1
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Ewbank AC, Fuentes-Castillo D, Sacristán C, Cardoso B, Esposito F, Fuga B, de Macedo EC, Lincopan N, Catão-Dias JL. Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli survey in wild seabirds at a pristine atoll in the southern Atlantic Ocean, Brazil: First report of the O25b-ST131 clone harboring bla CTX-M-8. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150539. [PMID: 34852430 DOI: 10.1016/j.scitotenv.2021.150539] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/03/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
Antimicrobial resistance is among the most serious public health threats of the 21st century, with great impact in terms of One Health. Among antimicrobial resistant bacteria (ARB), extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) represent major challenges to human healthcare. Wild birds have been commonly used as environmental bioindicators of ESBL-EC. Remote locations represent a unique opportunity to evaluate the occurrence, dissemination and epidemiology of ARB in the environment. Herein we surveyed ESBL-EC in 204 cloacal swabs from six nonsynanthropic seabird species at the pristine Rocas Atoll, Brazil. We identified ESBL-EC isolates in 2.4% (5/204) of the tested seabirds, all in magnificent frigatebirds (Fregata magnificens). We isolated strains of O25b-ST131-fimH22 harboring gene blaCTX-M-8 (3 clones), ST117 harboring gene blaSHV-12, and a novel ST11350 (clonal complex 349) harboring genes blaCTX-M-55 and fosA3. All the isolates presented Extraintestinal pathogenic E. coli (ExPEC) virulence profiles. We suggest that magnificent frigatebirds may act as "flying bridges", transporting ESBL-EC and ARGs from an anthropogenically-impacted archipelago geographically close to our pristine and remote study site. The characteristics of our isolates suggest zoonotic potential and, despite the apparent good health of all the evaluated birds, may represent a hypothetical potential threat to the avian population using the atoll. To our knowledge, this is the first description of: (1) the pandemic and public health relevant ST131-O25b harboring blaCTX-M-8 worldwide; (2) ST131-fimH22 in wild birds; and (3); fosA3 in wildlife. Our findings expand the current epidemiological knowledge regarding host and geographical distribution of ESBL-EC and ARGs in wild birds, and emphasize the disseminating characteristics and adaptability of ST131 and ST117 strains within the human-animal-interface. Herein we discuss the involvement of nonsynanthropic wild birds in the epidemiology of antimicrobial resistance and their potential as sentinels of ESBL E. coli in insular environments.
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Affiliation(s)
- Ana Carolina Ewbank
- Laboratory of Wildlife Comparative Pathology, Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, Brazil.
| | - Danny Fuentes-Castillo
- Laboratory of Wildlife Comparative Pathology, Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, Brazil; One Health Brazilian Resistance Project (OneBR), São Paulo, Brazil.
| | - Carlos Sacristán
- Laboratory of Wildlife Comparative Pathology, Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, Brazil.
| | - Brenda Cardoso
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; One Health Brazilian Resistance Project (OneBR), São Paulo, Brazil.
| | - Fernanda Esposito
- Department of Clinical Analysis, Faculty of Pharmacy, University of São Paulo, São Paulo, Brazil.; One Health Brazilian Resistance Project (OneBR), São Paulo, Brazil.
| | - Bruna Fuga
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Department of Clinical Analysis, Faculty of Pharmacy, University of São Paulo, São Paulo, Brazil.; One Health Brazilian Resistance Project (OneBR), São Paulo, Brazil.
| | - Eduardo Cavalcante de Macedo
- Chico Mendes Institute for Biodiversity Conservation (ICMBio) - Brazilian Ministry of the Environment, Rocas Atol Biological Reserve, Rio Grande do Norte, Brazil.
| | - Nilton Lincopan
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Department of Clinical Analysis, Faculty of Pharmacy, University of São Paulo, São Paulo, Brazil.; One Health Brazilian Resistance Project (OneBR), São Paulo, Brazil.
| | - José Luiz Catão-Dias
- Laboratory of Wildlife Comparative Pathology, Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, São Paulo, Brazil.
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Furlan JPR, Lopes R, Ramos MS, Dos Santos LDR, da Silva Rosa R, Savazzi EA, Stehling EG. Colistin-resistant mcr-1-positive Escherichia coli ST1775-H137 co-harboring bla CTX-M-2 and bla CMY-2 recovered from an urban stream. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2021; 96:105156. [PMID: 34823029 DOI: 10.1016/j.meegid.2021.105156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/04/2021] [Accepted: 11/19/2021] [Indexed: 12/31/2022]
Abstract
The rapid dissemination of colistin resistance mcr-type genes and extended-spectrum β-lactamase-encoding genes at the human-animal-environment interface has raised concerns worldwide. In this study, we performed a genomic investigation of a multidrug (MDR)- and colistin-resistant Escherichia coli strain recovered from an urban stream strongly affected by pollution and used for recreational purposes in Brazil. E. coli strain EW827 was resistant to clinically significant antimicrobials, including polymyxins, extended-spectrum cephalosporins, and fluoroquinolones. Whole-genome sequencing analysis revealed that EW827 strain belonged to ST1775 and carried the fimH137 allele, clinically relevant antimicrobial resistance genes (e.g., mcr-1.1, blaCTX-M-2, and blaCMY-2), tolerance genes to metals, and biocide resistance genes. Moreover, IncX4 and IncI1-ST12 replicon types were identified carrying mcr-1.1 and blaCMY-2, respectively. A novel genetic environment of the mcr-1.1 gene, in which a 258-bp ∆IS5-like was inserted in the opposite orientation upstream of the mcr-1.1-pap2 element, was also detected. Additionally, the blaCTX-M-2 gene was harbored by a Tn21-like element on the chromosome. The occurrence of MDR E. coli co-harboring mcr-1.1, blaCTX-M-2, and blaCMY-2 in urban water represents a potential risk to humans, animals, and environmental safety. Therefore, epidemiological studies are required to monitoring multidrug-resistant bacteria and their antimicrobial resistance genes in aquatic ecosystems to determine possible routes and fates of these genes.
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Affiliation(s)
- João Pedro Rueda Furlan
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP) - Ribeirão Preto, Brazil
| | - Ralf Lopes
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP) - Ribeirão Preto, Brazil
| | - Micaela Santana Ramos
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP) - Ribeirão Preto, Brazil
| | - Lucas David Rodrigues Dos Santos
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP) - Ribeirão Preto, Brazil
| | - Rafael da Silva Rosa
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP) - Ribeirão Preto, Brazil
| | | | - Eliana Guedes Stehling
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP) - Ribeirão Preto, Brazil.
