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Elsayed AGA, Badr DF, El Kheir NYA, Zaki MES, Mossad AEM, Mahmoud EMF. Prevalence of extended-spectrum beta-lactamase and molecular detection of blaTEM, blaSHV, and blaCTX-M genotypes among gram-negative Bacilli isolates from hospital acquired infections in pediatrics, one institutional study. Ital J Pediatr 2024; 50:31. [PMID: 38402215 PMCID: PMC10893665 DOI: 10.1186/s13052-024-01599-9] [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: 09/20/2023] [Accepted: 01/27/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Gram-negative bacilli represents an important pathogen in hospital-acquired infections (HAIs) worldwide. The emergence of antibiotic resistance in these pathogens warrants attention for the proper management of infections. Extended-spectrum beta-lactamase (ESBL) resistance represents a major therapeutic problem in infections due to Gram-negative bacilli. The present study aimed to study the extended-spectrum beta-lactamase genes blaTEM, blaSHV, and blaCTX-M by multiplex polymerase reaction in isolated Gram-negative bacilli from HAIs in pediatric patients. METHODS The study included one hundred-five isolates of Gram-negative bacilli from pediatric patients with different types of HAIs. The isolates were subjected to full microbiological identification, antibiotics susceptibility by disc diffusion method, the phenotypic study of ESBL, and the genetic study of ESBL genes by multiplex PCR. RESULTS Fifty isolates of Gram-Negative bacilli showed ESBL activity by a phenotypic study by double disc diffusion method (50/105). All ESBL producers' isolates were positive by PCR for ESBL genes. The most frequent gene was blaTEM (64%), followed by blaSHV (30%) and CTX-M (22%). Mixed genes were found in 4 isolates (8%) for blaTEM and blaSHV, blaTEM and CTX-M. There was a significant association between PCR for ESBL genes and phenotypic ESBL detection (P = 0.001). There was significant detection of ESBL genes in E. coli (28%), followed by Enterobacter spp. (26%), Klebsiella spp. (24%), Serratia (14%), Pseudomonas spp. (6%) and Proteus (2%), P = 0.01. There Seventy percent of isolates positive for ESBL production had an insignificant association between MDR and PCR for ESBL genes (P = 0.23). CONCLUSION The present study highlights the prevalence of ESBL activity among clinical isolates of Gram-negative bacilli isolated from hospital-acquired infections in pediatric patients. The most common gene responsible for this activity was blaTEM gee followed by blaSHV and blaCTX-M. There was a high prevalence of multiple antibiotic resistance among isolates with ESBL activity. The finding of the present study denotes the importance of screening extended beta-lactamase among Gram-negative bacilli associated with HAIs in pediatric patients.
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Affiliation(s)
| | - Dina F Badr
- Medical Microbiology and Immunology, Mansoura Faculty of Medicine, Mansoura, Egypt
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2
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Elgriw N, Métayer V, Drapeau A, François P, Azaiez S, Mastouri M, Rhim H, Elzagheid A, Soufiyah N, Madec JY, Chaouch C, Mansour W, Haenni M. Clonal, Plasmidic and Genetic Diversity of Multi-Drug-Resistant Enterobacterales from Hospitalized Patients in Tripoli, Libya. Antibiotics (Basel) 2023; 12:1430. [PMID: 37760726 PMCID: PMC10525897 DOI: 10.3390/antibiotics12091430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Resistance to extended-spectrum cephalosporins (ESC) and carbapenems in Enterobacterales is a major issue in public health. Carbapenem resistance in particular is associated with increased morbidity and mortality. Moreover, such resistance is often co-harbored with resistance to non-beta-lactam antibiotics, and pathogens quickly become multi-drug-resistant (MDR). Only a few studies have been published on AMR in Libyan hospitals, but all reported worrisome results. Here, we studied 54 MDR isolates that were collected from 49 patients at the Tripoli University Hospital between 2019 and 2021. They were characterized using phenotypic methods, PCR and PFGE, and a sub-set of isolates were short- and long-read whole-genome sequenced. The results showed the frequent occurrence of Klebsiella pneumoniae (49/54), among which several high-risk clones were responsible for the spread of resistance, namely, ST11, ST17, ST101 and ST147. ESC and carbapenem resistance was due to a wide variety of enzymes (CTX-M, OXA-48, NDM, KPC), with their corresponding genes carried by different plasmids, including IncF-IncHI2 and IncF-IncR hybrids. This study highlights that implementation of infection prevention, control and surveillance measures are needed in Libya to fight against AMR.
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Affiliation(s)
- Nada Elgriw
- Department of Microbiology, Libyan Biotechnology Reseaerch Center, Tripoli P.O. Box 30313, Libya;
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Véronique Métayer
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Antoine Drapeau
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Pauline François
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Sana Azaiez
- Laboratoire de Recherche Biophysique Métabolique et Pharmacologie Appliquée, Faculté de Médecine Ibn Al Jazzar Sousse, Université de Sousse, LR12ES02, Sousse 4002, Tunisia; (S.A.); (W.M.)
| | - Maha Mastouri
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Hajer Rhim
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Adam Elzagheid
- Department of Genetic Engineering, Libyan Biotechnology Reseaerch Center, Tripoli P.O. Box 30313, Libya;
| | - Najeeb Soufiyah
- Medical Microbiology and Immunology Department, Faculty of Pharmacy, University of Tripoli, Tripoli P.O. Box 13275, Libya;
| | - Jean-Yves Madec
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
| | - Cherifa Chaouch
- Faculty of pharmacy Monastir, Doctoral commission in Pharmaceutical Sciences, University of Monastir, Monastir 5000, Tunisia; (M.M.); (H.R.); (C.C.)
- Laboratory of Transmissible Diseases and Biologically Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir 5000, Tunisia
| | - Wejdene Mansour
- Laboratoire de Recherche Biophysique Métabolique et Pharmacologie Appliquée, Faculté de Médecine Ibn Al Jazzar Sousse, Université de Sousse, LR12ES02, Sousse 4002, Tunisia; (S.A.); (W.M.)
| | - Marisa Haenni
- Unité Antibiorésistance et Virulence Bactériennes, ANSES—Université de Lyon, 69007 Lyon, France; (V.M.); (A.D.); (P.F.); (J.-Y.M.)
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3
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Xie H, Yamada K, Tamai S, Shimamoto H, Nukazawa K, Suzuki Y. Disappearance and prevalence of extended-spectrum β-lactamase-producing Escherichia coli and other coliforms in the wastewater treatment process. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:83950-83960. [PMID: 37351753 DOI: 10.1007/s11356-023-28382-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/18/2023] [Indexed: 06/24/2023]
Abstract
Antibiotic-resistant bacteria (ARBs) can now be detected not only in clinical institutions but also in wastewater treatment plants (WWTPs), extending the range of emergence to residential areas. In this study, we investigated the change of antibiotic-resistant Escherichia coli (E. coli) and other coliforms in each treatment process at WWTPs. Throughout the treatment process, the numbers of E. coli and other coliforms were significantly reduced to less than 5.7 ± 0.5 CFU/100 ml and 2.4 ± 0.0×102 CFU/100 ml, respectively. However, ESBL-producing E. coli and other coliforms were detected in each treatment process (even after chlorination) at 5.6% and 4.8%, compared to the total E. coli and other coliforms counts. Then, ESBL-producing-related genes were identified via PCR analyses, and the most predominant gene was CTX-M-9 in both E. coli (47.2%) and other coliforms (47.3%). Although actual WWTPs greatly reduced the number of bacteria, the relative prevalence of ESBL-producing bacteria was increased, suggesting that ESBL-producing bacteria remain in the effluent at minimal concentrations and could be diffusing to water bodies.
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Affiliation(s)
- Hui Xie
- Department of Environment and Resource Sciences, Interdisciplinary Graduate School of Agriculture and Engineering, University of Miyazaki, Miyazaki, Japan
| | - Kana Yamada
- Department of Civil and Environmental Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan
| | - Soichiro Tamai
- Department of Civil and Environmental Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan
| | - Hiroshi Shimamoto
- Department of Civil and Environmental Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan
| | - Kei Nukazawa
- Department of Civil and Environmental Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan
| | - Yoshihiro Suzuki
- Department of Civil and Environmental Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan.
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Tanimoto H, Shigemura K, Osawa K, Kado M, Onishi R, Fang SB, Sung SY, Miyara T, Fujisawa M. Comparative genetic analysis of the antimicrobial susceptibilities and virulence of hypermucoviscous and non-hypermucoviscous ESBL-producing Klebsiella pneumoniae in Japan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2023; 56:93-103. [PMID: 36068121 DOI: 10.1016/j.jmii.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/06/2022] [Accepted: 08/14/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hypermucoviscous (HMV) Klebsiella pneumoniae produces large amounts of capsular polysaccharides, leading to high mortality. Since extended spectrum beta-lactamase (ESBL)-producing HMV K. pneumoniae strains have increased in Japan, we investigated and compared the antimicrobial susceptibilities and genetic characteristics of HMV and non-HMV ESBL-producing K. pneumoniae. METHODS We investigated 291 ESBL-producing K. pneumoniae collected between 2012 and 2018, and in them 54 HMV strains were identified and comparable 53 non-HMV strains were selected. Then, ESBL gene detection, plasmid replicon typing, and virulence gene detection were done by PCR amplification. RESULTS Almost all of the HMV K. pneumoniae strains possessed uge (98.1%), wabG (96.3%), rmpA (94.4%), iucA (79.6%), fimH (70.4%), iroB (70.4%), and peg-344 (70.4%). These genes were found less frequently in non-HMV strains (uge 20.8%, wabG 83.0%, rmpA 7.5%, iucA 3.8%, fimH 9.4%, iroB 5.7%, and peg-344 1.9%). K2 capsule type (40.7%) was most common in HMV strains. HMV strains showed higher resistance to cefepime (p = 0.001) and piperacillin/tazobactam (p = 0.005) than non-HMV strains. CTX-M-15 (75.9%, 60.4%) was the dominant ESBL type in both HMV and non-HMV strains, and the most common plasmid replicon type was IncFII (52.1%) in CTX-M-15-producing strains. CONCLUSIONS We found that HMV strains had more virulence genes and showed higher resistance to antibiotics than non-HMV strains. The most common capsule type was K2. CTX-M-15 was the most common type of ESBL gene in both HMV and non-HMV strains in Japan. The FII plasmid might be related to the spread of CTX-M-15 among K. pneumoniae strains.
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Affiliation(s)
- Hiroshi Tanimoto
- Division of Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka Suma-ku, Kobe, 654-0142, Japan.
| | - Katsumi Shigemura
- Division of Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka Suma-ku, Kobe, 654-0142, Japan; Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Kayo Osawa
- Department of Medical Technology, Kobe Tokiwa University, 2-6-2 Otani-cho, Nagata-ku, Kobe, 653-0838, Japan.
| | - Mitsuki Kado
- Division of Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka Suma-ku, Kobe, 654-0142, Japan.
| | - Reo Onishi
- Division of Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka Suma-ku, Kobe, 654-0142, Japan.
| | - Shiuh-Bin Fang
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, 291 Jhong Jheng Road, Jhong Ho District, New Taipei City, 23561, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, 250, Wu Hsing Street, Hsin Yi District, Taipei, 11031, Taiwan.
| | - Shian-Ying Sung
- International Ph.D. Program for Translational Science, College of Medical Science and Technology, Taipei Medical University, 250 Wu-Hsing St., Taipei, 110, Taiwan.
| | - Takayuki Miyara
- Infection Control Team, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Masato Fujisawa
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
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Molecular Characterization of
bla
NDM
-Carrying IncX3 Plasmids:
bla
NDM-16b
Likely Emerged from a Mutation of
bla
NDM-5
on IncX3 Plasmid. Microbiol Spectr 2022; 10:e0144922. [PMID: 35867355 PMCID: PMC9430178 DOI: 10.1128/spectrum.01449-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dissemination of blaNDM, which is carried on the IncX3 plasmid, among Enterobacterales has been reported worldwide. In particular, blaNDM-5-carrying IncX3 plasmids can spread among several hosts, facilitating their dissemination. Other variants, such as blaNDM-17-, blaNDM-19-, blaNDM-20-, blaNDM-21-, and blaNDM-33-carrying IncX3 plasmids, have also been reported. Here, we characterized, using whole-genome sequencing (WGS), a blaNDM-16b-carrying IncX3 plasmid harbored by Escherichia coli strain TA8571, which was isolated from a urine specimen of a hospital inpatient in Tokyo, Japan. The blaNDM-16b differed in sequence from blaNDM-5 (C > T at site 698, resulting in an Ala233Val substitution). This blaNDM-16b-carrying IncX3 plasmid (pTMTA8571-1) is 46,161 bp in length and transferred via conjugation. Transconjugants showed high resistance to β-lactam antimicrobials (except for aztreonam). Because pTMTA8571-1, which carries the Tn125-related region containing blaNDM and conjugative transfer genes, was similar to the previously reported IncX3 plasmids, we performed phylogenetic analysis based on the sequence of 34 shared genes in 142 blaNDM-carrying IncX3 plasmids (22,846/46,923 bp). Comparative analysis of the shared genes revealed short branches on the phylogenetic tree (average of 1.08 nucleotide substitutions per shared genes), but each blaNDM variant was divided into separate groups, and the structure of the tree correlated with the flowchart of blaNDM nucleotide substitutions. The blaNDM-carrying IncX3 plasmids may thereby have evolved from the same ancestral plasmid with subsequent mutation of the blaNDM. Therefore, pTMTA8571-1 likely emerged from a blaNDM-5-carrying IncX3 plasmid. This study suggested that the spread of blaNDM-carrying IncX3 plasmids may be a hotbed for the emergence of novel variants of blaNDM. IMPORTANCEblaNDM-carrying IncX3 plasmids have been reported worldwide. Harbored blaNDM variants were mainly blaNDM-5, but there were also rare variants like blaNDM-17, blaNDM-19, blaNDM-20, blaNDM-21, and blaNDM-33, including blaNDM-16b detected in this study. For these plasmids, previous reports analyzed whole genomes or parts of sequences among a small number of samples, whereas, in this study, we performed an analysis of 142 blaNDM-carrying IncX3 plasmids detected around the world. The results showed that regardless of the blaNDM variants, blaNDM-carrying IncX3 plasmids harbored highly similar shared genes. Because these plasmids already spread worldwide may be a hotbed for the emergence of rare or novel variants of blaNDM, increased attention should be paid to blaNDM-carrying IncX3 plasmids in the future.
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Persistence of Antibiotic-Resistant Escherichia coli Strains Belonging to the B2 Phylogroup in Municipal Wastewater under Aerobic Conditions. Antibiotics (Basel) 2022; 11:antibiotics11020202. [PMID: 35203805 PMCID: PMC8868233 DOI: 10.3390/antibiotics11020202] [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: 01/05/2022] [Revised: 01/24/2022] [Accepted: 02/02/2022] [Indexed: 02/05/2023] Open
Abstract
Escherichia coli is classified into four major phylogenetic groups (A, B1, B2, and D) that are associated with antibiotic resistance genes. Although antibiotic-resistant E. coli is commonly detected in municipal wastewater, little is known about the relationship between the phylogenetic groups and antibiotic-resistant E. coli in wastewater. In this study, the survival of E. coli in wastewater and the changes to the relationships between each phylogroup and the antibiotic-resistant profiles of E. coli isolates from wastewater were investigated under aerobic conditions for 14 days. The isolates were classified into the phylogroups A, B1, B2, and D or others by multiplex PCR. In addition, the susceptibility of the isolates to 11 antibiotics was assessed with the minimum inhibitory concentration (MIC) assay. While E. coli counts decreased in the wastewater with time under aerobic conditions, the prevalence of phylogroup B2 had increased to 73% on day 14. Furthermore, the MIC assay revealed that the abundance of antibiotic-resistant E. coli also increased on day 14. After batch-mixing the experiments under aerobic conditions, the surviving antibiotic-resistant E. coli included mainly multidrug-resistant and beta-lactamase-producing isolates belonging to phylogroup B2. These results suggest that the phylogroup B2 isolates that have acquired antibiotic resistance had a high survivability in the treated wastewater.
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7
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Akine D, Sasahara T, Kiga K, Ae R, Kosami K, Yoshimura A, Kubota Y, Sasaki K, Kimura Y, Ogawa M, Watanabe S, Morisawa Y, Cui L. Distribution of Extended-Spectrum β-Lactamase Genes and Antimicrobial Susceptibility among Residents in Geriatric Long-Term Care Facilities in Japan. Antibiotics (Basel) 2021; 11:antibiotics11010036. [PMID: 35052913 PMCID: PMC8773109 DOI: 10.3390/antibiotics11010036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 12/30/2022] Open
Abstract
A high prevalence of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) may call for monitoring in geriatric long-term care facilities (g-LTCFs). We surveyed the distribution of ESBL-causative gene types and antimicrobial susceptibility in ESBL-PE strains from residents in g-LTCFs, and investigated the association between ESBL-causative gene types and antimicrobial susceptibility. First, we analyzed the types of ESBL-causative genes obtained from 141 ESBL-PE strains collected from the feces of residents in four Japanese g-LTCFs. Next, we determined the minimum inhibitory concentration values for alternative antimicrobial agents against ESBL-PE, including β-lactams and non-β-lactams. Escherichia coli accounted for 96% of the total ESBL-PE strains. Most strains (94%) contained blaCTX-M group genes. The genes most commonly underlying resistance were of the blaCTX-M-9 and blaCTX-M-1 groups. Little difference was found in the distribution of ESBL-causative genes among the facilities; however, antimicrobial susceptibility differed widely among the facilities. No specific difference was found between antimicrobial susceptibility and the number of ESBL-causative genes. Our data showed that ESBL-PEs were susceptible to some antimicrobial agents, but the susceptibility largely differed among facilities. These findings suggest that each g-LTCF may require specific treatment strategies based on their own antibiogram. Investigations into drug resistance should be performed in g-LTCFs as well as acute medical facilities.
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Affiliation(s)
- Dai Akine
- Division of Clinical Infectious Diseases, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (D.A.); (Y.M.)
- Health Service Center, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan;
| | - Teppei Sasahara
- Division of Clinical Infectious Diseases, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (D.A.); (Y.M.)
- Division of Bacteriology, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (K.K.); (S.W.); (L.C.)
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan;
- Correspondence: (T.S.); (R.A.); Tel.: +81-285-58-7580 (T.S.)
| | - Kotaro Kiga
- Division of Bacteriology, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (K.K.); (S.W.); (L.C.)
| | - Ryusuke Ae
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan;
- Correspondence: (T.S.); (R.A.); Tel.: +81-285-58-7580 (T.S.)
| | - Koki Kosami
- Division of Public Health, Center for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan;
| | - Akio Yoshimura
- Medical Corporation Sanikukai Nissin Hospital, Hishimachi 3 chome, Kiryu 376-0001, Gunma, Japan;
| | - Yoshinari Kubota
- Nikko Citizen’s Hospital, Kiyotakiarasawamachi 1752-10, Nikko 321-1441, Tochigi, Japan;
| | - Kazumasa Sasaki
- Clinical Microbiology Laboratory, Jichi Medical University Hospital, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (K.S.); (Y.K.)
| | - Yumiko Kimura
- Clinical Microbiology Laboratory, Jichi Medical University Hospital, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (K.S.); (Y.K.)
| | - Masanori Ogawa
- Health Service Center, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan;
| | - Shinya Watanabe
- Division of Bacteriology, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (K.K.); (S.W.); (L.C.)
| | - Yuji Morisawa
- Division of Clinical Infectious Diseases, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (D.A.); (Y.M.)
| | - Longzhu Cui
- Division of Bacteriology, School of Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke 329-0498, Tochigi, Japan; (K.K.); (S.W.); (L.C.)
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8
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Abstract
The causative agents of recurrent Escherichia coli bacteremia can be genetically identical or discordant, but the differences between them remain unclear. This study aimed to explore these differences, with regard to their clinical and microbiological features. Patients were recruited from a Japanese tertiary teaching hospital based on blood culture data and the incidence of recurrent E. coli bacteremia. We compared the patients' clinical and microbiological characteristics between the two groups (those with identical or discordant E. coli bacteremia) divided by the result of enterobacterial repetitive intergenic consensus PCR. Among 70 pairs of recurrent E. coli bacteremia strains, 49 pairs (70%) were genetically identical. Patients with genetically identical or discordant E. coli bacteremia were more likely to have renal failure or neoplasms, respectively. The virulence factor (VF) scores of genetically identical E. coli strains were significantly higher than those of genetically discordant strains, with the prevalence of eight VF genes being significantly higher in genetically identical E. coli strains. No significant differences were found between the two groups regarding antimicrobial susceptibility and biofilm formation potential. This study showed that genetically identical E. coli bacteremia strains have more VF genes than genetically discordant strains in recurrent E. coli bacteremia. IMPORTANCEEscherichia coli causes bloodstream infection, although not all strains are pathogenic to humans. In some cases, this infection reoccurs, and several reports have described the clinical characteristics and/or molecular microbiology of recurrent Escherichia coli bacteremia. However, these studies focused on patients with specific characteristics, and they included cases caused by microorganisms other than Escherichia coli. Hence, little is known about the pathogenicity of Escherichia coli isolated from the recurrent one. The significance of our study is in evaluating the largest cohorts to date, as no cohort studies have been conducted on this topic.
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9
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Interplay between Bacterial Clones and Plasmids in the Spread of Antibiotic Resistance Genes in the Gut: Lessons from a Temporal Study in Veal Calves. Appl Environ Microbiol 2021; 87:e0135821. [PMID: 34613750 DOI: 10.1128/aem.01358-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Intestinal carriage of extended spectrum β-lactamase (ESBL)-producing Escherichia coli is a frequent, increasing, and worrying phenomenon, but little is known about the molecular scenario and the evolutionary forces at play. We screened 45 veal calves, known to have high prevalence of carriage, for ESBL-producing E. coli on 514 rectal swabs (one randomly selected colony per sample) collected over 6 months. We characterized the bacterial clones and plasmids carrying blaESBL genes with a combination of genotyping methods, whole genome sequencing, and conjugation assays. One hundred and seventy-three ESBL-producing E. coli isolates [blaCTX-M-1 (64.7%), blaCTX-M-14 (33.5%), or blaCTX-M-15 (1.8%)] were detected, belonging to 32 bacterial clones, mostly of phylogroup A. Calves were colonized successively by different clones with a trend in decreasing carriage. The persistence of a clone in a farm was significantly associated with the number of calves colonized. Despite a high diversity of E. coli clones and blaCTX-M-carrying plasmids, few blaCTX-M gene/plasmid/chromosomal background combinations dominated, due to (i) efficient colonization of bacterial clones and/or (ii) successful plasmid spread in various bacterial clones. The scenario "clone versus plasmid spread" depended on the farm. Thus, epistatic interactions between resistance genes, plasmids, and bacterial clones contribute to optimize fitness in specific environments. IMPORTANCE The gut microbiota is the epicenter of the emergence of resistance. Considerable amount of knowledge on the molecular mechanisms of resistance has been accumulated, but the ecological and evolutionary forces at play in nature are less studied. In this context, we performed a field work on temporal intestinal carriage of extended spectrum β-lactamase (ESBL)-producing Escherichia coli in veal farms. Veal calves are animals with one of the highest levels of ESBL producing E. coli fecal carriage, due to early high antibiotic exposure. We were able to show that calves were colonized successively by different ESBL-producing E. coli clones, and that two main scenarios were at play in the spread of blaCTX-M genes among calves: efficient colonization of several calves by a few bacterial clones and successful plasmid spread in various bacterial clones. Such knowledge should help develop new strategies to fight the emergence of antibiotic-resistance.
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Al-Mir H, Osman M, Drapeau A, Hamze M, Madec JY, Haenni M. Spread of ESC-, carbapenem- and colistin-resistant Escherichia coli clones and plasmids within and between food workers in Lebanon. J Antimicrob Chemother 2021; 76:3135-3143. [PMID: 34534282 DOI: 10.1093/jac/dkab327] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/05/2021] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Knowledge on the dynamic of MDR Escherichia coli in the human community is still limited, especially in low- and middle-income countries. Our goal was to decipher the dynamics of E. coli lineages and plasmids resistant to ESC, carbapenem and colistin within and between food workers in Lebanon using genomic-based approaches. METHODS Eighty-four healthy adults working in three bakeries were sampled twice at a 6 monthly interval. E. coli resistant to ESC (ESC-E), carbapenem (CP-E) and colistin (CO-E) were collected on selective plates. Non-duplicate isolates were whole-genome sequenced using the Illumina technology and plasmid transmission was assessed by long-read sequencing. Data were analysed using bioinformatics tools and SNP-based phylogeny. RESULTS ESC-E carriage rate reached 34.5% (t0) and 52.9% (t6), and 15 workers were positive at both t0 and t6. Carbapenem resistance (blaOXA-181, blaOXA-204, blaNDM-5) was found in five workers at t0 and two at t6, while colistin resistance (mcr-1.1) was found in five workers at t0 and one at t6. Forty-seven different STs were identified, of which three STs were predominant (ST131, n = 9; ST10, n = 5; ST69, n = 5). One worker presented the same ESC-E clone at t0 and t6. Twelve different events of clonal transmission among individuals were exemplified while plasmid transmission was only shown once. CONCLUSIONS Our study revealed a high carriage rate of MDR E. coli (60.7%) and the emergence of CP and colistin resistance in the Lebanese community. Incidental and long-term ESC-E carriage was observed in 41.7% and 17.9% of the workers, respectively. The high clonal diversity suggests an important dynamic of acquisition and loss of MDR E. coli and limited plasmid spread.
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Affiliation(s)
- Hiba Al-Mir
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Université de Lyon-ANSES laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
| | - Marwan Osman
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon.,Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA
| | - Antoine Drapeau
- Université de Lyon-ANSES laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Sciences and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Jean-Yves Madec
- Université de Lyon-ANSES laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
| | - Marisa Haenni
- Université de Lyon-ANSES laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
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Yasugi M, Hatoya S, Motooka D, Matsumoto Y, Shimamura S, Tani H, Furuya M, Mie K, Miyake M, Nakamura S, Shimada T. Whole-genome analyses of extended-spectrum or AmpC β-lactamase-producing Escherichia coli isolates from companion dogs in Japan. PLoS One 2021; 16:e0246482. [PMID: 33544781 PMCID: PMC7864471 DOI: 10.1371/journal.pone.0246482] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/19/2021] [Indexed: 11/21/2022] Open
Abstract
The emergence and global spread of extended-spectrum or AmpC β-lactamase (ESBL/AmpC)-producing Enterobacteriaceae in companion animals have led to the hypothesis that companion animals might be reservoirs for cross-species transmission because of their close contact with humans. However, current knowledge in this field is limited; therefore, the role of companion animals in cross-species transmission remains to be elucidated. Herein, we studied ESBL/AmpC-producing Enterobacteriaceae, Escherichia coli in particular, isolated from extraintestinal sites and feces of companion dogs. Whole-genome sequencing analysis revealed that (i) extraintestinal E. coli isolates were most closely related to those isolated from feces from the same dog, (ii) chromosomal sequences in the ST131/C1-M27 clade isolated from companion dogs were highly similar to those in the ST131/C1-M27 clade of human origin, (iii) certain plasmids, such as IncFII/pMLST F1:A2:B20/blaCTX-M-27, IncI1/pMLST16/blaCTX-M-15, or IncI1/blaCMY-2 from dog-derived E. coli isolates, shared high homology with those from several human-derived Enterobacteriaceae, (iv) chromosomal blaCTX-M-14 was identified in the ST38 isolate from a companion dog, and (v) eight out of 14 tested ESBL/AmpC-producing E. coli isolates (i.e., ST131, ST68, ST405, and ST998) belonged to the human extraintestinal pathogenic E. coli (ExPEC) group. All of the bla-coding plasmids that were sequenced genome-wide were capable of horizontal transfer. These results suggest that companion dogs can spread ESBL/AmpC-producing ExPEC via their feces. Furthermore, at least some ESBL/AmpC-producing ExPECs and bla-coding plasmids can be transmitted between humans and companion dogs. Thus, companion dogs can act as an important reservoir for ESBL/AmpC-producing E. coli in the community.
