{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:44:42Z","timestamp":1789101882294,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p><jats:italic>Samonella<\/jats:italic> is 1 of 4 key global causes of diarrhoeal diseases, sometimes it can be serious, especially for yong children. Due to the extensive resistance of <jats:italic>salmonella<\/jats:italic> serotypes to conventional first-line drugs, macrolides (such as azithromycin) have been designated as the most important antibiotics for the treatment of <jats:italic>salmonella<\/jats:italic>. Antimicrobial resistance is a major public health problem in the world, and the mechanism of azithromycin resistance is rarely studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study determined the azithromycin resistance and plasmids of <jats:italic>Salmonella<\/jats:italic> enterica isolates from children attending the Shenzhen Children\u2019s Hospital. The susceptibility of ampicillin (AMP), ciprofloxacin (CIP), ceftriaxone (CRO), sulfamethoxazole (SMZ), chloramphenicol (CL), and azithromycin (AZM) were detected and the genes and plasmids from azithromycin-resistant <jats:italic>Salmonella<\/jats:italic> were detected by Illumina hi-seq and Nanopore MinIone whole genome sequencing (WGS) using a map-based method, and the genomic background of these factors was evaluated using various bioinformatics tools.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 15 strains of nontyphoid <jats:italic>Salmonella<\/jats:italic> strains that were isolated (including <jats:italic>S.<\/jats:italic> typhimurium, <jats:italic>S.<\/jats:italic>London, <jats:italic>S.<\/jats:italic> Goldcoast, and <jats:italic>S.<\/jats:italic>Stanley) demonstrated resistance to azithromycin (minimum inhibitory concentration,MIC from 32 to &amp;gt;256 \u00b5g\/mL), and the resistance rate was 3.08% (15\/487). The sensitivity test to other antibiotics demonstrated 100% resistance to AMP, and the resistance to SMZ and CL was 86.7% and 80.0%, respectively. Through WGS analysis, all isolates were positive for a plasmid-encoded <jats:italic>mphA<\/jats:italic> gene. Plasmid incompatibility typing identified five <jats:italic>IncFIB(K)<\/jats:italic>, five <jats:italic>IncHI2\/HI2A\/Q1<\/jats:italic>, two <jats:italic>IncC<\/jats:italic>, one <jats:italic>IncHI2\/HI2A\/N<\/jats:italic>, one <jats:italic>IncR<\/jats:italic>, one <jats:italic>IncFII<\/jats:italic> and one <jats:italic>IncHI2\/HI2A<\/jats:italic> plasmids. Sequence analyses of plasmids revealed extensive homology to various plasmids or transposons in regions involved in plasmid replication\/maintenance functions and\/or in antibiotic resistance gene clusters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>mphA<\/jats:italic> is the main gene involved in azithromycin, a macrolide, and resistance to <jats:italic>Salmonella<\/jats:italic>. It is usually located on plasmids and easily spreads, hence posing a great threat to the current treatment of <jats:italic>Salmonella<\/jats:italic> infection. The plasmid sequence similarities suggest that the plasmids acquired resistance genes from a variety of enterica bacteria and underscore the importance of a further understanding of horizontal gene transfer among enterica bacteria.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2023.1116172","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T05:47:15Z","timestamp":1680068835000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Characterization of resistance genes and plasmids from sick children caused by Salmonella enterica resistance to azithromycin in Shenzhen, China"],"prefix":"10.3389","volume":"13","author":[{"given":"Hongmei","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baoxing","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiumei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsheng","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jikui","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"D517","DOI":"10.1093\/nar\/gkz935","article-title":"CARD 2020: Antibiotic resistome surveillance with the comprehensive antibiotic resistance database","volume":"48","author":"Alcock","year":"2020","journal-title":"Nucleic Acids Res."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2164-12-402","article-title":"BLAST ring image generator (BRIG): Simple prokaryote genome comparisons","volume":"12","author":"Alikhan","year":"2011","journal-title":"BMC Genomics"},{"key":"B3","first-page":"73","article-title":"Notes from the field: Multistate outbreak of human salmonella typhimurium infections linked to contact with pet hedgehogs - united states, 2011-2013","volume":"62","year":"2013","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"B4","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1038\/s41396-020-00819-4","article-title":"Plasmid- and strain-specific factors drive variation in ESBL-plasmid spread","volume":"15","author":"Benz","year":"2021","journal-title":"Vitro vivo ISME J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.plasmid.2017.02.006","article-title":"Carriage of type II toxin-antitoxin systems by the growing group of IncX plasmids","volume":"91","author":"Bustamante","year":"2017","journal-title":"Plasmid."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-10-421","article-title":"BLAST+: Architecture and applications","volume":"10","author":"Camacho","year":"2009","journal-title":"BMC Bioinf."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3895","DOI":"10.1128\/AAC.02412-14","article-title":"In silico detection and typing of plasmids using PlasmidFinder and plasmid multilocus sequence typing","volume":"58","author":"Carattoli","year":"2014","journal-title":"Antimicrob. 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