Genome-based surveillance reveals cross-transmission of MRSA ST59 between humans and retail livestock products in Hanzhong, China.

Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized in hospitals, community and livestock animals and the epidemiology of MRSA is undergoing a major evolution among humans and animals in the last decade. This study investigated the prevalence of MRSA isolates from ground pork, retail whole chicken, and patient samples in Hanzhong, China. The further characterization was performed by antimicrobial susceptibility testing and in-depth genome-based analysis to identify the resistant determinants and their phylogenetic relationship. A total of 93 MRSA isolates were recovered from patients (n = 67) and retail livestock products (n = 26) in Hanzhong, China. 83.9% (78/93) MRSA isolates showed multiple drug resistant phenotype. Three dominant livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) sequence types were identified: ST59-t437 (n = 47), ST9-t899 (n = 10) and ST398 (n = 7). There was a wide variation among sequence types in the distribution of tetracycline-resistance, scn-negative livestock markers and virulence genes. A previous major human MRSA ST59 became the predominant interspecies MRSA sequence type among humans and retail livestock products. A few LA-MRSA isolates from patients and livestock products showed close genetic similarity. The spreading of MRSA ST59 among livestock products deserving special attention and active surveillance should be enacted for the further epidemic spread of MRSA ST59 in China. Data generated from this study will contribute to formulation of new strategies for combating spread of MRSA.

Effect of leave-on cosmetic antimicrobial preservatives on healthy skin resident Staphylococcus epidermidis.

BACKGROUND: The effect of high doses preservatives in the leave-on cosmetic products to the skin microbiota is not clear. Studies have shown that the preservatives might alter the balance of the skin microbiota. AIM: In this study, we aimed to evaluate antimicrobial effect of nine cosmetic chemical preservatives. MATERIAL & METHOD: A total of 77 Staphylococcus epidermidis isolates from 46 healthy zygomatic skin samples were characterized by multilocus sequence typing (MLST). Nine preservatives used in leave-on cosmetics were analyzed by testing the minimal inhibitory concentrations (MICs) against S. epidermidis isolates. We also determined the mutant prevention concentration (MPC) and bactericidal kinetics on selected isolates. RESULTS: More than 17 sequence types were recognized among 77 S. epidermidis isolates. Our data demonstrated that the maximum permitted doses of 2-bromo-2-nitro-1,3-propanediol, ethyl 4-hydroxybenzoate, hexadecyltrimethylammonium bromide, and imidazolidinyl urea were significantly higher than both their MICs and MPCs. We showed that, at the maximum permitted doses, two preservatives could completely kill 107 CFU/mL S. epidermidis in less than 1 h in MH broth. CONCLUSION: Our data demonstrated that certain preservatives of the leave-on cosmetics might inhibit or kill S. epidermidis cells and perturb the skin microbiota balance. The determination of the maximum permitted doses of the preservatives should not only be based on the toxicological data, but also antimicrobial susceptibility analysis. This comprehensive evaluation would ensure a balanced and healthy skin microbiota.

In vitro activity of lactone ketolide nafithromycin (WCK 4873) against Streptococcus pneumoniae isolates enriched with macrolide-resistance phenotype collected from mainland China.

Background: Widespread MDR Streptococcus pneumoniae in China translates clinically into a substantial pneumococcal disease burden and related morbidity and mortality, particularly in the elderly and children. Nafithromycin (WCK 4873), a novel lactone ketolide class of antibiotic designed with a 3 day, once-daily regimen is highly active against resistant pneumococci and other community respiratory pathogens. It is currently in clinical development for the treatment of community-acquired bacterial pneumonia (CABP). Objectives: To determine the in vitro activity of nafithromycin against clinical S. pneumoniae isolates collected during 2015-21 from three hospitals in mainland China. Methods: A total of 920 clinical isolates (one isolate per patient), which predominantly with the macrolide- and clindamycin-resistant phenotype were included in this study. The MICs of nafithromycin and other antibiotics tested were determined using the reference broth microdilution method. Results: Clinical S. pneumoniae isolates used in this study showed high macrolide and clindamycin resistance (>95% against erythromycin and azithromycin and 80% against clindamycin) for which nafithromycin showed potent activity (MIC50/90; 0.03/0.06 mg/L) with 100% susceptibility at a proposed pharmacokinetics/pharmacodynamics (PK/PD) breakpoint of 0.25 mg/L. Among other classes of antibiotics tested, moxifloxacin also showed good activity while amoxicillin/clavulanate and ceftriaxone showed lower susceptibility. Conclusions: Nafithromycin exhibited therapeutically relevant in vitro antibacterial activity against contemporary highly resistant pneumococci collected from mainland China. This study supports the clinical development of nafithromycin for the management of CABP caused by pneumococci in China.

