Antimicrobial Multidrug Resistance Research Articles

Molecular and phenotypic characterization of methicillin-resistant Staphylococcus pseudintermedius from ocular surfaces of dogs and cats suffering from ophthalmological diseases

Methicillin-resistant Staphylococcus pseudintermedius (MRSP) have recently emerged as a major therapeutic challenge in small animal medicine because of their antimicrobial multidrug resistance and their role as nosocomial pathogens. This study focused on the prevalence, molecular characteristics and antimicrobial resistance pheno- and genotypes of MRSP isolated from conjunctival swabs of dogs and cats. Conjunctival swabs were collected from 72 dogs and 24 cats suffering from conjunctivitis/blepharitis, keratitis or uveitis and screened for the presence of MRSP. S. pseudintermedius was isolated from 38 (39.6 %) of all samples. Three (7.9 %) S. pseudintermedius isolates were confirmed as MRSP. They harboured the mecA gene and originated from dogs. One MRSP isolate was from a case of uveitis while the other two MRSP isolates originated from cases of conjunctivitis/blepharitis. All MRSP isolates were subjected to broth microdilution and whole genome sequencing (WGS). Resistance and virulence genes, multilocus sequence (MLS), spa, dru and SCCmec types were deduced from WGS data. Two of the three MRSP isolates, IMT360/16 and IMT515/16, shared the same MLS type (ST71), spa type (t02), dru type (dt9a), SCCmec type (II-III), and indistinguishable multidrug resistance pheno- and genotypes, including resistance to β-lactams (blaZ, mecA), erythromycin and clindamycin (erm(B)), streptomycin (aphA3), gentamicin (aacA-aphD), enrofloxacin (mutations in grlA and gyrA), tetracycline (tet(K)), and trimethoprim (dfrG)/sulfamethoxazole. The third isolate, IMT1670/16, differed in all those characteristics (MLST (ST1403), dru type (dt10h), SCCmec type (IVg), except the spa type (t02). In addition, isolate IMT1670/16 carried a different tetracycline resistance gene (tet(M)) and was susceptible to erythromycin and clindamycin.

Treatment of Helicobacter pylori.

Helicobacter pylori eradication has become more challenging over the past decade due to increasing antimicrobial resistance, especially to clarithromycin and levofloxacin. We identified 508 recent publications on H. pylori treatment (published between January 2018 and June 2019), focusing on the most highly clinically relevant for this review. Declining H. pylori eradication rates with clarithromycin triple therapy have led to most guidelines recommending 14 days bismuth-based quadruple therapy or concomitant therapy as the best initial empiric regimen. Substituting amoxicillin for tetracycline or metronidazole in quadruple therapy, and a three-in-one pill version of the regimen, also appear effective. Vonoprazan, a potent acid inhibitor, can overcome much clarithromycin resistance in triple therapy. High-dose dual therapy (proton pump inhibitor with amoxicillin) is a promising alternative approach. Reviewing resistance patterns to select suitable first-line empiric therapies is important in high resistance regions. Molecular methods to evaluate H. pylori antimicrobial susceptibility promise to be simpler than standard microbiological culture. The cost-effectiveness of antimicrobial susceptibility testing in refractory cases remains unproven. Updating clinicians treating H. pylori is important to combat the emerging problems of multidrug antimicrobial resistance in H. pylori strains. Truly novel approaches to H. pylori eradication are needed.

Antimicrobial Drug Interactions: Systematic Evaluation of Protein and Nucleic Acid Synthesis Inhibitors.

