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High frequency of silver resistance genes in invasive isolates of Enterobacter and Klebsiella species
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.ORCID iD: 0000-0001-6770-0878
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2017 (English)In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 96, no 3, 256-261 p.Article in journal (Refereed) Published
Abstract [en]

Background: Silver-based products have been marketed as an alternative to antibiotics, and their consumption has increased. Bacteria may, however, develop resistance to silver. Aim: To study the presence of genes encoding silver resistance (silE, silP, silS) over time in three clinically important Enterobacteriaceae genera. Methods: Using polymerase chain reaction (PCR), 752 bloodstream isolates from the years 1990–2010 were investigated. Age, gender, and ward of patients were registered, and the susceptibility to antibiotics and silver nitrate was tested. Clonality and single nucleotide polymorphism were assessed with repetitive element sequence-based PCR, multi-locus sequence typing, and whole-genome sequencing. Findings: Genes encoding silver resistance were detected most frequently in Enterobacter spp. (48%), followed by Klebsiella spp. (41%) and Escherichia coli 4%. Phenotypical resistance to silver nitrate was found in Enterobacter (13%) and Klebsiella (3%) isolates. The lowest carriage rate of sil genes was observed in blood isolates from the neonatology ward (24%), and the highest in blood isolates from the oncology/haematology wards (66%). Presence of sil genes was observed in international high-risk clones. Sequences of the sil and pco clusters indicated that a single mutational event in the silS gene could have caused the phenotypic resistance. Conclusion: Despite a restricted consumption of silver-based products in Swedish health care, silver resistance genes are widely represented in clinical isolates of Enterobacter and Klebsiella species. To avoid further selection and spread of silver-resistant bacteria with a high potential for healthcare-associated infections, the use of silver-based products needs to be controlled and the silver resistance monitored.

Place, publisher, year, edition, pages
2017. Vol. 96, no 3, 256-261 p.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Bioinformatics
Identifiers
URN: urn:nbn:se:uu:diva-326299DOI: 10.1016/j.jhin.2017.04.017OAI: oai:DiVA.org:uu-326299DiVA: diva2:1120012
Funder
Swedish Research Council Formas, 2011-1692Science for Life Laboratory - a national resource center for high-throughput molecular bioscience
Available from: 2017-07-05 Created: 2017-07-05 Last updated: 2017-07-05

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