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Tchesnokova V, Larson L, Basova I, Sledneva Y, Choudhury D, Solyanik T, Heng J, Bonilla TC, Pasumansky I, Bowers V, Pham S, Madziwa LT, Holden E, Tartof SY, Ralston JD, Sokurenko EV. Gut resident Escherichia coli profile predicts the eighteen-month probability and antimicrobial susceptibility of urinary tract infections. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.05.24305377. [PMID: 38645148 PMCID: PMC11030298 DOI: 10.1101/2024.04.05.24305377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Community-acquired UTI is the most common bacterial infection managed in general medical practice that can lead to life-threatening outcomes. While UTIs are primarily caused by Escherichia coli colonizing the patient's gut, it is unclear whether the gut resident E. coli profiles can predict the person's risks for UTI and optimal antimicrobial treatments. Thus, we conducted an eighteen-month long community-based observational study of fecal E. coli colonization and UTI in women aged 50 years and above. Methods and Findings We enrolled a total of 1,804 women distributed among age groups 50-59 yo (437 participants), 60-69 yo (632), 70-79 yo (532), and above 80 yo (203), lacking antibiotic prescriptions for at least one year. The provided fecal samples were plated for the presence of E. coli and other enterobacteria resistant to trimethoprim/sulfamethoxazole (TMP/STX), ciprofloxacin (CIP) and 3rd generation cephalosporins (3GC). E. coli was also characterized as belonging to the pandemic multi-drug resistant clonal groups ST131 (subclone H30) and ST1193. Following sample collection, the women were monitored for 18 months for occurrence of UTI.E. coli was cultured from 90.8% fecal samples, with 24.1% containing bacteria resistant to TMP/STX, 19.4% to CIP, and 7.9% to 3GC. In 62.5% samples, only all-susceptible E. coli were present. Overall, there were no age-related differences in resistance prevalence. However, while the total E. coli H30 and ST1193 carriage rates were similar (4.3% and 4.2%, respectively), there was a notable increase of H30 carriage with age (P = .001), while carriage decreased with age for ST1193 (P = .057).Within 18 months, 184 women (10.2%) experienced at least one episode of UTI - 10.9% among the gut E. coli carriers and 3.0% among the non-carriers (P=.0013). The UTI risk among carriers of E. coli H30 but not ST1193 was significantly above average (24.3%, P = .0004). The UTI probability increased with age, occurring in 6.4% of 50-59 yo and 19.7% of 80+ yo (P<.001), with the latter group being especially at high risk for UTI, if they were colonized by E. coli H30 (40.0%, P<.001).E. coli was identified in 88.1% of urine samples, with 16.1% resistant to TMP/STX, 16.1% to CIP, 4.2% to 3GC and 73.1% to none of the antibiotics. Among tested urinary E. coli resistant to antibiotics, 86.1% matched the resistance profile of E. coli in the fecal samples, with the clonotyping and whole genome sequencing confirming the matching strains' identity. Positive predictive value (PPV) of using gut resistance profiles to predict UTI pathogens' susceptibility to TMP/STX, CIP, 3GC and all three antibiotics were 98.4%, 98.3%, 96.6% and 95.3%, respectively. Corresponding negative predictive values (NPV) were 63.0%, 54.8%, 44.4% and 75.8%, respectively. The AUC ROC curve values for the accuracy of fecal diagnostic testing for the prediction of UTI resistance ranged .86-.89. The fecal test-guided drug-bug mismatch rate for empirical (pre-culture) prescription of TMP-SXT or CIP is reduced to ≤2% in 89.6% of patients and 94.8% of patients with an optional 3GC prescription. Conclusion The resistance profile and clonal identity of gut colonizing E. coli, along with the carrier's age, can inform personalized prediction of a patients' UTI risk and the UTI pathogen's antibiotic susceptibility within an 18-month period.
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Affiliation(s)
- Veronika Tchesnokova
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Lydia Larson
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Irina Basova
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Yulia Sledneva
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Debarati Choudhury
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Thalia Solyanik
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Jennifer Heng
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Teresa Cristina Bonilla
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Isaac Pasumansky
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Victoria Bowers
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Sophia Pham
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
| | - Lawrence T. Madziwa
- Kaiser Permanente Washington, 2715 Naches Ave. SW, Renton, WA 98057, USA
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1466, USA
| | - Erika Holden
- Kaiser Permanente Washington, 2715 Naches Ave. SW, Renton, WA 98057, USA
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1466, USA
| | - Sara Y. Tartof
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, 100 S Los Robles, Pasadena, CA 91101, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Department of Health Systems Science, 100 S Los Robles, Pasadena, CA 91101, USA
| | - James D. Ralston
- Kaiser Permanente Washington, 2715 Naches Ave. SW, Renton, WA 98057, USA
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1466, USA
| | - Evgeni V. Sokurenko
- Department of Microbiology, University of Washington School of Medicine, 1705 NE Pacific St., Seattle, WA 98195, USA
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Zakhour J, El Ayoubi LW, Kanj SS. Metallo-beta-lactamases: mechanisms, treatment challenges, and future prospects. Expert Rev Anti Infect Ther 2024; 22:189-201. [PMID: 38275276 DOI: 10.1080/14787210.2024.2311213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/24/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Metallo-beta-lactamases (MBLs) are responsible for resistance to almost all beta-lactam antibiotics. Found predominantly in Gram-negative bacteria, they severely limit treatment options. Understanding the epidemiology, risk factors, treatment, and prevention of infections caused by MBL-producing organisms is essential to reduce their burden. AREAS COVERED The origins and structure of MBLs are discussed. We describe the mechanisms of action that differentiate MBLs from other beta-lactamases. We discuss the global epidemiology of MBL-producing organisms and their impact on patients' outcomes. By exposing the mechanisms of transmission of MBLs among bacterial populations, we emphasize the importance of infection prevention and control. EXPERT OPINION MBLs are spreading globally and challenging the majority of available antibacterial agents. Genotypic tests play an important role in the identification of MBL production. Phenotypic tests are less specific but may be used in low-resource settings, where MBLs are more predominant. Infection prevention and control are critical to reduce the spread of organisms producing MBL in healthcare systems. New combinations such as avibactam-aztreonam and new agents such as cefiderocol have shown promising results for the treatment of infections caused by MBL-producing organisms. New antibiotic and non-antibiotic agents are being developed and may improve the management of infections caused by MBL-producing organisms.
