Dynamics of Resistance Plasmids in Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae during Postinfection Colonization
Autor: | Linus Sandegren, Öjar Melefors, Fredrika Rajer, Emilia Titelman, Christian G. Giske, Alma Brolund |
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Rok vydání: | 2019 |
Předmět: |
Gut flora
beta-Lactamases Epidemiology and Surveillance Microbiology Feces 03 medical and health sciences Plasmid Antibiotic resistance Bacterial Proteins Enterobacteriaceae Humans Pharmacology (medical) Colonization 030304 developmental biology Pharmacology 0303 health sciences biology Resistance (ecology) 030306 microbiology Colonization rate Enterobacteriaceae Infections biology.organism_classification Infectious Diseases Carrier State Urinary Tract Infections Plasmids |
Zdroj: | Antimicrobial Agents and Chemotherapy. 63 |
ISSN: | 1098-6596 0066-4804 |
DOI: | 10.1128/aac.02201-18 |
Popis: | Extended-spectrum β-lactamase-producing Enterobacteriaceae (EPE) are a major cause of bloodstream infections, and the colonization rate of EPE in the gut microbiota of individuals lacking prior hospitalization or comorbidities is increasing. In this study, we performed an in-depth investigation of the temporal dynamics of EPE and their plasmids during one year by collecting fecal samples from three patients initially seeking medical care for urinary tract infections. In two of the patients, the same strain that caused the urinary tract infection (UTI) was found at all consecutive samplings from the gut microbiota, and no other EPEs were detected, while in the third patient the UTI strain was only found in the initial UTI sample. Instead, this patient presented a complex situation where a mixed microbiota of different EPE strain types, including three different E. coli ST131 variants, as well as different bacterial species, was identified over the course of the study. Different plasmid dynamics were displayed in each of the patients, including the spread of plasmids between different strain types over time and the transposition of bla(CTX-M-15) from the chromosome to a plasmid, followed by subsequent loss through homologous recombination. Small cryptic plasmids were found in all isolates from all patients, and they appear to move frequently between different strains in the microbiota. In conclusion, we could demonstrate an extensive variation of EPE strain types, plasmid composition, rearrangements, and horizontal gene transfer of genetic material illustrating the high dynamics nature and interactive environment of the gut microbiota during post-UTI carriage. |
Databáze: | OpenAIRE |
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