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Nery Garcia BL, Dantas STA, da Silva Barbosa K, Mendes Mitsunaga T, Butters A, Camargo CH, Nobrega DB. Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Other Antimicrobial-Resistant Gram-Negative Pathogens Isolated from Bovine Mastitis: A One Health Perspective. Antibiotics (Basel) 2024; 13:391. [PMID: 38786120 PMCID: PMC11117280 DOI: 10.3390/antibiotics13050391] [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: 03/31/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/25/2024] Open
Abstract
Antimicrobial resistance (AMR) poses an imminent threat to global public health, driven in part by the widespread use of antimicrobials in both humans and animals. Within the dairy cattle industry, Gram-negative coliforms such as Escherichia coli and Klebsiella pneumoniae stand out as major causative agents of clinical mastitis. These same bacterial species are frequently associated with severe infections in humans, including bloodstream and urinary tract infections, and contribute significantly to the alarming surge in antimicrobial-resistant bacterial infections worldwide. Additionally, mastitis-causing coliforms often carry AMR genes akin to those found in hospital-acquired strains, notably the extended-spectrum beta-lactamase genes. This raises concerns regarding the potential transmission of resistant bacteria and AMR from mastitis cases in dairy cattle to humans. In this narrative review, we explore the distinctive characteristics of antimicrobial-resistant E. coli and Klebsiella spp. strains implicated in clinical mastitis and human infections. We focus on the molecular mechanisms underlying AMR in these bacterial populations and critically evaluate the potential for interspecies transmission. Despite some degree of similarity observed in sequence types and mobile genetic elements between strains found in humans and cows, the existing literature does not provide conclusive evidence to assert that coliforms responsible for mastitis in cows pose a direct threat to human health. Finally, we also scrutinize the existing literature, identifying gaps and limitations, and propose avenues for future research to address these pressing challenges comprehensively.
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Affiliation(s)
- Breno Luis Nery Garcia
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga 13635-900, SP, Brazil; (B.L.N.G.); (S.T.A.D.); (K.d.S.B.); (T.M.M.)
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Stéfani Thais Alves Dantas
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga 13635-900, SP, Brazil; (B.L.N.G.); (S.T.A.D.); (K.d.S.B.); (T.M.M.)
| | - Kristian da Silva Barbosa
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga 13635-900, SP, Brazil; (B.L.N.G.); (S.T.A.D.); (K.d.S.B.); (T.M.M.)
| | - Thatiane Mendes Mitsunaga
- Department of Animal Nutrition and Production, School of Veterinary Medicine and Animal Science, University of São Paulo, Pirassununga 13635-900, SP, Brazil; (B.L.N.G.); (S.T.A.D.); (K.d.S.B.); (T.M.M.)
| | - Alyssa Butters
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | | | - Diego Borin Nobrega
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
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AL-Muzahmi M, Rizvi M, AL-Quraini M, AL-Muharrmi Z, AL-Jabri Z. Comparative Genomic Analysis Reveals the Emergence of ST-231 and ST-395 Klebsiella pneumoniae Strains Associated with the High Transmissibility of blaKPC Plasmids. Microorganisms 2023; 11:2411. [PMID: 37894068 PMCID: PMC10608898 DOI: 10.3390/microorganisms11102411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023] Open
Abstract
Conjugative transposons in Gram-negative bacteria have a significant role in the dissemination of antibiotic-resistance-conferring genes between bacteria. This study aims to genomically characterize plasmids and conjugative transposons carrying integrons in clinical isolates of Klebsiella pneumoniae. The genetic composition of conjugative transposons and phenotypic assessment of 50 multidrug-resistant K. pneumoniae isolates from a tertiary-care hospital (SQUH), Muscat, Oman, were investigated. Horizontal transferability was investigated by filter mating conjugation experiments. Whole-genome sequencing (WGS) was performed to determine the sequence type (ST), acquired resistome, and plasmidome of integron-carrying strains. Class 1 integrons were detected in 96% of isolates and, among integron-positive isolates, 18 stains contained variable regions. Horizontal transferability by conjugation confirmed the successful transfer of integrons between cells and WGS confirmed their presence in conjugative plasmids. Dihydrofolate reductase (dfrA14) was the most prevalent (34.8%) gene cassette in class 1 integrons. MLST analysis detected predominantly ST-231 and ST-395. BlaOXA-232 and blaCTX-M-15 were the most frequently detected carbapenemases and beta-lactamases in the sequenced isolates. This study highlighted the high transmissibility of MDR-conferring conjugative plasmids in clinical isolates of K. pneumoniae. Therefore, the wise use of antibiotics and the adherence to effective infection control measures are necessary to limit the further dissemination of multidrug-resistant bacteria.
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Affiliation(s)
| | - Meher Rizvi
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman;
| | - Munawr AL-Quraini
- Microbiology and Immunology Diagnostic Laboratory, Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Muscat 123, Oman; (M.A.-Q.); (Z.A.-M.)
| | - Zakariya AL-Muharrmi
- Microbiology and Immunology Diagnostic Laboratory, Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Muscat 123, Oman; (M.A.-Q.); (Z.A.-M.)
| | - Zaaima AL-Jabri
- Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman;
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Fadare FT, Fadare TO, Okoh AI. Prevalence, molecular characterization of integrons and its associated gene cassettes in Klebsiella pneumoniae and K. oxytoca recovered from diverse environmental matrices. Sci Rep 2023; 13:14373. [PMID: 37658232 PMCID: PMC10474106 DOI: 10.1038/s41598-023-41591-7] [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: 07/18/2022] [Accepted: 08/29/2023] [Indexed: 09/03/2023] Open
Abstract
The high prevalence of infections arising from Klebsiella species is related to their ability to acquire and disseminate exogenous genes associated with mobile genetic elements such as integrons. We assessed the prevalence, diversity, and associated gene cassettes (GCs) of integrons in Klebsiella species. The isolates recovered from wastewater and hospital effluents, rivers, and animal droppings were identified using the conventional Polymerase Chain Reaction (PCR) with primers targeting the gryA, pehX, and 16S-23S genes. The antimicrobial resistance profile and the Extended-Spectrum and Metallo β-lactamases production were carried out using standard microbiological techniques. PCR, DNA sequencing analyses, and Restriction Fragment Length Polymorphism were used to characterize the integrons and their associated GCs. Furthermore, the genotypic relationships between the different isolated K. pneumoniae were determined using Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR. About 98% (51/52) of the confirmed isolates harboured an integrase gene, with 80% intI1, while the remaining 20% concurrently harboured intI1 and intI2, with no intI3 observed. About 78% (40/51) of the bacterial strains were positive for a promoter, the P2R2, investigated, while 80% (41/51) harboured at least one of the qacEΔ1 and sul1. Three different GCs arrangements identified were aac(6')-Ib, aadA1-dfrA1, and dfrA1-sat2. At a similarity index of 60%, the ERIC-PCR fingerprints generated were categorized into nine clusters. Our study is the first to reveal the features of integrons in Klebsiella spp. recovered from environmental sources in the Eastern Cape Province, South Africa. We conclude that the organisms' sources are repositories of integrons harbouring various gene cassettes, which can be readily mobilized to other microorganisms in similar or varied niches.
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Affiliation(s)
- Folake Temitope Fadare
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, South Africa.
- Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, Alice, South Africa.
| | - Taiwo Olawole Fadare
- Department of Microbiology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Anthony Ifeanyi Okoh
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, South Africa
- Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, Alice, South Africa
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Wang L, Zhu M, Yan C, Zhang Y, He X, Wu L, Xu J, Lu J, Bao Q, Hu Y, Xu T, Liang J. Class 1 integrons and multiple mobile genetic elements in clinical isolates of the Klebsiella pneumoniae complex from a tertiary hospital in eastern China. Front Microbiol 2023; 14:985102. [PMID: 36950157 PMCID: PMC10026359 DOI: 10.3389/fmicb.2023.985102] [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: 07/03/2022] [Accepted: 02/07/2023] [Indexed: 03/08/2023] Open
Abstract
Background The emergence of highly drug-resistant K. pneumoniae, has become a major public health challenge. In this work, we aim to investigate the diversity of species and sequence types (STs) of clinical Klebsiella isolates and to characterize the prevalence and structure of class 1 integrons. Methods Based on the whole genome sequencing, species identification was performed by 16S rRNA gene homology and average nucleotide identity (ANI) analysis. STs were determined in accordance with the international MLST schemes for K. pneumoniae and K. variicola. Integron characterization and comparative genomic analysis were performed using various bioinformatic tools. Results Species identification showed that the 167 isolates belonged to four species: K. pneumoniae, K. variicola subsp. variicola, K. quasipneumoniae and K. aerogenes. Thirty-six known and 5 novel STs were identified in K. pneumoniae, and 10 novel STs were identified in K. variicola subsp. variicola. Class 1 integrons were found in 57.49% (96/167) of the isolates, and a total of 169 resistance gene cassettes encoding 19 types of resistance genes, including carbapenem resistance gene (bla IPM-4) and class D β-lactamases gene (bla OXA-1 and bla OXA-10), were identified. Among the 17 complete genomes, 29 class 1 integrons from 12 groups were found, only 1 group was encoded on chromosomes. Interestingly, one plasmid (pKP167-261) carrying two copies of approximately 19-kb IS26-Int1 complex resistance region that contains an integron and a multidrug resistance gene fragment. Conclusion The results of this work demonstrated that the species and STs of the clinical Klebsiella isolates were more complex by the whole genome sequence analysis than by the traditional laboratory methods. Finding of the new structure of MGEs related to the resistance genes indicates the great importance of deeply exploring the molecular mechanisms of bacterial multidrug resistance.
