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<p><i>Enterobacter hormaechei</i> (<i>E. hormaechei</i>), a member of the <i>Enterobacter cloacae</i> complex, has emerged as an important pathogen in healthcare-associated infections. In this study, a multidrug-resistant <i>E. hormaechei</i> EH001 co-carrying <i>mcr-9</i> and <i>bla</i><sub>NDM-5</sub> was isolated from a patient with bloodstream infection in China. To investigate the genomic characteristics of a multidrug-resistant <i>E. hormaechei</i> EH001 co-carrying <i>mcr-9</i> and <i>bla</i><sub>NDM-5</sub>, whole-genome sequencing was employed and conjugation experiment was performed by using the recipient <i>E. coli</i> EC600. The antimicrobial susceptibility profiles of <i>E. hormaechei</i> EH001 revealed resistance to the most commonly used antimicrobial agents, with the exception of polymyxin B, polymyxin E, and minocycline. <i>E. hormaechei</i> EH001 was classified as sequence type 78 (ST78) and harbored multiple resistance genes, especially co-carried <i>mcr-9</i> and <i>bla</i><sub>NDM-5</sub> located on an IncHI2 plasmid (pMCR9_EH001) and an IncX3 plasmid (pNDM5_EH001), respectively. Both plasmids were successfully co-transferred to <i>E. coli</i> EC600 by conjugation. Analysis of the genetic environment of <i>mcr-9</i> and <i>bla</i><sub>NDM-5</sub> revealed the multiple mobile genetic elements, such as insertion sequences (IS) and transposon (Tn). ∆Tn<i>3-</i>IS<i>3000-</i>∆IS<i>Aba125-5′</i>-IS<i>5</i>-∆IS<i>Aba125-3′</i> were situated upstream of <i>bla</i><sub>NDM-5</sub>, while <i>ble</i><sub>MBL</sub>-<i>trpF-dsbD-CutA-</i>IS<i>26</i> were situated downstream of it. In addition, <i>rcnR</i>, <i>rcnA</i>, <i>pcoE</i>, <i>pcoS</i>, and IS<i>5</i> family transposase (IS<i>903B</i>) were situated upstream of <i>mcr-9</i>, while IS<i>3000</i> was situated downstream of it, followed by <i>bla</i><sub>CTX-M-3</sub> and IS<i>26</i>. The majority of the plasmid-mediated resistance genes reside within or adjacent to diverse mobile genetic elements, which may potentially promote the horizontal transfer of antibiotic resistance determinants. This study represents the initial investigation providing the detailed genomic characteristics associated with co-occurrence of <i>mcr-9</i> and <i>bla</i><sub>NDM-5</sub> in <i>E. hormaechei</i>. The findings advocate for heightened clinical vigilance toward such strains, particularly to prevent nosocomial transmission.</p>

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Co-occurrence of mcr-9 and blaNDM-5 in Multidrug-Resistant Enterobacter hormaechei Strain Isolated from a Patient with Bloodstream Infection

  • 期刊论文

  • 发表日期：

    2025年3月5日

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  • Ru Li,
  • Junfeng Wang,
  • Weiting Zhang,
  • Chenhao Zhao,
  • Mingxiao Han,
  • Hong Du,
  • Haifang Zhang

摘要

Enterobacter hormaechei (E. hormaechei), a member of the Enterobacter cloacae complex, has emerged as an important pathogen in healthcare-associated infections. In this study, a multidrug-resistant E. hormaechei EH001 co-carrying mcr-9 and blaNDM-5 was isolated from a patient with bloodstream infection in China. To investigate the genomic characteristics of a multidrug-resistant E. hormaechei EH001 co-carrying mcr-9 and blaNDM-5, whole-genome sequencing was employed and conjugation experiment was performed by using the recipient E. coli EC600. The antimicrobial susceptibility profiles of E. hormaechei EH001 revealed resistance to the most commonly used antimicrobial agents, with the exception of polymyxin B, polymyxin E, and minocycline. E. hormaechei EH001 was classified as sequence type 78 (ST78) and harbored multiple resistance genes, especially co-carried mcr-9 and blaNDM-5 located on an IncHI2 plasmid (pMCR9_EH001) and an IncX3 plasmid (pNDM5_EH001), respectively. Both plasmids were successfully co-transferred to E. coli EC600 by conjugation. Analysis of the genetic environment of mcr-9 and blaNDM-5 revealed the multiple mobile genetic elements, such as insertion sequences (IS) and transposon (Tn). ∆Tn3-IS3000-∆ISAba125-5′-IS5-∆ISAba125-3′ were situated upstream of blaNDM-5, while bleMBL-trpF-dsbD-CutA-IS26 were situated downstream of it. In addition, rcnR, rcnA, pcoE, pcoS, and IS5 family transposase (IS903B) were situated upstream of mcr-9, while IS3000 was situated downstream of it, followed by blaCTX-M-3 and IS26. The majority of the plasmid-mediated resistance genes reside within or adjacent to diverse mobile genetic elements, which may potentially promote the horizontal transfer of antibiotic resistance determinants. This study represents the initial investigation providing the detailed genomic characteristics associated with co-occurrence of mcr-9 and blaNDM-5 in E. hormaechei. The findings advocate for heightened clinical vigilance toward such strains, particularly to prevent nosocomial transmission.