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Menck-Costa MF, Baptista AAS, Sanches MS, dos Santos BQ, Cicero CE, Kitagawa HY, Justino L, Medeiros LP, de Souza M, Rocha SPD, Nakazato G, Kobayashi RKT. Resistance and Virulence Surveillance in Escherichia coli Isolated from Commercial Meat Samples: A One Health Approach. Microorganisms 2023; 11:2712. [PMID: 38004724 PMCID: PMC10672981 DOI: 10.3390/microorganisms11112712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Escherichia coli is a key indicator of food hygiene, and its monitoring in meat samples points to the potential presence of antimicrobial-resistant strains capable of causing infections in humans, encompassing resistance profiles categorized as serious threats by the Centers for Disease Control and Prevention (CDC), such as Extended-Spectrum Beta-Lactamase (ESBL)-a problem with consequences for animal, human, and environmental health. The objective of the present work was to isolate and characterize ESBL-producing E. coli strains from poultry, pork, and beef meat samples, with a characterization of their virulence and antimicrobial resistance profiles. A total of 450 meat samples (150 chicken, 150 beef, and 150 pork) were obtained from supermarkets and subsequently cultured in medium supplemented with cefotaxime. The isolated colonies were characterized biochemically, followed by antibiogram testing using the disk diffusion technique. Further classification involved biofilm formation and the presence of antimicrobial resistance genes (blaCTX-M, AmpC-type, mcr-1, and fosA3), and virulence genes (eaeA, st, bfpA, lt, stx1, stx2, aggR, iss, ompT, hlyF, iutA, iroN, fyuA, cvaC, and hylA). Statistical analysis was performed via the likelihood-ratio test. In total, 168 strains were obtained, with 73% originating from chicken, 22% from pork, and 17% from beef samples. Notably, strains exhibited greater resistance to tetracycline (51%), ciprofloxacin (46%), and fosfomycin (38%), apart from β-lactams. The detection of antimicrobial resistance in food-isolated strains is noteworthy, underscoring the significance of antimicrobial resistance as a global concern. More than 90% of the strains were biofilm producers, and strains carrying many ExPEC genes were more likely to be biofilm formers (OR 2.42), which increases the problem since the microorganisms have a greater chance of environment persistence and genetic exchange. Regarding molecular characterization, bovine samples showed a higher prevalence of blaCTX-M-1 (OR 6.52), while chicken strains were more likely to carry the fosA3 gene (OR 2.43, CI 1.17-5.05) and presented between 6 to 8 ExPEC genes (OR 2.5, CI 1.33-5.01) compared to other meat samples. Concerning diarrheagenic E. coli genes, two strains harbored eae. It is important to highlight these strains, as they exhibited both biofilm-forming capacities and multidrug resistance (MDR), potentially enabling colonization in diverse environments and causing infections. In conclusion, this study underscores the presence of β-lactamase-producing E. coli strains, mainly in poultry samples, compared to beef and pork samples. Furthermore, all meat sample strains exhibited many virulence-associated extraintestinal genes, with some strains harboring diarrheagenic E. coli (DEC) genes.
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Affiliation(s)
- Maísa Fabiana Menck-Costa
- Department of Microbiology, Center for Biological Science (CCB), State University of Londrina (UEL), Londrina 86057-970, Brazil; (M.F.M.-C.); (M.S.S.); (H.Y.K.); (L.P.M.); (S.P.D.R.); (G.N.)
| | - Ana Angelita Sampaio Baptista
- Department of Preventive Veterinary Medicine, Center for Agricultural Sciences (CCA), State University of Londrina (UEL), Londrina 86057-970, Brazil; (A.A.S.B.); (B.Q.d.S.); (C.E.C.); (L.J.); (M.d.S.)
| | - Matheus Silva Sanches
- Department of Microbiology, Center for Biological Science (CCB), State University of Londrina (UEL), Londrina 86057-970, Brazil; (M.F.M.-C.); (M.S.S.); (H.Y.K.); (L.P.M.); (S.P.D.R.); (G.N.)
| | - Beatriz Queiroz dos Santos
- Department of Preventive Veterinary Medicine, Center for Agricultural Sciences (CCA), State University of Londrina (UEL), Londrina 86057-970, Brazil; (A.A.S.B.); (B.Q.d.S.); (C.E.C.); (L.J.); (M.d.S.)
| | - Claudinéia Emidio Cicero
- Department of Preventive Veterinary Medicine, Center for Agricultural Sciences (CCA), State University of Londrina (UEL), Londrina 86057-970, Brazil; (A.A.S.B.); (B.Q.d.S.); (C.E.C.); (L.J.); (M.d.S.)
| | - Hellen Yukari Kitagawa
- Department of Microbiology, Center for Biological Science (CCB), State University of Londrina (UEL), Londrina 86057-970, Brazil; (M.F.M.-C.); (M.S.S.); (H.Y.K.); (L.P.M.); (S.P.D.R.); (G.N.)
| | - Larissa Justino
- Department of Preventive Veterinary Medicine, Center for Agricultural Sciences (CCA), State University of Londrina (UEL), Londrina 86057-970, Brazil; (A.A.S.B.); (B.Q.d.S.); (C.E.C.); (L.J.); (M.d.S.)
| | - Leonardo Pinto Medeiros
- Department of Microbiology, Center for Biological Science (CCB), State University of Londrina (UEL), Londrina 86057-970, Brazil; (M.F.M.-C.); (M.S.S.); (H.Y.K.); (L.P.M.); (S.P.D.R.); (G.N.)
| | - Marielen de Souza
- Department of Preventive Veterinary Medicine, Center for Agricultural Sciences (CCA), State University of Londrina (UEL), Londrina 86057-970, Brazil; (A.A.S.B.); (B.Q.d.S.); (C.E.C.); (L.J.); (M.d.S.)
| | - Sergio Paulo Dejato Rocha
- Department of Microbiology, Center for Biological Science (CCB), State University of Londrina (UEL), Londrina 86057-970, Brazil; (M.F.M.-C.); (M.S.S.); (H.Y.K.); (L.P.M.); (S.P.D.R.); (G.N.)
| | - Gerson Nakazato
- Department of Microbiology, Center for Biological Science (CCB), State University of Londrina (UEL), Londrina 86057-970, Brazil; (M.F.M.-C.); (M.S.S.); (H.Y.K.); (L.P.M.); (S.P.D.R.); (G.N.)
| | - Renata Katsuko Takayama Kobayashi
- Department of Microbiology, Center for Biological Science (CCB), State University of Londrina (UEL), Londrina 86057-970, Brazil; (M.F.M.-C.); (M.S.S.); (H.Y.K.); (L.P.M.); (S.P.D.R.); (G.N.)
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Marouf S, Li X, Salem HM, Ahmed ZS, Nader SM, Shaalan M, Awad FH, Zhou H, Cheang T. Molecular detection of multidrug-resistant Pseudomonas aeruginosa of different avian sources with pathogenicity testing and in vitro evaluation of antibacterial efficacy of silver nanoparticles against multidrug-resistant P. aeruginosa. Poult Sci 2023; 102:102995. [PMID: 37566970 PMCID: PMC10440575 DOI: 10.1016/j.psj.2023.102995] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Pseudomonas aeruginosa (P. aeruginosa) is a serious zoonotic pathogen threaten the poultry industry causing severe economic losses therefor, this study aimed to isolation, phenotypic, molecular identification of P. aeruginosa from different avian sources (chickens, turkey, pigeons, table eggs, and dead in shell chicken embryos), from different Egyptian governorates (Giza, Qalubia, Beheira, El-Minya, and Al-Sharqia) with applying of antibiotic sensitivity test on all P. aeruginosa isolates. Highly resistant isolates (n = 49) were subjected to molecular identification of P. aeruginosa with detection of resistant genes including carbapenemase-encoding genes blaKPC, blaOXA-48, and blaNDM. On the base of molecular results, a highly resistant P. aeruginosa strain was tested for its pathogenicity on day old specific pathogen free (SPF) chicks. Also, in vitro experiment was adopted to evaluate the efficacy of silver nanoparticles (Ag-NPs) against highly antibiotic-resistant P. aeruginosa strains. The overall isolation percentage was from all examined samples were 36.2% (571/1,576) representing 45.2% (532/1,176) from different birds' tissues and 39/400 (9.7%) from total egg samples. Some of isolated strains showed multidrug resistance (MDR) against kanamycin, amoxicillin, amoxicillin-clavulanic acid, neomycin, chloramphenicol, vancomycin, cefotaxime clavulanic acid, lincomycin-spectinomycin, co-trimoxazole, cefoxitin, gentamycin, and doxycycline. These MDR strains were also molecularly positive for ESBL and carbapenemase-encoding genes. MDR strain showed high pathogenicity with histopathological alterations in different organs in challenged birds. Main histopathological lesions were necrosis of hepatocytes, renal tubular epithelium, and heart muscle bundles. The MDR strain showed in vitro sensitivity to Ag-NPs. In conclusion, MDR P. aeruginosa is a serious pathogen causing high morbidity, mortality, and pathological tissue alterations. Ag NPs revealed a promising in vitro antimicrobial sensitivity against MDR P. aeruginosa and further in vivo studies were recommended.
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Affiliation(s)
- Sherif Marouf
- Department of Microbiology, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt
| | - Xiting Li
- Department of Periodontology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Heba M Salem
- Department of Poultry Diseases, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt
| | - Zeinab S Ahmed
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt
| | - Sara M Nader
- Department of Zoonoses, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt
| | - Mohamed Shaalan
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, 12211 Giza, Egypt.
| | | | - Hongyan Zhou
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Tuckyun Cheang
- Department of Breast Care Surgery, the First Affiliated Hospital of clinical Medicine of Guangdong Pharmaceutical University, Guangzhou 510080, China
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Ragueh AA, Aboubaker MH, Mohamed SI, Rolain JM, Diene SM. Emergence of Carbapenem-Resistant Gram-Negative Isolates in Hospital Settings in Djibouti. Antibiotics (Basel) 2023; 12:1132. [PMID: 37508230 PMCID: PMC10376901 DOI: 10.3390/antibiotics12071132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Introduction: The antimicrobial resistance (AMR) of bacteria is increasing rapidly against all classes of antibiotics, with the increasing detection of carbapenem-resistant isolates. However, while growing prevalence has been reported around the world, data on the prevalence of carbapenem resistance in developing countries are fairly limited. In this study, we investigated and determined the resistance rate to carbapenems among multidrug-resistant Gram-negative bacteria (MDR-GNB) isolated in Djibouti and characterized their resistance mechanisms. Results: Of the 256 isolates, 235 (91.8%) were identified as Gram-negative bacteria (GNB). Of these GNBs, 225 (95.7%) isolates exhibited a multidrug resistance phenotype, and 20 (8.5%) isolates were resistant to carbapenems, including 13 Escherichia coli, 4 Acinetobacter baumannii, 2 Klebsiella pneumoniae and 1 Proteus mirabilis. The most predominant GNB in this hospital setting were E. coli and K. pneumoniae species. Carbapenemase genes such as blaOXA-48 and blaNDM-5 were identified, respectively, in six and four E. coli isolates, whereas the carbapenemase blaNDM-1 was identified in three E. coli, two K. pneumoniae, one P. mirabilis and one A. baumannii. Moreover, three A. baumannii isolates co-hosted blaOXA-23 and blaNDM-1. Materials and Methods: A total of 256 clinical strains collected between 2019 and 2020 were identified using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). Antibiotic susceptibility testing was performed using disk diffusion and E-test methods. Real-time polymerase chain reaction (RT-PCR), standard PCR and sequencing were used to investigate genes encoding for extended-spectrum-β-lactamases, carbapenemases and colistin resistance genes. Conclusions: We report, for the first time, the presence of MDR-GNB clinical isolates and the emergence of carbapenem-resistant isolates in Djibouti. In addition to performing antimicrobial susceptibility testing, we recommend phenotypic and molecular screening to track the spread of carbapenemase genes among clinical GNB isolates.
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Affiliation(s)
- Ayan Ali Ragueh
- Campus Balbala Croisement RN2-RN5, Université de Djibouti, Djibouti 1904, Djibouti
- MEPHI, IRD, AP-HM, IHU-Méditerranée Infection, Faculté de Pharmacie, Aix-Marseille Universite, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
| | | | - Sitani Idriss Mohamed
- Laboratoire de Biologie et de Biochimie Clinique de L'hôpital Général Peltier, 1323, Avenue Maréchal, Djibouti 1119, Djibouti
| | - Jean-Marc Rolain
- MEPHI, IRD, AP-HM, IHU-Méditerranée Infection, Faculté de Pharmacie, Aix-Marseille Universite, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
| | - Seydina M Diene
- MEPHI, IRD, AP-HM, IHU-Méditerranée Infection, Faculté de Pharmacie, Aix-Marseille Universite, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France
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Bastidas-Caldes C, Romero-Alvarez D, Valdez-Vélez V, Morales RD, Montalvo-Hernández A, Gomes-Dias C, Calvopiña M. Extended-Spectrum Beta-Lactamases Producing Escherichia coli in South America: A Systematic Review with a One Health Perspective. Infect Drug Resist 2022; 15:5759-5779. [PMID: 36204394 PMCID: PMC9531622 DOI: 10.2147/idr.s371845] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Carlos Bastidas-Caldes
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
- Doctoral Program in Public and Animal Health, Faculty of Veterinary Medicine, University of Extremadura, Cáceres, Spain
- Correspondence: Carlos Bastidas-Caldes, One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, 170124, Ecuador, Tel +593 983 174949, Email
| | - Daniel Romero-Alvarez
- One Health Reserch Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
- Biodiversity Institute and Department of Ecology & Evolutionary Biology, The University of Kansas, Lawrence, KS, USA
| | - Victor Valdez-Vélez
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Roberto D Morales
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Andrés Montalvo-Hernández
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Cicero Gomes-Dias
- Department of Basic Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Manuel Calvopiña
- One Health Reserch Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
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Rybak B, Potrykus M, Plenis A, Wolska L. Raw Meat Contaminated with Cephalosporin-Resistant Enterobacterales as a Potential Source of Human Home Exposure to Multidrug-Resistant Bacteria. Molecules 2022; 27:molecules27134151. [PMID: 35807396 PMCID: PMC9267975 DOI: 10.3390/molecules27134151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023] Open
Abstract
The prevalence of cephalosporine-resistant (3GC-R) strains among United States community-related research samples ranged from 5.6 to 10.8%, while, in the European countries, it was 1.2% to 10.1%. Several studies suggest that meat of animal origin could be one of the reservoirs of 3GC-R bacteria. Here, 86 raw meat samples (turkey, pork, chicken and beef) were collected randomly and verified for the presence of 3GC-R bacteria. The 3GC-R bacteria were isolated, identified and characterized phenotypically (antibiotic resistance, motility and biofilm) and genotypically (repetitive-sequence-based rep-PCR) to elucidate any correlations with principal component analysis (PCA). From 28 3GC-R positive samples, 41 strains were isolated, from which the majority belonged to Serratia fonticola (39%), followed by Escherichia coli (19.5%), Enterobacter cloacae (17.1%) and Klebsiella pneumoniae (14.6%). The isolates of E. coli and S. fonticola presented diverse profiles in rep-PCR. Generally, 3GC-R strains were more resistant to antibiotics used in veterinary medicine than in human medicine. PCA derived from antibiotic resistance, motility and biofilm formation of S. fonticola and E. coli strains showed that resistance to beta-lactams was separated from the resistance to other antibiotic classes. Moreover, for the S. fonticola, E. coli and En. cloacae, the type of meat can create a specific tendency towards antibiotic resistance and phenotypic characteristics for S. fonticola, while these relationships were not found for other tested species.
