Azithromycin represents a valid therapeutic option for gastrointestinal and systemic infections caused by multidrug resistant (MDR) diarrheagenic Escherichia coli, Shigella and Salmonella species. However, acquired macrolide resistance in these species has been increasingly described, mostly related to macrolide modifying enzymes encoded by mph- and erm-type genes. In this study, we characterized the first blaCTX-M-14/ermB-carrying IncI1 plasmid from Latin America, which was detected in a MDR E. coli clinical isolate from Uruguay. Plasmid pUR-EC07 was a 105,836-bp IncI1 ST80 plasmid harboring blaCTX-M-14,blaTEM-1 and ermB, and characterized by a backbone region of 92,554 bp, and a multi resistance region (MRR) of 13,282 bp, bounded by two directly-oriented IS26 elements, and inserted upstream of ResD. The MRR comprised two nested IS26-composite transposons (Tn6651 and Tn6652). Tn6651 included the ermBL-ermB operon flanked by two IS26 copies in opposite direction. Tn6652 included blaTEM-1, with an upstream remnant of a Tn3-family transposon, and blaCTX-M-14, located in a genetic context consisting of ISEcp1∆-IS10-blaCTX-M-14-IS903D. To the best of our knowledge, pUR-EC07 represents the first IncI1 plasmid harboring ermB and blaCTX-M-14 described in Latin America. Given the wide dissemination of IncI-type plasmids in Salmonella enterica, an important concern is represented by the potential transfer of similar plasmids to strains resistant to ciprofloxacin, which would result in the loss of the three main therapeutic resources.

中文翻译：

---

来自拉丁美洲的第一个blaCTX-M-14 / ermB携带IncI1质粒的表征。

阿奇霉素代表了由多重耐药性（MDR）腹泻性大肠杆菌，志贺氏菌和沙门氏菌引起的胃肠道和全身感染的有效治疗选择。但是，已经越来越多地描述了在这些物种中获得的大环内酯抗药性，主要与由mph和erm型基因编码的大环内酯修饰酶有关。在这项研究中，我们表征了来自拉丁美洲的第一个blaCTX-M-14 / ermB携带IncI1质粒，该质粒在来自乌拉圭的MDR大肠杆菌临床分离株中检测到。质粒pUR-EC07是一个105,836-bp IncI1 ST80质粒，带有blaCTX-M-14，blaTEM-1和ermB，特征在于92,554 bp的主链区域和13,282 bp的多抗性区域（由两个结合）直接面向IS26元素，并插入ResD的上游。MRR包含两个嵌套的IS26复合转座子（Tn6651和Tn6652）。Tn6651包括ermBL-ermB操纵子，其两侧是相反方向的两个IS26拷贝。Tn6652包括blaTEM-1和blaCTX-M-14，其具有Tn3家族转座子的上游残基，而blaCTX-M-14位于由ISEcp1Δ-IS10-blaCTX-M-14-IS903D组成的遗传背景中。据我们所知，pUR-EC07代表拉丁美洲第一个包含ermB和blaCTX-M-14的IncI1质粒。鉴于IncI型质粒在肠炎沙门氏菌中的广泛传播，将潜在质粒转移到对环丙沙星耐药的菌株中是一个重要的问题，这将导致三种主要治疗资源的损失。Tn6652包括blaTEM-1和blaCTX-M-14，其具有Tn3家族转座子的上游残基，而blaCTX-M-14位于由ISEcp1Δ-IS10-blaCTX-M-14-IS903D组成的遗传背景中。据我们所知，pUR-EC07代表拉丁美洲第一个包含ermB和blaCTX-M-14的IncI1质粒。鉴于IncI型质粒在肠炎沙门氏菌中的广泛传播，将潜在质粒转移到对环丙沙星耐药的菌株中是一个重要的问题，这将导致三种主要治疗资源的损失。Tn6652包括blaTEM-1和blaCTX-M-14，其具有Tn3家族转座子的上游残基，而blaCTX-M-14位于由ISEcp1Δ-IS10-blaCTX-M-14-IS903D组成的遗传背景中。据我们所知，pUR-EC07代表拉丁美洲第一个包含ermB和blaCTX-M-14的IncI1质粒。鉴于IncI型质粒在肠炎沙门氏菌中的广泛传播，将潜在质粒转移到对环丙沙星耐药的菌株中是一个重要的问题，这将导致三种主要治疗资源的损失。pUR-EC07代表拉丁美洲第一个带有ermB和blaCTX-M-14的IncI1质粒。鉴于IncI型质粒在肠炎沙门氏菌中的广泛传播，将潜在质粒转移到对环丙沙星耐药的菌株中是一个重要的问题，这将导致三种主要治疗资源的损失。pUR-EC07代表拉丁美洲第一个带有ermB和blaCTX-M-14的IncI1质粒。鉴于IncI型质粒在肠炎沙门氏菌中的广泛传播，将潜在质粒转移到对环丙沙星耐药的菌株中是一个重要的问题，这将导致三种主要治疗资源的损失。