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Abdullah S, Almusallam A, Li M, Mahmood MS, Mushtaq MA, Eltai NO, Toleman MA, Mohsin M. Whole genome-based genetic insights of blaNDM producing clinical E. coli isolates in hospital settings of Pakistan. Microbiol Spectr 2023; 11:e0058423. [PMID: 37668386 PMCID: PMC10581159 DOI: 10.1128/spectrum.00584-23] [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: 02/08/2023] [Accepted: 07/02/2023] [Indexed: 09/06/2023] Open
Abstract
Carbapenem resistance among Enterobacterales has become a global health concern. Clinical Escherichia coli isolates producing the metallo β-lactamase NDM have been isolated from two hospitals in Faisalabad, Pakistan. These E. coli strains were characterized by MALDI-TOF, PCR, antimicrobial susceptibility testing, XbaI and S1 nuclease pulsed-field gel electrophoresis (PFGE), conjugation assay, DNA hybridization, whole genome sequencing, bioinformatic analysis, and Galleria mellonella experiments. Thirty-four blaNDM producing E. coli strains were identified among 52 nonduplicate carbapenem-resistant strains. More than 90% of the isolates were found to be multidrug resistant by antimicrobial susceptibility testing. S1 PFGE confirmed the presence of blaNDM gene on plasmids ranging from 40 kbps to 250 kbps, and conjugation assays demonstrated transfer frequencies of blaNDM harboring plasmids ranging from 1.59 × 10-1 to 6.46 × 10-8 per donor. Whole genome sequencing analysis revealed blaNDM-5 as the prominent NDM subtype with the highest prevalence of blaOXA-1, blaCTX-M-15, aadA2, aac(6')-Ib-cr, and tet(A) associated resistant determinants. E. coli sequence types: ST405, ST361, and ST167 were prominent, and plasmid Inc types: FII, FIA, FIB, FIC, X3, R, and Y, were observed among all isolates. The genetic environment of blaNDM region on IncF plasmids included partial ISAba125, the bleomycin ble gene, and a class I integron. The virulence genes terC, traT, gad, fyuA, irp2, capU, and sitA were frequently observed, and G. mellonella experiments showed that virulence correlated with the number of virulence determinants. A strong infection control management in the hospital is necessary to check the emergence of carbapenem resistance in Gram-negative bacteria.IMPORTANCEWe describe a detailed analysis of highly resistant clinical E. coli isolates from two tertiary care centers in Pakistan including carbapenem resistance as well as common co-resistance mechanisms. South Asia has a huge problem with highly resistant E. coli. However, we find that though these isolates are very difficult to treat they are of low virulence. Thus the Western world has an increasing problem with virulent E. coli that are mostly of low antibiotic resistance, whereas, South Asia has an increasing problem with highly resistant E. coli that are of low virulence potential. These observations allow us to start to devise methodologies to limit both virulence and resistance and combat problems in developing nations as well as the Western world.
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Affiliation(s)
- Sabahat Abdullah
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
| | - Abdulrahman Almusallam
- Department of Medical Microbiology, School of Medicine, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
| | - Mei Li
- Department of Medical Microbiology, School of Medicine, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
| | | | | | - Nahla O. Eltai
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Mark A. Toleman
- Department of Medical Microbiology, School of Medicine, Institute of Infection and Immunity, Cardiff University, Cardiff, United Kingdom
| | - Mashkoor Mohsin
- Institute of Microbiology, University of Agriculture, Faisalabad, Pakistan
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2
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Antonelli A, Coppi M, Tellapragada C, Hasan B, Maruri A, Gijón D, Morecchiato F, de Vogel C, Verbon A, van Wamel W, Kragh KN, Frimodt-Møller N, Cantón R, Giske CG, Rossolini GM. Isothermal microcalorimetry versus checkerboard assay to evaluate in vitro synergism of meropenem-amikacin and meropenem-colistin combinations against multidrug-resistant Gram-negative pathogens. Int J Antimicrob Agents 2022; 60:106668. [PMID: 36038097 DOI: 10.1016/j.ijantimicag.2022.106668] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 07/28/2022] [Accepted: 08/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the activity of meropenem-amikacin and meropenem-colistin combinations with checkerboard broth microdilution (CKBM) compared to isothermal microcalorimetry (ITMC) assays against a multicentric collection of multidrug-resistant Gram-negative (MDR-GN) clinical isolates, to compare the Fractional inhibitory concentration index (FICI) and time to results of CKBM and ITMC assays. METHODS A collection of 333 MDR-GNs showing reduced susceptibility to meropenem (121 Klebsiella pneumoniae, 14 Escherichia coli, 130 Pseudomonas aeruginosa and 68 Acinetobacter baumannii) isolated from different centres (Florence, Madrid, Rotterdam, and Stockholm) was included in the study. The antimicrobial activity of selected combinations was evaluated with CKBM and ITMC. FICI results were interpreted as synergistic/additive and indifferent for values ≤0.5/0.5<x≤1 and >1, respectively. WGS data in a subset of strains was used to evaluate their clonality. RESULTS A total of 254 and 286 strains were tested with meropenem-colistin and meropenem-amikacin combinations with ITMC and CKBM, respectively. Synergism/additive effects were observed with 46 strains (20 K. pneumoniae, 4 E. coli, 22 P. aeruginosa) and 20 strains (3 K. pneumoniae, 11 P. aeruginosa and 6 A. baumannii) with meropenem-amikacin and meropenem-colistin combination, respectively, with CKBM. ITMC showed a good concordance with CKBM with 89.5% and 92.2% of cases interpreted within the same FICI category for meropenem-amikacin and meropenem-colistin combinations, respectively. Most of the synergism/additivity effects were detected within 6 hours by ITMC. CONCLUSIONS ITMC showed a very good concordance with CKBM against a large collection of MDR-GN and could be implemented for the rapid evaluation of in vitro activity of antimicrobial combinations.
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Affiliation(s)
- Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Chaitanya Tellapragada
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Badrul Hasan
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ainhize Maruri
- Servicio de Microbiologia, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Desiree Gijón
- Servicio de Microbiologia, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Fabio Morecchiato
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy
| | - Corné de Vogel
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands
| | - Annelies Verbon
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands
| | - Willem van Wamel
- Department of Medical Microbiology and Infectious Diseases, Erasmus University, Rotterdam, Netherlands
| | - Kasper Nørskov Kragh
- Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark; Costerton Biofilm Center, University of Copenhagen, Copenhagen, Denmark
| | | | - Rafael Cantón
- Servicio de Microbiologia, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; CIBER de Enfermedades Infecciosas. Instituto de Salud Carlos III. Madrid, Spain
| | - Christian G Giske
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Clinical microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.
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Antibiotic Resistance in Bacteria—A Review. Antibiotics (Basel) 2022; 11:antibiotics11081079. [PMID: 36009947 PMCID: PMC9404765 DOI: 10.3390/antibiotics11081079] [Citation(s) in RCA: 128] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background: A global problem of multi-drug resistance (MDR) among bacteria is the cause of hundreds of thousands of deaths every year. In response to the significant increase of MDR bacteria, legislative measures have widely been taken to limit or eliminate the use of antibiotics, including in the form of feed additives for livestock, but also in metaphylaxis and its treatment, which was the subject of EU Regulation in 2019/6. Numerous studies have documented that bacteria use both phenotypis and gentic strategies enabling a natural defence against antibiotics and the induction of mechanisms in increasing resistance to the used antibacterial chemicals. The mechanisms presented in this review developed by the bacteria have a significant impact on reducing the ability to combat bacterial infections in humans and animals. Moreover, the high prevalence of multi-resistant strains in the environment and the ease of transmission of drug-resistance genes between the different bacterial species including commensal flora and pathogenic like foodborne pathogens (E. coli, Campylobacter spp., Enterococcus spp., Salmonella spp., Listeria spp., Staphylococcus spp.) favor the rapid spread of multi-resistance among bacteria in humans and animals. Given the global threat posed by the widespread phenomenon of multi-drug resistance among bacteria which are dangerous for humans and animals, the subject of this study is the presentation of the mechanisms of resistance in most frequent bacteria called as “foodborne pathoges” isolated from human and animals. In order to present the significance of the global problem related to multi-drug resistance among selected pathogens, especially those danger to humans, the publication also presents statistical data on the percentage range of occurrence of drug resistance among selected bacteria in various regions of the world. In addition to the phenotypic characteristics of pathogen resistance, this review also presents detailed information on the detection of drug resistance genes for specific groups of antibiotics. It should be emphasized that the manuscript also presents the results of own research i.e., Campylobacter spp., E. coli or Enetrococcus spp. This subject and the presentation of data on the risks of drug resistance among bacteria will contribute to initiating research in implementing the prevention of drug resistance and the development of alternatives for antimicrobials methods of controlling bacteria.
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4
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OUP accepted manuscript. J Antimicrob Chemother 2022; 77:2199-2208. [DOI: 10.1093/jac/dkac142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/25/2022] [Indexed: 11/14/2022] Open
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5
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Taylor E, Bal AM, Balakrishnan I, Brown NM, Burns P, Clark M, Diggle M, Donaldson H, Eltringham I, Folb J, Gadsby N, Macleod M, Ratnaraja NVDV, Williams C, Wootton M, Sriskandan S, Woodford N, Hopkins KL. A prospective surveillance study to determine the prevalence of 16S rRNA methyltransferase-producing Gram-negative bacteria in the UK. J Antimicrob Chemother 2021; 76:2428-2436. [PMID: 34142130 DOI: 10.1093/jac/dkab186] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/06/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To determine the prevalence of 16S rRNA methyltransferase- (16S RMTase-) producing Gram-negative bacteria in patients in the UK and to identify potential risk factors for their acquisition. METHODS A 6 month prospective surveillance study was conducted from 1 May to 31 October 2016, wherein 14 hospital laboratories submitted Acinetobacter baumannii, Enterobacterales and Pseudomonas aeruginosa isolates that displayed high-level amikacin resistance according to their testing methods, e.g. no zone of inhibition with amikacin discs. Isolates were linked to patient travel history, medical care abroad, and previous antibiotic exposure using a surveillance questionnaire. In the reference laboratory, isolates confirmed to grow on Mueller-Hinton agar supplemented with 256 mg/L amikacin were screened by PCR for 16S RMTase genes armA, rmtA-rmtH and npmA, and carbapenemase genes (blaKPC, blaNDM, blaOXA-48-like and blaVIM). STs and total antibiotic resistance gene complement were determined via WGS. Prevalence was determined using denominators for each bacterial species provided by participating hospital laboratories. RESULTS Eighty-four isolates (44.7%), among 188 submitted isolates, exhibited high-level amikacin resistance (MIC >256 mg/L), and 79 (94.0%) of these harboured 16S RMTase genes. armA (54.4%, 43/79) was the most common, followed by rmtB (17.7%, 14/79), rmtF (13.9%, 11/79), rmtC (12.7%, 10/79) and armA + rmtF (1.3%, 1/79). The overall period prevalence of 16S RMTase-producing Gram-negative bacteria was 0.1% (79/71 063). Potential risk factors identified through multivariate statistical analysis included being male and polymyxin use. CONCLUSIONS The UK prevalence of 16S RMTase-producing Gram-negative bacteria is low, but continued surveillance is needed to monitor their spread and inform intervention strategies.
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Affiliation(s)
- Emma Taylor
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK.,Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, NW9 5EQ, UK
| | - Abhijit M Bal
- Microbiology, University Hospital Crosshouse, NHS Ayrshire and Arran, Kilmarnock, KA2 0BE, UK
| | | | - Nicholas M Brown
- Clinical Microbiology and Public Health Laboratory Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QW, UK
| | - Phillipa Burns
- Manchester Medical Microbiology Partnership, Manchester University NHS Foundation Trust, Manchester Royal Infirmary, Oxford Rd, Manchester, M13 9WL, UK
| | - Marilyn Clark
- Department of Medical Microbiology, Ninewells Hospital, Dundee, DD2 1SY, UK
| | - Mathew Diggle
- Nottingham University Hospitals National Health Service Trust, Hucknall Rd, Nottingham, NG5 1PB, UK
| | - Hugo Donaldson
- Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
| | - Ian Eltringham
- Microbiology Department, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK
| | - Jonathan Folb
- Liverpool University Hospitals NHS Foundation Trust, Prescot St, Liverpool, L7 8XP, UK
| | - Naomi Gadsby
- Medical Microbiology, Department of Laboratory Medicine, Royal Infirmary of Edinburgh, 51 Little France Cres, Edinburgh, EH16 4SA, UK
| | - Mairi Macleod
- Clinical Microbiology, Glasgow Royal Infirmary Hospital, Level 4 New Lister Building, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
| | - Natasha V D V Ratnaraja
- Department of Microbiology, Sandwell and West Birmingham NHS Trust, Dudley Road, Birmingham, B18 7QH, UK
| | - Cheryl Williams
- Microbiology Laboratory, First Floor, Pathology Laboratory, Royal Oldham Hospital, Rochdale Road, Oldham, OL1 2JH, UK
| | - Mandy Wootton
- Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, CF14 4XW, UK
| | - Shiranee Sriskandan
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK.,MRC Centre for Molecular Bacteriology & Infection, Imperial College London, London, SW7 2DD, UK
| | - Neil Woodford
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK.,Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, NW9 5EQ, UK
| | - Katie L Hopkins
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK.,Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, NW9 5EQ, UK
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6
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Tavoschi L, Forni S, Porretta A, Righi L, Pieralli F, Menichetti F, Falcone M, Gemignani G, Sani S, Vivani P, Bellandi T, Tacconi D, Turini L, Toccafondi G, Privitera G, Lopalco P, Baggiani A, Gemmi F, Luchini G, Petrillo M, Roti L, Pezzotti P, Pantosti A, Iannazzo S, Mechi MT, Rossolini GM, On Behalf Of The Tuscan Clinical Microbiology Laboratory Network. Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019. ACTA ACUST UNITED AC 2021; 25. [PMID: 32070467 PMCID: PMC7029447 DOI: 10.2807/1560-7917.es.2020.25.6.2000085] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) have increased since November 2018. Between November 2018 and October 2019, 1,645 samples were NDM-CRE-positive: 1,270 (77.2%) cases of intestinal carriage, 129 (7.8%) bloodstream infections and 246 (14.9%) infections/colonisations at other sites. Klebsiella pneumoniae were prevalent (1,495; 90.9%), with ST147/NDM-1 the dominant clone. Delayed outbreak identification and response resulted in sustained NDM-CRE transmission in the North-West area of Tuscany, but successfully contained spread within the region.
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Affiliation(s)
- Lara Tavoschi
- Department of Translational Research and New technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Silvia Forni
- Regional Health Agency of Tuscany, Florence, Italy
| | - Andrea Porretta
- University Hospital of Pisa, Pisa, Italy.,Department of Translational Research and New technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lorenzo Righi
- Quality of care and Clinical networks, Tuscany Region, Florence, Italy
| | | | | | | | | | - Spartaco Sani
- Livorno Hospital, Toscana North-West Health Authority, Livorno, Italy
| | - Paola Vivani
- Massa Carrara Hospital, Toscana North-West Health Authority, Massa Carrara, Italy
| | | | - Danilo Tacconi
- Arezzo Hospital, Toscana South-East Health Authority, Arezzo, Italy
| | - Lucia Turini
- Toscana North-West Health Authority, Pisa, Italy
| | - Giulio Toccafondi
- Quality of care and Clinical networks, Tuscany Region, Florence, Italy
| | - Gaetano Privitera
- University Hospital of Pisa, Pisa, Italy.,Department of Translational Research and New technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pierluigi Lopalco
- University Hospital of Pisa, Pisa, Italy.,Department of Translational Research and New technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Angelo Baggiani
- University Hospital of Pisa, Pisa, Italy.,Department of Translational Research and New technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | | | | | | | - Lorenzo Roti
- Toscana North-West Health Authority, Pisa, Italy
| | | | | | | | | | - Gian Maria Rossolini
- Department of Experimental Medicine, University of Florence, Florence, Italy.,Florence Careggi University Hospital, Florence, Italy
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7
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Ripabelli G, Sammarco ML, Salzo A, Scutellà M, Felice V, Tamburro M. New Delhi metallo-β-lactamase (NDM-1)-producing Klebsiella pneumoniae of sequence type ST11: first identification in a hospital of central Italy. Lett Appl Microbiol 2020; 71:652-659. [PMID: 32916001 DOI: 10.1111/lam.13384] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/29/2020] [Accepted: 09/01/2020] [Indexed: 12/19/2022]
Abstract
The emergence of novel resistant markers hampers the efficacy of beta-lactam antibiotics to treat infections caused by micro-organisms carrying such resistances. This study investigated the antimicrobial susceptibility pattern, the carpapenem-associated determinants and the molecular epidemiology of Klebsiella pneumoniae showing a New Delhi (NDM) metallo-β-lactamase phenotype, isolated from a patient admitted to intensive care unit of the main hospital for acute care of Molise region, central Italy. Antimicrobial susceptibility was assessed for nineteen antibiotics by disc diffusion and agar dilution methods. Carbapenem-associated resistance determinants were detected through gene-specific amplifications, targeting blaNDM-1 , blaSHV and blaTEM , blaCTX-M , blaKPC , blaVIM , blaIMP , blaGES and blaOXA-48-lixe . Molecular characterization was carried out through multilocus sequence typing. The strain showed a multidrug resistant profile, and PCR and sequencing confirmed the presence of blaNDM-1 gene. Among the multiple resistance-associated determinants tested, the isolate, which was assigned to the sequence type ST11, only harboured blaSHV and blaTEM genes. This is the first report of NDM-1 variant in the regional healthcare setting for acute patients, raising significant concerns about the increase in the antimicrobials resistance spread through a different mechanism from the endemic KPC carbapenemase, and underlining the circulation of a virulent clone never identified before in this area.
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Affiliation(s)
- G Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - M L Sammarco
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - A Salzo
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - M Scutellà
- Laboratory Medicine Unit, "Antonio Cardarelli" Hospital, Campobasso Local Health Unit n 1, Molise Regional Health Authority, Campobasso, Italy
| | - V Felice
- Laboratory Medicine Unit, "Antonio Cardarelli" Hospital, Campobasso Local Health Unit n 1, Molise Regional Health Authority, Campobasso, Italy
| | - M Tamburro
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
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8
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The evolutionary puzzle of Escherichia coli ST131. INFECTION GENETICS AND EVOLUTION 2020; 81:104265. [PMID: 32112974 DOI: 10.1016/j.meegid.2020.104265] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/22/2020] [Accepted: 02/26/2020] [Indexed: 01/02/2023]
Abstract
The abrupt expansion of Escherichia coli sequence type (ST) 131 is unmatched among Gram negative bacteria. In many ways, ST131 can be considered a real-world model for the complexities involved in the evolution of a multidrug resistant pathogen. While much progress has been made on our insights into the organism's population structure, pathogenicity and drug resistance profile, significant gaps in our knowledge remain. Whole genome studies have shed light on key mutations and genes that have been selected against the background of antibiotics, but in most cases such events are inferred and not supported by experimental data. Notable examples include the unknown fitness contribution made by specific plasmids, genomic islands and compensatory mutations. Furthermore, questions remain like why this organism in particular achieved such considerable success in such a short time span, compared to other more pathogenic and resistant clones. Herein, we document what is known regarding the genetics of this organism since its first description in 2008, but also highlight where work remains to be done for a truly comprehensive understanding of the biology of ST131, in order to account for its dramatic rise to prominence.
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9
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Sundaramoorthy NS, Suresh P, Selva Ganesan S, GaneshPrasad A, Nagarajan S. Restoring colistin sensitivity in colistin-resistant E. coli: Combinatorial use of MarR inhibitor with efflux pump inhibitor. Sci Rep 2019; 9:19845. [PMID: 31882661 PMCID: PMC6934491 DOI: 10.1038/s41598-019-56325-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 12/10/2019] [Indexed: 02/07/2023] Open
Abstract
Antibiotics like colistin are the last resort to deal with infections by carbapenem-resistant Enterobacteriaceae (CREB). Resistance to colistin severely restricts therapeutic options. To tackle this dire situation, urgent measures to restore colistin sensitivity are needed. In this study, whole-genome sequencing of colistin-resistant E. coli strain was performed and the genome analysis revealed that the strain belonged to the sequence type ST405. Multiple mutations were observed in genes implicated in colistin resistance, especially those related to the L-Ara-4-N pathway but mgrB was unmutated and mcr1-9 genes were missing. MarR inhibitor salicylate was used to re-sensitize this strain to colistin, which increased the negative charge on the cell surface especially in colistin resistant E. coli (U3790 strain) and thereby facilitated a decrease in colistin MIC by 8 fold. It is indeed well known that MarR inhibition by salicylate triggers the expression of AcrAB efflux pumps through MarA. So, in order to fully restore colistin sensitivity, a potent efflux pump inhibitor (BC1), identified earlier by this group was employed. The combination of colistin with both salicylate and BC1 caused a remarkable 6 log reduction in cell counts of U3790 in time-kill assay. Infection of muscle tissue of zebrafish with U3790 followed by various treatments showed that the combination of colistin + salicylate + BC1 was highly effective in reducing bioburden in infected muscle tissue by 4 log fold. Thus, our study shows that a combination of MarR inhibitor to enhance colistin binding and efflux pump inhibitor to reduce colistin extrusion was highly effective in restoring colistin sensitivity in colistin-resistant clinical isolate of E. coli in vitro and in vivo.
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Affiliation(s)
- Niranjana Sri Sundaramoorthy
- Center for Research on Infectious Diseases, School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, Tamil Nadu, India
| | - Pavithira Suresh
- Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, Tamil Nadu, India
| | - Subramaniapillai Selva Ganesan
- Department of Chemistry, School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, Tamil Nadu, India
| | - ArunKumar GaneshPrasad
- Center for Research on Infectious Diseases, School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, Tamil Nadu, India
| | - Saisubramanian Nagarajan
- Center for Research on Infectious Diseases, School of Chemical and Biotechnology, SASTRA Deemed to be University, Thanjavur, Tamil Nadu, India.
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10
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Qamar MU, Walsh TR, Toleman MA, Tyrrell JM, Saleem S, Aboklaish A, Jahan S. Dissemination of genetically diverse NDM-1, -5, -7 producing-Gram-negative pathogens isolated from pediatric patients in Pakistan. Future Microbiol 2019; 14:691-704. [PMID: 31148474 DOI: 10.2217/fmb-2019-0012] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: To determine the prevalence of New Delhi metallo-β-lactamase (NDM)-producing Gram-negative pathogens isolated from children's samples. Materials & methods: Carbapenem-resistant clinical isolates (n = 117) were confirmed by VITEK® 2 compact system, matrix-assisted laser desorption ionization-time of flight and multilocus sequence typing. MIC (μg/ml) of various antibiotics was determined by VITEK 2 compact system. Molecular characterization of the isolates was performed by PCR, DNA sequencing, PFGE and DNA hybridization. Results: Out of 117 carbapenemase producers, 37 (31.6%) and 29 (24.7%) were Klebsiella pneumoniae and Acinetobacter baumannii, respectively. 72 (61.5%) isolates were NDM positive and among these 60, 9 and 3 were NDM-1, -5 and -7, respectively. Majority of the NDM-producing K. pneumoniae belonged to ST11 and ST273 while most of the Escherichia coli belonged to ST405 and ST101. blaNDM were mainly located on 150kb plasmids. MIC displayed high resistance against β-lactams drugs including carbapenems, and the most sensitive drugs were tigecycline and colistin. Conclusion: Dissemination of blaNDM-producing pathogens, particularly in children clinical settings, is a matter of great public health concern.
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Affiliation(s)
- Muhammad Usman Qamar
- Department of Microbiology, University of Health Sciences, Punjab, Pakistan.,Department of Microbiology, Faculty of Life Sciences, Government College University, Punjab, Pakistan.,Department of Medical Microbiology & Infectious Diseases, Institute of Infection & Immunity, School of Medicine, Cardiff University, Wales, UK
| | - Timothy R Walsh
- Department of Medical Microbiology & Infectious Diseases, Institute of Infection & Immunity, School of Medicine, Cardiff University, Wales, UK
| | - Mark A Toleman
- Department of Medical Microbiology & Infectious Diseases, Institute of Infection & Immunity, School of Medicine, Cardiff University, Wales, UK
| | - Jonathan M Tyrrell
- Department of Medical Microbiology & Infectious Diseases, Institute of Infection & Immunity, School of Medicine, Cardiff University, Wales, UK
| | - Sidrah Saleem
- Department of Microbiology, University of Health Sciences, Punjab, Pakistan
| | - Ali Aboklaish
- Department of Medical Microbiology & Infectious Diseases, Institute of Infection & Immunity, School of Medicine, Cardiff University, Wales, UK
| | - Shah Jahan
- Department of Immunology, University of Health Sciences, Punjab, Pakistan
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11
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Dynamics of Resistance Plasmids in Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae during Postinfection Colonization. Antimicrob Agents Chemother 2019; 63:AAC.02201-18. [PMID: 30745391 DOI: 10.1128/aac.02201-18] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 02/05/2019] [Indexed: 01/01/2023] Open
Abstract
Extended-spectrum β-lactamase-producing Enterobacteriaceae (EPE) are a major cause of bloodstream infections, and the colonization rate of EPE in the gut microbiota of individuals lacking prior hospitalization or comorbidities is increasing. In this study, we performed an in-depth investigation of the temporal dynamics of EPE and their plasmids during one year by collecting fecal samples from three patients initially seeking medical care for urinary tract infections. In two of the patients, the same strain that caused the urinary tract infection (UTI) was found at all consecutive samplings from the gut microbiota, and no other EPEs were detected, while in the third patient the UTI strain was only found in the initial UTI sample. Instead, this patient presented a complex situation where a mixed microbiota of different EPE strain types, including three different E. coli ST131 variants, as well as different bacterial species, was identified over the course of the study. Different plasmid dynamics were displayed in each of the patients, including the spread of plasmids between different strain types over time and the transposition of bla CTX-M-15 from the chromosome to a plasmid, followed by subsequent loss through homologous recombination. Small cryptic plasmids were found in all isolates from all patients, and they appear to move frequently between different strains in the microbiota. In conclusion, we could demonstrate an extensive variation of EPE strain types, plasmid composition, rearrangements, and horizontal gene transfer of genetic material illustrating the high dynamics nature and interactive environment of the gut microbiota during post-UTI carriage.
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12
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NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings. Clin Microbiol Rev 2019; 32:32/2/e00115-18. [PMID: 30700432 DOI: 10.1128/cmr.00115-18] [Citation(s) in RCA: 385] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
New Delhi metallo-β-lactamase (NDM) is a metallo-β-lactamase able to hydrolyze almost all β-lactams. Twenty-four NDM variants have been identified in >60 species of 11 bacterial families, and several variants have enhanced carbapenemase activity. Klebsiella pneumoniae and Escherichia coli are the predominant carriers of bla NDM, with certain sequence types (STs) (for K. pneumoniae, ST11, ST14, ST15, or ST147; for E. coli, ST167, ST410, or ST617) being the most prevalent. NDM-positive strains have been identified worldwide, with the highest prevalence in the Indian subcontinent, the Middle East, and the Balkans. Most bla NDM-carrying plasmids belong to limited replicon types (IncX3, IncFII, or IncC). Commonly used phenotypic tests cannot specifically identify NDM. Lateral flow immunoassays specifically detect NDM, and molecular approaches remain the reference methods for detecting bla NDM Polymyxins combined with other agents remain the mainstream options of antimicrobial treatment. Compounds able to inhibit NDM have been found, but none have been approved for clinical use. Outbreaks caused by NDM-positive strains have been reported worldwide, attributable to sources such as contaminated devices. Evidence-based guidelines on prevention and control of carbapenem-resistant Gram-negative bacteria are available, although none are specific for NDM-positive strains. NDM will remain a severe challenge in health care settings, and more studies on appropriate countermeasures are required.
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13
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Girija SAS, Jayaseelan VP, Arumugam P. Prevalence of VIM- and GIM-producing Acinetobacter baumannii from patients with severe urinary tract infection. Acta Microbiol Immunol Hung 2018; 65:539-550. [PMID: 30111160 DOI: 10.1556/030.65.2018.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Carbapenems are administered as the final drug of choice for treating complicated nosocomial infections caused by multidrug-resistant Acinetobacter baumannii strains. It is currently a worldwide issue that metallo-β-lactamases (MBLs) as carbapenem-hydrolyzing enzymes are one of the major drug resistance mechanisms. This investigation is thus aimed to assess the prevalence and characterize the MBL-producing strains of A. baumannii both by phenotypic assays and by genotypic characterization. A total of 73 isolates of A. baumannii were phenotypically and genotypically characterized from patients (N = 1,000) with severe urinary tract infection. Tested strains were subjected to double disc synergy testing (DDST) by Kirby-Bauer disc diffusion method with imipenem (IMP) and IMP/EDTA combination discs. Plasmid DNA was molecularly screened for MBL-encoding blaIMP, blaVIM, blaGIM, and blaNDM genes by PCR for the genetic relatedness of the MBL genes with carbapenem resistance. Carbapenem resistance profile showed 100%, 45%, and 49% non-susceptibility against imipenem, doripenem, and meropenem, respectively. Altogether 42.46% (n = 31) of the isolates showed MBL production upon double disc phenotypic test with IMP and IMP/EDTA discs. The blaVIM and blaGIM were detected in 34.24% (n = 25) and 16.43% (n = 12) of the isolates, respectively, while the co-occurrence of blaVIM and blaGIM was 2.73% among the isolates. DDST-positive isolates showed 21.19% and 9.58% strains positive for blaVIM and blaGIM, respectively, whereas 1.36% of the strains for both genes. None of the strains yielded blaIMP and blaNDM genes. The findings of this study showed prevalence of carbapenem resistance among A. baumannii from urine samples and the frequency of blaVIM and blaGIM.
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Affiliation(s)
- Smiline AS Girija
- 1 Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | | | - Paramasivam Arumugam
- 3 Department of Human Genetics, Centre for Cellular and Molecular Biology, Hyderabad, India
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14
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Taylor E, Sriskandan S, Woodford N, Hopkins KL. High prevalence of 16S rRNA methyltransferases among carbapenemase-producing Enterobacteriaceae in the UK and Ireland. Int J Antimicrob Agents 2018; 52:278-282. [PMID: 29596903 DOI: 10.1016/j.ijantimicag.2018.03.016] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/12/2018] [Accepted: 03/21/2018] [Indexed: 11/18/2022]
Abstract
The emergence of 16S rRNA methyltransferases (16S RMTases) worldwide is a growing concern due to their ability to confer high-level resistance (minimum inhibitory concentrations (MICs) >256 mg/L) to all clinically relevant aminoglycosides. As the occurrence of 16S RMTases in the United Kingdom has not been investigated to date, we screened 806 Enterobacteriaceae isolates displaying high-level aminoglycoside resistance (amikacin, gentamicin and tobramycin MICs ≥64, ≥32 and ≥32 mg/L, respectively) for 16S RMTases either by analysing whole-genome sequence (WGS) data (which were available for 449 isolates) or by polymerase chain reaction. A total of 94.5% (762/806) pan-aminoglycoside-resistant Enterobacteriaceae were positive for one or more 16S RMTase genes; armA was the most common (340, 44.6%) followed by rmtC (146, 19.2%), rmtF (137, 18.0%), rmtB (87, 11.4%) and various two-gene combinations (52, 6.8%). Most (93.4%; 712/762) 16S RMTase producers also carried acquired carbapenemase genes, with blaNDM the most common (592/712; 83.1%). Additionally, high-risk bacterial clones associated with blaNDM were identified in the subset of isolates with WGS data. These included Escherichia coli sequence types (STs) 405 (21.8%, 19/87), 167 (20.7%, 18/87) 410 (12.6%, 11/87) and K. pneumoniae STs 14 (35.6%, 112/315), 231 (15.6%, 49/315) and 147 (10.5%, 33/315). These accounted for 4.2% (15/358), 5.0% (18/358), 3.1% (11/358), 28.2% (101/358), 3.1% (11/358) and 7.0% (25/358) blaNDM-producing isolates, respectively. This study shows that 16S RMTases occur in the UK and Ireland and carbapenemases are particularly prevalent in 16S RMTase-producing Enterobacteriaceae. This association poses a risk to the treatment of multidrug-resistant Gram-negative infections in the clinical setting.
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Affiliation(s)
- Emma Taylor
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK; Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK.
| | - Shiranee Sriskandan
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK
| | - Neil Woodford
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK; Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK
| | - Katie L Hopkins
- National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Hospital, Du Cane Road, London, UK; Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK
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15
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Giani T, Antonelli A, Caltagirone M, Mauri C, Nicchi J, Arena F, Nucleo E, Bracco S, Pantosti A, Luzzaro F, Pagani L, Rossolini GM. Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients. ACTA ACUST UNITED AC 2018; 22:30583. [PMID: 28797330 PMCID: PMC5553057 DOI: 10.2807/1560-7917.es.2017.22.31.30583] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 12/20/2016] [Indexed: 12/31/2022]
Abstract
Extended-spectrum beta-lactamases (ESBLs), AmpC-type beta-lactamases (ACBLs) and carbapenemases are among the most important resistance mechanisms in Enterobacteriaceae. This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates of Escherichia coli (n = 2,352), Klebsiella pneumoniae (n = 697), and Proteus mirabilis (n = 275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCR-carbaS isolates were ESBL-positive (90.5%), and most of them were contributed by E. coli carrying blaCTX-M group 1 genes. Acquired ACBLs were less common and mostly detected in P. mirabilis. ESCR-carbaR isolates were mostly contributed by K. pneumoniae (25.1% and 7.7% among K. pneumoniae isolates from inpatients and outpatients, respectively), with blaKPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients.
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Affiliation(s)
- Tommaso Giani
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,These authors contributed equally to this work
| | - Alberto Antonelli
- These authors contributed equally to this work.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Mariasofia Caltagirone
- Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy
| | - Carola Mauri
- Microbiology and Virology Unit, Department of Laboratory Medicine, A. Manzoni Hospital, Lecco, Italy
| | - Jessica Nicchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Fabio Arena
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Elisabetta Nucleo
- Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy
| | - Silvia Bracco
- Microbiology and Virology Unit, Department of Laboratory Medicine, A. Manzoni Hospital, Lecco, Italy
| | - Annalisa Pantosti
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Italian National Health Institute, Rome, Italy
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- The AMCLI-CoSA survey participants are listed at the end of the article
| | - Francesco Luzzaro
- Microbiology and Virology Unit, Department of Laboratory Medicine, A. Manzoni Hospital, Lecco, Italy
| | - Laura Pagani
- Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, Section of Microbiology, University of Pavia, Pavia, Italy
| | - Gian Maria Rossolini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Clinical Microbiology, Virology and Serology Unit, Florence Careggi University Hospital, Florence, Italy
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16
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Giufrè M, Errico G, Accogli M, Monaco M, Villa L, Distasi MA, Del Gaudio T, Pantosti A, Carattoli A, Cerquetti M. Emergence of NDM-5-producing Escherichia coli sequence type 167 clone in Italy. Int J Antimicrob Agents 2018; 52:76-81. [PMID: 29501819 DOI: 10.1016/j.ijantimicag.2018.02.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/23/2018] [Accepted: 02/24/2018] [Indexed: 11/29/2022]
Abstract
The emergence of carbapenemase-producing Enterobacteriaceae (CPE) is a critical concern worldwide. In Italy, CPE isolates are very frequent, with the KPC enzyme types strongly predominant whereas the New Delhi metallo-β-lactamase (NDM) enzymes are extremely rare. Here we report the first detection of NDM-5-producing Escherichia coli sequence type 167 (ST167) isolates from two patients with urinary tract infection (Ec001 and Ec002 from urines), including one with colonisation (Ec003 from faeces) admitted to the same hospital 2 months apart in 2017. Minimum inhibitory concentrations (MICs) were determined by broth microdilution. The carbapenemase type was identified both by phenotypic and genotypic methods. Isolate genotypes were investigated by phylogenetic typing, multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Next-generation sequencing (NGS) was used to obtain complete sequences of plasmids. The three E. coli isolates carried the blaNDM-5 gene, shared the same resistance phenotype and belonged to ST167. By PFGE, isolates showed the same profile, suggesting that they were the same strain. NGS revealed that the blaNDM-5 gene was located on a 99-kb multireplicon plasmid (designed pNDM-5-IT) with a peculiar scaffold constituted by four replicons of the IncF type (FIA, FIB and two copies of the FII replicon). pNDM-5-IT plasmid harboured multiple resistance and virulence determinants, including the arginine deaminase (ADI) cluster never found associated with plasmids before. Since NDM-5-producing E. coli ST167 has been regarded as a successful epidemic clone in China, the emergence of such a clone carrying a plasmid associated both with multiresistance and virulence could be a public-health threat.