Molecular epidemiology and carbapenem resistance characteristics of Acinetobacter baumannii causing bloodstream infection from 2009 to 2018 in northwest China.

Bloodstream infection (BSI) caused by Acinetobacter baumannii poses a serious threat to health and is correlated with high mortality in patients with hospital-acquired infections, so the molecular epidemiology and antimicrobial resistance characteristics of this pathogen urgently need to be explored. A. baumannii isolates from BSI patients were collected in three tertiary hospitals in northwest China from 2009 to 2018. Antimicrobial susceptibility testing was used to determine the MICs of the A. baumannii isolates. Whole-genome sequencing based on the Illumina platform was performed for molecular epidemiological analyses and acquired resistance gene screening. The efflux pump phenotype was detected by examining the influence of an efflux pump inhibitor. The expression of efflux pump genes was evaluated by RT-PCR. In total, 47 A. baumannii isolates causing BSI were collected and they presented multidrug resistance, including resistance to carbapenems. Clone complex (CC) 92 was the most prevalent with 30 isolates, among which a cluster was observed in the phylogenetic tree based on the core genome multi-locus sequence type, indicating the dissemination of a dominant clone. BSI-related A. baumannii isolates normally harbour multiple resistance determinants, of which oxacillinase genes are most common. Except for the intrinsic bla OXA-51 family, there are some carbapenem-resistant determinants in these A. baumannii isolates, including bla OXA-23, which is encoded within the Tn2006, Tn2008 or Tn2009 transposon structures and bla OXA-72. The transfer of bla OXA-72 was suggested by XerC/D site-specific recombination. The AdeABC efflux pump system contributed to carbapenem resistance in A. baumannii isolates, as evidenced by the high expression of some of its encoding genes. Both the clone dissemination and carbapenem resistance mediated by oxacillinase or efflux pumps suggest an effective strategy for hospital infection control.

Corrigendum: Whole-genome sequencing provides insight into antimicrobial resistance and molecular characteristics of Salmonella from livestock meat and diarrhea patient in Hanzhong, China.

[This corrects the article DOI: 10.3389/fmicb.2022.899024.].

Whole-Genome Sequencing Provides Insight Into Antimicrobial Resistance and Molecular Characteristics of Salmonella From Livestock Meat and Diarrhea Patient in Hanzhong, China.

Salmonella is a major zoonotic pathogen, which usually contaminates food resulting in salmonellosis in humans. Exploring the characteristics and origins of Salmonella is essential in formulating prevention and control measures for Salmonella infection. We used slide agglutination, antimicrobial susceptibility testing, and whole-genome sequencing to analyze and compare Salmonella's phenotype, genotyping diversity, and genetic relatedness from livestock meat and diarrhea patients in Hanzhong, China, from 2018 to 2020. Totally 216 Salmonella enterica isolates were screened from frozen whole chicken carcasses (44.3%, 70/158), frozen raw ground pork (36.2%, 59/163), and diarrhea patients (4.4%, 87/1964). Salmonella Typhimurium was the dominant serotype. Notably, compared with other sources, isolates obtained from frozen whole chicken carcasses showed significant resistance to third-generation cephalosporin and fluoroquinolones (p < 0.05). All strains were assigned into 36 sequence types (STs) and two novel STs, and an excellent consistency was observed between ST and serotype. Genomic data revealed that extended-spectrum ß-lactamase genes were responsible for third-generation cephalosporin resistance in 52 Salmonella strains, and the most predominant resistance determinant was bla CTX-M. Furthermore, of the 60 ciprofloxacin-resistant isolates, five single-base mutations in quinolone resistance-determining regions were identified in gyrA or parC, and the plasmid-mediated quinolone resistance gene aac(6')Ib-cr was most often detected. The cgMLST clusters show that five clusters among four serotypes (including S. Typhimurium, S. London, S. Derby, and S. Agona) cover samples from diarrhea patients and livestock meat pathway isolate, indicating a possibility of cross-host transmission. In conclusion, the livestock meat isolates have a higher level of resistance than diarrhea patients' isolates and could be an essential source of human Salmonella infection.

