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Samarra A, Flores E, Bernabeu M, Cabrera-Rubio R, Bäuerl C, Selma-Royo M, Collado MC. Shaping Microbiota During the First 1000 Days of Life. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1449:1-28. [PMID: 39060728 DOI: 10.1007/978-3-031-58572-2_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Given that the host-microbe interaction is shaped by the immune system response, it is important to understand the key immune system-microbiota relationship during the period from conception to the first years of life. The present work summarizes the available evidence concerning human reproductive microbiota, and also, the microbial colonization during early life, focusing on the potential impact on infant development and health outcomes. Furthermore, we conclude that some dietary strategies including specific probiotics and other-biotics could become potentially valuable tools to modulate the maternal-neonatal microbiota during this early critical window of opportunity for targeted health outcomes throughout the entire lifespan.
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Affiliation(s)
- Anna Samarra
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna-Valencia, Spain
| | - Eduard Flores
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna-Valencia, Spain
| | - Manuel Bernabeu
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna-Valencia, Spain
| | - Raul Cabrera-Rubio
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna-Valencia, Spain
| | - Christine Bäuerl
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna-Valencia, Spain
| | - Marta Selma-Royo
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna-Valencia, Spain
| | - Maria Carmen Collado
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Paterna-Valencia, Spain.
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Angulo-Zamudio UA, Flores-Villaseñor H, Leon-Sicairos N, Zazueta-Armenta D, Martínez-Villa FA, Tapia-Pastrana G, Angulo-Rocha J, Murillo-Llanes J, Barajas-Olivas MF, Canizalez-Roman A. Virulence-associated genes and antimicrobial resistance patterns in bacteria isolated from pregnant and nonpregnant women with urinary tract infections: the risk of neonatal sepsis. Can J Microbiol 2023; 69:488-500. [PMID: 37815047 DOI: 10.1139/cjm-2023-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Uropathogenic Escherichia coli (UPEC) is classified as the major causative agent of urinary tract infections (UTIs). UPEC virulence and antibiotic resistance can lead to complications in pregnant women and (or) newborns. Therefore, the aim of this study was to determine the etiological agents of UTIs, as well as to identify genes related to virulence factors in bacteria isolated from pregnant and nonpregnant women. A total of 4506 urine samples were collected from pregnant and nonpregnant women. Urine cultures were performed, and PCR was used to identify phylogroups and virulence-related genes. Antibiotic resistance profiles were determined. The incidence of UTIs was 6.9% (pregnant women, n = 206 and nonpregnant women, n = 57), and UPEC belonging to phylogroup A was the most prevalent. The presence of genes related to capsular protection, adhesins, iron acquisition, and serum protection in UPEC was associated with not being pregnant, while the presence of genes related to adhesins was associated with pregnancy. Bacteria isolated from nonpregnant women were more resistant to antibiotics; 36.5% were multidrug resistant, and 34.9% were extensively drug resistant. Finally, UTIs were associated with neonatal sepsis risk, particularly in pregnant women who underwent cesarean section while having a UTI caused by E. coli. In conclusion, UPEC isolated from nonpregnant women carried more virulence factors than those isolated from pregnant women, and maternal UTIs were associated with neonatal sepsis risk.
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Affiliation(s)
| | - Hector Flores-Villaseñor
- School of Medicine, Autonomous University of Sinaloa, 80246 Culiacan Sinaloa, Mexico
- The Sinaloa State Public Health Laboratory, Secretariat of Health, 80200 Culiacan Sinaloa, Mexico
| | - Nidia Leon-Sicairos
- School of Medicine, Autonomous University of Sinaloa, 80246 Culiacan Sinaloa, Mexico
- Pediatric Hospital of Sinaloa, 80200 Culiacan Sinaloa, Mexico
| | - Dina Zazueta-Armenta
- School of Medicine, Autonomous University of Sinaloa, 80246 Culiacan Sinaloa, Mexico
- The Women's Hospital, Secretariat of Health, 80127 Culiacan Sinaloa, Mexico
| | | | - Gabriela Tapia-Pastrana
- Laboratorio de Investigación Biomédica, Hospital Regional de Alta Especialidad de Oaxaca, 71256 Oaxaca, Mexico
| | - Jorge Angulo-Rocha
- The Women's Hospital, Secretariat of Health, 80127 Culiacan Sinaloa, Mexico
| | | | | | - Adrian Canizalez-Roman
- School of Medicine, Autonomous University of Sinaloa, 80246 Culiacan Sinaloa, Mexico
- The Women's Hospital, Secretariat of Health, 80127 Culiacan Sinaloa, Mexico
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3
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Choi YS, Kim Y, Hong SY, Cho HJ, Sung JH, Choi SJ, Kim JS, Oh SY, Roh CR. Abnormal Vaginal Flora in Cervical Incompetence Patients - the Impact of Escherichia coli. Reprod Sci 2023; 30:3010-3018. [PMID: 37118059 DOI: 10.1007/s43032-023-01242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/09/2023] [Indexed: 04/30/2023]
Abstract
The purpose of this study was to investigate the prevalence of abnormal vaginal colonization in women with cervical incompetence and to analyze its impact on obstetric and neonatal outcomes and placental inflammation. We included 138 pregnant women diagnosed with cervical incompetence and delivered in our hospital. Patients with major fetal anomaly or multifetal pregnancy were excluded. Upper vaginal culture was performed on the day of admission. A total of 60.9% (84/138) of cervical incompetence patients had abnormal bacterial colonization, and Escherichia coli (E. coli) was the most common colonized pathogen (33.3%, 46/138). The positive vaginal E. coli group had a higher rate of prior preterm birth (p = 0.021) and an earlier gestational age at which cervical incompetence was diagnosed (p < 0.01) than the negative group. The positive vaginal E. coli group had higher rates of clinical chorioamnionitis (p = 0.008) and subchorionic microabscess of the placenta (p = 0.012). Importantly, the positive vaginal E. coli group had significantly higher rates of proven early-onset neonatal sepsis (EONS) (p = 0.046), necrotizing enterocolitis (NEC) (p = 0.001), and neonatal mortality (p = 0.023). After adjusting for confounding variables, the positive vaginal E. coli group had significantly higher risk for proven EONS (OR: 3.853, 95% CI: 1.056-14.055) and NEC (OR: 12.410, 95% CI: 1.290-119.351). In conclusion, E. coli was the most common vaginal microorganism isolated from patients with cervical incompetence. Maternal vaginal E. coli colonization was associated with adverse neonatal outcomes including proven EONS and NEC and was characterized by a higher rate of placental subchorionic microabscess.
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Affiliation(s)
- Yun-Sun Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea, 06351
| | - Yejin Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea, 06351
| | - Sir-Yeon Hong
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea, 06351
| | - Hye Jung Cho
- Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Ji-Hee Sung
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea, 06351
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea, 06351
| | - Jung-Sun Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo-Young Oh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea, 06351.
| | - Cheong-Rae Roh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea, 06351
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Limaye MA, Brubaker S, Randis TM, Ratner AJ. Vaginal carriage of Haemophilus influenzae in a non-pregnant reproductive-age population. BMC Microbiol 2023; 23:141. [PMID: 37208594 PMCID: PMC10197216 DOI: 10.1186/s12866-023-02885-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 05/08/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Haemophilus influenzae (Hi) is an emerging cause of early onset neonatal sepsis, but mechanisms of transmission are not well understood. We aimed to determine the prevalence of vaginal carriage of Hi in reproductive age women and to examine behavioral and demographic characteristics associated with its carriage. METHODS We performed a secondary analysis of stored vaginal lavage specimens from a prospective cohort study of nonpregnant reproductive-age women. After extraction of bacterial genomic DNA, samples were tested for the presence of the gene encoding Haemophilus protein d (hpd) by quantitative real-time polymerase chain reaction (PCR) using validated primers and probe. PCR for the V3-V4 region of the 16 S rRNA gene (positive control) assessed sample quality. Samples with cycle threshold (CT) value < 35 were defined as positive. Sanger sequencing confirmed the presence of hpd. Behavioral and demographic characteristics associated with vaginal carriage of Hi were examined. RESULTS 415 samples were available. 315 (75.9%) had sufficient bacterial DNA and were included. 14 (4.4%) were positive for hpd. There were no demographic or behavioral differences between the women with Hi vaginal carriage and those without. There was no difference in history of bacterial vaginosis, vaginal microbiome community state type, or presence of Group B Streptococcus in women with and without vaginal carriage of Hi. CONCLUSION Hi was present in vaginal lavage specimens of 4.4% of this cohort. Hi presence was unrelated to clinical or demographic characteristics, though the relatively small number of positive samples may have limited power to detect such differences.
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Affiliation(s)
- Meghana A Limaye
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA.
| | - Sara Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, USA
| | - Tara M Randis
- Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Adam J Ratner
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA
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Barinov SV, Di Renzo GC, Tsibizova VI, Shifman EМ, Leont'eva NN, Arbuzov AB. Detoxification treatment in Gynecology using a modified molded sorbent. Best Pract Res Clin Obstet Gynaecol 2023:102346. [PMID: 37225639 DOI: 10.1016/j.bpobgyn.2023.102346] [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: 01/31/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 05/26/2023]
Abstract
Postpartum endometritis is a common complication of cesarean section, the progression of which often leads to the loss of the uterus and the patient's fertility. We evaluated a detoxification therapy for treating patients with postpartum endometritis using an intrauterine application of a modified molded sorbent containing polyvinylpyrrolidone. A retrospective, controlled study included 124 patients with postpartum endometritis. The study group, n = 63, was composed of puerperae with postpartum endometritis after cesarean section, receiving antibacterial therapy in combination with the intrauterine application of a molded modified sorbent containing polyvinylpyrrolidone (FSMP) for 24 h daily for 5 days. The control group, n = 61, was composed of puerperae with postpartum endometritis after cesarean section, receiving antibacterial treatment only. The uterine cavity was infected by coccal flora (Enterococcus faecalis (26.6%), Staphylococcus spp. (21.3%), E. faecium (14.3%), and Gram-negative Escherichia coli (9.6%). A combination of these microorganisms was present in 40.5% of crops. Antibiotic resistance was detected in 53.6%-68.3% of the cases. In the study group, we observed: a faster and higher decrease in neutrophils (p < 0.05); a lower uterine concentration of pro-inflammatory cytokines: interleukin-1 beta (IL-1β) and tumor necrosis factor α (TNFα) - 4.0 and 3.2 times, respectively, compared with the control group (p < 0.05); and a significant decrease in the uterus volume and cavity (M-echo). Using a newly modified sorbent associated with antibiotic treatment in patients with postpartum endometritis, compared with antibiotics alone, we showed a sharp reduction of inflammatory parameters, residual microorganism growth, and faster uterine volume involution. Moreover, the frequency of hysterectomy decreased by 14.4 times.
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Affiliation(s)
- S V Barinov
- Federal State Budget Institution of Higher Education, "Omsk State Medical University" of the Russian Ministry of Health, Omsk, Russian Federation.
| | - G C Di Renzo
- Centre for Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy; Wayne State University Medical School and Perinatal Research Branch, NIH-NICHD, Detroit, MI, 48201, USA; PREIS International and European School of Perinatal, Neonatal and Reproductive Medicine, Florence, Italy; Department of Obstetrics, Gynecology and Perinatal Medicine of the Clinical Institute of Children's Health Named After N.F. Filatov, I.M. Sechenov First State Medical University Under Ministry of Health of the Russian Federation, Moscow, Russian Federation.
| | - V I Tsibizova
- Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre, Saint-Petersburg, Russian Federation; PREIS International and European School of Perinatal, Neonatal and Reproductive Medicine, Florence, Italy.
| | - E М Shifman
- Department of Anesthesiology and Сritical Care of Moscow Regional M.V. Vladimirsky Moscow`s Regional Research Clinical Institute, Moscow, Russian Federation.
| | - N N Leont'eva
- Center of New Chemical Technologies Boreskov Institute of Catalysis, Omsk, Russian Federation.
| | - A B Arbuzov
- Center of New Chemical Technologies Boreskov Institute of Catalysis, Omsk, Russian Federation.
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Choi YS, Kim JH, Kim Y, Cho HJ, Sung JH, Choi SJ, Oh SY, Kim YJ, Roh CR. Growing threat of extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in high-risk pregnancies: A cross-sectional study. BJOG 2023; 130:415-423. [PMID: 35445798 DOI: 10.1111/1471-0528.17194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/10/2022] [Accepted: 03/20/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the epidemiological changes in extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) vaginal colonisation in pregnant women deemed at high risk, and to identify independent risk factors. Further, the differences in perinatal outcomes according to maternal ESBL-E vaginal colonisation were analysed. DESIGN Cross-sectional study. SETTING Republic of Korea. POPULATION A cohort of 1460 women admitted to our high-risk pregnancy unit between 14+0 and 36+6 weeks of gestation. METHODS The trend of changes in the association of ESBL-E vaginal colonisation from January 2010 to December 2020 was analysed. The main outcomes were analysed over the study period and ESBL-E vaginal colonisation. MAIN OUTCOME MEASURES Rate of ESBL-E vaginal colonisation, risk factors for ESBL-E vaginal colonisation and perinatal outcomes. RESULTS The ESBL-E vaginal colonisation rate has tended to increase over the past 11 years, which was attributed to a significantly higher proportion of ESBL-producing Escherichia coli. Cerclage (RR 3.7, 95% CI 2.19-6.40) and prior antibiotic treatment (RR 4.0, 95% CI 2.44-6.54) were found as independent risk factors for ESBL-E vaginal colonisation. Earlier gestational age at delivery and higher proven early-onset neonatal sepsis (EONS) rate were observed in the ESBL-E-positive group. CONCLUSIONS The ESBL-E vaginal colonisation rate in pregnant patients at high risk has increased over the past decade, and the independent risk factors for colonisation are cerclage and prior antibiotic treatment. Additionally, maternal ESBL-E vaginal colonisation is associated with higher rates of proven EONS.
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Affiliation(s)
- Yun-Sun Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin-Ha Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yejin Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Jung Cho
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji-Hee Sung
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Soo-Young Oh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yae-Jean Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Cheong-Rae Roh
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Olmos-Ortiz A, Hernández-Pérez M, Flores-Espinosa P, Sedano G, Helguera-Repetto AC, Villavicencio-Carrisoza Ó, Valdespino-Vazquez MY, Flores-Pliego A, Irles C, Rivas-Santiago B, Moreno-Verduzco ER, Díaz L, Zaga-Clavellina V. Compartmentalized Innate Immune Response of Human Fetal Membranes against Escherichia coli Choriodecidual Infection. Int J Mol Sci 2022; 23:ijms23062994. [PMID: 35328414 PMCID: PMC8949057 DOI: 10.3390/ijms23062994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 12/29/2022] Open
Abstract
An infectious process into the uterine cavity represents a major endangered condition that compromises the immune privilege of the maternal-fetal unit and increases the risk for preterm birth (PTB) and premature rupture of membranes (PROM). Fetal membranes are active secretors of antimicrobial peptides (AMP), which limit bacterial growth, such as Escherichia coli. Nevertheless, the antibacterial responses displayed by chorioamniotic membranes against a choriodecidual E. coli infection have been briefly studied. The objective of this research was to characterize the profile of synthesis, activity, and spatial distribution of a broad panel of AMPs produced by fetal membranes in response to E. coli choriodecidual infection. Term human chorioamniotic membranes were mounted in a two independent compartment model in which the choriodecidual region was infected with live E. coli (1 × 105 CFU/mL). Amnion and choriodecidual AMP tissue levels and TNF-α and IL-1β secretion were measured by the enzyme-linked immunosorbent assay. The passage of bacterium through fetal membranes and their effect on structural continuity was followed for 24 h. Our results showed that E. coli infection caused a progressive mechanical disruption of the chorioamniotic membranes and an activated inflammatory environment. After the challenge, the amnion quickly (2-4 h) induced production of human beta defensins (HBD)-1, HBD-2, and LL-37. Afterwards (8-24 h), the amnion significantly produced HBD-1, HBD-2, HNP-1-3, S100A7, sPLA2, and elafin, whereas the choriodecidua induced LL-37 synthesis. Therefore, we noticed a temporal- and tissue-specific pattern regulation of the synthesis of AMPs by infected fetal membranes. However, fetal membranes were not able to contain the collagen degradation or the bacterial growth and migration despite the battery of produced AMPs, which deeply increases the risk for PTB and PROM. The mixture of recombinant HBDs at low concentrations resulted in increased bactericidal activity compared to each HBD alone in vitro, encouraging further research to study AMP combinations that may offer synergy to control drug-resistant infections in the perinatal period.
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Affiliation(s)
- Andrea Olmos-Ortiz
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología (INPer), Mexico City 11000, Mexico; (A.O.-O.); (M.H.-P.); (P.F.-E.); (G.S.); (A.C.H.-R.); (Ó.V.-C.); (A.F.-P.)
| | - Mayra Hernández-Pérez
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología (INPer), Mexico City 11000, Mexico; (A.O.-O.); (M.H.-P.); (P.F.-E.); (G.S.); (A.C.H.-R.); (Ó.V.-C.); (A.F.-P.)
| | - Pilar Flores-Espinosa
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología (INPer), Mexico City 11000, Mexico; (A.O.-O.); (M.H.-P.); (P.F.-E.); (G.S.); (A.C.H.-R.); (Ó.V.-C.); (A.F.-P.)
| | - Gabriela Sedano
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología (INPer), Mexico City 11000, Mexico; (A.O.-O.); (M.H.-P.); (P.F.-E.); (G.S.); (A.C.H.-R.); (Ó.V.-C.); (A.F.-P.)
| | - Addy Cecilia Helguera-Repetto
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología (INPer), Mexico City 11000, Mexico; (A.O.-O.); (M.H.-P.); (P.F.-E.); (G.S.); (A.C.H.-R.); (Ó.V.-C.); (A.F.-P.)
| | - Óscar Villavicencio-Carrisoza
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología (INPer), Mexico City 11000, Mexico; (A.O.-O.); (M.H.-P.); (P.F.-E.); (G.S.); (A.C.H.-R.); (Ó.V.-C.); (A.F.-P.)
| | | | - Arturo Flores-Pliego
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología (INPer), Mexico City 11000, Mexico; (A.O.-O.); (M.H.-P.); (P.F.-E.); (G.S.); (A.C.H.-R.); (Ó.V.-C.); (A.F.-P.)
| | - Claudine Irles
- Departamento de Fisiología y Desarrollo Celular, INPer, Mexico City 11000, Mexico;
| | | | | | - Lorenza Díaz
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico;
| | - Verónica Zaga-Clavellina
- Departamento de Fisiología y Desarrollo Celular, INPer, Mexico City 11000, Mexico;
- Correspondence: ; Tel.: +52-55-5520-9900 (ext. 478)
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Saraf VS, Bhatti T, Javed S, Bokhari H. Antimicrobial Resistance Pattern in E. coli Isolated from Placental Tissues of Pregnant Women in Low-Socioeconomic Setting of Pakistan. Curr Microbiol 2022; 79:83. [PMID: 35122538 DOI: 10.1007/s00284-022-02769-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/14/2022] [Indexed: 11/27/2022]
Abstract
Infections during pregnancy can culminate in adverse pregnancy outcomes, including preterm birth (PTB). Pakistan is among the top ten nations with high PTB-associated neonatal mortality rates, where access to prenatal as well as neonatal care is only afforded by the privileged few. Societal stigma further discourages women seeking healthcare for minor infections. Microbial pathogens associated with genitourinary infections can lead to gestational complications culminating in earlier onset of labor. In this study, association of Escherichia coli (E. coli) with PTB in Pakistani women of low-socioeconomic status is examined. 57 paired vaginal swabs and placenta samples from mothers with full term and preterm deliveries were collected and processed for isolation and molecular characterization of extraintestinal pathogenic E. coli (ExPEC). ExPEC isolated from vaginal swabs and placenta showed phylotype B2 being most prevalent (Vagina n = 3 (9), 33%) (Placenta n = 4 (12), 33%) in preterm cases followed by phylotype B1 (Vagina n = 2 (9), 22%) (Placenta n = 3 (12), 25%) and untypeable strains. Antibiotic susceptibility profiling showed a large percentage of resistant isolates to multiple antibiotics, including carbapenem and included extended-spectrum beta-lactamase (ESBL) producers. Our study is the first to report different phylotypes of E. coli from placental tissues in preterm deliveries which may be a cause for concern for maternal and neonatal health. ExPEC from vaginal swabs and placental of females delivering preterm shows the pathogenic phylotype B2 dominance with a large percentage of isolates resistant to multiple antibiotics, including carbapenem and included ESBL producers. The placental isolates may indicate ascending infection from vagina or urinary tract which may lead to preterm birth.
