1
|
Mariano LSS, Nakamura-Silva R, Macedo LMDD, Oliveira-Silva MD, Goulart RDS, Pelisson M, Vespero EC, Silva-Sousa YTC, Pitondo-Silva A. Identification and antimicrobial susceptibility profile of bacteria isolated from primary endodontic infections. Braz Oral Res 2024; 38:e024. [PMID: 38597544 DOI: 10.1590/1807-3107bor-2024.vol38.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 10/03/2023] [Indexed: 04/11/2024] Open
Abstract
This study aimed to identify and characterize the antimicrobial susceptibility profile of bacteria found in primary endodontic infections in the teeth of patients treated at the Dental Clinic of the University of Ribeirão Preto, São Paulo, Brazil. From September to December 2019, samples were obtained from 21 patients with primary endodontic infections. The collections were carried out in triplicate using paper cones placed close to the total length of the root canal. Bacterial isolation was performed in Brain Heart Infusion agar, Blood agar, and other selective culture media cultured at 37°C for up to 48 h under aerobiosis and microaerophilic conditions. The bacterial species were identified using the Vitek 2 automated system. The disk diffusion method on agar Müeller-Hinton was used to assess antimicrobial susceptibility with the recommended antimicrobials for each identified bacterial species. A total of 49 antibiotics were evaluated. Fifteen of the 21 samples collected showed bacterial growth, and 17 bacterial isolates were found. There were 10 different bacterial species identified: Enterococcus faecalis (four isolates), Streptococcus mitis/oralis (three isolates), Streptococcus anginosus (three isolates) being the most common, followed by Staphylococcus epidermidis, Enterococcus faecium, Streptococcus constellatus, Streptococcus alactolyticus, Enterobacter cloacae, Klebsiella variicola, and Providencia rettgeri (one isolate of each species). The analysis demonstrated significant susceptibility to most of the tested antibiotics. However, some Enterococcus isolates resisted the antibiotic's erythromycin, ciprofloxacin, and tetracycline. A Staphylococcus epidermidis isolate was characterized as multidrug-resistant. Five Streptococcus isolates were non-susceptible to all antibiotics tested.
Collapse
Affiliation(s)
| | - Rafael Nakamura-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | | | - Mariana de Oliveira-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Rafael da Silva Goulart
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
| | - Marsileni Pelisson
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | - Eliana Carolina Vespero
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | | | - André Pitondo-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
| |
Collapse
|
2
|
Morgado S, Fonseca É, Freitas F, Caldart R, Vicente AC. In-depth analysis of Klebsiella aerogenes resistome, virulome and plasmidome worldwide. Sci Rep 2024; 14:6538. [PMID: 38503805 PMCID: PMC10951357 DOI: 10.1038/s41598-024-57245-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/15/2024] [Indexed: 03/21/2024] Open
Abstract
Klebsiella aerogenes is an emergent pathogen associated with outbreaks of carbapenem-resistant strains. To date, studies focusing on K. aerogenes have been small-scale and/or geographically restricted. Here, we analyzed the epidemiology, resistome, virulome, and plasmidome of this species based on 561 genomes, spanning all continents. Furthermore, we sequenced four new strains from Brazil (mostly from the Amazon region). Dozens of STs occur worldwide, but the pandemic clones ST93 and ST4 have prevailed in several countries. Almost all genomes were clinical, however, most of them did not carry ESBL or carbapenemases, instead, they carried chromosomal alterations (omp36, ampD, ampG, ampR) associated with resistance to β-lactams. Integrons were also identified, presenting gene cassettes not yet reported in this species (blaIMP, blaVIM, blaGES). Considering the virulence loci, the yersiniabactin and colibactin operons were found in the ICEKp10 element, which is disseminated in genomes of several STs, as well as an incomplete salmochelin cluster. In contrast, the aerobactin hypervirulence trait was observed only in one ST432 genome. Plasmids were common, mainly from the ColRNAI replicon, with some carrying resistance genes (mcr, blaTEM, blaNDM, blaIMP, blaKPC, blaVIM) and virulence genes (EAST1, senB). Interestingly, 172 genomes of different STs presented putative plasmids containing the colicin gene.
Collapse
Affiliation(s)
- Sergio Morgado
- Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil.
| | - Érica Fonseca
- Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Fernanda Freitas
- Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Raquel Caldart
- Centro de Ciências da Saúde, Universidade Federal de Roraima, Boa Vista, RR, 69300-000, Brazil
| | - Ana Carolina Vicente
- Laboratório de Genética Molecular de Microrganismos, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, 21040-360, Brazil
| |
Collapse
|
3
|
Das S, Mallick A, Barik M, Sarkar S, Saha P. The emergence of clonally diverse carbapenem-resistant Enterobacter cloacae complex in West Bengal, India: a dockyard of β-lactamases periling nosocomial infections. Int Microbiol 2023:10.1007/s10123-023-00451-0. [PMID: 37985632 DOI: 10.1007/s10123-023-00451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 11/22/2023]
Abstract
Carbapenem-resistant Enterobacter cloacae complex (CRECC) constitutes a global public health threat challenging clinical treatment and infection control, especially in low- and middle-income countries such as India. We analyzed the antimicrobial susceptibility, major β-lactamase genes, plasmid profiles, and genetic relatedness to understand the molecular epidemiology of CRECC clinical isolates (n = 44) in West Bengal, India, during 2021-2022. The majority (> 55%) of the isolates were resistant to fluoroquinolones, aminoglycosides, and co-trimoxazole, even > 20% for tigecycline and > 35% were extensively drug-resistant. Co-β-lactamase production was categorized into twenty-seven types, importantly NDM (84%), OXA-48 (40%), TEM (61%), CTX-M (46%), OXA-1 (55%), and MIR (27%). The NDM-1 and OXA-181 were major variants with the first observations of NDM-24 and -29 variants in India. Wide-range of plasmids (2 to > 212 kb) were harbored by the β-lactamase-producing isolates: small (91%), medium (27%), large (9%), and mega (71%). IncX3, ColE1, and HI2 were noted in about 30% of isolates, while IncF and R were carried by < 20% of isolates. The clonally diverse CRECC isolates were noted to cause cross-infections, especially at superficial site, bloodstream, and urinary-tract. This is the first molecular surveillance on CRECC in India. The study isolates serve as the dockyard of NDM, TEM, and CTX-M harboring a wide range of plasmids. The outcomes of the study may strengthen local and national policies for infection prevention and control practices, clarifying the genetic diversity among CRECC. Extensive genomic study may further intersect the relationships between these different plasmids, especially with their sizes, types, and antibiotic resistance markers.
Collapse
Affiliation(s)
- Surojit Das
- Department of Biomedical Laboratory Science and Management, Vidyasagar University, Midnapore, West Bengal, 721102, India.
| | - Abhi Mallick
- Department of Biomedical Laboratory Science and Management, Vidyasagar University, Midnapore, West Bengal, 721102, India
| | - Mili Barik
- Department of Biomedical Laboratory Science and Management, Vidyasagar University, Midnapore, West Bengal, 721102, India
| | - Soma Sarkar
- Department of Microbiology at Nil Ratan Sirkar Medical College Hospital, Kolkata, West Bengal, India
- Department of Microbiology at Infectious Diseases & Beleghata General Hospital, Kolkata, West Bengal, India
| | - Puranjoy Saha
- Department of Microbiology, Malda Medical College and Hospital, Malda, West Bengal, India
| |
Collapse
|
4
|
Hu J, Xu J, Lu Y, Wang L, Wang Y, Chen C, Zhu W. Rapid Detection of Enterobacter cloacae With a Visualized Isothermal Recombinase Polymerase Amplification Assay. Curr Microbiol 2023; 80:233. [PMID: 37273073 DOI: 10.1007/s00284-023-03269-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/13/2023] [Indexed: 06/06/2023]
Abstract
Enterobacter cloacae exhibits strong adhesion and invasion properties that contribute its ability to infect the host; it is considered an important opportunistic pathogen throughout the world. To control the spread of E. cloacae, simple, rapid, and accurate detection methods are required. Current methods suffer from various shortcomings and do not meet the demand for on-site quickly detection. Using recombinase polymerase amplification combined with lateral flow strip (RPA-LFS), an isothermal detection method was developed to target the outer membrane protein X (ompX) gene of E. cloacae. This reaction can be performed in 30 min at 37 °C. Limit of detection of 10 CFU/reaction was equivalent to that of the qPCR method. The detection accuracy of clinical samples was also equal to that of the qPCR method. In this study, we developed the RPA-LFS assay, which is simple, rapid, accurate, and does not require a laboratory facility. This assay may prove useful for detecting E. cloacae on-site.
Collapse
Affiliation(s)
- Juan Hu
- Department of Medicine Laboratory & Department of Oncology, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Jing Xu
- Department of Medicine Laboratory & Department of Oncology, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Yingzhi Lu
- Department of Medicine Laboratory & Department of Oncology, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Lei Wang
- Department of Medicine Laboratory & Department of Oncology, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China
| | - Yan Wang
- Department of Medicine Laboratory & Department of Oncology, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China.
- Department of Medicine Laboratory, Lianyungang Second People's Hospital, Kangda College of Nanjing Medical University, Lianyungang, China.
| | - Cheng Chen
- Department of Medicine Laboratory & Department of Oncology, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China.
- Department of Oncology, Lianyungang Hospital Affiliated to Jiangsu University, Lianyungang, China.
| | - Wenjun Zhu
- Department of Medicine Laboratory & Department of Oncology, The Second People's Hospital of Lianyungang (Cancer Hospital of Lianyungang), Lianyungang, China.
| |
Collapse
|
5
|
Liu H, Wang D, Tang M, Jia P, Huo Y, Wei E, Xu H, Chi X, Wang H. Genetic Characterization of Enterobacter hormaechei Co-Harboring blaNDM-1 and mcr-9 Causing Upper Respiratory Tract Infection. Infect Drug Resist 2022; 15:5035-5042. [PMID: 36068833 PMCID: PMC9441144 DOI: 10.2147/idr.s367073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose With the spread of multiple drug-resistant bacteria, blaNDM-1 and mcr-9 have been detected in various bacteria worldwide. However, the simultaneous detection of blaNDM-1 and mcr-9 in Enterobacter hormaechei has been rarely reported. This study identified an E. hormaechei strain carrying both blaNDM-1 and mcr-9. We investigated the genetic characteristics of these two resistance genes in detail, elucidating various potential mechanisms by which they may be transmitted. Methods Bacterial genomic features and possible origins were assessed by whole-genome sequencing (WGS) with Illumina and PacBio platforms and phylogenetic analysis. Subsequent investigations were performed, including antimicrobial susceptibility testing and multilocus sequence typing (MLST). Results We isolated an E. hormaechei strain DY1901 carrying both blaNDM-1 and mcr-9 from the sputum sample. Susceptibility testing showed that the isolate was multidrug-resistant. Multiple antibiotic resistance genes and virulence genes are widely distributed in DY1901. S1-PFGE, Southern blotting, and plasmid replicon typing showed that DY1901 carried four plasmids. The plasmid carrying mcr-9 was 259Kb in size and belonged to IncHI2, while the plasmid carrying blaNDM-1 was 45Kb in length and belonged to IncX3. Conclusion The E. hormaechei strain isolated in this study has a broad antibiotic resistance spectrum, posing a challenge to clinical treatment. Plasmids carrying mcr-9 are fusion plasmids, and those taking NDM are widely disseminated in China, suggesting that we should conduct routine genomic surveillance on such plasmids to curb the spread of drug-resistant bacteria in the region.
Collapse
Affiliation(s)
- Huiqiong Liu
- Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China
| | - Dao Wang
- Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China
| | - Miaomiao Tang
- Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China
| | - Peisheng Jia
- Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China
| | - Yufeng Huo
- Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China
| | - Erhu Wei
- Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China
| | - Hao Xu
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Xiaohui Chi
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Huaili Wang
- Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China
- Correspondence: Huaili Wang, Department of Pediatric Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, No. 1 Longhu East Zhonghuan Road, Zhengzhou, 450052, People’s Republic of China, Tel +86-371-66271057, Email
| |
Collapse
|
6
|
Molecular Characterization of Enterobacter cloacae Isolated from Urinary Tract Infections. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm-122718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background: Urinary tract infections represent a major expensive, common public health problem worldwide due to their high prevalence and the difficulties associated with their management. Objectives: This study aimed to characterize the Enterobacter cloacae strains isolated from urinary tract infections in the medical diagnostic laboratories of Shahrekord, Iran. Methods: Urine samples from patients with urinary tract infections from the Shahrekord medical diagnostic laboratories located in Chaharmahal and Bakhtiari Province, Iran, were collected from June 2019 to February 2020. When the samples were cultured, the different isolates of E. cloacae were identified by biochemical tests. Biofilm production capacity was evaluated. Bacterial susceptibility to antibiotics was determined using the Kirby Bauer method, and antibiotic resistance genes were researched by the multiplex PCR technique. Results: In this study, 65 isolates of E. cloacae were obtained. The highest percentage of resistance was observed for co-trimoxazole (84.62%), ampicillin (76.93%), tetracycline (73.85%), and above half of the E. cloacae strain isolates (53,85%) were strongly involved in biofilm production. Some genes, including qnr A, qnr B, qnr S, tetA, tet B, sul1, bla CTXM, bla SHV, and(2)la, ant(3)la, and aac(3)IIa, were detected in the genome of these isolates. Conclusions: The strains are multi-resistant, and their resistance has already reached the carbapenem class. This requires further investigation, and urgent measures must be adopted.
Collapse
|
7
|
Su W, Jiang Z, Wang C, Xu B, Lu Z, Wang F, Zong X, Jin M, Wang Y. Dynamics of defatted rice bran in physicochemical characteristics, microbiota and metabolic functions during two-stage co-fermentation. Int J Food Microbiol 2022; 362:109489. [PMID: 34823081 DOI: 10.1016/j.ijfoodmicro.2021.109489] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/27/2021] [Accepted: 11/16/2021] [Indexed: 11/19/2022]
Abstract
Defatted rice bran (DFRB) is an inexpensive and easily available agricultural byproduct. Existence of anti-nutritional factors (ANFs), high fiber and low protein content, susceptible to oxidation and rancidity make DFRB currently underutilized. In this study, Bacillus subtilis with high enzyme activities, Saccharomyces cerevisiae with high single-cell proteins concentration and Lactiplantibacillus plantarum with excellent acid secreting capacity were screened to co-fermented DFRB with phytase, and multiple physicochemical analyses combined with high-throughput sequencing were applied to provide insights into the dynamics of the physicochemical characteristics and the complex microbiome during the two-stage co-fermentation of DFRB. The results showed that co-fermentation effectively improved the nutritional value by degrading ANFs (trypsin inhibitors and phytic acid), fiber (acid detergent fiber and neutral detergent fiber) and allergenic protein, and increasing the trichloroacetic acid soluble protein, amino acids and organic acid. In addition, co-fermentation prevented lipid oxidation by enhancing antioxidant activity and reducing the activity of lipase and lipoxygenase. High-throughput sequencing results suggested that co-fermentation optimized microbial community of DFRB by increasing desirable Lactobacillus, Pediococcus, Saccharomyces and Talaromyces and reducing undesirable bacteria (Enterobacter and Pseudomonas) and animal and plant-pathogenic fungi (Blumeria, Alternaria, Fusarium, etc.). Furthermore, high-throughput sequencing and gas chromatography-mass spectrometry (GC-MS) were adopted to predict microbial metabolic functions and metabolic pathways during whole DFRB co-fermentation.
Collapse
Affiliation(s)
- Weifa Su
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China
| | - Zipeng Jiang
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China
| | - Cheng Wang
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China
| | - Bocheng Xu
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China
| | - Zeqing Lu
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China.
| | - Fengqin Wang
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China
| | - Xin Zong
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China
| | - Mingliang Jin
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China.
| | - Yizhen Wang
- National Engineering Laboratory of Biological Feed Safety and Pollution Prevention and Control, Key Laboratory of Animal Nutrition and Feed, Ministry of Agriculture, Key Laboratory of Animal Nutrition and Feed Science of Zhejiang Province, Institute of Feed Science, Zhejiang University, 866 Yuhang Tang Road, Hangzhou, Zhejiang 310058, PR China.
