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Baranchyk Y, Gestels Z, Van den Bossche D, Abdellati S, Britto Xavier B, Manoharan-Basil SS, Kenyon C. Effect of erythromycin residuals in food on the development of resistance in Streptococcus pneumoniae: an in vivo study in Galleria mellonella. PeerJ 2024; 12:e17463. [PMID: 38827315 PMCID: PMC11141549 DOI: 10.7717/peerj.17463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/05/2024] [Indexed: 06/04/2024] Open
Abstract
Background The use of antimicrobials to treat food animals may result in antimicrobial residues in foodstuffs of animal origin. The European Medicines Association (EMA) and World Health Organization (WHO) define safe antimicrobial concentrations in food based on acceptable daily intakes (ADIs). It is unknown if ADI doses of antimicrobials in food could influence the antimicrobial susceptibility of human-associated bacteria. Objectives This aim of this study was to evaluate if the consumption of ADI doses of erythromycin could select for erythromycin resistance in a Galleria mellonella model of Streptococcus pneumoniae infection. Methods A chronic model of S. pneumoniae infection in G. mellonella larvae was used for the experiment. Inoculation of larvae with S. pneumoniae was followed by injections of erythromycin ADI doses (0.0875 and 0.012 μg/ml according to EMA and WHO, respectively). Isolation of S. pneumoniae colonies was then performed on selective agar plates. Minimum inhibitory concentrations (MICs) of resistant colonies were measured, and whole genome sequencing (WGS) was performed followed by variant calling to determine the genetic modifications. Results Exposure to single doses of both EMA and WHO ADI doses of erythromycin resulted in the emergence of erythromycin resistance in S. pneumoniae. Emergent resistance to erythromycin was associated with a mutation in rplA, which codes for the L1 ribosomal protein and has been linked to macrolide resistance in previous studies. Conclusion In our in vivo model, even single doses of erythromycin that are classified as acceptable by the WHO and EMA induced significant increases in erythromycin MICs in S. pneumoniae. These results suggest the need to include the induction of antimicrobial resistance (AMR) as a significant criterion for determining ADIs.
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Affiliation(s)
- Yuliia Baranchyk
- UnivLyon, Université Claude Bernard Lyon 1, Lyon, France
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Zina Gestels
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | | | - Saïd Abdellati
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Basil Britto Xavier
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- Hospital Outbreak Support Team-HOST, Ziekenhuis Netwerk Antwerpen Middelheim, Antwerp, Belgium
| | | | - Chris Kenyon
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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2
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Johnson CN, Wilde S, Tuomanen E, Rosch JW. Convergent impact of vaccination and antibiotic pressures on pneumococcal populations. Cell Chem Biol 2024; 31:195-206. [PMID: 38052216 PMCID: PMC10938186 DOI: 10.1016/j.chembiol.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/08/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023]
Abstract
Streptococcus pneumoniae is a remarkably adaptable and successful human pathogen, playing dual roles of both asymptomatic carriage in the nasopharynx and invasive disease including pneumonia, bacteremia, and meningitis. Efficacious vaccines and effective antibiotic therapies are critical to mitigating morbidity and mortality. However, clinical interventions can be rapidly circumvented by the pneumococcus by its inherent proclivity for genetic exchange. This leads to an underappreciated interplay between vaccine and antibiotic pressures on pneumococcal populations. Circulating populations have undergone dramatic shifts due to the introduction of capsule-based vaccines of increasing valency imparting strong selective pressures. These alterations in population structure have concurrent consequences on the frequency of antibiotic resistance profiles in the population. This review will discuss the interactions of these two selective forces. Understanding and forecasting the drivers of antibiotic resistance and capsule switching are of critical importance for public health, particularly for such a genetically promiscuous pathogen as S. pneumoniae.
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Affiliation(s)
- Cydney N Johnson
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Shyra Wilde
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Elaine Tuomanen
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
| | - Jason W Rosch
- Department of Host-Microbe Interactions, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
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3
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Ortiz-Miravalles L, Sánchez-Angulo M, Sanz JM, Maestro B. Drug Repositioning as a Therapeutic Strategy against Streptococcus pneumoniae: Cell Membrane as Potential Target. Int J Mol Sci 2023; 24:ijms24065831. [PMID: 36982905 PMCID: PMC10058218 DOI: 10.3390/ijms24065831] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
A collection of repurposing drugs (Prestwick Chemical Library) containing 1200 compounds was screened to investigate the drugs' antimicrobial effects against planktonic cultures of the respiratory pathogen Streptococcus pneumoniae. After four discrimination rounds, a set of seven compounds was finally selected, namely (i) clofilium tosylate; (ii) vanoxerine; (iii) mitoxantrone dihydrochloride; (iv) amiodarone hydrochloride; (v) tamoxifen citrate; (vi) terfenadine; and (vii) clomiphene citrate (Z, E). These molecules arrested pneumococcal growth in a liquid medium and induced a decrease in bacterial viability between 90.0% and 99.9% at 25 µM concentration, with minimal inhibitory concentrations (MICs) also in the micromolar range. Moreover, all compounds but mitoxantrone caused a remarkable increase in the permeability of the bacterial membrane and share a common, minimal chemical structure consisting of an aliphatic amine linked to a phenyl moiety via a short carbon/oxygen linker. These results open new possibilities to tackle pneumococcal disease through drug repositioning and provide clues for the design of novel membrane-targeted antimicrobials with a related chemical structure.
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Affiliation(s)
- Laura Ortiz-Miravalles
- Protein Engineering against Antimicrobial Resistance Group, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 28040 Madrid, Spain
- Department of Animal Health, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Manuel Sánchez-Angulo
- Department of Vegetal Production and Microbiology, Universidad Miguel Hernández, 03202 Elche, Spain
| | - Jesús M Sanz
- Protein Engineering against Antimicrobial Resistance Group, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Beatriz Maestro
- Protein Engineering against Antimicrobial Resistance Group, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), 28040 Madrid, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Biology, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain
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4
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Nzoyikorera N, Diawara I, Katfy M, Katfy K, Maaloum F, Nyandwi J, Belabbes H, Elmdaghri N, Zerouali K. Serotype distribution and antimicrobial susceptibility of invasive Streptococcus pneumoniae isolates among adult and elderly population before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco. BMC Infect Dis 2023; 23:24. [PMID: 36639755 PMCID: PMC9838000 DOI: 10.1186/s12879-023-07981-y] [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: 09/15/2022] [Accepted: 01/02/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae (S. pneumoniae), remains a major cause of mortality and morbidity worldwide. The objective of this study was to determine the trends of invasive pneumococcal diseases (IPD) in adult and elderly population in Casablanca (Morocco) before and after introduction of pneumococcal conjugate vaccine (PCV) by determining the distribution of pneumococcal serotypes and antibiotic resistance profile of isolated strains. METHOD The proposed study is a retrospective laboratory-based surveillance of IPD in hospitalized adult (15-59 years old) and elderly (≥ 60 years old) patients in Ibn Rochd University Hospital Centre from 2007 to 2019 (13 years). All the 250 non-duplicate clinical invasive isolates from adult and elderly patients, confirmed as S. pneumoniae according to the laboratory standard identification procedures, are included in this study. RESULTS A significant decrease of the overall incidence in IPD was observed only in adults from 0.71 to 0.54/100000 populations (P = 0.02) and to 0.47/100000 populations (P = 0.0137) in the early and mature post-vaccine period respectively compared to the pre-vaccine period. Our results also showed a significant reduction in the overall prevalence of vaccine serotypes from 28.17 to 6.90% (P = 0.0021) for the PCV-10 serotypes, and from 46.48 to 25.86% (P = 0.0164) for the PCV-13 serotypes only in the mature post-vaccine period (2015-2019). In parallel, the rate of non-vaccine serotypes did not significantly change in the early post-vaccine period (2011-2014) while it increased considerably from 54 to 74.14% (P = 0.0189) during the mature post-vaccine period. The rate of penicillin non-susceptible pneumococcal isolates decreased significantly from 23.94 to 8.77% (P = 0.02) in adult patients, and the rate of cotrimoxazole non-susceptible pneumococcal isolates significantly decreased from 29.58 to 8.77% in the early post-vaccine period (P = 0.003) and to 7.24% in the mature post-vaccine period (P = 0.0007). CONCLUSION Although childhood vaccination has considerably reduced the incidence of IPD in adult population through the herd effect, IPD remain a real public health problem due to the alarming increase in non-vaccine serotypes (NVS) and the lack of herd effect among elderly population. The rate of antibiotic resistance was relatively low. Nevertheless, resistance constitutes a serious problem to the therapeutic arsenal due to the known capacity for genetic dissemination in the pneumococcus.
