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Minerdi D, Loqui D, Sabbatini P. Monooxygenases and Antibiotic Resistance: A Focus on Carbapenems. BIOLOGY 2023; 12:1316. [PMID: 37887026 PMCID: PMC10604202 DOI: 10.3390/biology12101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023]
Abstract
Carbapenems are a group of broad-spectrum beta-lactam antibiotics that in many cases are the last effective defense against infections caused by multidrug-resistant bacteria, such as some strains of Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Resistance to carbapenems has emerged and is beginning to spread, becoming an ongoing public-health problem of global dimensions, causing serious outbreaks, and dramatically limiting treatment options. This paper reviews the role of flavin monooxygenases in antibiotic resistance, with a specific focus on carbapenem resistance and the recently discovered mechanism mediated by Baeyer-Villiger monooxygenases. Flavin monooxygenases are enzymes involved in the metabolism and detoxification of compounds, including antibiotics. Understanding their role in antibiotic resistance is crucial. Carbapenems are powerful antibiotics used to treat severe infections caused by multidrug-resistant bacteria. However, the rise of carbapenem-resistant strains poses a significant challenge. This paper explores the mechanisms by which flavin monooxygenases confer resistance to carbapenems, examining molecular pathways and genetic factors. Additionally, this paper highlights the discovery of Baeyer-Villiger monooxygenases' involvement in antibiotic resistance. These enzymes catalyze the insertion of oxygen atoms into specific chemical bonds. Recent studies have revealed their unexpected role in promoting carbapenem resistance. Through a comprehensive analysis of the literature, this paper contributes to the understanding of the interplay between flavin monooxygenases, carbapenem resistance, and Baeyer-Villiger monooxygenases. By exploring these mechanisms, it aims to inform the development of strategies to combat antibiotic resistance, a critical global health concern.
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Affiliation(s)
- Daniela Minerdi
- Department of Agricultural, Forestry and Food Sciences, University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, TO, Italy;
| | - Davide Loqui
- Emergency Department, Città della Salute e della Scienza of Turin, 10100 Turin, TO, Italy;
| | - Paolo Sabbatini
- Department of Agricultural, Forestry and Food Sciences, University of Turin, Largo Paolo Braccini 2, 10095 Grugliasco, TO, Italy;
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2
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Liang Z, Yu Y, Wang X, Liao W, Li G, An T. The exposure risks associated with pathogens and antibiotic resistance genes in bioaerosol from municipal landfill and surrounding area. J Environ Sci (China) 2023; 129:90-103. [PMID: 36804245 DOI: 10.1016/j.jes.2022.09.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 06/18/2023]
Abstract
Pathogenic microbes with antibiotic resistance can thrive on municipal solid waste as nutrients and be aerosolized and transported to vicinities during waste disposal processes. However, the characterization of pathogenic bioaerosols and assessment of their exposure risks are lacking. Herein, particle size, concentration, activity, antibiotic resistance, and pathogenicity of airborne microorganisms were assessed in different sectors of a typical landfill. Results showed that active sector in downwind direction has the highest bioaerosol level (1234 CFU/m3), while residential area has the highest activity (14.82 mg/L). Botanical deodorizer from mist cannon can effectively remove bioaerosol. Most bioaerosols can be inhaled into respiratory system till bronchi with sizes ranging from 2.1-3.3 and 3.3-4.7 µm. Pathogenic bacteria (Bacilli, Bacillus, and Burkholderia-Paraburkholderia) and allergenic fungi (Aspergillus, Cladosporium, and Curvularia) prevailed in landfill. Although high abundance of microbial volatile organic compounds (mVOCs) producing bioaerosols were detected, these mVOCs contributed little to odor issues in landfill. Notably, surrounding areas have higher levels of antibiotic-resistance genes (ARGs) than inner landfill with tetC, acrB, acrF, mdtF, and bacA as dominant ones. Most ARGs were significantly correlated with bacterial community, while environmental parameters mainly influenced fungal prevalence. These findings can assist in reducing and preventing respiratory allergy or infection risks in occupational environments relating to waste management.
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Affiliation(s)
- Zhishu Liang
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China; Guangzhou Key Laboratory of Environmental Catalysis and Pollution Control, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, School of Environmental Science and Engineering, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China
| | - Yun Yu
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China
| | - Xiaolong Wang
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China
| | - Wen Liao
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China
| | - Guiying Li
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China; Guangzhou Key Laboratory of Environmental Catalysis and Pollution Control, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, School of Environmental Science and Engineering, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China.
| | - Taicheng An
- Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China; Guangzhou Key Laboratory of Environmental Catalysis and Pollution Control, Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control, School of Environmental Science and Engineering, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou 510006, China
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3
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Wang Y, Yang L, Wild O, Zhang S, Yang K, Wang W, Li L. ADMS simulation and influencing factors of bioaerosol diffusion from BRT under different aeration modes in six wastewater treatment plants. WATER RESEARCH 2023; 231:119624. [PMID: 36689881 DOI: 10.1016/j.watres.2023.119624] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/05/2022] [Accepted: 01/15/2023] [Indexed: 06/17/2023]
Abstract
Bioaerosols produced by municipal wastewater treatment plants (MWTP) can spread in air, thereby polluting the atmosphere and causing safety hazards to workers and surrounding residents. In this study, the biological reaction tanks (BRTs) of six MWTPs undergoing typical processes in North China, Yangtze River Delta, and the Greater Bay Area were selected to set up sampling points and investigate the production characteristics of bioaerosols. The Atmospheric Dispersion Modelling System method was used to simulate the diffusion of bioaerosols in the MWTPs. The concentrations of bacteria and, specifically, intestinal bacteria in the bioaerosols ranged from 389 CFU/m3 to 1,536 CFU/m3 and 30 CFU/m3 to 152 CFU/m3, respectively, and the proportion of the intestinal bacteria was 8.85%. The concentration of soluble chemicals (SCs) in the bioaerosols was 18.36 μg/m3-82.19 μg/m3, and the main SCs found were Mg2+, Ca2+, and SO42-. The proportion of intestinal bacteria (75.79%) produced via surface aeration by a BRT attached to large-sized bioaerosol particles was higher than that of a BRT undergoing the bottom aeration process (37.28%). The main microorganisms found in the bioaerosols included Moraxellaceae, Escherichia-Shigella, Psychrobacter, and Cyanobacteria. The generation of bioaerosols exhibited regional characteristics. The wastewater treatment scale, wastewater quality, and aeration mode were the main factors influencing bioaerosol production. Model simulation showed that, after 1 h, the diffusion distance of bioaerosol was 292 m-515 m, and the affected area was 42,895 m2-91,708 m2. The diffusion distance and range of the bioaerosols were significantly correlated with the concentration at the bioaerosol source and the aeration mode adopted by the BRTs. Wind speed and direction were two environmental factors that affected the diffusion of bioaerosols. With an increase in the diffusion distance, the concentration of microorganisms, intestinal bacteria, ions, and fine particles in the bioaerosols decreased significantly, resulting in a corresponding reduction in the exposure risk. This study provides new insights to help predict bioaerosol risks at MWTPs and identify safe areas around MWTPs. The study also provides a basis for selecting safe MWTP sites and reducing bioaerosol pollution risks.
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Affiliation(s)
- Yanjie Wang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China; State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China
| | - Liying Yang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Oliver Wild
- Lancaster Environment Centre, Lancaster University, United Kingdom
| | - Song Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Kai Yang
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China
| | - Wenwen Wang
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China
| | - Lin Li
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China.
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Cruz-López F, Martínez-Meléndez A, Villarreal-Treviño L, Morfín-Otero R, Maldonado-Garza H, Garza-González E. Contamination of healthcare environment by carbapenem-resistant Acinetobacter baumannii. Am J Med Sci 2022; 364:685-694. [PMID: 35853519 DOI: 10.1016/j.amjms.2022.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 06/12/2022] [Accepted: 07/12/2022] [Indexed: 01/25/2023]
Abstract
Acinetobacter baumannii is frequently found on floors, devices, and environmental sites in hospitals and can survive for prolonged periods and accumulate resistance determinants. The infection and presence of carbapenem-resistant A. baumannii (CRAB) in patients is associated with increased mortality, severe clinical outcomes, and longer lengths of stay at hospitals. This review addresses contamination by CRAB in corporal surfaces of patients and healthcare workers and environmental sites at healthcare-related settings. We summarized published data during the last decade on potential reservoirs for CRAB, including contamination frequency and the involved resistance mechanisms, and some measures associated with the elimination of CRAB from hospital surfaces.
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Affiliation(s)
- Flora Cruz-López
- Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Adrián Martínez-Meléndez
- Facultad de Ciencias Químicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Licet Villarreal-Treviño
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Rayo Morfín-Otero
- Hospital Civil de Guadalajara 'Fray Antonio Alcalde', e Instituto de Patología Infecciosa y Experimental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Héctor Maldonado-Garza
- Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, México
| | - Elvira Garza-González
- Facultad de Medicina y Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, México.
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5
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Yan X, Ma J, Chen X, Lei M, Li T, Han Y. Characteristics of airborne bacterial communities and antibiotic resistance genes under different air quality levels. ENVIRONMENT INTERNATIONAL 2022; 161:107127. [PMID: 35180669 DOI: 10.1016/j.envint.2022.107127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/05/2022] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
Pathogenic bacteria and antibiotic resistance genes (ARGs) in bioaerosols are major threats to human health. In this study, the microbial community structure and ARG distribution characteristics of airborne bacteria in total suspended particulates (TSP) and PM2.5 were investigated under different air quality levels in Xinxiang, Central China. The results revealed that with the deterioration of air quality, the concentrations of airborne bacteria in both TSP and PM2.5 decreased; however, the relative amounts of pathogenic bacteria increased. The predominant genera in pathogenic bacteria of Bacillus, Sphingomonas, Corynebacterium, Rhodococcus, and Staphylococcus were identified in both TSP and PM2.5. Although the airborne bacteria concentrations and absolute abundances of ARGs in TSP were higher than those in PM2.5 under identical air quality conditions, the bacterial community structure and relative amounts of pathogenic bacteria were similar. In addition, the relationship between environmental factors of ions, metal elements, and meteorological parameters and the community structures of airborne bacteria and pathogenic bacteria were also analyzed. The effects of soluble ions and metal elements on several dominant genera of total bacteria and pathogenic bacteria differed, probably due to the strong tolerance of pathogenic bacteria to harsh atmospheric environments Different subtypes of ARGs showed various distribution characteristics with variations in air quality. The deterioration of air quality can inhibit the dissemination of ARGs, as the minimum values of all ARGs and class 1 integrase intI1 were observed under Severely Polluted conditions. This study provides a comprehensive understanding of the effect of air pollution levels on the airborne bacteria community composition and ARG distribution.
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Affiliation(s)
- Xu Yan
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China.
| | - Jiahui Ma
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Xinqing Chen
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Miao Lei
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Tianning Li
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Yunping Han
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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6
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Lynch JP, Clark NM, Zhanel GG. Infections Due to Acinetobacter baumannii-calcoaceticus Complex: Escalation of Antimicrobial Resistance and Evolving Treatment Options. Semin Respir Crit Care Med 2022; 43:97-124. [PMID: 35172361 DOI: 10.1055/s-0041-1741019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Bacteria within the genus Acinetobacter (principally A. baumannii-calcoaceticus complex [ABC]) are gram-negative coccobacilli that most often cause infections in nosocomial settings. Community-acquired infections are rare, but may occur in patients with comorbidities, advanced age, diabetes mellitus, chronic lung or renal disease, malignancy, or impaired immunity. Most common sites of infections include blood stream, skin/soft-tissue/surgical wounds, ventilator-associated pneumonia, orthopaedic or neurosurgical procedures, and urinary tract. Acinetobacter species are intrinsically resistant to multiple antimicrobials, and have a remarkable ability to acquire new resistance determinants via plasmids, transposons, integrons, and resistance islands. Since the 1990s, antimicrobial resistance (AMR) has escalated dramatically among ABC. Global spread of multidrug-resistant (MDR)-ABC strains reflects dissemination of a few clones between hospitals, geographic regions, and continents; excessive antibiotic use amplifies this spread. Many isolates are resistant to all antimicrobials except colistimethate sodium and tetracyclines (minocycline or tigecycline); some infections are untreatable with existing antimicrobial agents. AMR poses a serious threat to effectively treat or prevent ABC infections. Strategies to curtail environmental colonization with MDR-ABC require aggressive infection-control efforts and cohorting of infected patients. Thoughtful antibiotic strategies are essential to limit the spread of MDR-ABC. Optimal therapy will likely require combination antimicrobial therapy with existing antibiotics as well as development of novel antibiotic classes.
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Affiliation(s)
- Joseph P Lynch
- Division of Pulmonary, Critical Care Medicine, Allergy, and Clinical Immunology; Department of Medicine; The David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Nina M Clark
- Division of Infectious Diseases, Department of Medicine, Loyola University Medical Center, Maywood, Illinois
| | - George G Zhanel
- Department of Medical Microbiology/Infectious Diseases, University of Manitoba, Max Rady College of Medicine, Winnipeg, Manitoba, Canada
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7
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Cáliz J, Subirats J, Triadó-Margarit X, Borrego CM, Casamayor EO. Global dispersal and potential sources of antibiotic resistance genes in atmospheric remote depositions. ENVIRONMENT INTERNATIONAL 2022; 160:107077. [PMID: 35016024 DOI: 10.1016/j.envint.2022.107077] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/01/2022] [Accepted: 01/02/2022] [Indexed: 06/14/2023]
Abstract
Antibiotic resistance has become a major Global Health concern and a better understanding on the global spread mechanisms of antibiotic resistant bacteria (ARB) and intercontinental ARB exchange is needed. We measured atmospheric depositions of antibiotic resistance genes (ARGs) by quantitative (q)PCR in rain/snow collected fortnightly along 4 y. at a remote high mountain LTER (Long-Term Ecological Research) site located above the atmospheric boundary layer (free troposphere). Bacterial composition was characterized by 16S rRNA gene sequencing, and air mass provenances were determined by modelled back trajectories and rain/snow chemical composition. We hypothesize that the free troposphere may act as permanent reservoir and vector for ARB and ARGs global dispersal. We aimed to i) determine whether ARGs are long-range intercontinental and persistently dispersed through aerosols, ii) assess ARGs long-term atmospheric deposition dynamics in a remote high mountain area, and iii) unveil potential diffuse ARGs pollution sources. We showed that the ARGs sul1 (resistance to sulfonamides), tetO (resistance to tetracyclines), and intI1 (a proxy for horizontal gene transfer and anthropogenic pollution) were long-range and persistently dispersed in free troposphere aerosols. Major depositions of tetracyclines resistance matched with intensification of African dust outbreaks. Potential ARB mostly traced their origin back into agricultural soils. Our study unveils that air masses pathways are shaping ARGs intercontinental dispersal and global spread of antibiotic resistances, with potential predictability for interannual variability and remote deposition rates. Because climate regulates aerosolization and long-range air masses movement patterns, we call for a more careful evaluation of the connections between land use, climate change and ARB long-range intercontinental dispersal.
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Affiliation(s)
- Joan Cáliz
- Integrative Freshwater Ecology Group, Centre of Advanced Studies of Blanes-Spanish Council for Research CEAB-CSIC, Blanes E-17300, Spain.
| | - Jèssica Subirats
- Catalan Institute for Water Research (ICRA), Scientific and Technological Park of the University of Girona, Girona E-17003, Spain
| | - Xavier Triadó-Margarit
- Integrative Freshwater Ecology Group, Centre of Advanced Studies of Blanes-Spanish Council for Research CEAB-CSIC, Blanes E-17300, Spain
| | - Carles M Borrego
- Catalan Institute for Water Research (ICRA), Scientific and Technological Park of the University of Girona, Girona E-17003, Spain; Group of Molecular Microbial Ecology, Institute of Aquatic Ecology, University of Girona, Girona E-17003, Spain
| | - Emilio O Casamayor
- Integrative Freshwater Ecology Group, Centre of Advanced Studies of Blanes-Spanish Council for Research CEAB-CSIC, Blanes E-17300, Spain.
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Gwenzi W, Shamsizadeh Z, Gholipour S, Nikaeen M. The air-borne antibiotic resistome: Occurrence, health risks, and future directions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 804:150154. [PMID: 34798728 DOI: 10.1016/j.scitotenv.2021.150154] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
Antibiotic resistance comprising of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) is an emerging problem causing global human health risks. Several reviews exist on antibiotic resistance in various environmental compartments excluding the air-borne resistome. An increasing body of recent evidence exists on the air-borne resistome comprising of antibiotic resistance in air-borne bioaerosols from various environmental compartments. However, a comprehensive review on the sources, dissemination, behavior, fate, and human exposure and health risks of the air-borne resistome is still lacking. Therefore, the current review uses the source-pathway-receptor-impact-mitigation framework to investigate the air-borne resistome. The nature and sources of antibiotic resistance in the air-borne resistome are discussed. The dissemination pathways, and environmental and anthropogenic drivers accounting for the transfer of antibiotic resistance from sources to the receptors are highlighted. The human exposure and health risks posed by air-borne resistome are presented. A health risk assessment and mitigation strategy is discussed. Finally, future research directions including key knowledge gaps are summarized.
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Affiliation(s)
- Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, Department of Agricultural and Biosystems Engineering, Faculty of Agriculture, University of Zimbabwe, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe.
| | - Zahra Shamsizadeh
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, Environmental Science and Technology Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sahar Gholipour
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahnaz Nikaeen
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Zhou Z, Berglund B, Liu J, Zhao L, Xia H, Zou H, Zhao Q, Li X. Emergence of IncX3 Plasmid-Harboring blaNDM-5 in a Citrobacter sedlakii Isolated from Outdoor Aerosol in Wastewater Treatment Plant. Microb Drug Resist 2021; 28:199-204. [PMID: 34520266 DOI: 10.1089/mdr.2021.0057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A carbapenem-resistant Citrobacter sedlakii strain AA2CS carrying blaNDM-5 was detected in outdoor aerosols of a wastewater treatment plant (WWTP) in China and the whole genome was sequenced subsequently. AA2CS was captured in an aerobic tank with aerosol particles of sizes ranging from 4.7 to 7.0 μm. Besides blaNDM-5, AA2CS also harbored 21 other antibiotic resistance genes and displayed a high level of resistance to ampicillin, cefotaxime, ceftazidime, tetracycline, and meropenem. BlaNDM-5 was located on the IncX3 plasmid (pCSNDM-5) with an IS3000-IS5-blaNDM-5-bleMBL-trpF-dsbD-IS26 structure. pCSNDM-5 was highly homologous to other blaNDM-5-carrying IncX3 plasmids in China and can be transferred to the Escherichia coli recipient J53. To our knowledge, this is the first report of carbapenem-resistant Enterobacteriaceae in outdoor aerosols in WWTPs.
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Affiliation(s)
- Ziyu Zhou
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Björn Berglund
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jiaqi Liu
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ling Zhao
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huiyu Xia
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Huiyun Zou
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qian Zhao
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xuewen Li
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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10
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Concentrations, Size Distribution, and Community Structure Characteristics of Culturable Airborne Antibiotic-Resistant Bacteria in Xinxiang, Central China. ATMOSPHERE 2021. [DOI: 10.3390/atmos12081077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Antimicrobial resistance is considered an important threat to global health and has recently attracted significant attention from the public. In this study, the concentrations and size distribution characteristics of culturable airborne total bacteria (TB) and four antibiotic-resistant bacteria (tetracycline-resistant bacteria (TRB), ciprofloxacin-resistant bacteria (CRB), erythromycin-resistant bacteria (ERB), and ampicillin-resistant bacteria (ARB)) were investigated for approximately one year to explore their variations under different seasons, diurnal periods, and air quality levels. The concentrations of TB and four antibiotic-resistant bacteria in winter and night were higher than during other seasons and diurnal periods. Their maximum concentrations were detected from air under moderate pollution or heavy pollution. PM2.5, PM10, SO2, and NO2 were positively related to TB and four antibiotic-resistant bacteria (p < 0.01), whereas O3 and wind speed were negatively related to them (p < 0.05). The particle size of TB and four antibiotic-resistant bacteria were mainly distributed in stage V (1.1–2.2 µm). Bacillus was the dominant genus of ARB (75.97%) and CRB (25.67%). Staphylococcus and Macrococcus were the dominant genera of TRB (46.05%) and ERB (47.67%), respectively. The opportunistic pathogens of Micrococcus, Sphingomonas, Enterococcus, Rhodococcus, and Stenotrophomonas were also identified. This study provides important references for understanding the threat of bioaerosols to human health.
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11
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Air dispersal of multidrug-resistant Acinetobacter baumannii: implications for nosocomial transmission during the COVID-19 pandemic. J Hosp Infect 2021; 116:78-86. [PMID: 34403765 PMCID: PMC8429036 DOI: 10.1016/j.jhin.2021.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 12/24/2022]
Abstract
AIM To describe the nosocomial transmission of Air, multidrug-resistant, Acinetobacter baumannii, nosocomial, COVID-19 Acinetobacter baumannii (MRAB) in an open-cubicle neurology ward with low ceiling height, where MRAB isolates collected from air, commonly shared items, non-reachable high-level surfaces and patients were analysed epidemiologically and genetically by whole-genome sequencing. This is the first study to understand the genetic relatedness of air, environmental and clinical isolates of MRAB in the outbreak setting. FINDINGS Of 11 highly care-dependent patients with 363 MRAB colonization days during COVID-19 pandemic, 10 (90.9%) and nine (81.8%) had cutaneous and gastrointestinal colonization, respectively. Of 160 environmental and air samples, 31 (19.4%) were MRAB-positive. The proportion of MRAB-contaminated commonly shared items was significantly lower in cohort than in non-cohort patient care (0/10, 0% vs 12/18, 66.7%; P<0.001). Air dispersal of MRAB was consistently detected during but not before diaper change in the cohort cubicle by 25-min air sampling (4/4,100% vs 0/4, 0%; P=0.029). The settle plate method revealed MRAB in two samples during diaper change. The proportion of MRAB-contaminated exhaust air grills was significantly higher when the cohort cubicle was occupied by six MRAB patients than when fewer than six patients were cared for in the cubicle (5/9, 55.6% vs 0/18, 0%; P=0.002). The proportion of MRAB-contaminated non-reachable high-level surfaces was also significantly higher when there were three or more MRAB patients in the cohort cubicle (8/31, 25.8% vs 0/24, 0%; P=0.016). Whole-genome sequencing revealed clonality of air, environment, and patients' isolates, suggestive of air dispersal of MRAB. CONCLUSIONS Our findings support the view that patient cohorting in enclosed cubicles with partitions and a closed door is preferred if single rooms are not available.
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Deering RW, Whalen KE, Alvarez I, Daffinee K, Beganovic M, LaPlante KL, Kishore S, Zhao S, Cezairliyan B, Yu S, Rosario M, Mincer TJ, Rowley DC. Identification of a bacteria-produced benzisoxazole with antibiotic activity against multi-drug resistant Acinetobacter baumannii. J Antibiot (Tokyo) 2021; 74:370-380. [PMID: 33580212 PMCID: PMC7879144 DOI: 10.1038/s41429-021-00412-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/21/2020] [Accepted: 01/04/2021] [Indexed: 01/05/2023]
Abstract
The emergence of multi-drug resistant pathogenic bacteria represents a serious and growing threat to national healthcare systems. Most pressing is an immediate need for the development of novel antibacterial agents to treat Gram-negative multi-drug resistant infections, including the opportunistic, hospital-derived pathogen, Acinetobacter baumannii. Herein we report a naturally occurring 1,2-benzisoxazole with minimum inhibitory concentrations as low as 6.25 μg ml-1 against clinical strains of multi-drug resistant A. baumannii and investigate its possible mechanisms of action. This molecule represents a new chemotype for antibacterial agents against A. baumannii and is easily accessed in two steps via de novo synthesis. In vitro testing of structural analogs suggest that the natural compound may already be optimized for activity against this pathogen. Our results demonstrate that supplementation of 4-hydroxybenzoate in minimal media was able to reverse 1,2-benzisoxazole's antibacterial effects in A. baumannii. A search of metabolic pathways involving 4-hydroxybenzoate coupled with molecular modeling studies implicates two enzymes, chorismate pyruvate-lyase and 4-hydroxybenzoate octaprenyltransferase, as promising leads for the target of 3,6-dihydroxy-1,2-benzisoxazole.
