Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018

Miao, Yi; Zou, Jiaqi; Zhao, Jinxin; Tang, Yu; Yuan, Yaling; Yang, Bingxue; Huang, Jinzhu; Xia, Peiwen; Xia, Yun

doi:10.2147/idr.s339761

Cited by 11 publications

(9 citation statements)

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“…It was found mainly in gram-positive bacteria, which might be associated with decreased penicillin susceptibility (Tran et al, 2011). Although we did not find vancomycin resistance genes, more attention should be given to monitoring the VRE that carries transferable oxazolidinone resistance genes (Yi et al 2022). A total of 175 enterococcal isolates harbored multiple resistance genes, which indicated a broad antibiotic resistance spectrum of enterococcal isolates.…”

Section: Discussionmentioning

confidence: 62%

“…Enterococci in animals used for food production may contaminate food and the environment, creating a risk of human infection through anthropozoonosis ( He et al, 2016 ). Enterococcus faecalis and Enterococcus faecium often cause urinary tract and soft tissue infections, and in severe situations, they may cause septicemia or meningitis ( Yi et al, 2022 ). Notably, E. faecium and E. faecalis are important nosocomial pathogens worldwide ( Bender et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

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Persistence of transferable oxazolidinone resistance genes in enterococcal isolates from a swine farm in China

Huang

Bai²,

Wang³

et al. 2022

Front. Microbiol.

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The appearance of transferable oxazolidinone resistance genes poses a major challenge to public health and environmental safety. These genes not only lead pathogenic bacteria to become resistant to linezolid but also reduce sensitivity to florfenicol, which is widely used in the veterinary field. To verify the dissemination of oxazolidinone resistance genes in enterococcal isolates from pigs at different production stages in a swine farm in China, we collected 355 enterococcal isolates that were resistant to florfenicol from 600 (150 per stage) fresh fecal swabs collected from a swine farm. Through initial PCR screening and whole-genome sequencing, 175 isolates harboring different oxazolidinone resistance genes were identified. All isolates carried the optrA gene. A total of 161 (92%, 161/175) isolates carried only the optrA gene. Three (1.71%, 3/175) isolates carried both the optrA and poxtA genes, and 11 (3.1%, 11/175) isolates contained the optrA gene and poxtA2 and cfr(D) variants. A total of 175 isolates that harbored oxazolidinone resistance genes included 161 E. faecalis, 6 E. faecium, and 8 E. hirae. By sequencing the whole genomes, we found that the 161 isolates of E. faecalis belonged to 28 different STs, including 8 new STs, and the 6 isolates of E. faecium belonged to four different STs, including one new ST. The phylogenetic tree based on SNPs of the core genome showed that both clonal spread and horizontal transfer mediated the diffusion of oxazolidone resistance genes in enterococcal isolates at specific stages in pig farms. Moreover, enterococcal isolates carrying oxazolidone resistance genes could spread from breeding pigs to fattening pigs, while transferable oxazolidone resistance genes in enterococcal isolates could persist on a pig farm throughout all production stages. Representative enterococcal isolates with different oxazolidinone resistance genes were further studied through Nanopore sequencing. We identified a novel plasmid, pM4-80 L4 (15,008 bp), carrying the poxtA2 and cfr(D) genes in enterococcal isolates at different stages. We also found three different plasmids harboring the poxtA gene with high genetic variation, and all poxtA genes were flanked by two copies of IS1216E elements. In addition, four genetically distinct plasmids carrying the optrA gene were identified, and Tn554 was found to mediate chromosome-localized optrA gene transfer. Our study highlighted that transferable oxazolidinone resistance genes in enterococcal isolates could persist throughout all production stages on a pig farm, and the prevalence and dissemination of oxazolidinone resistance genes in enterococcal isolates from animal farms should be continually monitored.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Persistence of transferable oxazolidinone resistance genes in enterococcal isolates from a swine farm in China

Huang

Bai²,

Wang³

et al. 2022

Front. Microbiol.