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Affiliation(s)
- Néhémie Nzoyikorera
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.501379.90000 0004 6022 6378Higher Institute of Biosciences and Biotechnology, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco ,grid.501379.90000 0004 6022 6378Laboratory of Microbial Biotechnology and Infectiology Research, Mohammed VI Center for Research & Innovation, Rabat, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco ,National Reference Laboratory, National Institute of Public Health, Bujumbura, Burundi
| | - Idrissa Diawara
- grid.501379.90000 0004 6022 6378Higher Institute of Biosciences and Biotechnology, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco ,grid.501379.90000 0004 6022 6378Laboratory of Microbial Biotechnology and Infectiology Research, Mohammed VI Center for Research & Innovation, Rabat, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Mostafa Katfy
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Khalid Katfy
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Fakhreddine Maaloum
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco
| | - Joseph Nyandwi
- grid.7749.d0000 0001 0723 7738Département de Médecine, Faculté de Médecine, Université du Burundi, Bujumbura, Burundi ,grid.490693.1Ministère de la Santé Publique et de la Lutte contre le Sida, Institut National de Santé Publique de Bujumbura, Bujumbura, Burundi
| | - Houria Belabbes
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Naima Elmdaghri
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Khalid Zerouali
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
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5
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Naranjo-Lucena A, Slowey R. Invited review: Antimicrobial resistance in bovine mastitis pathogens: A review of genetic determinants and prevalence of resistance in European countries. J Dairy Sci 2023; 106:1-23. [PMID: 36333144 DOI: 10.3168/jds.2022-22267] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022]
Abstract
Antimicrobial resistance is an urgent and growing problem worldwide, both for human and animal health. In the animal health sector actions have been taken as concerns grow regarding the development and spread of antimicrobial resistance. Mastitis is the most common infection in dairy cattle. We aimed to summarize the genetic determinants found in staphylococci, streptococci, and Enterobacteriaceae isolated from mastitic milk samples and provide a comparison of percentage resistance to a variety of antimicrobials in European countries.
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Affiliation(s)
- Amalia Naranjo-Lucena
- National Reference Laboratory for Antimicrobial Resistance, Department of Agriculture, Food and the Marine, Backweston Laboratory Campus, Celbridge, Ireland W23 VW2C.
| | - Rosemarie Slowey
- National Reference Laboratory for Antimicrobial Resistance, Department of Agriculture, Food and the Marine, Backweston Laboratory Campus, Celbridge, Ireland W23 VW2C
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6
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Reslan L, Youssef N, Boutros CF, Assaf-Casals A, Fayad D, Khafaja S, Akl F, Finianos M, Rizk AA, Shaker R, Zaghlout A, Lteif M, El Hafi B, Moumneh MB, Feghali R, Ghanem S, Jisr T, Karayakoupoglou G, Naboulsi M, Hamze M, Samad S, Khoury E, Sarraf R, Osman M, Bou Raad E, El Amin H, Abadi I, Abdo H, Chedid M, Chamseddine F, Barakat A, Houmani M, Haddad A, Abdel Nour G, Mokhbat JE, Daoud Z, El-Zaatari M, Salem Sokhn E, Ghosn N, Ammar W, Hamadeh R, Matar GM, Araj GF, Dbaibo GS. The impact of vaccination on the burden of invasive pneumococcal disease from a nationwide surveillance program in Lebanon: an unexpected increase in mortality driven by non-vaccine serotypes. Expert Rev Vaccines 2022; 21:1905-1921. [PMID: 36342411 DOI: 10.1080/14760584.2022.2143349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The impact of pneumococcal conjugate vaccines (PCVs) on the burden of invasive pneumococcal disease (IPD) and serotype distribution was examined across age groups from data collected by the Lebanese Inter-Hospital Pneumococcal Surveillance Program. METHODS Between 2005 and 2020, 593 invasive Streptococcus pneumoniae isolates were collected from 79 hospitals throughout Lebanon. Serotypes and antimicrobial resistance (AMR) profiles were identified, and trends compared over 3 eras: PCV7, post-PCV7/ pre-PCV13, and PCV13 eras. RESULTS The prevalence of PCV7 serotypes decreased significantly from 43.6% in the PCV7 era to 17.8% during the PCV13 era (p<0.001). PCV13-only serotypes remained stable in the PCV13 compared to the post-PCV7 eras, especially serotypes 1 and 3, whereas non-vaccine types (NVT) increased throughout the study period, especially 24 and 16F. The mortality rate increased substantially from 12.5% (PCV7 era) to 24.8% (PCV13 era). A significant decrease in AMR was observed across the three study eras. CONCLUSION PCVs substantially impacted IPD and AMR in vaccinated and unvaccinated populations despite an increase in mortality driven by NVT. Broadening the recommendation of vaccination to include older age-groups, using higher valency vaccines, and implementing stringent antimicrobial stewardship are likely to further impact the burden of IPD.
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Affiliation(s)
- Lina Reslan
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Nour Youssef
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Celina F Boutros
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Aia Assaf-Casals
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Danielle Fayad
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Sarah Khafaja
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Fata Akl
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Marc Finianos
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Microbiology, Faculty of Medicine, and University Hospital in Pilsen, Charles University, Pilsen, Czech Republic.,Biomedical Center, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Amena A Rizk
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Rouba Shaker
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
| | - Alissar Zaghlout
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Mireille Lteif
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Bassam El Hafi
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Experimental Pathology, Immunology, and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohammad Bahij Moumneh
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Rita Feghali
- Department of Laboratory Medicine, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Soha Ghanem
- Department of Pediatrics, Makassed General Hospital, Beirut, Lebanon.,Department of Pediatrics, Saint Georges Hospital University Medical Center, Achrafieh, Beirut, Lebanon
| | - Tamima Jisr
- Laboratory medicine and transfusion medicine department, Makassed General Hospital, Beirut, Lebanon
| | | | - Malak Naboulsi
- Department of Laboratory Medicine, Haykal Hospital, Tripoli, Lebanon
| | - Monzer Hamze
- Department of Microbiology, Nini Hospital, Tripoli, Lebanon
| | - Salam Samad
- Department of Laboratory Medicine, Centre Hospitalier du Nord, Zgharta, Lebanon
| | - Elie Khoury
- Department of Laboratory Medicine, Centre Hospitalier du Nord, Zgharta, Lebanon
| | - Ricardo Sarraf
- Department of Laboratory Medicine, Monla Hospital, Tripoli, Lebanon
| | - Marwan Osman
- Department of Microbiology, El-Youssef Hospital Center, Halba, Lebanon.,Department of Public and Ecosystem Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Elie Bou Raad
- Department of Microbiology, El-Youssef Hospital Center, Halba, Lebanon
| | - Hadi El Amin
- Department of Microbiology, El-Youssef Hospital Center, Halba, Lebanon
| | - Ibrahim Abadi
- Department of Laboratory Medicine, Al Rassoul Al Azam, Beirut, Lebanon
| | - Hicham Abdo
- Department of Laboratory Medicine, Dar El Shifa, Tripoli, Lebanon
| | - Marwan Chedid
- Department of Laboratory Medicine, New Mazloum Hospital, Tripoli, Lebanon
| | | | - Angelique Barakat
- Department of Laboratory Medicine, Bellevue Medical Center, Mansourieh, Lebanon
| | - Mohammad Houmani
- Department of Laboratory Medicine, Labib Medical Center, Saida, Lebanon
| | - Antoine Haddad
- Department of Clinical Pathology and Blood Bank, Sacre Coeur Hospital, Lebanese University, Mount Lebanon, Lebanon
| | - Georges Abdel Nour
- Department of Laboratory Medicine, Notre Dame des Secours University Hospital Center, Jbeil, Mount Lebanon, Lebanon
| | - Jacques E Mokhbat
- Department of Internal Medicine, Division of Infectious Diseases, Lebanese American of Beirut Medical Center-Rizk Hospital, Achrafieh, Beirut, Lebanon
| | - Ziad Daoud
- Keserwan Medical Center, Jounieh, Mount Lebanon, Lebanon.,Department of Clinical Microbiology and Infection Prevention, College of Medicine, Central Michigan University and Michigan Health Clinic, Michigan, USA.,Department of Laboratory Medicine, Saint Georges Hospital University Medical Center, Achrafieh, Saida, Lebanon
| | - Mohamad El-Zaatari
- Department of Laboratory Medicine, Hammoud Hospital University Medical Center, Saida, Lebanon
| | - Elie Salem Sokhn
- Department of Laboratory Medicine, Lebanese Hospital Geitaoui-University Medical Center (UMC), Achrafieh, Beirut, Lebanon.,Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Nada Ghosn
- Epidemiological Surveillance Unit, Ministry of Public Health, Beirut, Lebanon
| | - Walid Ammar
- General Director, Lebanese Ministry of Public Health, Beirut, Lebanon
| | - Randa Hamadeh
- PHC Department, Lebanese Ministry of Public Health. Global Health Team of Experts (GHTE), Lebanon
| | - Ghassan M Matar
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Experimental Pathology, Immunology, and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - George F Araj
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghassan S Dbaibo
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut, Faculty of Medicine, Beirut, Lebanon
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7
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Characterization of Streptococcus pneumoniae Macrolide Resistance and Its Mechanism in Northeast China over a 20-Year Period. Microbiol Spectr 2022; 10:e0054622. [PMID: 35938873 PMCID: PMC9602527 DOI: 10.1128/spectrum.00546-22] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Due to the resistance of Streptococcus pneumoniae to β-lactams, macrolides, and tetracyclines, treatment alternatives have become increasingly limited worldwide. We aim to describe the characterization of erythromycin-resistant S. pneumoniae (ERSP) strains in northeastern China over a period of 20 years. A total of 1,240 ERSP strains were collected and classified into five groups based on the ages of the patients. Etest strips and Kirby-Bauer disk diffusion were performed for drug susceptibility testing. The capsule swelling test was used for capsule typing. The phenotype of drug resistance was detected by the erythromycin and clindamycin double-disk method. The ermB, ermTR, mefA, and tetM genes were detected by PCR. Among the 1,240 ERSP strains, 510 were invasive isolates, and 730 were noninvasive isolates. The results of drug susceptibility testing showed that the rates of resistance to penicillin, amoxicillin, cefotaxime, ceftriaxone, meropenem, tetracycline, trimethoprim-sulfamethoxazole, and chloramphenicol varied among the different age groups. 19F, 19A, 23F, 14, and 6B were the serotypes that were commonly found among ERSP strains. Among all strains, 99.03% (1,228/1,240) exhibited an MLSB (macrolide-lincosamide-streptogramin B) resistance phenotype, of which 1,221 strains displayed a constitutive MLSB (cMLSB) phenotype and 7 strains showed an inducible MLSB (iMLSB) phenotype. All of these strains carried the ermB gene. In contrast, only 0.97% of strains of M phenotypes were found to carry the mefA gene. Both the ermB and mefA genes were detected in 704 strains that exhibited multidrug resistance, whereas the ermTR gene was not detected. Furthermore, 1,185 tetracycline-resistant strains were found to carry the tetM gene. Macrolide antimicrobial drugs should be used cautiously for the empirical treatment of S. pneumoniae infections. IMPORTANCE This study presents a retrospective analysis using 1,240 clinical erythromycin-resistant Streptococcus pneumoniae (ERSP) isolates collected in northeastern China between January 2000 and December 2019. The serotype distribution, corresponding vaccine coverage, as well as resistance phenotypes, genes, and mechanisms to macrolide and tetracycline of these isolates were systematically described, analyzed, and discussed. We hope that this study will inform clinicians in their respective regions when selecting antimicrobial agents. We also hope that this study is useful for researchers in related fields. Finally, we emphasize in this study that vaccination is the best preventive measure for S. pneumoniae infection considering its resistance to commonly used antibiotics. The determination of the S. pneumoniae serotype distribution also provides valuable empirical evidence for local health authorities when introducing appropriate vaccines in a specific area.
