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Macrolide Resistance in the Aerococcus urinae Complex: Implications for Integrative and Conjugative Elements
Jyoti Lamichhane1, Brian I Choi1, Natalie Stegman2
1Department of Microbiology and Immunology, Loyola University Chicago, Maywood, IL 60153, USA.
Abstract:
The recognition of the Aerococcus urinae complex (AUC) as an emerging uropathogen has led to growing concerns due to a limited understanding of its disease spectrum and antibiotic resistance profiles. Here, we investigated the prevalence of macrolide resistance within urinary AUC isolates, shedding light on potential genetic mechanisms. Phenotypic testing revealed a high rate of macrolide resistance: 45%, among a total of 189 urinary AUC isolates. Genomic analysis identified integrative and conjugative elements (ICEs) as carriers of the macrolide resistance gene ermA, suggesting horizontal gene transfer as a mechanism of resistance. Furthermore, comparison with publicly available genomes of related pathogens revealed high ICE sequence homogeneity, highlighting the potential for cross-species dissemination of resistance determinants. Understanding mechanisms of resistance is crucial for developing effective surveillance strategies and improving antibiotic use. Furthermore, the findings underscore the importance of considering the broader ecological context of resistance dissemination, emphasizing the need for community-level surveillance to combat the spread of antibiotic resistance within the urinary microbiome.
Insights
Emerging uropathogen Aerococcus urinae complex shows high macrolide resistance. Integrative and conjugative elements carrying ermA genes suggest horizontal gene transfer, potentially spreading resistance across species.
Area of Science:
- Microbiology
- Genetics
- Antimicrobial Resistance
Background:
- Aerococcus urinae complex (AUC) is an emerging uropathogen with poorly understood disease spectrum and resistance.
- Growing concerns necessitate investigation into AUC's antibiotic resistance profiles, particularly macrolide resistance.
Purpose of the Study:
- To determine the prevalence of macrolide resistance in urinary AUC isolates.
- To elucidate the genetic mechanisms underlying macrolide resistance in AUC.
Main Methods:
- Phenotypic antimicrobial susceptibility testing on 189 urinary AUC isolates.
- Genomic analysis to identify resistance genes and mobile genetic elements.
- Comparative genomics of AUC isolates and related pathogens.
Main Results:
- 45% of AUC isolates exhibited macrolide resistance.
- The macrolide resistance gene ermA was identified on integrative and conjugative elements (ICEs).
- High sequence homogeneity of ICEs across related pathogens suggests potential for cross-species resistance dissemination.
Conclusions:
- Horizontal gene transfer via ICEs is a likely mechanism for macrolide resistance in AUC.
- Understanding AUC resistance mechanisms is vital for surveillance and antibiotic stewardship.
- Community-level surveillance is needed to combat urinary microbiome resistance spread.
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