| |
Collapse
|
8
|
Virulence factors of Proteus mirabilis clinical isolates carrying bla KPC-2 and bla NDM-1 and first report bla OXA-10 in Brazil. J Infect Chemother 2021; 28:363-372. [PMID: 34815168 DOI: 10.1016/j.jiac.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/22/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Proteus mirabilis is one of the main pathogens that cause urinary tract infections. Therefore, the aim of this study was to analyze and compare the genetic profile of 36 clinical isolates of P. mirabilis that carry and do not carry the blaKPC and blaNDM gene with respect to virulence factors (mrpG, pmfA, ucaA, nrpG and pbtA) and antimicrobial resistance (blaVIM,blaIMP, blaSPM, blaGES,blaOXA-23-like, blaOXA-48-like, blaOXA-58-like and blaOXA-10-like). METHODS The virulence and resistance genes were investigated by using PCR and sequencing. RESULTS ERIC-PCR typing showed that the isolates showed multiclonal dissemination and high genetic variability. The gene that was most found blaOXA-10-like (n = 18), followed by blaKPC (n = 10) and blaNDM (n = 8). To our knowledge, this is the first report of blaOXA-10 in P. mirabilis in Brazil, as well as the first report of the occurrence of P. mirabilis co-carrying blaOXA-10/blaKPC and blaOXA-10/blaNDM. The blaNDM or blaKPC carrier isolates showed important virulence genes, such as ucaA (n = 8/44.4%), pbtA (n = 10/55.5%) and nrpG (n = 2/11.1%). However, in general, the non-carrier isolates of blaKPC and blaNDM showed a greater number of virulence genes when compared to the carrier group. CONCLUSION Clinical isolates of P. mirabilis, in addition to being multi-drug resistant, presented efficient virulence factors that can establish infection outside the gastrointestinal tract.
Collapse
|
9
|
Mateos M, Hernández-García M, Del Campo R, Martínez-García L, Gijón D, Morosini MI, Ruiz-Garbajosa P, Cantón R. Emergence and Persistence over Time of Carbapenemase-Producing Enterobacter Isolates in a Spanish University Hospital in Madrid, Spain (2005-2018). Microb Drug Resist 2020; 27:895-903. [PMID: 33090918 DOI: 10.1089/mdr.2020.0265] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Carbapenemase production is constantly increasing among different Enterobacterales species. We analyzed the microbiological characteristics and population structure of all carbapenemase-producing Enterobacter spp. (CP-Ent) isolates recovered at the Ramón y Cajal Hospital between 2005 and 2018. Overall, 178 CP-Ent isolates (60.7% colonization, 39.3% clinical) were recovered from 165 hospitalized patients (165/176, 93.7%; medical [102/165], surgical [34/165], and intensive care unit [29/165] areas), emergency unit (4/176, 2.3%), and ambulatory patients (7/176, 4.0%). In addition, three CP-Ent were found in environmental sources. Clinical samples were mainly urine (37.1%). The most frequent matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF)-identified species were Enterobacter cloacae (n = 85) and Enterobacter asburiae (n = 49). hsp60 gene sequencing showed a higher species diversity than MALDI-TOF: 70 Enterobacter hormaechei-clusters III, VI, VIII; 69 Enterobacter roggenkampii-IV; 15 Enterobacter kobei-II; 9 E. asburiae-I; 3 Enterobacter ludwigii-V; and 1 E. cloacae subsp. dissolvens-XII. Nine Klebsiella aerogenes were also identified. Overall, a high clonal diversity (Simpson Diversity Index >0.90) was found among CP-Ent-clusters. Environmental isolates were clonally related to clinical ones. Amikacin and tigecycline showed the highest susceptibility (>93%). VIM-1 (n = 133/181, 73.5%) and OXA-48 (n = 34/181, 18.8%) carbapenemases were predominant, followed by KPC-2 (n = 9/181, 5.0%), KPC-3 (n = 2/181, 1.1%), VIM-2 (n = 1/181, 0.6%), and two coproducers (VIM-1+KPC-2 and VIM-1+KPC-3). Extended-spectrum beta-lactamase (ESBL) coproduction (14.4%) emerged in 2012, mainly associated with blaSHV-12 (p < 0.001), E. roggenkampii (p < 0.001), and colonization (p = 0.03). VIM-1- and OXA-48-CP-Ent fecal carriers increased in our hospital, particularly between 2011 and 2018 (p < 0.001). Moreover, KPC and OXA-48 producers emerged in 2010 and 2012, respectively. They superimposed over VIM producers, which were persistently recovered since first detection in 2005. These results depict increased complexity over time of CP-Ent.
