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Gadaime NK, Haddadin RN, Shehabi AA, Omran IN. Antimicrobial resistance and carbapenemase dissemination in Pseudomonas aeruginosa isolates from Libyan hospitals: a call for surveillance and intervention. Libyan J Med 2024; 19:2344320. [PMID: 38643488 PMCID: PMC11034451 DOI: 10.1080/19932820.2024.2344320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 04/23/2024] Open
Abstract
Pseudomonas aeruginosa is a multidrug-resistant bacterium capable of forming biofilms. This study aimed to assess resistance of clinical isolates from Libyan hospitals to antipseudomonal antibiotics, the prevalence of selected extended-spectrum β-lactamases and carbapenemase genes among these isolates, and the microorganisms' capacity for alginate and biofilm production. Forty-five isolates were collected from four hospitals in Benghazi and Derna, Libya. Antimicrobial susceptibility was determined using agar disc diffusion. The presence of resistance genes (blaCTXM, blaTEM, blaSHV-1, blaGES-1, blaKPC, and blaNDM) was screened using PCR. Biofilm formation was quantified via the crystal violet assay, while alginate production was measured spectrophotometrically. Resistance to antipseudomonal antibiotics ranged from 48.9% to 75.6%. The most prevalent resistance gene was blaNDM (26.7%), followed by blaGES-1 (17.8%). Moreover, all isolates demonstrated varying degrees of biofilm-forming ability and alginate production. No statistically significant correlation was found between biofilm formation and alginate production. The dissemination of resistant genes in P. aeruginosa, particularly carbapenemases, is of great concern. This issue is compounded by the bacteria's biofilm-forming capability. Urgent intervention and continuous surveillance are imperative to prevent further deterioration and the catastrophic spread of resistance among these formidable bacteria.
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Affiliation(s)
- Nasrin K. Gadaime
- School of Medicine, The University of Jordan, Amman, Jordan
- Department of Lab Medicine, Faculty of Medical Technology-Derna, National Board for technical and Vocational Education, Derna, Libya
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Ibrahim K, Thwood D, ELgheriani H, Salem M, Elgadiym Z, Zaghdani A, Alhudiri I, Habibi A, Elfahem A, Belaid S, Ermithi O, Almaghrabi M, ELmaryul A, Almadah S, Rayes A, El Meshri SE, El Salabi A, Elzagheid A. Prevalence of multi-drug resistant bacteria in intensive care units at Tripoli University Hospital, Tripoli, Libya. Libyan J Med 2024; 19:2348235. [PMID: 38718270 PMCID: PMC11080667 DOI: 10.1080/19932820.2024.2348235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Among hospitalized patients worldwide, infections caused by multidrug-resistant (MDR) bacteria are a major cause of morbidity and mortality. This study aimed to isolate MDR bacteria from five intensive care units (ICUs) at Tripoli University Hospital (TUH). A prospective cross-sectional study was conducted over a seven-month period (September 2022 to March 2023) across five ICUs at TUH. A total of 197 swabs were collected from Patients', healthcare workers' and ICUs equipment. Samples collected from patients were nasal swabs, oral cavity swabs, hand swabs, sputum specimens, skin swabs, umbilical venous catheter swabs, and around cannula. Swabs collected from health care workers were nasal swabs, whereas ICUs equipment's samples were from endotracheal tubes, oxygen masks, and neonatal incubators. Identification and antimicrobial susceptibility test was confirmed by using MicroScan auto SCAN 4 (Beckman Coulter). The most frequent strains were Gram negative bacilli 113 (57.4%) with the predominance of Acinetobacter baumannii 50/113 (44%) followed by Klebsiella pneumoniae 44/113 (40%) and Pseudomonas aeruginosa 6/113 (5.3%). The total Gram positive bacterial strains isolated were 84 (42.6%), coagulase negative Staphylococci 55 (66%) with MDRs (89%) were the most common isolates followed by Staphylococcus aureus 15 (17.8%). Different antibiotics were used against these isolates; Gram- negative isolates showed high resistance rates to ceftazidime, gentamicin, amikacin and ertapenem. A. baumannii were the most frequent MDROs (94%), and the highest resistance rates in Gram-positive strains were observed toward ampicillin, oxacillin, ampicillin/sulbactam and Cefoxitin, representing 90% of total MDR Gram-positive isolates. ESBL and MRS were identified in most of strains. The prevalence of antibiotic resistance was high for both Gram negative and Gram positive isolates. This prevalence requires strict infection prevention and control intervention, continuous monitoring, implementation of effective antibiotic stewardship, immediate, concerted and collaborative action to monitor its prevalence and spread in the hospital.
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Affiliation(s)
- Khaled Ibrahim
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Dalal Thwood
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Hajer ELgheriani
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Mohamed Salem
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Zaynab Elgadiym
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Ahmed Zaghdani
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Inas Alhudiri
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Abdulraouf Habibi
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Abdurrezagh Elfahem
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Saadeddin Belaid
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Otman Ermithi
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Mahmoud Almaghrabi
- Pediatric Intensive Care Unit, Tripoli University Hospital, Tripoli, Libya
| | - Abubaker ELmaryul
- Medical Intensive Care Unit, Tripoli University Hospital, Tripoli, Libya
| | - Suad Almadah
- Neonatal Intensive Care Unit, Tripoli University Hospital, Tripoli, Libya
| | - Abdunnabi Rayes
- Infection Control Office, Tripoli University Hospital, Tripoli, Libya
| | - Salah Edin El Meshri
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
| | - Allaaeddin El Salabi
- Department of Environmental Health, Faculty of Public Health, University of Benghazi, Benghazi, Libya
| | - Adam Elzagheid
- Department of Microbiology, Libyan Biotechnology Research Center, Tripoli, Libya
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Tadesse S, Geteneh A, Hailu T. Emergence of Extended-Spectrum Beta-Lactamase and Carbapenemase Producing Gram Negative Non-Fermenters at Selected Hospitals of Northeast Ethiopia: A Prospective Cross-Sectional Study. Infect Drug Resist 2023; 16:4891-4901. [PMID: 37534064 PMCID: PMC10391048 DOI: 10.2147/idr.s407151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background The emergence and spread of extended-spectrum β-lactamases (ESβLs) and carbapenemase (CP) producing gram negative non-fermenters are becoming a serious public health threat globally. Infections caused by these pathogens limit treatment options and contribute to the significant morbidity and mortality. Thus, to reduce their spread, early detection of these superbugs is very crucial. This study therefore aimed to assess the prevalence of ESβLs and CP producing gram negative non-fermenters at selected hospitals of North East Ethiopia. Methods A cross-sectional study was conducted from January to June 2021. Acinetobacter baumannii (A. baumannii) and Pseudomonas aeruginosa (P. aeruginosa) were identified using standard bacteriological techniques. ESβL and CP production were detected by combined disk diffusion and modified carbapenem inhibitory methods, respectively. Data were collected via face-to-face interview and patient card review. Chi-squared and Fisher's exact tests were calculated and p-value < 0.05 was considered statistically significant. Results A total of 384 patients participated in this study. Overall, 30 (7.8%) patients had positive culture for A. baumannii and P. aeruginosa. The prevalence of A. baumannii was 20 (5.2%) and that of P. aeruginosa was 10 (2.6%). From the overall isolates, 16 (53.3%) were ESβL and the proportion of carbapenemase production was 4 (13.3%). ESβL production was 8 (40%) in A. baumannii and 8 (80%) in P. aeruginosa isolates. ESβL production infections were significantly associated with hospitalization (p=0.004). Intravenous catheterization, hospitalization, and surgery had significant association with ESβL production (p<0.005). All isolates of A. baumannii and P. aeruginosa were MDR. Conclusion ESβL and carbapenemase production among A. baumannii and P. aeruginosa were high in the selected hospitals. The treatment of such resistant infectious agents should be guided by antimicrobial susceptibility test in a study setting. Thus, restricted and wise use of antibiotics is highly recommended to contain the spread of these superbugs. Hospitals should develop infection prevention guidelines to prevent the spread of resistant pathogens in hospitalized patients.
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Affiliation(s)
- Selamyhun Tadesse
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Alene Geteneh
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tilahun Hailu
- School of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Slimene K, Salabi AE, Dziri O, Mathlouthi N, Diene SM, Mohamed EA, Amhalhal JMA, Aboalgasem MO, Alrjael JF, Rolain JM, Chouchani C. Epidemiology, Phenotypic and Genotypic Characterization of Carbapenem-Resistant Gram-Negative Bacteria from a Libyan Hospital. Microb Drug Resist 2023. [PMID: 37145891 DOI: 10.1089/mdr.2022.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
Antimicrobial resistance, particularly resistance to carbapenems, has become one of the major threats to public health. Seventy-two isolates were collected from patients and hospital environment of Ibn Sina Hospital, Sirte, Libya. Antibiotic susceptibility tests, using the disc diffusion method and E-Test strips, were performed to select carbapenem-resistant strains. The colistin (CT) resistance was also tested by determining the minimum inhibitory concentration (MIC). RT-PCR was conducted to identify the presence of carbapenemase encoding genes and plasmid-mediated mcr CT resistance genes. Standard PCR was performed for positive RT-PCR and the chromosome-mediated CT resistance genes (mgrB, pmrA, pmrB, phoP, phoQ). Gram-negative bacteria showed a low susceptibility to carbapenems. Molecular investigations indicated that the metallo-β-lactamase New Delhi metallo-beta-lactamases-1 was the most prevalent (n = 13), followed by Verona integron-encoded metallo-beta-lactamase (VIM) enzyme (VIM-2 [n = 6], VIM-1 [n = 1], and VIM-4 [n = 1]) that mainly detected among Pseudomonas spp. The oxacillinase enzyme OXA-23 was detected among six Acinetobacter baumannii, and OXA-48 was detected among one Citrobacter freundii and three Klebsiella pneumoniae, in which one coharbored the Klebsiella pneumoniae carbapenemase enzyme and showed resistance to CT (MIC = 64 μg/mL) by modification in pmrB genes. In this study, we report for the first time the emergence of Pseudomonas aeruginosa carrying the blaNDM-1 gene and belonging to sequence type773 in Libya. Our study reported also for the first time CT resistance by mutation in the pmrB gene among Enterobacteriaceae isolates in Libya.
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Affiliation(s)
- Khouloud Slimene
- Faculté de Médecine et de Pharmacie, Aix-Marseille Université, IRD, APHM, MEPHI, Marseille Cedex 05, France
- IHU Méditerranée Infection, Marseille Cedex 05, France
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie
- Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
- Unité de Service en Commun Pour la Recherche « Plateforme Génomique » Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
| | - Allaaeddin El Salabi
- Department of Environmental Health, Faculty of Public Health, University of Benghazi, Benghazi, Libya
| | - Olfa Dziri
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie
- Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
- Unité de Service en Commun Pour la Recherche « Plateforme Génomique » Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
| | - Najla Mathlouthi
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie
- Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
- Unité de Service en Commun Pour la Recherche « Plateforme Génomique » Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
| | - Seydina M Diene
- Faculté de Médecine et de Pharmacie, Aix-Marseille Université, IRD, APHM, MEPHI, Marseille Cedex 05, France
- IHU Méditerranée Infection, Marseille Cedex 05, France
| | | | - Jadalla M A Amhalhal
- Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Sirte University, Sirte, Libya
- ICU Department, Ibn Sina Hospital, Sirte, Libya
| | - Mohammed O Aboalgasem
- Department of Internal Medicine, Faculty of Medicine, University of Sirte, Sirte, Libya
- Infection Prevention and Patient Safety Office, Ibn Sina Hospital, Sirte, Libya
| | - Jomaa F Alrjael
- ICU Department, Ibn Sina Hospital, Sirte, Libya
- Department of Anesthesia, Ibn Sina Hospital, Sirte, Libya
| | - Jean-Marc Rolain
- Faculté de Médecine et de Pharmacie, Aix-Marseille Université, IRD, APHM, MEPHI, Marseille Cedex 05, France
- IHU Méditerranée Infection, Marseille Cedex 05, France
| | - Chedly Chouchani
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie
- Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
- Unité de Service en Commun Pour la Recherche « Plateforme Génomique » Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Tunis, Tunisie
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Agyepong N, Fordjour F, Owusu-Ofori A. Multidrug-resistant Acinetobacter baumannii in healthcare settings in Africa. FRONTIERS IN TROPICAL DISEASES 2023. [DOI: 10.3389/fitd.2023.1110125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
The emergence of multidrug-resistant Acinetobacter baumannii is a major concern to healthcare providers and facilities in many parts of the world. This bacterial pathogen is commonly implicated in hospital-acquired infections, particularly in critically ill patients admitted to the intensive care unit (ICU). The extensive use of antibiotics, particularly in ICUs, and the lack of proper infection control interventions in many hospitals have led to an increased emergence of multidrug-resistant A. baumannii. Infections due to multidrug-resistant A. baumannii are associated with prolonged hospital stays and high morbidity and mortality, particularly among hospitalized ICU patients. The lack of antibiotic stewardship programmes in many healthcare facilities has exacerbated the burden of A. baumannii infections in many parts of Africa. This review discusses the prevalence and antibiotic-resistance pattern of the multidrug-resistant A. baumannii, and the possible ways to address or minimise its emergence in healthcare settings in Africa.
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Alawami AA, Al Haji H, Hamied MIK, Chouchani C, El Salabi AA. Letter to the Editor: New Treatment Options of Blood Stream Infections Caused by Multidrug-Resistant Acinetobacter baumannii in Some Libyan Patients. Microb Drug Resist 2021; 28:99-101. [PMID: 34495752 DOI: 10.1089/mdr.2020.0493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Alhussain A Alawami
- Infection Control & Patient Safety Office, New Marwa Hospital, Benghazi, Libya
| | - Houwayda Al Haji
- Pediatric Intensive Care Unit, Tripoli Children Hospital, Tripoli, Libya
| | | | - Chedly Chouchani
- Infection Control Office, Aljalla Trauma Hospital, Benghazi, Libya.,Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Hammam-Lif, Tunisie.,Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, El-ManarII, Tunisie
| | - Allaaeddin A El Salabi
- Infection Control & Patient Safety Office, New Marwa Hospital, Benghazi, Libya.,Department of Environmental Health, Faculty of Public Health, University of Benghazi, Benghazi, Libya
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Occurrence of NDM-1 and VIM-2 Co-Producing Escherichia coli and OprD Alteration in Pseudomonas aeruginosa Isolated from Hospital Environment Samples in Northwestern Tunisia. Diagnostics (Basel) 2021; 11:diagnostics11091617. [PMID: 34573959 PMCID: PMC8467603 DOI: 10.3390/diagnostics11091617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 12/03/2022] Open
Abstract
Hospital environments constitute the main reservoir of multidrug-resistant bacteria. In this study we aimed to investigate the presence of Gram-negative bacteria in one Northwestern Tunisian hospital environment, and characterize the genes involved in bacterial resistance. A total of 152 environmental isolates were collected from various surfaces and isolated using MacConkey medium supplemented with cefotaxime or imipenem, with 81 fermenter bacteria (27 Escherichia coli, and 54 Enterobacter spp., including 46 Enterobacter cloacae), and 71 non-fermenting bacteria (69 Pseudomonas spp., including 54 Pseudomonas aeruginosa, and 2 Stenotrophomonas maltophilia) being identified by the MALDI-TOF-MS method. Antibiotic susceptibility testing was performed by disk diffusion method and E-Test was used to determine MICs for imipenem. Several genes implicated in beta-lactams resistance were characterized by PCR and sequencing. Carbapenem resistance was detected among 12 isolates; nine E. coli (blaNDM-1 (n = 8); blaNDM-1 + blaVIM-2 (n = 1)) and three P. aeruginosa were carbapenem-resistant by loss of OprD porin. The whole-genome sequencing of P. aeruginosa 97H was determined using Illumina MiSeq sequencer, typed ST285, and harbored blaOXA-494. Other genes were also detected, notably blaTEM (n = 23), blaCTX-M-1 (n = 10) and blaCTX-M-9 (n = 6). These new epidemiological data imposed new surveillance strategies and strict hygiene rules to decrease the spread of multidrug-resistant bacteria in this area.
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Diversity of Sequence Types and Impact of Fitness Cost among Carbapenem-Resistant Acinetobacter baumannii Isolates from Tripoli, Libya. Antimicrob Agents Chemother 2021; 65:e0027721. [PMID: 34097495 DOI: 10.1128/aac.00277-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We investigated the molecular epidemiology of 21 carbapenem-resistant Acinetobacter baumannii isolates from Libya and assessed their relative fitness. Core genome multilocus sequence typing (MLST) revealed five interhospital transmission clusters. Three clusters were associated with the international clones (IC) IC1, IC2, and IC7. Carbapenem-resistance was associated with blaOXA-23, blaGES-11, or blaNDM-1. Compared to that of A. baumannii DSM 30008, the doubling time was similar over 10 h, but after 16 h, half the isolates grew to higher densities, suggesting a fitness advantage.
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Slimene K, El Salabi AA, Dziri O, Mabrouk A, Miniaoui D, Gharsa H, Shokri SA, Alhubge AM, Achour W, Rolain JM, Chouchani C. High Carbapenem Resistance Caused by VIM and NDM Enzymes and OprD Alteration in Nonfermenter Bacteria Isolated from a Libyan Hospital. Microb Drug Resist 2021; 27:1546-1554. [PMID: 34029121 DOI: 10.1089/mdr.2020.0175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Acinetobacter baumannii and Pseudomonas aeruginosa are among the most prevalent pathogens causing a wide range of serious infections in hospitalized patients and contaminating intensive care units and inanimate surfaces. The purpose of this study was to investigate the mechanism of carbapenem resistance in clinical and hospital environmental isolates of A. baumannii and P. aeruginosa recovered from a Libyan hospital. From a total of 82 Gram-negative bacteria, 8 isolates of A. baumannii and 3 isolates of P. aeruginosa exhibited resistance to imipenem with minimum inhibitory concentrations ranging from 16 to >32 μg/mL. Five isolates of A. baumannii harbored blaOXA-23 gene, from which three isolates were collected from patients and two from hospital environment. Only one isolate harbored blaNDM-1 gene, which was responsible for carbapenem resistance in A. baumannii. The OprD gene seems to be disturbed by an insertion sequence (IS) in two isolates and affected by polymorphism in one isolate. Pulsed-field gel electrophoresis results showed high genetic diversity among carbapenemase producing A. baumannii. This study highlights the dissemination of blaOXA-23 and blaNDM-1 genes in a Libyan setting. Therefore, infection prevention and control practices, antimicrobial stewardship initiatives, and antimicrobial resistance surveillance systems should be implemented to prevent the wide spread of antimicrobial resistance.
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Affiliation(s)
- Khouloud Slimene
- Microbes Evolution Phylogenie et Infections (MEPHI), Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France.,IHU Méditerranée Infection, Valorisation and Transfer, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France.,Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie.,Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Borj-Cedria, Tunisie
| | - Allaaeddin Ali El Salabi
- Department of Environmental Health, Faculty of Public Health, University of Benghazi, Benghazi, Libya
| | - Olfa Dziri
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie.,Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Borj-Cedria, Tunisie
| | - Aymen Mabrouk
- Faculté de Médecine de Tunis, LR18ES39, Centre National de Greffe de Moelle Osseuse, Université Tunis El Manar, Tunis, Tunisie
| | - Dhouha Miniaoui
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie.,Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Borj-Cedria, Tunisie
| | - Haythem Gharsa
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie.,Institut Supérieur des Sciences Biologiques et Appliqués de Tunis, Université Tunis El Manar, Tunis, Tunisie
| | - Salah A Shokri
- Department of Microbiology, Faculty of Science, Misurata University, Misurata, Libya
| | - Altaher M Alhubge
- Department of Microbiology, Faculty of Science, Misurata University, Misurata, Libya
| | - Wafa Achour
- Faculté de Médecine de Tunis, LR18ES39, Centre National de Greffe de Moelle Osseuse, Université Tunis El Manar, Tunis, Tunisie
| | - Jean-Marc Rolain
- Microbes Evolution Phylogenie et Infections (MEPHI), Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France.,IHU Méditerranée Infection, Valorisation and Transfer, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Chedly Chouchani
- Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis El-Manar, Tunis, Tunisie.,Laboratoire de Recherche des Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage, Borj-Cedria, Tunisie
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Al-Orphaly M, Hadi HA, Eltayeb FK, Al-Hail H, Samuel BG, Sultan AA, Skariah S. Epidemiology of Multidrug-Resistant Pseudomonas aeruginosa in the Middle East and North Africa Region. mSphere 2021; 6:e00202-21. [PMID: 34011686 PMCID: PMC8265635 DOI: 10.1128/msphere.00202-21] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Over the last decades, there has been a dramatic global increase in multidrug-resistant (MDR) pathogens particularly among Gram-negative bacteria (GNB). Pseudomonas aeruginosa is responsible for various health care-associated infections, while MDR P. aeruginosa causes significant morbidity and mortality. Middle East and North Africa (MENA) represent an unexplored geographical region for the study of drug resistance since many of these countries are at crossroads of high volume of travel, diverse expatriate populations, as well as high antibiotic consumption despite attempts to implement antimicrobial stewardship programs. This minireview analyzes epidemiology, microbiological, and genomic characteristics of MDR P. aeruginosa in the MENA region. Published data on MDR P. aeruginosa prevalence, antimicrobial resistance patterns, and genetic profiles from studies published during the past 10 years from 19 MENA countries have been included in this minireview. There is wide variation in the epidemiology of MDR P. aeruginosa in the MENA region in terms of prevalence, antimicrobial characteristics, as well as genetic profiles. Overall, there is high prevalence of MDR P. aeruginosa seen in the majority of the countries in the MENA region with similarities between neighboring countries, which might reflect comparable population and antibiotic-prescribing cultures. Isolates from critical care units are significantly resistant particularly from certain countries such as Saudi Arabia, Egypt, Libya, Syria, and Lebanon with high-level resistance to cephalosporins, carbapenems, and aminoglycosides. Colistin susceptibility patterns remains high apart from countries with high-level antibiotic resistance such as Saudi Arabia, Syria, and Egypt.
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Affiliation(s)
- Mahmood Al-Orphaly
- Department of Medical Education, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Hamad Abdel Hadi
- Department of Infectious Diseases, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | | | - Hissa Al-Hail
- Department of Medical Education, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Bincy Gladson Samuel
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - Sini Skariah
- Department of Microbiology and Immunology, Weill Cornell Medicine - Qatar, Education City, Qatar Foundation, Doha, Qatar
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Sleiman A, Fayad AGA, Banna H, Matar GM. Prevalence and molecular epidemiology of carbapenem-resistant Gram-negative bacilli and their resistance determinants in the Eastern Mediterranean Region over the last decade. J Glob Antimicrob Resist 2021; 25:209-221. [PMID: 33812049 DOI: 10.1016/j.jgar.2021.02.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/05/2021] [Accepted: 02/28/2021] [Indexed: 12/14/2022] Open
Abstract
Carbapenem resistance in Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa is increasing worldwide, which has led the World Health Organization (WHO) to list these bacteria in the critical priority pathogens group. Infections by such pathogens pose a serious threat to hospitalised patients and are associated with clinical and economic consequences. What worsens the case is the weak pipeline of available antimicrobial agents to treat such infections and the absence of new drugs. The aim of this review was to shed light on all studies tackling carbapenem resistance in Enterobacteriaceae, A. baumannii and P. aeruginosa in the Eastern Mediterranean region, with indication for each country, description of studies timeline, prevalence of carbapenem resistance, and carbapenem resistance-encoding genes detected in these countries.
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Affiliation(s)
- Ahmad Sleiman
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon; World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens, Beirut, Lebanon
| | - Antoine G Abou Fayad
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon; World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens, Beirut, Lebanon.
| | - Hanin Banna
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon; World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens, Beirut, Lebanon
| | - Ghassan M Matar
- Department of Experimental Pathology, Immunology and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Center for Infectious Diseases Research, American University of Beirut, Beirut, Lebanon; World Health Organization (WHO) Collaborating Center for Reference and Research on Bacterial Pathogens, Beirut, Lebanon.
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12
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Molecular Epidemiology of Carbapenem-Resistant Acinetobacter baumannii Isolates from Northern Africa and the Middle East. Antibiotics (Basel) 2021; 10:antibiotics10030291. [PMID: 33799540 PMCID: PMC8002098 DOI: 10.3390/antibiotics10030291] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023] Open
Abstract
At the Bundeswehr Hospitals of Hamburg and Westerstede, patients repatriated from subtropical war and crisis zones of Northern Africa and the Middle East were medically treated, including microbiological assessment. Within a six-year interval, 16 Acinetobacter spp. strains, including 14 Acinetobacter baumannii (Ab) isolates with resistance against carbapenems and origins in Afghanistan (n = 4), Iraq (n = 2), Libya (n = 2), and Syria (n = 8) were collected. While clonal relationships of Libyan and Syrian strains had been assessed by superficial next generation sequencing (NGS) and “DiversiLab” repetitive elements sequence-based (rep-)PCR so far, this study provides core genome-based sequence typing and thus more detailed epidemiological information. In detail, sequencing allowed a definitive species identification and comparison with international outbreak-associated Ab strains by core genome multi locus sequence typing (cgMLST) and the identification of MLST lineages, as well as the identification of known resistance genes. The sequence analysis allowed for the confirmation of outbreak-associated clonal clusters among the Syrian and Afghan Ab isolates, indicating likely transmission events. The identified acquired carbapenem resistance genes comprised blaOXA-23, blaOXA-58, blaNDM-1, and blaGES-11, next to other intrinsic and acquired, partly mobile resistance-associated genes. Eleven out of 14 Ab isolates clustered with the previously described international clonal lineages IC1 (4 Afghan strains), IC2 (6 Syrian strains), and IC7 (1 Syrian strain). Identified Pasteur sequence types of the 14 Ab strains comprised ST2 (Syrian), ST25 (Libyan), ST32 (Iraqi), ST81 (Afghan), ST85 (Libyan), and ST1112 (Syrian), respectively. In conclusion, the study revealed a broad spectrum of resistance genes in Ab isolated from war-injured patients from Northern Africa and the Middle East, thereby broadening the scarcely available data on locally abundant clonal lineages and resistance mechanisms.
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Carbapenemase-Producing Non-Glucose-Fermenting Gram-Negative Bacilli in Africa, Pseudomonas aeruginosa and Acinetobacter baumannii: A Systematic Review and Meta-Analysis. Int J Microbiol 2020; 2020:9461901. [PMID: 33204275 PMCID: PMC7658691 DOI: 10.1155/2020/9461901] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 10/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background Studies have reported that the existence of CP bacteria in Africa, but, in general, comprehensive data about the molecular epidemiology of CP organisms are limited. Therefore, this systematic review and meta-analysis expound the pooled prevalence of CP P. aeruginosa and CP A. baumannii clinical isolates in Africa. It also identified the diversity of carbapenemases or their encoding genes among the isolates in Africa. Lastly, the review observed the trends of these CP isolates in Africa. Methods A comprehensive search was performed between July 2019 and October 2019 in the following databases: PubMed, Google Scholar, and African Journal online. The included articles were published only in English. The screening was done by two authors independently. The data extracted on Excel spreadsheet were transferred to STATA 11 software for analysis. Results From a total of 1,454 articles searched, 42 articles were eligible. Most of the studies were conducted in the North Africa region. But there was no report from Central Africa. The pooled prevalence of CP P. aeruginosa and CP A. baumannii among the clinical specimens in Africa was 21.36% and 56.97%, respectively. OXA-23 and VIM were the most prevailing carbapenemase among P. aeruginosa and A. baumannii, respectively. The cumulative meta-analysis revealed a relative increment of the prevalence of CP P. aeruginosa over time in Africa but it showed a higher prevalence of CP A. baumannii isolates across years. Conclusion The review revealed a high pooled prevalence of CP A. baumannii clinical isolates in Africa which needs urgent action. Moreover, the emergence of concomitant carbapenemases, especially OXA-23 + NDM among CP A. baumannii, was also an alarming problem.
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Shanmugakani RK, Sugawara Y, Akeda Y, Hagiya H, Sakamoto N, Aye MM, Myint T, Hamada S, Tomono K. bla OXA -731 , a new chromosome-encoded bla OXA -48 -like variant in Shewanella sp. from the aquatic environment in Myanmar. ENVIRONMENTAL MICROBIOLOGY REPORTS 2020; 12:548-554. [PMID: 32776437 DOI: 10.1111/1758-2229.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
Shewanella sp., the progenitors of blaOXA-48 -like genes are increasingly reported with the possession of different blaOXA-48 -like variants. This study aims to characterize blaOXA-731 , a new variant of a blaOXA-48 -like gene identified in Shewanella sp. isolated from the aquatic environment in Myanmar. Phylogenetic analysis of the blaOXA-731 sequence with other blaOXA-48 -like variants showed that it has the highest nucleotide identity of 86.09% with blaOXA-48 . However, the active site motifs in OXA-731 were 100% identical to that in OXA-48. Whole-genome sequencing analysis showed that blaOXA-731 is not surrounded by any mobile genetic elements. The genetic context of blaOXA-731 was found as similar to other blaOXA-48 -like genes previously identified in Shewanella sp. S1 nuclease pulsed-field gel electrophoresis followed by Southern blotting confirmed the location of blaOXA-731 in the chromosome of the Shewanella genome. Cloning and expression studies showed that OXA-731 has β-lactamase activity similar to OXA-48 and OXA-181, but it has no significant carbapenemase activity. Our results showed the significance of blaOXA-48 -like-carrying Shewanella sp. in the spreading of blaOXA-48 -like genes in the community.
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Affiliation(s)
- Rathina Kumar Shanmugakani
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, 565-0871, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, 565-0871, Japan
| | - Yo Sugawara
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, 565-0871, Japan
| | - Yukihiro Akeda
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, 565-0871, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, 565-0871, Japan
| | - Hideharu Hagiya
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, 565-0871, Japan
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, 565-0871, Japan
| | - Noriko Sakamoto
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, 565-0871, Japan
| | - Mya Mya Aye
- Bacteriology Research Division, Department of Medical Research, Dagon Township, Yangon, 11191, Myanmar
| | - Thuzar Myint
- Bacteriology Research Division, Department of Medical Research, Dagon Township, Yangon, 11191, Myanmar
| | - Shigeyuki Hamada
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, 565-0871, Japan
| | - Kazunori Tomono
- Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University, Suita, Osaka, 565-0871, Japan
- Division of Infection Control and Prevention, Osaka University Hospital, Suita, Osaka, 565-0871, Japan
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Shahbandeh M, Taati Moghadam M, Mirnejad R, Mirkalantari S, Mirzaei M. The Efficacy of AgNO3 Nanoparticles Alone and Conjugated with Imipenem for Combating Extensively Drug-Resistant Pseudomonas aeruginosa. Int J Nanomedicine 2020; 15:6905-6916. [PMID: 33061358 PMCID: PMC7518771 DOI: 10.2147/ijn.s260520] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The extensive drug-resistant (XDR) Pseudomonas aeruginosa (P. aeruginosa) causes a range of infections with high mortality rate, which inflicts additional costs on treatment. The use of nano-biotechnology-based methods in medicine has opened a new perspective against drug-resistant bacteria. The aim of this study was to evaluate the effectiveness of the AgNO3 nanoparticles alone and conjugated with imipenem (IMI) to combat extensively drug-resistant P. aeruginosa. METHODS Antibiotic susceptibility was carried out using disc diffusion method. Detection of different resistant genes was performed using standard polymerase chain reaction (PCR). The chemically synthesized AgNO3 particles were characterized using scanning electron microscope (SEM), dynamic light scattering (DLS) and X-ray diffraction (XRD) methods. Fourier transform infrared spectroscopy (FTIR) was accomplished to confirm the binding of AgNO3 with IMI. The microdilution broth method was used to obtain minimum inhibitory concentration (MIC) of AgNO3 and IMI-conjugated AgNO3. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay was carried out on L929 cell line to study the cytotoxicity of nanoparticles. The data were analyzed by Eta correlation ratio and chi-square (X 2) test. RESULTS Analysis of the antibiotic resistance pattern showed that 12 (24%) isolates were XDR, and MIC values of IMI were between 64 and 128 μg/mL. Frequency of SHV, TEM, CTX M, IMP, VIM, OPR, SIM, SPM, GIM, NDM, VEB, PER, KPC, OXA, intI, intII, and intIII genes were 29 (58%), 26 (52%), 26 (52%), 32 (64%), 23 (46%), 43 (86%), 3 (6%), 6 (12%), 3 (6%), 4 (8%), 7 (14%), 6 (12%), 18 (36%), 4 (8%), 19 (38%), 16 (32%), and 2 (4%), respectively. The XRD, SEM, DLS, and FTIR analysis confirmed the synthesis of AgNO3 nanoparticles and their conjugation with IMI. The AgNO3 nanoparticles had antimicrobial activity, and their conjugation with IMI showed enhanced effectiveness against XDR isolates. The synthesized AgNO3 showed no cytotoxic effects. CONCLUSION The results suggest that IMI-conjugated AgNO3 has a strong potency as a powerful antibacterial agent against XDR P. aeruginosa.
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Affiliation(s)
- Mahsa Shahbandeh
- Young Researchers and Elite Club, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Majid Taati Moghadam
- Department of Microbiology, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Mirnejad
- Molecular Biology Research Center, System Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shiva Mirkalantari
- Microbiology, Faculty of Medicine, Microbiology Department, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Mirzaei
- Department of Microbiology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
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Nasser M, Gayen S, Kharat AS. Prevalence of β-lactamase and antibiotic-resistant Pseudomonas aeruginosa in the Arab region. J Glob Antimicrob Resist 2020; 22:152-160. [DOI: 10.1016/j.jgar.2020.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/26/2019] [Accepted: 01/13/2020] [Indexed: 11/24/2022] Open
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Evaluating the antimicrobial resistance patterns and molecular frequency of bla oxa-48 and bla GES-2 genes in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from burn wound infection in Tehran, Iran. New Microbes New Infect 2020; 37:100686. [PMID: 32774866 PMCID: PMC7394744 DOI: 10.1016/j.nmni.2020.100686] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/23/2020] [Accepted: 04/16/2020] [Indexed: 02/08/2023] Open
Abstract
The aim of this study is to evaluate the antimicrobial resistance patterns and molecular frequency of blaGES-2 and blaoxa-48 genes in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from burn wound infection in Tehran, Iran. In this study, 50 isolates of A. baumannii and 48 isolates of P. aeruginosa were collected from the Burn Unit of Shahid Motahari Hospital at Tehran, Iran. Antibiotic susceptibility tests of all isolates were carried out using the disc diffusion method, and the production of extended-spectrum β-lactamases (ESBLs) in isolates was surveyed by the double disc synergy method and based on CLSI (2019 AST M100) criteria. Finally, the frequency of blaGES-2 and blaoxa-48 genes was surveyed by PCR. Antibiotic susceptibility tests showed that 48/48 (100%) of P. aeruginosa isolates and 49/50 (98%) of A. baumannii isolates were resistant to ceftriaxone and cefotaxime, respectively. Ceftazidime exhibited the lowest (26/48; 54.1%) resistance rates against P. aeruginosa isolates. The production of ESBLs was seen in 8/48 (16.6%) and 3/50 (6%) of P. aeruginosa and A. baumannii isolates, respectively. On the basis of conventional PCR and sequencing, the frequencies of the blaGES-2 gene among P. aeruginosa and A. baumannii was 87.5% and 58%, respectively. Moreover, blaoxa-48 gene was detected in 70.83% and 92% of P. aeruginosa and A. baumannii isolates, respectively. Results suggest that antibiotic-resistant A. baumannii and P. aeruginosa strains isolated from burn patients are frequently found; therefore, it is absolutely necessary to implement continuous screening and follow-up programmes for detecting antimicrobial resistance.
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Mlynarcik P, Chalachanova A, Vagnerovă I, Holy O, Zatloukalova S, Kolar M. PCR Detection of Oxacillinases in Bacteria. Microb Drug Resist 2020; 26:1023-1037. [PMID: 32212994 DOI: 10.1089/mdr.2019.0330] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Oxacillinases (OXA) have been mostly described in Enterobacteriaceae, Acinetobacter, and Pseudomonas species. Recent years have witnessed an increased prevalence of intrinsic and/or acquired β-lactamase-producing Acinetobacter in food-producing animals. This study was conducted to assess the prevalence of OXA among selected bacterial species and to characterize these enzymes by in silico analysis. Screening of OXA was performed by PCR amplification using specific pairs of oligonucleotides. Overall, 40 pairs of primers were designed, of which 6 were experimentally tested in vitro. Among 49 bacterial isolates examined, the presence of blaOXA-1-like genes was confirmed in 20 cases (41%; 19 times in Klebsiella pneumoniae and once in Enterobacter cloacae). No OXA were found in animal isolates. The study results confirmed the specificity of the designed oligonucleotide pairs. Furthermore, the designed primers were found to possess the ability to specifically detect 90.2% of all OXA. These facts suggest that the in silico and in vitro tested primers could be used for single or multiplex PCR to screen for the presence of OXA in various bacteria, as well as to monitor their spread. At the same time, the presence of conserved characteristic amino acids and motifs was confirmed by in silico analysis of sequences of representative members of OXA.
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Affiliation(s)
- Patrik Mlynarcik
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Andrea Chalachanova
- Department of Cell Biology and Genetics, Faculty of Science, Palacky University Olomouc, Olomouc, Czech Republic
| | - Iva Vagnerovă
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Ondrej Holy
- Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Simona Zatloukalova
- Department of Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Milan Kolar
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic.,Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
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Dissemination of bla OXA-23-harbouring carbapenem-resistant Acinetobacter baumannii clones in Pakistan. J Glob Antimicrob Resist 2020; 21:357-362. [PMID: 32006748 DOI: 10.1016/j.jgar.2020.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/24/2019] [Accepted: 01/05/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The rise of carbapenem resistance in Acinetobacter baumannii represents a challenge for the therapeutic management of infections. The present study aimed to investigate the sequence types (STs) and carbapenem resistance in A. baumannii strains collected from various clinical specimens from patients admitted to five tertiary-care hospitals in Pakistan. METHODS A total of 156 A. baumannii clinical strains were analysed for antimicrobial susceptibility, followed by genetic screening for carbapenem resistance determinants. All of the strains were typed by multilocus sequence typing (MLST) according to the Pasteur scheme. RESULTS Of the 156 A. baumannii isolates, 139 (89.1%) were carbapenem-resistant, of which 136 carried blaOXA-23-like genes. Interestingly, the most commonly identified ST was ST589 (n = 52), classified as clonal complex 1 (CC1). ST2 was the second most common (n = 38), corresponding to CC2/92 (Pasteur/Oxford scheme), which was distributed in all five hospitals. CONCLUSION Diverse clones of carbapenem-resistant A. baumannii, including previously reported STs as well as new STs, carrying blaOXA-23 are distributed in Pakistan. This is the first study to describe the molecular epidemiology of widely disseminated A. baumannii isolates in Pakistan. The findings will help to improve our knowledge of the predominant STs and will be valuable for a deeper understanding of resistance mechanisms among various STs.
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Codjoe FS, Brown CA, Smith TJ, Miller K, Donkor ES. Genetic relatedness in carbapenem-resistant isolates from clinical specimens in Ghana using ERIC-PCR technique. PLoS One 2019; 14:e0222168. [PMID: 31513633 PMCID: PMC6742460 DOI: 10.1371/journal.pone.0222168] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022] Open
Abstract
AIM Enterobacterial repetitive intergenic consensus (ERIC) sequence analysis is a powerful tool for epidemiological analysis of bacterial species. This study aimed to determine the genetic relatedness or variability in carbapenem-resistant isolates by species using this technique. METHODS A total of 111 non-duplicated carbapenem-resistant (CR) Gram-negative bacilli isolates from a three-year collection period (2012-2014) were investigated by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) in four selected hospital laboratories in Ghana. The isolates were also screened for carbapenemase and extended spectrum β-lactamase genes by PCR. RESULTS A proportion of 23.4% (26/111) of the genomic DNA extracts were carriers of PCR-positive carbapenemase genes, including 14.4% blaNDM-1, 7.2% blaVIM-1 and 1.8% blaOXA-48. The highest prevalence of carbapenemase genes was from non-fermenters, Acinetobacter baumannii and Pseudomonas aeruginosa. For the ESBL genes tested, 96.4% (107/111) of the CR isolates co-harboured both TEM-1 and SHV-1 genes. The ERIC-PCR gel analysis exhibited 1 to 8 bands ranging from 50 to 800 bp. Band patterns of 93 complex dissimilarities were visually distinguished from the 111 CR isolates studied, while the remaining 18 showed band similarities in pairs. CONCLUSION Overall, ERIC-PCR fingerprints have shown a high level of diversity among the species of Gram-negative bacterial pathogens and specimen collection sites in this study. ERIC-PCR optimisation assays may serve as a suitable genotyping tool for the assessment of genetic diversity or close relatedness of isolates that are found in clinical settings.
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Affiliation(s)
- Francis S. Codjoe
- Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, England, United Kingdom
| | - Charles A. Brown
- Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | - Thomas J. Smith
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, England, United Kingdom
| | - Keith Miller
- Biomolecular Science Research Centre, Sheffield Hallam University, Sheffield, England, United Kingdom
- * E-mail: (KM); (ESD)
| | - Eric S. Donkor
- Department of Medical Microbiology, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
- * E-mail: (KM); (ESD)
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Kumburu HH, Sonda T, van Zwetselaar M, Leekitcharoenphon P, Lukjancenko O, Mmbaga BT, Alifrangis M, Lund O, Aarestrup FM, Kibiki GS. Using WGS to identify antibiotic resistance genes and predict antimicrobial resistance phenotypes in MDR Acinetobacter baumannii in Tanzania. J Antimicrob Chemother 2019; 74:1484-1493. [PMID: 30843063 PMCID: PMC6524488 DOI: 10.1093/jac/dkz055] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 12/11/2018] [Accepted: 01/16/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Reliable phenotypic antimicrobial susceptibility testing can be a challenge in clinical settings in low- and middle-income countries. WGS is a promising approach to enhance current capabilities. AIM To study diversity and resistance determinants and to predict and compare resistance patterns from WGS data of Acinetobacter baumannii with phenotypic results from classical microbiological testing at a tertiary care hospital in Tanzania. METHODS AND RESULTS MLST using Pasteur/Oxford schemes yielded eight different STs from each scheme. Of the eight, two STs were identified to be global clones 1 (n = 4) and 2 (n = 1) as per the Pasteur scheme. Resistance testing using classical microbiology determined between 50% and 92.9% resistance across all drugs. Percentage agreement between phenotypic and genotypic prediction of resistance ranged between 57.1% and 100%, with coefficient of agreement (κ) between 0.05 and 1. Seven isolates harboured mutations at significant loci (S81L in gyrA and S84L in parC). A number of novel plasmids were detected, including pKCRI-309C-1 (219000 bp) carrying 10 resistance genes, pKCRI-43-1 (34935 bp) carrying two resistance genes and pKCRI-49-1 (11681 bp) and pKCRI-28-1 (29606 bp), each carrying three resistance genes. New ampC alleles detected included ampC-69, ampC-70 and ampC-71. Global clone 1 and 2 isolates were found to harbour ISAba1 directly upstream of the ampC gene. Finally, SNP-based phylogenetic analysis of the A. baumannii isolates revealed closely related isolates in three clusters. CONCLUSIONS The validity of the use of WGS in the prediction of phenotypic resistance can be appreciated, but at this stage is not sufficient for it to replace conventional antimicrobial susceptibility testing in our setting.
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Affiliation(s)
- Happiness H Kumburu
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Tolbert Sonda
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | | | | | | | - Blandina T Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Michael Alifrangis
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ole Lund
- DTU-Bioinformatics, Technical University of Denmark, Copenhagen, Denmark
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Chairat S, Ben Yahia H, Rojo-Bezares B, Sáenz Y, Torres C, Ben Slama K. High prevalence of imipenem-resistant and metallo-beta-lactamase-producing Pseudomonas aeruginosa in the Burns Hospital in Tunisia: detection of a novel class 1 integron. J Chemother 2019; 31:120-126. [PMID: 30849001 DOI: 10.1080/1120009x.2019.1582168] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Pseudomonas aeruginosa is one of the most important causes of nosocomial infections, and its eradication is very difficult due to its multidrug resistance. The objective of the present study was to characterize the metallo-beta-lactamases (MBLs), integrons, OprD modifications and virulence factors of P. aeruginosa strains isolated from burn patients and to analyze their genetic relatedness by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Sixty-seven P. aeruginosa isolates were recovered from different clinical samples of burn patients hospitalized in the Intensive Care Burn Unit of the Centre de Traumatologie et des Grands Brulés (Ben Arous, Tunisia), and MBLs and alterations in porin OprD were analyzed among imipenem-resistant isolates. Class 1 and 2 integrons were studied by PCR and sequencing of corresponding variable regions. The presence of eight genes involved in the virulence of P. aeruginosa was investigated by PCR. Fourteen of the 36 imipenem-resistant P. aeruginosa (IRPA) isolates (38.8%) were MBLs producers and harbored the blaVIM-2 gene, in all cases included into class 1 integrons. A new class 1 integron was identified (intI1-blaOXA-10-aadB-blaVIM-2-aadB-blaOXA-10). Five sequence types were detected among IRPA isolates: ST1, ST112, ST238, ST308 and ST395. P. aeruginosa is a major nosocomial pathogen in patients suffering burns, and the spreading of multidrugs resistant and MBL-producing isolates should be controlled in burn units. Moreover, the implantation of infection control guidelines is crucial to decrease the morbidity and mortality of nosocomial infections due to multidrug resistant P. aeruginosa.
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Affiliation(s)
- Sarra Chairat
- a Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis , Université de Tunis El Manar , Tunis , Tunisia
| | - Houssem Ben Yahia
- a Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis , Université de Tunis El Manar , Tunis , Tunisia
| | - Beatriz Rojo-Bezares
- b Área de Microbiología Molecular , Centro de Investigación Biomédica de La Rioja (CIBIR) , Logroño , Spain
| | - Yolanda Sáenz
- b Área de Microbiología Molecular , Centro de Investigación Biomédica de La Rioja (CIBIR) , Logroño , Spain
| | - Carmen Torres
- c Área de Bioquímica y Biología Molecular , Universidad de La Rioja , Logroño , Spain
| | - Karim Ben Slama
- a Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis , Université de Tunis El Manar , Tunis , Tunisia.,d Institut Supérieur des Sciences Biologiques Appliquées de Tunis , Université de Tunis El Manar , Tunis , Tunisia
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Peyclit L, Chanteloup A, Hadjadj L, Rolain JM. Role of Institut Hospitalo-Universitaire Méditerranée Infection in the surveillance of resistance to antibiotics and training of students in the Mediterranean basin and in African countries. New Microbes New Infect 2018; 26:S52-S64. [PMID: 30402244 PMCID: PMC6205572 DOI: 10.1016/j.nmni.2018.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Surveillance of antibiotic resistance has become a public global concern after the rapid worldwide dissemination of several antibiotic resistance genes. Here we report the role of the Institut Hospitalo-Universitaire Méditerranée Infection created in 2011 in the identification and description of multidrug-resistant bacteria thanks to collaborations and training of students from the Mediterranean basin and from African countries. Since the creation of the institute, 95 students and researchers have come from 19 different countries from these areas to characterize 6359 bacterial isolates from 7280 samples from humans (64%), animals (28%) and the environment (8%). Most bacterial isolates studied were Gram-negative bacteria (n = 5588; 87.9%), mostly from Algeria (n = 4190), Lebanon (n = 946), Greece (n = 610), Saudi Arabia (n = 299) and Senegal (n = 278). Antibiotic resistance was diversified with the detection and characterization of extended-spectrum β-lactamases, carbapenemases and resistance to colistin, vancomycin and methicillin. All those studies led to 97 indexed international scientific papers. Over the last 6 years, our institute has created a huge network of collaborations by training students that plays a major role in the surveillance of resistance to antibiotics in these countries.
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Affiliation(s)
| | | | | | - J.-M. Rolain
- Aix-Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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Moghnieh RA, Kanafani ZA, Tabaja HZ, Sharara SL, Awad LS, Kanj SS. Epidemiology of common resistant bacterial pathogens in the countries of the Arab League. THE LANCET. INFECTIOUS DISEASES 2018; 18:e379-e394. [PMID: 30292478 DOI: 10.1016/s1473-3099(18)30414-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 06/03/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022]
Abstract
No uniformly organised collection of data regarding antimicrobial resistance has occurred in the countries of the Arab League. 19 countries of the Arab League have published data for antimicrobial susceptibility for the WHO priority organisms, and seven of 14 of these organisms are included in this Review (Escherichia coli, Klebsiella spp, Pseudomonas aeruginosa, Acinetobacter baumannii, Salmonella spp, Staphylococcus aureus, and Streptococcus pneumoniae). Although E coli and Klebsiella spp resistance to third-generation cephalosporins is common in all countries, with prevalence reaching more than 50% in Egypt and Syria, carbapenem resistance is emerging, albeit with a prevalence of less than 10%. Conversely, a large amount of carbapenem resistance has been reported for P aeruginosa and A baumannii across the Arab League, reaching 50% and 88% of isolates in some countries. As for Salmonella spp, the prevalence of fluoroquinolone resistance has exceeded 30% in several areas. With regards to the Gram-positive pathogens, the prevalence of meticillin resistance in S aureus is reported to be between 20% and 30% in most countries, but exceeds 60% in Egypt and Iraq. The prevalence of penicillin non-susceptibility among pneumococci has reached more than 20% in Algeria, Egypt, Morocco, Saudi Arabia, and Tunisia. These findings highlight the need for structured national plans in the region to target infection prevention and antimicrobial stewardship.
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Affiliation(s)
- Rima A Moghnieh
- Division of Infectious Diseases, Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon
| | - Zeina A Kanafani
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Hussam Z Tabaja
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Sima L Sharara
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lyn S Awad
- Pharmacy Department, Makassed General Hospital, Beirut, Lebanon
| | - Souha S Kanj
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
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25
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Maltezou HC, Theodoridou M, Daikos GL. Antimicrobial resistance and the current refugee crisis. J Glob Antimicrob Resist 2017; 10:75-79. [DOI: 10.1016/j.jgar.2017.03.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/13/2017] [Accepted: 03/19/2017] [Indexed: 10/19/2022] Open
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26
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Tacão M, Silva I, Henriques I. Culture-independent methods reveal high diversity of OXA-48-like genes in water environments. JOURNAL OF WATER AND HEALTH 2017; 15:519-525. [PMID: 28771149 DOI: 10.2166/wh.2017.260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The carbapenemase OXA-48 was identified for the first time in 2001 and is now one of the greatest concerns in terms of antibiotic resistance. While many studies report clinical OXA-48-like producers, few reports refer blaOXA-48-like genes in environmental bacteria. The main goal of this study was to evaluate the diversity of blaOXA-48-like genes in aquatic systems, using culture-independent approaches. For that, environmental DNA was obtained from riverine and estuarine water and used to construct clone libraries of blaOXA-48-like gene polymerase chain reaction amplicons. blaOXA-48-like libraries from river and estuarine water DNA comprised 75 and 70 clones, respectively. Sequence analysis showed that environmental blaOXA-48-like genes show a broader diversity than that so far observed in clinical settings. In total, 50 new OXA-48 variants were identified as well as sequences identical to previously reported OXA-48, OXA-181, OXA-199, OXA-204 and OXA-162. Though we have no evidence that these genes were carried by bacteria that are members of the natural heterotrophic flora or bacteria that have entered this particular water environment through anthropogenic sources, these results reinforce the role of aquatic systems as antibiotic resistance reservoirs. The variants of blaOXA-48 here described should be taken into account when designing molecular strategies for detecting this gene.
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Affiliation(s)
- Marta Tacão
- Biology Department & CESAM, University of Aveiro, Campus Universitário Santiago, Aveiro 3810-193, Portugal E-mail:
| | - Isabel Silva
- Biology Department & CESAM, University of Aveiro, Campus Universitário Santiago, Aveiro 3810-193, Portugal E-mail:
| | - Isabel Henriques
- Biology Department & CESAM, University of Aveiro, Campus Universitário Santiago, Aveiro 3810-193, Portugal E-mail:
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Mathlouthi N, Ben Lamine Y, Somai R, Bouhalila-Besbes S, Bakour S, Rolain JM, Chouchani C. Incidence of OXA-23 and OXA-58 Carbapenemases Coexpressed in Clinical Isolates of Acinetobacter baumannii in Tunisia. Microb Drug Resist 2017; 24:136-141. [PMID: 28691891 DOI: 10.1089/mdr.2016.0306] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Acinetobacter baumannii is an important opportunistic and multidrug-resistant pathogen responsible for nosocomial infections in health facilities. The aim of this study was to characterize the molecular mechanisms of carbapenem resistance in A. baumannii isolates isolated from Mohamed Kassab Orthopedic Institute in Tunis, Tunisia. Twenty-five imipenem-resistant A. baumannii clinical isolates collected between 2013 and 2016 were identified using API 20NE and were confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS). Carbapenemase activity was detected using microbiological tests and PCR. The epidemiological relatedness of the isolates was studied using multilocus sequence typing (MLST). The isolates were resistant to all antibiotics tested with increased minimum inhibitory concentration values (>32 mg/L). The microbiological tests showed that the 25 A. baumannii were positive for modified Hodge test and for the Carba NP test; however, β-lactamase activity was not inhibited by EDTA. All the isolates harbored the naturally occurring blaOXA-51-like gene and the blaOXA-23-like carbapenemase gene. Among these isolates, one isolate coexpressed the blaOXA-58 gene. MLST revealed several sequence types (STs) with the predominance of ST2 imipenem-resistant A. baumannii (14/25; 56%). In this study we report the prevalence of ST2 imipenem resistance and for the first time the coexpression of blaOXA-23 and blaOXA-58 in clinical isolates of A. baumannii in a Tunisian hospital.
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Affiliation(s)
- Najla Mathlouthi
- 1 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université , Marseille, France .,2 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Campus Universitaire, Université Tunis El-Manar , Tunis, Tunisie.,3 Laboratoire de Recherche Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage , Technopôle de Borj-Cedria, Hammam-Lif, Tunisie
| | - Yomna Ben Lamine
- 4 Laboratoire de Biologie Clinique, Unité de Microbiologie, Institut Mohamed Kassab d'orthopédie Tunis , Tunis, Tunisie
| | - Rania Somai
- 2 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Campus Universitaire, Université Tunis El-Manar , Tunis, Tunisie
| | - Sophia Bouhalila-Besbes
- 4 Laboratoire de Biologie Clinique, Unité de Microbiologie, Institut Mohamed Kassab d'orthopédie Tunis , Tunis, Tunisie
| | - Sofiane Bakour
- 1 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université , Marseille, France
| | - Jean-Marc Rolain
- 1 Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université , Marseille, France
| | - Chedly Chouchani
- 2 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Campus Universitaire, Université Tunis El-Manar , Tunis, Tunisie.,3 Laboratoire de Recherche Sciences et Technologies de l'Environnement, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria, Université de Carthage , Technopôle de Borj-Cedria, Hammam-Lif, Tunisie
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Tacão M, Araújo S, Vendas M, Alves A, Henriques I. Shewanella species as the origin of bla OXA-48 genes: insights into gene diversity, associated phenotypes and possible transfer mechanisms. Int J Antimicrob Agents 2017; 51:340-348. [PMID: 28666748 DOI: 10.1016/j.ijantimicag.2017.05.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 05/15/2017] [Accepted: 05/27/2017] [Indexed: 11/30/2022]
Abstract
Chromosome-encoded beta-lactamases of Shewanella spp. have been indicated as probable progenitors of blaOXA-48-like genes. However, these have been detected in few Shewanella spp. and dissemination mechanisms are unclear. Thus, our main objective was to confirm the role of Shewanella species as progenitors of blaOXA-48-like genes. In silico analysis of Shewanella genomes was performed to detect blaOXA-48-like genes and context, and 43 environmental Shewanella spp. were characterised. Clonal relatedness was determined by BOX-PCR. Phylogenetic affiliation was assessed by 16S rDNA and gyrB sequencing. Antibiotic susceptibility phenotypes were determined. The blaOXA-48-like genes and genetic context were inspected by PCR, hybridisation and sequence analysis. Gene variants were cloned in Escherichia coli and MICs were determined. Shewanella isolates were screened for integrons, plasmids and insertion sequences. Analysis of Shewanella spp. genomes showed that putative blaOXA-48-like is present in the majority and in an identical context. Isolates presenting unique BOX profiles affiliated with 11 Shewanella spp. blaOXA-48-like genes were detected in 22 isolates from 6 species. Genes encoded enzymes identical to OXA-48, OXA-204, OXA-181, and 7 new variants differing from OXA-48 from 2 to 82 amino acids. IS1999 was detected in 24 isolates, although not in the vicinity of blaOXA-48 genes. Recombinant E. coli strains presented altered MICs. The presence/absence of blaOXA-48-like genes was species-related. Gene variants encoded enzymes with hydrolytic spectra similar to OXA-48-like from non-shewanellae. From the mobile elements previously described in association with blaOXA-48-like genes, only the IS1999 was found in Shewanella, which indicates its relevance in blaOXA-48-like genes transfer to other hosts.
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Affiliation(s)
- Marta Tacão
- Biology Department & CESAM, University of Aveiro, Aveiro, Portugal.
| | - Susana Araújo
- Biology Department & CESAM, University of Aveiro, Aveiro, Portugal
| | - Maria Vendas
- Biology Department & CESAM, University of Aveiro, Aveiro, Portugal
| | - Artur Alves
- Biology Department & CESAM, University of Aveiro, Aveiro, Portugal
| | - Isabel Henriques
- Biology Department & CESAM, University of Aveiro, Aveiro, Portugal
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Elramalli A, Almshawt N, Ahmed MO. Current problematic and emergence of carbapenemase-producing bacteria: a brief report from a Libyan hospital. Pan Afr Med J 2017; 26:180. [PMID: 28674573 PMCID: PMC5483376 DOI: 10.11604/pamj.2017.26.180.9637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 03/06/2017] [Indexed: 11/11/2022] Open
Abstract
A collection of 94 Gram-negative bacteria isolates, showing different antimicrobial resistance phenotypes including to the carbapenem classes was investigated. Strains were originated form clinical sources from a single hospital in Tripoli, Libya during 2015 and were identified based on cultural and phenotypic characteristics, and fully characterized by the VITEK automated system. Forty-eight percent (48%) of the collection was identified as Acinetobacter baumannii, 50% Klebsiella pneumoniae and 2% Escherichia coli. Resistance to the carbapenem classes was reported in 96% of the A. baumannii strains and 94% of the K. pneumonia strains. Seventy-eight percent (78%) of the isolates showed different multidrug-resistant (MDR) phenotypes, of which K. pneumoniae expressing the highest rates of MDRs(i.e. 91%). Emergence of resistance to carbapenems in the Gram-negative bacteria is a challenging global problem, particularly for Africa. Surveillance of these pathogens and appropriate actions are urgently required in Libyan healthcare settings.
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Affiliation(s)
| | - Nariman Almshawt
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Libya
| | - Mohamed Omar Ahmed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, Libya
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30
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Bouguenoun W, Bakour S, Bentorki AA, Al Bayssari C, Merad T, Rolain JM. Molecular epidemiology of environmental and clinical carbapenemase-producing Gram-negative bacilli from hospitals in Guelma, Algeria: Multiple genetic lineages and first report of OXA-48 in Enterobacter cloacae. J Glob Antimicrob Resist 2016; 7:135-140. [PMID: 27794265 DOI: 10.1016/j.jgar.2016.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/16/2016] [Accepted: 08/22/2016] [Indexed: 11/18/2022] Open
Abstract
This study was designed to investigate environmental colonisation in Algerian hospitals by carbapenem-resistant Gram-negative bacilli (GNB), including molecular characterisation of their resistance, and to perform a comparative molecular analysis between clinical and environmental strains. GNB isolated from hospitalised patients and the hospital environment were identified using microbiological methods and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). Antibiotic susceptibility testing was performed by disk diffusion and Etest methods. Carbapenemase- and extended-spectrum β-lactamase (ESBL)-encoding genes were searched for using PCR and sequencing. Clonality of the environmental and clinical strains was assessed by multilocus sequencing typing (MLST). A total of 32 carbapenem-resistant GNB were isolated, including 16 (29%) of 56 multidrug-resistant (MDR) GNB from clinical specimens and 16 (48%) of 33 MDR-GNB from inanimate surfaces. Of the 32 carbapenem-resistant isolates, 14 produced a carbapenemase. The blaOXA-48 gene was detected both in clinical and surface isolates of Klebsiella pneumoniae (n=3) and Enterobacter cloacae (n=2). Clinical and surface isolates of Acinetobacter baumannii were found to produce the carbapenemases NDM-1 (7 isolates) and OXA-23 (2 isolates). MLST revealed clonal diversity and a relationship between environmental and clinical strains with identical sequence types. Here we report the first description of an OXA-48-producing E. cloacae isolate in Algeria. We also highlight the important role of inanimate surfaces in the spread of carbapenem-resistant bacteria and the emergence of nosocomial infections.
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Affiliation(s)
- Widad Bouguenoun
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France; Laboratoire de Biochimie et Microbiologie appliquée, Université de Annaba, Annaba, Algeria
| | - Sofiane Bakour
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France
| | | | - Charbel Al Bayssari
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France
| | - Tarek Merad
- Laboratoire d'Amélioration Génétique des Plantes, Université de Annaba, Annaba, Algeria
| | - Jean-Marc Rolain
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France.
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Kraiem AG, Zorgani A, Elahmer O, El Salabi AA, Ghenghesh KS. Carbapenem-resistant gram-negative bacilli in Tripoli, Libya. Am J Infect Control 2016; 44:1192-1194. [PMID: 27473769 DOI: 10.1016/j.ajic.2016.04.245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
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32
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Phenotypic and Molecular Detection of Metallo-Beta-Lactamase Genes Among Imipenem Resistant Pseudomonas aeruginosa and Acinetobacter baumannii Strains Isolated From Patients with Burn Injuries. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.39036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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33
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Mathlouthi N, Al-Bayssari C, Bakour S, Rolain JM, Chouchani C. RETRACTED ARTICLE: Prevalence and emergence of carbapenemases-producing Gram-negative bacteria in Mediterranean basin. Crit Rev Microbiol 2016; 43:43-61. [DOI: 10.3109/1040841x.2016.1160867] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Najla Mathlouthi
- Université Tunis El-Manar, Faculté des Sciences de Tunis, Laboratoire des Microorganismes et Biomolécules Actives, Campus Universitaire, El-Manar II, Tunisia
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
- Université de Carthage, Institut Supérieur des Sciences et Technologies de l’Environnement de Borj-Cedria, Technopôle de Borj-Cedria, BP-1003, Hammam-Lif, Tunisia
| | - Charbel Al-Bayssari
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Sofiane Bakour
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Jean Marc Rolain
- Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Chedly Chouchani
- Université Tunis El-Manar, Faculté des Sciences de Tunis, Laboratoire des Microorganismes et Biomolécules Actives, Campus Universitaire, El-Manar II, Tunisia
- Université de Carthage, Institut Supérieur des Sciences et Technologies de l’Environnement de Borj-Cedria, Technopôle de Borj-Cedria, BP-1003, Hammam-Lif, Tunisia
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34
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Mathlouthi N, El Salabi AA, Ben Jomàa-Jemili M, Bakour S, Al-Bayssari C, Zorgani AA, Kraiema A, Elahmer O, Okdah L, Rolain JM, Chouchani C. Early detection of metallo-β-lactamase NDM-1- and OXA-23 carbapenemase-producing Acinetobacter baumannii in Libyan hospitals. Int J Antimicrob Agents 2016; 48:46-50. [DOI: 10.1016/j.ijantimicag.2016.03.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/17/2016] [Accepted: 03/23/2016] [Indexed: 11/30/2022]
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Bakthavatchalam YD, Anandan S, Veeraraghavan B. Laboratory Detection and Clinical Implication of Oxacillinase-48 like Carbapenemase: The Hidden Threat. J Glob Infect Dis 2016; 8:41-50. [PMID: 27013843 PMCID: PMC4785756 DOI: 10.4103/0974-777x.176149] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Carbapenemase producing Gram-negative pathogen is of great concern for physician. The challenging aspects are treatment option and infection control. Monitoring of respective carbapenemase resistance mechanism is necessary to prevent the outbreaks. Currently, the rapid emergence of oxacillinase (OXA-48) like is alarming. Increasing frequency of OXA-48 is seen than the classical carbapenemase (KPC, NDM, IMP, and VIM) across the world. The bla OXA-48 gene is commonly identified in Escherichia coli and Klebsiella pneumoniae. The transferrable plasmid of OXA-48 is associated with rapid spread and inter-species dissemination. In general, OXA-48-like enzymes weakly hydrolyzes both carbapenem and broad spectrum cephalosporins. Except OXA-163, which effectively hydrolyze cephalosporin. This poor hydrolytic profile obscures the detection of OXA-48-like. It may go undetected in routine diagnosis and complicates the treatment option. Co-production of OXA-48-like with CTX-M-15 and other carbapenemase (NDM, VIM) leads to the emergence of multidrug resistant strains.
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Affiliation(s)
| | - Shalini Anandan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
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Morfin-Otero R, Noriega ER, Dowzicky MJ. Antimicrobial susceptibility trends among gram-positive and -negative clinical isolates collected between 2005 and 2012 in Mexico: results from the Tigecycline Evaluation and Surveillance Trial. Ann Clin Microbiol Antimicrob 2015; 14:53. [PMID: 26667651 PMCID: PMC4678478 DOI: 10.1186/s12941-015-0116-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/02/2015] [Indexed: 11/10/2022] Open
Abstract
Background The Tigecycline Evaluation and Surveillance Trial (T.E.S.T) is a global antimicrobial surveillance study of both gram-positive and gram-negative organisms. This report presents data on antimicrobial susceptibility among organisms collected in Mexico between 2005 and 2012 as part of T.E.S.T., and compares rates between 2005–2007 and 2008–2012. Method Each center in Mexico submitted at least 200 isolates per collection year; including 65 gram-positive isolates and 135 gram-negative isolates. Minimum inhibitory concentrations (MICs) were determined using Clinical Laboratory Standards Institute (CLSI) broth microdilution methodology and antimicrobial susceptibility was established using the 2013 CLSI-approved breakpoints. For tigecycline US Food and Drug Administration (FDA) breakpoints were applied. Isolates of E. coli and K. pneumoniae with a MIC for ceftriaxone of >1 mg/L were screened for ESBL production using the phenotypic confirmatory disk test according to CLSI guidelines. Results The rates of some key resistant phenotypes changed during this study: vancomycin resistance among Enterococcus faecium decreased from 28.6 % in 2005–2007 to 19.1 % in 2008–2012, while β-lactamase production among Haemophilus influenzae decreased from 37.6 to 18.9 %. Conversely, methicillin-resistant Staphylococcus aureus increased from 38.1 to 47.9 %, meropenem-resistant Acinetobacter spp. increased from 17.7 to 33.0 % and multidrug-resistant Acinetobacter spp. increased from 25.6 to 49.7 %. The prevalence of other resistant pathogens was stable over the study period, including extended-spectrum β-lactamase-positive Escherichia coli (39.0 %) and Klebsiella pneumoniae (25.0 %). The activity of tigecycline was maintained across the study years with MIC90s of ≤2 mg/L against Enterococcus spp., S. aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Enterobacter spp., E. coli, K. pneumoniae, Klebsiella oxytoca, Serratia marcescens, H. influenzae, and Acinetobacter spp. All gram-positive organisms were susceptible to tigecycline and susceptibility among gram-negatives ranged from 95.0 % for K. pneumoniae to 99.7 % for E. coli. Conclusion Antimicrobial resistance continues to be high in Mexico. Tigecycline was active against gram-positive and gram-negative organisms, including resistant phenotypes, collected during the study.
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Affiliation(s)
- Rayo Morfin-Otero
- Hospital Civil de Guadalajara, Fray Antonio Alcalde, Instituto de Patologia Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
| | - Eduardo Rodriguez Noriega
- Hospital Civil de Guadalajara, Fray Antonio Alcalde, Instituto de Patologia Infecciosa y Experimental, Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico.
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Kraiem AG, Zorgani A, Elahmer O, Hammami A, Chaaben BM, Ghenghesh KS. New Delhi metallo-β-lactamase and OXA-48 carbapenemases in Gram-negative bacilli isolates in Libya. Libyan J Med 2015; 10:29206. [PMID: 26294290 PMCID: PMC4543448 DOI: 10.3402/ljm.v10.29206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Abdulaziz Zorgani
- Department of Microbiology and Immunology Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Omar Elahmer
- National Centre for Disease Control, Tripoli, Libya
| | - Adnene Hammami
- CHU Habib Bourguiba, Faculté de Médecine, Avenue Elferdaous, Sfax, Tunisie
| | - Basma M Chaaben
- CHU Habib Bourguiba, Faculté de Médecine, Avenue Elferdaous, Sfax, Tunisie
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