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3
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Conte D, Palmeiro J, Bavaroski A, Rodrigues L, Cardozo D, Tomaz A, Camargo J, Dalla‐Costa L. Antimicrobial resistance in
Aeromonas
species isolated from aquatic environments in Brazil. J Appl Microbiol 2021; 131:169-181. [DOI: https:/doi.org/10.1111/jam.14965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- D. Conte
- Faculdades Pequeno Príncipe (FPP) Curitiba, Paraná Brazil
- Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP) Curitiba, Paraná Brazil
| | - J.K. Palmeiro
- Faculdades Pequeno Príncipe (FPP) Curitiba, Paraná Brazil
- Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP) Curitiba, Paraná Brazil
- Departamento de Análises Clínicas Universidade Federal de Santa Catarina (ACL‐UFSC) Florianópolis, Santa Catarina Brazil
| | - A.A. Bavaroski
- Faculdades Pequeno Príncipe (FPP) Curitiba, Paraná Brazil
- Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP) Curitiba, Paraná Brazil
| | - L.S. Rodrigues
- Faculdades Pequeno Príncipe (FPP) Curitiba, Paraná Brazil
- Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP) Curitiba, Paraná Brazil
| | - D. Cardozo
- Liga Paranaese de Combate ao Câncer ‐ Hospital Erasto Gaertner (HEG) Curitiba, Paraná Brazil
| | - A.P. Tomaz
- Faculdades Pequeno Príncipe (FPP) Curitiba, Paraná Brazil
- Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP) Curitiba, Paraná Brazil
- Complexo Hospital de ClínicasUniversidade Federal do Paraná (CHC‐UFPR) Curitiba, Paraná Brazil
| | - J.O. Camargo
- Departamento de Bioquímica e Biologia Molecular Universidade Federal do Paraná (UFPR) Curitiba, Paraná Brazil
- Setor de Educação Profissional e Tecnológica (SEPT) Programa de Graduação em Bioinformática Universidade Federal do Paraná (UFPR) Curitiba, Paraná Brazil
| | - L.M. Dalla‐Costa
- Faculdades Pequeno Príncipe (FPP) Curitiba, Paraná Brazil
- Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP) Curitiba, Paraná Brazil
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El-Mokhtar MA, Daef E, Mohamed Hussein AAR, Hashem MK, Hassan HM. Emergence of Nosocomial Pneumonia Caused by Colistin-Resistant Escherichia coli in Patients Admitted to Chest Intensive Care Unit. Antibiotics (Basel) 2021; 10:antibiotics10030226. [PMID: 33668302 PMCID: PMC7996192 DOI: 10.3390/antibiotics10030226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 12/29/2022] Open
Abstract
(1) Background: Colistin is a last-resort antibiotic used in treating multidrug-resistant Gram-negative infections. The growing emergence of colistin resistance in Escherichia coli (E. coli) represents a serious health threat, particularly to intensive care unit (ICU) patients. (2) Methods: In this work, we investigated the emergence of colistin resistance in 140 nosocomial E. coli isolated from patients with pneumonia and admitted to the chest ICU over 36 months. Virulence and resistance-related genes and E. coli pathotypes in colistin-resistant and colistin-sensitive isolates were determined. (3) Results: Colistin resistance was observed in 21/140 (15%) of the nosocomial E. coli isolates. The MIC50 of the resistant strains was 4 mg/L, while MIC90 was 16 mg/L. Colistin-resistant isolates were also co-resistant to amoxicillin, amoxicillin/clavulanic, aztreonam, ciprofloxacin, and chloramphenicol. The mechanism of colistin resistance was represented by the presence of mcr-1 in all resistant strains. Respectively, 42.9% and 36.1% of colistin-resistant and colistin-sensitive groups were extended-spectrum β-lactamase (ESBL) producers, while 23.8% and 21% were metallo β-lactamase (MBL) producers. blaTEM-type was the most frequently detected ESBL gene, while blaIMP-type was the most common MBL in both groups. Importantly, most resistant strains showed a significantly high prevalence of astA (76.2%), aggR (76.2%), and pic (52.4%) virulence-related genes. Enteroaggregative E. coli (76%) was the most frequently detected genotype among the colistin-resistant strains. (4) Conclusion: The high colistin resistance rate observed in E. coli strains isolated from patients with nosocomial pneumonia in our university hospital is worrisome. These isolates carry different drug resistance and virulence-related genes. Our results indicate the need for careful monitoring of colistin resistance in our university hospital. Furthermore, infection control policies restricting the unnecessary use of extended-spectrum cephalosporins and carbapenems are necessary.
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Affiliation(s)
- Mohamed A. El-Mokhtar
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt; (M.A.E.-M.); (E.D.)
- Microbiology and Immunology Department, Faculty of Pharmacy, Sphinx University, Assiut 71515, Egypt
| | - Enas Daef
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt; (M.A.E.-M.); (E.D.)
| | | | - Maiada K. Hashem
- Chest Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt; (A.A.R.M.H.); (M.K.H.)
| | - Hebatallah M. Hassan
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt; (M.A.E.-M.); (E.D.)
- Correspondence: ; Tel.: +2-010-2218-2086
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5
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Gozi KS, Deus Ajude LPT, Barroso MDV, Silva CRD, Peiró JR, Mendes LCN, Nogueira MCL, Casella T. Potentially Pathogenic Multidrug-Resistant Escherichia coli in Lamb Meat. Microb Drug Resist 2021; 27:1071-1078. [PMID: 33417827 DOI: 10.1089/mdr.2020.0488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Extended-spectrum cephalosporin (ESC) resistance remains a threat since ESC are important antimicrobials used to treat infections in humans and animals. Escherichia coli is an important source of ESC-resistance genes, such as those encoding extended-spectrum β-lactamases (ESBLs). E. coli is a common commensal of lambs. Reports that contaminated food can be a source of ESC-resistant bacteria in humans and that ESBL-producing E. coli are found in sheep in Brazil led us to survey their presence in retail lamb meat. Twenty-five samples intended for human consumption were screened for ESC-resistant E. coli, and the isolates were characterized. IncI1-blaCTX-M-8 and IncHI2-blaCTX-M-2 were the main plasmids responsible for ESC resistance. The plasmids harbored common ESBL genes in Enterobacteriaceae from food-producing animals in Brazil. IncI1-blaCTX-M-14 and IncF-blaCTX-M-55 plasmids, associated with human infections, were also detected. Few CTX-M-producing E. coli have been clustered by typing methods, and some may be genetically pathogenic. The findings indicate the presence of diverse strains of E. coli, harboring important ESBL genes, in lamb meat in Brazil. Surveillance of ESC-resistant bacteria could reduce the spread of antimicrobial resistance through the food chain.
