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Frimodt-Møller N, Simonsen GS, Larsen AR, Kahlmeter G. Pivmecillinam, the paradigm of an antibiotic with low resistance rates in Escherichia coli urine isolates despite high consumption. J Antimicrob Chemother 2022; 78:289-295. [PMID: 36441168 DOI: 10.1093/jac/dkac396] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/22/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Pivmecillinam, the oral version of mecillinam, represents one of the major recommended and used antibiotics for empiric and targeted treatment of urinary tract infections in primary care in Denmark, Norway and Sweden. Mecillinam resistant mutants in Escherichia coli develop easily in vitro, but their fitness cost has been shown to be high. METHODS We revisited the resistance and consumption data from the monitoring programmes in the three countries and compared pivmecillinam with ciprofloxacin from 2010 to 2020. RESULTS Mecillinam resistance rates in Escherichia coli remained around 6% in Denmark and Norway relative to a constant consumption in Norway of 1.6-1.8 DID (defined daily doses per 1000 inhabitants per day), and even increasing in Denmark from 1.6 to 2.3 DID. In Sweden resistance was significantly lower at 4% related to the lower consumption of 0.5 DID. For ciprofloxacin, resistance rates fluctuated around 6%-12%, highest in Sweden with the highest consumption (0.8-0.6 DID) and lowest in Denmark (0.55-0.35 DID) and Norway (0.7-0.3 DID), although consumption declined significantly in all three countries. CONCLUSIONS Pivmecillinam is an example of an antibiotic, which easily develops resistance in vitro, but apparently can be used broadly in primary care without increase in resistance rates.
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Affiliation(s)
- Niels Frimodt-Møller
- Department of Clinical Microbiology, Rigshospitalet, DK2100, Copenhagen, Denmark
| | - Gunnar Skov Simonsen
- Department of Microbiology and Infection Control, University Hospital of North Norway, and Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Anders Rhod Larsen
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Gunnar Kahlmeter
- Department of Clinical Microbiology, Central Hospital, Växjö, Sweden
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Emeraud C, Godmer A, Girlich D, Vanparis O, Mahamdi F, Creton E, Jousset AB, Naas T, Bonnin RA, Dortet L. Activity of mecillinam against carbapenem-resistant Enterobacterales. J Antimicrob Chemother 2022; 77:2835-2839. [PMID: 35815675 PMCID: PMC9525088 DOI: 10.1093/jac/dkac226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/03/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Despite the fact that carbapenem-resistant Enterobacterales (CRE) mostly cause urinary tract infections (UTIs), only few studies have focused on the efficacity of mecillinam against these CRE. OBJECTIVES To evaluate the mecillinam susceptibility of a huge collection of CRE, including carbapenemase-producing Enterobacterales (CPE) and non-CPE (ESBL and AmpC producers with decreased permeability of the outer membrane). METHODS A total of 8310 non-duplicate clinical CRE, including 4042 OXA-48-like producers, 1094 NDM producers, 411 VIM producers, 174 KPC producers, 42 IMI producers, 153 multiple-carbapenemase producers and 45 isolates producing other types of carbapenemases (such as IMP-like enzymes or GES-5), were included in the study. WGS was performed on all CPE using Illumina technology. Categorization of susceptibility to mecillinam was performed using disc diffusion (mecillinam discs at 10 μg; I2A, France) according to EUCAST recommendations. The results were interpreted according to EUCAST guidelines (S ≥15 mm). RESULTS Significantly higher susceptibility rates were observed for carbapenem-resistant Proteus spp. (85%) and carbapenem-resistant Escherichia coli (84%), which are the two most common species responsible for UTIs, than for Klebsiella pneumoniae (67%), Enterobacter cloacae complex (75%), Citrobacter spp. (65%), Serratia spp. (34%) and Morganella morganii (12%). Susceptibility rates were 84%, 71% and 91% for OXA-48-like, NDM and IMI producers and 70% for non-CPE CRE. Mecillinam was less active against VIM and KPC producers (14% and 0%, respectively). CONCLUSIONS Mecillinam might be an alternative for the treatment of infections due to CRE, particularly UTIs, except for VIM and KPC producers and for M. morganii and Serratia spp species.
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Affiliation(s)
- Cécile Emeraud
- Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France,INSERM UMR 1184, RESIST Unit, Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France,French National Reference Centre for Antimicrobial Resistance, Le Kremlin-Bicêtre, France
| | - Alexandre Godmer
- Department of Bacteriology, Saint-Antoine Hospital, APHP.Sorbonne-Université, Paris, France,Sorbonne Université, Centre d’Immunologie et des Maladies Infectieuses (Cimi-Paris), UMR 1135, Centre National de Référence des Mycobactéries, Paris, France
| | - Delphine Girlich
- INSERM UMR 1184, RESIST Unit, Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Océane Vanparis
- French National Reference Centre for Antimicrobial Resistance, Le Kremlin-Bicêtre, France
| | - Fériel Mahamdi
- French National Reference Centre for Antimicrobial Resistance, Le Kremlin-Bicêtre, France
| | - Elodie Creton
- French National Reference Centre for Antimicrobial Resistance, Le Kremlin-Bicêtre, France
| | - Agnès B Jousset
- Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France,INSERM UMR 1184, RESIST Unit, Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France,French National Reference Centre for Antimicrobial Resistance, Le Kremlin-Bicêtre, France
| | - Thierry Naas
- Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France,INSERM UMR 1184, RESIST Unit, Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France,French National Reference Centre for Antimicrobial Resistance, Le Kremlin-Bicêtre, France
| | - Rémy A Bonnin
- INSERM UMR 1184, RESIST Unit, Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France,French National Reference Centre for Antimicrobial Resistance, Le Kremlin-Bicêtre, France
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Menck-Costa MF, Baptista AAS, Gazal LEDS, Justino L, Sanches MS, de Souza M, Nishio EK, Queiroz Dos Santos B, Cruz VD, Berbert JVM, Gonçalves BC, Andrade G, Vespero EC, Nakazato G, Kobayashi RKT. High-Frequency Detection of fosA3 and bla CTX-M-55 Genes in Escherichia coli From Longitudinal Monitoring in Broiler Chicken Farms. Front Microbiol 2022; 13:846116. [PMID: 35663865 PMCID: PMC9158547 DOI: 10.3389/fmicb.2022.846116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Considering the worrying emergence of multidrug resistance, including in animal husbandry and especially in food-producing animals, the need to detect antimicrobial resistance strains in poultry environments is relevant, mainly considering a One Health approach. Thus, this study aimed to conduct longitudinal monitoring of antimicrobial resistance in broiler chicken farms, with an emphasis on evaluating the frequency of resistance to fosfomycin and β-lactams. Escherichia coli was isolated from broiler chicken farms (cloacal swabs, meconium, poultry feed, water, poultry litter, and Alphitobius diaperinus) in northern Paraná from 2019 to 2020 during three periods: the first period (1st days of life), the second period (20th to 25th days of life), and third period (40th to 42nd days of life). Antibiogram tests and the detection of phenotypic extended-spectrum β-lactamase (ESBL) were performed, and they were confirmed by seaching for genes from the blaCTX–M group. The other resistance genes searched were mcr-1 and fosA3. Some ESBL blaCTX–M–1 group strains were selected for ESBL identification by sequencing and enterobacterial repetitive intergenic consensus-polymerase chain reaction analysis. To determine the transferability of the blaCTX–M–1– and fosA3-carrying plasmids, strains were subjected to conjugation experiments. A total of 507 E. coli were analyzed: 360 from cloacal swabs, 24 from meconium samples, 3 from poultry feed samples, 18 from water samples, 69 from poultry litter samples, and 33 from A. diaperinus samples. Among the strain isolate, 80% (406/507) were multidrug-resistant (MDR), and 51% (260/507) were ESBL-positive, with the blaCTX–M–1 group being the most frequent. For the fosA3 gene, 68% (344/507) of the strains isolated were positive, deserves to be highlighted E. coli isolated from day-old chickens (OR 6.34, CI 2.34–17.17), when compared with strains isolated from other origins (poultry litter, A. diaperinus, water, and poultry feed). This work alerts us to the high frequency of the fosA3 gene correlated with the CTX-M-1 group (OR 3.57, CI 95% 2.7–4.72, p < 0.05), especially the blaCTX–M–55 gene, in broiler chickens. This profile was observed mainly in day-old chicken, with a high percentage of E. coli that were MDR. The findings emphasize the importance of conducting longitudinal monitoring to detect the primary risk points during poultry production.
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Affiliation(s)
- Maísa Fabiana Menck-Costa
- Department of Microbiology, Biological Sciences Center, State University of Londrina, Londrina, Brazil
| | - Ana Angelita Sampaio Baptista
- Department of Preventive Veterinary Medicine, Avian Medicine Laboratory, State University of Londrina, Londrina, Brazil
| | | | - Larissa Justino
- Department of Preventive Veterinary Medicine, Avian Medicine Laboratory, State University of Londrina, Londrina, Brazil
| | - Matheus Silva Sanches
- Department of Microbiology, Biological Sciences Center, State University of Londrina, Londrina, Brazil
| | - Marielen de Souza
- Department of Preventive Veterinary Medicine, Avian Medicine Laboratory, State University of Londrina, Londrina, Brazil
| | - Erick Kenji Nishio
- Department of Microbiology, Biological Sciences Center, State University of Londrina, Londrina, Brazil
| | - Beatriz Queiroz Dos Santos
- Department of Preventive Veterinary Medicine, Avian Medicine Laboratory, State University of Londrina, Londrina, Brazil
| | - Victor Dellevedove Cruz
- Department of Microbiology, Biological Sciences Center, State University of Londrina, Londrina, Brazil
| | - João Vitor Monteiro Berbert
- Department of Preventive Veterinary Medicine, Avian Medicine Laboratory, State University of Londrina, Londrina, Brazil
| | - Bruna Carolina Gonçalves
- Department of Microbiology, Biological Sciences Center, State University of Londrina, Londrina, Brazil
| | - Galdino Andrade
- Department of Microbiology, Biological Sciences Center, State University of Londrina, Londrina, Brazil
| | - Eliana Carolina Vespero
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | - Gerson Nakazato
- Department of Microbiology, Biological Sciences Center, State University of Londrina, Londrina, Brazil
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