Plasmid-mediated azithromycin resistance in non-typhoidal Salmonella recovered from human infections

Xi-Wei Zhang; Jing-Jie Song; Shi-Han Zeng; Yu-Lan Huang; Jia-Jun Luo; Wei-Long Guo; Xiao-Yan Li

doi:10.1093/jac/dkae281

journal article Open Access Aug 09, 2024

Plasmid-mediated azithromycin resistance in non-typhoidal Salmonella recovered from human infections

Xi-Wei Zhang

Jing-Jie Song Shi-Han Zeng Yu-Lan Huang Jia-Jun Luo Wei-Long Guo Xiao-Yan Li

Journal of Antimicrobial Chemotherapy Vol. 79 No. 10 pp. 2688-2697 · Oxford University Press (OUP)

View at Publisher Save 10.1093/jac/dkae281

Abstract

Abstract

Objectives
Mechanisms of non-typhoidal Salmonella (NTS) resistance to azithromycin have rarely been reported. Here we investigate the epidemiology and genetic features of 10 azithromycin-resistant NTS isolates.

Methods
A total of 457 NTS isolates were collected from a tertiary hospital in Guangzhou. We performed antimicrobial susceptibility tests, conjugation experiments, efflux pump expression tests, whole-genome sequencing and bioinformatics analysis to conduct the study.

Results
The results showed that 10 NTS isolates (2.8%) were resistant to azithromycin with minimum inhibitory concentration values ranging from 128 to 512 mg/L and exhibited multidrug resistance. The phylogenetic tree revealed that 5 S. London isolates (AR1–AR5) recognized at different times and departments were closely related [3–74 single-nucleotide polymorphisms (SNPs)] and 2 S. Typhimurium isolates (AR7 and AR8) were clones (&lt;3 SNPs) at 3-month intervals. The azithromycin resistance was conferred by mph(A) gene found on different plasmids, including IncFIB, IncHI2, InFII, IncC and IncI plasmids. Among them, IncFIB, InFII and IncHI2 plasmids carried different IS26-class 1 integron (intI1) arrangement patterns that mediated multidrug resistance transmission. Conjugative IncC plasmid encoded resistance to ciprofloxacin, ceftriaxone and azithromycin. Furthermore, phylogenetic analysis demonstrated that mph(A)-positive plasmids closely related to 10 plasmids in this study were mainly discovered from NTS, Escherichia coli, Klebsiella pneumonia and Enterobacter hormaechei. The genetic environment of mph(A) in 10 NTS isolates was IS26-mph(A)-mrx(A)-mphR(A)-IS6100/IS26 that co-arranged with intI1 harbour multidrug-resistant (MDR) gene cassettes on diverse plasmids.

Conclusions
These findings highlighted that the dissemination of these plasmids carrying mph(A) and various intI1 MDR gene cassettes would seriously restrict the availability of essential antimicrobial agents for treating NTS infections.

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Published: Aug 09, 2024
Vol/Issue: 79(10)
Pages: 2688-2697
License: View

Authors

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Xi-Wei Zhang