Predomination of hypervirulent ST283 and genetic diversity of levofloxacin resistance in multidrug-resistant, hypervirulent Streptococcus agalactiae in Thailand

泰国多重耐药、高毒力无乳链球菌中高毒力ST283菌株占主导地位,且左氧氟沙星耐药基因多样性较高

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Abstract

Introduction. Group B Streptococcus (GBS) is a multi-host pathogen causing pneumonia and meningitis in humans as well as streptococcal diseases in tilapia and mastitis in cattle. Thailand has experienced a significant increase in GBS infections that greatly impact health and economics.Gap statement. The antimicrobial resistance (AMR) and genotype data of GBS in Thailand are still limited and require further study.Aim. This study aimed to describe AMR profiles and molecular characteristics, especially antimicrobial resistance genes (ARGs) and virulence factor (VF) genes of GBS in Thailand.Methodology. AMR profiles of 221 GBS isolates from humans, fish and freshwater were examined. Whole-genome sequencing of 41 representative isolates was used to investigate capsular genotypes and sequence types (STs), ARGs and VF genotypes.Results. All GBS isolates were susceptible to penicillin; the majority (99.1%) showed resistance to tetracycline. In addition, the rates of resistance to clindamycin, erythromycin and levofloxacin were 22.6%, 20.4% and 2.3%, respectively; multidrug-resistant (MDR) isolates (TE-E-CM and TE-E-CM-LVX) were 19.5%. Among 41 representative isolates, the dominant types were capsular genotype III (63.4%) and ST283 (43.9%). ARGs associated with resistance to tetracycline (tetM, tetO and tetS), erythromycin (ermB, ermA, mefA and msrD) and clindamycin (lsaC, lsaE and lnuB) were identified. Additionally, point mutations responsible for levofloxacin resistance, S81L in GyrA, S79F/Y in ParC and H221Y in ParE, were found. The MDR isolates belonged to various STs, predominantly clustering in capsular types III (60.0%) and Ib (30.0%). The MDR-hypervirulent ST17 and ST19 harboured multiple ARGs and mutations affecting quinolone resistance. Different VF gene patterns were found among hypervirulent STs (ST12, ST17, ST19 and ST283). Notably, a unique nt deletion [c.(1013_1020)delG] in pilA was found only in ST283.Conclusion. This study elucidated significant antimicrobial characteristics of a substantial number of GBS in Thailand. Moreover, the distribution of the hypervirulent ST283 and the genotypes of MDR-hypervirulent GBS were first described.

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