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Background  CTX-M-55 extended-spectrum beta-lactamases are being rapidly disseminated and transmitted in clinical practices around the world. The genetic contexts of the transferable plasmid-mediated  bla  CTX-M-55  gene in  Enterobacteriaceae  were detected and characterized in this study.    Methods  Isolates were obtained from the First Affiliated Hospital of Zhengzhou University between September 2015 and March 2016. Based on polymerase chain reaction and BLAST analysis, resistance genes and genetic context of the  bla  CTX-M-55  gene were investigated. Conjugation experiments and multilocus sequence typing were performed to demonstrate plasmid-mediated  bla   CTX - M - 55   transmission.    Results  Thirteen  bla  CTX-M-55 -positive isolates of  Enterobacteriaceae  were obtained. Seven isolates were  Escherichia coli , 3 were  Klebsiella pneumoniae , 1 was  Citrobacter freundii , 1 was  Morganella morganii  and 1 was  Serratia marcescens . The  bla  CTX-M-55  gene has not previously been identified from  C. freundii  and  M. morganii . Four different  bla   CTX - M - 55   genetic contexts were identified, and all of them harbored  ISEcp1  in the region upstream of  bla  CTX-M-55  (in two cases,  ISEcp1  was truncated by  IS26 , and in one case, it was truncated by  IS1294 ), whereas  ORF477  was detected downstream of the  bla  CTX-M-55  gene from 12 of 13 strains. The novel genetic context of  ISEcp1∆ - bla   CTX - M - 55  - ∆IS903  was firstly detected the  IS903  element which was identified downstream of  bla  CTX-M-55 . A conjugation assay revealed that all  bla   CTX - M - 55   plasmids were quickly and easily transferable to recipient  E. coli , which then presented resistance to multiple antibiotics.    Conclusions  Numerous  bla   CTX - M - 55  -positive strains were isolated in a short period of 7 months. The findings indicate that  bla   CTX - M - 55   was rapidly disseminated. The genetic context and conjugative transfer found in this study demonstrate that there is active transmission of  bla  CTX-M-55  among strains of  Enterobacteriaceae  in China, which could give rise to an urgent global public health threat.

Genetic contexts related to the diffusion of plasmid-mediated CTX-M-55 extended-spectrum beta-lactamase isolated from Enterobacteriaceae in China