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Di Francesco A, Salvatore D, Sakhria S, Bertelloni F, Catelli E, Ben Yahia S, Tlatli A. Colistin Resistance Genes in Broiler Chickens in Tunisia. Animals (Basel) 2023; 13:ani13081409. [PMID: 37106971 PMCID: PMC10135375 DOI: 10.3390/ani13081409] [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: 02/23/2023] [Revised: 03/20/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Colistin is a polymyxin antibiotic that has been used in veterinary medicine for decades, as a treatment for enterobacterial digestive infections as well as a prophylactic treatment and growth promoter in livestock animals, leading to the emergence and spread of colistin-resistant Gram-negative bacteria and to a great public health concern, considering that colistin is one of the last-resort antibiotics against multidrug-resistant deadly infections in clinical practice. Previous studies performed on livestock animals in Tunisia using culture-dependent methods highlighted the presence of colistin-resistant Gram-negative bacteria. In the present survey, DNA extracted from cloacal swabs from 195 broiler chickens from six farms in Tunisia was tested via molecular methods for the ten mobilized colistin resistance (mcr) genes known so far. Of the 195 animals tested, 81 (41.5%) were mcr-1 positive. All the farms tested were positive, with a prevalence ranging from 13% to 93%. These results confirm the spread of colistin resistance in livestock animals in Tunisia and suggest that the investigation of antibiotic resistance genes by culture-independent methods could be a useful means of conducting epidemiological studies on the spread of antimicrobial resistance.
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Affiliation(s)
- Antonietta Di Francesco
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, 40064 Bologna, Italy
| | - Daniela Salvatore
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, 40064 Bologna, Italy
| | - Sonia Sakhria
- Institute of Veterinary Research of Tunisia, University of Tunis El Manar, Tunis 1006, Tunisia
| | | | - Elena Catelli
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, 40064 Bologna, Italy
| | - Salma Ben Yahia
- Institute of Veterinary Research of Tunisia, University of Tunis El Manar, Tunis 1006, Tunisia
| | - Aida Tlatli
- Institute of Veterinary Research of Tunisia, University of Tunis El Manar, Tunis 1006, Tunisia
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Dziri O, Dziri R, El Salabi AA, Alawami AA, Ksouri R, Chouchani C. Polymyxin E-Resistant Gram-Negative Bacteria in Tunisia and Neighboring Countries: Are There Commonalities? Infect Drug Resist 2021; 14:4821-4832. [PMID: 34815678 PMCID: PMC8605809 DOI: 10.2147/idr.s327718] [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: 07/03/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
The current global dissemination of polymyxin E resistance constitutes a real public health threat because of the restricted therapeutic options. This review provides a comprehensive assessment of the epidemiology of polymyxin E-resistant bacteria, with special reference to colistin-resistant Gram-negative bacteria in Tunisia and neighboring countries, based on available published data to January 2020. We aimed to determine their prevalence by species and origin, shedding light on the different genes involved and illustrating their genetic support, genetic environment, and geographic distribution. We found that colistin resistance varies considerably among countries. A majority of the research has focused on Algeria (13 of 32), followed by Tunisia (nine of 32), Egypt (nine of 32), and Libya (one of 32). All these reports showed that colistin-resistant Gram-negative bacteria were dramatically disseminated in these countries, as well as in African wildlife. Moreover, high prevalence of these isolates was recorded from various sources (humans, animals, food products, and natural environments). Colistin resistance was mainly reported among Enterobacteriaceae, particularly Klebsiella pneumoniae and Escherichia coli. It was associated with chromosomal mutations and plasmid-mediated genes (mcr). Four mcr variants (mcr1, mcr2, mcr3, and mcr8), mobilized by several plasmid types (IncHI2, IncP, IncFIB, and IncI2), were detected in these countries and were responsible for their rapid spread. Countrywide dissemination of high-risk clones was also observed, including E. coli ST10 and K. pneumoniae ST101 and ST11. Intensified efforts to raise awareness of antibiotic use and legalization thereon are required in order to monitor and minimize the spread of multidrug-resistant bacteria.