Antimicrobial multidrug resistance and its transmission among strains are serious problems. Success rate is decreased and treatment options are narrowed due to increasing bacterial multidrug resistance. On the other hand, the need for long-term efforts to discover new antibiotics and difficulties finding new treatment protocols make this problem more complex. Combination therapy, especially with synergistic use of antimicrobials is a rational treatment option with huge benefits. Thus, screening antibiotic interactions is crucial for finding better treatment options. Clinicians currently use combinatorial antibiotic treatment as an effective treatment option. However, antibiotics can show synergistic or antagonistic interactions when used together. In our study, we aimed to investigate interactions of antibiotics with different mechanisms of action. Antibiotics, which act as protein synthesis inhibitors (P) and nucleic acid synthesis inhibitors (N) were used in our study. We tested 66 (PN), 15 (NN), and 55 (PP) drug pairs on the Escherichia coli strain. The Loewe additivity model was used and alpha scores were calculated for analysis of interactions of drug combinations. Drug interactions were categorized as synergistic or antagonistic. Accordingly, pairwise combinations of protein synthesis inhibitors (PP) showed stronger synergistic interactions than those of nucleic acid synthesis inhibitors (NN) and nucleic acid synthesis–protein synthesis inhibitors (PN). As a result, the importance of mechanisms of action of drugs is emphasized in the selection of synergistic drug combinations.

Genome analysis of antimicrobial resistance, virulence, and plasmid presence in Turkish Salmonella serovar Infantis isolates

Salmonella enterica subsp. enterica serovar Infantis (S. Infantis) isolates were found to have a multi-drug resistance profile (kanamycin, streptomycin, nalidixic acid, tetracycline, sulfonamide, and sometimes to ampicillin) and high prevalence (91%) in Turkish poultry in our previous studies. To investigate the mechanism behind multi-drug antimicrobial resistance (AMR) and high prevalence in Turkish poultry, 23 of the isolates were sequenced for comparative genomic analyses including: SNP-based comparison to S. Infantis from other countries, comparison of antimicrobial resistance genes (AMGs) with AMR phenotypes, and plasmid identification and annotation. Whole-genome SNP-based phylogenetic analysis found that all 23 Turkish S. Infantis isolates formed a distinct, well-supported clade, separate from 243 comparison S. Infantis genomes in GenomeTrakr identified as from the US and EU; the isolates most closely related to the cluster of these Turkish isolates were from Israel and Egypt. AMGs identified by bioinformatic analysis, without differentiating chromosomal or plasmid located genes, implied AMR phenotypes with 94% similarity overall to wet lab data, which was performed by phenotypic and conventional PCR methods. Most of the S. Infantis (21/23) isolates had identifiable plasmids, with 76% (16/21) larger than 100 kb and 48% (10/21) larger than 200 kb. A plasmid larger than 200 kb, with the incompatibility type of IncX1, similar to United States S. Infantis plasmid N55391 (99% query coverage and 99% identity overall), which itself is similar to Italian and Hungarian S. Infantis plasmids. Turkish S. Infantis plasmids had different beta-lactam resistance genes (blaTEM-70, blaTEM-148 and blaTEM-198) than the gene blaCTX-M-65 found in S. Infantis plasmids from other countries. This is the first observation of these three genes in S. Infantis isolates. The plasmids larger than 200 kb had two distinct regions of interest: Site 1 and Site 2. Site 1 (around 130 kb) had virulence- and bacteriocin- associated genes such as bacteriocin secretion system and type II toxin-antitoxin system genes (vagC, ccdA, ccdB, mchE, cvaB) and an aminoglycoside resistance gene (str). Site 2 (around 75–110 kb) had the antimicrobial resistance genes (aadA, sulI, tetA, tetR) and mercury (mer) resistance gene on tranposons Tn552 and Tn501. Presence of these AMR and virulence genes suggests they may have a role in the emergence of S. Infantis in poultry and support treating this serotype as a an important human health hazard.

Reconciling Antimicrobial Susceptibility Testing and Clinical Response in Antimicrobial Treatment of Chronic Cystic Fibrosis Lung Infections.