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“…in healthcare environments. Due to its clinical and public health significance, the World Health Organization (WHO) and the U.S. Centers for Diseases Control and Prevention listed VRE as a high-priority pathogen in urgent need of drug research and development (Ayobami et al, 2020;Yi et al, 2022). Emaneini et al (2016) reported that the prevalence of vancomycin-resistant Enterococci infec-tions among Enterococcus species was 9.4% (95% C.I.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis of the Global Prevalence of Enterococcus spp. in Foods: Antibiotic Resistance Profile of Enterococcus faecalis and Enterococcus faecium

Barel

Çelik

Güngör

et al. 2023

Annals of Animal Science

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Aim: The objective of this study was to evaluate the prevalence and diversity of Enterococcus spp. and antibiotic-resistant Enterococcus faecalis and Enterococcus faecium isolates in different foods worldwide. Method and Result: This study used meta-analytical methods. Besides, Web of Science (n= 705), Medline (n= 6), and Scopus (n= 1.338) were searched for studies in the years 1995-2021 using related keywords. Results showed that the pooled prevalence for Enterococcus spp. and antibiotic-resistant of E. faecalis and E. faecium isolates were found 0.41 (95% C.I. 0.34-0.47), 0.25 (95% C.I. 0.13-0.38), respectively. According to the results of the subgroup analysis, the lowest and highest prevalence of Enterococcus spp. in food types were calculated for red meat (0.56), and fermented foods (0.29). Also, as a result of subgroup analyses by country the highest prevalence of Enterococcus spp. was calculated in studies conducted in Slovakia (0.74). In contrast, the lowest prevalence was calculated in studies conducted in Georgia (0.07). Conclusion: The meta-analyses improved our understanding of the prevalence of Enterococcus spp. and the antibiotic resistance of E. faecalis and E. faecium isolates in different foods and provided results that can be useful as input for quantitative microbiological risk evaluation modeling. Significance and Impact of Study: We demonstrated the antibiotic resistance of E. faecalis and E. faecium in foods and gaps that could be addressed in the future. Therefore, it is believed that the results compiled herein will contribute to the epidemiological surveillance of the presence and antibiotic resistance of E. faecalis and E. faecium in foods.

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“…OptrA was primary mechanism in LRE that was first detected in a clinical E. faecalis from China in 2015, and was commonly localized within chromosomes or plasmids and can be transmitted through horizontal gene transfer (HGT) via mobile genetic elements such as transposons, integrative and conjugative elements, and insertion sequences [ 38 , 39 ]. The recently reported poxtA gene, mediating resistance to oxazolidinones, tetracyclines, and phenicols, was first described in an MRSA isolate from an Italian patient [ 40 ]. Yi et al reported that 46.7% (7/15) of linezolid-resistant clinical isolated E. faecium were positive for optrA , and 13.3% (2/15) of isolates had poxtA in China [ 41 ].…”

Section: Enterococcus Faeciummentioning

confidence: 99%

ESKAPE in China: epidemiology and characteristics of antibiotic resistance

Luo,

Lu,

Chen

et al. 2024

Emerging Microbes & Infections

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The escalation of antibiotic resistance and the diminishing antimicrobial pipeline have emerged as significant threats to public health. The ESKAPE pathogens – Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. – were initially identified as critical multidrug-resistant bacteria, demanding urgently effective therapies. Despite the introduction of various new antibiotics and antibiotic adjuvants, such as innovative β-lactamase inhibitors, these organisms continue to pose substantial therapeutic challenges. People’s Republic of China, as a country facing a severe bacterial resistance situation, has undergone a series of changes and findings in recent years in terms of the prevalence, transmission characteristics and resistance mechanisms of antibiotic resistant bacteria. The increasing levels of population mobility have not only shaped the unique characteristics of antibiotic resistance prevalence and transmission within People’s Republic of China but have also indirectly reflected global patterns of antibiotic-resistant dissemination. What’s more, as a vast nation, People’s Republic of China exhibits significant variations in the levels of antibiotic resistance and the prevalence characteristics of antibiotic resistant bacteria across different provinces and regions. In this review, we examine the current epidemiology and characteristics of this important group of bacterial pathogens, delving into relevant mechanisms of resistance to recently introduced antibiotics that impact their clinical utility in China.

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Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018

Cited by 11 publications

References 45 publications

Persistence of transferable oxazolidinone resistance genes in enterococcal isolates from a swine farm in China

Persistence of transferable oxazolidinone resistance genes in enterococcal isolates from a swine farm in China

Meta-Analysis of the Global Prevalence of Enterococcus spp. in Foods: Antibiotic Resistance Profile of Enterococcus faecalis and Enterococcus faecium

ESKAPE in China: epidemiology and characteristics of antibiotic resistance

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