DETERMINATION OF FOSFOMYCIN RESISTANT GENE (fosA3) IN β-LACTAMASE PRODUCING Escherichia coli FROM HOSPITAL WASTEWATER

Authors

  • Ngo Thanh Phong Institute of Food and Biotechnology, Can Tho University , HCMC Public Health Institute Author
  • Dang Van Chinh HCMC Public Health Institute Author
  • Huynh Thanh Huu Vinh Long General Hospital Author
  • Tran Do Hung Can Tho University of Medicine and Pharmacy Author
  • Huynh Xuan Phong Institute of Food and Biotechnology, Can Tho University Corresponding Author

DOI:

https://doi.org/10.62985/j.huit_ojs.vol26.no1E.341

Keywords:

Fosfomycin resistant, fosA3 gene, ESBL-E. coli, hospital wastewater

Abstract

This study aims to determine the fosfomycin resistant gene (fosA3) from 22 ESBL-E. coli strains (11 E. coli strains carrying the blaCTX-M-1 gene and 11 strains carrying both genes (blaTEM + blaCTX-M-1)), which were isolated from treated wastewater at Vinh Long General Hospital (2023). In total, 22 strains had a fosfomycin (FO 200) resistance phenotype and 7 strains carried the fosA3 gene (accounting for 31.82%) and 15 strains did not contain fosA3 (68.18%). The characteristics of the seven ESBL-producing E. coli strains carrying the fosA3 gene were identified. Among them, five strains exhibited resistance to 9 of the 11 antibiotics tested and harbored three resistance genes (blaTEM, blaCTX-M-1, fosA3). In addition, two strains (TVL8 and TVL21) displayed resistance to 9 of the 11 antibiotics and simultaneously carried four resistance genes (blaTEM, blaCTX-M-1, mcr-1, fosA3). The presence of the fosA3 gene in wastewater environments highlights the risk of antibiotic resistance gene transmission within the community. This study emphasizes the necessity of controlling antibiotic use and monitoring resistance genetic elements to limit the development and spread of fosfomycin-resistant and other antibiotic-resistant bacterial strains.

References

[1] M. C. La Rosa et al., "The impact of wastewater on antimicrobial resistance: A scoping review of transmission pathways and contributing factors", Antibiotics, vol. 14, no. 2, Art. no. 131, 2025, doi: https://doi.org/10.3390/antibiotics14020131.

[2] S. R. Partridge, S. M. Kwong, N. Firth, and S. O. Jensen, "Mobile genetic elements associated with antimicrobial resistance", Clin. Microbiol. Rev., vol. 31, no. 4, Art. no. e00088-17, 2018, doi: https://doi.org/10.1128/CMR.00088-17.

[3] N. D. Tám et al., "Phân tích mức độ tiêu thụ kháng sinh fosfomycin tại Bệnh viện Trung ương Quân đội 108 từ năm 2020 đến năm 2022", Tạp chí Y Dược lâm sàng 108, vol. 18, pp. 132–138, 2023, doi: https://doi.org/10.52389/ydls.v18idbv.1965.

[4] A. Babiker, L. Clarke, Y. Doi, and R. K. Shields, "Fosfomycin for treatment of multidrug-resistant pathogens causing urinary tract infection: A real-world perspective and review of the literature", Diagn. Microbiol. Infect. Dis., vol. 95, no. 3, Art. no. 114856, 2019, doi: https://doi.org/10.1016/j.diagmicrobio.2019.06.008.

[5] M. E. Falagas, F. Athanasaki, G. L. Voulgaris, N. A. Triarides, and K. Z. Vardakas, "Resistance to fosfomycin: Mechanisms, frequency and clinical consequences", Int. J. Antimicrob. Agents, vol. 53, no. 1, pp. 22–28, 2019, doi: https://doi.org/10.1016/j.ijantimicag.2018.09.013.

[6] S. Zhang et al., "Updates on the global dissemination of colistin-resistant Escherichia coli: An emerging threat to public health", Sci. Total Environ., vol. 799, Art. no. 149280, 2021, doi: https://doi.org/10.1016/j.scitotenv.2021.149280.