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Affiliation(s)
- Johnny Zakhour
- Internal Medicine Department, Henry Ford Hospital, Detroit, MI, USA
| | - L'Emir Wassim El Ayoubi
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Souha S Kanj
- Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Center for Infectious Diseases Research, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Ruef M, Emonet S, Merglen A, Dewez JE, Obama BM, Catho G, Andrey DO, Kowalski M, Harbarth S, Combescure C, Wagner N, Galetto-Lacour A. Carriage of third-generation cephalosporin-resistant and carbapenem-resistant Enterobacterales among children in sub-Saharan Africa: a systematic review and meta-analysis. EClinicalMedicine 2024; 70:102508. [PMID: 38500839 PMCID: PMC10945212 DOI: 10.1016/j.eclinm.2024.102508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/09/2024] [Accepted: 02/16/2024] [Indexed: 03/20/2024] Open
Abstract
Background The increasing resistance of Enterobacterales to third-generation cephalosporins and carbapenems in sub-Saharan Africa (SSA) is a major public health concern. We did a systematic review and meta-analysis of studies to estimate the carriage prevalence of Enterobacterales not susceptible to third-generation cephalosporins or carbapenems among paediatric populations in SSA. Methods We performed a systematic literature review and meta-analysis of cross-sectional and cohort studies to estimate the prevalence of childhood (0-18 years old) carriage of extended-spectrum cephalosporin-resistant Enterobacterales (ESCR-E) or carbapenem-resistant Enterobacterales (CRE) in SSA. Medline, EMBASE and the Cochrane Library were searched for studies published from 1 January 2005 to 1 June 2022. Studies with <10 occurrences per bacteria, case reports, and meta-analyses were excluded. Quality and risk of bias were assessed using the Newcastle-Ottawa scale. Meta-analyses of prevalences and odds ratios were calculated using generalised linear mixed-effects models. Heterogeneity was assessed using I2 statistics. The protocol is available on PROSPERO (CRD42021260157). Findings Of 1111 studies examined, 40 met our inclusion criteria, reporting on the carriage prevalence of Enterobacterales in 9408 children. The pooled carriage prevalence of ESCR-E was 32.2% (95% CI: 25.2%-40.2%). Between-study heterogeneity was high (I2 = 96%). The main sources of bias pertained to participant selection and the heterogeneity of the microbiological specimens. Carriage proportions were higher among sick children than healthy ones (35.7% vs 16.9%). The pooled proportion of nosocomial acquisition was 53.8% (95% CI: 32.1%-74.1%) among the 922 children without ESCR-E carriage at hospital admission. The pooled odds ratio of ESCR-E carriage after antibiotic treatment within the previous 3 months was 3.20 (95% CI: 2.10-4.88). The proportion of pooled carbapenem-resistant for Enterobacterales was 3.6% (95% CI: 0.7%-16.4%). Interpretation This study suggests that ESCR-E carriage among children in SSA is frequent. Microbiology capacity and infection control must be scaled-up to reduce the spread of those multidrug-resistant microorganisms. Funding There was no funding source for this study.
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Affiliation(s)
- Micaela Ruef
- Children’s Hospital, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephane Emonet
- Division of Infectious Diseases, Hospital of Valais, Sion, and Faculty of Medicine, Geneva, Switzerland
| | - Arnaud Merglen
- Division of General Paediatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Juan Emmanuel Dewez
- Medical Department, Médecins Sans Frontières, Operational Centre Geneva, Geneva, Switzerland
| | - Basilice Minka Obama
- Paediatric Infectious Diseases Unit, Children’s Hospital, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Regional Hospital Centre for Ebolowa, Cameroon
| | - Gaud Catho
- Infectious Diseases Division, Central Institute, Hospital of Valais, Switzerland
- Infection Control Division, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Diego O. Andrey
- Division of Infectious Diseases, Department of Medicine and Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Morgane Kowalski
- Children’s Hospital, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Stephan Harbarth
- Infection Control Programme and World Health Organization Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Christophe Combescure
- Centre for Clinical Research, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Noémie Wagner
- Medical Department, Médecins Sans Frontières, Operational Centre Geneva, Geneva, Switzerland
- Paediatric Infectious Diseases Unit, Children’s Hospital, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Annick Galetto-Lacour
- Division of Paediatric Emergency Medicine, Children’s Hospital, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Custódio DADC, Pereira CR, Gonçalves MS, Costa ACTRB, de Oliveira PFR, da Silva BHP, Carneiro GB, Coura FM, Lage AP, Heinemann MB, da Costa GMÁ, Dorneles EMS. Antimicrobial resistance and public and animal health risks associated with pathogenic Escherichia coli isolated from calves. Comp Immunol Microbiol Infect Dis 2024; 107:102149. [PMID: 38442544 DOI: 10.1016/j.cimid.2024.102149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/31/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
We aimed to determine the antimicrobial susceptibility profile of pathogenic Escherichia coli strains isolated from fecal samples of calves and buffalo calves (2008-2013), in Minas Gerais, Brazil, as well as the frequency of O157 gene and strains carrying extended-spectrum beta-lactamases (ESBL) and mobile colistin resistance (mcr) genes. E. coli strains (n=518) were tested for susceptibility against ten antimicrobials. Tetracycline was the antimicrobial with the highest resistance rate (382/518), followed by ampicillin (321/518), sulfamethoxazole/trimethoprim (312/518), chloramphenicol (192/518), gentamicin (126/518), ciprofloxacin (148/518), cefazolin (89/518), colistin (54/518) and cefoxitin (34/518). Multidrug resistance (MDR) was observed in 381/518 isolates. No strain harbored mcr or O157 genes, whereas 19/99 were ESBL positive. The most prevalent pathotype and phylogroup were STEC and B1, respectively. Age, EHEC pathotype and resistance to aminoglycoside and cephem were significantly associated with MDR in the multivariate model. Overall, E. coli strains showed high rates of resistance to penicillin, tetracyclines and folate inhibitors, in addition to an alarming rate of MDR and ESBL-producing strains.
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Affiliation(s)
- Dircéia Aparecida da Costa Custódio
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Carine Rodrigues Pereira
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Maysa Serpa Gonçalves
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Anna Cecília Trolesi Reis Borges Costa
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Pedro Felipe Rodrigues de Oliveira
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Bruna Henrique Pinto da Silva
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Giovanna Botelho Carneiro
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Fernanda Morcatti Coura
- Departamento de Ciências Agrárias do Instituto Federal de Minas Gerais - Campus Bambuí, Rodovia Bambuí/Medeiros Km 05, Caixa Postal 05, Bambuí, MG 38900-000, Brazil
| | - Andrey Pereira Lage
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, São Luiz, Belo Horizonte, MG 31270-901, Brazil
| | - Marcos Bryan Heinemann
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Av. Prof. Orlando Marques de Paiva, 87 - Butantã, São Paulo, SP 05508-270, Brazil
| | - Geraldo M Árcio da Costa
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil
| | - Elaine Maria Seles Dorneles
- Departamento de Medicina Veterinária, Faculdade de Zootecnia e Medicina Veterinária, Universidade Federal de Lavras, Campus Universitário S/N, Caixa Postal 3037, Lavras, MG 37200-900, Brazil.
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5
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Allegretti YH, Yamaji R, Adams-Sapper S, Riley LW. Genetic features of antimicrobial drug-susceptible extraintestinal pathogenic Escherichia coli pandemic sequence type 95. Microbiol Spectr 2024; 12:e0418922. [PMID: 38059630 PMCID: PMC10783064 DOI: 10.1128/spectrum.04189-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/13/2023] [Indexed: 12/08/2023] Open
Abstract
IMPORTANCE Despite the increasing prevalence of antibiotic-resistant Escherichia coli strains that cause urinary tract and bloodstream infections, a major pandemic lineage of extraintestinal pathogenic E. coli (ExPEC) ST95 has a comparatively low frequency of drug resistance. We compared the genomes of 1,749 ST95 isolates to identify genetic features that may explain why most strains of ST95 resist becoming drug-resistant. Identification of such genomic features could contribute to the development of novel strategies to prevent the spread of antibiotic-resistant genes and devise new measures to control antibiotic-resistant infections.
