title: Complete Sequence of Four Multidrug-Resistant MOBQ1 Plasmids Harboring blaGES-5 Isolated from Escherichia coli and Serratia marcescens Persisting in a Hospital in Canada.
abstract: The usefulness of carbapenems for gram-negative infections is becoming compromised by organisms harboring carbapenemases, enzymes which can hydrolyze the drug. Currently KPC (class A), NDM (class B), and OXA-48 types (class D) are the most globally widespread carbapenemases. However, among the GES-type class A extended-spectrum β-lactamases (ESBLs) there are variants that hydrolyze carbapenems, with blaGES-5 being the most common. Two Escherichia coli and two Serratia marcescens harboring blaGES-5 on plasmids were isolated by the Canadian Nosocomial Infection Surveillance Program (CNISP) from four different patients in a single hospital over a 2-year period. Complete sequencing of the blaGES-5 plasmids indicated that all four had nearly identical backbones consisting of genes for replication, partitioning, and stability, but contained variant accessory regions consisting of mobile elements and antimicrobial resistance genes. The plasmids were of a novel replicon type, but belonged to the MOBQ1 group based on relaxase sequences, and appeared to be mobilizable, but not self-transmissible. Considering the time periods of bacterial isolation, it would appear the blaGES-5 plasmid has persisted in an environmental niche for at least 2 years in the hospital. This has implications for infection control and clinical care when it is transferred to clinically relevant gram-negative organisms.
authors.affiliation: 1National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Boyd
authors.affiliation: 2Faculty of Medicine and Dentistry, University of Alberta Hospital, Edmonton, AB, Canada.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Taylor
authors.affiliation: 2Faculty of Medicine and Dentistry, University of Alberta Hospital, Edmonton, AB, Canada.
authors.forename: Jeff
authors.initials: J
authors.lastname: Fuller
authors.affiliation: 3Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bryce
authors.affiliation: 4Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Embree
authors.affiliation: 5Centre for Communicable Disease and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
authors.forename: Denise
authors.initials: D
authors.lastname: Gravel
authors.affiliation: 6Infection Prevention and Control, North York General Hospital, Toronto, ON, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Katz
authors.affiliation: 7Department of Laboratory Medicine, Victoria General Hospital, Victoria, BC, Canada.
authors.forename: Pamela
authors.initials: P
authors.lastname: Kibsey
authors.affiliation: 8The Moncton Hospital, Moncton, NB, Canada.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kuhn
authors.affiliation: 9IWK Health Centre, Halifax, NS, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Langley
authors.affiliation: 1National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Mataseje
authors.affiliation: 5Centre for Communicable Disease and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
authors.forename: Robyn
authors.initials: R
authors.lastname: Mitchell
authors.affiliation: 3Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: Diane
authors.initials: D
authors.lastname: Roscoe
authors.affiliation: 10Infectious Diseases Division, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Simor
authors.affiliation: 11Children's and Women's Health Centre, Vancouver, BC, Canada.
authors.forename: Eva
authors.initials: E
authors.lastname: Thomas
authors.affiliation: 12Hôtel-Dieu de Québec du CHUQ, Québec, QC, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Turgeon
authors.affiliation: 1National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Mulvey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000595:Amino Acid Sequence; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D002170:Canada / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004706:Endodeoxyribonucleases / Q000235:genetics / Q000378:metabolism; D004926:Escherichia coli / Q000145:classification / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D015964:Gene Expression Regulation, Bacterial; D016680:Genome, Bacterial; D006761:Hospitals; D006801:Humans; D020071:Interspersed Repetitive Sequences; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism*; D012093:Replicon; D016415:Sequence Alignment; D017422:Sequence Analysis, DNA; D016868:Serratia Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D012706:Serratia marcescens / Q000145:classification / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D004706:Endodeoxyribonucleases; C120220:MobM protein, bacteria; D001618:beta-Lactamases