[7] K. Zurfluh, A. Treier, K. Schmitt, and R. Stephan, "Mobile fosfomycin resistance genes in Enterobacteriaceae - An increasing threat", MicrobiologyOpen, vol. 9, no. 12, Art. no. e1135, 2020, doi: https://doi.org/10.1002/mbo3.1135.

[8] M. Biggel, K. Zurfluh, A. Treier, M. Nüesch-Inderbinen, and R. Stephan, "Characteristics of fosA-carrying plasmids in E. coli and Klebsiella spp. isolates originating from food and environmental samples", J. Antimicrob. Chemother., vol. 76, no. 8, pp. 2004–2011, 2021, doi: https://doi.org/10.1093/jac/dkab119.

[9] C. Ö. Güneri, K. Stingl, M. Grobbel, J. A. Hammerl, and C. Kürekci, "Different fosA genes were found on mobile genetic elements in Escherichia coli from wastewaters of hospitals and municipals in Turkey", Sci. Total Environ., vol. 824, Art. no. 153928, 2022, doi: https://doi.org/10.1016/j.scitotenv.2022.153928.

[10] R. Ito, M. P. Pacey, R. T. Mettus, N. Sluis-Cremer, and Y. Doi, "Origin of the plasmid-mediated fosfomycin resistance gene fosA3", J. Antimicrob. Chemother., vol. 73, no. 2, pp. 373–376, 2018, doi: https://doi.org/10.1093/jac/dkx389.

[11] N. T. Phong et al., "Antibiotic resistance genes, colistin‑resistant Escherichia coli, and physicochemicals in health care wastewater in Vinh Long General Hospital, Vietnam", Environ. Monit. Assess. vol. 196, Art. no. 1187, 2024, doi: https://doi.org/10.1007/s10661-024-13345-z.

[12] W. W. Wilfinger, K. Mackey, and P. Chomczynski, "Effect of pH and ionic strength on the spectrophotometric assessment of nucleic acid purity". Biotechniques, vol. 22, no. 3, pp. 474–481, 1997, doi: https://doi.org/10.2144/97223st01.

[13] J. Hou et al., "Dissemination of the fosfomycin resistance gene fosA3 with CTX-M β-lactamase genes and rmtB carried on incfII plasmids among Escherichia coli isolates from pets in China", Antimicrob. Agents Chemother., vol. 56, no. 4, pp. 2135–2138, 2012, doi: https://doi.org/10.1128/AAC.05104-11.

[14] L. Lv et al., "Multiple plasmid vectors mediate the spread of fosA3 in extended-spectrum-β-lactamase-producing Enterobacterales isolates from retail vegetables in China", mSphere, vol. 5, no. 4, Art. no. e00507-20, 2020, doi: https://doi.org/10.1128/msphere.00507-20.

[15] S. Y. Lee et al., "Prevalence of acquired fosfomycin resistance among extended-spectrum-lactamase-producing Escherichia coli and Klebsiella pneumoniae clinical isolates in Korea and IS26-composite transposon surrounding fosA3", J. Antimicrob. Chemother., vol. 67, no. 12, pp. 2843–2847, 2012, doi: https://doi.org/10.1093/jac/dks319.

[16] N. Sato, K. Kawamura, K. Nakane, J. I. Wachino, and Y. Arakawa, "First detection of fosfomycin resistance gene fosA3 in CTX-M-producing Escherichia coli isolates from healthy individuals in Japan'', Microb. Drug Resist., vol. 19, no. 6, pp. 477–482, 2013, doi: https://doi.org/10.1089/mdr.2013.0061.

[17] T. Y. Yang, P. L. Lu, and S. P. Tseng, "Update on fosfomycin-modified genes in Enterobacteriaceae", J. Microbiol. Immunol. Infect., vol. 52, no. 1, pp. 9–21, 2019, doi: https://doi.org/10.1016/j.jmii.2017.10.006.

[18] J. Findlay et al., "Plasmid-mediated fosfomycin resistance in Escherichia coli isolates of worldwide origin", J. Glob. Antimicrob. Resist., vol. 35, pp. 137–142, 2023, doi: https://doi.org/10.1016/j.jgar.2023.09.003.

Published

2026-05-15

Issue

Section

Biology