Two different types of fosfomycin resistance in clinical isolates of Klebsiella pneumoniae

Abstract The fosfomycin susceptibility of 100 clinical isolates of Klebsiella pneumoniae and the resistance mechanisms utilized by resistant strains were examined. Washed cells prepared from the strains demonstrating MICs of more than 8 μg ml⁻¹ of fosfomycin inactivated the drug. A crude extract from strain Tf129B, highly resistant to fosfomycin, was used to study the enzymatic properties of the drug-inactivating enzyme. The optimum pH for inactivation was 7.8 and the optimum temperature of the reaction was 37°C. Glutathione was shown to be effective as a cofactor in the inactivation. It was suggested that the inactivating enzyme of Klebsiella pneumoniae was fosfomycin: glutathione-S-transferase, a constitutive enzyme located in the periplasmic space. A good correlation was found between the specific activities of this enzyme and the MIC levels; however, certain strains showed a low level of fosfomycin: glutathione-S-transferase activity which could not account for the increased MIC. Strains Tf129B and Tf408E, both demonstrating MICs of more than 1024 μg ml⁻¹ of fosfomycin carried a transferable resistance plasmid. In strain Tf129B, the mechanism of fosfomycin resistance was due to a high level of enzymic activity. In strain Tf408E, it was determined to be mainly due to the reduced permeability of the cell membrane.     

Characterization of staphylococcal plasmids hybridizing with the fosfomycin resistance gene fosB

The distribution of the fosB gene, coding for fosfomycin resistance, in 105 fosfomycin-resistant isolates of Staphylococcus from various geographical areas, was studied by Southern blot hybridization. Nucleotide sequences related to fosB were detected in 36 strains belonging to five species. Plasmids bearing fosB were often of a size similar to that of pIP1842 (2.54 kb) in S. epidermidis, most often small (2.4 to 4.1 kb) in other species including S. aureus where a 2.7-kb plasmid was found in 16 out of the 18 strains studied. The fosB gene was geographically dispersed since it was present in six different locations in France and also in Japan. The weak hybridization observed with plasmid DNA of certain strains of S. aureus, S. epidermidis, S. haemolyticus, S. saprophyticus, and S. warneri may indicate gene heterogeneity for fosfomycin resistance in Staphylococcus spp.     

Dispersion of a gene that codifies fosfomycin resistance among plasmids from enterobacteriaceae isolated from sewage

Abstract The presence of plasmid encoded resistance to fostomycin among enterobacteriaceae isolated from sewage was studied. These plasmids found were classified into 7 varieties according to their original host, size, resistance determinants, restriction pattern and incompatibility group. All of them were related to the Inc M group, indicating a probable common origin from an ancestral replicon. The bacteria carrying these plasmids modified fosfomycin as did those carrying fosfomycin resistant (Fo^r) hospital plasmids. The plasmids showed positive hybridization with a 1-kb DNA fragment which carried a Fo^r-determinant from a hospital plasmid.     

Molecular determination of oxytetracycline-resistant bacteria and their resistance genes from mariculture environments of China

AIMS: To assess the diversity of antibiotic-resistant bacteria and their resistance genes in typical maricultural environments. METHODS AND RESULTS: Multidrug-resistant bacteria and resistance genes from a mariculture farm of China were analysed via cultivation and polymerase chain reaction (PCR) methods. Oxytetracycline (OTC)-resistant bacteria were abundant in both abalone and turbot rearing waters, accounting for 3.7% and 9.9% of the culturable microbes. Multidrug resistance was common, with simultaneous resistance to OTC, chloramphenicol and ampicillin the most common resistance phenotype. 16S rDNA sequence analyses indicate that the typical resistant isolates belonged to marine Vibrio, Pseudoalteromonas or Alteromonas species, with resistance most common in Vibrio splendidus isolates. For OTC resistance, tet(A), tet(B) and tet(M) genes were detected in some multidrug-resistant isolates, with tet(D) being the most common molecular determinant. For chloramphenicol resistance, cat II was common, and floR was also detected, especially in marine Pseudoalteromonas strains. CONCLUSIONS: There is the risk of multidrug-resistant bacteria contamination in mariculture environments and marine Vibrio and Pseudoalteromonas species serve as reservoirs of specific antibiotic resistance determinants. SIGNIFICANCE AND IMPACT OF THE STUDY: This paper and similar findings from Korea and Japan indicate the potential for widespread distribution of antibiotic resistance genes in mariculture environments from the East Asian region of the world.     

