1
|
Shafiq M, Ahmed I, Saeed M, Malik A, Fatima S, Akhtar S, Khurshid M, Hyder MZ. Predominance of blaNDM- and blaIMP-Harboring Escherichia coli Belonging to Clonal Complexes 131 and 23 in a Major University Hospital. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1528. [PMID: 39336569 PMCID: PMC11434522 DOI: 10.3390/medicina60091528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 09/06/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: Carbapenem resistance is a growing global challenge for healthcare, and, therefore, monitoring its prevalence and patterns is crucial for implementing targeted interventions to mitigate its impact on patient outcomes and public health. This study aimed to determine the prevalence of carbapenem resistance among Escherichia coli (E. coli) strains in the largest tertiary care hospital of the capital territory of Pakistan and to characterize the isolates for the presence of antimicrobial resistance genes. Additionally, the most prevalent sequence types were analyzed. Materials and Methods: A total of 15,467 clinical samples were collected from November 2020 to May 2022, underwent antimicrobial susceptibility testing, and were analyzed for antimicrobial resistance genes through conventional PCR and sequence typing using MLST. Results: In carbapenem-resistant E. coli (CR-EC), 74.19% of isolates harbored the blaNDM gene, with blaNDM-1 (66.96%), blaNDM-5 (12.17%), and blaNDM-7 (20.87%) variants detected. Additionally, blaIMP was found in 25.81% and blaOXA-48 in 35.48% of isolates. The presence of blaCTX-M15 and blaTEM was identified in 83.87% and 73.55% of CR-EC isolates, respectively, while armA and rmtB were detected in 40% and 65.16% of isolates, respectively. Colistin and tigecycline were the most effective drugs against CR-EC isolates, with both showing an MIC50 of 0.5 µg/mL. The MIC90 for colistin was 1 µg/mL, while for tigecycline, it was 2 µg/mL. MLST analysis revealed that the CR-EC isolates belonged to ST131 (24.52%), ST2279 (23.87%), ST3499 (16.13%), ST8051 (15.48%), ST8900 (9.68%), ST3329 (7.10%), ST88 (1.94%), and ST6293 (1.29%). The ST131 complex (70.97%) was the most prevalent, harboring 95.65% of the blaNDM gene, while the ST23 complex (18.06%) harbored 62.50% of the blaIMP gene. Conclusions: Implementing large-scale surveillance studies to monitor the spread of specific pathogens, along with active infection control policies, is crucial for the effective containment and prevention of future epidemics.
Collapse
Affiliation(s)
- Muhammad Shafiq
- Department of Biosciences, COMSATS University Islamabad, Park Road, Islamabad 45550, Pakistan; (M.S.); (M.S.)
| | - Iftikhar Ahmed
- National Culture Collection of Pakistan (NCCP), Land Resources Research Institute (LRRI), National Agriculture Research Centre, Park Road, Islamabad 45500, Pakistan;
| | - Muhammad Saeed
- Department of Biosciences, COMSATS University Islamabad, Park Road, Islamabad 45550, Pakistan; (M.S.); (M.S.)
| | - Abdul Malik
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11564, Saudi Arabia;
| | - Sabiha Fatima
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12371, Saudi Arabia;
| | - Suhail Akhtar
- Department of Biochemistry, A.T. Still University of Health Sciences, Kirksville, MO 63501, USA;
| | - Mohsin Khurshid
- Institute of Microbiology, Government College University, Faisalabad 38000, Pakistan
| | - Muhammad Zeeshan Hyder
- Department of Biosciences, COMSATS University Islamabad, Park Road, Islamabad 45550, Pakistan; (M.S.); (M.S.)
| |
Collapse
|
2
|
Tuhamize B, Asiimwe BB, Kasaza K, Sabiiti W, Holden M, Bazira J. Klebsiella pneumoniae carbapenamases in Escherichia coli isolated from humans and livestock in rural south-western Uganda. PLoS One 2023; 18:e0288243. [PMID: 37440483 PMCID: PMC10343067 DOI: 10.1371/journal.pone.0288243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The accumulation of resistance genes in Escherichia coli (E. coli) strains imposes limitations in the therapeutic options available for the treatment of infections caused by E.coli. Production of Klebsiella pneumoniae carbapenemase (KPC) by E. coli renders it resistant to broad-spectrum β-lactam antibiotics. Globally there is existing evidence of spread of carbapenem-resistant E. coli in both humans and livestock driven by acquisition of the several other carbapenemase genes. Overall, there is little information regarding the extent of KPC gene distribution in E. coli. We set out to determine the prevalence, and evaluate the phenotypic and genotypic patterns of KPC in E. coli isolated from humans and their livestock in rural south western Uganda. METHODS A laboratory-based, descriptive cross-sectional study was conducted involving 96 human and 96 livestock isolates collected from agro-pastoralist communities in Mbarara district in south western Uganda. Phenotypic and molecular methods (PCR) were used for presence and identification of KPC genes in the E. coli isolates. A chi-square test of independence was used to evaluate the differences in resistant patterns between carbapenems and isolates. RESULTS The overall prevalence of carbapenem resistance by disk diffusion susceptibility testing (DST) for both humans and livestock isolates were 41.7% (80/192). DST-based resistance was identical in both human and livestock isolates (41.7%). The prevalence of carbapenem resistance based on Modified Hodge Test (MHT) was 5% (2/40) and 10% (4/40) for humans and livestock isolates respectively. Both human and livestock isolates, 48.7% (95/192) had the KPC gene, higher than phenotypic expression; 41.7% (80/192). blaKPC gene prevalence was overall similar in human isolates (51%; 49/96) vs livestock isolates (47.9%; 46/96). Approximately, 19% (15/80) of the isolates were phenotypically resistant to carbapenems and over 70% (79/112) of the phenotypically sensitive strains harbored the blaKPC gene. CONCLUSION Our results suggest that both human and livestock isolates of E. coli in our setting carry the blaKPC gene with a high percentage of strains not actively expressing the blaKPC gene. The finding of fewer isolates carrying the KPC gene than those phenotypically resistant to carbapenems suggests that other mechanisms are playing a role in this phenomenon, calling for further researcher into this phenomenon.
Collapse
Affiliation(s)
- Barbra Tuhamize
- Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Benon B. Asiimwe
- Department of Medical Microbiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kennedy Kasaza
- Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Wilber Sabiiti
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Mathew Holden
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, United Kingdom
| | - Joel Bazira
- Department of Microbiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| |
Collapse
|
3
|
Kumar M, Tandel K, Shergill S, Bhalla G, Mahajan P, Swarnim V, Sahai K, Gupta R. Rapid detection of carbapenem resistance among gram-negative organisms directly from positive blood culture bottles. Med J Armed Forces India 2023; 79:267-274. [PMID: 37193528 PMCID: PMC10182285 DOI: 10.1016/j.mjafi.2021.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 03/28/2021] [Indexed: 10/21/2022] Open
Abstract
Background Carbapenemase producing gram-negative bacteria (GNB) has become a huge problem in majority of tertiary care centers worldwide. They are associated with very high morbidity and mortality rates, especially when they cause invasive infections. Therefore, rapid detection of these organisms is very important for prompt and adequate antibiotic therapy as well as infection control. The aim of this study was rapid detection of carbapenemase genes and thereby likely carbapenem resistance, 24-48 hours in advance, directly from the positive-flagged blood culture bottles using CHROMagar and Xpert® Carba-R. Methods Aspirate from positively flagged blood culture bottles was subjected to differential centrifuge. All gram-negative bacilli on gram stain from the deposit were processed in Xpert® Carba-R and inoculated on CHROMagar. The presence of genes and growth on CHROMagar was compared with carbapenem resistance on VITEK-2 Compact. Results A total of 119 GNB isolates were processed. One or more of the carbapenemase genes were detected in 80 isolates. On comparison with VITEK-2 result, 92 samples showed concordance for carbapenem resistance 48 hours in advance. There was discordance in 21 isolates with 12 major errors and 09 minor errors. The sensitivity of direct Xpert® Carba-R test for rapid detection of carbapenem resistance, 48 hours in advance, was 81.42%. The sensitivity of direct CHROMagar test for accurate detection of carbapenem resistance, 24 hours in advance, was 92.06%. Conclusion The ability to detect carbapenem resistance with very high accuracy, 48 hours in advance, helps in appropriate antibiotic therapy and implementation of effective infection control practices.
Collapse
Affiliation(s)
- Mahadevan Kumar
- Professor (Microbiology), Bharati Vidyapeeth Medical College, BVDUMC, Pune, India
| | - Kundan Tandel
- Classfied Specialist (Microbiology), Command Hospital (Central Command), Lucknow, India
| | - S.P.S. Shergill
- Assistant Professor, Department of Microbiology, Armed Forces Medical College, Pune, India
| | - G.S. Bhalla
- Classified Specialist (Microbiology), Military Hospital Namkum, India
| | - Pooja Mahajan
- Resident (Microbiology), Army Hospital (R&R), Delhi Cantt, India
| | - Vijaya Swarnim
- Resident (Microbiology), Army Hospital (R&R), Delhi Cantt, India
| | - Kavita Sahai
- Deputy Commandant, Command Hospital (Northern Command), Udhampur, India
| | - R.M. Gupta
- MG (Med), HQ Western Command, C/o 56 APO, India
| |
Collapse
|
4
|
Jun SH, Lee DE, Hwang HR, Kim N, Kwon KT, Kim YK, Lee JC. Clonal evolution and antimicrobial resistance of Acinetobacter baumannii isolates from Korean hospitals over the last decade. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2023; 108:105404. [PMID: 36638876 DOI: 10.1016/j.meegid.2023.105404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 01/12/2023]
Abstract
The wide-spread of drug-resistant Acinetobacter baumannii is a global health problem. This study investigated the clonal distribution and antimicrobial resistance of 167 A. baumannii isolates from two Korean university hospitals from 2009 to 2019 by analyzing the sequence types (STs), antimicrobial resistance, and resistance determinants of carbapenems and aminoglycosides. Twenty STs, including 16 pre-existing STs and four unassigned STs, were identified in A. baumannii isolates using the Oxford multilocus sequence typing scheme. Two STs, ST191 (n = 77) and ST451 (n = 40), were prevalent, and majority (n = 153) of the isolates belonged to clonal complex 208. The ST191 isolates were detected during the study period, whereas ST451 isolates were detected after 2016. One hundred forty-seven (87%) of 167 A. baumannii isolates were non-susceptible to carbapenems. The ST191 and ST451 isolates exhibited higher resistance to antimicrobial agents than that of the sporadic ST isolates. Interestingly, ST451 isolates exhibited lower susceptibility to minocycline and tigecycline than the other ST isolates. All carbapenem-non-susceptible A. baumannii isolates, except four, carried the ISAbaI-blaOXA-23 structure. armA was detected in all amikacin-non-susceptible isolates (n = 128) except for one isolate. Five aminoglycoside-modifying enzyme (AME) genes were detected, but their carriage varied between STs; ant(3″)-Ia and aac(6')-Ib were more common in ST191 than in ST451, while aph(3')-Ia was more common in ST451 than in ST191. This study demonstrated the clonal evolution related to antimicrobial resistance in A. baumannii.
Collapse
Affiliation(s)
- So Hyun Jun
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea
| | - Da Eun Lee
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea
| | - Hye Ryeong Hwang
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea
| | - Nayeong Kim
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Ki Tae Kwon
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea; Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Yu Kyung Kim
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea; Department of Laboratory Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Je Chul Lee
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea; Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, South Korea.
| |
Collapse
|
5
|
Cruz-Vargas SA, García-Muñoz L, Cuervo-Maldonado SI, Álvarez-Moreno CA, Saavedra-Trujillo CH, Álvarez-Rodríguez JC, Arango-Gutiérrez A, Gómez-Rincón JC, García-Guzman K, Leal AL, Garzón-Herazo J, Martínez-Vernaza S, Guevara FO, Jiménez-Cetina LP, Mora LM, Saavedra SY, Cortés JA. Molecular and Clinical Data of Antimicrobial Resistance in Microorganisms Producing Bacteremia in a Multicentric Cohort of Patients with Cancer in a Latin American Country. Microorganisms 2023; 11:microorganisms11020359. [PMID: 36838324 PMCID: PMC9960769 DOI: 10.3390/microorganisms11020359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 02/04/2023] Open
Abstract
Patients with cancer have a higher risk of severe bacterial infections. This study aims to determine the frequency, susceptibility profiles, and resistance genes of bacterial species involved in bacteremia, as well as risk factors associated with mortality in cancer patients in Colombia. In this prospective multicenter cohort study of adult patients with cancer and bacteremia, susceptibility testing was performed and selected resistance genes were identified. A multivariate regression analysis was carried out for the identification of risk factors for mortality. In 195 patients, 206 microorganisms were isolated. Gram-negative bacteria were more frequently found, in 142 cases (68.9%): 67 Escherichia coli (32.5%), 36 Klebsiella pneumoniae (17.4%), and 21 Pseudomonas aeruginosa (10.1%), and 18 other Gram-negative isolates (8.7%). Staphylococcus aureus represented 12.4% (n = 25). Among the isolates, resistance to at least one antibiotic was identified in 63% of them. Genes coding for extended-spectrum beta-lactamases and carbapenemases, blaCTX-M and blaKPC, respectively, were commonly found. Mortality rate was 25.6% and it was lower in those with adequate empirical antibiotic treatment (22.0% vs. 45.2%, OR: 0.26, 95% CI: 0.1-0.63, in the multivariate model). In Colombia, in patients with cancer and bacteremia, bacteria have a high resistance profile to beta-lactams, with a high incidence of extended-spectrum beta-lactamases and carbapenemases. Adequate empirical treatment diminishes mortality, and empirical selection of treatment in this environment of high resistance is of key importance.
Collapse
Affiliation(s)
- Sergio Andrés Cruz-Vargas
- Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Bogotá 111321, Colombia
| | - Laura García-Muñoz
- Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Bogotá 111321, Colombia
| | - Sonia Isabel Cuervo-Maldonado
- Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Bogotá 111321, Colombia
- Infectious Diseases Group, Instituto Nacional de Cancerología-ESE, Bogotá 111511, Colombia
- Research Group in Cancer Infectious Diseases and Hematological Alterations (GREICAH), Bogotá 111321, Colombia
| | - Carlos Arturo Álvarez-Moreno
- Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Bogotá 111321, Colombia
- Clínica Universitaria Colombia, Bogota 111321, Colombia
| | | | - José Camilo Álvarez-Rodríguez
- Infectious Diseases Group, Instituto Nacional de Cancerología-ESE, Bogotá 111511, Colombia
- Research Group in Cancer Infectious Diseases and Hematological Alterations (GREICAH), Bogotá 111321, Colombia
- Hospital Universitario Clínica San Rafael, Bogotá 110111, Colombia
| | | | | | | | - Aura Lucía Leal
- Department of Microbiology, Universidad Nacional de Colombia, Bogotá 111321, Colombia
| | - Javier Garzón-Herazo
- Infectious Diseases Unit, Hospital Universitario San Ignacio, Bogotá 110231, Colombia
| | - Samuel Martínez-Vernaza
- Infectious Diseases Unit, Hospital Universitario San Ignacio, Bogotá 110231, Colombia
- Research Group in Infectious Diseases, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | | | | | - Liliana Marcela Mora
- Microbiology Laboratory, Instituto Nacional de Cancerología-ESE, Bogotá 111511, Colombia
| | | | - Jorge Alberto Cortés
- Department of Internal Medicine, Universidad Nacional de Colombia, Sede Bogotá, Bogotá 111321, Colombia
- Diseases Unit, Hospital Universitario Nacional, Bogotá 111321, Colombia
- Correspondence:
| |
Collapse
|
6
|
Phenotypic Carbapenemase Production and bla
OXA detecting by PCR in Acinetobacter baumannii isolates from a Hospital of Infectious Diseases from North-East Romania. REV ROMANA MED LAB 2022. [DOI: 10.2478/rrlm-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract
Introduction: In the last 40 years, Acinetobacter baumannii has been among the bacteria known to acquire multiple mechanisms of antibiotic resistance and, as a result, it is now one of the pathogens involved in healthcare-associated infections with multidrug resistant strains. Our study aimed to assess the production of carbapenemases in carbapenem-resistant A. baumannii by means of phenotypic methods and polymerase chain reaction technique (PCR), as well as to appraise the performances of carbapenemase detection by phenotypic tests compared to the PCR approach.
Materials and Methods: We used phenotypic methods (E-test MBL, CIM, MHT, Rosco® Kit/OXA/MBL, OXA-23 K-SeT® assay) to investigate the production of carbapenemases in 43 carbapenem-resistant A. baumannii isolates, and PCR to screen for the genes blaOXA-23, blaOXA-24, blaOXA-58, blaOXA-51, blaVIM, blaIMP and blaNDM.
Results: The carbapenem inactivation method (CIM) at 2 hours, CIM at 4h, OXA-23 K-SeT® assay, Rosco® Kit/OXA, and modified Hodge test (MHT) identified 26%, 63%, 65%, 81%, and 42% carbapenemase-producing isolates, respectively. The phenotypic E-test MBL detected metallo-β-lactamase (MBL) production in 79% of strains. PCR revealed blaOXA-51 in all the isolates, blaOXA-23 in 35/43 (81%), blaOXA-24 in 28/43 (65%), blaVIM in 7/43 (3%) and blaOXA-58, blaIMP, blaNDM were not detected.
Conclusion: Because phenotypic tests do not highlight all the carbapenemase-producing strains, their results must be interpreted with caution relative to their level of performance, and negative results should be confirmed by means of PCR.
Collapse
|
7
|
Yehouenou CL, Soleimani R, Kpangon AA, Simon A, Dossou FM, Dalleur O. Carbapenem-Resistant Organisms Isolated in Surgical Site Infections in Benin: A Public Health Problem. Trop Med Infect Dis 2022; 7:tropicalmed7080200. [PMID: 36006292 PMCID: PMC9414794 DOI: 10.3390/tropicalmed7080200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
An alarming worldwide increase in antimicrobial resistance is complicating the management of surgical site infections (SSIs), especially in low-middle income countries. The main objective of this study was to describe the pattern of carbapenem-resistant bacteria in hospitalized patients and to highlight the challenge of their detection in Benin. We collected pus samples from patients suspected to have SSIs in hospitals. After bacterial identification by MALDI-TOF mass spectrometry, antimicrobial susceptibility was performed according to the Kirby–Bauer method. Carbapenem-resistant strains were characterized using, successively, the Modified Hodge Test (MHT), the RESIST-5 O.K.N.V.I: a multiplex lateral flow and finally the polymerase chain reaction. Six isolates were resistant to three tested carbapenems and almost all antibiotics we tested but remained susceptible to amikacin. Four (66.7%) of them harbored some ESBL genes (blaCTX-M-1 and blaTEM-1). The MHT was positive for Carbapenems but not for Pseudomonas aeruginosa and Acinetobacter baumannii. As surgical antimicrobial prophylaxis, five of the six patients received ceftriaxone. The following carbapenems genes were identified: bla OXA-48(33.3%, n = 2), blaNDM (33.3%, n = 2) and blaVIM (33.3%, n = 2). These findings indicate a need for local and national antimicrobial resistance surveillance and the strengthening of antimicrobial stewardship programs in the country.
Collapse
Affiliation(s)
- Carine Laurence Yehouenou
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Avenue Emmanuel Mounier 73, 1200 Brussels, Belgium
- Laboratoire de Référence des Mycobactéries (LRM), Cotonou BP 817, Benin
- Faculté des Sciences de la Santé (FSS), Université d’Abomey Calavi (UAC), Cotonou BP 526, Benin
- Correspondence:
| | - Reza Soleimani
- Department of Laboratory Medicine, CHU UCL Namur, 5530 Yvoir, Belgium
| | - Arsène A. Kpangon
- Ecole nationale des Techniciens Supérieurs en Santé Publique et Surveillance Epidémiologique, Université de Parakou, Parakou BP 123, Benin
| | - Anne Simon
- Centres hospitaliers Jolimont, Prévention et Contrôle des infections, Groupe Jolimont asbl, Rue Ferrer, 7100 Haine-Saint-Paul, Belgium
| | - Francis M. Dossou
- Department of Surgery and Surgical Specialties, Faculty of Health Sciences, Campus Universitaire, Champs de Foire, Cotonou BP 188, Benin
| | - Olivia Dalleur
- Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Avenue Emmanuel Mounier 73, 1200 Brussels, Belgium
- Pharmacy, Clinique universitaire Saint-Luc, Université catholique de Louvain, UCLouvain, Avenue Hippocrate 10, 1200 Brussels, Belgium
| |
Collapse
|
8
|
Rodríguez-Noriega E, Garza-González E, Bocanegra-Ibarias P, Paz-Velarde BA, Esparza-Ahumada S, González-Díaz E, Pérez-Gómez HR, Escobedo-Sánchez R, León-Garnica G, Morfín-Otero R. A case–control study of infections caused by Klebsiella pneumoniae producing New Delhi metallo-beta-lactamase-1: Predictors and outcomes. Front Cell Infect Microbiol 2022; 12:867347. [PMID: 35967868 PMCID: PMC9366880 DOI: 10.3389/fcimb.2022.867347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/24/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Infections caused by antimicrobial-resistant bacteria are a significant cause of death worldwide, and carbapenemase-producing bacteria are the principal agents. New Delhi metallo-beta-lactamase-1 producing Klebsiella pneumoniae (KP-NDM-1) is an extensively drug-resistant bacterium that has been previously reported in Mexico. Our aim was to conduct a case–control study to describe the risk factors associated with nosocomial infections caused by K. pneumoniae producing NDM-1 in a tertiary-care hospital in Mexico. Methods A retrospective case–control study with patients hospitalized from January 2012 to February 2018 at the Hospital Civil de Guadalajara “Fray Antonio Alcalde” was designed. During this period, 139 patients with a culture that was positive for K. pneumoniae NDM-1 (cases) and 486 patients hospitalized in the same department and on the same date as the cases (controls) were included. Data were analyzed using SPSS v. 24, and logistic regression analysis was conducted to calculate the risk factors for KP-NDM-1 infection. Results One hundred and thirty-nine case patients with a KP-NDM-1 isolate and 486 control patients were analyzed. In the case group, acute renal failure was a significant comorbidity, hospitalization days were extended, and significantly more deaths occurred. In a multivariate analysis of risk factors, the independent variables included the previous use of antibiotics (odds ratio, OR = 12.252), the use of a urinary catheter (OR = 5.985), the use of a central venous catheter (OR = 5.518), the use of mechanical ventilation (OR = 3.459), and the length of intensive care unit (ICU) stay (OR = 2.334) as predictors of infection with NDM-1 K. pneumoniae. Conclusion In this study, the previous use of antibiotics, the use of a urinary catheter, the use of a central venous catheter, the use of mechanical ventilation, and ICU stay were shown to be predictors of infection with NDM-1 K. pneumoniae and were independent risk factors for infection with NDM-1 K. pneumoniae.
