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Liu X, Qin P, Wen H, Wang W, Zhao J. Seasonal meropenem resistance in Acinetobacter baumannii and influence of temperature-driven adaptation. BMC Microbiol 2024; 24:149. [PMID: 38678219 PMCID: PMC11055336 DOI: 10.1186/s12866-024-03271-y] [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: 03/22/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Recognition of seasonal trends in bacterial infection and drug resistance rates may enhance diagnosis, direct therapeutic strategies, and inform preventive measures. Limited data exist on the seasonal variability of Acinetobacter baumannii. We investigated the seasonality of A. baumannii, the correlation between temperature and meropenem resistance, and the impact of temperature on this bacterium. RESULTS Meropenem resistance rates increased with lower temperatures, peaking in winter/colder months. Nonresistant strain detection exhibited temperature-dependent seasonality, rising in summer/warmer months and declining in winter/colder months. In contrast, resistant strains showed no seasonality. Variations in meropenem-resistant and nonresistant bacterial resilience to temperature changes were observed. Nonresistant strains displayed growth advantages at temperatures ≥ 25 °C, whereas meropenem-resistant A. baumannii with β-lactamase OXA-23 exhibited greater resistance to low-temperature (4 °C) stress. Furthermore, at 4 °C, A. baumannii upregulated carbapenem resistance-related genes (adeJ, oxa-51, and oxa-23) and increased meropenem stress tolerance. CONCLUSIONS Meropenem resistance rates in A. baumannii display seasonality and are negatively correlated with local temperature, with rates peaking in winter, possibly linked to the differential adaptation of resistant and nonresistant isolates to temperature fluctuations. Furthermore, due to significant resistance rate variations between quarters, compiling monthly or quarterly reports might enhance comprehension of antibiotic resistance trends. Consequently, this could assist in formulating strategies to control and prevent resistance within healthcare facilities.
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Affiliation(s)
- Xiaoxuan Liu
- Hebei Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China
| | - Pu Qin
- Hebei Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China
| | - Hainan Wen
- Department of Laboratory Medicine, Affiliated Hospital of Chengde Medical University, Chengde, 067000, People's Republic of China
| | - Weigang Wang
- Hebei Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China
| | - Jianhong Zhao
- Hebei Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, People's Republic of China.
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Hailemichael T, Girma L, Fissiha P, Geteneh A, Kassa T. Isolation of virulent phages against multidrug-resistant Acinetobacter baumannii recovered from inanimate objects of Jimma Medical Center, Southwest Ethiopia. BMC Infect Dis 2023; 23:820. [PMID: 37993809 PMCID: PMC10666304 DOI: 10.1186/s12879-023-08823-7] [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: 10/30/2022] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Because of the multidrug resistance features of Acinetobacter baumannii, endurance to diverse conditions, and causing health fatalities in healthcare settings, the global health system is looking for the development of new antimicrobials for such bacteria. As the new antimicrobial drugs pipeline is running dry, it is imperative to look for eco-friendly bio-control strategies. In this regard, phages are one to combat the biofilm producer and MDR A. baumannii. Thus, the study aimed to isolate and examine the role of phages against biofilm producers and MDR A. baumannii from inanimate objects at Jimma Medical Center (JMC), Ethiopia. METHOD Institution-based cross-sectional study was conducted from June to November 2019. A total of 309 swab samples were collected from inanimate objects and the environment in JMC. Isolation of A. baumannii, antimicrobial susceptibility testing, and biofilm detection were carried out according to standard protocol. Kirby Bauer disk diffusion and microliter plate were methods for AST and biofilm detection, respectively. Specific phage was isolated and characterized from sewage at JMC compound. The data were analyzed by SPSS version 25.0, and chi-square (X2) cross-tabulation was used to determine the correlation of variables. A P-value of < 0.05 was considered a statistically significant association. RESULT A. baumannii from inanimate objects and surfaces of different environments at JMC was detected in 6.5% of the samples. From 20 of the isolates, 85% were biofilm producers, and 60% were MDR. The lytic phage isolated specifically against A. baumannii was found host specific, and thermally stable ranging from 10-50°C. The phage was active against 42% of MDR A. baumannii, 40% of both biofilm-producing and MDR A. baumannii (MDRAB), and 35.3% of the biofilm-producing isolates. CONCLUSION The good activity of phages towards MDRAB isolates, its biofilm degradation capability, thermal stability, and host specificity in our study encourages viewing the potential use of phages as a bio-control agent besides the routine cleansing agents. Therefore, we recommend isolation of specific phages in the eradication of MDRAB from health facilities with additional efforts to characterize in detail and assess their efficacy in animal models.
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Affiliation(s)
- Terefe Hailemichael
- Department of Medical Laboratory Science, Mizan Aman College of Health Sciences, Aman, Ethiopia
| | - Lencho Girma
- Department of Medical Laboratory Science, College of Health Sciences, Bonga University, Bonga, Ethiopia
| | - Paulos Fissiha
- Amhara Public Health Institute (APHI), Bahir Dar, Ethiopia
| | - Alene Geteneh
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia.
| | - Tesfaye Kassa
- School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia
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Wiradiputra MRD, Thirapanmethee K, Khuntayaporn P, Wanapaisan P, Chomnawang MT. Comparative genotypic characterization related to antibiotic resistance phenotypes of clinical carbapenem-resistant Acinetobacter baumannii MTC1106 (ST2) and MTC0619 (ST25). BMC Genomics 2023; 24:689. [PMID: 37978344 PMCID: PMC10655397 DOI: 10.1186/s12864-023-09734-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/11/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The prevalence of Acinetobacter baumannii in nosocomial infections and its remarkable ability to develop antimicrobial resistance have been a critical issue in hospital settings. Here, we examined the genomic features related to resistance phenotype displayed by carbapenem-resistant A. baumannii (CRAB) MTC1106 (ST2) and MTC0619 (ST25). RESULTS Resistome analysis of both strains revealed that MTC1106 possessed higher numbers of antimicrobial resistance genes compared to MTC0619. Some of those genetic determinants were present in accordance with the susceptibility profile of the isolates. The predicted ISAba1 region upstream of blaOXA-23 gene was related to carbapenem resistance since this IS element was well-characterized to mediate overexpression of carbapenemase genes and eventually provided capability to confer resistance. Unlike MTC0619 strain, which only carried class B and D β-lactamase genes, MTC1106 strain also possessed blaTEM-1D, a class A β-lactamase. Regarding to aminoglycosides resistance, MTC0619 contained 5 related genes in which all of them belonged to three groups of aminoglycosides modifying enzyme (AME), namely, N-acetyltransferase (AAC), O-nucleotidyltransferase (ANT), and O-phosphotransferase (APH). On the other hand, MTC1106 lacked only the AAC of which found in MTC0619, yet it also carried an armA gene encoding for 16S rRNA methyltransferase. Two macrolides resistance genes, mph(E) and msr(E), were identified next to the armA gene of MTC1106 isolate in which they encoded for macrolide 2'-phosphotransferase and ABC-type efflux pump, respectively. Besides acquired resistance genes, some chromosomal genes and SNPs associated with resistance to fluoroquinolones (i.e. gyrA and parC) and colistin (i.e. pmrCAB, eptA, and emrAB) were observed. However, gene expression analysis suggested that the genetic determinants significantly contributing to low-level colistin resistance remained unclear. In addition, similar number of efflux pumps genes were identified in both lineages with only the absence of adeC, a part of adeABC RND-type multidrug efflux pump in MTC0619 strain. CONCLUSIONS We found that MTC1106 strain harbored more antimicrobial resistance genes and showed higher resistance to antibiotics than MTC0619 strain. Regarding genomic characterization, this study was likely the first genome comparative analysis of CARB that specifically included isolates belonging to ST2 and ST25 which were widely spread in Thailand. Taken altogether, this study suggests the importance to monitor the resistance status of circulating A. baumannii clones and identify genes that may contribute to shifting the resistance trend among isolates.