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Affiliation(s)
- Maria Giufrè
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Giulia Errico
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Marisa Accogli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Monica Monaco
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Laura Villa
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | | | - Tito Del Gaudio
- U.O. Clinical Pathology Unit, Lorenzo Bonomo Hospital, Andria, Italy
| | - Annalisa Pantosti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alessandra Carattoli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Marina Cerquetti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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17
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Coppi M, Antonelli A, Giani T, Spanu T, Liotti FM, Fontana C, Mirandola W, Gargiulo R, Barozzi A, Mauri C, Principe L, Rossolini GM. Multicenter evaluation of the RAPIDEC® CARBA NP test for rapid screening of carbapenemase-producing Enterobacteriaceae and Gram-negative nonfermenters from clinical specimens. Diagn Microbiol Infect Dis 2017; 88:207-213. [PMID: 28502395 DOI: 10.1016/j.diagmicrobio.2017.04.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 12/21/2022]
Abstract
The rapid diagnosis of carbapenemase-producing (CP) bacteria is essential for the management of therapy and infection control. In this study, RAPIDEC® CARBA NP (RCNP) was evaluated for the rapid screening of CP Enterobacteriaceae, Acinetobacter baumannii complex, and Pseudomonas aeruginosa from clinical specimens collected at five Italian hospitals. Firstly, each site tested 20 well-characterized strains in a blinded fashion. Secondly, each center prospectively tested 25 isolates from blood cultures processed with a rapid workflow (6h after subculture) and 25 isolates from other specimens processed after an overnight culture. The presence of carbapenemases was confirmed by multiplex real-timePCRs targeting carbapenemase genes. RCNP presented an overall sensitivity, specificity, positive predictive value, and negative predictive value of 70%, 94%, 82%, and 89%, respectively, with a higher performance in detection of CP Enterobacteriaceae and a poorer performance in detection of CP A. baumannii complex. With isolates from blood cultures, RCNP could significantly reduce the time required for identification of CP Enterobacteriaceae (less than 9h since the positivization of blood cultures).
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Affiliation(s)
- Marco Coppi
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Tommaso Giani
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Teresa Spanu
- Institute of Microbiology, Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy
| | - Flora Marzia Liotti
- Institute of Microbiology, Catholic University of the Sacred Heart, Agostino Gemelli Hospital, Rome, Italy
| | - Carla Fontana
- Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy; Clinical Microbiology Laboratories, Polyclinic of Tor Vergata Foundation, Rome, Italy
| | - Walter Mirandola
- Clinical Microbiology Laboratories, Polyclinic of Tor Vergata Foundation, Rome, Italy
| | - Raffaele Gargiulo
- Provincial Laboratory of Clinical Microbiology, S. Agostino-Estense Hospital, Modena, Italy
| | - Agostino Barozzi
- Provincial Laboratory of Clinical Microbiology, S. Agostino-Estense Hospital, Modena, Italy
| | - Carola Mauri
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Luigi Principe
- Microbiology and Virology Unit, A. Manzoni Hospital, Lecco, Italy
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy.
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18
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Sully EK, Geller BL, Li L, Moody CM, Bailey SM, Moore AL, Wong M, Nordmann P, Daly SM, Sturge CR, Greenberg DE. Peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) restores carbapenem susceptibility to NDM-1-positive pathogens in vitro and in vivo. J Antimicrob Chemother 2017; 72:782-790. [PMID: 27999041 PMCID: PMC5890718 DOI: 10.1093/jac/dkw476] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/16/2016] [Accepted: 10/05/2016] [Indexed: 02/06/2023] Open
Abstract
Objectives The objective of this study was to test the efficacy of an inhibitor of the New Delhi metallo-β- lactamase (NDM-1). Inhibiting expression of this type of antibiotic-resistance gene has the potential to restore antibiotic susceptibility in all bacteria carrying the gene. Methods We have constructed a peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) that selectively inhibits the expression of NDM-1 and examined its ability to restore susceptibility to meropenem in vitro and in vivo . Results In vitro , the PPMO reduced the MIC of meropenem for three different genera of pathogens that express NDM-1. In a murine model of lethal E. coli sepsis, the PPMO improved survival (92%) and reduced systemic bacterial burden when given concomitantly with meropenem. Conclusions These data show that a PPMO can restore antibiotic susceptibility in vitro and in vivo and that the combination of PPMO and meropenem may have therapeutic potential against certain class B carbapenem-resistant infections in multiple genera of Gram-negative pathogens.
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Affiliation(s)
- Erin K. Sully
- Department of Microbiology, Oregon State University, Corvallis, OR, USA
| | - Bruce L. Geller
- Department of Microbiology, Oregon State University, Corvallis, OR, USA
| | - Lixin Li
- Department of Microbiology, Oregon State University, Corvallis, OR, USA
| | | | | | | | - Michael Wong
- Sarepta Therapeutics, Cambridge, MA, USA
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Patrice Nordmann
- Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland
| | - Seth M. Daly
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Carolyn R. Sturge
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - David E. Greenberg
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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19
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Bachiri T, Bakour S, Ladjouzi R, Thongpan L, Rolain JM, Touati A. High rates of CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae in wild boars and Barbary macaques in Algeria. J Glob Antimicrob Resist 2017; 8:35-40. [DOI: 10.1016/j.jgar.2016.10.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 10/13/2016] [Accepted: 10/14/2016] [Indexed: 02/07/2023] Open
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20
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First report of NDM-1-producing Klebsiella pneumoniae imported from Africa to Italy: Evidence of the need for continuous surveillance. J Glob Antimicrob Resist 2017; 8:23-27. [DOI: 10.1016/j.jgar.2016.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/17/2016] [Indexed: 01/22/2023] Open
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21
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Xu M, Fan Y, Wang M, Lu X. Characteristics of Extended-Spectrum β-Lactamases-Producing Escherichia coli in Fecal Samples of Inpatients of Beijing Tongren Hospital. Jpn J Infect Dis 2016; 70:290-294. [PMID: 27795466 DOI: 10.7883/yoken.jjid.2016.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to investigate the prevalence of extended-spectrum β-lactamases (ESBL)-producing Escherichia coli in Beijing Tongren hospital and to identify a possible relation between colonization and infection. The clinical data on 650 inpatients between March 2012 and July 2012 were retrospectively reviewed. The prevalence of ESBL-producing E. coli among the inpatients was 25.7% (167/650), with the highest level (50.0%) in the rheumatology ward and the lowest (10.0%) in intensive care units. Hospital stay more than 2 years prior to infection, the use of antibiotics within 3 months of infection, and the use of glucocorticoids or immunosuppressive drugs were found to be significantly associated with carriage of ESBL-producing E. coli (P < 0.05). In total, 76 sequence types (STs) were revealed by multilocus sequence typing. ST38 (n = 12, 7.2%) was the most common ST, followed by ST10 (n = 10, 6.0%) and ST131 and ST167 (n = 9 and 5.4% each). Among the fecal carriers, only one patient had an active infection, which was caused by an ST38 strain. In conclusion, in Beijing Tongren hospital, the prevalence of ESBL-producing E. coli was not high. The risk factors of carriage of ESBL-producing E. coli are hospitalization and use of antibiotics, glucocorticoids, or immunosuppressive drugs. ST38, ST10, ST131, and ST167 are the prominent genotypes, but almost 50.0% of STs were scarcely distributed.
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Affiliation(s)
- Maoye Xu
- Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University
| | - Yanyan Fan
- Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University
| | - Mei Wang
- Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University
| | - Xinxin Lu
- Department of Clinical Laboratory, Beijing Tongren Hospital, Capital Medical University
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22
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Colistin- and Carbapenem-Resistant Escherichia coli Harboring mcr-1 and blaNDM-5, Causing a Complicated Urinary Tract Infection in a Patient from the United States. mBio 2016; 7:mBio.01191-16. [PMID: 27578755 PMCID: PMC4999550 DOI: 10.1128/mbio.01191-16] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Colistin is increasingly used as an antibiotic of last resort for the treatment of carbapenem-resistant Gram-negative infections. The plasmid-borne colistin resistance gene mcr-1 was initially identified in animal and clinical samples from China and subsequently reported worldwide, including in the United States. Of particular concern is the spread of mcr-1 into carbapenem-resistant bacteria, thereby creating strains that approach pan-resistance. While several reports of mcr-1 have involved carbapenem-resistant strains, no such isolates have been described in the United States. Here, we report the isolation and identification of an Escherichia coli strain harboring both mcr-1 and carbapenemase gene blaNDM-5 from a urine sample in a patient without recent travel outside the United States. The isolate exhibited resistance to both colistin and carbapenems, but was susceptible to amikacin, aztreonam, gentamicin, nitrofurantoin, tigecycline, and trimethoprim-sulfamethoxazole. The mcr-1- and blaNDM-5-harboring plasmids were completely sequenced and shown to be highly similar to plasmids previously reported from China. The strain in this report was first isolated in August 2014, highlighting an earlier presence of mcr-1 within the United States than previously recognized. Colistin has become the last line of defense for the treatment of infections caused by Gram-negative bacteria resistant to multiple classes of antibiotics, in particular carbapenem-resistant Enterobacteriaceae (CRE). Resistance to colistin, encoded by the plasmid-borne gene mcr-1, was first identified in animal and clinical samples from China in November 2015 and has subsequently been reported from numerous other countries. In April 2016, mcr-1 was identified in a carbapenem-susceptible Escherichia coli strain from a clinical sample in the United States, followed by a second report from a carbapenem-susceptible E. coli strain originally isolated in May 2015. We report the isolation and identification of an E. coli strain harboring both colistin (mcr-1) and carbapenem (blaNDM-5) resistance genes, originally isolated in August 2014 from urine of a patient with recurrent urinary tract infections. To our knowledge, this is the first report in the United States of a clinical bacterial isolate with both colistin and carbapenem resistance, highlighting the importance of active surveillance efforts for colistin- and carbapenem-resistant organisms.