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8
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Zhu Y, Huang WE, Yang Q. Clinical Perspective of Antimicrobial Resistance in Bacteria. Infect Drug Resist 2022; 15:735-746. [PMID: 35264857 PMCID: PMC8899096 DOI: 10.2147/idr.s345574] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/18/2022] [Indexed: 12/22/2022] Open
Abstract
Antimicrobial resistance (AMR) has become a global clinical problem in recent years. With the discovery of antibiotics, infections were not a deadly problem for clinicians as they used to be. However, worldwide AMR comes with the overuse/misuse of antibiotics and the spread of resistance is deteriorated by a multitude of mobile genetic elements and relevant resistant genes. This review provides an overview of the current situation, mechanism, epidemiology, detection methods and clinical treatment for antimicrobial resistant genes in clinical important bacteria including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), penicillin-resistant Streptococcus pneumoniae (PRSP), extended-spectrum β-lactamase-producing Enterobacteriaceae, acquired AmpC β-lactamase-producing Enterobacteriaceae, carbapenemase-producing Enterobacteriaceae (CPE), multidrug-resistant (MDR) Acinetobacter baumannii and Pseudomonas aeruginosa.
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Affiliation(s)
- Ying Zhu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Wei E Huang
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| | - Qiwen Yang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Correspondence: Qiwen Yang; Wei E Huang, Email ;
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9
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Safari D, Putri HFM, Bimantari A, Paramaiswari WT, Tafroji W, Khoeri MM, Salsabila K. Genetic characterization of co-trimoxazole non-susceptible Streptococcus pneumoniae isolates from Indonesia. Access Microbiol 2021; 3:000271. [PMID: 34816091 PMCID: PMC8604174 DOI: 10.1099/acmi.0.000271] [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: 05/04/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
We investigated the genetic variation of folA and folP genes encoding dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR) enzymes amongst trimethoprim/sulfamethoxazole (co-trimoxazole) non-susceptible Streptococcus pneumoniae isolated from the Indonesian population. Archived S. pneumoniae isolates were screened for the presence and analysis of folA and folP genes using the polymerase chain reaction sequencing method. We found that 80 % of co-trimoxazole non-susceptible isolates (n=30/39) showed a 6 bp insertion in the sulphonamide-binding site of DHPS. The Asp-92-Ala and Ile-100-Leu substitutions were more common on DHFR (42 %; 22/53) followed by the Asp-92–Ala, Glu-94–Asp and Ile-100–Leu substitutions (32 %; 17/53). The combination of the Ile-100–Leu substitution at the DHFR region and the 6 bp insertion was the most dominant combination among isolates having both folA and folP genes.
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Affiliation(s)
- Dodi Safari
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
- *Correspondence: Dodi Safari,
| | - Hanifah Fajri Maharani Putri
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
- Biology Program, Surya University, Tangerang, Indonesia
| | | | | | - Wisnu Tafroji
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
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Pathogen spectrum changes of respiratory tract infections in children in Chaoshan area under the influence of COVID-19. Epidemiol Infect 2021. [PMCID: PMC8365104 DOI: 10.1017/s0950268821001606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
From 24 January 2020 to 18 May 2020, Chaoshan took measures to limit the spread of coronavirus disease 2019 (COVID-19), such as restricting public gatherings, wearing masks and suspending classes. We explored the effects of these measures on the pathogen spectrum of paediatric respiratory tract infections in Chaoshan. Pharyngeal swab samples were collected from 4075 children hospitalised for respiratory tract infection before (May–December 2019) and after (January–August 2020) the COVID-19 outbreak. We used liquid chip technology to analyse 14 respiratory pathogens. The data were used to explore between-group differences, age-related differences and seasonal variations in respiratory pathogens. The number of cases in the outbreak group (1222) was 42.8% of that in the pre-outbreak group (2853). Virus-detection rates were similar in the outbreak (48.3%, 590/1222) and pre-outbreak groups (51.5%, 1468/2853; χ2 = 3.446, P = 0.065), while the bacteria-detection rate was significantly lower in the outbreak group (26.2%, 320/1222) than in the pre-outbreak group (44.1%, 1258/2853; χ2 = 115.621, P < 0.05). With increasing age, the proportions of respiratory syncytial virus (RSV) and cytomegalovirus (CMV) infections decreased, while those of Mycoplasma pneumoniae and adenovirus infections increased. Streptococcus pneumoniae, CMV and rhinovirus infections peaked in autumn and winter, while RSV infections peaked in summer and winter. We found that the proportion of virus-only detection decreased with age, while the proportion of bacteria-only detection increased with age (Table 2). Anti-COVID-19 measures significantly reduced the number of paediatric hospitalisations for respiratory tract infections, significantly altered the pathogen spectrum of such infections and decreased the overall detection rates of 14 common respiratory pathogens. The proportion of bacterial, but not viral, infections decreased.
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Torumkuney D, Mokaddas E, Jiman-Fatani A, Ageel A, Daoud Z, Bouferraa Y, Zerdan MB, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2015-17 in the Middle East (Kuwait, Lebanon and Saudi Arabia): data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. J Antimicrob Chemother 2021; 75:i60-i75. [PMID: 32337592 DOI: 10.1093/jac/dkaa084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2015-17 from Kuwait, Lebanon and Saudi Arabia. METHODS MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS A total of 139 S. pneumoniae isolates were collected from four centres in Kuwait, Lebanon and Saudi Arabia in 2015-17 and 55 H. influenzae isolates were collected and analysed from Saudi Arabia over the same time period. Pneumococci from all three countries were commonly non-susceptible to penicillin based on CLSI oral or low-dose IV penicillin using EUCAST breakpoints (39% in Kuwait to 57.1% in Lebanon) but by CLSI IV and EUCAST high-dose breakpoints most isolates were susceptible (∼90% in Kuwait and Saudi Arabia, and 100% in Lebanon). Isolates from Lebanon were highly susceptible to most other antibiotics (>90%) except cefaclor, oral cefuroxime and cefpodoxime (EUCAST breakpoints only). Overall, susceptibility was significantly lower in Kuwait and Saudi Arabia than Lebanon. Although all H. influenzae isolates (Saudi Arabia only) were β-lactamase negative, 3.6% and 12.7% were ampicillin resistant by CLSI and EUCAST breakpoints, respectively. Otherwise susceptibility was high in H. influenzae. The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. CONCLUSIONS Relatively low antibiotic susceptibility was observed in S. pneumoniae from Kuwait and Saudi Arabia in contrast to Lebanon, where rates of susceptibility were generally higher. Isolates of H. influenzae from Saudi Arabia were susceptible to most antibiotics. These factors are important in decision making for empirical therapy of CA-RTIs.
