Genomic characterization of carbapenem and colistin-resistant Klebsiella pneumoniae isolates from humans and dogs.

Introduction: Carbapenem and colistin-resistant Enterobacteriaceae, including Klebsiella pneumoniae, have become a growing global concern, posing a significant threat to public health. Currently, there is limited information about the genetic background of carbapenem and colistin-resistant K. pneumoniae isolates infecting humans and dogs in Thailand. This study aimed to characterize carbapenem and colistin-resistant genes in six resistant K. pneumoniae clinical isolates (three from humans and three from dogs) which differed in their pulse field gel electrophoresis profiles. Methods: Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), antimicrobial susceptibility testing, and whole-genome sequencing were employed to identify and analyze the isolates. Results and discussion: All six isolates were carbapenemase-producing K. pneumoniae isolates with chromosomally carried blaSHV, fosA, oqxA and oqxB genes, as well as nine to 21 virulence genes. The isolates belonged to five multilocus sequence types (STs): one isolate from a human and one from a dog belonged to ST16, with the other two human isolates being from ST340 and ST1269 and the other two dog isolates were ST147 and ST15. One human isolate and two dog isolates harbored the same blaOXA-232 gene on the ColKP3 plasmid, and one dog isolate carried the blaOXA-48 gene on the IncFII plasmid. Notably, one human isolate exhibited resistance to colistin mediated by the mcr-3.5 gene carried on the IncFII plasmid, which co-existed with resistance determinants to other antibiotics, including aminoglycosides and quinolones. In conclusion, this study provides a comprehensive characterization of both chromosome- and plasmid-mediated carbapenem and colistin resistance in a set of K. pneumoniae clinical isolates from unrelated humans and dogs in Thailand. The similarities and differences found contribute to our understanding of the potential widescale dissemination of these important resistance genes among clinical isolates from humans and animals, which in turn may contribute to outbreaks of emerging resistant clones in hospital settings.

Distribution of sequence types and antimicrobial resistance of clinical Pseudomonas aeruginosa isolates from dogs and cats visiting a veterinary teaching hospital in Thailand.

BACKGROUND: Pseudomonas aeruginosa is an important opportunistic pathogen in dogs and cats and is resistant to several antimicrobial drugs; however, data on the clonal distribution of P. aeruginosa in veterinary hospital are limited. This study aimed to investigate the clonal dissemination and antimicrobial resistance of clinical P. aeruginosa in a veterinary teaching hospital in Thailand within a 1-year period. Minimum inhibitory concentration determination and whole genome sequencing were used for antimicrobial susceptibility analysis and genetic determination, respectively. RESULTS: Forty-nine P. aeruginosa were isolated mostly from the skin, urinary tract, and ear canal of 39 dogs and 10 cats. These isolates belonged to 39 sequence types (STs) that included 9 strains of high-risk clones of ST235 (n = 2), ST244 (n = 2), ST274 (n = 2), ST277 (n = 1), ST308 (n = 1), and ST357 (n = 1). Overall antimicrobial resistance rate was low (< 25%), and no colistin-resistant strains were found. Two carbapenem-resistant strains belonging to ST235 and ST3405 were identified. CONCLUSIONS: Clinical P. aeruginosa in dogs and cats represent STs diversity. High-risk clones and carbapenem-resistant strains are a public health concern. Nevertheless, this study was limited by a small number of isolates. Continuous monitoring is needed, particularly in large-scale settings with high numbers of P. aeruginosa, to restrict bacterial transfer from companion animal to humans in a veterinary hospital.

Molecular epidemiology of antimicrobial-resistant Pseudomonas aeruginosa in a veterinary teaching hospital environment.

