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Sabino CP, Ribeiro MS, Wainwright M, Dos Anjos C, Sellera FP, Dropa M, Nunes NB, Brancini GTP, Braga GUL, Arana-Chavez VE, Freitas RO, Lincopan N, Baptista MS. The Biochemical Mechanisms of Antimicrobial Photodynamic Therapy. Photochem Photobiol 2022; 99:742-750. [PMID: 35913428 DOI: 10.1111/php.13685] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/22/2022] [Indexed: 11/27/2022]
Abstract
The unbridled dissemination of multidrug-resistant pathogens is a major threat to global health and urgently demands novel therapeutic alternatives. Antimicrobial photodynamic therapy (aPDT) has been developed as a promising approach to treat localized infections regardless of drug resistance profile or taxonomy. Even though this technique has been known for more than a century, discussions and speculations regarding the biochemical mechanisms of microbial inactivation have never reached a consensus on what is the primary cause of cell death. Since photochemically generated oxidants promote ubiquitous reactions with various biomolecules, researchers simply assumed that all cellular structures are equally damaged. In this study, biochemical, molecular, biological, and advanced microscopy techniques were employed to investigate whether protein, membrane or DNA damage correlates better with dose-dependent microbial inactivation kinetics. We showed that although mild membrane permeabilization and late DNA damage occur, no correlation with inactivation kinetics was found. On the other hand, protein degradation was analyzed by 3 different methods and showed a dose-dependent trend that matches microbial inactivation kinetics. Our results provide a deeper mechanistic understanding of aPDT that can guide the scientific community towards the development of optimized photosensitizing drugs and also rationally propose synergistic combinations with antimicrobial chemotherapy.
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Affiliation(s)
- Caetano P Sabino
- BioLambda, Scientific and Commercial Ltd., São Paulo, SP, Brazil, 05595-000.,Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil, 05508-000
| | - Martha S Ribeiro
- Center for Lasers and Applications, Energy and Nuclear Research Institute, São Paulo, SP, Brazil, 05508-000
| | - Mark Wainwright
- School of Pharmacy & Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
| | - Carolina Dos Anjos
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil, 05508-270.,Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Vaccine and Immunotherapy Center, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Fábio P Sellera
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil, 05508-270.,School of Veterinary Medicine, Metropolitan University of Santos, Santos, SP, Brazil, 11080-300
| | - Milena Dropa
- Public Health Laboratory, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Nathalia B Nunes
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Guilherme T P Brancini
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Gilberto U L Braga
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-903, Brazil
| | - Victor E Arana-Chavez
- Department of Biomaterials and Oral Biology, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Raul O Freitas
- Brazilian Synchrotron Light Laboratory, Brazilian Center for Research in Energy and Materials, 13083-970, Campinas, SP, Brazil, 13083-970
| | - Nilton Lincopan
- Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil, 05508-000.,Department of Microbiology, Institute for Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil, 05508-000
| | - Maurício S Baptista
- Department of Biochemistry, Institute of Chemistry, University of São Paulo, São Paulo, SP, Brazil, 05513-970
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2
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Žagar D, Zore A, Torkar KG. The occurrence of antibiotic-resistant bacteria on the clothes of nursery teachers in daycare centres. J Appl Microbiol 2022; 132:4517-4530. [PMID: 35267237 PMCID: PMC9314099 DOI: 10.1111/jam.15520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/28/2022]
Abstract
AIMS Childcare facilities act as microenvironments that facilitate and promote the selection, spread, and transmission of antibiotic-resistant microorganisms in the community. We focused on the study of antimicrobial resistance and genetic predispositions for β-lactamase production in bacterial isolates from nursery teachers' clothing. METHODS AND RESULTS Antimicrobial resistance of bacterial strains belonging to Enterobacteriaceae, Enterococcus, Staphylococcus spp., Pseudomonas spp. and Bacillus spp. isolated from 80 samples of nursery teachers' clothing was determined. The selected ESβL genes were found in 30 (44.1%) of 68 strains examined. The CTX-M type ESβL determinants were detected in 15.4%, 71.5%, and 42.5% of the Enterobacteriaceae, Pseudomonas, and Bacillus isolates, respectively. The OXA-type coding genes were detected only in strains of the genera Pseudomonas (57.1%) and Bacillus (48.6%). Thus, most B. cereus strains were sensitive to the recommended antibiotics used to treat infections caused by these bacteria. Methicillin resistance was phenotypically confirmed in 27 (14.6%) of 185 staphylococcal isolates. Four isolates (2.2%) were identified as MRSA. Vancomycin resistance was not observed in any of the staphylococcal and enterococci strains. CONCLUSIONS This study has shown that potential pathogens have been isolated from the clothing of nursery teachers, posing a risk of transmission to children. These clothes should be maintained and properly laundered to avoid cross-contamination and the spread of multidrug-resistant (MDR) bacteria in childcare centres. SIGNIFICANCE AND IMPACT OF THE STUDY This study provides insight into the route of transmission of MDR microorganisms through the clothing of nursery teachers, to which greater importance should be given in the future. Proper procedures for the cleaning and use of clothing in daycare centres should be clarified and standardised.
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Affiliation(s)
- Dominika Žagar
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
| | - Anamarija Zore
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
| | - Karmen Godič Torkar
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
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3
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Ibrahim ME, Algak TB, Abbas M, Elamin BK. Emergence of bla TEM, bla CTX-M, bla SHV and bla OXA genes in multidrug-resistant Enterobacteriaceae and Acinetobacter baumannii in Saudi Arabia. Exp Ther Med 2021; 22:1450. [PMID: 34721692 PMCID: PMC8549092 DOI: 10.3892/etm.2021.10885] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 09/07/2021] [Indexed: 01/09/2023] Open
Abstract
Multidrug-resistant (MDR) patterns due to extended-spectrum β-lactamase (ESBL) production in pathogenic bacteria are now becoming prevalent in hospitals worldwide, posing a public health challenge. The aim of the present study was to determine the antibiotic susceptibility patterns and distribution of the bla TEM, bla CTX-M, bla SHV and bla OXA ESBL resistance genes in MDREnterobacteriaceae and Acinetobacter baumannii (A. baumannii). A cross-sectional study was conducted between September 2017 and August 2018 in the King Abdullah Hospital (Bisha, Saudi Arabia). Bacterial isolates were collected from the clinical samples of patients; these were identified and screened for ESBL production and their antibiotic susceptibility was examined using standard microbiology methods. Multiplex-PCR runs were performed to identify genes encoding ESBL producers. DNA sequencing analysis was used to identify the specific gene variants. Of the 274 isolates, 173 (63.1%) exhibited MDR patterns to different antibiotics. A. baumannii revealed the highest resistance rates for cefuroxime (100%), gentamicin (88%) and amikacin (86%). Klebsiella pneumoniae (K. pneumoniae) isolates had the highest resistance rates for cefuroxime (98%), aztreonam and trimethoprim/sulfamethoxazole (87% for each). Escherichia coli (E. coli) exhibited high resistance rates for trimethoprim/sulfamethoxazole (92%) and cefuroxime (87%). Of the 173 MDR isolates, 78 (45.1%) exhibited ESBL production. Of these, 88.9% (72/78) carried ESBL genes. The most prevalent gene-encoding isolates were bla TEM (84.7%), followed by bla CTX-M (33.3%), bla SHV (2.7%) and bla OXA-1 (1.4%). A single bla TEM gene was predominantly produced by K. pneumoniae (60.7%), A. baumannii (78.9%) and Proteus mirabilis (80%), whereas bla CTX-M was harbored by E. coli (33.3%). The co-existence of two different genes in a single bacterium was revealed in 22.2% of isolates, commonly between bla TEM and bla CTX-M (19.4%). Sequencing analysis revealed that bla CTX-M-15 and bla TEM-1 were predominant variants of the bla CTX-M and bla TEM genes, respectively. The present study revealed a diversity of ESBL genes in Gram-negative bacterial isolates, with bla TEM being the most prevalent type. The emergence of various ESBL genes with several co-existing genotypes is alarming, rendering extensive surveillance studies necessary to understand the transmission and epidemiology of such resistant gene-carrying isolates.
