Background
Lactobacilli are Gram-positive rod-shaped non-pathogenic bacteria considered to be beneficial components of the gastrointestinal microbiota of humans and animals, including birds. They play an important role in the physiology of their host, as they maintain the microbial balance around mucous membranes via ecological interactions with the resident flora and beneficially influence the immune system via the GALT. Moreover, they improve digestion and assimilation of nutrients and remove toxic substances [
1]. Owing to their health-promoting properties, many
Lactobacillus strains are used to produce probiotic preparations for humans and animals, and interest in applications for these bacteria continues to grow.
As modern intensive poultry farming and the associated high density of birds are conducive to the rapid spread of germs, the demand for veterinary drugs, including antibiotics, is high. However, antibiotics are becoming less effective due to bacterial resistance, and the hypothesis that the gastrointestinal tract (GIT) acts as a reservoir of antibiotic resistance genes is widely accepted [
2]. High density of micro-organisms within this ecosystem facilitates the exchange of resistance genes among members of the microbiota, including both commensals and pathogens. Antibiotic-resistant strains not only pose a danger to animals, but as they spread via the food chain, also contribute to problems in humans.
The aim of this study was to determine the susceptibility of
Lactobacillus strains derived from chickens to antibiotic substances and to detect drug-resistance genes. To the best of our knowledge, the current literature does not provide comprehensive studies on the antibiotic susceptibility of chicken lactobacilli. There are only two reliable reports [
3,
4] of phenotypic and genotypic susceptibility of chicken lactobacilli to tetracycline and MLS antibiotics (macrolides, lincosamides and streptogramins).
Most of the antibiotics and chemotherapeutics tested are currently approved for treatment of poultry diseases in the EU. Tetracyclines, such as oxytetracycline, chlortetracycline, and doxycycline, are recommended for controlling mycoplasmosis and chlamydiosis in poultry, as well as against susceptible strains of various bacteria, including spirochetes, and some protozoa. Macrolides and lincosamides are common therapeutic agents for necrotic enteritis (
Clostridium perfringens) and intestinal spirochetes (
Brachyspira pilosicoli), while tylosin and tiamulin are important drugs in controlling chronic respiratory diseases caused by mycoplasmas [
5]. Aminoglycosides are particularly effective against Gram-negative bacteria and are poorly absorbed from the gastrointestinal tract. Hence neomycin is commonly used against enteric infections (e.g., salmonellosis or colibacillosis) in poultry [
5]. Penicillins, such as amoxicillin, are effective against susceptible strains of various Gram-positive and Gram-negative bacteria, especially in the treatment of
E. coli septicaemia, salmonellosis, pasteurellosis, necrotic enteritis and chronic respiratory disease in poultry. Fluoroquinolones, including enrofloxacin, flumequine and difloxacin, are synthetic broad-spectrum bactericidal drugs that are frequently used in poultry production to treat salmonellosis, colibacillosis and fowl cholera [
6].
The mechanism of action of tetracyclines, MLS antibiotics, aminoglycosides, pleuromutilins and chloramphenicol is based on inhibition of protein synthesis in bacterial cells. Tetracyclines bind to the 30S subunit of ribosomes and prevent the attachment of tRNAs carrying amino acids. MLS antibiotics, tiamulin, and chloramphenicol bind to the 50S ribosomal subunit and/or to peptidyl transferase—an enzyme responsible for forming peptide bonds between amino acids [
7]. Beta-lactam antibiotics inhibit bacterial cell wall synthesis by interacting with penicillin binding proteins (PBPs) [
5], while fluoroquinolones inhibit DNA replication by binding to the DNA gyrase [
6].
The use of antibacterial agents creates selective pressure for the emergence of resistant strains, both pathogenic and commensal. Antibiotic resistance, which is implicated in elevated morbidity and mortality rates as well as increased treatment costs, is considered a major global public health threat (
http://www.who.int/drugresistance/en/). Bacteria may be intrinsically resistant to antimicrobial agents or may acquire resistance by de novo mutation or via the acquisition of resistance genes from other organisms. Acquired resistance genes may enable a bacterium to produce enzymes that destroy the antibacterial drug, to express efflux systems that prevent the drug from reaching its intracellular target, to modify the drug’s target site, or to produce an alternative metabolic pathway that bypasses the action of the drug. Many antibiotic resistance genes are carried on plasmids, transposons or integrons that can act as vectors that transfer these genes to other members of the same bacterial species, as well as to bacteria of other genera or species. Horizontal gene transfer may occur via three main mechanisms: transformation, transduction or conjugation [
8].
Lactobacilli are commonly used as probiotics and according to the EFSA’s FEEDAP Panel (European Food Safety Authority Panel on Additives and Products or Substances used in Animal Feed) all bacterial strains intended for use as feed additives must be examined to establish their susceptibility to the most relevant antibiotics and chemiotherapeutics. As a basic requirement, the minimum inhibitory concentration (MIC) of the antimicrobials should be determined in order to distinguish susceptible and resistant strains. Strains carrying acquired resistance should not be used as a feed additives unless it can be demonstrated that it is a result of chromosomal mutation(s) [
9].
Discussion
In this study we assayed 88 Lactobacillus isolates of chicken origin with regard to their susceptibility to 13 antibacterial agents. We found high prevalence of resistance to tiamulin (90% resistant isolates), tetracyclines (74%), and lincosamides (70%), and moderately high frequency of resistance to enrofloxacin (48%), macrolides (42%), aminoglycosides (12.5–31%), ampicillin (26% resistant isolates) and chloramphenicol (23%).
Tiamulin, doxycycline, chlortetracycline, oxytetracycline, erythromycin, tylosin, lincomycin and enrofloxacin are currently approved for treatment of poultry diseases in Poland, and in the past some of these antibiotics were commonly used as feed additives for chickens. The intensive use and misuse of antibiotics in animal husbandry are unquestionably the major forces contributing to the development of resistance in bacteria, both pathogenic and commensal [
20].
In this work we have presented the first reliable data on the sensitivity of lactobacilli to tiamulin. According to the proposed criteria, most isolates (90%) were resistant to tiamulin (MIC ≥8 μg/ml) and the most commonly observed MIC value was 64–128 μg/ml (for 64% of isolates). For
L. salivarius,
L. agilis,
L. reuteri and
L. ingluviei, we observed bimodal distribution of MIC values, with the MIC of 9% isolates as low as ≤0.5 μg/ml. MIC values for tiamulin determined by Karpetkov et al. [
21] for 3 isolates of
Lactobacillus (
L. acidophilus,
L. helveticus and L. bulgaricus) were in the range of 0.5–1 μg/ml, while the sensitivity of other Gram-positive bacteria to tiamulin is varied. Callens et al. [
22] showed that the MIC for
Streptococcus suis (332 isolates tested) from pigs ranged from 0.03 to 128 μg/ml, and MIC = 4 μg/ml was established as an epidemiological cut-off value. Jones et al. [
23] showed that MIC90 was >32 μg/ml for enterococci (71 isolates tested), and 2 μg/ml for
S. aureus (150 isolates).
The observed phenotypic resistance of lactobacilli to tiamulin may be due to mutation in the 23S rRNA or in the
rplC genes encoding ribosomal proteins. The presence of multidrug efflux pumps (
vga and
lsa) is also possible [
24]. None of the isolates contained the
cfr gene coding for RNA methyltransferase or the
vgaA,
vgaAv and
lsaC genes encoding ABC transporters that confer combined resistance to pleuromutilins, lincosamides and streptogramin A antibiotics (PLS
A) in Gram-positive bacteria [
24]. However, in 10 isolates we detected the
lsaE gene, which has previously been identified in staphylococci, enterococci (Europe, Asia) and
Streptococcus agalactiae (South America) [
25]. Eight
lasE-positive isolates simultaneously contained the
aadE or
ant(6)-
Ia gene conferring resistance to streptomycin. This observation is in line with findings by Si et al. [
25], who demonstrated the presence of the
lsaE gene within plasmid or chromosomal clusters comprising several resistance genes, including
aadE.
High prevalence of tetracycline resistance (74% of isolates) in the lactobacilli tested is in line with observations by Cauwerts et al. [
3], who found that over 78% of lactobacilli isolated from Belgian broiler farms were resistant to tetracycline, with a particularly high rate of resistance observed among strains of
L. reuteri,
L. gallinarum,
L. crispatus and
L. salivarius. Also, Vieira De Souza et al. [
26] reported a high incidence of tetracycline resistance (MIC ≥128 μg/ml) among lactobacilli isolated from the GIT of free-range broiler chickens when resistance was determined by the microplate method using MRS broth. A lower incidence of resistance to tetracyclines (28%) and macrolides (29%) in faecal chicken lactobacilli was noted by Kmet and Piatnicova [
27].
Acquired tetracycline resistance in bacteria is determined mainly by
tet genes, which code for energy-dependent efflux proteins (e.g.,
tetK and
tetL) or ribosomal protection proteins (e.g.,
tetM,
tetO,
tetQ or tetW) [
28,
29]. We showed the presence of
tetL,
tetM and
tetW in the
Lactobacillus isolates with phenotypic tetracycline-resistance. The occurrence of these genes, as well as
tetK and
tetZ, in chicken lactobacilli (76% of strains tested) was also observed by Cauwerts et al. [
3]. However, in contrast to our results, these authors more frequently detected
tetL and
tetM than
tetW. In a study by Chang et al. [
30], 100% of
Lactobacillus strains isolated from swine intestines (in Taiwan) were resistant to tetracyclines; among 5
tet genes detected the most predominant was
tetW (in 82% strains), followed by
tetM (22.5%),
L (14.4%),
K (8.1%) and
Q (0.9%). The
tetW and
tetM genes have also been found in
Lactobacillus strains derived from humans, probiotics and food products Klare et al. [
31]. Our finding that the
tetW gene is characteristic for
L. crispatus,
L. johnsonii and
L. reuteri is consistent with the observations of other authors [
3,
32,
33].
High rates of resistance to macrolides and lincosamides among chicken lactobacilli have previously been reported by Cauwerts et al. [
4], who demonstrated that 78% of
Lactobacillus strains (belonging to 5 species) from Belgian broiler farms displayed resistance to erythromycin and tylosin (MIC ≥16 μg/ml) and 87% were resistant to lincomycin (MIC ≥64 μg/ml). Chin et al. [
34] found that 58% of lactobacilli isolated from the GIT of chickens exhibited a high degree of resistance to erythromycin (MIC ≥200 μg/ml). A clear bimodal distribution of MICs for erythromycin and tylosin, indicative of acquired resistance, has also been reported by other authors in MLS-resistant lactobacilli derived from various sources [
4,
12,
33,
35].
We have shown that the vast majority of
Lactobacillus strains characterized by phenotypic resistance to macrolides and/or lincosamides contained resistance-related genes. PCR detection of methylase genes (
erm), efflux genes (
mef and
msr) and the lincosamide
O-nucleotidyltransferase gene (
lnuA) confirmed a high incidence of
ermB (in 39% of isolates) and
lnuA (39%) in chicken lactobacilli, while
ermC occurred less frequently (12%). Our results are consistent with those of Cauwerts et al. [
4], who found that carriage of the
ermB gene always concurred with phenotypic resistance to macrolides and lincosamides in chicken lactobacilli. The same authors reported the occasional occurrence of the
lnuA,
mefA and
ermC genes. The
ermB gene is also widespread in other poultry-derived LAB [
36,
37]. Four of 11
ermC-positive isolates were susceptible to macrolides and at the same time displayed low resistance to lincomycin (MIC 16–64 μg/ml). Our results are consistent with those of Cauwerts et al. [
4], who showed that chicken
Lactobacillus strains may carry the
ermC gene without exhibiting phenotypic macrolide or lincosamide (MIC ≥64 μg/ml) resistance. Note, however, that according to the cut-offs adopted by Cauwerts et al. [
4], three of our strains carrying the
ermC gene would be considered susceptible to both macrolides and lincosamides.
In this work, the
lnuA gene encoding a transferase inducing inactivation of lincosamides was detected mainly in
L. reuteri and
L. ingluviei strains. The presence of
lnuA in
L. reuteri has previously been reported by Cauwerts et al. [
4] (in chicken lactobacilli) and by Kastner et al. [
32] (in the probiotic strain
L. reuteri ATCC 55730).
Resistance to tetracyclines and macrolides and the
tet and
erm genes also occurs among
Lactobacillus and
Lactococcus strains isolated from various food sources, including poultry meat products [
38,
39].