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Affiliation(s)
- D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | - E Mokaddas
- Microbiology Department, Faculty of Medicine, Kuwait University, Jabrya, Kuwait
| | - A Jiman-Fatani
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia and Clinical and Molecular Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - A Ageel
- Pathology and Clinical Laboratory Medicine Administration, King Fahad Medical City, Dhabab Street, PO Box 59046 Riyadh, Saudi Arabia
| | - Z Daoud
- Faculty of Medicine and Medical Sciences, University of Balamand, Al Koura, Tripoli, Lebanon
| | - Y Bouferraa
- Faculty of Medicine and Medical Sciences, University of Balamand, Al Koura, Tripoli, Lebanon
| | - M B Zerdan
- Faculty of Medicine and Medical Sciences, University of Balamand, Al Koura, Tripoli, Lebanon
| | - I Morrissey
- IHMA Europe Sàrl, Route de l'Ile-au-Bois 1A, 1870 Monthey/VS, Switzerland
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Abboud Z, Galuppo L, Tolone M, Vitale M, Puleio R, Osman M, Loria GR, Hamze M. Molecular Characterization of Antimicrobial Resistance and Virulence Genes of Bacterial Pathogens from Bovine and Caprine Mastitis in Northern Lebanon. Microorganisms 2021; 9:1148. [PMID: 34071800 PMCID: PMC8228836 DOI: 10.3390/microorganisms9061148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/08/2021] [Accepted: 05/18/2021] [Indexed: 12/26/2022] Open
Abstract
Mastitis is an infectious disease encountered in dairy animals worldwide that is currently a growing concern in Lebanon. This study aimed at investigating the etiology of the main mastitis-causing pathogens in Northern Lebanon, determining their antimicrobial susceptibility profiles, and identifying their antimicrobial resistance (AMR) genes. A total of 101 quarter milk samples were collected from 77 cows and 11 goats presenting symptoms of mastitis on 45 dairy farms. Bacterial identification was carried out through matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Antimicrobial susceptibility was tested by disc diffusion and broth microdilution methods. Molecular characterization included polymerase chain reaction (PCR) screening for genes encoding extended-spectrum beta-lactamases (ESBLs) and plasmid-mediated AmpC among Enterobacterales isolates, and virulence factors among Staphylococcus isolates. Escherichia coli isolates were subjected to phylogenetic typing by a quadruplex PCR method. The most frequently identified species were Streptococcus uberis (19.2%), Streptococcus agalactiae (15.1%), E. coli (12.3%), and Staphylococcus aureus (10.96%). Gram-positive bacteria were resistant to macrolides and tetracycline, whereas gram-negative bacteria displayed resistance to ampicillin and tetracycline. Two ESBL genes, blaTEM (83.3%) and blaOXA (16.7%), and one AmpC beta-lactamase gene, blaCMY-II (16.7%), were detected among six E. coli isolates, which mainly belonged to phylogenetic group B1. Among Staphylococcus spp., the mecA gene was present in three isolates. Furthermore, four isolates contained at least one toxin gene, and all S. aureus isolates carried the ica operon. These findings revealed the alarming risk of AMR in the Lebanese dairy chain and the importance of monitoring antimicrobial usage.
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Affiliation(s)
- Zahie Abboud
- Laboratoire Microbiologie Santé et Environnement, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli P.O. Box 146404, Lebanon;
| | - Lucia Galuppo
- Istituto Zooprofilattico Sperimentale della Sicilia, Via G. Marinuzzi 3, 90129 Palermo, Italy; (L.G.); (M.V.); (R.P.)
| | - Marco Tolone
- Dipartimento di Scienze Agrarie, Alimentari e Forestali, University of Palermo, Viale delle Scienze, 90128 Palermo, Italy;
| | - Maria Vitale
- Istituto Zooprofilattico Sperimentale della Sicilia, Via G. Marinuzzi 3, 90129 Palermo, Italy; (L.G.); (M.V.); (R.P.)
| | - Roberto Puleio
- Istituto Zooprofilattico Sperimentale della Sicilia, Via G. Marinuzzi 3, 90129 Palermo, Italy; (L.G.); (M.V.); (R.P.)
| | - Marwan Osman
- Laboratoire Microbiologie Santé et Environnement, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli P.O. Box 146404, Lebanon;
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA
| | - Guido Ruggero Loria
- Istituto Zooprofilattico Sperimentale della Sicilia, Via G. Marinuzzi 3, 90129 Palermo, Italy; (L.G.); (M.V.); (R.P.)
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement, Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli P.O. Box 146404, Lebanon;
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Khademi F, Sahebkar A. Is Penicillin-Nonsusceptible Streptococcus pneumoniae a Significant Challenge to Healthcare System? A Systematic Review and Meta-Analysis. SCIENTIFICA 2021; 2021:5573345. [PMID: 34136307 PMCID: PMC8175142 DOI: 10.1155/2021/5573345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In recent years, antibiotic-resistant pathogens including penicillin-nonsusceptible Streptococcus pneumoniae (PNSP) have posed serious threats against human health. The aim of this meta-analysis was to investigate the prevalence of Streptococcus pneumoniae drug resistance particularly the incidence of PNSP strains in Iran. METHODS A systematic search was done in national and international electronic databases using Persian and English keywords. Up until May 20, 2020, a total of 58 publications were detected as eligible articles based on the inclusion and exclusion criteria, and then the selected studies were enrolled for data extraction and meta-analysis according to the PRISMA guidelines. RESULTS A high rate of PNSP (46.9%) and multidrug-resistant (MDR) S. pneumoniae (45.3%) in our isolates were evident. Furthermore, total frequency resistance to other drugs in S. pneumoniae was as follows: erythromycin 41.1%, azithromycin 53.2%, tetracycline 39.9%, levofloxacin 1.7%, rifampin 1.2%, clindamycin 31.7%, vancomycin 1.7%, trimethoprim/sulfamethoxazole 63.9%, chloramphenicol 20%, ceftriaxone 10.9%, amoxicillin 30.5%, ciprofloxacin 8.3%, imipenem 6.1%, linezolid 0%, and cefotaxime 8.3%. CONCLUSION Although the overall prevalence of cephalosporin- and carbapenem-resistant Streptococcus pneumoniae was low, penicillin-resistant strains, especially PNSP, could become a significant challenge to the healthcare system in Iran. Hence, the prescription of penicillin as the first-choice antibiotic in the treatment of S. pneumoniae infections should be avoided.
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Affiliation(s)
- Farzad Khademi
- Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Lannes-Costa PS, de Oliveira JSS, da Silva Santos G, Nagao PE. A current review of pathogenicity determinants of Streptococcus sp. J Appl Microbiol 2021; 131:1600-1620. [PMID: 33772968 DOI: 10.1111/jam.15090] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/16/2021] [Accepted: 03/24/2021] [Indexed: 12/16/2022]
Abstract
The genus Streptococcus comprises important pathogens, many of them are part of the human or animal microbiota. Advances in molecular genetics, taxonomic approaches and phylogenomic studies have led to the establishment of at least 100 species that have a severe impact on human health and are responsible for substantial economic losses to agriculture. The infectivity of the pathogens is linked to cell-surface components and/or secreted virulence factors. Bacteria have evolved sophisticated and multifaceted adaptation strategies to the host environment, including biofilm formation, survival within professional phagocytes, escape the host immune response, amongst others. This review focuses on virulence mechanism and zoonotic potential of Streptococcus species from pyogenic (S. agalactiae, S. pyogenes) and mitis groups (S. pneumoniae).
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Affiliation(s)
- P S Lannes-Costa
- Laboratory of Molecular Biology and Physiology of Streptococci, Institute of Biology Roberto Alcantara Gomes, Rio de Janeiro State University (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - J S S de Oliveira
- Laboratory of Molecular Biology and Physiology of Streptococci, Institute of Biology Roberto Alcantara Gomes, Rio de Janeiro State University (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - G da Silva Santos
- Laboratory of Molecular Biology and Physiology of Streptococci, Institute of Biology Roberto Alcantara Gomes, Rio de Janeiro State University (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - P E Nagao
- Laboratory of Molecular Biology and Physiology of Streptococci, Institute of Biology Roberto Alcantara Gomes, Rio de Janeiro State University (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
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Ayehubizu Z, Mulu W, Biadglegne F. Common bacterial causes of external ocular infections, associated risk factors and antibiotic resistance among patients at ophthalmology unit of Felege Hiwot Referral Hospital, Northwest Ethiopia: a cross-sectional study. J Ophthalmic Inflamm Infect 2021; 11:7. [PMID: 33644821 PMCID: PMC7917034 DOI: 10.1186/s12348-021-00238-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 02/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ocular infections are a serious public health problem in Ethiopia with increased incidence of morbidity and blindness. Empirical therapy with topical ophthalmic broad spectrum antibiotic formulations is also a prevailing practice. The aim of this study was to determine the bacterial causes of external ocular infections (EOIs), antimicrobial resistance and its associated risk factors among patients at Felege Hiwot Referral Hospital, Northwest Ethiopia. METHODS A hospital based cross - sectional study was conducted from 1 February to 30 April 2019. Patients with EOIs were consecutively included from 1 February to 30 April, 2019. Data were collected using structured questionnaire by face-to-face interview and complemented with patient card review. Conjunctival, eyelid margin and lacrimal sac swabs were collected aseptically. Bacterial species were identified using standard bacteriological techniques. Antimicrobial susceptibility testing was done using Kirby-Bauer disk diffusion method. Binary logistic regression analysis was calculated to identify the factors associated with EOIs. P.value (p) < < 0.05 was considered as statistically significant. RESULTS A total of 360 patients took part in the study and majority of them were males (64.7%). The median age of study participants was 59.5 years. Overall, 208(57.8%) (95%CI = 52.6- - 62.8%) of patients had culture confirmed bacterial EOIs. The proportion of culture confirmed EOIs was 60.4% among conjunctivitis cases and 55.8% among blepharitis. Ocular trauma (P < < 0.001), ocular disease (P < < 0.001) and having eye allergy (P = 0.027) were significantly associated with EOIs. The most frequent isolates were S. aureus (37%), K. pneumoniae (13.5%), Proteus(7.2%) spp., S. pneumoniae (4.3%), Citrobacter spp. (3.4%) and P. aeruginosa (2.9%). Gram positive isolates were resistant to penicillin in 87% and ampicillin in 86.2%. Gram negative isolates were resistant to ampicillin (87.5%). P.aeruginosa isolates (85.3%) were resistant to piperacillin and 50% were resistant to tobramycin. Overall, 45.2% of the isolates were multi-drug resistant. The percentage of multi-drug resistance was 80% among Enterobacter isolates and 64.3% among K. pneumoniae. CONCLUSIONS Bacterial external ocular infections linked with multi-drug resistance and resistance to penicillin, ampicillin, tetracycline and piperacillin are high. Therefore, empirical treatment of eye infections in the study area needs to be monitored by regular antimicrobial-susceptibility testing of isolates.
