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Lv H, Zhang W, Zhao Z, Wei Y, Bao Z, Li Y, Hu Z, Deng D, Yuan W. The impact of oxygen content on Staphylococcus epidermidis pathogenesis in ocular infection based on clinical characteristics, transcriptome and metabolome analysis. Front Microbiol 2024; 15:1409597. [PMID: 39050640 PMCID: PMC11266177 DOI: 10.3389/fmicb.2024.1409597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction This study aims to delineate the etiology and prevalence of isolated pathogens, along with the clinical characteristics of endophthalmitis patients over a 9-year period at hospital in Southwest of China. Additionally, we investigating the metabolic and cellular processes related to environmental factors may offer novel insights into endophthalmitis. Methods We analyzed data pertaining to endophthalmitis patients treated at the Affiliated Hospital of Yunnan University from 2015 to 2023. According to our clinical data, we conducted an experiment based on transcriptomics and metabolomics analysis to verify whether environmental factors affect behavior of S. epidermidis by culturating S. epidermidis under oxic and microoxic condition. Results In this study, 2,712 fungi or bacteria strains have been analyzed, gram-positive bacteria constituted 65.08%, with S. epidermidis being the most predominant species (25.55%). Ophthalmic trauma was the primary pathogenic factor for S. epidermidis ocular infections. Regarding fluoroquinolones, S. epidermidis exhibited the higher resistance rate to levofloxacin than moxifloxacin. Moreover, our investigation revealed that S. epidermidis in microoxic environment increase in energy metabolism, amino acid metabolism, and membrane transport. Conclusion Our findings underscore the significance of S. epidermidis as a crucial pathogen responsible for infectious endophthalmitis. It is crucial to exercise vigilance when considering Levofloxacin as the first-line drug for empiric endophthalmitis treatment. The metabolites alteration observed during the commensal-to-pathogen conversion under microoxic condition serve as a pivotal environmental signal contributing to S. epidermidis metabolism remodeling, toward more pathogenic state.
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Affiliation(s)
- Hongling Lv
- Department of Clinical Laboratory, The Affiliated Hospital of Yunnan University, Kunming, China
| | - Wenjia Zhang
- Yunnan Eye Institute and Key Laboratory of Yunnan Province, Yunnan Eye Disease Clinical Medical Center, Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China
| | - Zhu Zhao
- Department of Clinical Laboratory, The Affiliated Hospital of Yunnan University, Kunming, China
| | - Yingpu Wei
- Department of Clinical Laboratory, The Affiliated Hospital of Yunnan University, Kunming, China
| | - Zhengyilin Bao
- Yunnan Eye Institute and Key Laboratory of Yunnan Province, Yunnan Eye Disease Clinical Medical Center, Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China
| | - Yizheng Li
- Department of Clinical Laboratory, The Affiliated Hospital of Yunnan University, Kunming, China
| | - Zhulin Hu
- Yunnan Eye Institute and Key Laboratory of Yunnan Province, Yunnan Eye Disease Clinical Medical Center, Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China
| | - Deyao Deng
- Department of Clinical Laboratory, The Affiliated Hospital of Yunnan University, Kunming, China
| | - Wenli Yuan
- Department of Clinical Laboratory, The Affiliated Hospital of Yunnan University, Kunming, China
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Zuo Z, Pan Y, Huang X, Yuan T, Liu C, Cai X, Xu Z. Seasonal distribution of human-to-human pathogens in airborne PM 2.5 and their potential high-risk ARGs. Front Microbiol 2024; 15:1422637. [PMID: 39027113 PMCID: PMC11254772 DOI: 10.3389/fmicb.2024.1422637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024] Open
Abstract
Airborne microorganisms, an emerging global health threat, have attracted extensive studies. However, few attentions have been paid to the seasonal distribution of airborne pathogens, in particular their associations with antibiotic resistance genes (ARGs). To this end, two-week daily PM2.5 samples were consecutively collected from Nanchang in four seasons, and the human-to-human pathogens were screened based on high-throughput sequencing. The results showed that there were 20 pathogenic taxa in PM2.5 in Nanchang, and the highest relative abundance of pathogens was observed in winter (5.84%), followed by summer (3.51%), autumn (2.66%), and spring (1.80%). Although more than half of pathogenic taxa were shared by the four seasons, the analysis of similarities showed that pathogenic community was shaped by season (r = 0.16, p < 0.01). Co-occurrence network analysis disclosed significant interactions among pathogens in each season. Moreover, some dominant pathogens such as Plesiomonas shigelloides, Bacteroides fragilis, and Escherichia-Shigella were hub pathogens. In addition, PICRUSt2 predicted that there were 35 high-risk ARG subtypes in PM2.5, and the pathogens had strongly positive correlations with these ARGs. Even some pathogens like Plesiomonas shigelloides, Bacteroides fragilis, Aeromonas, Citrobacter, may be multi-drug resistant pathogens, including beta-lactam, aminoglycosides, chloramphenicol and multi-drug resistances, etc. Both air pollutants and meteorological conditions contributed to the seasonal variation of airborne pathogenic bacteria (r = 0.15, p < 0.01), especially CO, O3, PM2.5, temperature and relative humidity. This study furthers our understanding of airborne pathogens and highlights their associations with ARGs.
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Affiliation(s)
- Zhiwei Zuo
- Jiangxi Provincial Key Laboratory of Genesis and Remediation of Groundwater Pollution, East China University of Technology, Nanchang, China
| | - Yuanyuan Pan
- Jiangxi Provincial Key Laboratory of Genesis and Remediation of Groundwater Pollution, East China University of Technology, Nanchang, China
| | - Xueyun Huang
- Jiangxi Provincial Key Laboratory of Genesis and Remediation of Groundwater Pollution, East China University of Technology, Nanchang, China
| | - Tao Yuan
- Jiangxi Provincial Key Laboratory of Genesis and Remediation of Groundwater Pollution, East China University of Technology, Nanchang, China
| | - Cheng Liu
- Jiangxi Provincial Key Laboratory of Genesis and Remediation of Groundwater Pollution, East China University of Technology, Nanchang, China
| | - Xihong Cai
- Jiangxi Provincial Key Laboratory of Genesis and Remediation of Groundwater Pollution, East China University of Technology, Nanchang, China
| | - Zhongji Xu
- Jiangxi Center for Patriotic Health and Health Promotion, Nanchang, China
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Yang T, Wang X, Jiang L, Sui X, Bi X, Jiang B, Zhang Z, Li X. Antibiotic resistance genes associated with size-segregated bioaerosols from wastewater treatment plants: A review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123169. [PMID: 38128715 DOI: 10.1016/j.envpol.2023.123169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/23/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
The antibiotic-resistant pollution in size-segregated bioaerosols from wastewater treatment plants (WWTPs) is of increasing concern due to its public health risks, but an elaborate review is still lacking. This work overviewed the profile, mobility, pathogenic hosts, source, and risks of antibiotic resistance genes (ARGs) in size-segregated bioaerosols from WWTPs. The dominant ARG type in size-segregated bioaerosols from WWTPs was multidrug resistance genes. Treatment units that equipped with mechanical facilities and aeration devices, such as grilles, grit chambers, biochemical reaction tanks, and sludge treatment units, were the primary sources of bioaerosol antibiotic resistome in WWTPs. Higher enrichment of antibiotic resistome in particulate matter with an aerodynamic diameter of <2.5 μm, was found along the upwind-downwind-WWTPs gradient. Only a small portion of ARGs in inhalable bioaerosols from WWTPs were flanked by mobile genetic elements. The pathogens with multiple drug resistance had been found in size-segregated bioaerosols from WWTPs. Different ARGs or antibiotic resistant bacteria have different aerosolization potential associated with bioaerosols from various treatment processes. The validation of pathogenic antibiotic resistance bacteria, deeper investigation of ARG mobility, emission mechanism of antibiotic resistome, and development of treatment technologies, should be systematically considered in future.
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Affiliation(s)
- Tang Yang
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao, 266033, PR China.
| | - Xuyi Wang
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao, 266033, PR China.
| | - Lu Jiang
- College of Oceanic and Atmospheric Sciences, Ocean University of China, Qingdao, 266100, PR China.
| | - Xin Sui
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao, 266033, PR China.
| | - Xuejun Bi
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao, 266033, PR China.
| | - Bo Jiang
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao, 266033, PR China.
| | - Zhanpeng Zhang
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao, 266033, PR China.
| | - Xinlong Li
- School of Environmental and Municipal Engineering, Qingdao University of Technology, Qingdao, 266033, PR China.
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Tang L, Zhou S, Li F, Sun L, Lu H. Ozone Micronano-bubble-Enhanced Selective Degradation of Oxytetracycline from Production Wastewater: The Overlooked Singlet Oxygen Oxidation. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:18550-18562. [PMID: 36474357 DOI: 10.1021/acs.est.2c06008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The efficient and selective removal of refractory antibiotics from high-strength antibiotic production wastewater is crucial but remains a substantial challenge. In this study, a novel ozone micronano-bubble (MNB)-enhanced treatment system was constructed for antibiotic production wastewater treatment. Compared with conventional ozone, ozone MNBs exhibit excellent treatment efficiency for oxytetracycline (OTC) degradation and toxicity decrease. Notably, this study identifies the overlooked singlet oxygen (1O2) for the first time as a crucial active species in the ozone MNB system through probe and electron paramagnetic resonance methods. Subsequently, the oxidation mechanisms of OTC by ozone MNBs are systematically investigated. Owing to the high reactivity of OTC toward 1O2, ozone MNBs enhance the selective and anti-interference performance of OTC degradation in raw OTC production wastewater with complex matrixes. This study provides insights into the mechanism of ozone MNB-enhanced pollutant degradation and a new perspective for the efficient treatment of high-concentration industrial wastewater using ozone MNBs. In addition, this study presents a promising technology with scientific guidance for the treatment of antibiotic production wastewater.
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Affiliation(s)
- Lan Tang
- School of Environmental Science and Engineering, Sun Yat-sen University, Guangzhou510275, China
- Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou510275, China
| | - Sining Zhou
- School of Environmental Science and Engineering, Sun Yat-sen University, Guangzhou510275, China
- Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou510275, China
| | - Fan Li
- Key Laboratory for Water Quality and Conservation of the Pearl River Delta, Ministry of Education, Institute of Environmental Research at Greater Bay, Guangzhou University, Guangzhou510006, China
| | - Lianpeng Sun
- School of Environmental Science and Engineering, Sun Yat-sen University, Guangzhou510275, China
- Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou510275, China
| | - Hui Lu
- School of Environmental Science and Engineering, Sun Yat-sen University, Guangzhou510275, China
- Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou510275, China
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Lobo J, Kamath A, Kalwaje Eshwara V. Degenerate Beta autoregressive model for proportion time-series with zeros or ones: An application to antimicrobial resistance rate using R shiny app. Front Public Health 2023; 10:969777. [PMID: 36703859 PMCID: PMC9873260 DOI: 10.3389/fpubh.2022.969777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background Antimicrobial resistance has emerged as one of the foremost public health troubles of the 21st century. This has ended in a public health disaster of the global situation, which threatens the exercise of present-day remedy. There is an urgent requirement for a cost-effective strategy to reduce antimicrobial resistance. Infectious disease control researchers most often analyze and predict antimicrobial resistance rate data that includes zeros or ones. Commonly used time-series analysis such as autoregressive moving average model is inappropriate for such data and may arrive at biased results. Objective This study aims to propose a time-series model for continuous rates or proportions when the interval of series includes zeros or ones and compares the model with existing models. Data The Escherichia coli, isolated from blood cultures showing variable susceptibility results to different antimicrobial agents, has been obtained from a clinical microbiology laboratory of a tertiary care hospital, Udupi district, Karnataka, during the years between 2011 and 2019. Methodology We proposed a Degenerate Beta Autoregressive model which is a mixture of continuous and discrete distributions with probability mass at zero or one. The proposed model includes autoregressive terms along with explanatory variables. The estimation is done using maximum likelihood with a non-linear optimization algorithm. An R shiny app has been provided for the same. Results The proposed Degenerate Beta Autoregressive model performed well compared to the existing autoregressive moving average models. The forecasted antimicrobial resistance rate has been obtained for the next 6 months. Conclusion The findings of this article could be beneficial to the infectious disease researchers to use an appropriate time-series model to forecast the resistance rate for the future and to have better or advance public health policies to control the rise in resistance rate.
