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Bazan IGM, Lobo BBP, Schreiber AZ, Calil R, Marba STM, de Siqueira Caldas JP. Long-lasting Effects of Control Measures on Trends in Incidence in Neonatal Late-onset Sepsis due to Multiresistant Bacteria in a Brazilian Neonatal Unit. Am J Infect Control 2024:S0196-6553(24)00642-4. [PMID: 39147138 DOI: 10.1016/j.ajic.2024.08.007] [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: 03/20/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND In 1995, due an outbreak of sepsis caused by multiresistant (MR) Gram-negative bacteria (GNB) our neonatal unit established a series of control and prevention measures. This study assessed the long-term impact of these measures on late-onset neonatal sepsis (LONS) caused by MR bacteria in a Brazilian level III neonatal unit from 2000 to 2020 and examined its relationship with in-hospital death. METHODS Newborns with LONS, confirmed by positive blood and/or cerebrospinal fluid cultures caused by Staphylococcus aureus, GNB, and Enterococcus sp, were analyzed. MR criteria followed CDC and local infectious disease guidelines. The annual sepsis trend was evaluated using joinpoint regression analysis. RESULTS Over 21 years, the confirmed LONS rate was 4.6%, showing a significant decline from 2000 to 2016 (P <.0001, negative slope of -0.36). From 2016 to 2020, there was a non-significant increase (slope = +0.92, P =.08). MR agents were present in 36/227 cases of sepsis (15.8%). MR sepsis showed a non-significant upward trend (slope = +0.50, P =.08) without inflection points. In-hospital death rates for MR LONS did not differ significantly from non-MR LONS (37.1% vs. 30.1%, P =.413). DISCUSSION The study indicates a low prevalence of MR sepsis due to effective antimicrobial use and educational interventions. CONCLUSION MR sepsis prevalence remained low and stable, not increasing in-hospital mortality.
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Affiliation(s)
| | | | | | - Roseli Calil
- Women's Hospital - State University of Campinas (Unicamp), Campinas, Brazil
| | - Sergio Tadeu Martins Marba
- Department of Pediatrics - School of Medical Sciences - State University of Campinas (Unicamp), Campinas, Brazil
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İnat G, Sırıken B, Çiftci A, Erol İ, Başkan C, Yıldırım T. Molecular characterization of extended-spectrum β-lactamases-producing Enterobacteriaceae species in ground beef and chicken meat. Int J Food Microbiol 2023; 398:110228. [PMID: 37148785 DOI: 10.1016/j.ijfoodmicro.2023.110228] [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: 01/19/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023]
Abstract
The objectives of this study were i) to characterize extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) using pheno- and genotyping methods, ii) to evaluate the antimicrobial resistance pattern against 10 antibiotics, and iii) to investigate class 1 integron (intI1) in 80 Enterobacteriaceae isolates obtained from chicken meat (n = 40; 47 isolates) and ground beef (n = 40; 33 isolates) samples. Through the study, we found that 55 (68.7 %) of 80 Enterobacteriaceae isolates were capable of β-lactamase activity, and 38 (47.5 %) of them were multi-drug-resistant (MDR). The ground meat-origin isolates are 1.2 times more likely to produce imipenem resistance compared to chicken-meat-origin isolates (z = 2.1, p < 0.05, OR = 1.42). ESBL-E was found in 18 (22.5 %) of the isolates, 16.3 % of chicken meat and 6.3 % of ground beef origin. The bla genes were detected in 14 isolates [bla-TEM (n = 10; 12.5 %); bla-SHV (n = 4; 5.0 %); bla-CTX-M (n = 0)], where the predominant species were Escherichia (E.) coli and Citrobacter braakii. The nine ESBL-E isolates were MDR. Twenty-eight (35.0 %) of 80 isolates were found to be resistant to at least one third-generation cephalosporin, and eight (28.6 %) of them were also ESBL-E. Eleven of 16 (48.5 %) carbapenem-resistant isolates were ESBL-E. The intI1 gene was found in 13 (16.3 %) isolates, five of which were ESBL-E, and four of which were MDR. Co-existing with bla-TEM and the intI1 isolate was ESBL-E. coli, which was resistant to nine antibiotics. In conclusion, chicken meat and ground beef may pose a potential risk of containing ESBL-E, and bla genes which could be spread to the entire food chain.
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Affiliation(s)
- Gökhan İnat
- Department of Food Hygiene and Technology, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Samsun, Türkiye
| | - Belgin Sırıken
- Department of Aquatic Animal Diseases, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Samsun, Türkiye.
| | - Alper Çiftci
- Department of Microbiology, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Samsun, Türkiye
| | - İrfan Erol
- Faculty of Health Sciences, Lokman Hekim University, Ankara, Türkiye
| | - Ceren Başkan
- Department of Physical Therapy and Rehabilitation, Sabuncuoğlu Şerefeddin Health Services Vocational School, Amasya University, Amasya, Türkiye
| | - Tuba Yıldırım
- Department of Biology, Faculty of Arts and Sciences, Amasya University, Amasya, Türkiye
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Rakitin AL, Yushina YK, Zaiko EV, Bataeva DS, Kuznetsova OA, Semenova AA, Ermolaeva SA, Beletskiy AV, Kolganova TV, Mardanov AV, Shapovalov SO, Tkachik TE. Evaluation of Antibiotic Resistance of Salmonella Serotypes and Whole-Genome Sequencing of Multiresistant Strains Isolated from Food Products in Russia. Antibiotics (Basel) 2021; 11:1. [PMID: 35052878 PMCID: PMC8773070 DOI: 10.3390/antibiotics11010001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/14/2022] Open
Abstract
Food products may be a source of Salmonella, one of the main causal agents of food poisoning, especially after the emergence of strains resistant to antimicrobial preparations. The present work dealt with investigation of the occurrence of resistance to antimicrobial preparations among S. enterica strains isolated from food. The isolates belonged to 11 serovars, among which Infantis (28%), Enteritidis (19%), and Typhimurium (13.4%) predominated. The isolates were most commonly resistant to trimethoprim/sulfamethoxazole (n = 19, 59.38%), cefazolin (n = 15, 46.86%), tetracycline (n = 13, 40.63%), and amikacin (n = 9, 28.13%). Most of the strains (68.75%) exhibited multiple resistance to commonly used antibiotics. High-throughput sequencing was used to analyse three multidrug-resistant strains (resistant to six or more antibiotics). Two of them (SZL 30 and SZL 31) belonged to S. Infantis, while one strain belonged to S. Typhimurium (SZL 38). Analysis of the genomes of the sequenced strains revealed the genes responsible for antibiotic resistance. In the genomes of strains SZL 30 and SZL 31 the genes of antibiotic resistance were shown to be localized mostly in integrons within plasmids, while most of the antibiotic resistance genes of strain SZL 38 were localized in a chromosomal island (17,949 nt). Genomes of the Salmonella strains SZL 30, SZL 31, and SZL 38 were shown to contain full-size pathogenicity islands: SPI-1, SPI-2, SPI-4, SPI-5, SPI-9, SPI-11, SPI-13, SPI-14, and CS54. Moreover, the genome of strain SZL 38 was also found to contain the full-size pathogenicity islands SPI-3, SPI-6, SPI-12, and SPI-16. The emergence of multidrug-resistant strains of various Salmonella serovars indicates that further research on the transmission pathways for these genetic determinants and monitoring of the distribution of these microorganisms are necessary.
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Affiliation(s)
- Andrey L. Rakitin
- Research Center of Biotechnology, Institute of Bioengineering, Russian Academy of Sciences, 119071 Moscow, Russia; (A.L.R.); (A.V.B.); (T.V.K.); (A.V.M.)
| | - Yulia K. Yushina
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, 109316 Moscow, Russia; (E.V.Z.); (D.S.B.); (O.A.K.); (A.A.S.)
| | - Elena V. Zaiko
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, 109316 Moscow, Russia; (E.V.Z.); (D.S.B.); (O.A.K.); (A.A.S.)
| | - Dagmara S. Bataeva
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, 109316 Moscow, Russia; (E.V.Z.); (D.S.B.); (O.A.K.); (A.A.S.)
| | - Oksana A. Kuznetsova
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, 109316 Moscow, Russia; (E.V.Z.); (D.S.B.); (O.A.K.); (A.A.S.)
| | - Anastasia A. Semenova
- V.M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, 109316 Moscow, Russia; (E.V.Z.); (D.S.B.); (O.A.K.); (A.A.S.)
| | - Svetlana A. Ermolaeva
- Federal Research Center for Virology and Microbiology, Nizhny Novgorod Research Veterinary Institute Branch, 603950 Nizhny Novgorod, Russia;
- Gamaleya National Research Centre for Epidemiology and Microbiology, 123098 Moscow, Russia
| | - Aleksey V. Beletskiy
- Research Center of Biotechnology, Institute of Bioengineering, Russian Academy of Sciences, 119071 Moscow, Russia; (A.L.R.); (A.V.B.); (T.V.K.); (A.V.M.)
| | - Tat’yana V. Kolganova
- Research Center of Biotechnology, Institute of Bioengineering, Russian Academy of Sciences, 119071 Moscow, Russia; (A.L.R.); (A.V.B.); (T.V.K.); (A.V.M.)
| | - Andrey V. Mardanov
- Research Center of Biotechnology, Institute of Bioengineering, Russian Academy of Sciences, 119071 Moscow, Russia; (A.L.R.); (A.V.B.); (T.V.K.); (A.V.M.)
| | - Sergei O. Shapovalov
- Research and Scientific Testing Center “Cherkizovo”, 108805 Moscow, Russia; (S.O.S.); (T.E.T.)
| | - Timofey E. Tkachik
- Research and Scientific Testing Center “Cherkizovo”, 108805 Moscow, Russia; (S.O.S.); (T.E.T.)