This study aimed to investigate sites for colonization and molecular epidemiology of antimicrobial-resistant Pseudomonas aeruginosa in a veterinary teaching hospital. Bacterial specimens from surface and liquid samples (n = 165) located in five rooms were collected three times every 2 months, and antimicrobial susceptibility was subsequently determined by minimum inhibitory concentrations. The genomes of resistant strains were further analyzed using whole-genome sequencing. Among 19 P. aeruginosa isolates (11.5%, 19/165), sinks were the most frequent colonization site (53.3%), followed by rubber tubes (44.4%), and anesthesia-breathing circuit (33.3%). The highest resistance to gentamicin (47.4%), followed by piperacillin/tazobactam (36.8%), levofloxacin (36.8%), and ciprofloxacin (36.8%), was observed from 19 P. aeruginosa isolates, of which 10 were resistant strains. Of these 10 antimicrobial-resistant isolates, five were multidrug-resistant isolates, including carbapenem. From the multilocus sequence typing (MLST) analysis, five sequence types (STs), including a high-risk clone of human ST235 (n = 3), and ST244 (n = 3), ST606 (n = 2), ST485 (n = 1), and ST3405 (n = 1) were identified in resistant strains. Multiresistant genes were identified consistent with STs, except ST235. The MLST approach and single nucleotide polymorphism analysis revealed a link between resistant strains from ward rooms and those from examination, wound care, and operating rooms. The improvement of routine cleaning, especially of sink environments, and the continued monitoring of antimicrobial resistance of P. aeruginosa in veterinary hospitals are necessary to prevent the spread of resistant clones and ensure infection control.

Novel Organization of the Staphylococcal Cassette Chromosome mec Composite Island in Clinical Staphylococcus haemolyticus and Staphylococcus hominis Subspecies hominis Isolates from Dogs.

Staphylococcus haemolyticus and Staphylococcus hominis subsp. hominis are common coagulase-negative staphylococcus opportunistic pathogens. In Thailand, the clinical strains S. haemolyticus 1864 and 48 and S. hominis subsp. hominis 384 and 371 have been recovered from sick dogs. These strains were methicillin resistant with the nontypeable staphylococcal cassette chromosome mec (NT-SCCmec). The SCCmec element distribution in the clinical isolates from dogs was analyzed using whole-genome sequencing, which revealed the presence of different SCCmec composite islands (CIs) and gene structure. The SCCmec-CIs of ψSCCmec1864 (13 kb) and ψSCC1864 (11 kb) with a class C1 mec complex but no ccr gene were discovered in S. haemolyticus 1864. The CIs of ψSCCmec48 with a C1 mec complex (28 kb), SCC48 with ccrA4B4 (23 kb), and ψSCC48 (2.6 kb) were discovered in S. haemolyticus 48. In SCC48, insertion sequence IS256 contained an aminoglycoside-resistant gene [aph(2″)-Ia]. Two copies of IS431 containing the tetracycline-resistant gene tet(K) were found downstream of ψSCC48. In S. hominis subsp. hominis, the SCCmec-CI in strain 384 had two separate sections: ψSCCmec384 (20 kb) and SCCars (23 kb). ψSCCmec384 lacked the ccr gene complex but carried the class A mec complex. Trimethoprim-resistant dihydrofolate reductase (dfrC) was discovered on ψSCCmec384 between two copies of IS257. In strain 371, SCCmec VIII (4A) (37 kb) lacking a direct repeat at the chromosomal end was identified. This study found SCCmec elements in clinical isolates from dogs that were structurally complex and varied in their genetic content, with novel organization. IMPORTANCE In Thailand, the staphylococcal cassette chromosome mec (SCCmec) element, which causes methicillin resistance through acquisition of the mec gene, has been studied in clinical coagulase-negative Staphylococcus isolates from various companion animals, and Staphylococcus haemolyticus and Staphylococcus hominis subsp. hominis were found to have the most nontypeable (NT)-SCCmec elements. These species are more prone to causing illness and more resistant to a variety of antimicrobials than other coagulase-negative staphylococci. However, full characterization of NT-SCCmec in clinical S. haemolyticus and S. hominis subsp. hominis isolates from such animals has been limited. Our findings support the use of full nucleotide sequencing rather than PCR designed for Staphylococcus aureus in further research of novel SCCmec elements. Moreover, several antimicrobial resistance and heavy metal resistance genes were identified on the SCCmec elements; these are important as they could limit the therapeutic options available in veterinary medicine.

Frequency, Distribution, and Antimicrobial Resistance of Coagulase-Negative Staphylococci Isolated from Clinical Samples in Dogs and Cats.

