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Ballesteros-Monrreal MG, Mendez-Pfeiffer P, Ortíz B, Bolado-Martínez E, Álvarez-Ainza ML, Enciso-Martínez Y, Arenas-Hernández MMP, Diaz-Murrieta B, Barrios-Villa E, Valencia D. Uropathogenic E. coli and Hybrid Pathotypes in Mexican Women with Urinary Tract Infections: A Comprehensive Molecular and Phenotypic Overview. Curr Issues Mol Biol 2024; 46:5909-5928. [PMID: 38921024 PMCID: PMC11202577 DOI: 10.3390/cimb46060353] [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: 05/01/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
Uropathogenic Escherichia coli (UPEC) is the main cause of urinary tract infections (UTIs) and carries virulence and resistance factors often found in mobilizable genetic elements, such as plasmids or pathogenicity islands (PAIs). UPEC is part of the extraintestinal pathogenic E. coli (ExPEC), but hybrid strains possessing both diarrheagenic E. coli (DEC) and ExPEC traits, termed "hypervirulent", present a significant health threat. This study assessed the prevalence of UPEC PAIs, ExPEC sequence types (ST), DEC genes, carbapenemase and extended-spectrum β-lactamase (ESBL) phenotypes, resistance genotypes, and plasmids in 40 clinical isolates of UPEC. Results showed that 72.5% of isolates had PAIs, mainly PAI IV536 (53%). ESBL phenotypes were found in 65% of β-lactam-resistant isolates, with 100% of carbapenem-resistant isolates producing carbapenemase. The predominant ESBL gene was blaCTX-M-2 (60%), and the most common resistance gene in fluoroquinolone and aminoglycoside-resistant isolates was aac(6')Ib (93%). Plasmids were present in 57% of isolates, and 70% belonged to the ST131 clonal group. Molecular markers for DEC pathotypes were detected in 20 isolates, with 60% classified as hybrid pathotypes. These findings indicate significant pathogenic potential and the presence of hybrid pathotypes in E. coli UTI clinical isolates in the Mexican population.
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Affiliation(s)
- Manuel G. Ballesteros-Monrreal
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Pablo Mendez-Pfeiffer
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Bryan Ortíz
- Instituto de Investigaciones en Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
| | - Enrique Bolado-Martínez
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Hermosillo CP 83000, Sonora, Mexico; (E.B.-M.); (M.L.Á.-A.)
| | - Maritza Lizeth Álvarez-Ainza
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Hermosillo CP 83000, Sonora, Mexico; (E.B.-M.); (M.L.Á.-A.)
| | - Yessica Enciso-Martínez
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Margarita M. P. Arenas-Hernández
- Posgrado en Microbiología, Centro de Investigación en Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Ciudad Universitaria, Puebla CP 72570, Pue, Mexico
| | - Betsaida Diaz-Murrieta
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Edwin Barrios-Villa
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Dora Valencia
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
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Nasrollahian S, Graham JP, Halaji M. A review of the mechanisms that confer antibiotic resistance in pathotypes of E. coli. Front Cell Infect Microbiol 2024; 14:1387497. [PMID: 38638826 PMCID: PMC11024256 DOI: 10.3389/fcimb.2024.1387497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
The dissemination of antibiotic resistance in Escherichia coli poses a significant threat to public health worldwide. This review provides a comprehensive update on the diverse mechanisms employed by E. coli in developing resistance to antibiotics. We primarily focus on pathotypes of E. coli (e.g., uropathogenic E. coli) and investigate the genetic determinants and molecular pathways that confer resistance, shedding light on both well-characterized and recently discovered mechanisms. The most prevalent mechanism continues to be the acquisition of resistance genes through horizontal gene transfer, facilitated by mobile genetic elements such as plasmids and transposons. We discuss the role of extended-spectrum β-lactamases (ESBLs) and carbapenemases in conferring resistance to β-lactam antibiotics, which remain vital in clinical practice. The review covers the key resistant mechanisms, including: 1) Efflux pumps and porin mutations that mediate resistance to a broad spectrum of antibiotics, including fluoroquinolones and aminoglycosides; 2) adaptive strategies employed by E. coli, including biofilm formation, persister cell formation, and the activation of stress response systems, to withstand antibiotic pressure; and 3) the role of regulatory systems in coordinating resistance mechanisms, providing insights into potential targets for therapeutic interventions. Understanding the intricate network of antibiotic resistance mechanisms in E. coli is crucial for the development of effective strategies to combat this growing public health crisis. By clarifying these mechanisms, we aim to pave the way for the design of innovative therapeutic approaches and the implementation of prudent antibiotic stewardship practices to preserve the efficacy of current antibiotics and ensure a sustainable future for healthcare.
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Affiliation(s)
- Sina Nasrollahian
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jay P. Graham
- Environmental Health Sciences Division, School of Public Health, University of California, Berkeley, CA, United States
| | - Mehrdad Halaji
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Medical Microbiology and Biotechnology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
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Raja MMM, Reehana N, Ahamed AA, Begum AF. Characterization of bioactive compound isolated from Micromonospora marina KPMS1 and its activity against emerging antibiotics resistant strains of Klebsiella pneumoniae HAUTI7 and Proteus vulgaris HAUTI14. Int J Biol Macromol 2023; 250:125954. [PMID: 37532185 DOI: 10.1016/j.ijbiomac.2023.125954] [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: 05/12/2023] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
Multiple antibiotic resistances have increased gradually in many classes of antibiotics among the gram negative organisms like Klebsiella pneumoniae and Proteus vulgaris which are the major causes of infection among worldwide. Nearly a hundred urine samples were collected, among them 16 urine samples were having plasmid and its resistant to various antibiotics. This present investigation has determined the resistant plasmid pattern of multi drug resistant Klebsiella pneumoniae and Proteus vulgaris from urinary tract site isolated from hospital patients. The detection and characterization of antimicrobial metabolite derived from marine sediments that produce potent activity against multidrug resistant pathogen. The 16S rRNA sequencing results and phylogeny showed that the resistant bacteria belong to the genera of Klebsiella pneumoniae HAUTI7 and Proteus vulgaris HAUTI14. The antibacterial activity and the characterization of bioactive compound like FT-IR and NMR studies were performed to analyze the structural elucidation of active compounds derived from marine source Micromonospora marina KPMS1. The 16S rRNA sequences of Micromonospora marina KPMS1was deposited in the Gen bank with the accession number MH036351. The effective bioactive compound derived from marine sediments are virtually unlimited interest that control the emerging multiple antibiotic resistant strains.