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Thomas C, Martin A, Sachsenröder J, Bandick N. Effects of modified atmosphere packaging on an extended-spectrum beta-lactamase-producing Escherichia coli, the microflora, and shelf life of chicken meat. Poult Sci 2020; 99:7004-7014. [PMID: 33248617 PMCID: PMC7704958 DOI: 10.1016/j.psj.2020.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 11/21/2022] Open
Abstract
The effects of modified atmosphere packaging on an extended-spectrum beta-lactamase-producing Escherichia coli strain and product quality characteristics of skinless chicken meat were determined. The samples were packed separately in air, 100% N2, and prefabricated gas mixtures with 75% O2 + 25% CO2 and 70% CO2 + 15% O2 + 15% N2 and incubated at 3°C for 7 d. To investigate the influence of the headspace ratio, samples were packed in identical trays to 600 g and 120 g. After 0, 2, 5, and 7 d of incubation, the samples were analyzed microbiologically and photometrically, and pH was measured. The results show that the development of the microorganisms depends on the atmosphere, with the 70% CO2 + 15% O2 + 15% N2 atmosphere having the highest development-inhibiting effect. This effect is increased with increased headspace. No significant effects on the pH and color of the samples were observed.
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Affiliation(s)
- Christian Thomas
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
| | - Annett Martin
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
| | - Jana Sachsenröder
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
| | - Niels Bandick
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany.
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Warning of outbreak of important antibiotic resistance in strains of urology and nephrology wards. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Amin M, Wasito EB, Triyono EA. Comparison between Exposure of Ciprofloxacin and Cefotaxime on Developing of Escherichia coli ESBL. FOLIA MEDICA INDONESIANA 2020. [DOI: 10.20473/fmi.v56i2.21203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to compare ciprofloxacin and cefotaxime exposure to develop ESBL producing Escherichia coli (E. coli). A total of 16 isolates of cefotaxime sensitive E. coli and ciprofloxacin were exposed to ciprofloxacin and cefotaxime for 14 days using the Kirby-Bauer antibiotic disc diffusion method. Colonies that grew on the edge of the inhibiting zone were exposed each day by the same method. Furthermore, we observed the occurrence of resistance to cefotaxime as ESBL screening test. Isolates were resistant, the following day the ESBL was confirmed by the Modified Double Disk Sinergy Test (MDDST) method using Cefotaxime (CTX), Ceftazidime (CAZ), Aztreonam (ATM), and Amoxilin Clavulanate (AMC) antibiotic discs. From 16 isolates of ESBL producing E. coli exposed to ciprofloxacin, it was obtained 4 (25%) to ESBL E. coli. ESBL production occurred after E. coli was exposed to ciprofloxacin on days 5, 6, 7, and 12. While those exposed to cefotaxime none becomes ESBL E. coli. There was no difference between ciprofloxacin and cefotaxime exposure to develop ESBL producing E. coli (p=0.101; Chi-square).
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Pérez-Fontán M, Lueiro F. Escherichia Coli Peritonitis in Patients Undergoing Peritoneal Dialysis: A Serious Problem that may Get Worse. Perit Dial Int 2020. [DOI: 10.1177/089686080602600208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Miguel Pérez-Fontán
- Division of Nephrology Health Science Institute University of A Coruña A Coruña, Spain
- Hospital Juan Canalejo Department of Medicine Health Science Institute University of A Coruña A Coruña, Spain
| | - Francisco Lueiro
- Division of Microbiology Health Science Institute University of A Coruña A Coruña, Spain
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Complete Genome Sequence of Proteus mirabilis Phage Mydo. Microbiol Resour Announc 2019; 8:8/47/e01312-19. [PMID: 31753956 PMCID: PMC6872898 DOI: 10.1128/mra.01312-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Proteus mirabilis is a pathogen that has been linked to nosocomial infections. Studies on phages infecting P. mirabilis may provide therapeutics for infections caused by antibiotic-resistant strains of this pathogen. Here, we announce the complete genome sequence of a P. mirabilis myophage, Mydo, which is distantly related to Escherichia coli phage rv5. Proteus mirabilis is a pathogen that has been linked to nosocomial infections. Studies on phages infecting P. mirabilis may provide therapeutics for infections caused by antibiotic-resistant strains of this pathogen. Here, we announce the complete genome sequence of a P. mirabilis myophage, Mydo, which is distantly related to Escherichia coli phage rv5.
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9
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Husan O, Çadirci Ö. Determination of extended spectrum β‐lactamase producing Enterobacteriaceae from cheese samples sold in public bazaars. J Food Saf 2019. [DOI: 10.1111/jfs.12680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Omar Husan
- Faculty of Veterinary Medicine, Department of Food Hygiene and TechnologyOndokuz Mayıs University Kurupelit/Samsun Turkey
| | - Özgür Çadirci
- Faculty of Veterinary Medicine, Department of Food Hygiene and TechnologyOndokuz Mayıs University Kurupelit/Samsun Turkey
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Detection of Colony Adhesion Factors and Genetic Background of Adhesion Genes Among Multidrug-Resistant Uropathogenic Escherichia coli Isolated in Iraq. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.4.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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Abdel Aziz SA, Abdel-Latef GK, Shany SA, Rouby SR. Molecular detection of integron and antimicrobial resistance genes in multidrug resistant Salmonella isolated from poultry, calves and human in Beni-Suef governorate, Egypt. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2018. [DOI: 10.1016/j.bjbas.2018.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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Leulmi Z, Kandouli C, Mihoubi I, Benlabed K, Lezzar A, Rolain JM. First report of bla OXA-24 carbapenemase gene, armA methyltransferase and aac(6')-Ib-cr among multidrug-resistant clinical isolates of Proteus mirabilis in Algeria. J Glob Antimicrob Resist 2018; 16:125-129. [PMID: 30217548 DOI: 10.1016/j.jgar.2018.08.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Carbapenemase-producing, or carbapenem-resistant, Enterobacteriaceae are an emerging threat to human and animal health because they are resistant to many of the last-line antimicrobials available for treatment of infection. The aim of this study was to analyse the antimicrobial resistance patterns and their encoding genes of Proteus mirabilis isolated in Constantine, Algeria. METHODS A total of 108 Proteus, Morganella and Providencia (PMP) strains were isolated from a large variety of clinical specimens at University Hospital of Constantine in Algeria. Isolates were identified using the API 20E system and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). Diagnostic accuracy was determined by independent comparison of each method to phylogenetic analysis based on 16S rRNA gene sequencing. Antimicrobial susceptibility was determined by the standard disk diffusion and Etest methods. The presence of antimicrobial resistance genes was screened for by PCR amplification and sequencing. RESULTS A total of 72 PMP strains were multidrug-resistant (MDR). Among them, one P. mirabilis isolate was resistant to imipenem with a minimum inhibitory concentration (MIC) of ≥12μg/mL. PCR and sequencing showed the presence of various antimicrobial resistance genes, including blaCTX-M-15, blaTEM-1, blaTEM-2, blaPER-1, blaSHV-11, aadA1, aadA2, armA, aac(6')-Ib, aac(6')-Ib-cr, aac(3)-Ia and ant(2″)-I, forming different resistance profiles. Moreover, the blaOXA-24 gene was detected in the imipenem-resistant P. mirabilis strain. CONCLUSION In this study, a MDR P. mirabilis isolate harbouring the blaOXA-24, armA 16S rRNA methylase and aac(6)-Ib-cr genes was found for the first time in Algeria.
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Affiliation(s)
- Zineb Leulmi
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes, URMITE CNRS-IRD, UMR 6236, Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France; Laboratoire Microbiologie, CHU de Constantine, Constantine, Algeria
| | - Chouaib Kandouli
- Laboratoire de Biologie et Environnement, Faculté des Sciences de la Nature et de la Vie, Université des Frères Mentouri Constantine 1, Constantine, Algeria
| | - Ilhem Mihoubi
- Laboratoire de Mycologie, Biotechnologie et de l'Activité Microbienne, Faculté des Sciences de la Nature et de la Vie, Université des Frères Mentouri Constantine 1, Constantine, Algeria
| | - Kaddour Benlabed
- Laboratoire Microbiologie, CHU de Constantine, Constantine, Algeria
| | - Abdeslam Lezzar
- Laboratoire Microbiologie, CHU de Constantine, Constantine, Algeria
| | - Jean-Marc Rolain
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes, URMITE CNRS-IRD, UMR 6236, Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France.
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Engda T, Moges F, Gelaw A, Eshete S, Mekonnen F. Prevalence and antimicrobial susceptibility patterns of extended spectrum beta-lactamase producing Entrobacteriaceae in the University of Gondar Referral Hospital environments, northwest Ethiopia. BMC Res Notes 2018; 11:335. [PMID: 29788988 PMCID: PMC5964971 DOI: 10.1186/s13104-018-3443-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/11/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study aimed at assessing the magnitude, distribution, and the antimicrobial susceptibility of the extended spectrum beta-lactamase producing Entrobacteriaceae in the University of Gondar Referral Hospital environments. RESULTS Out of a total of 384 samples, 14.8% were ESBL producing Entrobacteriaceae, where 42.10% Klebsiella pneumoniae, 35.09% Escherchia coli and 7.01% Proteus mirabilis were the predominant isolates. Most ESBL producing isolates, that is, 24.56, 22.8, and 22.8% were found from waste water, sinks and bedside tables respectively. All ESBL producing Entrobacteriaceae were found to be resistant to ceftriaxone, ceftazidime, cefpirome, cefpodoxime, and amoxicillin with Clavulanic acid. Resistance rate was also high for non-beta-lactam antimicrobials, like chloramphenicol (70.18%), cotrimoxazole (64.91%), norfloxacin (42.10%), ciprofloxacin (43.86%), and gentamicin (19.30%).