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Affiliation(s)
- Robert W Deering
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
| | | | - Ivan Alvarez
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
| | - Kathryn Daffinee
- Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Maya Beganovic
- Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Kerry L LaPlante
- Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
| | - Shreya Kishore
- Department of Biology, Haverford College, Haverford, PA, USA
| | - Sijing Zhao
- Department of Biology, Haverford College, Haverford, PA, USA
| | | | - Shen Yu
- Octagon Therapeutics, Inc., Cambridge, MA, USA
| | - Margaret Rosario
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
| | - Tracy J Mincer
- Wilkes Honors College and Harbor Branch Oceanographic Institute, Florida Atlantic University, Boca Raton, FL, USA.
| | - David C Rowley
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, USA.
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El Hafa H, Nayme K, Sbiti M, Timinouni M, Belhaj A. Evaluation of genetic diversity of carbapenem-resistant Acinetobacter baumannii isolates using ERIC-PCR. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lima WG, Silva Alves GC, Sanches C, Antunes Fernandes SO, de Paiva MC. Carbapenem-resistant Acinetobacter baumannii in patients with burn injury: A systematic review and meta-analysis. Burns 2019; 45:1495-1508. [DOI: 10.1016/j.burns.2019.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/09/2019] [Accepted: 07/03/2019] [Indexed: 12/25/2022]
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15
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El Hafa H, Nayme K, El Hamzaoui N, Maroui I, Sbiti M, Zerouali K, Timinouni M, Belhaj A. Dissemination of carbapenem-resistant Acinetobacter baumannii strains carrying the bla GES, bla NDM and bla OXA23 in Morocco. Germs 2019; 9:133-141. [PMID: 31646143 DOI: 10.18683/germs.2019.1168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 07/27/2019] [Accepted: 08/05/2019] [Indexed: 01/18/2023]
Abstract
Background Acinetobacter baumannii is a microorganism which has been classified by the World Health Organization in the list of the bacterial strains that pose the biggest danger to human health. This study was performed to determine the susceptibility profile to carbapenems and to detect carbapenemases production in 111 A. baumannii isolates. Among these 30 are environmental isolates and 81 are from the three major hospitals in Morocco. Methods All strains of A. baumannii were tested against diverse antimicrobial agents (13 antibiotic drugs) by the agar diffusion test. Minimum inhibitory concentration (MIC) of imipenem on carbapenem-resistant strains (CRAB) was determined by the E-test technique. Simple phenotypic tests were used to detect carbapenemases and metallo-β-lactamases (MBLs) production including the modified Hodge test, EDTA test, and the cloxacillin test. The presence of carbapenemases-encoding resistance genes of CRAB strains was examined using polymerase chain reaction (PCR). Results Carbapenem resistance was observed in 23 clinical Acinetobacter isolates showing dissemination of the multiresistance profile. Molecular biology techniques indicated that all these strains encoded the naturally occurring bla OXA-51-like gene and were proved as A. baumannii. The bla OXA-23 gene was detected in 16 strains (69.6%). The metallo-β-lactamase bla NDM gene was detected in five isolates (21.7%). GES-type carbapenemases were found in 15 strains, the existence of three classes of carbapenemases (bla GES, bla NDM, and bla OXA-23) was detected in three strains, while none of the CRAB isolates contained the bla OXA-58, bla OXA-24, bla VIM, bla OXA-48 or bla KPC encoding genes. Conclusions This study established baseline proof of three classes of carbapenemases producing A. baumannii in Morocco, showing the important role of surveillance in controlling their spread.
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Affiliation(s)
- Hanane El Hafa
- MD, Team of Ecology and Biodiversity of Wetlands, Department of Biology, Moulay Ismail University Faculty of Sciences, BP 11201 Zitoune Meknes, Morocco
| | - Kawtar Nayme
- PhD, Molecular Bacteriology Laboratory, Pasteur Institute of Morocco, 1, Place Louis Pasteur, 20360 Casablanca, Morocco
| | - Najia El Hamzaoui
- PhD, Medical Biology Laboratory of Regional Hospital Mohammed V, Mohamed Zerktouni Street, BP 50000 Meknes, Morocco
| | - Itto Maroui
- PhD, Basic Sciences Department, Faculty of Dental Medicine, Mohammed V University of Rabat, BP 6212 Madinat Al Irfane, Rabat, Morocco
| | - Mohammed Sbiti
- Dr, Microbiology Department, Moulay Ismail Military Hospital, El Hansali Street, 50000 Meknes, Morocco
| | - Khalid Zerouali
- PhD, Microbiology Laboratory, University Hospital Center, Ibn Rochd, 1 Street Hospital, 20360 Casablanca, Morocco
| | - Mohammed Timinouni
- PhD, Molecular Bacteriology Laboratory, Pasteur Institute of Morocco, 1, Place Louis Pasteur, 20360 Casablanca, Morocco
| | - Abdelhaq Belhaj
- PhD, Team of Ecology and Biodiversity of Wetlands, Department of Biology, Moulay Ismail University Faculty of Sciences, BP 11201 Zitoune Meknes, Morocco
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Zhang T, Li X, Wang M, Chen H, Yang Y, Chen QL, Yao M. Time-resolved spread of antibiotic resistance genes in highly polluted air. ENVIRONMENT INTERNATIONAL 2019; 127:333-339. [PMID: 30953816 DOI: 10.1016/j.envint.2019.03.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 02/26/2019] [Accepted: 03/02/2019] [Indexed: 06/09/2023]
Abstract
Antibiotic resistance genes (ARGs) have emerged as a global health concern. A large volume of work has already been devoted to ARGs in aquatic ecosystems. However, ARG dispersal patterns in air remain to be largely unknown despite of its greater role in transmission. This work aims to investigate time-resolved airborne spread of ARGs and their corresponding subtype bacterial carriers in highly polluted air. Time-resolved air samples (20 m3 each with three samples) were collected using a high volume sampler (1 m3/min) every 4 h continuously (both day and night) during low (14-93 μg/m3) and high PM2.5 (36-205 μg/m3) pollution times (over 6 days with a total of 69 air samples) in Beijing. All air samples were subjected to 16S rRNA sequence analysis for 39 ARG subtypes. Pure culturable bacterial isolates from Beijing and Shijiazhuang were Sanger sequenced for species identification and also subjected to high throughput ARG subtype detection. ARG and its subtype relative abundances in the air were observed to differ greatly (up to 3 folds for abundance) both day and night, and the blaTEM gene was found to lead the ARG abundance. For an early morning time, the multi-drug resistant NDM-1 gene was detected up to 30% of total ARG abundance in highly polluted air. Identified as a major NDM-1 and vanB gene carrier, Bacillus halotolerans were also shown to disseminate more ARG subtypes. On another front, tnpA and intI1 were shown to vary greatly in abundance, while the sul3 gene was found widespread among the culturable Bacillus isolates in the air. Principal component analysis (PCA) showed different gene co-occurrence networks for different PM2.5 pollution episodes, e.g., tnpA and intI1 for gene transfer and integration, respectively, were found more abundant for the high PM2.5 pollution episode. This study highlights a serious yet previously unidentified public health threat from time-resolved airborne spread of ARGs. Further work is urgently warranted to track the sources of ARGs for their optimized control during high PM2.5 pollution episodes.