Metalloprotease ADAM10 inhibition mitigates acute liver injury via repression of intrahepatic inflammation.

BACKGROUND: Acute liver injury (ALI) is associated with the occurrence and progress of intrahepatic inflammation. Recent studies have shown that ADAM10, a significant member of metalloproteinase family, has modulated the inflammation level in various neurologic diseases. However, it is elusive whether ADAM10 regulation exert a hepatic protective effect on ALI by the suppression of inflammation level. The study aimed to explore the regulated function of ADAM10 on acute liver injury. METHODS: C57BL/6J mice (eight-week-old male) were carried out intraperitoneal injection of tetrachloromethane (CTC) to provoke ALI. ADAM10 loaded in adeno-associated viral vectors (AAV-ADAM10) or short hairpin RNA loaded in lentivirus aimed at murine ADAM10 mRNA (sh-RNA-ADAM10) were respectively delivered to mice via tail intravenous injection to achieve overexpression or silence of ADAM10. Western blotting, reverse transcription-polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA), immunohistochemical (IHC) and hematoxylin and eosin (HE) staining were conducted to measure ADAM10 alteration, inflammation level, histology and liver function. RESULTS: We show that the expression of ADAM10 markedly increases in CTC-induced injured liver tissues. Moreover, we demonstrate that the knockdown of ADAM10 attenuates the intrahepatic inflammation and protects hepatic histology and function in ALI mice; however, the overexpression of ADAM10 aggravates inflammation and liver lesion. CONCLUSIONS: The above suggested that the inhibition of ADAM10 ameliorates ALI through inhibiting inflammation. Our research provides novel view on the ADAM10 modulation of process of ALI by the inflammation aspect and verify a potential target for the therapy of ALI in the future.

Risk factors and outcomes of bloodstream infections caused by Acinetobacter baumannii: a case-control study.

The risk factors and outcomes of patients with bloodstream infections (BSIs) caused by Acinetobacter baumannii are major concerns in clinical therapy. Multicenter case-control studies were performed to compare the clinical characteristics of 47 A. baumannii BSI patients and 124 matched controls with nonbloodstream A. baumannii infections and the clinical and molecular characteristics of BSI survivors and nonsurvivors. Additionally, the mortality of BSIs was assessed. The clinical characteristics, including neutropenia, ICU admission prior to positive culture, primary infection in the central nervous system, and carbapenem use prior to positive culture, were independently associated with BSI caused by A. baumannii. The mortality of the BSI patients was significantly higher than that of the controls. A high Pitt bacteremia score was found to be an independent predictor of mortality in the BSI patients. The healthcare-associated factors, disease severity level, or antibiotic usage increased the risks of A. baumannii BSI and related mortality.

miR-21 promotes proliferation and inhibits apoptosis of hepatic stellate cells through targeting PTEN/PI3K/AKT pathway.

To investigate the effect of microRNA 21 (miR-21) on hepatic stellate cells (HSCs) proliferation and apoptosis, and further to study its potential mechanisms. LX-2 cells were divided into miR-21 mimic group (Mimic), miR-21 mimic negative control group (NM), miR-21 inhibitor group (Inhibitor), miR-21 inhibitor negative control group (NC), and blank control group (Control). The cell proliferation was detected by CCK-8 assay and the cell migration and invasion were detected by scratch and transwell assay. Cell cycle and apoptosis were detected by flow cytometry. The levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-ß1 were detected by enzyme-linked immunosorbent assay (ELISA). Proliferation, apoptosis, and phosphatase and tensin homolog (PTEN)/phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway related genes and proteins were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot, respectively. The cells proliferation, migration, and invasion were promoted in Mimic group. The levels of IL-6, TNF-α, and TGF-ß1 were increased after miR-21 administration. The expression of α-smooth muscle actin (SMA) and collagen 1 (Colla1) were increased, while Bax/B-cell lymphoma (Bcl)-2 ratio and programed cell death 4 (PDCD4) were reduced after miR­21 treatment. Meanwhile, the mRNA and protein expression of PTEN were reduced and PI3K/AKT pathway been promoted. Our study demonstrated that miR-21 could promote proliferation and inhibit apoptosis of HSCs, and its mechanism may be related to PTEN/PI3K/AKT pathway.

[Analysis of community-associated bloodstream infections caused by Escherichia coli producing extended-spectrum ß-lactamase].

OBJECTIVE: To compare the risk factors and resistance characterizations between the Community-associated (CA) and Hospital-associated (HA) bloodstream infections (BSIs) caused by extended-spectrum ß-lactamase-producing ESBLs) Escherichia coli. Infections control strategy must be made for the spread of CA E. Coli. METHODS: Fifty-one samples of ESBLs-producing BSI E. Coli were collected in 3201 hospital affiliated of Xi'an jiaotong University School of Medicine from 2008 to 2013. Antimicrobial agents susceptibility test and ESBLs confirmation test were determined by K-B method. PFGE was used to investigate the clonality of clinical isolates. PCR amplification and sequencing were used to screen ESBLs genes. Plasmid conjugation assay was used by filter mating. An S1-PFGE assay on plasmid and southern blot were performed to determine the plasmid molecular size and resistance genes location. RESULTS: There were 27 community-associated samples, while 24 hospital-associated samples in 51. And patients with community-acquired infections were increasing year by year. Also there was a significant difference between patients with urinary tract infection and cancer in CA and HA. Cases of urinary tract infection were mainly CA, reaching to 18. 40 of OR value, and from 2. 161 to 156. 7 of 95% confidence interval. While Cases of cancer gave priority to HA, OR value was 0. 147 7 with 0. 034 85 to 0. 626 30 of 95% confidence interval. PFGE results did not support the evidence of clone dissemination. Among 51 strains, 26 TEM genotype, including 12 CA strains, 12 SHV genotype, including 5 CA strains, 21 CTX-M-1 genotype, including 10 CA strains , and 25 CTX-M-9 genotype. including 13 CA strains. All ESBLs resistant genotypes were no significant differences in the two groups. Conclusions Urinary tract infection is risk factor for community-aassociated bloodstream infection caused by E. Coli relatively. Degree of drug resistance of ESBLs-producing E. Coli isolated from Community-Associated Bloodstream Infections is close to Hospital-Associated. So the public health control measures are needed to prevent the further spread of CA ESBLs-producing E. Coli. [Key words] Bloodstream infection; Risk factor; Resistance; Pulsed field gel electrophoresis; Plasmid

Recovery method development of sodium chloride-susceptible methicillin-resistant Staphylococcus aureus isolates from ground pork samples.

The growth of certain methicillin-resistant Staphylococcus aureus (MRSA) isolates could be inhibited by NaCl higher than 2.5%. The objective of this study was to develop an enrichment method to recover NaCl-susceptible MRSA isolates from meat samples. The growth of 12 MRSA and 10 non-MRSA strains was measured in Mueller-Hinton (MH) broth supplemented with 2.5%, 4%, 6.5%, and 7.5% NaCl. Selective agents, including aztreonam, polymyxin B, NaCl, nalidixic acid, and NaN3, were determined for their inhibitory effect to MRSA and non-MRSA strains in MH broth. Based on these data, a two-step enrichment method was developed to recover both NaCl-susceptible and -resistant MRSA isolates in meat products. Comparing to the enrichment method that only used MH broth supplemented with 6.5% NaCl, five additional NaCl-susceptible MRSA isolates were recovered from 92 retail ground pork samples by this newly developed two-step enrichment method. To the best of our knowledge, this is the first study that considers NaCl-susceptible MRSA recovery from ground pork samples. The application of this new enrichment method might expand the diversity of MRSA isolates recovered from various samples.

Prevalence and characterization of cefotaxime and ciprofloxacin co-resistant Escherichia coli isolates in retail chicken carcasses and Ground Pork, China.