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Affiliation(s)
- Viqar Sayeed Saraf
- Public Health and Microbiology Lab, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan
| | - Theophilus Bhatti
- Public Health and Microbiology Lab, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan
| | - Sundus Javed
- Public Health and Microbiology Lab, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan.
| | - Habib Bokhari
- Public Health and Microbiology Lab, Department of Biosciences, COMSATS University Islamabad, Park road, Tarlai Kalan, Islamabad, Pakistan.
- Kohsar University Murree, Kashmir point, Murree, Punjab, Pakistan.
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9
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Scalise ML, Garimano N, Sanz M, Padola NL, Leonino P, Pereyra A, Casale R, Amaral MM, Sacerdoti F, Ibarra C. Detection of Shiga Toxin-Producing Escherichia coli (STEC) in the Endocervix of Asymptomatic Pregnant Women. Can STEC Be a Risk Factor for Adverse Pregnancy Outcomes? Front Endocrinol (Lausanne) 2022; 13:945736. [PMID: 35957815 PMCID: PMC9358589 DOI: 10.3389/fendo.2022.945736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
The presence of Escherichia coli in the vaginal microbiome has been associated with pregnancy complications. In previous works, we demonstrated that Shiga toxin-producing Escherichia coli (STEC) can produce abortion and premature delivery in rats and that Shiga toxin type 2 (Stx2) can impair human trophoblast cell lines. The hypothesis of this work was that STEC may colonize the lower female reproductive tract and be responsible for adverse pregnancy outcomes. Thus, the aim of this work was to evaluate the presence and prevalence of virulence factor genes from STEC in the endocervix of asymptomatic pregnant women. For that purpose, endocervical swabs were collected from pregnant women during their prenatal examination. Swab samples were enriched in a differential medium to select Enterobacteria. Then, positive samples were analyzed by PCR to detect genes characteristic of Escherichia sp. (such as uidA and yaiO), genes specific for portions of the rfb (O-antigen-encoding) regions of STEC O157 (rfbO157), and STEC virulence factor genes (such as stx1, stx2, eae, lpfAO113, hcpA, iha, sab, subAB). The cytotoxic effects of stx2-positive supernatants from E. coli recovered from the endocervix were evaluated in Vero cells. Our results showed that 11.7% of the endocervical samples were positive for E. coli. Additionally, we found samples positive for stx2 and other virulence factors for STEC. The bacterial supernatant from an isolate identified as E. coli O113:NT, carrying the stx2 gene, exhibited cytotoxic activity in Vero, Swan 71 and Hela cells. Our results open a new perspective regarding the presence of STEC during pregnancy.
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Affiliation(s)
- María Luján Scalise
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica, IFIBIO-Houssay (UBA-CONICET), Departamento de Ciencias Fisiológicas, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nicolás Garimano
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica, IFIBIO-Houssay (UBA-CONICET), Departamento de Ciencias Fisiológicas, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Marcelo Sanz
- CIVETAN-Centro de Investigación Veterinaria Tandil (CONICET, CICPBA), Facultad de Ciencias Veterinarias, Tandil, Argentina
| | - Nora Lia Padola
- CIVETAN-Centro de Investigación Veterinaria Tandil (CONICET, CICPBA), Facultad de Ciencias Veterinarias, Tandil, Argentina
| | - Patricia Leonino
- Departamento de Obstetricia, Hospital Nacional “Prof. A. Posadas”, Buenos Aires, Argentina
| | - Adriana Pereyra
- Departamento de Obstetricia, Hospital Nacional “Prof. A. Posadas”, Buenos Aires, Argentina
| | - Roberto Casale
- Departamento de Obstetricia, Hospital Nacional “Prof. A. Posadas”, Buenos Aires, Argentina
| | - María Marta Amaral
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica, IFIBIO-Houssay (UBA-CONICET), Departamento de Ciencias Fisiológicas, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Flavia Sacerdoti
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica, IFIBIO-Houssay (UBA-CONICET), Departamento de Ciencias Fisiológicas, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
- *Correspondence: Cristina Ibarra, ; Flavia Sacerdoti,
| | - Cristina Ibarra
- Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica, IFIBIO-Houssay (UBA-CONICET), Departamento de Ciencias Fisiológicas, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
- *Correspondence: Cristina Ibarra, ; Flavia Sacerdoti,
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Genotyping of Escherichia coli Causing Vaginal Infection in Dysplastic Patients with Similar Genetic Backgrounds Between Commensal and Virulent Strains. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.117488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Escherichia coli in the vagina includes several virulence factors in its genome mobile genetic elements and can facilitate colonization, mainly in immunosuppressed patients. Objectives: This work aimed to demonstrate that E. coli strains of vaginal origin isolated from dysplastic patients possess virulence and resistance genes Methods: This study included one hundred and five E. coli strains isolated from women with cervical dysplasia and vaginal infection. The strains were characterized by antimicrobial susceptibility. The Clermont algorithm performed the phylogenetic assignment. The structure of class 1 integrons was performed by identifying integrase (int1), the variable region, and qacEΔ1-sul1 genes. The variable region was amplified, sequenced, and analyzed. Enterobacterial repetitive intergenic consensus (ERIC) PCR and virus typing typed strains with identical genetic arrangements by detecting virulence genes related to cytotoxicity, adherence, and iron uptake. Results: Escherichia coli strains showed great resistance to β-lactams and quinolones, and phylogenetic assignment showed that the group A/C was highly predominant. Sixteen integrons were identified, with monogenic arrays represented by aadA1, dfrB4dfrA7, dfr2D, and dfrA17 cassettes. The prevalence of the biogenic arrays aadA1/dfrA1 and aadA5/dfrA17 was lower than that of blaOXA-1/aadA1. Concerning virulence genes, fimH, traT, and iutA were the most predominant. Conclusions: The high incidence of virulence and resistance factors in commensal and virulent strains of E. coli revealed potential tools in the pathogenesis of vaginal infection.
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Villegas JAA, Reyes HM, Sánchez MA, Cruz Rosas MF, Sanchez Monroy R, Zamudio JEB, Palacios Rodriguez AP. Identification of Escherichia coli strains in the vaginal cultures of healthy women and their patterns of antibiotic resistance. MEDICAL SCIENCE PULSE 2021. [DOI: 10.5604/01.3001.0015.4250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Bacterial vaginosis is the most common cause of vaginitis in women of childbearing age, and
it predominantly affects young sexually active women. Escherichia coli is one of the most common bacteria
found in the genital tract of non-pregnant (9–28%) and pregnant women (24–31%). E. coli strains can colonize
the vaginal and endocervical regions in pregnant women, and may lead to the development of urinary
tract, intra-amniotic or puerperal infections.
Aim of the study: Isolation and identification of the antibiotic resistance patterns of extended spectrum
beta-lactamase (ESBL)-producing and non-producing E. coli in the vaginal cultures of healthy women.
Material and methods: Vaginal samples were taken from 55 healthy women. For the bacterial identification
and resistance patterns, automated equipment from Beckman Coulter was used. Phenotypic techniques were
used to confirm the presence or absence of ESBL.
Results: Fifty-five cultures developed E. coli, with the rest of the strains corresponding to different bacteria.
Of the 55 E. coli cultures, 35 (63.63%) were ESBL-producing and 20 (36.36%) did not produce ESBL. There
was an 80% resistance to penicillin, and a 76.4% and 65.5% resistance to the first and fourth generation
cephalosporins, respectively. A 45.5% resistance was observed for the fluoroquinolones, 52.7% for trimethoprim/
sulfamethoxazole, and 100% sensitivity to carbapenemics and amikacin.
Conclusions: A large presence of vaginal ESBL-producing E. coli was observed in healthy women, which increases
the risk of therapeutic failure due to high levels of antibiotic resistance.
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Affiliation(s)
| | - Harold Mondragon Reyes
- School of Biological Pharmaceutical Chemistry, University of Ixtlahuaca CUI, Ixtlahuaca, Mexico
| | - Mariana Aguilar Sánchez
- School of Biological Pharmaceutical Chemistry, University of Ixtlahuaca CUI, Ixtlahuaca, Mexico
| | | | - Regina Sanchez Monroy
- School of Biological Pharmaceutical Chemistry, University of Ixtlahuaca CUI, Ixtlahuaca, Mexico
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Saghafi F, Mirzaie F, Gorji E, Nabimeybodi R, Fattahi M, Mahmoodian H, Zareshahi R. Antibacterial and anti-Trichomonas Vaginalis effects of Rosa Damascena mill petal oil (a persian medicine product), aqueous and hydroalcoholic extracts. BMC Complement Med Ther 2021; 21:265. [PMID: 34670535 PMCID: PMC8527719 DOI: 10.1186/s12906-021-03434-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/28/2021] [Indexed: 12/15/2022] Open
Abstract
Background Oils in traditional medicine are important products and used routinely for therapeutic purposes. Rose oil (Rosa damascene Mill), a product of Persian medicine, is advised for the treatment of Infectious diseases related to the female genitourinary tract. In the present study, R. damascena petal oil, aqueous, and hydroalcoholic extracts were evaluated for their in vitro antibacterial and anti-Trichomonas vaginalis effects. Methods Anti-trichomonas activity evaluation of extracts and oil were assayed by the Homocytometery method. Their antibacterial effects against Escherichia coli, methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and clinically isolated Group B Streptococcus were assayed by broth microdilution in 96-well plates. Results The MIC of hydroalcoholic and aqueous extracts ranged from 25-50 and 25-100 mg/ml, respectively. Rose oil at all administered doses failed to show any antibacterial activity. Conclusion All extracts and oil concentrations showed some degree of growth inhibition activity on T. vaginalis; however, hydroalcoholic extract was more efficient.