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Affiliation(s)
- Mayo Yasugi
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
- Asian Health Science Research Institiute, Osaka Prefecture University, Izumisano, Osaka, Japan
- * E-mail:
| | - Shingo Hatoya
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Daisuke Motooka
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Yuki Matsumoto
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Shunsuke Shimamura
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Hiroyuki Tani
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Masaru Furuya
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Keiichiro Mie
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Masami Miyake
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Shota Nakamura
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Terumasa Shimada
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
- Asian Health Science Research Institiute, Osaka Prefecture University, Izumisano, Osaka, Japan
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Rochegüe T, Haenni M, Cazeau G, Metayer V, Madec JY, Ferry T, Lupo A. An inventory of 44 qPCR assays using hydrolysis probes operating with a unique amplification condition for the detection and quantification of antibiotic resistance genes. Diagn Microbiol Infect Dis 2021; 100:115328. [PMID: 33819858 DOI: 10.1016/j.diagmicrobio.2021.115328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/22/2021] [Accepted: 01/24/2021] [Indexed: 01/28/2023]
Abstract
Early antibiotic resistance determinants (ARDs) detection in humans or animals is crucial to counteract their propagation. The ARDs quantification is fundamental to understand the perturbation caused by disruptors, such as antibiotics, during therapies. Forty-three qPCRs on the most diffused ARDs and integrons among human and animal Enterobacterales, and one on the 16S rDNA for bacteria quantification, were developed. The qPCRs, using hydrolysis probes, operated with a unique amplification condition and were tested analytically and diagnostically performing 435 reactions on five positive and negative controls for each qPCR. Diagnostic sensitivity and specificity were confirmed by PCR and genome sequencing of control isolates, demonstrating 100% performance for all qPCRs. An easy and rapid discrimination method for the epidemiologically relevant blaCTX-Ms is provided. This large, noncommercial qPCRs inventory could serve for precise quantification of ARDs, but also as a rapid screening tool for surveillance purposes, providing the basis for further high-throughput developments.
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Affiliation(s)
- Tony Rochegüe
- ANSES - Université de Lyon, Unité Antibiorésistance et Virulence Bactériennes (AVB), Lyon, France
| | - Marisa Haenni
- ANSES - Université de Lyon, Unité Antibiorésistance et Virulence Bactériennes (AVB), Lyon, France
| | - Géraldine Cazeau
- ANSES - Université de Lyon, Unité Epidémiologie et Appui à la Surveillance (EAS), Lyon, France
| | - Véronique Metayer
- ANSES - Université de Lyon, Unité Antibiorésistance et Virulence Bactériennes (AVB), Lyon, France
| | - Jean-Yves Madec
- ANSES - Université de Lyon, Unité Antibiorésistance et Virulence Bactériennes (AVB), Lyon, France
| | - Tristan Ferry
- Service des maladies infectieuses et tropicales, CHU de Lyon, Hôpital de la Croix-Rousse, Lyon, France; Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France
| | - Agnese Lupo
- ANSES - Université de Lyon, Unité Antibiorésistance et Virulence Bactériennes (AVB), Lyon, France.
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Shimojima Y, Nishino Y, Fukui R, Kuroda S, Suzuki J, Sadamasu K. [Salmonella Serovars Isolated from Retail Meats in Tokyo, Japan and Their Antimicrobial Susceptibility]. Food Hygiene and Safety Science (Shokuhin Eiseigaku Zasshi) 2021; 61:211-217. [PMID: 33390528 DOI: 10.3358/shokueishi.61.211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To identify the risk of Salmonella in meat, we investigated the prevalence of Salmonella, serovars and their antimicrobial susceptibility patterns. Salmonella was found in 353 out of 849 (41.6%) chicken, 9 out of 657 (1.4%) pork, 1 out of 517 (0.2%) Beef, 6 out of 8 (75.0%) chicken offal, 43 out of 142 (30.3%) pork offal and 4 out of 198 (2.0) beef offal samples collected from retail meats in Tokyo, Japan between 2009 and 2017. Salmonella Infantis was the most common serovar, followed by S. Schwarzengrund in the isolates from domestic chicken meats. The prevalence rate of S. Infantis decreased while that of S. Schwarzengrund increased by the year. Apart from this, the most prevalent serovars were S. Heidelberg in the imported chicken meat isolates, S. Typhimurium and Salmonella O4:i:- in pork, and S. Derby in beef isolates. Antimicrobial testing revealed high resistance to tetracycline (TC) in all meat sample isolates; however, all the isolates were sensitive to carbapenem and fluoroquinolone. Fourteen cefotaxime (CTX) resistant strains, seven extended spectrum β-lactamase (ESBL) producing strains and twenty-three AmpC producing strains were isolated from chicken meat samples. These findings indicate that the serovar and antimicrobial susceptibility varied among meat samples.
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Affiliation(s)
| | | | - Rie Fukui
- Tokyo Metropolitan Institute of Public Health
| | | | - Jun Suzuki
- Tokyo Metropolitan Institute of Public Health
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Haenni M, Métayer V, Jarry R, Drapeau A, Puech MP, Madec JY, Keck N. Wide Spread of bla CTX-M-9/ mcr-9 IncHI2/ST1 Plasmids and CTX-M-9-Producing Escherichia coli and Enterobacter cloacae in Rescued Wild Animals. Front Microbiol 2020; 11:601317. [PMID: 33329492 PMCID: PMC7717979 DOI: 10.3389/fmicb.2020.601317] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022] Open
Abstract
Wildlife has recently been pinpointed as one of the drivers of dissemination of genes conferring resistances to clinically important antimicrobials. The presence of both extended-spectrum beta-lactamase- (ESBL) and carbapenemase-encoding genes has notably been reported in wild birds, that can act as sentinels of antimicrobial resistance (AMR) contamination but also as long-distance spreaders in case of migratory birds. Here, 424 wild birds brought to a rescue center in France were sampled over a 6-month period. These birds encompassed 62 different sedentary or migratory species. A further 16 wild mammals present in the center were also investigated. No carbapenemase-producer was found, but we identified a surprisingly high proportion (24.1%) of ESBL-positive isolates. A total of 144 non-duplicate isolates were collected, including Escherichia coli (n = 88), Enterobacter cloacae (n = 51), and Citrobacter freundii (n = 5), of which 123 carried the blaCTX–M–9 gene. PFGE, phylogroup, and MLST revealed the presence of a limited number of ESBL-positive clones circulating in these animals, all presenting multiple associated resistances. Next-generation sequencing on a subset of isolates, followed by Southern blot hybridization, showed the wide dissemination of an IncHI2/ST1 plasmid carrying the blaCTX–M–9, blaSHV–12 and mcr-9 genes. In all, our results undoubtedly reflect cross transmissions of ESC-resistance (ESC-R) Enterobacteriaceae within the rescue center – similarly to nosocomial spreads observed at hospital, rather than the true bacterial flora of birds. We also showed that the spread of ESC-R in this rescue center did not only rely on clonal but also on a highly successful plasmidic transmission. Since most animals are intended to get back to nature after a few days or weeks, this is obviously an issue with regard to ESBL dissemination in natural environments.
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Affiliation(s)
- Marisa Haenni
- ANSES, Laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes - Université de Lyon, Lyon, France
| | - Véronique Métayer
- ANSES, Laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes - Université de Lyon, Lyon, France
| | - Romane Jarry
- Laboratoire Départemental Vétérinaire de l'Hérault, Montpellier, France
| | - Antoine Drapeau
- ANSES, Laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes - Université de Lyon, Lyon, France
| | | | - Jean-Yves Madec
- ANSES, Laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes - Université de Lyon, Lyon, France
| | - Nicolas Keck
- Laboratoire Départemental Vétérinaire de l'Hérault, Montpellier, France
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Yamanaka T, Funakoshi H, Kinoshita K, Iwashita C, Horikoshi Y. CTX-M group gene distribution of extended spectrum beta-lactamase-producing Enterobacteriaceae at a Japanese Children's hospital. J Infect Chemother 2020; 26:1005-1007. [PMID: 32586731 DOI: 10.1016/j.jiac.2020.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 11/17/2022]
Abstract
Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae have spread globally as one of the most common multidrug resistant organisms. Although a wide variety of ESBL genes were known in each geographical region, few reports existed on the distribution of ESBL genes in Japanese children. To clarify the distribution of ESBL genes, we investigated the CTX-M type of the ESBL-producing Enterobacteriaceae and patient characteristics among hospital-acquired and community-acquired cases. Total of 253 isolates of ESBL-producing Enterobacteriaceae were recovered from 238 pediatric patients. ESBL-producing Enterobacteriaceae were mostly recovered from children with underlying diseases (76.5%). Ratio of community-acquired and hospital-acquired cases was 58.8% and 41.2%, respectively. Compared to the hospital-acquired cases, community-acquired cases had younger age, fewer underlying diseases, and the dominant detection of Escherichia coli. The most common ESBL-producing Enterobacteriaceae was E. coli (79.8%), followed by Klebsiella pneumoniae (9.1%). CTX-M9 group was the most prevalent CTX-M group gene (63.2%), which was dominantly detected in E. coli (72.7%). This was the largest descriptive study to find CTX-M9 group as the most prevalent ESBL genotype among Enterobacteriaceae isolated from Japanese children in line with adult's epidemiology.
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Affiliation(s)
- Takayuki Yamanaka
- Department of Pediatrics Niigata City General Hospital, Niigata, Japan; Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan.
| | - Hanako Funakoshi
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Kazue Kinoshita
- Division of Molecular Laboratory, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Chinami Iwashita
- Division of Microbiology, Department of Laboratory, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
| | - Yuho Horikoshi
- Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
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Valat C, Drapeau A, Beurlet S, Bachy V, Boulouis HJ, Pin R, Cazeau G, Madec JY, Haenni M. Pathogenic Escherichia coli in Dogs Reveals the Predominance of ST372 and the Human-Associated ST73 Extra-Intestinal Lineages. Front Microbiol 2020; 11:580. [PMID: 32373083 PMCID: PMC7186358 DOI: 10.3389/fmicb.2020.00580] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/17/2020] [Indexed: 12/12/2022] Open
Abstract
Escherichia coli is a ubiquitous commensal and pathogen that has also been recognized as a multi-sectoral indicator of antimicrobial resistance (AMR). Given that latter focus, such as on resistances to extended-spectrum cephalosporins (ESC) and carbapenems, the reported population structure of E. coli is generally biased toward resistant isolates, with sequence type (ST)131 being widely reported in humans, and ST410 and ST648 being reported in animals. In this study, we characterized 618 non-duplicate E. coli isolates collected throughout France independently of their resistance phenotype. The B2 phylogroup was over-represented (79.6%) and positively associated with the presence of numerous virulence factors (VFs), including those defining the extra-intestinal pathogenic E. coli isolates (presence of ≥2 VFs: papA, sfaS, focG, afaD, iutA, and kpsMTII) and those more specifically related to uropathogenic E. coli (cnf1, hlyD). The major STs associated with clinical isolates from dogs were by far the dog-associated ST372 (20.7%) and ST73 (20.1%), a lineage that had commonly been considered until now as human-associated. Resistance to ESC was found in 33 isolates (5.3%), along with one carbapenemase-producing isolate, and was mostly restricted to non-B2 isolates. In conclusion, the presence of virulent E. coli lineages may be the issue, rather than the presence of ESC-resistant isolates, and the risk of transmission of such virulent isolates to humans needs to be further studied.
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Affiliation(s)
- Charlotte Valat
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon – Université de Lyon, Lyon, France
| | - Antoine Drapeau
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon – Université de Lyon, Lyon, France
| | | | | | - Henri-Jean Boulouis
- Unité de Bactériologie, BioPôle, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | | | - Géraldine Cazeau
- Unité Epidémiologie et Appui à la Surveillance, ANSES Laboratoire de Lyon – Université de Lyon, Lyon, France
| | - Jean-Yves Madec
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon – Université de Lyon, Lyon, France
| | - Marisa Haenni
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon – Université de Lyon, Lyon, France
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Arakawa Y. Systematic research to overcome newly emerged multidrug-resistant bacteria. Microbiol Immunol 2020; 64:231-251. [PMID: 32068266 DOI: 10.1111/1348-0421.12781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/05/2020] [Accepted: 02/08/2020] [Indexed: 11/30/2022]
Abstract
In the 1980s, I found that the chromosomal β-lactamase of Klebsiella pneumoniae LEN-1 showed a very high similarity to the R-plasmid-mediated penicillinase TEM-1 on the amino acid sequence level, and this strongly suggested the origination of TEM-1 from the chromosomal penicillinases of K. pneumoniae or related bacteria. Moreover, the chromosomal K1 β-lactamase (KOXY) of Klebsiella oxytoca was found to belong to the class A β-lactamases that include LEN-1 and TEM-1, although KOXY can hydrolyze cefoperazone (CPZ) like the chromosomal AmpC-type cephalosporinases of various Enterobacteriaceae that can hydrolyze several cephalosporins including CPZ. Furthermore, my collaborators and I found plural novel serine-type β-lactamases, such as MOX-1, SHV-24, TEM-91, CTX-M-64, CMY-9, CMY-19, GES-3, GES-4, and TLA-3, mediated by plasmids. Besides these serine-type β-lactamases, we also first identified exogenously acquired metallo-β-lactamases (MBLs), IMP-1 and SMB-1, in imipenem-resistant Serratia marcescens, and the IMP-1-producing S. marcescens TN9106 became the index case for carbapenemase-producing Enterobacteriaceae. I developed the sodium mercaptoacetic acid (SMA)-disk test for the simple identification of MBL-producing bacteria. We were also the first to identify a variety of plasmid-mediated 16S ribosomal RNA methyltransferases, RmtA, RmtB, RmtC, and NpmA, from various Gram-negative bacteria that showed very high levels of resistance to a wide range of aminoglycosides. Furthermore, we first found plasmid-mediated quinolone efflux pump (QepA) and fosfomycin-inactivating enzymes (FosA3 and FosK). We also first characterized penicillin reduced susceptible Streptococcus agalactiae, macrolide-resistant Mycoplasma pneumoniae, as well as Campylobacter jejuni, and Helicobacter pylori, together with carbapenem-resistant Haemophilus influenzae. We constructed a PCR-based open reading frame typing method for rapid identification of Acinetobacter baumannii international clones.