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Affiliation(s)
- M Mohamed Mahroop Raja
- PG and Research Department of Microbiology, Jamal Mohamed College (Autonomous), Affiliated to Bharathidasan University, Tiruchirappalli 620 020, Tamil Nadu, India.
| | - N Reehana
- PG and Research Department of Microbiology, Jamal Mohamed College (Autonomous), Affiliated to Bharathidasan University, Tiruchirappalli 620 020, Tamil Nadu, India
| | - A Asrar Ahamed
- PG and Research Department of Chemistry, Jamal Mohamed College (Autonomous), Affiliated to Bharathidasan University, Tiruchirappalli 620 020, Tamil Nadu, India
| | - A Fasila Begum
- PG and Research Department of Microbiology, Jamal Mohamed College (Autonomous), Affiliated to Bharathidasan University, Tiruchirappalli 620 020, Tamil Nadu, India
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Whelan S, Lucey B, Finn K. Uropathogenic Escherichia coli (UPEC)-Associated Urinary Tract Infections: The Molecular Basis for Challenges to Effective Treatment. Microorganisms 2023; 11:2169. [PMID: 37764013 PMCID: PMC10537683 DOI: 10.3390/microorganisms11092169] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Urinary tract infections (UTIs) are among the most common bacterial infections, especially among women and older adults, leading to a significant global healthcare cost burden. Uropathogenic Escherichia coli (UPEC) are the most common cause and accounts for the majority of community-acquired UTIs. Infection by UPEC can cause discomfort, polyuria, and fever. More serious clinical consequences can result in urosepsis, kidney damage, and death. UPEC is a highly adaptive pathogen which presents significant treatment challenges rooted in a complex interplay of molecular factors that allow UPEC to evade host defences, persist within the urinary tract, and resist antibiotic therapy. This review discusses these factors, which include the key genes responsible for adhesion, toxin production, and iron acquisition. Additionally, it addresses antibiotic resistance mechanisms, including chromosomal gene mutations, antibiotic deactivating enzymes, drug efflux, and the role of mobile genetic elements in their dissemination. Furthermore, we provide a forward-looking analysis of emerging alternative therapies, such as phage therapy, nano-formulations, and interventions based on nanomaterials, as well as vaccines and strategies for immunomodulation. This review underscores the continued need for research into the molecular basis of pathogenesis and antimicrobial resistance in the treatment of UPEC, as well as the need for clinically guided treatment of UTIs, particularly in light of the rapid spread of multidrug resistance.
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Affiliation(s)
- Shane Whelan
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland;
| | - Brigid Lucey
- Department of Biological Sciences, Munster Technological University, Bishopstown, T12 P928 Cork, Ireland;
| | - Karen Finn
- Department of Analytical, Biopharmaceutical and Medical Sciences, Atlantic Technological University Galway City, Dublin Road, H91 T8NW Galway, Ireland
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Yang J, Shan G, Yu G, Wei J, Zhang Q, Su W, Lin Q, Zheng Z, Wu G, Li G, Chang Q, Yuan H, He Y, Chen Y, Zhang Y, Huang H, Hu W, Song R, Weng Y, Li X, Liu S. Whole genome sequencing of multidrug-resistant Proteus mirabilis strain PM1162 recovered from a urinary tract infection in China. J Glob Antimicrob Resist 2023; 33:44-50. [PMID: 36870531 DOI: 10.1016/j.jgar.2023.02.014] [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: 10/20/2022] [Revised: 01/26/2023] [Accepted: 02/19/2023] [Indexed: 03/06/2023] Open
Abstract
OBJECTIVES Proteus mirabilis is an important opportunistic Gram-negative pathogen. This study reports the whole genome sequence of multidrug-resistant (MDR) P. mirabilis PM1162 and explores its antibiotic resistance genes (ARGs) and their genetic environments. METHODS P. mirabilis PM1162 was isolated from a urinary tract infection in China. Antimicrobial susceptibility was determined, and whole genome sequencing (WGS) was performed. ARGs, insertion sequence (IS) elements, and prophages were identified using ResFinder, ISfinder, and PHASTER software, respectively. Sequence comparisons and map generation were performed using BLAST and Easyfig, respectively. RESULTS On its chromosome, P. mirabilis PM1162 harboured 15 ARGs, including cat, tet(J), blaCTX-M-14 (three copies), aph(3')-Ia, qnrB4, blaDHA-1, qacE, sul1, armA, msr(E), mph(E), aadA1, and dfrA1. We focused our analysis on the four related MDR regions: (1) genetic contexts associated with blaCTX-M-14; (2) the prophage containing blaDHA-1, qnrB4, and aph(3')-Ia; (3) genetic environments associated with mph(E), msr(E), armA, sul, and qacE; and (4) the class II integron harbouring dfrA1, sat2, and aadA1. CONCLUSION This study reported the whole genome sequence of MDR P. mirabilis PM1162 and the genetic context of its ARGs. This comprehensive genomic analysis of MDR P. mirabilis PM1162 provides a deeper understanding of its MDR mechanism and elucidates the horizontal spread of its ARGs, thus providing a basis for the containment and treatment of the bacteria.