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Affiliation(s)
- Bartosz Rybak
- Department of Environmental Toxicology, Faculty of Health Sciences, Medical University of Gdansk, Debowa Str. 23A, 80-204 Gdansk, Poland; (B.R.); (M.P.); (L.W.)
| | - Marta Potrykus
- Department of Environmental Toxicology, Faculty of Health Sciences, Medical University of Gdansk, Debowa Str. 23A, 80-204 Gdansk, Poland; (B.R.); (M.P.); (L.W.)
| | - Alina Plenis
- Department of Analytical Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Hallera Str. 107, 80-416 Gdansk, Poland
- Correspondence: ; Tel.: +48-58-349-10-96
| | - Lidia Wolska
- Department of Environmental Toxicology, Faculty of Health Sciences, Medical University of Gdansk, Debowa Str. 23A, 80-204 Gdansk, Poland; (B.R.); (M.P.); (L.W.)
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Clemente L, Leão C, Moura L, Albuquerque T, Amaro A. Prevalence and Characterization of ESBL/AmpC Producing Escherichia coli from Fresh Meat in Portugal. Antibiotics (Basel) 2021; 10:antibiotics10111333. [PMID: 34827270 PMCID: PMC8615096 DOI: 10.3390/antibiotics10111333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 10/25/2022] Open
Abstract
The present study aimed to characterize the extended-spectrum β-lactamases and plasmid-mediated AmpC β-lactamases (ESBL/PMAβ) among Escherichia coli producers isolated from beef, pork, and poultry meat collected at retail, in Portugal. A total of 638 meat samples were collected and inoculated on selective medium for the search of E. coli resistant to 3rd generation cephalosporins. Isolates were characterized by antimicrobial susceptibility testing, molecular assays targeting ESBL/AmpC, plasmid-mediated quinolone resistance (PMQR), and plasmid-mediated colistin resistance (PMCR) encoding genes. The highest frequency of E. coli non-wild type to 3rd generation cephalosporins and fluoroquinolones was observed in broiler meat (30.3% and 93.3%, respectively). Overall, a diversity of acquired resistance mechanisms, were detected: blaESBL [blaCTX-M-1 (n = 19), blaCTX-M-15 (n = 4), blaCTX-M-32 (n = 12), blaCTX-M-55 (n = 8), blaCTX-M-65 (n = 4), blaCTX-M-27 (n = 2), blaCTX-M-9 (n = 1), blaCTX-M-14 (n = 11), blaSHV-12 (n = 27), blaTEM-52 (n = 1)], blaPMAβ [blaCMY-2 (n = 8)], PMQR [qnrB (n = 27), qnrS (n = 21) and aac(6')-Ib-type (n = 4)] and PMCR [mcr-1 (n = 8)]. Our study highlights that consumers may be exposed through the food chain to multidrug-resistant E. coli carrying diverse plasmid-mediated antimicrobial resistance genes, posing a great hazard to food safety and a public health risk.
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Affiliation(s)
- Lurdes Clemente
- Laboratory of Bacteriology and Mycology, National Reference Laboratory of Animal Health, INIAV—National Institute of Agrarian and Veterinary Research, 2780-157 Oeiras, Portugal; (C.L.); (L.M.); (T.A.); (A.A.)
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Science, University of Lisbon, 1300-477 Lisbon, Portugal
- Correspondence:
| | - Célia Leão
- Laboratory of Bacteriology and Mycology, National Reference Laboratory of Animal Health, INIAV—National Institute of Agrarian and Veterinary Research, 2780-157 Oeiras, Portugal; (C.L.); (L.M.); (T.A.); (A.A.)
- MED—Mediterranean Institute for Agriculture, Environment and Development, 7006-554 Évora, Portugal
| | - Laura Moura
- Laboratory of Bacteriology and Mycology, National Reference Laboratory of Animal Health, INIAV—National Institute of Agrarian and Veterinary Research, 2780-157 Oeiras, Portugal; (C.L.); (L.M.); (T.A.); (A.A.)
- Faculty of Pharmacy Science, University of Lisbon, FFUL, 1649-019 Lisbon, Portugal
| | - Teresa Albuquerque
- Laboratory of Bacteriology and Mycology, National Reference Laboratory of Animal Health, INIAV—National Institute of Agrarian and Veterinary Research, 2780-157 Oeiras, Portugal; (C.L.); (L.M.); (T.A.); (A.A.)
| | - Ana Amaro
- Laboratory of Bacteriology and Mycology, National Reference Laboratory of Animal Health, INIAV—National Institute of Agrarian and Veterinary Research, 2780-157 Oeiras, Portugal; (C.L.); (L.M.); (T.A.); (A.A.)
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Abd El-Ghany WA. Pseudomonas aeruginosa infection of avian origin: Zoonosis and one health implications. Vet World 2021; 14:2155-2159. [PMID: 34566334 PMCID: PMC8448624 DOI: 10.14202/vetworld.2021.2155-2159] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/20/2021] [Indexed: 12/31/2022] Open
Abstract
Zoonotic diseases are diseases that are transmitted from animals to humans and vice versa. Pseudomonas aeruginosa (P. aeruginosa) is a pathogen with zoonotic nature. Commercial poultry could be infected with P. aeruginosa, especially at young ages with great losses. Infection of embryos with P. aeruginosa induced death in the shell, while infection of chicks led to septicemia, respiratory and enteric infections, and high mortality. Humans are also highly susceptible to P. aeruginosa infection, and the disease is associated with severe lung damage, especially in immunocompromised patients. Chicken carcass and related poultry retail products play an important role in the transmission of P. aeruginosa to humans, especially after processing in abattoirs. Treatment of P. aeruginosa infection is extremely difficult due to continuous development of antibiotic resistance. The transfer of antibiotic-resistant genes from poultry products to humans creates an additional public health problem. Accordingly, this study focused on avian pseudomonad, especially P. aeruginosa, with respect to infection of poultry, transmission to humans, and treatment and antibiotic resistance.