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Affiliation(s)
- Yoshichika Arakawa
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Palmeira JD, Haenni M, Metayer V, Madec JY, Ferreira HMN. Epidemic spread of IncI1/pST113 plasmid carrying the Extended-Spectrum Beta-Lactamase (ESBL) bla CTX-M-8 gene in Escherichia coli of Brazilian cattle. Vet Microbiol 2020; 243:108629. [PMID: 32273008 DOI: 10.1016/j.vetmic.2020.108629] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The prevalence of Extended-Spectrum Beta-Lactamase (ESBL)-producing Enterobacteriaceae is increasing worldwide and the Agri-Food sector acts as a reservoir of clinically relevant ESBL genes. Our study aimed at detecting and characterizing ESBL-producing Enterobacteriaceae responsible for intestinal colonization of Brazilian bovines. MATERIAL AND METHODS ESBL-producing E. coli isolates were recovered from fecal samples of healthy cattle in Northwest Brazil. Antimicrobial susceptibility was determined by disk diffusion. Resistance and virulence genes were identified by PCR and amplicons were sequenced, clonality was assessed by PFGE and MLST, and plasmids were characterized by replicon typing, S1-PFGE and Southern blot hybridizations. Transferability of ESBL genes was assessed by conjugation assay. RESULTS A total of 40 ESBL-producing E. coli were characterized, which originated from 34/191 animals (17.8 %) and 15/22 farms (68.2 %). The blaCTX-M-8 gene was the most frequent ESBL gene (62.5 %), followed by blaSHV-2a (20.0 %), blaCTX-M-2 (10.0 %), and blaCTX-M-15 (7.5 %). The blaCTX-M-8 gene was localized on the IncI1/pST113 plasmid in multiple E. coli sequence types across unrelated animals and farms. DISCUSSION We report the first characterization and a high prevalence of ESBL-producing E. coli in the beef cattle sector in Brazil, which is mainly supported by the spread of an epidemic IncI1/pST113/blaCTX-M-8 plasmid. Since Brazil is one of the biggest beef meat exporters worldwide, the spread of this ESBL plasmid across other sectors, countries and continents should be considered with attention.
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Affiliation(s)
- Josman Dantas Palmeira
- Microbiology - Biological Sciences Department, Faculty of Pharmacy, University of Porto, Porto, Portugal; UCIBIO - Research Unit on Applied Molecular Biosciences, REQUIMTE, Portugal.
| | - Marisa Haenni
- Unité Antibiorésistance et Virulence Bactériennes, Université de Lyon - Anses Laboratoire de Lyon, France
| | - Véronique Metayer
- Unité Antibiorésistance et Virulence Bactériennes, Université de Lyon - Anses Laboratoire de Lyon, France
| | - Jean-Yves Madec
- Unité Antibiorésistance et Virulence Bactériennes, Université de Lyon - Anses Laboratoire de Lyon, France
| | - Helena Maria Neto Ferreira
- Microbiology - Biological Sciences Department, Faculty of Pharmacy, University of Porto, Porto, Portugal; UCIBIO - Research Unit on Applied Molecular Biosciences, REQUIMTE, Portugal
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Takayama Y, Sekizuka T, Matsui H, Adachi Y, Eda R, Nihonyanagi S, Wada T, Matsui M, Suzuki S, Takaso M, Kitasato H, Kuroda M, Hanaki H. Characterization of the IncFII-IncFIB(pB171) Plasmid Carrying bla NDM-5 in Escherichia coli ST405 Clinical Isolate in Japan. Infect Drug Resist 2020; 13:561-566. [PMID: 32110066 PMCID: PMC7035895 DOI: 10.2147/idr.s232943] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/19/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose New Delhi metallo-β-lactamase 5 (NDM-5) shows stronger resistance to carbapenems and broad-spectrum cephalosporins than NDM-1 because NDM-5 differs from NDM-1 by two amino acid substitutions. In this study, our aim was to characterize a NDM-5-producing Escherichia coli isolate KY1497 from a patient with urinary tract infection in Japan, who had no recent history of overseas travel. Patients and Methods NDM-5-producing E. coli isolate KY1497 was detected in the urine sample of a patient hospitalized in a tertiary hospital in Japan. The complete genome sequence of isolate KY1497 was determined by short- and long-read sequencing with hybrid assembly, followed by multilocus sequence typing (MLST), core-genome phylogeny analysis, plasmid analysis, and transconjugation experiments. Results KY1497 was classified as ST405 by MLST, and core-genome phylogeny exhibited the closest lineage to the clinical isolates in Nepal (IOMTU605) and Canada (FDAARGOS_448). KY1497 harbors blaNDM-5 in the IncFII-IncFIB(pB171) replicon plasmid (pKY1497_1, 123,767 base pairs). Plasmid analysis suggested that the cognate plasmids of pKY1497_1 have a minor plasmid background, rather than the globally disseminated IncX3 plasmid carrying blaNDM-5. Transconjugation analysis revealed that pKY1497_1 is transmissible to the recipient E. coli J53 strain. Conclusion We characterized a novel Inc replicon plasmid (IncFII-IncFIB[pB171]) carrying blaNDM-5 and its host E. coli strain. NDMs are associated with a high risk of infection worldwide because of their antibiotic resistance and untreatable and hard-to-treat infections. Other patients in the hospital showed negative results for carbapenem-resistant Enterobacteriaceae. As NDM-producing strains are only sporadically detected in Japan, attention should be provided to the community prevalence of NDM-producing E. coli strains to prevent nosocomial infections.
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Affiliation(s)
- Yoko Takayama
- Department of Infection Control and Infectious Diseases, Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Kanagawa, Japan.,Department of Infection Control and Prevention, Kitasato University Hospital, Kanagawa, Japan
| | - Tsuyoshi Sekizuka
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hidehito Matsui
- Infection Control Research Center, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Yuzuru Adachi
- Infection Control Research Center, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Ryotaro Eda
- Department of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Shin Nihonyanagi
- Department of Infection Control and Prevention, Kitasato University Hospital, Kanagawa, Japan
| | - Tatsuhiko Wada
- Department of Infection Control and Prevention, Kitasato University Hospital, Kanagawa, Japan
| | - Mari Matsui
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satowa Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masashi Takaso
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Hidero Kitasato
- Department of Microbiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Makoto Kuroda
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
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Truncated Class 1 Integron Gene Cassette Arrays Contribute to Antimicrobial Resistance of Diarrheagenic Escherichia coli. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4908189. [PMID: 32090095 PMCID: PMC7013361 DOI: 10.1155/2020/4908189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022]
Abstract
Class 1 integrons (c1-integrons) are associated with multidrug resistance in diarrheagenic Escherichia coli (DEC). However, little is known about gene cassettes located within these c1-integrons, particularly truncated c1-integrons, in DEC strains. Therefore, the aims of the present study were to reveal the relationship between antimicrobial resistance and the presence of truncated c1-integrons in DEC isolates derived from human stool samples in Japan. A total of 162 human stool-derived DEC isolates from Japan were examined by antimicrobial susceptibility testing, PCR-based gene detection, and next-generation sequencing analyses. Results showed that 44.4% (12/27) of c1-integrons identified in the DEC isolates harbored only intI1 (an element of c1-integrons) and were truncated by IS26, Tn3, or IS1-group insertion sequences. No difference in the frequency of antimicrobial resistance was recorded between intact and truncated c1-integron-positive DEC isolates. Isolates containing intact/truncated c1-integrons, particularly enteroaggregative E. coli isolates, were resistant to a greater number of antimicrobials than isolates without c1-integrons. aadA and dfrA were the most prevalent antimicrobial resistance genes in the intact/truncated c1-integrons examined in this study. Therefore, gene cassettes located within these intact/truncated c1-integrons may only play a limited role in conferring antimicrobial resistance among DEC. However, DEC harboring truncated c1-integrons may be resistant to a greater number of antimicrobials than c1-integron-negative DEC, similar to strains harboring intact c1-integrons.
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Ogawa Y, Nakano R, Kasahara K, Mizuno T, Hirai N, Nakano A, Suzuki Y, Kakuta N, Masui T, Yano H, Mikasa K. Comparison of the inoculum size effects of antibiotics on IMP-6 β-lactamase-producing Enterobacteriaceae co-harboring plasmid-mediated quinolone resistance genes. PLoS One 2019; 14:e0225210. [PMID: 31721789 PMCID: PMC6853314 DOI: 10.1371/journal.pone.0225210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/29/2019] [Indexed: 11/19/2022] Open
Abstract
Almost all cases of carbapenemase-producing Enterobacteriaceae infections in Japan are caused by blaIMP-positive Enterobacteriaceae (especially blaIMP-6) and infections caused by other types of carbapenemase-producing Enterobacteriaceae are quite rare. We examined drug resistance genes co-harboring with blaIMP-6 and their inoculum size effects. We screened β-lactamase genes, plasmid-mediated quinolone resistance (PMQR) genes, and aminoglycoside-modifying enzyme genes by PCR and performed sequencing for 14 blaIMP-6-positive Enterobacteriaceae. Further, all PMQR-positive isolates were submitted to conjugation and inoculum effect evaluation. Our data showed that 13 of the 14 isolates harbored CTX-M-2 and one co-harbored CTX-M-2 and CTX-M-1 as extended-spectrum β-lactamases. All isolates carried one or more PMQRs; aac(6')-Ib-cr was the most prevalent (92.8%), and was followed by oqxA (64.3%), qnrS (50%), oqxAB (21.4%), and qnrB (14.3%). However, Klebsiella pneumoniae contains chromosomal OqxAB. Inoculum size effects were significant in all strains for meropenem, 13 strains for imipenem, 7 for levofloxacin, and 3 for amikacin. We observed that 11 of the experimental strains (100%), 8 strains (72.7%), and 1 strain showed inoculum size effects for meropenem, imipenem, and amikacin, respectively. However, four strains harbored qnr genes and two strains harbored qnr genes and QRDR mutations concurrently; no inoculum size effect was seen for levofloxacin. The blaIMP-6-positive Enterobacteriaceae that we studied was found to harbor at least one plasmid-mediated drug resistance gene. The inoculum size effect for carbapenems was thought to be mainly due to IMP-6-type metallo-β-lactamase; however qnrB and qnrS also had a minimal impact on the inoculum size effect for levofloxacin.
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Affiliation(s)
- Yoshihiko Ogawa
- Center for Infectious Diseases, Nara Medical University, Kashihara, Japan
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Ryuichi Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
- * E-mail:
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Tomoki Mizuno
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Nobuyasu Hirai
- Center for Infectious Diseases, Nara Medical University, Kashihara, Japan
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Akiyo Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Yuki Suzuki
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Naoki Kakuta
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Takashi Masui
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Kashihara, Japan
| | - Keiichi Mikasa
- Center for Infectious Diseases, Nara Medical University, Kashihara, Japan
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Prevalence of Quinolone Resistance of Extended-Spectrum β-Lactamase-Producing Escherichia coli with ST131- fimH30 in a City Hospital in Hyogo, Japan. Int J Mol Sci 2019; 20:ijms20205162. [PMID: 31635210 PMCID: PMC6829264 DOI: 10.3390/ijms20205162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022] Open
Abstract
Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolates are known to tolerate superior quinolone antimicrobials compared with other antibacterial agents. Among the clones belonging to sequence type (ST) 131 by multilocus sequence typing, the involvement of the H30-Rx subclone has been reported worldwide with various fimH genes encoding type 1 pili. We investigated 83 isolates of ESBL-producing E. coli and performed antimicrobial susceptibility test, CH (fumC/fimH) ST131 by typing the specific PCR. Moreover, mutation analysis of genes involved in quinolone antibiotic resistance (gyrA and parC) and ESBL genotypes were determined. As a result, 54 of 83 isolates (65.1%) of CH40-30 clones corresponding to ST131-fimH30 were detected, and all were resistant to levofloxacin. Mutations associated with this resistance were common, and included S83L and D87N of gyrA and S80I and E84V of parC. Subclone analysis revealed a high proportion of fimH30-non-Rx (40 isolates, 74.1%). Each subclone was characterized by ESBL genotype, and the CTX-M-15 type was mainly seen for fimH30-Rx, with the CTX-M-14 type or CTX-M-27 type seen for fimH30-non-Rx. This study suggests that an increase in ESBL-producing quinolone-resistant E. coli in a city hospital in Hyogo, Japan, was caused by the spread of subclones belonging to fimH30-non-Rx of ST131.
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Okai M, Aoki H, Ishida M, Urano N. Antibiotic-resistance of Fecal Coliforms at the Bottom of the Tama River, Tokyo. Biocontrol Sci 2019; 24:173-178. [PMID: 31527349 DOI: 10.4265/bio.24.173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
We investigated the midstream bottom of the Tama River, which flows through Tokyo, to evaluate the occurrence and degree of antibiotic-resistant fecal coliforms including multidrug-resistant fecal coliforms. The genera Klebsiella and Escherichia were the major isolates among the fecal coliforms. For the genus Klebsiella, the highest antibiotic resistance was observed for ampicillin (100%) , followed by kanamycin, tetracycline, cefotaxime, and cefoxitin. The highest resistance to E. coli was found for kanamycin (44.4%) , followed by ampicillin, tetracycline, chloramphenicol, amoxicillin-clavulanate, cefotaxime, ceftazidime, and aztreonam. Multidrug resistance (MDR) was observed in three E. coli isolates. A double disc synergy test confirmed the production of extended-spectrum β-lactamases by the six-antibiotic-resistant isolate E. coli hfa7, and the strain had CTX-M-1 group gene. Assessments of antibiotic-resistant fecal coliforms at the bottom of the Tama River are important toward the goals of preventing the spread of antibiotic-resistant fecal coliforms in humans, animals, and the environment.
