Tracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing

ABSTRACT Infections with multidrug-resistant bacteria often leave limited or no treatment options. The transfer of antimicrobial resistance genes (ARG) carrying plasmids between bacterial species by horizontal gene transfer represents an important mode of expansion of ARGs. Here, we demonstrate the...

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Autores principales: Silke Peter, Mattia Bosio, Caspar Gross, Daniela Bezdan, Javier Gutierrez, Philipp Oberhettinger, Jan Liese, Wichard Vogel, Daniela Dörfel, Lennard Berger, Matthias Marschal, Matthias Willmann, Ivo Gut, Marta Gut, Ingo Autenrieth, Stephan Ossowski
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Publicado: American Society for Microbiology 2020
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spelling oai:doaj.org-article:35b1d28e71cc428eb732c4f78e2caa9f2021-11-15T15:30:51ZTracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing10.1128/mSphere.00525-202379-5042https://doaj.org/article/35b1d28e71cc428eb732c4f78e2caa9f2020-08-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mSphere.00525-20https://doaj.org/toc/2379-5042ABSTRACT Infections with multidrug-resistant bacteria often leave limited or no treatment options. The transfer of antimicrobial resistance genes (ARG) carrying plasmids between bacterial species by horizontal gene transfer represents an important mode of expansion of ARGs. Here, we demonstrate the application of Nanopore sequencing in a hospital setting for monitoring transfer and rapid evolution of antibiotic resistance plasmids within and across multiple species. In 2009, we experienced an outbreak with extensively multidrug-resistant Pseudomonas aeruginosa harboring the carbapenemase-encoding blaIMP-8 gene. In 2012, the first Citrobacter freundii and Citrobacter cronae strains harboring the same gene were detected. Using Nanopore and Illumina sequencing, we conducted comparative analysis of all blaIMP-8 bacteria isolated in our hospital over a 6-year period (n = 54). We developed the computational platform plasmIDent for Nanopore-based characterization of clinical isolates and monitoring of ARG transfer, comprising de novo assembly of genomes and plasmids, plasmid circularization, ARG annotation, comparative genome analysis of multiple isolates, and visualization of results. Using plasmIDent, we identified a 40-kb plasmid carrying blaIMP-8 in P. aeruginosa and C. freundii, verifying the plasmid transfer. Within C. freundii, the plasmid underwent further evolution and plasmid fusion, resulting in a 164-kb megaplasmid, which was transferred to C. cronae. Multiple rearrangements of the multidrug resistance gene cassette were detected in P. aeruginosa, including deletions and translocations of complete ARGs. In summary, plasmid transfer, plasmid fusion, and rearrangement of the ARG cassette mediated the rapid evolution of opportunistic pathogens in our hospital. We demonstrated the feasibility of near-real-time monitoring of plasmid evolution and ARG transfer in clinical settings, enabling successful countermeasures to contain plasmid-mediated outbreaks. IMPORTANCE Infections with multidrug-resistant bacteria represent a major threat to global health. While the spread of multidrug-resistant bacterial clones is frequently studied in the hospital setting, surveillance of the transfer of mobile genetic elements between different bacterial species was difficult until recent advances in sequencing technologies. Nanopore sequencing technology was applied to track antimicrobial gene transfer in a long-term outbreak of multidrug-resistant Pseudomonas aeruginosa, Citrobacter freundii, and Citrobacter cronae in a German hospital over 6 years. We developed a novel computational pipeline, pathoLogic, which enables de novo assembly of genomes and plasmids, antimicrobial resistance gene annotation and visualization, and comparative analysis. Applying this approach, we detected plasmid transfer between different bacterial species as well as plasmid fusion and frequent rearrangements of the antimicrobial resistance gene cassette. This study demonstrated the feasibility of near-real-time tracking of plasmid-based antimicrobial resistance gene transfer in hospitals, enabling countermeasures to contain plasmid-mediated outbreaks.Silke PeterMattia BosioCaspar GrossDaniela BezdanJavier GutierrezPhilipp OberhettingerJan LieseWichard VogelDaniela DörfelLennard BergerMatthias MarschalMatthias WillmannIvo GutMarta GutIngo AutenriethStephan OssowskiAmerican Society for MicrobiologyarticleplasmidsNanoporelong readIMP-8Pseudomonas aeruginosapathoLogicMicrobiologyQR1-502ENmSphere, Vol 5, Iss 4 (2020)
institution DOAJ
collection DOAJ
language EN
topic plasmids
Nanopore
long read
IMP-8
Pseudomonas aeruginosa
pathoLogic
Microbiology