Collapse
Affiliation(s)
- Eduardo Rodríguez-Noriega
- Instituto de Patología Infecciosa y Experimental “Dr. Francisco Ruiz Sánchez”, Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
| | | | | | | | - Sergio Esparza-Ahumada
- Instituto de Patología Infecciosa y Experimental “Dr. Francisco Ruiz Sánchez”, Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
- Hospital Civil de Guadalajara. Epidemiology, Microbiology and Infectious Disease Department, Guadalajara, Mexico
| | - Esteban González-Díaz
- Instituto de Patología Infecciosa y Experimental “Dr. Francisco Ruiz Sánchez”, Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
- Hospital Civil de Guadalajara. Epidemiology, Microbiology and Infectious Disease Department, Guadalajara, Mexico
| | - Héctor R. Pérez-Gómez
- Instituto de Patología Infecciosa y Experimental “Dr. Francisco Ruiz Sánchez”, Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
| | - Rodrigo Escobedo-Sánchez
- Hospital Civil de Guadalajara. Epidemiology, Microbiology and Infectious Disease Department, Guadalajara, Mexico
| | - Gerardo León-Garnica
- Instituto de Patología Infecciosa y Experimental “Dr. Francisco Ruiz Sánchez”, Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
- Hospital Civil de Guadalajara. Epidemiology, Microbiology and Infectious Disease Department, Guadalajara, Mexico
| | - Rayo Morfín-Otero
- Instituto de Patología Infecciosa y Experimental “Dr. Francisco Ruiz Sánchez”, Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
- *Correspondence: Rayo Morfín-Otero,
| |
Collapse
|
9
|
Jun SH, Lee DE, Hwang HR, Kim N, Kim HJ, Lee YC, Kim YK, Lee JC. Clonal change of carbapenem-resistant Acinetobacter baumannii isolates in a Korean hospital. INFECTION GENETICS AND EVOLUTION 2021; 93:104935. [PMID: 34029723 DOI: 10.1016/j.meegid.2021.104935] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/06/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022]
Abstract
The expansion of specific carbapenem-resistant Acinetobacter baumannii (CRAB) clones is a global concern due to its therapeutic difficulty and epidemicity. To understand the prevalence of CRAB isolates in a Korean hospital, we investigated the epidemiological characteristics of 96 CRAB isolates between 2016 and 2018, including the sequence types (STs), antimicrobial susceptibility, and genetic background of resistance to carbapenems and aminoglycosides. Six STs were identified using the Oxford multilocus sequence typing scheme; ST191 (n = 8), ST208 (n = 12), ST229 (n = 11), and ST369 (n = 21) were previously identified clones in the study hospital, whereas gpi variants of ST208, ST451 (n = 34) and ST784 (n = 10), were emerging clones. ST208 isolates exhibited higher resistance rates to minocycline than other ST isolates, whereas ST369 isolates exhibited lower resistance rates to aminoglycosides and trimethoprim/sulfamethoxazole than other ST isolates. All CRAB isolates previously isolated in the study hospital carried ISAbaI-blaOXA-23 for carbapenem resistance, but 10 ST229 isolates carried only ISAbaI-blaOXA-51. The carriage of armA was lower in ST369 isolates (38%) than in other ST isolates (≥83%). The frequency and diversity of aminoglycoside-modifying enzyme genes were decreased among the CRAB isolates between 2016 and 2018 compared with CRAB isolates between 2013 and 2015 at the study hospital. In conclusion, clonal complex 208 CRAB isolates are predominant in the study hospital. This study demonstrates the evolutionary change of CRAB isolates in the study hospital in relation to the emergence of new STs and selection of resistant genes.
Collapse
Affiliation(s)
- So Hyun Jun
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Da Eun Lee
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea
| | - Hye Ryeong Hwang
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea
| | - Nayeong Kim
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Hyo Jeong Kim
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Yoo Chul Lee
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, South Korea; Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea
| | - Yu Kyung Kim
- Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea; Department of Clinical Pathology, School of Medicine, Kyungpook National University, Daegu, South Korea.
| | - Je Chul Lee
- Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, South Korea; Kyungpook National University Hospital National Culture Collection for Pathogens (KNUH-NCCP), Kyungpook National University Hospital, Daegu, South Korea.
| |
Collapse
|
10
|
Zidovudine in synergistic combination with fosfomycin: an in vitro and in vivo evaluation against multidrug-resistant Enterobacterales. Int J Antimicrob Agents 2021; 58:106362. [PMID: 34010710 DOI: 10.1016/j.ijantimicag.2021.106362] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/29/2021] [Accepted: 05/08/2021] [Indexed: 12/20/2022]
Abstract
Multidrug-resistant (MDR) Enterobacterales are a priority health issue with few treatment options. Recently, fosfomycin has been reconsidered for MDR bacterial infections. Zidovudine, licensed for the treatment of human immunodeficiency virus (HIV), has unexploited antibacterial properties and has been considered for drug repurposing. The aim of this study was to assess the effect of the combination of fosfomycin plus zidovudine against clinical MDR Enterobacterales isolates. Minimum inhibitory concentration (MIC) determination and checkerboard assays for 36 MDR Enterobacterales strains were performed. In addition, fosfomycin-resistant strains were evaluated using time-kill assay and in an in vivo Galleria mellonella infection model. Zidovudine and fosfomycin MICs ranged between 0.06 to >64 mg/L and 0.125 to >512 mg/L, respectively. A synergistic effect [fractional inhibitory concentration index (FICI) ≤0.5] was observed in 25 isolates and no antagonistic effect was observed in the remaining isolates. For 7 of 8 fosfomycin-resistant strains (MIC > 32 mg/L), zidovudine combination was able to restore fosfomycin susceptibility. These results were confirmed by time-kill assays. Fosfomycin + zidovudine presented greater larval survival (20-50%) than monotherapy. Synergistic activity was observed for fosfomycin + zidovudine in 69.4% of the tested strains. In vivo experiments confirmed the enhanced effectiveness of the combination. The zidovudine concentrations tested here can be reached in human serum using the actual licensed dosage, therefore this combination deserves further clinical investigation.
Collapse
|
11
|
Yang BS, Park JA. Detection of blaKPC and blaNDM Genes from Gram-Negative Rod Bacteria Isolated from a General Hospital in Gyeongnam. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.1.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Byoung Seon Yang
- Department of Medical Laboratory Science, Jinju Health College, Jinju, Korea
| | - Ji Ae Park
- Department of Medical Laboratory Science, Jinju Health College, Jinju, Korea
| |
Collapse
|
12
|
Swathi C, Sudhaharan S, Lakshmi V, Suguna Ratnakar K, Sritharan V. Direct Detection and Discrimination of Carbapenemases of Acinetobacter baumannii from Uncultured Tracheal Aspirates. Microb Drug Resist 2020; 26:1153-1162. [PMID: 32364821 DOI: 10.1089/mdr.2019.0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Carbapenemases play important roles in conferring resistance to beta-lactam antibiotics, including the carbapenems. Detection of carbapenemase activity helps to understand the possible mechanism(s) of carbapenem resistance. Identification of carbapenemases is currently being done by various phenotypic methods and molecular methods. However, innovative biochemical and spectrophotometric methods are desirable as they will be easy to perform, affordable, and rapid. A novel chromogenic method called Carba NP test was introduced recently to screen for carbapenemases in clinical isolates of gram-negative pathogens. We adopted this assay (1) to detect the total carbapenemase activity, (2) to discriminate Class A, B, and D carbapenemases with inhibitors, (3) to compare with carbapenemase genotype, and (4) for direct differential diagnosis of carbapenemases in uncultured clinical sample such as tracheal aspirate. The study included 132 purulent tracheal aspirates. All samples were processed and screened by a protocol optimized in our laboratory, which showed good sensitivity and correlation with genotyping and conventional phenotyping. Our protocol not only offers the fastest way to identify the pathogen but also its carbapenemase profile, directly from uncultured clinical samples in less than 4 hr. Our protocol is currently being validated on other types of clinical specimens in our laboratory.
Collapse
Affiliation(s)
- Cheguri Swathi
- Department of Molecular Diagnostics & Biomarkers, Global Medical Education and Research Foundation (GMERF), Hyderabad, India
| | - Sukanya Sudhaharan
- Department of Microbiology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, India
| | - Vemu Lakshmi
- Department of Microbiology, Nizam's Institute of Medical Sciences (NIMS), Hyderabad, India
| | - Kamaraju Suguna Ratnakar
- Department of Molecular Diagnostics & Biomarkers, Global Medical Education and Research Foundation (GMERF), Hyderabad, India
| | - Venkataraman Sritharan
- Department of Molecular Diagnostics & Biomarkers, Global Medical Education and Research Foundation (GMERF), Hyderabad, India
| |
Collapse
|
13
|
Molecular investigation of integron types and imipenem-resistance encoded genes in Acinetobacter baumannii strains isolated from burns patients in Iran. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
14
|
Yang F, Gu Y, Zhou J, Zhang K. Swine waste: A reservoir of high-risk bla NDM and mcr-1. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 683:308-316. [PMID: 31132710 DOI: 10.1016/j.scitotenv.2019.05.251] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/05/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
Multidrug resistance associated with pigs not only affects pig production but also threatens human health by influencing the farm surrounding and contaminating the food chain. This paper focused on the occurrence and prevalence of high-risk resistance genes (using blaNDM and mcr-1 as marker genes) in two Chinese swine farms, and investigated their fate and seasonal changes in piggery wastewater treatment systems (PWWTSs). Results revealed that blaNDM and mcr-1 were prevalent in both confined swine farms, and even prevailed through various processing stages of PWWTSs. Moreover, the abundance of blaNDM and mcr-1 in winter was higher than that in summer, with 0.01-1.01 logs variation in piggery wastewater. Of concern is that considerable amounts of blaNDM and mcr-1 were present in final effluent that is applied to farmland (up to 102-104copies/mL), raising the risk of propagation to indigenous bacteria. Worse still, those pig-derived isolates harboring the blaNDM/mcr-1 gene were confirmed to spread multidrug resistance to other bacteria, which further increased their dissemination potential in agricultural environment. This study highlights the prevalence of blaNDM and mcr-1 in swine farms, meanwhile, also emphasizes the necessary to mitigate the release and propagation of these high-risk genes from swine farms following land fertilization and wastewater usage.
