title: High prevalence of fosfomycin resistance gene fosA3 in bla CTX-M-harbouring Escherichia coli from urine in a Chinese tertiary hospital during 2010-2014.
abstract: Fosfomycin has become a therapeutic option in urinary tract infections. We identified 57 fosfomycin-resistant Escherichia coli from 465 urine-derived extended-spectrum β-lactamase (ESBL)-producing isolates from a Chinese hospital during 2010-2014. Of the 57 fosfomycin-resistant isolates, 51 (89·5%) carried fosA3, and one carried fosA1. Divergent pulsed-field gel electrophoresis profiles and multi-locus sequence typing results revealed high clonal diversity in the fosA3-positive isolates. Conjugation experiments showed that the fosA3 genes from 50 isolates were transferable, with IncFII or IncI1 being the most prevalent types of plasmids. The high prevalence of fosA3 was closely associated with that of bla CTX-M. Horizontal transfer, rather than clonal expansion, might play a central role in dissemination. Such strains may constitute an important reservoir of fosA3 and bla CTX-M, which may well be readily disseminated to other potential human pathogens. Since most ESBL-producing E. coli have acquired resistance to fluoroquinolones worldwide, further spread of fosA3 in such E. coli isolates should be monitored closely.
authors.affiliation: Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,People's Republic of China.
authors.forename: X-L
authors.initials: XL
authors.lastname: Cao
authors.affiliation: Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,People's Republic of China.
authors.forename: H
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Medical Laboratory, Northern Coal Group General Hospital,Suzhou City,Anhui,People's Republic of China.
authors.forename: Y-Y
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,People's Republic of China.
authors.forename: X-J
authors.initials: XJ
authors.lastname: Xu
authors.affiliation: Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,People's Republic of China.
authors.forename: Z-F
authors.initials: ZF
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,People's Republic of China.
authors.forename: L
authors.initials: L
authors.lastname: Cheng
authors.affiliation: Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu,People's Republic of China.
authors.forename: J-H
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Department of Bacteriology,Nagoya University Graduate School of Medicine,Showa-ku,Nagoya,Aichi,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Arakawa
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002681:China / Q000453:epidemiology; D003227:Conjugation, Genetic; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000235:genetics*; D005578:Fosfomycin / Q000494:pharmacology; D022761:Gene Transfer, Horizontal; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D058885:Multilocus Sequence Typing; D010957:Plasmids / Q000032:analysis / Q000145:classification; D015995:Prevalence; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D014556:Urine / Q000382:microbiology*; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D029968:Escherichia coli Proteins; C000607929:FosA(3) protein, E coli; D005578:Fosfomycin; D001618:beta-Lactamases; C000602253:beta-lactamase CTX-M, E coli
keywords: 
                 Escherichia coli
              ; 
                 fosA3
              ; ESBL; fosfomycin; urinary tract infection