Co-existence of a novel plasmid-mediated efflux pump with colistin resistance gene mcr in one plasmid confers transferable multidrug resistance in Klebsiella pneumoniae. Issue 1 (1st January 2020)

• Record Type: Journal Article
• Authors: Sun, Shijun; Gao, Hua; Liu, Yudong; Jin, Longyang; Wang, Ruobing; Wang, Xiaojuan; Wang, Qi; Yin, Yuyao; Zhang, Yawei; Wang, Hui
• Is Part Of: Emerging microbes & infections. Volume 9:Issue 1(2020)
• Page Start: 1102
• Page End: 1113
• Publication Date: 2020-01-01
• Subjects: Plasmid-mediated tigecycline-resistant K. pneumoniae -- tmexCD1-toprJ1 efflux pump -- mcr-8·5 -- tmexCD1-mcr co-harbouring plasmid -- CRKP; Medical microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.9041
• DOI: 10.1080/22221751.2020.1768805
• Languages: English
• ISSNs: 2222-1751

Abstract

ABSTRACT: Tigecycline is considered one of the last-resort antimicrobials for carbapenem-resistant K. pneumoniae . Plasmid-mediated tigecycline resistance remains largely unclear. Here, by utilizing whole genome sequencing, we report a plasmid-mediated tigecycline resistance mechanism, a 6, 489 bp Resistance-nodulation-division family (RND) efflux pump ( tmexCD1-toprJ1 pump ), that confers transferable tigecycline resistance in K pneumoniae isolated from patients and chickens. In addition, we identified high prevalence of the plasmids co-harbouring both tmexCD1-toprJ1 pump and mcr ( tmexCD1-mcr co-harbouring plasmid) from human in our nationwide collection. Even worse, the tmexCD1-toprJ1 and mcr co-harbouring plasmid was also co-existed with bla NDM -harbouring IncX3 plasmid in the same host, resulting in pandrug resistance. Phylogenetic analysis suggested that the plasmid-borne tmexCD1-toprJ1 originated from the chromosome of Aeromonas spp. through Tn 5393 -mediating translocation. Both plasmid-harbored tmexCD1-toprJ1 gene and mcr-8 likely originated from animal isolates and then spread to human. Our findings highlight a substantial threat of tmexCD1-toprJ1-mcr8 co-harbouring IncFIA/IncFII plasmid to public health due to their mobile resistance to both tigecycline and colistin, emphasizing an urgent need for further global surveillance on this plasmid.