The incidence of ampicillin resistance (26% isolates) recorded in this study is higher than that observed by other researchers working on poultry LAB over the past 15 years. Kmet and Piatnicova [
27] showed that 100% of
Lactobacillus strains from cloacal swabs of broiler chickens raised on farms in Slovakia were susceptible to penicillin and ampicillin. High sensitivity of LAB isolated from Malaysian broiler chickens to β-lactams (penicillin, ampicillin and amoxicillin) has also been reported by Shazali et al. [
40], and Lonkar et al. [
41] noted only sporadic β-lactam resistance among poultry lactobacilli (≤ 3.5%). Low ampicillin MICs (MIC ≤4 μg/ml) have also been demonstrated for goose-derived lactobacilli [
11]. We were unable to explain the resistance mechanism of
Lactobacillus isolates against ampicillin, but we ruled out the involvement of β-lactamases. This is consistent with other studies demonstrating the absence of the
blaZ gene in lactobacilli despite their phenotypic resistance to β-lactam antibiotics [
12,
18].
In our study, 23% of isolates showed resistance to chloramphenicol, but for most of them the MICs were 8 μg/ml, while the established cut-off value is 4 μg/ml. A high MIC value, 64 μg/ml, was recorded for only one isolate. The
cat gene encoding chloramphenicol acetyltransferase was detected in 37.5% of isolates, both phenotypically resistant and susceptible. A similar range of MIC values for chloramphenicol, i.e. 1–8 μg/ml for most lactobacilli tested, was observed by Mayrhofer et al. [
42] and by Danielsen and Wind [
43], while high MIC values ≥32 μg/ml have been noted only occasionally [
12,
43]. Hummel et al. [
18] demonstrated that the
cat gene can be present in chloramphenicol-susceptible lactobacillus isolates, and furthermore that the
cat gene in these strains was not expressed (RNA level) in either inducing or non-inducing conditions. The authors speculated that a mutation in the regulatory region may be responsible for the inhibition of
cat expression in phenotypically susceptible isolates.
The frequency of resistance to aminoglycoside antibiotics among the
Lactobacillus isolates was in a range of 12.5–31%, with
L. salivarius dominant among resistant isolates. High MIC values, i.e. ≥128 μg/ml for streptomycin, gentamicin and neomycin, were reported for 18, 7 and 1% of isolates, respectively. Similarly, high-level resistance (MIC ≥128 μg/ml) to streptomycin and gentamicin were reported by Danielsen and Wind [
43] in 61 and 3%, respectively, of
Lactobacillus isolates of different species. Greater susceptibility of lactobacilli to aminoglycosides was observed by Korhonen [
44] in bovine isolates, with MIC ranges of 0.25–8 μg/ml for gentamicin and 0.25–32 μg/ml for neomycin, while in the case of streptomycin an MIC of 2–32 μg/ml was recorded for 98% of isolates and MIC = 128 μg/ml for only one
L. salivarius strain.
We were not able to establish the resistance status of all phenotypically resistant isolates, but in some of them we detected genes encoding aminoglycoside-modifying enzymes. Enzymatic modification is the most common type of aminoglycoside resistance, and the modifying enzymes are divided into three groups: N-acetyltransferases (AAC), O-adenyltransferases (ANT, e.g., the ANT(6) group encoded by
ant(6)-
Ia,
ant(6) and
aadE and the ANT(3″) group encoded by
aadA genes) and O-phosphoryltransferases (APH; encoded by
aph genes, including
aph(3
′
)-
IIIa and
aph(6)-
Ia, also known as
strA [
17].
Among the lactobacilli tested we identified
ant(6)-
Ia (10% isolates),
aac(6′
)-
Ie-
aph(2′
)-
Ia (8%),
aph(2″
)-
Ic (6%) and
aadE (4.5%). Our results are largely consistent with literature data, which indicate that the most frequently detected aminoglycoside resistance genes in LAB are
aac(6
′
)-
Ie-
aph(2″
)-
Ia,
ant(6)-
Ia,
ant(6),
aac(6
′
)-
Ii,
aph(2″
)-
Ic,
aph(3
′
)-
IIIa,
aadA and
aadE [
15,
45‐
48]. Tenorio et al. [
49] demonstrated the presence of the bifunctional gene
aac(
6
′
)-
Ie-
aph(2
”)-
Ia in 7 of 9 phenotypically gentamicin-resistant (MIC of ≥ 64 μg/ml) strains, including
L. salivarius, from pigs and pets. Jaimee and Halami [
50] and Rojo-Bezares et al. [
48] noted the presence of
aac(6′
)Ie-
aph(2″
)Ia,
aph(3′
)-
IIIa,
aad6 and
ant(6) among
L. plantarum isolates derived from meat products or wine. The presence of
aadE,
aph(
3′
)-
IIIa and
aadA in 3 of 16 tested isolates of
L. casei,
L. paracasei and
L. plantarum was reported by Ouoba et al. [
51]. Similarly to our results, the presence of aminoglycoside resistance genes in phenotypically sensitive lactobacillus strains has been observed by Shao et al. [
47], who detected
ant(6),
aadE and aadA (conferring resistance to streptomycin) in 3
L. casei isolates (streptomycin MIC 16–32 μg/ml) and in 5
L. plantarum isolates (MIC 16–512 μg/ml) from food sources. The authors stated that these eight isolates were phenotypically resistant to streptomycin, but according to breakpoints established by the EFSA (2012),
L. casei strains are regarded as resistant if streptomycin MIC ≥128 μg/ml, while there are no established breakpoints for
L. plantarum. Another imprecision in the publication by Shao et al. [
47] is the size of the PCR product for the
aadE gene—the amplicon size obtained using the described primers is 1100 bp, not 565 bp.
In this work we observed the co-occurrence of
ant(6)-
Ia and
aadE genes in a few
L. salivarius isolates. Both genes determine resistance to streptomycin, belong to the ANT(6) subclass [
17] and some authors use their names interchangeably [
52,
53]. Thus it is very likely that
ant(6)-
Ia and
aadE identified in this study are the same gene detected with different primers. Sequencing of
ant(6)-
Ia and
aadE amplicons revealed 97–99% homology to the sequence of
aadE gene located on the
lsa(E)-carrying multidrug resistance cluster of
Enterococcus faecalis (GenBank Accession No. KX156279.1) and to
aadE gene of
Staphylococcus aureus (GenBank Accession No. JQ861959.1) (data not shown).
The range of MICs observed in this work for fluoroquinolones, i.e. 2–256 μg/ml for enrofloxacin and 8–512 μg/ml for flumequine, was similar to the range of MICs previously recorded for goose lactobacilli [
11]. However, according to the proposed cut-off value, the rate of enrofloxacin-resistant strains (MIC ≥64 μg/ml) was higher among chicken isolates (48%) than in isolates derived from geese (23%). Other authors have reported greater susceptibility of LAB to enrofloxacin. The MIC range noted by Ishihara et al. [
54] for lactobacilli isolated from dairy products was 1–8 μg/ml, and in the case of bovine lactobacilli MIC ≥64 μg/ml was noted for only 3% of isolates [
44]. The presence of low MIC values for enrofloxacin, i.e. 0.5–2.0 μg/ml, was also observed by Marrow et al. [
55] for enterococci isolates from free-living and captive raptors.
Among the genes coding efflux pumps we detected only
acrA, which was present in all
Lactobacillus isolates. High prevalence of
acrA among LAB isolated from fermented olives has previously been noted by Casado Muñoz et al. [
56]. These authors also observed a high frequency of
mepA and
mdeA and lower frequency of
norA. According to some reports [
57,
58], the overexpression of all these genes in
Enterobacteriaceae is correlated with fluoroquinolone and multidrug resistance. In this work we did not evaluate the expression of the
acrA gene, but its presence in all isolates indicates its role in cell physiology rather than its involvement in antibiotic resistance.
Resistance genes are commonly found on mobile genetic elements, such as plasmids, transposons or integrons, contributing to their widespread distribution among bacteria. Some authors have shown that LAB, including lactobacilli, may contain
tetL-,
tetM-,
tetW-,
ermB-,
ermC, lnuA,
aac(
6′
)-
Ie-
aph(2
”)-
Ia-,
aadE-,
ant(6)-
Ia or
lsaE-carrying plasmids or transposons [
33,
59‐
63]. It has also been shown that the resistance genes
ermB and
tetM can be transferred between different
Lactobacillus species, as well from lactobacilli to other LAB bacteria, including potentially pathogenic strains of
E. faecalis [
26,
60].