Collapse
Affiliation(s)
- Fengxia Yang
- Agro-Environmental Protection Institute, Ministry of Agriculture, Tianjin 300191, China
| | - Yanru Gu
- College of Resources and Environment, Northeast Agricultural University, Harbin 150036, China
| | - Jing Zhou
- College of Resources and Environment, Northeast Agricultural University, Harbin 150036, China
| | - Keqiang Zhang
- Agro-Environmental Protection Institute, Ministry of Agriculture, Tianjin 300191, China.
| |
Collapse
|
15
|
Bello-López E, Castro-Jaimes S, Cevallos MÁ, Rocha-Gracia RDC, Castañeda-Lucio M, Sáenz Y, Torres C, Gutiérrez-Cazares Z, Martínez-Laguna Y, Lozano-Zarain P. Resistome and a Novel blaNDM-1-Harboring Plasmid of an Acinetobacter haemolyticus Strain from a Children's Hospital in Puebla, Mexico. Microb Drug Resist 2019; 25:1023-1031. [PMID: 31335270 PMCID: PMC6743090 DOI: 10.1089/mdr.2019.0034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Acinetobacter calcoaceticus-baumannii complex isolates have been frequently associated with hospital and community infections, with A. baumannii being the most common. Other Acinetobacter spp. not belonging to this complex also cause infections in hospital settings, and the incidence has increased over the past few years. Some species of the Acinetobacter genus possess a great diversity of antibiotic resistance mechanisms, such as efflux pumps, porins, and resistance genes that can be acquired and disseminated by mobilizable genetic elements. By means of whole-genome sequencing, we describe in the clinical Acinetobacter haemolyticus strain AN54 different mechanisms of resistance that involve blaOXA-265, blaNDM-1, aphA6, aac(6’)-Ig, and a resistance-nodulation-cell division-type efflux pump. This strain carries six plasmids, of which the plasmid pAhaeAN54e contains blaNDM-1 in a Tn125-like transposon that is truncated at the 3′ end. This strain also has an insertion sequence IS91 and seven genes encoding hypothetical proteins. The pAhaeAN54e plasmid is nontypable and different from other plasmids carrying blaNDM-1 that have been reported in Mexico and other countries. The presence of these kinds of plasmids in an opportunistic pathogen such as A. haemolyticus highlights the role that these plasmids play in the dissemination of antibiotic resistance genes, especially against carbapenems, in Mexican hospitals.
Collapse
Affiliation(s)
- Elena Bello-López
- Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Semiramis Castro-Jaimes
- Programa de Genómica Evolutiva, Centro de Ciencias Genómicas, Universidad Nacional Autónoma de México, Cuernavaca, México
| | - Miguel Ángel Cevallos
- Programa de Genómica Evolutiva, Centro de Ciencias Genómicas, Universidad Nacional Autónoma de México, Cuernavaca, México
| | - Rosa Del Carmen Rocha-Gracia
- Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Miguel Castañeda-Lucio
- Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Yolanda Sáenz
- Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, España
| | - Carmen Torres
- Área Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, España
| | | | - Ygnacio Martínez-Laguna
- Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Patricia Lozano-Zarain
- Centro de Investigaciones de Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, México
| |
Collapse
|
16
|
Occurrence of Metallo-β-lactamase Genes among Acinetobacter baumannii Isolated from Different Clinical Samples. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.2.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
17
|
Molecular Characterization of Carbapenemase-Producing Gram-negative Bacteria Isolated from Clinical Specimens in Baghdad, Iraq. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.2.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
18
|
Bocanegra-Ibarias P, Garza-González E, Padilla-Orozco M, Mendoza-Olazarán S, Pérez-Alba E, Flores-Treviño S, Garza-Ramos U, Silva-Sánchez J, Camacho-Ortiz A. The successful containment of a hospital outbreak caused by NDM-1-producing Klebsiella pneumoniae ST307 using active surveillance. PLoS One 2019; 14:e0209609. [PMID: 30759100 PMCID: PMC6373926 DOI: 10.1371/journal.pone.0209609] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/07/2018] [Indexed: 12/29/2022] Open
Abstract
The worldwide dissemination of high-risk carbapenemase-producing Klebsiella pneumoniae clones has become a major threat to healthcare facilities. This study describes the successful containment of a hospital outbreak caused by NDM-1-producing K. pneumoniae Sequence Type (ST) 307 using active surveillance. The outbreak began when a patient was transferred from a local hospital. After 48 hours in our hospital, a tracheal aspirate was positive for a meropenem resistant and carbapenemase-producing K. pneumoniae. All patients in the medical intensive care unit (ICU) and the neurology wards were subject to contact precautions. The hospital surfaces and devices, healthcare workers, and patients from these wards were screened by cultures. Fecal swabs were placed into broth and PCR for blaKPC, blaOXA-48, blaIMP, blaVIM, and blaNDM, which were performed directly from the broth after 12 hours. PCRs were also performed on DNA extracted from carbapenemase-producing species from subcultured broths. Five and nine days later, two more patients' rectal swabs tested positive. Molecular assays identified K. pneumoniae blaNDM-1 onto a 130-kb conjugative plasmid (IncY, IncFIIs, and IncFIIY), ST307. After the three patients were discharged, monitoring continued, and after three weeks with negative results, rectal swabbing ended. In conclusion, it was possible to contain a hospital outbreak caused by NDM-1-producing K. pneumoniae ST307 through epidemiological and microbiological surveillance. With the methodology used, the detection of NDM-type genes in fecal samples was obtained in approximately 15 hours after obtaining the fecal sample.
Collapse
Affiliation(s)
- Paola Bocanegra-Ibarias
- Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Elvira Garza-González
- Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Magaly Padilla-Orozco
- Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Soraya Mendoza-Olazarán
- Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Eduardo Pérez-Alba
- Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Samantha Flores-Treviño
- Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Ulises Garza-Ramos
- Laboratorio de Resistencia Bacteriana; Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Jesus Silva-Sánchez
- Laboratorio de Resistencia Bacteriana; Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Adrián Camacho-Ortiz
- Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| |
Collapse
|
19
|
NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings. Clin Microbiol Rev 2019; 32:32/2/e00115-18. [PMID: 30700432 DOI: 10.1128/cmr.00115-18] [Citation(s) in RCA: 385] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
New Delhi metallo-β-lactamase (NDM) is a metallo-β-lactamase able to hydrolyze almost all β-lactams. Twenty-four NDM variants have been identified in >60 species of 11 bacterial families, and several variants have enhanced carbapenemase activity. Klebsiella pneumoniae and Escherichia coli are the predominant carriers of bla NDM, with certain sequence types (STs) (for K. pneumoniae, ST11, ST14, ST15, or ST147; for E. coli, ST167, ST410, or ST617) being the most prevalent. NDM-positive strains have been identified worldwide, with the highest prevalence in the Indian subcontinent, the Middle East, and the Balkans. Most bla NDM-carrying plasmids belong to limited replicon types (IncX3, IncFII, or IncC). Commonly used phenotypic tests cannot specifically identify NDM. Lateral flow immunoassays specifically detect NDM, and molecular approaches remain the reference methods for detecting bla NDM Polymyxins combined with other agents remain the mainstream options of antimicrobial treatment. Compounds able to inhibit NDM have been found, but none have been approved for clinical use. Outbreaks caused by NDM-positive strains have been reported worldwide, attributable to sources such as contaminated devices. Evidence-based guidelines on prevention and control of carbapenem-resistant Gram-negative bacteria are available, although none are specific for NDM-positive strains. NDM will remain a severe challenge in health care settings, and more studies on appropriate countermeasures are required.
Collapse
|
20
|
Jaidane N, Naas T, Oueslati S, Bernabeu S, Boujaafar N, Bouallegue O, Bonnin RA. Whole-genome sequencing of NDM-1-producing ST85 Acinetobacter baumannii isolates from Tunisia. Int J Antimicrob Agents 2018; 52:916-921. [DOI: 10.1016/j.ijantimicag.2018.05.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/16/2018] [Accepted: 05/23/2018] [Indexed: 12/30/2022]
|
21
|
Uddin F, McHugh TD, Roulston K, Platt G, Khan TA, Sohail M. Detection of carbapenemases, AmpC and ESBL genes in Acinetobacter isolates from ICUs by DNA microarray. J Microbiol Methods 2018; 155:19-23. [PMID: 30423363 DOI: 10.1016/j.mimet.2018.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/04/2018] [Accepted: 11/09/2018] [Indexed: 10/27/2022]
Abstract
The accumulation of multiple inherent and acquired resistance mechanisms in Acinetobacter spp. results in emergence of "pandrug resistant" strains which is one of the major concerns in healthcare sectors worldwide. Surveillance of the carbapenemase/ extended-spectrum β-lactamases (ESBLs) genes in A. baumannii by phenotypic methods is challenging especially in developing countries, like Pakistan. In this context, a novel microarray (CT 103XL Check-MDR) assay was used for simultaneous detection of genes encoding clinically important carbapenemases and ESBLs. The results were compared with the phenotypic methods including MHT, Rapidec Carba NP, EDTA+DDST and Rosco (KPC/MBL). The results of the microarray were also confirmed by PCR. All of the strains of A. baumannii (47) were resistant to imipenem and meropenem. Microarray and PCR results showed presence of OXA-23 in all the isolates of A. baumannii while 36.17% also harbored PER. Rosco kit test showed 100% sensitivity to detect carbapenemases but exhibited low specificity to classify them. Rapidec Carba NP test has 100% sensitivity and specificity to detect the carbapenemases when compared with microarray. Sensitivity and specificity of microarray assay were 100% for bla-genes in comparison to PCR. This reveals that Check-MDR CT103 XL assay is an accurate method for the identification of ESBLs and carbapenemase genes in A. baumannii in comparison to the other methods.
Collapse
Affiliation(s)
- Fakhur Uddin
- Department of Microbiology, University of Karachi, Karachi 75270, Pakistan
| | | | - Kerry Roulston
- Centre for Clinical Microbiology, University College London, UK
| | - Gareth Platt
- Centre for Clinical Microbiology, University College London, UK
| | - Taseer Ahmed Khan
- Department of Physiology, University of Karachi, Karachi 75270, Pakistan
| | - Muhammad Sohail
- Department of Microbiology, University of Karachi, Karachi 75270, Pakistan.
| |
Collapse
|
22
|
Mohammadpour B, Rouhi S, Moradi M, Ramazanzadeh R, Saniyi E, Zandi S, Salimizand H. Prevalence of Metallo-β-Lactamases in Acinetobacter Baumannii in Iran: A Review and Meta-Analysis. Infect Disord Drug Targets 2018; 19:350-361. [PMID: 30324896 DOI: 10.2174/1871526518666181016101430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/29/2018] [Accepted: 10/05/2018] [Indexed: 01/26/2023]
Abstract
Acinetobacter baumannii (A. baumannii) is an important opportunistic pathogen that causes major public health concerns, especially in hospitalized patients due to acquisition of resistant genes. The aim of this study was to systematically review the published data on the prevalence and dispersion of metallo-β-lactamases (MBLs) genes in A. baumannii in different provinces of Iran and provide an overall prevalence rate using meta-analysis. All available national and international databanks from 2011 to 2017 were searched to find published studies. Quality of studies was assessed by STROBE. Due to the fact that a significant heterogeneity was observed, the random effects model was used to combine the results. Statistical analysis was performed by comprehensive meta-analysis (CMA) V2 software. Out of 78 articles, 28 were extracted based on certain inclusion and exclusion criteria. Most of the A. baumannii isolates were obtained from intensive care unit (ICU) ward of hospitals. Based on phenotypic and molecular detection tests, pooled prevalence of all MBLs was 58%, and blaVIM, blaIMP, and blaSPM-1 genes were estimated to be at 10.5, 6, and 5%, respectively. Based on the results, further attention should be given to report MBL genes in A. baumannii based on molecular detection rather than the phenotypic one. Furthermore, more effort should be focused on ICU sections in order to avoid the distribution of resistant genes.