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Affiliation(s)
- Lan Wang
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Mei Zhu
- Department of Clinical Laboratory, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Chunxia Yan
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Yanfang Zhang
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Xuying He
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Lin Wu
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Jiefeng Xu
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Junwan Lu
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
| | - Qiyu Bao
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yunliang Hu
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
| | - Teng Xu
- Institute of Translational Medicine, Baotou Central Hospital, Baotou, China
- *Correspondence: Teng Xu,
| | - Jialei Liang
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, China
- The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- Jialei Liang,
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Shahid M, Ahmad N, Saeed NK, Shadab M, Joji RM, Al-Mahmeed A, Bindayna KM, Tabbara KS, Dar FK. Clinical carbapenem-resistant Klebsiella pneumoniae isolates simultaneously harboring blaNDM-1, blaOXA types and qnrS genes from the Kingdom of Bahrain: Resistance profile and genetic environment. Front Cell Infect Microbiol 2022; 12:1033305. [PMID: 36304935 PMCID: PMC9592905 DOI: 10.3389/fcimb.2022.1033305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022] Open
Abstract
The prevalence of Carbapenem-resistant Klebsiella pneumoniae (CRKP) is currently increasing worldwide, prompting WHO to classify it as an urgent public health threat. CRKP is considered a difficult to treat organism owing to limited therapeutic options. In this study, a total of 24 CRKP clinical isolates were randomly collected from Salmaniya Medical Complex, Bahrain. Bacterial identification and antibiotic susceptibility testing were performed, on MALDI-TOF and VITEK-2 compact, respectively. The isolates were screened for carbapenem resistance markers (blaNDM,blaOXA-23,blaOXA-48 and blaOXA-51) and plasmid-mediated quinolone resistance genes (qnrA, qnrB, and qnrS) by monoplex PCR. On the other hand, only colistin-resistant isolates (n=12) were screened for MCR-1, MCR-2 and MCR-3 genes by monoplex PCR. Moreover, the Genetic environment of blaNDM, integrons analysis, and molecular characterization of plasmids was also performed. Antibiotic susceptibility revealed that all the isolates (100%) were resistant to ceftolozane/tazobactam, piperacillin/tazobactam, 96% resistant to ceftazidime, trimethoprim/sulfamethoxazole, 92% resistant to meropenem, gentamicin and cefepime, 88% resistant to ciprofloxacin, imipenem, and 37% resistant to amikacin. Ceftazidime/avibactam showed the least resistance (12%). 75% (n=12/16) were resistant to colistin and 44% (n=7/16) showed intermediate susceptibility to tigecycline. The detection of resistant determinants showed that the majority (95.8%) of CRKP harbored blaNDM-1, followed by blaOXA-48 (91.6%) blaOXA-51 (45.8%), and blaOXA-23 (41.6%). Sequencing of the blaNDM amplicons revealed the presence of blaNDM-1. Alarmingly, 100% of isolates showed the presence of qnrS. These predominant genes were distributed in various combinations wherein the majority were blaNDM-1 + blaOXA-51+ qnrS + blaOXA-48 (n =10, 41.7%), blaNDM-1 + blaOXA-23+ qnrS + blaOXA-48 (n=8, 33.3%), among others. In conclusion, the resistance rate to most antibiotics is very high in our region, including colistin and tigecycline, and the genetic environment of CRKP is complex with the carriage of multiple resistance markers. Resistance to ceftazidime/avibactam is uncommon and hence can be used as a valuable option for empirical therapy. Molecular data on resistance markers and the genetic environment of CRKP is lacking from this geographical region; this would be the first report addressing the subject matter. Surveillance and strict infection control strategies should be reinforced in clinical settings to curb the emergence and spread of such isolates.
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Affiliation(s)
- Mohammad Shahid
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
- *Correspondence: Mohammad Shahid,
| | - Nayeem Ahmad
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Nermin Kamal Saeed
- Department of Pathology, Microbiology Section, Salmaniya Medical Complex, Manama, Bahrain
| | - Mohd Shadab
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ronni Mol Joji
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ali Al-Mahmeed
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Khalid M. Bindayna
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Khaled Saeed Tabbara
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Fazal K. Dar
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Fadare FT, Elsheikh EAE, Okoh AI. In Vitro Assessment of the Combination of Antibiotics against Some Integron-Harbouring Enterobacteriaceae from Environmental Sources. Antibiotics (Basel) 2022; 11:antibiotics11081090. [PMID: 36009959 PMCID: PMC9404769 DOI: 10.3390/antibiotics11081090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
One strategy for combating antimicrobial resistance in many infections is to combine antibacterial compounds to create combinations that outperform each molecule alone. In this study, we examine and study the inhibitory effect of combining two drugs belonging to different antibiotic classes to obtain a possible potentiating effect against some Enterobacteriaceae isolates harbouring integrons recovered from rivers and effluents of hospital and wastewater treatment plants in Eastern Cape Province, South Africa. These integrons could easily enable the isolates to acquire genes that confer additional resistance against conventional antibiotics. The minimum inhibitory concentration of the various antibiotics was determined using the broth microdilution, while the checkerboard method was used to determine the fractional inhibitory concentration indices (FICIs). A total of 26.3% (10/38) of the interactions were categorised as synergistic, while 73.7% (28/38) were indifferent. None of the combinations were antagonistic. The time–kill assays revealed all the synergistic interactions as bactericidal. Therefore, the combinations of gentamicin with tetracycline, ciprofloxacin, and ceftazidime against multidrug-resistant (MDR) Klebsiella pneumoniae, tetracycline–ceftazidime combination against MDR Escherichia coli, colistin combinations with ceftazidime and gentamicin, and tetracycline–gentamicin combinations against MDR Citrobacter freundii may be future therapeutic alternatives. Hence, the synergistic combinations reported in this study must be assessed further in vivo before their clinical applications.
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Affiliation(s)
- Folake Temitope Fadare
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice 5700, South Africa
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice 5700, South Africa
- Correspondence:
| | - Elsiddig A. E. Elsheikh
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
| | - Anthony Ifeanyin Okoh
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice 5700, South Africa
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice 5700, South Africa
- Department of Environmental Health Sciences, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
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Asghari B, Goodarzi R, Mohammadi M, Nouri F, Taheri M. Detection of mobile genetic elements in multidrug-resistant Klebsiella pneumoniae isolated from different infection sites in Hamadan, west of Iran. BMC Res Notes 2021; 14:330. [PMID: 34446103 PMCID: PMC8394604 DOI: 10.1186/s13104-021-05748-9] [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: 05/20/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022] Open
Abstract
Objective Klebsiella pneumoniae is one of most opportunistic pathogens that can be related to nosocomial infections. Increased acquisitions of multidrug resistance in this bacterium as well as the transfer of genes to other strains have caused concern. Integrons play key role in the acquisition and the spread of resistance genes. The aim of this study was evaluated the frequency of resistance genes sulI, sulII, tetA, tetB, class I (intI gene), class II integrons (intII gene) and the association between multidrug resistance and the presence of integrons in K. pneumoniae. Results Antibiotics susceptibility test was performed on 126 of K. pneumoniae isolates. Also, DNA extraction was done and genes were detected using PCR method. In this study, 67 isolates (53%), carrying both the sulI and sulII genes. Forty-five percent tetracycline-resistant isolates were tetA or tetB positive. The prevalence of intI gene was 96%, while only sixteen isolate harboring intII gene (12.5%). Our results showed the high prevalence of integrons in MDR K. pneumoniae, indicating the important role of these genes in the transmission of antibiotic resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05748-9.
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Affiliation(s)
- Babak Asghari
- Department of Medical Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rezvan Goodarzi
- Department of Medical Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Milad Mohammadi
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Nouri
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Mohammad Taheri
- Department of Medical Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
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Ajayi AO, Perry B, Yost CK, Jamieson R, Truelstrup Hansen L, Rahube T. Comparative Genomic Analyses of the β-lactamase (blaCMY-42) Encoding Plasmids Isolated from Wastewater Treatment Plants in Canada. Can J Microbiol 2021; 67:737-748. [PMID: 34077692 DOI: 10.1139/cjm-2021-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Wastewater treatment plants are useful environments for investigating the occurrence, diversity, and evolution of plasmids encoding clinically relevant antibiotic resistance genes. Our objective was to isolate and sequence plasmids encoding meropenem resistance from bacterial hosts within Canadian WWTPs. We used two enrichment culture approaches for primary plasmid isolation, followed by screening of antibiotic resistance, conjugative mobility, and stability in enteric bacteria. Isolated plasmids were sequenced using Illumina MiSeq and Sanger sequencing methods. Bioinformatics analyses resolved a multi-resistance IncF/MOBF12 plasmid, pFEMG (209,357 bp), harbouring resistance genes to beta-lactam (blaCMY-42, blaTEM-1β, and blaNDM-5), macrolide (mphA-mrx-mphR), tetracycline (tetR-tetB-tetC-tetD), trimethoprim (dfrA12), aminoglycoside (aadA2), and sulfonamide (sul1) antibiotic classes. We also isolated an IncI1/MOBP12 plasmid pPIMR (172,280 bp), carrying similar beta-lactamase and a small multidrug efflux resistance gene cluster (blaCMY-42-blc-sugE) to pFEMG. The co-occurrence of different ARGs within a single 24,552 bp cluster in pFEMG - intersperced with transposons, insertion sequence elements, and a class 1 integron - maybe of significant interest to human and veterinary medicine. Additionally, the presence of conjugative and plasmid maintenance genes in the studied plasmids corresponds to the observed high conjugative transfer frequencies and stable maintenance. Extensive investigation is required to further understand the fitness trade offs of plasmids having differing types of conjugative transfer and maintenance modules.
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Affiliation(s)
| | - Ben Perry
- University of Regina, 6846, Regina, Saskatchewan, Canada;
| | | | - Rob Jamieson
- Dalhousie University, 3688, Halifax, Nova Scotia, Canada;
| | - Lisbeth Truelstrup Hansen
- Dalhousie University, 3688, Department of Process Engineering and Applied Science, Halifax, Canada.,Technical University of Denmark, 5205, Department of Process Engineering and Applied Science, Lyngby, Denmark;
| | - Teddie Rahube
- University of Regina, 6846, Biology Department, Regina, Canada, S4S 0A2.,Botswana International University of Science and Technology, 357305, Biology Department, Palapye, Botswana;
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Dobrindt U, Wami HT, Schmidt-Wieland T, Bertsch D, Oberdorfer K, Hof H. Compared with Cotrimoxazole Nitroxoline Seems to Be a Better Option for the Treatment and Prophylaxis of Urinary Tract Infections Caused by Multidrug-Resistant Uropathogens: An In Vitro Study. Antibiotics (Basel) 2021; 10:645. [PMID: 34071539 PMCID: PMC8230139 DOI: 10.3390/antibiotics10060645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 01/17/2023] Open
Abstract
The resistance of uropathogens to various antibiotics is increasing, but nitroxoline remains active in vitro against some relevant multidrug resistant uropathogenic bacteria. E. coli strains, which are among the most common uropathogens, are unanimously susceptible. Thus, nitroxoline is an option for the therapy of urinary tract infections caused by multiresistant bacteria. Since nitroxoline is active against bacteria in biofilms, it will also be effective in patients with indwelling catheters or foreign bodies in the urinary tract. Cotrimoxazole, on the other hand, which, in principle, can also act on bacteria in biofilms, is frequently inactive against multiresistant uropathogens. Based on phenotypic resistance data from a large number of urine isolates, structural characterisation of an MDR plasmid of a recent ST131 uropathogenic E. coli isolate, and publicly available genomic data of resistant enterobacteria, we show that nitroxoline could be used instead of cotrimoxazole for intervention against MDR uropathogens. Particularly in uropathogenic E. coli, but also in other enterobacterial uropathogens, the frequent parallel resistance to different antibiotics due to the accumulation of multiple antibiotic resistance determinants on mobile genetic elements argues for greater consideration of nitroxoline in the treatment of uncomplicated urinary tract infections.
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Affiliation(s)
- Ulrich Dobrindt
- Institut für Hygiene, Universitätsklinikum Münster, 48149 Münster, Germany;
| | - Haleluya T. Wami
- Institut für Hygiene, Universitätsklinikum Münster, 48149 Münster, Germany;
| | - Torsten Schmidt-Wieland
- MVZ Labor Limbach und Kollegen, Im Breitspiel 16, 69126 Heidelberg, Germany; (T.S.-W.); (D.B.); (K.O.); (H.H.)
| | - Daniela Bertsch
- MVZ Labor Limbach und Kollegen, Im Breitspiel 16, 69126 Heidelberg, Germany; (T.S.-W.); (D.B.); (K.O.); (H.H.)
| | - Klaus Oberdorfer
- MVZ Labor Limbach und Kollegen, Im Breitspiel 16, 69126 Heidelberg, Germany; (T.S.-W.); (D.B.); (K.O.); (H.H.)
| | - Herbert Hof
- MVZ Labor Limbach und Kollegen, Im Breitspiel 16, 69126 Heidelberg, Germany; (T.S.-W.); (D.B.); (K.O.); (H.H.)
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Souque C, Escudero JA, MacLean RC. Integron activity accelerates the evolution of antibiotic resistance. eLife 2021; 10:62474. [PMID: 33634790 PMCID: PMC8024014 DOI: 10.7554/elife.62474] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
Mobile integrons are widespread genetic platforms that allow bacteria to modulate the expression of antibiotic resistance cassettes by shuffling their position from a common promoter. Antibiotic stress induces the expression of an integrase that excises and integrates cassettes, and this unique recombination and expression system is thought to allow bacteria to 'evolve on demand' in response to antibiotic pressure. To test this hypothesis, we inserted a custom three-cassette integron into Pseudomonas aeruginosa and used experimental evolution to measure the impact of integrase activity on adaptation to gentamicin. Crucially, integrase activity accelerated evolution by increasing the expression of a gentamicin resistance cassette through duplications and by eliminating redundant cassettes. Importantly, we found no evidence of deleterious off-target effects of integrase activity. In summary, integrons accelerate resistance evolution by rapidly generating combinatorial variation in cassette composition while maintaining genomic integrity.
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Affiliation(s)
- Célia Souque
- University of Oxford, Department of Zoology, Oxford, United Kingdom
| | - José Antonio Escudero
- University of Oxford, Department of Zoology, Oxford, United Kingdom.,Universidad Complutense de Madrid, Departamento de Sanidad Animal and VISAVET, Madrid, Spain
| | - R Craig MacLean
- University of Oxford, Department of Zoology, Oxford, United Kingdom
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Yakout MA, Ali GH. Multidrug Resistance in Integron Bearing Klebsiella pneumoniae isolated from Alexandria University Hospitals, Egypt. Curr Microbiol 2020; 77:3897-3902. [PMID: 32975642 DOI: 10.1007/s00284-020-02217-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/17/2020] [Indexed: 12/14/2022]
Abstract
Klebsiella pneumoniae is by far one of the most common Enterobacteriaceae associated with hospital-acquired infections. The dissemination of multi drug resistant Klebsiella pneumoniae is causing difficulty to treat infections worldwide. Of additional concern, multi drug resistant Klebsiella pneumoniae acquires and transfers antibiotic resistance genes among other bacterial isolates. Integrons have the main role in the acquisition as well as dissemination of resistance genes. Accordingly we aimed to investigate the frequency of resistance genes sul1, sul2, tetA, tetB and aac (3) IIa, class one (int1 gene) and class two integrons(int2 gene) in Klebsiella pneumoniae clinical isolates from four major hospitals in Alexandria, Egypt using Polymerase Chain Reaction. In addition we aimed to evaluate the association between multidrug resistance and presence of integrons in hospital-acquired Klebsiella pneumoniae in our hospitals. To the best of our knowledge, there is little information about integrons and acquisition of multiple antibiotic resistance in Klebsiella pneumoniae in hospitals in Alexandria, Egypt. In this study 76 isolates were resistant to sulphamethoxazole /trimethoprim. Of these 38 isolates (50%) harbored both genes sul1 and sul2 genes. 42 isolates out of the 60 (70%) isolates that showed resistance to tetracycline were tetA or tetB positive. The prevalence of int1 gene among all isolates tested was 90%, while only one isolate harbored the int2 gene (1%). Our results were indicative of the high prevalence of multidrug resistant Klebsiella pneumoniae as well as integrons that were found to play an essential role in the dissemination of antibiotic resistance genes in our hospitals.
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Affiliation(s)
- Marwa Atef Yakout
- Department of Microbiology and Immunology, Faculty of Pharmacy and Drug Manufacturing, Pharos University in Alexandria, Smouha, Mahmoudeya Canal, Alexandria, 21311, Egypt.
| | - Ghada Hani Ali
- Department of Microbiology and Immunology, Faculty of Pharmacy and Drug Manufacturing, Pharos University in Alexandria, Smouha, Mahmoudeya Canal, Alexandria, 21311, Egypt
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Truncated Class 1 Integron Gene Cassette Arrays Contribute to Antimicrobial Resistance of Diarrheagenic Escherichia coli. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4908189. [PMID: 32090095 PMCID: PMC7013361 DOI: 10.1155/2020/4908189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022]
Abstract
Class 1 integrons (c1-integrons) are associated with multidrug resistance in diarrheagenic Escherichia coli (DEC). However, little is known about gene cassettes located within these c1-integrons, particularly truncated c1-integrons, in DEC strains. Therefore, the aims of the present study were to reveal the relationship between antimicrobial resistance and the presence of truncated c1-integrons in DEC isolates derived from human stool samples in Japan. A total of 162 human stool-derived DEC isolates from Japan were examined by antimicrobial susceptibility testing, PCR-based gene detection, and next-generation sequencing analyses. Results showed that 44.4% (12/27) of c1-integrons identified in the DEC isolates harbored only intI1 (an element of c1-integrons) and were truncated by IS26, Tn3, or IS1-group insertion sequences. No difference in the frequency of antimicrobial resistance was recorded between intact and truncated c1-integron-positive DEC isolates. Isolates containing intact/truncated c1-integrons, particularly enteroaggregative E. coli isolates, were resistant to a greater number of antimicrobials than isolates without c1-integrons. aadA and dfrA were the most prevalent antimicrobial resistance genes in the intact/truncated c1-integrons examined in this study. Therefore, gene cassettes located within these intact/truncated c1-integrons may only play a limited role in conferring antimicrobial resistance among DEC. However, DEC harboring truncated c1-integrons may be resistant to a greater number of antimicrobials than c1-integron-negative DEC, similar to strains harboring intact c1-integrons.
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Sabbagh P, Ferdosi-Shahandashti A, Rajabnia M, Maali A, Ferdosi Shahandashti E. Investigating Class I Integron and Antimicrobial Resistance Profile of Klebsiella pneumonia isolates in Babol, North of Iran. JOURNAL OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASES 2020. [DOI: 10.29252/jommid.8.1.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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14
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Jahanbin F, Marashifard M, Jamshidi S, Zamanzadeh M, Dehshiri M, Malek Hosseini SAA, Khoramrooz SS. Investigation of Integron-Associated Resistance Gene Cassettes in Urinary Isolates of Klebsiella pneumoniae in Yasuj, Southwestern Iran During 2015-16. Avicenna J Med Biotechnol 2020; 12:124-131. [PMID: 32431797 PMCID: PMC7229451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Growing antibiotic resistance among urinary opportunistic pathogens such as Klebsiella pneumoniae (K. pneumonia) has created a worrisome condition in the treatment of the Urinary Tract Infections (UTIs) in recent years. Integrons play a significant role in the dissemination of antibiotic resistance genes. The present study was conducted to investigate class 1-3 integrons and the corresponding resistance gene cassettes in urinary K. pneumoniae isolates. METHODS In this study, from December 2015 to September 2016, a total of 196 K. pneumoniae isolates were collected from the patients with UTI referred to medical diagnostic laboratories in Yasouj, Southwestern Iran. Antibiotic susceptibility patterns of isolates were determined using 12 antibiotics by the disc diffusion method. Polymerase Chain Reaction (PCR) was used for detection of integron genes (intI1, intI2, and intI3). The variable regions of integrons were amplified by PCR and sequenced to identify the corresponding gene cassettes. RESULTS Thirty-nine different antibiotic resistance profiles were observed among K. pneumoniae isolates. Only 12.2% of K. pneumoniae isolates were found to harbor the intI1 gene. While 17 (60.7%) out of 28 Multidrug Resistance (MDR) K. pneumoniae isolates carried the intI1 gene, only 4.2% of non-MDR isolates harbored intI1 gene. Totally 7 different gene cassette arrays were found in the intI1 gene of K. pneumoniae isolates. The aadA1 was the most prominent gene cassette. Also, high frequency of dfrA containing gene cassettes was observed. CONCLUSION Continuous monitoring and characterization of integrons and their associated gene cassettes could be helpful in controlling the rising rate of antibiotic resistance.
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Affiliation(s)
- Fariba Jahanbin
- Department of Basic Sciences, Islamic Azad University, Yasuj Branch, Yasuj, Iran
| | - Masoud Marashifard
- Treatment Management of Social Security Organization of Kohgiluyeh and Boyer-Ahmad Province, Yasuj, Iran
| | - Sanaz Jamshidi
- Department of Basic Sciences, Islamic Azad University, Yasuj Branch, Yasuj, Iran
| | - Maryam Zamanzadeh
- Department of Basic Sciences, Islamic Azad University, Yasuj Branch, Yasuj, Iran
| | - Masumeh Dehshiri
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Seyed Sajjad Khoramrooz
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran, Department of Microbiology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran,Corresponding author: Seyed Sajjad Khoramrooz, Ph.D., Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran, Tel/Fax: +98 743 323 5153, E-mail: ,
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Karami P, Ghazalibina M, Khaledi A, Saburi E. Frequency of class 1, 2 and 3 integrons in clinical Klebsiella pneumoniae isolates; a systematic review and meta-analysis of cross-sectional studies. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Fuga B, Royer S, Campos PAD, Ferreira ML, Rossi I, Machado LG, Cerdeira LT, Fonseca Batistão DWD, Brito CSD, Lincopan N, Gontijo-Filho PP, Ribas RM. Molecular Detection of Class 1 Integron-Associated Gene Cassettes in KPC-2-Producing Klebsiella pneumoniae Clones by Whole-Genome Sequencing. Microb Drug Resist 2019; 25:1127-1131. [DOI: 10.1089/mdr.2018.0437] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bruna Fuga
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Sabrina Royer
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Paola Amaral de Campos
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Melina Lorraine Ferreira
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Iara Rossi
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Luiz Gustavo Machado
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | | | | | - Cristiane Silveira de Brito
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Nilton Lincopan
- Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Pinto Gontijo-Filho
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Rosineide Marques Ribas
- Laboratório de Microbiologia Molecular, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
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Gupta R, Chauhan SL, Kumar S, Jindal N, Mahajan NK, Joshi VG. Carriage of Class 1 integrons and molecular characterization of intI1 gene in multidrug-resistant Salmonella spp. isolates from broilers. Vet World 2019; 12:609-613. [PMID: 31190719 PMCID: PMC6515832 DOI: 10.14202/vetworld.2019.609-613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/12/2019] [Indexed: 11/29/2022] Open
Abstract
Aim: The present study was conducted with the following aims: (i) To screen the Salmonella spp. isolates recovered from suspected cases of fowl typhoid for carriage of Class 1 integrons and analyze their association with antimicrobial resistance and (ii) to carry out molecular characterization and phylogenetic analysis of Class 1 integron-integrase (intI1) gene. Materials and Methods: A total of 43 Salmonella isolates were subjected to polymerase chain reaction (PCR) assay to determine the presence of Class1 intI1. Differences between different serotypes in relation to their carriage of integrons and the differences between strains containing or not containing an integron and being resistant to different antimicrobials were analyzed by Fisher exact test using STATA™ (StataCorp, College Station, TX). Phylogenetic analysis was carried out using MEGA6 software. Results: Out of 43 isolates, 40 (93.02%) were found positive for Class 1 integrons. 35/40 (87.5%) intI1-positive isolates were multidrug resistance (MDR) (resistant to ≥4 antibiotics), which support the hypothesis of an association between the presence of Class 1 integrons and emerging MDR in Salmonella. There was no significant difference among isolates resistant to different antimicrobials in Class 1 integron carrying isolates and the Class 1 integron negative isolates (p<0.05). Further, there was no significant difference among different serotypes in respect of their carriage of Class 1 integrons. Conclusion: It can be concluded that the high prevalence of Class 1 integrons indicates a high potential of Salmonella isolates for horizontal transmission of antimicrobial genes, especially among Gram-negative organisms.
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Affiliation(s)
- Renu Gupta
- Department of Veterinary Public Health and Epidemiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - Sneh Lata Chauhan
- Department of Veterinary Public Health and Epidemiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - Sunil Kumar
- Department of Veterinary Public Health and Epidemiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - Naresh Jindal
- Department of Veterinary Public Health and Epidemiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - N K Mahajan
- Department of Veterinary Public Health and Epidemiology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
| | - V G Joshi
- Department of Animal Biotechnology, College of Veterinary Sciences, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar, Haryana, India
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Firoozeh F, Mahluji Z, Khorshidi A, Zibaei M. Molecular characterization of class 1, 2 and 3 integrons in clinical multi-drug resistant Klebsiella pneumoniae isolates. Antimicrob Resist Infect Control 2019; 8:59. [PMID: 30976386 PMCID: PMC6440154 DOI: 10.1186/s13756-019-0509-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to characterize class 1,2 and 3 integrons in clinical MDR Klebsiella pneumoniae isolates in Kashan, Iran. Methods One hundred-eighty one Klebsiella pneumoniae were recovered from clinical specimens during November 2013 to October 2014. Antimicrobial susceptibility patterns were determined by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines for detection of MDR strains. Of the 181 Klebsiella pneumoniae, 146 (80.7%) of isolates were isolated from nosocomial infected patients and 150 (82.9%) identified as MDR isolates. The PCR amplification was used to show presence of class 1, 2 and 3 integrons among MDR strains. The PCR method and sequencing were used for evaluation of cassette content of integrons. Results Of the MDR K. pneumoniae isolates, 150 (100%) and 55 (36.7%) carried intI1 and intI2 genes, respectively. None of the MDR Klebsiella pneumoniae isolates carried class 3 integrons. Amplification of conserved segment (CS) of class 1 and class 2 integrons revealed 10 different arrays including: No. cassette; dfrA5, dfrA30; aadA2; aadA2, dfrA12; dfrA17, aadA5, aadA4; dfrA5, dfrA30, aadA2; dfrA5, dfrA30, aadA2, dfrA12, dfrA5, dfrA30, dfrA17, aadA5, aadA4; aadA2, aadA2, dfrA12; dfrA5, dfrA30, aadA2, aadA2, dfrA12 and 4 arrays including: No. cassette; aadA1; dfrA1-sat1; aadA1, dfrA1-sat1, respectively. Conclusions The finding of present study revealed a high prevalence of integrons especially class 1 among MDR K. pneumoniae isolates from nosocomial infections in Kashan, which led to rapid extension of MDR strains.
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Affiliation(s)
- Farzaneh Firoozeh
- 1Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.,2Department of Microbiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Zeinab Mahluji
- 2Department of Microbiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Ahmad Khorshidi
- 2Department of Microbiology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Zibaei
- 3Evidence-based Phytotherapy & Complementary Medicine Research Center, Alborz University of Medical Sciences, Karaj, Iran.,4Department of Parasitology and Mycology, School of Medicine, Alborz University of Medical Sciences, P.O. Box: 3149779453, Karaj, Iran
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In vitro activity of imipenem-relebactam against non-MBL carbapenemase-producing Klebsiella pneumoniae isolated in Greek hospitals in 2015-2016. Eur J Clin Microbiol Infect Dis 2019; 38:1143-1150. [PMID: 30825054 DOI: 10.1007/s10096-019-03517-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
Abstract
Relebactam is a β-lactamase inhibitor of class A and class C β-lactamases, including carbapenemases. We evaluated the ability of relebactam to restore imipenem susceptibility against a collection of Klebsiella pneumoniae isolates from Greek hospitals. We tested 314 non-MBL carbapenemase-producing K. pneumoniae consecutive clinical strains isolated from unique patients at 18 hospitals in Greece, between November 2014 and December 2016. Susceptibility testing of imipenem, imipenem-relebactam, meropenem, doripenem, gentamicin, and colistin was performed using broth microdilution. Additionally, MICs of ceftazidime-avibactam, fosfomycin, and tigecycline were determined by MIC Test Strips. MICs were interpreted per EUCAST breakpoints. Imipenem-relebactam MICs were interpreted using the breakpoints proposed for imipenem. Carbapenemase genes were detected using PCR. Whole genome sequencing was performed for selected isolates. Imipenem-relebactam inhibited 98.0% of the KPC-producing isolates at ≤ 2 mg/L (MIC50/90, 0.25/1 mg/L) and was considerably more active than imipenem (MIC50/90, 32/> 64 mg/L). Reduced activity of imipenem-relebactam was rarely detected (2%) and was associated with chromosomal factors (ompK35 disruption and/or mutated ompK36). Only ceftazidime-avibactam showed in vitro activity comparable to imipenem-relebactam (99.6% susceptible). Relebactam provided only weak potentiation of imipenem activity against K. pneumoniae with class D OXA-48-like enzymes. Relebactam exhibited strong potential for restoring the in vitro activity of imipenem against KPC-producing K. pneumoniae, lowering the imipenem MIC50 and MIC90 from 32 to 0.25 mg/L, and from > 64 to 1 mg/L, respectively. Production of KPC carbapenemase represents the main cause of carbapenem resistance among K. pneumoniae in Greek hospitals (66.5%), and this carbapenemase appears to be very well inhibited by relebactam.
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Heinrichs A, Argudín MA, De Mendonça R, Deplano A, Roisin S, Dodémont M, Coussement J, Filippin L, Dombrecht J, De Bruyne K, Huang TD, Supply P, Byl B, Glupczynski Y, Denis O. An Outpatient Clinic as a Potential Site of Transmission for an Outbreak of New Delhi Metallo-β-Lactamase–producing Klebsiella pneumoniae Sequence Type 716: A Study Using Whole-genome Sequencing. Clin Infect Dis 2018; 68:993-1000. [DOI: 10.1093/cid/ciy581] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/11/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Amélie Heinrichs
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - Maria Angeles Argudín
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - Ricardo De Mendonça
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - Ariane Deplano
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - Sandrine Roisin
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - Magali Dodémont
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - Julien Coussement
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | | | | | | | - Te-Din Huang
- Laboratory of Clinical Microbiology, Belgian National Reference Center for Monitoring Antimicrobial Resistance in Gram-negative Bacteria, CHU UCL Namur, Yvoir, Belgium
| | - Philip Supply
- INSERM U1019, CNRS-UMR 8204, Center for Infection and Immunity of Lille, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Baudouin Byl
- Ecole de Santé Publique, Université Libre de Bruxelles
- Clinique d’Epidémiologie et d’Hygiène Hospitalière, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Youri Glupczynski
- Laboratory of Clinical Microbiology, Belgian National Reference Center for Monitoring Antimicrobial Resistance in Gram-negative Bacteria, CHU UCL Namur, Yvoir, Belgium
| | - Olivier Denis
- Laboratoire de Microbiologie, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels
- Ecole de Santé Publique, Université Libre de Bruxelles
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21
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Zaman TU, Alrodayyan M, Albladi M, Aldrees M, Siddique MI, Aljohani S, Balkhy HH. Clonal diversity and genetic profiling of antibiotic resistance among multidrug/carbapenem-resistant Klebsiella pneumoniae isolates from a tertiary care hospital in Saudi Arabia. BMC Infect Dis 2018; 18:205. [PMID: 29724185 PMCID: PMC5934806 DOI: 10.1186/s12879-018-3114-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/25/2018] [Indexed: 11/10/2022] Open
Abstract
Background The nexus between resistance determinants, plasmid type, and clonality appears to play a crucial role in the dissemination and survival of carbapenem-resistant Klebsiella pneumoniae (CRKP). The incidence of infections involving CRKP in Saudi Arabia is increasing and there is a need for detailed molecular profiling of this pathogen for CRKP surveillance and control. Methods The resistance determinants of 71 non-redundant CRKP isolates were investigated by polymerase chain reaction (PCR) and sequencing. Plasmid typing was performed using PCR-based replicon typing and the clonality of isolates was determined by multilocus sequence typing. Capsular polysaccharide synthesis genes and other virulence factors were examined using multiplex PCR. Diversity was calculated using DIVEIN, clonal relationship was determined using eBURST, and phylogenetic analysis was performed using SplitsTree4. Results A polyclonal OXA-48 gene alone was the most common carbapenemase detected in 48/71 (67.6%) isolates followed by NDM-1 alone in 9/71 (12.7%) isolates. Coproduction of OXA-48 and NDM-1 was observed in 6/71 (8.5%) isolates. Both carbapenemase genes could be transferred into an Escherichia coli recipient. CTX-M-15 was the most abundant extended-spectrum β-lactamase gene detected in 47/71 (66.2%) isolates, whereas clone-specific CTX-M-14 (ST-199 and -709) was found in 15/71 (21%) isolates. Sixty-seven of 71 isolates were positive for one or more plasmid replicons. The replicons detected were: IncFII; IncFIIK; IncFIA; IncFIB; L/M; IncI1; and IncN. FIIK and L/M were predominant, with 69 and 67% positivity, respectively. All isolates were negative for the magA (K1), rmpA, and K2 genes and presented a non-hypermucoviscous phenotype. Conclusion A polyclonal CRKP reservoir of sequence types (STs)-37, − 199, and − 152 was observed and ST-152 appeared to be a “frequent carrier” of the NDM-1 gene. ST-199, a singleton not previously reported, showed a sequence diversity suggestive of positive selection. A significant association was evident between resistance determinants and the clonal types of K. pneumoniae: all ST-152 isolates were positive for NDM-1 but negative for OXA-48; ST-199 isolates were positive for OXA-48 but negative for NDM-1; and ST-709 and -199 isolates were positive for CTX-M-14. The incidence of certain clonal types in large numbers predicts an outbreak-like situation and warrants stringent surveillance and infection control. Electronic supplementary material The online version of this article (10.1186/s12879-018-3114-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Taher Uz Zaman
- Infectious Diseases Section, King Abdullah International Medical Research Center National Guard Health Affairs, P.O. Box 22490, Mail Code 1515, Riyadh, 11426, Kingdom of Saudi Arabia. .,King Saud Bin Abdul-Aziz University of Health Sciences, Riyadh, Kingdom of Saudi Arabia.
| | - Maha Alrodayyan
- Infectious Diseases Section, King Abdullah International Medical Research Center National Guard Health Affairs, P.O. Box 22490, Mail Code 1515, Riyadh, 11426, Kingdom of Saudi Arabia.,King Saud Bin Abdul-Aziz University of Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Maha Albladi
- Infectious Diseases Section, King Abdullah International Medical Research Center National Guard Health Affairs, P.O. Box 22490, Mail Code 1515, Riyadh, 11426, Kingdom of Saudi Arabia.,King Saud Bin Abdul-Aziz University of Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Aldrees
- Infectious Diseases Section, King Abdullah International Medical Research Center National Guard Health Affairs, P.O. Box 22490, Mail Code 1515, Riyadh, 11426, Kingdom of Saudi Arabia.,King Saud Bin Abdul-Aziz University of Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | | | - Sameera Aljohani
- King Saud Bin Abdul-Aziz University of Health Sciences, Riyadh, Kingdom of Saudi Arabia.,Microbiology Section- King Abdul-Aziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Hanan H Balkhy
- Infectious Diseases Section, King Abdullah International Medical Research Center National Guard Health Affairs, P.O. Box 22490, Mail Code 1515, Riyadh, 11426, Kingdom of Saudi Arabia. .,King Saud Bin Abdul-Aziz University of Health Sciences, Riyadh, Kingdom of Saudi Arabia. .,Infection Prevention and Control Prevention, King Abdul-Aziz Medical City, National Guard Health Affairs, P.O. Box 22490, Riyadh-11426, Riyadh, Kingdom of Saudi Arabia.
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Bokaeian M, Shahraki Zahedani S, Delarampoor A, Atashgah M, Dahmarde B. Evaluation of Antibiotic Resistance Patterns of Clinical Klebsiella pneumoniae Isolates from Educational Hospitals in Zahedan, Iran. MEDICAL LABORATORY JOURNAL 2018. [DOI: 10.29252/mlj.12.3.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Mokhtari H, Eslami G, Zandi H, Dehghan-Banadkouki A, Vakili M. Evaluating the Frequency of aac(6')-IIa, ant(2″)-I, intl1, and intl2 Genes in Aminoglycosides Resistant Klebsiella pneumoniae Isolates Obtained from Hospitalized Patients in Yazd, Iran. Avicenna J Med Biotechnol 2018; 10:115-119. [PMID: 29849989 PMCID: PMC5960057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Klebsiella pneumoniae (K. pneumoniae) is an opportunistic pathogen that could be resistant to many antimicrobial agents. Resistance genes can be carried among gram-negative bacteria by integrons. Enzymatic inactivation is the most important mechanism of resistance to aminoglycosides. In this study, the frequencies of two important resistance gene aac(6')-IIa and ant(2″)-I, and genes coding integrase I and II, in K. pneumoniae isolates resistant to aminoglycosides were evaluated. METHODS In this cross-sectional study, an attempt was made to assess the antibiotic susceptibility of 130 K. pneumoniae isolates obtained from different samples of patients hospitalized in training hospitals of Yazd evaluated by disk diffusion method. The frequencies of aac(6')-IIa, ant(2″)-I, intl1, and intl2 genes were determined by PCR method. Data were analyzed by chi-square method using SPSS software (Ver. 16). RESULTS our results showed that resistance to gentamicin, tobramycin, kanamycin, and amikacin were 34.6, 33.8, 43.8, and 14.6%, respectively. The frequencies of aac (6')-IIa, ant(2″)-I, intl1, and intl2 genes were 44.6, 27.7, 90, and 0%, respectively. CONCLUSION This study showed there are high frequencies of genes coding aminoglycosides resistance in K. pneumoniae isolates. Hence, it is very important to monitor and inhibit the spread of antibiotic resistance genes.