Median cystic fibrosis (CF) survival has increased dramatically over time due to several factors, including greater availability and use of antimicrobial therapies. During the progression of CF lung disease, however, the emergence of multidrug antimicrobial resistance can limit treatment effectiveness, threatening patient longevity. Current planktonic-based antimicrobial susceptibility testing lacks the ability to predict clinical response to antimicrobial treatment of chronic CF lung infections. There are numerous reasons for these limitations including bacterial phenotypic and genotypic diversity, polymicrobial interactions, and impaired antibiotic efficacy within the CF lung environment. The parallels to other chronic diseases such as non-CF bronchiectasis are discussed as well as research priorities for moving forward.

Evaluation of antibiotic resistance of Enterobacteriaceae bacteria isolated from water objects of the north-west of the Murmansk region

Multidrug antimicrobial resistance among different species of the family Enterobacteriaceae remains a major problem worldwide. In this paper, we report the data on antimicrobial susceptibility of 145 isolates of Enterobacteriaceae collected in 14 water environments of the north-west of the Murmansk region in autumn 2016. The number of Enterobacteriaceae in the examined rivers was rather low. Only the concentration of enterobacteria exceed the regulations in water samples from lake Kuetsjarvi. The detected isolates were assigned to eight species of enterobacteria. The most abundant species were Enterobacter spp. (26.9%) and Citrobacter freundii (25.3%). Isolates of Escherichia coli were not detected. Most of the isolates (96.6%) were multi-drug resistance (MDR). Notably, 16.6% of the all isolates were categorized as possible extensively drug-resistant (XDR). Almost all isolates were showing high level resistance to β-lactams, especially to cefepime and imipenem. Most effective antimicrobial agentы were tobramycin and norfloxacin.

Engineering microbes for targeted strikes against human pathogens.

Lack of pathogen specificity in antimicrobial therapy causes non-discriminant microbial cell killing that disrupts the microflora present. As a result, potentially helpful microbial cells are killed along with the pathogen, altering the biodiversity and dynamic interactions within the population. Moreover, the unwarranted exposure of antibiotics to microbes increases the likelihood of developing resistance and perpetuates the emergence of multidrug resistance. Synthetic biology offers an alternative solution where specificity can be conferred to reduce the non-specific, non-targeted activity of currently available antibiotics, and instead provides targeted therapy against specific pathogens and minimising collateral damage to the host's inherent microbiota. With a greater understanding of the microbiome and the available genetic engineering tools for microbial cells, it is possible to devise antimicrobial strategies for novel antimicrobial therapy that are able to precisely and selectively remove infectious pathogens. Herein, we review the strategies developed by unlocking some of the natural mechanisms used by the microbes and how these may be utilised in targeted antimicrobial therapy, with the promise of reducing the current global bane of multidrug antimicrobial resistance.

Multidrug resistant Salmonella enterica isolated from conventional pig farms using antimicrobial agents in preventative medicine programmes

A longitudinal study was conducted to investigate the presence of multidrug antimicrobial resistance (multi-AR) in Salmonella enterica in pigs reared under conventional preventative medicine programmes in Spain and the possible association of multi-AR with ceftiofur or tulathromycin treatment during the pre-weaning period. Groups of 7-day-old piglets were treated by intramuscular injection with ceftiofur on four farms (n=40 piglets per farm) and with tulathromycin on another four farms (n=40 piglets per farm). A control group of untreated piglets (n=30 per farm) was present on each farm. Faecal swabs were collected for S. enterica culture prior to treatment, at 2, 7 and 180days post-treatment, and at slaughter. Minimal inhibitory concentrations of 14 antimicrobial agents, pulsed-field gel electrophoresis and detection of resistance genes representing five families of antimicrobial agents were performed. Plasmids carrying cephalosporin resistant (CR) genes were characterised. Sixty-six S. enterica isolates were recovered from five of eight farms. Forty-seven isolates were multi-AR and four contained blaCTX-M genes harboured in conjugative plasmids of the IncI1 family; three of these isolates were recovered before treatment with ceftiofur. The most frequent AR genes detected were tet(A) (51/66, 77%), sul1 (17/66, 26%); tet(B) (15/66, 23%) and qnrB (10/66, 15%). A direct relation between the use of ceftiofur in these conditions and the occurrence of CR S. enterica was not established. However, multi-AR was common, especially for ampicillin, streptomycin, sulphonamides and tetracycline. These antibiotics are used frequently in veterinary medicine in Spain and, therefore, should be used sparingly to minimise the spread of multi-AR.

Prevalence of multi drug antimicrobial resistance in Mannheimia haemolytico isolated from high-risk Stocker cattle at arrival and two weeks after processing

Bovine respiratory disease (BRD) is the leading cause of morbidity and mortality in North American beef cattle. Mannheimia haemolytica (Mh) is the bacterial pathogen most frequently isolated from cattle with BRD and the prevalence of antimicrobial resistance in this pathogen has been increasing. Administration of antimicrobials to prevent BRD is commonplace in stocker cattle. Our objectives were to determine the prevalence of Mh isolated from the nasopharynx of high-risk stocker cattle at arrival and at resampling 10 to 14 days later, and second, to determine the prevalence of antimicrobial resistant Mh at these same time points.

Molecular characterization of antimicrobial multi-drug resistance in non-typhoidal Salmonellae from chicken and clam in Mangalore, India.

Salmonella enterica has been documented as one of the leading causes of salmonellosis throughout the world and is most commonly associated with the consumption of contaminated food products. Thus, this research was aimed at studying the antimicrobial susceptibility pattern and detection of quinolone resistance in Salmonella spp isolated from food of animal origin. Thirty-six Salmonella isolates comprising 8 from poultry and 28 from seafood (clams) were identified, serotyped and characterized for their antimicrobial susceptibility against 10 different antibiotics. Plasmid DNA was isolated from all the isolates by alkaline lysis, quinolone resistant non-typhoidal S. Weltevreden were examined for mutation in the DNA gyrase coding gene. Among the 36 Salmonella isolates, 20 were S. weltevreden (8 from poultry and 12 from seafood) and 16 were S. Typhimurium (from seafood). All the isolates showed multiple resistance to nalidixic acid, tetracycline, co-trimoxazole and nitrofurantoin, but, interestingly, the isolates were 100% susceptible to ampicillin, chloramphenicol and gentamicin. Resistant isolates from the study carried the genes responsible for resistance to respective antibiotics. The strain S130 isolated in the study showed single point mutation, Asp87Gly, at position 87 in quinolone resistance determining region. It revealed mutation in quinolone resistance determining region as a cause for quinolone resistance in non-typhoidal Salmonellae. The occurrence of genes accountable for plasmid mediated resistance to quinolones (viz., qnrA, qnrB and qnrS) in plasmid of non-typhoidal Salmonellae isolates provides evidence for plasmid mediated quinolone resistance.

Antimicrobial Susceptibility of Neisseria gonorrhoeae in Japan from 2000 to 2015.

Gonococcal infections are difficult to treat because of their multidrug antimicrobial resistance. The outbreak of antimicrobial-resistant Neisseria gonorrhoeae has begun in Asia and particularly in Japan. Therefore, it is very important that we understand the trend of antimicrobial resistance of N. gonorrhoeae in Asia including Japan. Our surveillance of the antimicrobial susceptibility of N. gonorrhoeae began in 2000 under the guidance of the Department of Urology, Gifu University. We report our surveillance data from 2000 to 2015. We collected N. gonorrhoeae strains isolated from patients with gonococcal infections who visited our cooperating medical institutions in Japan from 2000 to 2015. MICs of penicillin G, cefixime, ceftriaxone, tetracycline, spectinomycin, azithromycin, and levofloxacin were determined by the agar dilution method approved by the Clinical and Laboratory Standards Institute. From 2000 to 2015, 2471 isolates of N. gonorrhoeae were collected in Japan. High rates of nonsusceptibility to penicillin, tetracycline, levofloxacin, cefixime, and azithromycin were shown. Around 5% to 10% of the strains isolated had a 0.25-mg/L MIC of ceftriaxone in each year, and 6 strains (0.24%) with a 0.5-mg/L MIC of ceftriaxone were isolated throughout the study period. Approximately 5% to 10% of the strains were resistant to each of ceftriaxone, azithromycin, and levofloxacin according to European Committee on Antimicrobial Susceptibility Testing breakpoints, and the rate has not increased significantly. From this study and previous pharmacodynamic analyses, a single 1-g dose of ceftriaxone is recommended to treat gonorrhea. As strains with high-level ceftriaxone resistance continue to spread, higher doses of ceftriaxone in monotherapy or multiple doses of ceftriaxone should be considered.