This study aimed to investigate the frequency, distribution, and antimicrobial resistance of coagulase-negative staphylococci (CoNS) obtained from clinical samples from dogs and cats and to classify any methicillin-resistant CoNS (MRCoNS). The samples were collected in 2017-2018, and species identification and antimicrobial susceptibility testing were routinely performed using the Vitek2 system. Among 1,056 staphylococci, 185 CoNS (17.5%) were obtained and included 18 species from dogs (n = 116) and 14 species from cats (n = 69). The predominant species were Staphylococcus chromogenes (31.4%), Staphylococcus hominis ssp. hominis (16.2%), Staphylococcus warneri (10.8%), and Staphylococcus epidermidis (8.1%). The primary isolation sites were the skin and urinary tract. High levels of resistance to ß-lactams (65.4%), tetracycline (44.3%), clindamycin (36.8%), and erythromycin (30.8%) were observed. Twenty-five MRCoNS (13.4%), mainly Staphylococcus haemolyticus (n = 8), S. epidermidis (n = 6), and S. hominis ssp. hominis (n = 5), were identified. SCCmec type V (n = 8) was the most common type, followed by SCCmec type IV (n = 6) and SCCmec type III (n = 2), whereas nontypable SCCmec were classified into nine MRCoNS. Some CoNS have been recorded in humans, and these might be transferred to and cause subsequent infections in humans. Moreover, the diversity of SCCmec types and resistant strains suggested that they may serve as a reservoir of resistance genes among staphylococci.

Genomic insights into methicillin-resistant Staphylococcus pseudintermedius isolates from dogs and humans of the same sequence types reveals diversity in prophages and pathogenicity islands.

Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is an important opportunistic pathogenic bacterium of dogs that also occasionally colonize and infect humans. However, whether MRSP can adapt to human hosts is not clear and whole genome sequences of MRSP from humans are still limited. Genomic comparative analyses of 3 couples of isolates from dogs (n = 3) and humans (n = 3) belonging to ST45, ST112, and ST181, the dominant clones in Thailand were conducted to determine the degree of similarities between human and animal MRSP of a same ST. Among eight prophages, three prophages associated with the leucocidins genes (lukF/S-I), φVB88-Pro1, φVB16-Pro1 and φAP20-Pro1, were distributed in the human MRSPs, while their remnants, φAH18-Pro1, were located in the dog MRSPs. A novel composite pathogenicity island, named SpPI-181, containing two integrase genes was identified in the ST181 isolates. The distribution of the integrase genes of the eight prophages and SpPI-181 was also analysed by PCR in 77 additional MRSP isolates belonging to different STs. The PCR screen revealed diversity in prophage carriage, especially in ST45 isolates. Prophage φAK9-Pro1 was only observed in ST112 isolates from dogs and SpPI-181 was found associated with ST181 clonal lineage. Among the 3 couple of isolates, ST45 strains showed the highest number of single nucleotide polymorphisms (SNP) in their core genomes (3,612 SNPs). The genomic diversity of ST45 isolates suggested a high level of adaptation that may lead to different host colonization of successful clones. This finding provided data on the genomic differences of MRSP associated with colonization and adaption to different hosts.

Typing of mecD Islands in Genetically Diverse Methicillin-Resistant Macrococcus caseolyticus Strains from Cattle.