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Affiliation(s)
- Masahiko Okai
- Department of Ocean Sciences, Tokyo University of Marine Science and Technology
| | - Hanako Aoki
- Department of Ocean Sciences, School of Marine Science, Tokyo University of Marine Science and Technology
| | - Masami Ishida
- Department of Ocean Sciences, Tokyo University of Marine Science and Technology
| | - Naoto Urano
- Department of Marine Resources and Energy, Tokyo University of Marine Science and Technology
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Increased community-acquired upper urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli in children and the efficacy of flomoxef and cefmetazole. Clin Exp Nephrol 2019; 23:1306-1314. [PMID: 31428892 PMCID: PMC6797641 DOI: 10.1007/s10157-019-01775-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/06/2019] [Indexed: 11/24/2022]
Abstract
Background Urinary tract infections caused by extended-spectrum beta-lactamase-producing bacteria are increasing worldwide. At our hospital, the number of pediatric patients hospitalized because of an upper urinary tract infection has dramatically increased since 2016. In total, 60.5% of urinary tract infections are caused by extended-spectrum beta-lactamase-producing Escherichia coli. Such a high prevalence of extended-spectrum beta-lactamase-producing E. coli has not been detected previously in Japan. Therefore, we evaluated the clinical and bacteriologic characteristics and efficacy of antibiotics against upper urinary tract infections caused by E. coli in children. Methods This retrospective study surveyed 152 patients who were hospitalized in the pediatric department of Shimane Prefectural Central Hospital because of upper urinary tract infections caused by E. coli. Medical records were reviewed to examine patient characteristics. O antigens, antibiotic susceptibility, gene typing, and pulse-field gel electrophoresis were studied at the Shimane Prefectural Institute of Public Health and Environmental Science. Results Urine sample analyses showed extended-spectrum beta-lactamase types such as CTX-M-9 and plural virulence genes. We changed the primary antibiotic treatment to flomoxef or cefmetazole to treat upper urinary tract infections caused by Gram-negative bacilli. After changing treatment, the time to fever alleviation was significantly shortened. Conclusion Extended-spectrum beta-lactamase-producing E. coli should be suspected in community-acquired upper urinary tract infections. Therefore, when treating patients, it is necessary to focus on antibiotic susceptibility and the prevalence of extended-spectrum beta-lactamase-producing bacteria found in each area. Flomoxef and cefmetazole are useful primary treatments for upper urinary tract infections caused by extended-spectrum beta-lactamase-producing E. coli.
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Messaoudi A, Haenni M, Bouallègue O, Saras E, Chatre P, Chaouch C, Boujâafar N, Mansour W, Madec JY. Dynamics and molecular features of OXA-48-like-producing Klebsiella pneumoniae lineages in a Tunisian hospital. J Glob Antimicrob Resist 2019; 20:87-93. [PMID: 31306816 DOI: 10.1016/j.jgar.2019.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/18/2019] [Accepted: 07/03/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to elucidate the molecular features of genes, plasmids and clones of OXA-48-like producingKlebsiella pneumoniae isolates recovered in Sahloul Hospital (Sousse, Tunisia) in the period 2012-2014. METHODS In vitro antimicrobial susceptibility testing, S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), Southern blotting and PCR-based replicon typing (PBRT) were performed. Extended-spectrum β-lactamase (ESBL) and carbapenemases genes were detected by PCR and sequencing. The clonality of isolates was assessed by PFGE and multilocus sequence typing (MLST). RESULTS Klebsiella pneumoniae accounted for 26.8% (1095/4083) of clinical Enterobacterales isolates identified during 2012-2014, of which 21.9% (240/1095) were resistant to carbapenems, mostly harbouring blaOXA-48-like genes (196/240; 81.7%). Plasmid analysis showed that blaOXA-204 and blaOXA-48 were mostly carried by IncA/C and IncL plasmids, respectively. The current data highlight the dominance of two ST101 and ST147 lineages spreading OXA-48 and OXA-204, respectively, through successive clonal spreads at this hospital. In addition, a large diversity of other K. pneumoniae lineages was also identified, such as ST15, ST36 and ST525 spreading OXA-48 as well as ST340, ST2032, ST301, ST199 and ST1561 spreading OXA-48 or OXA-204, constituting a reservoir of possible dominant clones in the future. CONCLUSION This study reports the full molecular characterisation of carbapenem resistance in K. pneumoniae and the predominance of a few clones responsible for the dissemination of OXA-48 and OXA-204 enzymes in a Tunisian hospital.
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Affiliation(s)
- Aziza Messaoudi
- Research Unit: Emergent Bacterial Resistance and Safety of Care (UR12SP37), Laboratory of Microbiology, University Hospital Sahloul, Sousse, Tunisia
| | - Marisa Haenni
- Université de Lyon-French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
| | - Olfa Bouallègue
- Research Unit: Emergent Bacterial Resistance and Safety of Care (UR12SP37), Laboratory of Microbiology, University Hospital Sahloul, Sousse, Tunisia; Faculty of Medicine Ibn Al Jazzar Sousse, University of Sousse, Sousse, Tunisia
| | - Estelle Saras
- Université de Lyon-French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
| | - Pierre Chatre
- Université de Lyon-French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
| | - Cherifa Chaouch
- Research Unit: Emergent Bacterial Resistance and Safety of Care (UR12SP37), Laboratory of Microbiology, University Hospital Sahloul, Sousse, Tunisia; Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Noureddine Boujâafar
- Research Unit: Emergent Bacterial Resistance and Safety of Care (UR12SP37), Laboratory of Microbiology, University Hospital Sahloul, Sousse, Tunisia; Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Wejdene Mansour
- Research Unit: Emergent Bacterial Resistance and Safety of Care (UR12SP37), Laboratory of Microbiology, University Hospital Sahloul, Sousse, Tunisia; Faculty of Medicine Ibn Al Jazzar Sousse, University of Sousse, Sousse, Tunisia; Laboratory of Metabolic Biophysics and Applied Pharmacology (LR12ES02), Department of Biophysics, Faculty of Medicine Ibn El Jazzar Sousse, University of Sousse, Sousse, Tunisia.
| | - Jean-Yves Madec
- Université de Lyon-French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
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Kikuchi K, Lee K, Ueno H, Tomari K, Kobori S, Kaetsu A, Matsui M, Suzuki S, Sekizuka T, Kuroda M, Miyazaki M, Ohnishi M. Enterohaemorrhagic Escherichia coli O121:H19 acquired an extended-spectrum β-lactamase gene during the development of an outbreak in two nurseries. Microb Genom 2019; 5. [PMID: 31215859 PMCID: PMC6700663 DOI: 10.1099/mgen.0.000278] [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] [Indexed: 02/06/2023] Open
Abstract
Enterohaemorrhagic Escherichia coli (EHEC) is an important human pathogen worldwide. Although serotype O157 is currently the most dominant and important EHEC strain, serotypes O26, O111, O91, O103 and O121 are also recognized as serious pathogens that affect public health. EHEC outbreaks often occur in nurseries and elderly care facilities. In 2012, a nursery outbreak of EHEC O121 occurred during which the bacterium acquired a plasmid-borne extended-spectrum β-lactamase (ESBL) gene. ESBL-producing E. coli O86 was concurrently isolated from one of the EHEC patients. Therefore, we investigated the isolates by whole-genome sequence (WGS) analysis to elucidate the transmission dynamics of the EHEC strains and the ESBL plasmid. According to WGS-based phylogeny, all 17 EHEC O121 isolates were clonal, while E. coli O86 was genetically distant from the EHEC O121 isolates. The complete sequence of an ESBL plasmid encoding the CTX-M-55 β-lactamase was determined using S1-PFGE bands, and subsequent mapping of the WGS reads confirmed that the plasmid sequences from EHEC O121 and E. coli O86 were identical. Furthermore, conjugation experiments showed that the plasmid was capable of conjugative transfer. These results support the hypothesis that EHEC O121 acquired an ESBL-producing plasmid from E. coli O86 during the outbreak. This report demonstrates the importance of implementing preventive measures during EHEC outbreaks to control both secondary infection and the spread of antimicrobial resistance factors.
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Affiliation(s)
- Koji Kikuchi
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Kenichi Lee
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroyuki Ueno
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Kentaro Tomari
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Sumie Kobori
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | | | - Mari Matsui
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satowa Suzuki
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tsuyoshi Sekizuka
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Kuroda
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motonobu Miyazaki
- Saitama City Institute of Health Science and Research, Saitama, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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Gay E, Bour M, Cazeau G, Jarrige N, Martineau C, Madec JY, Haenni M. Antimicrobial Usages and Antimicrobial Resistance in Commensal Escherichia coli From Veal Calves in France: Evolution During the Fattening Process. Front Microbiol 2019; 10:792. [PMID: 31031738 PMCID: PMC6473463 DOI: 10.3389/fmicb.2019.00792] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 03/27/2019] [Indexed: 11/13/2022] Open
Abstract
Extended-Spectrum-Cephalosporin (ESC)-resistant Enterobacteriaceae have widely spread in all settings worldwide. In animals, Extended-Spectrum Beta-Lactamase (ESBL) producers have been frequently identified in veal calves. The objectives of this study were to investigate the trends in the ESBL load and antimicrobial resistance (AMR) proportions, and antimicrobial usages (AMU) in veal calves during the fattening process. Ten fattening farms were selected and 50 animals per farm were sampled. AMR was assessed in bacteria from the dominant flora (collected on non-selective MacConckey agar) and in ESBL/AmpC-carrying bacteria from the subdominant flora (selected on ChromID ESBL selective plates) upon arrival and 5-6 months later before slaughter. The number and types of treatments during fattening were also collected. Rates of ESBL-producing E. coli from the subdominant flora significantly decreased in all farms (arrival: 67.7%; departure: 20.4%) whereas rates of multidrug-resistant E. coli from the dominant flora have significantly increased (arrival: 60.2%; departure: 67.2%; p = 0.025). CTX-M-1 was the most frequently identified ESBL enzyme (arrival: 59.3%; departure: 52.0%). The plasmid-mediated mcr-1 gene was also identified occasionally. In parallel, levels of resistances to non-critically important antimicrobials were already high upon arrival but have still further increased over time until slaughter. Our study also highlighted that if only ESBL-producing isolates were monitored, it might have led to a partial (and partly false) picture of AMR rates globally decreasing during the fattening period. The mean number of antimicrobial treatments per calf (NTPC) was 8.75 but no association between AMU and AMR was evidenced. Most ESBL producers were clonally unrelated suggesting multiple sources and not cross-contaminations among calves during transportation. Feeding milk containing antimicrobial residues to veal calves is hypothesized to explain the high ESBL loads in animals at the entrance on farms.
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Affiliation(s)
- Emilie Gay
- Université de Lyon - ANSES, Laboratoire de Lyon, Unité Épidémiologie et Appui à la Surveillance, Lyon, France
| | - Maxime Bour
- Université de Lyon - ANSES, Laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes, Lyon, France.,Centre National de Référence de la Résistance aux Antibiotiques, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Géraldine Cazeau
- Université de Lyon - ANSES, Laboratoire de Lyon, Unité Épidémiologie et Appui à la Surveillance, Lyon, France
| | - Nathalie Jarrige
- Université de Lyon - ANSES, Laboratoire de Lyon, Unité Épidémiologie et Appui à la Surveillance, Lyon, France
| | | | - Jean-Yves Madec
- Université de Lyon - ANSES, Laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
| | - Marisa Haenni
- Université de Lyon - ANSES, Laboratoire de Lyon, Unité Antibiorésistance et Virulence Bactériennes, Lyon, France
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Saidani M, Messadi L, Soudani A, Daaloul-Jedidi M, Châtre P, Ben Chehida F, Mamlouk A, Mahjoub W, Madec JY, Haenni M. Epidemiology, Antimicrobial Resistance, and Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Clinical Bovine Mastitis in Tunisia. Microb Drug Resist 2018; 24:1242-1248. [DOI: 10.1089/mdr.2018.0049] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Mariem Saidani
- Service de Microbiologie et d'Immunologie, Ecole Nationale de Médecine Vétérinaire, Université de La Manouba, Sidi Thabet, Tunisie
- Institut National Agronomique de Tunisie, Université de Carthage, Tunis, Tunisie
| | - Lilia Messadi
- Service de Microbiologie et d'Immunologie, Ecole Nationale de Médecine Vétérinaire, Université de La Manouba, Sidi Thabet, Tunisie
| | - Alya Soudani
- Service de Microbiologie et d'Immunologie, Ecole Nationale de Médecine Vétérinaire, Université de La Manouba, Sidi Thabet, Tunisie
| | - Monia Daaloul-Jedidi
- Service de Microbiologie et d'Immunologie, Ecole Nationale de Médecine Vétérinaire, Université de La Manouba, Sidi Thabet, Tunisie
| | - Pierre Châtre
- Unité Antibiorésistance et Virulence Bactériennes, Université Claude Bernard Lyon 1 - ANSES Site de Lyon, Lyon, France
| | - Faten Ben Chehida
- Service de Microbiologie et d'Immunologie, Ecole Nationale de Médecine Vétérinaire, Université de La Manouba, Sidi Thabet, Tunisie
| | - Aymen Mamlouk
- Service de Microbiologie et d'Immunologie, Ecole Nationale de Médecine Vétérinaire, Université de La Manouba, Sidi Thabet, Tunisie
| | - Wassim Mahjoub
- Service de Microbiologie et d'Immunologie, Ecole Nationale de Médecine Vétérinaire, Université de La Manouba, Sidi Thabet, Tunisie
| | - Jean-Yves Madec
- Unité Antibiorésistance et Virulence Bactériennes, Université Claude Bernard Lyon 1 - ANSES Site de Lyon, Lyon, France
| | - Marisa Haenni
- Unité Antibiorésistance et Virulence Bactériennes, Université Claude Bernard Lyon 1 - ANSES Site de Lyon, Lyon, France
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29
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Melo LC, Oresco C, Leigue L, Netto HM, Melville PA, Benites NR, Saras E, Haenni M, Lincopan N, Madec JY. Prevalence and molecular features of ESBL/pAmpC-producing Enterobacteriaceae in healthy and diseased companion animals in Brazil. Vet Microbiol 2018; 221:59-66. [PMID: 29981709 DOI: 10.1016/j.vetmic.2018.05.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/13/2018] [Accepted: 05/29/2018] [Indexed: 01/08/2023]
Abstract
Extended-spectrum beta-lactamase (ESBL)- and plasmid-mediated AmpC (pAmpC)-carrying Enterobacteriaceae have widely disseminated in human, animal and environmental reservoirs. Pets have been recognized as a source of ESBL/pAmpC worldwide, and are possibly also a source of human contamination. The aim of this study was to document to what extent cats and dogs may act as a driving force in the spread of ESBLs and pAmpCs in Brazil. A total of 113 healthy stray cats and dogs and 74 sick pets were sampled, and extended-spectrum cephalosporin-resistant Enterobacteriaceae (ESC-R) were detected in 28/113 (24.8%) and 8/74 (10.8%) tested animals, respectively. Different Enterobacteriaceae isolates (mostly E. coli), a large number of E. coli clones (with ST90, ST457, ST973 and ST2541 being predominant), and several ESBL/pAmpC genes and plasmids were characterized, highlighting the ability of stray and pet cats and dogs to further spread a wide range of ESC-resistance determinants. The ESBL phenotype was due to the blaCTX-M-2 and blaCTX-M-8 genes, as found in human epidemiology in Brazil, but blaCTX-M-9 and blaCTX-M-15 were also identified. The pAmpC phenotype was systematically due to the presence of the blaCMY-2 gene, mostly carried by IncI1 ST12 plasmids. Our results showed that pets can be considered a significant reservoir of multidrug-resistant bacteria in Brazil. This is especially true for healthy stray dogs that displayed the highest prevalence (24.8%) of ESBLs/pAmpC resistance determinants, which can then be further spread both to the environment and to other animals or humans by contact.
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Affiliation(s)
- Luana C Melo
- Department of Microbiology, Institute of Biomedical Sciences, Universidade de São Paulo, São Paulo, Brazil; Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon - Université Claude Bernard Lyon 1, Lyon, France
| | - Cíntia Oresco
- Department of Microbiology, Institute of Biomedical Sciences, Universidade de São Paulo, São Paulo, Brazil
| | - Lucianne Leigue
- Department of Microbiology, Institute of Biomedical Sciences, Universidade de São Paulo, São Paulo, Brazil
| | | | - Priscilla A Melville
- Department of Preventive Veterinary Medicine and Animal Health, Faculty of Veterinary Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Nilson R Benites
- Department of Preventive Veterinary Medicine and Animal Health, Faculty of Veterinary Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Estelle Saras
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon - Université Claude Bernard Lyon 1, Lyon, France
| | - Marisa Haenni
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon - Université Claude Bernard Lyon 1, Lyon, France.
| | - Nilton Lincopan
- Department of Microbiology, Institute of Biomedical Sciences, Universidade de São Paulo, São Paulo, Brazil
| | - Jean-Yves Madec
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Laboratoire de Lyon - Université Claude Bernard Lyon 1, Lyon, France
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30
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Kawamura K, Hayashi K, Matsuo N, Kitaoka K, Kimura K, Wachino JI, Kondo T, Iinuma Y, Murakami N, Fujimoto S, Arakawa Y. Prevalence of CTX-M-Type Extended-Spectrum β-Lactamase-Producing Escherichia coli B2-O25-ST131 H30R Among Residents in Nonacute Care Facilities in Japan. Microb Drug Resist 2018; 24:1513-1520. [PMID: 29791251 DOI: 10.1089/mdr.2018.0068] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated the prevalence and characteristics of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli among 258 residents of long-term care facilities (LTCFs) in Japan. Out of 258 fecal samples collected from nine LTCFs between November 2015 and March 2017, we recovered 59 ESBL-producing E. coli isolates. All isolates carried blaCTX-M genes, mainly blaCTX-M-27 (42.4%), blaCTX-M-14 (23.7%), and blaCTX-M-15 (18.6%). The isolates showed 7 serotypes (STs), including ST131 (n = 49, 83.1%) and ST38 (n = 4, 6.8%), and 47 (79.7%) out of 49 isolates belonging to ST131 were identified as H30R. The 59 ESBL producers were divided into four groups, B2 (86.4%), D (8.5%), A (3.4%), and C (1.7%); 44 (74.6%) were epidemic clone B2-O25-ST131 H30R, of which 21, 11, and 6 harbored blaCTX-M-27, blaCTX-M-15, and blaCTX-M-14, respectively. Most plasmids were of IncF replicon types (n = 33), and 22 blaCTX-M-27-carrying plasmids showed multiple replicon types, including IncFII, FIA, and FIB. The ESBL producers were susceptible to imipenem, amikacin, and fosfomycin, but resistant to ceftazidime (49.2%), and ciprofloxacin (88.1%); in particular, the isolates harboring the blaCTX-M-15 gene showed significantly high resistance rate to ceftazidime (p < 0.01). Our findings indicate that a considerable proportion of the examined LTCF residents carried ESBL-producing E. coli isolates in feces and had high prevalence of epidemic clone B2-O25-ST131. Furthermore, continuous investigations would be very necessary to monitor actual carriage states of ESBL-producers among the LTCF residents from the viewpoint of both public health and healthcare viewpoints.
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Affiliation(s)
- Kumiko Kawamura
- 1Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kengo Hayashi
- 1Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Nao Matsuo
- 1Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kazuki Kitaoka
- 2Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kouji Kimura
- 2Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Jun-Ichi Wachino
- 2Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Takaaki Kondo
- 1Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshitsugu Iinuma
- 3Department of Infectious Diseases, Kanazawa Medical University, Ishikawa, Japan
| | - Nobuo Murakami
- 4Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Shuhei Fujimoto
- 5Department of Bacteriology and Bacterial Infection Division of Host Defence Mechanism, Tokai University School of Medicine, Kanagawa, Japan
| | - Yoshichika Arakawa
- 2Department of Bacteriology, Nagoya University Graduate School of Medicine, Aichi, Japan
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31
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Yokoyama K, Uehara Y, Sasaki T, Hiramatsu K. Risk factors of fecal colonization with extended-spectrum β-lactamase-producing Enterobacteriaceae in special nursing homes in Japan. J Gen Fam Med 2018; 19:90-96. [PMID: 29744262 PMCID: PMC5931344 DOI: 10.1002/jgf2.161] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 01/29/2018] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Japanese welfare facilities for the elderly are called as special nursing home (SNH), providing conventional-type with group care or unit-type with individual care. We investigated the risk factors of fecal colonization with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) of elderly who required care at SNH in Japan. METHODS The feces discharged on diaper were obtained from the total of 100 residents with fecal incontinence in 9 SNHs located in Tokyo, Japan. The samples were cultured on ESBL selection agar, and ESBL-E were determined by the antimicrobial susceptibility test and genetic analysis. The status of the residents and the characteristics of facilities, especially about the incontinence care, were obtained by questionnaire methods. Statistical analysis was performed to determine the factors related to carriage of ESBL-E. RESULTS Extended-spectrum β-lactamase-producing Enterobacteriaceae was isolated from 53 of 100 SNH residents. Risk factors of colonization among the individual residents were not found. The prevalence of ESBL-E carriage was significantly higher in the 6 conventional-type facilities than in the 3 unit-type facilities (P = .015). The cart for diaper exchange was used in 5 of 6 conventional-type facilities in 9 SNHs, and their residents tended to show high of ESBL-E colonization rate. The residents living in unit-type facilities which do not use gloves for changing diaper tended to show high ESBL-E colonization rate than other 2 facilities using gloves. CONCLUSIONS It is suggested that using the cart for changing diaper has relation to carry ESBL-E. In the facilities using cart, revision of their methods of excretion care will be needed.
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Affiliation(s)
- Kumi Yokoyama
- Faculty of Health Care and NursingJuntendo UniversityUrayasu‐shiChibaJapan
- Department of Infection Control ScienceGraduate School of MedicineJuntendo UniversityBunkyo‐kuTokyoJapan
| | - Yuki Uehara
- Department of Infection Control ScienceGraduate School of MedicineJuntendo UniversityBunkyo‐kuTokyoJapan
- Department of General MedicineFaculty of MedicineJuntendo UniversityBunkyo‐kuTokyoJapan
| | - Takashi Sasaki
- Animal Research Center, School of MedicineSapporo Medical UniversityChuo‐kuSapporoJapan
- Center of Excellence for Infection Control ScienceJuntendo University Graduate School of MedicineTokyoJapan
| | - Keiichi Hiramatsu
- Department of Infection Control ScienceGraduate School of MedicineJuntendo UniversityBunkyo‐kuTokyoJapan
- Center of Excellence for Infection Control ScienceJuntendo University Graduate School of MedicineTokyoJapan
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32
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Horie H, Ito I, Konishi S, Yamamoto Y, Yamamoto Y, Uchida T, Ohtani H, Yoshida Y. Isolation of ESBL-producing Bacteria from Sputum in Community-acquired Pneumonia or Healthcare-associated Pneumonia Does Not Indicate the Need for Antibiotics with Activity against This Class. Intern Med 2018; 57:487-495. [PMID: 29021461 PMCID: PMC5849542 DOI: 10.2169/internalmedicine.8867-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective In the past decade, extended-spectrum β-lactamase (ESBL)-producing bacteria have increasingly frequently been isolated from various kinds of clinical specimens. However, the appropriate treatment of pneumonia in which ESBL-producing bacteria are isolated from sputum culture is poorly understood. To investigate whether or not ESBL-producing bacteria isolated from sputum in pneumonia cases should be treated as the causative bacteria. Methods and Patients In this retrospective study, we screened for patients, admitted between January 2009 and December 2015 in whom pneumonia was suspected and for whom sputum cultures yielded Escherichia coli or Klebsiella spp. isolates. We identified patients with community-acquired pneumonia (CAP) or healthcare-associated pneumonia (HCAP) from whom ESBL-producing bacteria had been isolated from sputum culture and to whom antibiotic treatment had been given with a diagnosis of pneumonia. We analyzed the patients' backgrounds and the effect of the antibiotic treatment for the initial 3-5 days. Results From 400 patients initially screened, 27 with ESBL-producing bacteria were secondarily screened. In this subset of patients, 15 were diagnosed with pneumonia, including 7 with CAP (5 E. coli and 2 K. pneumoniae) and 8 with HCAP (8 E. coli). These patients exhibited an average age of 84.1 years old, and 9 of 15 were men. No patients were initially treated with antimicrobials that are effective against isolated ESBL-producing bacteria. However, 13 of 15 patients showed improvement of pneumonia following the initial antibiotic treatment. Conclusion ESBL-producing bacteria isolated from sputum are not likely to be the actual causative organisms of pneumonia.
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Affiliation(s)
- Hideyuki Horie
- Departments of Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
| | - Isao Ito
- Departments of Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
- Department of Respiratory Medicine, Kyoto University Hospital, Japan
| | - Satoshi Konishi
- Departments of Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
- Department of Respiratory Medicine, Kyoto University Hospital, Japan
| | - Yuki Yamamoto
- Departments of Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
- Department of Respiratory Medicine, Kyoto University Hospital, Japan
| | - Yuko Yamamoto
- Departments of Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
- Department of Respiratory Medicine, Kyoto University Hospital, Japan
| | - Tatsuya Uchida
- Departments of Laboratory Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
| | - Hideo Ohtani
- Departments of Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
| | - Yoshiharu Yoshida
- Departments of Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
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33
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Takano C, Seki M, Shiihara H, Komine-Aizawa S, Kuroda K, Takahashi S, Ushijima H, Hayakawa S. Frequent isolation of extended-spectrum beta-lactamase-producing bacteria from fecal samples of individuals with severe motor and intellectual disabilities. J Infect Chemother 2018; 24:182-187. [PMID: 29398476 DOI: 10.1016/j.jiac.2017.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/20/2017] [Accepted: 10/03/2017] [Indexed: 02/06/2023]
Abstract
Extended-spectrum beta-lactamase (ESBL) producing bacteria spread worldwide and became major concern for antibiotic treatment. Although surveillance reports in general hospitals and long-term care facilities are increasing, their frequencies in individuals with severe motor and intellectual disabilities (SMID) are so far unknown. In this study, we examined the frequency of ESBL in stool samples collected from 146 asymptomatic SMID subjects hospitalized in a single institution. With their clinical information, we evaluated possible risk factors for ESBL colonization. From 146 fecal samples, ESBL-producing bacteria were isolated in 45 cases (31%). Drug sensitivity testing showed that 82% of the isolates were resistant to levofloxacin but were sensitive to tazobactam/piperacillin and cefmetazole. The most frequent genotype was CTX-M-9 detected in 36/45 (80%). A high degree of disability, antibiotic use within three months before sampling and post-tracheostomy were statistically significant risk factors. Tube feeding was also strongly correlated with ESBL colonization (p < 0.001) and associated with lower micro-organismic diversities. Our findings are the first to reveal a high prevalence of ESBL in the fecal samples of SMID individuals and suggest possible relationships between high degree disability, tube feeding and latest histories of antibiotic use.
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Affiliation(s)
- Chika Takano
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan; Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Mitsuko Seki
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Hiroaki Shiihara
- Ashikaga-no-mori Ashikaga Hospital, 615, Onumatacho, Ashikaga-shi, Tochigi 326-0011, Japan
| | - Shihoko Komine-Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Kazumichi Kuroda
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Shori Takahashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Hiroshi Ushijima
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan
| | - Satoshi Hayakawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo 173-8610, Japan.
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Negishi T, Matsumoto T, Horiuchi K, Kasuga E, Natori T, Matsuoka M, Ogiwara N, Sugano M, Uehara T, Nagano N, Honda T. Characterization of clinically isolated thymidine-dependent small-colony variants of Escherichia coli producing extended-spectrum β-lactamase. J Med Microbiol 2017; 67:33-39. [PMID: 29143727 DOI: 10.1099/jmm.0.000634] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Thymidine-dependent small-colony variants (TD-SCVs) are difficult to detect or test for antimicrobial susceptibility. We investigated the characteristics of clonal TD-SCVs of Escherichia coli, both with and without blaCTX-M-3, isolated from a patient. METHODOLOGY Mutation in the thyA gene was analysed by sequencing, and morphological abnormalities in the colonies and cells of the isolates were examined. Additionally, conjugational transfer experiments were performed to prove the horizontal transferability of plasmids harbouring resistance genes. RESULTS The TD-SCVs contained a single nucleotide substitution in the thyA gene, c.62G>A, corresponding to p.Arg21His. Morphologically, their colonies were more translucent and flattened than those of the wild-type strain. In addition, cells of the TD-SCVs were swollen and elongated, sometimes with abnormal and incomplete divisions; a large amount of cell debris was also observed. Changing c.62G>A back to the wild-type sequence reversed these abnormalities. Conjugational transfer experiments showed that the TD-SCV of E. coli with blaCTX-M-3 failed to transfer blaCTX-M-3 to E. coli CSH2. However, the TD-SCV of E. coli without blaCTX-M-3 experimentally received the plasmid encoding blaSHV-18 from Klebsiella pneumoniae ATCC 700603 and transferred it to E. coli CSH2. CONCLUSION Mutation in the thyA gene causes morphological abnormalities in the colonies and cells of E. coli, as well as inducing thymidine auxotrophy. In addition, TD-SCVs horizontally transmit plasmids encoding resistance genes. It is important to detect TD-SCVs based on their characteristics because they serve as reservoirs of transferable antibiotic resistance plasmids.
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Affiliation(s)
- Tatsuya Negishi
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.,Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Takehisa Matsumoto
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma 371-8514, Japan
| | - Kazuki Horiuchi
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Eriko Kasuga
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Tatsuya Natori
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Mina Matsuoka
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Naoko Ogiwara
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Mitsutoshi Sugano
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Takeshi Uehara
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Noriyuki Nagano
- Department of Health and Medical Sciences, Shinshu University Graduate School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Takayuki Honda
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
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Chen CM, Ke SC, Li CR, Wu YC, Chen TH, Lai CH, Wu XX, Wu LT. High Diversity of Antimicrobial Resistance Genes, Class 1 Integrons, and Genotypes of Multidrug-ResistantEscherichia coliin Beef Carcasses. Microb Drug Resist 2017; 23:915-924. [DOI: 10.1089/mdr.2016.0223] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Chih-Ming Chen
- Department of Health Food, Chung Chou University of Science and Technology, Changhua, Taiwan
- Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Se-Chin Ke
- Infection Control Office, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Chia-Ru Li
- Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Ying-Chen Wu
- Graduate Institute of Veterinary Pathology, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ter-Hsin Chen
- Graduate Institute of Veterinary Pathology, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chih-Ho Lai
- Institute of Basic Medical Science, School of Medicine, China Medical University and Hospital, Taichung, Taiwan
- Department of Microbiology and Immunology, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Xin-Xia Wu
- Department of Microbiology, The Institute of Medical Science, China Medical University Hospital, Taichung, Taiwan
| | - Lii-Tzu Wu
- Department of Microbiology, The Institute of Medical Science, China Medical University Hospital, Taichung, Taiwan
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Casella T, Nogueira MCL, Saras E, Haenni M, Madec JY. High prevalence of ESBLs in retail chicken meat despite reduced use of antimicrobials in chicken production, France. Int J Food Microbiol 2017; 257:271-275. [DOI: 10.1016/j.ijfoodmicro.2017.07.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 06/02/2017] [Accepted: 07/05/2017] [Indexed: 11/26/2022]
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Shimizu T, Harada K, Tsuyuki Y, Kimura Y, Miyamoto T, Hatoya S, Hikasa Y. In vitro efficacy of 16 antimicrobial drugs against a large collection of β-lactamase-producing isolates of extraintestinal pathogenic Escherichia coli from dogs and cats. J Med Microbiol 2017; 66:1085-1091. [PMID: 28749329 DOI: 10.1099/jmm.0.000535] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aim of this study was to assess the in vitro efficacy of candidate antimicrobials against extended-spectrum β-lactamase (ESBL)-producing isolates of extraintestinal pathogenic Escherichia coli (ExPEC) from companion animals. METHODOLOGY A total of 90 ESBL-producing ExPEC isolates from dogs and cats were tested for susceptibility to 16 antimicrobials with the agar dilution method. We also identified the ESBLs and AmpC β-lactamases of these isolates with PCR and DNA sequencing.Results/Key findings. All isolates were susceptible to meropenem, tebipenem and amikacin (AMK), and various proportions were susceptible to latamoxef (LMX, 97.8 %), fosfomycin (FOM, 97.8 %), faropenem (FPM, 96.7 %), nitrofurantoin (NFT, 96.7 %), flomoxef (FMX, 93.3 %), piperacillin/tazobactam (PTZ, 92.2 %), cefmetazole (CMZ, 91.1 %), chloramphenicol (80.0 %), trimethoprim/sulfamethoxazole (64.4 %), amoxicillin/clavulanic acid (63.3 %), ceftibuten (60.0 %), tetracycline (52.2 %) and enrofloxacin (10.0 %). A genetic analysis showed that 83 of the 90 (92.2 %) isolates were positive for CTX-M-type genes: CTX-M-14 (n=26), CTX-M-27 (n=20), CTX-M-55 (n=17), CTX-M-15 (n=12), CTX-M-2 (n=5), CTX-M-24 (n=2), CTX-M-104 (n=2) and CTX-M-3 (n=1). Eight isolates also expressed AmpC β-lactamase phenotypes. CONCLUSION This study demonstrates that the susceptibility rates to PTZ, CMZ, LMX, AMK, FOM, FPM, NFT and FMX were similar to those to carbapenems (>90 %), implying that these drugs are available alternatives to carbapenems for the treatment of companion animals infected with ExPEC-producing CTX-M-type ESBLs. Further in vivo studies of the effective use of these antimicrobials are required.
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Affiliation(s)
- Takae Shimizu
- The United Graduate School of Veterinary Science, Yamaguchi University, 1677-1 Yoshida, Yamaguchi-shi, Yamaguchi 753-8511, Japan.,Joint Department of Veterinary Medicine, Tottori University, Minami 4-101, Koyama-cho, Tottori-shi, Tottori 680-8553, Japan
| | - Kazuki Harada
- Joint Department of Veterinary Medicine, Tottori University, Minami 4-101, Koyama-cho, Tottori-shi, Tottori 680-8553, Japan.,The United Graduate School of Veterinary Science, Yamaguchi University, 1677-1 Yoshida, Yamaguchi-shi, Yamaguchi 753-8511, Japan
| | - Yuzo Tsuyuki
- Sanritsu Zelkova Veterinary Laboratory, 2-5-8 Kuji, Takatsuku, Kawasaki, Kanagawa 213-0032, Japan
| | - Yui Kimura
- Miyamoto Animal Hospital, 2265-8 Kurokawa, Yamaguchi-shi, Yamaguchi 753-0851, Japan
| | - Tadashi Miyamoto
- Miyamoto Animal Hospital, 2265-8 Kurokawa, Yamaguchi-shi, Yamaguchi 753-0851, Japan
| | - Shingo Hatoya
- Department of Advanced Pathobiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano, Osaka 598-8531, Japan
| | - Yoshiaki Hikasa
- The United Graduate School of Veterinary Science, Yamaguchi University, 1677-1 Yoshida, Yamaguchi-shi, Yamaguchi 753-8511, Japan.,Joint Department of Veterinary Medicine, Tottori University, Minami 4-101, Koyama-cho, Tottori-shi, Tottori 680-8553, Japan
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38
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Kawamura K, Sugawara T, Matsuo N, Hayashi K, Norizuki C, Tamai K, Kondo T, Arakawa Y. Spread of CTX-Type Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates of Epidemic Clone B2-O25-ST131 Among Dogs and Cats in Japan. Microb Drug Resist 2017; 23:1059-1066. [PMID: 28380311 DOI: 10.1089/mdr.2016.0246] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study was performed to investigate the carriage rates of CTX-M-type extended-spectrum β-lactamase (ESBL)-producing Escherichia coli among ill companion animals in Japan. Among the 178 nonrepetitive E. coli isolates, including 131 from dogs and 47 from cats, collected between September and November 2015, 42 (23.6%) isolates from 29 dogs and 13 cats were identified as ESBL producers. The antimicrobial susceptibility, O serotype, phylogenetic group, β-lactamase genotype, plasmid replicon type, and sequence type (ST) of each isolate were analyzed. The major ESBL types were CTX-M-14 (26.8%), CTX-M-15 (24.4%), CTX-M-27 (19.5%), and CTX-M-55 (19.5%); predominant replicon types of blaCTX-M-carrying plasmid were IncF group and IncI1-Iγ. The most prevalent STs were ST131 (n = 15, 35.7%), followed by ST38, ST10, and ST410. The 15 isolates of ST131 belonged to B2-O25. E. coli B2-O25-ST131 isolates harboring blaCTX-M-15 or blaCTX-M-27 were resistant to ceftazidime and ciprofloxacin. In particular, CTX-M-15 producers showed multidrug resistance. Our results demonstrated that the CTX-M-producing pandemic E. coli clone B2-O25-ST131 has already spread in Japanese companion animals as well. Moreover, the similarity of genotypes, serotypes, phylogenetic groups, and STs of the isolates from companion animals to those from humans suggested probable transmission of resistant bacteria between pets and humans.
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Affiliation(s)
- Kumiko Kawamura
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - Tae Sugawara
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - Nao Matsuo
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - Kengo Hayashi
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - Chihiro Norizuki
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - Kiyoko Tamai
- 2 Miroku Medical Laboratory, Co., Ltd. , Saku, Nagano, Japan
| | - Takaaki Kondo
- 1 Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - Yoshichika Arakawa
- 3 Department of Bacteriology, Nagoya University Graduate School of Medicine , Nagoya, Japan
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Kubomura A, Misaki T, Homma S, Matsuo C, Okabe N. Phenotypic and Molecular Characterization of Enteroaggregative Escherichia coli Isolated in Kawasaki, Japan. Jpn J Infect Dis 2017; 70:507-512. [PMID: 28367879 DOI: 10.7883/yoken.jjid.2016.387] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Enteroaggregative Escherichia coli (EAEC), an enteric pathogen, causes persistent diarrhea in children, HIV-infected individuals, and travelers in economically developing countries. However, the pathogenesis of EAEC infection is not well understood. This study aimed to characterize EAEC in Japan. Between 2012 and 2014, we identified 40 EAEC strains carrying the aggR gene at the Kawasaki City Institute for Public Health, Japan. We characterized these strains using O:H-antigen typing, polymerase chain reaction (for pCVD432, astA, extended-spectrum beta-lactamase, and 4 aggregative adherence fimbriae genes), HEp-2 cell adherence, clump formation, and antimicrobial susceptibility testing. We were able to classify the 40 EAEC strains into 20 O:H types. Although specific O:H types were not correlated with HEp-2 cell aggregative adherence, all the O99:H10, O131:H27, and O176:H34 EAEC strains that were the most frequent O:H types detected in this study showed co-resistance to ampicillin, sulfamethoxazole-trimethoprim, and tetracycline. Based on results of the adhesion assay and detection of virulence-related genes, no significant difference was found between asymptomatic and symptomatic cases. Irrespective of the origin, their potential for virulence was retained. Further characterization is vital to determine whether EAEC is virulent in Japan.
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Diab M, Hamze M, Madec JY, Haenni M. High Prevalence of Non-ST131 CTX-M-15-ProducingEscherichia coliin Healthy Cattle in Lebanon. Microb Drug Resist 2017; 23:261-266. [DOI: 10.1089/mdr.2016.0019] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mohamad Diab
- Laboratoire Microbiologie Santé et Environnement (LMSE), Ecole Doctorale en Sciences et Technologies, Faculté de Santé Publique, Université Libanaise, Tripoli, Liban
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Site de Lyon, Lyon, France
| | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), Ecole Doctorale en Sciences et Technologies, Faculté de Santé Publique, Université Libanaise, Tripoli, Liban
- Faculté de Sante Publique, Université Libanaise, Tripoli, Liban
| | - Jean-Yves Madec
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Site de Lyon, Lyon, France
| | - Marisa Haenni
- Unité Antibiorésistance et Virulence Bactériennes, ANSES Site de Lyon, Lyon, France
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41
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Yaici L, Haenni M, Métayer V, Saras E, Mesbah Zekar F, Ayad M, Touati A, Madec JY. Spread of ESBL/AmpC-producing Escherichia coli and Klebsiella pneumoniae in the community through ready-to-eat sandwiches in Algeria. Int J Food Microbiol 2017; 245:66-72. [DOI: 10.1016/j.ijfoodmicro.2017.01.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 01/15/2017] [Accepted: 01/20/2017] [Indexed: 02/06/2023]
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Kamei J, Yagihara Y, Kume H, Horiuchi T, Sato T, Nakagawa T, Fujimura T, Fukuhara H, Moriya K, Homma Y. Prevalence and characteristics of fecal antimicrobial-resistant Escherichia coli in a cohort of Japanese men undergoing prostate biopsy. Int J Urol 2017; 24:295-300. [PMID: 28222483 DOI: 10.1111/iju.13308] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 01/10/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To examine resistant Escherichia coli in rectal swab culture of Japanese men undergoing prostate biopsy, and to determine its prevalence, genotypic characteristics and carriage risk factors. METHODS Rectal swabs of consecutive men undergoing transrectal ultrasound-guided prostate biopsy from April 2013 to March 2015 were cultured to isolate fluoroquinolone-resistant and extended-spectrum β-lactamase-producing E. coli. The prevalence and antimicrobial susceptibility of these resistant E. coli strains and extended-spectrum β-lactamase genotyping were examined. The risk factors of antimicrobial resistance carriage were also examined. RESULTS The cohort was 376 men with a mean age of 67.8 years. Fluoroquinolone-resistant E. coli and extended-spectrum β-lactamase-producing E. coli were detected in 37 men (9.8%) and 22 men (5.9%), respectively, with fluoroquinolone-resistant and/or extended-spectrum β-lactamase-producing E. coli in 48 men (13.0%). All 49 antimicrobial-resistant strains were susceptible to tazobactam/piperacillin, amikacin, fosfomycin, meropenem and faropenem. CTX-M-9 and CTX-M-1 group were detected in 14 (63.6%) and eight (36.4%) men, respectively. CTX-M-9 showed relatively higher susceptibility to LVFX and minocycline compared with CTX-M-1. Diabetes mellitus was a significant factor for carriage of resistance by multivariate analysis (odds ratio 2.12, P = 0.039). CONCLUSIONS The present study showed the fecal carriage of fluoroquinolone-resistant E. coli and extended-spectrum β-lactamase-producing E. coli at 9.8% and 5.9%, respectively, with CTX-M-9 group of extended-spectrum β-lactamase-producing E. coli comprising 63.6%, in Japanese men receiving prostate biopsy. The carriage of fluoroquinolone-resistant and/or extended-spectrum β-lactamase-producing E. coli was significantly related to diabetes.
