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We investigated  cfr -positive and -negative MRSA strains isolated from animals and humans in different geographical areas of China, from 2011 to 2016. Twenty  cfr -positive strains (15.6%) were identified from 128 MRSA strains including 17 from food animals and three from humans. The resistance rates and prevalence of the tested antibiotic resistance genes (ARGs) in the  cfr -positive MRSA isolates were higher than that in the  cfr -negative MRSA isolates. All  cfr -positive MRSA isolates were co-carrying  fexA  and  ermC , and had significantly higher  optrA  incidence rate vs. the  cfr -negative isolates ( P  < 0.05). In addition, multilocus sequence typing (MLST) assays showed that ST9 and  spa -type t899 were the most prevalent ST and  spa  types in the study strains. However, all of the 20  cfr -positive and 10 randomly selected  cfr -negative MRSA isolates were clonally unrelated as determined by pulsed-field gel electrophoresis (PFGE) analyses. Importantly, the  cfr  gene was successfully transferred to a recipient  Staphylococcus aureus  strain RN4220 from 13 of the 20  cfr -positive MRSA isolates by electroporation. Among these 13  cfr -positive MRSA isolates, two different genetic contexts surrounding  cfr  were determined and each was associated with one type of  cfr -carrying plasmids. Of note, the predominant genetic context of  cfr  was found to be a Tn 558  variant and locate on large plasmids (∼50 kb) co-harboring  fexA  in 11 of the 13 MRSA isolates. Furthermore, the  cfr  gene was also identified on small plasmids (∼ 7.1 kb) that co-carried  ermC  in two of the 13 MRSA isolates. Our results demonstrated a high occurrence of multi-drug resistance in  cfr -positive MRSA isolates, and the spread of  cfr  might be attributed to horizontal dissemination of similar  cfr -carrying transposons and plasmids.

frontiers in microbiology

Characterization of the Multi-Drug Resistance Gene cfr in Methicillin-Resistant Staphylococcus aureus (MRSA) Strains Isolated From Animals and Humans in China