Emerging High‐Level Tigecycline Resistance: Novel Tetracycline Destructases Spread via the Mobile Tet(X)

Antibiotic resistance in bacteria has become a great threat to global public health. Tigecycline is a next‐generation tetracycline that is the final line of defense against severe infections by pan‐drug‐resistant bacterial pathogens. Unfortunately, this last‐resort antibiotic has been challenged by...

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Bibliographic Details
Published in:BioEssays Vol. 42; no. 8; pp. e2000014 - n/a
Main Authors: Fang, Liang‐Xing, Chen, Chong, Cui, Chao‐Yue, Li, Xing‐Ping, Zhang, Yan, Liao, Xiao‐Ping, Sun, Jian, Liu, Ya‐Hong
Format: Journal Article
Language:English
Published: Cambridge Wiley Subscription Services, Inc 01.08.2020
Subjects:
Antibiotic resistance
Antibiotics
Bacteria
Epidemiology
Gram-negative bacteria
high‐level tigecycline resistance
humans
molecular epidemiology
pan‐drug‐resistant
plasmid reservoirs
plasmid‐encoding tigecycline enzymatic inactivation
Public health
Tet(X)
tetracycline
tetracycline antibiotics
tetracycline destructases
Tetracyclines
Tigecycline
Veterinary medicine
ISSN:0265-9247, 1521-1878, 1521-1878
Online Access:Get full text
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Summary:Antibiotic resistance in bacteria has become a great threat to global public health. Tigecycline is a next‐generation tetracycline that is the final line of defense against severe infections by pan‐drug‐resistant bacterial pathogens. Unfortunately, this last‐resort antibiotic has been challenged by the recent emergence of the mobile Tet(X) orthologs that can confer high‐level tigecycline resistance. As it is reviewed here, these novel tetracycline destructases represent a growing threat to the next‐generation tetracyclines, and a basic framework for understanding the molecular epidemiology and resistance mechanisms of them is presented. However, further large‐scale epidemiological and functional studies are urgently needed to better understand the prevalence and dissemination of these newly discovered Tet(X) orthologs among Gram‐negative bacteria in both human and veterinary medicine. The novel mobile tetracycline‐inactivating enzymes, Tet(X3)–Tet(X5), could confer high‐level tigecycline resistance. They have been disseminated in diverse bacterial hosts from a wide range of ecological niches through promiscuous plasmids and ISCR2. This complex dissemination can be driven by selective pressure from the massive use of the early tetracyclines.
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ISSN:0265-9247
1521-1878
1521-1878
DOI:10.1002/bies.202000014