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Affiliation(s)
- Mutasim E. Ibrahim
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Asir 61922, Kingdom of Saudi Arabia,Correspondence to: Dr Mutasim E. Ibrahim, Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, 9054 King Saud Road, Bisha, Asir 61922, Kingdom of Saudi Arabia ;
| | - Tarig B. Algak
- Department of Basic Medical Sciences (Pathology Unit), College of Medicine, University of Bisha, Bisha, Asir 61922, Kingdom of Saudi Arabia
| | - Mohammed Abbas
- Department of Pediatrics, College of Medicine, Arabian Gulf University, Manama 26671, Kingdom of Bahrain
| | - Bahaeldin K. Elamin
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Asir 61922, Kingdom of Saudi Arabia,Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum 11115, Republic of Sudan
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4
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Ejaz H, Younas S, Abosalif KOA, Junaid K, Alzahrani B, Alsrhani A, Abdalla AE, Ullah MI, Qamar MU, Hamam SSM. Molecular analysis of blaSHV, blaTEM, and blaCTX-M in extended-spectrum β-lactamase producing Enterobacteriaceae recovered from fecal specimens of animals. PLoS One 2021; 16:e0245126. [PMID: 33412564 PMCID: PMC7790543 DOI: 10.1371/journal.pone.0245126] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/22/2020] [Indexed: 02/02/2023] Open
Abstract
Colonization of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae as animal gut microbiota is a substantial global threat. This study aimed to determine the molecular characterization of blaSHV, blaTEM, and blaCTX-M variants in animals, as well as to evaluate the antimicrobial resistance conferred by these genes. We prospectively analyzed 1273 fecal specimens of farm and domestic animals for the isolation of enterobacteria that had the ESBL phenotype by using biochemical methods. The extracted genes were amplified by polymerase chain reaction and sequenced for the characterization of blaSHV, blaTEM, and blaCTX-M variants. The drug-resistance spectrum and hierarchical clusters were analyzed against 19 antibacterial agents. Out of 245 (19.2%) ESBL enterobacteria, 180 (75.5%) Escherichia coli and 34 (13.9%) Klebsiella pneumoniae were prevalent species. A total of 73.9% blaCTX-M, 26.1% blaTEM, and 14.2% blaSHV were found among the enterobacteria; however, their association with farm or domestic animals was not statistically significant. The distribution of bla gene variants showed the highest number of blaCTX-M-1 (133; 54.3%), followed by blaCTX-M-15 (28; 11.4%), blaTEM-52 (40; 16.3%), and blaSHV-12 (22; 9%). In addition, 84.5% of the enterobacteria had the integrons intI1. We observed ±100% enterobacteria resistant to cephalosporin, 7 (2.9%) to colistin (minimum inhibitory concentration breakpoint ≥4 μg/mL), 9 (3.7%) to piperacillin-tazobactam, 11 (4.5%) to imipenem, 14 (5.7%) to meropenem, and 18 (7.3%) to cefoperazone-sulbactam, without statistically significant association. Animal gut microbiota contain a considerable number of blaCTX-M, blaTEM, blaSHV, and integrons, which are a potential source of acquired extensive drug resistance in human strains and leaves fewer therapeutic substitutes.
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Affiliation(s)
- Hasan Ejaz
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia
| | - Sonia Younas
- Department of Pathology, Tehsil Headquarter Hospital Kamoke, District Gujranwala, Pakistan
| | - Khalid O. A. Abosalif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia
- Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Omdurman, Sudan
| | - Kashaf Junaid
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia
| | - Badr Alzahrani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia
| | - Abdullah Alsrhani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia
| | - Abualgasim Elgaili Abdalla
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia
- Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Omdurman, Sudan
| | - Muhammad Ikram Ullah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al Jouf, Saudi Arabia
| | - Muhammad Usman Qamar
- Department of Microbiology, Faculty of Life Sciences, Government College University, Faisalabad, Pakistan
| | - Sanaa S. M. Hamam
- Faculty of Medicine, Department of Medical Microbiology and Immunology, Menoufia University, Menoufia, Egypt
- Department of Microbiology, King Abdulaziz Specialist Hospital, Sakaka, Saudi Arabia
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5
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Urzedo JE, de Paula Menezes R, Porto JP, Ferreira ML, Gonçalves IR, de Brito CS, Gontijo-Filho PP, Ribas RM. High mortality by nosocomial infections caused by carbapenem-resistant P. aeruginosa in a referral hospital in Brazil: facing the perfect storm. J Med Microbiol 2020; 69:1388-1397. [PMID: 33170119 DOI: 10.1099/jmm.0.001273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction. Carbapenem-resistant Pseudomonas aeruginosa is responsible for increased patient mortality.Gap Statement. Five and 30 day in-hospital all-cause mortality in patients with P. aeruginosa infections were assessed, followed by evaluations concerning potential correlations between the type III secretion system (TTSS) genotype and the production of metallo-β-lactamase (MBL).Methodology. This assessment comprised a retrospective cohort study including consecutive patients with carbapenem-resistant infections hospitalized in Brazil from January 2009 to June 2019. PCR analyses were performed to determine the presence of TTSS-encoding genes and MBL genes.Results. The 30-day and 5-day mortality rates for 262 patients were 36.6 and 17.9 %, respectively. The unadjusted survival probabilities for up to 5 days were 70.55 % for patients presenting exoU-positive isolates and 86 % for those presenting exo-negative isolates. The use of urinary catheters, as well as the presence of comorbidity conditions, secondary bacteremia related to the respiratory tract, were independently associated with death at 5 and 30 days. The exoS gene was detected in 64.8 % of the isolates, the presence of the exoT and exoY genes varied and exoU genes occurred in 19.3 % of the isolates. The exoU genotype was significantly more frequent among multiresistant strains. MBL genes were not detected in 92 % of the isolates.Conclusions. Inappropriate therapy is a crucial factor regarding the worse prognosis among patients with infections caused by multiresistant P. aeruginosa, especially those who died within 5 days of diagnosis, regardless of the genotype associated with TTSS virulence.
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Affiliation(s)
- Jane Eire Urzedo
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Ralciane de Paula Menezes
- Technical School of Health (ESTES), Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Juliana Pena Porto
- Medical College (FAMED), Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Melina Lorraine Ferreira
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Iara Rossi Gonçalves
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Cristiane Silveira de Brito
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Paulo P Gontijo-Filho
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Rosineide Marques Ribas
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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6
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Colistin Heteroresistance among Extended Spectrum β-lactamases-Producing Klebsiella pneumoniae. Microorganisms 2020; 8:microorganisms8091279. [PMID: 32825799 PMCID: PMC7569871 DOI: 10.3390/microorganisms8091279] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 01/24/2023] Open
Abstract
Colistin-heteroresistant (CST-HR) Enterobacterales isolates have been identified recently, challenging the clinical laboratories since routine susceptibility tests fail to detect this phenotype. In this work we describe the first CST-HR phenotype in extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolates in South America. Additionally, we determine the genomic mechanisms of colistin heteroresistance in these strains. The CST-HR phenotype was analyzed by the population analysis profile (PAP) method, and mutations associated with this phenotype were determined by whole-genome sequencing (WGS) and the local BLAST+ DB tool. As a result, 8/60 isolates were classified as CST-HR according to the PAP method. From WGS, we determined that the CST-HR isolates belong to three different Sequence Types (STs) and four K-loci: ST11 (KL15 and KL81), ST25 (KL2), and ST1161 (KL19). We identified diverse mutations in the two-component regulatory systems PmrAB and PhoPQ, as well as a disruption of the mgrB global regulator mediated by IS1-like and IS-5-like elements, which could confer resistance to CST in CST-HR and ESBL-producing isolates. These are the first descriptions in Chile of CST-HR in ESBL-producing K. pneumoniae isolates. The emergence of these isolates could have a major impact on the effectiveness of colistin as a “last resort” against these isolates, thus jeopardizing current antibiotic alternatives; therefore, it is important to consider the epidemiology of the CST-HR phenotype.
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7
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Ohadian Moghadam S, Afshar D, Nowroozi MR, Behnamfar A, Farzin A. Molecular Epidemiology of Carbapenemase-Producing Pseudomonas aeruginosa Isolated from an Iranian University Hospital: Evidence for Spread of High-Risk Clones. Infect Drug Resist 2020; 13:1583-1592. [PMID: 32581561 PMCID: PMC7277578 DOI: 10.2147/idr.s253756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose Given the importance of treatment failure due to multidrug-resistant (MDR) strains, studies on population structure of these organisms are necessary to improve control strategies. Accordingly, the current study aimed to determine the prevalence of carbapenem-resistant P. aeruginosa (CRPA) at a teaching referral hospital in Iran and to analyz their molecular clonality by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) for epidemiological purposes. Methods In this study, modified Hodge test (MHT) and double-disk synergy test (DDST) were used for carbapenemase production and metallo-β-lactamases (MBLs) screening, respectively. All P. aeruginosa isolates were tested for antimicrobial resistance. Moreover, MBL genes (blaIMP, blaVIM, blaSPM, blaNDM) were detected by multiplex PCR assay. Results Among 68 P. aeruginosa clinical isolates, 38 (55.88%) isolates were CRPA. Antibiotic susceptibility testing revealed that most of these isolates were MDR. PFGE analyses showed 5 common types and 27 single types among CRPA isolates. MLST analysis revealed three major clusters (MLST-sequence types (STs): 235, 357, and 861) among them. The 30 non-CRPA isolates corresponded mainly to MLST-STs 253, 360, and 446. Conclusion Our results showed that internationally distributed MLST-STs with widely genomic diversity have spread in our hospital, and clonal expansion of MDR strains of P. aeruginosa was described as well.
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Affiliation(s)
| | - Davoud Afshar
- Department of Microbiology and Virology, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Amir Behnamfar
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Farzin
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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8
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Antibiotic resistance in bacterial isolates from freshwater samples in Fildes Peninsula, King George Island, Antarctica. Sci Rep 2020; 10:3145. [PMID: 32081909 PMCID: PMC7035346 DOI: 10.1038/s41598-020-60035-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 02/04/2020] [Indexed: 11/08/2022] Open
Abstract
Anthropic activity in Antarctica has been increasing considerably in recent years, which could have an important impact on the local microbiota affecting multiple features, including the bacterial resistome. As such, our study focused on determining the antibiotic-resistance patterns and antibiotic-resistance genes of bacteria recovered from freshwater samples collected in areas of Antarctica under different degrees of human influence. Aerobic heterotrophic bacteria were subjected to antibiotic susceptibility testing and PCR. The isolates collected from regions of high human intervention were resistant to several antibiotic groups, and were mainly associated with the presence of genes encoding aminoglycosides-modifying enzymes (AMEs) and extended-spectrum β-lactamases (ESBLs). Moreover, these isolates were resistant to synthetic and semi-synthetic drugs, in contrast with those recovered from zones with low human intervention, which resulted highly susceptible to antibiotics. On the other hand, we observed that zone A, under human influence, presented a higher richness and diversity of antibiotic-resistance genes (ARGs) in comparison with zones B and C, which have low human activity. Our results suggest that human activity has an impact on the local microbiota, in which strains recovered from zones under anthropic influence were considerably more resistant than those collected from remote regions.
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Faecal indicator bacteria and antibiotic-resistant β-lactamase producing Escherichia coli in blackwater: a pilot study. Arh Hig Rada Toksikol 2019; 70:140-148. [DOI: 10.2478/aiht-2019-70-3212] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 06/01/2019] [Indexed: 01/14/2023] Open
Abstract
Abstract
The aim of this study was to identify and quantify faecal indicator bacteria in blackwater collected from a source separation unit and determine the amount of E. coli isolates resistant to antimicrobials and their potential to produce extended spectrum β-lactamases (ESβLs) and metallo-β-lactamases (MβLs), which hydrolyse the most important antibiotics used in clinical practice. Most of the isolates were resistant to amoxicillin with clavulanic acid (36.4 %), followed by ticarcillin with clavulanic acid (22.7 %) and tetracycline (18.2 %). ESβL-producing genes bla
CTX-M and bla
TEM were found in three (13.6 %) and four (18.2 %) E. coli strains, respectively, while MβL genes were found in two (9.1 %). By separating at source, this pilot study clearly shows that gastrointestinal bacteria of healthy people can be an important source of antibiotic resistance released into the environment through wastewaters. One way to prevent that is to treat wastewater with a combination of TiO2, UV light, or ozone, as successful methods to remove resistant bacteria and prevent their spread in the environment.
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10
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Rojs OZ, Zdovc I, Dovč A, Žgajnar J, Slavec B, Krapež U, Ambrožič JA. Presence and distribution of extended-spectrum and AmpC beta-lactamases-producing Escherichia coli on poultry farms in Slovenia. J APPL POULTRY RES 2019. [DOI: 10.3382/japr/pfy021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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Whole genome sequence revealed the fine transmission map of carbapenem-resistant Klebsiella pneumonia isolates within a nosocomial outbreak. Antimicrob Resist Infect Control 2018; 7:70. [PMID: 29881543 PMCID: PMC5984795 DOI: 10.1186/s13756-018-0363-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 05/22/2018] [Indexed: 11/16/2022] Open
Abstract
Background Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of nosocomial infections worldwide. The transmission route of CRKP isolates within an outbreak is rarely described. This study aimed to reveal the molecular characteristics and transmission route of CRKP isolates within an outbreak of nosocomial infection. Methods Collecting case information, active screening and targeted environmental monitoring were carried out. The antibiotic susceptibility, drug-resistant genes, molecular subtype and whole genome sequence of CRKP strains were analyzed. Results Between October and December 2011, 26 CRKP isolates were collected from eight patients in a surgical intensive care unit and subsequent transfer wards of Beijing Tongren hospital, China. All 26 isolates harbored blaKPC-2, blaSHV-1, and blaCTX-M-15 genes, had the same or similar pulsed-field gel electrophoresis patterns, and belonged to the sequence type 11 (ST11) clone. By comprehensive consideration of genomic and epidemiological information, a putative transmission map was constructed, including identifying one case as an independent event distinct from the other seven cases, and revealing two transmissions starting from the same case. Conclusions This study provided the first report confirming an outbreak caused by K. pneumoniae ST11 clone co-harboring the blaKPC-2, blaCTX-M-15, and blaSHV-1 genes, and suggested that comprehensive consideration of genomic and epidemiological data can yield a fine transmission map of an outbreak and facilitate the control of nosocomial transmission.
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Torkar KG, Ivić S. Surveillance of bacterial colonisation on contact surfaces in different medical wards. Arh Hig Rada Toksikol 2018; 68:116-126. [PMID: 28665797 DOI: 10.1515/aiht-2017-68-2892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 05/01/2017] [Indexed: 11/15/2022] Open
Abstract
This study was conducted to determine the bacterial colonization of some bacterial groups, including extended-spectrum β-lactamase (ESBLs) producers and methicillin-resistant Staphylococcus aureus (MRSA), on surfaces of the equipment and instruments in patient rooms and other workspaces in three different medical wards. The number of microorganisms on swabs was determined with the colony count method on selective microbiological mediums. The aerobic mesophylic microorganisms were found in 73.5 % out of 102 samples, with the average and maximum values of 2.6 × 102 and 4.6 × 103 colony forming units (CFU) 100 cm-2, respectively. Members of the family Enterobacteriaceae, coagulase positive staphylococci, coagulase-negative staphylococci, and enterococci were detected in 23.4, 31.4, 53.2, and 2.9 % of samples, respectively. The differences in bacterial counts on the surfaces of the psychiatric, oncology, and paediatric wards were statistically significant (P<0.001). About 40 % out of 19 isolates from the family Enterobacteriaceae showed multiple resistance to three or more different groups of tested antibiotics, while ESBL was confirmed for only one strain. Staphylococci isolates were mostly resistant to penicillin. MRSA was confirmed in 5.2 % of the tested S. aureus isolates. Greater attention should be paid to cleaning and the appropriate choice of disinfectants, especially in the psychiatric ward. Employees should be informed about the prevention of the spreading of nosocomial infections. Routine application of rapid methods for hygiene control of surfaces is highly recommended.
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Križman M, Kirbiš A, Jamnikar-Ciglenečki U. Antimicrobial-resistant bacteria in wild game in Slovenia. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1755-1315/85/1/012083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Molecular epidemiological survey of bacteremia by multidrug resistant Pseudomonas aeruginosa: the relevance of intrinsic resistance mechanisms. PLoS One 2017; 12:e0176774. [PMID: 28481953 PMCID: PMC5421754 DOI: 10.1371/journal.pone.0176774] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 04/17/2017] [Indexed: 01/16/2023] Open
Abstract
The bacterial factors associated with bacteremia by multidrug-resistant and extensively drug-resistant P. aeruginosa, including overexpression of efflux pumps, AmpC overproduction, and loss/alteration of the OprD porin in isolates that are non-Metallo-β-Lactamase producing were analyzed in a retrospective study. Molecular analyses included strain typing by Pulsed Field Gel Electrophoresis and identification of key genes via qualitative and quantitative PCR-based assays. Previous use of carbapenems and tracheostomy was independently associated with the development of bacteremia by extensively drug-resistant and multidrug-resistant strains of P. aeruginosa. A high consumption of antimicrobials was observed, and 75.0% of the isolates contained amplicons with the blaSPM-1 and blaVIM genes. Of the 47 non-Metallo-β-Lactamase isolates, none had another type of carbapenemase. However, the isolates exhibited high rates of hyperproduction of AmpC, loss of the OprD porin (71.4%) and the presence of MexABOprM (57.1%) and MexXY (64.3%). This study suggests that in non-Metallo-β-Lactamase isolates, the association of intrinsic resistance mechanisms could contributes to the expression of multidrug-resistant/extensively drug-resistant phenotypes.
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Karkaba A, Grinberg A, Benschop J, Pleydell E. Characterisation of extended-spectrum β-lactamase and AmpC β-lactamase-producing Enterobacteriaceae isolated from companion animals in New Zealand. N Z Vet J 2017; 65:105-112. [PMID: 27973988 DOI: 10.1080/00480169.2016.1271730] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIMS To assess the occurrence of, and characterise, extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase (AmpC)-producing Enterobacteriaceae isolated by veterinary diagnostic laboratories from infection sites in companion animals in New Zealand. METHODS Selected Enterobacteriaceae isolates were submitted by seven New Zealand veterinary diagnostic laboratories. They were isolated from infection sites in companion animals between June 2012 and June 2013, and were resistant to amoxicillin-clavulanic acid, fluoroquinolones, or any combination of two or more antimicrobials. Based on disk diffusion test results, the isolates were phenotypically categorised according to production of ESBL and AmpC. Genes for ESBL and AmpC production were amplified by PCR and sequenced. Escherichia coli isolates were also typed by multilocus sequence typing. RESULTS A total of 115 isolates matching the inclusion criteria were obtained from the participating laboratories, of which 74 (64%) originated from dogs and 29 (25%) from cats. Seven bacterial species were identified, of which E. coli was the most common (87/115, 76%). Of the 115 isolates, 10 (9%) expressed the ESBL phenotype, 43 (37%) the AmpC phenotype, and seven (6%) both ESBL and AmpC phenotypes. Of the 60 ESBL and AmpC-producing isolates, 36 (60%) were E. coli. Amongst these isolates, 27/60 (45%) were classified as multidrug resistant, compared with 15/55 (27%) non-ESBL or AmpC-producing isolates (p<0.01). Ninety five isolates were resistant to amoxicillin-clavulanic acid and 58 (61%) of these were ESBL or AmpC-producing. The predominant ESBL genes were blaCTX-M-14 and blaCTX-M-15, and the dominant plasmid-encoded AmpC gene was blaCMY-2. Thirty-eight E. coli multilocus sequence types (ST) were identified, and the most prevalent were ST12 (12/89, 13%), ST131 (6/89, 7%) and ST648 (6/89, 7%). ESBL and AmpC-producing isolates accounted for 35/1,082 (3.2%) of the Enterobacteriaceae isolated by one laboratory network over the study period. CONCLUSIONS AND CLINICAL RELEVANCE ESBL and AmpC-producing Enterobacteriaceae were associated with clinical infections in companion animals in New Zealand, and were often multidrug resistant. In this study, these organisms accounted for <5% of all Enterobacteriaceae isolated from infection sites by one laboratory network, but their prevalence among isolates resistant to amoxicillin-clavulanic acid was 61%. Therefore routine secondary testing for ESBL and AmpC production by Enterobacteriaceae that are resistant to amoxicillin-clavulanic acid in primary testing could improve the accuracy of definitive antimicrobial therapy in companion animals in New Zealand.
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Affiliation(s)
- A Karkaba
- a Institute of Veterinary Animal and Biomedical Sciences , Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
| | - A Grinberg
- a Institute of Veterinary Animal and Biomedical Sciences , Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
| | - J Benschop
- a Institute of Veterinary Animal and Biomedical Sciences , Massey University , Private Bag 11222, Palmerston North 4442 , New Zealand
| | - E Pleydell
- b mEpiLab, Hopkirk Research Institute, Institute of Veterinary Animal and Biomedical Sciences , Massey University , Palmerston North 4442 , New Zealand
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16
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Krizman M, Avgustin JA, Zdovc I, Golob M, Trkov M, Ciglenecki UJ, Biasizzo M, Kirbis A. Antimicrobial Resistance and Molecular Characterization of Extended-Spectrum β-Lactamases and Other Escherichia coli Isolated from Food of Animal Origin and Human Intestinal Isolates. J Food Prot 2017; 80:113-120. [PMID: 28221881 DOI: 10.4315/0362-028x.jfp-16-214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Antibiotics have always appeared miraculous, saving innumerable lives. However, the unwise use of antimicrobial drugs has led to the appearance of resistant bacteria. The purpose of this study was to evaluate antimicrobial resistance in Escherichia coli (n =160) isolated from food of animal origin. The focus was on E. coli -producing extended-spectrum β-lactamases. E. coli was chosen because it is a part of the normal microbiota in mammals and can enter the food chain during slaughtering and food manipulation. Subsequently, its resistance genes can be transferred to pathogenic bacteria and human microbiota. Phenotypic and genotypic analyses of selected antimicrobial resistances were carried out together with a molecular analysis of virulence genes. E. coli isolates from food of animal origin were compared with clinical E. coli strains isolated from the human intestinal tract. Extended-spectrum β-lactamase-producing E. coli isolates were found in 9.4% of food isolates and in 1.8% of intestinal isolates. Phylogenetically, the majority of food (86.3%) and intestinal E. coli (58.1%) isolates were found to belong to the commensal phylogenetic groups A and B1. The distribution of 4 of 14 analyzed virulence factors was similar in the food and intestinal isolates. Strains isolated from food in Slovenia harbored resistance genes and virulence factors, which can constitute a problem for food safety if not handled properly.
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Affiliation(s)
- Manja Krizman
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Irena Zdovc
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Majda Golob
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Marija Trkov
- Department for Public Health Microbiology, Centre for Medical Microbiology, National Laboratory of Health, Environment and Food, 1000 Ljubljana, Slovenia
| | - Urska Jamnikar Ciglenecki
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Majda Biasizzo
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Andrej Kirbis
- Institute of Food Safety, Feed and Environment, Veterinary Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
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17
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Rossi Gonçalves I, Dantas RCC, Ferreira ML, Batistão DWDF, Gontijo-Filho PP, Ribas RM. Carbapenem-resistant Pseudomonas aeruginosa: association with virulence genes and biofilm formation. Braz J Microbiol 2016; 48:211-217. [PMID: 28034598 PMCID: PMC5470431 DOI: 10.1016/j.bjm.2016.11.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 04/25/2016] [Indexed: 11/30/2022] Open
Abstract
Pseudomonas aeruginosa is an opportunistic pathogen that causes frequently nosocomial infections, currently becoming more difficult to treat due to the various resistance mechanisms and different virulence factors. The purpose of this study was to determine the risk factors independently associated with the development of bacteremia by carbapenem-resistant P. aeruginosa, the frequency of virulence genes in metallo-β-lactamases producers and to evaluate their ability to produce biofilm. We conducted a case–control study in the Uberlândia Federal University – Hospital Clinic, Brazil. Polymerase Chain Reaction was performed for metallo-β-lactamases and virulence genes. Adhesion and biofilm assays were done by quantitative tests. Among the 157 strains analyzed, 73.9% were multidrug-resistant, 43.9% were resistant to carbapenems, 16.1% were phenotypically positive for metallo-β-lactamases, and of these, 10.7% were positive for blaSPM gene and 5.3% positive for blaVIM. The multivariable analysis showed that mechanical ventilation, enteral/nasogastric tubes, primary bacteremia with unknown focus, and inappropriate therapy were independent risk factors associated with bacteremia. All tested strains were characterized as strongly biofilm producers. A higher mortality was found among patients with bacteremia by carbapenem-resistant P. aeruginosa strains, associated independently with extrinsic risk factors, however it was not evident the association with the presence of virulence and metallo-β-lactamases genes.
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Affiliation(s)
- Iara Rossi Gonçalves
- Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Laboratório de Microbiologia, Uberlândia, MG, Brazil.
| | | | - Melina Lorraine Ferreira
- Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Laboratório de Microbiologia, Uberlândia, MG, Brazil
| | | | - Paulo Pinto Gontijo-Filho
- Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Laboratório de Microbiologia, Uberlândia, MG, Brazil
| | - Rosineide Marques Ribas
- Universidade Federal de Uberlândia, Instituto de Ciências Biomédicas, Laboratório de Microbiologia, Uberlândia, MG, Brazil
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18
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Grazziotin AL, Vidal NM, Palmeiro JK, Dalla-Costa LM, Venancio TM. Genome Sequencing of Four Multidrug-Resistant Enterobacter aerogenes Isolates from Hospitalized Patients in Brazil. Front Microbiol 2016; 7:1649. [PMID: 27833588 PMCID: PMC5081556 DOI: 10.3389/fmicb.2016.01649] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/04/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ana Laura Grazziotin
- Laboratório de Química e Função de Proteínas e Peptídeos, Centro de Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense Darcy RibeiroCampos dos Goytacazes, Brazil
| | - Newton M. Vidal
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of HealthBethesda, MD, USA
| | - Jussara K. Palmeiro
- Laboratório de Bacteriologia, Unidade Laboratório de Análises Clínicas, Hospital de Clínicas, Universidade Federal do ParanáCuritiba, Brazil
- Faculdades e Instituto de Pesquisa Pelé Pequeno PríncipeCuritiba, Brazil
| | - Libera Maria Dalla-Costa
- Laboratório de Bacteriologia, Unidade Laboratório de Análises Clínicas, Hospital de Clínicas, Universidade Federal do ParanáCuritiba, Brazil
- Faculdades e Instituto de Pesquisa Pelé Pequeno PríncipeCuritiba, Brazil
| | - Thiago M. Venancio
- Laboratório de Química e Função de Proteínas e Peptídeos, Centro de Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense Darcy RibeiroCampos dos Goytacazes, Brazil
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19
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Lewis JA, Moore PCL, Arnold DL, Lawrance LM. Multi-locus sequence typing of Escherichia coli isolates with acquired ampC genes and ampC promoter mutations. Diagn Microbiol Infect Dis 2016; 86:265-267. [PMID: 27595455 DOI: 10.1016/j.diagmicrobio.2016.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/08/2016] [Accepted: 08/10/2016] [Indexed: 11/16/2022]
Abstract
Multi-locus sequence typing was used to reveal a high degree of diversity amongst the E. coli isolates with AmpC plasmid genes, and a high prevalence of the -32 mutation present.
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Affiliation(s)
- Jonathan A Lewis
- Department of Microbiology, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN.
| | - Philippa C L Moore
- Department of Microbiology, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN
| | - Dawn L Arnold
- Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY
| | - Lynne M Lawrance
- Faculty of Health and Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY
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20
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Teethaisong Y, Eumkeb G, Chumnarnsilpa S, Autarkool N, Hobson J, Nakouti I, Hobbs G, Evans K. Phenotypic detection of AmpC β-lactamases, extended-spectrum β-lactamases and metallo-β-lactamases in Enterobacteriaceae using a resazurin microtitre assay with inhibitor-based methods. J Med Microbiol 2016; 65:1079-1087. [PMID: 27481506 DOI: 10.1099/jmm.0.000326] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dissemination of antibiotic resistance in Enterobacteriaceae mediated by AmpC β-lactamase, extended-spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) is clinically significant. A simple and relatively quick method for the detection of these resistance phenotypes would greatly improve chemotherapeutic recommendation. This technology would provide valuable input in our surveillance of resistance on a global stage, particularly if the methodology could be applicable to resource-poor settings. A resazurin microtitre plate (RMP) assay incorporating cloxacillin, clavulanic acid and EDTA for the rapid phenotypic identification of AmpC, ESBL and MBL and the co-existence of β-lactamases has been developed. A total of 47 molecularly characterized Enterobacteriaceae clinical isolates producing AmpCs, ESBLs, co-producers of ESBL and AmpC, MBLs and co-producers of ESBL and MBL were phenotypically examined using the RMP assay. The ceftazidime- and cefotaxime-based RMP assays successfully detected all 16 AmpC, 14 ESBL and 9 MBL producers, 6 ESBL-AmpC co-producers and 2 ESBL-MBL co-producers without false-positive results. The ceftazidime-based assay was more reliable in detecting AmpC alone, while the cefotaxime-based assay performed better in identifying co-producers of ESBL and AmpC. There was no difference in the detection of ESBL and MBL producers. The findings of the present study suggest that use of the RMP assay with particular β-lactamase inhibitors explicitly detects three different β-lactamases, as well as co-existence of β-lactamases, within 6 h of initial isolation of the pathogen. This assay is applicable to carry out in any laboratory, is cost-effective and is easy to interpret. It could be implemented in screening patients and controlling infection and for surveillance purposes.
