International journal of antimicrobial agents · 2025
Emergence of carbapenem-resistant Citrobacter spp. across human, animal, and water environments in China.
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Ju Xiaoyang, Xiong Panfeng, Yan Zelin, Chen Gongxiang, Cai Chang, Zhang Rong
Аннотация
OBJECTIVE: With the rise of carbapenem-resistant Citrobacter spp. (CRC), it is essential to investigate their distribution and resistance characteristics across diverse ecological niches. This study aims to collect CRCs from humans, animals, and water environments to analyze their epidemiology, genetic characteristics, and resistance mechanisms, providing insights into transmission dynamics.
METHODS: CRCs were isolated from different samples using methods including filtration, enrichment, screening, and purification. Antimicrobial susceptibility tests were conducted using the broth microdilution method. Transconjugation experiments were performed through filter mating. Whole genome sequencing and bioinformatics analysis were carried out to analyze genomic features of CRCs.
RESULTS: Total of 171 CRCs were isolated from diverse Chinese provinces between 2016 and 2023. All strains are classified into seven Citrobacter species. Citrobacter freundii is the most common (76.02%), with ST116 and ST22 being the predominant strains. Among all strains, 63.16% carried blaNDM-1, and 41.52% carried blaKPC-2. Hospital wastewater was the primary source of CRCs harbouring two carbapenemase genes, with the most prevalent combination being blaNDM-1 and blaKPC-2 (85.71%, 24/28). All strains showed multi-drug resistance, with over 95% resistant to various carbapenems. Transconjugation experiments showed that carbapenemase genes in the majority of CRCs were located on the plasmids and can be transferred to the recipient strains. Phylogenetic analysis displayed that clonal transmission was observed among a few CRCs.
CONCLUSIONS: Multiple mobile genetic elements mediate the spread and prevalence of carbapenem resistance in Citrobacter spp. Monitoring carbapenemase genes and CRCs across ecological niches is needed to controlling carbapenem resistance, particularly in high-risk sources like hospital wastewater.
METHODS: CRCs were isolated from different samples using methods including filtration, enrichment, screening, and purification. Antimicrobial susceptibility tests were conducted using the broth microdilution method. Transconjugation experiments were performed through filter mating. Whole genome sequencing and bioinformatics analysis were carried out to analyze genomic features of CRCs.
RESULTS: Total of 171 CRCs were isolated from diverse Chinese provinces between 2016 and 2023. All strains are classified into seven Citrobacter species. Citrobacter freundii is the most common (76.02%), with ST116 and ST22 being the predominant strains. Among all strains, 63.16% carried blaNDM-1, and 41.52% carried blaKPC-2. Hospital wastewater was the primary source of CRCs harbouring two carbapenemase genes, with the most prevalent combination being blaNDM-1 and blaKPC-2 (85.71%, 24/28). All strains showed multi-drug resistance, with over 95% resistant to various carbapenems. Transconjugation experiments showed that carbapenemase genes in the majority of CRCs were located on the plasmids and can be transferred to the recipient strains. Phylogenetic analysis displayed that clonal transmission was observed among a few CRCs.
CONCLUSIONS: Multiple mobile genetic elements mediate the spread and prevalence of carbapenem resistance in Citrobacter spp. Monitoring carbapenemase genes and CRCs across ecological niches is needed to controlling carbapenem resistance, particularly in high-risk sources like hospital wastewater.