Collapse
Affiliation(s)
- Bashir Mohammadpour
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Samaneh Rouhi
- Lung Diseases and Allergy Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Masoud Moradi
- Vice Chancellor for Research and Technology, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Rashid Ramazanzadeh
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ebrahim Saniyi
- Watershed Management, Gorgan University of Agricultural Science and Natural Resource, Gorgan, Iran
| | - Sairan Zandi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Himen Salimizand
- Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| |
Collapse
|
23
|
Jeon H, Kim S, Kim MH, Kim SY, Nam D, Park SC, Park SH, Bae H, Lee HJ, Cho JH, Lee WK, Lee YC, Lee SH, Shin MS, Lee JC. Molecular epidemiology of carbapenem-resistant Acinetobacter baumannii isolates from a Korean hospital that carry blaOXA-23. INFECTION GENETICS AND EVOLUTION 2018; 58:232-236. [DOI: 10.1016/j.meegid.2018.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/20/2017] [Accepted: 01/04/2018] [Indexed: 10/18/2022]
|
24
|
Shahram SZ, Javadi R. Evaluation of Antibiotic Resistance Patterns and Frequency of Carbapenemase-Producing Acinetobacter baumannii Isolates by the Carbacineto NP Test. MEDICAL LABORATORY JOURNAL 2018. [DOI: 10.29252/mlj.12.2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
25
|
Gautier G, Guillard T, Podac B, Bercot B, Vernet-Garnier V, de Champs C. Detection of different classes of carbapenemases: Adaptation and assessment of a phenotypic method applied to Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii, and proposal of a new algorithm. J Microbiol Methods 2018; 147:26-35. [PMID: 29486226 DOI: 10.1016/j.mimet.2018.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/22/2018] [Accepted: 02/22/2018] [Indexed: 10/18/2022]
Abstract
A new phenotypic method for detecting carbapenemases has been adapted (assembling of two MAST® kits, including one that contains faropenem to which a temocillin disk has been added) then assessed using 101 bacterial strains (Enterobacteriaceae with assays on Pseudomonas aeruginosa and Acinetobacter baumannii) including 62 which produce genetically identified carbapenemases. Concerning Carbapenemase-Producing Enterobacteriaceae (CPE), there is 100% sensitivity for Klebsiella pneumoniae carbapenemase (KPC, Ambler class A) and OXA-48 (Ambler class D), and 91% for metallo-beta-lactamase (MBL, Ambler class B), with a 97% sensitivity for all carbapenemases, with a specificity of 100%. The test is also efficient for detecting Pseudomonas aeruginosa carbapenemases (sensitivity between 82 and 100% and 100% specificity). The major innovation is the combined use of faropenem and temocillin for reliable detection (excellent performance with 100% sensitivity and specificity) of OXA-48. This study has led to the development of a new algorithm to detect the different classes of carbapenemases, for first-line diagnosis, by combining this modified MAST® test with immunochromatographic methods and molecular biology techniques.
Collapse
Affiliation(s)
- Guillaume Gautier
- Bacteriology-Virology-Hygiene Department, Bacteriology Unit, Robert Debré University Hospital, avenue du général Koenig, 51092 Reims Cedex, France; Medical Biology Laboratory, Microbiology Department, Bacteriology Unit, William Morey General Hospital, 4 rue capitaine Drillien, 71321 Chalon-sur-Saône Cedex, France.
| | - Thomas Guillard
- Bacteriology-Virology-Hygiene Department, Bacteriology Unit, Robert Debré University Hospital, avenue du général Koenig, 51092 Reims Cedex, France; Research Unit EA 4687 SFR Cap-Santé (FED 4231), Acquired Resistance in Enterobacteriaceae, Reims Champagne-Ardenne University, 51 rue Cognacq-Jay, 51095 Reims Cedex, France.
| | - Bianca Podac
- Medical Biology Laboratory, Microbiology Department, Bacteriology Unit, William Morey General Hospital, 4 rue capitaine Drillien, 71321 Chalon-sur-Saône Cedex, France.
| | - Béatrice Bercot
- AP-HP, Saint-Louis-Lariboisière-Fernand-Widal Hospital Group, Laboratory of Bacteriology, associated for the National Reference Center for gonococci, 1 avenue Claude Vellefaux, 75010 Paris, France; IAME, UMR 1137, INSERM, Paris Diderot University, 16 rue Henri Huchard, 75890 Paris Cedex 18, France.
| | - Véronique Vernet-Garnier
- Bacteriology-Virology-Hygiene Department, Bacteriology Unit, Robert Debré University Hospital, avenue du général Koenig, 51092 Reims Cedex, France; Research Unit EA 4687 SFR Cap-Santé (FED 4231), Acquired Resistance in Enterobacteriaceae, Reims Champagne-Ardenne University, 51 rue Cognacq-Jay, 51095 Reims Cedex, France.
| | - Christophe de Champs
- Bacteriology-Virology-Hygiene Department, Bacteriology Unit, Robert Debré University Hospital, avenue du général Koenig, 51092 Reims Cedex, France; Research Unit EA 4687 SFR Cap-Santé (FED 4231), Acquired Resistance in Enterobacteriaceae, Reims Champagne-Ardenne University, 51 rue Cognacq-Jay, 51095 Reims Cedex, France.
| |
Collapse
|
26
|
Nairoukh YR, Mahafzah AM, Irshaid A, Shehabi AA. Molecular Characterization of Multidrug Resistant Uropathogenic E. Coli Isolates from Jordanian Patients. Open Microbiol J 2018; 12:1-7. [PMID: 29456773 PMCID: PMC5806174 DOI: 10.2174/1874285801812010001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/27/2017] [Accepted: 01/02/2018] [Indexed: 11/22/2022] Open
Abstract
Background Emergence of multi-drug resistant uropathogenic E. coli strains is an increasing problem to empirical treatment of urinary tract infections in many countries. This study investigated the magnitude of this problem in Jordan. Methods A total of 262 E. coli isolates were recovered from urine samples of Jordanian patients which were suspected to have urinary tract infections (UTIs). All isolates were primarily identified by routine biochemical tests and tested for antimicrobial susceptibility by disc diffusion method. Fifty representative Multidrug Resistance (MDR) E. coli isolates to 3 or more antibiotic classes were tested for the presence of resistance genes of blaCTX-M- 1, 9 and 15, carbapenemase (blaIMP, blaVIM, blaNDM-1, blaOXA-48), fluoroquinolones mutated genes (parC and gyrA) and clone of ST131 type using PCR methods. Results A total of 150/262 (57.3%) of E. coli isolates were MDR. Urine samples of hospitalized patients showed significantly more MDR isolates than outpatients. Fifty representative MDR E. coli isolates indicated the following molecular characteristics: All were positive for mutated parC gene and gyrA and for ST131 clone, and 78% were positive for genes of CTX-M-15, 76% for CTX-M-I and for 8% CTX-M-9, respectively. Additionally, all 50 MDR E. coli isolates were negative for carbapenemase genes (blaIMP, blaVIM, blaNDM-1, blaOXA-48), except of one isolate was positive for blaKPC-2 . Conclusion This study indicates alarming high rates recovery of MDR uropathogenic E. coli from Jordanian patients associated with high rates of positive ST131 clone, fluoroquinolone resistant and important types of blaCTX-M.
Collapse
Affiliation(s)
- Yacoub R Nairoukh
- Department of Pathology-Microbiology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Azmi M Mahafzah
- Department of Pathology-Microbiology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Amal Irshaid
- Department of Pathology-Microbiology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Asem A Shehabi
- Department of Pathology-Microbiology, School of Medicine, The University of Jordan, Amman, Jordan
| |
Collapse
|
27
|
Codjoe FS, Donkor ES. Carbapenem Resistance: A Review. Med Sci (Basel) 2017; 6:medsci6010001. [PMID: 29267233 PMCID: PMC5872158 DOI: 10.3390/medsci6010001] [Citation(s) in RCA: 271] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/25/2017] [Accepted: 12/05/2017] [Indexed: 12/16/2022] Open
Abstract
Carbapenem resistance is a major and an on-going public health problem globally. It occurs mainly among Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, and may be intrinsic or mediated by transferable carbapenemase-encoding genes. This type of resistance genes are already widespread in certain parts of the world, particularly Europe, Asia and South America, while the situation in other places such as sub-Saharan Africa is not well documented. In this paper, we provide an in-depth review of carbapenem resistance providing up-to-date information on the subject.
Collapse
Affiliation(s)
- Francis S Codjoe
- Department of Medical Laboratory Sciences (Microbiology Division), School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Korle Bu KB 143 Accra, Ghana.
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK.
| | - Eric S Donkor
- Department of Medical Microbiology, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Korle Bu KB 143 Accra, Ghana.
| |
Collapse
|
28
|
Results of the national surveillance of antimicrobial resistance of Enterobacteriaceae and Gram negative bacilli in health care-associated infections in Colombia, 2012-2014. BIOMEDICA 2017; 37:473-485. [DOI: 10.7705/biomedica.v37i4.3432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 12/12/2016] [Indexed: 01/16/2023]
Abstract
Introducción. En el tercer trimestre de 2012, comenzó a operar el Sistema Nacional de Vigilancia de Resistencia Antimicrobiana en las infecciones asociadas a la atención en salud, con el fin de recabar y analizar la información referente al problema en Colombia.Objetivo. Describir los perfiles de resistencia y los resultados de la vigilancia por el laboratorio con base en los datos recolectados en el Sistema.Materiales y métodos. Se hizo un estudio descriptivo y retrospectivo con base en la información del Sistema Nacional de Vigilancia en Salud Pública, Sivigila, 1 de septiembre de 2012 a 31 de diciembre de 2014, así como de las bases de datos Whonet con los datos notificados por las unidades primarias generadoras de datos y los resultados de la confirmación por el laboratorio de la caracterización fenotípica y genotípica de la resistencia a carbapenemasas en 1.642 aislamientos (927 de enterobacterias, 614 de Pseudomonas spp. y 101 de Acinetobacter spp.).Resultados. La resistencia de Escherichia coli a las cefalosporinas de tercera generación presentó un incremento significativo, alcanzando 26,3 % en unidades de cuidados intensivos y 22,5 % en otras áreas de hospitalización. La resistencia a ertapenem de Klebsiella pneumoniae registró un incremento y alcanzó 14,6 % en unidades de cuidados intensivos. La resistencia de Acinetobacter baumannii a los carbapenémicos superó el 50 % en dichas unidades, en tanto que en Pseudomonas aeruginosa se presentaron porcentajes más bajos (38,8 %). Las carbapenemasas más frecuentes en enterobacterias fueron la KPC (n=574), seguida de la NDM (n=57); en P. aeruginosa, la VIM (n=229) y la KPC (n=114), y en A. baumannii, la OXA-23 (n=87). Se detectaron varias combinaciones de carbapenemasas, siendo la de KPC y VIM la más frecuente en Pseudomonas spp., y en enterobacterias.Conclusión. La información obtenida a partir del Sistema Nacional de Vigilancia ha permitido conocer los perfiles y los mecanismos de resistencia a carbapenémicos de las cepas que están circulando en las instituciones de salud del país.