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Affiliation(s)
- Wafaa A Abd El-Ghany
- Department of Poultry Diseases, Faculty of Veterinary Medicine, Cairo University, Egypt
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Lay KK, Jeamsripong S, Sunn KP, Angkititrakul S, Prathan R, Srisanga S, Chuanchuen R. Colistin Resistance and ESBL Production in Salmonella and Escherichia coli from Pigs and Pork in the Thailand, Cambodia, Lao PDR, and Myanmar Border Area. Antibiotics (Basel) 2021; 10:657. [PMID: 34072965 PMCID: PMC8226727 DOI: 10.3390/antibiotics10060657] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/22/2021] [Accepted: 05/28/2021] [Indexed: 02/01/2023] Open
Abstract
The study aimed to examine the prevalence and genetic characteristics of ESBL-production and colistin resistance in Salmonella and Escherichia coli from pigs and pork in the border area among Thailand, Cambodia, Lao PDR, and Myanmar. Salmonella (n = 463) and E. coli (n = 767) isolates were collected from pig rectal swab from slaughterhouses (n = 441) and pork from retail markets (n = 368) during October 2017 and March 2018. All were determined for susceptibility to colistin and cephalosporins, ESBL production and mcr and ESBL genes. Salmonella was predominantly found in Cambodia (65.8%). Serovars Rissen (35.6%) and Anatum (15.3%) were the most common. The E. coli prevalence in pork was above 91% in all countries. Colistin-resistance rate in E. coli (10.4%) was significantly higher than Salmonella (2.6%). ESBL-producing Salmonella (1.9%) and E. coli (6.3%) were detected. The blaCTX-M-55 and blaCTX-M-14 were identified. The mcr-1 gene was detected in Salmonella (n = 12) and E. coli (n = 68). The mcr-1/blaCTX-M-55 and mcr-3/blaCTX-M-55 co-concurrence was observed in one Salmonella and three E. coli isolates, respectively. In conclusion, pigs and pork serve as carriers of colistin and new generation cephalosporins resistance. Testing for resistance to last line antibiotics should be included in national AMR surveillance program using One Health approach.
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Affiliation(s)
- Khin Khin Lay
- Department of Animal Science, University of Veterinary Science, Nay Phi Tau 15013, Myanmar;
| | - Saharuetai Jeamsripong
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.J.); (K.P.S.); (R.P.); (S.S.)
| | - Kyaw Phyoe Sunn
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.J.); (K.P.S.); (R.P.); (S.S.)
- Division of Public Health, Department of Livestock Breeding and Veterinary, Ministry of Agriculture, Livestock and Irrigation, Nay Phi Tau 15011, Myanmar
| | - Sunpetch Angkititrakul
- Research Group for Prevention Technology in Livestock, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Ransiya Prathan
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.J.); (K.P.S.); (R.P.); (S.S.)
| | - Songsak Srisanga
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.J.); (K.P.S.); (R.P.); (S.S.)
| | - Rungtip Chuanchuen
- Research Unit in Microbial Food Safety and Antimicrobial Resistance, Department of Veterinary Public Health, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand; (S.J.); (K.P.S.); (R.P.); (S.S.)
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Díaz-Gavidia C, Álvarez FP, Munita JM, Cortés S, Moreno-Switt AI. Perspective on Clinically-Relevant Antimicrobial Resistant Enterobacterales in Food: Closing the Gaps Using Genomics. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.667504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Antimicrobial resistance is one of the most important public health concerns—it causes 700,000 deaths annually according to the World Health Organization (WHO). Enterobacterales such as E. coli and Klebsiella pneumoniae, have become resistant to many relevant antimicrobials including carbapenems and extended spectrum cephalosporins. These clinically relevant resistant Enterobacterales (CRRE) members are now globally distributed in the environment including different food types (meats, produce, dairy). Unlike known foodborne pathogens, CRRE are not usually part of most food surveillance systems. However, numerous reports of CRRE highlight the importance of these bacteria in food and have been shown to contribute to the overall crisis of antimicrobial resistance. This is especially important in the context of carriage of these pathogens by immuno-compromised individuals. CRRE infections upon consumption of contaminated food could colonize the human gastrointestinal tract and eventually be a source of systemic infections such as urinary tract infections or septicemia. While different aspects need to be considered to elucidate this, whole genome sequencing along with metadata could be used to understand genomic relationships of CRRE obtained from foods and humans, including isolates from clinical infections. Once robust scientific data is available on the role of CRRE in food, countries could move forward to better survey and control CRRE in food.
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Multidrug-Resistant Campylobacer jejuni on Swine Processing at a Slaughterhouse in Eastern Spain. ANIMALS : AN OPEN ACCESS JOURNAL FROM MDPI 2021; 11:ani11051339. [PMID: 34066771 PMCID: PMC8150584 DOI: 10.3390/ani11051339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 01/06/2023]
Abstract
Campylobacteriosis is the most commonly reported gastrointestinal disease in humans in the EU, mainly from poultry meat consumption. C. jejuni is the main species involved in the human disease. However, little is known about the role of swine meat in its epidemiology. Thus, the aim of this study was to assess the epidemiology and antimicrobial resistance of C. jejuni on swine processing at the slaughterhouse. To this end, a total of 21 pig herds were intensively sampled at the slaughterhouse. Campylobacter isolation was based on official method ISO 10272-1:2018, speciation was determined by the hippurate hydrolysis test, and antibiotic susceptibility was performed according to standard disc diffusion assay. The results showed that all batches shed Campylobacter in faeces upon arrival at the slaughterhouse and remained positive at the end of the slaughtering process (42.8%). Moreover, 41.5% of Campylobacter strains isolated were C. jejuni and all of them were resistant to at least one antibiotic, and 96.3% were multidrug-resistant strains. In conclusion, the high level of multidrug-resistant C. jejuni swine batch contamination at the slaughterhouse makes it necessary to include the swine sector in national control programmes to reduce the bacterium and its resistance.
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Ejikeugwu C, Nworie O, Saki M, Al-Dahmoshi HOM, Al-Khafaji NSK, Ezeador C, Nwakaeze E, Eze P, Oni E, Obi C, Iroha I, Esimone C, Adikwu MU. Metallo-β-lactamase and AmpC genes in Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa isolates from abattoir and poultry origin in Nigeria. BMC Microbiol 2021; 21:124. [PMID: 33882823 PMCID: PMC8059301 DOI: 10.1186/s12866-021-02179-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/30/2021] [Indexed: 01/04/2023] Open
Abstract
Background Gram-negative bacteria (GNB) including Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae represent the most relevant reservoir of resistance genes such as metallo-β-lactamase (MBL) and AmpC genes that give them the undue advantage to resist antimicrobial onslaught. This study aimed to investigate the occurrence of MBL (blaIMP-1, blaIMP-2, blaVIM-1, blaVIM-2) and AmpC (blaFOX, blaDHA, blaCMY, blaACC) resistance genes in aforementioned GNB collected from abattoir and poultry sources in Nigeria. Results In total, 370 isolates were collected from abattoir tables (n = 130), anal region of cows (n = 120), and the cloacae of poultry birds (n = 120). The test isolates showed high rate of resistance to cephalosporins and carbapenems. The MBLs were phenotypically detected in 22 E. coli, 22 P. aeruginosa, and 18 K. pneumoniae isolates using combined disc test (CDT). However, only 11 E. coli, 24 P. aeruginosa, and 18 Klebsiella pneumoniae isolates were phenotypically confirmed to be AmpC producers using cefoxitin-cloxacillin double disk synergy test (CC-DDST). MBL encoding genes (particularly the blaIMP-1 genes and blaIMP-2 genes) were detected by polymerase chain reaction (PCR) in 12 (54.6%) E. coli, 15 (83.3%) K. pneumoniae, and 16 (72.7%) P. aeruginosa isolates. AmpC genes (particularly the blaCMY genes and blaFOX genes) were found in a total of 5 (29.4%) E. coli isolates, 5 (27.8%) isolates of K. pneumoniae, and 10 (41.7%) isolates of P. aeruginosa. Conclusions Our study showed the circulation of MBL and AmpC genes in GNB from abattoir and poultry origin in Nigeria. Adoption of regular control policies is necessary to reduce the spread of these species as soon as possible, especially in poultry and slaughterhouses.