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Affiliation(s)
- Fatemeh Saghafi
- Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farzaneh Mirzaie
- Department of Parasitology and Mycology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Gorji
- Herbal Medicines Research Center, Student Research Committee, School of Pharmacy, Shahid Sadoughi University of Medical Science Health Services, Yazd, Iran
| | - Razieh Nabimeybodi
- Department of Persian Medicine, School of Persian Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran
| | - Mehdi Fattahi
- Department of Microbiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Rahele Zareshahi
- Department of Pharmacognosy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Birhane Fiseha S, Mulatu Jara G, Azerefegn Woldetsadik E, Belayneh Bekele F, Mohammed Ali M. Colonization Rate of Potential Neonatal Disease-Causing Bacteria, Associated Factors, and Antimicrobial Susceptibility Profile Among Pregnant Women Attending Government Hospitals in Hawassa, Ethiopia. Infect Drug Resist 2021; 14:3159-3168. [PMID: 34429615 PMCID: PMC8374838 DOI: 10.2147/idr.s326200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/30/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Vaginal colonization with some species of bacteria during the last term of pregnancy can affect the health of fetuses and newborns resulting in high morbidity and mortality among newborns. Objective The aim of this study was to determine the colonization rate of potential neonatal disease-causing bacteria, factors associated with colonization rate, and the antimicrobial susceptibility profile of bacteria among pregnant women. Methods Institution-based cross-sectional study was conducted on pregnant women from October 13 to December 28, 2020, at government hospitals located in Hawassa, Ethiopia. Background data were captured using a structured questionnaire. Vaginal swabs were collected to isolate bacteria using the standard method. Antimicrobial susceptibility test was performed using the modified Kirby–Bauer disc diffusion method. Data were analyzed using SPSS. Factors that could predict vaginal colonization with potential neonatal disease-causing bacteria were determined using logistic regression. Results Overall bacterial colonization rate among pregnant women was 271 (98.9%) 95 CI (97.4‒100.1). The prevalence of potential neonatal disease-causing bacteria was 95 (34.7%) 95 CI (28.8‒40.1). The proportion of potential neonatal disease-causing bacteria were as follows: Escherichia coli (n=82, 29.9%), Acinetobacter species (n=9, 3.3%), Staphylococcus aureus (n=7. 2.6%), and Klebsiella pneumoniae (n=4, 1.5%). Pregnant women with a gestational age of 38‒40 weeks were 1.9 times (AOR= 1.9, 95% CI= 1.0–3.4, p=0.04) were more likely to be colonized by potential neonatal disease-causing bacteria. All E. coli, Klebsiella species, and Acinetobacter species were susceptible to gentamicin and imipenem. All S. aureus were susceptible to penicillin, tetracycline, clindamycin, and erythromycin. Conclusion High proportion of pregnant women in this study were colonized with potential neonatal disease-causing bacteria. E. coli was the predominant bacteria. Most bacteria isolated in this study were susceptible to antimicrobial agents tested. Gestational age was significantly associated with the colonization rate of potential neonatal disease-causing bacteria.
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Affiliation(s)
| | - Getamesay Mulatu Jara
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | | | - Fanuel Belayneh Bekele
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Musa Mohammed Ali
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Megli CJ, Coyne CB. Infections at the maternal-fetal interface: an overview of pathogenesis and defence. Nat Rev Microbiol 2021; 20:67-82. [PMID: 34433930 PMCID: PMC8386341 DOI: 10.1038/s41579-021-00610-y] [Citation(s) in RCA: 148] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 02/08/2023]
Abstract
Infections are a major threat to human reproductive health, and infections in pregnancy can cause prematurity or stillbirth, or can be vertically transmitted to the fetus leading to congenital infection and severe disease. The acronym ‘TORCH’ (Toxoplasma gondii, other, rubella virus, cytomegalovirus, herpes simplex virus) refers to pathogens directly associated with the development of congenital disease and includes diverse bacteria, viruses and parasites. The placenta restricts vertical transmission during pregnancy and has evolved robust mechanisms of microbial defence. However, microorganisms that cause congenital disease have likely evolved diverse mechanisms to bypass these defences. In this Review, we discuss how TORCH pathogens access the intra-amniotic space and overcome the placental defences that protect against microbial vertical transmission. Infections during pregnancy can be associated with devastating outcomes for the pregnant mother and developing fetus. In this Review, Megli and Coyne discuss placental defences and provide an overview of how various viral, bacterial and parasitic pathogens traverse the maternal–fetal interface and cause disease.
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Affiliation(s)
- Christina J Megli
- Division of Maternal-Fetal Medicine, Division of Reproductive Infectious Disease, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine and the Magee Womens Research Institute, Pittsburgh, PA, USA.
| | - Carolyn B Coyne
- Department of Molecular Genetics and Microbiology and the Duke Human Vaccine Institute, Duke University School of Medicine, Durham, NC, USA.
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Patangia DV, Ryan CA, Dempsey E, Stanton C, Ross RP. Vertical transfer of antibiotics and antibiotic resistant strains across the mother/baby axis. Trends Microbiol 2021; 30:47-56. [PMID: 34172345 DOI: 10.1016/j.tim.2021.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/06/2021] [Accepted: 05/20/2021] [Indexed: 02/07/2023]
Abstract
Antibiotic resistance is a health and socioeconomic crisis recognized as a serious threat affecting humans worldwide. Overuse of antibiotics enhances the spread of multidrug-resistant bacteria, causing drug-resistant infections which can be difficult to treat. This resistance, mostly of the acquired type, is thus a major clinical issue. Acquired resistance can occur by horizontal transfer of genes between bacteria (community settings), by vertical transmission that can occur between mother and her offspring at birth and during lactation, or spontaneously due to antibiotic exposure. While there have been multiple studies about the horizontal transfer of antibiotic-resistance genes, not many studies have been conducted to study their vertical transmission. Vertical transmission is of importance as the early bacterial colonization of infants has an impact on their health and immune programming throughout life. This review discusses some possible mechanisms of mother-to-infant transmission of antibiotics and antibiotic-resistant strains and addresses the knowledge gaps for further studies.
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Affiliation(s)
- Dhrati V Patangia
- School of Microbiology, University College Cork, Cork, Ireland; Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland; APC Microbiome Ireland, Cork, Ireland
| | - C Anthony Ryan
- School of Microbiology, University College Cork, Cork, Ireland
| | - Eugene Dempsey
- School of Microbiology, University College Cork, Cork, Ireland
| | - Catherine Stanton
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland; APC Microbiome Ireland, Cork, Ireland
| | - R Paul Ross
- School of Microbiology, University College Cork, Cork, Ireland; APC Microbiome Ireland, Cork, Ireland.
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16
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Viet NT, Van Du V, Thuan ND, Van Tong H, Toan NL, Van Mao C, Van Tuan N, Pallerla SR, Nurjadi D, Velavan TP, Son HA. Maternal Vaginal Colonization and Extended-Spectrum Beta-Lactamase-Producing Bacteria in Vietnamese Pregnant Women. Antibiotics (Basel) 2021; 10:antibiotics10050572. [PMID: 34067975 PMCID: PMC8152252 DOI: 10.3390/antibiotics10050572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/27/2021] [Accepted: 05/11/2021] [Indexed: 02/07/2023] Open
Abstract
Extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) resistance to commonly prescribed drugs is increasing in Vietnam. During pregnancy, ESBL-E may predispose women to reproductive tract infections and increases the risk for neonatal morbidity. Vaginal colonization and infections by Escherichia coli and Klebsiella pneumoniae are seldom studied in Vietnam. In this study, we investigated ESBL-producing Enterobacterales in the birth canal of pregnant women. Between 2016 and 2020, vaginal swabs were collected from 3104 pregnant women (mean gestational age of 31 weeks) and inoculated onto MacConkey agar plates. Colonies were subjected to direct identification and antimicrobial susceptibility testing using the VITEK®-2 automated compact system and disk diffusion. ESBL production was determined phenotypically. E. coli, Klebsiella species were identified in 30% (918/3104) of the vaginal swabs, with E. coli being the most common (73%; 667/918). ESBL-production was detected in 47% (432/918) of Enterobacterales, with frequent multidrug-resistant phenotype. The overall prevalence of carbapenem resistance was low (8%). Over 20% of Klebsiella spp. were carbapenem-resistant. Pregnant women had a high prevalence of colonization and may transmit ESBL-E to neonates at birth, an important risk factor to be considered. The high rate of ESBL-producers and carbapenem resistance in Enterobacterales in Vietnam emphasizes the need for consequent surveillance and access to molecular typing.
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Affiliation(s)
- Nguyen Thanh Viet
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi 121-08, Vietnam; (N.T.V.); (H.V.T.)
| | - Vu Van Du
- National Hospital of Obstetrics and Gynecology, Hanoi 110-02, Vietnam;
| | - Nghiem Duc Thuan
- ENT Department, 103 Military Hospital, Vietnamese Military Medical University, Hanoi 121-08, Vietnam;
| | - Hoang Van Tong
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi 121-08, Vietnam; (N.T.V.); (H.V.T.)
| | - Nguyen Linh Toan
- Department Post-Graduate Training Management, Vietnamese Military Medical University, Hanoi 121-08, Vietnam;
- Department of Pathophysiology, Vietnamese Military Medical University, Hanoi 121-08, Vietnam;
| | - Can Van Mao
- Department of Pathophysiology, Vietnamese Military Medical University, Hanoi 121-08, Vietnam;
| | - Nguyen Van Tuan
- Department of Rehabilitation, Vietnamese Military Medical University, Hanoi 121-08, Vietnam;
| | - Srinivas Reddy Pallerla
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Wilhelmstrasse 27, 72074 Tübingen, Germany
| | - Dennis Nurjadi
- Department of Infectious Diseases, Medical Microbiology and Hygiene, University Hospital Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany;
| | - Thirumalaisamy P. Velavan
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Wilhelmstrasse 27, 72074 Tübingen, Germany
- Vietnamese-German Centre for Medical Research (VG-CARE), Hanoi 116-10, Vietnam
- Correspondence: (T.P.V.); (H.A.S.); Tel.: +49-7071-2985981 (T.P.V.); +84-978-437-229 (H.A.S.)
| | - Ho Anh Son
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi 121-08, Vietnam; (N.T.V.); (H.V.T.)
- Correspondence: (T.P.V.); (H.A.S.); Tel.: +49-7071-2985981 (T.P.V.); +84-978-437-229 (H.A.S.)