Collapse
|
29
|
Christophy R, Osman M, Mallat H, Achkar M, Ziedeh A, Moukaddem W, Dabboussi F, Hamze M. Prevalence, antibiotic susceptibility and characterization of antibiotic resistant genes among carbapenem-resistant Gram-negative bacilli and yeast in intestinal flora of cancer patients in North Lebanon. J Infect Public Health 2017; 10:716-720. [DOI: 10.1016/j.jiph.2016.10.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 08/08/2016] [Accepted: 10/01/2016] [Indexed: 11/28/2022] Open
|
30
|
Saavedra-Rojas SY, Duarte-Valderrama C, González-de-Arias MN, Ovalle-Guerro MV. Emergencia de Providencia rettgeri NDM-1 en dos departamentos de Colombia, 2012-2013. Enferm Infecc Microbiol Clin 2017; 35:354-358. [DOI: 10.1016/j.eimc.2015.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
|
31
|
Bialvaei AZ, Kafil HS, Asgharzadeh M, Yousef Memar M, Yousefi M. Current methods for the identification of carbapenemases. J Chemother 2017; 28:1-19. [PMID: 26256147 DOI: 10.1179/1973947815y.0000000063] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Detection of carbapenemases in clinical microbiology labs is a challenging issue. Comparison of the results of susceptibility testing with the breakpoint values of carbapenems is the first step in the screening of carbapenemase producers. To date, screening of carbapenemase-producing (CP) bacteria has been mostly performed by a selective medium. Although these media are practical for the detection of most CP isolates, the inoculated plates have to be incubated overnight. Subsequently, we need the confirmation of the carbapenemase producers present in the culture medium by additional testing [e.g. inhibition studies with liquid or solid media, modified Hodge test (MHT), or gradient strips], which can take up to another 48 hours. Despite the lack of discrimination between the three different classes of carbapenemases (KPC, MBL and OXA) and difficulties in the interpretation of the results, the MHT is usually deemed as the phenotypic reference method for the confirmation of carbapenemase production. Molecular techniques, such as real-time polymerase chain reaction (PCR) assays, in contrast to phenotypic methods that are very time consuming, are faster and allow for the quick identification of carbapenemase genes. These techniques can detect and characterize carbapenemases, including NDM- and KPC-mediated resistance, which is critical for epidemiological investigations. The aim of this review is to gather a summary of the available methods for carbapenemase detection and describe the strengths and weaknesses of each method.
Collapse
Affiliation(s)
- Abed Zahedi Bialvaei
- a Drug Applied Research Center, Faculty of Medical Sciences , Tabriz University of Medical Sciences , Iran
| | - Hossein Samadi Kafil
- a Drug Applied Research Center, Faculty of Medical Sciences , Tabriz University of Medical Sciences , Iran
| | | | - Mohammad Yousef Memar
- c Infectious Disease and Tropical Medicine Research Center , Tabriz University of Medical Sciences , Iran
| | - Mehdi Yousefi
- d Immunology Research Center , Tabriz University of Medical Sciences , Iran
| |
Collapse
|
32
|
Abouseada N, Raouf M, El-Attar E, Moez P. Matrix-assisted Laser Desorption Ionisation Time-of-flight Mass Spectrometry Rapid Detection of Carbapenamase Activity in Acinetobacter baumannii Isolates. Indian J Med Microbiol 2017; 35:85-89. [PMID: 28303824 DOI: 10.4103/0255-0857.202335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
33
|
Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods. Clin Microbiol Rev 2016; 29:1-27. [PMID: 26511484 DOI: 10.1128/cmr.00108-14] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Carbapenemases have become a significant mechanism for broad-spectrum β-lactam resistance in Enterobacteriaceae and other Gram-negative bacteria such as Pseudomonas and Acinetobacter spp. Intestinal carriage of carbapenemase-producing organisms (CPOs) is an important source of transmission. Isolation of carriers is one strategy that can be used to limit the spread of these bacteria. In this review, we critically examine the clinical performance, advantages, and disadvantages of methods available for the detection of intestinal carriage of CPOs. Culture-based methods (Centers for Disease Control and Prevention [CDC] protocols, chromogenic media, specialized agars, and double-disk synergy tests) for detecting carriage of CPOs are convenient due to their ready availability and low cost, but their limited sensitivity and long turnaround time may not always be optimal for infection control practices. Contemporary nucleic acid amplification techniques (NAATs) such as real-time PCR, hybridization assays, loop-mediated isothermal amplification (LAMP), or a combined culture and NAAT approach may provide fast results and/or added sensitivity and specificity compared with culture-based methods. Infection control practitioners and clinical microbiologists should be aware of the strengths and limitations of available methods to determine the most suitable approach for their medical facility to fit their infection control needs.
Collapse
|
34
|
Gniadek TJ, Carroll KC, Simner PJ. Carbapenem-Resistant Non-Glucose-Fermenting Gram-Negative Bacilli: the Missing Piece to the Puzzle. J Clin Microbiol 2016; 54:1700-1710. [PMID: 26912753 PMCID: PMC4922101 DOI: 10.1128/jcm.03264-15] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The non-glucose-fermenting Gram-negative bacilli Pseudomonas aeruginosa and Acinetobacter baumannii are increasingly acquiring carbapenem resistance. Given their intrinsic antibiotic resistance, this can cause extremely difficult-to-treat infections. Additionally, resistance gene transfer can occur between Gram-negative species, regardless of their ability to ferment glucose. Thus, the acquisition of carbapenemase genes by these organisms increases the risk of carbapenemase spread in general. Ultimately, infection control practitioners and clinical microbiologists need to work together to determine the risk carried by carbapenem-resistant non-glucose-fermenting Gram-negative bacilli (CR-NF) in their institution and what methods should be considered for surveillance and detection of CR-NF.
Collapse
Affiliation(s)
- Thomas J Gniadek
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Karen C Carroll
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Patricia J Simner
- Department of Pathology, Division of Medical Microbiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| |
Collapse
|
35
|
Milan A, Furlanis L, Cian F, Bressan R, Luzzati R, Lagatolla C, Deiana ML, Knezevich A, Tonin E, Dolzani L. Epidemic Dissemination of a Carbapenem-Resistant Acinetobacter baumannii Clone Carrying armA Two Years After Its First Isolation in an Italian Hospital. Microb Drug Resist 2016; 22:668-674. [PMID: 26990617 DOI: 10.1089/mdr.2015.0167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study describes the dissemination of a carbapenem-resistant Acinetobacter baumannii (CRAB) strain in a university hospital in Northeast Italy. Characterization of the outbreak strain was combined with a retrospective analysis of all CRAB isolates collected in the same hospital during the 5 years preceding the outbreak, with the aim of elucidating the origin of the epidemic spread. The outbreak strain was shown to belong to the International Clone II and carry the blaOXA-23 gene, flanked by two ISAba1 sequences in opposite orientation (Tn2006 arrangement). The epidemic clone harbored also the blaOXA-66 allele of the carbapenemase intrinsic to A. baumannii, the determinant of ArmA 16S rRNA methylase and a class 1 integron, with the aacA4, catB8, and aadA1 cassette array. Genotype analysis, performed by macrorestriction analysis and VRBA, revealed that isolates related to outbreak strain had been sporadically collected from inpatients in the 2 years preceding outbreak start. Carriage of blaOXA-66, armA, and the integron further supported relatedness of these isolates to the outbreak clone. Outbreak initially involved three medical wards, typically hosting elderly patients with a history of prolonged hospitalization. The study highlights the need to adopt strict infection control measures also when CRAB isolation appears to be a sporadic event.
Collapse
Affiliation(s)
- Annalisa Milan
- 1 Department of Life Sciences, University of Trieste , Trieste, Italy
| | - Linda Furlanis
- 1 Department of Life Sciences, University of Trieste , Trieste, Italy
| | - Franca Cian
- 2 Department of Laboratory Medicine, Microbiology CS, Azienda Ospedaliero-Universitaria "Ospedali Riuniti," Trieste, Italy
| | - Raffaela Bressan
- 1 Department of Life Sciences, University of Trieste , Trieste, Italy
| | - Roberto Luzzati
- 3 Division of Infective Diseases, Azienda Ospedaliero-Universitaria "Ospedali Riuniti," Trieste, Italy .,4 Department of Medical, Surgical and Health Sciences, University of Trieste , Trieste, Italy
| | | | - Maria Luisa Deiana
- 2 Department of Laboratory Medicine, Microbiology CS, Azienda Ospedaliero-Universitaria "Ospedali Riuniti," Trieste, Italy
| | - Anna Knezevich
- 2 Department of Laboratory Medicine, Microbiology CS, Azienda Ospedaliero-Universitaria "Ospedali Riuniti," Trieste, Italy
| | - Enrico Tonin
- 1 Department of Life Sciences, University of Trieste , Trieste, Italy
| | - Lucilla Dolzani
- 1 Department of Life Sciences, University of Trieste , Trieste, Italy
| |
Collapse
|
36
|
Wei WJ, Yang HF, Ye Y, Li JB. New Delhi Metallo-β-Lactamase-Mediated Carbapenem Resistance: Origin, Diagnosis, Treatment and Public Health Concern. Chin Med J (Engl) 2016; 128:1969-76. [PMID: 26168840 PMCID: PMC4717920 DOI: 10.4103/0366-6999.160566] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To review the origin, diagnosis, treatment and public health concern of New Delhi metallo-β-lactamase (NDM)-producing bacteria. Data Sources: We searched database for studies published in English. The database of PubMed from 2007 to 2015 was used to conduct a search using the keyword term “NDM and Acinetobacter or Enterobacteriaceae or Pseudomonas aeruginosa.” Study Selection: We collected data including the relevant articles on international transmission, testing methods and treatment strategies of NDM-positive bacteria. Worldwide NDM cases were reviewed based on 22 case reports. Results: The first documented case of infection caused by bacteria producing NDM-1 occurred in India, in 2008. Since then, 13 blaNDM variants have been reported. The rise of NDM is not only due to its high rate of genetic transfer among unrelated bacterial species, but also to human factors such as travel, sanitation and food production and preparation. With limited treatment options, scientists try to improve available therapies and create new ones. Conclusions: In order to slow down the spread of these NDM-positive bacteria, a series of measures must be implemented. The creation and transmission of blaNDM are potentially global health issues, which are not issues for one country or one medical community, but for global priorities in general and for individual wound care practitioners specifically.