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Affiliation(s)
- Yothin Teethaisong
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK.,School of Pharmacology, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Griangsak Eumkeb
- School of Pharmacology, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Sakesit Chumnarnsilpa
- School of Biochemistry, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Nongluk Autarkool
- School of Biochemistry, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand.,Faculty of Medical Science, Nakhon Ratchasima College, Nakhon Ratchasima 30000, Thailand
| | - Jon Hobson
- Mast Group Ltd, Bootle, Liverpool L20 1EA, UK
| | - Ismini Nakouti
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK
| | - Glyn Hobbs
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK
| | - Katie Evans
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Byrom Street, Liverpool L3 3AF, UK
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21
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Akhi MT, Khalili Y, Ghotaslou R, Kafil HS, Yousefi S, Nagili B, Goli HR. Carbapenem inactivation: a very affordable and highly specific method for phenotypic detection of carbapenemase-producing Pseudomonas aeruginosa isolates compared with other methods. J Chemother 2016; 29:144-149. [PMID: 27443547 DOI: 10.1080/1120009x.2016.1199506] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This investigation was undertaken to compare phenotypic and molecular methods for detection of carbapenemase-producing Pseudomonas aeruginosa. A total of 245 non-duplicated isolates of P. aeruginosa were collected from hospitalized patients. Disc diffusion method was used to identify carbapenem-resistant bacteria. Three phenotypic methods, including Modified Hodge Test (MHT), Modified Carba NP (MCNP) test and Carbapenem Inactivation Method (CIM) were used for investigation of carbapenemase production. In addition, polymerase chain reaction (PCR) was used to detect carbapenemase encoding genes. Of 245 P. aeruginosa isolates investigated, 121 isolates were carbapenem-resistant. Among carbapenem-resistant isolates, 40, 39 and 35 isolates exhibited positive results using MHT, MCNP test and CIM, respectively. PCR indicated the presence of carbapenemase genes in 35 of carbapenem-resistant isolates. MHT showed low sensitivity and specificity for carbapenemase detection among P. aeruginosa isolates in comparison to PCR. CIM was most affordable and highly specific than MCNP test compared with the molecular method.
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Affiliation(s)
- Mohammad Taghi Akhi
- a Immunology Research Center, Tabriz University of Medical Sciences , Tabriz , Iran.,b Faculty of Medicine, Department of Microbiology , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Younes Khalili
- a Immunology Research Center, Tabriz University of Medical Sciences , Tabriz , Iran.,b Faculty of Medicine, Department of Microbiology , Tabriz University of Medical Sciences , Tabriz , Iran.,e Social Security Organization, Emam Reza Hospital , Urmia , Iran
| | - Reza Ghotaslou
- b Faculty of Medicine, Department of Microbiology , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hossein Samadi Kafil
- b Faculty of Medicine, Department of Microbiology , Tabriz University of Medical Sciences , Tabriz , Iran
| | - Saber Yousefi
- c Faulty of Medicine, Department of Microbiology and Virology , Urmia University of Medical Sciences , Urmia , Iran
| | - Behroz Nagili
- d Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences , Tabriz , Iran
| | - Hamid Reza Goli
- b Faculty of Medicine, Department of Microbiology , Tabriz University of Medical Sciences , Tabriz , Iran
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22
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Palanisami A, Khan S, Erdem SS, Hasan T. Guiding Empiric Treatment for Serious Bacterial Infections via Point of Care [Formula: see text]-Lactamase Characterization. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2016; 4:2800410. [PMID: 27602307 PMCID: PMC5003167 DOI: 10.1109/jtehm.2016.2573305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/31/2016] [Accepted: 04/26/2016] [Indexed: 01/21/2023]
Abstract
Fever is one of the most common symptoms of illness in infants and represents a clinical challenge due to the potential for serious bacterial infection. As delayed treatment for these infections has been correlated with increased morbidity and mortality, broad-spectrum [Formula: see text]-lactam antibiotics are often prescribed while waiting for microbiological lab results (1-3 days). However, the spread of antibiotic resistance via the [Formula: see text]-lactamase enzyme, which can destroy [Formula: see text]-lactam antibiotics, has confounded this paradigm; empiric antibiotic regimens are increasingly unable to cover all potential bacterial pathogens, leaving some infants effectively untreated until the pathogen is characterized. This can lead to lifelong sequela or death. Here, we introduce a fluorescent, microfluidic assay that can characterize [Formula: see text]-lactamase derived antibiotic susceptibility in 20 min with a sensitivity suitable for direct human specimens. The protocol is extensible, and the antibiotic spectrum investigated can be feasibly adapted for the pathogens of regional relevance. This new assay fills an important need by providing the clinician with hitherto unavailable point of care information for treatment guidance in an inexpensive and simple diagnostic format.
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Affiliation(s)
- Akilan Palanisami
- Wellman Center for PhotomedicineMassachusetts General HospitalBostonMA02114USA
| | - Shazia Khan
- Wellman Center for PhotomedicineMassachusetts General HospitalBostonMA02114USA
- Current Address: ElsevierCambridgeMA02139USA
| | - Sultan Sibel Erdem
- Wellman Center for PhotomedicineMassachusetts General HospitalBostonMA02114USA
- Current Address: International School of Medicine and Regenerative and Restorative Medicine Research Centerİstanbul Medipol UniversityIstanbul34810Turkey
| | - Tayyaba Hasan
- Wellman Center for PhotomedicineMassachusetts General HospitalBostonMA02114USA
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23
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Araujo BF, Ferreira ML, de Campos PA, Royer S, Batistão DWDF, Dantas RCC, Gonçalves IR, Faria ALS, de Brito CS, Yokosawa J, Gontijo-Filho PP, Ribas RM. Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac(6')-Ib-cr, qnrS1 and blaSPM Genes in Brazil. PLoS One 2016; 11:e0155914. [PMID: 27219003 PMCID: PMC4878783 DOI: 10.1371/journal.pone.0155914] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 05/08/2016] [Indexed: 11/19/2022] Open
Abstract
We described a comprehensive analysis of the molecular epidemiology of multidrug-resistant (MDR) P. aeruginosa. Molecular analysis included typing by Pulsed Field Gel Electrophoresis, identification of genes of interest through PCR-based assays and sequencing of target genes. Case-control study was conducted to better understand the prognostic of patients and the impact of inappropriate therapy in patients with bacteremia, as well as the risk factors of MDR infections. We observed a high rate of MDR isolates (40.7%), and 51.0% of them was independently associated with inappropriate antibiotic therapy. Bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), qnrS1 and aac(6')Ib-cr, were detected in two different nosocomial isolates (5.3%), and the aac(6')-Ib7 variant was detected at a high frequency (87.5%) in those negative to PMQR. The presence of mutations in gyrA and parC genes was observed in 100% and 85% of selected isolates, respectively. Isolates harboring PMQR genes or mutations in gyrA and parC were not closely related, except in those containing SPM (São Paulo metallo-β-lactamase) clone. In addition, there is no study published in Brazil to date reporting the presence of Pseudomonas aeruginosa isolates harboring both qnrS1 and aac(6')Ib-cr genes, with alarming frequency of patients with inappropriate therapy.
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Affiliation(s)
- Bruna Fuga Araujo
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Melina Lorraine Ferreira
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Paola Amaral de Campos
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Sabrina Royer
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Deivid William da Fonseca Batistão
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Raquel Cristina Cavalcanti Dantas
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Iara Rossi Gonçalves
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Ana Luiza Souza Faria
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Cristiane Silveira de Brito
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Jonny Yokosawa
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Virology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Paulo Pinto Gontijo-Filho
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Rosineide Marques Ribas
- Instituto de Ciências Biomédicas (ICBIM), Laboratory of Molecular Microbiology, Universidade Federal de Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
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Ogutu JO, Zhang Q, Huang Y, Yan H, Su L, Gao B, Zhang W, Zhao J, Cai W, Li W, Zhao H, Chen Y, Song W, Chen X, Fu Y, Zhang F. Development of a multiplex PCR system and its application in detection of blaSHV, blaTEM, blaCTX-M-1, blaCTX-M-9 and blaOXA-1 group genes in clinical Klebsiella pneumoniae and Escherichia coli strains. J Antibiot (Tokyo) 2015; 68:725-33. [DOI: 10.1038/ja.2015.68] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/07/2015] [Accepted: 05/10/2015] [Indexed: 11/09/2022]
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Sudarwanto M, Akineden Ö, Odenthal S, Gross M, Usleber E. Extended-Spectrum β-Lactamase (ESBL)-Producing Klebsiella pneumoniae in Bulk Tank Milk from Dairy Farms in Indonesia. Foodborne Pathog Dis 2015; 12:585-90. [PMID: 26135892 DOI: 10.1089/fpd.2014.1895] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bulk tank milk from 80 dairy farms located in the West Java Region of Indonesia was analyzed for the presence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Isolates from seven dairy farms were ESBL positive, and all were identified as Klebsiella pneumoniae. The isolates showed ESBL-characteristic antibiotic resistance patterns. Further analysis revealed that all K. pneumoniae isolates harbored the blaSHV gene, and two isolates were additionally positive for the blaTEM-1 and blaCTX-M-15 genes. Isolates from different farms were clonally diverse according to macrorestriction analysis. The results indicate that the relatively high frequency of ESBL-producing K. pneumoniae in bulk tank milk implies the risk that milk is both a source of local exposure and a vector contributing to the supraregional spread of antibiotic-resistant bacteria by trade.