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Phenotypic Detection of Metallo-Beta-Lactamases in Carbapenem Resistant Acinetobacter baumannii Isolated from Pediatric Patients in Pakistan. J Pathog 2016; 2016:8603964. [PMID: 27123345 PMCID: PMC4829712 DOI: 10.1155/2016/8603964] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 01/14/2016] [Accepted: 03/02/2016] [Indexed: 11/17/2022] Open
Abstract
Multidrug resistant A. baumannii has emerged as an important and problematic human pathogen as it is the causative agent of several types of infections especially in neonates and immunocompromised patients because they have least capacity to fight against infections. Carbapenems are used as last resort antibiotics for treating these infections but currently resistance against carbapenems due to MBL production is on the rise. The objective of this study was to determine the frequency of antibiotic resistance in A. baumannii and also to compare the efficacy of combined disk test and double disk synergy test for detection of metallo-beta-lactamases. A total of 112 A. baumannii were identified from various clinical samples and antibiotic susceptibility profile was determined by Kirby-Bauer Disk Diffusion method. Out of 112, 66 (58.9%) isolates were resistant to both imipenem and meropenem (OXOID). These resistant isolates were tested for carbapenemase production, and 55 (83.3%) were carbapenemase producers by Modified Hodge Test. These isolates were further tested for MBL production by combined disk test and double disk synergy test. Out of 66, 49 isolates were positive by both methods, CDT and DDST, and only one isolate was detected as negative (with kappa value = 0.038). All MBL producing strains showed remarkable resistance to cephalosporins, fluoroquinolones, aminoglycosides, and piperacillin/tazobactam (OXOID). The antibiotic resistance was very high in A. baumannii which were isolated from children in Pakistan specially attending a nephrology unit.
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Albiger B, Glasner C, Struelens MJ, Grundmann H, Monnet DL. Carbapenemase-producing Enterobacteriaceae in Europe: assessment by national experts from 38 countries, May 2015. Euro Surveill 2015; 20:30062. [DOI: 10.2807/1560-7917.es.2015.20.45.30062] [Citation(s) in RCA: 290] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 11/06/2015] [Indexed: 01/01/2023] Open
Abstract
In 2012, the European Centre for Disease Prevention and Control (ECDC) launched the ‘European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE)’ project to gain insights into the occurrence and epidemiology of carbapenemase-producing Enterobacteriaceae (CPE), to increase the awareness of the spread of CPE, and to build and enhance the laboratory capacity for diagnosis and surveillance of CPE in Europe. Data collected through a post-EuSCAPE feedback questionnaire in May 2015 documented improvement compared with 2013 in capacity and ability to detect CPE and identify the different carbapenemases genes in the 38 participating countries, thus contributing to their awareness of and knowledge about the spread of CPE. Over the last two years, the epidemiological situation of CPE worsened, in particular with the rapid spread of carbapenem-hydrolysing oxacillinase-48 (OXA-48)- and New Delhi metallo-beta-lactamase (NDM)-producing Enterobacteriaceae. In 2015, 13/38 countries reported inter-regional spread of or an endemic situation for CPE, compared with 6/38 in 2013. Only three countries replied that they had not identified one single case of CPE. The ongoing spread of CPE represents an increasing threat to patient safety in European hospitals, and a majority of countries reacted by establishing national CPE surveillances systems and issuing guidance on control measures for health professionals. However, 14 countries still lacked specific national guidelines for prevention and control of CPE in mid-2015.
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Affiliation(s)
- Barbara Albiger
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Corinna Glasner
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Current affiliation: The Centre for Genomic Pathogen Surveillance (cGPS), Wellcome Genome Campus, Hinxton, Cambridgeshire, United Kingdom
| | - Marc J. Struelens
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Hajo Grundmann
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Dominique L. Monnet
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Rath S, Padhy RN. Surveillance of acute community acquired urinary tract bacterial infections. JOURNAL OF ACUTE DISEASE 2015. [DOI: 10.1016/j.joad.2015.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Mishra MP, Debata NK, Padhy RN. Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian. Asian Pac J Trop Biomed 2015; 3:315-24. [PMID: 23620859 DOI: 10.1016/s2221-1691(13)60071-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/12/2013] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To record surveillance, antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months. METHODS Urine samples from wards and cabins were used for isolating urinary tract infection (UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests; and their antibiograms were ascertained by Kirby-Bauer's disc diffusion method, in each 6-month interval of the study period, using 18 antibiotics of five different classes. RESULTS From wards and cabins, 1 245 samples were collected, from which 996 strains of bacteria belonging to 11 species were isolated, during April 2011 to September 2012. Two Gram-positive, Staphylococcus aureus (S. aureus) and Enterococcus faecalis (E. faecalis), and nine Gram-negative bacteria, Acinetobacter baumannii, Citrobacter sp., Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Klebsiella oxytoca, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were isolated. Both S. aureus and E. faecalis were vancomycin resistant, and resistant-strains of all pathogens increased in each 6-month period of study. Particularly, all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole, the most preferred antibiotics of empiric therapy for UTI. CONCLUSIONS Antibiograms of 11 UTI-causing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied, generating the fear of precipitating fervent episodes in public health particularly with bacteria, Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and S. aureus. Moreover, vancomycin resistance in strains of S. aureus and E. faecalis is a matter of concern.
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Affiliation(s)
- Monali Priyadarsini Mishra
- Department of Microbiology, IMS & Sum Hospital, Siksha 'O' Anusandhan University, Kalinga Nagar, Bhubaneswar, 751003, Odisha, India
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Cavaliere E, De Cesari S, Landini G, Riccobono E, Pallecchi L, Rossolini GM, Gavioli L. Highly bactericidal Ag nanoparticle films obtained by cluster beam deposition. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2015; 11:1417-23. [PMID: 25804414 DOI: 10.1016/j.nano.2015.02.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 02/19/2015] [Accepted: 02/28/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED The recent emergence of bacterial pathogens resistant to most or all available antibiotics is among the major global public health problems. As indirect transmission through contaminated surfaces is a main route of dissemination for most of such pathogens, the implementation of effective antimicrobial surfaces has been advocated as a promising approach for their containment, especially in the hospital settings. However, traditional wet synthesis methods of nanoparticle-based antimicrobial materials leave a number of key points open for metal surfaces: such as adhesion to the surface and nanoparticle coalescence. Here we demonstrate an alternative route, i.e. supersonic cluster beam deposition, to obtain antimicrobial Ag nanoparticle films deposited directly on surfaces. The synthesized films are simple to produce with controlled density and thickness, are stable over time, and are shown to be highly bactericidal against major Gram positive and Gram negative bacterial pathogens, including extensively drug-resistant strains. FROM THE CLINICAL EDITOR The use of silver nanoparticle in health care is getting more widespread. The authors here describe the technique of cluster beam deposition for spraying silver on surfaces used in health care sectors. This may open a new avenue for future anti-bacterial coatings.
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Affiliation(s)
- Emanuele Cavaliere
- Interdisciplinary Laboratories for Advanced Material Physics (i-LAMP) & Dipartimento di Matematica e Fisica, Università Cattolica del Sacro Cuore di Brescia, Brescia, Italy
| | - Sebastiano De Cesari
- Interdisciplinary Laboratories for Advanced Material Physics (i-LAMP) & Dipartimento di Matematica e Fisica, Università Cattolica del Sacro Cuore di Brescia, Brescia, Italy
| | - Giulia Landini
- Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Eleonora Riccobono
- Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Lucia Pallecchi
- Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, Policlinico Santa Maria alle Scotte, Siena, Italy
| | - Gian Maria Rossolini
- Dipartimento di Biotecnologie Mediche, Università degli Studi di Siena, Policlinico Santa Maria alle Scotte, Siena, Italy; Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze & SOD Microbiologia e Virologia, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Luca Gavioli
- Interdisciplinary Laboratories for Advanced Material Physics (i-LAMP) & Dipartimento di Matematica e Fisica, Università Cattolica del Sacro Cuore di Brescia, Brescia, Italy.
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Coppo E, Del Bono V, Ventura F, Camera M, Orengo G, Viscoli C, Marchese A. Identification of a New Delhi metallo-β-lactamase-4 (NDM-4)-producing Escherichia coli in Italy. BMC Microbiol 2014; 14:148. [PMID: 24906230 PMCID: PMC4060580 DOI: 10.1186/1471-2180-14-148] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 05/28/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During June-July 2012, six imipenem-resistant Escherichia coli isolates were isolated from two patients hospitalized in a ward of one large tertiary-care hospital in Genoa, Italy. Genetic features associated with blaNDM-4 gene were investigated. RESULTS The isolates exhibited the same PFGE profile and a multidrug-resistant (MDR) phenotype to aminoglycosides, fluoroquinolones, and β-lactams. The strains produced the NDM-4 carbapenemase and the blaNDM-4 gene was part of the variable region of a class 1 integron. MLST analysis revealed that all isolates belonged to sequence type 405 (ST405). CONCLUSIONS This is the first report on the emergence of an MDR strain of E.coli producing the NDM-4 MBL in Italy.
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Affiliation(s)
| | | | | | | | | | | | - Anna Marchese
- Microbiology Unit DISC, University of Genoa, IRCCS AOU San Martino-IST, Largo R, Benzi 10, 16132 Genoa, Italy.
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Berrazeg M, Diene SM, Medjahed L, Parola P, Drissi M, Raoult D, Rolain JM. New Delhi Metallo-beta-lactamase around the world: An eReview using Google Maps. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.20.20809] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Gram-negative carbapenem-resistant bacteria, in particular those producing New Delhi Metallo-beta-lactamase-1 (NDM-1), are a major global health problem. To inform the scientific and medical community in real time about worldwide dissemination of isolates of NDM-1-producing bacteria, we used the PubMed database to review all available publications from the first description in 2009 up to 31 December 2012, and created a regularly updated worldwide dissemination map using a web-based mapping application. We retrieved 33 reviews, and 136 case reports describing 950 isolates of NDM-1-producing bacteria. Klebsiella pneumoniae (n= 359) and Escherichia coli (n=268) were the most commonly reported bacteria producing NDM-1 enzyme. Several case reports of infections due to imported NDM-1 producing bacteria have been reported in a number of countries, including the United Kingdom, Italy, and Oman. In most cases (132/153, 86.3%), patients had connections with the Indian subcontinent or Balkan countries. Those infected were originally from these areas, had either spent time and/or been hospitalised there, or were potentially linked to other patients who had been hospitalised in these regions. By using Google Maps, we were able to trace spread of NDM-1-producing bacteria. We strongly encourage epidemiologists to use these types of interactive tools for surveillance purposes and use the information to prevent the spread and outbreaks of such bacteria.
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Affiliation(s)
- M Berrazeg
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Marseille, France
- Laboratoire Antibiotiques, Antifongiques: physico- chimie, Synthèse et Activité Biologiques, Faculté des Sciences de la Nature, de la Vie, de la Terre et de l’Univers, Université Abou Bekr Belkaid, Tlemcen, Algeria
| | - S M Diene
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Marseille, France
| | - L Medjahed
- Département d'Informatique, Faculté de technologie, Université Abou Bekr Belkaid, Tlemcen, Algeria
| | - P Parola
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Marseille, France
| | - M Drissi
- Laboratoire Antibiotiques, Antifongiques: physico- chimie, Synthèse et Activité Biologiques, Faculté des Sciences de la Nature, de la Vie, de la Terre et de l’Univers, Université Abou Bekr Belkaid, Tlemcen, Algeria
| | - D Raoult
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Marseille, France
| | - J M Rolain
- Aix-Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Marseille, France
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Pediatric infection and intestinal carriage due to extended-spectrum-cephalosporin-resistant Enterobacteriaceae. Antimicrob Agents Chemother 2014; 58:3997-4004. [PMID: 24798269 DOI: 10.1128/aac.02558-14] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of this study is to describe the epidemiology of intestinal carriage with extended-spectrum-cephalosporin-resistant Enterobacteriaceae in children with index infections with these organisms. Patients with resistant Escherichia coli or Klebsiella bacteria isolated from the urine or a normally sterile site between January 2006 and December 2010 were included in this study. Available infection and stool isolates underwent phenotypic and molecular characterization. Clinical data relevant to the infections were collected and analyzed. Overall, 105 patients were identified with 106 extended-spectrum-cephalosporin-resistant E. coli (n = 92) or Klebsiella (n = 14) strains isolated from urine or a sterile site. Among the 27 patients who also had stool screening for resistant Enterobacteriaceae, 17 (63%) had intestinal carriage lasting a median of 199 days (range, 62 to 1,576). There were no significant differences in demographic, clinical, and microbiological variables between those with and those without intestinal carriage. Eighteen (17%) patients had 37 subsequent resistant Enterobacteriaceae infections identified: 31 urine and 6 blood. In a multivariable analysis, antibiotic intake in the 91 days prior to subsequent urine culture was significantly associated with subsequent urinary tract infection with a resistant organism (hazard ratio, 14.3; 95% confidence interval [CI], 1.6 to 130.6). Intestinal carriage and reinfection were most commonly due to bacterial strains of the same sequence type and with the same resistance determinants as the index extended-spectrum-cephalosporin-resistant Enterobacteriaceae, but carriage and reinfection with different resistant Enterobacteriaceae strains also occurred.
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Guh AY, Limbago BM, Kallen AJ. Epidemiology and prevention of carbapenem-resistant Enterobacteriaceae in the United States. Expert Rev Anti Infect Ther 2014; 12:565-80. [PMID: 24666262 PMCID: PMC6494086 DOI: 10.1586/14787210.2014.902306] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Carbapenem-resistant Enterobacteriaceae (CRE) are multidrug-resistant organisms with few treatment options that cause infections associated with substantial morbidity and mortality. CRE outbreaks have been increasingly reported worldwide and are mainly due to the emergence and spread of strains that produce carbapenemases. In the United States, transmission of CRE is primarily driven by the spread of organisms carrying the Klebsiella pneumoniae carbapenemase enzyme, but other carbapenemase enzymes, such as the New-Delhi metallo-β-lactamase, have also emerged. Currently recommended control strategies for healthcare facilities include the detection of patients infected or colonized with CRE and implementation of measures to prevent further spread. In addition to efforts in individual facilities, effective CRE control requires coordination across all healthcare facilities in a region. This review describes the current epidemiology and surveillance of CRE in the United States and the recommended approach to prevention.
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Affiliation(s)
- Alice Y Guh
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brandi M Limbago
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alexander J Kallen
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jain A, Hopkins KL, Turton J, Doumith M, Hill R, Loy R, Meunier D, Pike R, Livermore DM, Woodford N. NDM carbapenemases in the United Kingdom: an analysis of the first 250 cases. J Antimicrob Chemother 2014; 69:1777-84. [PMID: 24769387 DOI: 10.1093/jac/dku084] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Gram-negative bacteria with diverse carbapenemases, including New Delhi metallo-β-lactamase (NDM) enzymes, have been increasingly recorded in the UK since 2007. We analysed patient data for NDM-positive isolates confirmed by the national reference laboratory from UK laboratories from February 2008 to July 2013. METHODS Isolates resistant to carbapenems and with imipenem MICs reduced ≥8-fold by EDTA were tested by PCR for genes encoding acquired class B carbapenemases. MICs were determined by BSAC agar dilution methodology. When requested by the sender, or when they were members of apparent clusters, NDM-positive isolates were typed by variable number tandem repeat (VNTR) analysis or PFGE. Data provided by the sending laboratories were collated and reviewed. RESULTS From February 2008 to July 2013 the reference laboratory confirmed 326 NDM-positive isolates from 250 patients, submitted by 83 laboratories. Most (85%, 213/250) patients were already hospitalized when the NDM-positive bacteria were detected, were male (61%, 152/250) and were aged >60 years (58%, 145/250). Travel history was available for only 40% of patients, but 52% (53/101) of these had documented healthcare contact within or travel to the Indian subcontinent. Most NDM-positive isolates (94%, 306/326) were Enterobacteriaceae with just 6% (20/326) non-fermenters; the predominant hosts were Klebsiella spp. (55%, 180/326) and Escherichia coli (25%, 80/326). Almost all NDM-positive isolates were resistant to multiple antibiotic classes, but 90% remained susceptible to colistin. CONCLUSIONS Gram-negative bacteria with NDM carbapenemases are a growing challenge, especially for elderly hospitalized patients, including those with healthcare contact in the Indian subcontinent, and leave few therapeutic options. UK outbreaks remain rare and contained.
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Affiliation(s)
- Anu Jain
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - Katie L Hopkins
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - Jane Turton
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - Michel Doumith
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - Robert Hill
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - Richard Loy
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - Daniele Meunier
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - Rachel Pike
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
| | - David M Livermore
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Neil Woodford
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London NW9 5EQ, UK
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Cross-infection of solid organ transplant recipients by a multidrug-resistant Klebsiella pneumoniae isolate producing the OXA-48 carbapenemase, likely derived from a multiorgan donor. J Clin Microbiol 2014; 52:2702-5. [PMID: 24759725 DOI: 10.1128/jcm.00511-14] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
We describe two cases of bacteremic infections caused by a multidrug-resistant Klebsiella pneumoniae isolate producing the OXA-48 carbapenemase that occurred in two solid organ transplant (liver and kidney) recipients, which was apparently transmitted with the allografts. This finding underscores the risk of donor-derived infections by multidrug-resistant Gram-negative pathogens in solid organ transplant recipients and emphasizes the need for rapid screening of organ donors for carriage of similar pathogens.
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Outbreak caused by NDM-1- and RmtB-producing Escherichia coli in Bulgaria. Antimicrob Agents Chemother 2014; 58:2472-4. [PMID: 24514099 DOI: 10.1128/aac.02571-13] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Twelve consecutive carbapenem-resistant Escherichia coli isolates were recovered from patients (infection or colonization) hospitalized between March and September 2012 in different units at a hospital in Bulgaria. They all produced the carbapenemase NDM-1 and the extended-spectrum-β-lactamase CTX-M-15, together with the 16S rRNA methylase RmtB, conferring high-level resistance to all aminoglycosides. All those isolates were clonally related and belonged to the same sequence type, ST101. In addition to being the first to identify NDM-producing isolates in Bulgaria, this is the very first study reporting an outbreak of NDM-1-producing E. coli in the world.
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Aschbacher R, Giani T, Corda D, Conte V, Arena F, Pasquetto V, Scalzo K, Nicoletti M, Rossolini GM, Pagani E. Carbapenemase-producing Enterobacteriaceae during 2011-12 in the Bolzano area (Northern Italy): increasing diversity in a low-endemicity setting. Diagn Microbiol Infect Dis 2013; 77:354-6. [DOI: 10.1016/j.diagmicrobio.2013.08.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 08/08/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
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Wailan AM, Paterson DL. The spread and acquisition of NDM-1: a multifactorial problem. Expert Rev Anti Infect Ther 2013; 12:91-115. [DOI: 10.1586/14787210.2014.856756] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jakobsen L, Hammerum AM, Hansen F, Fuglsang-Damgaard D. An ST405 NDM-4-producing Escherichia coli isolated from a Danish patient previously hospitalized in Vietnam. J Antimicrob Chemother 2013; 69:559-60. [PMID: 24013194 DOI: 10.1093/jac/dkt356] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lotte Jakobsen
- Department of Microbiological Surveillance and Research, Statens Serum Institut, 5 Artillerivej, DK-2300 Copenhagen, Denmark
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Liu Z, Li W, Wang J, Pan J, Sun S, Yu Y, Zhao B, Ma Y, Zhang T, Qi J, Liu G, Lu F. Identification and characterization of the first Escherichia coli strain carrying NDM-1 gene in China. PLoS One 2013; 8:e66666. [PMID: 23762496 PMCID: PMC3677923 DOI: 10.1371/journal.pone.0066666] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 05/08/2013] [Indexed: 11/23/2022] Open
Abstract
New Delhi metallo-β-lactamase-1 (NDM-1), an acquired class B carbapenemase, is a significant clinical threat due to its extended hydrolysis of β-lactams including carbapenems. In this study, we identified the first confirmed clinical isolate of Escherichia coli BJ01 harboring bla(NDM-1) in China. The isolate is highly resistant to all tested antimicrobials except polymyxin. bla(NDM-1), bla(CTX-M-57), and bla TEM-1 were identified in the isolate. bla(NDM-1) was transferable to E. coli EC600 and DH5α in both plasmid conjugation experiments and plasmid transformation tests. BJ01 was identified as a new sequence type, ST224, by multilocus sequence typing. Analysis of genetic environment shows complex transposon-like structures surrounding the bla NDM-1 gene. Genetic analysis revealed that the region flanking bla(NDM-1) was very similar to previously identified NDM-positive Acinetobacter spp. isolated in China. The findings of this study raise attention to the emergence and spread of NDM-1-carrying Enterobacteriaceae in China.