Molecular characterization of antimicrobial resistance in Gram-negative bacteria isolated from bovine mastitis in Egypt

The aim of this study was to characterize the genetic basis of multidrug resistance in Gram-negative bacteria isolated from bovine mastitis cases in Egypt. Multidrug resistance phenotypes were found in 34 of 112 (30.4%) Gram-negative bacterial isolates, which harbored at least one antimicrobial resistance gene. The most prevalent multidrug-resistant (MDR) species were Enterobacter cloacae (8 isolates, 7.1%), Klebsiella pneumoniae (7 isolates, 6.3%), Klebsiella oxytoca (7 isolates, 6.3%), Escherichia coli (5 isolates, 4.5%), and Citrobacter freundii (3 isolates, 2.7%). The most commonly observed resistance phenotypes were against ampicillin (97.0%), streptomycin (94.1%), tetracycline (91.2%), trimethoprim-sulfamethoxazole (88.2%), nalidixic acid (85.3%), and chloramphenicol (76.5%). Class 1 integrons were detected in 28 (25.0%) isolates. The gene cassettes within class 1 integrons included those encoding resistance to trimethoprim (dfrA1, dfrA5, dfrA7, dfrA12, dfrA15, dfrA17, and dfrA25), aminoglycosides (aadA1, aadA2, aadA5, aadA7, aadA12, aadA22, and aac(3)-Id), chloramphenicol (cmlA), erythromycin (ereA2), and rifampicin (arr-3). Class 2 integrons were identified in 6 isolates (5.4%) with three different profiles. Furthermore, the β-lactamase encoding genes, bla(TEM), bla(SHV), bla(CTX-M), and bla(OXA), the plasmid-mediated quinolone resistance genes, qnr and aac(6)-Ib-cr, and the florfenicol resistance gene, floR, were also identified. To the best of our knowledge, the results identified class 2 integrons, qnr and aac(6)-Ib-cr from cases of mastitis for the first time. This is the first report of molecular characterization for antimicrobial resistance in Gram-negative bacteria isolated from bovine mastitis in Africa.     

Structure of fosfomycin resistance protein FosA from transposon Tn2921

The crystal structure of fosfomycin resistance protein FosA from transposon Tn2921 has been established at a resolution of 2.5 A. The protein crystallized without bound Mn(II) and K+, ions crucial for efficient catalysis, providing a structure of the apo enzyme. The protein maintains the three-dimensional domain-swapped arrangement of the paired betaalphabetabetabeta-motifs observed in the genomically encoded homologous enzyme from Pseudomonas aeruginosa (PA1129). The basic architecture of the active site is also maintained, despite the absence of the catalytically essential Mn(II). However, the absence of K+, which has been shown to enhance enzymatic activity, appears to contribute to conformational heterogeneity in the K(+)-binding loops.     

胆汁分离细菌种类及主要分离菌株耐药性分析

目的了解2000年至2008年临床胆汁普通培养分离细菌的种类,并分析主要分离菌株的耐药性。方法回顾性分析近9年710例胆囊炎和胆囊结石患者胆汁普通培养分离细菌的分布情况及耐药率;用微量稀释法进行药物敏感性测定。结果710例患者胆汁培养共分离出细菌435株,检出率为61.27%,前5位分别为大肠埃希菌、肠球菌、假单胞菌、肺炎克雷伯菌和凝固酶阴性葡萄球菌。革兰阴性杆菌对亚胺培南、阿米卡星的耐药率均低于10%,对常用青霉素类和头孢菌素类抗生素耐药率超过50%。结论胆汁分离细菌以肠道细菌为主,阿米卡星可以作为经验治疗的首选药物。     