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Affiliation(s)
- Mirnawati Sudarwanto
- 1 Laboratory of Veterinary Public Health, Faculty of Veterinary Medicine, Bogor Agricultural University , Bogor, West Java, Indonesia
| | - Ömer Akineden
- 2 Dairy Sciences, Institute of Veterinary Food Science , Justus-Liebig University Giessen, Giessen, Germany
| | - Sabrina Odenthal
- 2 Dairy Sciences, Institute of Veterinary Food Science , Justus-Liebig University Giessen, Giessen, Germany
| | - Madeleine Gross
- 2 Dairy Sciences, Institute of Veterinary Food Science , Justus-Liebig University Giessen, Giessen, Germany
| | - Ewald Usleber
- 2 Dairy Sciences, Institute of Veterinary Food Science , Justus-Liebig University Giessen, Giessen, Germany
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26
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Royer S, Faria ALS, Seki LM, Chagas TPG, Campos PAD, Batistão DWDF, Asensi MD, Gontijo Filho PP, Ribas RM. Spread of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa clones in patients with ventilator-associated pneumonia in an adult intensive care unit at a university hospital. Braz J Infect Dis 2015; 19:350-7. [PMID: 25997783 PMCID: PMC9427451 DOI: 10.1016/j.bjid.2015.03.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/24/2015] [Accepted: 03/29/2015] [Indexed: 01/09/2023] Open
Abstract
Background In Brazil, ventilator-associated pneumonia (VAP) caused by carbapenem resistant Acinetobacter baumannii and Pseudomonas aeruginosa isolates are associated with significant mortality, morbidity and costs. Studies on the clonal relatedness of these isolates could lay the foundation for effective infection prevention and control programs. Objectives We sought to study the epidemiological and molecular characteristics of A. baumannii vs. P. aeruginosa VAP in an adult intensive care unit (ICU). Methods It was conducted a cohort study of patients with VAP caused by carbapenem resistant A. baumannii and P. aeruginosa during 14 months in an adult ICU. Genomic studies were used to investigate the clonal relatedness of carbapenem resistant OXA-23-producing A. baumannii and P. aeruginosa clinical isolates. The risk factors for acquisition of VAP were also evaluated. Clinical isolates were collected for analysis as were samples from the environment and were typed using pulsed field gel electrophoresis. Results Multivariate logistic regression analysis identified trauma diagnosed at admission and inappropriate antimicrobial therapy as independent variables associated with the development of A. baumannii VAP and hemodialysis as independent variable associated with P. aeruginosa VAP. All carbapenem resistant clinical and environmental isolates of A. baumannii were OXA-23 producers. No MBL-producer P. aeruginosa was detected. Molecular typing revealed a polyclonal pattern; however, clone A (clinical) and H (surface) were the most frequent among isolates of A. baumannii tested, with a greater pattern of resistance than other isolates. In P. aeruginosa the most frequent clone I was multi-sensitive. Conclusion These findings suggest the requirement of constant monitoring of these microorganisms in order to control the spread of these clones in the hospital environment.
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Affiliation(s)
- Sabrina Royer
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
| | - Ana Luiza Souza Faria
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Liliane Miyuki Seki
- Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Thiago Pavoni Gomes Chagas
- Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Paola Amaral de Campos
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Marise Dutra Asensi
- Laboratório de Pesquisa em Infecção Hospitalar, Instituto Oswaldo Cruz - Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Paulo P Gontijo Filho
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Rosineide Marques Ribas
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
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Ferreira ML, Dantas RC, Faria ALS, Gonçalves IR, Silveira de Brito C, Queiroz LL, Gontijo-Filho PP, Ribas RM. Molecular epidemiological survey of the quinolone- and carbapenem-resistant genotype and its association with the type III secretion system in Pseudomonas aeruginosa. J Med Microbiol 2015; 64:262-271. [PMID: 25596115 DOI: 10.1099/jmm.0.000023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study evaluated the predictors of mortality and the impact of inappropriate therapy on the outcomes of patients with bacteraemia and ventilator-associated pneumonia (VAP). Additionally, we evaluated the correlation of the type III secretion system (TTSS) effector genotype with resistance to carbapenems and fluoroquinolones, mutations in the quinolone resistance-determining regions (QRDRs), metallo-β-lactamase and virulence factors. A retrospective cohort was conducted at a tertiary hospital in patients with multidrug-resistant (MDR) P. aeruginosa bacteraemia (157 patients) and VAP (60 patients). The genes for blaIMP, blaVIM, blaSIM, blaGIM and blaSPM and virulence genes (exoT, exoS, exoY, exoU, lasB, algD and toxA) were detected; sequencing was conducted for QRDR genes on fluoroquinolone-resistant strains. The multivariate analyses showed that the predictors independently associated with death in patients with bacteraemia were cancer and inappropriate therapy. Carbapenem resistance was more frequent among strains causing VAP (53.3 %), and in blood we observed the blaSPM genotype (66.6 %) and blaVIM genotype (33.3 %). The exoS gene was found in all isolates, whilst the frequency was low for exoU (9.4 %). Substitution of threonine to isoleucine at position 83 in gyrA was the most frequent mutation among fluoroquinolone-resistant strains. Our study showed a mutation at position 91 in the parC gene (Glu91Lys) associated with a mutation in gyrA (Thre83Ile) in a strain of extensively drug-resistant P. aeruginosa, with the exoT(+)exoS(+)exoU(+) genotype, that has not yet been described in Brazil to the best of our knowledge. This comprehensive analysis of resistance mechanisms to carbapenem and fluoroquinolones and their association with TTSS virulence genes, covering MDR P. aeruginosa in Brazil, is the largest reported to date.
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Affiliation(s)
| | | | - Ana Luiza Souza Faria
- Laboratory of Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Iara Rossi Gonçalves
- Laboratory of Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | | | - Paulo P Gontijo-Filho
- Laboratory of Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Rosineide Marques Ribas
- Laboratory of Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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Aksoy MD, Çavuşlu Ş, Tuğrul HM. Investigation of Metallo Beta Lactamases and Oxacilinases in Carbapenem Resistant Acinetobacter baumannii Strains Isolated from Inpatients. Balkan Med J 2015; 32:79-83. [PMID: 25759776 DOI: 10.5152/balkanmedj.2015.15302] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 11/30/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Resistance to beta-lactam antibiotics is widespread among Acinetobacter strains. Plasmid-mediated metallo beta lactamases (MBL) are responsible for carbapenem resistance, as are oxacillinases (OXA). In recent years, MBL producing carbapenem-resistant strains have been reported in the world and in Turkey in increasing rates. In our country, besides the OXA 51-like enzyme which is inherent in A. baumannii strains, OXA 58-like and OXA 23-like carbapenemases producing strains have also been widely detected. In addition, Verona Imipenemase (VIM) and (IMP)-type MBL have been reported in some centers. AIMS The aim of our study was to investigate the presence of carbapenemases in Acinetobacter strains isolated from hospitalized patients in Edirne. STUDY DESIGN Cross-sectional study. METHODS A total of 52 imipenem-resistant A. baumannii strains isolated between January and March 2013 were investigated. The presence of MBL was described phenotypically by the combined disk diffusion test (CDDT), double disk synergy test (DDST), MBL E-test (only performed in 28 strains) and modified Hodge test. blaIMP, blaVIM, blaGIM, blaSIM, blaSPM genes and blaOXA-23, blaOXA-51, blaOXA-40, blaOXA-58 genes were investigated by multiplex polymerase chain reaction (PCR). The blaNDM-1 gene was determined by PCR. RESULTS By modified Hodge test, 50 strains (96%) were found to be MBL positive. Positivity of MBL was 21% by both CDDT (0.1 M EDTA) and DDST. Twenty-four of 28 strains (85.7%) were positive by MBL E-test. OXA 23-like and OXA 51-like carbapenemases were detected in all strains, but OXA 58-like and OXA 40-like carbapenemases-producing A. baumannii were not detected. Also, MBL genes were not detected by genotypic methods. CONCLUSION Only OXA 23-like carbapenemase was responsible for carbapenem resistance in carbapenem-resistant Acinetobacter strains in Edirne. The MBL-producing Acinetobacter strain is not yet a problem in our hospital. MBL resistance was found by phenotyping tests, which must be confirmed by genotypic methods; multiplex PCR tests can be easily used for screening MBL.