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Affiliation(s)
- Made Rai Dwitya Wiradiputra
- Antimicrobial Resistance Interdisciplinary Group (AmRIG), Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Biopharmaceutical Sciences Program, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Krit Thirapanmethee
- Antimicrobial Resistance Interdisciplinary Group (AmRIG), Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Department of Microbiology, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Piyatip Khuntayaporn
- Antimicrobial Resistance Interdisciplinary Group (AmRIG), Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Department of Microbiology, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Pagakrong Wanapaisan
- Antimicrobial Resistance Interdisciplinary Group (AmRIG), Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Department of Microbiology, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Mullika Traidej Chomnawang
- Antimicrobial Resistance Interdisciplinary Group (AmRIG), Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
- Department of Microbiology, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
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Ding Y, Hao J, Xiao W, Ye C, Xiao X, Jian C, Tang M, Li G, Liu J, Zeng Z. Role of efflux pumps, their inhibitors, and regulators in colistin resistance. Front Microbiol 2023; 14:1207441. [PMID: 37601369 PMCID: PMC10436536 DOI: 10.3389/fmicb.2023.1207441] [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: 04/17/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Colistin is highly promising against multidrug-resistant and extensively drug-resistant bacteria clinically. Bacteria are resistant to colistin mainly through mcr and chromosome-mediated lipopolysaccharide (LPS) synthesis-related locus variation. However, the current understanding cannot fully explain the resistance mechanism in mcr-negative colistin-resistant strains. Significantly, the contribution of efflux pumps to colistin resistance remains to be clarified. This review aims to discuss the contribution of efflux pumps and their related transcriptional regulators to colistin resistance in various bacteria and the reversal effect of efflux pump inhibitors on colistin resistance. Previous studies suggested a complex regulatory relationship between the efflux pumps and their transcriptional regulators and LPS synthesis, transport, and modification. Carbonyl cyanide 3-chlorophenylhydrazone (CCCP), 1-(1-naphthylmethyl)-piperazine (NMP), and Phe-Arg-β-naphthylamide (PAβN) all achieved the reversal of colistin resistance, highlighting the role of efflux pumps in colistin resistance and their potential for adjuvant development. The contribution of the efflux pumps to colistin resistance might also be related to specific genetic backgrounds. They can participate in colistin tolerance and heterogeneous resistance to affect the treatment efficacy of colistin. These findings help understand the development of resistance in mcr-negative colistin-resistant strains.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jinbo Liu
- Department of Laboratory Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Zhangrui Zeng
- Department of Laboratory Medicine, the Affiliated Hospital of Southwest Medical University, Luzhou, China
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Worldwide Prevalence of Carbapenem Resistance in Acinetobacter baumannii. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2023. [DOI: 10.1097/ipc.0000000000001236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Chen CH, Wu PH, Lu MC, Ho MW, Hsueh PR. Geographic patterns of carbapenem-resistant, multi-drug-resistant and difficult-to-treat Acinetobacter baumannii in the Asia-Pacific region: results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program, 2020. Int J Antimicrob Agents 2023; 61:106707. [PMID: 36608719 DOI: 10.1016/j.ijantimicag.2022.106707] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/07/2022] [Accepted: 12/25/2022] [Indexed: 01/04/2023]
Abstract
This study evaluated the in-vitro activity of multiple classes of antibiotics, including novel β-lactam combination agents, tigecycline and colistin, against carbapenem-resistant (CRAB), multi-drug-resistant (MDRAB) and difficult-to-treat (DTRAB) Acinetobacter baumannii. Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method. Susceptibility profiles and the distribution of selected antimicrobials among countries were illustrated and examined based on the breakpoints of the Clinical and Laboratory Standards Institute, European Committee on Antimicrobial Susceptibility Testing and the US Food and Drug Administration. In total, 847 A. baumannii isolates were evaluated, and 692 isolates were characterized as CRAB, MDRAB or DTRAB. The prevalence of drug-resistant A. baumannii was >70.0% in South Korea, India and China, while the resistance rate of tigecycline was <5.5%. The MICs of meropenem and meropenem/vaborbactam for drug-resistant A. baumannii were equal (both MIC50 and MIC90 were 32 mg/L, range 0.25-32 mg/L). The overall resistance rate remained high for multiple classes of antibiotics, including penicillins, cephalosporins, carbapenems, quinolones and aminoglycosides (>84.0%, >96.0%, >98.0%, >88.0% and >87.0%, respectively), but not colistin or tigecycline (1.1% and 4.3%, respectively). China showed the lowest susceptibility to tigecycline for drug-resistant A. baumannii isolates compared with other countries. In conclusion, the resistance rate of drug-resistant A. baumannii remains high against multiple classes of antimicrobials. Colistin was the most potent agent, followed by tigecycline. The geographic pattern of tigecycline-resistant A. baumannii varied among countries. Therefore, continuous surveillance of A. baumannii resistance profiles in different regions is required.
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Affiliation(s)
- Chih-Hao Chen
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Pin-Han Wu
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Min-Chi Lu
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Microbiology and Immunology, School of Medicine, China Medical University, Taichung, Taiwan
| | - Mao-Wang Ho
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan
| | - Po-Ren Hsueh
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan; Department of Laboratory Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan; PhD Program for Aging, School of Medicine, China Medical University, Taichung, Taiwan; Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Mahapatra A, Pati A, Gupta K. Role of Efflux Pumps in Reduced Susceptibility to Tigecycline among Clinical Isolates of Acinetobacter baumannii. Int J Appl Basic Med Res 2022; 12:243-248. [PMID: 36726662 PMCID: PMC9886155 DOI: 10.4103/ijabmr.ijabmr_219_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/16/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Acinetobacter baumannii (A. baumannii) is a very well-known emerging pathogen and has become a major burden on healthcare system especially in intensive care units (ICUs). Tigecycline is the last resort drug for treatment of multidrug-resistant A. baumannii infections. However, non-susceptibility to this drug is a rising problem. Resistance to tigecycline is mediated by Resistance-nodulation-cell division (RND) efflux pumps. Objective This study was done to detect efflux pump genes (adeABC) and regulator genes (adeS,adeR) responsible for tigecycline resistance among the clinical isolates of A. baumannii. Materials and Methods A total of 150 OXA-51 confirmed clinical isolates were subjected for tigecycline susceptibility test by broth microdilution (BMD) method. All isolates irrespective of their MIC were subjected to conventional PCR for detection of efflux genes (adeABC) and regulator genes (adeRS). Results Prevalence of tigecycline resistance was found to be 14 (9.33%) by the reference broth microdilution method (BMD). Overall prevalence of efflux genes was highest for adeB (69%) and lowest for adeR (29%). Combination of genes especially three, four or five were found more prevalent among resistant isolates with higher minimum inhibitory concentration (MIC). Conclusion Combination of efflux genes confer higher MIC and can be a major contributor for resistance to tigecycline.
