title: Integron, Plasmid and Host Strain Characteristics of Escherichia coli from Humans and Food Included in the Norwegian Antimicrobial Resistance Monitoring Programs.
abstract: Antimicrobial resistant Escherichia coli (n=331) isolates from humans with bloodstream infections were investigated for the presence of class 1 and class 2 integrons. The integron cassettes arrays were characterized and the findings were compared with data from similar investigations on resistant E. coli from meat and meat products (n=241) produced during the same time period. All isolates were obtained from the Norwegian monitoring programs for antimicrobial resistance in human pathogens and in the veterinary sector. Methods used included PCR, sequencing, conjugation experiments, plasmid replicon typing and subtyping, pulsed-field-gel-electrophoresis and serotyping. Integrons of class 1 and 2 occurred significantly more frequently among human isolates; 45.4% (95% CI: 39.9-50.9) than among isolates from meat; 18% (95% CI: 13.2 -23.3), (p<0.01, Chi-square test). Identical cassette arrays including dfrA1-aadA1, aadA1, dfrA12-orfF-aadA2, oxa-30-aadA1 (class 1 integrons) and dfrA1-sat1-aadA1 (class 2 integrons) were detected from both humans and meat. However, the most prevalent cassette array in human isolates, dfrA17-aadA5, did not occur in isolates from meat, suggesting a possible linkage between this class 1 integron and a subpopulation of E. coli adapted to a human host. The drfA1-aadA1 and aadA1 class 1 integrons were found frequently in both human and meat isolates. These isolates were subjected to further studies to investigate similarities with regard to transferability, plasmid and host strain characteristics. We detected incF plasmids with pMLST profile F24:A-:B1 carrying drfA1-aadA1 integrons in isolates from pork and in a more distantly related E. coli strain from a human with septicaemia. Furthermore, we showed that most of the class 1 integrons with aadA1 were located on incF plasmids with pMLST profile F51:A-:B10 in human isolates. The plasmid was present in unrelated as well as closely related host strains, demonstrating that dissemination of this integron also could be attributed to clonal spread. In conclusion, among the systematically collected isolates from two different sources, some significant differences concerning integron prevalence and integron variants were observed. However, closely related plasmids as vehicles for specific class 1 integrons in isolates from meat and from a human with bloodstream infection were found. The occurrence of similar multi-resistance plasmids in bacteria from a food source and from a human clinical sample highlights the possible role of meat as a source of resistance elements for pathogenic bacteria.
authors.affiliation: Department of Laboratory Services, Norwegian Veterinary Institute, Oslo, Norway.
authors.forename: Marianne
authors.initials: M
authors.lastname: Sunde
authors.affiliation: Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway; Research Group for Host-Microbe Interaction, Institute of Medical Biology, Faculty of Health Sciences, University of Tromsø -The Norwegian Arctic University, Tromsø, Norway.
authors.forename: Gunnar Skov
authors.initials: GS
authors.lastname: Simonsen
authors.affiliation: Department of Laboratory Services, Norwegian Veterinary Institute, Oslo, Norway.
authors.forename: Jannice Schau
authors.initials: JS
authors.lastname: Slettemeås
authors.affiliation: Department of Laboratory Services, Norwegian Veterinary Institute, Oslo, Norway.
authors.forename: Inger
authors.initials: I
authors.lastname: Böckerman
authors.affiliation: Department of Health Surveillance, Norwegian Veterinary Institute, Oslo, Norway.
authors.forename: Madelaine
authors.initials: M
authors.lastname: Norström
mesh_terms: D000818:Animals; D002417:Cattle; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000235:genetics* / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D032023:Integrons; D008460:Meat / Q000382:microbiology*; D008461:Meat Products / Q000382:microbiology; D009664:Norway / Q000453:epidemiology; D010957:Plasmids / Q000235:genetics*; D011200:Poultry; D013552:Swine