Retail meat products could serve as an important medium for the transfer of multidrug resistant isolates from food-producing animals to the community. In this study, the prevalence and characteristics of cefotaxime and ciprofloxacin co-resistant Escherichia coli isolates were investigated in retail chicken and ground pork samples from four provinces of China. The isolates were subjected to phylogenetic group typing and antimicrobial susceptibility testing. All isolates were further characterized by pulsed-field gel electrophoresis to determine the genetic relatedness. These isolates were also screened for beta-lactamase genes, quinolone resistance determinants by PCR, and followed by DNA sequence analysis. Cefotaxime and ciprofloxacin co-resistant E. coli isolates with diverse genetic origins were recovered in 31.9% (106/332) of retail meat samples. E. coli isolates of phylogenetic group A were dominant (59.4%, 63/106), and all isolates showed multidrug resistant profiles. The dominant resistant profiles were AMP-CAZ-CTX-CIP-CHL-GEN-SXT-TET (n=43) and AMP-CAZ-CTX-CIP-CHL-SXT-TET (n=43). Point mutations in quinolone resistance determination regions of topoisomerases were identified in all the isolates, and most of the isolates accumulated three (n=78) or four (n=21) point mutations. Plasmid-mediated quinolone-resistant determinants were identified in 68 isolates, including oqxAB (n=66), qnrS1 (n=7), qnrS2 (n=4), and aac(6')-Ib-cr (n=9). Eight subtypes of bla(CTX-M) were identified in 103 E. coli isolates, and blaCTX-M-55 (n=90) was dominant. This study highlights that retail meat could serve as an important reservoir of cefotaxime and ciprofloxacin co-resistant E. coli isolates. It is necessary to evaluate their contribution in the community and hospital infections.

Functional characterization of quinolone-resistant mechanisms in a lab-selected Salmonella enterica typhimurium mutant.

Correlation has been widely accepted between quinolone resistance and topoisomerase point mutations in quinolone resistance determination regions (QRDRs). Acquirement of point mutations in QRDRs usually increases the microbial resistance to both nalidixic acid and fluoroquinolones. The quinolone-resistant mechanisms accumulated in a lab-selected mutant were characterized through the construction of isogenic mutants using phage λ Red recombinase system and phage P22. The function of a quinolone-resistant mechanism that increased resistance to fluoroquinolones, but decreased resistance to nalidixic acid was fully characterized. A previous reported point mutation in ParC (G78D) was identified in the lab-selected mutant LT2-128. Minimal inhibitory concentrations (MICs) of isogenic mutants showed that acquirement of this point mutation in the host with topoisomerase mutations in GyrA could increase 8- to 32-fold fluoroquinolones MICs, but decrease eight-fold nalidixic acid MICs. Multiple-resistant mechanisms, such as the overexpressed effluxes, were accumulated besides the point mutations in QRDRs in LT2-128 during the mutant selection process. Through biological costs comparison among isogenic mutants, we found the biological cost in LT2-128 was not from the mutations in QRDRs, instead it was from other mutations accumulated during the mutant selection process, such as the mechanisms related to constitutively overexpressed effluxes. Mutation in ParC (G78D) was responsible for the increased resistance to fluoroquinolones, but decreased resistance to nalidixic acid. The existence of this mechanism demonstrated mutations in ParC could play different roles in nalidixic acid and ciprofloxacin resistance.

Possible variation of the human oral bacterial community after wearing removable partial dentures by DGGE.

Although it is well-known that variations of the microbial community in a specific location of human body may be associated with some diseases, the developing change of the oral microbiota related to oral diseases before and after wearing the removable partial dentures (RPD) is not completely understood. In this study, three kinds of samples (saliva, supra- and subgingival plaque, and oral mucosal surfaces) were collected from the 10-patients group at three different times: before, 1-month and 6-months after the treatment. Ten healthy adults were also selected as the control group. Denaturing gradient gel electrophoresis was applied to identify the bacterial profiles and to analyze the dynamics of the oral microbial population in the pre- and post-therapy. The ANOVA of Repeated Measurement Data indicated that, in the saliva and mucosal surfaces, wearing RPDs caused significant change of numbers of amplicons. As many as 607 amplicons were chosen to cut out and re-amplify by PCR. After cloning and sequencing, a total of 16 bacterial genera were identified. The health-associated genera such as Streptococcus, Neisseria, Rothia, Corynebacterium, Leptotrichia, Gemella, Veillonella, Selenomona and Actinomyces tended to decrease, whereas the disease-associated species including Streptococcus mutans tended to increase. In general, wearing RPDs influenced the diversity of the bacterial species in the oral microbial ecosystem. It is noteworthy that the oral environment will be changed from the healthy status towards the disease status after the treatment.