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Affiliation(s)
- Ashoka Mahapatra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Amresh Pati
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kavita Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Drug Resistance among Major Non-fermenting Gram-negative Pathogens Isolated from Respiratory Tract Infections in a Tertiary Care Hospital of South Karnataka. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.3.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Non-fermenting gram-negative bacteria (NFGNB) frequently exhibit drug resistance. The purpose of this study was to determine the drug resistance pattern among the NFGNB isolates causing respiratory tract infections (RTIs). A retrospective analysis of the antimicrobial susceptibility pattern of non-fermenters causing RTIs over four years (2016- 2019) was done and the change in drug resistance pattern was studied. A total of 653 cases were obtained that included 191 (29.2%) Moraxella catarrhalis, 283 (43.3%) Pseudomonas aeruginosa, and 132 (20.2%) Acinetobacter baumannii, 47 (7.2%) Stenotrophomonas maltophilia isolates. A higher resistance (82.6%) was observed for piperacillin-tazobactam and cefpirome, followed by imipenem (79.5%) and ciprofloxacin (76.5 %) for A. baumannii isolates. A sharp decline in resistance pattern for piperacillin, cefpirome, Imipenem and cefoperazone-sulbactam in 2019 and an increasing resistance to gentamycin and ciprofloxacin were noted. Among P. aeruginosa isolates, 94% aztreonam and 83.4% cefoperazone-sulbactam resistance were detected. There was an increased resistance for cefpirome and piperacillin and a decreased resistance for Imipenem was recorded in 2019. In cases of M. catarrhalis, 22.51% of isolates were resistant to ciprofloxacin, followed by erythromycin (18.32%) and tetracycline (17.80 %). S. maltophilia showed a 100% sensitivity for co-trimoxazole and 2.1% resistance for ciprofloxacin. A constantly changing antibiotic-resistant pattern of non-fermenters compels for a continuous update of drug-resistant trends through a longitudinal surveillance program in different geographical areas.
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Chen ZR, Guo HW, Liu J, Pan Q, Fu MZ, Qiu YK, Wong NK, Huang YC. Resistance traits and molecular characterization of multidrug-resistant Acinetobacter baumannii isolates from an intensive care unit of a tertiary hospital in Guangdong, southern China. Int Microbiol 2022; 25:471-479. [PMID: 35098390 DOI: 10.1007/s10123-022-00233-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/24/2021] [Accepted: 01/11/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aims to characterize antimicrobial resistance (AMR) of all the non-duplicated Acinetobacter baumannii strains isolated from an intensive care unit in a tertiary hospital during the period of January 1 to December 31, 2015. METHODS A. baumannii (n = 95 strains) isolated from patients was subjected to antimicrobial susceptibility test (AST) by Vitek 2 Compact system to determine minimum inhibitory concentrations, followed by genotyping by enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR). Resistance genes of interest were PCR amplified and sequenced. RESULTS All isolates were qualified as MDR, with a resistance rate of > 80% to 8 antimicrobials tested. In terms of beta-lactamase detection, the blaOXA23, blaTEM-1, and armA genes were detected frequently at 92.63%, 9 1.58%, and 88.42%, respectively. The metallo-β-lactamase genes blaIMP and blaVIM were undetected. Aph (3')-I was detected in 82 isolates (86.32%), making it the most prevalent aminoglycoside-modifying enzyme (AMEs) encoding gene. In addition, ant (3″)-I was detected at 30.53%, while 26.32% of the strains harbored an aac (6')-Ib gene. ERIC-PCR typing suggested moderate genetic diversity among the isolates, which might be organized into 10 distinct clusters, with cluster A (n = 86 isolates or 90.53%) being the dominant cluster. CONCLUSIONS All of the A. baumannii strains detected in the ICU were MDR clones exhibiting extremely high resistance to carbapenems and aminoglycosides as monitored throughout the study period. They principally belonged to a single cluster of isolates carrying blaOXA23 and armA co-producing different AMEs genes.
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Affiliation(s)
- Zhuo-Ran Chen
- Microbiology Division, Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Hui-Wu Guo
- Microbiology Division, Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Jun Liu
- Microbiology Division, Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Qing Pan
- College of Life Sciences and Oceanology, Shenzhen Key Laboratory of Microbial Genetic Engineering, Shenzhen University, Shenzhen, 518055, China
| | - Mao-Zhang Fu
- Microbiology Division, Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Ying-Kun Qiu
- Microbiology Division, Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Nai-Kei Wong
- Department of Infection Diseases, Shenzhen Third People's Hospital, The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, 518112, China
| | - Yuan-Chun Huang
- Microbiology Division, Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
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Liu N, Zheng X, Zhu Q, He Z, Hu S. The Dissemination of NDM-1 in Acinetobacter baumannii Strains. Curr Microbiol 2022; 79:117. [PMID: 35218435 DOI: 10.1007/s00284-022-02812-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/14/2022] [Indexed: 11/03/2022]
Abstract
Acinetobacter baumannii is a common pathogen in hospitals and usually causes bacteremia, pneumonia, meningitis, peritonitis and other diseases. Isolates carried NDM-1 gene can make several antibiotics such as carbapenems and other beta-lactams ineffective. Nowadays, the number of A. baumannii strains carrying NDM-1 has been climbing year by year in recent years. To characterise the transmission of NDM-1 in A. baumannii, we collected 2576 human-derived genomes of A. baumannii strains from NCBI database and found that 186 strains contained NDM-1 gene. The multi-locus sequence typing, phylogenetic tree, NDM-1 gene organization and the single nucleotide polymorphisms of NDM-1 were investigated. We hope that our work will provide a theoretical basis for the prevention of dissemination of NDM-1 in A. baumannii.
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Affiliation(s)
- Na Liu
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing, 100191, People's Republic of China.,School of Engineering Medicine, Beihang University, 37 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China
| | - Xin Zheng
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qianhui Zhu
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zilong He
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Interdisciplinary Innovation Institute of Medicine and Engineering, Beihang University, Beijing, 100191, People's Republic of China. .,School of Engineering Medicine, Beihang University, 37 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China.
| | - Songnian Hu
- State Key Laboratory of Microbial Resources, Institute of Microbiology, Chinese Academy of Sciences, Beijing, 100101, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China.
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Kurihara MNL, Sales ROD, Silva KED, Silva GD, Mansano MCT, Mahmoud FF, Simionatto S. High lethality rate of carbapenem-resistant Acinetobacter baumannii in Intensive Care Units of a Brazilian hospital: An epidemiologic surveillance study. Rev Soc Bras Med Trop 2022; 55:e05292021. [PMID: 35522809 PMCID: PMC9070061 DOI: 10.1590/0037-8682-0529-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/16/2022] [Indexed: 05/31/2023] Open
Abstract
Background: Methods: Results: Conclusions:
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Kumar S, Anwer R, Azzi A. Virulence Potential and Treatment Options of Multidrug-Resistant (MDR) Acinetobacter baumannii. Microorganisms 2021; 9:microorganisms9102104. [PMID: 34683425 PMCID: PMC8541637 DOI: 10.3390/microorganisms9102104] [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: 08/26/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022] Open
Abstract
Acinetobacter baumannii is an opportunistic pathogen which is undoubtedly known for a high rate of morbidity and mortality in hospital-acquired infections. A. baumannii causes life-threatening infections, including; ventilator-associated pneumonia (VAP), meningitis, bacteremia, and wound and urinary tract infections (UTI). In 2017, the World Health Organization listed A. baumannii as a priority-1 pathogen. The prevalence of A. baumannii infections and outbreaks emphasizes the direct need for the use of effective therapeutic agents for treating such infections. Available antimicrobials, such as; carbapenems, tigecycline, and colistins have insufficient effectiveness due to the appearance of multidrug-resistant strains, accentuating the need for alternative and novel therapeutic remedies. To understand and overcome this menace, the knowledge of recent discoveries on the virulence factors of A. baumannii is needed. Herein, we summarized the role of various virulence factors, including; outer membrane proteins, efflux pumps, biofilm, penicillin-binding proteins, and siderophores/iron acquisition systems. We reviewed the recent scientific literature on different A. baumannii virulence factors and the effective antimicrobial agents for the treatment and management of bacterial infections.
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Affiliation(s)
- Sunil Kumar
- Department of Biotechnology, Maharishi Markandeshwar (Deemed to Be University), Mullana, Ambala 133207, India;
| | - Razique Anwer
- Department of Pathology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia;
| | - Arezki Azzi
- Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13317-4233, Saudi Arabia
- Correspondence:
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Zhang H, Jia P, Zhu Y, Zhang G, Zhang J, Kang W, Duan S, Zhang W, Yang Q, Xu Y. Susceptibility to Imipenem/Relebactam of Pseudomonas aeruginosa and Acinetobacter baumannii Isolates from Chinese Intra-Abdominal, Respiratory and Urinary Tract Infections: SMART 2015 to 2018. Infect Drug Resist 2021; 14:3509-3518. [PMID: 34511942 PMCID: PMC8418378 DOI: 10.2147/idr.s325520] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose In recent years, less options are available for treating carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa. The present study investigates the susceptibility rates to imipenem/relebactam for the treatment of intra-abdominal infections (IAIs), respiratory tract infections (RTIs) and urinary tract infections (UTIs) caused by A. baumannii and P. aeruginosa in China. Patients and Methods A total of 1886 P. aeruginosa and 1889 A. baumannii isolates were collected in 21 centers (7 regions) as a part of the global SMART surveillance program between 2015 and 2018. Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) recommendations using the broth microdilution methodology at Peking Union Medical College Hospital. Results For P. aeruginosa, overall susceptibility rates to imipenem/relebactam were 84.2% at a CLSI breakpoint of ≤2 mg/L compared to 55.7% for imipenem. Susceptibility rates of imipenem-non-susceptible P. aeruginosa to imipenem/relebactam were 64.4% and for multidrug-resistance (MDR) P. aeruginosa susceptibility rates were increased from 25.2% for imipenem to 65.8% for imipenem/relebactam. The susceptibilities of imipenem-non-susceptible and MDR P. aeruginosa strains were similarly restored by imipenem/relebactam in non-ICU and ICU wards. The rate of imipenem-non-susceptibilities A. baumannii isolates was 79.0%, whereas the MDR rate was 81.9%. Relebactam did not change the susceptibilities of imipenem-non susceptible or MDR A. baumannii isolates. Conclusion Imipenem/relebactam provides a therapy option to treat infections caused by MDR or imipenem-non-susceptible P. aeruginosa but not A. baumannii infections in China.
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Affiliation(s)
- Hui Zhang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Peiyao Jia
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Ying Zhu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, People's Republic of China
| | - Ge Zhang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jingjia Zhang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wei Kang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Simeng Duan
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Weijuan Zhang
- MRL Global Medical Affairs, MSD China, Shanghai, People's Republic of China
| | - Qiwen Yang
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yingchun Xu
- Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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14
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Yan Q, Hao S, Shi F, Zou Y, Song X, Li L, Li Y, Guo H, He R, Zhao L, Ye G, Tang H. Epigallocatechin-3-gallate reduces liver and immune system damage in Acinetobacter baumannii-loaded mice with restraint stress. Int Immunopharmacol 2021; 92:107346. [PMID: 33412390 DOI: 10.1016/j.intimp.2020.107346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/08/2020] [Accepted: 12/25/2020] [Indexed: 11/28/2022]
Abstract
AIM Due to the significant increase in the antimicrobial resistance of Acinetobacter baumannii (A. baumannii), new drugs to block the progression of infection are strongly needed. Epigallocatechin-3-gallate (EGCG), a major component of green tea, has exhibited potential activity against A. baumannii in vitro. The aim of this study was to determine if EGCG could be used for pretreating stress-related effects, liver damage, and immune dysfunction caused by A. baumannii infection in vivo. METHODS Levels of stress hormones, oxidative stress, liver damage, and immune components were analyzed in a murine infection model in which the mice were pretreated with EGCG for one week then intranasally inoculated with A. baumannii. The mice were restrained for 12 h to promote infection because A. baumannii is an opportunistic pathogen. The pretreatment efficacy of EGCG against A. baumannii in mice was assessed for 24 h after the bacterial infection. RESULTS Restraint stress strengthened the damage from the A. baumannii infection. Pretreatment with EGCG in the murine pneumonia model markedly reduced stress hormones, oxidative metabolites, and proinflammatory cytokine production. EGCG also increased the immune function by increasing the levels of sIgA, T cells and neutrophils after infection. Moreover, pretreatment with EGCG significantly decreased the liver damage by inhibiting the levels of transaminases, oxidative stress metabolites, and cytokines, while maintaining the normal activity of CYP450 enzymes in the liver. CONCLUSION EGCG was efficacious as a preventative treatment for the damage seen in an experimental model of A. baumannii infection.
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Affiliation(s)
- Qiaohua Yan
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Suqi Hao
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Fei Shi
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Yuanfeng Zou
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Xu Song
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Lixia Li
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Yinglun Li
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Hongrui Guo
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Ran He
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Ling Zhao
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Gang Ye
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China
| | - Huaqiao Tang
- Department of Pharmacy, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu 611130, China.
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15
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Kareem SM. Emergence of mcr- and fosA3-mediated colistin and fosfomycin resistance among carbapenem-resistant Acinetobacter baumannii in Iraq. Meta Gene 2020. [DOI: 10.1016/j.mgene.2020.100708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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16
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Lyu C, Zhang Y, Liu X, Wu J, Zhang J. Clinical efficacy and safety of polymyxins based versus non-polymyxins based therapies in the infections caused by carbapenem-resistant Acinetobacter baumannii: a systematic review and meta-analysis. BMC Infect Dis 2020; 20:296. [PMID: 32316926 PMCID: PMC7175513 DOI: 10.1186/s12879-020-05026-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background The prevalence of infections due to carbapenem-resistant Acinetobacter baumannii (CRAB) is on the rise worldwide. Polymyxins are considered as last-resort drugs for CRAB infections, but there is still controversy regarding the efficacy and safety of polymyxins based therapies in CRAB infections. The present systematic review was designed to compare the efficacy and safety of polymyxins based therapies versus non-polymyxins based therapies in CRAB infections. Methods We performed a systematic literature search in PubMed, Embase, CINAHL, Cochrane Library, and clinicaltrials.gov to identify eligible studies reporting the clinical outcomes of patients with CRAB infections. The meta-analysis employed a random-effects model to estimate the odds ratio (OR) and standardized mean difference (SMD) with 95% confidence interval (CI). The primary outcome was 1-month mortality for any cause. We also examined clinical response, microbiological response, length of stay in hospital, and adverse events. Results Eleven eligible studies were analyzed (1052 patients in total), including 2 randomized clinical trials. Serious risk of bias was found in 8 out of the 11 studies. There was no statistically significant difference between polymyxins based therapies and non-polymyxins based therapies in 1-month mortality for any cause (OR, 0.95; 95% CI, 0.59 to 1.53), microbiological response (OR, 3.83; 95% CI, 0.90 to 16.29) and length of stay in hospital (SMD, 0.24; 95% CI, − 0.08 to 0.56). The pooled OR of clinical response indicated a significant difference in favor of polymyxin based therapies (OR, 1.99; 95% CI, 1.31 to 3.03). The pooled OR of adverse events showed that non-polymyxins based therapies were associated with fewer adverse events (OR, 4.32; 95% CI, 1.39 to 13.48). Conclusion The performance of polymyxins based therapies was better than non-polymyxin based therapies in clinical response rate and similar to non-polymyxin based therapies in terms of 1-month mortality and microbiological response in treating CRAB infections. Due to the limitations of our study, we cannot draw a firm conclusion on the optimal treatment of CRAB infections, but polymyxins would be a relatively effective treatment for CRAB infections. Adequate and well-designed large scale randomized controlled trials are required to clarify the relative efficacy of polymyxins based and non-polymyxins based therapies.
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Affiliation(s)
- Cheng Lyu
- Institute of Antibiotics, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, China.,Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission, Shanghai, China
| | - Yuyi Zhang
- Shanghai Public Health Clinical Center, Shanghai, China
| | - Xiaofen Liu
- Institute of Antibiotics, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, China.,Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission, Shanghai, China
| | - Jufang Wu
- Institute of Antibiotics, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, China
| | - Jing Zhang
- Institute of Antibiotics, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, 200040, China. .,Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission, Shanghai, China.
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Abouelfetouh A, Torky AS, Aboulmagd E. Role of plasmid carrying bla NDM in mediating antibiotic resistance among Acinetobacter baumannii clinical isolates from Egypt. 3 Biotech 2020; 10:170. [PMID: 32206504 PMCID: PMC7076099 DOI: 10.1007/s13205-020-2157-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/28/2020] [Indexed: 01/01/2023] Open
Abstract
We investigated antibiotic resistance levels among blaNDM-positive (n = 9) and -negative (n = 65) A. baumannii clinical isolates collected in 2010 and 2015 from Alexandria Main University Hospital, Egypt using disc diffusion and minimum inhibitory concentration (MIC) determination. Plasmids from blaNDM-positive isolates were transformed into a carbapenem-susceptible A. baumannii (CS-AB) isolate to assess the role of plasmid transfer in mediating carbapenem resistance. Imipenem, meropenem, and ertapenem MIC90 values against blaNDM-positive isolates were 128, > 256, and 256 µg/mL, respectively. Plasmid isolation and polymerase chain reaction revealed that blaNDM was plasmid mediated. The plasmids were electroporated into the cells of a CS-AB isolate at an efficiency of 1.3 × 10–8 to 2.6 × 10–7, transforming them to blaNDM-positive carbapenem-resistant cells with an imipenem MIC increase of 256-fold. In addition to carbapenem resistance, the blaNDM-positive isolates also exhibited higher levels of cephalosporins, tetracycline, aminoglycosides, fluoroquinolones, and colistin resistance than the blaNDM-negative isolates. Acquisition of blaNDM-carrying plasmids dramatically increased imipenem resistance among A. baumannii isolates. Intriguingly, blaNDM-positive isolates also showed a high degree of resistance to antibiotics of different classes. The potential co-existence of different resistance determinants on A. baumannii plasmids and their possible transfer owing to the natural competence of the pathogen are especially alarming. More effective infection control and antibiotic stewardship programs are needed to curb the spread and treat such infections in both hospital and community settings.
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Affiliation(s)
- Alaa Abouelfetouh
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, 1 Khartoum Sq., Azarita, Alexandria, 21521 Egypt
| | - Aisha S. Torky
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, 1 Khartoum Sq., Azarita, Alexandria, 21521 Egypt
| | - Elsayed Aboulmagd
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, 1 Khartoum Sq., Azarita, Alexandria, 21521 Egypt
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18
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Su CH, Tsai MH, Lin CY, Ma YD, Wang CH, Chung YD, Lee GB. Dual aptamer assay for detection of Acinetobacter baumannii on an electromagnetically-driven microfluidic platform. Biosens Bioelectron 2020; 159:112148. [PMID: 32291246 DOI: 10.1016/j.bios.2020.112148] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/30/2020] [Accepted: 03/09/2020] [Indexed: 02/06/2023]
Abstract
Rapid detection of Acinetobacter baumannii (AB) is critical for limiting healthcare-associated infections and providing the best treatment for infected individuals. Herein an integrated microfluidic device for AB diagnosis utilizing a new dual aptamer assay was developed for point-of-care (POC) applications; magnetic beads coated with AB-specific aptamers were used to capture bacteria, and quantum dots (QD) bound to a second aptamer were utilized to quantify the amount of bacteria with a light-emitting diode (LED)-induced fluorescence module integrated into the device. Within a rapid detection of 30 min, a limit of detection of only 100 colony-forming units (CFU)/reaction was obtained, and all necessary microfluidic devices were actuated by a combination of permanent magnets and electromagnets. The pumping rate of the micropump was 270 μL/min at only 10 V, which is amenable for POC applications with lower power consumption, and only 10 μL of sample and reagents were required. Given these attributes, an automatic POC device was demonstrated which could perform a dual aptamer assay to diagnose AB by using electromagnetically-driven microfluidic system. This system provides a rapid, sensitive, low power and reagents consumption and fully automated for AB detection by using a dual aptamer assay. It will allow rapid clinical diagnosis of AB in the near future.
