Journal of global antimicrobial resistance · 2026
Plasmid-mediated tigecycline resistance gene tet(X4) in Escherichia coli from patients with diarrhoea-predominant irritable bowel syndrome.
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Wu Xuan, Chen Guorong, Yang Lu, Lv Zexun, Liang Chuncai, Chen Yizhu, Wu Yige, Li Hui, Shao Bing
Аннотация
OBJECTIVE: The tigecycline resistance gene tet(X4) poses a growing threat to public health, yet its occurrence in Escherichia coli from patients with diarrhoea-predominant irritable bowel syndrome (IBS-D) remains unknown. This study aimed to characterize tet(X4)-harbouring isolates and their genetic contexts in this clinical population.
METHODS: Antimicrobial resistance surveillance was conducted among IBS-D patients in China (2022-2023). Tigecycline-resistant E. coli isolates were screened for tet(X4) by PCR. Antimicrobial susceptibility testing followed CLSI/EUCAST guidelines. Hybrid genome sequencing was performed to characterize plasmids and resistance determinants, and conjugation assays evaluated transferability.
RESULTS: Three tet(X4)-positive E. coli isolates (ST641, ST648, ST88) were identified, showing tigecycline MICs of 4-8 µg/mL and multidrug-resistant phenotypes. Genomic sequencing revealed three distinct conjugative plasmids (IncFIB-, IncHI1B/HI1A/IncFIA-type) carrying tet(X4) with additional resistance genes including blaTEM-1, blaCTX-M-55, and qnrS1. A novel IS6-floR-ISCR2-tet(X4)-estT-virD4-IS6 cassette was identified, suggesting a potential mechanism for gene mobilization. Conjugation experiments demonstrated plasmid transfer at frequencies of 10-2-10-4, accompanied by acquisition of tigecycline resistance.
CONCLUSIONS: This study provides the first evidence of tet(X4)-carrying E. coli in IBS-D patients and highlights the diversity and mobility of associated plasmids. These findings underscore the need for continued surveillance of plasmid-mediated tigecycline resistance in clinical gastrointestinal populations.
METHODS: Antimicrobial resistance surveillance was conducted among IBS-D patients in China (2022-2023). Tigecycline-resistant E. coli isolates were screened for tet(X4) by PCR. Antimicrobial susceptibility testing followed CLSI/EUCAST guidelines. Hybrid genome sequencing was performed to characterize plasmids and resistance determinants, and conjugation assays evaluated transferability.
RESULTS: Three tet(X4)-positive E. coli isolates (ST641, ST648, ST88) were identified, showing tigecycline MICs of 4-8 µg/mL and multidrug-resistant phenotypes. Genomic sequencing revealed three distinct conjugative plasmids (IncFIB-, IncHI1B/HI1A/IncFIA-type) carrying tet(X4) with additional resistance genes including blaTEM-1, blaCTX-M-55, and qnrS1. A novel IS6-floR-ISCR2-tet(X4)-estT-virD4-IS6 cassette was identified, suggesting a potential mechanism for gene mobilization. Conjugation experiments demonstrated plasmid transfer at frequencies of 10-2-10-4, accompanied by acquisition of tigecycline resistance.
CONCLUSIONS: This study provides the first evidence of tet(X4)-carrying E. coli in IBS-D patients and highlights the diversity and mobility of associated plasmids. These findings underscore the need for continued surveillance of plasmid-mediated tigecycline resistance in clinical gastrointestinal populations.