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Affiliation(s)
| | | | | | - Lee W. Riley
- University of California Berkeley, Berkeley, California, USA
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6
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Smit CCH, Lambert M, Rogers K, Djordjevic SP, Van Oijen AM, Keighley C, Taxis K, Robertson H, Pont LG. One Health Determinants of Escherichia coli Antimicrobial Resistance in Humans in the Community: An Umbrella Review. Int J Mol Sci 2023; 24:17204. [PMID: 38139033 PMCID: PMC10743193 DOI: 10.3390/ijms242417204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023] Open
Abstract
To date, the scientific literature on health variables for Escherichia coli antimicrobial resistance (AMR) has been investigated throughout several systematic reviews, often with a focus on only one aspect of the One Health variables: human, animal, or environment. The aim of this umbrella review is to conduct a systematic synthesis of existing evidence on Escherichia coli AMR in humans in the community from a One Health perspective. PubMed, EMBASE, and CINAHL were searched on "antibiotic resistance" and "systematic review" from inception until 25 March 2022 (PROSPERO: CRD42022316431). The methodological quality was assessed, and the importance of identified variables was tabulated across all included reviews. Twenty-three reviews were included in this study, covering 860 primary studies. All reviews were of (critically) low quality. Most reviews focused on humans (20), 3 on animals, and 1 on both human and environmental variables. Antibiotic use, urinary tract infections, diabetes, and international travel were identified as the most important human variables. Poultry farms and swimming in freshwater were identified as potential sources for AMR transmission from the animal and environmental perspectives. This umbrella review highlights a gap in high-quality literature investigating the time between variable exposure, AMR testing, and animal and environmental AMR variables.
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Affiliation(s)
- Chloé C. H. Smit
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2008, Australia; (C.C.H.S.); (K.R.)
| | - Maarten Lambert
- Department of PharmacoTherapy, -Epidemiology and -Economics, Faculty of Science and Engineering, University of Groningen, 9713 AV Groningen, The Netherlands; (M.L.); (K.T.)
| | - Kris Rogers
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2008, Australia; (C.C.H.S.); (K.R.)
| | - Steven P. Djordjevic
- The Australian Institute for Microbiology & Infection, University of Technology Sydney, Sydney, NSW 2007, Australia;
| | - Antoine M. Van Oijen
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia;
| | - Caitlin Keighley
- Southern.IML Pathology, Sonic Healthcare, 3 Bridge St, Wollongong, NSW 2500, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Katja Taxis
- Department of PharmacoTherapy, -Epidemiology and -Economics, Faculty of Science and Engineering, University of Groningen, 9713 AV Groningen, The Netherlands; (M.L.); (K.T.)
| | - Hamish Robertson
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia;
| | - Lisa G. Pont
- Graduate School of Health, University of Technology Sydney, Sydney, NSW 2008, Australia; (C.C.H.S.); (K.R.)
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7
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Pek HB, Kadir SA, Arivalan S, Osman S, Mohamed R, Ng LC, Wong JC, Octavia S. Screening for extended-spectrum beta-lactamase Escherichia coli in recreational beach waters in Singapore. Future Microbiol 2023; 18:867-873. [PMID: 37650710 DOI: 10.2217/fmb-2023-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
Aims: As part of Singapore's One Health antimicrobial resistance (AMR) management, this work was designed to understand the AMR burden in recreational beach waters using extended-spectrum beta-lactamase Escherichia coli (ESBL-EC) as an indicator. Materials & methods: A total of 90 water samples were collected from six different recreational beaches over three different time periods. Only 28/90 (31.3%) water samples yielded E. coli colonies ranging from 1 to 80 colony-forming units/100 ml. Results & conclusion: Screening of all colonies using CHROMID® ESBL agar and Luria-Bertani broth supplemented with ceftriaxone showed that none was ESBL-EC. Further monitoring is required to understand the prevalence of ESBL-EC spatiotemporally, contributing to the national AMR surveillance program and providing timely risk assessment for exposure to ESBL-EC.
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Affiliation(s)
- Han Bin Pek
- Environmental Health Institute, National Environment Agency, Singapore
| | - Sharain A Kadir
- Environmental Health Institute, National Environment Agency, Singapore
| | - Sathish Arivalan
- Environmental Health Institute, National Environment Agency, Singapore
| | - Sheereen Osman
- Environmental Health Institute, National Environment Agency, Singapore
| | - Roslinda Mohamed
- Environmental Health Institute, National Environment Agency, Singapore
| | - Lee Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Judith Cc Wong
- Environmental Health Institute, National Environment Agency, Singapore
| | - Sophie Octavia
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biotechnology & Biomolecular Sciences, University of New South Wales, Australia
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Caliskan-Aydogan O, Alocilja EC. A Review of Carbapenem Resistance in Enterobacterales and Its Detection Techniques. Microorganisms 2023; 11:1491. [PMID: 37374993 DOI: 10.3390/microorganisms11061491] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Infectious disease outbreaks have caused thousands of deaths and hospitalizations, along with severe negative global economic impacts. Among these, infections caused by antimicrobial-resistant microorganisms are a major growing concern. The misuse and overuse of antimicrobials have resulted in the emergence of antimicrobial resistance (AMR) worldwide. Carbapenem-resistant Enterobacterales (CRE) are among the bacteria that need urgent attention globally. The emergence and spread of carbapenem-resistant bacteria are mainly due to the rapid dissemination of genes that encode carbapenemases through horizontal gene transfer (HGT). The rapid dissemination enables the development of host colonization and infection cases in humans who do not use the antibiotic (carbapenem) or those who are hospitalized but interacting with environments and hosts colonized with carbapenemase-producing (CP) bacteria. There are continuing efforts to characterize and differentiate carbapenem-resistant bacteria from susceptible bacteria to allow for the appropriate diagnosis, treatment, prevention, and control of infections. This review presents an overview of the factors that cause the emergence of AMR, particularly CRE, where they have been reported, and then, it outlines carbapenemases and how they are disseminated through humans, the environment, and food systems. Then, current and emerging techniques for the detection and surveillance of AMR, primarily CRE, and gaps in detection technologies are presented. This review can assist in developing prevention and control measures to minimize the spread of carbapenem resistance in the human ecosystem, including hospitals, food supply chains, and water treatment facilities. Furthermore, the development of rapid and affordable detection techniques is helpful in controlling the negative impact of infections caused by AMR/CRE. Since delays in diagnostics and appropriate antibiotic treatment for such infections lead to increased mortality rates and hospital costs, it is, therefore, imperative that rapid tests be a priority.
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Affiliation(s)
- Oznur Caliskan-Aydogan
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI 48824, USA
- Global Alliance for Rapid Diagnostics, Michigan State University, East Lansing, MI 48824, USA
| | - Evangelyn C Alocilja
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI 48824, USA
- Global Alliance for Rapid Diagnostics, Michigan State University, East Lansing, MI 48824, USA
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Aghamohammad S, Rohani M. Antibiotic resistance and the alternatives to conventional antibiotics: The role of probiotics and microbiota in combating antimicrobial resistance. Microbiol Res 2022; 267:127275. [PMID: 36493661 DOI: 10.1016/j.micres.2022.127275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
From the introduction of the first antibiotic to the present day, the emergence of antibiotic resistance has been a difficult problem for medicine. Regardless of the type of antibiotic resistance, the presence of resistant isolates in clinical and even asymptomatic fecal carriers becomes a difficult public health problem. Therefore, the use of new antimicrobial combination therapies or alternative agents with antimicrobial activity that have the least side effects, including plant-, metal-, and nanoparticle-based agents, could be crucial and useful. Recently, the use of probiotics as a hypothetical candidate to combat infectious disease control and antimicrobial resistance has received notable attention. Considering the alteration of the microbiota in fecal carriers and also in patients with resistant bacterial isolates, the use of probiotics could have an appropriate effect on the balance of the microbial population. In this review, we have attempted to discuss the history of antimicrobial resistance and provide an overview of microbiota change and the use of probiotics as new agents with antimicrobial activity associated with the emergence of resistant isolates.
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Affiliation(s)
| | - Mahdi Rohani
- Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran.