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Wójkowska-Mach J, Pomorska-Wesołowska M, Romanik M, Romaniszyn D. Prevalence and Antimicrobial Susceptibility Profiles of Microorganisms Associated with Lower Reproductive Tract Infections in Women from Southern Poland-Retrospective Laboratory-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18010335. [PMID: 33466345 PMCID: PMC7794702 DOI: 10.3390/ijerph18010335] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/11/2022]
Abstract
Objective: Female infections affecting the genital tract include sexually transmitted diseases, endogenous infections such as vulvovaginal candidiasis, bacterial vaginosis (BV) or aerobic vaginitis (AV) and healthcare-associated infections. The aim of the study was to analyze the etiological factors of the vaginal dysbacteriosis, and the antimicrobial susceptibility of the dominant bacterial and fungal infections in different age groups of outpatient women from the Silesian Region. Materials and methods: A retrospective laboratory-based multi-center study encompassed 4994 women of different ages in Silesian Voivodeship, in the south of Poland; patients who had vaginal swabs collected as per physicians’ orders during the period from 1 January 2017 until 30 June 2018 were included in the study. The inclusion criteria were: non-hospitalized female, aged ≤80, with suspected vulvovaginal candidiasis or bacterial vaginosis and clinical sings of infections. Results: Gram-positive cocci were the ones most often isolated: Enterococcus faecalis (29.2%) and Streptoccoccus agalactiae (13.1%), followed by bacilli from the Enterobacteriaceae group, including Escherichia coli (26.3%). The presence of Streptococcus agalactiae was confirmed in 13.1%, slightly more often in the 45–80 age group, and Gardnerella vaginalis in 6.4%, most often in women aged 15–24. The prevalence of yeast-like infections was 24.3%, Candida albicans accounted for 78.3%, whereas among C. non-albicans spp.—C. glabrata dominated (14.9%) followed by C. parapsilosis (3.8%). The highest resistance was observed only in Streptococcus agalactiae as the MLSB mechanism (Macrolide-lincosamide-streptogramin B) was identified in 38.6% of strains. The prevalence of vulvovaginal candidiasis was 24.3%, the highest in women aged 15–44. Conclusions: Drug resistance in studied vulvovaginitis was associated only with Streptococcus agalactiae. A high proportion of yeast-like aetiology was found, probably associated with recurrent infections. In the analyzed cases only the Amsel criteria and culture methods were used for diagnosis without preparations and microbiological Nugent criteria.
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Affiliation(s)
- Jadwiga Wójkowska-Mach
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland; or
- Correspondence: or
| | - Monika Pomorska-Wesołowska
- Department of Microbiology, Analytical and Microbiological Laboratory of KORLAB NZOZ, 41-700 Ruda Śląska, Poland;
| | - Małgorzata Romanik
- Department of Medical Microbiology, Medical University of Silesia, 40-055 Katowice, Poland; or
| | - Dorota Romaniszyn
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland; or
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A systematic review and meta-analysis on the prevalence of Escherichia coli and extended-spectrum β-lactamase-producing Escherichia coli in pregnant women. Arch Gynecol Obstet 2021; 303:363-379. [PMID: 33386957 DOI: 10.1007/s00404-020-05903-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/17/2020] [Indexed: 01/05/2023]
Abstract
PROPOSE The aim of the present study was to determine the prevalence of E. coli and extended-spectrum β-lactamase-producing (ESBL) E. coli in pregnant women in a systematic review and meta-analysis study. METHODS We searched important databases, including Medline (PubMed), Embase, Scopus, Web of sciences, Cochrane library, Ovid, and CINHAL to retrieve all articles reporting the prevalence of ESBL E. coli in pregnant women that published from January 1990 to June 2020. RESULTS The pooled prevalence of E. coli in pregnant women with and without symptoms of UTI after combining 82 studies with a sample size of 33,118 was 29% (29%; %95 CI 23, 36%). The prevalence based on urine, Feacal, and vagina samples was 26% (% 95 CI 19-34%), 77% (% 95 CI 22-98%), and 32% (% 95 CI 17-48%), respectively. Also, 19 studies with a sample size of 9,200 reported ESBL E. coli prevalence in pregnant women. After combining the results of these studies, the pooled prevalence of ESBL E. coli in pregnant women was 34% (34%; %95 CI 24, 43%). The pooled prevalence of E. coli in pregnant women with HIV was 9%(9%; %95 CI 7, 11%). CONCLUSION According to the results of this study, the prevalence of E. coli and ESBL E. coli is high in pregnant women. Also, the overuse of antibiotics was higher in European and Asian pregnant women than other continents.
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An Observational Cohort Study Evaluating Antimicrobial Use in Peripartum Sepsis: A Tendency towards Overdiagnosis? PHARMACY 2020; 8:pharmacy8040211. [PMID: 33187105 PMCID: PMC7712400 DOI: 10.3390/pharmacy8040211] [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: 09/20/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 12/04/2022] Open
Abstract
(1) Background: Sepsis is the leading cause of maternal death in 11–15% of women worldwide. This emphasises the importance of administrating timely and appropriate antibiotic therapy to women with sepsis. We aimed to evaluate the appropriateness of antimicrobial prescribing in women diagnosed with peripartum sepsis. (2) Method: A prospective observational cohort study in a single Scottish health region with 12,233 annual live births. Data were collected on women diagnosed with sepsis in the peripartum period using physical and electronic medical records, drug Kardex® (medication administration) and ward handover records. (3) Results: A sepsis diagnosis was concluded in 89 of the 2690 pregnancy cases reviewed, with a median hospital stay of four days. Good overall adherence to the local guidelines for the empiric antimicrobial treatment of sepsis was observed. Group B Streptococcus was associated with 20.8% of maternal sepsis cases, whilst in 60% of clinical specimens tested no causative pathogen was isolated. (4) Conclusion: The lack of specific and sensitive clinical markers for sepsis, coupled with their inconsistent clinical application to inform diagnosis, hindered effective antimicrobial stewardship. This was further exacerbated by the lack of positive culture isolates from clinical specimens, which meant that patients were often continued on broader-spectrum empiric treatment.
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Mwandigha AM, Kamori D, Kibwana UO, Masoud S, Manyahi J, Majigo M. Fecal carriage and factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae among pregnant women at the tertiary referral hospital, Tanzania. Trop Med Health 2020; 48:84. [PMID: 33061787 PMCID: PMC7545914 DOI: 10.1186/s41182-020-00271-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background Infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are increasing worldwide. Evidence indicates that fecal carriage of ESBL-E in pregnancy predisposes women to potential life-threatening urinary tract infections and subsequently increasing the risk of neonatal infections. There is limited data regarding fecal carriage of ESBL-E and associated factors among pregnant women in Tanzania. We aimed to address the gap by determining the proportion of pregnant women with ESBL-E fecal carriage and identify the related factors. Methodology A hospital-based cross-sectional study was conducted at Muhimbili National Hospital in Dar es Salaam, Tanzania. A total of 182 pregnant women at the gestational age of 37 weeks and above were enrolled. Participants’ socio-demographic, clinical, and hygienic information were collected by using a well-structured questionnaire. Rectal swabs were collected and processed for isolation of ESBL-E. The extended-spectrum β-lactamase production and antibiotic susceptibility test (AST) were performed using a double-disc synergy test and Kirby-Bauer disc diffusion method, respectively. Results A total of 117 (64.3%) pregnant women were found to carry ESBL-E. Factors such as self-prescription of antibiotic medication during pregnancy, low education level, and toilet sharing were independently associated with ESBL-E fecal carriage. Five ESBL-E species that were isolated include Escherichia coli (84.6%), Klebsiella pneumoniae (8.9%), Klebsiella oxytoca (3.3%), Citrobacter spp. (1.6%), and Enterobacter spp. (1.6%). ESBL-E isolates demonstrated high resistance to aztreonam and sulphamethoxazole-trimethoprim. Conclusion This study has revealed a relatively high fecal carriage of ESBL-E among pregnant women, suggesting that there is a need for routine screening among that population. We recommend further studies to explore comprehensively the factors associated with high fecal carriage of ESBL-E in pregnancy and the potential transmission kinetics to their newborn babies.
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Affiliation(s)
- Ambele M Mwandigha
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Doreen Kamori
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Upendo O Kibwana
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Salim Masoud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Joel Manyahi
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
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Virulence gene transcription, phylogroups, and antibiotic resistance of cervico-vaginal pathogenic E. coli in Mexico. PLoS One 2020; 15:e0234730. [PMID: 32569308 PMCID: PMC7307731 DOI: 10.1371/journal.pone.0234730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 06/01/2020] [Indexed: 11/19/2022] Open
Abstract
The pathogenicity of Escherichia coli strains that cause cervico-vaginal infections (CVI) is due to the presence of several virulence genes. The objective of this study was to define the variability regarding the genotype of antibiotic resistance, the transcription profiles of virulence genes after in vitro infection of the vaginal cell line A431 and the phylogroup composition of a group of cervico-vaginal E. coli strains (CVEC). A total of 200 E. coli strains isolated from Mexican women with CVI from two medical units of the Mexican Institute of Social Security were analysed. E. coli strains and antibiotic resistance genes were identified using conventional polymerase chain reaction (PCR), and phylogroups were identified using multiplex PCR. Virulence gene transcription was measured through reverse-transcriptase real-time PCR after infection of the vaginal cell line A431. The most common antibiotic resistance genes among the CVEC strains were aac(3)II, TEM, dfrA1, sul1, and qnrA. The predominant phylogroup was B2. The genes most frequently transcribed in these strains were fimH, papC, irp2, iroN, kpsMTII, cnf1, and ompT, mainly in CVEC strains isolated from chronic and occasional vaginal infections. The strains showed a large diversity of transcription of the virulence genes phenotype and antibiotic resistance genotype, especially in the strains of phylogroups, B2, A, and D. The strains formed 2 large clusters, which contained several subclusters. The genetic diversity of CVEC strains was high. These strains have a large number of transcription patterns of virulence genes, and one-third of them carry three to seven antibiotic resistance genes.
