title: Outbreak of Serratia marcescens Coproducing ArmA and CTX-M-15 Mediated High Levels of Resistance to Aminoglycoside and Extended-Spectrum Beta-Lactamases, Algeria.
abstract: Serratia marcescens is one of the most important pathogens responsible for nosocomial infections worldwide. Here, we have investigated the molecular support of antibiotic resistance and genetic relationships in a series of 54 S. marcescens clinical isolates collected from Eastern Algeria between December 2011 and July 2013. The 54 isolates were identified by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS). Antibiotic susceptibility testing was performed by disc diffusion and E-test methods. Antibiotic resistance genes were detected by polymerase chain reaction (PCR). The genetic transfer of antibiotic resistance was performed by conjugation using azide-resistant Escherichia coli J53 as the recipient strain, and plasmid analysis was done by PCR-based replicon typing. The relatedness of our isolates was determined by phylogenetic analysis based on partial sequences of four protein-encoding genes (gyrB, rpoB, infB, and atpD) and then compared to MALDI-TOF MS clustering. Thirty-five out of 54 isolates yielded an extended-spectrum β-lactamase (ESBL) phenotype and carried bla(CTX-M-15) (n=32), bla(TEM-1) (n=26), bla(TEM-71) (n=1), bla(SHV-1a) (n=1), and bla(PER-2) (n=12). Among these isolates, we identified a cluster of 15 isolates from a urology unit that coharbored ESBL and the 16S rRNA methyltransferase armA. Conjugation was successful for five selected strains, demonstrating the transferability of a conjugative plasmid of incompatibility group incL/M type. Phylogenetic analysis along with MALDI-TOF clustering likely suggested an outbreak of such isolates in the urology unit. In this study, we report for the first time the co-occurrence of armA methyltransferase with ESBL in S. marcescens clinical isolates in Eastern Algeria.
authors.affiliation: 1 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1905, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Université de la Méditerranée , Marseille, France .|2 Laboratoire de Biochimie et de Microbiologie Appliquée, Département de Biochimie, Université Badji Mokhtar Annaba , Annaba, Algerie.
authors.forename: Rima
authors.initials: R
authors.lastname: Batah
authors.affiliation: 1 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1905, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Université de la Méditerranée , Marseille, France .|3 Laboratoire de Biotechnologie des Molecules Bioactives et de la Physiopathologie Cellulaire, Université El Hadj Lakhdar , Batna, Algerie.
authors.forename: Lotfi
authors.initials: L
authors.lastname: Loucif
authors.affiliation: 1 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1905, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Université de la Méditerranée , Marseille, France .
authors.forename: Abiola Olumuyiwa
authors.initials: AO
authors.lastname: Olaitan
authors.affiliation: 2 Laboratoire de Biochimie et de Microbiologie Appliquée, Département de Biochimie, Université Badji Mokhtar Annaba , Annaba, Algerie.
authors.forename: Nafissa
authors.initials: N
authors.lastname: Boutefnouchet
authors.affiliation: 4 Laboratoire de Bactériologie, Clinique Rénale Daksi Constantine , Constantine, Algerie.
authors.forename: Hamoudi
authors.initials: H
authors.lastname: Allag
authors.affiliation: 1 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1905, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Université de la Méditerranée , Marseille, France .
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rolain
mesh_terms: D000462:Algeria / Q000453:epidemiology; D000617:Aminoglycosides / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003227:Conjugation, Genetic; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D016868:Serratia Infections / Q000453:epidemiology / Q000382:microbiology*; D012706:Serratia marcescens / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D012336:RNA, Ribosomal, 16S; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases