Search Results (74)

Background: The global spread of antimicrobial resistance in Escherichia coli (E. coli) from food-producing animals is a critical concern within the One Health framework, particularly because of the potential transmission of clinically relevant resistance determinants across the animal–environment–human interface. Although extended-spectrum β-lactamase (ESBL)-producing E. coli strains have been widely characterized, the genomic mechanisms underlying resistance to the last-resort and critically important antimicrobials colistin and fluoroquinolones remain incompletely understood in animal-associated populations. This study characterized these resistance mechanisms in multidrug-resistant (MDR) E. coli from diseased food-producing animals. Methods: We used whole-genome sequencing (WGS) to characterize 77 MDR E. coli isolates from diseased livestock and poultry in Taiwan and analyzed the underlying resistance mechanisms and their co-occurrence. Results: Plasmid-mediated colistin resistance genes, including mcr-1.1, mcr-3.1, and mcr-3.5, were identified alongside chromosomal mutations, such as pmrB substitutions, indicating multiple evolutionary pathways to colistin resistance. Fluoroquinolone resistance was driven by both chromosomal mutations in quinolone resistance-determining regions and plasmid-mediated quinolone resistance genes, including qnr variants and aac(6′)-Ib-cr. Notably, the frequent co-occurrence of resistance determinants targeting multiple antimicrobial classes suggests the presence of mobile genetic elements facilitating horizontal gene transfer. Conclusions: Although a subset of isolates overlapped with those reported in our previous ESBL-focused study, the present work presents a comprehensive genomic dissection of resistance mechanisms beyond β-lactamases. The convergence of colistin, fluoroquinolone, and ESBL-associated resistance determinants within individual isolates highlights the potential role of food-producing animals as reservoirs of multidrug resistance, with potential implications for cross-sectoral transmission. These findings underscore the importance of integrated surveillance strategies addressing potential zoonotic transmission under the One Health framework. Full article

Serratia spp., particularly Serratia marcescens, have emerged as clinically important opportunistic pathogens and are increasingly recognized as causes of healthcare-associated infections, especially among critically ill and immunocompromised patients. Their remarkable ecological adaptability, persistence in hospital environments, and capacity to acquire multiple antimicrobial resistance determinants have contributed to the global emergence of multidrug-resistant strains and complicated therapeutic management. This review aims to comprehensively analyze the epidemiology, virulence mechanisms, antimicrobial resistance patterns, and current and emerging therapeutic strategies associated with Serratia spp. The manuscript is based on a critical review and analysis of previously published literature retrieved from electronic scientific databases focusing on clinically relevant Serratia spp. infections and resistance trends. The reviewed literature demonstrates that Serratia spp. combine intrinsic resistance mechanisms, particularly inducible chromosomal AmpC β-lactamases, with acquired resistance determinants including extended-spectrum β-lactamases, carbapenemases, aminoglycoside-modifying enzymes, and plasmid-mediated quinolone resistance. Horizontal gene transfer and biofilm formation further enhance bacterial persistence, dissemination, and adaptation within healthcare settings. Clinically, these pathogens are associated with device-related infections, bloodstream infections, pneumonia, urinary tract infections, and hospital outbreaks, where increasing multidrug and carbapenem resistance significantly limits therapeutic options. Novel β-lactam/β-lactamase inhibitor combinations and cefiderocol represent promising therapeutic approaches, although treatment success remains highly dependent on accurate identification of underlying resistance mechanisms. This review highlights the growing public health importance of Serratia spp. and underscores the need for improved surveillance, molecular diagnostics, antimicrobial stewardship, and the development of innovative therapeutic strategies in the context of the evolving antimicrobial resistance crisis. Full article

Background: Colistin- and carbapenem-resistant Acinetobacter baumannii (CRAB) represent a critical threat in intensive care unit (ICU) settings. This study aimed to provide a comprehensive molecular epidemiological characterization of extensively drug-resistant (XDR) A. baumannii clinical isolates from a tertiary-care hospital in Kırşehir, Central Anatolia, a region previously absent from the national surveillance literature. Methods: A total of 43 non-duplicate XDR A. baumannii isolates recovered from ICU patients between November 2021 and December 2023 were included. Antimicrobial susceptibility testing was performed by automated systems and broth microdilution for colistin. Resistance genes, including OXA-type carbapenemases, extended-spectrum β-lactamases (ESBLs), metallo-β-lactamases, plasmid-mediated colistin resistance (mcr-1 to mcr-5), plasmid-mediated quinolone resistance genes (qnr, qepA, oqxAB, aac(6′)-Ib-cr), and class 1 and 2 integrons, were screened by PCR. Integron gene cassettes were characterized by sequencing. Clonal relatedness was assessed by pulsed-field gel electrophoresis (PFGE) using ApaI digestion. Results: All 43 isolates exhibited the XDR phenotype with universal resistance to carbapenems, colistin, fluoroquinolones, aminoglycosides (except amikacin), piperacillin, cephalosporins, and tobramycin. Amikacin susceptibility was retained in 58.1% of isolates. blaOXA-51 was detected in all isolates (100%), and blaOXA-23 was the predominant acquired carbapenemase (90.7%). Notably, blaOXA-48, a carbapenemase typically associated with Enterobacteriaceae, was identified in 3 isolates (7.0%), each belonging to a distinct pulsotype. No blaOXA-24/40, blaOXA-58, or class B metallo-β-lactamase genes were detected. ESBL genes were found in a subset of isolates, with blaCTX-M group 1 being the most prevalent (20.9%). The aac(6′)-Ib-cr gene was detected in 81.4% of isolates, and oqxA/oqxB in 60.5% and 39.5%, respectively. No mcr or classical qnr genes were identified. Class 1 and 2 integrons were detected in 4.7% and 7.0% of isolates, respectively, carrying dfrA12-DUF1010-aadA2 (class 1) and dfrA1-sat-1 (class 2) gene cassettes. PFGE identified 12 pulsotypes among the typeable isolates; PT4 (n = 20, 47.6%) and PT11 (n = 8, 19.0%) were the dominant clonal clusters, together accounting for 65.1% of typeable isolates. Conclusions: This study presents one of the first comprehensive molecular epidemiological analyses of XDR A. baumannii from Central Anatolia. The dominance of OXA-23-carrying clonal lineages, the detection of blaOXA-48 in A. baumannii distributed across three distinct pulsotypes, the high prevalence of aac(6′)-Ib-cr, and the concurrent distribution of resistance determinants across genetically diverse clonal backgrounds indicate that both clonal expansion and possible horizontal gene transfer contribute to resistance dissemination in this setting. These findings underscore the need for systematic molecular surveillance and reinforced infection control strategies in ICU settings, at both the regional and national levels. Full article

Background/Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major nosocomial pathogen. Although newer agents have reduced colistin use in high-income countries, this polymyxin remains important in many low- and middle-income settings. Colistin resistance in K. pneumoniae is most commonly associated with chromosomal alterations affecting the MgrB–PhoPQ pathway, or with plasmid-mediated mcr genes. This study aimed to investigate chromosomally mediated colistin resistance in CRKP clinical isolates from a Tunisian tertiary hospital. Methods: Between 2010 and 2015, 317 non-duplicate CRKP isolates were collected at Charles Nicolle Hospital, Tunis. Colistin MICs were determined by broth microdilution. Phenotypic tests and PCR characterized carbapenemases, extended-spectrum β-lactamases, AmpC, plasmid-mediated quinolone resistance, mcr and virulence genes. Porins (OmpK35/OmpK36) and the mgrB, phoP and phoQ loci were analyzed by SDS-PAGE and sequencing. Clonal relatedness was assessed by ERIC-PCR and multilocus sequence typing. We additionally compared colistin-resistant isolates with a panel of colistin-susceptible CRKP controls and assessed phenotypic stability after serial passages without colistin. Results: Five isolates (1.6%) were colistin-resistant. All were multidrug-resistant, produced OXA-48, and two also carried NDM-1. The isolates belonged to five distinct sequence types, including high-risk clones (ST11, ST101, ST147). No mcr genes were detected. Four isolates carried disruptive mutations in mgrB, and the remaining strain harbored inactivating mutations in both phoP and phoQ with an intact mgrB. Truncating alterations in PhoP/PhoQ and frequent loss or truncation of OmpK35/OmpK36 were observed. No mgrB/phoP/phoQ alterations were detected among colistin-susceptible controls, and colistin MICs remained stable after 7 days of drug-free passaging. Conclusions: In Tunisian CRKP, colistin resistance was associated with chromosomal alterations, predominantly involving disruption of the MgrB–PhoPQ pathway, in the absence of mcr genes. These mechanisms in both high-risk and emerging sequence types underscore the adaptability of CRKP and the need for surveillance where colistin remains an important therapeutic option. Full article

