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Gagliardo CM, Noto D, Giammanco A, Catanzaro A, Cimino MC, Presti RL, Tuttolomondo A, Averna M, Cefalù AB. Derivation and validation of a predictive mortality model of in-hospital patients with Acinetobacter baumannii nosocomial infection or colonization. Eur J Clin Microbiol Infect Dis 2024; 43:1109-1118. [PMID: 38607579 PMCID: PMC11178602 DOI: 10.1007/s10096-024-04818-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE Acinetobacter baumannii (Ab) is a Gram-negative opportunistic bacterium responsible for nosocomial infections or colonizations. It is considered one of the most alarming pathogens due to its multi-drug resistance and due to its mortality rate, ranging from 34 to 44,5% of hospitalized patients. The aim of the work is to create a predictive mortality model for hospitalized patient with Ab infection or colonization. METHODS A cohort of 140 sequentially hospitalized patients were randomized into a training cohort (TC) (100 patients) and a validation cohort (VC) (40 patients). Statistical bivariate analysis was performed to identify variables discriminating surviving patients from deceased ones in the TC, considering both admission time (T0) and infection detection time (T1) parameters. A custom logistic regression model was created and compared with models obtained from the "status" variable alone (Ab colonization/infection), SAPS II, and APACHE II scores. ROC curves were built to identify the best cut-off for each model. RESULTS Ab infection status, use of penicillin within 90 days prior to ward admission, acidosis, Glasgow Coma Scale, blood pressure, hemoglobin and use of NIV entered the logistic regression model. Our model was confirmed to have a better sensitivity (63%), specificity (85%) and accuracy (80%) than the other models. CONCLUSION Our predictive mortality model demonstrated to be a reliable and feasible model to predict mortality in Ab infected/colonized hospitalized patients.
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Affiliation(s)
- Carola Maria Gagliardo
- Department of Health Promotion, Maternal and Child Health, Internal and Specialized Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Via del Vespro 127, Palermo, 90127, Italy
| | - Davide Noto
- Department of Health Promotion, Maternal and Child Health, Internal and Specialized Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Via del Vespro 127, Palermo, 90127, Italy.
| | - Antonina Giammanco
- Department of Health Promotion, Maternal and Child Health, Internal and Specialized Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Via del Vespro 127, Palermo, 90127, Italy
| | - Andrea Catanzaro
- Department of Engineering, University of Palermo, Palermo, Italy
| | - Maria Concetta Cimino
- Department of Health Promotion, Maternal and Child Health, Internal and Specialized Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Via del Vespro 127, Palermo, 90127, Italy
| | - Rosalia Lo Presti
- Department of Psychological, Pedagogical, Exercise and Training Sciences, University of Palermo, Palermo, Italy
| | - Antonino Tuttolomondo
- Department of Health Promotion, Maternal and Child Health, Internal and Specialized Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Via del Vespro 127, Palermo, 90127, Italy
| | - Maurizio Averna
- Department of Health Promotion, Maternal and Child Health, Internal and Specialized Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Via del Vespro 127, Palermo, 90127, Italy
- Institute of Biophysics, National Research Council, Palermo, Italy
| | - Angelo Baldassare Cefalù
- Department of Health Promotion, Maternal and Child Health, Internal and Specialized Medicine of Excellence "G. D. Alessandro" (PROMISE), University of Palermo, Via del Vespro 127, Palermo, 90127, Italy
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Abdel-Hamid RM, El-Mahallawy HA, Allam RM, Zafer MM, Elswify M. Changing patterns of bacterial profile and antimicrobial resistance in high-risk patients during the COVID-19 pandemic at a tertiary oncology hospital. Arch Microbiol 2024; 206:250. [PMID: 38722362 DOI: 10.1007/s00203-024-03965-x] [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: 03/13/2024] [Accepted: 04/16/2024] [Indexed: 06/18/2024]
Abstract
The widespread evolution of phenotypic resistance in clinical isolates over the years, coupled with the COVID-19 pandemic onset, has exacerbated the global challenge of antimicrobial resistance. This study aimed to explore changes in bacterial infection patterns and antimicrobial resistance during the COVID-19 pandemic. This study involved the periods before and during COVID-19: the pre-pandemic and pandemic eras. The surveillance results of bacterial isolates causing infections in cancer patients at an Egyptian tertiary oncology hospital were retrieved. The Vitek®2 or Phoenix systems were utilized for species identification and susceptibility testing. Statistical analyses were performed comparing microbiological trends before and during the pandemic. Out of 2856 bacterial isolates, Gram-negative bacteria (GNB) predominated (69.7%), and Gram-positive bacteria (GPB) comprised 30.3% of isolates. No significant change was found in GNB prevalence during the pandemic (P = 0.159). Elevated rates of Klebsiella and Pseudomonas species were demonstrated during the pandemic, as was a decrease in E. coli and Acinetobacter species (P < 0.001, 0.018, < 0.001, and 0.046, respectively) in hematological patients. In surgical patients, Enterobacteriaceae significantly increased (P = 0.012), while non-fermenters significantly decreased (P = 0.007). GPB species from either hematological or surgical wards exhibited no notable changes during the pandemic. GNB resistance increased in hematological patients to carbapenems, amikacin, and tigecycline and decreased in surgical patients to amikacin and cefoxitin (P < 0.001, 0.010, < 0.001, < 0.001, and 0.016, respectively). The study highlights notable shifts in the microbial landscape during the COVID-19 pandemic, particularly in the prevalence and resistance patterns of GNB in hematological and surgical wards.
