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Wen-Chun Huang1, Yu-Tsung Huang2, Wen-Chien Ko3

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The first tigecycline resistance gene tet(X4) in Escherichia coli was found in Taiwan, carried on mobile plasmids in carbapenem-susceptible strains. This highlights the need for ongoing surveillance of antibiotic resistance genes.

Keywords:
PlasmidTet(X4)TigecyclineTigecycline-resistant E. coli

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Area of Science:

  • Microbiology
  • Genetics
  • Public Health

Background:

  • Plasmid-mediated tet(X4) confers high-level tigecycline resistance and was first identified in China.
  • Escherichia coli (E. coli) serves as a significant reservoir for this resistance gene.
  • No confirmed cases of tet(X4) in E. coli had been reported in Taiwan prior to this study.

Purpose of the Study:

  • To investigate the presence and characteristics of tet(X4) in tigecycline-resistant E. coli isolates from Taiwan.
  • To identify the genetic elements and plasmids carrying tet(X4).
  • To understand the evolutionary divergence and potential for horizontal gene transfer of tet(X4).

Main Methods:

  • Analysis of 81 tigecycline-resistant E. coli isolates collected in Taiwan between 2015-2022.
  • Whole-genome sequencing of 36 isolates to identify resistance mechanisms.
  • Plasmid characterization and identification of mobile genetic elements.

Main Results:

  • Two E. coli isolates (2.5%) harbored tet(X4) on novel plasmids, pEC1360-1 and pEC1638-1.
  • The tet(X4) gene was found within the mobile ISVsa3-estT-tet(X4)-ISVsa3 (IETI) element.
  • Tet(X4) was detected exclusively in carbapenem-susceptible strains and located on different Inc-type plasmids, distinct from previously reported Chinese strains.

Conclusions:

  • This study confirms the first occurrence of tet(X4)-positive E. coli in Taiwan, specifically in carbapenem-susceptible isolates.
  • The identification of novel mobile plasmids carrying tet(X4) emphasizes the risk of horizontal gene transfer.
  • Continuous surveillance of tet(X) genes and other critical antibiotic resistance mechanisms is crucial to prevent further dissemination.