Inorganic-ion resistance by bacteria isolated from a Mexico City freeway

Bacteria were isolated from soil samples, containing high exchangeable lead concentrations, obtained from a busy freeway in the México City metropolitan area. Forty-five selected strains (86.7% Gram-positive) had a single MIC distribution pattern for lead (800–1600 µg/ml lead nitrate) and were considered lead-resistant. The isolates showed variable levels of resistance to arsenate (86.7%), chromate (66.7%), cadmium (57.6%), and mercury (31.1%) ions. Multiple inorganic-ion resistance was shown by all strains.     

重症监护病房的病原调查及耐药性监测研究

目的调查浙江中医药大学附属第一医院重症监护病房（ICU）临床分离株的病原分布及细菌耐药状况,并与非ICU相比较,观察二者的区别,为临床用药提供有效的参考价值。方法收集该院2010年1月至2011年6月临床送检的各类标本,采用VITEK-2 compact全自动微生物鉴定仪,用GPI、GNI、ANC、YST鉴定卡、AST—GN13、AST—GP67药敏卡进行菌株的鉴定和药敏,根据美国临床实验室标准化协会（CLSI2010）制定的指导原则,判断细菌的耐药率。结果共计分离到2341株细菌,其中ICU有505株占21．6％,非ICU有1836株占78．4％。在ICU分离到的细菌中,革兰阳性菌占23．2％（117／505）;非发酵菌占47．3％（239／505）。在非ICU中,革兰阳性菌占34．4％（632／1836）;非发酵菌20．2％（371／1836）。ICU前3位细菌分别为鲍曼不动杆菌、肺炎克雷伯杆菌、洋葱伯克霍尔德菌。非ICU前3位依次为大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌。非发酵菌中,铜绿假单胞菌和鲍曼不动杆菌对哌拉西林／他唑巴坦、头孢他啶、头孢吡肟、亚胺培南、美洛培南的耐药率,ICU和非ICU差异有统计学意义（P〈0．05）。亚胺培南对ICU铜绿假单胞中的MIC50是非ICU的8倍,MIC。值相当。ICU与非ICU分离的葡萄球菌属细菌对头孢唑啉、环丙沙星、左旋氧氟沙星的耐药率差异有统计学意义（P〈0．05）。ICU和非ICU葡萄球菌对利奈唑胺、万古霉素、替考拉宁全部敏感。结论ICU患者分离的细菌以革兰阴性菌为主,其中又以非发酵菌占大多数。非ICU患者分离的革兰阳性菌比例明显要比ICU高。在主要的致病菌中,ICU的耐药率明显高于非ICU。     

Tolerance of pesticides and antibiotic resistance in bacteria isolated from wastewater-irrigated soil

A total of 64 bacterial isolates (40 Pseudomonas spp., 12 Azotobacter and 12 Rhizobium spp.) were characterized on the basis of morphological, cultural and biochemical characteristics. All the isolates were tested for their tolerance to the pesticides endosulfan, carbofuran, and malathion. 12.5% of the Pseudomonas isolates from soil tolerated concentrations of 1600 g malathion ml whereas 7.5% of isolates tolerated the same concentration of carbofuran. However, Pseudomonas isolates demonstrated a tolerance limit to endosulfan at a concentration of 800 g/ml. Asymbiotic N₂-fixers (Azotobacter) and symbiotic N₂-fixers (Rhizobium spp.) were also able to tolerate concentrations of pesticides up to 1600 g/ml. All the isolates were further tested for their antibiotic susceptibility against seven different antibiotics, nalidixic acid, cloxacillin, chloramphenicol, tetracycline, amoxycillin, methicillin, doxycycline. 100% of the Pseudomonas isolates were resistant to cloxacillin and 57.5% were resistant to methicillin. 7.5% of the isolates exhibited multiple resistance to five different antibiotics in three different combinations whereas 25% of the isolates showed multiple resistance to four different antibiotics in seven different combinations. Some of the resistant isolates were also screened for plasmid DNA and found to harbour a single plasmid.     

