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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.

Antibiotics (Basel, Switzerland)
|May 24, 2024
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Summary

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.

Keywords:
Aerococcus urinae complexermAhorizontal gene transferintegrative and conjugative elementsmacrolideresistanceuropathogen

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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.