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Prediction of drug resistance profile of multidrug-resistant Mycobacterium tuberculosis (MDR-MTB) isolates from newly diagnosed case by whole genome sequencing (WGS): a study from a high tuberculosis burden country. BMC Infect Dis 2022; 22:499. [PMID: 35624432 PMCID: PMC9137048 DOI: 10.1186/s12879-022-07482-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Our aim was to assess the ability of the Whole-genome sequencing (WGS) in predicting drug resistance profile of multidrug-resistant mycobacterium tuberculosis (MDR-MTB) from newly diagnosed cases in China. METHODS We validated the Phenotypic drug Sensitivity Test (pDST) for 12 anti-tuberculosis drugs using the Bactec MGIT 960 system. We described the characteristics of the isolates enrolled and compared the pDST results with resistance profiles predicted by WGS. RESULTS The pDST showed that of the 43 isolates enrolled, 25.6% were sensitive to rifabutin (RFB); 97.7%、97.7%、93.0% and 93.0% were sensitive to cycloserine (Cs), amikacin/kanamycin (Ak/Km), para-aminosalicylic acid (Pas) and ethionamide Eto), respectively; 18.6% were resistant to fluoroquinolones (FQs) or second-line injections. Genotype DST determined by WGS of Ak/Km、Eto and RFP reached high consistency to 97.7% compared with pDST, followed by moxifloxacin (Mfx) 95.3%, levofloxaci (Lfx) and Pas 93%, streptomycin (Sm) 90.3%. The genotype DST of RFB and EMB showed low consistency with the pDST of 67.2 and 79.1%. WGS also detected 27.9% isolates of pyrazinamide(PZA)-related drug-resistant mutation. No mutations associated with linezolid (Lzd), bedaquiline (Bdq) and clofazimine (Cfz) were detectd. CONCLUSIONS WGS has the potential to infer resistance profiles without time-consuming phenotypic methods, which could be provide a basis to formulate reasonable treatment in high TB burden areas.
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Morroni G, Fioriti S, Salari F, Brenciani A, Brescini L, Mingoia M, Giovanetti E, Pocognoli A, Giacometti A, Molinelli E, Offidani A, Simonetti O, Cirioni O. Characterization and Clonal Diffusion of Ceftaroline Non-Susceptible MRSA in Two Hospitals in Central Italy. Antibiotics (Basel) 2021; 10:antibiotics10081026. [PMID: 34439075 PMCID: PMC8388857 DOI: 10.3390/antibiotics10081026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/13/2021] [Accepted: 08/21/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Ceftaroline represents a novel fifth-generation cephalosporin to treat infections caused by methicillin-resistant Staphylococcus aureus (MRSA). Methods: Ceftaroline susceptibility of 239 MRSA isolates was assessed by disk diffusion and a MIC test strip following both EUCAST and CLSI guidelines. Non-susceptible isolates were epidemiologically characterized by pulsed-field gel electrophoresis, spa typing, and multilocus sequence typing, and further investigated by PCR and whole genome sequencing to detect penicillin-binding protein (PBP) mutations as well as antibiotic resistance and virulence genes. Results: Fourteen isolates out of two hundred and thirty-nine (5.8%) were non-susceptible to ceftaroline (MIC > 1 mg/L), with differences between the EUCAST and CLSI interpretations. The characterized isolates belonged to seven different pulsotypes and three different clones (ST228/CC5-t041-SCCmecI, ST22/CC22-t18014-SCCmecIV, and ST22/CC22-t022-SCCmecIV), confirming a clonal diffusion of ceftaroline non-susceptible strains. Mutations in PBPs involved PBP2a for ST228-t041-SCCmecI strains and all the other PBPs for ST22-t18014-SCCmecIV and ST22-t022-SCCmecIV clones. All isolates harbored antibiotic resistance and virulence genes with a clonal distribution. Conclusion: Our study demonstrated that ceftaroline non-susceptibile isolates belonged not only to ST228 strains (the most widespread clone in Italy) but also to ST22, confirming the increasing role of these clones in hospital infections.