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Affiliation(s)
- Zhiyuan Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
- Department of Microbiology, Center for Infectious Diseases, Peking University Health Science Center, Beijing, PR China
| | - Wei Li
- Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, PR China
| | - Jie Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Jian Pan
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Shipeng Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Yanhua Yu
- Department of Clinical Laboratory, Beijing You'an Hospital, Capital Medical University, Beijing, PR China
| | - Bing Zhao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Yuzhi Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Tingju Zhang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Jie Qi
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Guijian Liu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China
| | - Fengmin Lu
- Department of Microbiology, Center for Infectious Diseases, Peking University Health Science Center, Beijing, PR China
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Bushnell G, Mitrani-Gold F, Mundy LM. Emergence of New Delhi metallo-β-lactamase type 1-producing Enterobacteriaceae and non-Enterobacteriaceae: global case detection and bacterial surveillance. Int J Infect Dis 2013; 17:e325-33. [DOI: 10.1016/j.ijid.2012.11.025] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 11/08/2012] [Accepted: 11/10/2012] [Indexed: 01/01/2023] Open
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Johnson AP, Woodford N. Global spread of antibiotic resistance: the example of New Delhi metallo-β-lactamase (NDM)-mediated carbapenem resistance. J Med Microbiol 2013; 62:499-513. [PMID: 23329317 DOI: 10.1099/jmm.0.052555-0] [Citation(s) in RCA: 303] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The rapidity with which new types of antibiotic resistance can disseminate globally following their initial emergence or recognition is exemplified by the novel carbapenemase New Delhi metallo-β-lactamase (NDM). The first documented case of infection caused by bacteria producing NDM occurred in 2008, although retrospective analyses of stored cultures have identified the gene encoding this enzyme (blaNDM) in Enterobacteriaceae isolated in 2006. Since its first description, NDM carbapenemase has been reported from 40 countries worldwide, encompassing all continents except South America and Antarctica. The spread of NDM has a complex epidemiology involving the spread of a variety of species of NDM-positive bacteria and the inter-strain, inter-species and inter-genus transmission of diverse plasmids containing blaNDM, with the latter mechanism having played a more prominent role to date. The spread of NDM illustrates that antibiotic resistance is a public health problem that transcends national borders and will require international cooperation between health authorities if it is to be controlled.
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Affiliation(s)
- Alan P Johnson
- Department of Healthcare Associated Infection & Antimicrobial Resistance, HPA Health Protection Services Colindale, NW9 5EQ, London, UK
| | - Neil Woodford
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, HPA Microbiology Services Colindale, NW9 5EQ, London, UK
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41
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D. Vaze N, L. Emery C, J. Hamilton R, D. Brooks A, G. Joshi S. Patient Demographics and Characteristics of Infection with Carbapenem-Resistant <i>Acinetobacter baumannii</i> in a Teaching Hospital from the United States. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/aid.2013.31002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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42
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Mohapatra PR. Metallo-β-lactamase 1--why blame New Delhi & India? Indian J Med Res 2013; 137:213-5. [PMID: 23481076 PMCID: PMC3657891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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43
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Bhaskar E. Clinical correlates of New Delhi metallo-beta lactamase isolates--a survey of published literature. Indian J Med Res 2012; 136:1054-9. [PMID: 23391806 PMCID: PMC3612313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Emmanuel Bhaskar
- Department of Medicine, Sri Ramachandra Medical College & Research Institute, Chennai 600 116, India
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44
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Wang Y, Wu C, Zhang Q, Qi J, Liu H, Wang Y, He T, Ma L, Lai J, Shen Z, Liu Y, Shen J. Identification of New Delhi metallo-β-lactamase 1 in Acinetobacter lwoffii of food animal origin. PLoS One 2012; 7:e37152. [PMID: 22629360 PMCID: PMC3356367 DOI: 10.1371/journal.pone.0037152] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 04/14/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To investigate the presence of metallo-β-lactamase (MBL) genes and the genetic environment of the New Delhi metallo-β-lactamase gene bla(NDM-1) in bacteria of food animal origin. METHODOLOGY/PRINCIPAL FINDINGS Gram-negative bacteria with low susceptibility to imipenem (MIC>8 µg/mL) were isolated from swab samples collected from 15 animal farms and one slaughterhouse in eastern China. These bacteria were selected for phenotypic and molecular detection of known MBL genes and antimicrobial susceptibility testing. For the bla(NDM-1) positive isolate, conjugation and transformation experiments were carried out to assess plasmid transfer. Southern blotting was conducted to localize the bla(NDM-1) genes, and DNA sequencing was performed to determine the sequences of bla(NDM-1) and the flanking genes. In total, nine gram-negative bacteria of four different species presented a MBL phenotype. bla(NDM-1) was identified on a mobile plasmid named pAL-01 in an Acinetobacter lwoffii isolate of chicken origin. Transfer of pAL-01 from this isolate to E. coli J53 and JM109 resulted in resistance to multiple β-lactams. Sequence analysis revealed that the bla(NDM-1) gene is attached to an intact insertion element ISAba125, whose right inverted repeat (IR-R) overlaps with the promoter sequence of bla(NDM-1). Thus, insertion of ISAba125 likely enhances the expression of bla(NDM-1). CONCLUSION The identification of a bla(NDM-1)- carrying strain of A. lwoffii in chickens suggests the potential for zoonotic transmission of bla(NDM-1) and has important implications for food safety.
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Affiliation(s)
- Yang Wang
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Congming Wu
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Qijing Zhang
- Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Jing Qi
- Institute of Animal Science and Veterinary Medicine, Shandong Academy of Agricultural Sciences, Jinan, People's Republic of China
| | - Hebing Liu
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Yu Wang
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Tao He
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Licai Ma
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Jing Lai
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Zhangqi Shen
- Department of Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Yuqing Liu
- Institute of Animal Science and Veterinary Medicine, Shandong Academy of Agricultural Sciences, Jinan, People's Republic of China
| | - Jianzhong Shen
- Key Laboratory of Development and Evaluation of Chemical and Herbal Drugs for Animal Use, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
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Infections and organ transplantation: new challenges for prevention and treatment--a colloquium. Transplantation 2012; 93:S4-S39. [PMID: 22374265 DOI: 10.1097/tp.0b013e3182481347] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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46
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Khan AU, Nordmann P. Spread of carbapenemase NDM-1 producers: The situation in India and what may be proposed. ACTA ACUST UNITED AC 2012; 44:531-5. [DOI: 10.3109/00365548.2012.669046] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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47
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48
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Escherichia coli from Italy producing OXA-48 carbapenemase encoded by a novel Tn1999 transposon derivative. Antimicrob Agents Chemother 2012; 56:2211-3. [PMID: 22290939 DOI: 10.1128/aac.00035-12] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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49
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VIM-1-producing Pseudomonas mosselii isolates in Italy, predating known VIM-producing index strains. Antimicrob Agents Chemother 2012; 56:2216-7. [PMID: 22290983 DOI: 10.1128/aac.06005-11] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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50
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Nordmann P, Poirel L, Walsh TR, Livermore DM. The emerging NDM carbapenemases. Trends Microbiol 2011; 19:588-95. [PMID: 22078325 DOI: 10.1016/j.tim.2011.09.005] [Citation(s) in RCA: 454] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 09/28/2011] [Accepted: 09/28/2011] [Indexed: 10/15/2022]
Abstract
Carbapenems were the last β-lactams retaining near-universal anti-Gram-negative activity, but carbapenemases are spreading, conferring resistance. New Delhi metallo-β-lactamase (NDM) enzymes are the latest carbapenemases to be recognized and since 2008 have been reported worldwide, mostly in bacteria from patients epidemiologically linked to the Indian subcontinent, where they occur widely in hospital and community infections, and also in contaminated urban water. The main type is NDM-1, but minor variants occur. NDM enzymes are present largely in Enterobacteriaceae, but also in non-fermenters and Vibrionaceae. Dissemination predominantly involves transfer of the blaNDM-1 gene among promiscuous plasmids and clonal outbreaks. Bacteria with NDM-1 are typically resistant to nearly all antibiotics, and reliable detection and surveillance are crucial.
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Affiliation(s)
- Patrice Nordmann
- Service de Bactériologie-Virologie, Hôpital de Bicêtre, Institut National de la Santé et de la Recherche Médical (INSERM) Unité 914, Faculté de Médecine et Université Paris Sud, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre, France.
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