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Affiliation(s)
- Rasha M Abdel-Hamid
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
| | - Hadir A El-Mahallawy
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Rasha M Allam
- Cancer Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mai M Zafer
- Microbiology and Immunology Department, Faculty of Pharmacy, Ahram Canadian University, Cairo, Egypt
| | - Marwa Elswify
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt
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Abdel Hadi H, Dargham SR, Eltayeb F, Ali MOK, Suliman J, Ahmed SAM, Omrani AS, Ibrahim EB, Chen Y, Tsui CKM, Skariah S, Sultan A. Epidemiology, Clinical, and Microbiological Characteristics of Multidrug-Resistant Gram-Negative Bacteremia in Qatar. Antibiotics (Basel) 2024; 13:320. [PMID: 38666996 PMCID: PMC11047403 DOI: 10.3390/antibiotics13040320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/29/2024] Open
Abstract
Antimicrobial resistance is a global healthcare threat with significant clinical and economic consequences peaking at secondary and tertiary care hospitals where multidrug-resistant Gram-negative bacteria (MDR GNB) lead to poor outcomes. A prospective study was conducted between January and December 2019 for all invasive bloodstream infections (BSIs) secondary to MDR GNB in Qatar identified during routine microbiological service to examine their clinical, microbiological, and genomic characteristics. Out of 3238 episodes of GNB BSIs, the prevalence of MDR GNB was 13% (429/3238). The predominant MDR pathogens were Escherichia coli (62.7%), Klebsiella pneumoniae (20.4%), Salmonella species (6.6%), and Pseudomonas aeruginosa (5.3%), while out of 245 clinically evaluated patients, the majority were adult males, with the elderly constituting almost one-third of the cohort and with highest observed risk for prolonged hospital stays. The risk factors identified included multiple comorbidities, recent healthcare contact, previous antimicrobial therapy, and admission to critical care. The in-hospital mortality rate was recorded at 25.7%, associated with multiple comorbidities, admission to critical care, and the acquisition of MDR Pseudomonas aeruginosa. Resistant pathogens demonstrated high levels of antimicrobial resistance but noticeable susceptibility to amikacin and carbapenems. Genomic analysis revealed that Escherichia coli ST131 and Salmonella enterica ST1 were the predominant clones not observed with other pathogens.
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Affiliation(s)
- Hamad Abdel Hadi
- Communicable Diseases Centre, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar; (S.A.M.A.); (A.S.O.)
- College of Medicine, Qatar University, Doha P.O. Box 2713, Qatar
| | - Soha R. Dargham
- Department of Medical Education, Weill Cornell Medicine, Qatar Foundation, Doha P.O. Box 24144, Qatar;
| | - Faiha Eltayeb
- Division of Microbiology, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar; (F.E.); (E.B.I.)
| | - Mohamed O. K. Ali
- Department of Internal Medicine, University Health Truman Medical Centre, Kansas City, MO 64108, USA;
| | - Jinan Suliman
- Department of Community Medicine, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar;
| | - Shiema Abdalla M. Ahmed
- Communicable Diseases Centre, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar; (S.A.M.A.); (A.S.O.)
| | - Ali S. Omrani
- Communicable Diseases Centre, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar; (S.A.M.A.); (A.S.O.)
- College of Medicine, Qatar University, Doha P.O. Box 2713, Qatar
| | - Emad Bashir Ibrahim
- Division of Microbiology, Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar; (F.E.); (E.B.I.)
- Biomedical Research Centre, Qatar University, Doha P.O. Box 2713, Qatar
| | - Yuzhou Chen
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (Y.C.); (C.K.M.T.)
| | - Clement K. M. Tsui
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore; (Y.C.); (C.K.M.T.)