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Affiliation(s)
- Zimam Ayehubizu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wondemagegn Mulu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Fantahun Biadglegne
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Reslan L, Finianos M, Bitar I, Moumneh MB, Araj GF, Zaghlout A, Boutros C, Jisr T, Nabulsi M, Kara Yaccoub G, Hamze M, Osman M, Bou Raad E, Hrabak J, Matar GM, Dbaibo G. The Emergence of Invasive Streptococcus pneumoniae Serotype 24F in Lebanon: Complete Genome Sequencing Reveals High Virulence and Antimicrobial Resistance Characteristics. Front Microbiol 2021; 12:637813. [PMID: 33746930 PMCID: PMC7967862 DOI: 10.3389/fmicb.2021.637813] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/29/2021] [Indexed: 12/16/2022] Open
Abstract
Background Invasive pneumococcal disease (IPD) remains a global health problem. IPD incidence has significantly decreased by the use of pneumococcal conjugate vaccines (PCV). Nevertheless, non-PCV serotypes remain a matter of concern. Eight Streptococcus pneumoniae serotype 24F isolates, belonging to a non-PCV serotype, were detected through the Lebanese Inter-Hospital Pneumococcal Surveillance Program. The aim of the study is to characterize phenotypic and genomic features of the 24F isolates in Lebanon. Methods WGS using long reads sequencing (PacBio) was performed to produce complete circular genomes and to determine clonality, antimicrobial resistance and virulence determinants. Results The sequencing results yielded eight closed circular genomes. Three multilocus sequence typing (MLST) types were identified (ST11618, ST14184, ST15253). Both MLST and WGS analyses revealed that these isolates from Lebanon were genetically homogenous belonging to clonal complex CC230 and clustered closely with isolates originating from Canada, United States of America, United Kingdom and Iceland. Their penicillin binding protein profiles correlated with both β-lactam susceptibility patterns and MLST types. Moreover, the isolates harbored the macrolide and tetracycline resistance genes and showed a similar virulence gene profile. To our knowledge, this study represents the first report of complete phenotypic and genomic characterization of the emerging Streptococcus pneumoniae, serotype 24F, in the Middle East and North Africa region.
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Affiliation(s)
- Lina Reslan
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Marc Finianos
- Department of Microbiology, Faculty of Medicine and University Hospital in Plzen, Charles University, Plzen, Czechia
| | - Ibrahim Bitar
- Department of Microbiology, Faculty of Medicine and University Hospital in Plzen, Charles University, Plzen, Czechia
| | - Mohamad Bahij Moumneh
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - George F Araj
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Alissar Zaghlout
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Celina Boutros
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon
| | - Tamima Jisr
- Department of Laboratory and Blood, Makassed General Hospital, Beirut, Lebanon
| | | | | | - Monzer Hamze
- Department of Microbiology, Nini Hospital, Tripoli, Lebanon
| | - Marwan Osman
- El-Youssef Hospital Center, Department of Clinical Laboratory, Halba, Lebanon
| | - Elie Bou Raad
- El-Youssef Hospital Center, Department of Clinical Laboratory, Halba, Lebanon
| | - Jaroslav Hrabak
- Department of Microbiology, Faculty of Medicine and University Hospital in Plzen, Charles University, Plzen, Czechia
| | - Ghassan M Matar
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Experimental Pathology, Immunology, and Microbiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan Dbaibo
- Center for Infectious Diseases Research (CIDR) and WHO Collaborating Center for Reference and Research on Bacterial Pathogens, American University of Beirut, Beirut, Lebanon.,Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Truppa C, Abo-Shehada MN. Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: a systematic review. BMC Infect Dis 2020; 20:936. [PMID: 33297983 PMCID: PMC7724697 DOI: 10.1186/s12879-020-05503-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In spite of the evident general negative effects of armed conflict on countries' health systems and populations' health outcomes, little is known about similar impacts of conflicts on the spread of antimicrobial resistances (AMR). This review was to address this evidence gap and describe: 1. Patterns of AMR in the Middle East (ME) and resistance profiles of pathogens included in the Global AMR Surveillance System (GLASS) supported by the World Health Organization; 2. Differences in proportions of AMR isolates between conflict and non-conflict countries. METHODS A systematic literature review was conducted following PRISMA guidelines and searching five electronic databases. Subject heading and free text were searched for "antimicrobial resistances" and "Middle East", to identify observational studies on AMR published from January 2011 to June 2018. Data were extracted from included articles on a predefined set of variables. Percentages of AMR were analysed as median and interquartile ranges. Risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 132 articles met the inclusion criteria. Included studies showed heterogeneity in study design, laboratory methods and standards for interpretation of results, and an overall high risk of bias. Main findings were the following: 1. High proportions of carbapenem resistance in Acinetobacter spp. (median 74.2%), and both carbapenem resistance (median 8.1 and 15.4% for E. coli and K. pneumoniae respectively) and ESBL-production (median 32.3 and 27.9% for E. coli and K. pneumoniae respectively) amongst Enterobacteriaceae. S. aureus isolates showed a median methicillin resistance percentage of 45.1%, while vancomycin resistance was almost absent. A median of 50% of the strains of S. pneumoniae showed non-susceptibility to penicillin. 2. Similar trends were observed in conflict and non-conflict affected countries. CONCLUSIONS There is a lack of standardization in the methodological approach to AMR research in the Middle East. The proportion of antibiotic resistances among specific GLASS pathogens is high, particularly among Acinetobacter spp.
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Affiliation(s)
- Claudia Truppa
- International Committee of the Red Cross, Geneva, Switzerland
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Mahmoud N. Abo-Shehada
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
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Seid M, Beyene G, Alemu Y, Workalemahu B, Delbo M, Taddesse D, Biresaw G, Manilal A. Does cotrimoxazole prophylaxis in HIV patients increase the drug resistance of pneumococci? A comparative cross-sectional study in southern Ethiopia. PLoS One 2020; 15:e0243054. [PMID: 33284828 PMCID: PMC7721141 DOI: 10.1371/journal.pone.0243054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/15/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Infections caused by antibiotic-resistant bacteria results in high rates of morbidity and mortality. Although the prolonged cotrimoxazole (CTX) prophylaxis is arguably associated with the risk of increasing drug resistance in the common pathogens, information regarding its impact on Streptococci pneumoniae / pneumococcus is very limited. OBJECTIVE This study was conducted to investigate the effect of cotrimoxazole prophylaxis on nasopharyngeal colonization rate and antimicrobial resistance using Streptococci pneumoniae (pneumococcus) as an indicator organism among HIV patients in Arba Minch, Ethiopia. MATERIALS AND METHODS A comparative cross-sectional study was designed and conducted among HIV patients attending the Anti-Retroviral Treatment (ART) clinic of Arba Minch General Hospital (AMGH) from April 01 to August 31, 2018. A total of 252 participants were systematically selected and clustered into two study groups based on their CTX prophylaxis status, one taking CTX prophylaxis, and the second one, the control group (without prophylaxis). A structured questionnaire was used to collect socio-demographic and clinical data from patients. A nasopharyngeal swab was collected and cultured for pneumococcal isolation and identification in accordance with standard microbiological techniques. An antibiotics sensitivity test was performed according to the CLSI guidelines. Data were analyzed using the Statistical package for social science (SPSS) version 20. The primary outcome was determined using logistic regression analysis. RESULTS Of the 252 enrolled HIV patients (mean age (37.38± 9.03 years), 144 (57.14%) were males. The overall, nasopharyngeal colonization rate of S. pneumoniae was 13.5% (95% CI: 8.4-15.6). Asymptomatic pneumococcal carriage rates among patients on CTX prophylaxis and the control group were 16.3%, and 10.3% respectively (p-value = 0.03). Regarding the risk factors analyzed, CTX prophylaxis (AOR: 2.2; 95% CI: 1.05-4.9) and gender (AOR: 2.5; 95% CI: 1.09-5.93) were significantly associated with pneumococcal colonization, showing a male preponderance. Cotrimoxazole-resistant pneumococci were 85.7% vs. 47.4% in the prophylaxis group and the control group respectively and it was statistically significant (AOR: 6.7; 95% CI: 1.3-36). Percentages of multi-drug resistant isolates in these two groups were 38.09 and 15.38 respectively (p-value = 0.04). Among the CTX resistant pneumococci isolates, 85% were also found to be co-resistant towards penicillin and was statistically significant. CONCLUSION The percentage prevalence of nasopharyngeal pneumococci colonization was higher in patients taking CTX prophylaxis. It was noted that CTX prophylaxis eventually results in the selection of cotrimoxazole resistance and multi-drug resistance in pneumococci. There is evidence of existing cross-resistance between cotrimoxazole and penicillin antibiotics. Therefore, CTX prophylaxis must be administered judiciously. Surveillance for antimicrobial susceptibility is warranted where the prophylaxis is common.