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Affiliation(s)
- Chika Ejikeugwu
- Department of Applied Microbiology, Ebonyi State University, Abakaliki, Nigeria
| | - Okoro Nworie
- Department of Biological Sciences, Alex Ekwueme Federal University, Ndufu-Alike Ikwo, Ikwo, Nigeria
| | - Morteza Saki
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hussein O M Al-Dahmoshi
- Biology Department, College of Science, University of Babylon, Hilla City, Babylon Province, Iraq
| | - Noor S K Al-Khafaji
- Biology Department, College of Science, University of Babylon, Hilla City, Babylon Province, Iraq
| | - Chika Ezeador
- Department of Medical Microbiology & Parasitology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Emmanuel Nwakaeze
- Department of Applied Microbiology, Ebonyi State University, Abakaliki, Nigeria
| | - Peter Eze
- Department of Environmental Health Science, Nnamdi Azikiwe University, Awka, Nigeria
| | - Eniola Oni
- Department of Microbiology, Federal University of Agriculture, Abeokuta, Nigeria
| | - Chidiebere Obi
- Department of Microbiology, Federal University, Birnin Kebbi, Nigeria
| | - Ifeanyichukwu Iroha
- Department of Applied Microbiology, Ebonyi State University, Abakaliki, Nigeria
| | - Charles Esimone
- Department of Pharmaceutical Microbiology and Biotechnology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Michael U Adikwu
- Department of Pharmaceutics, University of Nigeria, Nsukka, Nigeria
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12
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da Silva SF, Reis IB, Monteiro MG, Dias VC, Machado ABF, da Silva VL, Diniz CG. Influence of Human Eating Habits on Antimicrobial Resistance Phenomenon: Aspects of Clinical Resistome of Gut Microbiota in Omnivores, Ovolactovegetarians, and Strict Vegetarians. Antibiotics (Basel) 2021; 10:276. [PMID: 33803337 PMCID: PMC8001852 DOI: 10.3390/antibiotics10030276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/17/2022] Open
Abstract
The use of xenobiotics in food production and how food intake is carried out in different cultures, along with different eating habits (omnivorism (ON), ovolactovegetarianism (VT), and strict vegetarianism (VG)) seem to have implications for antimicrobial resistance, especially in the human gut microbiota. Thus, the aim of this study was to evaluate aspects of the clinical resistome of the human gut microbiota among healthy individuals with different eating habits. Volunteers were divided into 3 groups: n = 19 omnivores (ON), n = 20 ovolactovegetarians (VT), and n = 19 strict vegetarians (VG), and nutritional and anthropometric parameters were measured. Metagenomic DNA from fecal samples was used as a template for PCR screening of 37 antimicrobial resistance genes (ARG) representative of commonly used agents in human medicine. The correlation between eating habits and ARG was evaluated. There were no significant differences in mean caloric intake. Mean protein intake was significantly higher in ON, and fiber and carbohydrate consumption was higher in VG. From the screened ARG, 22 were detected. No clear relationship between diets and the occurrence of ARG was observed. Resistance genes against tetracyclines, β-lactams, and the MLS group (macrolides, lincosamides, and streptogramins) were the most frequent, followed by resistance genes against sulfonamides and aminoglycosides. Vegetables and minimally processed foods seem to be the main source of ARG for the human gut microbiota. Although eating habits vary among individuals, the open environment and the widespread ARG from different human activities draw attention to the complexity of the antimicrobial resistance phenomenon which should be addressed by a One Health approach.
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Affiliation(s)
| | | | | | | | | | | | - Cláudio Galuppo Diniz
- Laboratory of Bacterial Physiology and Molecular Genetics, Center for Studies in Microbiology, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, Brazil; (S.F.d.S.); (I.B.R.); (M.G.M.); (V.C.D.); (A.B.F.M.); (V.L.d.S.)
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13
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Bergšpica I, Kaprou G, Alexa EA, Prieto M, Alvarez-Ordóñez A. Extended Spectrum β-Lactamase (ESBL) Producing Escherichia coli in Pigs and Pork Meat in the European Union. Antibiotics (Basel) 2020; 9:E678. [PMID: 33036406 PMCID: PMC7600538 DOI: 10.3390/antibiotics9100678] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to review the fast and worldwide distribution of ESBL enzymes and to describe the role of the pork production chain as a reservoir and transmission route of ESBL-producing Escherichia coli and ESBLs in the European Union (EU). The use of β-lactam antibiotics in swine production and the prevalence of ESBL producing E. coli in fattening pigs and pork meat across Europe is analyzed. Overall, an increasing trend in the prevalence of presumptive ESBL producing E. coli in fattening pigs in the EU has been observed in the last decade, although with major differences among countries, linked to different approaches in the use of antimicrobials in pork production within the EU. Moreover, the various dissemination pathways of these bacteria along the pork production chain are described, along with factors at farm and slaughterhouse level influencing the risk of introducing or spreading ESBL producing bacteria throughout the food chain.
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Affiliation(s)
- Ieva Bergšpica
- Department of Food Hygiene and Technology, Universidad de León, 24007 León, Spain; (G.K.); (E.A.A.); (M.P.)
- Institute of Food Safety, Animal Health and Environment BIOR, LV-1076 Riga, Latvia
| | - Georgia Kaprou
- Department of Food Hygiene and Technology, Universidad de León, 24007 León, Spain; (G.K.); (E.A.A.); (M.P.)
| | - Elena A. Alexa
- Department of Food Hygiene and Technology, Universidad de León, 24007 León, Spain; (G.K.); (E.A.A.); (M.P.)
| | - Miguel Prieto
- Department of Food Hygiene and Technology, Universidad de León, 24007 León, Spain; (G.K.); (E.A.A.); (M.P.)
- Institute of Food Science and Technology, Universidad de León, 24007 León, Spain
| | - Avelino Alvarez-Ordóñez
- Department of Food Hygiene and Technology, Universidad de León, 24007 León, Spain; (G.K.); (E.A.A.); (M.P.)
- Institute of Food Science and Technology, Universidad de León, 24007 León, Spain
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14
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Tanimoto K, Nomura T, Hashimoto Y, Hirakawa H, Watanabe H, Tomita H. Isolation of Serratia fonticola Producing FONA, a Minor Extended-Spectrum β-Lactamase (ESBL), from Imported Chicken Meat in Japan. Jpn J Infect Dis 2020; 74:79-81. [PMID: 32741928 DOI: 10.7883/yoken.jjid.2020.114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Five novel strains of Serratia fonticola that produce FONA, a minor extended-spectrum beta-lactamase (ESBL), were isolated during routine surveillance of ESBL-producing Enterobacteriaceae in imported chicken meat in Japan in 2017 and 2018. These strains exhibited a clear ESBL phenotype in susceptibility tests carried out in the presence of clavulanic acid; however, all strains tested negative in a multiplex polymerase chain reaction assay used to detect TEM, SHV, and CTX-M β-lactamase genes. After identification of the bacterial species as S. fonticola, full length blaFONA genes were amplified and the DNA sequences were determined. The blaFONA genes from all 5 strains were different from those previously reported (blaFONA-1 to blaFONA-6); they clustered close to one another but were distinct from previously reported blaFONA genes in a phylogenic analysis based on amino acid sequences.