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Affiliation(s)
- Hesam Mokhtari
- International Campus, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Gilda Eslami
- Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Department of Parasitology and Mycology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hengameh Zandi
- Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Department of Microbiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,Corresponding author: Hengameh Zandi, Ph.D., Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Tel: +98 41 33364665 Fax: +98 35 38203414 E-mail:
| | - Amin Dehghan-Banadkouki
- Department of Pathobiology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Vakili
- Department of Public Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Akya A, Elahi A, Chegenelorestani R, Rezaee M. Dissemination of Multidrug-Resistant, Class I and II Integrons and Molecular Typing of CTX-M-producing Klebsiella pneumoniae. Int J Appl Basic Med Res 2018; 8:100-105. [PMID: 29744322 PMCID: PMC5932916 DOI: 10.4103/ijabmr.ijabmr_333_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Klebsiella pneumoniae (K. pneumoniae) is an important opportunistic pathogen causes serious community and hospital-acquired infections, which is highly resistant to antibiotics. We aimed to determine the frequency of multidrug resistant (MDR) and molecular typing of clinical isolates of K. pneumoniae. Methodology One hundred isolates of K. pneumoniae were collected from clinical samples in three general hospitals in Kermanshah. The antimicrobial susceptibility and extended-spectrum beta-lactamases (ESBL) production of isolates were determined using disk diffusion and combined disk methods, respectively. The blaCTX-M gene, class I and II integrons were detected using polymerase chain reaction. The blaCTX-M positive isolates were selected for genotyping using pulsed-field gel electrophoresis (PFGE). Results MDR phenotype was observed in 56% of isolates. The 40% of isolates were ESBL positive and 35 isolates contained blaCTX-M. Class I and II of integrons were detected in 50 (89.2%) and 39 (69.6%) of MDR isolates, respectively. PFGE patterns of K. pneumoniaeblaCTX-M positive isolates indicated 19 clusters (X1-19) with different genotype patterns. Conclusions The study findings highlight the concern of circulating MDR strains of K. pneumoniae with blaCTX-M and class I and II integrons in Kermanshah hospitals. The presence of integrons among isolates may facilitate the spread of new resistance genes in this bacterium. Therefore, surveillance for the spread of MDR strains of this bacterium is recommended in hospitals.
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Affiliation(s)
- Alisha Akya
- Department of Medical Microbiology, Nosocomial Infection Research Centre, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azam Elahi
- Nosocomial Infection Research Centre, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Chegenelorestani
- Nosocomial Infection Research Centre, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahya Rezaee
- Nosocomial Infection Research Centre, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Brhelova E, Antonova M, Pardy F, Kocmanova I, Mayer J, Racil Z, Lengerova M. Investigation of next-generation sequencing data of Klebsiella pneumoniae using web-based tools. J Med Microbiol 2017; 66:1673-1683. [PMID: 29068275 DOI: 10.1099/jmm.0.000624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Rapid identification and characterization of multidrug-resistant Klebsiella pneumoniae strains is necessary due to the increasing frequency of severe infections in patients. The decreasing cost of next-generation sequencing enables us to obtain a comprehensive overview of genetic information in one step. The aim of this study is to demonstrate and evaluate the utility and scope of the application of web-based databases to next-generation sequenced (NGS) data. METHODOLOGY The whole genomes of 11 clinical Klebsiella pneumoniae isolates were sequenced using Illumina MiSeq. Selected web-based tools were used to identify a variety of genetic characteristics, such as acquired antimicrobial resistance genes, multilocus sequence types, plasmid replicons, and identify virulence factors, such as virulence genes, cps clusters, urease-nickel clusters and efflux systems. RESULTS Using web-based tools hosted by the Center for Genomic Epidemiology, we detected resistance to 8 main antimicrobial groups with at least 11 acquired resistance genes. The isolates were divided into eight sequence types (ST11, 23, 37, 323, 433, 495 and 562, and a new one, ST1646). All of the isolates carried replicons of large plasmids. Capsular types, virulence factors and genes coding AcrAB and OqxAB efflux pumps were detected using BIGSdb-Kp, whereas the selected virulence genes, identified in almost all of the isolates, were detected using CLC Genomic Workbench software. CONCLUSION Applying appropriate web-based online tools to NGS data enables the rapid extraction of comprehensive information that can be used for more efficient diagnosis and treatment of patients, while data processing is free of charge, easy and time-efficient.
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Affiliation(s)
- Eva Brhelova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.,Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Mariya Antonova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.,Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Filip Pardy
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Iva Kocmanova
- Department of Clinical Microbiology, University Hospital Brno, Brno, Czech Republic
| | - Jiri Mayer
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.,Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Zdenek Racil
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.,Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Martina Lengerova
- CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Department of Internal Medicine - Hematology and Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
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Integrons in Enterobacteriaceae: diversity, distribution and epidemiology. Int J Antimicrob Agents 2017; 51:167-176. [PMID: 29038087 DOI: 10.1016/j.ijantimicag.2017.10.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/29/2017] [Accepted: 10/07/2017] [Indexed: 01/03/2023]
Abstract
Integrons are versatile gene acquisition systems that allow efficient capturing of exogenous genes and ensure their expression. Various classes of integrons possessing a wide variety of gene cassettes are ubiquitously distributed in enteric bacteria worldwide. The epidemiology of integrons associated multidrug resistance in Enterobacteriaceae is rapidly evolving. In the past two decades, the incidence of integrons in enteric bacteria has increased drastically with evolution of multiple gene cassettes, novel gene arrangements and complex chromosomal integrons such as Salmonella genomic islands. This review focuses on the distribution, versatility, spread and global trends of integrons among important members of the Enterobacteriaceae, including Escherichia coli, Klebsiella, Shigella and Salmonella, which are known to cause infections globally. Such a comprehensive understanding of integron-associated antibiotic resistance, their role in the spread of such resistance traits and their clinical relevance especially with regard to each genus individually is paramount to contain the global spread of antibiotic resistance.
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Szekeres E, Baricz A, Chiriac CM, Farkas A, Opris O, Soran ML, Andrei AS, Rudi K, Balcázar JL, Dragos N, Coman C. Abundance of antibiotics, antibiotic resistance genes and bacterial community composition in wastewater effluents from different Romanian hospitals. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 225:304-315. [PMID: 28347610 DOI: 10.1016/j.envpol.2017.01.054] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 05/21/2023]
Abstract
Antimicrobial resistance represents a growing and significant public health threat, which requires a global response to develop effective strategies and mitigate the emergence and spread of this phenomenon in clinical and environmental settings. We investigated, therefore, the occurrence and abundance of several antibiotics and antibiotic resistance genes (ARGs), as well as bacterial community composition in wastewater effluents from different hospitals located in the Cluj County, Romania. Antibiotic concentrations ranged between 3.67 and 53.05 μg L-1, and the most abundant antibiotic classes were β-lactams, glycopeptides, and trimethoprim. Among the ARGs detected, 14 genes confer resistance to β-lactams, aminoglycosides, chloramphenicol, macrolide-lincosamide-streptogramin B (MLSB) antibiotics, sulfonamides, and tetracyclines. Genes encoding quaternary ammonium resistance and a transposon-related element were also detected. The sulI and qacEΔ1 genes, which confer resistance to sulfonamides and quaternary ammonium, had the highest relative abundance with values ranging from 5.33 × 10-2 to 1.94 × 10-1 and 1.94 × 10-2 to 4.89 × 10-2 copies/16 rRNA gene copies, respectively. The dominant phyla detected in the hospital wastewater samples were Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria. Among selected hospitals, one of them applied an activated sludge and chlorine disinfection process before releasing the effluent to the municipal collector. This conventional wastewater treatment showed moderate removal efficiency of the studied pollutants, with a 55-81% decrease in antibiotic concentrations, 1-3 order of magnitude lower relative abundance of ARGs, but with a slight increase of some potentially pathogenic bacteria. Given this, hospital wastewaters (raw or treated) may contribute to the spread of these emerging pollutants in the receiving environments. To the best of our knowledge, this study quantified for the first time the abundance of antibiotics and ARGs in wastewater effluents from different Romanian hospitals.