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Affiliation(s)
- Mohammed Seid
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- * E-mail: (MS); (AM)
| | - Getnet Beyene
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Yared Alemu
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Bereket Workalemahu
- Department of Medical Laboratory Science, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
| | - Mulugeta Delbo
- Department of Medical Laboratory Science, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
| | - Dagimawie Taddesse
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gelila Biresaw
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Aseer Manilal
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- * E-mail: (MS); (AM)
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Beheshti M, Jabalameli F, Feizabadi MM, Hahsemi FB, Beigverdi R, Emaneini M. Molecular characterization, antibiotic resistance pattern and capsular types of invasive Streptococcus pneumoniae isolated from clinical samples in Tehran, Iran. BMC Microbiol 2020; 20:167. [PMID: 32546124 PMCID: PMC7298763 DOI: 10.1186/s12866-020-01855-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/12/2020] [Indexed: 11/18/2022] Open
Abstract
Background Streptococcus pneumoniae causes serious infections worldwide. The aim of this study was to determine the molecular characteristic, antibiotic resistance pattern and capsular types of invasive S. pneumoniae in Tehran, Iran. Results Of the 44 pneumococcal invasive isolates, 39 (89%) were isolated from children and 5 (11%) from adults. The results show that all pneumococcal isolates were susceptible to linezolid but had varying resistance to trimethoprim-sulfamethoxazole (86%), erythromycin (73%), tetracycline (66%), clindamycin (43%), penicillin (16%), chloramphenicol (14%) and levofloxacin (2%). The range of erythromycin, tetracycline and penicillin MICs were 2 - ≥ 256 μg/mL, 4 - ≥ 48 μg/mL, and 0.047 - ≥ 256 respectively. All of the penicillin resistant isolates were multidrug resistant (MDR) and in addition to penicillin were resistant to tetracycline, erythromycin and trimethoprim-sulfamethoxazole. The most common capsular types detected in 64% of the pneumococcal isolates was 6A/B, 19A, 15A, 23F. The multilocus sequence typing (MLST) of 10 pneumococcal isolates revealed 9 different sequence types (STs), including ST 15139 (capsular type 19A) and ST 15140 (capsular type 23F), which have not previously been reported. Conclusions The study revealed that the S. pneumoniae isolates belonged to diverse capsular types and clones with high rate of resistance to erythromycin, tetracycline, and penicillin.
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Affiliation(s)
- Maryam Beheshti
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina St., Keshavarz Blvd, Tehran, 14167-53955, Iran
| | - Fereshteh Jabalameli
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina St., Keshavarz Blvd, Tehran, 14167-53955, Iran
| | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina St., Keshavarz Blvd, Tehran, 14167-53955, Iran
| | - Farhad Bonakdar Hahsemi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina St., Keshavarz Blvd, Tehran, 14167-53955, Iran
| | - Reza Beigverdi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina St., Keshavarz Blvd, Tehran, 14167-53955, Iran
| | - Mohammad Emaneini
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Building No. 7, 100 Poursina St., Keshavarz Blvd, Tehran, 14167-53955, Iran.
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20
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Habibi Ghahfarokhi S, Mosadegh M, Ahmadi A, Pourmand MR, Azarsa M, Rahbar M, Nikmanesh B. Serotype Distribution and Antibiotic Susceptibility of Streptococcus pneumoniae Isolates in Tehran, Iran: A Surveillance Study. Infect Drug Resist 2020; 13:333-340. [PMID: 32099424 PMCID: PMC7007777 DOI: 10.2147/idr.s234295] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 01/23/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Encapsulated Streptococcus pneumoniae strains cause high morbidity and mortality, mainly in countries with no pneumococcal conjugate vaccines (PCVs) immunization program. This study investigated the epidemiological changes of S. pneumoniae isolates including serotype distribution and antimicrobial susceptibility in Tehran, Iran. Methods A total of 80 S. pneumoniae samples were collected from patients admitted to Shariati hospital over two periods. Half of the isolates were collected from February to September 2017 and the other half from July 2018 to March 2019. The antimicrobial susceptibility testing and PCV-13 serotype coverage of S. pneumoniae isolates were evaluated among patients with invasive and non-invasive infections. Results The most common serotypes were 23F (17.5%), 14 (16.3%), 3 (16.3%) 19F (12.5%), and 19A (12.5%) in the present study. The vaccine coverage rates of PCV-7, PCV-10 and PCV-13 were 52.6%, 52.6%, and 83.7%, respectively. S. pneumoniae isolates with the serotype of the PCV-13 showed an increasing trend during the study. Nearly half of the S. pneumoniae strains were MDR, while MDR serotype 19A increased (40%) during the study periods. A small minority of isolates (16%) belonged to non-vaccine serotypes, 65% of which were assigned to MDR. In general, the frequency of penicillin resistant and MDR strains were estimated about 27.5% and 51%, respectively. An increase was observed in resistance to erythromycin and co-trimoxazole. Conclusion The results showed that majority of the circulating serotypes in our study are related to PCV-13 serotypes. The use of conjugate vaccine in the immunization program and surveillance of antimicrobial resistance can be effective in reducing the pneumococcal clinical burden.
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Affiliation(s)
- Soheila Habibi Ghahfarokhi
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Mosadegh
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadi
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Pourmand
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Azarsa
- Department of Microbiology, Khoy University of Medical Sciences, Khoy, Iran
| | - Mohammad Rahbar
- Department of Microbiology, Reference Health Laboratories Research Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Bahram Nikmanesh
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Tannous R, Haddad RN, Torbey PH. Management of Community-Acquired Pneumonia in Pediatrics: Adherence to Clinical Guidelines. Front Pediatr 2020; 8:302. [PMID: 32637387 PMCID: PMC7316885 DOI: 10.3389/fped.2020.00302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 05/11/2020] [Indexed: 12/04/2022] Open
Abstract
Objectives: To evaluate adherence to guidelines for inpatient care of pediatric patients with community-acquired pneumonia (CAP). Background: Pediatric CAP is one of the most common acute infections requiring hospital admission. Discrepancies between recommended care and effective management are reported, raising the necessity to evaluate our local clinical practices. Patients and Methods: Retrospective data review of all children hospitalized for CAP at our institution was conducted between 2014 and 2017. Adherence to inpatient care guidelines was evaluated with a focus on indication of hospitalization, initial antibiotic choice, treatment duration, and hospital stay. A bivariate analysis was performed to identify clinical factors influencing adherence rates. Results: A total of 122 children (median age of 3.5 years) were identified. Hospital admission was indicated in 47.5% of patients and was driven by the value of serum CRP as well as prolonged fever. Median hospital stay was 4 days and was justified in 23.8% of patients. The choice of antibiotics was relevant in 91.8% of cases and amoxicillin-clavulanate was the most prescribed drug. The drugs dose, interval, and route of administration were respected in all cases. Antimicrobial therapy lasted for a median of 10 days and was in accordance with recommendations in 58.3% of patients. No clinical parameter was found to be significantly associated with length of stay or choice and duration of treatment. Conclusions: The choice of antibiotics was consistent with guidelines but treatment duration, indication and length of hospitalization still need to be improved.
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Affiliation(s)
- Rim Tannous
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Raymond N Haddad
- Department of Pediatrics, Hotel Dieu de France University Medical Center, Saint Joseph University, Beirut, Lebanon
| | - Paul-Henri Torbey
- Division of Pediatric Pulmonology, Department of Pediatrics, Hotel Dieu de France University Medical Center, Saint Joseph University, Beirut, Lebanon
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Osman M, Kamal-Dine K, El Omari K, Rafei R, Dabboussi F, Hamze M. Prevalence of Staphylococcus aureus methicillin-sensitive and methicillin-resistant nasal carriage in food handlers in Lebanon: a potential source of transmission of virulent strains in the community. Access Microbiol 2019; 1:e000043. [PMID: 32974533 PMCID: PMC7470302 DOI: 10.1099/acmi.0.000043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/25/2019] [Indexed: 11/22/2022] Open
Abstract
Purpose To determine the prevalence and virulence determinant genes of nasal colonization by Staphylococcus aureus among food handlers in Tripoli, Lebanon. Methodology Within a cross-sectional study design, nasal swab specimens were collected. Epidemiological and microbiological investigations were performed through conventional culture and MALDI-TOF-MS. Antibiotic susceptibility patterns and genetic virulence determinants including enterotoxin genes were also investigated for all isolates. Results The data herein show that S. aureus nasal carriage is highly prevalent (23.8 %), and that the rate of methicillin-resistant S. aureus (MRSA) carriage was twice as high as in our last report in 2008. Several enterotoxin genes were detected in five isolates including one MRSA and four methicillin-sensitive S. aureus. Conclusion To our knowledge, this is the first investigation in the last decade to examine the carriage prevalence of S. aureus among food handlers in Lebanon. This work reports a concerning level of MRSA, and enterotoxin-producing S. aureus nasal carriage, which could potentially act as a contamination reservoir and lead to food poisoning.