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Affiliation(s)
- Koichi Tanimoto
- Laboratory of Bacterial Drug Resistance, Gunma University Graduate School of Medicine, Japan
| | - Takahiro Nomura
- Department of Bacteriology, Gunma University Graduate School of Medicine, Japan
| | - Yusuke Hashimoto
- Department of Bacteriology, Gunma University Graduate School of Medicine, Japan
| | - Hidetada Hirakawa
- Department of Bacteriology, Gunma University Graduate School of Medicine, Japan
| | - Haruo Watanabe
- Department of Public Health, Faculty of Medicine, International University of Health and Welfare, Japan
| | - Haruyoshi Tomita
- Laboratory of Bacterial Drug Resistance, Gunma University Graduate School of Medicine, Japan.,Department of Bacteriology, Gunma University Graduate School of Medicine, Japan
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15
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Richter L, du Plessis EM, Duvenage S, Korsten L. Occurrence, Phenotypic and Molecular Characterization of Extended-Spectrum- and AmpC- β-Lactamase Producing Enterobacteriaceae Isolated From Selected Commercial Spinach Supply Chains in South Africa. Front Microbiol 2020; 11:638. [PMID: 32351477 PMCID: PMC7176360 DOI: 10.3389/fmicb.2020.00638] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
The increasing occurrence of multidrug-resistant (MDR) extended-spectrum β-lactamase- (ESBL) and/or AmpC β-lactamase-producing Enterobacteriaceae in health care systems, the environment and fresh produce is a serious concern globally. Production practices, processing and subsequent consumption of contaminated raw fruit and vegetables represent a possible human transmission route. The purpose of this study was to determine the presence of ESBL/AmpC-producing Enterobacteriaceae in complete spinach supply chains and to characterize the isolated strains phenotypically (antimicrobial resistance profiles) and genotypically (ESBL/AmpC genetic determinants, detection of class 1, 2, and 3 integrons). Water, soil, fresh produce, and contact surface samples (n = 288) from two commercial spinach production systems were screened for ESBL/AmpC-producing Enterobacteriaceae. In total, 14.58% (42/288) of the samples were found to be contaminated after selective enrichment, plating onto chromogenic media and matrix-assisted laser desorption ionization time-of-flight mass spectrometry identity confirmation of presumptive ESBL/AmpC isolates. This included 15.28% (11/72) water and 12.12% (16/132) harvested- and processed spinach, while 25% (15/60) retail spinach samples were found to be contaminated with an increase in isolate abundance and diversity in both scenarios. Dominant species identified included Serratia fonticola (45.86%), Escherichia coli (20.83%), and Klebsiella pneumoniae (18.75%). In total, 48 (81.36%) isolates were phenotypically confirmed as ESBL/AmpC-producing Enterobacteriaceae of which 98% showed a MDR phenotype. Genotypic characterization (PCR of ESBL/AmpC resistance genes and integrons) further revealed the domination of the CTX-M Group 1 ESBL type, followed by TEM and SHV; whilst the CIT-type was the only plasmid-mediated AmpC genetic determinant detected. Integrons were detected in 79.17% (n = 38) of the confirmed ESBL/AmpC-producing isolates, of which we highlight the high prevalence of class 3 integrons, detected in 72.92% (n = 35) of the isolates, mostly in S. fonticola. Class 2 integrons were not detected in this study. This is the first report on the prevalence of ESBL/AmpC-producing Enterobacteriaceae isolated throughout commercial spinach production systems harboring class 1 and/or class 3 integrons in Gauteng Province, South Africa. The results add to the global knowledge base regarding the prevalence and characteristics of ESBL/AmpC-producing Enterobacteriaceae in fresh vegetables and the agricultural environment required for future risk analysis.
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Affiliation(s)
- Loandi Richter
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria, South Africa
| | - Erika M du Plessis
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria, South Africa
| | - Stacey Duvenage
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria, South Africa.,Department of Science and Technology-National Research Foundation Centre of Excellence in Food Security, Bellville, South Africa
| | - Lise Korsten
- Department of Plant and Soil Sciences, University of Pretoria, Pretoria, South Africa.,Department of Science and Technology-National Research Foundation Centre of Excellence in Food Security, Bellville, South Africa
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16
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Dandachi I, Fayad E, Sleiman A, Daoud Z, Rolain JM. Dissemination of Multidrug-Resistant and mcr-1 Gram-Negative Bacilli in Broilers, Farm Workers, and the Surrounding Environment in Lebanon. Microb Drug Resist 2020; 26:368-377. [DOI: 10.1089/mdr.2019.0137] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Iman Dandachi
- Aix Marseille University, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
| | - Elie Fayad
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
| | - Ahmad Sleiman
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
| | - Ziad Daoud
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
- Division of Clinical Microbiology, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Jean-Marc Rolain
- Aix Marseille University, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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17
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Quantitative microbiological slaughter process analysis in a large-scale Swiss poultry abattoir. Food Control 2019. [DOI: 10.1016/j.foodcont.2019.05.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Gundran RS, Cardenio PA, Salvador RT, Sison FB, Benigno CC, Kreausukon K, Pichpol D, Punyapornwithaya V. Prevalence, Antibiogram, and Resistance Profile of Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates from Pig Farms in Luzon, Philippines. Microb Drug Resist 2019; 26:160-168. [PMID: 31532307 DOI: 10.1089/mdr.2019.0019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This cross-sectional study was conducted to determine the prevalence, antibiogram, and resistance profile of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) isolates from healthy pigs and pig farms in Luzon, Philippines. A total of 162 rectal samples from healthy finisher and breeder pigs and boot swab samples from pig houses were collected from 54 randomly selected pig farms. Bacteria were isolated and screened using MacConkey agar plate supplemented with 1 mg/L cefotaxime. Identification of bacteria and antimicrobial susceptibility test were carried out through Vitek® 2 and combined disk test. PCR amplifications were carried out in all isolates targeting blaCTX-M and its five major groupings, blaTEM, and blaSHV. The farm prevalence of ESBL-EC was 57.41% (95% confidence interval [CI] = 43.21-70.77). A total of 48 (29.63%) ESBL-EC isolates were isolated from samples that showed 14 different phenotypic multidrug resistance patterns. The prevalence of blaCTX-M gene was 91.67% (95% CI = 80.02-97.68). All major blaCTX-M-groups except blaCTX-M-25group were detected. The blaCTX-M-1 was the most prevalent blaCTX-M gene, 75.0% (95% CI = 60.40-86.36). The prevalence of blaTEM and blaSHV genes was 91.67% (95% CI = 80.02-97.68) and 60.42% (95% CI = 45.27-74.23), respectively. Coexistence of different blaCTX-M, blaTEM, and blaSHV genes was observed in 44 isolates with 20 different genotypic patterns. High prevalence, diverse antibiogram profile, and genotypic resistance pattern of ESBL-EC isolates from healthy pigs and pig farms were observed in this study that could result in possible transmission to farm workers, susceptible bacteria, and the environment.
