Identification of plasmid-mediated tigecycline resistance <i>tet</i> (x4) and New Delhi metallo-β-lactamase (NDM) in an <i>Escherichia coli</i> isolate from Canada
Bibliographic record
Abstract
ABSTRACT Rapid spread of carbapenemase-producing Enterobacterales is a global health threat for which tigecycline is one of the few remaining therapeutic options. Resistance by tet (x4) is particularly worrisome, given its presence on mobile genetic elements. Here we report on a tigecycline-resistant Escherichia coli strain isolated from a patient returning from Pakistan. A tet (x4) gene was found on an IncFII plasmid isolated from an ST410 E. coli co-harboring NDM-5. The combination of carbapenemase and tet (x4) is concerning. IMPORTANCE Tigecycline is one of the few last-resort therapeutic options available for treating multidrug-resistant gram-negative bacterial infections, particularly of interest in carbapenemase-producing isolates. Mobile tigecycline resistance is still relatively rare, especially in North America and among clinical isolates. Here we describe the identification of a high-risk clone ( E. coli ST410) in Canada that contains the tigecycline resistance gene tet (x4) on an IncFII plasmid and bla NDM-5 on a separate IncFIB plasmid. Here, we highlight a rare resistance gene in combination with a carbapenemase, both of which are plasmid mediated, complicating antimicrobial treatment options.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".