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Affiliation(s)
- Gianluca Morroni
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Simona Fioriti
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Federica Salari
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Andrea Brenciani
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Lucia Brescini
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Marina Mingoia
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Eleonora Giovanetti
- Department of Life and Environmental Sciences, Polytechnic University of Marche, 60126 Ancona, Italy;
| | | | - Andrea Giacometti
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
| | - Elisa Molinelli
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy; (E.M.); (A.O.)
| | - Annamaria Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy; (E.M.); (A.O.)
| | - Oriana Simonetti
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy; (E.M.); (A.O.)
- Correspondence: ; Tel.: +39-0715963494
| | - Oscar Cirioni
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, 60126 Ancona, Italy; (G.M.); (S.F.); (F.S.); (A.B.); (L.B.); (M.M.); (A.G.); (O.C.)
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Sader HS, Carvalhaes CG, Mendes RE. Ceftaroline activity against Staphylococcus aureus isolated from patients with infective endocarditis, worldwide (2010-2019). Int J Infect Dis 2021; 102:524-528. [PMID: 33207274 DOI: 10.1016/j.ijid.2020.11.130] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To evaluate the antimicrobial activity of ceftaroline against Staphylococcus aureus isolated from patients with infective endocarditis (IE). METHODS 23,833 S. aureus isolates were collected consecutively from patients with bloodstream infections (BSI) from 2010 to 2019, via the SENTRY Antimicrobial Surveillance Program, including 396 isolates from patients with a diagnosis of IE. Isolates were collected from 340 medical centers worldwide and susceptibility tested by reference broth microdilution in a monitoring laboratory. RESULTS The oxacillin resistance (MRSA) rate was 29.0% among IE isolates, and was higher in North America (40.3%) than in Europe (25.4%) or the Latin America/Asia-Pacific region (LATAM-APAC; 18.6%). Ceftaroline was active against 95.2% of IE isolates (MIC50/90, 0.25/1 mg/L), with ceftaroline susceptibility higher in North America (99.2%) and LATAM-APAC (98.3%) than in Europe (92.0%). Among MRSA isolates from IE (n = 115; MIC50/90, 1/2 mg/L), ceftaroline susceptibility was 98.0% in North America, 90.9% in LATAM-APAC, and 68.5% in Europe. Among BSI isolates, MRSA rates were 43.6% in North America and 25.6% in Europe, while ceftaroline susceptibility rates were 98.1% in North America and 95.4% in Europe. CONCLUSIONS Ceftaroline demonstrated potent in vitro activity against a large collection of S. aureus isolates recovered from patients with BSI, including IE.
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Gavrilova AA, Bontsevich RA, Vovk YR, Balabanova AA. Modern approaches to pharmacotherapy of Community-Acquired Pneumonia. RESEARCH RESULTS IN PHARMACOLOGY 2020. [DOI: 10.3897/rrpharmacology.6.52318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The study presents current views on the pharmacotherapy of community-acquired pneumonia (CAP). This study also describes in general terms the current pharmacoepidemiological situation of the CAP in Russia and abroad, which can both help medical professionals make an informed choice when choosing a pharmacotherapy, and inspire them to follow-up research and observations.
The aim of the study is to conduct an analysis of the available research on the pharmacotherapy of CAP in order to accelerate the accumulation and assimilation of knowledge in the field of this pathology.
Materials and methods: The following databases of medical publications and electronic libraries were used to search for the relevant sources of information: PubMed, Medline, Google Scholar, Crossref, and eLIBRARY.RU.
Results and discussion: The choice of a rational antimicrobial therapy (AMT) for CAP is of high relevance due to the widespread of the pathology. The article highlights modern approaches to the pharmacotherapy of CAP in adults, including a review of promising new drugs, and presents the main problematic issues related to the emergence of antibiotic resistance of pathogens, as well as methods to combat it.
Conclusion: The analyzed and generalized results of the conducted research allow the authors to make a conclusion about the feasibility of a more detailed study and raising the level of awareness of medical professionals in this pathology.
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Varela MC, Roch M, Taglialegna A, Long SW, Saavedra MO, Rose WE, Davis JJ, Hoffman LR, Hernandez RE, Rosato RR, Rosato AE. Carbapenems drive the collateral resistance to ceftaroline in cystic fibrosis patients with MRSA. Commun Biol 2020; 3:599. [PMID: 33093601 PMCID: PMC7582194 DOI: 10.1038/s42003-020-01313-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/30/2020] [Indexed: 01/14/2023] Open
Abstract
Chronic airways infection with methicillin-resistant Staphylococcus aureus (MRSA) is associated with worse respiratory disease cystic fibrosis (CF) patients. Ceftaroline is a cephalosporin that inhibits the penicillin-binding protein (PBP2a) uniquely produced by MRSA. We analyzed 335 S. aureus isolates from CF sputum samples collected at three US centers between 2015-2018. Molecular relationships demonstrated that high-level resistance of preceding isolates to carbapenems were associated with subsequent isolation of ceftaroline resistant CF MRSA. In vitro evolution experiments showed that pre-exposure of CF MRSA to meropenem with further selection with ceftaroline implied mutations in mecA and additional mutations in pbp1 and pbp2, targets of carbapenems; no effects were achieved by other β-lactams. An in vivo pneumonia mouse model showed the potential therapeutic efficacy of ceftaroline/meropenem combination against ceftaroline-resistant CF MRSA infections. Thus, the present findings highlight risk factors and potential therapeutic strategies offering an opportunity to both prevent and address antibiotic resistance in this patient population.
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Affiliation(s)
- Maria Celeste Varela
- Department of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Melanie Roch
- Department of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Agustina Taglialegna
- Department of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Scott W Long
- Department of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Matthew Ojeda Saavedra
- Department of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Warren E Rose
- School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA
| | - James J Davis
- Argonne National Laboratory (DOE), Lemont, IL, USA
- Computation Institute, University of Chicago, Chicago, IL, USA
| | - Lucas R Hoffman
- Department of Pediatrics and Department of Microbiology, University of Washington, Seattle, WA, USA
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Rafael E Hernandez
- Department of Pediatrics and Department of Microbiology, University of Washington, Seattle, WA, USA
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Roberto R Rosato
- Houston Methodist Cancer Center, Houston Methodist Hospital, Houston, USA
| | - Adriana E Rosato
- Department of Pathology and Genomic Medicine, Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX, USA.
- Riverside University Health System-Medical Center, 26520 Cactus Avenue, Moreno Valley, CA, 92555, USA.
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Duncan LR, Sader HS, Huband MD, Flamm RK, Mendes RE. Antimicrobial Activity of Telavancin Tested In Vitro Against a Global Collection of Gram-Positive Pathogens, Including Multidrug-Resistant Isolates (2015–2017). Microb Drug Resist 2020; 26:934-943. [DOI: 10.1089/mdr.2019.0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Sader HS, Jones RN. Impact of EUCAST, CLSI and USCAST ceftaroline breakpoint changes on the susceptibility of methicillin-resistant Staphylococcus aureus isolates collected from US medical centres (2015-2018). Clin Microbiol Infect 2020; 26:658-659. [PMID: 31899333 DOI: 10.1016/j.cmi.2019.12.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/19/2019] [Accepted: 12/21/2019] [Indexed: 12/18/2022]
Affiliation(s)
- H S Sader
- JMI Laboratories, North Liberty, IA, USA.
| | - R N Jones
- JMI Laboratories, North Liberty, IA, USA
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One Size Fits All? Application of Susceptible-Dose-Dependent Breakpoints to Pediatric Patients and Laboratory Reporting. J Clin Microbiol 2019; 58:JCM.01446-19. [PMID: 31666359 DOI: 10.1128/jcm.01446-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The Clinical and Laboratory Standards Institute antimicrobial and antifungal standards define a susceptible-dose-dependent (SDD) category for certain organisms and drug combinations. Reporting MICs within the SDD category suggests that treatment success is likely with increased drug exposure. These breakpoints are based on pharmacokinetic, pharmacodynamic, and clinical outcome data from adults and not pediatric patients. This commentary aims to discuss the implications of reporting SDD interpretations for pediatric patients and recommends laboratory reporting comments.
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