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Affiliation(s)
- Romeo S Gundran
- College of Veterinary Science and Medicine, Central Luzon State University, Science City of Munoz, Nueva Ecija, Philippines
| | - Paul A Cardenio
- College of Veterinary Science and Medicine, Central Luzon State University, Science City of Munoz, Nueva Ecija, Philippines
| | - Roderick T Salvador
- College of Veterinary Science and Medicine, Central Luzon State University, Science City of Munoz, Nueva Ecija, Philippines
| | - Fredelon B Sison
- College of Veterinary Science and Medicine, Central Luzon State University, Science City of Munoz, Nueva Ecija, Philippines
| | - Carolyn C Benigno
- Philippine College of Veterinary Epidemiologists and PHILVET Health Services, Inc., Quezon City, Philippines
| | | | - Duangporn Pichpol
- Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
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Dandachi I, Chaddad A, Hanna J, Matta J, Daoud Z. Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach. Front Microbiol 2019; 10:1941. [PMID: 31507558 PMCID: PMC6716069 DOI: 10.3389/fmicb.2019.01941] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 08/07/2019] [Indexed: 12/16/2022] Open
Abstract
In the last decade, extended-spectrum cephalosporin and carbapenem resistant Gram-negative bacilli (GNB) have been extensively reported in the literature as being disseminated in humans but also in animals and the environment. These resistant organisms often cause treatment challenges due to their wide spectrum of antibiotic resistance. With the emergence of colistin resistance in animals and its subsequent detection in humans, the situation has worsened. Several studies reported the transmission of resistant organisms from animals to humans. Studies from the middle east highlight the spread of resistant organisms in hospitals and to a lesser extent in livestock and the environment. In view of the recent socio-economical conflicts that these countries are facing in addition to the constant population mobilization; we attempt in this review to highlight the gaps of the prevalence of resistance, antibiotic consumption reports, infection control measures and other risk factors contributing in particular to the spread of resistance in these countries. In hospitals, carbapenemases producers appear to be dominant. In contrast, extended spectrum beta lactamases (ESBL) and colistin resistance are becoming a serious problem in animals. This is mainly due to the continuous use of colistin in veterinary medicine even though it is now abandoned in the human sphere. In the environment, despite the small number of reports, ESBL and carbapenemases producers were both detected. This highlights the importance of the latter as a bridge between humans and animals in the transmission chain. In this review, we note that in the majority of the Middle Eastern area, little is known about the level of antibiotic consumption especially in the community and animal farms. Furthermore, some countries are currently facing issues with immigrants, poverty and poor living conditions which has been imposed by the civil war crisis. This all greatly facilitates the dissemination of resistance in all environments. In the one health concept, this work re-emphasizes the need to have global intervention measures to avoid dissemination of antibiotic resistance in humans, animals and the environment in Middle Eastern countries.
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Affiliation(s)
- Iman Dandachi
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
| | - Amer Chaddad
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
| | - Jason Hanna
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
| | - Jessika Matta
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
| | - Ziad Daoud
- Faculty of Medicine and Medical Sciences, Clinical Microbiology Laboratory, University of Balamand, Beirut, Lebanon
- Division of Clinical Microbiology, Saint George Hospital University Medical Center, Beirut, Lebanon
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20
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Prevalence and Antibiotic Susceptibility among Gram Negative Bacteria Isolated from Intensive Care Units at a Tertiary Care Hospital in Riyadh, Saudi Arabia. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.1.21] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Clemente L, Manageiro V, Correia I, Amaro A, Albuquerque T, Themudo P, Ferreira E, Caniça M. Revealing mcr-1-positive ESBL-producing Escherichia coli strains among Enterobacteriaceae from food-producing animals (bovine, swine and poultry) and meat (bovine and swine), Portugal, 2010-2015. Int J Food Microbiol 2019; 296:37-42. [PMID: 30844701 DOI: 10.1016/j.ijfoodmicro.2019.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
Abstract
We screened 1840 Enterobacteriaceae isolates from food-producing animals, meat, meat products and animal feed, for the detection of plasmid-mediated colistin resistance, during 2010-2015. The mcr-1 gene was detected in 8.0% (97/1206) Escherichia coli and in 0.47% (3/634) Salmonella enterica isolates, with a high number of mcr-1 positive E. coli isolates (45.7%) being extended-spectrum β-lactamase or plasmid-mediated AmpC β-lactamase co-producers. No mcr-2 gene was detected. Our findings highlight the spread of mcr-1 genes within a wide-ranging sample of food-producing animals and meat, in Portugal.
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Affiliation(s)
- Lurdes Clemente
- INIAV - National Institute of Agrarian and Veterinary Research, Bacteriology and Micology Laboratory, Oeiras, Portugal
| | - Vera Manageiro
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, University of Oporto, Oporto, Portugal
| | - Ivone Correia
- INIAV - National Institute of Agrarian and Veterinary Research, Bacteriology and Micology Laboratory, Oeiras, Portugal
| | - Ana Amaro
- INIAV - National Institute of Agrarian and Veterinary Research, Bacteriology and Micology Laboratory, Oeiras, Portugal
| | - Teresa Albuquerque
- INIAV - National Institute of Agrarian and Veterinary Research, Bacteriology and Micology Laboratory, Oeiras, Portugal
| | - Patrícia Themudo
- INIAV - National Institute of Agrarian and Veterinary Research, Bacteriology and Micology Laboratory, Oeiras, Portugal
| | - Eugénia Ferreira
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, University of Oporto, Oporto, Portugal
| | - Manuela Caniça
- National Reference Laboratory of Antibiotic Resistances and Healthcare Associated Infections, Department of Infectious Diseases, National Institute of Health Dr Ricardo Jorge, Lisbon, Portugal; Centre for the Studies of Animal Science, Institute of Agrarian and Agri-Food Sciences and Technologies, University of Oporto, Oporto, Portugal.
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Abstract
Multidrug resistance in Escherichia coli has become a worrying issue that is increasingly observed in human but also in veterinary medicine worldwide. E. coli is intrinsically susceptible to almost all clinically relevant antimicrobial agents, but this bacterial species has a great capacity to accumulate resistance genes, mostly through horizontal gene transfer. The most problematic mechanisms in E. coli correspond to the acquisition of genes coding for extended-spectrum β-lactamases (conferring resistance to broad-spectrum cephalosporins), carbapenemases (conferring resistance to carbapenems), 16S rRNA methylases (conferring pan-resistance to aminoglycosides), plasmid-mediated quinolone resistance (PMQR) genes (conferring resistance to [fluoro]quinolones), and mcr genes (conferring resistance to polymyxins). Although the spread of carbapenemase genes has been mainly recognized in the human sector but poorly recognized in animals, colistin resistance in E. coli seems rather to be related to the use of colistin in veterinary medicine on a global scale. For the other resistance traits, their cross-transfer between the human and animal sectors still remains controversial even though genomic investigations indicate that extended-spectrum β-lactamase producers encountered in animals are distinct from those affecting humans. In addition, E. coli of animal origin often also show resistances to other-mostly older-antimicrobial agents, including tetracyclines, phenicols, sulfonamides, trimethoprim, and fosfomycin. Plasmids, especially multiresistance plasmids, but also other mobile genetic elements, such as transposons and gene cassettes in class 1 and class 2 integrons, seem to play a major role in the dissemination of resistance genes. Of note, coselection and persistence of resistances to critically important antimicrobial agents in human medicine also occurs through the massive use of antimicrobial agents in veterinary medicine, such as tetracyclines or sulfonamides, as long as all those determinants are located on the same genetic elements.