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Affiliation(s)
- Edina Szekeres
- NIRDBS, Institute of Biological Research, Cluj-Napoca, Romania; Molecular Biology and Biotechnology Department, Faculty of Biology and Geology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Andreea Baricz
- NIRDBS, Institute of Biological Research, Cluj-Napoca, Romania
| | - Cecilia Maria Chiriac
- NIRDBS, Institute of Biological Research, Cluj-Napoca, Romania; Molecular Biology and Biotechnology Department, Faculty of Biology and Geology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Anca Farkas
- Molecular Biology and Biotechnology Department, Faculty of Biology and Geology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Ocsana Opris
- National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Maria-Loredana Soran
- National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Adrian-Stefan Andrei
- Institute for Interdisciplinary Research in Bio-Nano-Sciences, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Knut Rudi
- Department of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Aas, Norway
| | - Jose Luis Balcázar
- Catalan Institute for Water Research (ICRA), Scientific and Technological Park of the University of Girona, Girona, Spain
| | - Nicolae Dragos
- NIRDBS, Institute of Biological Research, Cluj-Napoca, Romania; Molecular Biology and Biotechnology Department, Faculty of Biology and Geology, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Cristian Coman
- NIRDBS, Institute of Biological Research, Cluj-Napoca, Romania.
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Falco A, Ramos Y, Franco E, Guzmán A, Takiff H. A cluster of KPC-2 and VIM-2-producing Klebsiella pneumoniae ST833 isolates from the pediatric service of a Venezuelan Hospital. BMC Infect Dis 2016; 16:595. [PMID: 27770796 PMCID: PMC5075218 DOI: 10.1186/s12879-016-1927-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 10/12/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Klebsiella pneumoniae is a bacterial pathogen that has developed resistance to multiple antibiotics and is a major cause of nosocomial infections worldwide. Carbapenemase-producing Klebsiella pneumoniae have been isolated in many hospitals in Venezuela, but they have not been well-studied. The aim of this study was to characterize carbapenem-resistant Klebsiella pneumoniae isolates from the pediatric service of a hospital located in Anzoategui State, in the eastern part of Venezuela. METHODS Nineteen Klebsiella pneumoniae strains isolated in the hospital from April to July 2014 were evaluated phenotypically and molecularly for the presence of carbapenemases blaKPC, blaIMP and blaVIM. Molecular epidemiology was performed with Repetitive Extragenic Palindromic-PCR (REP-PCR) and Multilocus Sequence Typing (MLST). They were also studied for phenotypic and molecular resistance to a quaternary ammonium compound (QAC) disinfectant. RESULTS All 19 isolates contained both bla VIM-2 and bla KPC-2 genes, and the bla KPC-2 gene was associated with Tn4401b. All isolates were phenotypically sensitive to QACs and contained qacΔE and addA2 genes typical of class 1 integrons. Analysis by REP-PCR and MLST showed that all isolates had identical profiles characteristic of sequence type ST833. CONCLUSION All 19 strains are bla VIM-2 and bla KPC-2-producing ST833 K. pneumoniae sensitive to QACs. This analysis may help to understand the routes of dissemination and confirms that QAC disinfectants can be used to help control their spread.
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Affiliation(s)
- Aura Falco
- Laboratorio de Genética Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela
| | - Yusibeska Ramos
- Laboratorio B, Dirección de Energía y Ambiente, Instituto de Estudios Avanzados, Caracas, Venezuela
| | - Esther Franco
- Servicio de Laboratorio Clínico del anexo pediátrico "Dr. Rafael Tobías Guevara" del Complejo Hospitalario Universitario "Dr. Luis Razetti", Barcelona, Venezuela
| | - Alegría Guzmán
- Servicio de Laboratorio Clínico del anexo pediátrico "Dr. Rafael Tobías Guevara" del Complejo Hospitalario Universitario "Dr. Luis Razetti", Barcelona, Venezuela
| | - Howard Takiff
- Laboratorio de Genética Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela.
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Kheiri R, Akhtari L. Antimicrobial resistance and integron gene cassette arrays in commensal Escherichia coli from human and animal sources in IRI. Gut Pathog 2016; 8:40. [PMID: 27582900 PMCID: PMC5006490 DOI: 10.1186/s13099-016-0123-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/22/2016] [Indexed: 11/18/2022] Open
Abstract
Background The human and animal intestinal tract harbors a complex community of microbes which enables bacteria to inherit antibiotic resistance genes. The aims of this study were to investigate clonality, antimicrobial resistance, prevalence and gene cassette arrays of class I and II integrons among commensal Escherichia coli from human and animals. Methods A total of 200 E. coli isolates from human, chicken, cattle, and sheep were isolated followed by phenotypic antibiotic susceptibility testing and detection of class I and II integrons gene cassettes arrays. The clonal relationship of the isolates were analyzed by (GTG)5-PCR. Results Of 200 isolates, 136 isolates were multi drug resistance (MDR) including 47, 40, 31 and 18 isolates from chicken, human, cattle and sheep, respectively. Class I integron was detected in 50, 38, 6 and 16 %, while class II was detected in 26, 8, 0 and 4 % of chicken, human, cattle and sheep isolates, respectively. Variable regions were amplified and sequenced. Cassette arrays in class I integrons were: dfrA1, dfrA5, dfrA7, dfrA12, aadA1, dfrA17 aadA1, aadA22, aadB–aadA2 and dfrA12–orfF–aadA2, and for class II, dfrA1-sat-aadA1, and sat-sat1-aadA1 were detected. Six class I and three class II positive strains did not produce any amplicons for variable region. Integron-positive isolates showed higher rate of resistance to streptomycin and trimethoprim–sulphamethoxazole, especially in chicken isolates which were fed antibiotics. Low similarity and great genetic diversity of class I and II integrons carrying isolates indicated no clonal relation. Conclusions Integrons encoding for antibiotic resistance are significantly present among non-pathogenic commensal E. coli, especially from the hosts medicated by antibiotics. Uncontrolled use of antibiotics will increase the numbers of multiple drug resistant isolates and integrons prevalence.
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Affiliation(s)
- Roohollah Kheiri
- Molecular Microbiology, Quality Control Office, Alborz Province Water and Wastewater Company, Karaj, Alborz Islamic Republic of Iran
| | - Leili Akhtari
- Water Treatment Plant, Tehran Water and Wastewater Supply and Treatment Company, Tehran, Islamic Republic of Iran
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Manyahi J, Tellevik MG, Ndugulile F, Moyo SJ, Langeland N, Blomberg B. Molecular Characterization of Cotrimoxazole Resistance Genes and Their Associated Integrons in Clinical Isolates of Gram-Negative Bacteria from Tanzania. Microb Drug Resist 2016; 23:37-43. [PMID: 27533639 DOI: 10.1089/mdr.2016.0074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cotrimoxazole is widely used, particularly as a prophylactic drug in HIV patients. We assessed resistance mechanisms among cotrimoxazole resistant-Gram negative bacterial isolates (n = 123) obtained from blood (n = 69) and urine (n = 54) from Tanzanian patients. sul genes were detected in 98% (121/123) of the isolates. Coexistence of sul1 and sul2 was common (49/123). The dfr genes were found in 63% (77/123) of all isolates. sul1, dfrA15, and dfrA5 genes predominated among Klebsiella pneumoniae, while sul2 and dfrA1 genes were frequent in Escherichia coli isolates. Two isolates, both K. pneumoniae, carried sul3. Integrons were detected in 81.3% (100/123) of all isolates. Class 1 integrons were found in 95% (42/44), 53% (23/43), and 80.6% (25/31) of K. pneumoniae, E. coli, and other Enterobacteriaceae isolates, respectively. Class 2 integrons were found in 14% of E. coli, but not in K. pneumoniae. All sul1 genes in K. pneumoniae were carried in class 1 integrons. Gene cassette arrays dfrA5 and dfrA15-aadA1 were most frequently associated with class 1 integrons, while class 2 integrons contained only dfrA1-sat2-aadA1 gene cassettes. This is the first report of sul3 gene in K. pneumoniae from human sources. The finding that mechanisms differ between E. coli and K. pneumoniae may broaden our understanding of cotrimoxazole resistance.
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Affiliation(s)
- Joel Manyahi
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway .,2 Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences (MUHAS) , Dar es Salaam, Tanzania
| | - Marit Gjerde Tellevik
- 3 Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital , Bergen, Norway
| | - Faustine Ndugulile
- 2 Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences (MUHAS) , Dar es Salaam, Tanzania .,4 Parliament of Tanzania, United Republic of Tanzania , Dodoma, Tanzania
| | - Sabrina J Moyo
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway .,2 Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences (MUHAS) , Dar es Salaam, Tanzania
| | - Nina Langeland
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway .,3 Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital , Bergen, Norway
| | - Bjørn Blomberg
- 1 Department of Clinical Science, University of Bergen , Bergen, Norway .,3 Department of Medicine, National Centre for Tropical Infectious Diseases, Haukeland University Hospital , Bergen, Norway
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Xia W, Xu T, Qin T, Li P, Liu Y, Kang H, Gu B, Ma P. Characterization of integrons and novel cassette arrays in bacteria from clinical isloates in China, 2000-2014. J Biomed Res 2016; 30:292-303. [PMID: 27533938 PMCID: PMC4946320 DOI: 10.7555/jbr.30.20150153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/20/2015] [Accepted: 03/08/2016] [Indexed: 12/19/2022] Open
Abstract
Rapid dissemination of antibiotic resistance genes among bacterial isolates is an increasing problem in China. Integron, a conserved DNA sequence, which is carried on episomal genetic structures, plays a very important role in development of antibiotic resistance. This systematic analysis was based on MEDLINE and EMBASE databases. We summarized the distribution and proportion of different types of gene cassette arrays of integrons (including class 1, 2, 3 and atypical class 1 integron) from clinical bacteria isolates in China. Fifty-six literatures were included in this study. Most of the strains were Gram-negative bacteria (94.1%, 7,364/7,822) while only 5.9% strains were Gram-positive bacteria. Class 1 integrons were detected in 54.2% (3956/7295) Gram-negative strains. aadA2 was the most popular gene cassette array detected from 60 Gram-positive bacteria while dfrA17-aadA5 were detected in 426 Gram-negative bacteria. This study identified 12 novel gene cassette arrays which have not been previously found in any species. All the novel gene cassette arrays were detected from Gram-negative bacteria. A regional characteristic of distribution of integrons was presented in this study. The results highlight a need for continuous surveillance of integrons and provide a guide for future research on integron-mediated bacteria resistance.
