Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018

Miao Yi,1 Jiaqi Zou,2 Jinxin Zhao,1 Yu Tang,3 Yaling Yuan,1 Bingxue Yang,1 Jinzhu Huang,1 Peiwen Xia,1 Yun Xia1 1Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Clinical Laboratory, Chengdu Women’...

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Main Authors: Yi M, Zou J, Zhao J, Tang Y, Yuan Y, Yang B, Huang J, Xia P, Xia Y
Format: Article
Language:English
Published: Dove Medical Press 2022-01-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/emergence-of-optra-mediated-linezolid-resistance-in-enterococcus-faeci-peer-reviewed-fulltext-article-IDR
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author Yi M
Zou J
Zhao J
Tang Y
Yuan Y
Yang B
Huang J
Xia P
Xia Y
author_facet Yi M
Zou J
Zhao J
Tang Y
Yuan Y
Yang B
Huang J
Xia P
Xia Y
author_sort Yi M
collection DOAJ
description Miao Yi,1 Jiaqi Zou,2 Jinxin Zhao,1 Yu Tang,3 Yaling Yuan,1 Bingxue Yang,1 Jinzhu Huang,1 Peiwen Xia,1 Yun Xia1 1Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Clinical Laboratory, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 3Department of Laboratory Medicine, Chongqing University Three Gorges Hospital, Chongqing, People’s Republic of ChinaCorrespondence: Yun XiaDepartment of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, People’s Republic of ChinaTel +86-23-89012742Fax +86-23-89012513Email xiayun12cn@aliyun.comPurpose: To investigate the potential mechanism and molecular characteristics of linezolid-non-sensitive Enterococcus faecium from a tertiary hospital in southwest China and characterize the relevant plasmids.Patients and Methods: Linezolid-non-sensitive Enterococcus faecium (LNSEFM) isolates collected from January 2014 to December 2018 were screened for resistant genes 23s rRNA, rplC, rplD, rplV, optrA, cfr, poxtA, by PCR. Molecular epidemiological analysis was performed by multilocus sequence typing (MLST). The optrA-and-poxtA co-harboring strain EFM_7150 was subjected to the whole genome sequencing (WGS) by Illumina HiSeq and Oxford Nanopore MinION.Results: A total of 15 LNSEFM with linezolid MICs ranging from 4 to 16 mg/L were identified. About 66.7% (10/15) of isolates were linezolid-resistant. About 46.7% (7/15) of strains were positive for optrA. Two types of optrA variants (P and EYDNDM) were identified. About 13.3% (2/15) of isolates had poxtA. 1 harbored a L22 protein alteration (Ser77Thr). One isolate coharbored optrA (EYDNDM variant) and poxtA. There was no mutation in the gene that encoded the ribosomal protein L3/L4 or the domain V of 23S rRNA. No cfr gene was detected. Based on WGS data, optrA was associated with Tn558 inserted to radC gene and poxtA was flanked by IS1216E.Conclusion: OptrA is primary mechanism in linezolid-resistant Enterococcus faecium. This is the first report ofoptrA variants P and EYDNDM identified in Enterococcus faecium and optrA-and-poxtA co-harboring Enterococcus faecium clinically in southwest China. Besides, Tn558 and IS1216Es may play an important role in the dissemination of optrA and poxtA, respectively. The findings revealed the potential threat to nosocomial infection by optrA and coexistence of optrA and poxtA in Enterococcus faecium. Thus, clinical surveillance of linezolid-resistant Enterococcus is urgently needed.Keywords: optrA, poxtA, linezolid-non-sensitive Enterococcus faecium, WGS
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spelling doaj.art-291e806943d541eda6ad40ac1891ab552022-12-21T19:24:20ZengDove Medical PressInfection and Drug Resistance1178-69732022-01-01Volume 15132072005Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018Yi MZou JZhao JTang YYuan YYang BHuang JXia PXia YMiao Yi,1 Jiaqi Zou,2 Jinxin Zhao,1 Yu Tang,3 Yaling Yuan,1 Bingxue Yang,1 Jinzhu Huang,1 Peiwen Xia,1 Yun Xia1 1Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Clinical Laboratory, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China; 3Department of Laboratory Medicine, Chongqing University Three Gorges Hospital, Chongqing, People’s Republic of ChinaCorrespondence: Yun XiaDepartment of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, People’s Republic of ChinaTel +86-23-89012742Fax +86-23-89012513Email xiayun12cn@aliyun.comPurpose: To investigate the potential mechanism and molecular characteristics of linezolid-non-sensitive Enterococcus faecium from a tertiary hospital in southwest China and characterize the relevant plasmids.Patients and Methods: Linezolid-non-sensitive Enterococcus faecium (LNSEFM) isolates collected from January 2014 to December 2018 were screened for resistant genes 23s rRNA, rplC, rplD, rplV, optrA, cfr, poxtA, by PCR. Molecular epidemiological analysis was performed by multilocus sequence typing (MLST). The optrA-and-poxtA co-harboring strain EFM_7150 was subjected to the whole genome sequencing (WGS) by Illumina HiSeq and Oxford Nanopore MinION.Results: A total of 15 LNSEFM with linezolid MICs ranging from 4 to 16 mg/L were identified. About 66.7% (10/15) of isolates were linezolid-resistant. About 46.7% (7/15) of strains were positive for optrA. Two types of optrA variants (P and EYDNDM) were identified. About 13.3% (2/15) of isolates had poxtA. 1 harbored a L22 protein alteration (Ser77Thr). One isolate coharbored optrA (EYDNDM variant) and poxtA. There was no mutation in the gene that encoded the ribosomal protein L3/L4 or the domain V of 23S rRNA. No cfr gene was detected. Based on WGS data, optrA was associated with Tn558 inserted to radC gene and poxtA was flanked by IS1216E.Conclusion: OptrA is primary mechanism in linezolid-resistant Enterococcus faecium. This is the first report ofoptrA variants P and EYDNDM identified in Enterococcus faecium and optrA-and-poxtA co-harboring Enterococcus faecium clinically in southwest China. Besides, Tn558 and IS1216Es may play an important role in the dissemination of optrA and poxtA, respectively. The findings revealed the potential threat to nosocomial infection by optrA and coexistence of optrA and poxtA in Enterococcus faecium. Thus, clinical surveillance of linezolid-resistant Enterococcus is urgently needed.Keywords: optrA, poxtA, linezolid-non-sensitive Enterococcus faecium, WGShttps://www.dovepress.com/emergence-of-optra-mediated-linezolid-resistance-in-enterococcus-faeci-peer-reviewed-fulltext-article-IDRoptrapoxtalinezolid-non-sensitive enterococcus faeciumwgs
spellingShingle Yi M
Zou J
Zhao J
Tang Y
Yuan Y
Yang B
Huang J
Xia P
Xia Y
Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018
Infection and Drug Resistance
optra
poxta
linezolid-non-sensitive enterococcus faecium
wgs
title Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018
title_full Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018
title_fullStr Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018
title_full_unstemmed Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018
title_short Emergence of optrA-Mediated Linezolid Resistance in Enterococcus faecium: A Molecular Investigation in a Tertiary Hospital of Southwest China from 2014–2018
title_sort emergence of optra mediated linezolid resistance in enterococcus faecium a molecular investigation in a tertiary hospital of southwest china from 2014 ndash 2018
topic optra
poxta
linezolid-non-sensitive enterococcus faecium
wgs
url https://www.dovepress.com/emergence-of-optra-mediated-linezolid-resistance-in-enterococcus-faeci-peer-reviewed-fulltext-article-IDR
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