Background: Antimicrobial resistance is a One Health problem driven by the intricate interactions across human, animal, and environmental interfaces that enable microbial exchange and movement of mobile genetic elements encoding resistance and virulence. This study investigated the genomic epidemiology of ESBL and non-ESBL Escherichia coli across One Health interfaces in Oman. Methods: This prospective cross-sectional study analyzed 295 non-duplicate Escherichia coli isolates derived from 104 clinical, 173 animal [diseased (123) and healthy (50)], 14 sewage and four water sources. Antimicrobial susceptibility testing was performed phenotypically, and a representative subset of 50 ESBL and non-ESBL Escherichia coli from the three interfaces underwent whole genome sequencing to determine MLST, phylogroups, resistance genes, virulence determinants and plasmid replicons. Results: ESBL prevalence was highest in human isolates (73%), followed by sewage (28.6%) and animals (16.3% diseased; 8% healthy). blaCTX-M-15 predominated in humans, whereas blaCTX-M-55 dominated in animals and sewage, suggesting ecological partitioning with partial overlap. Quinolone resistance was lowest in the animal interface. Sewage isolates harbored the most complex resistome, including rmtB and plasmid-mediated quinolone resistance genes. MLST analysis revealed high diversity in human isolates, including globally recognized ExPEC lineages (ST10, ST38, ST73, ST127, ST131), while ST224 dominated in animals with evidence of possible spillover to humans. ST167 was confined to sewage, consistent with environmental maintenance of high-risk clones. Phylogroup structuring showed predominance of A, B2 and D among human isolates and A, B1, and E among animal and sewage isolates. Virulence profiling demonstrated broader virulome diversity in humans, but shared core determinants (fimH, sitA, traT) across all domains. IncFIB(AP001918) was the dominant plasmid replicon, particularly among ESBL isolates, underscoring its role in horizontal gene dissemination. Alarmingly, mutation in pmrB (V161G) was identified in a healthy animal isolate, pointing to a need for greater colistin restriction in animal husbandry. Conclusions: This study highlights plasmid-mediated resistance and shared virulence determinants linking reservoirs; although AMR profile was quite distinct across the three interfaces, human isolates demonstrated greater resistance than animal isolates, suggesting healthcare-driven AMR in Oman. Continued integrated genomic surveillance is essential to monitor gene flow and inform coordinated antimicrobial stewardship strategies. Full article

