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Inherent colistin resistance in genogroups of the Enterobacter cloacae complex: epidemiological, genetic and biochemical analysis from the BSAC Resistance Surveillance Programme.
Mushtaq, Shazad; Reynolds, Rosy; Gilmore, Michael C; Esho, Olubukola; Adkin, Rachael; García-Romero, Inmaculada; Chaudhry, Aiysha; Horner, Carolyne; Bartholomew, Toby L; Valvano, Miguel A; Dry, Magdalena; Murray, John; Pichon, Bruno; Livermore, David M.
Afiliación
  • Mushtaq S; Antimicrobial Resistance & Healthcare Associated Infection Reference Unit, Public Health England, Colindale, London.
  • Reynolds R; British Society for Antimicrobial Chemotherapy, Birmingham, UK.
  • Gilmore MC; Department of Medical Microbiology, Southmead Hospital, Bristol, UK.
  • Esho O; University of Bristol Medical School (Population Health Sciences), Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.
  • Adkin R; The Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK.
  • García-Romero I; Laboratory for Molecular Infection Medicine Sweden (MIMS), Department of Molecular Biology, Umeå University, Umeå, Sweden.
  • Chaudhry A; Department of Medical Microbiology, Norfolk and Norwich University Hospital, Norwich, UK.
  • Horner C; Department of Clinical Microbiology and Infection Control, Royal Gwent Hospital, Cardiff Road, Newport, Gwent NP20 2UB, UK.
  • Bartholomew TL; Antimicrobial Resistance & Healthcare Associated Infection Reference Unit, Public Health England, Colindale, London.
  • Valvano MA; The Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK.
  • Dry M; Antimicrobial Resistance & Healthcare Associated Infection Reference Unit, Public Health England, Colindale, London.
  • Murray J; British Society for Antimicrobial Chemotherapy, Birmingham, UK.
  • Pichon B; The Wellcome-Wolfson Institute for Experimental Medicine, Queens University, Belfast, UK.
  • Livermore DM; Excerpta Medica BV, 90 Southwark Street, London SE1 0SW, UK.
J Antimicrob Chemother ; 75(9): 2452-2461, 2020 09 01.
Article en En | MEDLINE | ID: mdl-32514538
BACKGROUND: Polymyxins have re-entered use against problem Gram-negative bacteria. Resistance rates are uncertain, with estimates confounded by selective testing. METHODS: The BSAC Resistance Surveillance Programme has routinely tested colistin since 2010; we reviewed data up to 2017 for relevant Enterobacterales (n = 10 914). Unexpectedly frequent resistance was seen among the Enterobacter cloacae complex isolates (n = 1749); for these, we investigated relationships to species, genome, carbon source utilization and LPS structure. RESULTS: Annual colistin resistance rates among E. cloacae complex isolates were 4.4%-20%, with a rising trend among bloodstream organisms; in contrast, annual rates for Escherichia coli and Klebsiella spp. (including K. aerogenes) generally remained <2%. WGS split the E. cloacae complex isolates into seven genogroup clusters, designated A-G. Among isolates assigned to genogroups A-D, 47/50 sequenced were colistin resistant, and many of those belonging to genogroups A-C identified as E. asburiae. Isolates belonging to genogroups E-G consistently identified as E. cloacae and were rarely (only 3/45 representatives sequenced) colistin resistant. Genogroups F and G, the predominant colistin-susceptible clusters, were metabolically distinct from other clusters, notably regarding utilization or not of l-fucose, formic acid, d-serine, adonitol, myo-inositol, l-lyxose and polysorbates. LPS from resistant organisms grown without colistin pressure lacked substitutions with 4-amino-arabinose or ethanolamine but was more structurally complex, with more molecular species present. CONCLUSIONS: Colistin resistance is frequent in the E. cloacae complex and increasing among bloodstream isolates. It is associated with: (i) particular genomic and metabolic clusters; (ii) identification as E. asburiae; and (iii) with more complex LPS architectures.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colistina / Infecciones por Enterobacteriaceae Tipo de estudio: Screening_studies Límite: Humans Idioma: En Revista: J Antimicrob Chemother Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colistina / Infecciones por Enterobacteriaceae Tipo de estudio: Screening_studies Límite: Humans Idioma: En Revista: J Antimicrob Chemother Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido