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Toyting J, Supha N, Thongpanich Y, Thapa J, Nakajima C, Suzuki Y, Utrarachkij F. Wide distribution of plasmid mediated quinolone resistance gene, qnrS, among Salmonella spp. isolated from canal water in Thailand. J Appl Microbiol 2024; 135:lxae134. [PMID: 38908908 DOI: 10.1093/jambio/lxae134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/28/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
AIMS This research focused on assessing the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants and antimicrobial susceptibility in Salmonella strains isolated from Thai canal water. METHODS AND RESULTS From 2016 to 2020, 333 water samples were collected from six canals across Bangkok, Thailand. Salmonella spp. was isolated, PMQR genes were detected through polymerase chain reactions, and the antimicrobial susceptibility was examined using the disk diffusion method. The results indicated a 92.2% prevalence of Salmonella spp. in canal water, being serogroups B and C the most frequently detected. Overall, 35.3% of isolates harbored PMQR genes, being qnrS the most prevalent gene (97.2%, n = 137/141). Other PMQR genes, including qnrB, qnrD, oqxAB, and aac(6')-Ib-cr, were detected. Notably, six isolates harbored multiple PMQR genes. Furthermore, 9.3% and 3.8% of the overall isolates were resistant to nalidixic acid (NAL) and ciprofloxacin (CIP), respectively. PMQR-positive isolates showed higher rates of non-susceptibility to both NAL (48.2%, n = 68/141) and CIP (92.2%, n = 130/141) compared to PMQR-negative isolates (NAL: 8.9%, n = 23/258; CIP: 11.2%, n = 30/258). CONCLUSIONS The high prevalence of Salmonella spp., significant PMQR-positive, and reduced susceptibility isolates in canal water is of public health concern in Bangkok.
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Affiliation(s)
- Jirachaya Toyting
- Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo 001-0020, Japan
| | - Neunghatai Supha
- Department of Microbiology, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | - Yuwanda Thongpanich
- Department of Microbiology, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | - Jeewan Thapa
- Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo 001-0020, Japan
| | - Chie Nakajima
- Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo 001-0020, Japan
- International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Sapporo 001-0020, Japan
| | - Yasuhiko Suzuki
- Division of Bioresources, Hokkaido University International Institute for Zoonosis Control, Sapporo 001-0020, Japan
- International Collaboration Unit, Hokkaido University International Institute for Zoonosis Control, Sapporo 001-0020, Japan
- Division of Research Support, Hokkaido University Institute for Vaccine Research & Development, Sapporo 001-0020, Japan
| | - Fuangfa Utrarachkij
- Department of Microbiology, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
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Shrestha RK, Thapa A, Shrestha D, Pokhrel S, Aryal A, Adhikari R, Shrestha N, Dhoubhadel BG, Parry CM. Characterization of Transferrable Mechanisms of Quinolone Resistance (TMQR) among Quinolone-resistant Escherichia coli and Klebsiella pneumoniae causing Urinary Tract Infection in Nepalese Children. BMC Pediatr 2023; 23:458. [PMID: 37704964 PMCID: PMC10498618 DOI: 10.1186/s12887-023-04279-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Transferrable mechanisms of quinolone resistance (TMQR) can lead to fluoroquinolone non-susceptibility in addition to chromosomal mechanisms. Some evidence suggests that fluoroquinolone resistance is increasing among the pediatric population. We sought to determine the occurrence of TMQR genes among quinolone-resistant E. coli and K. pneumoniae causing urinary tract infections among Nepalese outpatient children (< 18 years) and identify molecular characteristics of TMQR-harboring isolates. METHODS We performed antimicrobial susceptibility testing, phenotypic extended-spectrum β-lactamase (ESBL) and modified carbapenem inactivation method tests, and investigated the presence of six TMQR genes (qnrA, qnrB, qnrS, aac(6')-Ib-cr, oqxAB, qepA), three ESBL genes (blaCTX-M, blaTEM, blaSHV), and five carbapenemase genes (blaNDM, blaOXA-48, blaKPC, blaIMP, blaVIM). The quinolone resistance-determining region (QRDR) of gyrA and parC were sequenced for 35 TMQR-positive isolates. RESULTS A total of 74/147 (50.3%) isolates were TMQR positive by multiplex PCR [aac(6')-Ib-cr in 48 (32.7%), qnrB in 23 (15.7%), qnrS in 18 (12.3%), qnrA in 1 (0.7%), and oqxAB in 1 (0.7%) isolate]. The median ciprofloxacin minimum inhibitory concentration of TMQR-positive isolates (64 µg/mL) was two-fold higher than those without TMQR (32 µg/mL) (p = 0.004). Ser-83→Leu and Asp-87→Asn in GyrA and Ser-80→Ile in ParC were the most common QRDR mutations (23 of 35). In addition, there was a statistically significant association between TMQR and two β-lactamase genes; blaCTX-M (p = 0.037) and blaTEM (p = 0.000). CONCLUSION This study suggests a high prevalence of TMQR among the quinolone-resistant E. coli and K. pneumoniae isolates causing urinary tract infection in children in this area of Nepal and an association with the carriage of ESBL gene. This is a challenge for the management of urinary infections in children. Comprehensive prospective surveillance of antimicrobial resistance in these common pathogens will be necessary to devise strategies to mitigate the emergence of further resistance.
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Affiliation(s)
| | | | | | | | | | | | | | - Bhim Gopal Dhoubhadel
- School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki, Japan
- Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Christopher M Parry
- School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki, Japan
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Leinyuy JF, Ali IM, Ousenu K, Tume CB. Molecular characterization of antimicrobial resistance related genes in E. coli, Salmonella and Klebsiella isolates from broilers in the West Region of Cameroon. PLoS One 2023; 18:e0280150. [PMID: 36630464 PMCID: PMC9833522 DOI: 10.1371/journal.pone.0280150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Antibiotic resistance has become an enduring threat to human health. This has prompted extensive research to identify the determinants responsible in a bid to fight the spread of resistance and also develop new antibiotics. However, routine procedures focus on identifying genetic determinants of resistance only on phenotypically resistant isolates. We aimed to characterise plasmid mediated resistance determinants in key Enterobacteriaceae isolates with differential phenotypic susceptibility profiles and evaluated the contribution of resistance genes on phenotypic expression of susceptibility. METHODS The study was carried out on 200 Enterobacteriaceae isolates belonging to the genera E. coli, Salmonella, and Klebsiella; 100 resistant and 100 susceptible to quinolones, aminoglycosides, and ESBL-producing as determined by disk diffusion. Reduced susceptibility in susceptible isolates was determined as an increased MIC by broth microdilution. Plasmid-borne resistance genes were sought in all isolates by endpoint PCR. We performed correlations tests to determine the relationship between the occurrence of resistance genes and increased MIC in susceptible isolates. We then used the notion of penetrance to show adequacy between resistance gene carriage and phenotypic resistance as well as diagnostic odds ratio to evaluate how predictable phenotypic susceptibility profile could determine the presence of resistant genes in the isolates. RESULTS Reduced susceptibility was detected in 30% (9/30) ESBL negative, 50% (20/40) quinolone-susceptible and 53.33% (16/30) aminoglycoside-susceptible isolates. Plasmid-borne resistance genes were detected in 50% (15/30) of ESBL negative, 65% (26/40) quinolone susceptible and 66.67% (20/30) aminoglycoside susceptible isolates. Reduced susceptibility increased the risk of susceptible isolates carrying resistance genes (ORs 4.125, 8.36, and 8.89 respectively for ESBL, quinolone, and aminoglycoside resistance genes). Resistance gene carriage correlated significantly to reduced susceptibility for quinolone and aminoglycoside resistance genes (0.002 and 0.015 at CI95). Gene carriage correlated with phenotypic resistance at an estimated 64.28% for ESBL, 56.90% for quinolone, and 58.33% for aminoglycoside resistance genes. CONCLUSIONS A high carriage of plasmid-mediated genes for ESBL, quinolone, and aminoglycoside resistance was found among the Enterobacteriaceae tested. However, gene carriage was not always correlated with phenotypic expression. This allows us to suggest that assessing genetic determinants of resistance should not be based on AST profile only. Further studies, including assessing the role of chromosomal determinants will shed light on other factors that undermine antimicrobial susceptibility locally.
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Affiliation(s)
- Jude Fonbah Leinyuy
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, University of Dschang, Dschang, Cameroon
| | - Innocent Mbulli Ali
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, University of Dschang, Dschang, Cameroon
- The Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon
- * E-mail:
| | - Karimo Ousenu
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, University of Dschang, Dschang, Cameroon
| | - Christopher B. Tume
- Research Unit of Microbiology and Antimicrobial Substances, Department of Biochemistry, University of Dschang, Dschang, Cameroon
- Department of Biochemistry, Faculty of Science, University of Bamenda, Bamenda, Cameroon
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Patterns of Antibiotic Resistance in Enterobacteriaceae Isolates from Broiler Chicken in the West Region of Cameroon: A Cross-Sectional Study. CANADIAN JOURNAL OF INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY 2022; 2022:4180336. [PMID: 35722039 PMCID: PMC9203226 DOI: 10.1155/2022/4180336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/12/2022] [Accepted: 05/21/2022] [Indexed: 11/18/2022]
Abstract
Background. The emergence of multidrug-resistant food-borne pathogens of animal origin including Enterobacteriaceae is a growing concern. Identifying and monitoring resistance in isolates from human-related environments are of clinical and epidemiological significance in containing antimicrobial resistance. This study aimed to contribute towards the fight against antibiotic resistance and ameliorate the management/treatment of Enterobacteriaceae-linked diseases in Cameroon. Methods. Cloacal swabs from healthy broilers were enriched in buffered-peptone-water and cultured on EMB agar. Antibiotic susceptibility was tested on Mueller-Hinton-Agar by disc diffusion. Plasmid-borne genes for extended-spectrum beta lactamase (ESBL) and resistance to Quinolones (PMQR) and Aminoglycosides were detected by standard endpoint polymerase chain reaction (PCR). Results. A total of 394 isolates were identified belonging to 12 Enterobacteriaceae genera, the most prevalent were Escherichia coli (81/394 = 20.56%), Salmonella spp (74/394 = 18.78%), and Klebsiella spp (39/394 = 9.90%) respectively. Overall, 84/394 (21.32%) were ESBL producers, 164/394 (41.62%) were resistant to quinolones, 66/394 (16.75%) resistant to aminoglycosides with 44.0% (173/394) expressing MDR phenotype. Poor hygiene practice (OR 2.55, 95% CI: 1.67, 3.89,
) and rearing for >45 days, (OR = 7.98, 95% CI: 5.05, 12.6,
) were associated with increased carriage of MDR. Plasmid-borne resistance genes were detected in 76/84 (90.48%) of ESBL-producing isolates, 151/164 (92.07%) quinolone resistant isolates and 59/66 (89.39%) aminoglycoside resistant isolates with co-occurrence of two or more genes per isolate in 58/84 (69.05%) of ESBLs, 132/164 (80.49%) of quinolone resistant isolates and 28/66 (42.42%) of aminoglycoside resistant isolates. Conclusion. This study found high carriage and widespread distribution of Enterobacteriaceae with ESBL and MDR in broiler chicken in the West Region of Cameroon. Most PMQR genes in bacteria were found at levels higher than is seen elsewhere, representing a risk in the wider human community.
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Chromosomal studies on drug resistance genes in extended spectrum β-lactamases producing-Klebsiella pneumoniae isolated from equine. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2022. [DOI: 10.1186/s43088-022-00247-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
K. pneumoniae is one of the most virulent and multidrug resistant bacteria, of great concern in both human and veterinary medicine. Studies conducted on the drug resistance of Klebsiella pneumoniae in equine are lack in Egypt.
Results
The distribution pattern of ten drug resistance genes were investigated and analyzed among fifteen Klebsiella isolates (previously isolated, identified and antibiogram tested). The targeted determinant genes were coded on the chromosomes, conferring the resistance against β-lactams, carbapenems, fluoroquinolones and aminoglycosides, in addition to the gene determinants of porin protein and efflux pump. The study revealed an incidence rate of 86.7, 100, 23, 7.7, 0, 0, 73.3, 40, 100 and 0% for the genes blaCTX-M, blaTEM, blaKPC, blaNDM-1, blaVIM, qnrB, qnrS, aadA1, AcrAB and ompK35 respectively. The Extended Spectrum β-lactamase-production coding genes were detected in all strains with at least one of their genes. In addition, the efflux pump codding gene and mutation in porin protein gene, which are two important co-factors in the drug resistance mechanism were also detected in all strains. By investigating the association of the drug resistance determinants within a single strain, it was showed that 40% (6/15) of the strains harbored 5 associated genes, 27.7% (4/15) harbored 6 associated genes, 13.3% (2/15) harbored 4 and 7 genes as well and finally only 1 isolate harbored 3 determinants, with complete absence of strains having sole existence of one gene or even two. Pareto chart elucidated that the association of β-lactamases, AcrAB and Qnr with the mutation of the porin protein was the most existed (26.7%). Interestingly, the sequencing results of the CTX-M PCR amplicons were typed as OXY-5 (50%), CTX-M-15 (40%) and CTX-M-27 (10%).
Conclusions
The current study represented the first record of the drug resistance genes’ predominance and their association among the K. pneumoniae strains; recovered from equine in Egypt, offering a helpful guide for scientists seeking new alternatives other-than antibiotics.
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Xie M, Yang X, Xu Q, Ye L, Chen K, Zheng Z, Dong N, Sun Q, Shu L, Gu D, Chan EWC, Zhang R, Chen S. Clinical evolution of ST11 carbapenem resistant and hypervirulent Klebsiella pneumoniae. Commun Biol 2021; 4:650. [PMID: 34075192 PMCID: PMC8169677 DOI: 10.1038/s42003-021-02148-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/23/2021] [Indexed: 11/18/2022] Open
Abstract
Carbapenem-resistant and hypervirulent K. pneumoniae (CR-HvKP) strains that have emerged recently have caused infections of extremely high mortality in various countries. In this study, we discovered a conjugative plasmid that encodes carbapenem resistance and hypervirulence in a clinical ST86 K2 CR-HvKP, namely 17ZR-91. The conjugative plasmid (p17ZR-91-Vir-KPC) was formed by fusion of a non-conjugative pLVPK-like plasmid and a conjugative blaKPC-2-bearing plasmid and is present dynamically with two other non-fusion plasmids. Conjugation of p17ZR-91-Vir-KPC to other K. pneumoniae enabled them to rapidly express the carbapenem resistance and hypervirulence phenotypes. More importantly, genome analysis provided direct evidence that p17ZR-91-Vir-KPC could be directly transmitted from K2 CR-HvKP strain, 17ZR-91, to ST11 clinical K. pneumoniae strains to convert them into ST11 CR-HvKP strains, which explains the evolutionary mechanisms of recently emerged ST11 CR-HvKP strains. Carbapenem-resistant and hypervirulent Klebsiella pneumoniae strains are emerging. Here Xie et al. show that these phenotypes are carried on a plasmid formed from the fusion of a virulence plasmid with a conjugative plasmid.
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Affiliation(s)
- Miaomiao Xie
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Xuemei Yang
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Qi Xu
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Lianwei Ye
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Kaichao Chen
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Zhiwei Zheng
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Ning Dong
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Qiaoling Sun
- Department of Clinical Laboratory, Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, Hangzhou, China
| | - Lingbin Shu
- Department of Clinical Laboratory, Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, Hangzhou, China
| | - Danxia Gu
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Edward Wai-Chi Chan
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong.,State Key Lab of Chemical Biology and Drug Discovery, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Rong Zhang
- Department of Clinical Laboratory, Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, Hangzhou, China.
| | - Sheng Chen
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong.
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Khoshnood S, Heidary M, Hashemi A, Shahi F, Saki M, Kouhsari E, Eslami G, Goudarzi H. Involvement of the AcrAB Efflux Pump in Ciprofloxacin Resistance in Clinical Klebsiella Pneumoniae Isolates. Infect Disord Drug Targets 2020; 21:564-571. [PMID: 32888276 DOI: 10.2174/1871526520999200905121220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/06/2020] [Accepted: 06/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Increasing prevalence of multiple antibiotic resistance in Klebsiella pneumoniae strains confines the therapeutic options used to treat bacterial infections. OBJECTIVE We aimed in this study to investigate the role of AcrAB and qepA efflux pumps and AAC(6')-Ib-cr enzyme in ciprofloxacin resistance and to detect the RAPD-PCR fingerprint of K. pneumoniae isolates. METHODS A total of , 117 K. pneumoniae isolates were collected from hospitalized patients in three hospitals in Tehran, Iran, from August 2013 to March 2014. Antimicrobial susceptibility tests were performed by the disk diffusion method. Molecular identification and expression level of encoding quinolone resistance genes, acrA, acrB, qepA, and aac(6')-Ib-cr, were performed by PCR and real-- time PCR assays, respectively. All the K. pneumoniae isolates containing the mentioned genes were used simultaneously for RAPD-PCR typing. RESULTS Colistin and carbapenems were the most efficient antibiotics against the clinical isolates of K. pneumoniae. PCR assay demonstrated that among the 117 isolates, 110 (94%) and 102 (87%) were positive for acrA and acrB gene and 5 (4%) and 100 (85%) isolates showed to have qepA and aac(6')-Ib-cr genes, respectively. Determination for AcrAB pump expression in 21% of strains demonstrated an increased expression, and the mean increase expression for acrB genes was 0.5-81. The results of RAPD-PCR reflected that in 95% CI, all isolates belonged to a clone. CONCLUSION A high prevalence of genes encoding quinolone resistance in K. pneumoniae was detected in clinical samples. Therefore, the control of infection and prevention of drug-resistant bacteria spread need careful management of medication and identification of resistant isolates.
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Affiliation(s)
- Saeed Khoshnood
- Student Research Committee, School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Mohsen Heidary
- Department of Microbiology, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ali Hashemi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shahi
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Morteza Saki
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ebrahim Kouhsari
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Gita Eslami
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Goudarzi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yu X, Zhang D, Song Q. Profiles of gyrA Mutations and Plasmid-Mediated Quinolone Resistance Genes in Shigella Isolates with Different Levels of Fluoroquinolone Susceptibility. Infect Drug Resist 2020; 13:2285-2290. [PMID: 32765004 PMCID: PMC7367718 DOI: 10.2147/idr.s257877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Fluoroquinolone-resistant Shigella is considered a serious public health problem and has been put on the WHO global priority list of antibiotic-resistant bacteria. This study was aimed to investigate the fluoroquinolone resistance in Shigella and its relevant genetic mechanisms. Materials and Methods Shigella isolates that were isolated from diarrheal patient’s feces in Ningbo China from 2011 to 2018 were tested for susceptibility to ampicillin, gentamicin, tetracycline, nalidixic acid, ciprofloxacin, and cefotaxime. Genes related to quinolone resistance were amplified by PCR. Results A total of 118 Shigella isolates were collected, including 76 S. flexneri isolates, 40 S. sonnei isolates, and 2 S. boydii isolates. Ciprofloxacin susceptibility test identified 10 (9%) susceptible, 65 (55%) intermediate, and 43 (36%) resistant isolates. Of 76 S. flexneri isolates, 37 were ciprofloxacin resistant, a prevalence significantly higher than 6 of 40 S. sonnei isolates (P=0.01). The isolates collected during 2014–2018 displayed a significant increase in the prevalence of ciprofloxacin resistance (P=0.05) than those collected during 2011–2013. All the ciprofloxacin-intermediate and resistant isolates had mutations of gyrA(S83L) and parC (S80I), whereas only the ciprofloxacin-resistant isolates had gyrA (D87N) mutation and qnrB gene. Additionally, 30% of the ciprofloxacin-resistant isolates were positive for aac(6´)-Ib-cr gene. Conclusion This study shows the currently increasing prevalence of ciprofloxacin resistance. The reduced fluoroquinolone susceptibility is highly associated with gyrA (S83L) and parC (S80I) mutations, while the fluoroquinolone resistance is highly associated with gyrA (D87N) mutation, qnrB gene and perhaps aac(6´)-Ib-cr gene.
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Affiliation(s)
- Xuxia Yu
- Department of Hospital Infection, Ningbo City First Hospital, Ningbo, Zhejiang Province, People's Republic of China
| | - Danyang Zhang
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang Province, People's Republic of China
| | - Qifa Song
- Central Laboratory, Ningbo City First Hospital, Ningbo, Zhejiang Province, People's Republic of China
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Malek Jamshidi MR, Zandi H, Eftekhar F. Correlation of quinolone-resistance, qnr genes and integron carriage in multidrug-resistant community isolates of Klebsiella spp. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2020; 22:1387-1391. [PMID: 32133055 DOI: 10.22038/ijbms.2019.13985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objectives Plasmid-mediated quinolone resistance (PMQR) determinants and integrons have a considerable contribution to bacterial drug resistance in Gram-negative pathogens. We studied the prevalence of PMQR genes and integron carriage in multidrug-resistant community isolates of Klebsiella spp. Materials and Methods Two hundred and fifty Klebsiella spp. isolates were collected from outpatient specimens between August 2015 and October 2017 in Yazd central Laboratory, Iran. Antibiotic susceptibility was determined against 17 antibiotics and minimum inhibitory concentration (MIC) of ciprofloxacin was measured by E-test. Polymerase chain reaction (PCR) was employed for detection of qnrA, qnrB, qnrS, aac(6')-Ib-cr, oqxAB and qepA genes. Results Disc diffusion results showed that 17 isolates (6.8%) were multidrug resistant (MDR), two of which were Klebsiella oxytoca and 15 were Klebsiella pneumoniae. MIC measurements revealed 11 ciprofloxacin-resistant isolates (including the two K. oxytoca), three intermediately-resistant and three ciprofloxacin-susceptible isolates. All ciprofloxacin-resistant and intermediately-resistant isolates carried at least one and up to four PMQR genes. The most prevalent PMQR gene was oqxAB (93.75%) followed by aac(6')-ib-cr (50.0%), qnrB (25.0%) and qnrS (18.75%) but qnrA and qepA were not detected. Class 1 integron was observed in 14 (82.3%) isolates including nine ciprofloxacin-resistant, two intermediately-resistant, and three susceptible isolates. Class 2 and 3 integrons were not observed. Conclusion Presence of MDR, multiple PMQR determinants as well as class 1 integron in community isolates of Klebsiella spp. can be an important source of transmission of these opportunistic pathogens.
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Affiliation(s)
| | - Hengameh Zandi
- Department of Microbiology, Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fereshteh Eftekhar
- Department of Microbiology, Faculty of Life Sciences and Technology, Shahid Beheshti University, Tehran, Iran
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Esmaeel NE, Gerges MA, Hosny TA, Ali AR, Gebriel MG. Detection of Chromosomal and Plasmid-Mediated Quinolone Resistance Among Escherichia coli Isolated from Urinary Tract Infection Cases; Zagazig University Hospitals, Egypt. Infect Drug Resist 2020; 13:413-421. [PMID: 32104013 PMCID: PMC7023874 DOI: 10.2147/idr.s240013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/11/2020] [Indexed: 12/14/2022] Open
Abstract
Introduction Resistance to fluoroquinolones (FQ) in uropathogenic Escherichia coli (UPEC) has emerged as a growing problem. Chromosomal mutations and plasmid-mediated quinolone resistance (PMQR) determinants have been implicated. Data concerning the prevalence of these determinants in UPEC in our hospital are quite limited. Purpose To investigate the occurrence and genetic determinants of FQ resistance in UPEC isolated from urinary tract infection (UTI) cases in Zagazig University Hospitals. Patients and Methods Following their isolation, the identification and susceptibility of UPEC isolates were performed by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometer (MALDI-TOF MS). FQ resistance was detected by the disc diffusion method. Ciprofloxacin minimal inhibitory concentration (MIC) was determined using E-test. Chromosomal mutations in the gyrA gene were detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and for detection of PMQR, a couple of multiplex PCR reactions were used. Results Among a total of 192 UPEC isolates, 46.9% (n=90) were FQ resistant. More than half of the isolates (57.8%) exhibited high-level ciprofloxacin resistance (MIC > 32 µg/mL). Mutations in gyrA were detected in 76.7% of isolates, with 34.4% having mutations at more than one site. PMQR determinants were detected in 80.1% of UPEC isolates, with aac(6ʹ)-Ib-cr gene being the most frequent found in 61.1% of isolates. Conclusion There is a high prevalence of both gyrA mutations and PMQR determinants among UPEC isolates in our hospital which contribute to high-level ciprofloxacin resistance, a finding that may require the revision of the antibiotics used for empirical treatment of UTI.
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Affiliation(s)
- Noura E Esmaeel
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Marian A Gerges
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Thoraya A Hosny
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed R Ali
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Manar G Gebriel
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Abstract
While the description of resistance to quinolones is almost as old as these antimicrobial agents themselves, transferable mechanisms of quinolone resistance (TMQR) remained absent from the scenario for more than 36 years, appearing first as sporadic events and afterward as epidemics. In 1998, the first TMQR was soundly described, that is, QnrA. The presence of QnrA was almost anecdotal for years, but in the middle of the first decade of the 21st century, there was an explosion of TMQR descriptions, which definitively changed the epidemiology of quinolone resistance. Currently, 3 different clinically relevant mechanisms of quinolone resistance are encoded within mobile elements: (i) target protection, which is mediated by 7 different families of Qnr (QnrA, QnrB, QnrC, QnrD, QnrE, QnrS, and QnrVC), which overall account for more than 100 recognized alleles; (ii) antibiotic efflux, which is mediated by 2 main transferable efflux pumps (QepA and OqxAB), which together account for more than 30 alleles, and a series of other efflux pumps (e.g., QacBIII), which at present have been sporadically described; and (iii) antibiotic modification, which is mediated by the enzymes AAC(6')Ib-cr, from which different alleles have been claimed, as well as CrpP, a newly described phosphorylase.
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Lv D, Zhang D, Song Q. Expansion of Salmonella Typhi clonal lineages with ampicillin resistance and reduced ciprofloxacin susceptibility in Eastern China. Infect Drug Resist 2019; 12:2215-2221. [PMID: 31413599 PMCID: PMC6659784 DOI: 10.2147/idr.s208251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 05/30/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose This study was aimed to investigate the dynamics of antimicrobial resistance expansion among different lineages and isolates of S. Typhi. Materials and methods The S. Typhi isolates were collected from the patients clinically suspected of typhoid fever in Eastern China during 2005–2017. All isolates were tested retrospectively for susceptibility to eight antimicrobials and the genes related to quinolone and ampicillin resistance, including gyrA, ParC, qnrA, qnrB, qnrS, aac(6´)-Ib-cr, qepA and blaTEM. The isolates were subtyped by PFGE. Results Of 140 isolates, all were susceptible to ciprofloxacin, cefotaxime, chloramphenicol, and trimethoprim-sulfamethoxazole, 95 (68%) were nalidixic acid resistant, and 74 (53%) were ampicillin resistant. The resistance to ampicillin and nalidixic acid was first observed in 2006. Among the 95 nalidixic acid-resistant S. Typhi isolates, 62 possessed S83F mutation in gyrA and 25 possessed D87Y mutation. All ampicillin-resistant isolates harbored gene blaTEM-1. PFGE generated 47 distinguishable clonal lineages. Overall, 64% (89/140) belonged to seven prevalent lineages of clustering isolates. PFGE results illustrated the prevalence of nalidixic acid-resistant lineages increased steadily from 19% during 2005–2012 to 50% during 2013–2014, and thereafter to 74% during 2015–2017 and similar development of ampicillin-resistant lineages increased from 6% to 38%, and also to 39%. Conclusion The present study indicated the clonal expansion of S. Typhi with ampicillin resistance and reduced ciprofloxacin susceptibility. The findings also suggested that the differential development of antimicrobial resistance to various antimicrobial agents in S. Typhi, showing the rapid increase in ampicillin resistance and reduced ciprofloxacin susceptibility, and the high susceptibility to other traditional antimicrobial agents.
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Affiliation(s)
- Dingfeng Lv
- Department of Clinical Laboratory, Ningbo First Hospital, Ningbo, Zhejiang Province, People's Republic of China
| | - Danyang Zhang
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang Province, People's Republic of China
| | - Qifa Song
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang Province, People's Republic of China
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Salah FD, Soubeiga ST, Ouattara AK, Sadji AY, Metuor-Dabire A, Obiri-Yeboah D, Banla-Kere A, Karou S, Simpore J. Distribution of quinolone resistance gene ( qnr) in ESBL-producing Escherichia coli and Klebsiella spp. in Lomé, Togo. Antimicrob Resist Infect Control 2019; 8:104. [PMID: 31244995 PMCID: PMC6582466 DOI: 10.1186/s13756-019-0552-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 06/04/2019] [Indexed: 11/26/2022] Open
Abstract
Background Qnr genes are known to confer a low-level resistance to fluoroquinolone in Enterobacteriaceae. They are often found on the same resistance plasmids as extended spectrum β-lactamase (ESBL) and constitute the most common antibiotic resistance mechanism. This study aimed to detect the presence of qnr genes in ESBL-producing E. coli and Klebsiella spp. Methods From May 2013 to July 2015, 91 E. coli and 64 Klebsiella spp. strains with phenotypic resistance to quinolone were collected from several specimens and analyzed for the detection of qnrA, qnrB, qnrS genes and the β-lactamase resistance genes (blaCTX-M, blaTEM, blaSHV) using simplex and multiplex PCR. Results In the present study, 107 (69%; 61 E. coli and 46 Klebsiella spp.) of 155 bacterial strains tested were found harboring at least one qnr gene consisting of 74 (47.74%) qnrB, 73 (47.10%) qnrS and 4 (2.58%) qnrA. Of the 107 strains encoding qnr genes, 102, 96 and 52 carried CTX-M1, TEM and SHV type ESBL respectively. Conclusion This study identified quinolone resistance (qnr) gene in ESBL-producing E. coli and Klebsiella spp. in Togo. These finding which suggest a possible resistance to quinolone are of high interest for better management of patients and control of antimicrobial resistance in Togo. Electronic supplementary material The online version of this article (10.1186/s13756-019-0552-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Fortune Djimabi Salah
- Biomolecular and Genetic Laboratory (LABIOGENE), Pietro Annigoni Biomolecular Research Center (CERBA), Department of Biochemistry-Microbiology, University Ouaga I Prof Joseph Ki Zerbo, BP 364, Ouagadougou, Burkina Faso.,Bacteriology Laboratory, National Institute of Hygiene (INH), BP 1396, Lomé, Togo
| | - Serge Théophile Soubeiga
- Biomolecular and Genetic Laboratory (LABIOGENE), Pietro Annigoni Biomolecular Research Center (CERBA), Department of Biochemistry-Microbiology, University Ouaga I Prof Joseph Ki Zerbo, BP 364, Ouagadougou, Burkina Faso
| | - Abdoul Karim Ouattara
- Biomolecular and Genetic Laboratory (LABIOGENE), Pietro Annigoni Biomolecular Research Center (CERBA), Department of Biochemistry-Microbiology, University Ouaga I Prof Joseph Ki Zerbo, BP 364, Ouagadougou, Burkina Faso
| | - Adodo Yao Sadji
- Bacteriology Laboratory, National Institute of Hygiene (INH), BP 1396, Lomé, Togo
| | - Amana Metuor-Dabire
- Biomolecular and Genetic Laboratory (LABIOGENE), Pietro Annigoni Biomolecular Research Center (CERBA), Department of Biochemistry-Microbiology, University Ouaga I Prof Joseph Ki Zerbo, BP 364, Ouagadougou, Burkina Faso
| | - Dorcas Obiri-Yeboah
- 4Department of Microbiology and Immunology, School of Medical Sciences, University of cape Coast, PMB, Cape Coast, Ghana
| | - Abiba Banla-Kere
- Bacteriology Laboratory, National Institute of Hygiene (INH), BP 1396, Lomé, Togo
| | - Simplice Karou
- 3High School of Biological and Food Techniques (ESTBA), University of Lomé, BP 1515, Lomé, Togo
| | - Jacques Simpore
- Biomolecular and Genetic Laboratory (LABIOGENE), Pietro Annigoni Biomolecular Research Center (CERBA), Department of Biochemistry-Microbiology, University Ouaga I Prof Joseph Ki Zerbo, BP 364, Ouagadougou, Burkina Faso
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Xu Z, Song Q, Li C, Zhan Y. Characterization of ciprofloxacin-resistant and ESBL-producing Salmonella enteric serotype Derby in Eastern China. BMC Microbiol 2019; 19:61. [PMID: 30885127 PMCID: PMC6423743 DOI: 10.1186/s12866-019-1434-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/12/2019] [Indexed: 01/30/2023] Open
Abstract
Background Fluoroquinolone resistance and ESBL-production are concurrently found in a limited number of Salmonella serotypes. The present study was aimed to characterize fluoroquinolone-resistant and ESBL-producing Salmonella enteric serotype Derby (S. Derby) isolates in terms of antimicrobial susceptibility, relevant genetic mechanisms, and PFGE. Results From 2013 to 2017 in Ningbo China, 52 S. Derby isolates were identified out of 826 non-typhoidal Salmonella isolates from patient feces, food, and environmental water samples. Three S. derby isolates were identified to be fluoroquinolone-resistant and ESBL-producing with cefotaxime MIC of 64 μg/mL and ciprofloxacin MIC of 4 μg/mL. The three isolates contained the same genetic structure of quinolone resistance, including a silent gyrA mutation S (TCC) 83S (TCT) and three PMQR genes qnrB, qnrS and aac(6′)-Ib-cr. As withβ-lactams resistance mechanisms, two isolates contained blaTEM, blaOXA, and blaCTX-M genes and one isolate contained blaOXA and blaCTX-M genes. Additionally, two isolates displayed more identical PFGE pattern than the third isolate, whereas three isolates showed the same plasmid profile of I1, W and P by PCR-based replicon typing. The conjugation experiment showed no dissemination of β-lactam resistance by direct contact among isolates; the transformation experiment failed to transfer plasmid conferring ampicillin resistance to E. coli DH5a. Conclusion The present study demonstrates the emerging fluoroquinolone-resistant and ESBL-producing S. Derby in both humans and the environment. Seeing that S. Derby has become one of the most common Salmonella serotypes, this situation gives rise to a new major risk of food-borne diseases.
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Affiliation(s)
- Zhaojun Xu
- Intensive Care Unit, Ningbo No. 2 Hospital, Zhejiang, Zhejiang Province, People's Republic of China
| | - Qifa Song
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, No. 237 Yongfeng Road, Haishu District, Ningbo, 315010, Zhejiang Province, People's Republic of China.
| | - Chunhua Li
- Intensive Care Unit, Ningbo No. 2 Hospital, Zhejiang, Zhejiang Province, People's Republic of China
| | - Yefei Zhan
- Intensive Care Unit, Ningbo No. 2 Hospital, Zhejiang, Zhejiang Province, People's Republic of China
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Li B, Chen Y, Wu Z, Zhao Z, Wu J, Cao Y. Prevalence of Plasmid-Mediated Quinolone Resistance Genes Among Escherichia coli in the Gut of Healthy People in Fuzhou, China. Ann Lab Med 2019; 38:384-386. [PMID: 29611393 PMCID: PMC5895872 DOI: 10.3343/alm.2018.38.4.384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/18/2017] [Accepted: 03/12/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Bin Li
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Yao Chen
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Zhiyun Wu
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Zhichang Zhao
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Juan Wu
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Yingping Cao
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
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Sary K, Fairbrother JM, Arsenault J, de Lagarde M, Boulianne M. Antimicrobial Resistance and Virulence Gene Profiles Among Escherichia coli Isolates from Retail Chicken Carcasses in Vietnam. Foodborne Pathog Dis 2019; 16:298-306. [PMID: 30767657 DOI: 10.1089/fpd.2018.2555] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study evaluated virulence and resistance profiles of Escherichia coli in chicken carcasses from three retail systems in Vietnam. Fresh chicken carcasses from traditional markets and fresh and frozen chicken carcasses from supermarkets were sampled in Vietnam. E. coli isolates from carcass rinses were characterized for extraintestinal pathogenic E. coli (ExPEC) virulence factors (iucD, cnf, papC, tsh, KpsMT II, afa, and sfa) and for phenotypical antimicrobial resistance by Sensititre ARIS® as well as genotypically by polymerase chain reaction. An elevated proportion (30% to 70%) of samples resistant to antimicrobials critically important for human medicine was observed in routine isolates, with no significant differences between the three retail systems. Multidrug-resistant (MDR) ExPEC isolates of phylogroup B1 and, of greater concern, of phylogroup F were detected. Extended-spectrum β-lactamase (ESBL)- and AmpC β-lactamase-producing E. coli possessing blaCTX-M or blaCMY-2 resistance genes, respectively, were found. The presence of ExPEC with a high level of antimicrobial resistance (more than 50% of isolates) and MDR (91% of isolates) and detection of ESBL-producing E. coli underline the potential health threat for humans associated with mishandled chicken carcasses or consumption of undercooked chicken meat in Vietnam.
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Affiliation(s)
- Kathleen Sary
- 1 Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Canada
| | - John Morris Fairbrother
- 2 OIE Reference Laboratory for Escherichia coli (EcL), Université de Montréal, Saint-Hyacinthe, Canada
| | - Julie Arsenault
- 3 Swine and Poultry Infectious Diseases Research Center (CRIPA), Université de Montréal, Saint-Hyacinthe, Canada
| | - Maud de Lagarde
- 2 OIE Reference Laboratory for Escherichia coli (EcL), Université de Montréal, Saint-Hyacinthe, Canada
| | - Martine Boulianne
- 1 Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Canada
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Mutations in DNA gyrase and topoisomerase genes linked to fluoroquinolone resistance in Salmonella Typhimurium of animal origin in India. J Glob Antimicrob Resist 2018; 15:268-270. [PMID: 30312828 DOI: 10.1016/j.jgar.2018.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 10/02/2018] [Accepted: 10/02/2018] [Indexed: 11/23/2022] Open
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18
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Thi Quynh Nhi L, Thanh Tuyen H, Duc Trung P, Do Hoang Nhu T, Duy PT, Hao CT, Thi Thanh Nhan N, Vi LL, Thi Diem Tuyet H, Thi Thuy Tien T, Van Vinh Chau N, Khanh Lam P, Thwaites G, Baker S. Excess body weight and age associated with the carriage of fluoroquinolone and third-generation cephalosporin resistance genes in commensal Escherichia coli from a cohort of urban Vietnamese children. J Med Microbiol 2018; 67:1457-1466. [PMID: 30113307 DOI: 10.1099/jmm.0.000820] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Antimicrobial-resistant bacterial infections in low- and middle-income countries (LMICs) are a well-established global health issue. We aimed to assess the prevalence of and epidemiological factors associated with the carriage of ciprofloxacin- and ceftriaxone-resistant Escherichia coli and associated resistance genes in a cohort of 498 healthy children residing in urban Vietnam. METHODOLOGY We cultured rectal swabs onto MacConkey agar supplemented with resistant concentrations of ciprofloxacin and ceftriaxone. Additionally, we screened meta-E. coli populations by conventional PCR to detect plasmid-mediated quinolone resistance (PMQR)- and extended-spectrum β-lactamase (ESBL)-encoding genes. We measured the associations between phenotypic/genotypic resistance and demographic characteristics using logistic regression.Results/Key findings. Ciprofloxacin- and ceftriaxone-resistant E. coli were cultured from the faecal samples of 67.7 % (337/498) and 80.3 % (400/498) of children, respectively. The prevalence of any associated resistance marker in the individual samples was 86.7 % (432/498) for PMQR genes and 90.6 % (451/498) for β-lactamase genes. Overweight children were significantly more likely to carry qnr genes than children with lower weight-for-height z-scores [odds ratios (OR): 1.24; 95 % confidence interval (CI): 10.5-1.48 for each unit increase in weight for height; P=0.01]. Additionally, younger children were significantly more likely to carry ESBL CTX-M genes than older children (OR: 0.97, 95 % CI: 0.94-0.99 for each additional year, P=0.01). CONCLUSION The carriage of genotypic and phenotypic antimicrobial resistance is highly prevalent among E. coli in healthy children in the community in Vietnam. Future investigations on the carriage of antimicrobial resistant organisms in LMICs should focus on the progression of carriage from birth and structure of the microbiome in obesity.
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Affiliation(s)
- Le Thi Quynh Nhi
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- 2University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Ha Thanh Tuyen
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Pham Duc Trung
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Do Hoang Nhu
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Pham Thanh Duy
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Chung The Hao
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Thanh Nhan
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Lu Lan Vi
- 3The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | | | | | - Phung Khanh Lam
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- 5Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Stephen Baker
- 1The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- 6The Department of Medicine, University of Cambridge, Cambridge, UK
- 5Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
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Obayiuwana A, Ogunjobi A, Yang M, Ibekwe M. Characterization of Bacterial Communities and Their Antibiotic Resistance Profiles in Wastewaters Obtained from Pharmaceutical Facilities in Lagos and Ogun States, Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1365. [PMID: 29966226 PMCID: PMC6069043 DOI: 10.3390/ijerph15071365] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 06/25/2018] [Accepted: 06/27/2018] [Indexed: 12/27/2022]
Abstract
In Nigeria, pharmaceutical wastewaters are routinely disseminated in river waters; this could be associated with public health risk to humans and animals. In this study, we characterized antibiotic resistant bacteria (ARB) and their antibiotic resistance profile as well as screening for sul1 and sul2 genes in pharmaceutical wastewater effluents. Bacterial composition of the wastewater sources was isolated on non-selective media and characterized by the polymerase chain reaction (PCR) amplification of the 16S rRNA genes, with subsequent grouping using restriction fragment length polymorphism (RFLP) and sequencing. The antibiotics sensitivity profiles were investigated using the standard disk diffusion plate method and the minimum inhibitory concentrations (MICs) of selected antibiotics on the bacterial isolates. A total of 254 bacterial strains were isolated, and majority of the isolates were identified as Acinetobacter sp., Klebsiella pneumonia, Proteus mirabilis, Enterobacter sp. and Bacillus sp. A total of 218 (85.8%) of the bacterial isolates were multidrug resistant. High MICs values were observed for all antibiotics used in the study. The result showed that 31.7%, 21.7% and 43.3% of the bacterial isolates harbored sul1, sul2, and Intl1 genes, respectively. Pharmaceuticals wastewaters are potential reservoirs of ARBs which may harbor resistance genes with possible risk to public health.
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Affiliation(s)
- Amarachukwu Obayiuwana
- Department of Biological Sciences, Augustine University Ilara, Epe 106101, Lagos State, Nigeria.
| | - Adeniyi Ogunjobi
- Department of Microbiology, University of Ibadan, Ibadan 200284, Oyo State, Nigeria.
| | - Min Yang
- State Key Laboratory of Environmental Aquatic Chemistry, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China.
| | - Mark Ibekwe
- U.S. Salinity Laboratory, USDA-ARS, 450 West Big Springs Road, Riverside, CA 92507, USA.
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Mirzaii M, Jamshidi S, Zamanzadeh M, Marashifard M, Malek Hosseini SAA, Haeili M, Jahanbin F, Mansouri F, Darban-Sarokhalil D, Khoramrooz SS. Determination of gyrA and parC mutations and prevalence of plasmid-mediated quinolone resistance genes in Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infection in Iran. J Glob Antimicrob Resist 2018; 13:197-200. [PMID: 29747008 DOI: 10.1016/j.jgar.2018.04.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Fluoroquinolones (FQs) are recommended as the drugs of choice for the empirical treatment of urinary tract infections (UTIs). This study investigated the molecular determinants of FQ resistance in Escherichia coli and Klebsiella pneumoniae isolates in Iran. METHODS A total of 364 clinical isolates of E. coli (n=144) and K. pneumoniae (n=220) were collected from patients with UTI. Susceptibility of the isolates to ciprofloxacin, levofloxacin, gatifloxacin and nalidixic acid was evaluated by disk diffusion. The presence of qnrA, qnrB and qnrS genes was assessed by PCR. Nucleotide sequences of the gyrA and parC genes were determined. RESULTS Eighty-seven (60.4%) and 15 (6.8%) E. coli and K. pneumoniae isolates, respectively, were resistant to at least one of the tested FQs. Plasmid-mediated quinolone resistance (PMQR) genes were detected in 12.6% and 60.0% of FQ-resistant E. coli and K. pneumoniae, respectively. Whilst qnrB predominated in K. pneumoniae, qnrS was the most prevalent PMQR gene in E. coli. S83L (98.9%) and D87N (59.8%) were the most frequent mutations identified in GyrA of E. coli, and 55.2% (n=48) of FQ-resistant E. coli isolates had mutation in ParC harbouring S80I and E84V substitutions. The GyrAS83L substitution was found in only one FQ-resistant K. pneumoniae isolate. CONCLUSIONS FQ resistance was much more common in E. coli isolates than in K. pneumoniae. Whilst mutations in the drug target-encoding genes gyrA and parC were the major mechanisms involved in FQ resistance in E. coli, PMQR determinants commonly mediated FQ resistance in K. pneumoniae.
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Affiliation(s)
- Mehdi Mirzaii
- Faculty of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sanaz Jamshidi
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Maryam Zamanzadeh
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Masoud Marashifard
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Mehri Haeili
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Fariba Jahanbin
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Fariba Mansouri
- Department of Basic Sciences, Islamic Azad University, Yasooj Branch, Yasooj, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Sajjad Khoramrooz
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran; Department of Microbiology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
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Song Q, Xu Z, Gao H, Zhang D. Overview of the development of quinolone resistance in Salmonella species in China, 2005-2016. Infect Drug Resist 2018. [PMID: 29520157 PMCID: PMC5833789 DOI: 10.2147/idr.s157460] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose Several factors contribute to the complexity of quinolone resistance in Salmonella, including >2000 different Salmonella serotypes, a variety of hosts for Salmonella, and wide use of quinolones in human beings and animals. We thus aimed to obtain an overview of the development of quinolone resistance and relevant molecular mechanisms of such a resistance in Salmonella species. Materials and methods A total of 1,776 Salmonella isolates were collected in Ningbo, China, between 2005 and 2016. Antimicrobial susceptibility to quinolone and relevant genetic mechanisms in these isolates were retrospectively analyzed. Results The ratio for ciprofloxacin (CIP) resistant:reduced CIP susceptible:CIP susceptible was 26:522:1,228. CIP resistance was found in nine of 51 serotypes: Derby, London, Kentucky, Indiana, Corvallis, Rissen, Hadar, Typhimurium, and Agona. Of 26 CIP-resistant isolates, all were concurrently resistant to ampicillin and 21 were also concurrently resistant to cefotaxime and produced extended-spectrum β-lactamase (ESBL). The minimal inhibitory concentration values were at three levels: 2–4 μg/mL (serotypes except for Kentucky and Indiana), 16 μg/mL (one Kentucky isolate), and >32 μg/mL (Indiana isolates). As with the three most common serotypes, Salmonella Typhi showed quickly increased prevalence of reduced CIP susceptibility in recent years, Salmonella Enteritidis remained at a high prevalence of reduced CIP susceptibility throughout the study period, and several isolates of Salmonella Typhimurium were resistant to CIP. Transferable plasmid-mediated quinolone resistance gene qnrB was only found in all CIP-resistant isolates. In contrast, gyrA mutations were often found in reduced CIP-susceptible isolates and were not necessarily found in all CIP-resistant isolates. Conclusion We conclude that in Salmonella, there exists a high prevalence of reduced CIP susceptibility and a low prevalence of CIP resistance, which focuses on several serotypes. Our study also demonstrates that, rather than gyrA mutations, qnrB is the most common indicator for CIP resistance.
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Affiliation(s)
- Qifa Song
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Zhaojun Xu
- Intensive Care Unit, Ningbo No. 2 Hospital, Zhejiang, China
| | - Hong Gao
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Danyang Zhang
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang, China
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22
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Phenotypic and genotypic characteristics of ESBL and AmpC producing organisms associated with bacteraemia in Ho Chi Minh City, Vietnam. Antimicrob Resist Infect Control 2017; 6:105. [PMID: 29046783 PMCID: PMC5644090 DOI: 10.1186/s13756-017-0265-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 10/09/2017] [Indexed: 01/22/2023] Open
Abstract
Background Broad-spectrum antimicrobials are commonly used as empirical therapy for infections of presumed bacterial origin. Increasing resistance to these antimicrobial agents has prompted the need for alternative therapies and more effective surveillance. Better surveillance leads to more informed and improved delivery of therapeutic interventions, potentially leading to better treatment outcomes. Methods We screened 1017 Gram negative bacteria (excluding Pseudomonas spp. and Acinetobacter spp.) isolated between 2011 and 2013 from positive blood cultures for susceptibility against third generation cephalosporins, ESBL and/or AmpC production, and associated ESBL/AmpC genes, at the Hospital for Tropical Diseases in Ho Chi Minh City. Results Phenotypic screening found that 304/1017 (30%) organisms were resistance to third generation cephalosporins; 172/1017 (16.9%) of isolates exhibited ESBL activity, 6.2% (63/1017) had AmpC activity, and 0.5% (5/1017) had both ESBL and AmpC activity. E. coli and Aeromonas spp. were the most common organisms associated with ESBL and AmpC phenotypes, respectively. Nearly half of the AmpC producers harboured an ESBL gene. There was no significant difference (p > 0.05) between the antimicrobial resistance phenotypes of the organisms associated with community and hospital-acquired infections. Conclusion AmpC and ESBL producing organisms were commonly associated with bloodstream infections in this setting, with antimicrobial resistant organisms being equally distributed between infections originating from the community and healthcare settings. Aeromonas spp., which was associated with bloodstream infections in cirrhotic/hepatitis patients, were the most abundant AmpC producing organism. We conclude that empirical monotherapy with third generation cephalosporins may not be optimum in this setting. Electronic supplementary material The online version of this article (10.1186/s13756-017-0265-1) contains supplementary material, which is available to authorized users.
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23
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Lien LTQ, Lan PT, Chuc NTK, Hoa NQ, Nhung PH, Thoa NTM, Diwan V, Tamhankar AJ, Stålsby Lundborg C. Antibiotic Resistance and Antibiotic Resistance Genes in Escherichia coli Isolates from Hospital Wastewater in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E699. [PMID: 28661465 PMCID: PMC5551137 DOI: 10.3390/ijerph14070699] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 05/29/2017] [Accepted: 06/23/2017] [Indexed: 12/31/2022]
Abstract
The environmental spread of antibiotic-resistant bacteria has been recognised as a growing public health threat for which hospitals play a significant role. The aims of this study were to investigate the prevalence of antibiotic resistance and antibiotic resistance genes (ARGs) in Escherichia coli isolates from hospital wastewater in Vietnam. Wastewater samples before and after treatment were collected using continuous sampling every month over a year. Standard disk diffusion and E-test were used for antibiotic susceptibility testing. Extended-spectrum beta-lactamase (ESBL) production was tested using combined disk diffusion. ARGs were detected by polymerase chain reactions. Resistance to at least one antibiotic was detected in 83% of isolates; multidrug resistance was found in 32%. The highest resistance prevalence was found for co-trimoxazole (70%) and the lowest for imipenem (1%). Forty-three percent of isolates were ESBL-producing, with the blaTEM gene being more common than blaCTX-M. Co-harbouring of the blaCTX-M, blaTEM and qepA genes was found in 46% of isolates resistant to ciprofloxacin. The large presence of antibiotic-resistant E. coli isolates combined with ARGs in hospital wastewater, even post-treatment, poses a threat to public health. It highlights the need to develop effective processes for hospital wastewater treatment plants to eliminate antibiotic resistant bacteria and ARGs.
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Affiliation(s)
- La Thi Quynh Lien
- Health Systems and Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden.
- Department of Pharmaceutical Management and Pharmaco-Economics, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hoan Kiem District, Hanoi 110403, Vietnam.
| | - Pham Thi Lan
- Department of Dermatology and Venereology, Department of Family Medicine, Department of Microbiology, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi 116516, Vietnam.
| | - Nguyen Thi Kim Chuc
- Department of Dermatology and Venereology, Department of Family Medicine, Department of Microbiology, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi 116516, Vietnam.
| | - Nguyen Quynh Hoa
- National Centralized Drug Procurement Centre, Vietnam Ministry of Health, 138A Giang Vo Street, Ba Dinh district, Hanoi 118401, Vietnam.
| | - Pham Hong Nhung
- Department of Dermatology and Venereology, Department of Family Medicine, Department of Microbiology, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi 116516, Vietnam.
- Department of Microbiology, Bach Mai Hospital, 78 Giai Phong, Dong Da District, Hanoi 116365, Vietnam.
| | - Nguyen Thi Minh Thoa
- Department of Dermatology and Venereology, Department of Family Medicine, Department of Microbiology, Hanoi Medical University, 01 Ton That Tung, Dong Da District, Hanoi 116516, Vietnam.
| | - Vishal Diwan
- Health Systems and Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden.
- Department of Public Health & Environment, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India.
| | - Ashok J Tamhankar
- Health Systems and Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden.
- Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Agar Road, Ujjain 456006, India.
| | - Cecilia Stålsby Lundborg
- Health Systems and Policy (HSP): Improving the Use of Medicines, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 17177 Stockholm, Sweden.
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Izadi N, Naderi Nasab M, Harifi Mood E, Meshkat Z. The Frequency of qnr Genes in Extended-Spectrum β-lactamases and non-ESBLs Klebsiella pneumoniae Species Isolated from Patients in Mashhad, Iran. IRANIAN JOURNAL OF PATHOLOGY 2017; 12:377-383. [PMID: 29563934 PMCID: PMC5844683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 02/29/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Since the fluoroquinolones are the broad-spectrum antibiotics, they affect both Gram-negative and Gram-positive bacteria. These antibiotics are widely prescribed by physicians. As a result, some bacteria, especially Enterobacteriaceae, have shown a resistance to this family of antibiotics. The current study aimed at detecting the frequency of qnrA, qnrB, and qnrS genes, novel plasmid-mediated quinolone-resistance genes, among extended-spectrum β-lactamases (ESBL)-positive and ESBL-negative Klebsiella pneumoniae isolates. MATERIALS AND METHODS One hundred and thirty isolates of K. pneumoniae were collected from Imam Reza Hospital and its associated clinics from May 2011 to July 2012. The isolates were tested for ESBLs by the conventional methods. Polymerase chain reaction (PCR) was performed to amplify qnr A, B, and S. RESULTS Thirty-eight (29.3%) isolates were ciprofloxacin-resistant. Among 130 K. pneumoniae infectious isolates, 56 (43%) were capable of producing ESBL; 10.8% (n=14), 15.4% (n=20), and 20.8% (n=27) of ESBL-producing K. pneumonia were positive for qnrA, qnrS, and qnrB, respectively, and 13.8% (n=18) of the isolates harbored 2 or 3 qnr genes. CONCLUSION The results of the current study showed that quinolone-resistance genes were more frequent in ESBL-producing K. pneumoniae (37.5%) isolates, compared with the ESBL-negative isolates (20.89%). The prevalence of qnr genes was high in K. pneumoniae isolates, with higher frequency in ESBL-positive strains. Most of the isolates were positive for all 3 groups of qnr genes and the qnrB was the most common one.
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Affiliation(s)
- Nafiseh Izadi
- Student Research Committee (SRC), Mashhad University of Medical Sciences, Mashhad, Iran.,Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mahboubeh Naderi Nasab
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Elnaz Harifi Mood
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zahra Meshkat
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Corresponding Information: Dr. Zahra Meshkat. Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Use of Colistin and Other Critical Antimicrobials on Pig and Chicken Farms in Southern Vietnam and Its Association with Resistance in Commensal Escherichia coli Bacteria. Appl Environ Microbiol 2016; 82:3727-3735. [PMID: 27084016 PMCID: PMC4907207 DOI: 10.1128/aem.00337-16] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/08/2016] [Indexed: 02/05/2023] Open
Abstract
Antimicrobial resistance (AMR) is a global health problem, and emerging semi-intensive farming systems in Southeast Asia are major contributors to the AMR burden. We accessed 12 pig and chicken farms at key stages of production in Tien Giang Province, Vietnam, to measure antimicrobial usage and to investigate the prevalence of AMR to five critical antimicrobials (β-lactams, third-generation cephalosporins, quinolones, aminoglycosides, and polymyxins) and their corresponding molecular mechanisms among 180 Escherichia coli isolates. Overall, 94.7 mg (interquartile range [IQR], 65.3 to 151.1) and 563.6 mg (IQR, 398.9 to 943.6) of antimicrobials was used to produce 1 kg (live weight) of chicken and pig, respectively. A median of 3 (out of 8) critical antimicrobials were used on pig farms. E. coli isolates exhibited a high prevalence of resistance to ampicillin (97.8% and 94.4% for chickens and pigs, respectively), ciprofloxacin (73.3% and 21.1%), gentamicin (42.2% and 35.6%), and colistin (22.2% and 24.4%). The prevalence of a recently discovered colistin resistance gene, mcr-1, was 19 to 22% and had strong agreement with phenotypic colistin resistance. We conducted plasmid conjugation experiments with 37 mcr-1 gene-positive E. coli isolates and successfully observed transfer of the gene in 54.0% of isolates through a plasmid of approximately 63 kb, consistent with one recently identified in China. We found no significant correlation between total use of antimicrobials at the farm level and AMR. These data provide additional insight into the role of mcr-1 in colistin resistance on farms and outline the dynamics of phenotypic and genotypic AMR in semi-intensive farming systems in Vietnam. IMPORTANCE Our study provides accurate baseline information on levels of antimicrobial use, as well as on the dynamics of phenotypic and genotypic resistance for antimicrobials of critical importance among E. coli over the different stages of production in emerging pig and poultry production systems in Vietnam. E. coli isolates showed a high prevalence of resistance (>20%) to critically important antimicrobials, such as colistin, ciprofloxacin, and gentamicin. The underlying genetic mechanisms identified for colistin (the mcr-1 gene) and quinolone (gyrA gene mutations) are likely to play a major role in AMR to those compounds. Conjugation experiments led to the identification of a 63-kb plasmid, similar to one recently identified in China, as the potential carrier of the mcr-1 gene. These results should encourage greater restrictions of such antimicrobials in Southeast Asian farming systems.
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26
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Wasfi R, Elkhatib WF, Khairalla AS. Effects of Selected Egyptian Honeys on the Cellular Ultrastructure and the Gene Expression Profile of Escherichia coli. PLoS One 2016; 11:e0150984. [PMID: 26954570 PMCID: PMC4783026 DOI: 10.1371/journal.pone.0150984] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/21/2016] [Indexed: 01/22/2023] Open
Abstract
The purpose of this study was to: (i) evaluate the antibacterial activities of three Egyptian honeys collected from different floral sources (namely, citrus, clover, and marjoram) against Escherichia coli; (ii) investigate the effects of these honeys on bacterial ultrastructure; and (iii) assess the anti-virulence potential of these honeys, by examining their impacts on the expression of eight selected genes (involved in biofilm formation, quorum sensing, and stress survival) in the test organism. The minimum inhibitory concentration (MIC) of the honey samples against E. coli ATCC 8739 were assessed by the broth microdilution assay in the presence and absence of catalase enzyme. Impacts of the honeys on the cellular ultrastructure and the expression profiles of the selected genes of E. coli were examined using transmission electron microscopy (TEM) and quantitative real-time polymerase chain reaction (qPCR) analysis, respectively. The susceptibility tests showed promising antibacterial activities of all the tested honeys against E. coli. This was supported by the TEM observations, which revealed “ghost” cells lacking DNA, in addition to cells with increased vacuoles, and/or with irregular shrunken cytoplasm. Among the tested honeys, marjoram exhibited the highest total antibacterial activity and the highest levels of peroxide-dependent activity. The qPCR analysis showed that all honey-treated cells share a similar overall pattern of gene expression, with a trend toward reduced expression of the virulence genes of interest. Our results indicate that some varieties of the Egyptian honey have the potential to be effective inhibitor and virulence modulator of E. coli via multiple molecular targets.
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Affiliation(s)
- Reham Wasfi
- Department of Microbiology & Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Walid F. Elkhatib
- Department of Microbiology & Immunology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Ahmed S. Khairalla
- Department of Microbiology & Immunology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
- * E-mail:
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27
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Abstract
Three mechanisms for plasmid-mediated quinolone resistance (PMQR) have been discovered since 1998. Plasmid genes qnrA, qnrB, qnrC, qnrD, qnrS, and qnrVC code for proteins of the pentapeptide repeat family that protects DNA gyrase and topoisomerase IV from quinolone inhibition. The qnr genes appear to have been acquired from chromosomal genes in aquatic bacteria, are usually associated with mobilizing or transposable elements on plasmids, and are often incorporated into sul1-type integrons. The second plasmid-mediated mechanism involves acetylation of quinolones with an appropriate amino nitrogen target by a variant of the common aminoglycoside acetyltransferase AAC(6')-Ib. The third mechanism is enhanced efflux produced by plasmid genes for pumps QepAB and OqxAB. PMQR has been found in clinical and environmental isolates around the world and appears to be spreading. The plasmid-mediated mechanisms provide only low-level resistance that by itself does not exceed the clinical breakpoint for susceptibility but nonetheless facilitates selection of higher-level resistance and makes infection by pathogens containing PMQR harder to treat.
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28
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Le V, Nhu NTK, Cerdeno-Tarraga A, Campbell JI, Tuyen HT, Nhu TDH, Tam PTT, Schultsz C, Thwaites G, Thomson NR, Baker S. Genetic characterization of three qnrS1-harbouring multidrug-resistance plasmids and qnrS1-containing transposons circulating in Ho Chi Minh City, Vietnam. J Med Microbiol 2015; 64:869-878. [PMID: 26272054 PMCID: PMC4635468 DOI: 10.1099/jmm.0.000100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Plasmid-mediated quinolone resistance (PMQR) refers to a family of closely related genes that confer decreased susceptibility to fluoroquinolones. PMQR genes are generally associated with integrons and/or plasmids that carry additional antimicrobial resistance genes active against a range of antimicrobials. In Ho Chi Minh City (HCMC), Vietnam, we have previously shown a high frequency of PMQR genes within commensal Enterobacteriaceae. However, there are limited available sequence data detailing the genetic context in which the PMQR genes reside, and a lack of understanding of how these genes spread across the Enterobacteriaceae. Here, we aimed to determine the genetic background facilitating the spread and maintenance of qnrS1, the dominant PMQR gene circulating in HCMC. We sequenced three qnrS1-carrying plasmids in their entirety to understand the genetic context of these qnrS1-embedded plasmids and also the association of qnrS1-mediated quinolone resistance with other antimicrobial resistance phenotypes. Annotation of the three qnrS1-containing plasmids revealed a qnrS1-containing transposon with a closely related structure. We screened 112 qnrS1-positive commensal Enterobacteriaceae isolated in the community and in a hospital in HCMC to detect the common transposon structure. We found the same transposon structure to be present in 71.4 % (45/63) of qnrS1-positive hospital isolates and in 36.7 % (18/49) of qnrS1-positive isolates from the community. The resulting sequence analysis of the qnrS1 environment suggested that qnrS1 genes are widely distributed and are mobilized on elements with a common genetic background. Our data add additional insight into mechanisms that facilitate resistance to multiple antimicrobials in Gram-negative bacteria in Vietnam.
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Affiliation(s)
- Vien Le
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, CA, USA
| | - Nguyen Thi Khanh Nhu
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia
| | | | - James I Campbell
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK
| | - Ha Thanh Tuyen
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Do Hoang Nhu
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Pham Thi Thanh Tam
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Constance Schultsz
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Guy Thwaites
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK
| | - Nicholas R Thomson
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK.,London School of Hygiene and Tropical Medicine, London, UK
| | - Stephen Baker
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK.,Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,London School of Hygiene and Tropical Medicine, London, UK
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Thompson CN, Zelner JL, Nhu TDH, Phan MV, Hoang Le P, Nguyen Thanh H, Vu Thuy D, Minh Nguyen N, Ha Manh T, Van Hoang Minh T, Lu Lan V, Nguyen Van Vinh C, Tran Tinh H, von Clemm E, Storch H, Thwaites G, Grenfell BT, Baker S. The impact of environmental and climatic variation on the spatiotemporal trends of hospitalized pediatric diarrhea in Ho Chi Minh City, Vietnam. Health Place 2015; 35:147-54. [PMID: 26402922 PMCID: PMC4664115 DOI: 10.1016/j.healthplace.2015.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/21/2015] [Accepted: 08/02/2015] [Indexed: 01/29/2023]
Abstract
It is predicted that the integration of climate-based early warning systems into existing action plans will facilitate the timely provision of interventions to diarrheal disease epidemics in resource-poor settings. Diarrhea remains a considerable public health problem in Ho Chi Minh City (HCMC), Vietnam and we aimed to quantify variation in the impact of environmental conditions on diarrheal disease risk across the city. Using all inpatient diarrheal admissions data from three large hospitals within HCMC, we developed a mixed effects regression model to differentiate district-level variation in risk due to environmental conditions from the overarching seasonality of diarrheal disease hospitalization in HCMC. We identified considerable spatial heterogeneity in the risk of all-cause diarrhea across districts of HCMC with low elevation and differential responses to flooding, air temperature, and humidity driving further spatial heterogeneity in diarrheal disease risk. The incorporation of these results into predictive forecasting algorithms will provide a powerful resource to aid diarrheal disease prevention and control practices in HCMC and other similar settings.
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Affiliation(s)
- Corinne N Thompson
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, United Kingdom; The London School of Hygiene & Tropical Medicine, United Kingdom.
| | - Jonathan L Zelner
- Robert Wood Johnson Foundation Health and Society Scholars Program, 701A Knox Hall, Columbia University, New York, NY 10027, USA.
| | - Tran Do Hoang Nhu
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.
| | - My Vt Phan
- Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire, United Kingdom.
| | | | | | | | | | - Tuan Ha Manh
- Children's Hospital 2, Ho Chi Minh City, Vietnam.
| | | | - Vi Lu Lan
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
| | | | - Hien Tran Tinh
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, United Kingdom.
| | - Emmiliese von Clemm
- Department of Ecology and Evolutionary Biology, Princeton University, NJ, USA.
| | - Harry Storch
- Brandenburg University of Technology, Cottbus, Germany.
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, United Kingdom.
| | - Bryan T Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, NJ, USA; RAPIDD Program, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
| | - Stephen Baker
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, United Kingdom; The London School of Hygiene & Tropical Medicine, United Kingdom.