Collapse
Affiliation(s)
| | | | | | - Jia-Bin Li
- Department of Infectious Disease, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022; Department of Infectious Disease, Chaohu Hospital of Anhui Medical University, Hefei, Anhui 238000; Department of Molecular Biology, Institute of Bacterium Resistance, Anhui Medical University; Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui 230022, China
| |
Collapse
|
37
|
Pasteran F, Gonzalez LJ, Albornoz E, Bahr G, Vila AJ, Corso A. Triton Hodge Test: Improved Protocol for Modified Hodge Test for Enhanced Detection of NDM and Other Carbapenemase Producers. J Clin Microbiol 2016; 54:640-9. [PMID: 26719442 PMCID: PMC4767956 DOI: 10.1128/jcm.01298-15] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/20/2015] [Indexed: 11/20/2022] Open
Abstract
Accurate detection of carbapenemase-producing Gram-negative bacilli is of utmost importance for the control of nosocomial spread and the initiation of appropriate antimicrobial therapy. The modified Hodge test (MHT), a carbapenem inactivation assay, has shown poor sensitivity in detecting the worldwide spread of New Delhi metallo-β-lactamase (NDM). Recent studies demonstrated that NDM is a lipoprotein anchored to the outer membrane in Gram-negative bacteria, unlike all other known carbapenemases. Here we report that membrane anchoring of β-lactamases precludes detection of carbapenemase activity by the MHT. We also show that this limitation can be overcome by the addition of Triton X-100 during the test, which allows detection of NDM. We propose an improved version of the assay, called the Triton Hodge test (THT), which allows detection of membrane-bound carbapenemases with the addition of this nonionic surfactant. This test was challenged with a panel of 185 clinical isolates (145 carrying known carbapenemase-encoding genes and 40 carbapenemase nonproducers). The THT displayed test sensitivity of >90% against NDM-producing clinical isolates, while improving performance against other carbapenemases. Ertapenem provided the highest sensitivity (97 to 100%, depending on the type of carbapenemase), followed by meropenem (92.5 to 100%). Test specificity was not affected by the addition of Triton (87.5% and 92.5% with ertapenem and meropenem, respectively). This simple inexpensive test confers a large improvement to the sensitivity of the MHT for the detection of NDM and other carbapenemases.
Collapse
Affiliation(s)
- Fernando Pasteran
- Servicio Antimicrobianos, Laboratorio Nacional y Regional de Referencia en Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas, ANLIS Dr. Carlos G. Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lisandro J Gonzalez
- Instituto de Biología Molecular y Celular de Rosario, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Santa Fé, Argentina
| | - Ezequiel Albornoz
- Servicio Antimicrobianos, Laboratorio Nacional y Regional de Referencia en Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas, ANLIS Dr. Carlos G. Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| | - Guillermo Bahr
- Instituto de Biología Molecular y Celular de Rosario, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Santa Fé, Argentina
| | - Alejandro J Vila
- Instituto de Biología Molecular y Celular de Rosario, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Rosario, Santa Fé, Argentina
| | - Alejandra Corso
- Servicio Antimicrobianos, Laboratorio Nacional y Regional de Referencia en Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas, ANLIS Dr. Carlos G. Malbrán, Ciudad Autónoma de Buenos Aires, Argentina
| |
Collapse
|
38
|
Genetic basis of antimicrobial resistance and clonal dynamics of carbapenem-resistant Acinetobacter baumannii sequence type 191 in a Korean hospital. INFECTION GENETICS AND EVOLUTION 2015; 36:1-7. [PMID: 26341860 DOI: 10.1016/j.meegid.2015.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 08/11/2015] [Accepted: 09/01/2015] [Indexed: 11/20/2022]
Abstract
This study investigated the genetic basis of antimicrobial resistance and the epidemiological characteristics of 125 carbapenem-resistant Acinetobacter baumannii (CRAB) isolates collected from 2011 to 2012 in a Korean hospital. All CRAB isolates showed an extensively drug-resistant phenotype, but were susceptible to tigecycline. The blaOXA-23 and armA genes were mainly responsible for resistance to carbapenems and aminoglycosides, respectively. Four colistin-resistant CRAB isolates with different pulsotypes were identified. All four colistin-resistant isolates had a deletion at nucleotide 776 in lpxA, while one also had an insertion at nucleotide 732 in lpxA. All CRAB isolates belonged to three sequence types (STs): ST191 (n=118), ST208 (n=6), and ST436 (n=1), but were classified into 33 arbitrary pulsotypes. Of the CRAB ST191 isolates, two main arbitrary pulsotypes 5 (n=20) and 18 (n=17) emerged sequentially, but were not clonally related to CRAB isolates collected from 2009 to 2010 in the same hospital. Furthermore, of the two main pulsotypes identified among CRAB ST191 isolates from 2009 to 2010, one was clonally related to sporadic CRAB ST191 isolates from 2011 to 2012, but the other was not related to any CRAB isolate from 2011 to 2012. In conclusion, this study shows the clonal dynamics of CRAB ST191 isolates in a Korean hospital during the last four years.
Collapse
|
39
|
Rathinasabapathi P, Hiremath DS, Arunraj R, Parani M. Molecular Detection of New Delhi Metallo-Beta-Lactamase-1 (NDM-1) Positive Bacteria from Environmental and Drinking Water Samples by Loop Mediated Isothermal Amplification of bla NDM-1. Indian J Microbiol 2015; 55:400-5. [PMID: 26543265 DOI: 10.1007/s12088-015-0540-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/13/2015] [Indexed: 11/25/2022] Open
Abstract
New Delhi metallo-β-lactamase-1 gene (bla NDM-1 ) codes for New Delhi metallo-beta-lactamase-1 (NDM-1) enzyme that cleaves the amide bond of β-lactam ring, and provides resistance against major classes of β-lactam antibiotics. Dissemination of the plasmid borne bla NDM-1 through horizontal gene transfer is a potential threat to the society. In this study, a rapid non-culture method for detecting NDM-1 positive bacteria was developed by Loop Mediated Isothermal Amplification (LAMP) of bla NDM-1 . Sensitivity of this method was found to be one femtogram of plasmid DNA, which translates into 2.6-25.8 copies depending on the size of the plasmid DNA. This method was applied to detect NDM-1 positive bacteria in 81 water samples that were collected from environmental and drinking water sources. NDM-1 positive bacteria were detected in three drinking water samples by LAMP but not by PCR. These three samples were collected from the water sources that were treated with chlorine for decontamination before public distribution. NDM-1 positive bacteria were not detected in lake water samples or in the samples that were collected from the water sources that were purified by reverse osmosis before public distribution. Detection of NDM-1 positive bacteria using LAMP was found to be safe, sensitive and rapid for screening large number of samples from diverse sources. This method could be developed as on-field detection kit by using fluorescent dyes to visualize the amplified bla NDM-1 gene.
Collapse
Affiliation(s)
- P Rathinasabapathi
- Genomics Laboratory, Department of Genetic Engineering, SRM University, Kattankulathur, Chennai, 603203 Tamil Nadu India
| | - Deepak S Hiremath
- Genomics Laboratory, Department of Genetic Engineering, SRM University, Kattankulathur, Chennai, 603203 Tamil Nadu India
| | - Rex Arunraj
- Genomics Laboratory, Department of Genetic Engineering, SRM University, Kattankulathur, Chennai, 603203 Tamil Nadu India
| | - M Parani
- Genomics Laboratory, Department of Genetic Engineering, SRM University, Kattankulathur, Chennai, 603203 Tamil Nadu India
| |
Collapse
|
40
|
Detection of an NDM-1-producing Acinetobacter bereziniae strain in Brazil. J Glob Antimicrob Resist 2015; 3:147-148. [DOI: 10.1016/j.jgar.2015.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/24/2022] Open
|
41
|
Molecular epidemiology of Acinetobacter baumannii in different hospitals in Tripoli, Lebanon using bla(OXA-51-like) sequence based typing. BMC Microbiol 2015; 15:103. [PMID: 25976451 PMCID: PMC4432822 DOI: 10.1186/s12866-015-0441-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 05/11/2015] [Indexed: 12/31/2022] Open
Abstract
Background A. baumannii has emerged as an important nosocomial pathogen with an outstanding ability to acquire multidrug resistant mechanisms. In this study, we investigate the molecular epidemiology and carbapenem resistance mechanisms of A. baumannii in Tripoli, Northern Lebanon. Methods One hundred sixteen non-duplicate isolates isolated between 2011 and 2013 in different hospitals in Tripoli, Lebanon from Lebanese patients and wounded Syrian patients during Syrian war were studied. Antibiotic susceptibility testing was determined by agar disc diffusion and Etest. Carbapenemase-encoding genes were investigated by PCR. All isolates were typed by blaOXA-51-like sequence based typing (SBT) and 57 isolates were also analysed by MLST using Pasteur’s scheme followed by eBURST analysis. Results Of the 116 isolates, 70 (60 %) showed a carbapenem resistance phenotype. The blaOXA-23 with an upstream insertion of ISAba1 was the major carbapenem resistance mechanism and detected in 65 isolates. Five isolates, including four from wounded Syrian patients and one from a Lebanese patient, were positive for blaNDM-1. blaOXA-51-like SBT revealed the presence of 14 variants, where blaOXA-66 was the most common and present in 73 isolates, followed by blaOXA-69 in 20 isolates. MLST analysis identified 17 sequence types (ST) and showed a concordance with blaOXA-51-like SBT. Each clonal complex (CC) had a specific blaOXA-51-like sequence such as CC2, which harboured blaOXA-66 variant, and CC1 harbouring blaOXA-69 variant. NDM-1 producing isolates belonged to ST85 (4 Syrian isolates) and ST25 (1 Lebanese isolate). Conclusions Our results showed a successful predominance of international clone 2 with a widespread occurrence of OXA-23 carbapenemase in Lebanese hospitals. These findings emphasise the urgent need of effective measures to control the spread of A. baumannii in this country.