Background: Multidrug-resistant (MDR) Escherichia coli in intensive pig production represents a persistent animal health and One Health concern. Here, we integrated quantitative phenotypic susceptibility data with whole-genome sequencing (WGS) to characterize the resistome and its inferred genomic context (chromosomal vs. plasmid-predicted contigs and mobile genetic element (MGE)-proximal regions) in swine-associated MDR E. coli from Hungary. Methods: A total of 203 E. coli isolates from large-scale pig farms were tested by broth microdilution. Based on resistance-oriented screening from an extended-spectrum β-lactamase (ESBL)-screen-positive pool, 116 isolates were subjected to whole-genome sequencing (WGS) as a resistance-enriched subset. Resistance determinants were annotated using the Comprehensive Antibiotic Resistance Database (CARD). Results: Resistance-oriented screening indicated frequent β-lactamase activity and ESBL screening positivity (110/203 and 127/203 isolates, respectively), consistent with strong antimicrobial selection pressure in the source population. Across the full phenotypic panel, 78/203 isolates (38.4%) met the MDR definition (non-susceptible to ≥3 antimicrobial classes), with marked between-farm variation (p < 0.001) but no age-group effect (p = 0.75). Non-β-lactam minimum inhibitory concentration (MIC) distributions showed pronounced, site-dependent high-MIC “tails”, most notably for tetracyclines, trimethoprim–sulfamethoxazole, fluoroquinolones, and colistin. In the WGS cohort (n = 116), we detected 82 distinct resistance determinants (5433 total occurrences), featuring a conserved chromosomal backbone enriched for intrinsic multidrug resistance components and lipid A modification pathways, alongside common plasmid- and MGE-associated acquired ARG modules involving tetracycline (tetA/tetB), sulfonamide/trimethoprim (sul/dfrA), aminoglycoside-modifying enzymes, and phenicol determinants (floR/cat). High-priority mobile determinants were rare but present, including mcr-1 (3/116; plasmid-associated) and plasmid-mediated quinolone resistance qnrB5 (2/116). Conclusions: Importantly, mobility/context inferences are restricted to this ESBL-screen-enriched WGS subset. Swine-associated E. coli from Hungarian large-scale farms harbors complex resistance architectures shaped by co-selection of mobile ARG modules on top of a pervasive chromosomal resistance backbone. Mobility-aware surveillance and stewardship are warranted to mitigate dissemination risks at the animal–environment–human interface. Full article

Non-O1/non-O139 Vibrio cholerae strains are widely distributed in aquatic environments worldwide and are increasingly recognized as potential reservoirs of antimicrobial resistance and virulence-associated determinants. In this study, we performed an integrated phenotypic and genomic analysis of 116 V. cholerae isolates collected in 2024 from environmental and clinical sources in Jiaxing, China, including 106 non-O1/non-O139 isolates, 9 O1 isolates, and 1 O139 isolate. Antimicrobial susceptibility testing showed that most isolates remained susceptible to β-lactam/β-lactamase inhibitor combinations, third-generation cephalosporins, carbapenems, and tigecycline, whereas resistance was more frequently observed for ampicillin, streptomycin, nalidixic acid, and ciprofloxacin. Based on the non-susceptibility criteria of Maitrakas et al., 19 of 116 isolates (16.4%) were classified as multidrug-resistant, whereas none met the definition of extensively drug-resistant. Genomic analysis identified diverse resistance determinants, including plasmid-mediated quinolone resistance genes (qnrVC variants) and quinolone resistance-determining region mutations in gyrA and parC. Virulence-associated genes showed heterogeneous distributions: core regulatory and hemolysis-related genes were highly prevalent, whereas classical cholera toxin genes were largely absent. Several accessory virulence factors, including the RTX toxin operon, chxA, ninth, and makA, were detected in subsets of isolates. Core genome multilocus sequence typing revealed substantial genetic diversity, with environmental and clinical isolates distributed across multiple lineages and showing no clear clustering by isolation source. Overall, these data demonstrate the diverse antimicrobial resistance, virulence-associated gene repertoires, and population structure of the Jiaxing V. cholerae collection, with particular relevance to the predominant non-O1/non-O139 population. Full article