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Affiliation(s)
- Jevitha Lobo
- Department of Data Sciences, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Asha Kamath
- Department of Data Sciences, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Vandana Kalwaje Eshwara
- Department of Microbiology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
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Guan X, He R, Zhang B, Gao C, Liu F. Seasonal variations of microbial community structure, assembly processes, and influencing factors in karst river. Front Microbiol 2023; 14:1133938. [PMID: 37032860 PMCID: PMC10075313 DOI: 10.3389/fmicb.2023.1133938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
The physicochemical properties and microbial communities have significant annual and seasonal changes in karst aquifers. To explore the changes of microbial community and their relationships with environmental factors, water samples were collected from a typical karst river. Microbial communities in winter (Jan-2017 and Jan-2019) were stable with high similarity in spite of the 2 years sampling interval, but the microbial communities in Aug-2017 was different from that in Aug-2018. In four sampling times, there were 275 shared genera, whose average relative abundance ranging from 89.04 to 96.27%. The winter and summer specific genera were mainly from the recharge of tributary site K6 and discharge of waste water treatment plant (K2 and K3), respectively. The deterministic processes had a more significant effect on the microbial community assembly in winter than that in summer, which was affected by environmental pressure from pollution. Furthermore, antibiotics and inorganic nitrogen pollution affected element cycles of nitrogen and sulfur indirectly through microbial ecological modules in karst river, and the denitrification and desulfurization processes were potentially inhibited. These findings contributed to understand the changes and its assembly mechanism of microbial community, as well as the feedback to environment in polluted karst river.
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Affiliation(s)
- Xiangyu Guan
- School of Ocean Sciences, China University of Geosciences, Beijing, China
| | - Ruoxue He
- School of Ocean Sciences, China University of Geosciences, Beijing, China
- Department of Discipline Construction and Technology Development, Chengdu Technological University, Chengdu, China
| | - Biao Zhang
- School of Ocean Sciences, China University of Geosciences, Beijing, China
| | - Chengjie Gao
- Beijing Municipal Research Institute of Eco-Environmental Protection, Beijing, China
| | - Fei Liu
- Key Laboratory of Groundwater Conservation of MWR, China University of Geosciences, Beijing, China
- *Correspondence: Fei Liu,
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7
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Gong W, Tang W, Luo L, Zhang F, Cai C, Zhang J, Wu X, Shang J, Shu X, Wang T, Tu D, Jin Z, Zheng R. Trends and Correlation Between Antimicrobial Resistance and Antibiotics Consumption in a Specialist Children’s Hospital from 2016 to 2021. Infect Drug Resist 2022; 15:5679-5689. [PMID: 36193295 PMCID: PMC9526424 DOI: 10.2147/idr.s381604] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore the trends and correlation between antibiotics consumption and antimicrobial resistance in children in a specialist hospital from 2016–2021 in China. Patients and Methods This retrospective study investigated data on the consumption of antibiotics and antimicrobial resistance in children. Antibiotics consumption was expressed as defined daily doses (DDDs)/1000 patient-days based on the Guidelines for Anatomical Therapeutic Chemical. The trends in antibiotics consumption and antimicrobial resistance rates were analyzed by linear regression, while Spearman correlation analysis was employed to evaluate their correlations. Results An increasing trend in the annual consumption of carbapenems and monobactams was detected (all P<0.05). A significant upward trend was detected in the annual resistance rates of Enterococcus faecium to ciprofloxacin, Streptococcus pneumonia to ceftriaxone, Acinetobacter baumannii to carbapenems, Enterobacter cloacae to carbapenems, Pseudomonas aeruginosa to ceftazidime, and Escherichia coli to cefepime, while the annual resistance rates of Escherichia coli to carbapenems had a significant downward trend (all P<0.05). The consumption of cephalosporin/β-lactamase inhibitor (C/BLI) combinations and carbapenems had significant positive correlations with the resistance rates of Acinetobacter baumannii to carbapenems (r=0.763, P<0.001; r=0.806, P<0.001), Enterobacter cloacae to carbapenems (r=0.675, P<0.001; r=0.417, P=0.043), and Pseudomonas aeruginosa to ceftazidime (r=0.625, P=0.001; r=0.753, P<0.001), respectively. Also, increasing consumption of monobactams was related to the upward resistance rates of Acinetobacter baumannii to carbapenems (r=0.557, P=0.005) and Enterobacter cloacae to carbapenems (r=0.507, P= 0.011). Conclusion This study demonstrated significant positive associations between antibiotics consumption and specific antimicrobial resistance rates. The current findings pointed out some directions to pursue in controlling the prevalence of certain resistant bacterial strains in children.
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Affiliation(s)
- Wenting Gong
- Department of pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Wen Tang
- Department of Pediatric Intensive Care Unit, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Lan Luo
- Department of Child Health, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Furong Zhang
- Department of pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Chenyang Cai
- Department of pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Jiangyan Zhang
- Department of pharmacy, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiaolin Wu
- Department of Pediatric Nephrology, Rheumatology, and Immunology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Jianping Shang
- Department of Pediatric Nephrology, Rheumatology, and Immunology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Xiaolan Shu
- Department of Pediatric Intensive Care Unit, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Ting Wang
- Department of Pediatric Neurology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Danna Tu
- Department of Pediatric Cardiology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
| | - Zhengjiang Jin
- Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Zhengjiang Jin, Department of Clinical Laboratory, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, 745 Wu luo Road, Hongshan District, Wuhan, 430070, Hubei Province, People’s Republic of China, Email
| | - Ronghao Zheng
- Department of Pediatric Nephrology, Rheumatology, and Immunology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China
- Correspondence: Ronghao Zheng, Department of Pediatric Nephrology, Rheumatology, and Immunology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, 745 Wu luo Road, Hongshan District, Wuhan, 430070, Hubei Province, People’s Republic of China, Tel +86 02787169267, Email
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Yan X, Ma J, Chen X, Lei M, Li T, Han Y. Characteristics of airborne bacterial communities and antibiotic resistance genes under different air quality levels. ENVIRONMENT INTERNATIONAL 2022; 161:107127. [PMID: 35180669 DOI: 10.1016/j.envint.2022.107127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/05/2022] [Accepted: 01/29/2022] [Indexed: 06/14/2023]
Abstract
Pathogenic bacteria and antibiotic resistance genes (ARGs) in bioaerosols are major threats to human health. In this study, the microbial community structure and ARG distribution characteristics of airborne bacteria in total suspended particulates (TSP) and PM2.5 were investigated under different air quality levels in Xinxiang, Central China. The results revealed that with the deterioration of air quality, the concentrations of airborne bacteria in both TSP and PM2.5 decreased; however, the relative amounts of pathogenic bacteria increased. The predominant genera in pathogenic bacteria of Bacillus, Sphingomonas, Corynebacterium, Rhodococcus, and Staphylococcus were identified in both TSP and PM2.5. Although the airborne bacteria concentrations and absolute abundances of ARGs in TSP were higher than those in PM2.5 under identical air quality conditions, the bacterial community structure and relative amounts of pathogenic bacteria were similar. In addition, the relationship between environmental factors of ions, metal elements, and meteorological parameters and the community structures of airborne bacteria and pathogenic bacteria were also analyzed. The effects of soluble ions and metal elements on several dominant genera of total bacteria and pathogenic bacteria differed, probably due to the strong tolerance of pathogenic bacteria to harsh atmospheric environments Different subtypes of ARGs showed various distribution characteristics with variations in air quality. The deterioration of air quality can inhibit the dissemination of ARGs, as the minimum values of all ARGs and class 1 integrase intI1 were observed under Severely Polluted conditions. This study provides a comprehensive understanding of the effect of air pollution levels on the airborne bacteria community composition and ARG distribution.
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Affiliation(s)
- Xu Yan
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China.
| | - Jiahui Ma
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Xinqing Chen
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Miao Lei
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Tianning Li
- School of Environment, Key Laboratory for Yellow River and Huai River Water Environment and Pollution Control, Ministry of Education, Henan Key Laboratory for Environmental Pollution Control, Henan Normal University, Xinxiang 453007, China
| | - Yunping Han
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
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Zhang Z, Sun Z, Tian L. Antimicrobial Resistance Among Pathogens Causing Bloodstream Infections: A Multicenter Surveillance Report Over 20 Years (1998–2017). Infect Drug Resist 2022; 15:249-260. [PMID: 35115793 PMCID: PMC8800585 DOI: 10.2147/idr.s344875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/13/2022] [Indexed: 01/14/2023] Open
Abstract
Purpose Bloodstream infections (BSIs) are a common consequence of infectious diseases and cause high morbidity and mortality. Appropriate antibiotic use is critical for patients’ treatment and prognosis. Long-term monitoring and analysis of antimicrobial resistance are important in guiding physicians to choose appropriate antibiotics and understand the changes in antimicrobial resistance and infection control. Here, we report a retrospective study on the trends of antimicrobial resistance in the common BSI-associated pathogens. Methods The identification of strains and antimicrobial susceptibility tests were performed in each anticipating hospital independently. Data from the Hubei Province Antimicrobial Resistance Surveillance System (HBARSS) from 1998 to 2017 were retrospectively analyzed using WHONET 5.6 software. Results Data from HBARSS (1998–2017) revealed that 40,518 Gram-positive bacteria and 26,568 Gram-negative bacteria caused BSIs, the most common of which were Staphylococcus aureus and Escherichia coli. Salmonella typhi was a predominant BSI-associated pathogen in 1998–2003. Antimicrobial susceptibility data showed that the resistance rates of E. coli and Klebsiella pneumoniae to cefotaxime were significantly higher than those to ceftazidime. The proportion of strains of special antimicrobial resistance phenotypes including difficult-to-treat resistance (DTR), carbapenem-resistant (CR), extended-spectrum cephalosporin resistant (ECR) and fluoroquinolone resistant (FQR) in E. coli was 0.18%, 0.26%, 13.95%, 22.78% while in K. pneumoniae was 11.95%, 14.00%, 31.91% and 11.40%, respectively. In 2013–2017, K. pneumoniae showed resistance levels reaching 15.8% and 17.5% to imipenem and meropenem, respectively, and Acinetobacter baumannii showed high resistance rates ranging from 60 to 80% to common antibiotics. The detection rate of Salmonella typhi resistance to third-generation cephalosporins and fluoroquinolones was less than 5%. Control of methicillin-resistant Staphylococcus aureus (MRSA) remains a major challenge, and in 2009–2017, the MRSA detection rate was 40–50%. Conclusion Prevalence of CR K. pneumoniae has increased significantly in recent years. Resistance rates of A. baumannii to common antimicrobial agents have increased exponentially, reaching high levels. MRSA remains a challenge to control. For K. pneumoniae, DTR, CR, ECR and FQR were antimicrobial resistance phenotypes that could not be ignored while for E. coli DTR and CR were rare antimicrobial resistance phenotypes. CR K. pneumoniae, A. baumannii and MRSA present major challenges for controlling BSIs.
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Affiliation(s)
- Zhen Zhang
- Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China
| | - Ziyong Sun
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China
| | - Lei Tian
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China
- Correspondence: Lei Tian, Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People’s Republic of China, Email
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Mitchell J, Purohit M, Jewell CP, Read JM, Marrone G, Diwan V, Stålsby Lundborg C. Trends, relationships and case attribution of antibiotic resistance between children and environmental sources in rural India. Sci Rep 2021; 11:22599. [PMID: 34799577 PMCID: PMC8604955 DOI: 10.1038/s41598-021-01174-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/21/2021] [Indexed: 12/29/2022] Open
Abstract
Bacterial antibiotic resistance is an important global health threat and the interfaces of antibiotic resistance between humans, animals and the environment are complex. We aimed to determine the associations and overtime trends of antibiotic resistance between humans, animals and water sources from the same area and time and estimate attribution of the other sources to cases of human antibiotic resistance. A total of 125 children (aged 1-3 years old) had stool samples analysed for antibiotic-resistant bacteria at seven time points over two years, with simultaneous collection of samples of animal stools and water sources in a rural Indian community. Newey-West regression models were used to calculate temporal associations, the source with the most statistically significant relationships was household drinking water. This is supported by use of SourceR attribution modelling, that estimated the mean attribution of cases of antibiotic resistance in the children from animals, household drinking water and wastewater, at each time point and location, to be 12.6% (95% CI 4.4-20.9%), 12.1% (CI 3.4-20.7%) and 10.3% (CI 3.2-17.3%) respectively. This underlines the importance of the 'one health' concept and requires further research. Also, most of the significant trends over time were negative, suggesting a possible generalised improvement locally.
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Affiliation(s)
- Joseph Mitchell
- Department of Global Public Health, Health Systems and Policy (HSP): Improving Use of Medicines, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Manju Purohit
- Department of Global Public Health, Health Systems and Policy (HSP): Improving Use of Medicines, Karolinska Institutet, 171 77, Stockholm, Sweden.
- Department of Pathology, R.D. Gardi Medical College, Ujjain, 456006, India.
| | - Chris P Jewell
- Faculty of Health and Medicine, Lancaster Medical School, Lancaster University, Lancaster, England, UK
| | - Jonathan M Read
- Faculty of Health and Medicine, Lancaster Medical School, Lancaster University, Lancaster, England, UK
| | - Gaetano Marrone
- Department of Global Public Health, Health Systems and Policy (HSP): Improving Use of Medicines, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Vishal Diwan
- Department of Global Public Health, Health Systems and Policy (HSP): Improving Use of Medicines, Karolinska Institutet, 171 77, Stockholm, Sweden
- Division of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR - National Institute for Research in Environmental Health, Bhopal, 462030, India
| | - Cecilia Stålsby Lundborg
- Department of Global Public Health, Health Systems and Policy (HSP): Improving Use of Medicines, Karolinska Institutet, 171 77, Stockholm, Sweden
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Wang Y, Zhang X, Wang X, Lai X. Appropriateness of Empirical Fluoroquinolones Therapy in Patients Infected with Escherichia coli, Klebsiella pneumoniae, or Pseudomonas aeruginosa: The Importance of the CLSI Breakpoints Revision. Infect Drug Resist 2021; 14:3541-3552. [PMID: 34511945 PMCID: PMC8418362 DOI: 10.2147/idr.s329477] [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: 07/15/2021] [Accepted: 08/18/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose Empirical antibiotic therapy should follow the local bacterial susceptibility, and the breakpoints revisions of the antimicrobial susceptibility testing can reflect the changes in the antimicrobial susceptibility of bacteria. This study aimed to analyze whether the changes in the antimicrobial susceptibility to antibiotics caused by the breakpoint revision will affect the empirical antibiotic therapy and its appropriateness. Patients and Methods A retrospective study was conducted among 831 hospitalized patients infected by Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa from April 10, 2018, to April 11, 2020. We evaluated the appropriateness of empirical therapy based on the antimicrobial susceptibility testing results. The rate of empirical use and appropriateness of fluoroquinolones was calculated, and logistic regression was used to analyze influencing factors of empirical use of fluoroquinolones. Results The susceptibility rate of the three bacteria to levofloxacin (50.78% vs 32.06%) and ciprofloxacin (48.45% vs 21.90%) was decreased (P<0.001), while the resistance rate to levofloxacin (45.74% vs 58.73%) and ciprofloxacin (46.90% vs 66.67%) was increased (P<0.001) after the breakpoints revision. The empirical usage rate of fluoroquinolones in patients infected with Escherichia coli, Klebsiella pneumoniae, or Pseudomonas aeruginosa was 20.94%, which was influenced by the breakpoint revision (P=0.022), age (P=0.007), and the department (P=0.006); the appropriateness rate was 28.74%, affected by the pathogenic bacteria (P=0.001) and multidrug-resistant microorganism (P=0.001), department (P=0.024), and the length of stay before the empirical therapy (P=0.016). Conclusion The susceptibility of bacteria to antibiotics has changed significantly after the breakpoint revision while the clinicians’ empirical therapy failure to change accordingly, which results in the decrease of the appropriateness of empirical use. It is enlightened that we should conduct more research to evaluate the rational use of antibiotics from the laboratory perspective and carry out interventions such as education and supervision to strengthen the collaboration between the microbiology laboratories and clinicians to improve the empirical antibiotic therapy and slow down the antimicrobial resistance.
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Affiliation(s)
- Ying Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, HuBei, People's Republic of China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, HuBei, People's Republic of China
| | - Xuemei Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, HuBei, People's Republic of China
| | - Xiaoquan Lai
- Department of Nosocomial Infection Management, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, HuBei, People's Republic of China
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Consumption of anti-meticillin-resistant Staphylococcus aureus antibiotics in Swiss hospitals is associated with antibiotic stewardship measures. J Hosp Infect 2021; 117:165-171. [PMID: 34428507 DOI: 10.1016/j.jhin.2021.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Consumption of antibiotics active against meticillin-resistant Staphylococcus aureus (MRSA) has been described in numerous European studies. However, the underlying predictors of consumption are still poorly understood. AIM To describe the consumption of anti-MRSA antibiotics (daptomycin, intravenous glycopeptides, linezolid) in Switzerland over time and to identify underlying predictor variables. METHODS A retrospective observational multi-centre study was conducted in 21 Swiss hospitals over a period of 11 years (2009-2019). Multiple linear regression models were built to identify regional and hospital-specific predictor variables affecting the consumption of anti-MRSA antibiotics. FINDINGS Consumption of anti-MRSA antibiotics increased between 2009 and 2019 from 12.7 to 24.5 defined daily doses per 1000 bed-days (+93%). In the first model presented, which includes data of the whole study period, the following variables were associated with higher anti-MRSA antibiotic consumption: number of MRSA cases (P < 0.01), year (P < 0.01), hospital type (tertiary care university hospitals vs others, P < 0.01), hospital department (intensive care unit vs others, P < 0.01) and linguistic region (French vs German and German vs Italian, P < 0.01). In a second model including data from a query on hospital policies in place in 2019, the presence of an antibiotic stewardship group (P < 0.01) and prescription restrictions (P < 0.01) were associated with consumption of anti-MRSA antibiotics. CONCLUSION Our study shows that both the presence of an antibiotic stewardship group and the implementation of prescription restrictions, i.e. factors that can be controlled by the hospital itself, were associated with a lower consumption of anti-MRSA antibiotics.