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Affiliation(s)
- Tigist Engda
- Department of Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
| | - Feleke Moges
- Department of Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Aschalew Gelaw
- Department of Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Setegn Eshete
- Department of Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Feleke Mekonnen
- Department of Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
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Seni J, Moremi N, Matee M, van der Meer F, DeVinney R, Mshana SE, D Pitout JD. Preliminary insights into the occurrence of similar clones of extended-spectrum beta-lactamase-producing bacteria in humans, animals and the environment in Tanzania: A systematic review and meta-analysis between 2005 and 2016. Zoonoses Public Health 2017; 65:1-10. [PMID: 28834351 DOI: 10.1111/zph.12387] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Indexed: 11/26/2022]
Abstract
The emergence and spread of extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-PE) are complex and of the public health concern across the globe. This review aimed at assessing the ESBL-PE clones circulating in humans, animals and the environment to provide evidence-based insights for combating ESBL-PE using One Health approach. Systematic search from Medline/PubMed, Google Scholar and African Journals Online was carried out and retrieved nine eligible articles (of 131) based on phenotypic and genotypic detection of ESBL-PE between 2005 and 2016 in Tanzania. Analysis was performed using STATA 11.0 software to delineate the prevalence of ESBL-PE, phenotypic resistance profiles and clones circulating in the three interfaces. The overall prevalence of ESBL-PE in the three interfaces was 22.6% (95% CI: 21.1-24.2) with the predominance of Escherichia coli (E. coli) strains (51.6%). The majority of ESBL-PE were resistant to the commonly used antimicrobials such as trimethoprim-sulfamethoxazole and tetracycline/doxycycline, 38%-55% were resistant to ciprofloxacin and all were sensitive to meropenem/imipenem. ESBL-PE infections were more associated with deaths compared to non-ESBL-PE infections. Strikingly, E. coli ST38, ST131 and ST2852 were found to intersect variably across the three interfaces. The predominant allele, blaCTX-M-15, was found mostly in the conjugative IncF plasmids connoting transmission potential. The high prevalence of ESBL-PE and shared clones across the three interfaces, including the global E. coli ST131 clone, indicates wide and inter-compartmental spread that calls for One Health genomic-driven studies to track the resistome flow.
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Affiliation(s)
- J Seni
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.,Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - N Moremi
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - M Matee
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - F van der Meer
- Faculty of Veterinary Medicine: Ecosystem and Public Health, University of Calgary, Calgary, AB, Canada
| | - R DeVinney
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - J D D Pitout
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Antimicrobial Susceptibility Pattern and Prevalence of Extended-Spectrum β-Lactamase Genotypes among Clinical Isolates of Acinetobacter baumanii in Tabriz, North-West of Iran. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.13368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Wieland N, Boss J, Lettmann S, Fritz B, Schwaiger K, Bauer J, Hölzel C. Susceptibility to disinfectants in antimicrobial-resistant and -susceptible isolates of Escherichia coli, Enterococcus faecalis and Enterococcus faecium from poultry-ESBL/AmpC-phenotype of E. coli is not associated with resistance to a quaternary ammonium. J Appl Microbiol 2017; 122:1508-1517. [DOI: 10.1111/jam.13440] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/17/2017] [Accepted: 03/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- N. Wieland
- Chair of Animal Hygiene; WZW; TUM; Freising Germany
| | - J. Boss
- Bavarian Health and Food Safety Authority (LGL); Oberschleißheim Germany
| | - S. Lettmann
- Department of Veterinary Sciences; Faculty of Veterinary Medicine; LMU; München Germany
| | - B. Fritz
- Department of Veterinary Sciences; Faculty of Veterinary Medicine; LMU; München Germany
| | - K. Schwaiger
- Department of Veterinary Sciences; Faculty of Veterinary Medicine; LMU; München Germany
| | - J. Bauer
- Chair of Animal Hygiene; WZW; TUM; Freising Germany
| | - C.S. Hölzel
- Department of Veterinary Sciences; Faculty of Veterinary Medicine; LMU; München Germany
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17
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Maynou G, Bach A, Terré M. Feeding of waste milk to Holstein calves affects antimicrobial resistance of Escherichia coli and Pasteurella multocida isolated from fecal and nasal swabs. J Dairy Sci 2017; 100:2682-2694. [PMID: 28215892 DOI: 10.3168/jds.2016-11891] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/28/2016] [Indexed: 12/18/2022]
Abstract
The use of milk containing antimicrobial residues in calf feeding programs has been shown to select for resistant fecal Escherichia coli in dairy calves. However, information is scarce about the effects of feeding calves waste milk (WM) on the prevalence of multidrug-resistant bacteria. The objective of this study was to determine the antimicrobial resistance patterns of fecal E. coli and nasal Pasteurella multocida isolates from calves fed either milk replacer (MR) or WM in 8 commercial dairy farms (4 farms per feeding program). Fecal and nasal swabs were collected from 20 ± 5 dairy calves at 42 ± 3.2 d of age, and from 10 of these at approximately 1 yr of age in each study farm to isolate the targeted bacteria. Furthermore, resistance of E. coli isolates from calf-environment and from 5 calves at birth and their dams was also evaluated in each study farm. Resistances were tested against the following antimicrobial agents: amoxicillin-clavulanic acid, ceftiofur, colistin, doxycycline (DO), enrofloxacin (ENR), erythromycin, florfenicol, imipenem, and streptomycin. A greater number of fecal E. coli resistant to ENR, florfenicol, and streptomycin and more multidrug-resistant E. coli phenotypes were isolated in feces of calves fed WM than in those fed MR. However, the prevalence of fecal-resistant E. coli was also influenced by calf age, as it increased from birth to 6 wk of age for ENR and DO and decreased from 6 wk to 1 yr of age for DO regardless of the feeding program. From nasal samples, an increase in the prevalence of colistin-resistant P. multocida was observed in calves fed WM compared with those fed MR. The resistance patterns of E. coli isolates from calves and their dams tended to differ, whereas similar resistance profiles among E. coli isolates from farm environment and calves were observed. The findings of this study suggest that feeding calves WM fosters the presence of resistant bacteria in the lower gut and respiratory tracts of dairy calves.
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Affiliation(s)
- G Maynou
- Department of Ruminant Production, Institut de Recerca i Tecnologia Agroalimentàries, 08140 Caldes de Montbui, Spain
| | - A Bach
- Department of Ruminant Production, Institut de Recerca i Tecnologia Agroalimentàries, 08140 Caldes de Montbui, Spain; Institució Catalana de Recerca i Estudis Avançats, 08010 Barcelona, Spain
| | - M Terré
- Department of Ruminant Production, Institut de Recerca i Tecnologia Agroalimentàries, 08140 Caldes de Montbui, Spain.
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Conte D, Palmeiro JK, da Silva Nogueira K, de Lima TMR, Cardoso MA, Pontarolo R, Degaut Pontes FL, Dalla-Costa LM. Characterization of CTX-M enzymes, quinolone resistance determinants, and antimicrobial residues from hospital sewage, wastewater treatment plant, and river water. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2017; 136:62-69. [PMID: 27816836 DOI: 10.1016/j.ecoenv.2016.10.031] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/21/2016] [Accepted: 10/25/2016] [Indexed: 05/09/2023]
Abstract
Multidrug-resistant (MDR) bacteria are widespread in hospitals and have been increasingly isolated from aquatic environments. The aim of the present study was to characterize extended-spectrum β-lactamase (ESBL) and quinolone-resistant Enterobacteriaceae from a hospital effluent, sanitary effluent, inflow sewage, aeration tank, and outflow sewage within a wastewater treatment plant (WWTP), as well as river water upstream and downstream (URW and DRW, respectively), of the point where the WWTP treated effluent was discharged. β-lactamase (bla) genes, plasmid-mediated quinolone resistance (PMQR), and quinolone resistance-determining regions (QRDRs) were assessed by amplification and sequencing in 55 ESBL-positive and/or quinolone-resistant isolates. Ciprofloxacin residue was evaluated by high performance liquid chromatography. ESBL-producing isolates were identified in both raw (n=29) and treated (n=26) water; they included Escherichia coli (32), Klebsiella pneumoniae (22) and Klebsiella oxytoca (1). Resistance to both cephalosporins and quinolone was observed in 34.4% of E. coli and 27.3% of K. pneumoniae. Resistance to carbapenems was found in 5.4% of K. pneumoniae and in K. oxytoca. Results indicate the presence of blaCTX-M (51/55, 92.7%) and blaSHV (8/55, 14.5%) ESBLs, and blaGES (2/55, 3.6%) carbapenemase-encoding resistance determinants. Genes conferring quinolone resistance were detected at all sites, except in the inflow sewage and aeration tanks. Quinolone resistance was primarily attributed to amino acid substitutions in the QRDR of GyrA (47%) or to the presence of PMQR (aac-(6')-Ib-cr, oqxAB, qnrS, and/or qnrB; 52.9%) determinants. Ciprofloxacin residue was absent only from URW. Our results have shown strains carrying ESBL genes, PMQR determinants, and mutations in the gyrA QRDR genes mainly in hospital effluent, URW, and DRW samples. Antimicrobial use, and the inefficient removal of MDR bacteria and antibiotic residue during sewage treatment, may contribute to the emergence and spreading of resistance in the environment, making this a natural reservoir.
