Advances in mechanism study on novel tetracycline-inactivating enzymes tet(X) causing emerging tigecycline resistance

doi:10.16150/j.1671-2870.2023.01.012

Abstract

Abstract:

Antibiotic resistance in bacteria has become a great threat to global public health. Tigecycline is a next-generation tetracycline that is the final line of defense against severe infections by carbapenem-resistant Gram-negative bacteria. Unfortunately, this last-resort antibiotic has been challenged by the recent emergence of the mobile tet(X) orthologs that can confer high-level tigecycline resistance. This review will systematically introduce the latest progress in the type, distribution and dissemination, and genetic environment of this orthologs. At present, orthologs of tet(X) mainly include tet(X1), tet(X2), tet(X3), tet(X3.2), tet(X4), tet(X5), tet(X6) and tet(X7). The resistance gene has already been reported in a variety of bacterial hosts and spread to hospital-associated patients and environment in multiple countries/regions. The bacteria carrying tet(X3) and tet(X4) shows the highest resistance level. The insertion sequence ISCR2 is closely related to the horizontal spread of tet(X3), tet(X4) and tet(X5). In particular, the genetic environment of tet(X4) on plasmids is complex, that can be located on various mobile elements, which accelerates the spread of the drug resistance gene. The plasmid-mediated tigecycline resistance may further spread into a variety of ecological niches and into clinical high-risk pathogens and collective efforts are in urgent need to further strengthen the surveillance and research on tigecycline resistance.

Key words: Tigecycline, Resistance mechanisms, Tet(X), Horizontal spread

CLC Number:

R735

SHEN Pinghua, CHEN Huifen. Advances in mechanism study on novel tetracycline-inactivating enzymes tet(X) causing emerging tigecycline resistance[J]. Journal of Diagnostics Concepts & Practice, 2023, 22(01): 75-79.

Figures/Tables 1

References 35

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