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10
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Wang Y, Li Q, Peng X, Li Z, Xiang J, Chen Y, Hao K, Wang S, Nie D, Cui Y, Lv F, Wang Y, Wu W, Guo D, Si H. Green synthesis of silver nanoparticles through oil: Promoting full-thickness cutaneous wound healing in methicillin-resistant Staphylococcus aureus infections. Front Bioeng Biotechnol 2022; 10:856651. [PMID: 36082170 PMCID: PMC9445837 DOI: 10.3389/fbioe.2022.856651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/04/2022] [Indexed: 11/18/2022] Open
Abstract
Due to the emergence of multi-drug resistant microorganisms, the development and discovery of alternative eco-friendly antimicrobial agents have become a top priority. In this study, a simple, novel, and valid green method was developed to synthesize Litsea cubeba essential oil-silver nanoparticles (Lceo-AgNPs) using Lceo as a reducing and capping agent. The maximum UV absorbance of Lceo-AgNPs appeared at 423 nm and the size was 5–15 nm through transmission electron microscopy result. The results of Fourier transform infrared and DLS showed that Lceo provided sufficient chemical bonds for Lceo-AgNPs to reinforce its stability and dispersion. The in vitro antibacterial effects of Lceo-AgNPs against microbial susceptible multidrug-resistant Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) were determined. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Lceo-AgNPs against E. coli were 25 and 50 μg/ml. The MIC and MBC of Lceo-AgNPs against MRSA were 50 and 100 μg/ml, respectively. The results of scanning electron microscopy showed that the amount of bacteria obviously decreased and the bacteria cells were destroyed by Lceo-AgNPs. In vivo research disclosed significant wound healing and re-epithelialization effects in the Lceo-AgNPs group compared with the self-healing group and the healing activity was better than in the sulfadiazine silver group. In this experiment, Lceo-AgNPs has been shown to have effects on killing multidrug-resistant bacteria and promoting wound healing. This study suggested Lceo-AgNPs as an excellent new-type drug for wound treatment infected with multidrug-resistant bacteria, and now expects to proceed with clinical research.
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Affiliation(s)
- Yuhan Wang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Qinmei Li
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Xiaomin Peng
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Zheng Li
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Jun Xiang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Yunru Chen
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Kaiyuan Hao
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Shuaiyang Wang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Dongyang Nie
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Yao Cui
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Feifei Lv
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Ying Wang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
| | - Wenda Wu
- Engineering Center of Innovative Veterinary Drugs, MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| | - Dawei Guo
- Engineering Center of Innovative Veterinary Drugs, MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
- *Correspondence: Dawei Guo, ; Hongbin Si,
| | - Hongbin Si
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-bioresources, College of Animal Science and Technology, Guangxi University, Nanning, China
- *Correspondence: Dawei Guo, ; Hongbin Si,
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11
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Mondain V, Retur N, Bertrand B, Lieutier-Colas F, Carenco P, Diamantis S. Advocacy for Responsible Antibiotic Production and Use. Antibiotics (Basel) 2022; 11:antibiotics11070980. [PMID: 35884234 PMCID: PMC9311909 DOI: 10.3390/antibiotics11070980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/09/2022] [Accepted: 07/12/2022] [Indexed: 11/26/2022] Open
Abstract
Antibiotic-resistant bacteria have become one of humankind’s major challenges, as testified by the UN’s Call to Action on Antimicrobial Resistance in 2021. Our knowledge of the underlying processes of antibiotic resistance is steadily improving. Beyond the inappropriate use of antimicrobials in human medicine, other causes have been identified, raising ethical issues and requiring an approach to the problem from a “One Health” perspective. Indeed, it is now clear that the two main issues regarding the subject of antibiotics are their misuse in the global food industry and their method of production, both leading to the emergence and spread of bacterial resistance.
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Affiliation(s)
- Véronique Mondain
- Centre Hospitalo-Universitaire de Nice, Service des Maladies Infectieuses et Tropicales, Hôpital Archet 1, 06202 Nice, France
- Correspondence:
| | - Nicolas Retur
- Centre Hospitalo-Universitaire de Nice, Pharmacie, Hôpital Archet 1, 06202 Nice, France;
| | | | - Florence Lieutier-Colas
- AntibioEst, Regional Antibiotic Therapy Centre, Nancy University Hospital, Brabois Hospital, 54511 Vandoeuvre-les-Nancy, France;
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12
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The Molecular Characterization and Risk Factors of ST131 and Non-ST131 Escherichia coli in Healthy Fecal Carriers in Tehran, Iran. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm-122468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Commensal extended-spectrum β-lactamase (ESBL) producing Escherichia coli isolates in the gut can be the reservoir of virulence factors and resistance genes. Objectives: We investigated the molecular feature, risk factors, and quinolone/fluoroquinolone (Q/FQ) resistance in sequence type 131 (ST131) and non-ST131: ESBL-producing E. coli (EPE) isolates in healthy fecal carriers. Methods: A total of 540 fecal samples and its demographic data were collected from healthy adults in Tehran in 2018. ST131 isolates were identified by MLST analysis, and the characteristics of the virulence factor, phylogenic assay, and Q/FQ resistance genes in ST131 and non-ST131 were determined by polymerase chain reaction (PCR). Results: The EPE isolates mainly belonged to the commensal phylogenetic groups A (54.9%) and D (18.1%). The type 1 fimbriae (fimH; 89.6%) gene was the predominant virulence factor, and there was a significant correlation between ferric yersiniabactin uptake (fyuA; 52.9%), aerobactin receptor (iutA; 17.6%), and group II capsule synthesis (kpsMII; 35.3%) with ST131. In Q/FQ-resistant isolates, qnrS (19%) was the predominant gene, and mutations mostly occurred at codon S83 in GyrA The number of mutations in gyrA and parC genes was significantly higher in ST131 isolates than in non-ST131 isolates. There was a significant positive correlation between diabetes, male gender, and living in the south of the city with EPE carriage (P < 0.05). Conclusions: Accumulation of multiple virulence factors and high- level resistance to Q/FQ in some phylogroups (B2 and D), particularly ST131 isolates, require to be considered in detecting resistant isolates in healthy carriers. According to the risk factor for spreading of EPE isolates (diabetes, living in low-income parts of the city, and male gender), the necessary strategies are required to be developed to control the dissemination of antimicrobial-resistant isolates in the community.
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13
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Gruel G, Couvin D, Guyomard-Rabenirina S, Arlet G, Bambou JC, Pot M, Roy X, Talarmin A, Tressieres B, Ferdinand S, Breurec S. High Prevalence of bla CTXM-1/IncI1-Iγ/ST3 Plasmids in Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates Collected From Domestic Animals in Guadeloupe (French West Indies). Front Microbiol 2022; 13:882422. [PMID: 35651489 PMCID: PMC9149308 DOI: 10.3389/fmicb.2022.882422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) have been classified in the group of resistant bacteria of highest priority. We determined the prevalence of ESBL-E collected in feces from household and shelter pets in Guadeloupe (French West Indies). A single rectal swab was taken from 125 dogs and 60 cats between June and September 2019. The prevalence of fecal carriage of ESBL-E was 7.6% (14/185, 95% CI: 4.2-12.4), within the range observed worldwide. The only risk factor associated with a higher prevalence of ESBL-E rectal carriage was a stay in a shelter, suggesting that refuges could be hotspots for their acquisition. All but one (Klebsiella pneumoniae from a cat) were Escherichia coli. We noted the presence of a bla CTX-M-1/IncI1-Iγ/sequence type (ST3) plasmid in 11 ESBL-producing E. coli isolates belonging to ST328 (n = 6), ST155 (n = 4) and ST953 (n = 1). A bla CTX-M-15 gene was identified in the three remaining ESBL-E isolates. The bla CTX-M-1 and most of the antimicrobial resistance genes were present in a well-conserved large conjugative IncI1-Iγ/ST3 plasmid characterized by two accessory regions containing antibiotic resistance genes. The plasmid has been detected worldwide in E. coli isolates from humans and several animal species, such as food-producing animals, wild birds and pets, and from the environment. This study shows the potential role of pets as a reservoir of antimicrobial-resistant bacteria or genes for humans and underlines the importance of basic hygiene measures by owners of companion animals.