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Affiliation(s)
- Danieli Conte
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil.
| | - Jussara Kasuko Palmeiro
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil; Hospital de Clínicas, Universidade Federal do Paraná (HC-UFPR), Curitiba, Paraná, Brazil.
| | - Keite da Silva Nogueira
- Departamento de Patologia Básica, Setor de Ciências Biológicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | | | - Marco André Cardoso
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil; Pharmacy Department, Health Sciences Sector, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
| | - Roberto Pontarolo
- Pharmacy Department, Health Sciences Sector, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
| | - Flávia Lada Degaut Pontes
- Pharmacy Department, Health Sciences Sector, Universidade Federal do Paraná (UFPR), Curitiba, Paraná, Brazil.
| | - Libera Maria Dalla-Costa
- Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe (FPP/IPPPP), Curitiba, Paraná, Brazil; Hospital de Clínicas, Universidade Federal do Paraná (HC-UFPR), Curitiba, Paraná, Brazil.
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19
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Detection of antibiotic resistance genes β-lactamics in bacterial strains isolated from Umbilical Cord Blood Units for transplant. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2017. [DOI: 10.1016/j.hgmx.2016.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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20
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Mohamed S, Marwa A, Hamada H, Amro H. Mutations in -lactamases detected in multidrug resistant gram negative bacteria isolated from community acquired urinary tract infections in Assiut, Egypt. ACTA ACUST UNITED AC 2016. [DOI: 10.5897/ajmr2016.8150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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21
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Yabanoğlu H, Alışkan HE, Çalışkan K, Arer İ, Akdur A, Yıldırım S, Moray G, Haberal M. Early Infections in Renal Transplant Recipients: Incidence, Risk Factors, and Causative Microorganisms. EXP CLIN TRANSPLANT 2016; 13 Suppl 3:11-4. [PMID: 26640902 DOI: 10.6002/ect.tdtd2015.o9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This study aimed to compare renal transplant recipients with and without infection with respect to demographic and clinical characteristics as well as risk factors; to determine the incidence of posttransplant infections; and to study the antibiotic resistance patterns of bacterial species identified as the causative organisms in posttransplant infections. MATERIALS AND METHODS This study included a total of 136 patients undergoing renal transplant in a 4-year period. The patients were categorized into 2 groups. The 2 groups were compared with each other with respect to general clinical and demographic variables and the number and frequency of infectious attacks within a 1-year follow-up, infection type, and antibiotic resistance patterns. RESULTS Ninety-two (67.6%) of the subjects were male and 44 (32.4%) were female. A total of 57 (41.9%) patients developed 128 infectious attacks. Urinary tract infections were the most common infections (42.1%). There was a significant correlation between a clinically relevant urinary culture proliferation and postoperative infection rate (P = .002). There was a significant correlation between antimicrobial resistance and the number of infectious attacks (P = .023). There was a significant correlation between the proliferation of Extended Spectrum Beta Lactamase-positive Enterobactericeae species and the number of infectious attacks (P = .000). CONCLUSIONS Presence of a clinically relevant proliferation in the preoperative urinary culture, which was identified as a risk factor for infection, increased the number of infectious attacks. Moreover, Extended Spectrum Beta Lactamase-positive Enterobactericeae species increased the number of infections. These 2 principle results should be taken into account in patient management.
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Affiliation(s)
- Hakan Yabanoğlu
- From the Department of General Surgery, Baskent University, Turkey
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22
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Bialvaei AZ, Kafil HS, Asgharzadeh M, Aghazadeh M, Yousefi M. CTX-M extended-spectrum β-lactamase-producing Klebsiella spp, Salmonella spp, Shigella spp and Escherichia coli isolates in Iranian hospitals. Braz J Microbiol 2016; 47:706-11. [PMID: 27268117 PMCID: PMC4927670 DOI: 10.1016/j.bjm.2016.04.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 11/24/2015] [Indexed: 11/23/2022] Open
Abstract
This study was conducted in Iran in order to assess the distribution of CTX-M type ESBLs producing Enterobacteriaceae. From January 2012 to December 2013, totally 198 E. coli, 139 Klebsiella spp, 54 Salmonella spp and 52 Shigella spp from seven hospitals of six provinces in Iran were screened for resistance to extended-spectrum cephalosporins. After identification and susceptibility testing, isolates presenting multiple-drug resistance (MDR) were evaluated for ESBL production by the disk combination method and by Etest using (cefotaxime and cefotaxime plus clavulanic acid). All isolates were also screened for blaCTX-M using conventional PCR. A total of 42.92%, 33.81%, 14.81% and 7.69% of the E. coli, Klebsiella spp, Salmonella spp and Shigella spp isolates were MDR, respectively. The presence of CTX-M enzyme among ESBL-producing isolates was 85.18%, 77.7%, 50%, and 66.7%, in E. coli, Klebsiella spp, Salmonella spp and Shigella spp respectively. The overall presence of CTX-M genes in Enterobacteriaceae was 15.4% and among the resistant isolates was 47.6%. This study indicated that resistance to β-lactams mediated by CTX-M enzymes in Iran had similar pattern as in other parts of the world. In order to control the spread of resistance, comprehensive studies and programs are needed.
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Affiliation(s)
- Abed Zahedi Bialvaei
- Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Asgharzadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Aghazadeh
- Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Korytny A, Riesenberg K, Saidel-Odes L, Schlaeffer F, Borer A. Bloodstream infections caused by multi-drug resistant Proteus mirabilis: Epidemiology, risk factors and impact of multi-drug resistance. Infect Dis (Lond) 2016; 48:428-31. [PMID: 26763474 DOI: 10.3109/23744235.2015.1129551] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of antimicrobial co-resistance among ESBL-producing Enterobactereaceae is extremely high in Israel. Multidrug-resistant Proteus mirabilis strains (MDR-PM), resistant to almost all antibiotic classes have been described. The aim was to determine the risk factors for bloodstream infections caused by MDR-PM and clinical outcomes. METHODS A retrospective case-control study. Adult patients with PM bacteremia during 7 years were identified retrospectively and their files reviewed for demographics, underlying diseases, Charlson Comorbidity Index, treatment and outcome. RESULTS One hundred and eighty patients with PM-bloodstream infection (BSI) were included; 90 cases with MDR-PM and 90 controls with sensitive PM (S-PM). Compared to controls, cases more frequently were from nursing homes, had recurrent hospital admissions in the past year and received antibiotic therapy in the previous 3 months, were bedridden and suffered from peripheral vascular disease and peptic ulcer disease (p < 0.001). Two-thirds of the MDR-PM isolates were ESBL-producers vs 4.4% of S-PM isolates (p < 0.001, OR = 47.6, 95% CI = 15.9-142.6). In-hospital crude mortality rate of patients with MDR-PM BSI was 37.7% vs 23.3% in those with S-PM BSI (p = 0.0359, OR = 2, 95% CI = 1.4-3.81). CONCLUSIONS PM bacteremia in elderly and functionally-dependent patients is likely to be caused by nearly pan-resistant PM strains in the institution; 51.8% of the patients received inappropriate empiric antibiotic treatment. The crude mortality rate of patients with MDR-PM BSI was significantly higher than that of patients with S-PM BSI.
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Affiliation(s)
- Alexander Korytny
- a Infectious Diseases Institute, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Klaris Riesenberg
- a Infectious Diseases Institute, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Lisa Saidel-Odes
- a Infectious Diseases Institute, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Fransisc Schlaeffer
- a Infectious Diseases Institute, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
| | - Abraham Borer
- b Infection Control and Hospital Epidemiology Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva , Israel
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24
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Bajaj P, Kanaujia PK, Singh NS, Sharma S, Kumar S, Virdi JS. Quinolone co-resistance in ESBL- or AmpC-producing Escherichia coli from an Indian urban aquatic environment and their public health implications. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:1954-1959. [PMID: 26498967 DOI: 10.1007/s11356-015-5609-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/13/2015] [Indexed: 06/05/2023]
Abstract
Quinolone and β-lactam antibiotics constitute major mainstay of treatment against infections caused by pathogenic Escherichia coli. Presence of E. coli strains expressing co-resistance to both these antibiotic classes in urban aquatic environments which are consistently being used for various anthropogenic activities represents a serious public health concern. From a heterogeneous collection of 61 E. coli strains isolated from the river Yamuna traversing through the National Capital Territory of Delhi (India), those harboring blaCTX-M-15 (n = 10) or blaCMY-42 (n = 2) were investigated for co-resistance to quinolones and the molecular mechanisms thereof. Resistance was primarily attributed to amino acid substitutions in the quinolone resistance-determining regions (QRDRs) of GyrA (S83L ± D87N) and ParC (S80I ± E84K). One of the E. coli strains, viz., IPE, also carried substitutions in GyrB and ParE at positions Ser492→Asn and Ser458→Ala, respectively. The phenotypically susceptible strains nevertheless carried plasmid-mediated quinolone resistance (PMQR) gene, viz., qnrS, which showed co-transfer to the recipient quinolone-sensitive E. coli J53 along with the genes encoding β-lactamases and led to increase in minimal inhibitory concentrations of quinolone antibiotics. To the best of our knowledge, this represents first report of molecular characterization of quinolone co-resistance in E. coli harboring genes for ESBLs or AmpC β-lactamases from a natural aquatic environment of India. The study warrants true appreciation of the potential of urban aquatic environments in the emergence and spread of multi-drug resistance and underscores the need to characterize resistance genetic elements vis-à-vis their public health implications, irrespective of apparent phenotypic resistance.
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Affiliation(s)
- Priyanka Bajaj
- Microbial Pathogenicity Laboratory, Department of Microbiology, University of Delhi South Campus, Benito Juarez Road, New Delhi, 110021, India
| | - Pawan Kumar Kanaujia
- Microbial Pathogenicity Laboratory, Department of Microbiology, University of Delhi South Campus, Benito Juarez Road, New Delhi, 110021, India
| | - Nambram Somendro Singh
- Microbial Pathogenicity Laboratory, Department of Microbiology, University of Delhi South Campus, Benito Juarez Road, New Delhi, 110021, India
| | - Shalu Sharma
- Microbial Pathogenicity Laboratory, Department of Microbiology, University of Delhi South Campus, Benito Juarez Road, New Delhi, 110021, India
| | - Shakti Kumar
- Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, 781039, India
| | - Jugsharan Singh Virdi
- Microbial Pathogenicity Laboratory, Department of Microbiology, University of Delhi South Campus, Benito Juarez Road, New Delhi, 110021, India.
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25
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Durmaz S, Percin D, Ercal BD. Molecular epidemiology of quinolon resistant strains of extended spectrum beta-lactamase producing Escherichia coli. Pak J Med Sci 2015; 31:1067-72. [PMID: 26648988 PMCID: PMC4641257 DOI: 10.12669/pjms.315.8186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To determine the clonal relationship of ESBL-producing and quinolone resistant E.coli strains and to investigate the risk factors for infections with these microorganisms. Methods: A total of 95 ESBL-producing and quinolone resistant E.coli strains isolated from various clinical specimens of inpatients and outpatients in our hospital were included in the study. Risk factors for infections with ESBL-producing E.coli and demographic data of the patients were obtained from hospital records. The rep-PCR method was used for the determination of the genetic relationship of the strains. Results: Of the strains included in the study, 33(34.7%) were isolated from inpatients and 62(65.3%) from outpatients. At least one risk factor has been identified in all patients for infection with ESBL producing E.coli and the mean of the risk factors of patients was 4.2. The most common risk factor was urinary catheter insertion (57.9%). The distribution of the strains in each clone was as fallows: clone A: 9(9.5%), clone B: 10(10.5%), clone C: 38(40%), clone D: 12(12.5%), clone E: 6(6.3%), clone F: 7(7.3%) and clone G 5(5.3%). The clones A, D and C (dominant clone) were isolated from hospital and community acquired infections. Clones E, F and G were identified as nosocomial clones. Conclusion: Infections with multidrug resistant bacteria may be related to the hospital although they were isolated from outpatients. Developing a medical record system is vitally important to prevent the occurence and spread of resistant bacterial infections in the community.
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Affiliation(s)
- Suleyman Durmaz
- Suleyman Durmaz, Konya Numune Hospital, Microbiology Laboratory, Konya, Turkey
| | - Duygu Percin
- Duygu Percin, Erciyes University Faculty of Medicine, Department of Medical Microbiology, Kayseri, Turkey
| | - Baris Derya Ercal
- Baris Derya Ercal, Erciyes University Faculty of Medicine, Department of Medical Microbiology, Kayseri, Turkey
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26
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Deccache Y, Irenge LM, Ambroise J, Savov E, Marinescu D, Chirimwami RB, Gala JL. A qPCR and multiplex pyrosequencing assay combined with automated data processing for rapid and unambiguous detection of ESBL-producers Enterobacteriaceae. AMB Express 2015; 5:136. [PMID: 26260895 PMCID: PMC4531121 DOI: 10.1186/s13568-015-0136-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 07/23/2015] [Indexed: 12/22/2022] Open
Abstract
Rapid and specific detection of extended-spectrum β-lactamase-producing (ESBL) bacteria is crucial both for timely antibiotic therapy when treating infected patients as well as for appropriate infection control measures aimed at curbing the spread of ESBL-producing isolates. Whereas a variety of phenotypic methods are currently available for ESBL detection, they remain time consuming and sometimes difficult to interpret while being also affected by a lack of sensitivity and specificity. Considering the longer turnaround time (TAT) of susceptibility testing and culture results, DNA-based ESBL identification would be a valuable surrogate for phenotypic-based methods. Putative ESBL-positive Enterobacteriaceae isolates (n = 330) from clinical specimen were prospectively collected in Bulgaria, Romania and Democratic Republic of Congo and tested in this study. All isolates were assessed for ESBL-production by the E-test method and those giving undetermined ESBL status were re-tested using the combination disk test. A genotypic assay successively combining qPCR detection of blaCTX-M, blaTEM and blaSHV genes with a multiplex pyrosequencing of blaTEM and blaSHV genes was developed in order to detect the most common ESBL-associated TEM and SHV single nucleotides polymorphisms, irrespective of their plasmid and/or chromosomal location. This assay was applied on all Enterobacteriaceae isolates (n = 330). Phenotypic and genotypic results matched in 324/330 (98.2%). Accordingly, real-time PCR combined with multiplex pyrosequencing appears to be a reliable and easy-to-perform assay with high-throughput identification and fast TAT (~5 h).
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Affiliation(s)
- Emily W Gottenborg
- Hospital Medicine Section, Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Leprino Building, 4th Floor, Mailstop F-782, 12401 East 17th Avenue, Aurora, CO 80045, USA
| | - Michelle A Barron
- Division of Infectious Diseases, Department of Medicine, University of Colorado Hospital Infection Prevention and Control, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, B168, Aurora, CO 80045, USA
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28
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Ryou SH, Bae JW, Baek HJ, Lee DH, Lee SW, Choi GH, Han KH, Kim SW, Kim H, Hong G. Pulmonary Pneumatocele in a Pneumonia Patient Infected with Extended-Spectrum β-Lactamase Producing Proteus mirabilis. Tuberc Respir Dis (Seoul) 2015; 78:371-4. [PMID: 26508927 PMCID: PMC4620333 DOI: 10.4046/trd.2015.78.4.371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 06/15/2015] [Accepted: 06/19/2015] [Indexed: 11/24/2022] Open
Abstract
Pulmonary pneumatoceles are air-filled thin-walled spaces within the lung and are rare in adult cases of pneumonia. We report the case of a 74-year-old male who was admitted with a cough and sputum production. He had been treated with oral dexamethasone since a brain tumorectomy 6 months prior. Contrast-enhanced computed tomography (CT) of the chest revealed a large pneumatocele in the right middle lobe and peripheral pneumonic consolidation. Bronchoalveolar lavage was performed; cultures identified extended-spectrum β-lactamase (ESBL) producing Proteus mirabilis. A 4-week course of intravenous ertapenem was administered, and the pneumatocele with pneumonia resolved on follow-up chest CT. To the best of our knowledge, this is the first reported case of pulmonary pneumatocele caused by ESBL-producing P. mirabilis associated with pneumonia.
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Affiliation(s)
- Sung Hyeok Ryou
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Jong Wook Bae
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Hyun Jin Baek
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Doo Hyuk Lee
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Sang Won Lee
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Gyu Ho Choi
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Kyu Hyung Han
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Se Weon Kim
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Hyunbeom Kim
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Goohyeon Hong
- Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
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In Vitro Activity of Oral Cephalosporins (Cefprozil and Cefixime) Against Ciprofloxacin-Resistant Enterobacteriaceae from Community-Acquired Urinary-Tract Infections. Infect Dis Ther 2015; 4:425-32. [PMID: 26391612 PMCID: PMC4675762 DOI: 10.1007/s40121-015-0089-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION The global emergence of pathogens of urinary-tract infections resistant to ciprofloxacin or producing extended-spectrum β-lactamases (ESBL) led us to investigate the activity of older antimicrobials such as cefprozil and cefixime against a recent broad collection of urine enterobacteria from 2012 and 2013. METHODS Minimum inhibitory concentrations and minimum bactericidal concentrations of cefprozil, cefixime and ciprofloxacin were determined against 293 Escherichia coli (40 ESBL producers), 54 Klebsiella pneumoniae (10 ESBL producers) and 53 Proteus mirabilis isolates. RESULTS Cefprozil was more active than ciprofloxacin against non-ESBL-producing E. coli (93.7% vs 80.2%, p < 0.0001); this was not the case for cefixime (85.7% vs 80.2%, p: 0.125). Overall, cefprozil and cefixime inhibited 80-90% of ciprofloxacin-resistant isolates of all studied species. However, they were active against less than 20% of ESBL-producing isolates. CONCLUSION Results suggest that cefprozil and cefixime remain a good therapeutic alternative against urine enterobacteria particularly in case of ciprofloxacin-resistant pathogens. Their activity against ESBL-producing pathogens is limited.