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de Oliveira MS, Oshiro-Junior JA, Dantas MM, da Fonsêca NF, Ramos HA, da Silva JVB, de Medeiros ACD. An Overview of the Antimicrobial Activity of Polymeric Nanoparticles Against Enterobacteriaceae. Curr Pharm Des 2021; 27:1311-1322. [PMID: 33121399 DOI: 10.2174/1381612826666201029095327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 09/26/2020] [Indexed: 11/22/2022]
Abstract
Bacterial resistance is considered one of the most important public health problems of the century, due to the ability of bacteria to rapidly develop resistance mechanisms, which makes it difficult to treat infections, leading to a high rate of morbidity and mortality. Based on this, several options are being sought as an alternative to currently available treatments, with a particular focus on nanotechnology. Nanomaterials have important potential for use in medical interventions aimed at preventing, diagnosing and treating numerous diseases by directing the delivery of drugs. This review presents data on the use of polymeric nanoparticles having in vitro and in vivo activity against bacteria belonging to the Enterobacteriaceae family.
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Affiliation(s)
- Maísa Soares de Oliveira
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - João Augusto Oshiro-Junior
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Mariana Morais Dantas
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Naara Felipe da Fonsêca
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Hilthon Alves Ramos
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - João Victor Belo da Silva
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Ana Claudia Dantas de Medeiros
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
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Liang C, Zhang X, Zhou L, Meng G, Zhong L, Peng P. Trends and correlation between antibacterial consumption and carbapenem resistance in gram-negative bacteria in a tertiary hospital in China from 2012 to 2019. BMC Infect Dis 2021; 21:444. [PMID: 34001022 PMCID: PMC8130264 DOI: 10.1186/s12879-021-06140-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 05/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background To investigate the trends and correlation between antibacterial consumption and carbapenem resistance in Gram-negative bacteria from 2012 to 2019 in a tertiary-care teaching hospital in southern China. Methods This retrospective study included data from hospital-wide inpatients collected between January 2012 and December 2019. Data on antibacterial consumption were expressed as defined daily doses (DDDs)/1000 patient-days. Antibacterials were classified according to the Anatomical Therapeutic Chemical (ATC) classification system. The trends in antimicrobial usage and resistance were analyzed by linear regression, while Pearson correlation analysis was used for assessing correlations. Results An increasing trend in the annual consumption of tetracyclines, β-lactam/β-lactamase inhibitor (BL/BLI) combinations, and carbapenems was observed (P < 0.05). Carbapenem resistance in Acinetobacter baumannii (A. baumannii) significantly increased (P < 0.05) from 18% in 2012 to 60% in 2019. Moreover, significant positive correlations were found between resistance to carbapenems in A. baumannii (P < 0.05) and Escherichia coli (E. coli; P < 0.05) and consumption of carbapenems, while the resistance rate of A. baumannii to carbapenems was positively correlated with cephalosporin/β-lactamase inhibitor (C/BLI) combinations (P < 0.01) and tetracyclines usage (P < 0.05). We also found that use of quinolones was positively correlated with the resistance rate of Burkholderia cepacia (B. cepacia) to carbapenems (P < 0.05), and increasing uses of carbapenems (P < 0.01) and penicillin/β-Lactamase inhibitor (P/BLI) combinations (P < 0.01) were significantly correlated with reduced resistance of Enterobacter cloacae (E. cloacae) to carbapenems. Conclusion These results revealed significant correlations between consumption of antibiotics and carbapenem resistance rates in Gram-negative bacteria. Implementing proper management strategies and reducing the unreasonable use of antibacterial drugs may be an effective measure to reduce the spread of carbapenem-resistant Gram-negative bacteria (CRGN), which should be confirmed by further studies.
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Affiliation(s)
- Chunhong Liang
- Department of Pharmacy, Sixth Affiliated Hospital of Guangxi Medical University, Yulin, 537000, Guangxi, China
| | - Xueyan Zhang
- Department of Pharmacy, Sixth Affiliated Hospital of Guangxi Medical University, Yulin, 537000, Guangxi, China
| | - Lijuan Zhou
- Department of Pharmacy, Sixth Affiliated Hospital of Guangxi Medical University, Yulin, 537000, Guangxi, China
| | - Guangyi Meng
- Department of Pharmacy, Sixth Affiliated Hospital of Guangxi Medical University, Yulin, 537000, Guangxi, China
| | - Liqiu Zhong
- Department of Pharmacy, Sixth Affiliated Hospital of Guangxi Medical University, Yulin, 537000, Guangxi, China
| | - Pingzhi Peng
- Department of Pharmacy, Sixth Affiliated Hospital of Guangxi Medical University, Yulin, 537000, Guangxi, China.
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Belley A, Morrissey I, Hawser S, Kothari N, Knechtle P. Third-generation cephalosporin resistance in clinical isolates of Enterobacterales collected between 2016-2018 from USA and Europe: genotypic analysis of β-lactamases and comparative in vitro activity of cefepime/enmetazobactam. J Glob Antimicrob Resist 2021; 25:93-101. [PMID: 33746112 DOI: 10.1016/j.jgar.2021.02.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/27/2021] [Accepted: 02/28/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study aimed to investigate third-generation cephalosporin (3GC) resistance determinants [extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases and OXA-type β-lactamases] in contemporary clinical Enterobacterales isolates and to determine the in vitro activity of β-lactams and β-lactam/β-lactamase inhibitor combinations, including the investigational combination of cefepime and the novel β-lactamase inhibitor enmetazobactam. METHODS Antibacterial susceptibility of 7168 clinical Enterobacterales isolates obtained between 2016-2018 from North America and Europe was determined according to CLSI guidelines. Phenotypic resistance to the 3GC ceftazidime (MIC ≥ 16 µg/mL) and/or ceftriaxone (MIC ≥ 4 µg/mL) but retaining susceptibility to meropenem (MIC ≤ 1 µg/mL) was determined. β-Lactamase genotyping was performed on clinical isolates with ceftazidime, ceftriaxone, cefepime or meropenem MIC ≥ 1 µg/mL. RESULTS Phenotypic resistance to 3GCs occurred in 17.5% of tested isolates, whereas 2.1% of isolates were resistant to the carbapenem meropenem. Within the 3GC-resistant subgroup, 60.1% (n = 752) of isolates encoded an ESBL, 25.6% (n = 321) encoded an AmpC-type β-lactamase and 0.9% (n = 11) encoded an OXA-type β-lactamase. Susceptibility of the subgroup to piperacillin/tazobactam (57.5%) and ceftolozane/tazobactam (71.3%) was <90% based on breakpoints established by the CLSI. Projected susceptibility to cefepime/enmetazobactam was 99.6% when applying the cefepime susceptible, dose-dependent breakpoint of 8 µg/mL. Against ESBL-producing isolates (n = 801) confirmed by genotyping, only susceptibility to meropenem (96.0%) and cefepime/enmetazobactam (99.9%) exceeded 90%. CONCLUSION This study describes the antibacterial activity of important therapies against contemporary 3GC-resistant clinical Enterobacterales isolates and supports the development of cefepime/enmetazobactam as a carbapenem-sparing option for ESBL-producing pathogens.
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Said D, Willrich N, Ayobami O, Noll I, Eckmanns T, Markwart R. The epidemiology of carbapenem resistance in Acinetobacter baumannii complex in Germany (2014-2018): an analysis of data from the national Antimicrobial Resistance Surveillance system. Antimicrob Resist Infect Control 2021; 10:45. [PMID: 33648594 PMCID: PMC7923473 DOI: 10.1186/s13756-021-00909-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/12/2021] [Indexed: 12/12/2022] Open
Abstract
Background Carbapenem-resistant Acinetobacter baumannii complex (CRABC) has globally emerged as a serious public health challenge. This study aimed to describe epidemiological trends and risk factors of carbapenem resistance in A. baumannii complex isolates in Germany between 2014 and 2018.
Methods We analysed 43,948 clinical A. baumannii complex isolates using 2014 to 2018 data from the German Antimicrobial Resistance Surveillance system. We applied descriptive statistics and uni- and multivariable regression analyses to investigate carbapenem resistance in A. baumannii complex isolates. Results The proportion of carbapenem resistance in clinical A. baumannii complex isolates declined from 7.6% (95% confidence interval [95% CI] 4.4–12.7%) in 2014 to 3.5% (95% CI 2.5–4.7%) in 2018 (adjusted OR [aOR] 0.85 [95% CI 0.79–0.93, p ≤ 0.001]). Higher mean CRABC proportions for 2014 to 2018 were observed in secondary care hospitals (4.9% [95% CI 3.2–7.5%], aOR 3.6 [95% CI 2.4–5.3, p ≤ 0.001]) and tertiary care hospitals (5.9% [95% CI 3.0–11.2%], aOR 5.4 [95% CI 2.9–10.0, p ≤ 0.001) compared to outpatient clinics (1.3% [95% CI 1.1–1.6%]). CRABC proportions in hospitals varied between German regions and ranged between 2.4% (95% CI 1.6–3.5%) in the Southeast and 8.8% (95% CI 4.2–17.3%) in the Northwest. Lower CRABC proportions were observed in younger patients (< 1 year: 0.6% [95% CI 0.2–1.3%]; 1–19 years: 1.3% [95% CI 0.7–2.5%]) than adults (20–39 years: 7.7% [95% CI 4.4–13.0%]; 40–59 years: 6.2% [4.2–8.9%]; 60–79 years: 5.8% [95% CI 4.0–8.3%]). In the 20–39 year old patient age group, CRABC proportions were significantly higher for men than for women (14.6% [95% CI 8.6–23.6%] vs. 2.5% [95% CI 1.3–4.5%]). A. baumannii complex isolates from lower respiratory infections were more likely to be carbapenem-resistant than isolates from upper respiratory infections (11.4% [95% CI 7.9–16.2%] vs. 4.0% [95% CI 2.7–6.0%]; adjusted OR: 1.5 [95% CI 1.2–1.9, p ≤ 0.001]). Conclusions In contrast to many other regions worldwide, carbapenem resistance proportions among clinical A. baumannii complex isolates are relatively low in Germany and have declined in the last few years. Ongoing efforts in antibiotic stewardship and infection prevention and control are needed to prevent the spread of carbapenem-resistant A. baumannii complex in Germany. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-00909-8.
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Affiliation(s)
- Dunja Said
- Department 3: Infectious Disease Epidemiology, Unit 37: Healthcare Associated Infections, Surveillance of Antibiotic Resistance and Consumption, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Niklas Willrich
- Department 3: Infectious Disease Epidemiology, Unit 37: Healthcare Associated Infections, Surveillance of Antibiotic Resistance and Consumption, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Olaniyi Ayobami
- Department 3: Infectious Disease Epidemiology, Unit 37: Healthcare Associated Infections, Surveillance of Antibiotic Resistance and Consumption, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Ines Noll
- Department 3: Infectious Disease Epidemiology, Unit 37: Healthcare Associated Infections, Surveillance of Antibiotic Resistance and Consumption, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Tim Eckmanns
- Department 3: Infectious Disease Epidemiology, Unit 37: Healthcare Associated Infections, Surveillance of Antibiotic Resistance and Consumption, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany
| | - Robby Markwart
- Department 3: Infectious Disease Epidemiology, Unit 37: Healthcare Associated Infections, Surveillance of Antibiotic Resistance and Consumption, Robert Koch Institute, Nordufer 20, 13353, Berlin, Germany. .,Institute of General Practice and Family Medicine, Jena University Hospital, Bachstraße 18, 07743, Jena, Germany.
