Molecular Epidemiology of Myroides odoratimimus in Nosocomial Catheter-Related Infection at a General Hospital in China

Figures & data

Table 1 Demographic Data of Patients Included in This Study

Patient No.	Gender/Age	Diagnosis	Sample	Collection Date	Ward (Floor)	Infection Symptoms	Antibiotic Treatment After Operation	Outcome	PFGE	MALDI-TOF MS	MUS
RJ1	F/60	Pancreas neuroendocrine tumor	Drainage	7-Sep-15	Biliary and Pancreatic Surgery(13F)	None	Yes	Discharged with drainage tube	E	II	MUS-1
RJ2	M/76	Hepatolithiasis	Drainage	1-Sep-15	Biliary and Pancreatic Surgery(13F)	None	Yes	Discharged with drainage tube	E	III	MUS-1
RJ3	M/43	Pancreatic duct stones, choledochus cyst	Drainage	18-Sep-15	Biliary and Pancreatic Surgery(13F)	None	Yes	Discharged with drainage tube	E	III	MUS-1
RJ4	F/62	Uremia,Hemodialysis	Drainage	7-Sep-15	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ5	M/47	Pancreatic head carcinoma	Drainage	25-Aug-15	Biliary and Pancreatic Surgery(13F)	None	Yes	Favourable	E	II	MUS-1
RJ6	F/62	Uremia	Drainage	1-Aug-15	Urology(16F)	None	Yes	Favourable	D	I	MUS-3
RJ7	M/41	Uremia	Drainage	5-Aug-15	Urology(16F)	None	Yes	Favourable	C	III	MUS-3
RJ8	M/40	Uremia	Drainage	4-Aug-15	Urology(16F)	None	Yes	Favourable	C	I	MUS-3
RJ9	M/62	Uremia	Drainage	23-Jul-15	Urology(16F)	None	Yes	Favourable	C	I	MUS-3
RJ10	M/51	Uremia	Drainage	17-Jul-15	Urology(16F)	None	Yes	Favourable	C	I	MUS-3
RJ11	M/56	Common bile duct stones, liver cancer	Drainage	7-Sep-15	Biliary and Pancreatic Surgery(13F)	Fever	Yes	Died	E	II	MUS-1
RJ12	M/41	Uremia	Drainage	12-Jan-16	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ13	M/57	Renal carcinoma	Drainage	24-Jan-16	Urology(16F)	Fever	Yes	Favourable	A	I	MUS-3
RJ14	M/52	Chronic pancreatitis and pancreatic duct stone	Bile	26-Jan-15	Biliary and Pancreatic Surgery(13F)	Fever	Yes	Favourable	F	III	MUS-1
RJ15	M/28	Uremia	Drainage	21-May-16	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ16	F/53	Uremia	Drainage	1-Jun-16	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ17	M/31	Uremia	Drainage	1-Jun-16	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ18	M/57	Uremia	Drainage	4-Jun-16	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ19	F/38	Uremia	Drainage	4-Jun-16	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ20	M/36	Uremia	Drainage	4-Jun-16	Urology(16F)	None	Yes	Favourable	A	I	MUS-3
RJ21	F/36	Uremia	Urine	22-Jul-16	Urology(16F)	Fever	Yes	Favourable	B	IV	MUS-3
RJ22	F/46	Ureteral occlusion	Drainage	8-Aug-16	Urology(16F)	None	Yes	Discharged with drainage tube	B	IV	MUS-3

Table 2 Summary of MIC Results Among the 22 M. odoratimimus Isolates

Isolate No.	MIC(mg/mL)
	TZP	CAZ	CRO	FEP	ATM	CIP	AK	CN	IPM	MEM	LEV	SXT
RJ1	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	>256	4	4
RJ2	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	>256	4	4
RJ3	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	>256	4	4
RJ4	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	8	8	>256	8
RJ5	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	>256	4	8
RJ6	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	8	8	>256	>256
RJ7	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	>256	4	8
RJ8	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	16	4	>256	32
RJ9	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	8	4	>256	16
RJ10	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	8	4	>256	16
RJ11	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	64	8	2
RJ12	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	>256	>256	16
RJ13	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	>256	8	256
RJ14	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	>256	128	>256	4
RJ15	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	32	8	16	256
RJ16	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	32	8	>256	128
RJ17	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	32	8	>256	128
RJ18	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	64	8	>256	256
RJ19	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	32	8	>256	128
RJ20	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	8	8	>256	256
RJ21	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	16	16	>256	128
RJ22	≥128	≥64	≥64	≥64	≥64	≥4	≥64	≥16	8	4	>256	64