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Affiliation(s)
- Ting Zhang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xinyue Li
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Minfei Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Haoxuan Chen
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Ying Yang
- South China Sea Resource Exploitation and Protection Collaborative Innovation Center, School of Marine Sciences, Sun Yat-sen University, Guangzhou 510275, China
| | - Qing-Lin Chen
- Key Lab of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Maosheng Yao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
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Acinetobacter in veterinary medicine, with an emphasis on Acinetobacter baumannii. J Glob Antimicrob Resist 2018; 16:59-71. [PMID: 30144636 DOI: 10.1016/j.jgar.2018.08.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 08/11/2018] [Accepted: 08/14/2018] [Indexed: 12/21/2022] Open
Abstract
Acinetobacter spp. are aerobic, rod-shaped, Gram-negative bacteria belonging to the Moraxellaceae family of the class Gammaproteobacteria and are considered ubiquitous organisms. Among them, Acinetobacter baumannii is the most clinically significant species with an extraordinary ability to accumulate antimicrobial resistance and to survive in the hospital environment. Recent reports indicate that A. baumannii has also evolved into a veterinary nosocomial pathogen. Although Acinetobacter spp. can be identified to species level using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS) coupled with an updated database, molecular techniques are still necessary for genotyping and determination of clonal lineages. It appears that the majority of infections due to A. baumannii in veterinary medicine are nosocomial. Such isolates have been associated with several types of infection such as canine pyoderma, feline necrotizing fasciitis, urinary tract infection, equine thrombophlebitis and lower respiratory tract infection, foal sepsis, pneumonia in mink, and cutaneous lesions in hybrid falcons. Given the potential multidrug resistance of A. baumannii, treatment of diseased animals is often supportive and should preferably be based on in vitro antimicrobial susceptibility testing results. It should be noted that animal isolates show high genetic diversity and are in general distinct in their sequence types and resistance patterns from those found in humans. However, it cannot be excluded that animals may occasionally play a role as a reservoir of A. baumannii. Thus, it is of importance to implement infection control measures in veterinary hospitals to avoid nosocomial outbreaks with multidrug-resistant A. baumannii.
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The Role of Environmental Contamination in the Transmission of Nosocomial Pathogens and Healthcare-Associated Infections. Curr Infect Dis Rep 2018; 20:12. [PMID: 29704133 DOI: 10.1007/s11908-018-0620-2] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE OF REVIEW The aim of this review is to highlight the role of environmental contamination in healthcare-associated infections (HAIs) and to discuss the most commonly implicated nosocomial pathogens. RECENT FINDINGS Recent studies suggest that environmental contamination plays a significant role in HAIs and in the unrecognized transmission of nosocomial pathogens during outbreaks, as well as ongoing sporadic transmission. Several pathogens can persist in the environment for extended periods and serve as vehicles of transmission and dissemination in the hospital setting. Cross-transmission of these pathogens can occur via hands of healthcare workers, who become contaminated directly from patient contact or indirectly by touching contaminated environmental surfaces. Less commonly, a patient could become colonized by direct contact with a contaminated environmental surface. This review describes the role of environmental contamination in HAIs and provides context for reinforcing the importance of hand hygiene and environmental decontamination for the prevention and control of HAIs.
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Identification and Isolation of Insertion Sequences, in Carbapenem Resistant Clinical Isolates of Acinetobacter baumannii from Tehran Hospitals. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.58251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Munier AL, Biard L, Rousseau C, Legrand M, Lafaurie M, Lomont A, Donay JL, de Beaugrenier E, Flicoteaux R, Mebazaa A, Mimoun M, Molina JM. Incidence, risk factors, and outcome of multidrug-resistant Acinetobacter baumannii acquisition during an outbreak in a burns unit. J Hosp Infect 2017; 97:226-233. [PMID: 28751010 DOI: 10.1016/j.jhin.2017.07.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/19/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Multidrug-resistant Acinetobacter baumannii (MR-AB) can cause outbreaks in a burns unit. AIM To study the incidence, risk factors and outcome of MR-AB colonization during an outbreak. METHODS A prospective study was conducted from April to November 2014 in a burns unit in Paris. Weekly surveillance cultures of patients and their environment were performed. MR-AB acquisition, discharge, or death without MR-AB colonization were considered as competing events. To identify risk factors for colonization, baseline characteristics and time-dependent variables were investigated in univariate and multivariate analyses using Cox models. MR-AB strains were genotypically compared using multi-locus sequence typing. FINDINGS Eighty-six patients were admitted in the burns unit during the study period. Among 77 patients without MR-AB colonization at admission, 25 (32%) acquired MR-AB with a cumulative incidence of 30% at 28 days (95% CI: 20-40). Median time to MR-AB acquisition was 13 days (range: 5-34). In multivariate analysis, risk factors for MR-AB acquisition were ≥2 skin graft procedures performed [hazard ratio (HR): 2.97; 95% confidence interval (CI): 1.10-8.00; P = 0.032] and antibiotic therapy during hospitalization (HR: 4.42; 95% CI: 1.19-16.4; P = 0.026). A major sequence type of MR-AB (ST2) was found in 94% and 92% of patients and environmental strains, respectively, with all strains harbouring the blaOXA-23 gene. MR-AB colonization increased length of hospitalization (HR: 0.32; 95% CI: 0.17-0.58; P = 0.0002) by a median of 12 days. CONCLUSION A high incidence of MR-AB acquisition was seen during this outbreak with most strains from patients and their environment belonging to single sequence type. MR-AB colonization was associated with more skin graft procedures, antibiotic use, and prolonged hospitalization.