QR1-502
spellingShingle plasmids
Nanopore
long read
IMP-8
Pseudomonas aeruginosa
pathoLogic
Microbiology
QR1-502
Silke Peter
Mattia Bosio
Caspar Gross
Daniela Bezdan
Javier Gutierrez
Philipp Oberhettinger
Jan Liese
Wichard Vogel
Daniela Dörfel
Lennard Berger
Matthias Marschal
Matthias Willmann
Ivo Gut
Marta Gut
Ingo Autenrieth
Stephan Ossowski
Tracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing
description ABSTRACT Infections with multidrug-resistant bacteria often leave limited or no treatment options. The transfer of antimicrobial resistance genes (ARG) carrying plasmids between bacterial species by horizontal gene transfer represents an important mode of expansion of ARGs. Here, we demonstrate the application of Nanopore sequencing in a hospital setting for monitoring transfer and rapid evolution of antibiotic resistance plasmids within and across multiple species. In 2009, we experienced an outbreak with extensively multidrug-resistant Pseudomonas aeruginosa harboring the carbapenemase-encoding blaIMP-8 gene. In 2012, the first Citrobacter freundii and Citrobacter cronae strains harboring the same gene were detected. Using Nanopore and Illumina sequencing, we conducted comparative analysis of all blaIMP-8 bacteria isolated in our hospital over a 6-year period (n = 54). We developed the computational platform plasmIDent for Nanopore-based characterization of clinical isolates and monitoring of ARG transfer, comprising de novo assembly of genomes and plasmids, plasmid circularization, ARG annotation, comparative genome analysis of multiple isolates, and visualization of results. Using plasmIDent, we identified a 40-kb plasmid carrying blaIMP-8 in P. aeruginosa and C. freundii, verifying the plasmid transfer. Within C. freundii, the plasmid underwent further evolution and plasmid fusion, resulting in a 164-kb megaplasmid, which was transferred to C. cronae. Multiple rearrangements of the multidrug resistance gene cassette were detected in P. aeruginosa, including deletions and translocations of complete ARGs. In summary, plasmid transfer, plasmid fusion, and rearrangement of the ARG cassette mediated the rapid evolution of opportunistic pathogens in our hospital. We demonstrated the feasibility of near-real-time monitoring of plasmid evolution and ARG transfer in clinical settings, enabling successful countermeasures to contain plasmid-mediated outbreaks. IMPORTANCE Infections with multidrug-resistant bacteria represent a major threat to global health. While the spread of multidrug-resistant bacterial clones is frequently studied in the hospital setting, surveillance of the transfer of mobile genetic elements between different bacterial species was difficult until recent advances in sequencing technologies. Nanopore sequencing technology was applied to track antimicrobial gene transfer in a long-term outbreak of multidrug-resistant Pseudomonas aeruginosa, Citrobacter freundii, and Citrobacter cronae in a German hospital over 6 years. We developed a novel computational pipeline, pathoLogic, which enables de novo assembly of genomes and plasmids, antimicrobial resistance gene annotation and visualization, and comparative analysis. Applying this approach, we detected plasmid transfer between different bacterial species as well as plasmid fusion and frequent rearrangements of the antimicrobial resistance gene cassette. This study demonstrated the feasibility of near-real-time tracking of plasmid-based antimicrobial resistance gene transfer in hospitals, enabling countermeasures to contain plasmid-mediated outbreaks.
format article
author Silke Peter
Mattia Bosio
Caspar Gross
Daniela Bezdan
Javier Gutierrez
Philipp Oberhettinger
Jan Liese
Wichard Vogel
Daniela Dörfel
Lennard Berger
Matthias Marschal
Matthias Willmann
Ivo Gut
Marta Gut
Ingo Autenrieth
Stephan Ossowski
author_facet Silke Peter
Mattia Bosio
Caspar Gross
Daniela Bezdan
Javier Gutierrez
Philipp Oberhettinger
Jan Liese
Wichard Vogel
Daniela Dörfel
Lennard Berger
Matthias Marschal
Matthias Willmann
Ivo Gut
Marta Gut
Ingo Autenrieth
Stephan Ossowski
author_sort Silke Peter
title Tracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing
title_short Tracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing
title_full Tracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing
title_fullStr Tracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing
title_full_unstemmed Tracking of Antibiotic Resistance Transfer and Rapid Plasmid Evolution in a Hospital Setting by Nanopore Sequencing
title_sort tracking of antibiotic resistance transfer and rapid plasmid evolution in a hospital setting by nanopore sequencing
publisher American Society for Microbiology
publishDate 2020
url https://doaj.org/article/35b1d28e71cc428eb732c4f78e2caa9f
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