Macrococcus caseolyticus belongs to the normal bacterial flora of dairy cows and does not usually cause disease. However, methicillin-resistant M. caseolyticus strains were isolated from bovine mastitis milk. These bacteria had acquired a chromosomal island (McRI mecD -1 or McRI mecD -2) carrying the methicillin resistance gene mecD To gain insight into the distribution of McRI mecD types in M. caseolyticus from cattle, 33 mecD-containing strains from Switzerland were characterized using molecular techniques, including multilocus sequence typing, antibiotic resistance gene identification, and PCR-based McRI mecD typing. In addition, the same genetic features were analyzed in 27 mecD-containing M. caseolyticus strains isolated from bovine bulk milk in England/Wales using publicly available whole-genome sequences. The 60 strains belonged to 24 different sequence types (STs), with strains belonging to ST5, ST6, ST21, and ST26 observed in both Switzerland and England/Wales. McRI mecD -1 was found in different STs from Switzerland (n = 19) and England/Wales (n = 4). McRI mecD -2 was only found in 7 strains from Switzerland, all of which belonged to ST6. A novel island, McRI mecD -3, which contains a complete mecD operon (mecD-mecR1m-mecIm [where the subscript m indicates Macrococcus]) combined with the left part of McRI mecD -2 and the right part of McRI mecD -1, was found in heterogeneous STs from both collections (Switzerland, n = 7; England/Wales, n = 21). Two strains from England/Wales carried a truncated McRI mecD -3. Phylogenetic analyses revealed no clustering of strains according to geographical origin or carriage of McRI mecD -1 and McRI mecD -3. Circular excisions were also detected for McRI mecD -1 and McRI mecD -3 by PCR. The analyses indicate that these islands are mobile and may spread by horizontal gene transfer between genetically diverse M. caseolyticus strains.IMPORTANCE Since its first description in 2017, the methicillin resistance gene mecD has been detected in M. caseolyticus strains from different cattle sources and countries. Our study provides new insights into the molecular diversity of mecD-carrying M. caseolyticus strains by using two approaches to characterize mecD elements: (i) multiplex PCR for molecular typing of McRI mecD and (ii) read mapping against reference sequences to identify McRI mecD types in silico In combination with multilocus sequence typing, this approach can be used for molecular characterization and surveillance of M. caseolyticus carrying mecD.

Investigating the ability of methicillin-resistant Staphylococcus pseudintermedius isolates from different sources to adhere to canine and human corneocytes.

Assays were done to assess the ability of 5 methicillin-resistant Staphylococcus pseudintermedius (MRSP) isolates from difference sources to adhere to canine and human corneocytes. Cell wall-associated (CWA) protein gene profiles were examined to look for associations with adherence. Five MRSP strains were studied: 3 with the same CWA protein gene profile (14 genes) and belonging to sequence type (ST) 45 were isolated from a dog, a human, and the environment. The other 2 were an environmental isolate belonging to ST433 that had the lowest number of CWA protein genes (12) and a canine clinical isolate belonging to ST733 that had the greatest number of CWA protein genes (18). The 3 isolates of MRSP ST45, a major clone in Thailand, had the greatest ability to adhere to canine and human corneocytes. Nevertheless, MRSP adherence ability could not be predicted from the profile of genes encoding CWA proteins.

Des analyses ont été effectuées afin de déterminer la capacité de cinq isolats de Staphylococcus pseudintermedius résistants à la méthicilline (SPRM) provenant de différentes sources à adhérer à des cornéocytes canins et humains. Les profils de gènes des protéines associées à la paroi cellulaire (APC) furent examinés afin de vérifier des associations avec l'adhérence. Cinq souches de SPRM furent étudiées : trois avec le même profil de gène de protéines APC (14 gènes) et appartenant au type de séquence (ST) 45 isolées d'un chien, un humain et l'environnement. Les deux autres souches étaient un isolat provenant de l'environnement et appartenant à ST433 et qui avait le plus petit nombre de gènes de protéines APC (12) et un isolat clinique canin appartenant au ST733 et qui avait le plus grand nombre de gènes de protéines APC (18). Les trois isolats de ST45, un clone majeur en Thaïlande, avait la plus grande capacité d'adhérer aux cornéocytes canins et humains. Toutefois, la capacité d'adhérence des SPRM ne pouvait être prédite par le profil de gènes codant pour les protéines APC.(Traduit par Docteur Serge Messier).

Enterotoxin gene profile of methicillin-resistant Staphylococcus pseudintermedius isolates from dogs, humans and the environment.

PURPOSE: This study aimed to detect and identify staphylococcal enterotoxin (SE) genes in methicillin-resistant Staphylococcus pseudintermedius (MRSP) strains from different sources, and to investigate the relationship between their sequence types (STs) and SE gene patterns. METHODOLOGY: The profiles of 17 SE genes in 93 MRSP strains isolated from dogs (n=43), humans (n=18) and the environment (n=32) were detected by PCR. Multilocus sequence typing (MLST), SCCmec typing and pulsed-field gel electrophoresis (PFGE) were used to analyse the clonal relatedness between the molecular type and SE gene profiles.Results/Key findings. The human MRSP strains harboured the greatest number of SE genes (12/17; sea, sec, seg, sei, sek, sel, sem, sen, seo, sep, seq and tst-1) compared to those from dogs (5/17; sec, sel, sem, seq and tst-1) and environmental sources (3/17; sec, seq and tst-1). Using MLST and PFGE, different SE gene profiles were found within the same clonal type. CONCLUSION: We show that isolates of MRSP vary in their virulence gene profiles, depending on the source from which they have been isolated. This insight should encourage the development of appropriate monitoring and mitigation strategies to reduce the transmission of MRSP in veterinary hospitals and households.