- Infectious Diseases Research Laboratory, National Centre for Infectious Diseases, Singapore 308442, Singapore
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Sini Skariah
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha 2713, Qatar; (S.S.); (A.S.)
| | - Ali Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha 2713, Qatar; (S.S.); (A.S.)
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Gashaw M, Gudina EK, Ali S, Gabriele L, Seeholzer T, Alemu B, Froeschl G, Kroidl A, Wieser A. Molecular characterization of carbapenem-resistance in Gram-negative isolates obtained from clinical samples at Jimma Medical Center, Ethiopia. Front Microbiol 2024; 15:1336387. [PMID: 38328425 PMCID: PMC10848150 DOI: 10.3389/fmicb.2024.1336387] [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: 11/10/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Background In resource-constrained settings, limited antibiotic options make treating carbapenem-resistant bacterial infections difficult for healthcare providers. This study aimed to assess carbapenemase expression in Gram-negative bacteria isolated from clinical samples in Jimma, Ethiopia. Methods A cross-sectional study was conducted to assess carbapenemase expression in Gram-negative bacteria isolated from patients attending Jimma Medical Center. Totally, 846 Gram-negative bacteria were isolated and identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Phenotypic antibiotic resistance patterns were determined using the Kirby-Bauer disk diffusion method and Etest strips. Extended-spectrum β-lactamase phenotype was determined using MAST disks, and carbapenemases were characterized using multiplex polymerase chain reactions (PCR). Results Among the isolates, 19% (157/846) showed phenotypic resistance to carbapenem antibiotics. PCR analysis revealed that at least one carbapenemase gene was detected in 69% (107/155) of these strains. The most frequently detected acquired genes were blaNDM in 35% (37/107), blaVIM in 24% (26/107), and blaKPC42 in 13% (14/107) of the isolates. Coexistence of two or more acquired genes was observed in 31% (33/107) of the isolates. The most common coexisting acquired genes were blaNDM + blaOXA-23, detected in 24% (8/33) of these isolates. No carbapenemase-encoding genes could be detected in 31% (48/155) of carbapenem-resistant isolates, with P. aeruginosa accounting for 85% (41/48) thereof. Conclusion This study revealed high and incremental rates of carbapenem-resistant bacteria in clinical samples with various carbapenemase-encoding genes. This imposes a severe challenge to effective patient care in the context of already limited treatment options against Gram-negative bacterial infections in resource-constrained settings.
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Affiliation(s)
- Mulatu Gashaw
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
- CIHLMU Center for International Health, Ludwig Maximilians Universität München, Munich, Germany
| | | | - Solomon Ali
- Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Liegl Gabriele
- Max von Pettenkofer-Institute (Medical Microbiology), Ludwig Maximilian University of Munich, Munich, Germany
| | - Thomas Seeholzer
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
| | - Bikila Alemu
- School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia
| | - Guenter Froeschl
- CIHLMU Center for International Health, Ludwig Maximilians Universität München, Munich, Germany
- Division of Infectious Disease and Tropical Medicine, University Hospital (LMU), Munich, Germany
| | - Arne Kroidl
- CIHLMU Center for International Health, Ludwig Maximilians Universität München, Munich, Germany
- Division of Infectious Disease and Tropical Medicine, University Hospital (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Munich, Germany
| | - Andreas Wieser
- Max von Pettenkofer-Institute (Medical Microbiology), Ludwig Maximilian University of Munich, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
- Division of Infectious Disease and Tropical Medicine, University Hospital (LMU), Munich, Germany
- German Center for Infection Research (DZIF), Munich, Germany
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Serra N, Di Carlo P, Andriolo M, Mazzola G, Diprima E, Rea T, Anastasia A, Fasciana TMA, Pipitò L, Capra G, Giammanco A, Cascio A. Staphylococcus aureus and Coagulase-Negative Staphylococci from Bloodstream Infections: Frequency of Occurrence and Antimicrobial Resistance, 2018-2021. Life (Basel) 2023; 13:1356. [PMID: 37374138 DOI: 10.3390/life13061356] [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: 05/01/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The abuse of antibiotics during the SARS-CoV-2 pandemic might have disrupted efforts to curb the further development and spread of the antimicrobial resistance of Staphylococcus aureus infection and Staphylococcus spp. coagulase-negative (CoNS) agents of nosocomial bloodstream infections (NBSIs). The purpose of our work was to study the resistance patterns of Staphylococcus aureus and CoNS through the analysis of blood cultures in hospitalized SARS-CoV-2-positive and SARS-CoV-2-negative patients (pts.). MATERIALS AND METHODS During the period January 2018-June 2021, a retrospective case-control study was performed on blood cultures positive for Staphylococcus spp. detected in 177 adult pts. (≥18 years old) hospitalized for >48 