Background: Extended-spectrum β-lactamase (ESBL)-producing E. coli are a major One Health concern because they compromise critically important cephalosporins and may spread via mobile genetic elements, including plasmids and transposon-associated modules, within food-animal production systems. Objectives: The aim of this study was to characterize cefotaxime (CTX)/clavulanic acid (CLA) inhibitor-positive phenotype profiles in pig-associated multidrug-resistant (MDR) E. coli and resolve their genetic basis using whole-genome sequencing, with emphasis on ESBL determinants and their predicted mobility context. Methods: MDR E. coli isolates (n = 203) from four large-scale pig farms in Hungary were tested by broth microdilution minimum inhibitory concentration (MIC) determination and Clinical and Laboratory Standards Institute (CLSI) inhibitor-based ESBL confirmation using cefotaxime with/without clavulanic acid. CTX/CLA inhibitor-positive isolates (inhibitor-positive phenotype) were subjected to whole-genome sequencing (WGS; n = 116) and resistome profiling; antimicrobial resistance genes (ARGs) were called against the Comprehensive Antibiotic Resistance Database (CARD) and mobility context was inferred using plasmid-origin and MGE-proximity prediction. Results: Overall, 127/203 isolates (62.6%) showed a CTX/CLA inhibitor-positive phenotype with a pronounced inhibitory effect (median cefotaxime/cefotaxime–clavulanate ratio: 33.3). In the sequenced subset (n = 116), 5427 ARG hits were identified (82 unique ARGs in the export), including frequent acquired determinants affecting tetracyclines, sulfonamides/trimethoprim, aminoglycosides, and phenicols; plasmid-mediated quinolone resistance (qnrB5) and mobilizable colistin resistance (mcr-1) were detected at low frequency. Classical β-lactamase genes were detected, including CTX-M (ESBL genes) and TEM alleles. CTX-M and/or TEM were detected in 47/116 genomes (40.5%), dominated by CTX-M-32 (11.2%) and TEM-1 (23.3%); detected ESBL determinants were predominantly predicted to be located on contigs predicted to be of plasmid origin, with a subset showing signatures consistent with transposition-associated mobilization. Conclusion: The high burden of inhibitor-positive phenotype, together with an inferred plasmid-/MGE-associated context for a subset of ESBL genes, and substantial phenotype–genotype heterogeneity, supports integrated phenotypic–genomic surveillance to refine AMR risk assessment and guide targeted stewardship and biosecurity interventions in pig production. Full article

Knowledge about the potential roles of pets as reservoirs for plasmid-mediated quinolone resistance is still limited in Türkiye. Thus, in our study, the presence of plasmid-mediated quinolone genes (qnrA, qnrB and qnrS) was examined by multiplex Polymerase Chain Reaction (PCR) in 101 fecal Escherichia coli (Escherichia coli) strains isolated from healthy dogs. Moreover, the relationship between the presence of qnr genes and prevalence of quinolone resistance, extended spectrum beta-lactamase (ESBL) and plasmid replicon types, mostly detected among fecal E. coli isolates (F, K, FIB, N, FIA, FIC, and Y) were investigated. A total of 41 strains (40.6%) carried at least one qnr gene. Qnr genes were found in 38.8% of quinolone-resistant and 40.9% of quinolone-susceptible strains. ESBL production was detected in 27 strains, 10 of which also harbored a qnr gene. Among qnr-positive strains, 19 (46.3%) carried both IncK and IncF plasmids (p < 0.001). IncF plasmids were significantly more prevalent in quinolone-resistant strains than in susceptible ones (p < 0.001), suggesting a potential link between qnr carriage, quinolone resistance, and IncF plasmids. To our knowledge, this is the first study investigating the relationship between qnr genes and specific plasmid replicon types in E. coli from healthy dogs in Türkiye. Our findings suggest that domestic animals may serve as reservoirs for antibiotic-resistant E. coli, underscoring the importance of a One Health approach. Full article

Background/Objetives: The bacterial ribosome is a key target for several classes of antibiotics, including aminoglycosides, macrolides, tetracyclines, and amphenicols. Although resistance to these antibiotics is well documented in clinical settings, ribosome-targeting antibiotic resistance genes have received comparatively little attention in studies comprising aquatic environments, where research has primarily focused on β-lactams and fluoroquinolones. Moreover, while plasmid-mediated dissemination of resistance is well recognized, the chromosomal integration of resistance genes in Escherichia coli remains underexplored. Methods: In this study, E. coli isolates were recovered from two contaminated aquatic environments in Panama: surface water from the Juan Díaz River and influent wastewater from the Panama City wastewater treatment plant. Results: Overall, 80.8% of the isolates exhibited resistance to aminoglycosides, 37.4% to tetracycline, and 18.2% to chloramphenicol. Resistance genes against these antibiotics were identified via PCR, and their genomic location (plasmid or chromosome) was determined by whole-genome sequencing. Our results revealed a higher prevalence of plasmid-associated resistance genes in river isolates, while chromosomal integration was more frequent among wastewater isolates. Notably, ribosome-targeting antibiotic resistance genes were more frequently detected than those conferring resistance to β-lactams, quinolones, and sulfonamides together. Conclusions: These findings highlight distinct mechanisms underlying the dissemination of ribosome-targeting antibiotic resistance genes in aquatic environments, where pollutant pressure in surface waters may favor plasmid maintenance, while chromosomal integration may represent a strategy to reduce the fitness cost associated with plasmid carriage and ensure stable resistance persistence. Full article

Objectives: The Taihe Black-Boned Silky Fowl (TBSF) is a unique indigenous chicken breed in China, characterized by widespread melanin deposition throughout its body. Fluoroquinolones (FQs) such as enrofloxacin can persist in TBSF for an extended period exceeding 100 days. The aim of this study was to examine the current status and development trends of FQ resistance within the TBSF breeding environment. Methods: Whole-genome sequencing was utilized to identify the molecular presence of quinolone resistance-determining region (QRDR) mutations and plasmid-mediated quinolone resistance (PMQR) genes in Escherichia coli isolates obtained from TBSF farms. Network inference based on strong Spearman correlations (ρ > 0.5) and statistically significant associations (p-value < 0.05) was applied to investigate the co-occurrence patterns among FQ residues, resistance phenotypes, and antibiotic resistance genes. Results: The results showed that FQ residues were identified as the primary contributor to FQ resistance in E. coli isolates. Mutations at QRDR sites were the predominant factor driving FQ resistance, rather than PMQR determinants. This study also reported the first identification of GyrA-S83Q mutation being associated with FQ resistance. Conclusions: It was concluded that E. coli strains in TBSF environments, where chickens have a long-term residual metabolic cycle of antimicrobials, may develop and evolve new mechanisms to adapt to this environment. Further research is warranted to investigate the evolution of FQ resistance in E. coli strains within TBSF environments. Full article

Photobacterium damselae subsp. damselae is a well-recognized marine animal pathogen. Herein, 70 P. damselae subsp. damselae isolates were investigated for quinolone susceptibility and prevalence of the genes including quinolone resistance-determining regions (QRDRs) and plasmid-mediated quinolone resistance (PMQR) genes. A total of 18/70 isolates exhibited high-level resistance, and 23/70 isolates exhibited moderate resistance according to the MIC values. QRDR analysis showed that double mutants in both GyrA (Ser⁸³Ile) and ParC (6/17 Ser⁸⁰Phe or 11/17 Ser⁸⁰Tyr) were detected in 94.4% (17/18) high-level quinolone resistance P. damselae subsp. damselae strains. PMQR detection showed that 60.0% (42/70) carried at least one PMQR (1/42 qnrB coexistence with aac(6′)-Ib-cr, 1/42 qnrS coexistence with aac(6′)-Ib-cr, 44/46 qnrS). QnrA, QnrC, qnrD and qepA were not detected in all strains. Among the 42 PMQR-positive strains, 24 showed fluoroquinolones MICs ≤ 0.5 mg/L and 13 MICs ≥ 2 mg/L, all carrying QRDR mutations. For the twenty-eight non-PMQR strains, twenty-three showed fluoroquinolone MICs ≤ 0.5 mg/L without QRDR mutations, and five MICs ≥ 2 mg/L carrying QRDR mutations. In conclusion, qnrS (qnrS2 allele) is the major PMQR widespread in P. damselae subsp. damselae isolated from eastern China; however, QRDR mutation plays a marked role in mediating fluoroquinolone resistance. Full article