Collapse
Affiliation(s)
- Miriam Mateos
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Marta Hernández-García
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Rosa Del Campo
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Laura Martínez-García
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Desirée Gijón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - María Isabel Morosini
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Patricia Ruiz-Garbajosa
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| |
Collapse
|
10
|
García-Betancur JC, Appel TM, Esparza G, Gales AC, Levy-Hara G, Cornistein W, Vega S, Nuñez D, Cuellar L, Bavestrello L, Castañeda-Méndez PF, Villalobos-Vindas JM, Villegas MV. Update on the epidemiology of carbapenemases in Latin America and the Caribbean. Expert Rev Anti Infect Ther 2020; 19:197-213. [PMID: 32813566 DOI: 10.1080/14787210.2020.1813023] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Carbapenemases are β-lactamases able to hydrolyze a wide range of β-lactam antibiotics, including carbapenems. Carbapenemase production in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp., with and without the co-expression of other β-lactamases is a serious public health threat. Carbapenemases belong to three main classes according to the Ambler classification: class A, class B, and class D. AREAS COVERED Carbapenemase-bearing pathogens are endemic in Latin America. In this review, we update the status of carbapenemases in Latin America and the Caribbean. EXPERT OPINION Understanding the current epidemiology of carbapenemases in Latin America and the Caribbean is of critical importance to improve infection control policies limiting the dissemination of multi-drug-resistant pathogens and in implementing appropriate antimicrobial therapy.
Collapse
Affiliation(s)
| | - Tobias Manuel Appel
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque . Bogotá, Colombia
| | - German Esparza
- Programa de Aseguramiento de Calidad. PROASECAL SAS, Bogotá, Colombia
| | - Ana C Gales
- Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo - UNIFESP , São Paulo, Brazil
| | | | | | - Silvio Vega
- Complejo Hospitalario Metropolitano , Ciudad de Panamá, Panama
| | - Duilio Nuñez
- Infectious Diseases División, IPS Hospital Central , Asunción, Paraguay
| | - Luis Cuellar
- Servicio de Infectologia, Instituto Nacional de Enfermedades Neoplasicas , Lima, Peru
| | | | - Paulo F Castañeda-Méndez
- Department of Infectious Diseases, Hospital San Angel Inn Universidad , Ciudad de México, Mexico
| | | | - María Virginia Villegas
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque . Bogotá, Colombia.,Centro Médico Imbanaco . Cali, Colombia
| |
Collapse
|
11
|
Bispo Beltrão EM, de Oliveira ÉM, Dos Santos Vasconcelos CR, Cabral AB, Rezende AM, Souza Lopes AC. Multidrug-resistant Klebsiella aerogenes clinical isolates from Brazil carrying IncQ1 plasmids containing the bla KPC-2 gene associated with non-Tn4401 elements (NTE KPC-IId). J Glob Antimicrob Resist 2020; 22:43-44. [PMID: 32445743 DOI: 10.1016/j.jgar.2020.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/14/2020] [Accepted: 05/06/2020] [Indexed: 11/26/2022] Open
|
12
|
Gajdács M, Urbán E. Resistance Trends and Epidemiology of Citrobacter- Enterobacter- Serratia in Urinary Tract Infections of Inpatients and Outpatients (RECESUTI): A 10-Year Survey. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E285. [PMID: 31216725 PMCID: PMC6630883 DOI: 10.3390/medicina55060285] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 12/17/2022]
Abstract
Background and objectives: Urinary tract infections (UTIs) are the third most common infections in humans, representing a significant factor of morbidity, both among outpatients and inpatients. The pathogenic role of Citrobacter, Enterobacter, and Serratia species (CES bacteria) has been described in UTIs. CES bacteria present a therapeutic challenge due to the various intrinsic and acquired resistance mechanisms they possess. Materials and Methods: The aim of this study was to assess and compare the resistance trends and epidemiology of CES pathogens in UTIs (RECESUTI) in inpatients and outpatients during a 10-year study period. To evaluate the resistance trends of isolated strains, several antibiotics were chosen as indicator drugs based on local utilization data. 578 CES isolates were obtained from inpatients and 554 from outpatients, representing 2.57 ± 0.41% of all positive urine samples for outpatients and 3.02 ± 0.40% for inpatients. E. cloacae was the most prevalent species. Results: The ratio of resistant strains to most of the indicator drugs was higher in the inpatient group and lower in the second half of the study period. ESBL-producing isolates were detected in 0-9.75% from outpatient and 0-29.09% from inpatient samples. Conclusions: Resistance developments of CES bacteria, coupled with their intrinsic non-susceptibility to several antibiotics, severely limits the number of therapeutic alternatives, especially for outpatients.