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Affiliation(s)
- Katia Suemi Gozi
- Centro de Investigação de Microrganismos, FAMERP, São José do Rio Preto, Brazil
| | | | | | | | - Juliana Regina Peiró
- Faculdade de Medicina Veterinária, São Paulo State University (UNESP), Araçatuba, Brazil
| | | | | | - Tiago Casella
- Centro de Investigação de Microrganismos, FAMERP, São José do Rio Preto, Brazil.,Hospital de Base de São José do Rio Preto, São José do Rio Preto, Brazil
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6
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Conte D, Palmeiro JK, Bavaroski AA, Rodrigues LS, Cardozo D, Tomaz AP, Camargo JO, Dalla-Costa LM. Antimicrobial resistance in Aeromonas species isolated from aquatic environments in Brazil. J Appl Microbiol 2020; 131:169-181. [PMID: 33306232 DOI: 10.1111/jam.14965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 11/16/2020] [Accepted: 12/07/2020] [Indexed: 11/28/2022]
Abstract
AIM The current study was conducted to determine the antimicrobial resistance profile and genetic relatedness of Aeromonas sp. isolated from healthcare and urban effluents, wastewater treatment plant (WWTP) and river water. METHODS AND RESULTS We detected the presence of genes conferring resistance to β-lactam, quinolone and aminoglycoside. Multilocus sequence typing was carried out to differentiate the strains, and multilocus phylogenetic analysis was used to identify the species. A total of 28 cefotaxime-resistant Aeromonas sp. strains were identified, harbouring uncommon Guiana-extended-spectrum (GES)-type β-lactamases (GES-1, GES-5, GES-7 and GES-16). Multidrug-resistant Aeromonas sp. were found in hospital wastewater, WWTP and sanitary effluent, and A. caviae was identified as the most prevalent species (85·7%). CONCLUSION The release of untreated healthcare effluents, presence of antimicrobials in the environment, in addition to multidrug-resistant Aeromonas sp., are all potential factors for the spread of resistance. SIGNIFICANCE AND IMPACT OF THE STUDY We identified a vast repertoire of antimicrobial resistance genes (ARG) in Aeromonas sp. from diverse aquatic ecosystems, including those that encode enzymes degrading broad-spectrum antimicrobials widely used to treat healthcare-associated infections. Hospital and sanitary effluents serve as potential sources of bacteria harbouring ARG and are a threat to public health.
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Affiliation(s)
- D Conte
- Faculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil
| | - J K Palmeiro
- Faculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil.,Departamento de Análises Clínicas, Universidade Federal de Santa Catarina (ACL-UFSC), Florianópolis, Santa Catarina, Brazil
| | - A A Bavaroski
- Faculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil
| | - L S Rodrigues
- Faculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil
| | - D Cardozo
- Liga Paranaese de Combate ao Câncer - Hospital Erasto Gaertner (HEG), Curitiba, Paraná, Brazil
| | - A P Tomaz
- Faculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil.,Complexo Hospital de Clínicas, Universidade Federal do Paraná (CHC-UFPR), Curitiba, Paraná, Brazil
| | - J O Camargo
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.,Setor de Educação Profissional e Tecnológica (SEPT), Programa de Graduação em Bioinformática, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil
| | - L M Dalla-Costa
- Faculdades Pequeno Príncipe (FPP), Curitiba, Paraná, Brazil.,Instituto de Pesquisa Pelé Pequeno Príncipe (IPPPP), Curitiba, Paraná, Brazil
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7
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de Carvalho MPN, Fernandes MR, Sellera FP, Lopes R, Monte DF, Hippólito AG, Milanelo L, Raso TF, Lincopan N. International clones of extended-spectrum β-lactamase (CTX-M)-producing Escherichia coli in peri-urban wild animals, Brazil. Transbound Emerg Dis 2020; 67:1804-1815. [PMID: 32239649 PMCID: PMC7540485 DOI: 10.1111/tbed.13558] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/29/2020] [Accepted: 03/23/2020] [Indexed: 12/22/2022]
Abstract
CTX-M-type extended-spectrum β-lactamase (ESBL)-producing Escherichia coli clones have been increasingly reported worldwide. In this regard, although discussions of transmission routes of these bacteria are in evidence, molecular data are lacking to elucidate the epidemiological impacts of ESBL producers in wild animals. In this study, we have screened 90 wild animals living in a surrounding area of São Paulo, the largest metropolitan city in South America, to monitor the presence of multidrug-resistant (MDR) Gram-negative bacteria. Using a genomic approach, we have analysed eight ceftriaxone-resistant E. coli. Resistome analyses revealed that all E. coli strains carried blaCTX-M -type genes, prevalent in human infections, besides other clinically relevant resistance genes to aminoglycosides, β-lactams, phenicols, tetracyclines, sulphonamides, trimethoprim, fosfomycin and quinolones. Additionally, E. coli strains belonged to international sequence types (STs) ST38, ST58, ST212, ST744, ST1158 and ST1251, and carried several virulence-associated genes. Our findings suggest spread and adaptation of international clones of CTX-M-producing E. coli beyond urban settings, including wildlife from shared environments.
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Affiliation(s)
| | - Miriam R. Fernandes
- Department of Clinical and Toxicological AnalysisSchool of Pharmaceutical SciencesUniversity of Sao PauloSao PauloBrazil
| | - Fábio P. Sellera
- Department of Internal MedicineSchool of Veterinary Medicine and Animal ScienceUniversity of São PauloSão PauloBrazil
| | - Ralf Lopes
- Department of MicrobiologyInstituto de Ciências BiomédicasUniversidade de São PauloSão PauloBrazil
| | - Daniel F. Monte
- Department of Food and Experimental NutritionFaculty of Pharmaceutical SciencesFood Research CenterUniversity of São PauloSão PauloBrazil
| | - Alícia G. Hippólito
- Department of Veterinary Surgery and AnesthesiologySchool of Veterinary Medicine and Animal ScienceUniversidade Estadual Paulista (UNESP)BotucatuBrazil
| | - Liliane Milanelo
- Reception Center for WildlifeEcological Park TietêSão PauloBrazil
| | - Tânia F. Raso
- Department of PathologySchool of Veterinary Medicine and Animal ScienceUniversity of São PauloSão PauloBrazil
| | - Nilton Lincopan
- Department of Clinical and Toxicological AnalysisSchool of Pharmaceutical SciencesUniversity of Sao PauloSao PauloBrazil
- Department of MicrobiologyInstituto de Ciências BiomédicasUniversidade de São PauloSão PauloBrazil
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8
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Zeynudin A, Pritsch M, Schubert S, Messerer M, Liegl G, Hoelscher M, Belachew T, Wieser A. Prevalence and antibiotic susceptibility pattern of CTX-M type extended-spectrum β-lactamases among clinical isolates of gram-negative bacilli in Jimma, Ethiopia. BMC Infect Dis 2018; 18:524. [PMID: 30342476 PMCID: PMC6196031 DOI: 10.1186/s12879-018-3436-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 10/05/2018] [Indexed: 12/30/2022] Open
Abstract
Background The prevalence of extended-spectrum β-lactamases (ESBLs) have been reported in clinical isolates obtained from various hospitals in Ethiopia. However, there is no data on the prevalence and antibiotic susceptibility patterns of CTX-M type ESBL produced by Gram-negative bacilli. The aim of this study was to determine the frequency and distribution of the blaCTX-M genes and the susceptibility patterns in ESBL producing clinical isolates of Gram-negative bacilli in Jimma University Specialized Hospital (JUSH), southwest Ethiopia. Methods A total of 224 non-duplicate and pure isolates obtained from clinically apparent infections, were included in the study. Identification of the isolates was performed by MALDI-TOF mass spectrometry. Susceptibility testing and ESBL detection was performed using VITEK® 2, according to EUCAST v4.0 guidelines. Genotypic analysis was performed using Check-MDR CT103 Microarrays. Results Of the total 112 (50.0%) isolates screen positive for ESBLs, 63.4% (71/112) tested positive for ESBL encoding genes by Check-MDR array, which corresponds to 91.8% (67/73) of the total Enterobacteriaceae and 10.3% (4/39) of nonfermenting Gram-negative bacilli. Among the total ESBL gene positive isolates, 95.8% (68/71) carried blaCTX-M genes with CTX-M group 1 type15 being predominant (66/68; 97.1% of CTX-M genes). The blaCTX-M carrying Enterobacteriaceae (n = 64) isolates showed no resistance against imipenem and meropenem and a moderate resistance rate against tigecycline (14.1%), fosfomycin (10.9%) and amikacin (1.6%) suggesting the effectiveness of these antibiotics against most isolates. On the other hand, all the blaCTX-M positive Enterobacteriaceae showed a multidrug resistant (MDR) phenotype with remarkable co-resistances (non-susceptibility rates) to aminoglycosides (92.2%), fluoroquinolones (78.1%) and trimethoprim/sulfamethoxazol (92.2%). Conclusions This study demonstrates a remarkably high prevalence of blaCTX-M genes among ESBL-producing isolates. The high level of resistance to β-lactam and non-β-lactam antibiotics as well as the trend to a MDR profile associated with the blaCTX-M genes are alarming and emphasize the need for routine diagnostic antimicrobial susceptibility testing for appropriate choice of antimicrobial therapy. Electronic supplementary material The online version of this article (10.1186/s12879-018-3436-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ahmed Zeynudin
