Antimicrobial Resistance of Non-O157 Shiga Toxin-Producing Escherichia coli Isolated from Humans and Domestic Animals.

Yanyu Pan,Lijiao Cao,Juan Li,Dong Jin,Xiangning Bai,Hui Sun,Bin Hu,Qian Liu,Yanwen Xiong,Xi Yang,Ji Zhang

doi:10.3390/antibiotics10010074

Abstract

Non-O157 Shiga toxin-producing Escherichia coli (STEC) is an important pathogen that can cause zoonotic diseases. To investigate the antimicrobial resistance of STEC in China, non-O157 STEC isolates, recovered from domestic animals and humans from 12 provinces, were analyzed using antimicrobial susceptibility testing and whole genome characterization. Out of the 298 isolates tested, 115 strains showed resistance to at least one antimicrobial and 85 strains showed multidrug resistance. The highest resistance rate was to tetracycline (32.6%), followed by nalidixic acid (25.2%) and chloramphenicol and azithromycin (both 18.8%). However, imipenem and meropenem were effective against all isolates. Antimicrobial resistance patterns varied among strains from different sources. Strains from pig, sheep, humans, and cattle showed resistance rates of 100.0%, 46.9%, 30.3%, and 6.3% to one or more antimicrobials, respectively. Forty-three genes related to 11 antimicrobial classes were identified among these strains. The colistin-resistance gene mcr was only carried by strains from pigs. A new fosfomycin-resistant gene, fosA7, was detected in strains from humans, cattle, and sheep. Whole genome phylogenetic analysis showed that strains from the four sources were genetically diverse and scattered throughout the phylogenetic tree; however, some strains from the same source had a tendency to cluster closely. These results provide a reference to monitor the emergence and spread of multidrug resistant STEC strains among animals and humans. Furthermore, with a better understanding of antimicrobial genotypes and phenotypes among the diverse STEC strains obtained, this study could guide the administration of antimicrobial drugs in STEC infections when necessary.

Highlights

We investigated antimicrobial resistance (AMR) in a diverse collection of non-O157 Shiga toxin-producing Escherichia coli (STEC) isolates recovered from cattle, sheep, pigs, and human patients with diarrhea in China
The present study revealed an overview of antimicrobial resistance phenotypes and genotypes among non-O157 STEC strains from diverse sources in China
We identified mcr-1 and mcr-3 in pig-derived non-O157 STEC strains, and the existence of the fosA7 gene in non-O157 STECs from different sources in China

Summary

Introduction

Shiga toxin-producing Escherichia coli (STEC) is an important zoonotic foodborne pathogen, which can cause watery diarrhea, hemorrhagic colitis (HC), and even lifethreatening hemolytic uremic syndrome (HUS) [1,2]. STEC O157:H7 was first recognized as a cause of a foodborne outbreak in the USA in 1982, and remains the most predominant and virulent serotype associated with outbreaks and severe human illnesses worldwide [3]. Sporadic cases or outbreaks caused by non-O157 STEC strains have been reported increasingly, especially strains of several serogroups (O26, O45, O103, O111, O121, and O145, termed as the “top six”) that were the most prevalent during STEC outbreaks [6,7,8]. Stx is the essential virulence factor contributing to the development of HUS [9]. The treatment of STEC infections is mainly supportive, including rehydration therapy and dialysis where necessary [11]

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