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Imchen M, Kumavath R. Metagenomic insights into the antibiotic resistome of mangrove sediments and their association to socioeconomic status. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 268:115795. [PMID: 33068846 DOI: 10.1016/j.envpol.2020.115795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/03/2020] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
Mangrove sediments are prone to anthropogenic activities that could enrich antibiotics resistance genes (ARGs). The emergence and dissemination of ARGs are of serious concern to public health worldwide. Therefore, a comprehensive resistome analysis of global mangrove sediment is of paramount importance. In this study, we have implemented a deep machine learning approach to analyze the resistome of mangrove sediments from Brazil, China, Saudi Arabia, India, and Malaysia. Geography (RANOSIM = 39.26%; p < 0.005) as well as human intervention (RANOSIM = 16.92%; p < 0.005) influenced the ARG diversity. ARG diversity was also inversely correlated to the human development index (HDI) of the host country (R = -0.53; p < 0.05) rather than antibiotics consumption (p > 0.05). Several genes including multidrug efflux pumps were significantly (p < 0.05) enriched in the sites with human intervention. Resistome was consistently dominated by rpoB2 (19.26 ± 0.01%), multidrug ABC transporter (10.40 ± 0.23%), macB (8.84 ± 0.36n%), tetA (4.13 ± 0.35%), mexF (3.26 ± 0.19%), CpxR (2.93 ± 0.2%), bcrA (2.38 ± 0.24%), acrB (2.37 ± 0.18%), mexW (2.19 ± 0.17%), and vanR (1.99 ± 0.11%). Besides, mobile ARGs such as vanA, tet(48), mcr, and tetX were also detected in the mangrove sediments. Comparative analysis against terrestrial and ocean resistomes showed that the ocean ecosystem harbored the lowest ARG diversity (Chao1 = 71.12) followed by mangroves (Chao1 = 258.07) and terrestrial ecosystem (Chao1 = 294.07). ARG subtypes such as abeS and qacG were detected exclusively in ocean datasets. Likewise, rpoB2, multidrug ABC transporter, and macB, detected in mangrove and terrestrial datasets, were not detected in the ocean datasets. This study shows that the socioeconomic factors strongly determine the antibiotic resistome in the mangrove. Direct anthropogenic intervention in the mangrove environment also enriches antibiotic resistome.
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Affiliation(s)
- Madangchanok Imchen
- Department of Genomic Science, School of Biological Sciences, Central University of Kerala, Tejaswini Hills, Periya (P.O) Kasaragod, Kerala, 671320, India
| | - Ranjith Kumavath
- Department of Genomic Science, School of Biological Sciences, Central University of Kerala, Tejaswini Hills, Periya (P.O) Kasaragod, Kerala, 671320, India.
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Antimicrobial Resistance in Clinical Ureaplasma spp. and Mycoplasma hominis and Structural Mechanisms Underlying Quinolone Resistance. Antimicrob Agents Chemother 2020; 64:AAC.02560-19. [PMID: 32229497 DOI: 10.1128/aac.02560-19] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Antibiotic resistance is a global concern; however, data on antibiotic-resistant Ureaplasma spp. and Mycoplasma hominis are limited in comparison to similar data on other microbes. A total of 492 Ureaplasma spp. and 13 M. hominis strains obtained in Hangzhou, China, in 2018 were subjected to antimicrobial susceptibility testing for levofloxacin, moxifloxacin, erythromycin, clindamycin, and doxycycline using the broth microdilution method. The mechanisms underlying quinolone and macrolide resistance were determined. Meanwhile, a model of the topoisomerase IV complex bound to levofloxacin in wild-type Ureaplasma spp. was built to study the quinolone resistance mutations. For Ureaplasma spp., the levofloxacin, moxifloxacin, and erythromycin resistance rates were 84.69%, 51.44%, and 3.59% in U. parvum and 82.43%, 62.16%, and 5.40% in U. urealyticum, respectively. Of the 13 M. hominis strains, 11 were resistant to both levofloxacin and moxifloxacin, and five strains showed clindamycin resistance. ParC S83L was the most prevalent mutation in levofloxacin-resistant Ureaplasma strains, followed by ParE R448K. The two mutations GyrA S153L and ParC S91I were commonly identified in quinolone-resistant M. hominis A molecular dynamics-refined structure revealed that quinolone resistance-associated mutations inhibited the interaction and reduced affinity with gyrase or topoisomerase IV and quinolones. The novel mutations S21A in the L4 protein and G2654T and T2245C in 23S rRNA and the ermB gene were identified in erythromycin-resistant Ureaplasma spp. As fluoroquinolone resistance in Ureaplasma spp. and Mycoplasma hominis remains high in China, the rational use of antibiotics needs to be further enhanced.
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Bai Y, Liu Q, Gu J, Zhang X, Hu S. Analysis of Urinary Pathogen Cultures and Drug Sensitivity in Patients with Urinary Stones for Five Consecutive Years in Xiangya Hospital, China. Infect Drug Resist 2020; 13:1357-1363. [PMID: 32494167 PMCID: PMC7227811 DOI: 10.2147/idr.s241036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/23/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To analyze pathogen distribution and drug sensitivity in patients with urinary calculi and thereby gain insight into the most appropriate antibacterial drugs for perioperative therapy. Materials and Methods From January 2014 to December 2018, the results of mid-stream urine pathogen culture and drug sensitivity tests were evaluated retrospectively for 353 patients with urinary calculi. SPSS software version 23.0 was used to analyze the data. Results A total of 353 strains of pathogens were isolated from urine culture. Among these, 278 (79%) strains belonged to the top 10 most frequently isolated pathogens, comprising 209 (75.2%) Gram-negative bacilli and 69 (24.8%) Gram-positive cocci. Escherichia coli was the most frequently isolated pathogen overall and the most frequently isolated Gram-negative bacillus, and Enterococcus faecalis was the most frequently isolated Gram-positive coccus. Drug sensitivity levels were effectively unchanged for less commonly used drugs, whereas drug resistance rates remained high for commonly used drugs such as ampicillin trihydrate, ampicillin/sulbactam, cefazolin, ceftriaxone, aztreonam, levofloxacin and ciprofloxacin. Conclusion E. coli and E. faecalis remain the most common Gram-negative bacillus and Gram-positive coccus uropathogens, respectively, in patients with urinary calculi. Mid-stream urine pathogen culture and drug sensitivity tests should be used to select appropriate antibacterial drugs before treatment, particularly for perioperative patients with urinary calculi.
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Affiliation(s)
- Yao Bai
- Xiangya International Medical Center, Department of Geriatrics Urology, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China.,Medizinische Klinik and Poliklinik IV, Klinikum Der Universität München, Munich, Germany
| | - Qingxia Liu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Jie Gu
- Xiangya International Medical Center, Department of Geriatrics Urology, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China.,Martini-Klinik Prostate Cancer Center, Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Xiaobo Zhang
- Xiangya International Medical Center, Department of Geriatrics Urology, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
| | - Sheng Hu
- Xiangya International Medical Center, Department of Geriatrics Urology, Xiangya Hospital, Central South University, Changsha 410008, People's Republic of China
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