外科血培养标本中病原菌分布及耐药性分析

目的了解中山大学附属第一医院外科血标本中病原菌的菌种分布及常见菌株的耐药性。方法血标本用Bact/A lert-120全自动血培养仪进行血培养,阳性血培养转种后用VITEK-60 AMS细菌鉴定仪鉴定,用K-B法进行药敏试验。结果2002年1月至2005年12月血培养标本中共分离出病原菌256株,阳性率为10.6%。122株(47.7%)为革兰阴性杆菌,其中肠杆菌科细菌占72.1%(88/122),非发酵菌占27.9%(34/122);113株(44.1%)为革兰阳性球菌,其中葡萄球菌属占51.3%(58/113),肠球菌占38.1%(43/113);真菌21株(8.2%)。血培养中的革兰阴性杆菌对亚胺培南、美洛培南治疗敏感;革兰阳性球菌对万古霉素和替考拉宁敏感。结论肠杆菌科细菌和葡萄球菌是外科血培养中的主要病原菌,其耐药现象严重,宜根据药敏结果选用敏感抗菌药物治疗。     

血培养中病原菌的分布及其耐药状况分析

目的:了解血培养中病原菌的菌群分布及其耐药状况.方法:血培养标本用Bact/Alert-120自动血液分析系统和Vitek60鉴定仪进行血培养及鉴定,药敏用K-B法,用Whonet 5软件进行分析.结果:在3 680份血培养标本中分离出细菌348株,阳性检出率为9.4%,病原菌中以革兰阴性杆菌为主共分离出189株,占54.3%,其中主要为大肠埃希菌占15.5%,肺炎克雷伯菌占12.4%;革兰阳性菌138株,占39.7%,主要为凝固酶阴性葡萄球菌占14.9%,金黄色葡萄球菌占12.1%;链球菌占6.6%.血培养中的革兰阴性杆菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦治疗较为敏感:革兰阳性球菌对万古霉素和替考拉宁较为敏感.结论:肠杆菌科细菌和葡萄球菌是血培养中的主要病原菌,而产ESBLs菌株、MRSA、MRCNS耐药严重,提示应高度重视合理使用抗生素,减少细菌耐药性产生,以提高临床治疗效果.     

Short Communication: Antibiotic resistance among faecal coliform bacteria isolated from wastewater before and after treatment by an experimental sand filter

During the functioning period of a sand filter, 254 and 234 faecal-coliform strains were isolated from raw wastewater and reclaimed effluent, respectively. When tested for their susceptibility to ampicillin, kanamycin, chloramphenicol, streptomycin and tetracycline, 53% of the strains from the raw sewage and 84% of those isolated from the effluent were resistant to at least one antibiotic. The high incidence of drug resistance in the effluent was connected with a high proportion of Klebsiella pneumoniae, Enterobacter cloacae and Citrobacter freundii.     

Molecular epidemiology of Salmonella enterica serovar Enteritidis isolated in Taiwan

Incidence of Salmonella enterica serovar Enteritidis infection seems to be on the rise in Taiwan, and therefore, the characteristics of the isolate, including genotypes, were epidemiologically investigated. Of the 71 clinical strains isolated in 1997-1999, 61 (86%) remained susceptible to the eight antibiotics tested, while the remaining ten, eight of which were isolated in 1999, were resistant to one to three of the agents including three multiply resistant strains. The majority, 69 or 97% of the isolates, harbored a 60-kb spvC gene-carrying virulence plasmid and 12 of them harbored one or two additional various-sized plasmids. Strains with more than one plasmid were isolated mostly in 1999. Pulse-field gel electrophoresis (PFGE) revealed three major genotypes (Types A, B and C), in which type A was the predominant type. Of the 68 Type A, which contained 8 subtypes, 59 (83%) belonged to only two subtypes. Similar results were obtained with a PCR-based typing method, the infrequent-restriction-site (IRS) PCR. All four methods detected types that were rarely seen before and most of these were of recent isolates, indicating that these unusual types were new or strains of foreign origin. Though all four methods discriminated types well, PFGE and IRS-PCR showed higher sensitivity for classification. Between the two, the latter, though less discriminatory than PFGE, seems the method of choice, since it is simpler, less time-consuming and above all easy to perform.     

