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Demir M, Soki J, Tanrıverdi ES, Özkul C, Mahmood B, Otlu B, Hazırolan G. Molecular characterization and antibiotic resistance of clinical Bacteroides and related genera from a tertiary care center in Türkiye. Anaerobe 2024; 90:102912. [PMID: 39326493 DOI: 10.1016/j.anaerobe.2024.102912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 08/28/2024] [Accepted: 09/20/2024] [Indexed: 09/28/2024]
Abstract
OBJECTIVES This study was conducted to measure the prevalence of antibiotic resistance, and corresponding resistance genes among Bacteroides and related genera in a tertiary hospital. METHODS We examined 138 clinical strains of Bacteroides, Phocaeicola and Parabacteroides species isolated between July 2018 and June 2022. Antibiotic susceptibility tests were conducted using agar dilution. The bft gene and antibiotic resistance genes were targeted by real-time PCR. RESULTS Resistance rates of all strains against ampicillin, cefoxitin, piperacillin-tazobactam, meropenem, imipenem, clindamycin, metronidazole, and tigecycline were 97.8 %, 28.3 %, 11.6 %, 7.9 %, 5.1 %, 47.8 %, 0 % and 4.3 %, respectively. Non-fragilis Bacteroidales spp. (NFB) exhibited lower susceptibility rates compared to B. fragilis for cefoxitin, clindamycin, and piperacillin-tazobactam. The prevalence of meropenem resistance was higher in B. fragilis (15.5 %) than in NFB (0 %). Among all strains, the rates of cepA, cfxA, cfiA, ermF, ermG, ermB, nim, linA, mefA, msrSA, tetQ, tetX, tetX1 and bft genes were 42.8 %, 44.9 %, 8.7 %, 44.2 %, 10.9 %, 2.2 %, 0.7 %, 29.0 %, 17.4 %, 7.2 %, 76.1 %, 8.0 %, 37.7 % and 16.7 %, respectively. In five B. fragilis strains, insertion sequences [IS1187(n = 3), ISBf6(n = 1), IS612B(n = 1)] were detected in the upstream region of cfiA. NimE with ISBf6 on plasmid pBFM29b was detected in one B. fragilis strain, intermediate to metronidazole (MIC = 16 μg/mL). ErmF was the most abundant gene responsible for clindamycin resistance. TetQ and tetX1 genes exhibited a higher frequency in strains that were not susceptible to tigecycline (MIC ≥8 μg/ml). CONCLUSIONS Monitoring the resistance trends of Bacteroides and related genera is crucial given the observed resistance to all classes of antibiotics and the presence of various resistance mechanisms.
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Affiliation(s)
- Mervenur Demir
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye; ESCMID Study Group for Anaerobic Infections (ESGAI), Basel, Switzerland.
| | - Jozsef Soki
- ESCMID Study Group for Anaerobic Infections (ESGAI), Basel, Switzerland; Institute of Medical Microbiology, Albert Szent-Györgyi Health Centre and Medical School, University of Szeged, Szeged, Hungary.
| | - Elif Seren Tanrıverdi
- ESCMID Study Group for Anaerobic Infections (ESGAI), Basel, Switzerland; Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkiye.
| | - Ceren Özkul
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Hacettepe University, Ankara, Turkiye.
| | - Bakhtiyar Mahmood
- ESCMID Study Group for Anaerobic Infections (ESGAI), Basel, Switzerland; Institute of Medical Microbiology, Albert Szent-Györgyi Health Centre and Medical School, University of Szeged, Szeged, Hungary; Department of Biology, University of Garmian, Kalar, Kurdistan Region, Iraq.
| | - Barış Otlu
- Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkiye.
| | - Gülşen Hazırolan
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkiye; ESCMID Study Group for Anaerobic Infections (ESGAI), Basel, Switzerland.
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Cang W, Li X, Tang J, Wang Y, Mu D, Wu C, Shi H, Shi L, Wu J, Wu R. Therapeutic Potential of Bacteroides fragilis SNBF-1 as a Next-Generation Probiotic: In Vitro Efficacy in Lipid and Carbohydrate Metabolism and Antioxidant Activity. Foods 2024; 13:735. [PMID: 38472847 DOI: 10.3390/foods13050735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/11/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
This study explores the potential of aerotolerant Bacteroides fragilis (B. fragilis) strains as next-generation probiotics (NGPs), focusing on their adaptability in the gastrointestinal environment, safety profile, and probiotic functions. From 23 healthy infant fecal samples, we successfully isolated 56 beneficial B. fragilis strains. Notably, the SNBF-1 strain demonstrated superior cholesterol removal efficiency in HepG2 cells, outshining all other strains by achieving a remarkable reduction in cholesterol by 55.38 ± 2.26%. Comprehensive genotype and phenotype analyses were conducted, including sugar utilization and antibiotic sensitivity tests, leading to the development of an optimized growth medium for SNBF-1. SNBF-1 also demonstrated robust and consistent antioxidant activity, particularly in cell-free extracts, as evidenced by an average oxygen radical absorbance capacity value of 1.061 and a 2,2-diphenyl-1-picrylhydrazyl scavenging ability of 94.53 ± 7.31%. The regulation of carbohydrate metabolism by SNBF-1 was assessed in the insulin-resistant HepG2 cell line. In enzyme inhibition assays, SNBF-1 showed significant α-amylase and α-glucosidase inhibition, with rates of 87.04 ± 2.03% and 37.82 ± 1.36%, respectively. Furthermore, the cell-free supernatant (CFS) of SNBF-1 enhanced glucose consumption and glycogen synthesis in insulin-resistant HepG2 cells, indicating improved cellular energy metabolism. This was consistent with the observation that the CFS of SNBF-1 increased the proliferation of HepG2 cells by 123.77 ± 0.82% compared to that of the control. Overall, this research significantly enhances our understanding of NGPs and their potential therapeutic applications in modulating the gut microbiome.
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Affiliation(s)
- Weihe Cang
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
- Liaoning Engineering Research Center of Food Fermentation Technology, Shenyang 110866, China
| | - Xuan Li
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Jiayi Tang
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
- Shenyang Key Laboratory of Microbial Fermentation Technology Innovation, Shenyang 110866, China
| | - Ying Wang
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
- Liaoning Engineering Research Center of Food Fermentation Technology, Shenyang 110866, China
| | - Delun Mu
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
- Shenyang Key Laboratory of Microbial Fermentation Technology Innovation, Shenyang 110866, China
| | - Chunting Wu
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Haisu Shi
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Lin Shi
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
| | - Junrui Wu
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
- Shenyang Key Laboratory of Microbial Fermentation Technology Innovation, Shenyang 110866, China
| | - Rina Wu
- College of Food Science, Shenyang Agricultural University, Shenyang 110866, China
- Liaoning Engineering Research Center of Food Fermentation Technology, Shenyang 110866, China
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English J, Newberry F, Hoyles L, Patrick S, Stewart L. Genomic analyses of Bacteroides fragilis: subdivisions I and II represent distinct species. J Med Microbiol 2023; 72. [PMID: 37910167 DOI: 10.1099/jmm.0.001768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Abstract
Introduction. Bacteroides fragilis is a Gram-negative anaerobe that is a member of the human gastrointestinal microbiota and is frequently found as an extra-intestinal opportunistic pathogen. B. fragilis comprises two distinct groups - divisions I and II - characterized by the presence/absence of genes [cepA and ccrA (cfiA), respectively] that confer resistance to β-lactam antibiotics by either serine or metallo-β-lactamase production. No large-scale analyses of publicly available B. fragilis sequence data have been undertaken, and the resistome of the species remains poorly defined.Hypothesis/Gap Statement. Reclassification of divisions I and II B. fragilis as two distinct species has been proposed but additional evidence is required.Aims. To investigate the genomic diversity of GenBank B. fragilis genomes and establish the prevalence of division I and II strains among publicly available B. fragilis genomes, and to generate further evidence to demonstrate that B. fragilis division I and II strains represent distinct genomospecies.Methodology. High-quality (n=377) genomes listed as B. fragilis in GenBank were included in pangenome and functional analyses. Genome data were also subject to resistome profiling using The Comprehensive Antibiotic Resistance Database.Results. Average nucleotide identity and phylogenetic analyses showed B. fragilis divisions I and II represent distinct species: B. fragilis sensu stricto (n=275 genomes) and B. fragilis A (n=102 genomes; Genome Taxonomy Database designation), respectively. Exploration of the pangenome of B. fragilis sensu stricto and B. fragilis A revealed separation of the two species at the core and accessory gene levels.Conclusion. The findings indicate that B. fragilis A, previously referred to as division II B. fragilis, is an individual species and distinct from B. fragilis sensu stricto. The B. fragilis pangenome analysis supported previous genomic, phylogenetic and resistome screening analyses collectively reinforcing that divisions I and II are two separate species. In addition, it was confirmed that differences in the accessory genes of B. fragilis divisions I and II are primarily associated with carbohydrate metabolism and suggest that differences other than antimicrobial resistance could also be used to distinguish between these two species.
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Affiliation(s)
- Jamie English
- Institute for Global Food Security, School of Biological Sciences, Queen's University, Belfast, UK
| | - Fiona Newberry
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Lesley Hoyles
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Sheila Patrick
- Institute for Global Food Security, School of Biological Sciences, Queen's University, Belfast, UK
- Wellcome Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Linda Stewart
- Institute for Global Food Security, School of Biological Sciences, Queen's University, Belfast, UK
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Tang H, Zhou H, Zhang R. Antibiotic Resistance and Mechanisms of Pathogenic Bacteria in Tubo-Ovarian Abscess. Front Cell Infect Microbiol 2022; 12:958210. [PMID: 35967860 PMCID: PMC9363611 DOI: 10.3389/fcimb.2022.958210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
A tubo-ovarian abscess (TOA) is a common type of inflammatory lump in clinical practice. TOA is an important, life-threatening disease, and it has become more common in recent years, posing a major health risk to women. Broad-spectrum antimicrobial agents are necessary to cover the most likely pathogens because the pathogens that cause TOA are polymicrobial. However, the response rate of antibiotic treatment is about 70%, whereas one-third of patients have poor clinical consequences and they require drainage or surgery. Rising antimicrobial resistance serves as a significant reason for the unsatisfactory medical outcomes. It is important to study the antibiotic resistance mechanism of TOA pathogens in solving the problems of multi-drug resistant strains. This paper focuses on the most common pathogenic bacteria isolated from TOA specimens and discusses the emerging trends and epidemiology of resistant Escherichia coli, Bacteroides fragilis, and gram-positive anaerobic cocci. Besides that, new methods that aim to solve the antibiotic resistance of related pathogens are discussed, such as CRISPR, nanoparticles, bacteriophages, antimicrobial peptides, and pathogen-specific monoclonal antibodies. Through this review, we hope to reveal the current situation of antibiotic resistance of common TOA pathogens, relevant mechanisms, and possible antibacterial strategies, providing references for the clinical treatment of drug-resistant pathogens.
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Affiliation(s)
- Huanna Tang
- Women’s Reproductive Health Research Key Laboratory of Zhejiang Province and Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hui Zhou
- Department of Infectious Disease, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Hui Zhou, ; Runju Zhang,
| | - Runju Zhang
- Women’s Reproductive Health Research Key Laboratory of Zhejiang Province and Department of Reproductive Endocrinology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Hui Zhou, ; Runju Zhang,
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Antimicrobial-resistant Bacteroides fragilis in Thailand and their inhibitory effect in vitro on the growth of Clostridioides difficile. Anaerobe 2022; 73:102505. [DOI: 10.1016/j.anaerobe.2021.102505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/19/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022]
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Vu H, Hayashi M, Nguyen TN, Khong DT, Tran HT, Yamamoto Y, Tanaka K. Comparison of Phenotypic and Genotypic Patterns of Antimicrobial-Resistant Bacteroides fragilis Group Isolated from Healthy Individuals in Vietnam and Japan. Infect Drug Resist 2021; 14:5313-5323. [PMID: 34924764 PMCID: PMC8674666 DOI: 10.2147/idr.s341571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Normal non-pathogenic flora can harm the host by acting as a reservoir of resistance determinants that are potentially transferable to human pathogens. This study aimed to assess the phenotypic and genotypic antimicrobial susceptibility patterns of the Bacteroides fragilis group (BFG) isolated from healthy individuals in Vietnam and Japan in order to elucidate the prevalence of antimicrobial resistance in human flora in the two economically and geographically different countries. Materials and Methods BFG was isolated from fecal samples of 80 healthy individuals in Vietnam (n=51) and Japan (n=29). Isolated strains were identified using MALDI-TOF MS, and the minimum inhibitory concentration (MIC) of 18 antibiotics was determined using the agar dilution method. Additionally, 20 antimicrobial resistance genes were detected using standard PCR. Results A total of 139 BFG strains belonging to 11 BFG species were isolated from the two countries, with diversity in the prevalence of each species. B. fragilis was not the predominant species. Isolations from Vietnam and Japan showed some similarities in terms of MIC50 values, MIC90 values, and the percentage of resistant strains. However, isolations from Vietnam showed significantly higher resistance to piperacillin, cefmetazole, clindamycin, tetracycline, and minocycline. ErmB, tet36, tetM, nim, catA, and qnrA were not found in either country. CepA was more common in B. fragilis than in non-fragilis Bacteroides. In contrast, cfiA, ermG, mefA, msrSA, tetX, tetX1, bexA, qnrB, and qnrS were found only in non-fragilis Bacteroides. There were differences in the prevalence of ermG, linA, mefA, msrSA, and qnrS between isolates from Vietnam and Japan. Conclusion This study is the first report on the antimicrobial susceptibility patterns in the BFG isolated from healthy individuals in Vietnam and Japan. Compared to isolations from Japan, isolations from Vietnam showed significantly higher resistance to antimicrobial agents. The distribution of various antibiotic resistance genes also differed between the two countries.
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Affiliation(s)
- Hanh Vu
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Gifu City, Gifu, Japan
| | - Masahiro Hayashi
- Life Science Research Center, Gifu University, Gifu City, Gifu, Japan.,Institute for Glyco-core Research (iGCORE), Gifu University, Gifu City, Gifu, Japan
| | - Thang Nam Nguyen
- Center for Medical and Pharmaceutical Research and Service, Thai Binh University of Medicine and Pharmacy, Thai Binh City, Thai Binh, Vietnam
| | - Diep Thi Khong
- Center for Medical and Pharmaceutical Research and Service, Thai Binh University of Medicine and Pharmacy, Thai Binh City, Thai Binh, Vietnam
| | - Hoa Thi Tran
- Center for Medical and Pharmaceutical Research and Service, Thai Binh University of Medicine and Pharmacy, Thai Binh City, Thai Binh, Vietnam
| | - Yoshimasa Yamamoto
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Gifu City, Gifu, Japan
| | - Kaori Tanaka
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, Gifu City, Gifu, Japan.,Life Science Research Center, Gifu University, Gifu City, Gifu, Japan.,Institute for Glyco-core Research (iGCORE), Gifu University, Gifu City, Gifu, Japan
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Majewska A, Kierzkowska M, Kawecki D. What we actually know about the pathogenicity of Bacteroides pyogenes. Med Microbiol Immunol 2021; 210:157-163. [PMID: 33934237 PMCID: PMC8137477 DOI: 10.1007/s00430-021-00709-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/18/2021] [Indexed: 11/26/2022]
Abstract
The aim of the study was to evaluate the pathogenic potential of Bacteroides pyogenes, rarely identified in clinical laboratories anaerobic bacteria. To increase the knowledge about this poorly understood anaerobic microorganism, the study also includes cases of infections described so far in the literature. Only the use of 16S rRNA sequencing and mass spectrometry technique allowed the identification of B. pyogenes from clinical specimens. We reported 13 severe human infections caused by B. pyogenes. Bacteria were cultured from the wound after biting by animals, chronic infections within the oral cavity, from patients with histologically or radiological proven osteomyelitis, surgical site infection, and from urine sample collected after a urological procedure. Most (9/13) of the patients required hospitalization. Almost 70% of them needed urgent admission via the emergency room. Two inpatients due to a life-threatening condition were admitted to the intensive care unit. Almost 50% of isolates were resistant to penicillin. All resistant to penicillin strains were isolated from skin and mucous membrane infections.
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Affiliation(s)
- Anna Majewska
- Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str, 02-004, Warsaw, Poland.
| | - Marta Kierzkowska
- Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str, 02-004, Warsaw, Poland
| | - Dariusz Kawecki
- Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str, 02-004, Warsaw, Poland
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Jasemi S, Emaneini M, Ahmadinejad Z, Fazeli MS, Sechi LA, Sadeghpour Heravi F, Feizabadi MM. Antibiotic resistance pattern of Bacteroides fragilis isolated from clinical and colorectal specimens. Ann Clin Microbiol Antimicrob 2021; 20:27. [PMID: 33892721 PMCID: PMC8066845 DOI: 10.1186/s12941-021-00435-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/16/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Bacteroides fragilis is a part of the normal gastrointestinal flora, but it is also the most common anaerobic bacteria causing the infection. It is highly resistant to antibiotics and contains abundant antibiotic resistance mechanisms. METHODS The antibiotic resistance pattern of 78 isolates of B. fragilis (22 strains from clinical samples and 56 strains from the colorectal tissue) was investigated using agar dilution method. The gene encoding Bacteroides fargilis toxin bft, and antibiotic resistance genes were targeted by PCR assay. RESULTS The highest rate of resistance was observed for penicillin G (100%) followed by tetracycline (74.4%), clindamycin (41%) and cefoxitin (38.5%). Only a single isolate showed resistance to imipenem which contained cfiA and IS1186 genes. All isolates were susceptible to metronidazole. Accordingly, tetQ (87.2%), cepA (73.1%) and ermF (64.1%) were the most abundant antibiotic-resistant genes identified in this study. MIC values for penicillin, cefoxitin and clindamycin were significantly different among isolates with the cepA, cfxA and ermF in compare with those lacking such genes. In addition, 22.7 and 17.8% of clinical and GIT isolates had the bft gene, respectively. CONCLUSIONS The finding of this study shows that metronidazole is highly in vitro active agent against all of B. fragilis isolates and remain the first-line antimicrobial for empirical therapy.
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Affiliation(s)
- Seyedesomaye Jasemi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Poursina Street, Engelab-e-Eslami Avenue, Tehran, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Poursina Street, Engelab-e-Eslami Avenue, Tehran, Iran
| | - Zahra Ahmadinejad
- Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Fazeli
- Department of Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Leonardo A Sechi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Fatemah Sadeghpour Heravi
- Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Poursina Street, Engelab-e-Eslami Avenue, Tehran, Iran. .,Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
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Pricop GR, Gheorghe I, Pircalabioru GG, Cristea V, Popa M, Marutescu L, Chifiriuc MC, Mihaescu G, Bezirtzoglou E. Resistance and Virulence Features of Bacteroides spp. Isolated from Abdominal Infections in Romanian Patients. Pathogens 2020; 9:pathogens9110940. [PMID: 33198093 PMCID: PMC7696418 DOI: 10.3390/pathogens9110940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 12/16/2022] Open
Abstract
Anaerobic bacteria are predominant residents of the normal microbiota of the skin and mucous membranes but are also known to be associated with a number of human infections including peritonitis, appendicitis, abscesses, ulcers and wound infections. Herein, we investigate the antibiotic resistance profiles as well as the genetic support of antibiotic resistance and virulence determinants of anaerobic bacteria isolated from intra-abdominal infections. The study was performed on 198 Romanian patients from which different clinical samples were taken intra-operatory and sent for microbiological analyses. From the total number of isolated strains, a subset of 75 Bacteroides spp. were selected and further investigated for antibiotic resistance and virulence features, at phenotypic and genetic level. Our results obtained through the analysis of a significant number of Bacteroides strains could shed light on the virulence potential and mechanisms by which anaerobic bacteria can cause endogenous infections.
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Affiliation(s)
- Gabriela Roxana Pricop
- Faculty of Biology, Department of Microbiology and Immunology, University of Bucharest, 060101 Bucharest, Romania; (G.R.P.); (V.C.); (L.M.); (M.C.C.); (G.M.)
| | - Irina Gheorghe
- Faculty of Biology, Department of Microbiology and Immunology, University of Bucharest, 060101 Bucharest, Romania; (G.R.P.); (V.C.); (L.M.); (M.C.C.); (G.M.)
- Department of Earth, Environment and Life Sciences, The Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050095 Bucharest, Romania;
- Correspondence: (I.G.); (G.G.P.)
| | - Gratiela Gradisteanu Pircalabioru
- Department of Earth, Environment and Life Sciences, The Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050095 Bucharest, Romania;
- Correspondence: (I.G.); (G.G.P.)
| | - Violeta Cristea
- Faculty of Biology, Department of Microbiology and Immunology, University of Bucharest, 060101 Bucharest, Romania; (G.R.P.); (V.C.); (L.M.); (M.C.C.); (G.M.)
| | - Marcela Popa
- Department of Earth, Environment and Life Sciences, The Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050095 Bucharest, Romania;
| | - Luminita Marutescu
- Faculty of Biology, Department of Microbiology and Immunology, University of Bucharest, 060101 Bucharest, Romania; (G.R.P.); (V.C.); (L.M.); (M.C.C.); (G.M.)
- Department of Earth, Environment and Life Sciences, The Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050095 Bucharest, Romania;
| | - Mariana Carmen Chifiriuc
- Faculty of Biology, Department of Microbiology and Immunology, University of Bucharest, 060101 Bucharest, Romania; (G.R.P.); (V.C.); (L.M.); (M.C.C.); (G.M.)
- Department of Earth, Environment and Life Sciences, The Research Institute of the University of Bucharest (ICUB), University of Bucharest, 050095 Bucharest, Romania;
- Academy of Romanian Scientists, 050045 Bucharest, Romania
| | - Grigore Mihaescu
- Faculty of Biology, Department of Microbiology and Immunology, University of Bucharest, 060101 Bucharest, Romania; (G.R.P.); (V.C.); (L.M.); (M.C.C.); (G.M.)
| | - Eugenia Bezirtzoglou
- Laboratory of Microbiology, Biotechnology and Hygiene, Department of Food Science and Technology, Faculty of Agricultural Development, Democritus University of Thrace, 67100 Orestiada, Greece;
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Kokai-Kun JF, Le C, Trout K, Cope JL, Ajami NJ, Degar AJ, Connelly S. Ribaxamase, an Orally Administered β-Lactamase, Diminishes Changes to Acquired Antimicrobial Resistance of the Gut Resistome in Patients Treated with Ceftriaxone. Infect Drug Resist 2020; 13:2521-2535. [PMID: 32801790 PMCID: PMC7383106 DOI: 10.2147/idr.s260258] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/05/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction Intravenous (IV) β-lactam antibiotics, excreted through bile into the gastrointestinal (GI) tract, may disrupt the gut microbiome by eliminating the colonization resistance from beneficial bacteria. This increases the risk for Clostridium difficile infection (CDI) and can promote antimicrobial resistance by selecting resistant organisms and eliminating competition by non-resistant organisms. Ribaxamase is an orally administered β-lactamase for use with IV β-lactam antibiotics (penicillins and cephalosporins) and is intended to degrade excess antibiotics in the upper GI before they can disrupt the gut microbiome and alter the resistome. Methods Longitudinal fecal samples (349) were collected from patients who participated in a previous Phase 2b clinical study with ribaxamase for prevention of CDI. In that previous study, patients were treated with ceftriaxone for a lower respiratory tract infection and received concurrent ribaxamase or placebo. Extracted fecal DNA from the samples was subjected to whole-genome shotgun sequencing and analyzed for the presence of antimicrobial resistance (AMR) genes by alignment of sequences against the Comprehensive Antibiotic Resistance Database. A qPCR assay was also used to confirm some of the results. Results Database alignment identified ~1300 acquired AMR genes and gene variants, including those encoding β-lactamases and vancomycin resistance which were significantly increased in placebo vs ribaxamase-treated patients following antibiotic exposure. qPCR corroborated the presence of these genes and supported both new acquisition and expansion of existing gene pools based on no detectable copy number or a low copy number in pre-antibiotic samples which increased post-antibiotics. Additional statistical analyses demonstrated significant correlations between changes in the gut resistome and clinical study parameters including study drug assignment and β-lactamase and vancomycin resistance gene frequency. Discussion These findings demonstrated that ribaxamase reduced changes to the gut resistome subsequent to ceftriaxone administration and may help limit the emergence of AMR.
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Abstract
PURPOSE OF REVIEW Anaerobic bacteria are implicated in a broad range of infections and can cause significant morbidity and mortality. As such, development of antimicrobial resistance (AMR) increases the risk of worse clinical outcomes and death. RECENT FINDINGS Anaerobe AMR is highly variable according to region and species included in the survey. The overall trend is to increasing resistance, particularly in Europe and Asia, and in the Bacteroides fragilis group and Clostridium sp. Conversely, with the decline in RT027, resistance in Clostridiodes difficile is decreasing. Resistance to moxifloxacin and clindamycin has reached 30-50%, whereas prevalence of metronidazole and carbapenem resistance is generally low. Infections due to multidrug anaerobes have been increasingly reported, with clinical studies demonstrating adverse clinical outcomes, including higher mortality, with anaerobic resistance or inappropriate therapy. The role of antimicrobial stewardship in the setting of increasing anaerobe resistance is yet to be fully elucidated. SUMMARY These findings highlight the importance of continuous surveillance in monitoring emerging trends in anaerobe AMR. Mean inhibitory concentrations should be reported due to variable susceptibility breakpoints and for detection of isolates with reduced susceptibility. At a local level, the clinical microbiology laboratory has a key role in identifying and undertaking susceptibility testing to inform individual patient management, develop local antibiograms and liaise with antimicrobial stewardship teams. A greater understanding of the clinical impact of anaerobic resistance and the role of antimicrobial stewardship in preventing resistance is required.
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12
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Niestępski S, Harnisz M, Ciesielski S, Korzeniewska E, Osińska A. Environmental fate of Bacteroidetes, with particular emphasis on Bacteroides fragilis group bacteria and their specific antibiotic resistance genes, in activated sludge wastewater treatment plants. JOURNAL OF HAZARDOUS MATERIALS 2020; 394:122544. [PMID: 32224375 DOI: 10.1016/j.jhazmat.2020.122544] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 06/10/2023]
Abstract
The aim of this study was to determine the effect of the activated sludge process on the abundance of anaerobic bacteria of the phylum Bacteroidetes, with special emphasis on Bacteroides fragilis group (BFG) bacteria, in twelve full-scale wastewater treatment plants. The composition of bacterial phyla and classes in wastewater samples were analyzed by next-generation sequencing. The presence of specific to BFG bacteria genes and the abundance of ARGs and genes encoding class 1 integrase in wastewater samples were determined by qPCR. Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes were dominant bacterial phyla in wastewater samples. Next-generation sequencing revealed similar proportions of Bacteroidia (<1.0-8.2 % of all bacteria) in wastewater influents and effluents, which suggest that these microorganisms are not completely eliminated in the activated sludge process. The average copy numbers of specific to BFG bacteria gene, were 106, and 104 copies in 1 mL of wastewater influents and effluents, respectively. The results revealed a correlation between the abundance of BFG bacteria and BFG-specific genes encoding resistance to antibiotics. The observed changes in the prevalence of BFG-specific genes and ARGs in untreated and treated wastewater indicate that the activated sludge process decreases the number of gene copies in the effluent evacuated to the environment.
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Affiliation(s)
- Sebastian Niestępski
- Department of Environmental Microbiology, Faculty of Environmental Sciences, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1, 10-720, Olsztyn, Poland.
| | - Monika Harnisz
- Department of Environmental Microbiology, Faculty of Environmental Sciences, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1, 10-720, Olsztyn, Poland.
| | - Sławomir Ciesielski
- Department of Environmental Biotechnology, Faculty of Environmental Sciences, University of Warmia and Mazury in Olsztyn, Słoneczna 45G, 10-719, Olsztyn, Poland.
| | - Ewa Korzeniewska
- Department of Environmental Microbiology, Faculty of Environmental Sciences, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1, 10-720, Olsztyn, Poland.
| | - Adriana Osińska
- Department of Environmental Microbiology, Faculty of Environmental Sciences, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1, 10-720, Olsztyn, Poland.
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Wang Y, Han Y, Shen H, Lv Y, Zheng W, Wang J. Higher Prevalence of Multi-Antimicrobial Resistant Bacteroides spp. Strains Isolated at a Tertiary Teaching Hospital in China. Infect Drug Resist 2020; 13:1537-1546. [PMID: 32547123 PMCID: PMC7266338 DOI: 10.2147/idr.s246318] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose The study investigates the molecular epidemiology of multi-drug resistant (MDR) Bacteroides spp. isolates and the clinical characteristics of the patients. Materials and Methods Bacteroides spp. clinical strains were identified through MALDI-TOF MS and VITEK-2 anaerobes and corynebacterium (ANC) cards. A broth microdilution method was employed to detect the antimicrobial sensitivities of Bacteroides spp. isolates. PCR was used to detect the resistance genes, including cfxA, cepA, cfiA, ermF, nim, as well as the upstream insertion sequence (IS) element of the cfiA gene. The effects of broad-spectrum efflux pump inhibitors (EPIs) on the minimal inhibitory concentration (MICs) of cefoxitin, moxifloxacin, and imipenem for MDR Bacteroides spp. were investigated. Results The total resistance rates of 115 Bacteroides spp. isolates to cefoxitin, moxifloxacin, clindamycin, metronidazole, imipenem and meropenem were 4.3%, 16.5%, 80.0%, 5.2%, 13.9% and 13.9%, respectively. The positive rates of carbapenem resistance gene cfiA were 38.9% and 8.6% for B. fragilis and non-B. fragilis isolates, respectively. The isolation rate of MDR isolates reached up to 18.26% (21/115), and the isolation rate among the gastrointestinal cancer patients was significantly higher when compared to the non-gastrointestinal cancer patients (52.38%/26.08%, P = 0.006). Furthermore, MDR isolates were more likely to be isolated from the patients exposed to cephalosporins 3 months before Bacteroides spp. isolation (76.19%/31.52%, P = 0.000). Conclusion The overall resistance rates of Bacteroides spp. isolates against multiple antimicrobials were at a high level, especially for B. fragilis. The CfiA gene carrying rate among B. fragilis isolates was as high as 38.9%, and its mediated carbapenem resistance was the major resistance mechanism for B. fragilis. The findings of this study imply that the real resistance tendency of Bacteroides spp. may be underestimated and need to be given more attention.
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Affiliation(s)
- Yanyan Wang
- Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolian Medical University, Hohhot 010050, People's Republic of China
| | - Yanqiu Han
- Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolian Medical University, Hohhot 010050, People's Republic of China
| | - Huimin Shen
- Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolian Medical University, Hohhot 010050, People's Republic of China
| | - Yingying Lv
- Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolian Medical University, Hohhot 010050, People's Republic of China
| | - Wenqi Zheng
- Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolian Medical University, Hohhot 010050, People's Republic of China
| | - Junrui Wang
- Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolian Medical University, Hohhot 010050, People's Republic of China
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14
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Kierzkowska M, Majewska A, Mlynarczyk G. Trends and Impact in Antimicrobial Resistance Among Bacteroides and Parabacteroides Species in 2007-2012 Compared to 2013-2017. Microb Drug Resist 2020; 26:1452-1457. [PMID: 32407191 DOI: 10.1089/mdr.2019.0462] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose: The aim of this study was to analyze the susceptibility of Bacteroides and Parabacteroides spp. strains, isolated from patients hospitalized in the clinical hospital in Poland to penicillin, amoxicillin with clavulanic acid, imipenem, clindamycin, and metronidazole. Methods: We analyzed susceptibility of 476 isolates to routinely use for the treatment of anaerobic bacterial infections antibiotics. E test method was used to determining the minimal inhibitory concentration values. To show the trend of drug resistance, we compared data from two periods within the years 2003-2017. Results: Research results indicate that the problem of resistance is mainly related to strains belonging to non-fragilis Bacteroides. In the analyzed periods, there was an increase in the percentage of clindamycin-resistant isolates (35.21% vs. 53.33%), amoxicillin/clavulanic acid (2.83% vs. 8.15%), and imipenem (1.41% vs. 3.7%). In isolates belonging to Parabacteroides distasonis, we observed a constant high (∼50%) percentage of clindamycin-resistant strains. The overwhelming majority of B. fragilis strains were resistant to penicillin (>95%) and about 20% of the isolates were not susceptible to clindamycin. Conclusions: Clindamycin, due to the high and increasing percentage of resistant strains, may not be a good choice in the empirical therapy of infections caused by Bacteroides and P. distasonis. Our study highlighted the importance of a routine or at least periodic monitoring of antimicrobial susceptibility of anaerobic Gram-negative bacilli, providing important information for appropriate therapy. The study shows that infection caused (or suspected of being caused) by Bacteroides and Parabacteroides spp. can be empirically treated with metronidazole or imipenem.
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Affiliation(s)
- Marta Kierzkowska
- Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland.,Department of Medical Microbiology, The Infant Jesus Teaching Hospital, Warsaw, Poland
| | - Anna Majewska
- Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland.,Department of Medical Microbiology, The Infant Jesus Teaching Hospital, Warsaw, Poland
| | - Grazyna Mlynarczyk
- Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland.,Department of Medical Microbiology, The Infant Jesus Teaching Hospital, Warsaw, Poland
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15
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Jamal W, Khodakhast FB, AlAzmi A, Sόki J, AlHashem G, Rotimi VO. Prevalence and antimicrobial susceptibility of enterotoxigenic extra-intestinal Bacteroides fragilis among 13-year collection of isolates in Kuwait. BMC Microbiol 2020; 20:14. [PMID: 31941446 PMCID: PMC6964027 DOI: 10.1186/s12866-020-1703-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 01/09/2020] [Indexed: 02/08/2023] Open
Abstract
Background Some strains of Bacteroides fragilis species are associated with diarrhea as a result of enterotoxin production (bft or fragilysin). Fragilysin is activated by C11 protease (fpn) and together with C10 protease (bfp) play a significant role in its invasiveness. The objectives of this study were to investigate the proportion of clinical isolates from extra-intestinal sources that are toxin producers and characterize the genes mediating toxin production. Clinical isolates submitted to our reference laboratory over the last 13 years were screened for toxin production using PCR technique. All stool isolates were excluded. The isolates were tested for their susceptibility to 8 antimicrobial agents by E test. Carbapenem resistance gene cfiA was detected by PCR. Results A total of 421 B. fragilis isolates were viable. Out of these, bft was detected in 210 (49.9%) isolates. Of the 210 bft-positive isolates, 171 (81.4%), 33 (15.7%) and 6 (2.8%) harbored bft-1, bft-2, and bft-3 genes, respectively. Twenty (9.5%) of the bft-positive strains originated from bloodstream infections. Twenty-five, 20 and 9 strains harbored bfp-1, bfp-2 and bfp-3 gene, respectively. Two, 3, 4 bfp isotypes were detected simultaneously in some of strains. The resistance rates against amoxicillin-clavulanic acid was 32%, clindamycin 62%, cefoxitin 26%, imipenem 11%, meropenem 17%, metronidazole 4%, piperacillin 61% and tigecycline 14%. A chromosomally located cfiA gene that encode metallo-β-lactamase was identified in only 34 isolates (16.2%). Conclusions The prevalence of enterotoxin-producing B. fragilis was high among the extra-intestinal isolates. Metronidazole was the most active agent against all isolates. There was no statistically significance difference between resistance rates among bft-positive and bft-negative isolates except for clindamycin.
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Affiliation(s)
- Wafaa Jamal
- Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait.
| | - Fatima Bibi Khodakhast
- Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait
| | - Ameerah AlAzmi
- Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait
| | - Jόzsef Sόki
- Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary
| | - Ghayda AlHashem
- Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait
| | - Vincent O Rotimi
- Department of Microbiology, Faculty of Medicine, Kuwait University, P. O. Box 24923, 13110, Safat, Kuwait
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