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Affiliation(s)
- Jun Kamei
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuka Yagihara
- Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takamasa Horiuchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoaki Sato
- Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
| | - Tohru Nakagawa
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
| | - Yukio Homma
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Hayakawa K, Nagamatsu M, Mezaki K, Sugiki Y, Kutsuna S, Takeshita N, Yamamoto K, Mawatari M, Fujiya Y, Ohmagari N. Epidemiology of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli in Japan: Characteristics of community-associated versus healthcare-associated ESBL E. coli. J Infect Chemother 2017; 23:117-119. [DOI: 10.1016/j.jiac.2016.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/17/2016] [Accepted: 08/22/2016] [Indexed: 10/20/2022]
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Utilizing the Carba NP test as an indicator of expression level of carbapenemase genes in Enterobacteriaceae. J Microbiol Methods 2016; 133:35-39. [PMID: 28007530 DOI: 10.1016/j.mimet.2016.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 12/17/2016] [Accepted: 12/17/2016] [Indexed: 11/22/2022]
Abstract
The Carba NP test was developed to detect carbapenemase-producing Enterobacteriaceae, and uses imipenem as the reaction substrate. In Japan, IMP-6 metallo-β-lactamase (MBL) producers, which are usually resistant to meropenem but susceptible to imipenem, and IMP-1 MBL producers, which are usually resistant to both carbapenems are prevalent. We performed the Carba NP test with IMP-6 and IMP-1 MBL producers, and both types were detected by the Carba NP test with high sensitivity. All IMP-1 MBL producers were detected by the Carba NP test, but the minimum inhibitory concentrations (MICs) of imipenem varied from 0.25 to >32μg/mL, and the time to positivity varied from 0 to 30min. Time to positivity was significantly correlated with expression levels of blaIMP-1, but not with MICs of imipenem. These results suggested that the Carba NP test can be used as a screening assay for carbapenemase gene expression levels among producers of the same type of carbapenemase. Using this approach, it is possible to determine whether the carbapenem resistance of each carbapenemase-producing Enterobacteriaceae isolate is primarily due to carbapenemase production, or to another mechanism such as outer membrane impermeability.
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45
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Harada K, Shimizu T, Mukai Y, Kuwajima K, Sato T, Usui M, Tamura Y, Kimura Y, Miyamoto T, Tsuyuki Y, Ohki A, Kataoka Y. Phenotypic and Molecular Characterization of Antimicrobial Resistance in Klebsiella spp. Isolates from Companion Animals in Japan: Clonal Dissemination of Multidrug-Resistant Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae. Front Microbiol 2016; 7:1021. [PMID: 27446056 PMCID: PMC4925667 DOI: 10.3389/fmicb.2016.01021] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/15/2016] [Indexed: 12/25/2022] Open
Abstract
The emergence of antimicrobial resistance in Klebsiella spp., including resistance to extended-spectrum cephalosporins (ESC) and fluoroquinolones, is of great concern in both human and veterinary medicine. In this study, we investigated the prevalence of antimicrobial resistance in a total of 103 Klebsiella spp. isolates, consisting of Klebsiella pneumoniae complex (KP, n = 89) and K. oxytoca (KO, n = 14) from clinical specimens of dogs and cats in Japan. Furthermore, we characterized the resistance mechanisms, including extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC β-lactamase (PABL), and plasmid-mediated quinolone resistance (PMQR); and assessed genetic relatedness of ESC-resistant Klebsiella spp. strains by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Antimicrobial susceptibility testing demonstrated that resistance rates to ampicillin, cephalothin, enrofloxacin, ciprofloxacin, trimethoprim/sulfamethoxazole, cefotaxime, gentamicin, tetracycline, chloramphenicol, amoxicillin-clavulanic acid, and cefmetazole were 98.1, 37.9, 37.9, 35.9, 35.0, 34.0, 31.1, 30.1, 28.2, 14.6, and 6.8%, respectively. Phenotypic testing detected ESBLs and/or AmpC β-lactamases in 31 of 89 (34.8%) KP isolates, but not in KO isolates. Resistances to 5 of the 12 antimicrobials tested, as well as the three PMQRs [qnrB, qnrS, and aac(6′)-Ib-cr], were detected significantly more frequently in ESBL-producing KP, than in non-ESBL-producing KP and KO. The most frequent ESBL was CTX-M-15 (n = 13), followed by CTX-M-14 (n = 7), CTX-M-55 (n = 6), SHV-2 (n = 5), CTX-M-2 (n = 2), and CTX-M-3 (n = 2). Based on the rpoB phylogeny, all ESBL-producing strains were identified as K. pneumoniae, except for one CTX-M-14-producing strain, which was identified as K. quasipneumoniae. All of AmpC β-lactamase positive isolates (n = 6) harbored DHA-1, one of the PABLs. Based on MLST and PFGE analysis, ST15 KP clones producing CTX-M-2, CTX-M-15, CTX-M-55, and/or SHV-2, as well as KP clones of ST1844-CTX-M-55, ST655-CTX-M-14, and ST307-CTX-M-15, were detected in one or several hospitals. Surprisingly, specific clones were detected in different patients at an interval of many months. These results suggest that multidrug-resistant ESBL-producing KP were clonally disseminated among companion animals via not only direct but also indirect transmission. This is the first report on large-scale monitoring of antimicrobial-resistant Klebsiella spp. isolates from companion animals in Japan.
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Affiliation(s)
- Kazuki Harada
- Department of Veterinary Internal Medicine, Tottori University Tottori, Japan
| | - Takae Shimizu
- Department of Veterinary Internal Medicine, Tottori University Tottori, Japan
| | - Yujiro Mukai
- Laboratory of Veterinary Microbiology, Nippon Veterinary and Life Science University Tokyo, Japan
| | - Ken Kuwajima
- Laboratory of Veterinary Microbiology, Nippon Veterinary and Life Science University Tokyo, Japan
| | - Tomomi Sato
- Laboratory of Food Microbiology and Food Safety, Rakuno Gakuen University Hokkaido, Japan
| | - Masaru Usui
- Laboratory of Food Microbiology and Food Safety, Rakuno Gakuen University Hokkaido, Japan
| | - Yutaka Tamura
- Laboratory of Food Microbiology and Food Safety, Rakuno Gakuen University Hokkaido, Japan
| | - Yui Kimura
- Miyamoto Animal Hospital Yamaguchi, Japan
| | | | - Yuzo Tsuyuki
- Sanritsu Zelkova Veterinary Laboratory Kanagawa, Japan
| | | | - Yasushi Kataoka
- Laboratory of Veterinary Microbiology, Nippon Veterinary and Life Science University Tokyo, Japan
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Ondera N, Suzuki K, Takahashi M, Sakurai S, Suwabe A. [Epidemiological Survey of the Extended-spectrum β-lactamase-producing Bacteria in Hospitals and Nursing Homes in Morioka Secondary Medical Area Zone of Iwate Prefecture]. ACTA ACUST UNITED AC 2016; 90:105-12. [PMID: 27197436 DOI: 10.11150/kansenshogakuzasshi.90.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The spread of ESBL-producing bacteria (ESBLs) in local communities is a crucially important issue related to infection control. We investigated the relevance of isolation of ESBLs and the risk factors influencing the isolation rates of these organisms at medical facilities (4 rural hospitals, A-D; 4 nursing homes, a-d) located in the Morioka medical area. The isolation rates of ESBLs at 4 hospitals were estimated from the patient medical records from April 2013 to March 2014. Also, ESBLs were isolated from stool samples from residents in 4 nursing homes during almost the same period, and were analyzed to ascertain their genotypes. Furthermore, we compared the isolation rates of ESBLs among four hospitals to determine the influence of use of third-generation cephalosporins and alcohol-based hand rubs, and also among four nursing homes to identify the clinical backgrounds of the nursing home residents influencing the isolation rates. The isolation rates of ESBLs in hospitals and nursing homes were 13.3% (3.6-25.0%) and 9.3% (3.4-21.0%), respectively. Hospital B, which had the highest isolation rate of ESBLs, showed the highest rate of use of third-generation cephalosporins. On the other hand, Hospital A, with a lower isolation rate of ESBLs, showed the highest frequency of use of alcohol rubs. The rate of use of enteral nutrition was significantly higher in the nursing homes with higher isolation rate of ESBLs than those with lower isolation rates (odds ratio 2.71, p < 0.05). Nursing home c, with a significantly higher isolation rate of ESBLs, showed higher usage of adult diapers as well as higher rates of residents with recent hospitalization and high-level care. All ESBLs (13 Escherichia coli) isolated from nursing home c showed the same genotype: CTX-M-3. Although numerous ESBLs were isolated from the hospitals and nursing homes investigated in this study, the isolation rates of ESBLs and the clinical backgrounds of the patients differed greatly among the medical facilities in the same area. Furthermore, as patients and residents were transferred reciprocally among the hospitals and nursing homes, it was suggested that infection control for ESBLs at any individual facility alone was not sufficient and also that cooperative education and information sharing on ESBLs among facilities in the same area might be important.
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Community spread of extended-spectrum β-lactamase-producing bacteria detected in social insurance hospitals throughout Japan. J Infect Chemother 2016; 22:395-9. [PMID: 27066881 DOI: 10.1016/j.jiac.2016.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 12/10/2015] [Accepted: 03/02/2016] [Indexed: 11/20/2022]
Abstract
We surveyed the status of community-acquired infections involving four extended-spectrum β-lactamase (ESBL)-producing bacteria (Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis) isolated from clinical specimens from 11 social insurance hospitals in Japan in 2012. These are member hospitals of the Japan Community Healthcare Organization, an independent administrative hospital organization. The isolation rates for E. coli, K. pneumoniae, K. oxytoca, and P. mirabilis were 14.0% (165/1176), 3.3% (16/480), 3.1% (4/130), and 15.9% (17/107), respectively. The CTX-M-9 group, the most frequently detected genotype, was found in 77.0% (127/165) of E. coli and 43.8% (7/16) of K. pneumoniae isolates. Among K. oxytoca isolates, 75% (3/4) were the CTX-M-1 group, and all 17 P. mirabilis strains were the CTX-M-2 group. ESBL-producing bacteria isolation rates in each hospital ranged from 5.8% to 21.5% (median 9.5%), and the proportion of community-acquired infections among ESBL-producing bacteria isolates ranged from 1.6% to 30.8% (median 11.4%) in each hospital. Overall, the rates of ESBL-producing bacterial infection in all community-acquired infections and in all hospital infections were 10.6% (115/1081) and 10.7% (87/812), respectively. The ESBL-producing bacteria are not limited to certain regions or hospitals but are spreading in communities throughout Japan.
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Evaluation of the Check-Points Check MDR CT103 and CT103 XL Microarray Kits by Use of Preparatory Rapid Cell Lysis. J Clin Microbiol 2016; 54:1368-71. [PMID: 26888905 DOI: 10.1128/jcm.03302-15] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 02/09/2016] [Indexed: 12/22/2022] Open
Abstract
Using a rapid bacterial lysis method, the Check MDR CT103 and CT103 XL microarrays demonstrated accuracies of 98.1% and 94.2%, respectively, for detection of known resistance genes in 108 multidrug-resistant Gram-negative bacilli. In 45 isolates, 49 previously unrecognized extended-spectrum β-lactamase or plasmid AmpC targets were detected and confirmed by conventional PCR.
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Matsumura Y, Yamamoto M, Nagao M, Tanaka M, Takakura S, Ichiyama S. In vitro activities and detection performances of cefmetazole and flomoxef for extended-spectrum β-lactamase and plasmid-mediated AmpC β-lactamase-producing Enterobacteriaceae. Diagn Microbiol Infect Dis 2015; 84:322-7. [PMID: 26782634 DOI: 10.1016/j.diagmicrobio.2015.12.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 11/30/2015] [Accepted: 12/08/2015] [Indexed: 11/17/2022]
Abstract
To investigate the in vitro activities of cephamycins (cefmetazole and flomoxef) for extended-spectrum β-lactamase (ESBL)- and plasmid-mediated AmpC β-lactamase (pAmpC)-producing Enterobacteriaceae, a total of 574 third-generation cephalosporin-resistant clinical isolates were collected at a Japanese multicenter study. PCR and sequencing identified 394 isolates with only ESBL genes, 63 isolates with only pAmpC genes, and 6 isolates with both ESBL and pAmpC genes. blaCTX-M types predominated 95.5% of the ESBL genes, and blaCMY-2 predominated 91.3% of the pAmpC genes. The MIC50/90 values of cefmetazole and flomoxef were ≤ 1/4 and ≤ 1/≤ 1 μg/mL for isolates with only ESBL genes, respectively, and 16/>16 and 8/16 μg/mL for isolates with only pAmpC genes, respectively. Flomoxef ≥ 4 μg/mL had the best screening performance for the detection of isolates with pAmpC genes. Flomoxef had better in vitro activities against ESBL-producing Enterobacteriaceae and provided a clearer distinction between ESBL and pAmpC-producing Enterobacteriaceae compared to cefmetazole.
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Affiliation(s)
- Yasufumi Matsumura
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Masaki Yamamoto
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Michio Tanaka
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Shunji Takakura
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Satoshi Ichiyama
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
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Katoh R, Matsushita S, Shimojima Y, Ishitsuka R, Sadamasu K, Kai A. [Serovars and Drug-Resistance of Salmonella Strains Isolated from Domestic Chicken Meat in Tokyo (1992-2012)]. ACTA ACUST UNITED AC 2015; 89:46-52. [PMID: 26548296 DOI: 10.11150/kansenshogakuzasshi.89.46] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A total of 477 Salmonella strains isolated from retail domestic chicken meat during 1992-2012 in Tokyo, were examined regarding their serovars and drug-resistance. These strains were detected in 469 (29.8%) of 1,576 samples. The detection rate in every two years was 10.1% to 46.3% of the range. Serological typing results showed that 477 strains were classified into 22 serovars excepting 2 untypable strains. Among them, S. Infantis (312 strains) was the most prevalent, followed by II O4: b: [e, n, x] (S. II Sofia) (71 strains), S. Hadar (20 strains), S. Typhimurium (20 strains), S. Manhattan (12 strains), S. Schwarzengrund (9 strains), S. Agona (7 strains), and other 15 serovars (24 strains). Results of the antibacterial drug susceptibility test for 477 strains revealed that 89.9% was resistant to some of the 12 drugs tested, and multidrug-resistant strains accounted for 90.2% among them. The frequencies of resistance to each drug were 81.8%; 77.8%, 45.5%, 33.3%, 11.3%, 9.6%, 2.9%, 0.6%, 0.6% and 0.2%, in order with high frequency, for SM, TC, KM, ST, NA, ABPC, CP, FOM, CTX and CAZ, respectively. None of the strains was resistant to NFLX or IPM. Three CTX-resistant strains were CTX-M type extended-spectrum β-lactamase (ESBL) producers, and the group of CTX-M type ESBL genes were CTX-M-2 group (2 strains) and CTX-M-9 group (1 strain). CAZ-resistant 1 strain was an ESBL producer, but the ESBL gene was not determined.
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