- Chair of Medical Microbiology and Hospital Epidemiology, Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Marchioninistr. 17, 81377, Munich, Germany.,Institute of Health Sciences, Jimma University, Jimma, Ethiopia.,Center for International Health (CIH), University of Munich (LMU), 80802, Munich, Germany
| | - Michael Pritsch
- Chair of Medical Microbiology and Hospital Epidemiology, Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Marchioninistr. 17, 81377, Munich, Germany.,Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), 80802, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, 80802, Munich, Germany
| | - Sören Schubert
- Chair of Medical Microbiology and Hospital Epidemiology, Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Marchioninistr. 17, 81377, Munich, Germany
| | - Maxim Messerer
- Plant Genome and Systems Biology, Helmholtz Center Munich, German Research Center for Environmental Health, 85764, Neuherberg, Germany
| | - Gabriele Liegl
- Chair of Medical Microbiology and Hospital Epidemiology, Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Marchioninistr. 17, 81377, Munich, Germany
| | - Michael Hoelscher
- Center for International Health (CIH), University of Munich (LMU), 80802, Munich, Germany.,Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), 80802, Munich, Germany.,German Center for Infection Research (DZIF), Partner Site Munich, 80802, Munich, Germany
| | - Tefara Belachew
- Institute of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Andreas Wieser
- Chair of Medical Microbiology and Hospital Epidemiology, Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Marchioninistr. 17, 81377, Munich, Germany. .,Institute of Health Sciences, Jimma University, Jimma, Ethiopia. .,Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), 80802, Munich, Germany. .,German Center for Infection Research (DZIF), Partner Site Munich, 80802, Munich, Germany.
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Müller A, Jansen W, Grabowski NT, Monecke S, Ehricht R, Kehrenberg C. ESBL- and AmpC-producing Escherichia coli from legally and illegally imported meat: Characterization of isolates brought into the EU from third countries. Int J Food Microbiol 2018; 283:52-58. [DOI: 10.1016/j.ijfoodmicro.2018.06.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/25/2018] [Accepted: 06/11/2018] [Indexed: 11/16/2022]
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10
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Andrade LN, Novais Â, Stegani LMM, Ferreira JC, Rodrigues C, Darini ALC, Peixe L. Virulence genes, capsular and plasmid types of multidrug-resistant CTX-M(-2, -8, -15) and KPC-2-producing Klebsiella pneumoniae isolates from four major hospitals in Brazil. Diagn Microbiol Infect Dis 2018; 91:164-168. [PMID: 29459053 DOI: 10.1016/j.diagmicrobio.2018.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/06/2017] [Accepted: 01/08/2018] [Indexed: 01/20/2023]
Abstract
We performed a single-month snapshot study of the population diversity of multidrug resistant (MDR) Klebsiella pneumoniae isolates producing carbapenemases and/or extended-spectrum β-lactamases from four major hospitals in Brazil. Isolates produced diverse ESBL (CTX-M-2, -8, -15, SHV-2), KPC-2 or both (CTX-M-2 and KPC-2), linked to specific genetic backgrounds and plasmids from a few families (IncR, IncFIIk, IncL/M) that were shared among clonal lineages within and between hospitals. A high clonal diversity was identified, among isolates from the same ST (ST11, ST15, ST101 or ST340). Diverse capsular types (n=13 K-types) were identified, most of which linked to specific ST (ST11 and K27 or K64, ST101 and K17, ST340 and KL151, ST15 and K24 or ST17 and KL112). Isolates shared a common set of virulence genes (ureA, fimH, uge, wabG, mrkD, entB) and occasionally ybtS (42%) and kfuBC (18%). Our data suggest intra- and inter-hospital spread of common genetic structures and international MDR K. pneumoniae clones.
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Affiliation(s)
- Leonardo Neves Andrade
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Ângela Novais
- UCIBIO@REQUIMTE, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Lenita Maria Marcato Stegani
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Joseane Cristina Ferreira
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Carla Rodrigues
- UCIBIO@REQUIMTE, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Ana Lucia Costa Darini
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Luisa Peixe
- UCIBIO@REQUIMTE, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal.
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Conte D, Palmeiro JK, da Silva Nogueira K, de Lima TMR, Cardoso MA, Pontarolo R, Degaut Pontes FL, Dalla-Costa LM. Characterization of CTX-M enzymes, quinolone resistance determinants, and antimicrobial residues from hospital sewage, wastewater treatment plant, and river water. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2017; 136:62-69. [PMID: 27816836 DOI: 10.1016/j.ecoenv.2016.10.031] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/21/2016] [Accepted: 10/25/2016] [Indexed: 05/09/2023]
Abstract
Multidrug-resistant (MDR) bacteria are widespread in hospitals and have been increasingly isolated from aquatic environments. The aim of the present study was to characterize extended-spectrum β-lactamase (ESBL) and quinolone-resistant Enterobacteriaceae from a hospital effluent, sanitary effluent, inflow sewage, aeration tank, and outflow sewage within a wastewater treatment plant (WWTP), as well as river water upstream and downstream (URW and DRW, respectively), of the point where the WWTP treated effluent was discharged. β-lactamase (bla) genes, plasmid-mediated quinolone resistance (PMQR), and quinolone resistance-determining regions (QRDRs) were assessed by amplification and sequencing in 55 ESBL-positive and/or quinolone-resistant isolates. Ciprofloxacin residue was evaluated by high performance liquid chromatography. ESBL-producing isolates were identified in both raw (n=29) and treated (n=26) water; they included Escherichia coli (32), Klebsiella pneumoniae (22) and Klebsiella oxytoca (1). Resistance to both cephalosporins and quinolone was observed in 34.4% of E. coli and 27.3% of K. pneumoniae. Resistance to carbapenems was found in 5.4% of K. pneumoniae and in K. oxytoca. Results indicate the presence of blaCTX-M (51/55, 92.7%) and blaSHV (8/55, 14.5%) ESBLs, and blaGES (2/55, 3.6%) carbapenemase-encoding resistance determinants. Genes conferring quinolone resistance were detected at all sites, except in the inflow sewage and aeration tanks. Quinolone resistance was primarily attributed to amino acid substitutions in the QRDR of GyrA (47%) or to the presence of PMQR (aac-(6')-Ib-cr, oqxAB, qnrS, and/or qnrB; 52.9%) determinants. Ciprofloxacin residue was absent only from URW. Our results have shown strains carrying ESBL genes, PMQR determinants, and mutations in the gyrA QRDR genes mainly in hospital effluent, URW, and DRW samples. Antimicrobial use, and the inefficient removal of MDR bacteria and antibiotic residue during sewage treatment, may contribute to the emergence and spreading of resistance in the environment, making this a natural reservoir.