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Koizumi A, Maruyama K, Ohki Y, Nakayama A, Yamada Y, Kurosawa H, Tsukagoshi H, Fujiu T, Takahashi M, Kimura T, Saruki N, Murakami M, Arakawa H. Prevalence and Risk Factor for Antibiotic-resistant Escherichia coli Colonization at Birth in Premature Infants: A Prospective Cohort Study. Pediatr Infect Dis J 2020; 39:546-552. [PMID: 32118857 DOI: 10.1097/inf.0000000000002623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Escherichia coli causes neonatal early-onset sepsis (EOS) that is associated with high mortality and increasing antibiotic resistance. Thus, we estimated the prevalence, antibiotic susceptibility and risk factors for colonization of E. coli in premature infants at birth and characterized the pathogenicity of the isolates. METHODS A prospective surveillance study was conducted at three Japanese perinatal centers between August 2014 and February 2017. Infants weighing <2 kg and/or at gestational age <35 weeks at birth were enrolled. We screened the mothers and neonates for E. coli colonization. Pulsed-field gel electrophoresis was used to analyze the relatedness between the maternal and neonatal isolates. Virulence factors for the isolates were determined using polymerase chain reaction. RESULTS We enrolled 421 premature infants born to 382 mothers. The rate of colonization in mothers was 47.6%, comprising 5.9% extended-spectrum beta-lactamase-producing E. coli (ESBL-E) and 20.0% ampicillin-resistant strains. Ten (2.4%) infants exhibited colonization; ESBL-E and ampicillin-resistant strains colonized three and four infants, respectively. Three antibiotic-resistant, strain-positive infants developed EOS. Pulsed-field gel electrophoresis revealed vertical transmission of bacteria in four infants. Multivariate logistic regression analysis revealed that ESBL-E-positive mothers [odds ratio (OR), 19.2; 95% confidence interval (CI), 2.5-145.7)] and vaginal delivery (OR, 9.4; 95% CI, 1.7-50.7) were risk factors for neonatal colonization. The infant isolates possessed numerous virulence factors. CONCLUSIONS Although the prevalence of E. coli-colonized premature infants at birth was low, the rate of antibiotic resistance and the attack rate for EOS were high. Infants with ESBL-E positive mothers should be closely monitored for EOS.
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Affiliation(s)
- Aya Koizumi
- From the Department of Neonatology, Gunma Children's Medical Center, Shibukawa.,Department of Pediatrics and Developmental Medicine, Gunma University Graduate School of Medicine
| | - Kenichi Maruyama
- From the Department of Neonatology, Gunma Children's Medical Center, Shibukawa
| | - Yasushi Ohki
- Department of Pediatrics, Kiryu Kosei General Hospital, Kiryu, Gunma, Japan
| | - Akifumi Nakayama
- Department of Medical Technology, School of Health Sciences, Gifu University of Medical Science, Seki, Gifu, Japan
| | - Yoshiyuki Yamada
- Department of Allergy and Immunology, Gunma Children's Medical Center, Shibukawa
| | - Hajime Kurosawa
- Gunma Prefectural Institute of Public Health and Environmental Science
| | | | - Toru Fujiu
- Department of Pediatrics and Developmental Medicine, Gunma University Graduate School of Medicine
| | | | - Takao Kimura
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Nobuhiro Saruki
- Gunma Prefectural Institute of Public Health and Environmental Science
| | - Masami Murakami
- Department of Clinical Laboratory Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hirokazu Arakawa
- Department of Pediatrics and Developmental Medicine, Gunma University Graduate School of Medicine
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Liu TH, Wang HP, Cho FN, Wang JL, Hung CH, Chiou YH, Chen YS, Lee SSJ, Cheng MF. Rectovaginal Colonization With Pathogenic Escherichia coli During Pregnancy And Neonatal Outcomes. Infect Drug Resist 2019; 12:3103-3112. [PMID: 31686871 PMCID: PMC6777437 DOI: 10.2147/idr.s207857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 09/13/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The role of pathogenic Escherichia coli colonization in asymptomatic pregnant women is not well understood. The purpose of this work was to determine the prevalence, antimicrobial susceptibility, and neonatal outcomes of pathogenic E. coli colonization in pregnant women. Patients and methods A total of 137 women from southern Taiwan with singleton pregnancies were enrolled between March 2016 and June 2017. The women were prospectively screened for E. coli colonization in the rectovaginal region during prenatal examination. The exclusion criteria are twin pregnancy of the mother and major anomaly of the neonate. All E. coli isolates were identified as either pathogenic or commensal strains, and their susceptibility to various antimicrobials was investigated. Clinical data of the infants were retrieved from their medical records. Results Results showed that 35.8% of asymptomatic pregnant women had pathogenic E. coli colonization in the rectovaginal region. Neonates born to such mothers showed significant morbidities, including hospitalization (OR= 3.74, 95% CI= 1.18~11.87), hyperbilirubinemia (OR= 2.81, 95% CI= 1.24~6.38), and gastrointestinal symptoms (OR= 5.53, 95% CI= 1.39~21.94). Maternal colonization with pathogenic E. coli at rectoanal site was a risk factor for neonatal hyperbilirubinemia after Benjamini–Hochberg (BH) adjustment (52% vs 24%, adjusted P= 0.048). Conclusion The prevalence of pathogenic E. coli colonization in Taiwanese asymptomatic pregnant women was high, and the neonates born to colonized mothers exhibited potential neonatal morbidities. Larger studies are necessary to confirm these findings.
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Affiliation(s)
- Tzu-Hao Liu
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.,Department of Pediatrics, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung 81342, Taiwan
| | - Hsiao-Ping Wang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.,School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
| | - Fu-Nang Cho
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.,Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Jiun-Ling Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.,Department of Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chih-Hsin Hung
- Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 84001, Taiwan
| | - Yee-Hsuan Chiou
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.,School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
| | - Yao-Shen Chen
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.,Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Susan Shin-Jung Lee
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.,Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Ming-Fang Cheng
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.,School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.,Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 84001, Taiwan.,School of Nursing, Fooyin University, Kaohsiung 83102, Taiwan
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Vanić Ž, Rukavina Z, Manner S, Fallarero A, Uzelac L, Kralj M, Amidžić Klarić D, Bogdanov A, Raffai T, Virok DP, Filipović-Grčić J, Škalko-Basnet N. Azithromycin-liposomes as a novel approach for localized therapy of cervicovaginal bacterial infections. Int J Nanomedicine 2019; 14:5957-5976. [PMID: 31440052 PMCID: PMC6679693 DOI: 10.2147/ijn.s211691] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 06/25/2019] [Indexed: 01/09/2023] Open
Abstract
Background Efficient localized cervicovaginal antibacterial therapy, enabling the delivery of antibiotic to the site of action at lower doses while escaping systemic drug effects and reducing the risk of developing microbial resistance, is attracting considerable attention. Liposomes have been shown to allow sustained drug release into vaginal mucosa and improve delivery of antibiotics to bacterial cells and biofilms. Azithromycin (AZI), a potent broad-spectrum macrolide antibiotic, has not yet been investigated for localized therapy of cervicovaginal infections, although it is administered orally for the treatment of sexually transmitted diseases. Encapsulation of AZI in liposomes could improve its solubility, antibacterial activity, and allow the prolonged drug release in the cervicovaginal tissue, while avoiding systemic side effects. Purpose The objective of this study was to develop AZI-liposomes and explore their potentials for treating cervicovaginal infections. Methods AZI-liposomes that differed in bilayer elasticity/rigidity and surface charge were prepared and evaluated under simulated cervicovaginal conditions to yield optimized liposomes, which were assessed for antibacterial activity against several planktonic and biofilm-forming Escherichia coli strains and intracellular Chlamydia trachomatis, ex vivo AZI vaginal deposition/penetration, and in vitro cytotoxicity toward cervical cells. Results Negatively charged liposomes with rigid bilayers (CL-3), propylene glycol liposomes (PGL-2) and deformable propylene glycol liposomes (DPGL-2) were efficient against planktonic E. coli ATCC 700928 and K-12. CL-3 was superior for preventing the formation of E. coli ATCC 700928 and K-12 biofilms, with IC50 values (concentrations that inhibit biofilm viability by 50%) up to 8-fold lower than those of the control (free AZI). DPGL-2 was the most promising for eradication of already formed E. coli biofilms and for treating C. trachomatis infections. All AZI-liposomes were biocompatible with cervical cells and improved localization of the drug inside vaginal tissue compared with the control. Conclusion The performed studies confirm the potentials of AZI-liposomes for localized cervicovaginal therapy.
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Affiliation(s)
- Željka Vanić
- Department of Pharmaceutical Technology, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Zora Rukavina
- Department of Pharmaceutical Technology, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Suvi Manner
- Pharmaceutical Sciences Laboratory, Faculty of Science and Engineering, Åbo Akademi and University of Helsinki, 20520 Turku, Finland
| | - Adyary Fallarero
- Division of Pharmaceutical Biosciences, Pharmaceutical Biology, Faculty of Pharmacy, University of Helsinki, 00014 Helsinki, Finland
| | - Lidija Uzelac
- Department of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Marijeta Kralj
- Department of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Daniela Amidžić Klarić
- Department of Pharmaceutical Technology, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Anita Bogdanov
- Department of Medical Microbiology and Immunobiology, University of Szeged, 6720 Szeged, Hungary
| | - Tímea Raffai
- Department of Medical Microbiology and Immunobiology, University of Szeged, 6720 Szeged, Hungary
| | - Dezső Peter Virok
- Department of Medical Microbiology and Immunobiology, University of Szeged, 6720 Szeged, Hungary
| | - Jelena Filipović-Grčić
- Department of Pharmaceutical Technology, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Nataša Škalko-Basnet
- Drug Transport and Delivery Research Group, Department of Pharmacy, Faculty of Health Sciences, University of Tromsø the Arctic University of Norway, 5037 Tromsø, Norway
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Jalilian N, Kooshkiforooshani M, Ahmadi S, Nankali A. Colonisation with extended-spectrum β-lactamase-producing Enterobacteriaceae in pregnant/post-partum women: Systematic review and meta-analysis. J Glob Antimicrob Resist 2019; 19:338-347. [PMID: 31212106 DOI: 10.1016/j.jgar.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/26/2019] [Accepted: 06/10/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Maternal colonisation with extended-spectrum β-lactamase (ESBL)-producing micro-organisms can lead to transmission of such pathogens to neonates, resulting in considerable morbidity. The aim of this study was to determine the global prevalence of maternal colonisation with ESBL-producing Enterobacteriaceae (ESBL-E). METHODS A systematic review of PubMed, Embase, Scopus, Web of Science and ProQuest databases as well as the grey literature was performed. Studies reporting the prevalence of ESBL-E colonisation during pregnancy or postpartum period were included. Prevalence data were grouped by geographic region. The pooled prevalence and 95% confidence interval (CI) was estimated by meta-analysis using a random-effects model. RESULTS Nineteen studies with reports from 16 countries (seven studies from Africa, one study from South America, two studies from Asia and nine studies from Europe) reporting data for 7352 pregnant/postpartum women were included. The pooled prevalence of ESBL-E colonisation was 8% (95% CI 5-10%). Prevalence estimates were 15% (95% CI 5-24%) in Africa, 6% (95% CI 4-10%) in South America, 5% (95% CI 4-6%) in Asia and 4% (95% CI 2-5%) in Europe. The pooled prevalence was higher in studies with low risk of bias (10%; 95% CI 7-13%) compared with those with high risk of bias (3%; 95% CI 2-3%). CONCLUSION There was heterogeneity regarding ESBL-E colonisation rates in different continents. The pooled prevalence rate was higher in Africa compared with other areas. Given that the highest rate was observed in Africa, implementing screening efforts for ESBL-E colonisation during pregnancy may be justified.
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Affiliation(s)
- Nasrin Jalilian
- Fertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Shooba Ahmadi
- Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | - Anisodowleh Nankali
- Department of Obstetrics and Gynecology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Diagnostic of Early Onset Polycystic Kidney Disease in Neonates. CURRENT HEALTH SCIENCES JOURNAL 2019; 44:374-380. [PMID: 31123615 PMCID: PMC6421480 DOI: 10.12865/chsj.44.04.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 11/30/2018] [Indexed: 11/29/2022]
Abstract
Polycystic kidney disease represented by autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) have a major impact of mortality in children. We conducted a study of a premature infant with an estimated gestation date of 32 weeks with a presumptive prenatal diagnosis of right polycystic kidney. A 28-year-old primigravida with pre-eclampsia was admitted at the gynecology unit of Clinical Emergency County Hospital of Craiova. The clinical examination revealed a large abdominal distention due probably to the right polycystic kidney, suspected on prenatal ultrasound and radiography. The preterm neonate undergone right nephrectomy 5 days after birth. Histopathology of the kidney was performed in the Pathology Department of the Emergency County Hospital of Craiova and in the Center for Microscopic Morphology and Immunology of U.M.F. of Craiova. Microscopy revealed dilated cysts lined by simple cuboidal or flattened epithelium, and islets of remnant kidney parenchyma separated by edematous stroma. Immunohistochemistry for CD34 revealed incomplete blood arcades which did not seem to be in contact with all the tubular elements of the parenchyma, when compared to a control age-matched kidney. The patient had a favorable postoperative evolution, she was clinically stable on discharge from the hospital with a follow-up strategy including genetic testing.
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Forson AO, Tsidi WB, Nana-Adjei D, Quarchie MN, Obeng-Nkrumah N. Escherichia coli bacteriuria in pregnant women in Ghana: antibiotic resistance patterns and virulence factors. BMC Res Notes 2018; 11:901. [PMID: 30558656 PMCID: PMC6296117 DOI: 10.1186/s13104-018-3989-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 12/05/2018] [Indexed: 01/26/2023] Open
Abstract
Objectives The relevance of Escherichia coli associated bacteriuria infection in pregnant women is poorly understood, despite these strains sharing a similar virulence profile with other pathogenic E. coli causing severe obstetric and neonatal infections. We characterized and determined the antimicrobial susceptibility, resistance genes and virulence profiles of 82 E. coli isolates associated with asymptomatic bacteriuria in some pregnant in Ghana from February to August 2016 using Kirby–Bauer disc diffusion and polymerase chain reaction. Results High levels of antimicrobial resistance were observed to ampicillin (79.3%), tetracycline (70.7%) and cotrimoxazole (59.8%), except for cefuroxime (32.9%). Resistance genes analyses revealed 58.5% were positive for BlaTEM and 7.3% for aph(3)-Ia(aphA2). Virulence factors (VFs) was more widespread in pregnant women in the 2nd and 3rd trimesters than 1st trimester. VFs relating to adhesion (papC and iha), Protectins (traT), aerobactin acquisition (iutA) and iron acquisition systems (fyuA and irp2) were more prevalent in the resistant E. coli isolates. This study provides evidence for a link in bacteriuria and transmission of extra-intestinal E. coli in pregnant women to cause multi-resistant obstetric or neonatal infections. Considering the involvement of extra-intestinal E. coli in infections, results are helpful to develop strategies to prevent maternal and/ neonatal infections. Electronic supplementary material The online version of this article (10.1186/s13104-018-3989-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Akua Obeng Forson
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.
| | - Wilson Bright Tsidi
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - David Nana-Adjei
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Marjorie Ntiwaa Quarchie
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Noah Obeng-Nkrumah
- Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
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Merello M, Lotte L, Gonfrier S, Eleni Dit Trolli S, Casagrande F, Ruimy R, Bongain A. Enterobacteria vaginal colonization among patients with preterm premature rupture of membranes from 24 to 34 weeks of gestation and neonatal infection risk. J Gynecol Obstet Hum Reprod 2018; 48:187-191. [PMID: 30562580 DOI: 10.1016/j.jogoh.2018.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/06/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
AIM Premature rupture of membranes (PROM) increases the neonatal morbidity and mortality, because of its association with a high risk of prematurity and infection. The group B streptococcus (GBS) prophylaxis using amoxicillin doesn't seem to be adapted to the emergence of new bacteria found in vaginal samples (VS). Our study aim was to assess, for PROM occurring at 23-34 weeks' gestation (WG), if the presence of ampicillin-resistant enterobacteria in the vaginal microbiome is predictive of an increased risk of early-onset neonatal infection. MATERIAL AND METHODS We conducted a prospective, observational, single-center study at the Nice Academic Hospital (level 3 maternity ward), between March 16, 2014 and May 3, 2015, that evaluated patients with preterm PROM (24-34 WG). Two groups were constituted according to the VS bacteria isolates and the amoxycillin-resistant enterobacteria found. Two groups of newborns were constituted depending on the suspicion of perinatal maternal-fetal bacterial infection (MFI). An intent-to-treat analysis was performed. RESULTS Among the 67 patients included, 12 newborns presented a strong MFI suspicion, 83% of which were associated to the group of patients with untreated or amoxycillin-resistant enterobacteria VS isolates. CONCLUSION Our study showed that vaginal colonization of untreated or amoxycillin-resistant enterobacteria constitutes a major risk factor of neonatal infection.
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Affiliation(s)
- Marion Merello
- Department of Obstetrics and Gynecology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France.
| | - Laurène Lotte
- Department of Bacteriology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Sébastien Gonfrier
- Department of Geriatrics at Nice Academic Hospital, France; Department of Pediatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Sergio Eleni Dit Trolli
- Department of Geriatrics at Nice Academic Hospital, France; Department of Pediatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Florence Casagrande
- Department of Geriatrics at Nice Academic Hospital, France; Department of Pediatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - Raymond Ruimy
- Department of Bacteriology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
| | - André Bongain
- Department of Obstetrics and Gynecology at Nice Academic Hospital, France; Department of Geriatrics at Nice Academic Hospital, France; Nice Côte d'Azur University, Nice, France
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Gaillard T, Boxberger M, Madamet M, Pradines B. Has doxycycline, in combination with anti-malarial drugs, a role to play in intermittent preventive treatment of Plasmodium falciparum malaria infection in pregnant women in Africa? Malar J 2018; 17:469. [PMID: 30547849 PMCID: PMC6295070 DOI: 10.1186/s12936-018-2621-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/08/2018] [Indexed: 01/16/2023] Open
Abstract
According to the World Health Organization (WHO), Plasmodium falciparum malaria during pregnancy is responsible for deleterious consequences for the mother and her child. The administration of intermittent preventive treatment (IPTp) with sulfadoxine–pyrimethamine (SP) at each antenatal care visit as early as 13 weeks of gestation until the time of delivery is a strategy that is currently recommended by WHO for the prevention of malaria in pregnancy. However, the emergence and the spread of the resistance to SP in Africa raise the question of the short-term effectiveness of the strategy. Dihydroartemisinin–piperaquine 120 mg/960 mg once a day for 3 consecutive days administered at least three times during the pregnancy might be an option for IPTp. The combination of 200 mg of doxycycline once a day for 3 consecutive days seems to be a good option to retard the emergence and the spread of resistance to artemisinin-based combination therapy (ACT) in Africa and improve the effectiveness of ACT in term of preterm births, neonatal morbidity and mortality. Contrary to preconceived ideas, scientific and medical data suggest that the risk of congenital malformations in the fetus or of tooth staining in infants whose mothers take doxycycline and hepatotoxicity during pregnancy is very low or non-existent. Additionally, the use of doxycycline during the first and second trimesters leads to an increase in gestational age at delivery, a decrease in the number of preterm births and a reduction in neonatal morbidity and mortality due to the beneficial antimicrobial activity of doxycycline against other infections during pregnancy. Furthermore, doxycycline has anti-malarial properties and is already recommended as prophylaxis for travellers and for treatment of falciparum malaria in combination with other anti-malarial drugs.
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Affiliation(s)
- Tiphaine Gaillard
- Fédération des Laboratoires, Hôpital d'Instruction des Armées Desgenettes, Lyon, France
| | - Manon Boxberger
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, 19-21 Boulevard Jean Moulin, 13005, Marseille, France.,Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, IHU Méditerranée Infection, Marseille, France
| | - Marylin Madamet
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, 19-21 Boulevard Jean Moulin, 13005, Marseille, France.,Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, IHU Méditerranée Infection, Marseille, France.,Centre National de Référence du Paludisme, Institut de Recherche Biomédicale des Armées, Marseille, France
| | - Bruno Pradines
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, 19-21 Boulevard Jean Moulin, 13005, Marseille, France. .,Aix Marseille Univ, IRD, SSA, AP-HM, VITROME, IHU Méditerranée Infection, Marseille, France. .,Centre National de Référence du Paludisme, Institut de Recherche Biomédicale des Armées, Marseille, France.