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Affiliation(s)
- Wenying Xia
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.,National Key Clinical Department of Laboratory Medicine, Nanjing, Jiangsu 210029, China
| | - Ting Xu
- Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.,National Key Clinical Department of Laboratory Medicine, Nanjing, Jiangsu 210029, China
| | - Tingting Qin
- Medical Technology Institute of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China
| | - Pengpeng Li
- Medical Technology Institute of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China
| | - Yun Liu
- Medical Technology Institute of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China
| | - Haiquan Kang
- Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China
| | - Bing Gu
- Medical Technology Institute of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China.,Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China;
| | - Ping Ma
- Medical Technology Institute of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China.,Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221002, China
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Lombardo MN, G-Dayanandan N, Wright DL, Anderson AC. Crystal Structures of Trimethoprim-Resistant DfrA1 Rationalize Potent Inhibition by Propargyl-Linked Antifolates. ACS Infect Dis 2016; 2:149-56. [PMID: 27624966 DOI: 10.1021/acsinfecdis.5b00129] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Multidrug-resistant Enterobacteriaceae, notably Escherichia coli and Klebsiella pneumoniae, have become major health concerns worldwide. Resistance to effective therapeutics is often carried by class I and II integrons that can confer insensitivity to carbapenems, extended spectrum β-lactamases, the antifolate trimethoprim, fluoroquinolones, and aminoglycosides. Specifically of interest to the study here, a prevalent gene (dfrA1) coding for an insensitive dihydrofolate reductase (DHFR) confers 190- or 1000-fold resistance to trimethoprim for K. pneumoniae and E. coli, respectively. Attaining inhibition of both the wild-type and resistant forms of the enzyme is critical for new antifolates. For several years, we have been developing the propargyl-linked antifolates (PLAs) as effective inhibitors against trimethoprim-resistant DHFR enzymes. Here, we show that the PLAs are active against both the wild-type and DfrA1 DHFR proteins. We report two high-resolution crystal structures of DfrA1 bound to potent PLAs. The structure-activity relationships and crystal structures will be critical in driving the design of broadly active inhibitors against wild-type and resistant DHFR.
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Affiliation(s)
- Michael N. Lombardo
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
| | - Narendran G-Dayanandan
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
| | - Dennis L. Wright
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
| | - Amy C. Anderson
- Department
of Pharmaceutical Sciences, University of Connecticut, 69 North
Eagleville Road, Storrs, Connecticut 06269, United States
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Malek MM, Amer FA, Allam AA, El-Sokkary RH, Gheith T, Arafa MA. Occurrence of classes I and II integrons in Enterobacteriaceae collected from Zagazig University Hospitals, Egypt. Front Microbiol 2015; 6:601. [PMID: 26157425 PMCID: PMC4477160 DOI: 10.3389/fmicb.2015.00601] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 06/01/2015] [Indexed: 12/30/2022] Open
Abstract
Integrons are genetic units characterized by the ability to capture and incorporate gene cassettes, thus can contribute to the emergence and transfer of antibiotic resistance. The objectives of this study were: (1) to investigate the presence and distribution of class I and class II integrons and the characteristics of the gene cassettes they carry in Enterobacteriaceae isolated from nosocomial infections at Zagzig University Hospital in Egypt, (2) to determine their impact on resistance, and (3) to identify risk factors for the existence of integrons. Relevant samples and full clinical history were collected from 118 inpatients. Samples were processed; isolated microbes were identified and tested for antibiotic susceptibilities. Integrons were detected by polymerase chain reaction (PCR) and were characterized into class I or II by restriction fragment length polymorphism (RFLP). Integron-positive isolates were subjected to another PCR to detect gene cassette, followed by gene cassette sequencing. Risk factors were analyzed by logistic regression analysis. Seventy-six Enterobacteriaceae isolates were recognized, 41 of them (53.9%) were integron-positive; 39 strains carried class I and 2 strains carried class II integrons. Integrons had gene cassettes encoding different combinations and types of resistance determinants. Interestingly, blaOXA129 gene was found and ereA gene was carried on class I integrons. The same determinants were carried within isolates of the same species as well as isolates of different species. The presence of integrons was significantly associated with multidrug resistance (MDR). No risk factors were associated for integron carriage. We conclude that integrons carrying gene cassettes encoding antibiotic resistance are significantly present among Enterobacteriaceae causing nosocomial infection in our hospital. Risk factors for acquisition remain to be identified.
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Affiliation(s)
- Mai M. Malek
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Fatma A. Amer
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Ayman A. Allam
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Rehab H. El-Sokkary
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Tarek Gheith
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Mohamed A. Arafa
- Pediatrics Department, Faculty of Medicine, Zagazig UniversityZagazig, Egypt
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High prevalence of carbapenem resistance among plasmid-mediated AmpC β-lactamase-producing Klebsiella pneumoniae during outbreaks in liver transplantation units. Int J Antimicrob Agents 2014; 45:33-40. [PMID: 25455850 DOI: 10.1016/j.ijantimicag.2014.08.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 08/21/2014] [Accepted: 08/22/2014] [Indexed: 01/17/2023]
Abstract
During a prospective surveillance using PCR for the detection of plasmid-mediated AmpC β-lactamase (pAmpC)-producing Enterobacteriaceae, outbreaks due to pAmpC-producing Klebsiella pneumoniae (pAmpC-Kp) occurred in an adult liver transplantation unit (aLTU) and a paediatric liver transplantation unit (pLTU), with carbapenem-resistant (CR) variants. Between April 2010 and March 2012, a total of 32 patients infected with pAmpC-Kp were found by prospective surveillance using PCR detection at a Japanese university hospital. Multilocus sequence typing, analysis of outer membrane proteins, and detection of carbapenemases were performed. Clinical courses of patients with bloodstream infection (BSI) were reviewed. Of 32 pAmpC-Kp isolates from each patient, 20 (18 from aLTU patients) were DHA-1-producing sequence type 11 (DHA-1-ST11), 9 were CMY-2-ST45/778 (all from pLTU patients) and the other 3 isolates had different sequence types. CR variants were isolated from 8 aLTU patients with DHA-1-ST11 and from 1 pLTU patient with CMY-2-ST45. All of the pAmpC-Kp isolates, including CR variants, were negative for carbapenemases. All of the DHA-1-ST11 and CMY-2-ST45 isolates lacked OmpK35, and seven CR variants also lacked OmpK36. BSIs due to DHA-1-ST11 isolates, including CR variants, occurred in six aLTU patients, four of whom died. The outbreaks were controlled after application of intensified infection control measures. During pAmpC-Kp outbreaks involving 27 liver transplants, CR variants with porin loss developed in nine patients, and DHA-1-ST11 K. pneumoniae caused BSIs with high mortality.
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Rapa RA, Labbate M. The function of integron-associated gene cassettes in Vibrio species: the tip of the iceberg. Front Microbiol 2013; 4:385. [PMID: 24367362 PMCID: PMC3856429 DOI: 10.3389/fmicb.2013.00385] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 11/25/2013] [Indexed: 12/17/2022] Open
Abstract
The integron is a genetic element that incorporates mobile genes termed gene cassettes into a reserved genetic site via site-specific recombination. It is best known for its role in antibiotic resistance with one type of integron, the class 1 integron, a major player in the dissemination of antibiotic resistance genes across Gram negative pathogens and commensals. However, integrons are ancient structures with over 100 classes (including class 1) present in bacteria from the broader environment. While, the class 1 integron is only one example of an integron being mobilized into the clinical environment, it is by far the most successful. Unlike clinical class 1 integrons which are largely found on plasmids, other integron classes are found on the chromosomes of bacteria and carry diverse gene cassettes indicating a non-antibiotic resistance role(s). However, there is very limited knowledge on what these alternative roles are. This is particularly relevant to Vibrio species where gene cassettes make up approximately 1-3% of their entire genome. In this review, we discuss how emphasis on class 1 integron research has resulted in a limited understanding by the wider research community on the role of integrons in the broader environment. This has the capacity to be counterproductive in solving or improving the antibiotic resistance problem into the future. Furthermore, there is still a significant lack of knowledge on how gene cassettes in Vibrio species drive adaptation and evolution. From research in Vibrio rotiferianus DAT722, new insight into how gene cassettes affect cellular physiology offers new alternative roles for the gene cassette resource. At least a subset of gene cassettes are involved in host surface polysaccharide modification suggesting that gene cassettes may be important in processes such as bacteriophage resistance, adhesion/biofilm formation, protection from grazers and bacterial aggregation.
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Affiliation(s)
- Rita A Rapa
- ithree Institute, University of Technology Sydney, NSW, Australia ; Department of Medical and Molecular Biosciences, University of Technology Sydney, NSW, Australia
| | - Maurizio Labbate
- ithree Institute, University of Technology Sydney, NSW, Australia ; Department of Medical and Molecular Biosciences, University of Technology Sydney, NSW, Australia
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