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30
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Duong HP, Mong Hiep TT, Hoang DT, Janssen F, Lepage P, De Mol P, Blumental S, Ismaili K. [Practical problems related to the management of febrile urinary tract infection in Vietnamese children]. Arch Pediatr 2015; 22:848-52. [PMID: 26143997 DOI: 10.1016/j.arcped.2015.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/07/2015] [Accepted: 05/22/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND To describe the practical problems related to urinary tract infection (UTI) management in febrile Vietnamese children. METHODS During a prospective 28-month inclusion period, 143 febrile children with significant bacteriuria were treated for UTI in the nephrology department of Nhi Dong 2 children's hospital in Ho Chi Minh City, Vietnam. Patients were treated after blood and urine samples had been taken for culture, according to a local antibiotic protocol, parenterally with ceftriaxone 75mg/kg/day. Oral treatment with cefixime 8mg/kg/day was started after 48h of apyrexia for 2 weeks. According to local protocol, antibiotic therapy was only changed if children did not respond clinically to treatment regardless of antibiogram results. RESULTS Among these 143 children, 51% were girls and 80% of them had their first UTI before the age of 2 years. The commonest causative agent was Escherichia coli (80% of cases) with a high resistance rate to ampicillin (91%) and cotrimoxazole (74%). Extended-spectrum β-lactamase (ESBL) production was observed in 52% of Enterobacteriaceae isolates. According to antibiotic susceptibility, the initial treatment with ceftriaxone was found to be inappropriate in 63% of cases. CONCLUSIONS E. coli was responsible for 80% of UTIs in Vietnamese children with a high rate of resistance to first-line antibiotics. ESBL production was found to be extremely high in this study. Based on these data, we propose a new empiric treatment schedule for Vietnamese children suspected of UTI.
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Affiliation(s)
- H P Duong
- Département de néphrologie pédiatrique, hôpital Nhi Dong 2, université Pham Ngoc Thach, 14, Ly Tu Trong, Quận 1, Hô-Chi-Minh, Viet Nam.
| | - T T Mong Hiep
- Département de néphrologie pédiatrique, hôpital Nhi Dong 2, université Pham Ngoc Thach, 14, Ly Tu Trong, Quận 1, Hô-Chi-Minh, Viet Nam
| | - D T Hoang
- Département de néphrologie pédiatrique, hôpital Nhi Dong 2, université Pham Ngoc Thach, 14, Ly Tu Trong, Quận 1, Hô-Chi-Minh, Viet Nam
| | - F Janssen
- Département de néphrologie pédiatrique, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique
| | - P Lepage
- Département des maladies infectieuses, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique
| | - P De Mol
- Département de microbiologie médicale, CHU Sart-Tilman, université de Liège (ULg), Liège, Belgique
| | - S Blumental
- Département des maladies infectieuses, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique
| | - K Ismaili
- Département de néphrologie pédiatrique, hôpital universitaire des Enfants-Reine-Fabiola, université Libre de Bruxelles (ULB), Bruxelles, Belgique
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The Rising Dominance of Shigella sonnei: An Intercontinental Shift in the Etiology of Bacillary Dysentery. PLoS Negl Trop Dis 2015; 9:e0003708. [PMID: 26068698 PMCID: PMC4466244 DOI: 10.1371/journal.pntd.0003708] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Shigellosis is the major global cause of dysentery. Shigella sonnei, which has historically been more commonly isolated in developed countries, is undergoing an unprecedented expansion across industrializing regions in Asia, Latin America, and the Middle East. The precise reasons underpinning the epidemiological distribution of the various Shigella species and this global surge in S. sonnei are unclear but may be due to three major environmental pressures. First, natural passive immunization with the bacterium Plesiomonas shigelloides is hypothesized to protect populations with poor water supplies against S. sonnei. Improving the quality of drinking water supplies would, therefore, result in a reduction in P. shigelloides exposure and a subsequent reduction in environmental immunization against S. sonnei. Secondly, the ubiquitous amoeba species Acanthamoeba castellanii has been shown to phagocytize S. sonnei efficiently and symbiotically, thus allowing the bacteria access to a protected niche in which to withstand chlorination and other harsh environmental conditions in temperate countries. Finally, S. sonnei has emerged from Europe and begun to spread globally only relatively recently. A strong selective pressure from localized antimicrobial use additionally appears to have had a dramatic impact on the evolution of the S. sonnei population. We hypothesize that S. sonnei, which exhibits an exceptional ability to acquire antimicrobial resistance genes from commensal and pathogenic bacteria, has a competitive advantage over S. flexneri, particularly in areas with poorly regulated antimicrobial use. Continuing improvement in the quality of global drinking water supplies alongside the rapid development of antimicrobial resistance predicts the burden and international distribution of S. sonnei will only continue to grow. An effective vaccine against S. sonnei is overdue and may become one of our only weapons against this increasingly dominant and problematic gastrointestinal pathogen.
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Lyonga EE, Toukam M, Nkenfou C, Gonsu HK, Assoumou MCO, Mesembe MT, Eyoh AB, Ikomey GM, Ndze VN, Koulla-Shiro S. Resistance pattern of enterobacteriaceae isolates from urinary tract infections to selected quinolones in Yaoundé. Pan Afr Med J 2015; 21:105. [PMID: 26327943 PMCID: PMC4546718 DOI: 10.11604/pamj.2015.21.105.5469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 05/15/2015] [Indexed: 11/25/2022] Open
Abstract
Introduction It is estimated that 150 million urinary tract infections (UTIs) occur yearly worldwide, resulting in more than 6 billion dollar in direct healthcare cost. The etiology of UTIs is predictable, with Escherichia coli, an Enterobacteriaceae being the principal pathogen. Quinolones are usually the drug of choice. In this study, we report the resistance pattern of Enterobacteriaceae isolates from UTIs to quinolones among in-patients and out-patients at the Yaoundé Reference Hospital in Cameroon. Methods A cross-sectional descriptive study was carried out for a ten-month period. Consecutive clean-catch mid-stream urine samples were collected from 207 in and out-patients. Identification was done using the Api 20E, and susceptibility testing using the Kirby Bauer's disc diffusion method and the MIC was done using the E-test. Results Out of the 207 isolates, 58(28.0%) were found to be resistant to all the quinolones used in the study. The resistances observed by species were in the order: Enterobacter 4(30.8%); Klebsiella 19(29.7%); Escherichia 25 (29.4%); Proteus 2(11.8%); Serratia 4(25.0%). Quinolone resistance for Escherichia was 42.9% for In-Patients (IP) and 16.3% for Out-Patient (OP) (P-value = 0.006); Klebsiella 35.9% for IP and 20% for OP; Proteus 11.1% for IP and 12.5% for OP; Serratia 18.2% for IP and 40% for OP; Enterobacter 22.2 for IP and 50% for OP. Conclusion High resistance rates to quinolones were observed not only for in-patients but also for out-patients with urinary tract enterobacterial infections. These findings demonstrate the importance of antibiotics susceptibility testing in improving quinolones prescription practices in Cameroon.
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Affiliation(s)
- Emilia Enjema Lyonga
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon ; Centre for the Study and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Michel Toukam
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Celine Nkenfou
- Higher Teachers' Training College, University of Yaoundé 1, Yaoundé, Cameroon ; Systems Biology Laboratory, Chantal Biya's International Reference Centre (CBIRC), Yaoundé, Cameroon
| | - Hortense Kamga Gonsu
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Marie-Claire Okomo Assoumou
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon ; Centre for the Study and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Martha Tongo Mesembe
- Centre for the Study and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Agnes Bedie Eyoh
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon ; Centre for the Study and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - George Mondinde Ikomey
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon ; Centre for the Study and Control of Communicable Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Valantine Ngum Ndze
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Sinata Koulla-Shiro
- Department of Microbiology, Haematology, Parasitology and Infectious Diseases, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
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Yamaguchi T, Okihashi M, Harada K, Konishi Y, Uchida K, Do MHN, Bui HDT, Nguyen TD, Nguyen PD, Chau VV, Dao KTV, Nguyen HTN, Kajimura K, Kumeda Y, Bui CT, Vien MQ, Le NH, Hirata K, Yamamoto Y. Antibiotic residue monitoring results for pork, chicken, and beef samples in Vietnam in 2012-2013. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2015; 63:5141-5. [PMID: 25601049 DOI: 10.1021/jf505254y] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A monitoring plan of residual antibiotics in food of animal origin was conducted in Vietnam from 2012 to 2013. Meat samples were collected from slaughterhouses and retail stores in Ho Chi Minh City and Nha Trang. A total of 28 antibiotics were analyzed using a LC-MS/MS screening method. Sulfonamides, fluoroquinolones, and tilmicosin were detected in some of the samples. Sulfaclozine and fluoroquinolones were mainly detected in chicken samples, and sulfamethazine was mainly detected in pork samples. High levels of sulfonamide residues, ranging between 2500 and 2700 μg/kg sulfaclozine and between 1300 and 3600 μg/kg sulfamethazine, were present in two chicken and three pork samples, respectively. Tilmicosin was detected at ranges of 150-450 μg/kg in 10 chicken samples. Positive percentages were 17.3, 8.8, and 7.4% for chicken, pork, and beef, respectively, for an average of 11.9%. The results suggest an appropriate withdrawal period after drug administration had not been observed in some livestock.
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Affiliation(s)
- Takahiro Yamaguchi
- †Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
| | - Masahiro Okihashi
- †Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
| | - Kazuo Harada
- ‡Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshimasa Konishi
- †Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
| | - Kotaro Uchida
- †Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
| | - Mai Hoang Ngoc Do
- §Institute of Public Health, 159 Hung Phu, District 8, Ward 8, Ho Chi Minh City, Vietnam
| | - Huong Dang Thien Bui
- §Institute of Public Health, 159 Hung Phu, District 8, Ward 8, Ho Chi Minh City, Vietnam
| | - Thinh Duc Nguyen
- §Institute of Public Health, 159 Hung Phu, District 8, Ward 8, Ho Chi Minh City, Vietnam
| | - Phuc Do Nguyen
- §Institute of Public Health, 159 Hung Phu, District 8, Ward 8, Ho Chi Minh City, Vietnam
| | - Vien Van Chau
- #Pasteur Institute, 8-10 Pasteur Xuong Huan Ward, Nha Trang City, Vietnam
| | - Khanh Thi Van Dao
- #Pasteur Institute, 8-10 Pasteur Xuong Huan Ward, Nha Trang City, Vietnam
| | | | - Keiji Kajimura
- †Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
| | - Yuko Kumeda
- †Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
| | - Chien Trong Bui
- #Pasteur Institute, 8-10 Pasteur Xuong Huan Ward, Nha Trang City, Vietnam
| | - Mai Quang Vien
- #Pasteur Institute, 8-10 Pasteur Xuong Huan Ward, Nha Trang City, Vietnam
| | - Ninh Hoang Le
- §Institute of Public Health, 159 Hung Phu, District 8, Ward 8, Ho Chi Minh City, Vietnam
| | - Kazumasa Hirata
- ‡Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan
- ⊥Global Collaboration Center, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshimasa Yamamoto
- †Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
- ⊥Global Collaboration Center, Osaka University, 1-6 Yamadaoka, Suita, Osaka 565-0871, Japan
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Thompson CN, Phan MVT, Hoang NVM, Minh PV, Vinh NT, Thuy CT, Nga TTT, Rabaa MA, Duy PT, Dung TTN, Phat VV, Nga TVT, Tu LTP, Tuyen HT, Yoshihara K, Jenkins C, Duong VT, Phuc HL, Tuyet PTN, Ngoc NM, Vinh H, Chinh NT, Thuong TC, Tuan HM, Hien TT, Campbell JI, Chau NVV, Thwaites G, Baker S. A prospective multi-center observational study of children hospitalized with diarrhea in Ho Chi Minh City, Vietnam. Am J Trop Med Hyg 2015; 92:1045-52. [PMID: 25802437 PMCID: PMC4426562 DOI: 10.4269/ajtmh.14-0655] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 01/28/2015] [Indexed: 12/15/2022] Open
Abstract
We performed a prospective multicenter study to address the lack of data on the etiology, clinical and demographic features of hospitalized pediatric diarrhea in Ho Chi Minh City (HCMC), Vietnam. Over 2,000 (1,419 symptomatic and 609 non-diarrheal control) children were enrolled in three hospitals over a 1-year period in 2009–2010. Aiming to detect a panel of pathogens, we identified a known diarrheal pathogen in stool samples from 1,067/1,419 (75.2%) children with diarrhea and from 81/609 (13.3%) children without diarrhea. Rotavirus predominated in the symptomatic children (664/1,419; 46.8%), followed by norovirus (293/1,419; 20.6%). The bacterial pathogens Salmonella, Campylobacter, and Shigella were cumulatively isolated from 204/1,419 (14.4%) diarrheal children and exhibited extensive antimicrobial resistance, most notably to fluoroquinolones and third-generation cephalosporins. We suggest renewed efforts in generation and implementation of policies to control the sale and prescription of antimicrobials to curb bacterial resistance and advise consideration of a subsidized rotavirus vaccination policy to limit the morbidity due to diarrheal disease in Vietnam.
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Affiliation(s)
- Corinne N Thompson
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - My V T Phan
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Van Minh Hoang
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Pham Van Minh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Thanh Vinh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Cao Thu Thuy
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Thi Thu Nga
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Maia A Rabaa
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Pham Thanh Duy
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Thi Ngoc Dung
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Voong Vinh Phat
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Vu Thieu Nga
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Le Thi Phuong Tu
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ha Thanh Tuyen
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Keisuke Yoshihara
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Claire Jenkins
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Vu Thuy Duong
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Hoang Le Phuc
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Pham Thi Ngoc Tuyet
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Minh Ngoc
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ha Vinh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Tran Chinh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tang Chi Thuong
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ha Manh Tuan
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Tinh Hien
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - James I Campbell
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Van Vinh Chau
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Stephen Baker
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
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Plasmid-Mediated Antibiotic Resistance and Virulence in Gram-negatives: the Klebsiella pneumoniae Paradigm. Microbiol Spectr 2014; 2:1-15. [PMID: 25705573 DOI: 10.1128/microbiolspec.plas-0016-2013] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Plasmids harbor genes coding for specific functions including virulence factors and antibiotic resistance that permit bacteria to survive the hostile environment found in the host and resist treatment. Together with other genetic elements such as integrons and transposons, and using a variety of mechanisms, plasmids participate in the dissemination of these traits resulting in the virtual elimination of barriers among different kinds of bacteria. In this article we review the current information about physiology and role in virulence and antibiotic resistance of plasmids from the gram-negative opportunistic pathogen Klebsiella pneumoniae. This bacterium has acquired multidrug resistance and is the causative agent of serious communityand hospital-acquired infections. It is also included in the recently defined ESKAPE group of bacteria that cause most of US hospital infections.
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Pitondo-Silva A, Martins VV, Silva CFD, Stehling EG. Conjugation between quinolone-susceptible bacteria can generate mutations in the quinolone resistance-determining region, inducing quinolone resistance. Int J Antimicrob Agents 2014; 45:119-23. [PMID: 25262036 DOI: 10.1016/j.ijantimicag.2014.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 07/08/2014] [Accepted: 07/18/2014] [Indexed: 11/17/2022]
Abstract
Quinolones are an important group of antibacterial agents that can inhibit DNA gyrase and topoisomerase IV activity. DNA gyrase is responsible for maintaining bacteria in a negatively supercoiled state, being composed of subunits A and B. Topoisomerase IV is a homologue of DNA gyrase and consists of two subunits codified by the parC and parE genes. Mutations in gyrA and gyrB of DNA gyrase may confer resistance to quinolones, and the majority of resistant strains show mutations between positions 67 and 106 of gyrA, a region denoted the quinolone resistance-determining region (QRDR). The most frequent substitutions occur at positions 83 and 87, but little is known about the mechanisms promoting appearance of mutations in the QRDR. The present study proposes that some mutations in the QRDR could be generated as a result of the natural mechanism of conjugation between bacteria in their natural habitat. This event was observed following conjugation in vitro of two different isolates of quinolone-susceptible Pseudomonas aeruginosa, which transferred plasmids of different molecular weights to a recipient strain of Escherichia coli (HB101), also quinolone-susceptible, generating two different transconjugants that presented mutations in DNA gyrase and acquisition of resistance to all quinolones tested.
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Affiliation(s)
- André Pitondo-Silva
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Av. do Café, s/n, Monte Alegre, Riberão Preto, SP CEP: 14040-903, Brazil
| | - Vinicius Vicente Martins
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Av. do Café, s/n, Monte Alegre, Riberão Preto, SP CEP: 14040-903, Brazil
| | - Carolina Fávero da Silva
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Av. do Café, s/n, Monte Alegre, Riberão Preto, SP CEP: 14040-903, Brazil
| | - Eliana Guedes Stehling
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Av. do Café, s/n, Monte Alegre, Riberão Preto, SP CEP: 14040-903, Brazil.
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Seyedpour SM, Eftekhar F. Quinolone Susceptibility and Detection of qnr and aac(6')-Ib-cr Genes in Community Isolates of Klebsiella pneumoniae. Jundishapur J Microbiol 2014; 7:e11136. [PMID: 25368793 PMCID: PMC4216573 DOI: 10.5812/jjm.11136] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 06/01/2013] [Accepted: 08/01/2013] [Indexed: 01/16/2023] Open
Abstract
Background: Plasmid-mediated quinolone resistance genes (PMQR) have been shown to play not only an important role in quinolone resistance, but also resistance to other antibiotics, particularly β-lactams and aminoglycosides. These genes are mainly associated with clinical isolates of Enterobacteriaceae. However, detection of PMQR genes in the community isolates can increase the dissemination rate of resistance determinants among bacteria. Objectives: This study aimed to investigate quinolone resistance and distribution of qnr and aac (6’)-Ib-cr genes among the community isolates of Klebsiella pneumoniae. Materials and Methods: Fifty-two K. pneumoniae isolates were collected from the Central Laboratory in Karaj between July 2010 and January 2011. Antibacterial susceptibility was determined by the disc diffusion method. Quinolone and/or cephalosporin-resistant isolates were screened for the presence of qnrA, qnrB, qnrS and aac (6’)-Ib-cr genes by polymerase chain reaction (PCR). Results: Of the 52 K. pneumoniae isolates, 23 were resistant to cephalosporins and/or quinolones. Overall, 7 out of the 23 resistant isolates harbored qnr and/or aac (6’)-Ib-cr genes (30.4%). Among these, 5 isolates were resistant to both classes of antibiotics of which; 3 carried the aac (6’)-Ib-cr gene, one had the qnrS, and one harbored both aac (6’)-Ib-cr and qnrB genes. None of the isolates contained qnrA. Two isolates were sensitive to quinolones and resistant to cephalosporins of which; one had qnrS and the other carried the aac (6’)-Ib-cr gene. Conclusions: Our study showed that 30.4% of the quinolone and/or cephalosporin resistant community isolates of K. pneumoniae carried PMQR genes. These results confirm that community isolates can be an important source for spreading antibiotic resistance determinants among Gram negative pathogens. This is the first report from Iran on detection of PMQR in the community isolates of K. pneumoniae.
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Affiliation(s)
- Seyed Mohsen Seyedpour
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, G.C., Tehran, IR Iran
| | - Fereshteh Eftekhar
- Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, G.C., Tehran, IR Iran
- Corresponding author: Fereshteh Eftekhar, Department of Microbiology, Faculty of Biological Sciences, Shahid Beheshti University, G.C., Tehran, IR Iran. Tel: +98-2129903208, Fax: +98-2122431664, E-mail:
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Enterobacteriaceae resistant to third-generation cephalosporins and quinolones in fresh culinary herbs imported from Southeast Asia. Int J Food Microbiol 2014; 177:72-7. [DOI: 10.1016/j.ijfoodmicro.2014.02.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/07/2014] [Accepted: 02/18/2014] [Indexed: 01/08/2023]
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Baker S, Duy PT, Nga TVT, Dung TTN, Phat VV, Chau TT, Turner AK, Farrar J, Boni MF. Fitness benefits in fluoroquinolone-resistant Salmonella Typhi in the absence of antimicrobial pressure. eLife 2013; 2:e01229. [PMID: 24327559 PMCID: PMC3857714 DOI: 10.7554/elife.01229] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Fluoroquinolones (FQ) are the recommended antimicrobial treatment for typhoid, a severe systemic infection caused by the bacterium Salmonella enterica serovar Typhi. FQ-resistance mutations in S. Typhi have become common, hindering treatment and control efforts. Using in vitro competition experiments, we assayed the fitness of eleven isogenic S. Typhi strains with resistance mutations in the FQ target genes, gyrA and parC. In the absence of antimicrobial pressure, 6 out of 11 mutants carried a selective advantage over the antimicrobial-sensitive parent strain, indicating that FQ resistance in S. Typhi is not typically associated with fitness costs. Double-mutants exhibited higher than expected fitness as a result of synergistic epistasis, signifying that epistasis may be a critical factor in the evolution and molecular epidemiology of S. Typhi. Our findings have important implications for the management of drug-resistant S. Typhi, suggesting that FQ-resistant strains would be naturally maintained even if fluoroquinolone use were reduced. DOI:http://dx.doi.org/10.7554/eLife.01229.001 The fluoroquinolones are a group of antimicrobials that are used to treat a variety of life-threatening bacterial infections, including typhoid fever. Before the introduction of antimicrobials, the mortality rate from typhoid fever was 10–20%. Prompt treatment with fluoroquinolones has reduced this to less than 1%, and has also decreased the severity of symptoms suffered by people with the disease. Now, however, the usefulness of many antimicrobials, including the fluoroquinolones, is threatened by the evolution of antimicrobial resistance within the bacterial populations being treated. Drug resistance in bacteria typically arises through specific mutations, or following the acquisition of antimicrobial resistance genes from other bacteria. It is thought that the frequent use of antimicrobials in human and animal health puts selective pressure on bacterial populations, allowing bacterial strains with mutations or genes that confer antimicrobial resistance to survive, while bacterial strains that are sensitive to the antimicrobials die out. At first it was thought that specific mutations conferring antimicrobial resistance came at a fitness cost, which would mean that such mutations would be rare in the absence of antimicrobials. Now, based on research into typhoid fever, Baker et al. describe a system in which the majority of evolutionary routes to drug resistance are marked by significant fitness benefits, even in the absence of antimicrobial exposure. Typhoid is caused by a bacterial pathogen known as Salmonella Typhi, and mutations in two genes—gyrA and parC—result in resistance to fluoroquinolones. Baker et al. show that mutations in these genes confer a measurable fitness advantage over strains without these mutations, even in the absence of exposure to fluoroquinolones. Moreover, strains with two mutations in one of these genes exhibited a higher than predicted fitness, suggesting that there is a synergistic interaction between the two mutations. This work challenges the dogma that antimicrobial resistant organisms have a fitness disadvantage in the absence of antimicrobials, and suggests that increasing resistance to the fluoroquinolones is not solely driven by excessive use of this important group of drugs. DOI:http://dx.doi.org/10.7554/eLife.01229.002
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Affiliation(s)
- Stephen Baker
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
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Flach CF, Boulund F, Kristiansson E, Larsson DJ. Functional verification of computationally predicted qnr genes. Ann Clin Microbiol Antimicrob 2013; 12:34. [PMID: 24257207 PMCID: PMC4222258 DOI: 10.1186/1476-0711-12-34] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/14/2013] [Indexed: 01/17/2023] Open
Abstract
Background The quinolone resistance (qnr) genes are widely distributed among bacteria. We recently developed and applied probabilistic models to identify tentative novel qnr genes in large public collections of DNA sequence data including fragmented metagenomes. Findings By using inducible recombinant expressions systems the functionality of four identified qnr candidates were evaluated in Escherichia coli. Expression of several known qnr genes as well as two novel candidates provided fluoroquinolone resistance that increased with elevated inducer concentrations. The two novel, functionally verified qnr genes are termed Vfuqnr and assembled qnr 1. Co-expression of two qnr genes suggested non-synergistic action. Conclusion The combination of a computational model and recombinant expression systems provides opportunities to explore and identify novel antibiotic resistance genes in both genomic and metagenomic datasets.
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Affiliation(s)
- Carl-Fredrik Flach
- Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden.
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Tracking the establishment of local endemic populations of an emergent enteric pathogen. Proc Natl Acad Sci U S A 2013; 110:17522-7. [PMID: 24082120 DOI: 10.1073/pnas.1308632110] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Shigella sonnei is a human-adapted pathogen that is emerging globally as the dominant agent of bacterial dysentery. To investigate local establishment, we sequenced the genomes of 263 Vietnamese S. sonnei isolated over 15 y. Our data show that S. sonnei was introduced into Vietnam in the 1980s and has undergone localized clonal expansion, punctuated by genomic fixation events through periodic selective sweeps. We uncover geographical spread, spatially restricted frontier populations, and convergent evolution through local gene pool sampling. This work provides a unique, high-resolution insight into the microevolution of a pioneering human pathogen during its establishment in a new host population.
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Mandal J, Sangeetha V, Das A, Parija SC. Characterization of extended-spectrum beta-lactamase-producing clinical isolates of Shigella flexneri. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2013; 31:405-408. [PMID: 24288956 PMCID: PMC3805892 DOI: 10.3329/jhpn.v31i3.16834] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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A cointegrate-like plasmid that facilitates dissemination by conjugation of the extended-spectrum β-lactamase CTX-M-17. Antimicrob Agents Chemother 2013; 57:5191-2. [PMID: 23877684 DOI: 10.1128/aac.01365-13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Adachi F, Yamamoto A, Takakura KI, Kawahara R. Occurrence of fluoroquinolones and fluoroquinolone-resistance genes in the aquatic environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2013; 444:508-514. [PMID: 23291652 DOI: 10.1016/j.scitotenv.2012.11.077] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 11/12/2012] [Accepted: 11/22/2012] [Indexed: 06/01/2023]
Abstract
Fluoroquinolones (FQs) have been detected in aquatic environments in several countries. Long-term exposure to low levels of antimicrobial agents provides selective pressure, which might alter the sensitivity of bacteria to antimicrobial agents in the environment. Here, we examined FQ levels and the resistance of Escherichia coli (E. coli) to FQs by phenotyping and genotyping. In the aquatic environment in Osaka, Japan, ciprofloxacin, enoxacin, enfloxacin, lomefloxacin, norfloxacin, and ofloxacin were detected in concentrations ranging from 0.1 to 570 ng L(-1). FQ-resistant E. coli were also found. Although no obvious correlation was detected between the concentration of FQs and the presence of FQ-resistant E. coli, FQ-resistant E. coli were detected in samples along with FQs, particularly ciprofloxacin and ofloxacin. Most FQ-resistant E. coli carried mutations in gyrA, parC, and parE in quinolone resistance-determining regions. No mutations in gyrB were detected in any isolates. Amino acid changes in these isolates were quite similar to those in clinical isolates. Six strains carried the plasmid-mediated quinolone resistance determinant qnrS1 and expressed low susceptibility to ciprofloxacin and nalidixic acid: the minimum inhibitory concentrations ranged from 0.25 μg mL(-1) for ciprofloxacin, and from 8 to 16 μg mL(-1) for nalidixic acid. This finding confirmed that plasmids containing qnr genes themselves did not confer full resistance to quinolones. Because plasmids are responsible for much of the horizontal gene transfer, these genes may transfer and spread in the environment. To our knowledge, this is the first report of plasmid-mediated quinolone resistance determinant qnrS1 in the aquatic environment, and this investigation provides baseline data on antimicrobial resistance profiles in the Osaka area.
