{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:27:10Z","timestamp":1774949230724,"version":"3.50.1"},"reference-count":23,"publisher":"Microbiology Society","issue":"6","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81802044"],"award-info":[{"award-number":["81802044"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Major Research and Development Project of Lishui City of China","award":["2017ZDYF13"],"award-info":[{"award-number":["2017ZDYF13"]}]},{"name":"the Major Research and Development Project of Lishui City of China","award":["2020ZDYF11"],"award-info":[{"award-number":["2020ZDYF11"]}]},{"name":"Technology Planning Project for Medicine and Healthcare of Zhejiang Province","award":["2021KY1237"],"award-info":[{"award-number":["2021KY1237"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,25]]},"abstract":"\n Introduction.<\/jats:bold> Members of the genus \n \n Citrobacter<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> are facultative anaerobic Gram-negative bacilli belonging to the \n \n Enterobacterales<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> [Janda J Clin Microbiol<\/jats:italic> 1994; 32(8):1850\u20131854; Arens Clin Microbiol Infect<\/jats:italic> 1997;3(1):53\u201357]. Formerly, Citrobacter species<\/jats:italic> were occasionally reported as nosocomial pathogens with low virulence [Pepperell Antimicrob Agents Chemother<\/jats:italic> 2002;46(11):3555\u201360]. Now, they are consistently reported to cause nosocomial infections of the urinary tract, respiratory tract, bone, peritoneum, endocardium, meninges, intestines, bloodstream and central nervous system. Among \n \n Citrobacter<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> species, the most common isolates are \n \n C. koseri<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> and \n \n C. freundii<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic>, while \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> has seldom been isolated [Janda J Clin Microbiol<\/jats:italic> 1994; 32(8):1850\u20131854; Marak Infect Dis (Lond)<\/jats:italic> 2017;49(7):532\u20139]. Further, \n \n Citrobacter<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> spp. are usually susceptible to carbapenems, aminoglycosides, tetracyclines and colistin [Marak Infect Dis (Lond)<\/jats:italic> 2017;49(7):532\u20139].<\/jats:p>\n \n Hypothesis\/Gap Statement.<\/jats:bold> As \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> is rare, only one clinical isolate, coharbouring carbapenem resistance gene bla<\/jats:italic>\n IMP-4<\/jats:sub> and quinolone resistance gene qnrs1<\/jats:italic>, has been reported.<\/jats:p>\n \n Aim.<\/jats:bold> To characterize a carbapenem-resistant \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> strain from PR China coharbouring bla<\/jats:italic>\n IMP-4<\/jats:sub> and qnrs1<\/jats:italic>.<\/jats:p>\n \n Methodology.<\/jats:bold> Three hundred and forty nonrepetitive carbapenem-resistant \n \n Enterobacterales<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> (CRE) strains were collected during 2011\u20132018. A carbapenem-resistant \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> strain was detected and confirmed using a VITEK mass spectrometry-based microbial identification system and 16S rRNA sequencing. Minimum inhibitory concentrations (MICs) for clinical antimicrobials were obtained by the broth microdilution method. Whole-genome sequencing (WGS) was performed for antibiotic resistance gene analysis, and a phylogenetic tree of \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> strains was constructed using the Bacterial Pan Genome Analysis (BPGA) tool. The transferability of the resistance plasmid was verified by conjugal transfer.<\/jats:p>\n \n Results.<\/jats:bold> A rare carbapenem-resistant \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> strain (CA71) was recovered from a patient with cerebral obstruction and the sequences of 16S rRNA gene shared more than 99\u200a% similarity with \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> CITRO86, FDAARGOS 165. CA71 is resistant to \u03b2-lactam, quinolone and aminoglycoside antibiotics, and even imipenem and meropenem (MICs of 2 and 4\u2009mg\u2009l\u22121<\/jats:sup> respectively), and is only sensitive to polymyxin B and tigecycline. Six antibiotic resistance genes were detected via WGS, including the \u03b2-lactam genes bla<\/jats:italic>\n IMP-4<\/jats:sub>, bla<\/jats:italic>\n CTX-M-18<\/jats:sub> and bla<\/jats:italic>\n Sed1<\/jats:sub>, the quinolone gene qnrs1<\/jats:italic>, and the aminoglycoside genes AAC(3)-VIIIa, AadA24<\/jats:italic>. Interestingly, bla<\/jats:italic>\n IMP-4<\/jats:sub> and qnrs1<\/jats:italic> coexist on an IncN1-type plasmid (pCA71-IMP) and successfully transferred to \n \n Escherichia coli<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> J53 via conjugal transfer. Phylogenetic analysis showed that CA71 is most similar to \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> strain CJ25 and belongs to the same evolutionary cluster along with seven other strains.<\/jats:p>\n \n Conclusion.<\/jats:bold> To the best of our knowledge, this is the first report of a carbapenem-resistant \n \n C. amalonaticus<\/jats:ext-link>\n <\/jats:named-content>\n <\/jats:italic> isolate coharbouring bla<\/jats:italic>\n IMP-4<\/jats:sub> and qnrs1<\/jats:italic>.<\/jats:p>","DOI":"10.1099\/jmm.0.001364","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T13:15:24Z","timestamp":1624626924000},"source":"Crossref","is-referenced-by-count":9,"title":["Characterization of a carbapenem-resistant Citrobacter amalonaticus coharbouring bla\n IMP-4 and qnrs1 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