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Paudel R, Shrestha E, Chapagain B, Tiwari BR. Carbapenemase producing Gram negative bacteria: Review of resistance and detection methods. Diagn Microbiol Infect Dis 2024; 110:116370. [PMID: 38924837 DOI: 10.1016/j.diagmicrobio.2024.116370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Gram negative bacilli that are carbapenem resistant have emerged and are spreading worldwide. Infections caused by carbapenem resistant isolates posses a significant threat due to their high morbidity and mortality rates. Carbapenemases production by multi-drug resistant pathogens severely restricts treatment choices for illnesses caused by bacteria that are resistant to both carbapenems and majority of β-lactam antibiotics. Various phenotypic and genotypic methods for identification can distinguish between different classes of carbapenemase and identify pathogens that are resistant to carbapenems. The establishment of a quick, accurate and reliable test for identifying the clinical strains that produce the carbapenemase enzyme is essential for optimum diagnosis of microbial pathogens and management of the global rise in the prevalence of carbapenemase producing bacterial strains. The aim of this review was to summarize the mechanisms of carbapenem resistance and to provide an overview of different carbapenemase detection methods for carbapenem resistant Gram negative bacilli.
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Affiliation(s)
- Rajan Paudel
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal.
| | - Elina Shrestha
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | - Bipin Chapagain
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | - Bishnu Raj Tiwari
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
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Guibert F, Espinoza K, Taboada-Blanco C, Alonso CA, Oporto R, Castillo AK, Rojo-Bezares B, López M, Sáenz Y, Pons MJ, Ruiz J. Traditional marketed meats as a reservoir of multidrug-resistant Escherichia coli. Int Microbiol 2023:10.1007/s10123-023-00445-y. [PMID: 37995017 DOI: 10.1007/s10123-023-00445-y] [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: 08/19/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/24/2023]
Abstract
This study aimed to analyze Escherichia coli from marketed meat samples in Peru. Sixty-six E. coli isolates were recovered from 21 meat samples (14 chicken, 7 beef), and antimicrobial resistance levels and the presence of mechanisms of antibiotic resistance, as well as clonal relationships and phylogeny of colistin-resistant isolates, were established. High levels of antimicrobial resistance were detected, with 93.9% of isolates being multi-drug resistant (MDR) and 76.2% of samples possessing colistin-resistant E. coli; of these, 6 samples from 6 chicken samples presenting mcr-1-producer E. coli. Colistin-resistant isolates were classified into 22 clonal groups, while phylogroup A (15 isolates) was the most common. Extended-spectrum β-lactamase- and pAmpC-producing E. coli were found in 18 and 8 samples respectively, with blaCTX-M-55 (28 isolates; 16 samples) and blaCIT (8 isolates; 7 samples) being the most common of each type. Additionally, blaCTX-M-15, blaCTX-M-65, blaSHV-27, blaOXA-5/10-like, blaDHA, blaEBC and narrow-spectrum blaTEM were detected. In addition, 5 blaCTX-M remained unidentified, and no sought ESBL-encoding gene was detected in other 6 ESBL-producer isolates. The tetA, tetE and tetX genes were found in tigecycline-resistant isolates. This study highlights the presence of MDR E. coli in Peruvian food-chain. The high relevance of CTX-M-55, the dissemination through the food-chain of pAmpC, as well as the high frequency of unrelated colistin-resistant isolates is reported.
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Affiliation(s)
- Fernando Guibert
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - "One Health", Universidad Científica del Sur, Antigua Panamericana Sur Km 19, Villa El Salvador, 15067, Lima, Peru
| | - Kathya Espinoza
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - "One Health", Universidad Científica del Sur, Antigua Panamericana Sur Km 19, Villa El Salvador, 15067, Lima, Peru
| | - Clara Taboada-Blanco
- Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja, Logroño, Spain
| | - Carla A Alonso
- Servicio de Análisis Clínicos, Laboratorio de Microbiología, Hospital San Pedro, Logroño, Spain
| | - Rosario Oporto
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - "One Health", