A new plasmid carrying mphA causes prevalence of azithromycin resistance in enterotoxigenic Escherichia coli serogroup O6.

Publisher: BioMed Central Country of Publication: England NLM ID: 100966981 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2180 (Electronic) Linking ISSN: 14712180 NLM ISO Abbreviation: BMC Microbiol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Drug Resistance, Bacterial*; Azithromycin/*pharmacology ; Diarrhea/*microbiology ; Enterotoxigenic Escherichia coli/*classification ; Phosphotransferases/*genetics ; Plasmids/*genetics; Adult ; China ; Enterotoxigenic Escherichia coli/genetics ; Enterotoxigenic Escherichia coli/immunology ; Enterotoxigenic Escherichia coli/isolation & purification ; Escherichia coli Proteins/genetics ; Genome Size ; High-Throughput Nucleotide Sequencing ; Humans ; Microbial Sensitivity Tests ; Middle Aged ; Phylogeny ; Population Surveillance ; Sequence Analysis, DNA ; Serogroup ; Young Adult

Background: At present, azithromycin has become an effective treatment for severe diarrhea caused by Enterotoxigenic Escherichia coli (ETEC) infection. However, enterobacteria have begun to develop resistance to azithromycin and have attracted attention in recent years. This study conducted to described the emergence of a high proportion of azithromycin-resistant ETEC serogroup O6 strains in Shanghai and to analyzed the mechanisms of azithromycin resistance.
Results: Strains from adult diarrhea patients with ETEC serogroup O6 infections were collected by Shanghai Diarrhea Surveillance Network and the Foodborne Surveillance Network from 2016 to 2018. We tested 30 isolates of ETEC O6 serogroup, 26 of which were resistant to azithromycin. Phylogenetic analysis revealed that these ETEC serogroup O6 strains have formed an independent dominant clone. S1-PFGE and southern blotting revealed the presence of the mphA gene on the 103 kb plasmid. Illumina and Nanopore sequencing and plasmid coverage analysis further confirmed that azithromycin-resistant strains carried a novel IncFII plasmid harboring mphA and blaTEM-1 resistance genes.
Conclusions: This is the first study to report a high proportion of azithromycin resistance in a particular ETEC serogroup due to a specific plasmid carrying mphA. Our findings indicate the rapid spread of azithromycin resistance, highlighting the urgency of stringent surveillance and control measure.

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2018YFC1603801 International National Key R&D Program of China; 2017YFC1600105 International National Key R&D Program of China; 2018ZX10101003 International National Major Science and Technology Projects of China; 2018ZX10714002 International National Major Science and Technology Projects of China; 81872678 International National Nature Science Foundation of China; 81673237 International National Nature Science Foundation of China

Keywords: Azithromycin; Enterotoxigenic Escherichia coli; Nanopore sequencing; Plasmid; Whole-genome sequencing; mphA

0 (Escherichia coli Proteins)
83905-01-5 (Azithromycin)
EC 2.7.- (Phosphotransferases)

Date Created: 20200813 Date Completed: 20210712 Latest Revision: 20210712

20231215

PMC7418381

10.1186/s12866-020-01927-z

32782021