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Affiliation(s)
- A-L Munier
- Infectious Disease Department, St Louis Hospital, APHP and University Paris Diderot, Paris, France.
| | - L Biard
- Department of Biostatistics, St Louis Hospital, APHP and University Paris Diderot, Paris, France
| | - C Rousseau
- Microbiology Department, St Louis Hospital, APHP and EA4065, University Paris Descartes, Paris, France
| | - M Legrand
- Department of Anesthesiology, Critical Care and Burn Unit, St Louis Hospital, APHP and University Paris Diderot, Paris, France; INSERM U942, France
| | - M Lafaurie
- Infectious Disease Department, St Louis Hospital, APHP and University Paris Diderot, Paris, France
| | - A Lomont
- Microbiology Department, St Louis Hospital, APHP and EA4065, University Paris Descartes, Paris, France
| | - J-L Donay
- Microbiology Department, St Louis Hospital, APHP and EA4065, University Paris Descartes, Paris, France
| | - E de Beaugrenier
- Pharmacy Department, St Louis Hospital, APHP and University Paris Diderot, Paris, France
| | - R Flicoteaux
- Department of Biostatistics, St Louis Hospital, APHP and University Paris Diderot, Paris, France
| | - A Mebazaa
- Department of Anesthesiology, Critical Care and Burn Unit, St Louis Hospital, APHP and University Paris Diderot, Paris, France
| | - M Mimoun
- Plastic Surgery Department, St Louis Hospital, APHP and University Paris Diderot, Paris, France
| | - J-M Molina
- Infectious Disease Department, St Louis Hospital, APHP and University Paris Diderot, Paris, France
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Shamsizadeh Z, Nikaeen M, Nasr Esfahani B, Mirhoseini SH, Hatamzadeh M, Hassanzadeh A. Detection of antibiotic resistant Acinetobacter baumannii in various hospital environments: potential sources for transmission of Acinetobacter infections. Environ Health Prev Med 2017; 22:44. [PMID: 29165152 PMCID: PMC5664838 DOI: 10.1186/s12199-017-0653-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background Antibiotic resistant Acinetobacter baumannii has emerged as one of the most problematic hospital acquired pathogens around the world. This study was designed to investigate the presence of antibiotic resistant A. baumannii in various hospital environments. Methods Air, water and inanimate surface samples were taken in different wards of four hospitals and analyzed for the presence of A. baumannii. Confirmed A. baumannii isolates were analyzed for antimicrobial susceptibility and also screened for the presence of three most common OXA- type carbapenemase-encoding genes. Results A. baumannii was detected in 11% (7/64) of air samples with the highest recovery in intensive care units (ICUs). A. baumannii was also detected in 17% (7/42) and 2% (1/42) of surface and water samples, respectively. A total of 40 A. baumannii isolates were recovered and analysis of antimicrobial susceptibility showed the highest resistance towards ceftazidime (92.5%, 37/40). 85% (34/40) and 80% (32/40) of the isolates were also resistant to imipenem and gentamicin, respectively. Resistance genes analysis showed that 77.5% (31/40) strains contained OXA-23 and 5% (2/40) strains contained OXA-24, but OXA-58 was not detected in any of the strains. Conclusion Detection of antibiotic resistant A. baumannii in various samples revealed that hospital environments could act as a potential source for transmission of A. baumannii infections especially in ICUs. These results emphasize the importance of early detection and implementation of control measures to prevent the spread of A. baumannii in hospital environments.
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Affiliation(s)
- Zahra Shamsizadeh
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Iran
| | - Mahnaz Nikaeen
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Iran.
| | - Bahram Nasr Esfahani
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Hamed Mirhoseini
- Department of Environmental Health Engineering, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Maryam Hatamzadeh
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Iran
| | - Akbar Hassanzadeh
- Department of Statistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
Inhalation exposes the upper and lower respiratory tracts of humans to a variety of airborne particles and vapors. Airborne transmission of pathogenic microorganisms to humans from the environment, animals, or other humans can result in disease. Inhalation is an important route of exposure as the lung is more susceptible to infection than the gastrointestinal tract. Ingested microorganisms must pass through the acidic environment of the stomach before they can colonize tissue while inhaled microorganisms are deposited directly on the moist surfaces of the respiratory tract. Inhalation of microbial aerosols can elicit adverse human health effects including infection, allergic reaction, inflammation, and respiratory disease. Following inhalation, infectious viruses, bacteria, and fungi can establish in host cells of the respiratory tract. Some are translocated and infect the gastrointestinal tract and other tissues. This article discusses human viral, bacterial, and fungal diseases transmitted via aerosols. Viral diseases presented are influenza, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), enteric viruses related infections, hantavirus disease, measles, and varicella. Bacterial diseases are Legionnaires’ disease, tuberculosis, and nontubercule mycobacterial disease. Exposure to some Gram-negative and Gram-positive bacteria, endotoxin, and actinomycetes when dispersed through the air can result in disease following inhalation. Fungal diseases included are histoplasmosis, coccidiomycosis, blastomycosis, cryptococcosis, and aspergillosis. The threat of bioterrorism with airborne infectious agents is also briefly presented.