Irrigation water can serve as a reservoir and transmission route for pathogenic Escherichia coli, posing a threat to food safety and public health. This study builds upon a previous survey conducted in Hermosillo, Sonora (Mexico), where 445 samples were collected from a local Honeydew melon farm and associated packing facilities. Among the 32 E. coli strains recovered, two strains, A34 and A51, were isolated from irrigation water and selected for further molecular characterization by PCR, due to their high pathogenic potential. Both strains were identified as hybrid aEPEC/STEC pathotypes carrying bfpA and stx1 virulence genes. Adhesion assays in HeLa cells revealed aggregative and diffuse patterns, suggesting enhanced colonization capacity. Phylogenetic analysis classified A34 within group B2 as associated with extraintestinal pathogenicity and antimicrobial resistance, while A51 was unassigned to any known phylogroup. Serotyping revealed somatic antigens shared with Shigella boydii 16, suggesting possible horizontal gene transfer or antigenic convergence. Antibiotic susceptibility testing showed resistance to multiple β-lactam antibiotics, including cephalosporins, linked to the presence of bla_CTX-M-151 and bla_CTX-M-9. Although no plasmid-mediated quinolone resistance genes were detected, resistance may involve efflux pumps or mutations in gyrA and parC. These findings are consistent with previous reports of E. coli adaptability in agricultural environments, suggesting potential genetic adaptability. While our data support the presence of virulence and resistance markers, further studies would be required to demonstrate mechanisms such as horizontal gene transfer or adaptive evolution. Full article

Background: Mapping the local etiology and susceptibility of common pathogens causing complicated urinary tract infection (cUTI) is important for promoting evidence-based antimicrobial prescribing. Evaluating the prevalence of extended-spectrum beta-lactamase (ESBL), AmpC beta-lactamase (AmpC), and carbapenemase-producing Enterobacterales (CPEs) is equally important as it informs treatment guidelines and empiric management. Whole genome sequencing (WGS) enhances antimicrobial resistance (AMR) surveillance by complementing phenotypic antimicrobial susceptibility testing, offering deeper insights into resistance mechanisms, transmissions, and evolutions. Integrating it into routine AMR monitoring can significantly improve global efforts to combat antimicrobial resistance. Methods: Antimicrobial susceptibility profiles of isolates from cUTI were collected from patients presenting with Sultan Qaboos University Hospital, Muscat and Suhar Hospital, Suhar, Oman. Automated systems as well as manual methods were used for detection of ESBL, AmpC, and CPE. ESBLs, AmpC β-lactamases, and CPEs were further detected by manual methods: double-disk synergy test for ESBL; disk approximation assay and D69C AmpC detection set for AmpC, and mCIM and KPC/IMP/NDM/VIM/OXA-48 Combo test kit for CPE. WGS was carried out in 11 FOX-resistant E. coli and (22 carbapenem-resistant K. pneumoniae) isolates with varying susceptibilities to identify circulating clades, AMR genes, and plasmids. Bioinformatic analysis was performed using online tools. Results: The susceptibility patterns of E. coli from cUTI were as follows: nitrofurantoin (96%), fosfomycin (100%), fluoroquinolones (44%), aminoglycosides (93%), piperacillin-tazobactam (95%), and carbapenems (98%). In comparison, susceptibility rates of K. pneumoniae were far lower: nitrofurantoin (38%), fosfomycin (89%), aminoglycosides (82%), piperacillin-tazobactam (72%), and carbapenems (83%). K. pneumoniae, however, was more susceptible to fluoroquinolones at 47% in comparison to E. coli. The prevalence of ESBL among E. coli and K. pneumoniae was 37.2% and CRE was 6.2% while the estimated prevalence of AmpC was 5.4%. It was observed that E. coli was the predominant ESBL and AmpC producer, while K. pneumoniae was the major carbapenem-resistant Enterobacterales (CREs) producer. No predominant multi-locus sequence typing (MLST) lineage was observed in AmpC-producing E. coli with nine E. coli MLST lineages being identified from eleven isolates: ST-10, ST-69, ST-77, ST-131, ST-156, ST-167, ST-361, ST-1125, and ST-2520. On the other hand, a less diverse MLST spectrum (ST-2096, ST-231, ST-147, ST-1770, and ST-111) was observed in the CRE K. pneumoniae. Among the five MLST lineages, ST-2096 (twelve isolates) and ST-147 (seven isolates) predominated. WGS revealed that DHA-1 was the predominant plasmid-mediated AmpC gene in E. coli, while OXA-232 and NDM-5 were the most common carbapenemase genes in K. pneumoniae. All E. coli DHA-1-positive isolates co-harbored the quinolone resistance gene qnrB4 and the sulfonamide resistance gene sul1 while no aminoglycoside resistance genes were detected. The majority of CPE CRE K. pneumoniae carried other β-lactamase genes, such as blaCTX-M-15, blaSHV, and blaTEM; all co-harbored the quinolone resistance gene OqxAB; and 77% carried the aminoglycoside resistance gene armA. Conclusions: Our results suggest that fosfomycin is an excellent empiric choice for treating complicated cystitis caused by both E. coli and K. pneumoniae, while nitrofurantoin is an appropriate choice for E. coli cystitis but not for K. pneumoniae. Aminoglycosides and piperacillin-tazobactam are excellent intravenous alternatives that spare carbapenems. DHA-1 was the predominant AmpC in E. coli, while OXA-232 and NDM-5 were the predominant carbapenemases in K. pneumoniae. In AmpC-producing E. coli, no MLST predominated, suggesting a significant flux in E. coli with lack of stable clades in this region. In contrast, ST-2096 and ST-147 predominated in CRE Klebsiella pneumoniae, suggesting a stable circulation of these in Oman. WGS profiling provides a deeper understanding of the genetic basis of resistance and enhances surveillance and offers comprehensive insights into pathogen evolution and transmission patterns. Full article

Salmonella enteritidis is a major cause of foodborne illness worldwide, and the emergence of ciprofloxacin-resistant strains poses a significant threat to food safety and public health. This study aimed to investigate the prevalence, spread, and mechanisms of ciprofloxacin resistance in S. enteritidis isolates from food and patient samples in Shanghai, China. A total of 1625 S. enteritidis isolates were screened, and 34 (2.1%) exhibited resistance to ciprofloxacin. Pulsed-field gel electrophoresis (PFGE) results suggested that clonal spread might have persisted among these 34 isolates in the local area for several years. Multiple plasmid-mediated quinolone resistance (PMQR) genes, GyrA mutations in the quinolone resistance-determining region (QRDR), and overexpression of RND efflux pumps were identified as potential contributors to ciprofloxacin resistance. PMQR genes oqxAB, qnrA, qnrB, and aac(6’)-Ib-cr as well as GyrA mutations S83Y, S83R, D87Y, D87G, D87N, and S83Y-D87Y were identified. The co-transfer of the PMQR gene oqxAB with the ESBL gene bla_CTX-M-14/55 on an IncHI2 plasmid with a size of ~245 kbp was observed through conjugation, highlighting the role of horizontal gene transfer in the dissemination of antibiotic resistance. Sequencing of the oqxAB-bearing plasmid p12519A revealed a 248,746 bp sequence with a typical IncHI2 backbone. A 53,104 bp multidrug resistance region (MRR) was identified, containing two key antibiotic resistance determinants: IS26-oqxR-oqxAB-IS26 and IS26-ΔISEcp1-bla_CTX-M-14-IS903B. The findings of this study indicate that ciprofloxacin-resistant S. Enteritidis poses a significant threat to food safety and public health. The persistence of clonal spread and the horizontal transfer of resistance genes highlight the need for enhanced surveillance and control measures to prevent the further spread of antibiotic resistance. Full article