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Affiliation(s)
- Fumie Adachi
- Osaka Prefectural Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
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Schultsz C, Bootsma MCJ, Loan HT, Nga TTT, Thao LTP, Thuy TTD, Campbell J, Vien LM, Hoa NT, Hoang NVM, Wit F, Chau NVV, Farrar J, Bonten MJM, Yen LM. Effects of infection control measures on acquisition of five antimicrobial drug-resistant microorganisms in a tetanus intensive care unit in Vietnam. Intensive Care Med 2013; 39:661-71. [PMID: 23306583 PMCID: PMC3607730 DOI: 10.1007/s00134-012-2771-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 11/14/2012] [Indexed: 11/30/2022]
Abstract
Purpose To quantify the effects of barrier precautions and antibiotic mixing on prevalence and acquisition of five drug-resistant microorganisms within a single tetanus intensive care unit at a tertiary referral hospital in Ho Chi Minh City, Vietnam. Methods All patients admitted within the study period were included. After a 1-year baseline period, barrier precautions were implemented and the single empirical treatment ceftazidime was changed to mixing (per consecutive patient) of three different regimens (ceftazidime, ciprofloxacin, piperacillin–tazobactam). Markov chain modeling and genotyping were used to determine the effects of interventions on prevalence levels and the relative importance of cross-transmission and antibiotic-associated selection. Results A total of 190 patients were included in year 1 (2,708 patient days, 17,260 cultures) and 167 patients in year 2 (3,384 patient days, 20,580 cultures). In year 1, average daily prevalence rates for methicillin-resistant Staphylococcus aureus (MRSA), extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (excluding Klebsiella pneumoniae), Pseudomonas aeruginosa, gentamicin-resistant K. pneumoniae, and amikacin-resistant Acinetobacter species were 34.0, 61.3, 53.4, 65.7 and 57.1 %. After intervention, ceftazidime usage decreased by 53 %; the use of piperacillin–tazobactam and ciprofloxacin increased 7.2-fold and 4.5-fold, respectively. Adherence to hand hygiene after patient contact was 54 %. These measures were associated with a reduction of MRSA prevalence by 69.8 % (to 10.3 %), mainly because of less cross-transmission (88 % reduction), and of ESBL-producing Enterobacteriaceae prevalence by 10.3 % (non-significantly). In contrast, prevalence levels of the other three pathogens remained unaffected. Conclusion The combination of simple infection control measures and antibiotic mixing was highly effective in reducing the prevalence of MRSA, but not of Gram-negative microorganisms. Electronic supplementary material The online version of this article (doi:10.1007/s00134-012-2771-1) contains supplementary material.
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Affiliation(s)
- Constance Schultsz
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
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Intestinal Enterobacteriaceae and Escherichia coli populations in Japanese adults demonstrated by the reverse transcription-quantitative PCR and the clone library analyses. J Microbiol Methods 2012; 92:213-9. [PMID: 23262033 DOI: 10.1016/j.mimet.2012.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 12/08/2012] [Accepted: 12/09/2012] [Indexed: 01/15/2023]
Abstract
A primer set specific for Escherichia coli/Shigella 16S rRNA was developed and used for RT-qPCR analysis of fecal samples from 35 healthy adult volunteers in combination with the previously reported primer set specific for Enterobacteriaceae. Enterobacteriaceae and E. coli were present in the 29 out of 35 volunteers tested as intestinal commensals at the average population levels of 10(7.1±0.9) and 10(6.8±0.7)cellsg(-1) of stools (mean±standard deviation), respectively. Among the 7 volunteers, the significant deviation between the count of Enterobacteriaceae and that of E. coli was observed, suggesting non-E. coli/Shigella species were predominant in their Enterobacteriaceae populations. The clone library analysis revealed that the non-E. coli/Shigella populations included Citrobacter freundii, Citrobacter koseri, Enterobacter cloacae, Klebsiella oxytoca, Klebsiella pneumoniae/variicola and Morganella morganii. These data suggested that the RT-qPCR method with the primer sets specific to both Enterobacteriaceae and E. coli/Shigella enabled the accurate enumeration of intestinal E. coli populations and the other Enterobacteriaceae species populations.
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Vien LTM, Minh NNQ, Thuong TC, Khuong HD, Nga TVT, Thompson C, Campbell JI, de Jong M, Farrar JJ, Schultsz C, van Doorn HR, Baker S. The co-selection of fluoroquinolone resistance genes in the gut flora of Vietnamese children. PLoS One 2012; 7:e42919. [PMID: 22937000 PMCID: PMC3427306 DOI: 10.1371/journal.pone.0042919] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 07/16/2012] [Indexed: 01/18/2023] Open
Abstract
Antimicrobial consumption is one of the major contributing factors facilitating the development and maintenance of bacteria exhibiting antimicrobial resistance. Plasmid-mediated quinolone resistance (PMQR) genes, such as the qnr family, can be horizontally transferred and contribute to reduced susceptibility to fluoroquinolones. We performed an observational study, investigating the copy number of PMQR after antimicrobial therapy. We enrolled 300 children resident in Ho Chi Minh City receiving antimicrobial therapy for acute respiratory tract infections (ARIs). Rectal swabs were taken on enrollment and seven days subsequently, counts for Enterobacteriaceae were performed and qnrA, qnrB and qnrS were quantified by using real-time PCR on metagenomic stool DNA. On enrollment, we found no association between age, gender or location of the participants and the prevalence of qnrA, qnrB or qnrS. Yet, all three loci demonstrated a proportional increase in the number of samples testing positive between day 0 and day 7. Furthermore, qnrB demonstrated a significant increase in copy number between paired samples (p<0.001; Wilcoxon rank-sum), associated with non-fluoroquinolone combination antimicrobial therapy. To our knowledge, this is the first study describing an association between the use of non-fluoroquinolone antimicrobials and the increasing relative prevalence and quantity of qnr genes. Our work outlines a potential mechanism for the selection and maintenance of PMQR genes and predicts a strong effect of co-selection of these resistance determinants through the use of unrelated and potentially unnecessary antimicrobial regimes.
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Affiliation(s)
- Le Thi Minh Vien
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Ngo Ngoc Quang Minh
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Children's Hospital, Ho Chi Minh City, Vietnam
| | | | - Huynh Duy Khuong
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Tran Vu Thieu Nga
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Corinne Thompson
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - James I. Campbell
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Menno de Jong
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeremy J. Farrar
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Diseases, University of Oxford, Oxford, United Kingdom
| | - Constance Schultsz
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Department of Medical Microbiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - H. Rogier van Doorn
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Diseases, University of Oxford, Oxford, United Kingdom
| | - Stephen Baker
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Diseases, University of Oxford, Oxford, United Kingdom
- * E-mail:
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48
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Koirala KD, Thanh DP, Thapa SD, Arjyal A, Karkey A, Dongol S, Shrestha UM, Farrar JJ, Basnyat B, Baker S. Highly resistant Salmonella enterica serovar Typhi with a novel gyrA mutation raises questions about the long-term efficacy of older fluoroquinolones for treating typhoid fever. Antimicrob Agents Chemother 2012; 56:2761-2. [PMID: 22371897 PMCID: PMC3346606 DOI: 10.1128/aac.06414-11] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 02/16/2012] [Indexed: 01/17/2023] Open
Abstract
As a consequence of multidrug resistance, clinicians are highly dependent on fluoroquinolones for treating the serious systemic infection typhoid fever. While reduced susceptibility to fluoroquinolones, which lessens clinical efficacy, is becoming ubiquitous, comprehensive resistance is exceptional. Here we report ofloxacin treatment failure in typhoidal patient infected with a novel, highly fluoroquinolone-resistant isolate of Salmonella enterica serovar Typhi. The isolation of this organism has serious implications for the long-term efficacy of ciprofloxacin and ofloxacin for typhoid treatment.
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Affiliation(s)
| | - Duy Pham Thanh
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Sudeep Dhoj Thapa
- Oxford University Clinical Research Unit—Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Amit Arjyal
- Oxford University Clinical Research Unit—Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Abhilasha Karkey
- Oxford University Clinical Research Unit—Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Sabina Dongol
- Oxford University Clinical Research Unit—Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Upendra Man Shrestha
- Oxford University Clinical Research Unit—Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Jeremy J. Farrar
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Diseases, University of Oxford, Oxford, United Kingdom
| | - Buddha Basnyat
- Oxford University Clinical Research Unit—Patan Academy of Health Sciences, Kathmandu, Nepal
| | - Stephen Baker
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Diseases, University of Oxford, Oxford, United Kingdom
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49
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Lichtenstein SJ, De Leon L, Heller W, Marshall B, Cupp G, Foster K, McLean C, Levy S, Stroman DW. Topical ophthalmic moxifloxacin elicits minimal or no selection of fluoroquinolone resistance among bacteria isolated from the skin, nose, and throat. J Pediatr Ophthalmol Strabismus 2012; 49:88-97. [PMID: 22074357 DOI: 10.3928/01913913-20111101-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 07/14/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate whether moxifloxacin therapy of bacterial conjunctivitis in children changes the moxifloxacin susceptibility of bacterial isolates in eyes, cheeks below eyes, nares, and throat. METHODS Patients (age: 1 to 12 years, n = 105) with bacterial conjunctivitis were treated topically with moxifloxacin three times a day for 7 days. Gender- and age-matched subjects with normal eyes (age: 1 to 12 years, n = 57) served as the control group. Microbiological specimens were collected on days 1 (prior to therapy), 8 (1 day after end of therapy), and 42 (follow-up). Specimens were processed to recover total bacteria and bacteria that grew on fluoroquinolone-selective media. Bacteria were identified to the species level and susceptibility to moxifloxacin and selected other antibiotics determined. RESULTS The primary pathogens recovered from the infected eyes on day 1 before therapy were Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus. None of the pre-therapy isolates of H. influenzae and S. pneumoniae were resistant to moxifloxacin. Isolates of these two pathogenic species were also recovered primarily from the nose and eyes. Moxifloxacin-resistant S. aureus isolates (minimum inhibitory concentration 1.0 μg/mL or greater) were recovered from the nose and throat prior to topical dosing on day 1. However, there was no change in the frequency of moxifloxacin-resistant isolates of S. aureus following treatment with moxifloxacin. CONCLUSION Treatment of conjunctivitis with topical ophthalmic moxifloxacin did not select for moxifloxacin resistance in H. influenzae, S. pneumoniae, or S. aureus in the eye or distal body sites.
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Affiliation(s)
- Steven J Lichtenstein
- University of Illinois College of Medicine at Peoria & Chicago, Children's Hospital of Illinois, Peoria, Illinois, USA.
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50
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Lamikanra A, Crowe JL, Lijek RS, Odetoyin BW, Wain J, Aboderin AO, Okeke IN. Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use. BMC Infect Dis 2011; 11:312. [PMID: 22060770 PMCID: PMC3226678 DOI: 10.1186/1471-2334-11-312] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Accepted: 11/07/2011] [Indexed: 11/25/2022] Open
Abstract
Background Antibiotic resistance has necessitated fluoroquinolone use but little is known about the selective forces and resistance trajectory in malaria-endemic settings, where selection from the antimalarial chloroquine for fluoroquinolone-resistant bacteria has been proposed. Methods Antimicrobial resistance was studied in fecal Escherichia coli isolates in a Nigerian community. Quinolone-resistance determining regions of gyrA and parC were sequenced in nalidixic acid resistant strains and horizontally-transmitted quinolone-resistance genes were sought by PCR. Antimicrobial prescription practices were compared with antimicrobial resistance rates over a period spanning three decades. Results Before 2005, quinolone resistance was limited to low-level nalixidic acid resistance in fewer than 4% of E. coli isolates. In 2005, the proportion of isolates demonstrating low-level quinolone resistance due to elevated efflux increased and high-level quinolone resistance and resistance to the fluoroquinolones appeared. Fluoroquinolone resistance was attributable to single nucleotide polymorphisms in quinolone target genes gyrA and/or parC. By 2009, 35 (34.5%) of isolates were quinolone non-susceptible with nine carrying gyrA and parC SNPs and six bearing identical qnrS1 alleles. The antimalarial chloroquine was heavily used throughout the entire period but E. coli with quinolone-specific resistance mechanisms were only detected in the final half decade, immediately following the introduction of the fluoroquinolone antibacterial ciprofloxacin. Conclusions Fluoroquinolones, and not chloroquine, appear to be the selective force for fluoroquinolone-resistant fecal E. coli in this setting. Rapid evolution to resistance following fluoroquinolone introduction points the need to implement resistant containment strategies when new antibacterials are introduced into resource-poor settings with high infectious disease burdens.
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Affiliation(s)
- Adebayo Lamikanra
- Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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