Latency of Klebsiella species and Escherichia coli strains that harbor a conjugative IncA/C type plasmid carrying both rmtB and bla_<CTX-M-14>

Six high-level aminoglycoside and third generated cephalosporin of cefotaxime resistance Klebsiella pneumoniae, Klebsiella oxytoca, and Escherichia coli isolated from clinical specimens in the same Japanese hospital since 2001. These 6 strains were resistant to all 4,6-disubstituted deoxystreptamine including albekacin. The results of multiplex PCR for 16S rRNA methylase and bla_, bla_, bla_ specific PCR reaction show that these strains harbor 16S rRNA methylase of rmtB and β-lactamase resistance gene of bla_ group in the same large plasmid. Sequence analysis of bla_ group PCR products shows this β-lactamase is bla_. rmtB-harbored plasmids are classified the IncA/C by PCR and restriction pattern by EcoRI show only one or two band differences. Moreover, southern hybridization of EcoRI digested rmtB harbored plasmid by rmtB probe show the same hybridization pattern of 4.8 kbp bands. PFGE fingerprinting analysis of four K. pneumoniae revealed two fingerprinting patterns. These facts suggested that rmtB-positive starains not only spread horizontal transfer of rmtB-harbored plasmid but also clonal spread of the same strain

Global Spread of Multiple Aminoglycoside Resistance Genes

Emergence of the newly identified 16S rRNA methylases RmtA, RmtB, and ArmA in pathogenic gram-negative bacilli has been a growing concern. ArmA, which had been identified exclusively in Europe, was also found in several gram-negative pathogenic bacilli isolated in Japan, suggesting global dissemination of hazardous multiple aminoglycoside resistance genes

Simple and rapid detection method for qepA1 by loop-mediated isothermal amplification

Although fluoroquinolone (FQ) has been used for the treatment of various bacterial infectious diseases, its continued use has been problematic given the appearance of FQ-resistant bacteria. However, the recent discovery of four plasmid-mediated quinolone resistance (PMQR) genes comprising qnr, aac(6\u27)Ib-cr, qepA and OqxAB since 1998 has provided insights in the area of FQ-resistance. For practical detection of qepA in microbiology laboratory, a specific, simple, rapid and cost-effective isothermal amplification method designated as LAMP is the good candidate to use. In this study, the development of a new detection method using LAMP to identify qepA1, one variant of the qepA gene, was tried. As the results, the LAMP method using a qepA1-specific LAMP primer set comprising five primerscould detect all four qepA1-positive strains in addition to 17 qepA1-negative strains. The LAMP method is clearly much more advantageous for use in clinical laboratories. Furthermore, the time and accuracy benefits allow for the selection of antibiotics in a clinical setting

16S rRNA Methylase–producing, Gram-Negative Pathogens, Japan

To investigate the exact isolation frequency of 16S rRNA methylase–producing, gram-negative pathogenic bacteria, we tested 87,626 clinical isolates from 169 hospitals. Twenty-six strains from 16 hospitals harbored 16S rRNA methylase genes, which suggests sparse but diffuse spread of pan-aminoglycoside–resistant microbes in Japan

Complete Sequencing of the blaNDM-1-Positive IncA/C Plasmid from Escherichia coli ST38 Isolate Suggests a Possible Origin from Plant Pathogens

The complete sequence of the plasmid pNDM-1_Dok01 carrying New Delhi metallo-β-lactamase (NDM-1) was determined by whole genome shotgun sequencing using Escherichia coli strain NDM-1_Dok01 (multilocus sequence typing type: ST38) and the transconjugant E. coli DH10B. The plasmid is an IncA/C incompatibility type composed of 225 predicted coding sequences in 195.5 kb and partially shares a sequence with blaCMY-2-positive IncA/C plasmids such as E. coli AR060302 pAR060302 (166.5 kb) and Salmonella enterica serovar Newport pSN254 (176.4 kb). The blaNDM-1 gene in pNDM-1_Dok01 is terminally flanked by two IS903 elements that are distinct from those of the other characterized NDM-1 plasmids, suggesting that the blaNDM-1 gene has been broadly transposed, together with various mobile elements, as a cassette gene. The chaperonin groES and groEL genes were identified in the blaNDM-1-related composite transposon, and phylogenetic analysis and guanine-cytosine content (GC) percentage showed similarities to the homologs of plant pathogens such as Pseudoxanthomonas and Xanthomonas spp., implying that plant pathogens are the potential source of the blaNDM-1 gene. The complete sequence of pNDM-1_Dok01 suggests that the blaNDM-1 gene was acquired by a novel composite transposon on an extensively disseminated IncA/C plasmid and transferred to the E. coli ST38 isolate

Corynebacterium striatum Bacteremia Associated with a Catheter-Related Blood Stream Infection

A 49-year-old woman visited our emergency department because of exertional dyspnea due to severe left ventricular functional failure. It progressed to disseminated intravascular coagulation and disturbance of consciousness on day 67 of admission. Gram-positive bacilli were detected from two different blood culture samples on day 67 of admission. An API-Coryne test and sequencing (1~615 bp) of the 16S rRNA gene were performed, and the strain was identified as Corynebacterium striatum. The bacterium was detected from the removed central venous catheter tip too, and the patient was diagnosed with catheter-related bloodstream infection by C. striatum. However, treatment was not effective, and the patient died on day 73 of admission

Identification of 16S rRNA Methylase-Producing Acinetobacter baumannii Clinical Strains in North America▿

Five highly amikacin-resistant Acinetobacter baumannii isolates were collected at a medical center in Pennsylvania. The aminoglycoside resistance was due to the production of the 16S rRNA methylase ArmA. Two of the isolates coproduced OXA-23 β-lactamase and were highly resistant to carbapenems as well. The isolates were genetically closely related by pulsed-field gel electrophoresis

Plasmid-Mediated qepA Gene among Escherichia coli Clinical Isolates from Japan▿

Seven hundred fifty-one Escherichia coli clinical isolates collected from 140 Japanese hospitals between 2002 and 2006 were screened for the qepA and qnr genes. Two E. coli isolates (0.3%) harbored qepA, but no qnr was identified. The results suggested a low prevalence of E. coli harboring qepA or qnr in Japan