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Affiliation(s)
- Jing Yang
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Ge Shan
- Department of Urology, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Guangchao Yu
- Department of Clinical Laboratory, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jie Wei
- Department of Clinical Laboratory, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Qinghuan Zhang
- Department of Clinical Laboratory, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Wen Su
- Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Qiuping Lin
- Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Zhixiong Zheng
- Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Guangliang Wu
- Department of Pharmacy, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Guangtian Li
- Department of Anesthesiology, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China
| | - Qing Chang
- Medical Department, Hengqin Branch of Zhuhai People's Hospital, Zhuhai, China
| | - Hong Yuan
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Yanju He
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Yanling Chen
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Yi Zhang
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Haile Huang
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Wan Hu
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Rongqing Song
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China
| | - Yuqing Weng
- Department of Pulmonary and Critical Care Medicine, Zhuhai Hospital affiliated with Jinan University (Zhuhai People's Hospital), Zhuhai, China.
| | - Xiaobin Li
- Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, China.
| | - Shengming Liu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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Machado EC, Freitas DL, Leal CD, de Oliveira AT, Zerbini A, Chernicharo CA, de Araújo JC. Antibiotic resistance profile of wastewater treatment plants in Brazil reveals different patterns of resistance and multi resistant bacteria in final effluents. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159376. [PMID: 36240935 DOI: 10.1016/j.scitotenv.2022.159376] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Wastewater treatment plants (WWTPs) are recognized as important sources of Antibiotic Resistant Bacteria (ARBs) and Antibiotic Resistant Genes (ARGs), and might play a role in the removal and dissemination of antimicrobial resistance (AMR) in the environment. Detailed information about AMR removal by the different treatment technologies commonly applied in urban WWTPs is needed. This study investigated the occurrence, removal and characterization of ARBs in WWTPs employing different technologies: WWTP-A (conventional activated sludge-CAS), WWTP-B (UASB reactor followed by biological trickling filter) and WWTP-C (modified activated sludge followed by UV disinfection-MAS/UV). Samples of raw sewage (RI) and treated effluent (TE) were collected and, through the cultivation-based method using 11 antibiotics, the antibiotic resistance profiles were characterized in a one-year period. MAS was effective in reducing ARB counts (2 to 3 log units), compared to CAS (1 log unit) and UASB/BTF (0.5 log unit). The composition of cultivable ARB differed between RI and TE samples. Escherichia was predominant in RI (56/118); whilst in TE Escherichia (31/118) was followed by Bacillus (22/118), Shigella (14/118) and Enterococcus (14/118). Most of the isolates identified (370/394) harboured at least two ARGs and in over 80 % of the isolates, 4 or more ARG (int1, blaTEM, TetA, sul1 and qnrB) were detected. A reduction in the resistance prevalence was observed in effluents after CAS and MAS processes; whilst a slight increase was observed in treated effluents from UASB/BTF and after UV disinfection stage. The multi-drug resistance (MDR) phenotype was attributed to 84.3 % of the isolates from RI (27/32) and 63.6 % from TE (21/33) samples and 52.3 % of the isolates (34/65) were resistant to carbapenems (imipenem, meropenem, ertapenem). The results indicate that treated effluents are still a source for MDR bacteria and ARGs dissemination to aquatic environments. The importance of biological sewage treatment was reinforced by the significant reductions in ARB counts observed. However, implementation of additional treatments is needed to mitigate MDR bacteria release into the environment.
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Affiliation(s)
- Elayne Cristina Machado
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Deborah Leroy Freitas
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Cintia Dutra Leal
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Amanda Teodoro de Oliveira
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Adriana Zerbini
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Carlos Augusto Chernicharo
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil
| | - Juliana Calábria de Araújo
- Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos 6627, 31270-901 Belo Horizonte, MG, Brazil.
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Current and Emerging Treatment Options for Multidrug Resistant Escherichia coli Urosepsis: A Review. Antibiotics (Basel) 2022; 11:antibiotics11121821. [PMID: 36551478 PMCID: PMC9774639 DOI: 10.3390/antibiotics11121821] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Escherichia coli is a versatile commensal and pathogenic member of the human microflora. As the primary causative pathogen in urosepsis, E. coli places an immense burden on healthcare systems worldwide. To further exacerbate the issue, multi drug resistance (MDR) has spread rapidly through E. coli populations, making infections more troublesome and costlier to treat. This paper aimed to review the literature concerning the development of MDR in uropathogenic E. coli (UPEC) and explore the existing evidence of current and emerging treatment strategies. While some MDR strains maybe treated with β-lactam-β-lactamase inhibitor combinations as well as cephalosporins, cephamycin, temocillin and fosfomycin, current treatment strategies for many MDR UPEC strains are reliant on carbapenems. Carbapenem overreliance may contribute to the alarming dissemination of carbapenem-resistance amongst some UPEC communities, which has ushered in a new age of difficult to treat infections. Alternative treatment options for carbapenem resistant UPEC may include novel β-lactam-β-lactamase or carbapenemase inhibitor combinations, cefiderocol, polymyxins, tigecycline, aminoglycosides or fosfomycin. For metallo-β-lactamase producing strains (e.g., NDM, IMP-4), combinations of cefazidime-avibacam with aztreonam have been used. Additionally, the emergence of new antimicrobials brings new hope to the treatment of such infections. However, continued research is required to successfully bring these into the clinic for the treatment of MDR E. coli urosepsis.