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Affiliation(s)
- Danieli Conte
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil.
| | - Jussara Kasuko Palmeiro
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil; Hospital de Clínicas, Universidade Federal do Paraná (HC-UFPR), Curitiba, Paraná, Brazil.
| | - Keite da Silva Nogueira
- Departamento de Patologia Básica, Setor de Ciências Biológicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | | | - Marco André Cardoso
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil; Pharmacy Department, Health Sciences Sector, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
| | - Roberto Pontarolo
- Pharmacy Department, Health Sciences Sector, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
| | - Flávia Lada Degaut Pontes
- Pharmacy Department, Health Sciences Sector, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
| | - Libera Maria Dalla-Costa
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil; Hospital de Clínicas, Universidade Federal do Paraná (HC-UFPR), Curitiba, Paraná, Brazil.
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12
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First Report of Group CTX-M-9 Extended Spectrum Beta-Lactamases in Escherichia coli Isolates from Pediatric Patients in Mexico. PLoS One 2016; 11:e0168608. [PMID: 27992527 PMCID: PMC5167402 DOI: 10.1371/journal.pone.0168608] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 12/02/2016] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to identify the presence of group CTX-M-9 extended spectrum beta-lactamases (ESBL) in clinical Escherichia coli isolates from pediatric patients. A total of 404 non-repeated positive ESBL E. coli isolates were collected from documented clinical infections in pediatric patients over a 2-year period. The identification and susceptibility profiles were determined using an automated system. Isolates that suggested ESBL production based on their resistance profiles to third and fourth generation cephalosporin and monobactam were selected. ESBL production was phenotypically confirmed using a diffusion method with cefotaxime and ceftazidime discs alone and in combination with clavulanic acid. blaESBL gene identification was performed through PCR amplification and sequencing. Pulsed Field Gel Electrophoresis (PFGE) and Multilocus Sequence Typing (MLST) were performed to establish the clonal relationships of the E. coli isolates. CTX-M-9-type ESBLs were detected in 2.5% of the isolates. The subtypes corresponded to blaCTX-M-14 (n = 4) and blaCTX-M-27 (n = 6). Additionally, coexistence with other beta-lactamases was observed. A clonal relationship was established in three isolates; the rest were classified as non-related. We found seven different sequence type (ST) in CTX-M-9- producing E. coli isolates. ST38 was the most frequent. This study is the first report in Mexico to document the presence of group CTX-M-9 ESBLs in E. coli isolates from pediatric patients.
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13
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Sampaio JLM, Gales AC. Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins. Braz J Microbiol 2016; 47 Suppl 1:31-37. [PMID: 27825605 PMCID: PMC5156504 DOI: 10.1016/j.bjm.2016.10.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 10/07/2016] [Accepted: 10/07/2016] [Indexed: 12/22/2022] Open
Abstract
During the last 30 years there has been a dissemination of plasmid-mediated β-lactamases in Enterobacteriaceae in Brazil. Extended spectrum β-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo-β-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.
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Affiliation(s)
- Jorge Luiz Mello Sampaio
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Departamento de Análises Clínicas e Toxicológicas, São Paulo, SP, Brazil; Fleury Medicina e Saúde, Seção de Microbiologia, São Paulo, SP, Brazil.
| | - Ana Cristina Gales
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Interna, São Paulo, Brazil.
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14
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Ferreira JC, Penha Filho RAC, Andrade LN, Berchieri Junior A, Darini ALC. Evaluation and characterization of plasmids carrying CTX-M genes in a non-clonal population of multidrug-resistant Enterobacteriaceae isolated from poultry in Brazil. Diagn Microbiol Infect Dis 2016; 85:444-8. [DOI: 10.1016/j.diagmicrobio.2016.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 05/14/2016] [Accepted: 05/17/2016] [Indexed: 11/28/2022]
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15
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Rocha FR, Pinto VPT, Barbosa FCB. The Spread of CTX-M-Type Extended-Spectrum β-Lactamases in Brazil: A Systematic Review. Microb Drug Resist 2016; 22:301-11. [DOI: 10.1089/mdr.2015.0180] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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16
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Siqueira AK, Michael GB, Domingos DF, Ferraz MMG, Ribeiro MG, Schwarz S, Leite DS. Diversity of class 1 and 2 integrons detected in Escherichia coli isolates from diseased and apparently healthy dogs. Vet Microbiol 2016; 194:79-83. [PMID: 27302904 DOI: 10.1016/j.vetmic.2016.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/02/2016] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
Abstract
Escherichia coli is one of the major pathogens causing urinary tract infections (UTIs) and pyometra in dogs. The aims of this study were to investigate canine E. coli isolates for the presence of class 1 and 2 integrons by PCR/sequencing and to characterize these isolates and their integron-carrying plasmids. Isolates were characterized by phylotyping, XbaI-macrorestriction analysis and plasmid transfer experiments. Plasmids were analyzed by S1 nuclease-PFGE, replicon typing, conjugation and restriction analysis. Antimicrobial resistance was investigated by antimicrobial susceptibility testing and PCR/sequencing. From 158 E. coli of dogs suffering from UTIs (n=51) and pyometra (n=52) or being apparently healthy (n=55), 13 isolates harboured class 1 (n=10) or class 2 integrons (n=3). They were distributed among the phylogenetic groups A (3/13), B1 (6/13), B2 (3/13) and D (1/13). Two isolates showed indistinguishable XbaI-patterns, but differed in the remaining characteristics. Another two isolates (UTI or apparently healthy) displayed different XbaI-patterns, but harboured similar plasmids. Integrons were found on plasmids of incompatibility groups IncF, IncF-IncFIC, IncFIB-IncHI2, IncFIB-IncN, IncFIC or IncHI2 and three of them were conjugative. Resistances to aminoglycosides, sulphonamides and trimethoprim were commonly detected. Class 1 integrons carried the gene cassette arrays dfrA12-orfF-aadA28, ΔdfrA17-aadA5, dfrA29, aadA7, aadA29 or dfrA12-orfF-aadA2-cmlA1-aadA1. Class 2 integrons carried the array dfrA1-sat2-aadA30. Two extended-spectrum β-lactamase genes (blaCTX-M-2) and one AmpC β-lactamase gene (blaCMY-2) were also detected on plasmids. These findings indicate the potential risk of the dissemination and persistence of E. coli and/or integron-carrying plasmids in companion animals.