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Affiliation(s)
- Marwan Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Khadija Kamal-Dine
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Khaled El Omari
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Quality Control Center Laboratories at the Chamber of Commerce, Industry & Agriculture of Tripoli & North Lebanon, Tripoli, Lebanon
| | - Rayane Rafei
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Fouad Dabboussi
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
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Khoder M, Osman M, Diene SM, Okdah L, Lalaoui R, Al Achkar M, Mallat H, Hamze M, Rolain JM. Evaluation of different testing tools for the identification of non-gonococcal Neisseria spp. isolated from Lebanese male semen: a strong and significant association with infertility. J Med Microbiol 2019; 68:1012-1020. [DOI: 10.1099/jmm.0.000990] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- May Khoder
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
- Aix-Marseille University, IRD, APHM, MEPHI, IHU Méditerranée infection, Faculté de Médecine et de Pharmacie, 19-21 boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
| | - Marwan Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Seydina M. Diene
- Aix-Marseille University, IRD, APHM, MEPHI, IHU Méditerranée infection, Faculté de Médecine et de Pharmacie, 19-21 boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
| | - Liliane Okdah
- Aix-Marseille University, IRD, APHM, MEPHI, IHU Méditerranée infection, Faculté de Médecine et de Pharmacie, 19-21 boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
| | - Rym Lalaoui
- Aix-Marseille University, IRD, APHM, MEPHI, IHU Méditerranée infection, Faculté de Médecine et de Pharmacie, 19-21 boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
| | | | - Hassan Mallat
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Jean-Marc Rolain
- Aix-Marseille University, IRD, APHM, MEPHI, IHU Méditerranée infection, Faculté de Médecine et de Pharmacie, 19-21 boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
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Osman M, Al Mir H, Rafei R, Dabboussi F, Madec JY, Haenni M, Hamze M. Epidemiology of antimicrobial resistance in Lebanese extra-hospital settings: An overview. J Glob Antimicrob Resist 2019; 17:123-129. [DOI: 10.1016/j.jgar.2018.11.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/07/2018] [Accepted: 11/26/2018] [Indexed: 01/14/2023] Open
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Akdoğan Kittana FN, Mustak IB, Hascelik G, Saricam S, Gurler N, Diker KS. Erythromycin-resistant Streptococcus pneumoniae: phenotypes, genotypes, transposons and pneumococcal vaccine coverage rates. J Med Microbiol 2019; 68:874-881. [PMID: 31116101 DOI: 10.1099/jmm.0.000995] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To assess the antibiotic resistance, transposon profiles, serotype distribution and vaccine coverage rates in 110 erythromycin-resistant S. pneumoniae clinical isolates. METHODOLOGY Erythromycin, clindamycin, tetracycline, chloramphenicol and kanamycin susceptibilities were assessed using the E-test/disc diffusion method. Inducible macrolide resistance was tested using the erythromycin-clindamycin double disc diffusion test. Serogrouping and serotyping were performed using latex particle agglutination and the Quellung reaction, respectively. Drug resistance genes and transposon-specific genes were investigated by PCR. RESULTS Of the isolates, 93 % were resistant to clindamycin; 81 % were resistant to tetracycline; 76 % were multi-drug-resistant, having resistance to both clindamycin and tetracycline; and 12 % had extended-drug resistance, being resistant to clindamycin, tetracycline, chloramphenicol and kanamycin. The majority of isolates (88.2 %) exhibited the cMLSB phenotype. The association between the cMLSB phenotype and tetracycline resistance was related to transposons Tn2010 (38.2 %), Tn6002 (21.8 %) and Tn3872 (18.2 %). M and iMLSB phenotypes were observed in 7 and 5 % of the isolates, respectively. The most frequent serotype was 19 F (40 %). Among the erythromycin-resistant pneumococci, vaccine coverage rates for the 13-valent pneumococcal conjugate vaccine (PCV-13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV-23) were 76.4 and 79.1 %, respectively, compared to 82.2 and 85.1 % transposon-carrying isolates. CONCLUSIONS Multi-drug resistance among erythromycin-resistant S. pneumoniae isolates mainly occurs due to the horizontal spread of the Tn916 family of transposons. The majority of the transposon-carrying isolates are covered by 13- and 23-valent pneumococcal vaccines. Since serotype distribution and transposons in S. pneumoniae isolates may change over time, close monitoring is essential.
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Affiliation(s)
| | - Inci Basak Mustak
- 2 Ankara University, Faculty of Veterinary Science, Department of Microbiology, Ankara Turkey
| | - Gulsen Hascelik
- 1 Hacettepe University, Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Seyyide Saricam
- 2 Ankara University, Faculty of Veterinary Science, Department of Microbiology, Ankara Turkey
| | - Nezahat Gurler
- 3 Istanbul University, Faculty of Medicine, Department of Medical Microbiology, Istanbul, Turkey
| | - Kadir Serdar Diker
- 2 Ankara University, Faculty of Veterinary Science, Department of Microbiology, Ankara Turkey
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Zhang Z, Chen M, Yu Y, Pan S, Liu Y. Antimicrobial susceptibility among Streptococcus pneumoniae and Haemophilus influenzae collected globally between 2015 and 2017 as part of the Tigecycline Evaluation and Surveillance Trial (TEST). Infect Drug Resist 2019; 12:1209-1220. [PMID: 31190909 PMCID: PMC6524636 DOI: 10.2147/idr.s203121] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 04/08/2019] [Indexed: 12/23/2022] Open
Abstract
Purpose: In order to understand the prevalence of Streptococcus pneumoniae and Haemophilus influenzae globally and provide the basis for rational use of antimicrobials in clinical settings, in vitro activity of tigecycline and comparative agents was evaluated against 3929 S. pneumoniae and 4043 H. influenzae isolates obtained from 150 centers globally between 2015 and 2017 as a part of the Tigecycline Evaluation and Surveillance Trial (TEST). Methods: Broth microdilution methods were performed to determine the minimum inhibitory concentration (MIC) of the isolates according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). The CLSI breakpoint was used to determine antimicrobial susceptibilities, except for that of tigecycline, for which the US Food and Drug Administration (FDA) breakpoints were used. Results: More than 99% of S. pneumoniae isolates were susceptible to vancomycin (100%), linezolid (100%), tigecycline (99.9%), and levofloxacin (99.1%). Macrolides (erythromycin, azithromycin, and clarithromycin, 67.1-69.4% susceptibility globally) and penicillin (61.7% in globally) were the drugs with more resisitance to S. pneumoniae. Penicillin-intermediate and -resistant isolates were found in 24.8% and 13.6% of S. pneumoniae isolates. H. influenzae was highly susceptible (>98.7%) to all antibiotics tested except for ampicillin, for which susceptibility was 76.1%. The number of drugs with the lowest susceptibility calculated in Asia were far more than other regions, with 61.5% (8 in 13 drugs) in S. pneumoniae and 70.0% (7 in 10 drugs) in H. influenzae, respectively. Conclusions: Vancomycin, linezolid, tigecycline, and levofloxacin can be used as the first choice in the empirical therapy of infection disease caused by S. pneumoniae. But macrolides and penicillin should be used prudently in treatment of the infection caused by S. pneumoniae, as well as ampicillin treat the infection caused by H. influenzae. Asia was the region with the most severe resistance in S. pneumoniae and H. influenzae.
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Affiliation(s)
- Zhijie Zhang
- Clinical Laboratory Department, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
| | - Meng Chen
- Department of Rheumatology, Affiliated Hospital of Hebei University, Baoding, People’s Republic of China
| | - Ying Yu
- Medical Affairs Department, Pfizer Investment Co., Ltd, People’s Republic of China
| | - Sisi Pan
- Medical Affairs Department, Pfizer Investment Co., Ltd, People’s Republic of China
| | - Yong Liu
- Clinical Laboratory Department, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China
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Pneumococcal disease during Hajj and Umrah: Research agenda for evidence-based vaccination policy for these events. Travel Med Infect Dis 2019; 29:8-15. [DOI: 10.1016/j.tmaid.2018.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 12/30/2022]
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Sallam M, Abbadi J, Natsheh A, Ababneh NA, Mahafzah A, Özkaya Şahin G. Trends in Antimicrobial Drug Resistance of Streptococcus pneumoniae Isolates at Jordan University Hospital (2000⁻2018). Antibiotics (Basel) 2019; 8:E41. [PMID: 31013803 PMCID: PMC6628336 DOI: 10.3390/antibiotics8020041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 03/28/2019] [Accepted: 04/10/2019] [Indexed: 01/28/2023] Open
Abstract
Antimicrobial drug resistance (AMR) in pneumococci complicates the treatment of serious pneumococcal infections. Country-specific AMR patterns can help to establish guidelines for empiric therapy. The aim of the current study was to analyze the distribution of AMR among Streptococcus pneumoniae isolates at Jordan University Hospital (JUH) during 2000⁻2018. Paper-based and electronic clinical data registry records from 2000 to 2018 were retrospectively analyzed to study the AMR among pneumococcal isolates at JUH. Temporal trend analysis was done using two-tailed linear-by-linear test for association. The total number of unique pneumococcal isolates that were identified was 556, of which 544 isolates had antimicrobial susceptibility testing results. The most frequent specimens were eye (n = 117, 21.0%), bloodstream (n = 93, 16.7%) and sputum (n = 81, 14.6%). Invasive infections represented 23.6% of all unique isolates. The overall susceptibility of S. pneumoniae isolates during the study period to different antimicrobials was: 100% to vancomycin, 97.7% to ceftriaxone, 97.1% to cefotaxime, 94.9% to chloramphenicol, 89.7% to penicillin, 83.8% to levofloxacin, 67.7% to clindamycin and 52.1% to erythromycin. The prevalence of multi-drug resistance (MDR) was 8.6% (95% confidence interval: 6.4⁻11.5%). Trend analysis showed an increase in the prevalence of non-susceptibility to erythromycin, clindamycin and levofloxacin (p < 0.001). MDR prevalence increased from 1.6% in the first quarter to 14.6% in the fourth quarter (p < 0.001). The incidence of invasive infections declined over the study period (p < 0.001). The increase in the prevalence of AMR and MDR among pneumococcal isolates in Jordan demands judicious use of antimicrobials and regular surveillance of resistance.
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Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22362 Malmö, Sweden.
| | - Jumana Abbadi
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
| | - Anas Natsheh
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
| | - Nidaa A Ababneh
- Cell Therapy Center (CTC), The University of Jordan, Amman, Jordan.
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman 19328, Jordan.
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 22362, Jordan.
| | - Gülşen Özkaya Şahin
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22362 Malmö, Sweden.