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Interactions of Klebsiella pneumoniae with the innate immune system vary in relation to clone and resistance phenotype. Antimicrob Agents Chemother 2015; 59:7036-43. [PMID: 26349819 DOI: 10.1128/aac.01405-15] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 08/30/2015] [Indexed: 11/20/2022] Open
Abstract
Apart from inadequate antimicrobial treatment, specific virulence factors contribute to the high attributable mortality of infections caused by multidrug-resistant (MDR) Klebsiella pneumoniae. We explored the roles of MDR and clones as virulence determinants of K. pneumoniae and their interaction with innate immunity. Twenty isolates were studied and characterized by resistance phenotype and multilocus sequence type (MLST). Human peripheral blood mononuclear cells (PBMCs) were stimulated for the production of proinflammatory cytokines by live and heat-killed isolates and plasmid DNA; modulation by cellular pathway inhibitors was explored. Survival of 30 mice was recorded after intraperitoneal challenge with susceptible and K. pneumoniae carbapenemase (KPC)-producing isolates. Splenocytes of mice were stimulated for the production of pro- and anti-inflammatory cytokines. Isolates were divided into different patterns of production of tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β) poststimulation in relation to both the MLST clone and resistance phenotype. The sequence type 383 (ST383) clone producing Verona integron-encoded metallo-β-lactamase (VIM) stimulated high production of both TNF-α and IL-1β. Clone ST17 producing KPC elicited low TNF-α production; this was reversed by Toll-like receptor 9 (TLR9) antagonists, indicating an effect of plasmid DNA. This isolate was linked with early death of mice compared to high-TNF-α-producing isolates. We conclude that KPC-producing isolates seem to be highly virulent in a low-TNF-α-release environment, suggesting an immunoparalysis induction mechanism. KPC plasmids may directly contribute to the immune system stimulation.
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Njage PMK, Buys EM. Pathogenic and commensal Escherichia coli from irrigation water show potential in transmission of extended spectrum and AmpC β-lactamases determinants to isolates from lettuce. Microb Biotechnol 2015; 8:462-73. [PMID: 25488608 PMCID: PMC4408178 DOI: 10.1111/1751-7915.12234] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 10/07/2014] [Indexed: 11/28/2022] Open
Abstract
There are few studies on the presence of extended-spectrum β-lactamases and AmpC β-lactamases (ESBL/AmpC) in bacteria that contaminate vegetables. The role of the production environment in ESBL/AmpC gene transmission is poorly understood. The occurrence of ESBL/AmpC in Escherichia coli (n = 46) from lettuce and irrigation water and the role of irrigation water in the transmission of resistant E. coli were studied. The presence of ESBL/AmpC, genetic similarity and phylogeny were typed using genotypic and phenotypic techniques. The frequency of β-lactamase gene transfer was studied in vitro. ESBLs/AmpC were detected in 35 isolates (76%). Fourteen isolates (30%) produced both ESBLs/AmpC. Prevalence was highest in E. coli from lettuce (90%). Twenty-two isolates (48%) were multi-resistant with between two and five ESBL/AmpC genes. The major ESBL determinant was the CTX-M type (34 isolates). DHA (33% of isolates) were the dominant AmpC β lactamases. There was a high conjugation efficiency among the isolates, ranging from 3.5 × 10(-2) to 1 × 10(-2) ± 1.4 × 10(-1) transconjugants per recipient. Water isolates showed a significantly higher conjugation frequency than those from lettuce. A high degree of genetic relatedness between E. coli from irrigation water and lettuce indicated possible common ancestry and pathway of transmission.
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Affiliation(s)
- Patrick M K Njage
- Department of Food Science, University of Pretoria Lynwood RoadPretoria, 0002, South Africa
| | - Elna M Buys
- Department of Food Science, University of Pretoria Lynwood RoadPretoria, 0002, South Africa
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Otrock ZK, Oghlakian GO, Salamoun MM, Haddad M, Bizri ARN. Incidence of Urinary Tract Infection Following Transrectal Ultrasound Guided Prostate Biopsy at a Tertiary-Care Medical Center in Lebanon. Infect Control Hosp Epidemiol 2015; 25:873-7. [PMID: 15518032 DOI: 10.1086/502312] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractObjective:To determine the incidence of urinary tract infections (UTIs) following transrectal ultrasound guided needle biopsy of the prostate (TRUBP) and the bacteriology of these infections.Design:Retrospective evaluation of the charts and records of all patients who underwent TRUBP between June 1, 2002, and August 31, 2003.Setting:American University of Beirut Medical Center, a tertiary-care center in Lebanon.Patients:Two hundred seven patients underwent TRUBP. All received prophylactic antibiotics. One hundred twenty (58%) received ciprofloxacin alone, whereas 87 (42%) received both ciprofloxacin and gentamicin. Sixty-one patients (29.5%) had an enema prior to the procedure, whereas 146 (70.5%) did not.Results:Thirteen patients (6.3%) were admitted with UTI. All had rigors and fever on admission. Symptoms appeared at a mean of 2.7 days and the mean hospital stay was 9.2 days. The mean duration of antibiotic treatment was 23.2 days. Ten (77%) of the patients had positive bacteriology. Urine cultures were positive in 8 (61.5%) of the patients and blood cultures in 6 (46.2%). All positive cultures grew Escherichia coli resistant to ciprofloxacin, with 5 isolates producing extended-spectrum beta-lactamases.Conclusions:TRUBP continues to be associated with significant infectious complications, especially UTI. Given the increasing incidence of antibiotic resistance mainly among the Enterobacteriaceae, antimicrobial prophylaxis practices should be reevaluated and the universal administration of quinolones alone or in combination with aminoglycosides should be reconsidered.
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Affiliation(s)
- Zaher K Otrock
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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TEM and SHV Genes in Klebsiella pneumoniae Isolated from Cockroaches and Their Antimicrobial Resistance Pattern. Osong Public Health Res Perspect 2014; 6:3-8. [PMID: 25737824 PMCID: PMC4346594 DOI: 10.1016/j.phrp.2014.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 10/10/2014] [Accepted: 10/27/2014] [Indexed: 12/02/2022] Open
Abstract
Objectives Klebsiella pneumoniae is a gram-negative rod bacterium, a known cause of community-acquired bacterial pneumonia and is an important hospital-acquired pathogen that causes severe morbidity and mortality. The aim of this study was to identify the TEM and SHV genes in K. pneumoniae isolated from cockroaches obtained from hospitals. Methods In this study, 250 cockroaches were collected from different hospitals in the province of Chaharmahal Va Bakhtiari, which is located in southwest Iran. The samples were examined for the presence of K. pneumoniae by plating onto a combination of culture media, and the antimicrobial susceptibility patterns of isolated K. pneumoniae from samples were evaluated using the disk diffusion test. In addition, from the culture, genomic bacterial DNA was extracted, and sequence-specific targets (TEM and SHV genes) were amplified using the polymerase chain reaction (PCR) method. Results Out of 250 cockroach samples collected from various hospitals, 179 samples (71.60%) were positive for K. pneumoniae. PCR reaction was performed using specific oligonucleotide primers (TEM-F, TEM-R and SHV-F, SHV-R) for the amplification of each gene, and amplified products were visualized on 1% agarose gel electrophoresis. Of all the specimens amplified by PCR in this research, 32 samples (17.87%) were positive for TEM and 15 samples (8.37%) were positive for SHV. Conclusion Detection of TEM and SHV genes using molecular methods and their pattern of antimicrobial resistance can provide useful information about the epidemiology of and risk factors associated with K. pneumoniae infection.
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Logan LK, Braykov NP, Weinstein RA, Laxminarayan R. Extended-Spectrum β-Lactamase-Producing and Third-Generation Cephalosporin-Resistant Enterobacteriaceae in Children: Trends in the United States, 1999-2011. J Pediatric Infect Dis Soc 2014; 3:320-8. [PMID: 26625452 DOI: 10.1093/jpids/piu010] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 01/16/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND Enterobacteriaceae infections resistant to extended-spectrum β-lactams are an emerging problem in children. We used a large database of clinical isolates to describe the national epidemiology of extended-spectrum β-lactamase (ESBL)-producing and third-generation cephalosporin-resistant (G3CR) Enterobacteriaceae. METHODS Antimicrobial susceptibilities of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis reported to ∼300 laboratories participating in The Surveillance Network (TSN) between January 1999 and December 2011 were used to phenotypically identify G3CR and ESBL isolates cultured from patients <18 years. Bi-annual trends in the prevalence of each phenotype were stratified by species, patient location, culture site, age, and region. Children of age 0-1 years were excluded from analysis as data were only available from 2010 onwards. RESULTS Out of 368,398 pediatric isolates, 1.97% (7255) were identified as G3CR, and 0.47% (1734) as ESBL producers. The prevalence of both phenotypes increased, respectively, from 1.39% and 0.28% in 1999-2001 to 3% and 0.92% in 2010-2011. Trends were significant across all demographic and age groups, including outpatients, with the highest proportion of isolates in the 1-5-year-old age group. The majority of G3CR and ESBL isolates were E. coli (67.8% and 65.2%, respectively). Among ESBLs, resistance to ≥3 antibiotic classes was 74%. The lower regional prevalence of ESBL-producing bacteria in the upper Midwest relative to the rest of the country is consistent with recent local data. CONCLUSIONS Rates of G3CR and ESBL infections in children are increasing in both inpatient and ambulatory settings nationally. The identification of host factors and exposures leading to infection in children is essential.