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Molecular Factors and Mechanisms Driving Multidrug Resistance in Uropathogenic Escherichia coli-An Update. Genes (Basel) 2022; 13:genes13081397. [PMID: 36011308 PMCID: PMC9407594 DOI: 10.3390/genes13081397] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 02/06/2023] Open
Abstract
The rapid emergence of multidrug-resistant (MDR) bacteria indisputably constitutes a major global health problem. Pathogenic Escherichia coli are listed among the most critical group of bacteria that require fast development of new antibiotics and innovative treatment strategies. Among harmful extraintestinal Enterobacteriaceae strains, uropathogenic E. coli (UPEC) pose a significant health threat. UPEC are considered the major causative factor of urinary tract infection (UTI), the second-most commonly diagnosed infectious disease in humans worldwide. UTI treatment places a substantial financial burden on healthcare systems. Most importantly, the misuse of antibiotics during treatment has caused selection of strains with the ability to acquire MDR via miscellaneous mechanisms resulting in gaining resistance against many commonly prescribed antibiotics like ampicillin, gentamicin, cotrimoxazole and quinolones. Mobile genetic elements (MGEs) such as transposons, integrons and conjugative plasmids are the major drivers in spreading resistance genes in UPEC. The co-occurrence of various bacterial evasion strategies involving MGEs and the SOS stress response system requires further research and can potentially lead to the discovery of new, much-awaited therapeutic targets. Here, we analyzed and summarized recent discoveries regarding the role, mechanisms, and perspectives of MDR in the pathogenicity of UPEC.
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Belotindos LP, Tsunoda R, Villanueva MA, Nakajima C, Mingala CN, Suzuki Y. Characterisation of plasmids harbouring qnrA1, qnrS1, and qnrB4 in E. coli isolated in the Philippines from food-producing animals and their products. J Glob Antimicrob Resist 2022; 30:38-46. [PMID: 35447382 DOI: 10.1016/j.jgar.2022.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/19/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Determinants showing plasmid-mediated quinolone resistance, which usually leads to antimicrobial ineffectiveness, have become an emerging clinical problem. In our previous study in the Philippines, a high prevalence of Qnr determinants was found in clinical samples and food-producing animals and their food products. However, no qnr-carrying plasmids have been investigated in animals or animal-derived foods. Hence, in the present, we aimed to characterise qnr-carrying plasmids in Escherichia coli isolated from the food supply chain. METHODS Plasmids from 44 qnr-positive isolates were assigned to incompatibility groups by PCR-based replicon typing, and the presence of β-lactamase-encoding genes were investigated by PCR. Localisation of qnr in plasmids was determined by S1-PFGE and Southern blot hybridisation. The transferability of qnr-carrying plasmids was examined by conjugation analysis. RESULTS Overall, 77.3% (95%CI = 62.2 - 88.5) of the isolates harbouring qnr determinants were positive for seven plasmid types, and 56.8% concurrently harboured blaTEM-1. Plasmid IncFrepB was prevalent (65.9%, 95%CI = 50.1 - 79.5) among qnr determinants. Localisation of qnr determinants in IncFrepB and transferability of plasmids was further confirmed. CONCLUSIONS The current study proved that qnr in E. coli isolated from food-producing animals and their food products could spread via plasmid IncFrepB upon selective pressure with quinolones or other antimicrobials. Therefore, to curb the emergence and spread of qnr-harbouring bacteria in the Philippines, prudent use of antimicrobials in animal production and stricter hygiene and food handling are recommended.
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Affiliation(s)
- Lawrence P Belotindos
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan; Biosafety and Environment Section, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines.
| | - Risa Tsunoda
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan.
| | - Marvin A Villanueva
- Biosafety and Environment Section, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines.
| | - Chie Nakajima
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan; International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo 001-0021, Japan.
| | - Claro N Mingala
- Livestock Biotechnology Center, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines.
| | - Yasuhiko Suzuki
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan; International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo 001-0021, Japan.
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Ahmed N, Khalid H, Mushtaq M, Basha S, Rabaan AA, Garout M, Halwani MA, Al Mutair A, Alhumaid S, Al Alawi Z, Yean CY. The Molecular Characterization of Virulence Determinants and Antibiotic Resistance Patterns in Human Bacterial Uropathogens. Antibiotics (Basel) 2022; 11:antibiotics11040516. [PMID: 35453267 PMCID: PMC9025563 DOI: 10.3390/antibiotics11040516] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 01/27/2023] Open
Abstract
The high rates of bacterial infections affect the economy worldwide by contributing to the increase in morbidity and treatment costs. The present cross-sectional study was carried out to evaluate the prevalence of bacterial infection in urinary tract infection (UTI) patients and to evaluate the antimicrobial resistance rate (AMR) in a Tertiary Care Hospital in Lahore, Pakistan. The study was conducted for the period of one year from January 2020 to December 2020. A total of 1899 different clinical samples were collected and examined for bacterial cultures using standard procedures. Samples were inoculated on different culture media to isolate bacterial isolates and for identification and susceptibility testing. A total of 1107/1899 clinical samples were positive for Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa), Escherichia coli (E. coli) and other bacterial isolates. Methicillin-resistant S. aureus (MRSA) prevalence was 16.93% from these positive cases. MRSA strains were found to be highly resistant to amikacin, clindamycin, fusidic acid, gentamicin and tobramycin, while highest sensitivity was noted against vancomycin (100%) and linezolid (100%). MRSA and high rates of multidrug resistance (MDR) pose a serious therapeutic burden to critically ill patients. A systematic and concerted effort is essential to rapidly identify high-risk patients and to reduce the burden of AMR.
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Affiliation(s)
- Naveed Ahmed
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia;
- Department of Microbiology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Punjab, Pakistan
| | - Hira Khalid
- Department of Medical Education, King Edward Medical University, Lahore 54000, Punjab, Pakistan; (H.K.); (M.M.)
| | - Mariam Mushtaq
- Department of Medical Education, King Edward Medical University, Lahore 54000, Punjab, Pakistan; (H.K.); (M.M.)
| | - Sakeenabi Basha
- Department of Community Dentistry, Faculty of Dentistry, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Khyber Pakhtunkhwa, Pakistan
- Correspondence: (A.A.R.); (C.Y.Y.)
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Muhammad A. Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia;
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia;
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia;
| | - Zainab Al Alawi
- Division of Allergy and Immunology, College of Medicine, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Chan Yean Yean
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia;
- Correspondence: (A.A.R.); (C.Y.Y.)
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11
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The Prevalence and Characterization of Fecal Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Isolated from Pigs on Farms of Different Sizes in Latvia. Antibiotics (Basel) 2021; 10:antibiotics10091099. [PMID: 34572681 PMCID: PMC8468317 DOI: 10.3390/antibiotics10091099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/04/2021] [Accepted: 09/09/2021] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to determine the prevalence of fecal ESBL-producing Escherichia coli (E. coli) in pigs on large and small farms in Latvia, to characterize beta-lactamase genes and establish an antimicrobial resistance profile. Fecal samples (n = 615) were collected from 4-week, 5-week, 6-week, 8-week, 12-week and 20-week-old piglets, pigs and sows on four large farms (L1, L2, L3, L4) and three small farms (S1, S2, S3) in Latvia. ChromArt ESBL agar and combination disc tests were used for the screening and confirmation of ESBL-producing E. coli. The antimicrobial resistance was determined by the disc diffusion method and ESBL genes were determined by polymerase chain reaction (PCR). Subsequently, ESBL-producing E. coli was confirmed on three large farms, L1 (64.3%), L2 (29.9%), L3 (10.7%) and one small farm, S1 (47.5%); n = 144 (23.4%). The prevalence of ESBL-producing E. coli differed considerably between the large and small farm groups (26.9% vs. 12.7%). Of ESBL E. coli isolates, 96% were multidrug-resistant (MDR), demonstrating there were more extensive MDR phenotypes on large farms. The distribution of ESBL genes was blaTEM (94%), blaCTX-M (86%) and blaSHV (48%). On the small farm, blaSHV dominated, thus demonstrating a positive association with resistance to amoxicillin-clavulanic acid, ceftazidime and cefixime, while on the large farms, blaCTX-M with a positive association to cephalexin and several non-beta lactam antibiotics dominated. The results indicated the prevalence of a broad variety of ESBL-producing E. coli among the small and large farms, putting the larger farms at a higher risk. Individual monitoring of ESBL and their antimicrobial resistance could be an important step in revealing hazardous MDR ESBL-producing E. coli strains and reviewing the management of antibiotic use.
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12
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Ghosh A, Ghosh B, Mukherjee M. Epidemiologic and molecular characterization of β-lactamase-producing multidrug-resistant uropathogenic Escherichia coli isolated from asymptomatic hospitalized patients. Int Microbiol 2021; 25:27-45. [PMID: 34191193 DOI: 10.1007/s10123-021-00187-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/28/2021] [Accepted: 06/11/2021] [Indexed: 11/27/2022]
Abstract
Uropathogenic Escherichia coli (UPECs) are the predominant cause of asymptomatic bacteriuria (ABU) and symptomatic UTI. In this study, multidrug-resistant (MDR) ABU-UPECs from hospitalized patients of Kolkata, India, were characterized with respect to their ESBL phenotype, acquisition of β-lactamase genes, mobile genetic elements (MGEs), phylotype property, ERIC-PCR profile, sequence types (STs), clonal complexes (CCs) and evolutionary and quantitative relationships and compared to the symptomatic ones to understand their epidemiology and evolutionary origin. Statistically significant incidence of ESBL producers, β-lactamase genes, MGEs and novel phylotype property (NPP) among ABU-UPECs similar to the symptomatic ones indicated the probable incidence of chromosomal plasticity on resistance gene acquisition through MGEs due to indiscriminate drug usage. ERIC-PCR typing and MLST analysis showed clonal heterogeneity and predominance of ST940 (CC448) among asymptomatic isolates akin to symptomatic ones along with the evidence of zoonotic transmissions. Minimum spanning tree analysis showed a close association between ABU-UPEC with known and unidentified STs having NPPs with isolates that belonged to phylogroups clade I, D, and B2. This is the first study that reported the occurrence of MGEs and NPPs among ABU-UPECs with the predominance of ESBL production which displayed the deleterious effect of MDR among this pathogen demanding alternative therapeutic interventions. Moreover, this study for the first time attempted to introduce a new approach to ascertain the phylotype property of unassigned UPECs. Withal, increased recognition, proper understanding and characterization of ABU-UPECs with the implementation of appropriate therapeutic measures against them when necessary are the need of the era which otherwise might lead to serious complications in the vulnerable population.
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Affiliation(s)
- Arunita Ghosh
- Department of Biochemistry and Medical Biotechnology, School of Tropical Medicine, 108, C.R. Avenue, Kolkata, 700073, India
| | - Biplab Ghosh
- Department of Biochemistry and Medical Biotechnology, School of Tropical Medicine, 108, C.R. Avenue, Kolkata, 700073, India
| | - Mandira Mukherjee
- Department of Biochemistry and Medical Biotechnology, School of Tropical Medicine, 108, C.R. Avenue, Kolkata, 700073, India.