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Affiliation(s)
- Gaëlle Gruel
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - David Couvin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | | | | | | | - Matthieu Pot
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | | | - Antoine Talarmin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Benoit Tressieres
- INSERM 1424, Center for Clinical Investigation, University Hospital Center of Guadeloupe, Pointe-à-Pitre, France
| | - Séverine Ferdinand
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Sébastien Breurec
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France.,INSERM 1424, Center for Clinical Investigation, University Hospital Center of Guadeloupe, Pointe-à-Pitre, France.,Faculty of Medicine Hyacinthe Bastaraud, University of the Antilles, Pointe-à-Pitre, France
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14
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Pellegrini MC, Okada E, González Pasayo RA, Ponce AG. Prevalence of Escherichia coli strains in horticultural farms from Argentina: antibiotic resistance, biofilm formation, and phylogenetic affiliation. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:23225-23236. [PMID: 34802078 DOI: 10.1007/s11356-021-17523-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/10/2021] [Indexed: 06/13/2023]
Abstract
Escherichia coli is the bacteria most commonly used as an indicator of fecal contamination in agricultural environments. Moreover, E. coli is categorized as a priority pathogen due to its widespread antibiotic resistance. This study aimed to characterize E. coli strains isolated from 10 horticultural farms. Isolates were obtained from samples of vegetable crops (n = 62), the surrounding soil (n = 62), poultry litter (n = 8), and groundwater (n = 6). Phyllo-grouping assignment was performed on the total of E. coli isolates. Antibiograms and quantification of the minimal inhibitory concentration (MIC) were performed with antibiotics commonly used in humans. Biofilm formation capacity was studied by quantifying cells attached to culture tubes. Overall, 21 E. coli isolates were obtained. Three phylogenetic groups (A, B1, and C) and two Escherichia clade IV and IV-V were identified in the collection by polymerase chain reaction. Sixty-seven percent of the E. coli isolates were resistant to amoxicillin-clavulanic acid and/or ampicillin. Amoxicillin MIC values ranged from 11.9 to >190.5 µg/mL and ampicillin MIC values ranged from 3 to >190.5 µg/mL. All the E. coli isolates, resistant and non-resistant, had biofilm forming capacity. The presence of phenotypic resistance on fresh produce and environmental matrices could present significant opportunities for contamination that result in health risks for consumers. To the authors' best knowledge, this is the first environmental assessment of resistant E. coli occurrence in horticultural farms in South America.
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Affiliation(s)
- María Celeste Pellegrini
- Grupo de Investigación en Ingeniería en Alimentos (GIIA), Instituto de Ciencia y Tecnología de alimentos y ambiente (INCITAA, CIC-UNMDP), Facultad de Ingeniería, Universidad Nacional de Mar del Plata, Av. Juan B. Justo 4302, B7602AYL Mar del, Plata, Argentina.
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, CABA, Argentina.
| | - Elena Okada
- Instituto Nacional de Tecnología Agropecuaria (INTA) Centro Regional Buenos Aires Sur. Estación Experimental Agropecuaria Balcarce, Ruta 226 Km 73.5, 7620, Balcarce, Argentina
| | - Ramón Alejandro González Pasayo
- Instituto Nacional de Tecnología Agropecuaria (INTA), Instituto de Innovación para la Producción Agropecuaria y Desarrollo Sostenible (IPADS, CONICET-INTA), Ruta 226 km 73.5, Balcarce, 7620, Buenos Aires, Argentina
| | - Alejandra Graciela Ponce
- Grupo de Investigación en Ingeniería en Alimentos (GIIA), Instituto de Ciencia y Tecnología de alimentos y ambiente (INCITAA, CIC-UNMDP), Facultad de Ingeniería, Universidad Nacional de Mar del Plata, Av. Juan B. Justo 4302, B7602AYL Mar del, Plata, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, CABA, Argentina
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15
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A Metagenomic Approach for Characterizing Antibiotic Resistance Genes in Specific Bacterial Populations: Demonstration with Escherichia coli in Cattle Manure. Appl Environ Microbiol 2022; 88:e0255421. [PMID: 35285243 DOI: 10.1128/aem.02554-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The high diversity of bacterial antibiotic resistance genes (ARGs) and the different health risks due to their association with different bacterial hosts require environmental ARG risk assessment to have capabilities of both high throughput and host differentiation. Current whole genome sequencing of cultivated isolates is low in throughput, while direct metagenomic next generation sequencing (mNGS) of environmental samples is nonselective with respect to bacterial hosts. This study introduced a population metagenomic approach that combines isolate library construction and mNGS of the population metagenomic DNA, which enables studying ARGs and their association with mobile genetic elements (MGEs) in a specific bacterial population. The population metagenomic approach was demonstrated with the E. coli population in cattle manure, which detected the co-location of multiple ARGs on the same MGEs and their correspondence to the prevalence of resistance phenotypes of the E. coli isolates. When compared with direct mNGS of the cattle manure samples, the E. coli population metagenomes exhibited a significantly different resistome and an overall higher relative abundance of ARGs and horizontal gene transfer risks. IMPORTANCE Bacterial antibiotic resistance genes in the environment are ubiquitous and can pose different levels of human health risks due to their bacterial host association and subsequent mobility. This study introduced a population metagenomic approach to study ARGs and their mobility in specific bacterial populations through a combination of selective cultivation followed by next generation sequencing and bioinformatic analysis of the combined metagenome of isolates. The utility of this approach was demonstrated with the E. coli population in cattle manure samples, which showed that ARGs detected in the E. coli population corresponded to the observed resistance phenotypes, co-location of multiple ARGs on the same mobile genetic elements.
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16
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Lόpez-Vélez R, Lebens M, Bundy L, Barriga J, Steffen R. Bacterial travellers' diarrhoea: A narrative review of literature published over the past 10 years. Travel Med Infect Dis 2022; 47:102293. [PMID: 35247581 DOI: 10.1016/j.tmaid.2022.102293] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 02/04/2023]
Abstract
Travellers' diarrhoea (TD) is the most frequent illness experienced by international travellers to lower-income countries with bacterial agents considered to account for 80-90% of cases. In this review, we summarise evidence published on bacterial TD over the past 10 years, focusing on the epidemiology and aetiology of TD. Diarrhoeagenic Escherichia coli (DEC) continue to be the most commonly implicated bacteria in TD, although Enteropathogenic E. coli (EPEC) and Enteroaggregative E. coli (EAEC) now appear to be predominant where Enterotoxigenic E. coli (ETEC) was previously considered most prevalent globally. Where fluroquinolone resistance had primarily been documented for Campylobacter in Southeast Asia, widespread resistance has been observed in most regions of the world for multiple enteropathogens, including Shigella, Salmonella, ETEC and EAEC. Implementation of novel molecular methods for pathogen detection has led to identification of bacterial pathogens, including Clostridium difficile (with and without the use of prior antibiotics), Arcobacter species and Bacteroides fragilis, as aetiological agents in TD. The widespread resistance to first-line antibiotics in multiple bacterial enteropathogens warrants continued surveillance and re-evaluation of current treatment practices. Further investigations are required to determine the prevalence and geographical distribution of bacterial enteropathogens that have been more recently implicated in TD.
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Affiliation(s)
- Rogelio Lόpez-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, 28034, Madrid, Spain.
| | - Michael Lebens
- Department of Microbiology and Immunology, University of Gothenburg, Box 435, SE-40530, Gothenburg, Sweden.
| | - Leah Bundy
- Elements Communications Ltd, Westerham, TN16 1RQ, UK.
| | - Juan Barriga
- Department of Medical Affairs Europe, Emergent BioSolutions, 1455, Madrid, Spain.
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, World Health Organization Collaborating Centre for Travelers' Health, University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland; Epidemiology, Human Genetics and Environmental Sciences Division, University of Texas School of Public Health, Houston, TX 77030, Texas, USA.
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17
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de Pinho Rodrigues KM, de Rezende DF, Pinto MP, Dos Santos Tufic-Garutti S, Ramalho JVA, de Araújo Longo LG, de Carvalho Girão VB, de Oliveira GC, Vilar LC, Moreira BM. High levels of gut carriage of antimicrobial-resistant Escherichia coli in community settings in Rio de Janeiro, Brazil. Braz J Microbiol 2022; 53:205-212. [PMID: 34993919 PMCID: PMC8735885 DOI: 10.1007/s42770-021-00673-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/24/2021] [Indexed: 12/01/2022] Open
Abstract
The prevalence and risk factors for gut carriage of antimicrobial-resistant Escherichia coli among individuals living in the community in Rio de Janeiro, Brazil, are unknown. The aim of this study was to determine the prevalence of colonization with antimicrobial-resistant E. coli, including isolates producing ESBL and harboring plasmid-mediated quinolone resistant (PMQR) genes in this community. We performed a cross-sectional study and analyzed fecal specimens of individuals attending outpatient clinics in the city from January 2015 to July 2019. We investigated susceptibility to antimicrobial agents by disc diffusion tests and used PCR to determine ESBL types, PMQR, and the virulence genes that characterize an isolate as extraintestinal pathogenic E. coli (ExPEC). Among the 623 subjects, 212 (34%) carried an isolate resistant to at least one of the tested antimicrobial agents, with the highest frequencies of resistance to ampicillin (26%), trimethoprim-sulfamethoxazole (19%), cefazolin (14%), and ciprofloxacin (CIP, 9%). In addition, 13% (81) of subjects carried a multidrug-resistant-E.coli (MDR-E), including 47 (8% of all isolates) ESBL-producing E. coli (ESBL-E), mainly of CTX-M-8 (15, 32%) and CTX-M-15 (9, 20%) types. PMQR genes were present in 7% (42) of all isolates, including 60% (32) of the 53 resistant to CIP. Previous use of antimicrobial agents, particularly fluoroquinolones, was a risk factor for colonization with MDR-E (25%, 20/81 vs 13%, 70/542, p = 0.01), ESBL-E (28%, 13/47, vs 13%, 77/576, p = 0.01), and resistance to CIP (26%, 14/53, vs 12%, 70/570, p = 0.01). The most pathogenic phylogroups B2, C, and D were 37% of the MDR-E, 30% of the ESBL-E, 38% of the CIP-resistant, and 31% of PMQR gene carrying E. coli isolates. We show that carriage of MDR-E (mostly ESBL-E) reached high levels in the community in Rio de Janeiro, increased by the selection of antimicrobial agents. Much of the resistant E. coli isolates are potential pathogenic strains. The widespread use of antimicrobial agents during the COVID-19 pandemic in Brazil may have worsened this picture.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lucas Cecílio Vilar
- Instituto de Microbiologia Paulo de Góes, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Beatriz Meurer Moreira
- Instituto de Microbiologia Paulo de Góes, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil. .,Laboratório de Investigação Em Microbiologia Médica (LIMM), Instituto de Microbiologia Paulo de Góes, Universidade Federal Do Rio de Janeiro, Av. Carlos Chagas Filho, 373; Centro de Ciências da Saúde, Bloco i, Sala I2-59, CEP 21941-902, Rio de Janeiro, RJ, Brazil.
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18
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Desai AN, Mohareb AM, Hauser N, Abbara A. Antimicrobial Resistance and Human Mobility. Infect Drug Resist 2022; 15:127-133. [PMID: 35046676 PMCID: PMC8763254 DOI: 10.2147/idr.s305078] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/21/2021] [Indexed: 01/21/2023] Open
Affiliation(s)
- Angel N Desai
- Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, CA, USA
- Global Migration Center, University of California Davis, Davis, CA, USA
- Correspondence: Angel N Desai Department of Internal Medicine, Division of Infectious Diseases, University of California Davis, Sacramento, CA, USATel +1 9167340168Fax +1 251 333115250 Email
| | - Amir M Mohareb
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Naomi Hauser
- Department of Internal Medicine, Division of Infectious Diseases, University of California Davis Medical Center, Sacramento, CA, USA
| | - Aula Abbara
- Department of Infection, Imperial College, London, UK
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19
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Wu PC, Cheng MF, Chen WL, Hung WY, Wang JL, Hung CH. Risk Factors and Prevalence of mcr-1-Positive Escherichia coli in Fecal Carriages Among Community Children in Southern Taiwan. Front Microbiol 2021; 12:748525. [PMID: 34867866 PMCID: PMC8640213 DOI: 10.3389/fmicb.2021.748525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/25/2021] [Indexed: 12/24/2022] Open
Abstract
Colistin is the last resort antimicrobial for treating multidrug-resistant gram-negative bacterial infections. The plasmid-mediated colistin resistance gene, mcr-1, crucially influences colistin’s resistance transmission. Human fecal carriages of mcr-1-positive Escherichia coli (E. coli) were detected in many regions worldwide; however, only a few studies have focused on children. Therefore, we identified the prevalence and risk factors of mcr-1-positive E. coli in fecal carriages among community children in Southern Taiwan. In this study, 510 stool samples were collected from April 2016 to August 2019 from the pediatric department at a medical center in Southern Taiwan. These samples were collected within 3 days after admission and were all screened for the presence of the mcr-1 gene. Diet habits, travel history, pet contact, and medical history were also obtained from participants to analyze the risk factors of their fecal carriages to mcr-1-positive E. coli. Antimicrobial susceptibility testing was determined using the VITEK 2 system and the broth microdilution test. Twelve mcr-1-positive E. coli. were isolated from 2.4% of the fecal samples. Through multivariate analysis, frequent chicken consumption (at least 3 times per week) had a significantly positive association with the presence of mcr-1-positive E. coli in fecal carriages (adjust odds ratio 6.60, 95% confidence interval1.58– 27.62, p = 0.033). Additionally, multidrug resistance was more common in mcr-1-positive E. coli. (75.0% vs. 39.5%, p = 0.031) than in non-mcr-1-positive Escherichia coli. Furthermore, the percentage of extraintestinal pathogenic E. coli in mcr-1-positive isolates was 83.3%. Some multi-locus sequence types in our mcr-1-positive E. coli were also similar to those isolated from food animals in the literature. The prevalence of fecal carriages of mcr-1-positive E. coli was low among community children in Southern Taiwan. Our data shows that chicken consumption with a higher frequency increases the risk of mcr-1-positive E. coli. in fecal carriages.