Prevalence of multi drug antimicrobial resistance in Mannheimia haemolytica isolated from high-risk stocker cattle at arrival and two weeks after processing1

Bovine respiratory disease (BRD) is the leading cause of morbidity and mortality in North American beef cattle. () is the bacterial pathogen most frequently isolated from cattle with BRD and the prevalence of antimicrobial resistance in this pathogen has been increasing. Administration of antimicrobials to prevent BRD is commonplace in stocker cattle, but the impact of this practice on emergence of resistance in is unknown. High risk, sale barn origin bull and steer calves ( = 169) were transported to a stocker facility in central Georgia and sampled via deep nasopharyngeal swab (NPS) at arrival processing. All calves received the macrolide antimicrobial tulathromycin (2.5 mg/kg subcutaneously) at arrival processing. A second NPS was collected from each calf 10 to 14 d after arrival. The occasional calves diagnosed and treated for BRD prior to 10 to 14 d were swabbed and cultured prior to treatment. Swabs were submitted for culture and antimicrobial susceptibility testing using the Kirby-Bauer disk diffusion method. Of the 169 cattle enrolled, 27 (16.0%) were culture positive for at arrival processing and of these, a multi-drug resistant (MDR) strain of was detected in 1 (3.7%). In contrast, 123 (72.8%) cattle were culture positive for at second sampling and of these, a MDR strain of was detected in 122 (99.2%). The proportions of cattle culture positive for and positive for MDR at arrival processing and at second sampling were significantly different ( < 0.001). At the level of the individual bacterial isolate, 366 individual isolates were collected from the calves at the time of the second sampling. Of these isolates, 361 (98.6%) were intermediate or resistant to all macrolides tested (tilmicosin, gamithromycin, tulathromycin) and the fluoroquinolone enrofloxacin. In addition, 254 isolates (69.4%) were intermediate or resistant to florfenicol and 4 (1.1%) were intermediate or resistant to ceftiofur. There was a significant difference in the proportion of isolates resistant to all of the drug classes except cephalosporins at arrival processing versus second sampling ( < 0.001). Our results show that there was an increase in the proportion of calves positive for from arrival processing to second sampling, and that there was an increase in the proportion of calves that had MDR strains of detected from arrival processing to second sampling. More research is needed to understand the role of metaphylaxis on MDR in and the impact of MDR on morbidity and mortality in stocker cattle.

Prevalence of multi drug antimicrobial resistance in isolated from high-risk stocker cattle at arrival and two weeks after processing

Prevalence of multi drug antimicrobial resistance in isolated from high-risk stocker cattle at arrival and two weeks after processing

Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria.

The antibiotic pipeline continues to diminish and the majority of the public remains unaware of this critical situation. The cause of the decline of antibiotic development is multifactorial and currently most ICUs are confronted with the challenge of multidrug-resistant organisms. Antimicrobial multidrug resistance is expanding all over the world, with extreme and pandrug resistance being increasingly encountered, especially in healthcare-associated infections in large highly specialized hospitals. Antibiotic stewardship for critically ill patients translated into the implementation of specific guidelines, largely promoted by the Surviving Sepsis Campaign, targeted at education to optimize choice, dosage, and duration of antibiotics in order to improve outcomes and reduce the development of resistance. Inappropriate antimicrobial therapy, meaning the selection of an antibiotic to which the causative pathogen is resistant, is a consistent predictor of poor outcomes in septic patients. Therefore, pharmacokinetically/pharmacodynamically optimized dosing regimens should be given to all patients empirically and, once the pathogen and susceptibility are known, local stewardship practices may be employed on the basis of clinical response to redefine an appropriate regimen for the patient. This review will focus on the most severely ill patients, for whom substantial progress in organ support along with diagnostic and therapeutic strategies markedly increased the risk of nosocomial infections.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-015-3719-z) contains supplementary material, which is available to authorized users.