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Matinfar S, Ahmadi M, Sisakht AM, Sadeghi J, Javedansirat S. Phylogenetic and antibiotics resistance in extended-spectrum B-lactamase (ESBL) Uropathogenic Escherichia coli: An update review. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ghosh A, Bandyopadhyay D, Koley S, Mukherjee M. Uropathogenic Escherichia coli in India-an Overview on Recent Research Advancements and Trends. Appl Biochem Biotechnol 2021; 193:2267-2296. [PMID: 33595784 DOI: 10.1007/s12010-021-03521-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/27/2021] [Indexed: 11/24/2022]
Abstract
Urinary tract infection (UTI), a prevalent disease in India, also ranks among the most common infections in developing countries. The rapid emergence of antibiotic-resistant uropathogenic Escherichia coli (UPECs), the leading etiologic agent of UTI, in the last few years, led to an upsurge in the health care cost. This caused a considerable economic burden, especially in low-middle income country, India. This review aimed to provide an explicit overview of the recent advancements in E. coli-mediated UTI in India by incorporation of valuable information from the works published in PubMed and Google Scholar in the last six years (2015 to August, 2020). The literature survey demonstrated UPECs as the most predominant uropathogen in India, especially among females, causing both asymptomatic bacteriuria (ABU) and symptomatic UTI. An overall increasing national trend in resistance to penicillins, cephalosporins, aminoglycosides, fluoroquinolones, and sulfonamides was perceived irrespective of ABU and symptomatic UPECs during the aforementioned study period. High incidences of multidrug resistance, extended-spectrum β-lactamases, metallo β-lactamases, and AmpCs in UPECs were reported. Notable information on the pathogenic profiles, phylogroups, pathogenicity islands, and evidence of pathoadaptive FimH mutations was described. Alternative therapeutics and potential drug targets against UPECs were also reconnoitered. Therefore, the nationwide widespread occurrences of highly virulent MDR UPEC together with the limited availability of therapeutics highlighted the urgent need for promotion and invention of alternative therapeutics, search for which had already been started. Moreover, investigation of several mechanisms of UPEC infection and the search for potential drug targets might help to design newer therapeutics.
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Affiliation(s)
- Arunita Ghosh
- Department of Biochemistry and Medical Biotechnology, School of Tropical Medicine, 108, C.R. Avenue, Kolkata, 700073, India
| | - Debojyoty Bandyopadhyay
- Department of Biochemistry and Medical Biotechnology, School of Tropical Medicine, 108, C.R. Avenue, Kolkata, 700073, India
| | - Snehashis Koley
- Department of Biochemistry and Medical Biotechnology, School of Tropical Medicine, 108, C.R. Avenue, Kolkata, 700073, India
| | - Mandira Mukherjee
- Department of Biochemistry and Medical Biotechnology, School of Tropical Medicine, 108, C.R. Avenue, Kolkata, 700073, India.
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15
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Tsunoda R, Usui M, Tagaki C, Fukuda A, Boonla C, Anomasiri W, Sukpanyatham N, Akapelwa ML, Nakajima C, Tamura Y, Suzuki Y. Genetic characterization of coliform bacterial isolates from environmental water in Thailand. J Infect Chemother 2021; 27:722-728. [PMID: 33468426 DOI: 10.1016/j.jiac.2020.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In contrast to the study in other part of the world, information about characteristics of plasmids carrying antimicrobial resistance genes (ARGs) in Enterobacteriaceae derived from environmental water in tropical Asian countries including Thailand is limited. This study, therefore, aimed to gain insight into genetic information of antimicrobial resistance in environmental water in Thailand. METHODS Coliform bacteria were isolated from environmental water collected at 20 locations in Thailand and identified. Then, susceptibility profiles to ampicillin, cefazoline, cefotaxime, kanamycin, ciprofloxacin, sulfamethoxazole, tetracycline, and nalidixic acid were assessed. In addition, antimicrobial resistant genes integrons, and replicon types were analyzed. And furthermore, plasmids carrying blaTEM and tetM were identified by S1-PFGE analysis and confirmed transmissibility by transconjugation experiments. RESULTS In 130 coliform bacteria isolated, 89 were resistant to cefazoline while 41 isolates were susceptible. Cefazoline-resistant coliform bacteria were found to be significantly resistant to cefotaxime and tetracycline as compared to susceptible isolates. Hence, blaTEM and tetM correlating with β-lactam antibiotics and tetracycline, respectively, were analyzed found to co-localize on the IncFrepB plasmids in isolates from pig farms' wastewater by S1-PFGE analysis. And furthermore, transmissibility of the plasmids was confirmed. CONCLUSIONS Results obtained in this study suggested that ARGs in coliform bacteria may have been spreading on the farm via IncFrepB plasmids. Hence, appropriate use of antimicrobials and good hygiene management on the farm are required to prevent the emergence and spread of resistant bacteria.
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Affiliation(s)
- Risa Tsunoda
- Division of Bioresources, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Masaru Usui
- Laboratory of Food Microbiology and Food Safety, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan.
| | - Chie Tagaki
- Laboratory of Food Microbiology and Food Safety, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Akira Fukuda
- Laboratory of Food Microbiology and Food Safety, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Chanchai Boonla
- Department of Biochemistry, Chulalongkorn University, Bangkok, Thailand
| | - Wilai Anomasiri
- Department of Biochemistry, Chulalongkorn University, Bangkok, Thailand
| | - Nop Sukpanyatham
- Quality Vet Product Co., Ltd, Klongsamwa District, Bangkok, Thailand
| | - Mwangala Lonah Akapelwa
- Division of Bioresources, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Chie Nakajima
- Division of Bioresources, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yutaka Tamura
- Laboratory of Food Microbiology and Food Safety, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan.
| | - Yasuhiko Suzuki
- Division of Bioresources, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan.
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16
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Kaur R, Kaur R. Symptoms, risk factors, diagnosis and treatment of urinary tract infections. Postgrad Med J 2020; 97:803-812. [PMID: 33234708 DOI: 10.1136/postgradmedj-2020-139090] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/01/2020] [Accepted: 11/09/2020] [Indexed: 01/20/2023]
Abstract
Urinary tract infection (UTI) is a common microbial infection found in all ages and sexes which involves inflammation of the urinary tract. These infections can range from simple bladder inflammation, that is, cystitis, to severe cases of uroseptic shock. UTI ranks as the number 1 infection that leads to a prescription of antibiotics after a doctor's visit. These infections are sometimes distressing and even life threatening, and both males (12%) and females (40%) have at least one symptomatic UTI throughout their lives. Diagnostic failures in case of bacterial infections are the main contributing factor in improper use of antibiotics, delay in treatment and low survival rate in septic conditions. So, early diagnosis and appropriate therapy with antibiotics are the most significant requirements for preventing complicated UTI conditions such as urosepsis. This review article summarises the symptoms of the UTIs and the associated risk factors to it. The various conventional and recent diagnostic methods were also discussed in this review, along with treatment therapies with or without antibiotics.