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Affiliation(s)
- Latania K Logan
- Departments of Pediatrics Section of Pediatric Infectious Diseases, Rush Medical College, Rush University Medical Center, Chicago, Illinois John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
| | | | - Robert A Weinstein
- Internal Medicine, Division of Infectious Diseases John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
| | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics and Policy, Washington, DC Public Health Foundation of India, New Delhi, India Princeton University, New Jersey
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Logan LK, Meltzer LA, McAuley JB, Hayden MK, Beck T, Braykov NP, Laxminarayan R, Weinstein RA. Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Infections in Children: A Two-Center Case-Case-Control Study of Risk Factors and Outcomes in Chicago, Illinois. J Pediatric Infect Dis Soc 2014; 3:312-9. [PMID: 26625451 DOI: 10.1093/jpids/piu011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 11/12/2013] [Indexed: 11/13/2022]
Abstract
BACKGROUND Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae infections are an emerging problem in children. We sought to identify risk factors and describe outcomes associated with pediatric ESBL-producing bacterial infections at 2 hospitals in Chicago, IL from 2008 to 2011. METHODS A case-case-control study of children aged 0-17 years was conducted. Cases of Escherichia coli, Klebsiella, and Proteus spp. ESBL-producing bacterial infections (n = 30) were compared to uninfected controls and in parallel, cases of non-ESBL-producing bacterial infections (n = 30) were compared to uninfected controls (n = 60). We then qualitatively compared these results. RESULTS Median age of cases was 1.06 years; 62% of isolates were from urine, and 60% were E. coli. By multivariable analysis, ESBL cases were 5.7 and 3.3 times more likely to have gastrointestinal (P = .001; 95% confidence interval [CI] 1.9-17.0) and neurologic (P = .001; 95% CI 1.1-3.7) comorbidities, respectively, than controls; non-ESBL cases were also more likely to have gastrointestinal comorbidities than controls (P = .014; odds ratio 3.6; 95% CI 1.2-10.1). Study period prevalence remained stable (1.7%). Most (60%) infections occurred in the intensive care unit; however, 30% of children presented in the outpatient setting. Seventy-seven percent of isolates were multidrug resistant (ie, resistant to ≥3 antibiotic classes). Recurrence of infection occurred in 17% of ESBL cases. Crude mortality rates (7%) did not differ between cases and controls. CONCLUSIONS The incidence of pediatric infection due to ESBL-positive Enterobacteriaceae was stable at 2 large tertiary-care medical centers over a 4-year period. Multidrug resistance in pediatric ESBL isolates is common. Risk factors for infection due to ESBL-producing bacteria include neurologic medical conditions.
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Affiliation(s)
- Latania K Logan
- Departments of Pediatrics Section of Pediatric Infectious Diseases John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
| | | | - James B McAuley
- Departments of Pediatrics Section of Pediatric Infectious Diseases
| | | | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Rush Medical College, Chicago, Illinois
| | | | - Ramanan Laxminarayan
- Center for Disease Dynamics, Economics and Policy, Washington, DC Public Health Foundation of India, New Delhi, India Princeton University, New Jersey
| | - Robert A Weinstein
- Internal Medicine, Division of Infectious Diseases John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois
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Ali Abdel Rahim KA, Ali Mohamed AM. Prevalence of Extended Spectrum β-lactamase-Producing Klebsiella pneumoniae in Clinical Isolates. Jundishapur J Microbiol 2014; 7:e17114. [PMID: 25774279 PMCID: PMC4332241 DOI: 10.5812/jjm.17114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 03/02/2014] [Accepted: 04/14/2014] [Indexed: 11/24/2022] Open
Abstract
Background: Extended spectrum β-lactamase (ESBL) are gram-negative bacteria that produce the enzyme, β-lactamase, which can break down commonly used antibiotics, such as penicillin and cephalosporins, making infections with ESBL producing bacteria more difficult to treat. Extended spectrum β-lactamase-producing Klebsiella pneumoniae were first reported in 1983 from Germany, and since then a steady increase in resistance against cephalosporins has been seen causing health problems. Objectives: The aim of this study was to determine the prevalence of ESBL in strains of K. pneumoniae isolated from different clinical samples. Patients and Methods: One hundred and thirty isolates of K. pneumoniae were isolated from different clinical specimens from King Khalid hospital, Hafr Elbatin, Kingdom Saudi Arabia. These isolates were then characterized, tested for antimicrobial susceptibility and screened for ESBL production by the MicroScan WalkAway-96 SI System. Extended spectrum β-lactamase production was confirmed by the phenotypic confirmatory disc diffusion test (PCDDT) and the double disc synergy test (DDST). Results: Overall, 76.9% (100) of the isolates were resistant to cefuroxime, cefepime and cefazolin, 69.23% (90) were resistant to cefotaxime, and 46.15% (60) were resistant to cefoxitin. Extended spectrum β-lactamase was detected in 53.8% (70) of K. pneumoniae as detected by the MicroScan “WalkAway-96” SI System and 50.07% (66) by PCDDT and 46.15% (60) by DDST. All K. pneumoniae isolates were resistant to ampicillin followed by both piperacillin and mezlocillin 92.30% (120). K.pneumoniae isolates showed high sensitivity to imipenem (15.38%) (20), followed by ertapenem, tetracycline, tigecycline pipracilline/tazobactam and amikacin (23.07%) (30). Conclusions: Our study showed that the prevalence of ESBL-producing K. pneumoniae at King Khalid Hospital was significantly high. Routine detection of ESBL-producing microorganisms is required by each of the laboratory standard detection methods to control the spread of these infections and allow a proper therapeutic strategy. For detection, the phenotypic confirmatory disc diffusion test is simple, sensitive and cost effective. However, there is a need for larger scale drug susceptibility surveillance.
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Affiliation(s)
- Khalid Abdalla Ali Abdel Rahim
- Botany and Microbiology Department, College of Science, King Saud University, Saudi Arabia
- Botany Department, Faculty of Science, Sohag University, Sohag, Egypt
- Corresponding author: Khalid Abdalla Ali Abdel Rahim, Botany and Microbiology Department, College of Science, King Saud University P. O. Box: 2455, Saudi Arabia. Tel: +96-6114675818, Fax: +96-6114675833, E-mail:
| | - Ahmed Mohamed Ali Mohamed
- Department of Microbiology, College of Health Science, University of Dammam, Hafr Al Batin, Saudi Arabia
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Sipahi OR, Arda B, Nazli-Zeka A, Pullukcu H, Tasbakan M, Yamazhan T, Ozkoren-Calik S, Sipahi H, Ulusoy S. Piperacillin/tazobactam vs. cefoperazone/sulbactam in adult low-risk febrile neutropenia cases. Int J Clin Pract 2014; 68:230-5. [PMID: 24372736 DOI: 10.1111/ijcp.12279] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 08/08/2013] [Indexed: 11/30/2022] Open
Abstract
AIM The aim of this study was to compare the efficacy of piperacillin/tazobactam (P/T) and cefoperazone/sulbactam (C/S) in the empirical treatment of adult neutropenic fever. METHODS Data and outcomes of low-risk adult cases with neutropenic fever and treated with P/T (4.5 g q6h) or C/S (2 g q8h) between 2005 and 2011 June were extracted from our database. Risk evaluation was made according to criteria of Multinational Association for Supportive Care in Cancer (MASCC) and a score of ≥ 21 was considered as low risk. Data were collected prospectively by daily visits and evaluated retrospectively. Primary outcome was - fever defervescence at 72 h in combination with success without modification (referring to episodes where the patient recovered from fever with disappearance of signs of infection without modification to initial empirical treatment). All-cause mortality referred to death resulting from a documented or presumed infection or unidentified reason during the treatment and 30-day follow-up period. RESULTS A total of 172 patients (113 cases P/T and 59 cases C/S) fulfilled the study inclusion criteria. Persistent response in P/T arm was 73.5%, whereas it was 64.5% in C/S arm (p > 0.05). Rates of any modification were also similar in both treatment arms. All-cause mortality during the treatment and 30-day follow-up period was not significantly different (P/T: 4/113 vs. C/S: 2/59, p > 0.05). There was no severe adverse effect requiring antibiotic cessation in both cohorts. CONCLUSION In conclusion, our data suggest that C/S may be a safe alternative to P/T in the empirical treatment of adult low-risk febrile neutropenia cases.
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Affiliation(s)
- O R Sipahi
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
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Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for rapid detection of β-lactam resistance in Enterobacteriaceae derived from blood cultures. J Clin Microbiol 2014; 52:924-30. [PMID: 24403301 DOI: 10.1128/jcm.02691-13] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The identification of pathogens directly from blood cultures by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) can be a valuable tool for improving the treatment of patients with sepsis and bacteremia. However, the increasing incidence of multidrug-resistant Gram-negative bacteria makes it difficult to predict resistance patterns based only on pathogen identification. Most therapy regimens for sepsis caused by Gram-negative rods consist of at least one β-lactam antibiotic. Thus, it would be of great benefit to have an early marker of resistance against these drugs. In the current study, we tested 100 consecutive blood cultures containing Enterobacteriaceae for resistance against 3rd-generation cephalosporins in a MALDI-TOF MS β-lactamase assay. Escherichia coli was also tested for resistance against aminopenicillins. The results of the β-lactamase assay were compared with those of conventional methods. The assay permitted discrimination between E. coli strains that were resistant or susceptible to aminopenicillins with a sensitivity and a specificity of 100%. The same was true for resistance to 3rd-generation cephalosporins in Enterobacteriaceae that constitutively produced class C β-lactamases. Discrimination was more difficult in species expressing class A β-lactamases, as these enzymes can generate false-positive results. Thus, the sensitivity and specificity for this group were 100% and 91.5%, respectively. The test permitted the prediction of resistance within 2.5 h after the blood culture was flagged as positive.