- Department of Clinical Microbiology, Laboratory Medicine, Skåne University Hospital, 22362 Lund, Sweden.
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Al Omari S, Al Mir H, Wrayde S, Merhabi S, Dhaybi I, Jamal S, Chahine M, Bayaa R, Tourba F, Tantawi H, Al Atrouni A, El Omari K, Ayash O, Zeidan N, Mallat H, Dabboussi F, Hamze M, Osman M. First Lebanese Antibiotic Awareness Week campaign: knowledge, attitudes and practices towards antibiotics. J Hosp Infect 2019; 101:475-479. [DOI: 10.1016/j.jhin.2018.07.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/08/2018] [Indexed: 12/14/2022]
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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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Huang YY, Sun YH, Huang N, Liu XX, Yan J, Sun AH. Sublethal β-lactam antibiotics induce PhpP phosphatase expression and StkP kinase phosphorylation in PBP-independent β-lactam antibiotic resistance of Streptococcus pneumoniae. Biochem Biophys Res Commun 2018; 503:2000-2008. [PMID: 30135012 DOI: 10.1016/j.bbrc.2018.07.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 07/30/2018] [Indexed: 12/16/2022]
Abstract
StkP and PhpP of Streptococcus pneumoniae have been confirmed to compose a signaling couple, in which the former is a serine/threonine (Ser/Thr) kinase while the latter was annotated as a phosphotase. StkP has been reported to be involved in penicillin-binding protein (PBP)-independent penicillin resistance of S. pneumoniae. However, the enzymatic characterization of PhpP and the role of PhpP in StkP-PhpP couple remain poorly understood. Here we showed that 1/4 minimal inhibitory concentration (MIC) of penicillin (PCN) or cefotaxime (CTX), the representatives of β-lactam antibiotics, could induce the expression of stkP and phpP genes and phosphorylation of StkP in PCN/CTX-sensitive strain ATCC6306 and three isolates of S. pneumoniae (MICs: 0.02-0.5 μg/ml). The product of phpP gene hydrolyzed PP2C type Ser/Thr phosphotase-specific RRA (pT)VA phosphopeptide substrate with the Km and Kcat values of 277.35 μmoL/L and 0.71 S-1, and the hydrolytic activity was blocked by sodium fluoride, a PP2C type Ser/Thr phosphatase inhibitor. The phosphorylation levels of StkP in the four phpP gene-knockout (ΔphpP) mutants were significantly higher than that in the wild-type strains. In particular, the MICs of PCN and CTX against the ΔphpP mutants were significantly elevated as 4-16 μg/ml. Therefore, our findings confirmed that sublethal PCN and CTX act as environmental inducers to cause the increase of phpP and stkP gene expression and StkP phosphorylation. PhpP is a PP2C type Ser/Thr protein phosphatase responsible for dephosphorylation of StkP. Knockout of the phpP gene results in a high level of StkP phosphorylation and PBP-independent PCN/CTX resistance of S. pneumoniae.
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Affiliation(s)
- Yan-Ying Huang
- Faculty of Basic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, 310053, PR China; Department of Pathology, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, 310003, PR China.
| | - Yan-Hong Sun
- Department of Laboratory Medicine, The Children's Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310052, PR China.
| | - Nan Huang
- College of Medical Technology, Zhang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China.
| | - Xiao-Xiang Liu
- Faculty of Basic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, 310053, PR China.
| | - Jie Yan
- Division of Basic Medical Microbiology, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, PR China; Department of Medical Microbiology and Parasitology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, PR China.
| | - Ai-Hua Sun
- Faculty of Basic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, 310053, PR China.
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Gene expression analysis for pneumonia caused by Gram-positive bacterial infection. Exp Ther Med 2018; 15:3989-3996. [PMID: 29581747 DOI: 10.3892/etm.2018.5904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/25/2017] [Indexed: 12/14/2022] Open
Abstract
Gram-positive bacteria are an important pathogenic factor for bacterial pneumonia. The aim of the present study was to identify the differentially expressed genes (DEGs) and to explore their associated pathways or expression patterns. Expression profiling of gene arrays from two independent datasets, GSE6269 and GSE35716, were downloaded from the Gene Expression Omnibus. The DEGs between peripheral blood samples from healthy controls and patients with bacterial pneumonia were identified. The Functional Annotation Tool in the Database for Annotation, Visualization and Integrated Discovery was used to annotate and analyze the DEGs in Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Multiple proteins were used to generate a protein-protein interaction (PPI) network. A total of 624 (621 annotated) were identified in the GSE6269 dataset and 398 (295 annotated) DEGs were identified in the GSE35716 dataset between pneumonia and healthy samples. A total of 40 common DEGs were identified between the 2 datasets, including 4 downregulated and 32 upregulated DEGs. In the GO category cellular component, melanosome was highly enriched among 11 genes; in the category biological process, the three most enriched items were regulation of ruffle assembly, negative regulation of calcium ion transport and necroptotic process. In the KEGG terms, only the nuclear factor-κB signaling pathway (Homo sapiens 04064) was significantly enriched. In the PPI network, five genes (CCL4, TIMP metallopeptidase inhibitor 1, intercellular adhesion molecule 1, plasminogen activator, urokinase receptor and cathepsin B) were identified to have a high degree of interaction with other DEGs. In conclusion, these five genes may represent key genes associated with pneumonia caused by Gram-positive bacteria. All of these results provide primary information and basic knowledge to understand the mechanisms of the pathogenesis.
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Seok H, Kang CI, Huh K, Cho SY, Ha YE, Chung DR, Peck KR. Risk Factors for Community-Onset Pneumonia Caused by Levofloxacin-Nonsusceptible Streptococcus pneumoniae. Microb Drug Resist 2018; 24:1412-1416. [PMID: 29565225 DOI: 10.1089/mdr.2017.0416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fluoroquinolones are antibiotics commonly used in the treatment of infections caused by Streptococcus pneumoniae. However, rates of fluoroquinolone resistance are increasing with their frequent use. We designed this study to verify current fluoroquinolone resistance rates and risk factors for community-onset pneumococcal pneumonia. METHODS A retrospective case-control study was conducted in a tertiary referral hospital. The study population comprised patients admitted for pneumococcal pneumonia between January 2011 and May 2017. The case group included community-onset pneumonia caused by levofloxacin-nonsusceptible S. pneumoniae. The control group consisted of two patients with levofloxacin-susceptible S. pneumoniae who were admitted around the same time as each case. RESULTS A total of 198 pneumococcal pneumonia cases were identified during the study period. Twenty-five levofloxacin-resistant S. pneumoniae cases and 3 levofloxacin-intermediate S. pneumoniae cases were included in the case group (nonsusceptibility rate = 14.1%). Multivariate analysis showed that healthcare-associated factors (odds ratio [OR] 4.78, 95% confidence interval [CI] 1.39-16.43, p = 0.013), bronchopulmonary disease (OR 3.79, 95% CI 1.07-13.40, p = 0.039), cerebrovascular disease (OR 6.08, 95% CI 1.24-29.75, p = 0.026), and exposure to fluoroquinolones within the previous 3 months (OR 5.89, 95% CI 1.21-28.68, p = 0.028) were associated with nonsusceptibility to levofloxacin. CONCLUSION Independent risk factors for levofloxacin-nonsusceptible pneumococcal pneumonia were recent hospitalization, bronchopulmonary disease, cerebrovascular disease, and prior antibiotic use within 3 months. Careful selection of empirical antibiotics is thus needed in at-risk patients. Similarly, efforts to prevent the interpersonal spread of drug-resistant pathogens in long-term care facilities and to restrict unnecessary fluoroquinolone prescriptions are important.
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Affiliation(s)
- Hyeri Seok
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea
| | - Young Eun Ha
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul, Republic of Korea
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Phenotypic and molecular characterization of Streptococcus pneumoniae in pre-conjugate vaccine era: A Chinese hospital-based retrospective study. Vaccine 2017; 36:599-605. [PMID: 29289385 DOI: 10.1016/j.vaccine.2017.12.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Streptococcus pneumoniae (S. pneumoniae) is an important pathogen in causing global morbidity and mortality among children. This study aimed to determine phenotypic and molecular characteristics of S. pneumoniae causing infections in children under five years in China. METHODS A hospital-based retrospective study was conducted. All 537 S. pneumoniae isolates were tested for antimicrobial susceptibility by E-test method, molecular characteristics including resistance genes, virulence genes and serotypes by multiplex polymerase chain reaction (PCR) method, and sequence types (STs) by sequencing seven housekeeping genes. Minimum spanning tree and correspondence analysis were used to reveal the potential relationship between serotypes and STs. RESULTS Most of S. pneumoniae isolates were resistant to erythromycin (93.9%) and tetracycline (86.4%), with the predominant resistance genes being erm(B) (92.6%) and tet(M) (95.5%). The prevalent serotypes were 19F, 6B, 19A, 23F and 14, the coverage rate of PCV13 was high in 85.8%, and the predominant STs were ST271, ST320, ST3173, ST81 and ST876. A significant correlation existed between STs and serotypes, with ST271/19F and ST320/19A as the most prevalent clones. Notably, ST271/19F and ST320/19A isolates were associated with resistance to specific antibiotics and carrying of mef(A/E), rlrA and sipA genes. CONCLUSIONS Our findings suggest the introduction of PCV13 vaccine to Chinese children, and underscore the value of monitoring multiple characteristics to detect new epidemiologic trends and provide implications for the formulation of multivalent pneumococcal vaccines.
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