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Affiliation(s)
- Amanda K Siqueira
- Laboratório de Antígenos Bacterianos, Departamento de Genética, Evolução e Bioagentes, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil; Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut (FLI), Neustadt-Mariensee 31535, Germany
| | - Geovana B Michael
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut (FLI), Neustadt-Mariensee 31535, Germany.
| | - Daniela F Domingos
- Laboratório de Antígenos Bacterianos, Departamento de Genética, Evolução e Bioagentes, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
| | - Mirtis M G Ferraz
- Laboratório de Antígenos Bacterianos, Departamento de Genética, Evolução e Bioagentes, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
| | - Márcio G Ribeiro
- Departamento de Higiene Veterinária e Saúde Pública, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual de São Paulo, Botucatu, São Paulo, Brazil
| | - Stefan Schwarz
- Institute of Farm Animal Genetics, Friedrich-Loeffler-Institut (FLI), Neustadt-Mariensee 31535, Germany
| | - Domingos S Leite
- Laboratório de Antígenos Bacterianos, Departamento de Genética, Evolução e Bioagentes, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
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17
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Dropa M, Lincopan N, Balsalobre LC, Oliveira DE, Moura RA, Fernandes MR, da Silva QM, Matté GR, Sato MIZ, Matté MH. Genetic background of novel sequence types of CTX-M-8- and CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae from public wastewater treatment plants in São Paulo, Brazil. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:4953-4958. [PMID: 26782324 DOI: 10.1007/s11356-016-6079-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/06/2016] [Indexed: 05/29/2023]
Abstract
The release of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae to the environment is a public health issue worldwide. The aim of this study was to investigate the genetic background of genes encoding ESBLs in wastewater treatment plants (WWTPs) in São Paulo, southeastern Brazil. In 2009, during a local surveillance study, seven ESBL-producing Enterobacteriaceae strains were recovered from five WWTPs and screened for ESBL genes and mobile genetic elements. Multilocus sequence typing (MLST) was carried out, and wild plasmids were transformed into electrocompetent Escherichia coli. S1-PFGE technique was used to verify the presence of high molecular weight plasmids in wild-type strains and in bla ESBL-containing E. coli transformants. Strains harbored bla CTX-M-8, bla CTX-M-15, and/or bla SHV-28. Sequencing results showed that bla CTX-M-8 and bla CTX-M-15 genes were associated with IS26. MLST revealed new sequence types for E. coli (ST4401, ST4402, ST4403, and ST4445) and Klebsiella pneumoniae (ST1574), except for one K. pneumoniae from ST307 and Enterobacter cloacae from ST131. PCR and S1-PFGE results showed CTX-M-producing E. coli transformants carried heavy plasmids sizing 48.5-209 kb, which belonged to IncI1, IncF, and IncM1 incompatibility groups. This is the first report of CTX-M-8 and SHV-28 enzymes in environmental samples, and the present results demonstrate the plasmid-mediated spread of CTX-M-encoding genes through five WWTPs in São Paulo, Brazil, suggesting WWTPs are hotspots for the transfer of ESBL genes and confirming the urgent need to improve the management of sewage in order to minimize the dissemination of resistance genes to the environment.
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Affiliation(s)
- Milena Dropa
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil.
| | - Nilton Lincopan
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Avenida Professor Lineu Prestes, 1374, Butantã, 05508-900, São Paulo, SP, Brazil
- Department of Clinical Analysis, School of Pharmacy, University of São Paulo, Avenida Professor Lineu Prestes, 580, Butantã, 05434-070, São Paulo, SP, Brazil
| | - Livia C Balsalobre
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
| | - Danielle E Oliveira
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
| | - Rodrigo A Moura
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Avenida Professor Lineu Prestes, 1374, Butantã, 05508-900, São Paulo, SP, Brazil
| | - Miriam Rodriguez Fernandes
- Department of Clinical Analysis, School of Pharmacy, University of São Paulo, Avenida Professor Lineu Prestes, 580, Butantã, 05434-070, São Paulo, SP, Brazil
| | - Quézia Moura da Silva
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Avenida Professor Lineu Prestes, 1374, Butantã, 05508-900, São Paulo, SP, Brazil
| | - Glavur R Matté
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
| | - Maria I Z Sato
- Environmental Company of São Paulo State (CETESB), Avenida Professor Frederico Hermann Jr, 345, Pinheiros, 05489-900, São Paulo, SP, Brazil
| | - Maria H Matté
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
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Evaluating the microbicidal, antiparasitic and antitumor effects of CR-LAAO from Calloselasma rhodostoma venom. Int J Biol Macromol 2015; 80:489-97. [DOI: 10.1016/j.ijbiomac.2015.07.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 07/02/2015] [Accepted: 07/03/2015] [Indexed: 01/25/2023]
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Ferreira JC, Penha Filho RAC, Andrade LN, Berchieri A, Darini ALC. Detection of chromosomal bla(CTX-M-2) in diverse Escherichia coli isolates from healthy broiler chickens. Clin Microbiol Infect 2014; 20:O623-6. [PMID: 24438126 DOI: 10.1111/1469-0691.12531] [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: 09/01/2013] [Revised: 01/08/2014] [Accepted: 01/09/2014] [Indexed: 11/27/2022]
Abstract
The rise of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in food-producing animals is a growing concern for public health. We investigated ESBL producers isolated from broiler chickens in Brazil and characterized 19 CTX-M-2-producing E. coli. The ISCR1 was detected upstream of the chromosome-located gene bla(CTX-M-2), associated with sul-1 type integron structure. CTX-M-2-producing E. coli exhibited different PFGE-types and phylogenetic groups, showing a non-clonal dissemination. The sequence types found (ST93, ST155 and ST2309) have been associated with humans and animals worldwide. Herein, we report the chromosomal location of bla(CTX-M-2) on E. coli, highlighting the risks of multidrug-resistant bacteria in food-producing animals.
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Affiliation(s)
- J C Ferreira
- School of Pharmaceutical Sciences of Ribeirão Preto - São Paulo University (USP), Ribeirão Preto, SP, Brazil
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20
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Bonelli RR, Moreira BM, Picão RC. Antimicrobial resistance among Enterobacteriaceae in South America: history, current dissemination status and associated socioeconomic factors. Drug Resist Updat 2014; 17:24-36. [PMID: 24618111 DOI: 10.1016/j.drup.2014.02.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
South America exhibits some of the higher rates of antimicrobial resistance in Enterobactericeae worldwide. This continent includes 12 independent countries with huge socioeconomic differences, where the ample access to antimicrobials, including counterfeit ones, coexists with ineffective health systems and sanitation problems, favoring the emergence and dissemination of resistant strains. This work presents a literature review concerning the evolution and current status of antimicrobial resistance threats found among Enterobacteriaceae in South America. Resistance to β-lactams, fluoroquinolones and aminoglycosides was emphasized along with description of key epidemiological studies that highlight the success of specific resistance determinants in different parts of the continent. In addition, a discussion regarding political and socioeconomic factors possibly related to the dissemination of antimicrobial resistant strains in clinical settings and at the community is presented. Finally, in order to assess the possible sources of resistant bacteria, we compile the current knowledge about the occurrence of antimicrobial resistance in isolates in South American' food, food-producing animals and off-hospitals environments. By addressing that intensive intercontinental commerce and tourism neutralizes the protective effect of geographic barriers, we provide arguments reinforcing that globally integrated efforts are needed to decelerate the emergence and dissemination of antimicrobial resistant strains.