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Affiliation(s)
- Chin-Heng Su
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Min-Han Tsai
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Chia-Ying Lin
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Yu-Dong Ma
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Chih-Hung Wang
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Yi-Da Chung
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Gwo-Bin Lee
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan; Institute of NanoEngineering and Microsystems, National Tsing Hua University, Hsinchu, Taiwan; Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan.
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19
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Wang Y, Li X, Wang D, Sun S, Lu C. In vitro interactions of ambroxol hydrochloride or amlodipine in combination with antibacterial agents against carbapenem-resistant Acinetobacter baumannii. Lett Appl Microbiol 2019; 70:189-195. [PMID: 31808159 DOI: 10.1111/lam.13259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/30/2019] [Accepted: 11/30/2019] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the in vitro interactions of ambroxol hydrochloride (ABH) or amlodipine (AML) with commonly used antibacterial agents, including meropenem, imipenem-cilastatin sodium, biapenem, cefoperazone-sulbactam, polymyxin B, and tigecycline, against six carbapenem-resistant Acinetobacter baumannii (CRAB) clinical isolates. Drug interactions were interpreted using two models, that is, the fractional inhibitory concentration index (FICI) model and the percentage of growth difference (ΔE) model. The results show that a majority of the combination groups exhibited partial synergy and additive interactions, such as the combinations of carbapenems and cefoperazone-sulbactam (SCF) with ABH or AML. While the combination of PB/AML exhibited synergistic interactions against all tested isolates, and PB/ABH exhibited synergistic interactions against two isolates. The FICI and ΔE model correlated very well for the combinations of PBABH and PB/AML against AB2. The combinations of TGC with ABH or AML mainly exhibited additive and indifferent interactions. There were no antagonistic interactions observed in any of the combinations. In conclusion, this study revealed that the non-antibacterial agents ABH or AML can work synergistically or partial synergistically with antibacterial agents against CRAB. This finding is crucial for overcoming the carbapenem resistance of A. baumannii. SIGNIFICANCE AND IMPACT OF THE STUDY: Drug combination is an effective approach for the treatment of resistant bacterial infection. The significance of using drug combination is that it can reduce drug dosage requirements, reduce the toxic effects of agents and prevent or delay the emergence of drug resistance. This study measured the in vitro interactions between non-antimicrobial agents and antibacterial agents against carbapenem-resistant Acinetobacter baumannii and the results of this study provide new insight to find strategies to overcome the carbapenem resistance in A. baumannii.
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Affiliation(s)
- Y Wang
- Department of Pharmacy, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong Province, China.,Department of Pharmacy, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - X Li
- Department of Pharmacy, Qilu Children's Hospital of Shandong University, Jinan, Shandong Province, China
| | - D Wang
- School of Pharmaceutical Sciences, Shandong First Medical University, Taian, Shandong Province, China
| | - S Sun
- Department of Pharmacy, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong Province, China
| | - C Lu
- Department of Pharmacy, Shandong Provincial Qianfoshan Hospital, the First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong Province, China
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Shah MW, Yasir M, Farman M, Jiman-Fatani AA, Almasaudi SB, Alawi M, El-Hossary D, Azhar EI. Antimicrobial Susceptibility and Molecular Characterization of Clinical Strains ofAcinetobacter baumanniiin Western Saudi Arabia. Microb Drug Resist 2019; 25:1297-1305. [DOI: 10.1089/mdr.2019.0018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Muhammad Waseem Shah
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Biology Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhammad Yasir
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhammad Farman
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Biology Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Asif A. Jiman-Fatani
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Clinical and Molecular Microbiology Laboratories, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Saad B. Almasaudi
- Biology Department, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maha Alawi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Infection Control & Environmental Health Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Dalia El-Hossary
- Clinical and Molecular Microbiology Laboratories, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Esam I. Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Behçet M, AVCIOĞLU F, KARABÖRK Ş, KURTOĞLU MG. Yatan Hastalarda Çeşitli Klinik Örneklerden İzole Edilen Acinetobacter baumanni Suşlarının Antibiyotiklere Direnç Durumlarının İncelenmesi. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2019. [DOI: 10.33631/duzcesbed.540397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
While the description of resistance to quinolones is almost as old as these antimicrobial agents themselves, transferable mechanisms of quinolone resistance (TMQR) remained absent from the scenario for more than 36 years, appearing first as sporadic events and afterward as epidemics. In 1998, the first TMQR was soundly described, that is, QnrA. The presence of QnrA was almost anecdotal for years, but in the middle of the first decade of the 21st century, there was an explosion of TMQR descriptions, which definitively changed the epidemiology of quinolone resistance. Currently, 3 different clinically relevant mechanisms of quinolone resistance are encoded within mobile elements: (i) target protection, which is mediated by 7 different families of Qnr (QnrA, QnrB, QnrC, QnrD, QnrE, QnrS, and QnrVC), which overall account for more than 100 recognized alleles; (ii) antibiotic efflux, which is mediated by 2 main transferable efflux pumps (QepA and OqxAB), which together account for more than 30 alleles, and a series of other efflux pumps (e.g., QacBIII), which at present have been sporadically described; and (iii) antibiotic modification, which is mediated by the enzymes AAC(6')Ib-cr, from which different alleles have been claimed, as well as CrpP, a newly described phosphorylase.
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Leung ECM, Leung PHM, Lai RWM. Emergence of Carbapenem-Resistant Acinetobacter baumannii ST195 Harboring blaOXA-23 Isolated from Bacteremia in Hong Kong. Microb Drug Resist 2019; 25:1199-1203. [PMID: 31158046 DOI: 10.1089/mdr.2018.0433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Aims: The aim of the study was to analyze the epidemiology of Acinetobacter baumannii and investigate the genetic characteristics of carbapenem-resistant A. baumannii (CRAB) isolates isolated from blood cultures in a regional hospital in Hong Kong. Results: Twenty blood culture isolates were collected from a regional hospital in Hong Kong from 2014 to 2017. Twenty isolates were grouped into five existing sequence types (STs) and five new STs within the following prevalence: ST195 was predominant with a prevalence of 45% (n = 9), followed by ST373 and ST447 (10%; n = 2 each), and ST176 and ST345 (5%; n = 1 each). Resistance to carbapenem antibiotics was 55% (n = 11). Six carbapenem-resistant isolates harbored blaOXA-23 genes and ISAba1 mobile elements. Polymerase chain reaction confirmed that ISAba1 is located upstream to the blaOXA-23 genes, suggesting an association between ISAba1 and blaOXA-23 genes with carbapenem resistance. Conclusion: This study is the first to report the emergence of CRAB ST195 harboring blaOXA-23 in Hong Kong.