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ESβL E. coli isolated in pig's chain: Genetic analysis associated to the phenotype and biofilm synthesis evaluation. Int J Food Microbiol 2019; 289:162-167. [DOI: 10.1016/j.ijfoodmicro.2018.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 07/17/2018] [Accepted: 09/14/2018] [Indexed: 01/08/2023]
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Novel sensor platform for rapid detection and quantification of coliforms on food contact surfaces. J Microbiol Methods 2018; 153:74-83. [PMID: 30240812 DOI: 10.1016/j.mimet.2018.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/17/2018] [Accepted: 09/17/2018] [Indexed: 01/30/2023]
Abstract
In this paper, a novel sensor platform based on screen printed carbon electrode coated by graphene modified polyacrylamide gel (GR/PAAGC) was developed and implemented for sampling, detection and enumeration of coliform bacteria (coliforms) on food contact surfaces. The optimized formula of polyacrylamide (PAA) and agar-agar increased the adhesive properties of the gel, being crucial for the coliforms recovery, attached to food contact surfaces. The 6-Chloro-3-indoxyl-β-D-galactopyranoside (6-CIGP) was used as a new electrochemical reporter for β-D-galactosidase activity. The released 6,6'-Dichloro-Indigo (6-DI) was directly detected by GR/PAAGC sensor. The presence of Isopropyl-β-D-thiogalactopyranoside (IPTG) and n-Octyl-β-D-thiogalactopyranoside (OBDG) in the gel contributed to reduction of the detection time. The addition of graphene enhanced the voltammetric signal and increased the conductivity of PAA gel. The anodic and cathodic peaks of the released product were directly proportional to the concentration of coliforms. Bacterial cell concentrations ranging from 1.6log10CFU/mL to 6.6log10CFU/mL were detected. Well-shaped, sharp voltammetric curves were generated within 3 h. Redox peaks exhibited good sensitivity with detection limits (LOD) < 0.6log10CFU/mL. After series of optimization experiments, coliforms ranging from 0.6log10CFU/cm2 to 6.610CFU/cm2 on stainless steel surfaces have been detected within 30 min with a LOD of 0.1log10CFU/cm2. The developed rapid, sensitive, reproducible and specific sensor successfully applied for single detection as well as for real-time monitoring of growth of coliform bacteria on stainless steel surfaces during food processing.
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von Tippelskirch P, Gölz G, Projahn M, Daehre K, Friese A, Roesler U, Alter T, Orquera S. Prevalence and quantitative analysis of ESBL and AmpC beta-lactamase producing Enterobacteriaceae in broiler chicken during slaughter in Germany. Int J Food Microbiol 2018; 281:82-89. [DOI: 10.1016/j.ijfoodmicro.2018.05.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/22/2018] [Accepted: 05/21/2018] [Indexed: 12/14/2022]
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Ye Q, Wu Q, Zhang S, Zhang J, Yang G, Wang J, Xue L, Chen M. Characterization of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae From Retail Food in China. Front Microbiol 2018; 9:1709. [PMID: 30135680 PMCID: PMC6092486 DOI: 10.3389/fmicb.2018.01709] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/09/2018] [Indexed: 01/21/2023] Open
Abstract
In this study, we characterized the β-lactamase genes and phenotypic resistance of cephalosporin-resistant Enterobacteriaceae isolated from retail foods in China. Of 1,024 Enterobacteriaceae isolates recovered from raw meat products, aquatic products, raw vegetables, retail-level ready-to-eat (RTE) foods, frozen foods, and mushrooms from 2011 to 2014, 164 (16.0%) showed cefotaxime (CTX) and/or ceftazidime (CAZ) cephalosporin resistance, and 96 (9.4%) showed the extended-spectrum β-lactamase (ESBL) phenotype. More than 30% isolates were resistant to all antimicrobial agents except carbapenems (MEM 3.1% and IPM 5.2%), cefoxitin (FOX 6.3%), and amoxicillin/clavulanic acid (AMC 26%), and 94.8% of the strains were resistant to up to seven antibiotics. Polymerase chain reaction analysis showed that blaTEM (81.9%) was the most common gene, followed by blaCTX-M (68.1%) and blaSHV (38.9%). Moreover, 16.8% (72/429) of food samples contained ESBL-positive Enterobacteriaceae, with the following patterns: 32.9% (23/70) in frozen foods, 27.2% (5/29) in mushrooms, 17.6% (24/131) in raw meats, 13.3% (4/30) in fresh vegetables, 11.1% (8/72) in RTE foods, and 9.3% (9/97) in aquatic products. In addition, 24 of 217 foods collected in South China (11.1%), 25 of 131 foods collected in North of the Yangtze River region (19.1%), and 23 of 81 foods collected in South of the Yangtze River region (28.4%) were positive for ESBL- Enterobacteriaceae. Conjugation experiments demonstrated that the 22 of 72 isolates were transconjugants that had received the β-lactamase gene and were resistant to β-lactam antibiotics as well as some non-β-lactam antibiotics. These findings demonstrated that retail foods may be reservoirs for the dissemination of β-lactam antibiotics and that resistance genes could be transmitted to humans through the food chain; and the predominant ESBL-producing Enterobacteriaceae in China was isolated from in frozen chicken-meat, followed by frozen pork, cold noodles in sauce, cucumber, raw chicken meat, frozen pasta, brine-soaked chicken and tomato.
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Affiliation(s)
- Qinghua Ye
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Qingping Wu
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Shuhong Zhang
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Jumei Zhang
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Guangzhu Yang
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Juan Wang
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China.,College of Food Science, South China Agricultural University, Guangzhou, China
| | - Liang Xue
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
| | - Moutong Chen
- State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangdong Institute of Microbiology, Guangzhou, China
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Dandachi I, Sokhn ES, Dahdouh EA, Azar E, El-Bazzal B, Rolain JM, Daoud Z. Prevalence and Characterization of Multi-Drug-Resistant Gram-Negative Bacilli Isolated From Lebanese Poultry: A Nationwide Study. Front Microbiol 2018; 9:550. [PMID: 29628921 PMCID: PMC5876231 DOI: 10.3389/fmicb.2018.00550] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/12/2018] [Indexed: 12/12/2022] Open
Abstract
Currently, antimicrobial resistance is one of the most prominent public health issues. In fact, there is increasing evidence that animals constitute a reservoir of antimicrobial resistance. In collaboration with the Lebanese Ministry of Agriculture, the aim of this study was to determine the prevalence of intestinal carriage of multi-drug-resistant Gram-negative Bacilli in poultry farms at the national level. Between August and December 2015, 981 fecal swabs were obtained from 49 poultry farms distributed across Lebanon. The swabs were subcultured on MacConkey agar supplemented with cefotaxime (2 μg/ml). Isolated strains were identified using MALDI-TOF mass spectrometry. Multilocus sequence typing analysis was performed for Escherichia coli. Phenotypic detection of extended spectrum β-lactamases (ESBL) and AmpC production was performed using double disk synergy and the ampC disk test, respectively. β-lactamase encoding genes blaCTX-M, blaTEM, blaSHV, blaFOX, blaMOX, blaEBC, blaACC, blaDHA, and blaCMY using PCR amplification. Out of 981 fecal swabs obtained, 203 (20.6%) showed bacterial growth on the selective medium. Of the 235 strains isolated, 217 were identified as E. coli (92%), eight as Klebsiella pneumoniae (3%), three as Proteus mirabilis (1%) and three as Enterobacter cloacae (1%). MLST analysis of E. coli isolates showed the presence of ST156, ST5470, ST354, ST155, and ST3224. The phenotypic tests revealed that 43.5, 28.5, and 20.5% of the strains were ampC, ESBL, and ampC/ESBL producers, respectively. The putative TEM gene was detected in 83% of the isolates, SHV in 20%, CTX-M in 53% and CMY ampC β-lactamase gene in 65%. Our study showed that chicken farms in Lebanon are reservoirs of ESBL and AmpC producing Gram-negative bacilli. The level of antibiotic consumption in the Lebanese veterinary medicine should be evaluated. Future studies should focus on the risk factors associated with the acquisition of multi-drug-resistant organisms in farm animals in Lebanon.
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Affiliation(s)
- Iman Dandachi
- Clinical Microbiology Laboratory, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon.,IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Elie S Sokhn
- Clinical Microbiology Laboratory, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Elias A Dahdouh
- Clinical Microbiology Laboratory, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Eid Azar
- Clinical Microbiology Laboratory, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | | | - Jean-Marc Rolain
- IRD, APHM, MEPHI, IHU-Méditerranée Infection, Aix-Marseille Université, Marseille, France
| | - Ziad Daoud
- Clinical Microbiology Laboratory, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
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