Development of a set of multiplex PCRs for detection of genes encoding cell wall-associated proteins in Staphylococcus pseudintermedius isolates from dogs, humans and the environment.

Staphylococcus pseudintermedius commonly colonizes the skin of dogs, whilst nasal carriage may occur in humans who are in contact with dogs or the environment of veterinary hospitals. Genes encoding cell wall-associated (CWA) proteins have been described in Staphylococcus aureus but knowledge of their occurrence in S. pseudintermedius is still limited. The aim of the study was to develop a method to detect S. pseudintermedius surface protein genes (sps) encoding CWA proteins, and to examine the distribution of the genes in isolates from different sources. Four multiplex PCR assays (mPCR) were developed for detection of 18 sps genes, with 4-5 genes detected per mPCR. These were applied to 135 S. pseudintermedius isolates from carriage sites (n=35) and infected sites (n=35) in dogs, from the nasal cavity of humans (n=25), and from the environment of a veterinary hospital (n=40). The mPCRs were shown to detect all 18 known sps genes, and no discrepancies were found between uniplex and mPCR results. The mPCRs could detect at least 1pg/µl of DNA template. A total of 23 sps gene profiles were found among the 135 isolates, with diverse gene combinations. Only spsD, spsF, spsI, spsO, spsP, and spsQ were not detected in all isolates. spsP and spsQ were more frequently detected in the canine isolates from infected sites than from carriage sites. This finding suggests that these two genes may play a role in pathogenicity, whereas the presence of the 12 sps genes may contribute to adherence function at all surfaces where carriage occurs.

Nasal carriage of methicillin-resistant Staphylococcus pseudintermedius in dogs treated with cephalexin monohydrate.

This study aimed to investigate the nasal carriage of methicillin-resistant Staphylococcus pseudintermedius (MRSP) in dogs treated with oral cephalexin monohydrate. Ten dogs with superficial pyoderma were monitored longitudinally for carriage of MRSP for up to 1 year after treatment; the strains were typed and antibiograms were determined. Methicillin-susceptible S. pseudintermedius (MSSP) was recovered prior to treatment in all dogs and could be isolated after 12 months in 1 dog. Methicillin-resistant Staphylococcus pseudintermedius was detected within 1 week of treatment in all dogs, and 3 clones represented by ST45, ST112, and ST181 were consistently present for up to 12 months after treatment. All MRSP isolates were resistant to at least 7 common antimicrobials. Oral cephalexin monohydrate treatment selected for strains of multi-resistant MRSP, which were still present after 1 year.

Portage nasal deStaphylococcus pseudintermediusrésistant à la méthicilline chez les chiens traités à l'aide de céphalexine monohydrate. Cette étude visait à étudier le portage nasal de Staphylococcus pseudintermedius résistant à la méthicilline (SPRM) chez les chiens traités à l'aide de céphalexine monohydrate par voie orale. Dix chiens ayant une pyodermie superficielle ont été surveillés dans une étude longitudinale pour le portage de SPRM pendant jusqu'à un an après le traitement; les souches ont été typées et des antibiogrammes ont été réalisés. Staphylococcus pseudintermedius susceptible à la méthicilline (SPSM) a été récupéré avant le traitement chez tous les chiens et pouvait être isolé jusqu'à 12 mois chez un chien. Staphylococcus pseudintermedius résistant à la méthicilline a été détecté une semaine après le traitement chez tous les chiens et 3 clones représentés par ST45, ST112 et ST181 étaient continuellement présents jusqu'à 12 mois après le traitement. Tous les isolats de SPRM étaient résistants à au moins sept antimicrobiens communs. Le traitement à la céphalexine monohydrate par voie orale a été choisi pour les souches multirésistantes de SPRM qui étaient toujours présentes après un an.(Traduit par Isabelle Vallières).