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Affiliation(s)
- Pin-Chieh Wu
- Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan.,Department of Physical Examination Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Ming-Fang Cheng
- Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan.,Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Wan-Ling Chen
- Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Wan-Yu Hung
- Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Jiun-Ling Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.,Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsin Hung
- Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan
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20
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Takawira FT, Pitout JD, Thilliez G, Mashe T, Gutierrez AV, Kingsley RA, Peirano G, Matheu J, Midzi SM, Mwamakamba LW, Gally DL, Tarupiwa A, Mukavhi L, Ehlers MM, Mtapuri-Zinyowera S, Kock MM. Molecular epidemiology of extended-spectrum beta-lactamase-producing extra-intestinal pathogenic Escherichia coli strains over a 2-year period (2017-2019) from Zimbabwe. Eur J Clin Microbiol Infect Dis 2021:10.1007/s10096-021-04379-z. [PMID: 34779943 DOI: 10.1007/s10096-021-04379-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
This study was designed to characterize extended-spectrum beta-lactamase (ESBL)-producing extra-intestinal pathogenic Escherichia coli (E.coli) (ExPEC) associated with urinary tract infections in nine different geographic regions of Zimbabwe over a 2-year period (2017-2019). A total of 48 ESBL-positive isolates from urine specimen were selected for whole-genome sequencing from 1246 Escherichia coli isolates biobanked at the National Microbiology Reference laboratory using phenotypic susceptibility testing results from the National Escherichia coli Surveillance Programme to provide representation of different geographical regions and year of isolation. The majority of ESBL E. coli isolates produced cefotaximase-Munich (CTX-M)-15, CTX-M-27, and CTX-M-14. In this study, sequence types (ST) 131 and ST410 were the most predominant antimicrobial-resistant clones and responsible for the increase in ESBL-producing E. coli strains since 2017. Novel ST131 complex strains were recorded during the period 2017 to 2018, thus showing the establishment and evolution of this antimicrobial-resistant ESBL clone in Zimbabwe posing an important public health threat. Incompatibility group F plasmids were predominant among ST131 and ST410 isolates with the following replicons recorded most frequently: F1:A2:B20 (9/19, 47%), F2:A1: B (5/19, 26%), and F1:A1:B49 (8/13, 62%). The results indicate the need for continuous tracking of different ESBL ExPEC clones on a global scale, while targeting specific STs (e.g. ST131 and ST410) through control programs will substantially decrease the spread of ESBLs among ExPEC.
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Affiliation(s)
- Faustinos Tatenda Takawira
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
- National Microbiology Reference Laboratory, Harare, Zimbabwe
| | - Johann Dd Pitout
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
- Department of Microbiology, Alberta Precision Laboratories, Department Pathology and Laboratory Medicine, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Tapfumanei Mashe
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
- National Microbiology Reference Laboratory, Harare, Zimbabwe
| | | | | | - Gisele Peirano
- Department of Microbiology, Alberta Precision Laboratories, Department Pathology and Laboratory Medicine, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jorge Matheu
- World Health Organization (WHO), Geneva, Switzerland
| | | | | | - David L Gally
- Division of Infection and Immunity, The Roslin Institute, The University of Edinburgh, Edinburgh, Scotland
| | - Andrew Tarupiwa
- National Microbiology Reference Laboratory, Harare, Zimbabwe
| | - Leckson Mukavhi
- University of Zimbabwe College of Health Sciences, Health Professions Education, Harare, Zimbabwe
| | - Marthie M Ehlers
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
- National Health Laboratory Service, Academic Division, Pretoria, South Africa
| | | | - Marleen M Kock
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.
- National Health Laboratory Service, Academic Division, Pretoria, South Africa.
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21
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Use of molecular methods to detect Shigella and infer phenotypic resistance in a Shigella treatment study. J Clin Microbiol 2021; 60:e0177421. [PMID: 34669456 DOI: 10.1128/jcm.01774-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Molecular diagnostic methods improve detection of Shigella yet their ability to detect Shigella drug resistance on direct stool specimens is less clear. We tested 673 stools from a Shigella treatment study in Bangladesh, including 154 culture-positive stools and their paired Shigella isolate. We utilized a TaqMan Array Card that included qPCR assays for 24 enteropathogens and 36 antimicrobial resistance (AMR) genes. Shigella was detected by culture in 23% of stools (154/673) while qPCR detected Shigella at diarrhea-associated quantities in 49% (329/673; P <0.05). qPCR for AMR genes on the Shigella isolates yielded >94% sensitivity and specificity compared with the phenotypic susceptibility results for azithromycin and ampicillin. Performance for trimethoprim-sulfamethoxazole susceptibility was less robust and assessment of ciprofloxacin was limited because most isolates were resistant. Detection of AMR genes in direct stool generally yielded low specificities for predicting the resistance of the paired isolate, whereas the sensitivity and negative predictive values for predicting susceptibility were often higher. For example, detection of ermB or mphA in stool yielded a specificity of 56% but a sensitivity of 91% and negative predictive value of 91% versus the paired isolate. Patients that received azithromycin prior to presentation were universally culture negative (0/112), however qPCR still detected Shigella at diarrhea-associated quantities in 34/112 (30%). In sum, molecular diagnostics on direct stool greatly increases diagnostic yield for Shigella, including in the setting of prior antibiotics. Molecular detection of drug resistance genes in direct stool had low specificity for confirming resistance but could potentially "rule out" macrolide resistance.
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22
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Rincón-Gamboa SM, Poutou-Piñales RA, Carrascal-Camacho AK. Analysis of the assessment of antimicrobial susceptibility. Non-typhoid Salmonella in meat and meat products as model (systematic review). BMC Microbiol 2021; 21:223. [PMID: 34340654 PMCID: PMC8328484 DOI: 10.1186/s12866-021-02268-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The scientific publications of antimicrobial susceptibilities and resistance must be precise, with interpretations adjusted to the standard. In this frame, knowledge of antimicrobial resistance is fundamental in pathogenic microorganisms such as Salmonella spp., known for many annual deaths worldwide. The objective of this work was to compare the interpretation of standards, the concentrations, and the breakpoints, to study antimicrobial resistance in Non-Typhoidal Salmonella (NTS) isolated from beef, pork, and chicken meat, meat products, and propose additional considerations that improve the use and usefulness of published results. RESULTS After refining the search based on meeting the inclusion and exclusion criteria, 48 papers were selected. In 33 (68.8%) of them, the disc diffusion method was used, in 11 (22.9%) the MIC determination method, and in 4 (8.33%) were used both. In 24 (50%) of the articles, the selection of a different (correct) standard could have had an impact on the interpretation of antimicrobial susceptibility, which observed when considering three scenarios, i) comparison between the year of the isolation versus the implemented standard, ii) comparison between the year of submission versus implemented standard and iii) comparison between the year of publication versus implemented standard. CONCLUSIONS The most frequent scenario was the inadequate selection of standards, indicating that some studies had not ensured that applied standards kept in line with the date of isolation, date of publication and interpretation of susceptibilities. We proposed 2 years for standards use for resistance and multi-resistance interpretations. On the other hand, we invite researchers to publish their results in the shortest possible time, and editors and reviewers of scientific journals to prioritise these types of studies and verify the correspondence between the standard cited and the one used and the one to be taken into account.
