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Mutuku C, Melegh S, Kovacs K, Urban P, Virág E, Heninger R, Herczeg R, Sonnevend Á, Gyenesei A, Fekete C, Gazdag Z. Characterization of β-Lactamases and Multidrug Resistance Mechanisms in Enterobacterales from Hospital Effluents and Wastewater Treatment Plant. Antibiotics (Basel) 2022; 11:antibiotics11060776. [PMID: 35740182 PMCID: PMC9219941 DOI: 10.3390/antibiotics11060776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 01/11/2023] Open
Abstract
Antimicrobials in wastewater promote the emergence of antibiotic resistance, facilitated by selective pressure and transfer of resistant genes. Enteric bacteria belonging to Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Citrobacter species (n = 126) from hospital effluents and proximate wastewater treatment plant were assayed for susceptibility to four antimicrobial classes. The β-lactamase encoding genes harbored in plasmids were genotyped and the plasmids were sequenced. A multidrug resistance phenotype was found in 72% (n = 58) of E. coli isolates, 70% (n = 43) of Klebsiella species isolates, and 40% (n = 25) of Enterobacter and Citrobacter species. Moreover, 86% (n = 50) of E. coli, 77% (n = 33) of Klebsiella species, and 25% (n = 4) of Citrobacter species isolates phenotypically expressed extended spectrum β-lactamase. Regarding ESBL genes, blaCTX-M-27 and blaTEM-1 were found in E. coli, while Klebsiella species harbored blaCTX-M-15, blaCTX-M-30, or blaSHV-12. Genes coding for aminoglycoside modifying enzymes, adenylyltransferases (aadA1, aadA5), phosphotransferases (aph(6)-1d, aph(3″)-Ib), acetyltransferases (aac(3)-IIa), (aac(6)-Ib), sulfonamide/trimethoprim resistant dihydropteroate synthase (sul), dihydrofolate reductase (dfrA), and quinolone resistance protein (qnrB1) were also identified. Monitoring wastewater from human sources for acquired resistance in clinically important bacteria may provide a cheaper alternative in regions facing challenges that limit clinical surveillance.
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Affiliation(s)
- Christopher Mutuku
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
- Correspondence: (C.M.); (Z.G.)
| | - Szilvia Melegh
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Krisztina Kovacs
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Peter Urban
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Eszter Virág
- Educomat Ltd., Iskola utca 12/A, 8360 Keszthely, Hungary;
- Department of Molecular Biotechnology and Microbiology, Institute of Biotechnology, Faculty of Science and Technology, University of Debrecen, Egyetem Square 1, 4032 Debrecen, Hungary
| | - Reka Heninger
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
| | - Robert Herczeg
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Ágnes Sonnevend
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Attila Gyenesei
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Csaba Fekete
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
| | - Zoltan Gazdag
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
- Correspondence: (C.M.); (Z.G.)
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Ragheb SM, Govinden U, Osei Sekyere J. Genetic support of carbapenemases: a One Health systematic review and meta-analysis of current trends in Africa. Ann N Y Acad Sci 2021; 1509:50-73. [PMID: 34753206 DOI: 10.1111/nyas.14703] [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: 05/21/2020] [Revised: 09/06/2021] [Accepted: 09/26/2021] [Indexed: 11/28/2022]
Abstract
Antimicrobial resistance (AMR) is a public health threat globally. Carbapenems are β-lactam antibiotics used as last-resort agents for treating antibiotic-resistant infections. Mobile genetic elements (MGEs) play an important role in the dissemination and expression of antimicrobial resistance genes (ARGs), including the mobilization of ARGs within and between species. The presence of MGEs around carbapenem-hydrolyzing enzymes, called carbapenemases, in bacterial isolates in Africa is concerning. The association between MGEs and carbapenemases is described herein. Specific plasmid replicons, integrons, transposons, and insertion sequences were found flanking specific and different carbapenemases across the same and different clones and species isolated from humans, animals, and the environment. Notably, similar genetic contexts have been reported in non-African countries, supporting the importance of MGEs in driving the intra- and interclonal and species transmission of carbapenemases in Africa and globally. Technical and budgetary limitations remain challenges for epidemiological analysis of carbapenemases in Africa, as studies undertaken with whole-genome sequencing remained relatively few. Characterization of MGEs in antibiotic-resistant infections can deepen our understanding of carbapenemase epidemiology and facilitate the control of AMR in Africa. Investment in genomic epidemiology will facilitate faster clinical interventions and containment of outbreaks.
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Affiliation(s)
- Suzan Mohammed Ragheb
- Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt
| | - Usha Govinden
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - John Osei Sekyere
- Department of Microbiology & Immunology, Indiana University School of Medicine-Northwest, Gary, Indiana.,Department of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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3
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Benulič K, Pirš M, Couto N, Chlebowicz M, Rossen JWA, Zorec TM, Seme K, Poljak M, Lejko Zupanc T, Ružić-Sabljić E, Cerar T. Whole genome sequencing characterization of Slovenian carbapenem-resistant Klebsiella pneumoniae, including OXA-48 and NDM-1 producing outbreak isolates. PLoS One 2020; 15:e0231503. [PMID: 32282829 PMCID: PMC7153892 DOI: 10.1371/journal.pone.0231503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/24/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives The first hospital outbreak of carbapenemase-producing Enterobacteriaceae in Slovenia occurred in 2014–2016. Whole genome sequencing was used to analyse the population of carbapenem-resistant Klebsiella pneumoniae collected in Slovenia in 2014–2017, including OXA-48 and/or NDM-1 producing strains from the outbreak. Methods A total of 32 K. pneumoniae isolates were analysed using short-read sequencing. Multi-locus sequence typing and core genome multi-locus sequence typing were used to infer genetic relatedness. Antimicrobial resistance markers, virulence factors, plasmid content and wzi types were determined. Long-read sequencing was used for six isolates for detailed analysis of plasmids and their possible transmission. Results Overall, we detected 10 different sequence types (STs), the most common being ST437 (40.6%). Isolates from the initial outbreak belonged to ST437 (12/16) and ST147 (4/16). A second outbreak of four ST15 isolates was discovered. A new ST (ST3390) and two new wzi types (wzi-556, wzi-559) were identified. blaOXA-48 was found in 17 (53.1%) isolates, blaNDM-1 in five (15.6%), and a combination of blaOXA-48/NDM-1 in seven (21.9%) isolates. Identical plasmids carrying blaOXA-48 were found in outbreak isolates sequenced with long-read sequencing technology. Conclusions Whole genome sequencing of Slovenian carbapenem-resistant K. pneumoniae isolates revealed multiple clusters of STs, two of which were involved in the first hospital outbreak of carbapenem producing K. pneumoniae in Slovenia. Transmission of the plasmid carrying blaOXA-48 between two STs was likely to have occurred. A previously unidentified second outbreak was also discovered, highlighting the importance of whole genome sequencing in detection and/or characterization of hospital outbreaks and surveillance of drug-resistant bacterial clones.
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Affiliation(s)
- Katarina Benulič
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
- * E-mail:
| | - Mateja Pirš
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Natacha Couto
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Monika Chlebowicz
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - John W. A. Rossen
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Tomaž Mark Zorec
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Seme
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Mario Poljak
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Tatjana Lejko Zupanc
- Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Eva Ružić-Sabljić
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Tjaša Cerar
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
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Markovska R, Stoeva T, Boyanova L, Stankova P, Schneider I, Keuleyan E, Mihova K, Murdjeva M, Sredkova M, Lesseva M, Nedelcheva G, Petrova A, Ivanova D, Lazarova G, Kaneva R, Mitov I. Multicentre investigation of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Bulgarian hospitals - Interregional spread of ST11 NDM-1-producing K. pneumoniae. INFECTION GENETICS AND EVOLUTION 2019; 69:61-67. [PMID: 30654179 DOI: 10.1016/j.meegid.2019.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/09/2018] [Accepted: 01/11/2019] [Indexed: 11/24/2022]
Abstract
AIM The aim of this study was to investigate the mechanisms of beta-lactam-resistance and the clonal relatedness of carbapenem-nonsusceptible Klebsiella pneumoniae and Escherichia coli isolates, collected consecutively in eight centers in five Bulgarian cities from November 2014 to March 2018. Carbapenemase-producing enterobacteria were detected in all but one centers. Overall, 104 K. pneumoniae and one E. coli were analysed. MATERIALS AND METHODS Antimicrobial susceptibility and beta-lactamases were analysed. Conjugation experiments, plasmid fingerprinting and replicon typing, as well as MLST and ERIC-PCR were carried out. RESULTS KPC-2 (51%) and NDM-1 (47%) were the main carbapenemases identified. KPC-2 producing K. pneumoniae were classified into 10 MLST-types. The four dominating MLST-types ST29, ST15, ST336 and ST902 comprised 79% of the KPC-2 producers. All but one of the NDM-1 producing isolates belonged to the MLST-type ST11 and were found in seven centers. Furthermore, single K. pneumoniae isolates producing VIM-1 (ST147) and OXA-48 (ST15) were identified. In addition to the carbapenemases, the ESBLs CTX-M-15, CTX-M-3, and SHV-12 as well as AmpC enzyme CMY-4 were found. The FIIAs-replicon-type was found in all KPC-2 producers while the A/C-replicons dominated in NDM-1 producing isolates. The single NDM-1 producing E. coli was determined as MLST-Type ST10 (Warwick scheme). CONCLUSION The interregional clonal expansion of NDM-1 producing ST11 K. pneumoniae and the dissemination of blaKPC-2 carrying plasmids were responsible for the spread of carbapenemase-producing K. pneumoniae in Bulgaria. Our findings highlight the urgency to prevent dissemination of these highly transmissible and dangerous lineages.
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Affiliation(s)
- Rumyana Markovska
- Medical University of Sofia, Medical Faculty, Department of Medical Microbiology, Bulgaria.
| | - Temenuga Stoeva
- Medical University of Varna, Department of Microbiology and Virology, University Multiprofile Hospital for Active Treatment (UMHAT), St Marina, Varna, Bulgaria
| | - Lyudmila Boyanova
- Medical University of Sofia, Medical Faculty, Department of Medical Microbiology, Bulgaria
| | - Petya Stankova
- Medical University of Sofia, Medical Faculty, Department of Medical Microbiology, Bulgaria
| | | | - Emma Keuleyan
- Department of Clinical Microbiology, Medical Institute - Ministry of the Interior, Sofia, Bulgaria
| | - Kalina Mihova
- Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
| | - Marianna Murdjeva
- Medical University of Plovdiv, Department of Microbiology and Immunology, UMHAT, "St George", Plovdiv, Bulgaria
| | - Mariya Sredkova
- Medical University of Pleven, Department of Microbiology and Virology, UMHAT "Georgi Stranski", Pleven, Bulgaria
| | | | - Gergana Nedelcheva
- Medical University of Varna, Department of Microbiology and Virology, University Multiprofile Hospital for Active Treatment (UMHAT), St Marina, Varna, Bulgaria
| | - Atanaska Petrova
- Medical University of Plovdiv, Department of Microbiology and Immunology, UMHAT, "St George", Plovdiv, Bulgaria
| | - Dobrinka Ivanova
- Second Multiprofile Hospital for Active Treatment, Sofia, Bulgaria
| | - Grozdanka Lazarova
- UMHAT "Prof. dr St Kirkovich" Stara Zagora, Thracian University, Stara Zagora, Bulgaria
| | - Radka Kaneva
- Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
| | - Ivan Mitov
- Medical University of Sofia, Medical Faculty, Department of Medical Microbiology, Bulgaria
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5
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Matsumura Y, Peirano G, Devinney R, Bradford PA, Motyl MR, Adams MD, Chen L, Kreiswirth B, Pitout JDD. Genomic epidemiology of global VIM-producing Enterobacteriaceae. J Antimicrob Chemother 2018; 72:2249-2258. [PMID: 28520983 DOI: 10.1093/jac/dkx148] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 04/19/2017] [Indexed: 12/21/2022] Open
Abstract
Background International data on the molecular epidemiology of Enterobacteriaceae with VIM carbapenemases are limited. Methods We performed short read (Illumina) WGS on a global collection of 89 VIM-producing clinical Enterobacteriaceae (2008-14). Results VIM-producing (11 varieties within 21 different integrons) isolates were mostly obtained from Europe. Certain integrons with bla VIM were specific to a country in different species and clonal complexes (CCs) (In 87 , In 624 , In 916 and In 1323 ), while others had spread globally among various Enterobacteriaceae species (In 110 and In 1209 ). Klebsiella pneumoniae was the most common species ( n = 45); CC147 from Greece was the most prevalent clone and contained In 590 -like integrons with four different bla VIM s. Enterobacter cloacae complex was the second most common species and mainly consisted of Enterobacter hormaechei ( Enterobacter xiangfangensis , subsp. steigerwaltii and Hoffmann cluster III). CC200 (from Croatia and Turkey), CC114 (Croatia, Greece, Italy and the USA) and CC78 (from Greece, Italy and Spain) containing bla VIM-1 were the most common clones among the E. cloacae complex. Conclusions This study highlights the importance of surveillance programmes using the latest molecular techniques in providing insight into the characteristics and global distribution of Enterobacteriaceae with bla VIM s.
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Affiliation(s)
- Yasufumi Matsumura
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.,Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Gisele Peirano
- Departments of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.,Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada
| | - Rebekah Devinney
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Mark D Adams
- Department of Medical Microbiology, J. Craig Venter Institute, La Jolla, CA, USA
| | - Liang Chen
- Public Research Institute TB Center, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Barry Kreiswirth
- Public Research Institute TB Center, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Johann D D Pitout
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.,Departments of Pathology & Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.,Division of Microbiology, Calgary Laboratory Services, Calgary, Alberta, Canada.,Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
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6
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Markovska R, Stoeva T, Boyanova L, Stankova P, Pencheva D, Keuleyan E, Murjeva M, Sredkova M, Ivanova D, Lazarova G, Nedelcheva G, Kaneva R, Mitov I. Dissemination of successful international clone ST15 and clonal complex 17 among Bulgarian CTX-M-15 producing K. pneumoniae isolates. Diagn Microbiol Infect Dis 2017; 89:310-313. [PMID: 28988698 DOI: 10.1016/j.diagmicrobio.2017.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/04/2017] [Accepted: 08/21/2017] [Indexed: 10/19/2022]
Abstract
A total of 82 extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae and 4 Klebsiella oxytoca isolates were collected in 2014 from four geographical areas in Bulgaria and their multilocus sequence type (MLST) and transferability of the ESBL encoding genes were investigated. The predominant type was CTX-M-15 (87%), followed by CTX-M-3 (9%), SHV-12 or SHV-2 (2%) and CTX-M-14 (1%). The CTX-M-15 producers belonged to ST15 (34.1%) and to a lesser extent to CC17 (ST16, ST17, ST336). The CTX-M-15 transconjugants showed a presence of R, A/C2 and F replicons. The CTX-M-3 producers were assigned to ST29, ST70, ST432, ST542 and ST15 types and the transconjugants carried M2 replicons. To the best of our knowledge, this is the first report that fully describes the MLST types among Bulgarian ESBL producing K. pneumoniae and the first report of the detection of IncR plasmid replicon type in our country.
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Affiliation(s)
- Rumyana Markovska
- Medical University of Sofia, Department of Medical Microbiology, Sofia, Bulgaria.
| | - Temenuga Stoeva
- Medical University of Varna, Department of Microbiology and Virology; University Multiprofile Hospital for active treatment (UMHAT) "St Marina", Varna, Bulgaria
| | - Lyudmila Boyanova
- Medical University of Sofia, Department of Medical Microbiology, Sofia, Bulgaria
| | - Petya Stankova
- Medical University of Sofia, Department of Medical Microbiology, Sofia, Bulgaria
| | - Daniela Pencheva
- Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
| | - Emma Keuleyan
- Medical Institute, Ministry of the Interior, Sofia, Bulgaria
| | - Marianna Murjeva
- Medical University of Plovdiv, Department of Microbiology and Immunology, UMHAT "St George", Plovdiv, Bulgaria
| | - Marya Sredkova
- Medical University of Pleven, Department of Microbiology and Virology; UMHAT "Georgi Stranski", Pleven, Bulgaria
| | - Dobrinka Ivanova
- Second Multiprofile Hospital for active treatment, Sofia, Bulgaria
| | - Grozdanka Lazarova
- UMHAT "Prof. d-r St Kirkovich" Stara Zagora, Thracian University -, Stara Zagora, Bulgaria
| | - Gergana Nedelcheva
- Medical University of Varna, Department of Microbiology and Virology; University Multiprofile Hospital for active treatment (UMHAT) "St Marina", Varna, Bulgaria
| | - Radka Kaneva
- Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
| | - Ivan Mitov
- Medical University of Sofia, Department of Medical Microbiology, Sofia, Bulgaria
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7
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Mahanti A, Ghosh P, Samanta I, Joardar SN, Bandyopadhyay S, Bhattacharyya D, Banerjee J, Batabyal S, Sar TK, Dutta TK. Prevalence of CTX-M-Producing Klebsiella spp. in Broiler, Kuroiler, and Indigenous Poultry in West Bengal State, India. Microb Drug Resist 2017; 24:299-306. [PMID: 28829687 DOI: 10.1089/mdr.2016.0096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study was undertaken to detect the prevalence of CTX-M-producing Klebsiella spp. in healthy broiler, indigenous, and kuroiler birds reared in West Bengal (India) during November 2014-February 2015. In addition to CTX-M gene, the study was also conducted to reveal the occurrence of other β-lactamase and class I integron genes in Klebsiella spp. isolates along with their clonal relationship. A total of 321 cloacal swabs from healthy broiler, indigenous, and kuroiler birds were collected from different places of West Bengal, India. Klebsiella spp. isolation rate varies among different types of poultry birds (43.8-72.3%). In total, 33 (10.7%) Klebsiella spp. isolates were detected phenotypically as CTX-M producers and all the isolates possessed blaCTX-M in polymerase chain reaction. Whereas 17 (51.5%) and 16 (48.5%) Klebsiella spp. isolates possessed blaSHV, and blaTEM with blaCTX-M, respectively. None of the CTX-M-producing Klebsiella spp. isolates in this study possessed class I integron gene. Randomly amplified polymorphic DNA-based phylogenetic tree revealed the presence of clonal relationship among the CTX-M-producing Klebsiella spp. isolates, recovered from broilers and indigenous birds. This study identified broilers and indigenous game birds as a potential reservoir of CTX-M-producing Klebsiella spp., which could be transmitted to the human food chain directly or indirectly.
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Affiliation(s)
- Achintya Mahanti
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Pratik Ghosh
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Indranil Samanta
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Siddhartha Narayan Joardar
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | | | | | - Jaydeep Banerjee
- 2 Eastern Regional Station, Indian Veterinary Research Institute , Kolkata, India
| | - Subhasis Batabyal
- 3 Department of Veterinary Biochemistry, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Tapas Kumar Sar
- 4 Department of Veterinary Pharmacology and Toxicology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Tapan Kumar Dutta
- 5 Department of Veterinary Microbiology, Central Agricultural University , Aizawl, India
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Ben Tanfous F, Alonso CA, Achour W, Ruiz-Ripa L, Torres C, Ben Hassen A. First Description of KPC-2-ProducingEscherichia coliand ST15 OXA-48-PositiveKlebsiella pneumoniaein Tunisia. Microb Drug Resist 2017; 23:365-375. [DOI: 10.1089/mdr.2016.0090] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Farah Ben Tanfous
- Université de Carthage, Faculté des Sciences de Bizerte, 7021, Tunis, Tunisie
- Service des Laboratoires, Centre National de Greffe de Moelle Osseuse, Tunis, Tunisie
- Faculté de Médecine de Tunis, Université de Tunis El Manar, UR 12ES02, Tunis, Tunisie
| | - Carla Andrea Alonso
- Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Wafa Achour
- Service des Laboratoires, Centre National de Greffe de Moelle Osseuse, Tunis, Tunisie
- Faculté de Médecine de Tunis, Université de Tunis El Manar, UR 12ES02, Tunis, Tunisie
| | - Laura Ruiz-Ripa
- Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Carmen Torres
- Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Assia Ben Hassen
- Service des Laboratoires, Centre National de Greffe de Moelle Osseuse, Tunis, Tunisie
- Faculté de Médecine de Tunis, Université de Tunis El Manar, UR 12ES02, Tunis, Tunisie
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Kovács K, Nyul A, Mestyán G, Melegh S, Fenyvesi H, Jakab G, Szabó H, Jánvári L, Damjanova I, Tóth Á. Emergence and interhospital spread of OXA-48-producing Klebsiella pneumoniae ST395 clone in Western Hungary. Infect Dis (Lond) 2016; 49:231-233. [DOI: 10.1080/23744235.2016.1207252] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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10
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Lee CR, Lee JH, Park KS, Kim YB, Jeong BC, Lee SH. Global Dissemination of Carbapenemase-Producing Klebsiella pneumoniae: Epidemiology, Genetic Context, Treatment Options, and Detection Methods. Front Microbiol 2016; 7:895. [PMID: 27379038 PMCID: PMC4904035 DOI: 10.3389/fmicb.2016.00895] [Citation(s) in RCA: 456] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/26/2016] [Indexed: 01/08/2023] Open
Abstract
The emergence of carbapenem-resistant Gram-negative pathogens poses a serious threat to public health worldwide. In particular, the increasing prevalence of carbapenem-resistant Klebsiella pneumoniae is a major source of concern. K. pneumoniae carbapenemases (KPCs) and carbapenemases of the oxacillinase-48 (OXA-48) type have been reported worldwide. New Delhi metallo-β-lactamase (NDM) carbapenemases were originally identified in Sweden in 2008 and have spread worldwide rapidly. In this review, we summarize the epidemiology of K. pneumoniae producing three carbapenemases (KPCs, NDMs, and OXA-48-like). Although the prevalence of each resistant strain varies geographically, K. pneumoniae producing KPCs, NDMs, and OXA-48-like carbapenemases have become rapidly disseminated. In addition, we used recently published molecular and genetic studies to analyze the mechanisms by which these three carbapenemases, and major K. pneumoniae clones, such as ST258 and ST11, have become globally prevalent. Because carbapenemase-producing K. pneumoniae are often resistant to most β-lactam antibiotics and many other non-β-lactam molecules, the therapeutic options available to treat infection with these strains are limited to colistin, polymyxin B, fosfomycin, tigecycline, and selected aminoglycosides. Although, combination therapy has been recommended for the treatment of severe carbapenemase-producing K. pneumoniae infections, the clinical evidence for this strategy is currently limited, and more accurate randomized controlled trials will be required to establish the most effective treatment regimen. Moreover, because rapid and accurate identification of the carbapenemase type found in K. pneumoniae may be difficult to achieve through phenotypic antibiotic susceptibility tests, novel molecular detection techniques are currently being developed.
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Affiliation(s)
- Chang-Ro Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Jung Hun Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Kwang Seung Park
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Young Bae Kim
- Division of STEM, North Shore Community College, Danvers MA, USA
| | - Byeong Chul Jeong
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Sang Hee Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
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Markovska R, Stoeva T, Schneider I, Boyanova L, Popova V, Dacheva D, Kaneva R, Bauernfeind A, Mitev V, Mitov I. Clonal dissemination of multilocus sequence type ST15 KPC-2-producing Klebsiella pneumoniae in Bulgaria. APMIS 2015; 123:887-94. [PMID: 26303718 DOI: 10.1111/apm.12433] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 07/13/2015] [Indexed: 12/30/2022]
Abstract
A total of 36 consecutive clinical and two fecal-screening carbapenem-resistant Klebsiella pneumoniae isolates from two Bulgarian university hospitals (Varna and Pleven) were investigated. Susceptibility testing, conjugation experiments, and plasmid replicon typing were carried out. Beta-lactamases were characterized by isoelectric focusing, PCR, and sequencing. Clonal relatedness was investigated by RAPD and multilocus sequence typing (MLST). Most of the isolates demonstrated multidrug resistance profile. Amikacin and tigecycline retained good activity with susceptibility rates of 95 and 87%, respectively. The resistance rate to colistin was 63%. Six RAPD- and MLST-types were identified: the dominating MLST-type was ST15 (27 isolates), followed by ST76 (six isolates), and ST1350 (two isolates). ST101, ST258, and ST151 were detected once. All except one of the K. pneumoniae produced KPC-2, mostly in combination with CTX-M-15, while for one isolate (ST101) the enzymes OXA-48 and CTX-M-14 were found. All KPC-2-producing transconjugants revealed the presence of IncFII plasmid. The OXA-48- and CTX-M-14-producing isolate showed the presence of L/M replicon type. The dissemination of KPC-2-producing K.pneumoniae in Bulgaria is mainly due to the sustained spread of successful ST15 clone and to a lesser extent of ST76 clone. This is the first report of OXA-48 producing ST101 K. pneumoniae in Bulgaria.
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Affiliation(s)
- Rumyana Markovska
- Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | - Temenuga Stoeva
- Department of Microbiology, Medical University of Varna, Varna, Bulgaria
| | | | - Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
| | | | - Daniela Dacheva
- Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
| | - Radka Kaneva
- Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
| | | | - Vanyo Mitev
- Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
| | - Ivan Mitov
- Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
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