hours at Sant'Elia Hospital, Caltanissetta. RESULTS Staphylococcus aureus was isolated in 33.9% of blood culture samples, and among CoNS, the most frequent strains were Staphylococcus capitis (18.6%) and Staphylococcus hominis (18.1%). Patients aged ≥ 65 years, with a greater number of males, comprised the SARS-CoV-2-negative pts. (71.8% vs. 52.2%, p = 0.0154). Among the SARS-CoV-2-positive patients, the significant resistance of Staphylococcus aureus was only observed for erythromycin (57.1%). The oxacillin resistance of Staphylococcus capitis was higher in SARS-CoV-2-positive than in negative pts. (90% and 78.3%, respectively). Comparing the two groups, we found an increase in resistance in SARS-CoV-2-negative patients for the following antibiotics: gentamicin for Staphylococcus aureus (p = 0.007), clindamycin and erythromycin (p = 0.012) for Staphylococcus hominis and oxacillin and rifampicin for Staphylococcus haemoliticus (p = 0.012). CONCLUSIONS Our study confirms the relevance of oxacillin-resistant Staphylococcus aureus in being responsible for bloodstream infection and draws attention to highly oxacillin-resistant CoNS such as Staphylococcus capitis. The presence of resistant strains of CoNS in hospitals can be worrying, as it limits treatment options and worsens outcomes. The Infection Control Committee (ICC) recommends new treatment strategies to decrease colonization and infections. As part of the implementation of a bloodstream infection prevention program, the authors encourage the introduction of a report on the antimicrobial resistance of hospital bacteremia due to CoNS.
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Affiliation(s)
- Nicola Serra
- Department of Public Health, University Federico II of Naples, 80131 Napoli, Italy
| | - Paola Di Carlo
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro", Infectious Disease Unit, University of Palermo, 90127 Palermo, Italy
| | - Maria Andriolo
- Clinical Pathology Unit, S. Elia Hospital, 93100 Caltanissetta, Italy
| | - Giovanni Mazzola
- Infectious Disease Unit, Provincial Health Authority of Caltanissetta, 93100 Caltanissetta, Italy
| | - Elena Diprima
- Hypatia Degree Course, Caltanissetta, University of Palermo, 90127 Palermo, Italy
| | - Teresa Rea
- Department of Public Health, University Federico II of Naples, 80131 Napoli, Italy
| | - Antonio Anastasia
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro", Infectious Disease Unit, University of Palermo, 90127 Palermo, Italy
| | - Teresa Maria Assunta Fasciana
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Luca Pipitò
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro", Infectious Disease Unit, University of Palermo, 90127 Palermo, Italy
| | - Giuseppina Capra
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro", Microbiology and Virology Unit, University of Palermo, 90127 Palermo, Italy
| | - Anna Giammanco
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Maternal-Childhood, Internal Medicine of Excellence "G. D'Alessandro", Infectious Disease Unit, University of Palermo, 90127 Palermo, Italy
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Foglia F, Della Rocca M, Melardo C, Nastri B, Manfredini M, Montella F, De Filippis A, Finamore E, Galdiero M. Bloodstream infections and antibiotic resistance patterns: a six-year surveillance study from southern Italy. Pathog Glob Health 2023; 117:381-391. [PMID: 36190133 PMCID: PMC10177691 DOI: 10.1080/20477724.2022.2129161] [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: 10/10/2022] Open
Abstract
Bloodstream infections (BSI) are associated with high morbidity and mortality. This study aimed to describe the epidemiology of BSI and antimicrobial resistance patterns amongst its common bacterial causes. We conducted a retrospective record review of blood culture results of patients hospitalized with BSI at University Hospital 'L. Vanvitelli' from 2016 to 2021. For each patient records were obtained from the database using microbiological information. Gram-positive bacteria were the most predominant pathogens followed by Gram-negative bacteria. Among all isolates, bacterial pathogens most frequently identified included coagulase-negative Staphylococci (CoNS), Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and enterococci. We noted a general decrease in antimicrobial resistance amongst BSI pathogens in the latter years of the study. High levels of macrolide and aminoglycoside resistance amongst CoNS were reported. Carbapenem resistance amongst E. coli was barely reported, while resistance rates amongst K. pneumoniae declined considerably between 2018 and 2021. The prevalence of methicillin-resistant S. aureus decreased during the study period while that of methicillin-resistant CoNS remained relatively high throughout. The prevalence of extended spectrum ß-lactamase - producing E. coli increased considerably between 2016 and 2018 but showed a slight decrease thereafter. Conversely, there was a general decline in the resistant rates of extended spectrum ß-lactamase - producing K. pneumoniae between 2016 and 2018 with a similar trend being noted for carbapenem resistance in K. pneumoniae. Continuously monitoring the changes in the trends in BSI microbiological profiles, including pathogen profiles and the associated antibiotic resistance patterns, can help diagnostic approaches, treatment strategies and prevention programs.
