Evidence map›Paper›PMID 41775676›Full record

ArticleEnvironmental microbiology reports2026

Emergence of Tigecycline-Resistant Pseudomonas aeruginosa Harbouring tmexC6D6-toprJ1b From Hospital Sewage in Japan.

Shotaro Maehana, Masato Suzuki, Naoko Ishimura, Hiroki Izawa, Ryotaro Eda, Masaki Nakamura, Mohan Amarasiri, Takashi Furukawa, Fumiaki Kojima, Kazunari Sei and 1 more

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Article in Environmental microbiology reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Shotaro MaehanaDepartment of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.ORCID https://orcid.org/0009-0002-3187-2090
Masato SuzukiAntimicrobial Resistance Research Center, Japan Institute for Health Security, Tokyo, Japan.ORCID https://orcid.org/0000-0001-8975-2193
Naoko IshimuraDepartment of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.ORCID https://orcid.org/0009-0002-9564-3051
Hiroki IzawaDepartment of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.ORCID https://orcid.org/0009-0003-1382-368X
Ryotaro EdaResearch Center for Biosafety, Japan Institute for Health Security, Tokyo, Japan.ORCID https://orcid.org/0000-0002-6713-9256
Masaki NakamuraDepartment of Clinical Laboratory, Kitasato University Hospital, Kanagawa, Japan.ORCID https://orcid.org/0000-0003-1859-2342
Mohan AmarasiriEnvironmental Water Quality Engineering Laboratory, Department of Civil and Environmental Engineering, Graduate School of Engineering, Tohoku University, Miyagi, Japan.ORCID https://orcid.org/0000-0002-3509-3433
Takashi FurukawaDepartment of Environmental Hygiene, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.ORCID https://orcid.org/0000-0001-5019-2264
Fumiaki KojimaRegenerative Medicine and Cell Design Research Facility, Kanagawa, Japan.ORCID https://orcid.org/0000-0002-5160-1493
Kazunari SeiDepartment of Environmental Hygiene, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.ORCID https://orcid.org/0000-0002-0684-6002
Makoto KuboDepartment of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan.ORCID https://orcid.org/0000-0001-8264-1343

Funding

Environmental Restoration and Conservation Agency JPMEERF25S21212Environmental Restoration and Conservation Agency JPMEERF25S21220Japan Agency for Medical Research and Development JP24fk0108642Japan Agency for Medical Research and Development JP24fk0108665Japan Agency for Medical Research and Development JP24fk0108683Japan Agency for Medical Research and Development JP24fk0108712Japan Agency for Medical Research and Development JP24gm1610003Japan Agency for Medical Research and Development JP24wm0225022Japan Agency for Medical Research and Development JP24wm0225029Ministry of Education, Culture, Sports, Science and Technology JP22K17354Ministry of Education, Culture, Sports, Science and Technology JP22KK0058Ministry of Education, Culture, Sports, Science and Technology JP23H00536Ministry of Education, Culture, Sports, Science and Technology JP23K06556Ministry of Education, Culture, Sports, Science and Technology JP23K26235Ministry of Education, Culture, Sports, Science and Technology JP25K13531
6 · The paper itself

Abstract

The mobile tmexCD-toprJ gene clusters encode resistance-nodulation-division (RND)-type multidrug efflux pumps which confer resistance to multiple antimicrobials, including tigecycline. Here we report the first identification of tmexCD-toprJ-harbouring Pseudomonas aeruginosa strain KAM950, isolated from hospital sewage in Japan in 2022. The isolate exhibited reduced susceptibility to tigecycline and carbapenems. Complete genome sequence analysis showed that KAM950 belongs to sequence type 244 (ST244) according to multilocus sequence typing, an internationally recognised epidemic clone, and harbours multiple antimicrobial resistance genes, including the tmexCD-toprJ variant, tmexC6D6-toprJ1b. Notably, the tmexC6D6-toprJ1b gene cluster was located on the chromosome, adjacent to the transcriptional regulator gene tnfxB6 and an IS5/IS1182 family transposase gene. Furthermore, an IS4-mediated disruption of the porin gene oprD was observed, potentially contributing to carbapenem resistance. BLASTn analysis revealed that the IS5/IS1182-tnfxB6-tmexC6D6-toprJ1b gene cluster present in both chromosomal and plasmid sequences among the order Pseudomonadaceae, indicating potential horizontal gene transfer of tnfxB6-tmexC6D6-toprJ1b mediated by IS5/IS1182. Our findings highlight the ongoing expansion of variant diversity and geographic spread of tmexCD-toprJ-like gene clusters, and underscore the importance of genomic surveillance for emerging antimicrobial resistance determinants in both clinical and environmental settings.

Indexed as

Anti-Bacterial AgentsDrug Resistance, BacterialDrug Resistance, Multiple, BacterialPseudomonas aeruginosaSewageTigecyclineBacterial ProteinsCarbapenemsHospitalsHumansJapanMicrobial Sensitivity TestsMultigene FamilyMultilocus Sequence TypingAnti-Bacterial AgentsBacterial ProteinsCarbapenemsSewageTigecyclinehospital sewageJapanPseudomonas aeruginosatigecycline resistancetmexC6D6‐toprJ1b

Identifiers

PMID41775676
PMCPMC12956545

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.