Incidence and diversity of antimicrobial multidrug resistance profiles of uropathogenic bacteria.

The aim of this study was to assess the most frequent multidrug resistant (MDR) profiles of the main bacteria implicated in community-acquired urinary tract infections (UTI). Only the MDR profiles observed in, at least, 5% of the MDR isolates were considered. A quarter of the bacteria were MDR and the most common MDR profile, including resistance to penicillins, quinolones, and sulfonamides (antibiotics with different mechanisms of action, all mainly recommended by the European Association of Urology for empirical therapy of uncomplicated UTI), was observed, alone or in association with resistance to other antimicrobial classes, in the main bacteria implicated in UTI. The penicillin class was included in all the frequent MDR profiles observed in the ten main bacteria and was the antibiotic with the highest prescription during the study period. The sulfonamides class, included in five of the six more frequent MDR profiles, was avoided between 2000 and 2009. The results suggest that the high MDR percentage and the high diversity of MDR profiles result from a high prescription of antibiotics but also from antibiotic-resistant genes transmitted with other resistance determinants on mobile genetic elements and that the UTI standard treatment guidelines must be adjusted for the community of Aveiro District.

Geographical patterns in antimicrobial resistance of acinetobacter in clinical isolates.

Acinetobacter spp. has emerged as a threat to the healthcare workers throughout the globe, owing to its property of multidrug resistance. The aim of the present study was to evaluate the antimicrobial resistance patterns of Acinetobacter spp. among indoor and out patients in our hospital and compare the resistance patterns in India and abroad. In this retrospective study, which was carried out between Over a period of one year, a total of 5593 clinical specimens of pus and purulent fluids were examined and antimicrobial resistance pattern for Acinetobacter spp. using Modified Stoke's were evaluated. Also a comparison was done with the other similar studies. Using the proportions of sensitive and resistant, the statistical analysis was done. The total, mean and percentage were calculated by using SPSS. A high level of antimicrobial multidrug-resistance was found in almost all the clinical isolate. Our study was also found to be concordant with the results of other studies. There is an emerging need for identification of the genes and mechanisms for multidrug resistance among Acinetobacter spp.

Antimicrobial multidrug resistance and coresistance patterns of Mannheimia haemolytica isolated from bovine respiratory disease cases—a three-year (2009–2011) retrospective analysis

Bovine respiratory disease continues to be the most important ailment of feed yard cattle. While the disease is multifactorial in nature, therapy continues to target the primary bacterial pathogens, Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni. A survey of records from a single diagnostic laboratory was conducted to evaluate the percentage of M. haemolytica isolates that were resistant to multiple antimicrobials and if coresistance patterns could be detected. All susceptibility test results for M. haemolytica recovered from lung tissues of cattle were eligible for inclusion in the survey. There were no isolates over the course of the analysis that were resistant to all 6 antimicrobials, primarily due to a lack of resistance to ceftiofur. In 2009, just over 5% of isolates were resistant to 5 or more antimicrobials (pan-resistant). In 2011, more than 35% of the M. haemolytica isolates were characterized as pan-resistant. Significant antimicrobial coresistance patterns were only seen with oxytetracycline and tilmicosin; bacterial isolates that were resistant to either oxytetracycline or tilmicosin were more likely to be resistant to at least one other antimicrobial. The mechanisms by which M. haemolytica is developing multidrug resistance warrant investigation if antimicrobial utility in the therapy of bovine respiratory disease is to be preserved.