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Affiliation(s)
- F. Foglia
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - M.T. Della Rocca
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - C. Melardo
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - B.M. Nastri
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - M. Manfredini
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - F. Montella
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - A. De Filippis
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - E. Finamore
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Massimiliano Galdiero
- Section of Virology and Microbiology, University Hospital of Campania “Luigi Vanvitelli”, Naples, Italy
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
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da Silva DAV, Dieckmann R, Makarewicz O, Hartung A, Bethe A, Grobbel M, Belik V, Pletz MW, Al Dahouk S, Neuhaus S. Biocide Susceptibility and Antimicrobial Resistance of Escherichia coli Isolated from Swine Feces, Pork Meat and Humans in Germany. Antibiotics (Basel) 2023; 12:antibiotics12050823. [PMID: 37237726 DOI: 10.3390/antibiotics12050823] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Phenotypic susceptibility testing of Escherichia (E.) coli is an essential tool to gain a better understanding of the potential impact of biocide selection pressure on antimicrobial resistance. We, therefore, determined the biocide and antimicrobial susceptibility of 216 extended-spectrum β-lactamase-producing (ESBL) and 177 non-ESBL E. coli isolated from swine feces, pork meat, voluntary donors and inpatients and evaluated associations between their susceptibilities. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of benzalkonium chloride, chlorhexidine digluconate (CHG), chlorocresol (PCMC), glutaraldehyde (GDA), isopropanol (IPA), octenidine dihydrochloride and sodium hypochlorite (NaOCl) showed unimodal distributions, indicating the absence of bacterial adaptation to biocides due to the acquisition of resistance mechanisms. Although MIC95 and MBC95 did not vary more than one doubling dilution step between isolates of porcine and human origin, significant differences in MIC and/or MBC distributions were identified for GDA, CHG, IPA, PCMC and NaOCl. Comparing non-ESBL and ESBL E. coli, significantly different MIC and/or MBC distributions were found for PCMC, CHG and GDA. Antimicrobial susceptibility testing revealed the highest frequency of resistant E. coli in the subpopulation isolated from inpatients. We observed significant but weakly positive correlations between biocide MICs and/or MBCs and antimicrobial MICs. In summary, our data indicate a rather moderate effect of biocide use on the susceptibility of E. coli to biocides and antimicrobials.
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Affiliation(s)
- David Attuy Vey da Silva
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
- Department of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany
| | - Ralf Dieckmann
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
| | - Oliwia Makarewicz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, 07747 Jena, Germany
| | - Anita Hartung
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, 07747 Jena, Germany
| | - Astrid Bethe
- Institute of Microbiology and Epizootics, Centre for Infection Medicine, Department of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany
- Veterinary Centre for Resistance Research (TZR), Freie Universität Berlin, 14163 Berlin, Germany
| | - Mirjam Grobbel
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
| | - Vitaly Belik
- System Modeling Group, Institute of Veterinary Epidemiology and Biostatistics, Department of Veterinary Medicine, Freie Universität Berlin, 14163 Berlin, Germany
| | - Mathias W Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, 07747 Jena, Germany
| | - Sascha Al Dahouk
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
- Department of Internal Medicine, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Szilvia Neuhaus
- Department of Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany
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Di Lodovico S, Fasciana T, Di Giulio M, Cellini L, Giammanco A, Rossolini GM, Antonelli A. Spread of Multidrug-Resistant Microorganisms. Antibiotics (Basel) 2022; 11:antibiotics11070832. [PMID: 35884086 PMCID: PMC9311923 DOI: 10.3390/antibiotics11070832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Silvia Di Lodovico
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.D.G.); (L.C.)
- Correspondence:
| | - Teresa Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90133 Palermo, Italy; (T.F.); (A.G.)
| | - Mara Di Giulio
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.D.G.); (L.C.)
| | - Luigina Cellini
- Department of Pharmacy, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy; (M.D.G.); (L.C.)
| | - Anna Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90133 Palermo, Italy; (T.F.); (A.G.)
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (G.M.R.); (A.A.)
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy
| | - Alberto Antonelli
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (G.M.R.); (A.A.)
- Clinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, Italy
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