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Egrilmez S, Palamar M, Sipahi OR, Yagci A. Extended spectrum beta-lactamase producingKlebsiella pneumoniae-related keratitis. J Chemother 2013; 25:123-5. [DOI: 10.1179/1973947812y.0000000053] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Potential Role of Fosfomycin in the Treatment of Community-Acquired Lower Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli. Am J Ther 2013; 20:685-90. [DOI: 10.1097/mjt.0b013e3182204d60] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saleh I, Zouhairi O, Alwan N, Hawi A, Barbour E, Harakeh S. Antimicrobial resistance and pathogenicity ofEscherichia coliisolated from common dairy products in the Lebanon. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 103:39-52. [DOI: 10.1179/136485909x384965] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Bello H, González G, Dominguez M, Valenzuela L, Zemelman C, Mella S, Zemelman R, Amyes SGB. Detection of Extended- Spectrum β-Lactamases Produced by Chilean Isolates ofKlebsiella pneumoniaeby Two Synergy Methods. J Chemother 2013; 16:312-4. [PMID: 15330333 DOI: 10.1179/joc.2004.16.3.312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Prevalence of AmpC and SHV β-Lactamases in Clinical Isolates of Escherichia coli From Tehran Hospitals. Jundishapur J Microbiol 2013. [DOI: 10.5812/jjm.5043] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Comprehensive analysis of ß-lactam antibiotics including penicillins, cephalosporins, and carbapenems in poultry muscle using liquid chromatography coupled to tandem mass spectrometry. Anal Bioanal Chem 2013; 405:7859-74. [PMID: 23430185 DOI: 10.1007/s00216-013-6804-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 01/29/2013] [Accepted: 01/29/2013] [Indexed: 12/13/2022]
Abstract
A comprehensive method for the quantitative residue analysis of trace levels of 22 ß-lactam antibiotics, including penicillins, cephalosporins, and carbapenems, in poultry muscle by liquid chromatography in combination with tandem mass spectrometric detection is reported. The samples analyzed for ß-lactam residues are hydrolyzed using piperidine in order to improve compound stability and to include the total residue content of the cephalosporin ceftifour. The reaction procedure was optimized using a full experimental design. Following detailed isotope labeling, tandem mass spectrometry studies and exact mass measurements using high-resolution mass spectrometry reaction schemes could be proposed for all ß-lactams studied. The main reaction occurring is the hydrolysis of the ß-lactam ring under formation of the piperidine substituted amide. For some ß-lactams, multiple isobaric hydrolysis reaction products are obtained, in accordance with expectations, but this did not hamper quantitative analysis. The final method was fully validated as a quantitative confirmatory residue analysis method according to Commission Decision 2002/657/EC and showed satisfactory quantitative performance for all compounds with trueness between 80 and 110% and within-laboratory reproducibility below 22% at target level, except for biapenem. For biapenem, the method proved to be suitable for qualitative analysis only.
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Abstract
Extended spectrum beta lactamase (ESBL) producing bacteria that are capable of hydrolyzing even third generation cephalosporin are emerging as a potent threat. We report a seven-year-old child on continuous ambulatory peritoneal dialysis, who developed ESBL producing Klebsiella pneumoniae peritonitis. The bacterium was resistant to the usual intraperitoneal antibiotics. We successfully treated the child with intravenous meropenem along with oral cotrimoxazole. The case highlights the menace of ESBL peritonitis, as also a need for the development of guidelines for such a scenario, which is becoming increasingly common in India.
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Affiliation(s)
- R Sinha
- Consultant Paediatric Nephrologist, Vision Care Hospital, Kolkata, India
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Schaumann R, Knoop N, Genzel GH, Losensky K, Rosenkranz C, Stîngu CS, Schellenberger W, Rodloff AC, Eschrich K. A step towards the discrimination of beta-lactamase-producing clinical isolates of Enterobacteriaceae and Pseudomonas aeruginosa by MALDI-TOF mass spectrometry. Med Sci Monit 2013; 18:MT71-7. [PMID: 22936198 PMCID: PMC3560646 DOI: 10.12659/msm.883339] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Matrix-Assisted Laser-Desorption/Ionization Time of Flight Mass Spectrometry (MALDI-TOF MS) has already proven to be a powerful tool for species identification in microbiological laboratories. As adequate and rapid screening methods for antibiotic resistance are crucially needed, the present study investigated the discrimination potential of MALDI-TOF MS among extended-spectrum-beta-lactamase (ESBL) or metallo-beta-lactamases- (MBL) producing and the nonproducing strains of Escherichia coli (n=19), Klebsiella pneumoniae (n=19), and Pseudomonas aeruginosa (n=38), respectively. Material/Methods We used a MALDI-TOF MS protocol, usually applied for species identification, in order to integrate a screening method for beta-lactamases into the routine species identification workflow. The acquired spectra were analyzed by visual inspection, statistical similarity analysis and support vector machine (SVM) classification algorithms. Results Neither visual inspection nor mathematical similarity analysis allowed discrimination between spectra of beta-lactamase-producing and the nonproducing strains, but classification within a species by SVM-based algorithms could achieve a correct classification rate of up to 70%. Conclusions This shows that MALDI-TOF MS has definite potential to discriminate antibiotic-resistant strains due to ESBL and MBL production from nonproducing strains, but this performance is not yet sufficiently reliable for routine microbiological diagnostics.
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Affiliation(s)
- Reiner Schaumann
- Institute for Medical Microbiology and Epidemiology of Infectious Diseases, University of Leipzig, Leipzig, Germany.
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47
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Kurihara Y, Hitomi S, Oishi T, Kondo T, Ebihara T, Funayama Y, Kawakami Y. Characteristics of bacteremia caused by extended-spectrum beta-lactamase-producing Proteus mirabilis. J Infect Chemother 2013; 19:799-805. [DOI: 10.1007/s10156-013-0563-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 01/15/2013] [Indexed: 11/29/2022]
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48
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Matsumura Y, Yamamoto M, Matsushima A, Nagao M, Ito Y, Takakura S, Ichiyama S. Cefotaxime for the detection of extended-spectrum β-lactamase or plasmid-mediated AmpC β-lactamase and clinical characteristics of cefotaxime-non-susceptible Escherichia coli and Klebsiella pneumoniae bacteraemia. Eur J Clin Microbiol Infect Dis 2011; 31:1931-9. [DOI: 10.1007/s10096-011-1523-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 12/13/2011] [Indexed: 01/31/2023]
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49
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Sarojamma V, Ramakrishna V. Prevalence of ESBL-Producing Klebsiella pneumoniae Isolates in Tertiary Care Hospital. ISRN MICROBIOLOGY 2011; 2011:318348. [PMID: 23724303 PMCID: PMC3658478 DOI: 10.5402/2011/318348] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 10/19/2011] [Indexed: 11/23/2022]
Abstract
Extended-spectrum β lactamases (ESBLs) continue to be a major challenge in clinical setups world over, conferring resistance to the expanded-spectrum cephalosporins. An attempt was made to study the prevalence of ESBL-producing Klebsiella pneumoniae clinical isolates in a tertiary care hospital in Kurnool. A total of hundred collected isolates of Klebsiella pneumoniae was studied for their susceptibility patterns to various antibiotics and detection of ESBL producers by double disc synergy test (DDST) and phenotypic confirmatory disc diffusion test (PCDDT). Of the 100 isolates tested for their antibiogram, 61% isolates have shown susceptibility to 3rd-generation cepholosporins and 39% were resistant. Amoxycillin showed the highest percentage of resistance followed by tetracyclins and cotrimoxazole. Among 39 resistant isolates of Klebsiella pneumoniae, 17 were ESBL producers detected by DDST and PCDDT. ESBL producers were more in the hospital isolates (28%) compared to community isolates (6%). Maximum percentage of ESBL producers were noticed from blood sample with 57.14%. In the present study, a large number of isolates were found to be multidrug resistant and ESBL producers. PCDDT was found to be better than DDST in the detection of ESBLs. Continued monitoring of drug resistance is necessary in clinical settings for proper disease management.
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Affiliation(s)
- Vemula Sarojamma
- Department of Microbiology, Government Medical College, Anantapur 515001, India
| | - Vadde Ramakrishna
- Department of Biotechnology and Bioinformatics, Yogi Vemana University, Kadapa 516003, India
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50
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Risk factors for and outcomes associated with clinical isolates of Escherichia coli and Klebsiella species resistant to extended-spectrum cephalosporins among patients admitted to Canadian hospitals. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2011; 20:e43-8. [PMID: 20808455 DOI: 10.1155/2009/725872] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Clinical features associated with Gram-negative bacterial isolates with extended-spectrum beta-lactamase (ESBL)- and AmpC-mediated resistance identified in Canadian hospitals is largely unknown. The objective of the present study was to determine the demographics, risk factors and outcomes of patients with ESBL- or AmpC-mediated resistant organisms in Canadian hospitals. METHODS Patients with clinical cultures of Escherichia coli or Klebsiella species were matched with patients with a similar organism but susceptible to third-generation cephalosporins. Molecular identification of the AmpC or ESBL was determined using a combination of polymerase chain reaction and sequence analysis. Univariate and multivariate logistic regression analysis was performed to identify variables associated with becoming a case. RESULTS Eight Canadian hospitals identified 106 cases (ESBL/AmpC) and 106 controls. All risk factors identified in the univariate analysis as a predictor of being an ESBL/AmpC cases at the 0.20 P-value were included in the multivariate analysis. No significant differences in outcomes were observed (unfavourable responses 17% versus 15% and mortality rates 13% versus 7%, P not significant). Multivariate logistic regression found an association of becoming an ESBL/AmpC case with: previous admission to a nursing home (OR 8.28, P=0.01) or acute care facility (OR 1.96, P=0.03), length of stay before infection (OR 3.05, P=0.004), and previous use of first-generation cephalosporins (OR 2.38, P=0.02) or third-generation cephalosporins (OR 4.52, P=0.01). Appropriate antibiotics were more likely to be given to controls (27.0% versus 13.3%, P=0.05) and number of days to appropriate antibiotics was longer for cases (median 2.8 days versus 1.2 days, P=0.05). CONCLUSION The importance of patient medical history, present admission and antibiotic use should be considered for all E coli or Klebsiella species patients pending susceptibility testing results.
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