Notes: MIC breakpoints, imipenem (S≤4, I=8, R≥16); meropenem (S≤4, I =8, R≥16); levofloxacin (S≤2, I=4, R≥8); trimethoprim–sulfamethoxazole(S ≤2, R≥4).

Abbreviations: MIC, minimum inhibitory concentration; R, resistant; I, intermediate; S, sensitive; TZP, piperacillin–tazobactam; CAZ, ceftazidime; CRO, ceftriaxone; FEP, cefepime; ATM, aztreonam; CIP, ciprofloxacin; AK, amikacin; CN, gentamicin; IPM, imipenem; MEM, meropenem; SXT, trimethoprim–sulfamethoxazole; LEV, levofloxacin.

Table 3 Primers for the Carbapenemase Gene Sequencing Analysis

Gene Name	Primer Name	Sequence
blaKPC	blaKPC-F	5ʹ-AGGACTTTGGCGGCTCCAT-3’
	blaKPC-R	5ʹ-TCCCTCGAGCGCGAGTCTA-3’
blaOXA	blaOXA-F	5ʹ-GCGTGGTTAAGGATGAACAC-3’
	blaOXA-R	5ʹ-CATCAAGTTCAACCCAACCG-3’
blaVIM	blaVIM-F	5ʹ-GATGGTGTTTGGTCGCATA-3’
	blaVIM-R	5ʹ-CGAATGCGCAGCACCAG-3’
blaIMP	blaIMP-F	5ʹ-GGAATAGAGTGGCTTAAYTCTC-3’
	blaIMP-R	5ʹ-GGTTTAAYAAAACAACCACC-3’
blaMUS	blaMUS-F	5ʹ-CGTTAGGCACACCAGAAGAA-3’
	blaMUS-R	5ʹ-ATGCGAGTCTTACCACACCT-3’
blaTUS-1	blaTUS-1-F	5ʹ-TTAATCGTTTTTAGTTGA-3’
	blaTUS-1-R	5ʹ-TTATAATTGCTTGTTGTT-3’
blaNDM	blaNDM-F	5ʹ-ATGGAATTGCCCAATATTATGC −3’
	blaNDM-R	5ʹ-TCAGCGCAGCTTGTCGGC −3’
blaB	B-F	5ʹ-TAAATATGCCGCTAATGC-3’
	B-R	5ʹ-CCCCAGGTCTTTTGAATC-3’

Figure 1 PFGE image of the M. odoratimimus strains. The 22 isolates belonged to six distant PFGE groups (types A–F) by using a cut-off of 80% similarity (Δurology department, □biliary and pancreatic surgery department).

Figure 2 MALDI-TOF MS dendrograms for 22 isolates. Using PCA cluster analysis to construct a dendrogram, MALDI-TOF MS generated four clusters (types I, II, III, and IV) with a cut-off value of 3.

Figure 3 The level of resistance to meropenem between the clinical isolates of MUS-1 from the biliary and pancreatic surgery ward and MUS-3 from the urology ward (P < 0.05).

Figure 4 The secondary and tertiary structure prediction of MUS-1 wild-type and V60A-mutant proteins using bioinformatics tools. (A) Secondary structure prediction of the MUS wild-type protein by PSIPRED. (B) Secondary structure prediction of the MUS-3 (V60A) mutant protein by PSIPRED. A beta-strand is predicted to form at the mutation position (red triangle). (C) Tertiary structure prediction of the MUS protein by RaptorX, with the mutation marked inside (black oval).