Collapse
Affiliation(s)
- Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Eötvös utca 6., 6720 Szeged, Hungary.
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725 Szeged, Hungary.
| | - Edit Urbán
- Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged, Semmelweis utca 6., 6725 Szeged, Hungary.
| |
Collapse
|
13
|
Scavuzzi AML, Firmo EF, Oliveira ÉMD, Lopes ACDS. Emergence of bla NDM-1 associated with the aac(6')-Ib-cr, acrB, cps, and mrkD genes in a clinical isolate of multi-drug resistant Klebsiella pneumoniae from Recife-PE, Brazil. Rev Soc Bras Med Trop 2019; 52:e20180352. [PMID: 31141048 DOI: 10.1590/0037-8682-0352-2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/01/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The emergence of New Delhi metallo-β-lactamase (NDM) is concernig because it reduces the antibiotic therapy options for bacterial infections. METHODS Resistant and virulent genes from an isolate of Klebsiella pneumoniae derived from a patient with sepsis in a hospital in Recife-PE, Brazil, were investigated using PCR and DNA sequencing. RESULTS bla NDM-1, aac(6')-Ib-cr and acrB resistance genes, and cps and mrkD virulence genes were detected. CONCLUSIONS To our knowledge, this is the first report on bla NDM-1 in Recife-PE. This detection alerts researchers to the need to control the spread of bla NDM-1 resistance gene by this bacterium in Brazil.
Collapse
Affiliation(s)
| | - Elza Ferreira Firmo
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | | | | |
Collapse
|
14
|
Firmo EF, Cabral AB, Oliveira ÉMD, Lopes ACS. Emergence of aph(3’)-VI and accumulation of aminoglycoside modifying enzyme genes in KPC-2-possessing Enterobacter aerogenes isolates from infections and colonization in patients from Recife-PE, Brazil. Rev Soc Bras Med Trop 2019; 52:e20180460. [DOI: 10.1590/0037-8682-0460-2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/08/2019] [Indexed: 11/22/2022] Open
|
15
|
Azevedo PAA, Furlan JPR, Oliveira-Silva M, Nakamura-Silva R, Gomes CN, Costa KRC, Stehling EG, Pitondo-Silva A. Detection of virulence and β-lactamase encoding genes in Enterobacter aerogenes and Enterobacter cloacae clinical isolates from Brazil. Braz J Microbiol 2018; 49 Suppl 1:224-228. [PMID: 29858139 PMCID: PMC6328715 DOI: 10.1016/j.bjm.2018.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 03/02/2018] [Accepted: 04/19/2018] [Indexed: 12/03/2022] Open
Abstract
Enterobacter cloacae and E. aerogenes have been increasingly reported as important opportunistic pathogens. In this study, a high prevalence of multi-drug resistant isolates from Brazil, harboring several β-lactamase encoding genes was found. Several virulence genes were observed in E. aerogenes, contrasting with the E. cloacae isolates which presented none.
Collapse
Affiliation(s)
- Paola Aparecida Alves Azevedo
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - João Pedro Rueda Furlan
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - Mariana Oliveira-Silva
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - Rafael Nakamura-Silva
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - Carolina Nogueira Gomes
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | | | - Eliana Guedes Stehling
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil
| | - André Pitondo-Silva
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, SP, Brazil.
| |
Collapse
|