Impact of antimicrobial multidrug resistance on inpatient care cost: an evaluation of the evidence

This article evaluates the in-hospital costs attributable to antimicrobial multidrug resistance, defined as the difference in averaged costs of the patients infected with a multidrug-resistant (MDR) versus a non-MDR organism. PubMed and Scopus databases were searched to identify relevant studies. Twenty four studies were included: four on carbapenem-resistant or MDR Gram negative nonfermenters, eight on extended-spectrum b-lactamase-producing Enterobacteriaceae and 12 on methicillin-resistant Staphylococcus aureus. In two studies on carbapenem-resistant nonfermenters, the attributable mean hospital charges were US$58,457 and 85,299, respectively. The attributable mean total costs were US$4484 in a study referring to MDR Acinetobacter baumannii, while that varied from US$1584 to 30,093 among studies on extended-spectrum b-lactamase-producing Enterobacteriaceae. With respect to methicillin-resistant S. aureus, the attributable mean total costs varied from US$1014 to 40,090. The in-hospital costs attributable to multidrug resistance are alarmingly high, justifying the application of strict infection control measures in medical institutions with increased rate of MDR infections.

Isolation, identification and antimicrobial susceptibility of Bacteroides fragilis group strains recovered from broiler faeces

1. The objective was to evaluate the occurrence of cultivable components of the Bacteroides fragilis group in faeces of broiler chickens and their antimicrobial susceptibility patterns. 2. Faecal samples of 36 × 45-d-old Cobb broilers of both sexes from 15 different flocks on one farm were diluted 10-fold and plated on to Bacteroides-bile-esculin agar for colony count and isolation. Identification was by molecular methods and antimicrobial susceptibility in the agar dilution assay. 3. A total of 236 isolates was recovered from a mean population of 3·32 × 107 colony-forming units/g of faeces. B. fragilis was shown to be the predominant Bacteroides species (45·3%), followed by B. distasonis (35·6%), B. vulgatus (8·9%), B. ovatus (2·5%) and B. stercoris (1·3%). 4. Among 204 bacterial isolates tested, high resistance to ampicillin (98·5%), norfloxacin (95·1%) and tetracycline (88·2%) were observed. High (89·7%) multi-drug resistance was observed to 3–7 of the tested drugs. 5. Components of the B. fragilis group were sub-dominant in broiler faecal microbiota, with a different species pattern compared with human and high antimicrobial multi-drug resistance.

A Module Located at a Chromosomal Integration Hot Spot Is Responsible for the Multidrug Resistance of a Reference Strain from Escherichia coli Clonal Group A

Escherichia coli clonal group A (CGA) commonly exhibits a distinctive multidrug antimicrobial resistance phenotype-i.e., resistance to ampicillin, chloramphenicol, streptomycin, sulfonamides, tetracycline, and trimethoprim (ACSSuTTp)-and has accounted for up to 50% of trimethoprim-sulfamethoxazole-resistant E. coli urinary tract infections in some locales. Annotation of the whole-genome sequencing of UMN026, a reference CGA strain, clarified the genetic basis for this strain's ACSSuTTp antimicrobial resistance phenotype. Most of the responsible genes were clustered in a unique 23-kbp chromosomal region, designated the genomic resistance module (GRM), which occurred within a 105-kbp genomic island situated at the leuX tRNA. The GRM is characterized by numerous remnants of mobilization and rearrangement events suggesting multiple horizontal transfers. Additionally, comparative genomic analysis of the leuX tRNA genomic island in 14 sequenced E. coli genomes showed that this region is a hot spot of integration, with the presence/absence of specific subregions being uncorrelated with either the phylogenetic group or the pathotype. Our data illustrate the importance of whole-genome sequencing in the detection of genetic elements involved in antimicrobial resistance. Additionally, this is the first documentation of the bla(TEM) and dhfrVII genes in a chromosomal location in E. coli strains.