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Genomic Landscape of Multidrug Resistance and Virulence in Enterococcus faecalis IRMC827A from a Long-Term Patient
J Francis Borgio1, Reem AlJindan2, Lujeen H Alghourab3
1Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia.
Abstract:
We report on a highly virulent, multidrug-resistant strain of Enterococcus faecalis IRMC827A that was found colonizing a long-term male patient at a tertiary hospital in Khobar, Saudi Arabia. The E. faecalis IRMC827A strain carries several antimicrobial drug resistance genes and harbours mobile genetic elements such as Tn6009, which is an integrative conjugative element that can transfer resistance genes between bacteria and ISS1N via an insertion sequence. Whole-genome-sequencing-based antimicrobial susceptibility testing on strains from faecal samples revealed that the isolate E. faecalis IRMC827A is highly resistant to a variety of antibiotics, including tetracycline, doxycycline, minocycline, dalfopristin, virginiamycin, pristinamycin, chloramphenicol, streptomycin, clindamycin, lincomycin, trimethoprim, nalidixic acid and ciprofloxacin. The isolate IRMC827A carries several virulence factors that are significantly associated with adherence, biofilm formation, sortase-assembled pili, manganese uptake, antiphagocytosis, and spreading factor of multidrug resistance. The isolate also encompasses two mutations (G2576T and G2505A) in the 23S rRNA gene associated with linezolid resistance and three more mutations (gyrA p.S83Y, gyrA p.D759N and parC p.S80I) of the antimicrobial resistance phenotype. The findings through next-generation sequencing on the resistome, mobilome and virulome of the isolate in the study highlight the significance of monitoring multidrug-resistant E. faecalis colonization and infection in hospitalized patients. As multidrug-resistant E. faecalis is a serious pathogen, it is particularly difficult to treat and can cause fatal infections. It is important to have quick and accurate diagnostic tests for multidrug-resistant E. faecalis, to track the spread of multidrug-resistant E. faecalis in healthcare settings, and to improve targeted interventions to stop its spread. Further research is necessary to develop novel antibiotics and treatment strategies for multidrug-resistant E. faecalis infections.
Insights
A highly virulent, multidrug-resistant Enterococcus faecalis strain was identified in a Saudi Arabian hospital. This strain exhibits resistance to numerous antibiotics and carries virulence factors, posing a significant threat to hospitalized patients.
Area of Science:
- Microbiology
- Genomics
- Infectious Diseases
Background:
- Multidrug-resistant (MDR) Enterococcus faecalis is a growing concern in healthcare settings.
- The emergence of highly virulent strains necessitates detailed characterization.
Purpose of the Study:
- To characterize a novel, highly virulent, and multidrug-resistant E. faecalis strain (IRMC827A) identified in a Saudi Arabian hospital.
- To investigate the genetic basis of its antimicrobial resistance and virulence.
Main Methods:
- Whole-genome sequencing was performed on the E. faecalis IRMC827A isolate.
- Antimicrobial susceptibility testing was conducted using whole-genome sequencing data.
- Analysis of mobile genetic elements, resistance genes, and virulence factors was performed.
Main Results:
- The E. faecalis IRMC827A strain demonstrated high resistance to multiple antibiotics, including tetracyclines, macrolides, and fluoroquinolones.
- The strain harbors mobile genetic elements like Tn6009 and ISS1N, facilitating gene transfer.
- Key virulence factors associated with adherence, biofilm formation, and immune evasion were identified.
- Specific mutations in 23S rRNA and gyrA/parC genes correlated with resistance to linezolid and fluoroquinolones.
Conclusions:
- The study highlights the critical need for monitoring MDR E. faecalis colonization and infection in hospitalized patients.
- Rapid and accurate diagnostics are essential for controlling the spread of such pathogens.
- Further research into novel antibiotics and treatment strategies is crucial for combating MDR E. faecalis infections.
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