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30
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Risk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospital. Int J Microbiol 2018; 2018:6579139. [PMID: 30327672 PMCID: PMC6171204 DOI: 10.1155/2018/6579139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 07/31/2018] [Accepted: 08/02/2018] [Indexed: 12/16/2022] Open
Abstract
Introduction The proportion of women with severe maternal morbidity from obstructed labor is between 2 and 12% in resource-limited settings. Maternal vaginal colonization with group B streptococcus (GBS), Escherichia coli, and Enterococcus spp. is associated with maternal and neonatal morbidity. It is unknown if vaginal colonization with these organisms in obstructed labor women is associated with poor outcomes. Objectives To determine whether vaginal colonization with GBS, E. coli, or Enterococcus is associated with increased morbidity among women with obstructed labor and to determine the risk factors for colonization and antibiotic susceptibility patterns. Methods We screened all women presenting in labor to Uganda's Mbarara Regional Referral Hospital maternity ward from April to October 2015 for obstructed labor. Those meeting criteria had vaginal swabs collected prior to Cesarean delivery and surgical antibiotic prophylaxis. Swabs were inoculated onto sterile media for routine bacterial culture and antimicrobial susceptibility testing. Results Overall, 2,168 women were screened and 276 (13%) women met criteria for obstructed labor. Vaginal swabs were collected from 272 women (99%), and 170 (64%) were colonized with a potential pathogen: 49% with E. coli, 5% with GBS, and 8% with Enterococcus. There was no difference in maternal and fetal clinical outcomes between those colonized and not colonized. The number of hours in labor was a significant independent risk factor for vaginal colonization (aOR 1.02, 95% CI 1.00–1.03, P=0.04). Overall, 38% of GBS was resistant to penicillin; 61% of E. coli was resistant to ampicillin, 4% to gentamicin, and 5% to ceftriaxone and cefepime. All enterococci were ampicillin and vancomycin susceptible. Conclusion There was no difference in maternal or neonatal morbidity between women with vaginal colonization with E. coli, GBS, and Enterococcus and those who were not colonized. Duration of labor was associated with increased risk of vaginal colonization in women with obstructed labor.
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Low Maternal Microbiota Sharing across Gut, Breast Milk and Vagina, as Revealed by 16S rRNA Gene and Reduced Metagenomic Sequencing. Genes (Basel) 2018; 9:genes9050231. [PMID: 29724017 PMCID: PMC5977171 DOI: 10.3390/genes9050231] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 04/27/2018] [Accepted: 04/30/2018] [Indexed: 12/27/2022] Open
Abstract
The maternal microbiota plays an important role in infant gut colonization. In this work we have investigated which bacterial species are shared across the breast milk, vaginal and stool microbiotas of 109 women shortly before and after giving birth using 16S rRNA gene sequencing and a novel reduced metagenomic sequencing (RMS) approach in a subgroup of 16 women. All the species predicted by the 16S rRNA gene sequencing were also detected by RMS analysis and there was good correspondence between their relative abundances estimated by both approaches. Both approaches also demonstrate a low level of maternal microbiota sharing across the population and RMS analysis identified only two species common to most women and in all sample types (Bifidobacterium longum and Enterococcus faecalis). Breast milk was the only sample type that had significantly higher intra- than inter- individual similarity towards both vaginal and stool samples. We also searched our RMS dataset against an in silico generated reference database derived from bacterial isolates in the Human Microbiome Project. The use of this reference-based search enabled further separation of Bifidobacterium longum into Bifidobacterium longum ssp. longum and Bifidobacterium longum ssp. infantis. We also detected the Lactobacillus rhamnosus GG strain, which was used as a probiotic supplement by some women, demonstrating the potential of RMS approach for deeper taxonomic delineation and estimation.
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Virulence-associated genes and antibiotic susceptibility among vaginal and rectal Escherichia coli isolates from healthy pregnant women in Poland. Folia Microbiol (Praha) 2018; 63:637-643. [PMID: 29644511 PMCID: PMC6097025 DOI: 10.1007/s12223-018-0598-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 03/08/2018] [Indexed: 11/22/2022]
Abstract
Vaginal and/or rectal Escherichia coli colonization of pregnant women is sometimes associated with neonatal infections. Despite the relevance of these strains, they have been rarely described before. Thus, the aim of this study was to compare vaginal (VEC) and rectal E. coli (REC) isolates in respect of antimicrobial susceptibility and the frequency of virulence-associated genes (VAGs). The antimicrobial susceptibility of 50 VEC and 50 REC isolates was performed by using the disc diffusion method, and VAGs were detected by PCR. There were no significant differences in the antimicrobial resistance between VEC and REC. Both VEC and REC isolates were mostly resistant to ticarcillin (36 and 30%) and ampicillin (36 and 22%). None of the tested isolates was positive for ESBL. Gene’s fimH, fimA, sfa/foc, iutA, ibeA, hlyF, and neuC were detected, respectively, in 98, 92, 32, 28, 12, 8, and 2% of VEC and in 94, 72, 12, 34, 8, 10, and 8% of REC isolates. The co-occurrence of fimA/H and sfa/foc genes was significantly more prevalent among VEC isolates, in comparison to REC isolates. The study indicated that VEC and REC isolates are quite similar in terms of antimicrobial non-susceptibility and VAGs.
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Outbreak Caused by Escherichia coli O18: K1: H7 Sequence Type 95 in a Neonatal Intensive Care Unit in Barcelona, Spain. Pediatr Infect Dis J 2017. [PMID: 28650938 DOI: 10.1097/inf.0000000000001652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Escherichia coli is one of the most frequent causes of late-onset neonatal sepsis. The aim of this study was to characterize an outbreak of neonatal sepsis occurring in the neonatal intensive care unit of the Hospital Clinic of Barcelona from April to August 2013. METHODS After presentation of the index case, all E. coli isolates from previously hospitalized neonates, health-care workers and neonates admitted to the neonatal intensive care unit from April to October 2013 were tested for K1 antigen positivity and epidemiologically compared by pulse-field gel electrophoresis. Furthermore, the E. coli K1 strains collected from neonates during this period were analyzed by different methods (serotyping, phylotyping, polymerase chain reaction of virulence factors, antimicrobial resistance and "in vitro" assays in Human Brain Microvascular Endothelial Cells (HBMEC)). RESULTS An E. coli O18:K1:H7 sequence type 95 and phylogenetic group B2 strain was the cause of the outbreak involving 6 preterm neonates: 1 with late septicemia because of a urinary focus and 5 with late-onset septicemia and meningitis, 3 of whom died. All showed the same pulsotype, full resistance to ampicillin and intermediate resistance to gentamicin. The outbreak strain carried the pathogenicity island (PAI) IIJ96-like domain that could explain the high-grade bacteremia necessary to develop meningitis. CONCLUSIONS All the E. coli isolates responsible for this outbreak belonged to a single clone suggesting a common source of infection, and it was categorized as O18:K1:H7. Despite the bacteria's pathogenicity has an important role in the severity of infection, the host-associated factors were crucial for the fatal outcomes.
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Starčič Erjavec M, Predojević L, Žgur-Bertok D. Commentary: Comparative Analysis of Phylogenetic Assignment of Human and Avian ExPEC and Fecal Commensal Escherichia coli Using the (Previous and Revised) Clermont Phylogenetic Typing Methods and its Impact on Avian Pathogenic Escherichia coli (APEC) Classification. Front Microbiol 2017; 8:1904. [PMID: 29075235 PMCID: PMC5643425 DOI: 10.3389/fmicb.2017.01904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 09/19/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marjanca Starčič Erjavec
- Molecular Genetics Group, Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Predojević
- Molecular Genetics Group, Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Darja Žgur-Bertok
- Molecular Genetics Group, Department of Biology, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
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Haahr T, Glavind J, Axelsson P, Bistrup Fischer M, Bjurström J, Andrésdóttir G, Teilmann-Jørgensen D, Bonde U, Olsén Sørensen N, Møller M, Fuglsang J, Ovesen PG, Petersen JP, Stokholm J, Clausen TD. Vaginal seeding or vaginal microbial transfer from the mother to the caesarean-born neonate: a commentary regarding clinical management. BJOG 2017. [PMID: 28626982 DOI: 10.1111/1471-0528.14792] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- T Haahr
- Department of Obstetrics and Gynaecology, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus University, Skejby, Aarhus, Denmark
| | - J Glavind
- Department of Obstetrics and Gynaecology, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus University, Skejby, Aarhus, Denmark
| | - P Axelsson
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, University of Copenhagen, Hillerød, Denmark
| | - M Bistrup Fischer
- Department of Gynaecology and Obstetrics, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - J Bjurström
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - G Andrésdóttir
- Department of Gynaecology and Obstetrics, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - D Teilmann-Jørgensen
- Department of Gynaecology and Obstetrics, University Hospital of Odense, Odense, Denmark
| | - U Bonde
- Department of Gynaecology and Obstetrics, University Hospital of Odense, Odense, Denmark
| | - N Olsén Sørensen
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - M Møller
- Department of Gynaecology and Obstetrics, Aalborg University Hospital, Aalborg, Denmark
| | - J Fuglsang
- Department of Obstetrics and Gynaecology, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus University, Skejby, Aarhus, Denmark
| | - P G Ovesen
- Department of Obstetrics and Gynaecology, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus University, Skejby, Aarhus, Denmark
| | - J P Petersen
- Department of Paediatrics, Aarhus University Hospital, Skejby, Denmark
| | - J Stokholm
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev, Denmark.,Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - T D Clausen
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, University of Copenhagen, Hillerød, Denmark
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Characterization of Vaginal Escherichia coli Isolated from Pregnant Women in Two Different African Sites. PLoS One 2016; 11:e0158695. [PMID: 27387665 PMCID: PMC4936694 DOI: 10.1371/journal.pone.0158695] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 06/20/2016] [Indexed: 11/19/2022] Open
Abstract
The relevance of vaginal colonization of pregnant women by Escherichia coli is poorly understood, despite these strains sharing a similar virulence profile with other extraintestinal pathogenic E. coli producing severe obstetric and neonatal infections. We characterized the epidemiology, antimicrobial susceptibility and virulence profiles of 84 vaginal E. coli isolates from pregnant women from Rabat (Morocco) and Manhiça (Mozambique), two very distinct epidemiological settings. Low levels of antimicrobial resistance were observed to all drugs tested, except for trimethoprim-sulfamethoxazole in Manhiça, where this drug is extensively used as prophylaxis for opportunistic HIV infections. The most prevalent virulence factors were related to iron acquisition systems. Phylogroup A was the most common in Rabat, while phylogroups E and non-typeable were the most frequent in Manhiça. Regardless of the apparently "low virulence" of these isolates, the frequency of infections is higher and the outcomes more devastating in constrained-resources conditions, especially among pregnant women and newborns.
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