Nickel and cobalt resistance of various bacteria isolated from soil and highly polluted domestic and industrial wastes

Abstract From enrichment cultures in the presence of 1 mM NiCl₂ 200 strains of aerobic bacteria were isolated from 50 samples collected in the metal-processing industry, waste water treatment plants and from solid waste, highly polluted by heavy metals. The strains isolated were characterized with respect to their substrate spectrum and resistance to nickel, cobalt, zinc and cadmium salts and assigned to 21 groups. One representative of each group was described with respect to cell morphology. All strains were Gram-negative, non-sporing rods or cocci. The highest concentrations of nickel, cobalt, zinc, cadmium, copper, mercury, and silver allowing growth on solid media were estimated. Two strains were able to grow at 20 mM NiCl₂ and CoCl₂, one strain tolerated 12 mM and one 7.5 mM concentrations of these salts.
Fifteen out of 21 strains contained at least one plasmid two contained two plasmids. The plasmid sizes varied between 50 and 340 kbp, except strain 10A, which contained a miniplasmid (2.6 kbp). Attempts to cure four selected strains by exposure to mitomycin C or growth at elevated temperature failed.
By helper-assisted and unassisted conjugation the plasmids of strain 31A were shown to carry nickel and cobalt resistance determinants. Alcaligenes eutrophus strains H16 and N9A and denative of strain CH34 lacking one or both of its native metal resistance plasmids were used as recipients. Both plasmids, p TOM8 and pTOM9, of strain 31A carried resistance properties which were expressed in all recipients except. A. eutrophus H16, in which only nickel resistance was expressed.
Plasmid pTOM3 residing in strain 10A could not be transferred as such. However, transconjugants derived from helper (pULB113)-assisted matings carried co-integrates of various sizes and were resistant to nickel and cobalt.     

Molecular characterization of antimicrobial resistance in Salmonella isolated from animals in Japan

Aims:  To investigate the prevalence of integrons and antimicrobial resistance genes in Salmonella recovered from animals in Japan.
Methods and Results:  Forty-eight out of ninety-four (51·1%) Salmonella isolates showed multidrug resistance phenotypes and harboured at least one antimicrobial resistance gene. Twenty-two out of forty-seven (46·8%) Salmonella enterica serovar Typhimurium that were multidrug-resistant were of definitive phage type DT104. Class 1 integrons were identified in 34/94 isolates (36·2%): 21 isolates containing two gene cassettes, aadA2 and bla _PSE–1, and 13 containing one gene cassette, aadA1 , aadA2 or bla _PSE–1. Class 2 integrons containing estX - sat2 - aadA1 gene cassettes were only identified in Salmonella Enteritidis. The β-lactamase-encoding gene, bla _TEM, was only detected in S. Typhimurium. The plasmid-mediated quinolone resistance gene, qnrS1 , was identified in S. Typhimurium and Salmonella Thompson.
Conclusions:  Our results characterized integrons and antimicrobial resistance genes in Salmonella of animal origin. To the best of our knowledge, this is the first report of qnrS in Salmonella from Japan and also the first report of qnrS in S . Thompson.
Significance and Impact of the Study:  Little is known about the molecular basis of antimicrobial resistance in Salmonella isolated from animals. This study provides useful data on the incidence of integrons and resistance genes in Salmonella of animal origin.