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Detection of ISAba1 in Acinetobacter baumannii Strains Carrying OXA Genes Isolated From Iranian Burns Patients. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.39307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gong Y, Shen X, Huang G, Zhang C, Luo X, Yin S, Wang J, Hu F, Peng Y, Li M. Epidemiology and resistance features of Acinetobacter baumannii isolates from the ward environment and patients in the burn ICU of a Chinese hospital. J Microbiol 2016; 54:551-8. [PMID: 27480635 DOI: 10.1007/s12275-016-6146-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/20/2016] [Accepted: 06/29/2016] [Indexed: 01/13/2023]
Abstract
Acinetobacter baumannii is an important opportunistic pathogen that causes severe nosocomial infections, especially in intensive care units (ICUs). Over the past decades, an everincreasing number of hospital outbreaks caused by A. baumannii have been reported worldwide. However, little attention has been directed toward the relationship between A. baumannii isolates from the ward environment and patients in the burn ICU. In this study, 88 A. baumannii isolates (26 from the ward environment and 62 from patients) were collected from the burn ICU of the Southwest Hospital in Chongqing, China, from July through December 2013. Antimicrobial susceptibility testing results showed that drug resistance was more severe in isolates from patients than from the ward environment, with all of the patient isolates being fully resistant to 10 out of 19 antimicrobials tested. Isolations from both the ward environment and patients possessed the β-lactamase genes bla OXA-51, bla OXA-23, bla AmpC, bla VIM, and bla PER. Using pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), these isolates could be clustered into 4 major PFGE types and 4 main sequence types (ST368, ST369, ST195, and ST191) among which, ST368 was the dominant genotype. Epidemiologic and molecular typing data also revealed that a small-scale outbreak of A. baumannii infection was underway in the burn ICU of our hospital during the sampling period. These results suggest that dissemination of β-lactamase genes in the burn ICU might be closely associated with the high-level resistance of A. baumannii, and the ICU environment places these patients at a high risk for nosocomial infection. Cross-contamination should be an important concern in clinical activities to reduce hospitalacquired infections caused by A. baumannii.
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Affiliation(s)
- Yali Gong
- Department of Microbiology, Third Military Medical University, Chongqing, 400038, P. R. China.,Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Xiaodong Shen
- Department of Biochemistry and Molecular Biology, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Guangtao Huang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Cheng Zhang
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Xiaoqiang Luo
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Supeng Yin
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Jing Wang
- Department of Microbiology, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Fuquan Hu
- Department of Microbiology, Third Military Medical University, Chongqing, 400038, P. R. China
| | - Yizhi Peng
- Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, 400038, P. R. China.
| | - Ming Li
- Department of Microbiology, Third Military Medical University, Chongqing, 400038, P. R. China.
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Prevalence of and risk factors for multidrug-resistant Acinetobacter baumannii colonization among high-risk nursing home residents. Infect Control Hosp Epidemiol 2015; 36:1155-62. [PMID: 26072936 DOI: 10.1017/ice.2015.143] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To characterize the epidemiology of multidrug-resistant (MDR) Acinetobacter baumannii colonization in high-risk nursing home (NH) residents. DESIGN Nested case-control study within a multicenter prospective intervention trial. SETTING Four NHs in Southeast Michigan. PARTICIPANTS Case patients and control subjects were NH residents with an indwelling device (urinary catheter and/or feeding tube) selected from the control arm of the Targeted Infection Prevention study. Cases were residents colonized with MDR (resistant to ≥3 classes of antibiotics) A. baumannii; controls were never colonized with MDR A. baumannii. METHODS For active surveillance cultures, specimens from the nares, oropharynx, groin, perianal area, wounds, and device insertion site(s) were collected upon study enrollment, day 14, and monthly thereafter. A. baumannii strains and their susceptibilities were identified using standard microbiologic methods. RESULTS Of 168 NH residents, 25 (15%) were colonized with MDR A. baumannii. Compared with the 143 controls, cases were more functionally disabled (Physical Self-Maintenance Score >24; odds ratio, 5.1 [95% CI, 1.8-14.9]; P<.004), colonized with Proteus mirabilis (5.8 [1.9-17.9]; P<.003), and diabetic (3.4 [1.2-9.9]; P<.03). Most cases (22 [88%]) were colonized with multiple antibiotic-resistant organisms and 16 (64%) exhibited co-colonization with at least one other resistant gram-negative bacteria. CONCLUSION Functional disability, P. mirabilis colonization, and diabetes mellitus are important risk factors for colonization with MDR A. baumannii in high-risk NH residents. A. baumannii exhibits widespread antibiotic resistance and a preference to colonize with other antibiotic-resistant organisms, meriting enhanced attention and improved infection control practices in these residents.
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Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients. Infect Control Hosp Epidemiol 2015; 36:830-2. [PMID: 25825865 DOI: 10.1017/ice.2015.68] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Using a validated air sampling method we found Acinetobacter baumannii in the air surrounding only 1 of 12 patients known to be colonized or infected with A. baumannii. Patients' closed-circuit ventilator status, frequent air exchanges in patient rooms, and short sampling time may have contributed to this low burden.
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Obeidat N, Jawdat F, Al-Bakri AG, Shehabi AA. Major biologic characteristics of Acinetobacter baumannii isolates from hospital environmental and patients' respiratory tract sources. Am J Infect Control 2014; 42:401-4. [PMID: 24679567 DOI: 10.1016/j.ajic.2013.10.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 10/11/2013] [Accepted: 10/14/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND This prospective study investigated major biologic characteristics of Acinetobacter baumannii isolates from hospital environment and respiratory tract samples of patients admitted to adult intensive care units (ICUs) at the Jordan University Hospital. METHODS A baumannii isolates from both sources were examined for antimicrobial susceptibility and for presence of specific metallo-β-lactamase genes (VIM-2, IMP-1) and OXA-type β-lactamase genes (OXA-type) using polymerase chain reaction and biofilm formation and surviving under various temperatures and pH conditions. RESULTS The majority of A baumannii isolates from environmental and patients sources was multidrug resistant (MDR), except for colistin and tigecycline. All A baumannii examined carried a blaOXA51-like gene, 58% has a blaOXA23-like gene, and 38.8% has a blaOXA24-like gene. Representative MDR A baumannii isolates from both sources were capable to form biofilm. A baumannii environmental isolates were capable to survive for a longer time in tap, normal saline, and distilled water than respiratory tract isolates with pH range of 4.5 to 8 and temperature between 18°C to 37°C. CONCLUSIONS This study demonstrates that A baumannii isolates from the patients' respiratory tract and hospital environment carried much similar multidrug resistance patterns and biologic characteristics. In conclusion, this study shows that all MDR A baumannii strains survived well in the hospital environment, especially in water and moist environment and produced biofilm, which might be responsible for high colonization in the respiratory tract of patients in ICU.
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