transposition of a 9,467-bp sequence. The blaCTX-M-123-carrying IncI1 plasmid pB64 was 109,169 bp in length with pST108. The overall findings suggest that wastewater may act as a probable reservoir of clinically significant clonal lineages mediating antimicrobial resistance genes and chimeric genes that have not yet been identified from human isolates of domestic origin in Japan.IMPORTANCE Global spread of CTX-M-type extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is a critical concern in both clinical and community settings. This dominance of CTX-M-type ESBL producers may be largely due to the successful international spread of epidemic clones, as represented by the extraintestinal pathogenic Escherichia coli (ExPEC) ST131. Our findings highlight the worrisome presence of diverse E. coli clones associated with humans, including ExPEC lineages harboring the most common blaCTX-M variants in untreated wastewater samples. Moreover, the chimeric genes blaCTX-M-64 and blaCTX-M-123, which have not yet been identified from human isolates of domestic origin in Japan, were identified. Exposure to untreated wastewater through combined sewer overflow caused by heavy rains derived from abnormal weather change could pose a risk for human health due to ingesting those antimicrobial-resistant bacteria.
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Affiliation(s)
- Hayato Tanaka
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Wataru Hayashi
- Department of Medical Sciences, Shinshu University Graduate School of Medicine, Science and Technology, Matsumoto, Nagano, Japan
| | - Masaki Iimura
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Yui Taniguchi
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Eiji Soga
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Nao Matsuo
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kumiko Kawamura
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshichika Arakawa
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yukiko Nagano
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Noriyuki Nagano
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
- Department of Medical Sciences, Shinshu University Graduate School of Medicine, Science and Technology, Matsumoto, Nagano, Japan
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Wei Z, Xu X, Yan M, Chang H, Li Y, Kan B, Zeng M. Salmonella Typhimurium and Salmonella Enteritidis Infections in Sporadic Diarrhea in Children: Source Tracing and Resistance to Third-Generation Cephalosporins and Ciprofloxacin. Foodborne Pathog Dis 2019; 16:244-255. [PMID: 30779595 DOI: 10.1089/fpd.2018.2557] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aimed to trace the transmission source of Salmonella enterica serovar Typhimurium and Salmonella enterica serovar Enteritidis strains associated with enteric infections in Shanghainese children, and understand the molecular mechanism of resistance to third-generation cephalosporins and ciprofloxacin. MATERIALS AND METHODS The profiles of pulsed-field gel electrophoresis (PFGE) were compared among the isolates from children, animal, and environment. Antimicrobial susceptibility was determined using the minimal inhibitory concentrations and Kirby-Bauer disk diffusion method. Extended-spectrum β-lactamase (ESBL) producing isolates mediated by resistance genes were identified using polymerase chain reaction and sequencing. RESULTS Based on PFGE patterns, 49 (33.1%) of 148 human Salmonella Typhimurium isolates located in the dominant PFGE clusters were genetically related to the isolates from poultry source, environment water, aquatic products, and reptiles, whereas 97 (97.0%) of 100 human Salmonella Enteritidis isolates were genetically related to isolates from poultry and water. The rates of resistance to ceftriaxone among clinical Salmonella Typhimurium and Salmonella Enteritidis isolates were 42.0% and 14.2%, respectively. Besides, 35.1% of Salmonella Typhimurium isolates displayed resistance to ciprofloxacin; 64.9% of Salmonella Typhimurium isolates and 97.0% of Salmonella Enteritidis isolates displayed reduced susceptibility to ciprofloxacin. Of 64 ESBL/AmpC-producing strains, CTX-M, TEM, DHA, and CMY were detected at frequencies of 86.0%, 62.5%, 7.8%, 3.1%, and 3.1%, respectively. CONCLUSIONS The transmission sources of Salmonella Typhimurium and Salmonella Enteritidis infections in Shanghainese children were diverse. The high prevalence of resistance to third-generation cephalosporins and ciprofloxacin mediated by multiple molecular mechanisms needs continuous monitoring and intervention.
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Affiliation(s)
- Zhougqiu Wei
- 1 Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Xuebin Xu
- 2 Department of Microbiology, Shanghai Municipal Center For Disease Control and Prevention, Shanghai, China
| | - Meiying Yan
- 3 National Institute for Communicable Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Hailing Chang
- 1 Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Yuefang Li
- 1 Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Biao Kan
- 3 National Institute for Communicable Disease Control and Prevention, China Center for Disease Control and Prevention, Beijing, China
| | - Mei Zeng
- 1 Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
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