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Affiliation(s)
| | - Şaban Çavuşlu
- Department of Medical Microbiology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - H Murat Tuğrul
- Department of Medical Microbiology, Trakya University Faculty of Medicine, Edirne, Turkey
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Lewis JA, Moore PCL, Arnold DL, Lawrance LM. Chromosomal ampC mutations in cefpodoxime-resistant, ESBL-negative uropathogenic Escherichia coli. Br J Biomed Sci 2015; 72:7-11. [PMID: 25906485 DOI: 10.1080/09674845.2015.11666789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AmpC β-lactamase is an enzyme commonly produced by Escherichia coli that causes resistance to cephalosporins and penicillins. Enzyme production is controlled by the strength of the promoter encoded by the chromosomal ampC gene, with the level of production affected by the presence of certain mutations in this region. This study sets out to determine the prevalence of ampC promoter mutations present in a group of uropathogenic E. coli strains. A total of 50 clinical strains of E. coli were collected from urine samples between June 2011 and November 2011. Strains were investigated for the presence of mutations in the chromosomal ampC promoter region by amplification and sequencing of a 271 bp product. The presence of ampC-carrying plasmids derived from other species was also determined, to exclude these from further analysis. ampC-carrying plasmids were found in 10 of the 50 strains, all of which were of the CIT-type. Analysis of the chromosomal ampC promoter region in the 40 remaining strains showed mutations at 16 different positions, with 18 different genotype patterns detected overall. The most common ampC chromosomal mutation, present in 25 of 40 strains, was a T --> A transition at position -32. This mutation has been shown by others to increase enzyme production by up to 46-fold. Altogether, three separate mutations (-32, -42 and -13ins) were present in 90% of the 40 non-plasmid strains, indicating a strong association with the resistance observed. It appears, therefore, that the majority of AmpC-mediated resistance in E. coli can be accounted for by just three point mutations in the chromosome.
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Dantas RC, Ferreira ML, Gontijo-Filho PP, Ribas RM. Pseudomonas aeruginosa bacteraemia: independent risk factors for mortality and impact of resistance on outcome. J Med Microbiol 2014; 63:1679-1687. [DOI: 10.1099/jmm.0.073262-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The rates of multidrug-resistant, extensively drug-resistant and pandrug-resistant isolates amongst non-fermenting Gram-negative bacilli, particularly Pseudomonas aeruginosa, have risen worldwide. The clinical consequence of resistance and the impact of adverse treatment on the outcome of patients with P. aeruginosa bacteraemia remain unclear. To better understand the predictors of mortality, the clinical consequence of resistance and the impact of inappropriate therapy on patient outcomes, we analysed the first episode of P. aeruginosa bacteraemia in patients from a Brazilian tertiary-care hospital during the period from May 2009 to August 2011. Antimicrobial susceptibility testing was conducted; phenotypic detection of metallo-β-lactamase (MBL) and PCR of MBL genes were performed on carbapenem-resistant strains. Amongst the 120 P. aeruginosa isolates, 45.8 % were resistant to carbapenem and 36 strains were tested for MBL detection. A total of 30 % were phenotypically positive and, of these, 77.8 % expressed an MBL gene, bla
SPM-1 (57 %) and bla
VIM-type (43 %). The resistance rates to ceftazidime, cefepime, piperacillin/tazobactam, carbapenem, fluoroquinolone and aminoglycoside were 55, 42.5, 35, 45.8, 44 and 44 %, respectively. Previous antibiotic use, length of a hospital stay ≥30 days prior to P. aeruginosa, haemodialysis, tracheostomy, pulmonary source of bacteraemia and Intensive Care Unit admission were common independent risk factors for antimicrobial resistance. Cefepime resistance, multidrug resistance and extensive drug resistance were independently associated with inappropriate therapy, which was an important predictor of mortality, being synergistic with the severity of the underlying disease.
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Affiliation(s)
| | | | | | - Rosineide Marques Ribas
- Laboratory of Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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31
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Ciesielczuk H, Hornsey M, Choi V, Woodford N, Wareham DW. Development and evaluation of a multiplex PCR for eight plasmid-mediated quinolone-resistance determinants. J Med Microbiol 2013; 62:1823-1827. [DOI: 10.1099/jmm.0.064428-0] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to develop and validate an expanded multiplex PCR assay for the simultaneous detection of eight plasmid-mediated quinolone-resistance determinants in Enterobacteriaceae. Primers were designed to amplify conserved fragments of qnrABCDS, qepA, oqxAB and aac(6′)-Ib-cr genes and were optimized in uniplex and multiplex PCR assays with control template DNA. The assay was used to determine the prevalence of plasmid-mediated quinolone resistance (PMQR) genes in 174 ciprofloxacin-resistant and 43 ciprofloxacin-susceptible extraintestinal pathogenic Escherichia coli isolates. Each resistance gene could be detected alone and in combination. PMQR determinants were detected in 65 ciprofloxacin-resistant isolates (37 %) and one ciprofloxacin-susceptible isolate (2 %). Prevalences of the identified determinants were: aac(6′)-Ib-cr, 34.5 %; qnrS, 1.1 %; qepA, 1.1 %; and oqxAB, 0.6 %. In conclusion, we developed an eight-target multiplex PCR for the accurate detection of PMQR genes and confirmed that PMQR prevalence remains low among human Escherichia coli clinical isolates in the UK.
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Affiliation(s)
- H. Ciesielczuk
- Antimicrobial Resistance and Healthcare Associated Infections Reference Laboratory, Public Health England, London NW9 5EQ, UK
- Antimicrobial Research Group, Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AT, UK
| | - M. Hornsey
- Department of Life Sciences, Whitelands College, University of Roehampton, Holybourne Avenue, London SW15 4JD, UK
- Antimicrobial Research Group, Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AT, UK
| | - V. Choi
- Singapore General Hospital, Singapore 169037, Singapore
- Antimicrobial Research Group, Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AT, UK
| | - N. Woodford
- Antimicrobial Resistance and Healthcare Associated Infections Reference Laboratory, Public Health England, London NW9 5EQ, UK
- Antimicrobial Research Group, Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AT, UK
| | - D. W. Wareham
- Antimicrobial Research Group, Centre for Immunology and Infectious Disease, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AT, UK
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Drew R, Turton J, Hill R, Livermore D, Woodford N, Paulus S, Cunliffe N. Emergence of carbapenem-resistant Enterobacteriaceae in a UK paediatric hospital. J Hosp Infect 2013; 84:300-4. [DOI: 10.1016/j.jhin.2013.05.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 05/13/2013] [Indexed: 11/30/2022]
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Nóbrega DB, Guiduce MV, Guimarães FF, Riboli DF, Cunha ML, Langoni H, Pantoja JC, Lucheis SB. Molecular epidemiology and extended-spectrum β-lactamases production of Klebsiella pneumoniae isolated from three dairy herds. PESQUISA VETERINARIA BRASILEIRA 2013. [DOI: 10.1590/s0100-736x2013000700005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objectives of this study were to isolate Klebsiella pneumoniae from different sources in three dairy cattle herds, to use the pulsed-field gel electrophoresis (PFGE) to measure genotypic similarities between isolates within a dairy herd, to verify the production of extended-spectrum β-lactamases (ESBLs) by the double-disk synergy test (DDST), and to use the PCR to detect the main ESBLs subgroups genes. Three dairy farms were selected based on previous mastitis outbreaks caused by K. pneumoniae. Milk samples were collected from lactating cows and from the bulk tank. Swabs were performed in different locations, including milking parlors, waiting room, soil, animal's hind limbs and rectum. K. pneumoniae was isolated from 27 cases of intramammary infections (IMI) and from 41 swabs. For farm A isolates from IMI and bulk tank were considered of the same PGFE subtype. One isolate from a bulk tank, three from IMI cases and four from environmental samples were positive in the DDST test. All eight DDST positive isolates harbored the bla shv gene, one harbored the bla tem gene, and three harbored the bla ctx-m gene, including the bulk tank isolate. Our study confirms that ESBL producing bacteria is present in different locations in dairy farms, and may be responsible for IMI. The detection of ESBLs on dairy herds could be a major concern for both public and animal health.
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Bush K, Pannell M, Lock JL, Queenan AM, Jorgensen JH, Lee RM, Lewis JS, Jarrett D. Detection systems for carbapenemase gene identification should include the SME serine carbapenemase. Int J Antimicrob Agents 2013; 41:1-4. [DOI: 10.1016/j.ijantimicag.2012.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 08/15/2012] [Indexed: 10/27/2022]
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Abstract
A novel biochemical technique, the Carba NP test, has been evaluated to detect carbapenemase production in Pseudomonas spp. This test was specific (100%), sensitive (94.4%), and rapid (<2 h). This cost-effective test, which could be implemented in any microbiology laboratory, offers a reliable technique for identification of carbapenemase-producing Pseudomonas spp.