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Affiliation(s)
- Olfa Dziri
- Laboratory of Microorganisms and Active Biomolecules, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Laboratory of Research in Sciences and Technology of Environment, Higher Institute of Sciences and Technologies of Environment of Borj Cédria, University of Carthage, Hammam-Lif, Tunisia.,Joint Service Unit for Research Genomic Platform, Higher Institute of Environmental Sciences and Technologies of Environment of Borj Cédria, Center of Biotechnology of Borj Cédria, Hammam-Lif, Tunisia
| | - Raoudha Dziri
- Laboratory of Microorganisms and Active Biomolecules, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Allaaeddin A El Salabi
- Infection Control and Patient Safety Office, New Marwa Hospital, Benghazi, Libya.,Department of Environmental Health, Faculty of Public Health, University of Benghazi, Benghazi, Libya
| | - Alhussain A Alawami
- Infection Control and Patient Safety Office, New Marwa Hospital, Benghazi, Libya
| | - Riadh Ksouri
- Laboratory of Aromatic and Medicinal Plants, Center of Biotechnology of Borj Cédria, Hammam-Lif, Tunisia
| | - Chedly Chouchani
- Laboratory of Microorganisms and Active Biomolecules, Faculty of Sciences of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Laboratory of Research in Sciences and Technology of Environment, Higher Institute of Sciences and Technologies of Environment of Borj Cédria, University of Carthage, Hammam-Lif, Tunisia.,Joint Service Unit for Research Genomic Platform, Higher Institute of Environmental Sciences and Technologies of Environment of Borj Cédria, Center of Biotechnology of Borj Cédria, Hammam-Lif, Tunisia
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Polymyxin B in Combination with Enrofloxacin Exerts Synergistic Killing against Extensively Drug-Resistant Pseudomonas aeruginosa. Antimicrob Agents Chemother 2018; 62:AAC.00028-18. [PMID: 29632010 DOI: 10.1128/aac.00028-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/02/2018] [Indexed: 11/20/2022] Open
Abstract
Polymyxins are increasingly used as a last-resort class of antibiotics against extensively drug-resistant (XDR) Gram-negative bacteria. However, resistance to polymyxins can emerge with monotherapy. As nephrotoxicity is the major dose-limiting factor for polymyxin monotherapy, dose escalation to suppress the emergence of polymyxin resistance is not a viable option. Therefore, novel approaches are needed to preserve this last-line class of antibiotics. This study aimed to investigate the antimicrobial synergy of polymyxin B combined with enrofloxacin against Pseudomonas aeruginosa Static time-kill studies were conducted over 24 h with polymyxin B (1 to 4 mg/liter) and enrofloxacin (1 to 4 mg/liter) alone or in combination. Additionally, in vitro one-compartment model (IVM) and hollow-fiber infection model (HFIM) experiments were performed against P. aeruginosa 12196. Polymyxin B and enrofloxacin in monotherapy were ineffective against all of the P. aeruginosa isolates examined, whereas polymyxin B-enrofloxacin in combination was synergistic against P. aeruginosa, with ≥2 to 4 log10 kill at 24 h in the static time-kill studies. In both IVM and HFIM, the combination was synergistic, and the bacterial counting values were below the limit of quantification on day 5 in the HFIM. A population analysis profile indicated that the combination inhibited the emergence of polymyxin resistance in P. aeruginosa 12196. The mechanism-based modeling suggests that the synergistic killing is a result of the combination of mechanistic and subpopulation synergy. Overall, this is the first preclinical study to demonstrate that the polymyxin-enrofloxacin combination is of considerable utility for the treatment of XDR P. aeruginosa infections and warrants future clinical evaluations.
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Rodríguez-Rojas A, Makarova O, Müller U, Rolff J. Cationic Peptides Facilitate Iron-induced Mutagenesis in Bacteria. PLoS Genet 2015; 11:e1005546. [PMID: 26430769 PMCID: PMC4592263 DOI: 10.1371/journal.pgen.1005546] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022] Open
Abstract
Pseudomonas aeruginosa is the causative agent of chronic respiratory infections and is an important pathogen of cystic fibrosis patients. Adaptive mutations play an essential role for antimicrobial resistance and persistence. The factors that contribute to bacterial mutagenesis in this environment are not clear. Recently it has been proposed that cationic antimicrobial peptides such as LL-37 could act as mutagens in P. aeruginosa. Here we provide experimental evidence that mutagenesis is the product of a joint action of LL-37 and free iron. By estimating mutation rate, mutant frequencies and assessing mutational spectra in P. aeruginosa treated either with LL-37, iron or a combination of both we demonstrate that mutation rate and mutant frequency were increased only when free iron and LL-37 were present simultaneously. Colistin had the same effect. The addition of an iron chelator completely abolished this mutagenic effect, suggesting that LL-37 enables iron to enter the cells resulting in DNA damage by Fenton reactions. This was also supported by the observation that the mutational spectrum of the bacteria under LL-37-iron regime showed one of the characteristic Fenton reaction fingerprints: C to T transitions. Free iron concentration in nature and within hosts is kept at a very low level, but the situation in infected lungs of cystic fibrosis patients is different. Intermittent bleeding and damage to the epithelial cells in lungs may contribute to the release of free iron that in turn leads to generation of reactive oxygen species and deterioration of the respiratory tract, making it more susceptible to the infection.
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Affiliation(s)
- Alexandro Rodríguez-Rojas
- Evolutionary Biology, Institute for Biology, Free University Berlin, Berlin, Germany
- * E-mail: (ARR); (JR)
| | - Olga Makarova
- Evolutionary Biology, Institute for Biology, Free University Berlin, Berlin, Germany
| | - Uta Müller
- Evolutionary Biology, Institute for Biology, Free University Berlin, Berlin, Germany
| | - Jens Rolff
- Evolutionary Biology, Institute for Biology, Free University Berlin, Berlin, Germany
- * E-mail: (ARR); (JR)
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