Chromosomal Coharboring of Bla and Mcr-9 in Enterobacter Asburiae Isolated from a Japanese Woman with Empyema: a Case Report

Overview

Journal BMC Infect Dis

Publisher Biomed Central

Specialty Infectious Diseases

Date 2022 Sep 30

PMID 36180829

Authors

Yusuke Miyazato

Noriko Iwamoto

Masaru Usui

Toyotaka Sato

Tohru Miyoshi-Akiyama

Maki Nagashima

Kazuhisa Mezaki

Kayoko Hayakawa

Norio Ohmagari

Affiliations

Soon will be listed here.

Abstract

Background: Polymyxin E (colistin) is a last-resort antibiotic to treat infections caused by carbapenemase-producing Enterobacteriaceae (CPE). However, reports of CPEs resistant to colistin have been increasing, and the mcr genes are emerging as resistance mechanisms. Among them, plasmid-mediate mcr-9 is known to be associated with colistin resistance, whereas reports on chromosomal mcr-9 and its association with colistin resistance in humans are few.

Case Presentation: We identified Enterobacter asburiae harboring mcr-9 and bla in the pleural fluid of a patient with empyema. The long-read sequencing technique revealed that these genes were located on its chromosome. Despite the lack of exposure to colistin, the organism showed microcolonies in the inhibition circle in the E-test and disk diffusion test. Antibiotic susceptibility testing by broth microdilution confirmed its resistance to colistin.

Conclusion: Our case report showed that mcr-9 can be present not only on plasmids but also on the chromosome in E. asburiae, and that the presence of mcr-9 on its chromosome may influence its susceptibility to colistin.

Citing Articles

Chromosomal integration and plasmid fusion occurring in ST20 carbapenem-resistant isolates coharboring and induce resistance transmission and fitness variation.

Shi Q, Hu H, Yu Q, Huang W, Wang Y, Quan J Emerg Microbes Infect. 2024; 13(1):2339942.

PMID: 38584569 PMC: 11022923. DOI: 10.1080/22221751.2024.2339942.

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