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Jiang HX, Tang D, Liu YH, Zhang XH, Zeng ZL, Xu L, Hawkey PM. Prevalence and characteristics of -lactamase and plasmid-mediated quinolone resistance genes in Escherichia coli isolated from farmed fish in China. J Antimicrob Chemother 2012; 67:2350-3. [DOI: 10.1093/jac/dks250] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Morris D, Boyle F, Morris C, Condon I, Delannoy-Vieillard AS, Power L, Khan A, Morris-Downes M, Finnegan C, Powell J, Monahan R, Burns K, O'Connell N, Boyle L, O'Gorman A, Humphreys H, Brisse S, Turton J, Woodford N, Cormican M. Inter-hospital outbreak of Klebsiella pneumoniae producing KPC-2 carbapenemase in Ireland. J Antimicrob Chemother 2012; 67:2367-72. [PMID: 22744760 DOI: 10.1093/jac/dks239] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe an outbreak of KPC-2-producing Klebsiella pneumoniae with inter-hospital spread and measures taken to control transmission. METHODS Between January and March 2011, 13 K. pneumoniae isolates were collected from nine patients at hospital A and two patients at hospital B. Meropenem, imipenem and ertapenem MICs were determined by Etest, carbapenemase production was confirmed by the modified Hodge method and by a disc synergy test, and confirmed carbapenemase producers were tested for the presence of carbapenemase-encoding genes by PCR. PFGE, plasmid analysis, multilocus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST) analysis were performed on all or a subset of isolates. RESULTS Meropenem, imipenem and ertapenem MICs were 4 to >32, 8-32 and >16 mg/L, respectively. PCR and sequencing confirmed the presence of bla(KPC-2). PFGE identified four distinguishable (≥88%) pulsed-field profiles (PFPs). Isolates distinguishable by PFGE had identical MLVA profiles, and MLST analysis indicated all isolates belonged to the ST258 clone. Stringent infection prevention and control measures were implemented. Over a period of almost 8 months no further carbapenemase-producing Enterobacteriaceae (CPE) were isolated. However, KPC-2-producing K. pneumoniae was detected in two further patients in hospital A in August (PFP indistinguishable from previous isolates) and October 2011 (PFP similar to but distinguishable from previous isolates). CONCLUSIONS Stringent infection prevention and control measures help contain CPE in the healthcare setting; however, in the case of hospital A, where CPE appears to be established in the population served, it may be virtually impossible to achieve eradication or avoid reintroduction into the hospital.
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Affiliation(s)
- Dearbháile Morris
- Antimicrobial Resistance and Microbial Ecology (ARME) Group, School of Medicine, National University of Ireland Galway, Galway, Ireland.
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Multiplex PCR to identify macrolide resistance determinants in Mannheimia haemolytica and Pasteurella multocida. Antimicrob Agents Chemother 2012; 56:3664-9. [PMID: 22564832 DOI: 10.1128/aac.00266-12] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The bacterial pathogens Mannheimia haemolytica and Pasteurella multocida are major etiological agents in respiratory tract infections of cattle. Although these infections can generally be successfully treated with veterinary macrolide antibiotics, a few recent isolates have shown resistance to these drugs. Macrolide resistance in members of the family Pasteurellaceae is conferred by combinations of at least three genes: erm(42), which encodes a monomethyltransferase and confers a type I MLS(B) (macrolide, lincosamide, and streptogramin B) phenotype; msr(E), which encodes a macrolide efflux pump; and mph(E), which encodes a macrolide-inactivating phosphotransferase. Here, we describe a multiplex PCR assay that detects the presence of erm(42), msr(E), and mph(E) and differentiates between these genes. In addition, the assay distinguishes P. multocida from M. haemolytica by amplifying distinctive fragments of the 23S rRNA (rrl) genes. One rrl fragment acts as a general indicator of gammaproteobacterial species and confirms whether the PCR assay has functioned as intended on strains that are negative for erm(42), msr(E), and mph(E). The multiplex system has been tested on more than 40 selected isolates of P. multocida and M. haemolytica and correlated with MICs for the veterinary macrolides tulathromycin and tilmicosin, and the newer compounds gamithromycin and tildipirosin. The multiplex PCR system gives a rapid and robustly accurate determination of macrolide resistance genotypes and bacterial genus, matching results from microbiological methods and whole-genome sequencing.
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Ho PL, Li Z, Lai EL, Chiu SS, Cheng VCC. Emergence of NDM-1-producing Enterobacteriaceae in China. J Antimicrob Chemother 2012; 67:1553-5. [DOI: 10.1093/jac/dks095] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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40
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Infrequent finding of metallo-β-lactamase VIM-2 in carbapenem-resistant Pseudomonas aeruginosa strains from Croatia. Antimicrob Agents Chemother 2012; 56:2746-9. [PMID: 22371893 DOI: 10.1128/aac.05212-11] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
One hundred sixty-nine nonreplicate imipenem-resistant Pseudomonas aeruginosa strains isolated in a large hospital on the coastal region of Croatia were studied. The most active antibiotics were colistin and amikacin. Most of the isolates were multiresistant. The most prevalent serotype was O12, followed by O11. Six strains carried the bla(VIM-2) gene located in a novel class 1 integron composed in its variable part of the bla(VIM-2)-bla(oxa-10)-ΔqacF-aacA4 genes. Metallo-β-lactamase-producing strains belonged to sequence types ST235 and ST111.
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Nosocomial clustering of NDM-1-producing Klebsiella pneumoniae sequence type 340 strains in four patients at a South Korean tertiary care hospital. J Clin Microbiol 2012; 50:1433-6. [PMID: 22259206 DOI: 10.1128/jcm.06855-11] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In November 2010, NDM-1-producing Klebsiella pneumoniae (NDMKP) was identified for the first time in South Korea from four patients with no history of traveling abroad who stayed for 21 to 205 days in a tertiary care hospital. All were sequence type (ST) 340 and had nearly identical XbaI pulsed-field gel electrophoresis (PFGE) patterns. The bla(NDM-1)-carrying plasmids were in the IncN group, with sizes ranging from 50 to 200 kb. These findings suggest that NDMKP had already been introduced into South Korea before this clustering was found.
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Bush K, Fisher JF. Epidemiological expansion, structural studies, and clinical challenges of new β-lactamases from gram-negative bacteria. Annu Rev Microbiol 2012; 65:455-78. [PMID: 21740228 DOI: 10.1146/annurev-micro-090110-102911] [Citation(s) in RCA: 297] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
β-Lactamase evolution presents to the infectious disease community a major challenge in the treatment of infections caused by multidrug-resistant gram-negative bacteria. Because over 1,000 of these naturally occurring β-lactamases exist, attempts to correlate structure and function have become daunting. Although new enzymes in the extended-spectrum β-lactamase (ESBL) families are frequently identified, the older CTX-M-14 and CTX-M-15 enzymes have become the most prevalent ESBLs in global surveillance. Carbapenemases with either serine-based or zinc-facilitated hydrolysis mechanisms are posing some of the most critical problems. Most geographical regions now report KPC serine carbapenemases and the metallo-β-lactamases VIM, IMP, and NDM-1, even though NDM-1 was only recently identified. The rapid emergence of these newer enzymes, with multiple β-lactamases appearing in a single organism, makes the design of new β-lactamase inactivators or β-lactamase-stable β-lactams all the more difficult. Combination therapy will likely be required to counteract the continuing evolution of these insidious enzymes in multidrug-resistant pathogens.
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Affiliation(s)
- Karen Bush
- Biology Department, Indiana University, Bloomington, Indiana 47401, USA.
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Dissemination of an NDM-2-producing Acinetobacter baumannii clone in an Israeli rehabilitation center. Antimicrob Agents Chemother 2011; 55:5396-8. [PMID: 21825296 DOI: 10.1128/aac.00679-11] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
New Delhi metallo-β-lactamase (NDM-1) was initially identified in various Enterobacteriaceae and recently in Acinetobacter baumannii. This study described the clonal dissemination of an NDM-2-producing A. baumannii isolate in an Israeli rehabilitation ward and the genetic surroundings of the gene. The bla(NDM-2) gene was surrounded by the ble and trpF genes downstream and two copies of the ISAba125 on both sides. These are the first NDM-producing A. baumannii strains in Israel from patients with no previous travel or hospitalization on the Indian subcontinent.
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van der Bij AK, Mol M, van Westreenen M, Goessens WHF, Pitout JDD. The laboratory diagnosis of Pseudomonas aeruginosa that produce metallo-β-lactamases in a Dutch tertiary care centre. ACTA ACUST UNITED AC 2011; 43:596-602. [PMID: 21506891 DOI: 10.3109/00365548.2011.574148] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The laboratory detection of Pseudomonas aeruginosa that produce metallo-β-lactamases (MBLs) is not well defined in regions with a low prevalence of these enzymes. We report a study that developed ethylenediaminetetraacetic acid (EDTA) disk screen tests using doripenem, imipenem and meropenem and investigated the prevalence of these enzymes among clinical isolates of imipenem-resistant P. aeruginosa in Rotterdam during 2008-2009. METHODS Using strains with well-characterized β-lactamases and the Clinical and Laboratory Standards Institute (CLSI) disk methodology similar to extended-spectrum β-lactamase (ESBL) detection, inhibition zone diameters were determined in tests with doripenem, imipenem, and meropenem, alone and in combination with 370 μg of EDTA. These tests were compared with the MBL E-test. A positive test was a ≥5 mm increase in zone diameter in the presence of EDTA. RESULTS The imipenem EDTA disk screen test showed a sensitivity of 100% and a specificity of 90% in 96 recent clinical isolates. Imipenem in combination with doripenem performed better than imipenem alone, meropenem, and the MBL E-test (sensitivity of 100%; specificity of 95%). The majority of clinical isolates were isolated from patient respiratory specimens. Of the 96 imipenem-resistant P. aeruginosa isolated, 35 (36%) were positive for bla(VIM) genes. CONCLUSIONS The EDTA imipenem/doripenem disk test showed accurate and reproducible results with excellent sensitivity and specificity. It is simple to perform and interpret and can be easily introduced into the workflow of a clinical laboratory to screen for MBLs in imipenem-resistant P. aeruginosa. Due to its high specificity the test is also suitable for regions with a low prevalence of these enzymes.
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Affiliation(s)
- Akke K van der Bij
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, The Netherlands
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High prevalence of carbapenem-resistant Acinetobacter baumannii carrying the blaOXA-143 gene in Brazilian hospitals. Antimicrob Agents Chemother 2010; 55:1322-3. [PMID: 21149618 DOI: 10.1128/aac.01102-10] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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