Multiple interspecies recombination events documented by whole-genome sequencing in multidrug-resistant Haemophilus influenzae clinical isolates
Charlotte Michel1,2, Maria De Los Angeles Argudín3, Magali Wautier1,2
1Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB), Rue Haute 322, 1000 Brussels, Belgium.
Introduction:
Haemophilus influenzae (Hi) was long known as an easy-to-treat bacterium, but increasing resistance against beta-lactams and other critically important antibiotics is now a growing concern. We describe here the whole-genome sequencing (WGS) analysis of three non-typeable Hi isolates received in 2018-2019 by the Belgian National Reference Centre (NRC) for Haemophilus influenzae, as they presented an unusual multi-resistant profile.
Methods:
All three isolates were sequenced by WGS and mapped to the reference isolate Hi Rd KW20. Shorten uptake signal sequences (USSs) known to be associated with homologous recombination were sought in ftsI, murE and murF genes, and inner partial sequences were compared against the blast nucleotide database to look for similarity with other Haemophilus species. Their antimicrobial resistance (AMR) genotype was studied. Core-genome multilocus sequence typing (MLST) was performed on the NTHi database pubMLST to place our isolates in the actual worldwide epidemiology.
Results:
The isolates also harboured interspecies recombination patterns in the murF-murE-ftsI region involved in cell wall synthesis. The three isolates were multidrug resistant and two of them were also resistant to amoxicillin-clavulanic acid and showed a reduced susceptibility to meropenem. All three isolates belonged to the MLST clonal complex (CC) 422, and WGS revealed that the three were very similar. They harboured mobile genetic elements (carrying blaTEM-1B, mefA and msrD genes associated with resistance), mutations in gyrA and parC linked to fluoroquinolone resistance as well as remodelling events in ompP2 that might be related to lower carbapenem susceptibility.
Conclusion:
The Hi evolution towards antimicrobial multiresistance (AMR) is a complex and poorly understood phenomenon, although probably linked to a large degree to the presence of USSs and exchange within the family Pasteurellaceae. To better understand the respective roles of clonal expansion, horizontal gene transfers, spontaneous mutations and interspecies genetic rearrangements in shaping Hi AMR, both analysis of Hi communities over time within individuals and worldwide monitoring of non-typeable Hi causing infections should be conducted.
Insights
Increasing antibiotic resistance in Haemophilus influenzae (Hi) is a growing concern. Whole-genome sequencing revealed multi-drug resistant Hi isolates with complex resistance mechanisms, highlighting the need for global monitoring.
Area of Science:
- Microbiology
- Genomics
- Antimicrobial Resistance
Background:
- Haemophilus influenzae (Hi) is increasingly exhibiting resistance to critical antibiotics.
- This study focuses on non-typeable Hi isolates with unusual multi-resistant profiles.
Purpose of the Study:
- To analyze the whole-genome sequences of three multi-drug resistant non-typeable Hi isolates.
- To investigate the genetic basis of antimicrobial resistance (AMR) in these isolates.
- To understand the epidemiological context of these resistant Hi strains.
Main Methods:
- Whole-genome sequencing (WGS) of three non-typeable Hi isolates.
- Analysis of homologous recombination in key genes (ftsI, murE, murF).
- Antimicrobial resistance (AMR) genotyping and core-genome multilocus sequence typing (MLST).
Main Results:
- Isolates showed interspecies recombination patterns and were multidrug resistant.
- Resistance to amoxicillin-clavulanic acid and reduced susceptibility to meropenem were observed.
- WGS identified mobile genetic elements, fluoroquinolone resistance mutations, and ompP2 remodelling.
Conclusions:
- Hi's evolution towards AMR is complex, involving recombination, horizontal gene transfer, and mutations.
- Further analysis of Hi communities and global monitoring of non-typeable strains are crucial.
- Understanding these mechanisms is key to combating Hi AMR.
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