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Affiliation(s)
- Raquel Regina Bonelli
- LIM Laboratório Integrado de Microbiologia, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Beatriz Meurer Moreira
- LIM Laboratório Integrado de Microbiologia, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata Cristina Picão
- LIM Laboratório Integrado de Microbiologia, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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21
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Seki LM, Pereira PS, de Souza Conceição M, Souza MJ, Marques EA, Carballido JM, de Carvalho MES, Assef APDC, Asensi MD. Molecular epidemiology of CTX-M producing Enterobacteriaceae isolated from bloodstream infections in Rio de Janeiro, Brazil: emergence of CTX-M-15. Braz J Infect Dis 2013; 17:640-6. [PMID: 24055309 PMCID: PMC9427383 DOI: 10.1016/j.bjid.2013.03.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 02/20/2013] [Accepted: 03/21/2013] [Indexed: 11/19/2022] Open
Abstract
Objective The present study was designed to evaluate the molecular epidemiology of CTX-M producing Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli isolated from bloodstream infections at tertiary care hospitals in the State of Rio de Janeiro, Brazil. Material and methods A total of 231 nonduplicate Enterobacteriaceae were isolated from five Brazilian hospitals between September 2007 and September 2008. The antimicrobial susceptibility testing was performed by disk diffusion method according to the Clinical Laboratory Standard Institute. Isolates showing resistance to third-generation cephalosporins were screened for ESBL activity by the double-disk synergy test. The presence of blaCTX-M, blaCTX-M-15 and blaKPC genes was determined by Polymerase Chain Reaction (PCR) amplification and DNA sequencing. The molecular typing of CTX-M producing isolates was performed by pulsed-field gel electrophoresis (PFGE). Results and discussion Ninety-three isolates were screened as ESBL positive and 85 (91%) were found to carry CTX-M-type, as follows: K. pneumoniae 59 (49%), E. cloacae 15 (42%), and E. coli 11 (15%). Ten isolates resistant for carbapenems in K. pneumoniae were blaKPC-2 gene positive. Among CTX-M type isolates, CTX-M-15 was predominant in more than 50% of isolates for K. pneumoniae, E. coli, and E. cloacae. PFGE analysis of CTX-M producing isolates showed the predominance of CTX-M-15 in 10 of 24 pulsotypes in K. pneumoniae, 6 of 13 in E. cloacae and 3 of 6 in E. coli. CTX-M-15 was also predominant among KPC producing isolates. In conclusion, this study showed that CTX-M-15 was circulating in Rio de Janeiro state in 2007–2008. This data reinforce the need for continuing surveillance because this scenario may have changed over the years.
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Chagas TPG, Alves RM, Vallim DC, Seki LM, Campos LC, Asensi MD. Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil. Braz J Infect Dis 2012; 15:420-5. [PMID: 22230847 DOI: 10.1016/s1413-8670(11)70222-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2011] [Accepted: 02/18/2011] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The present study was undertaken to characterize CTX-M ESBL-producing Klebsiella pneumoniae collected from hospitals in different cities of Brazil. MATERIAL AND METHODS Eighty-five K. pneumoniae strains isolated from hospitalized patients in six different hospitals of three cities of Brazil were analyzed. ESBL production was confirmed by the standard double-disk synergy test and the Etest®. The MIC50 and MIC90 for ESBL-producing isolates were determined by the Etest® method. The antimicrobial susceptibilities of bacterial isolates were determined using the agar diffusion method according to the CLSI. Screening for blaTEM, blaSHV, blaCTX-M genes and class 1 integron was performed by PCR amplification. To determine the genomic diversity of CTX-M-producers, isolates were analyzed by macrorestriction profile analysis following PFGE. RESULTS AND DISCUSSION Seventy-one K. pneumoniae isolates were ESBL-producing. PCR and sequencing experiments detected 38 CTX-M-producing K. pneumoniae belonged to groups CTX-M 1, CTX-M 2, CTX-M 8 and CTX-M 9. The association of different types ESBL (CTX-M, SHV and TEM) was frequent. All K. pneumoniae isolates carried class 1 integron. PFGE analysis revealed thirty-one clonal types among CTX-M-producing isolates. The data presented herein illustrate the diversity of genotypes of CTX-M producing K. pneumoniae among Brazilians hospitals.
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Zhao WH, Hu ZQ. Epidemiology and genetics of CTX-M extended-spectrum β-lactamases in Gram-negative bacteria. Crit Rev Microbiol 2012; 39:79-101. [PMID: 22697133 PMCID: PMC4086240 DOI: 10.3109/1040841x.2012.691460] [Citation(s) in RCA: 203] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CTX-M enzymes, the plasmid-mediated cefotaximases, constitute a rapidly growing family of extended-spectrum β-lactamases (ESBLs) with significant clinical impact. CTX-Ms are found in at least 26 bacterial species, particularly in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis. At least 109 members in CTX-M family are identified and can be divided into seven clusters based on their phylogeny. CTX-M-15 and CTX-M-14 are the most dominant variants. Chromosome-encoded intrinsic cefotaximases in Kluyvera spp. are proposed to be the progenitors of CTX-Ms, while ISEcp1, ISCR1 and plasmid are closely associated with their mobilization and dissemination.
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Affiliation(s)
- Wei-Hua Zhao
- Department of Microbiology and Immunology, Showa University School of Medicine, Tokyo, Japan.
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Cantón R, González-Alba JM, Galán JC. CTX-M Enzymes: Origin and Diffusion. Front Microbiol 2012; 3:110. [PMID: 22485109 PMCID: PMC3316993 DOI: 10.3389/fmicb.2012.00110] [Citation(s) in RCA: 581] [Impact Index Per Article: 48.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 03/06/2012] [Indexed: 01/19/2023] Open
Abstract
CTX-M β-lactamases are considered a paradigm in the evolution of a resistance mechanism. Incorporation of different chromosomal blaCTX-M related genes from different species of Kluyvera has derived in different CTX-M clusters. In silico analyses have shown that this event has occurred at least nine times; in CTX-M-1 cluster (3), CTX-M-2 and CTX-M-9 clusters (2 each), and CTX-M-8 and CTX-M-25 clusters (1 each). This has been mainly produced by the participation of genetic mobilization units such as insertion sequences (ISEcp1 or ISCR1) and the later incorporation in hierarchical structures associated with multifaceted genetic structures including complex class 1 integrons and transposons. The capture of these blaCTX-M genes from the environment by highly mobilizable structures could have been a random event. Moreover, after incorporation within these structures, β-lactam selective force such as that exerted by cefotaxime and ceftazidime has fueled mutational events underscoring diversification of different clusters. Nevertheless, more variants of CTX-M enzymes, including those not inhibited by β-lactamase inhibitors such as clavulanic acid (IR-CTX-M variants), only obtained under in in vitro experiments, are still waiting to emerge in the clinical setting. Penetration and the later global spread of CTX-M producing organisms have been produced with the participation of the so-called “epidemic resistance plasmids” often carried in multi-drug resistant and virulent high-risk clones. All these facts but also the incorporation and co-selection of emerging resistance determinants within CTX-M producing bacteria, such as those encoding carbapenemases, depict the currently complex pandemic scenario of multi-drug resistant isolates.