Collapse
|
42
|
Wong MH, Li Y, Chan EW, Chen S. Functional categorization of carbapenemase-mediated resistance by a combined genotyping and two-tiered Modified Hodge Test approach. Front Microbiol 2015; 6:293. [PMID: 25932021 PMCID: PMC4399324 DOI: 10.3389/fmicb.2015.00293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/25/2015] [Indexed: 01/22/2023] Open
Abstract
The functional relationship between the detection of carbapenemase activity and phenotypic resistance in Gram-negative bacterial pathogens is often ill-defined. To address this issue, we developed a two-tiered Modified Hodge Test approach for carbapenemase detection and typing, in which the use of Pseudomonas aeruginosa strain PAO1 and Escherichia coli as indicator strains conferred two levels of sensitivities to carbapenemases. When applied alongside PCR genotyping tests for existence of known carbapenemase genes in 92 carbapenem resistant clinical isolates, this method is extremely useful in elucidating the relative role by which different enzymes contributed to the prevalent carbapenem-resistance phenotypes. With this study approach, we showed that the proportion of P. aeruginosa and Acinetobacter baumannii strains whose carbapenem resistance phenotypes could at least be partially attributed to carbapenemase were 34 and 89%, respectively. Our data also facilitates detailed functional categorization of carbapenem resistance phenotypes on the basis of the types and activities of detectable carbapenemase produced by the test organism. For example, six A. baumannii isolates harboring the blaOXA-51/23-like gene without detectable enzymatic activities were identified, suggesting that other resistance mechanisms may be involved. On the other hand, there were seven P. aeruginosa strains which produced carbapenemase phenotype without harboring known carbapenemase genes, inferring the existence of some hitherto unknown resistance determinants. Findings in this work therefore provide a comprehensive view on the cellular basis of carbapenem resistance phenotypes in major Gram-negative bacterial species, paving the way for development of novel strategies to reverse the effects of the major resistance mechanisms concerned.
Collapse
Affiliation(s)
- Marcus H Wong
- Shenzhen Key Laboratory for Food Biological Safety Control, Food Safety and Technology Research Centre, Shenzhen Research Institute, The Hong Kong Polytechnic University Shenzhen, China ; State Key Laboratory of Chirosciences, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University Hong Kong, China
| | - Yi Li
- Laboratory of Clinical Inspection, Henan Provincial People's Hospital Zhengzhou, China
| | - Edward W Chan
- Shenzhen Key Laboratory for Food Biological Safety Control, Food Safety and Technology Research Centre, Shenzhen Research Institute, The Hong Kong Polytechnic University Shenzhen, China ; State Key Laboratory of Chirosciences, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University Hong Kong, China
| | - Sheng Chen
- Shenzhen Key Laboratory for Food Biological Safety Control, Food Safety and Technology Research Centre, Shenzhen Research Institute, The Hong Kong Polytechnic University Shenzhen, China ; State Key Laboratory of Chirosciences, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University Hong Kong, China
| |
Collapse
|
43
|
|
44
|
Rafei R, Dabboussi F, Hamze M, Eveillard M, Lemarié C, Gaultier MP, Mallat H, Moghnieh R, Husni-Samaha R, Joly-Guillou ML, Kempf M. Molecular analysis of Acinetobacter baumannii strains isolated in Lebanon using four different typing methods. PLoS One 2014; 9:e115969. [PMID: 25541711 PMCID: PMC4277430 DOI: 10.1371/journal.pone.0115969] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 12/03/2014] [Indexed: 12/13/2022] Open
Abstract
This study analyzed 42 Acinetobacter baumannii strains collected between 2009-2012 from different hospitals in Beyrouth and North Lebanon to better understand the epidemiology and carbapenem resistance mechanisms in our collection and to compare the robustness of pulsed field gel electrophoresis (PFGE), multilocus sequence typing (MLST), repetitive sequence-based PCR (rep-PCR) and blaOXA-51 sequence-based typing (SBT). Among 31 carbapenem resistant strains, we have detected three carbapenem resistance genes: 28 carried the blaOXA-23 gene, 1 the blaOXA-24 gene and 2 strains the blaOXA-58 gene. This is the first detection of blaOXA-23 and blaOXA-24 in Lebanon. PFGE identified 11 types and was the most discriminating technique followed by rep-PCR (9 types), blaOXA-51 SBT (8 types) and MLST (7 types). The PFGE type A'/ST2 was the dominant genotype in our collection present in Beyrouth and North Lebanon. The clustering agreement between all techniques was measured by adjust Wallace coefficient. An overall agreement has been demonstrated. High values of adjust Wallace coefficient were found with followed combinations: PFGE to predict MLST types = 100%, PFGE to predict blaOXA-51 SBT = 100%, blaOXA-51 SBT to predict MLST = 100%, MLST to predict blaOXA-51 SBT = 84.7%, rep-PCR to predict MLST = 81.5%, PFGE to predict rep-PCR = 69% and rep-PCR to predict blaOXA-51 SBT = 67.2%. PFGE and MLST are gold standard methods for outbreaks investigation and population structure studies respectively. Otherwise, these two techniques are technically, time and cost demanding. We recommend the use of blaOXA-51 SBT as first typing method to screen isolates and assign them to their corresponding clonal lineages. Repetitive sequence-based PCR is a rapid tool to access outbreaks but careful interpretation of results must be always performed.
Collapse
Affiliation(s)
- Rayane Rafei
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, UPRES EA3142, Institut de Biologie en Santé – IRIS, CHU, Angers cedex, France
- Laboratoire de Santé et environnement, Centre AZM pour la recherche en Biotechnologie et ses applications, Université Libanaise, Tripoli, Liban
| | - Fouad Dabboussi
- Laboratoire de Santé et environnement, Centre AZM pour la recherche en Biotechnologie et ses applications, Université Libanaise, Tripoli, Liban
| | - Monzer Hamze
- Laboratoire de Santé et environnement, Centre AZM pour la recherche en Biotechnologie et ses applications, Université Libanaise, Tripoli, Liban
| | - Matthieu Eveillard
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, UPRES EA3142, Institut de Biologie en Santé – IRIS, CHU, Angers cedex, France
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, Angers cedex, France
| | - Carole Lemarié
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, Angers cedex, France
| | - Marie-Pierre Gaultier
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, Angers cedex, France
| | - Hassan Mallat
- Laboratoire de Santé et environnement, Centre AZM pour la recherche en Biotechnologie et ses applications, Université Libanaise, Tripoli, Liban
| | | | - Rola Husni-Samaha
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon
| | - Marie-Laure Joly-Guillou
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, UPRES EA3142, Institut de Biologie en Santé – IRIS, CHU, Angers cedex, France
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, Angers cedex, France
| | - Marie Kempf
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, UPRES EA3142, Institut de Biologie en Santé – IRIS, CHU, Angers cedex, France
- Laboratoire de Bactériologie, Institut de Biologie en Santé - PBH, CHU, Angers cedex, France
| |
Collapse
|
45
|
First report of NDM-1-producing Acinetobacter baumannii sequence type 25 in Brazil. Antimicrob Agents Chemother 2014; 58:7592-4. [PMID: 25288087 DOI: 10.1128/aac.03444-14] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
New Delhi metallo-β-lactamase 1 (NDM-1) was first identified in Brazil in Enterobacter hormaechei and Providencia rettgeri in 2013. Here, we describe the first case of NDM-1-producing Acinetobacter baumannii sequence type 25 isolated from the urinary tract of a 71-year-old man who died of multiple complications, including A. baumannii infection. The NDM-1 gene was detected by quantitative PCR, and its sequence confirmed its presence in an ∼ 100-kb plasmid.
Collapse
|
46
|
CarbAcineto NP test for rapid detection of carbapenemase-producing Acinetobacter spp. J Clin Microbiol 2014; 52:2359-64. [PMID: 24759709 DOI: 10.1128/jcm.00594-14] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Multidrug-resistant Acinetobacter baumannii isolates, particularly those that produce carbapenemases, are increasingly reported worldwide. The biochemically based Carba NP test, extensively validated for the detection of carbapenemase producers among Enterobacteriaceae and Pseudomonas spp., has been modified to detect carbapenemase production in Acinetobacter spp. A collection of 151 carbapenemase-producing and 69 non-carbapenemase-producing Acinetobacter spp. were tested using the Carba NP test and a modified Carba NP protocol (the CarbAcineto NP test) in this study. The CarbAcineto NP test requires modified lysis conditions and an increased bacterial inoculum compared to those of the original Carba NP test. The Carba NP test detects metallo-β-lactamase producers but failed to detect the production of other carbapenemase types among Acinetobacter spp. In contrast, the newly designed CarbAcineto NP test, which is rapid and reproducible, detects all types of carbapenemases with a sensitivity of 94.7% and a specificity of 100%. This cost-effective technique offers a reliable and affordable technique for identifying carbapenemase production in Acinetobacter spp., which is a marker of multidrug resistance in those species. Its use will facilitate the recognition of these carbapenemases and prevent their spread.
Collapse
|
47
|
Dortet L, Poirel L, Nordmann P. Worldwide dissemination of the NDM-type carbapenemases in Gram-negative bacteria. BIOMED RESEARCH INTERNATIONAL 2014; 2014:249856. [PMID: 24790993 PMCID: PMC3984790 DOI: 10.1155/2014/249856] [Citation(s) in RCA: 335] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 02/15/2014] [Indexed: 11/24/2022]
Abstract
The emergence of one of the most recently described carbapenemases, namely, the New Delhi metallo-lactamase (NDM-1), constitutes a critical and growingly important medical issue. This resistance trait compromises the efficacy of almost all lactams (except aztreonam), including the last resort carbapenems. Therapeutical options may remain limited mostly to colistin, tigecycline, and fosfomycin. The main known reservoir of NDM producers is the Indian subcontinent whereas a secondary reservoir seems to have established the Balkans regions and the Middle East. Although the spread of bla NDM-like genes (several variants) is derived mostly by conjugative plasmids in Enterobacteriaceae, this carbapenemase has also been identified in P. aeruginosa and Acinetobacter spp. Acinetobacter sp. may play a pivotal role for spreading bla NDM genes for its natural reservoir to Enterobacteriaceae. Rapid diagnostic techniques (Carba NP test) and screening of carriers are the cornerstone to try to contain this outbreak which threatens the efficacy of the modern medicine.
Collapse
Affiliation(s)
- Laurent Dortet
- INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Laurent Poirel
- INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
- Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, 3 Rue Albert Gockel, 1700 Fribourg, Switzerland
| | - Patrice Nordmann
- INSERM U914 “Emerging Resistance to Antibiotics”, 78 Avenue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
- Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, 3 Rue Albert Gockel, 1700 Fribourg, Switzerland
| |
Collapse
|
48
|
Abbott I, Cerqueira GM, Bhuiyan S, Peleg AY. Carbapenem resistance inAcinetobacter baumannii: laboratory challenges, mechanistic insights and therapeutic strategies. Expert Rev Anti Infect Ther 2014; 11:395-409. [DOI: 10.1586/eri.13.21] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
49
|
Bonnin RA, Nordmann P, Poirel L. Screening and deciphering antibiotic resistance inAcinetobacter baumannii: a state of the art. Expert Rev Anti Infect Ther 2014; 11:571-83. [DOI: 10.1586/eri.13.38] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
50
|
Detection of carbapenemase-producing bacteria by using an ultra-performance liquid chromatography-tandem mass spectrometry method. Antimicrob Agents Chemother 2013; 58:1231-4. [PMID: 24295978 DOI: 10.1128/aac.01540-13] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The emergence of carbapenemase-producing bacteria poses a new challenge in the management of antibiotic therapies for patients. This report describes a new method using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) for rapid detection of carbapenemase activity in enterobacteria, Pseudomonas aeruginosa, and Acinetobacter baumannii. In a panel of 78 isolates, including 41 carbapenemase-producing strains, the ULPC-MS/MS assay showed 100% agreement with molecular characterization, whereas six carbapenemase-producing isolates were not detected by the modified Hodge test.
Collapse
|