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Affiliation(s)
- Rajanbir Kaur
- Department of Botanical and Environmental Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Rajinder Kaur
- Department of Botanical and Environmental Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
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17
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Dhara L, Tripathi A. The use of eugenol in combination with cefotaxime and ciprofloxacin to combat ESBL-producing quinolone-resistant pathogenic Enterobacteriaceae. J Appl Microbiol 2020; 129:1566-1576. [PMID: 32502298 DOI: 10.1111/jam.14737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 05/05/2020] [Accepted: 05/19/2020] [Indexed: 11/29/2022]
Abstract
AIM Emergence of extended-spectrum beta-lactamase (ESBL) producing with quinolone-resistant (QR) pathogenic Enterobacteriaceae augmented the need to establish therapeutic options against them. Present study aimed towards determination of synergistic combination of eugenol (EG) with cefotaxime (CTX) and ciprofloxacin (CIP) to combat against this resistance and potentiation of antibacterial drugs by EG against these bacteria. METHODS AND RESULTS Synergistic interaction between EG and CTX/CIP (FICI: 0·08-0·5) were observed among ESBL-QR bacteria using checkerboard assay. Approximately, 2- to 1024-fold minimum inhibitory concentration value reduction and 17- to 165 030-fold dose reduction index strongly suggested synergistic interaction between EG and antibiotics. Cell viability assay showed reduction in log10 CFU per ml from 16·6 to 3·1 at synergistic concentration. Scanning electron microscopy further proved disruptive effect of EG on cell architecture. Eugenol and/or its combination also altered genes' expressions that imparted antibiotic resistance by ~1·6 to ~1226 folds. CONCLUSIONS Reduced doses of antibiotics, bacterial morphological alterations, efflux pump down regulation, porin over expression and beta-lactamase gene inhibition of ESBL-QR bacteria by EG alone or in combination with CTX/CIP might have reversed antibiotic resistance profile of ESBL-QR bacteria. SIGNIFICANCE AND IMPACT OF THE STUDY This study provided a molecular insight into action of EG and/with CTX and CIP, which might have potentiated antibiotic's activity against ESBL-QR bacteria.
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Affiliation(s)
- L Dhara
- Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, Kolkata, India
| | - A Tripathi
- Department of Biochemistry and Medical Biotechnology, Calcutta School of Tropical Medicine, Kolkata, India
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18
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Kammili N, Rani M, Styczynski A, Latha M, Pavuluri PR, Reddy V, Alsan M. Plasmid-mediated antibiotic resistance among uropathogens in primigravid women-Hyderabad, India. PLoS One 2020; 15:e0232710. [PMID: 32384111 PMCID: PMC7209122 DOI: 10.1371/journal.pone.0232710] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 04/20/2020] [Indexed: 01/24/2023] Open
Abstract
With the growing threat of antimicrobial resistance worldwide, uncovering the molecular epidemiology is critical for understanding what is driving this crisis. We aimed to evaluate the prevalence of plasmid-mediated-quinolone-resistance (PMQR) and extended-spectrum beta-lactamase- (ESBL) producing gram-negative organisms among primigravid women with bacteriuria. We collected urine specimens from primigravid women attending their first antenatal visit at Gandhi Hospital during October 1, 2015 to September 30, 2016. We determined antimicrobial susceptibility and ESBL and quinolone resistance using VITEK-2. We performed polymerase chain reaction amplification on resistant isolates for detection of ESBL-encoding genes (TEM, SHV, CTX-M) and PMQR genes (qnrA, qnrB, qnrD, qnrS, aac (6’)-Ib-cr). Of 1,841 urine samples, 133 demonstrated significant bacterial growth with gram-negative bacilli accounting for 85% of isolates, including Escherichia coli (n = 79), Klebsiella pneumoniae (n = 29), Sphingomonas (n = 3), Enterobacter (n = 1), and Citrobacter (n = 1). We found 65% of E. coli isolates and 41% of K. pneumoniae isolates were ESBL positive. Of ESBL-positive isolates, the most common genes conferring resistance were TEM-1 (66.7%) followed by CTX-M-15 (33.3%). Fifty-seven percent of ESBL-positive E. coli also demonstrated resistance to quinolones with the most common PMQR genes being qnr-S (62.5%) and aac (6')-Ib-cr (37.5%). We did not find any resistance to quinolones among ESBL-positive K. pneumoniae isolates. Across different classes of antibiotics we found a strong clustering of multi-drug resistance in E. coli with over 45% of ESBL-positive isolates demonstrating resistance to at least three classes of antibiotics. This study emphasizes the high prevalence of plasmid-mediated ESBL and quinolone resistance in community-acquired urinary tract infections of primigravid women. The overall abundance of multi-drug-resistant isolates in this population is alarming and may present therapeutic challenges.