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Affiliation(s)
- Sandra M Rincón-Gamboa
- Laboratorio de Microbiología de Alimentos. Grupo de Biotecnología Ambiental e Industrial (GBAI), Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
- Laboratorio Biotecnología Molecular. Grupo de Biotecnología Ambiental e Industrial (GBAI), Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Raúl A Poutou-Piñales
- Laboratorio Biotecnología Molecular. Grupo de Biotecnología Ambiental e Industrial (GBAI), Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia.
| | - Ana K Carrascal-Camacho
- Laboratorio de Microbiología de Alimentos. Grupo de Biotecnología Ambiental e Industrial (GBAI), Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
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23
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Prevalence and risk factors for faecal carriage of multidrug resistant Escherichia coli among slaughterhouse workers. Sci Rep 2021; 11:13362. [PMID: 34172803 PMCID: PMC8233315 DOI: 10.1038/s41598-021-92819-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
The increasing occurrence of antimicrobial-resistant Escherichia coli in human and animal population has become a global public health problem that requires immediate intervention. We aimed to investigate prevalence and risk factors for faecal carriage of drug-resistant E. coli among slaughterhouse workers. We conducted this cross-sectional study among 118 apparently healthy workers in the largest slaughterhouses in Abuja and Lagos from July to December 2020. E. coli was isolated from stool samples of slaughterhouse workers and antimicrobial susceptibility testing performed using the Kirby-Bauer disk diffusion method. Multi-drug resistance (MDR) was defined as resistance to three or more classes of antibiotics. Majority were males: 88.1% (n = 104), aged > 41 years: 28.8% (n = 34), married: 70.3% (n = 83), and were butchers: 53.4% (n = 63). Prevalence of MDR E. coli was 50% (n = 59), highest among butchers compared to slaughterhouse cleaners. Of 75 E. coli isolates identified, 25.3% (n = 19) were ESBL producers; 78.7% (n = 59) were MDR. Keeping animals (p = 0.01); eating at the slaughterhouse (p = 0.03) and collecting waste (p = 0.02) remained independent risk factors for acquiring MDR E. coli. Prevalence of resistant E. coli was highest among butchers and associated with keeping animals at home, eating at work, and waste-collection. Hand-hygiene and responsible use of antibiotics among slaughterhouse workers should be encouraged.
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Hu Y, Rubin J, Mussio K, Riley LW. Risk factors for faecal carriage of multidrug-resistant Escherichia coli in a college community: a penalised regression model. J Glob Antimicrob Resist 2021; 26:166-173. [PMID: 34051401 DOI: 10.1016/j.jgar.2021.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/02/2021] [Accepted: 05/16/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Bacterial antimicrobial resistance is a serious global public-health threat. Intestinal commensal drug-resistant bacteria have been suggested as an important reservoir of antimicrobial resistance genes (ARGs), which may be acquired via food. We aimed to identify risk factors associated with faecal carriage of drug-resistant commensal Escherichia coli among healthy adults focused on their dietary habits. METHODS We conducted a cross-sectional study targeting healthy adult volunteers in a college community. Faecal samples and questionnaires were obtained from 113 volunteers. We conducted backward elimination logistic regression and least absolute shrinkage and selection operator (LASSO) methods to identify risk factors. RESULTS We analysed responses from 81 of 113 volunteers who completed the questionnaire. The logistic regression and LASSO methods identified red meat consumption to be associated with an increased risk [OR = 6.13 (95% CI 1.83-24.2) and 1.82, respectively] and fish consumption with a reduced risk [OR = 0.27 (95% CI 0.08-0.85) and 0.81] for carriage of multidrug-resistant (MDR) E. coli, adjusted for biological sex, employment status, frequently used supermarket and previous travel. CONCLUSION Dietary habits are associated with risk of faecal carriage of MDR E. coli. This study supports the growing evidence that food may be an important source of ARGs present in human commensal E. coli.
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Affiliation(s)
- Yuan Hu
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA.
| | - Julia Rubin
- Division of Environmental Health Science, School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
| | - Kaitlyn Mussio
- Division of Environmental Health Science, School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
| | - Lee W Riley
- Division of Infectious Diseases and Immunology, School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
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25
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Thomas CM, Morkeberg OH, Walker PF, Stauffer WM. The cost of global connectivity: Faster and more efficient spread of antimicrobial resistance by international travelers - A controversial commentary. Travel Med Infect Dis 2021; 41:102045. [PMID: 33798743 DOI: 10.1016/j.tmaid.2021.102045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
Although the relationship between human mobility and global dissemination of antimicrobial resistance (AMR) is well established, there are important aspects regarding dynamics and character of this spread that have not been well described such as the decreasing time from emergence to global dissemination. In addition, AMR spread through migrants is increasingly being discussed and examined. We believe caution should be exercised to not overly focus on this population since we believe migrants play a minor role and there is a history of stigmatizing and blaming migrants for emerging infections and disease outbreaks. International travelers are proportionately much more likely to perpetuate AMR spread due to the vastly greater volume combined with the increasing efficiency and speed at which they travel. Research, infection prevention measures, and policy development are likely to have the greatest impact if focused on the international traveler rather than on migrant populations.
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Affiliation(s)
- Christine M Thomas
- Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA.
| | - Olaf H Morkeberg
- Undergraduate Studies, Department of Biology, Department of Exercise Science, St. Olaf College, Northfield, MN, USA
| | - Patricia F Walker
- Health Partners Institute, Bloomington, MN, USA; Department of Medicine, Global Health Medicine, University of Minnesota, Minneapolis, MN, USA
| | - William M Stauffer
- Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA.
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26
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Davtyan H, Grigoryan R, Niazyan L, Davidyants M, Ghalechyan T, Davtyan K. Antimicrobial Resistance in a Tertiary Care Hospital in Armenia: 2016-2019. Trop Med Infect Dis 2021; 6:tropicalmed6010031. [PMID: 33800026 PMCID: PMC8005984 DOI: 10.3390/tropicalmed6010031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 01/15/2023] Open
Abstract
Antimicrobial resistance (AMR) is the acquired ability of pathogens to withstand antimicrobial treatment. To bridge the gap in knowledge for implementing effective and targeted interventions in relation to the AMR in Armenia, we designed this study to explore the performance of AMR diagnostics and the profile of AMR in the Nork Infection Clinical Hospital (NICH) for the period of 2016-2019, particularly to (i) determine the proportions of antimicrobial resistance among all samples tested at the hospital laboratory, (ii) determine the proportion of resistance against specific antimicrobials, and (iii) identify factors associated with AMR. A cross-sectional study was conducted with a secondary data analysis that included all the patients tested for AMR in the laboratory of the NICH for the period of 2016-2019. For this period, only 107 (0.3%) patients out of 36,528 had their AMR test results available and of them, 87 (81%) had resistance at least to one tested antimicrobial. This study has provided some valuable information on the AMR situation in Armenia. The results call for immediate actions to control the access to and the use of antimicrobials, strengthen AMR surveillance, and improve laboratory capacity for the proper and fast identification of drug resistance through a comprehensive system.
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Affiliation(s)
- Hayk Davtyan
- Tuberculosis Research and Prevention Center NGO, Yerevan 0014, Armenia; (H.D.); (R.G.)
| | - Ruzanna Grigoryan
- Tuberculosis Research and Prevention Center NGO, Yerevan 0014, Armenia; (H.D.); (R.G.)
| | - Lyudmila Niazyan
- Nork Infection Clinical Hospital of Ministry of Health of Armenia, Yerevan 0047, Armenia; (L.N.); (M.D.); (T.G.)
| | - Mher Davidyants
- Nork Infection Clinical Hospital of Ministry of Health of Armenia, Yerevan 0047, Armenia; (L.N.); (M.D.); (T.G.)
| | - Tehmine Ghalechyan
- Nork Infection Clinical Hospital of Ministry of Health of Armenia, Yerevan 0047, Armenia; (L.N.); (M.D.); (T.G.)
| | - Karapet Davtyan
- Tuberculosis Research and Prevention Center NGO, Yerevan 0014, Armenia; (H.D.); (R.G.)
- Correspondence: ; Tel.: +374-77-077793
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