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Affiliation(s)
- Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, CIBER en Epidemiología y Salud Pública and Instituto Ramón y Cajal de Investigación Sanitaria Madrid, Spain
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García-Fulgueiras V, Bado I, Mota MI, Robino L, Cordeiro NF, Varela A, Algorta G, Gutkind G, Ayala JA, Vignoli R. Extended-spectrum β-lactamases and plasmid-mediated quinolone resistance in enterobacterial clinical isolates in the paediatric hospital of Uruguay. J Antimicrob Chemother 2011; 66:1725-9. [PMID: 21685201 DOI: 10.1093/jac/dkr222] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To analyse the prevalence of resistance to β-lactams and plasmid-mediated quinolone resistance in Enterobacteriaceae in the paediatric hospital of Uruguay. METHODS A total of 368 enterobacterial isolates collected between 1 May and 30 November 2009 were studied for the presence of extended-spectrum β-lactamases (ESBLs), qnr alleles and aac(6')Ib by phenotypic and molecular methods. The genomic context and transferability of β-lactamase and qnr genes were examined by PCR and conjugation, respectively. RESULTS The proportion of inpatients having an infection caused by ESBL-producing enterobacteria was 0.23% (16/7073) in paediatrics wards, 0.64‰ (3/4696) in the neonatology department and 0.03‰ (1/32 557) in the emergency department. ESBL-carrying enterobacteria constituted a total of 21.6% (16/74), 13% (3/23) and 0.37% (1/271) when samples were obtained from paediatrics wards, the neonatology department and the emergency department, respectively. Overall, CTX-M-2 (n = 7), CTX-M-9 (n = 3), CTX-M-8 (n = 2), CTX-M-15 (n = 1), SHV-5 (n = 5) and SHV-2 (n = 2) β-lactamases were detected. Thirteen out of 20 ESBL-producing isolates also carried the aac(6')Ib gene, and the cr variant was detected in one of them. qnr alleles were detected in four isolates comprising two qnrA1 genes, a qnrB8-like variant and a new qnrB gene showing 26 amino acid differences from QnrB1. CONCLUSIONS The proportion of ESBL-producing enterobacteria in Uruguay's paediatric hospital during the study period was 2.3 per 1000 hospitalized patients. The number of different microorganisms detected, as well as the various EBSLs, suggests the occurrence of sporadic episodes instead of nosocomial outbreaks. Nevertheless, the presence of new resistance genes reinforces the necessity for permanent surveillance programmes.
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Affiliation(s)
- Virginia García-Fulgueiras
- Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de República, Alfredo Navarro 3051, CP: 11600 Montevideo, Uruguay
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Millán B, Ghiglione B, Díaz T, Gutkind G, Araque M. CTX-M-14 β-lactamase-producing Citrobacter freundii isolated in Venezuela. Ann Clin Microbiol Antimicrob 2011; 10:22. [PMID: 21627834 PMCID: PMC3121586 DOI: 10.1186/1476-0711-10-22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 05/31/2011] [Indexed: 11/17/2022] Open
Abstract
A clinical isolate of C. freundii with reduced susceptibility to extended-spectrum β-lactams from a woman with cystocele associated with recurrent urinary tract infection was analyzed. Susceptibility tests, double disk synergy tests (DDST) and enzymatic activity by the agar iodometric method suggested the presence of ESBLs. Conjugation experiments revealed the presence of a large conjugative plasmid (pLM07/20) with an exclusive FrepB replicon type (IncF/FIB). PCR analysis and sequencing confirmed the presence of the blaCTX-M-14 gene in the pLM07/20 from C. freundii.LM07/10. Although this is the first report of CTX-M-14 in Venezuela, we alert the medical community that future increase of these β-lactamases in our city could be due to dissemination of plasmids into bacterial populations.
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Affiliation(s)
- Beatriz Millán
- Laboratorio de Microbiología Molecular, Facultad de Farmacia y Bioanálisis, Universidad de Los Andes, Mérida, Venezuela
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Peirano G, Asensi MD, Pitondo-Silva A, Pitout JDD. Molecular characteristics of extended-spectrum β-lactamase-producing Escherichia coli from Rio de Janeiro, Brazil. Clin Microbiol Infect 2011; 17:1039-43. [PMID: 21722255 DOI: 10.1111/j.1469-0691.2010.03440.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Twenty-five extended-spectrum β-lactamase (ESBL)-producing Escherichia coli clinical isolates from Rio de Janeiro, Brazil were characterized by isoelectric focusing, PCR and sequencing of bla(ESBL) genes, plasmid-mediated quinolone resistance determinants, phylogenetic groups, replicon typing, pulsed-field electrophoresis, and multilocus sequencing typing. Twenty-three (92%) ESBL-producing E. coli isolates were positive for bla(CTX-M) genes, aac(6')-Ib-cr, and qnrB. Genetic relatedness of ESBL producers clustered seven (28%) CTX-M-15-producing isolates as sequence type (ST)410, clonal complex (CC) 23, and two (8%) as clone O25-ST131. Our results illustrate the predominance of phylogroup A (52%), ST410 (CC 23) and CTX-M-15 among ESBL-producing E. coli isolates from hospitals in Rio de Janeiro.
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Affiliation(s)
- G Peirano
- Division of Microbiology, Calgary Laboratory Services, Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, AB, Canada
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Dhanji H, Murphy NM, Doumith M, Durmus S, Surman Lee S, Hope R, Woodford N, Livermore DM. Cephalosporin resistance mechanisms in Escherichia coli isolated from raw chicken imported into the UK. J Antimicrob Chemother 2010; 65:2534-7. [DOI: 10.1093/jac/dkq376] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Andrade LN, Minarini LAR, Pitondo-Silva A, Clímaco EC, Palazzo ICV, Medeiros MIC, Darini ALC. Determinants of beta-lactam resistance in meningitis-causing Enterobacteriaceae in Brazil. Can J Microbiol 2010; 56:399-407. [PMID: 20555402 DOI: 10.1139/w10-020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study analyzed resistance determinants in extended-spectrum beta-lactamase (ESBL)-producing enterobacteria and the epidemiology of 11 Escherichia coli isolates obtained from meningitis patients in a region of Brazil from 2000 to 2005. ESBL-encoding genes and their genetic environment were investigated by PCR and sequencing. The gene blaCTX-M-2 was identified in 3 different enterobacteria (E. coli, Serratia marcescens, and Proteus mirabilis) downstream of the insertion sequence ISCR1 (localized in class 1 integrons), but not as part of the resistance cassettes region. Multilocus sequence typing (MLST) was used to investigate genetic relationships between the 11 E. coli isolates in this study and strains associated with meningitis in the E. coli MLST database. MLST analysis indicated high genetic diversity among isolates, and no significant genetic relationship was identified with meningitis-causing E. coli in the database. The results in this report reinforce the need to be attentive to meningitis suspected to be due to ESBL-producing enterobacterial isolates, especially where ESBL epidemiology is well known.
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Affiliation(s)
- L N Andrade
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP 14040-903, Brazil
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