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Affiliation(s)
- Nagamani Kammili
- Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - Manisha Rani
- Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
| | - Ashley Styczynski
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Palo Alto, California, United States of America
| | - Madhavi Latha
- MDRU, Gandhi Medical College, Secunderabad, Telangana, India
| | | | | | - Marcella Alsan
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Palo Alto, California, United States of America
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Shahin K, Bouzari M, Wang R, Khorasgani MR. Distribution of antimicrobial resistance genes and integrons among Shigella spp. isolated from water sources. J Glob Antimicrob Resist 2019; 19:122-128. [DOI: 10.1016/j.jgar.2019.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/28/2019] [Accepted: 04/30/2019] [Indexed: 01/24/2023] Open
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20
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Conjugal transfer of PMQR from uropathogenic E.coli under high ciprofloxacin selection pressure generates gyrA mutation. Microb Pathog 2019; 132:26-29. [DOI: 10.1016/j.micpath.2019.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/02/2019] [Accepted: 04/11/2019] [Indexed: 11/21/2022]
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21
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Xicohtencatl-Cortes J, Cruz-Córdova A, Cázares-Domínguez V, Escalona-Venegas G, Zavala-Vega S, Arellano-Galindo J, Romo-Castillo M, Hernández-Castro R, Ochoa SA, Luna-Pineda VM. Uropathogenic Escherichia coli strains harboring tosA gene were associated to high virulence genes and a multidrug-resistant profile. Microb Pathog 2019; 134:103593. [PMID: 31195111 DOI: 10.1016/j.micpath.2019.103593] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 02/06/2023]
Abstract
TosA, a putative repeats-in-toxin protein that has recently gained importance as an antigenic molecule, has characteristics of nonfimbrial adhesins and can act as a virulence marker in uropathogenic Escherichia coli (UPEC) strains; however, little is known about the association of this protein with antibiotic resistance profiles in UPEC tosA+ clinical strains. The aim of this study was to evaluate UPEC tosA+ strains, including examining genetic diversity, associations with phylogenetic groups, resistance profiles, virulence genes, adherence assays, integrons, and extended-spectrum beta-lactamase phenotypes. Pulsed-field gel electrophoresis analysis grouped these strains into eight clusters with 62% genetic diversity. These strains were mainly associated with the multidrug-resistant profiles, together with an association with class 1 integron and the extended-spectrum beta-lactamase phenotype. Additionally, the strains exhibited a distribution of ≥96% for core-associated genes, while a variable distribution was identified for pathogenic islands-associated genes. Strong associations between UPEC tosA+ strains and two phylogenetic groups (B2 and D) were identified, including resistance to β-lactam and non-β-lactam antibiotics. The UPEC tosA+ clinical strains exhibited major adherence, which was related to the fitness and virulence genes. A recombinant TosA protein reacted with antibodies from the sera of urinary tract infection patients, and anti-recombinant TosA polyclonal antibodies also detected TosA expression in these strains. In conclusion, strains of UPEC tosA+ belonging to phylogenetic group B2 had a high frequency of fitness and virulence genes associated with class 1 integrons and the extended-spectrum beta-lactamase phenotype, which exhibited a high adherence profile. The TosA protein is expressed during infection with UPEC and is considered an immunogenic molecule.
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Affiliation(s)
- Juan Xicohtencatl-Cortes
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México "Federico Gómez", Cuauhtémoc, Ciudad de México, Mexico.
| | - Ariadnna Cruz-Córdova
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México "Federico Gómez", Cuauhtémoc, Ciudad de México, Mexico
| | - Vicenta Cázares-Domínguez
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México "Federico Gómez", Cuauhtémoc, Ciudad de México, Mexico
| | - Gerardo Escalona-Venegas
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México "Federico Gómez", Cuauhtémoc, Ciudad de México, Mexico
| | - Sergio Zavala-Vega
- Laboratorio de Neuropatología, Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez", Ciudad de México, Mexico; Departamento de Infectología, Hospital Infantil de México "Federico Gómez", Ciudad de México, Mexico
| | - José Arellano-Galindo
- Departamento de Infectología, Hospital Infantil de México "Federico Gómez", Ciudad de México, Mexico
| | - Mariana Romo-Castillo
- CONACyT-IMSS, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Ciudad de México, Mexico
| | - Rigoberto Hernández-Castro
- Departamento de Ecología de Agentes Patógenos, Hospital General "Dr. Manuel Gea González", Ciudad de México, Mexico
| | - Sara A Ochoa
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México "Federico Gómez", Cuauhtémoc, Ciudad de México, Mexico.
| | - Víctor M Luna-Pineda
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México "Federico Gómez", Cuauhtémoc, Ciudad de México, Mexico.
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22
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Wang H, Ji Z. Inhibition of p53 alleviates prostate cell apoptosis in Escherichia coli‑induced bacterial prostatitis. Mol Med Rep 2019; 20:895-902. [PMID: 31173258 DOI: 10.3892/mmr.2019.10354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 12/21/2018] [Indexed: 11/05/2022] Open
Abstract
Previous studies demonstrated that uropathogenic Escherichia coli infection contributes to human bacterial prostatitis. Apoptosis of prostate epithelial cells is closely associated with the progression of bacterial prostatitis. The aim of the present study was to investigate the effect of cellular tumor antigen p53 (p53) on the apoptosis of bacterial prostatitis cells. The prostate epithelial RWPE‑1 cell line was infected with Escherichia coli, and treated cells and the culture supernatant were obtained at specific time points. The cell apoptosis rates, protein and mRNA of p53 were detected in the different treatment groups. Flow cytometry and terminal deoxynucleotidyl‑transferase‑mediated dUTP nick end labeling assays were used for the detection of cell apoptosis, and cell proliferation was determined by a Cell Counting Kit‑8 assay. The expression of p53 was inhibited by small interfering (si)RNA, and its mRNA and protein were detected. An ELISA was used for detecting cytokines in the culture supernatant. The result demonstrated that Escherichia coli infection led to an increase in prostate epithelial cell apoptosis (P<0.05), and resulted in increases of interleukin (IL)‑4, IL‑6 and IL‑8, and decrease in IL‑10. p53, apoptosis regulator BAX (Bax), caspase‑9 and Caspase‑3 expression were upregulated upon Escherichia coli exposure (P<0.05). Following transfection with p53 siRNA, the promotion of cell apoptosis induced by Escherichia coli infection was decreased, and the p53 and Bax protein expression were additionally decreased. Therefore, it was suggested that Escherichia coli increases cell apoptosis in bacterial prostatitis by activating the death receptor pathway involving p53. Inhibition of p53 alleviated prostate cell apoptosis induced by Escherichia coli.
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Affiliation(s)
- Hai Wang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, P.R. China
| | - Zhigang Ji
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, P.R. China
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