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Affiliation(s)
- Eddie Chi-Man Leung
- Department of Microbiology, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China
| | - Polly Hang-Mei Leung
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
| | - Raymond Wai-Man Lai
- Department of Microbiology, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, China
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Bacterial susceptibility in bloodstream infections: Results from China Antimicrobial Resistance Surveillance Trial (CARST) Program, 2015–2016. J Glob Antimicrob Resist 2019; 17:276-282. [DOI: 10.1016/j.jgar.2018.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 11/19/2022] Open
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25
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Tateda K, Ohno A, Ishii Y, Murakami H, Yamaguchi K. Investigation of the susceptibility trends in Japan to fluoroquinolones and other antimicrobial agents in a nationwide collection of clinical isolates: A longitudinal analysis from 1994 to 2016. J Infect Chemother 2019; 25:594-604. [PMID: 30954447 DOI: 10.1016/j.jiac.2019.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/21/2019] [Accepted: 03/09/2019] [Indexed: 10/27/2022]
Abstract
The susceptibilities of clinical isolates to fluoroquinolones and other antimicrobial agents were surveyed to obtain an accurate understanding of trends in incidence and antimicrobial resistance. The samples were collected from across Japan, biennially or triennially, between 1994 and 2016 and a defined level of resistance to fluoroquinolone was determined. Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae exhibited stable and high rates of susceptibility to fluoroquinolones over the period examined. For methicillin-resistant Staphylococcus aureus the rate of resistance to levofloxacin and ciprofloxacin was 81.3-93.5% and 83.2-94.2%, respectively, which was markedly higher than that of methicillin-susceptible S. aureus, while sitafloxacin-resistant methicillin-susceptible and methicillin-resistant S. aureus were isolated at 0.3-0.7% and 16.9-36.5%, respectively. The rate of levofloxacin or ciprofloxacin-resistant Escherichia coli increased from around 2-3% between 1994 and 1998 to around 35% in 2016, but the rate of fluoroquinolone-susceptible Klebsiella pneumoniae stayed high at over 94.6% during the study period. Although no fluoroquinolone-resistance in clinical isolates of Salmonella spp. was detected from 1994 to 2002, the resistance rate increased slightly after 2004 and reached to 1.9%-4.7% in 2016. The rate of fluoroquinolone-susceptible Pseudomonas aeruginosa isolated from urinary tract and respiratory tract infections improved during the period examined from 41.8-67.0% to 91.2-94.2%, and from 78.9-88.5% to 90.1-94.6%, respectively. Against Acinetobacter spp., the susceptibility rate of fluoroquinolones was almost constant at around 90%, but one multidrug-resistant isolate was detected in 2013. Overall, the susceptibility to fluoroquinolones was maintained over 20 years against tested bacteria except for MRSA and E. coli.
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Affiliation(s)
- Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan; Department of Clinical Laboratory, Toho University Omori Medical Center, Japan.
| | - Akira Ohno
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
| | - Hinako Murakami
- Department of Clinical Laboratory, Toho University Omori Medical Center, Japan
| | - Keizo Yamaguchi
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Japan
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Akbari R, Hakemi-Vala M, Pashaie F, Bevalian P, Hashemi A, Pooshang Bagheri K. Highly Synergistic Effects of Melittin with Conventional Antibiotics Against Multidrug-Resistant Isolates of Acinetobacter baumannii and Pseudomonas aeruginosa. Microb Drug Resist 2019; 25:193-202. [DOI: 10.1089/mdr.2018.0016] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Reza Akbari
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojdeh Hakemi-Vala
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashaie
- Venom and Biotherapeutics Molecules Lab, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Parvaneh Bevalian
- Venom and Biotherapeutics Molecules Lab, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Ali Hashemi
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamran Pooshang Bagheri
- Venom and Biotherapeutics Molecules Lab, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
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Wang S, Hu YJ, Little P, Wang Y, Chang Q, Zhou X, Moore M, Harwell JI. The impact of the national action plan on the epidemiology of antibiotic resistance among 352,238 isolates in a teaching hospital in China from 2015 to 2018. Antimicrob Resist Infect Control 2019; 8:22. [PMID: 30728954 PMCID: PMC6352357 DOI: 10.1186/s13756-019-0473-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/14/2019] [Indexed: 12/16/2022] Open
Abstract
Background We sought to understand the epidemiology and characteristics of antimicrobial resistance (AMR) and the impact of the National Action Plan (NAP) on AMR. This information will be critical to develop interventions and strengthen antibiotic stewardship in hospital settings in China. Methods Cross-sectional data collection from the hospital information management system from 1 January 2015 to 30 August 2018. Variables included patient age, sex, diagnosis, hospital department and antibiotic sensitivity test. T-test for two samples method was applied to compare the results before and after NAP implementation. Multivariate analysis with binary logistic regression was conducted to examine the associations of risk factors for antimicrobial resistance. Results In total there were 352,238 isolates in the final analysis after excluding contamination strains and isolates with incomplete information. More than 50% of patients were > 66 years old. 62% were male. 40% of the total samples were sputum. Among the total sample, the total resistance rate was 42% among all isolates. The rate of resistance to all antibiotics declined by 5.3% (95% CI 4.96-5.64%, p < 0.0001) and culture positivity rate declined by 9.8% (95% CI 9.22-10.34%, p < 0.0001) after NAP. Logistical regression showed that the NAP had effect with an adjusted odds ratio of 0.76 (95% CI 0.71-0.81, p = 0.002). Being male, age > 65 years, ICU department, diagnosed with certain diseases were more likely to be associated with antimicrobial resistance. Conclusions Antibiotic resistance rates were high in this teaching hospital. However, the introduction of the China NAP since 2016 followed by hospital policy emphasis was associated with a declining AMR trend. Policies will need to incorporate antimicrobial stewardship with a focus on certain departments, with infection control practices and with increases in vaccination coverage among elderly.
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Affiliation(s)
- Shanjuan Wang
- Shanghai General Practice Medical Education and Research Center, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, No 1 Chengbei Rd, Jiading, Shanghai, 201800 China
| | - Yanhong Jessika Hu
- School of Public Health, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, Hong Kong
| | - Paul Little
- Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST UK
| | - Yifei Wang
- Shanghai General Practice Medical Education and Research Center, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, No 1 Chengbei Rd, Jiading, Shanghai, 201800 China
| | - Qing Chang
- Shanghai General Practice Medical Education and Research Center, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, No 1 Chengbei Rd, Jiading, Shanghai, 201800 China
| | - Xudong Zhou
- School of Public Health, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058 Zhejiang China
| | - Michael Moore
- Primary Care and Population Sciences, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST UK
| | - Joseph Irvin Harwell
- Clinical Science Team, Clinton Health Access Initiative, 383 Dorchester Ave, Boston, MA 02127 USA
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Timsit JF, Bassetti M, Cremer O, Daikos G, de Waele J, Kallil A, Kipnis E, Kollef M, Laupland K, Paiva JA, Rodríguez-Baño J, Ruppé É, Salluh J, Taccone FS, Weiss E, Barbier F. Rationalizing antimicrobial therapy in the ICU: a narrative review. Intensive Care Med 2019; 45:172-189. [PMID: 30659311 DOI: 10.1007/s00134-019-05520-5] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/04/2019] [Indexed: 12/13/2022]
Abstract
The massive consumption of antibiotics in the ICU is responsible for substantial ecological side effects that promote the dissemination of multidrug-resistant bacteria (MDRB) in this environment. Strikingly, up to half of ICU patients receiving empirical antibiotic therapy have no definitively confirmed infection, while de-escalation and shortened treatment duration are insufficiently considered in those with documented sepsis, highlighting the potential benefit of implementing antibiotic stewardship programs (ASP) and other quality improvement initiatives. The objective of this narrative review is to summarize the available evidence, emerging options, and unsolved controversies for the optimization of antibiotic therapy in the ICU. Published data notably support the need for better identification of patients at risk of MDRB infection, more accurate diagnostic tools enabling a rule-in/rule-out approach for bacterial sepsis, an individualized reasoning for the selection of single-drug or combination empirical regimen, the use of adequate dosing and administration schemes to ensure the attainment of pharmacokinetics/pharmacodynamics targets, concomitant source control when appropriate, and a systematic reappraisal of initial therapy in an attempt to minimize collateral damage on commensal ecosystems through de-escalation and treatment-shortening whenever conceivable. This narrative review also aims at compiling arguments for the elaboration of actionable ASP in the ICU, including improved patient outcomes and a reduction in antibiotic-related selection pressure that may help to control the dissemination of MDRB in this healthcare setting.
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Affiliation(s)
- Jean-François Timsit
- Medical and Infectious Diseases ICU, APHP, Bichat-Claude Bernard Hospital, 46 Rue Henri-Huchard, 75877, Paris Cedex 18, France.
- INSERM, IAME, UMR 1137, Paris-Diderot Sorbonne-Paris Cité University, Paris, France.
| | - Matteo Bassetti
- Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Olaf Cremer
- Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - George Daikos
- Scool of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Jan de Waele
- Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium
| | - Andre Kallil
- Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Eric Kipnis
- Surgical Critical Care Unit, Department of Anesthesiology, Critical Care and Perioperative Medicine, CHU Lille, Lille, France
| | - Marin Kollef
- Critical Care Research, Washington University School of Medicine and Respiratory Care Services, Barnes-Jewish Hospital, St. Louis, MO, USA
| | - Kevin Laupland
- Department of Medicine, Royal Inland Hospital, Kamloops, Canada
| | - Jose-Artur Paiva
- Intensive Care Medicine Department, Centro Hospitalar São João and Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jesús Rodríguez-Baño
- Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena, Departament of Medicine, University of Sevilla, Biomedicine Institute of Seville (IBiS), Seville, Spain
| | - Étienne Ruppé
- INSERM, IAME, UMR 1137, Paris-Diderot Sorbonne-Paris Cité University, Paris, France
- Bacteriology Laboratory, Bichat-Claude Bernard Hospital, APHP, Paris, France
| | - Jorge Salluh
- Department of Critical Care and Graduate Program in Translational Medicine, D'Or Institute for Research and Education, IDOR, Rio De Janeiro, Brazil
| | | | - Emmanuel Weiss
- Department of Anesthesiology and Critical Care, Beaujon Hospital, AP-HP, Clichy, France
- INSERM, CRI, UMR 1149, Paris-Diderot Sorbonne-Paris Cité University, Paris, France
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Royer S, de Campos PA, Araújo BF, Ferreira ML, Gonçalves IR, Batistão DWDF, Brígido RTES, Cerdeira LT, Machado LG, de Brito CS, Gontijo-Filho PP, Ribas RM. Molecular characterization and clonal dynamics of nosocomial blaOXA-23 producing XDR Acinetobacter baumannii. PLoS One 2018; 13:e0198643. [PMID: 29889876 PMCID: PMC5995351 DOI: 10.1371/journal.pone.0198643] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 05/22/2018] [Indexed: 01/28/2023] Open
Abstract
The emergence of infections associated to new antimicrobial resistance in Acinetobacter baumannii (Ab) genotypes represents a major challenge. In this context, this study aimed to determine the diversity of resistance mechanisms and investigate clonal dissemination and predominant sequence types (STs) in multidrug-resistant Ab strains of clinical (tracheal aspirate, n = 17) and environmental (surface, n = 6) origins. Additionally, the major clones found in clinical (A) and environmental (H) strains had their complete genomes sequenced. All strains were submitted to polymerase chain reactions (PCR) for the detection of the ISAba1/blaOXA-51-like and ISAba1/blaOXA-23-like genes, while the expression of genes encoding the carO porin, AdeABC (adeB), AdeFGH (adeG), and AdeIJK (adeJ) efflux pumps was determined by real time PCR (qPCR). Most of the strains were characterized as extensively drug-resistant (XDR) with high minimal inhibitory concentrations (MICs) detected for tigecycline and carbapenems. Associations between ISAba1/OXA-51 and ISAba1/OXA-23 were observed in 91.3% and 52.2% of the strains, respectively. Only the adeB gene was considered hyper-expressed. Furthermore, most of the strains analyzed by the MuLtilocus Sequence-Typing (MLST) were found to belong to the clonal complex 113 (CC113). In addition, a new ST, ST1399, belonging to CC229, was also discovered herein. Strains analyzed by whole genome sequencing presented resistance genes linked to multidrug-resistance phenotypes and confirmed the presence of Tn2008, which provides high levels carbapenem-resistance.
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Affiliation(s)
- Sabrina Royer
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- * E-mail:
| | - Paola Amaral de Campos
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Bruna Fuga Araújo
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Melina Lorraine Ferreira
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Iara Rossi Gonçalves
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | - Rebecca Tavares e Silva Brígido
- National Reference Center for Sanitary Dermatology and Leprosy (CREDESH) Clinical Hospital Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | | | - Luiz Gustavo Machado
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Cristiane Silveira de Brito
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Paulo Pinto Gontijo-Filho
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Rosineide Marques Ribas
- Institute of Biomedical Sciences (ICBIM), Laboratory of Molecular Microbiology, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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Shahram SZ, Javadi R. Evaluation of Antibiotic Resistance Patterns and Frequency of Carbapenemase-Producing Acinetobacter baumannii Isolates by the Carbacineto NP Test. MEDICAL LABORATORY JOURNAL 2018. [DOI: 10.29252/mlj.12.2.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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31
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Theuretzbacher U. Global antimicrobial resistance in Gram-negative pathogens and clinical need. Curr Opin Microbiol 2017; 39:106-112. [PMID: 29154024 DOI: 10.1016/j.mib.2017.10.028] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/28/2017] [Indexed: 12/29/2022]
Abstract
Resistance in Gram-negative bacteria has become a serious problem in many regions of the world as it may reduce the treatment options substantially. Carbapenem-resistance is a good marker for such situations and is most prevalent in Acinetobacter, Pseudomonas but also increasingly in Enterobacteriaceae, especially Klebsiella. This review gives a rough global picture highlighting the epicentres of resistance. The medical need for novel treatment options globally is undeniable even if many countries with good stewardship and infection control conditions are not highly affected. Antibiotic pipelines are encouraging, as new drugs in development reduce the resistance rate to individual pathogens. Despite some progress, efforts to discover and develop novel drugs that are not prone to cross-resistance to existing antibiotic classes should be intensified.
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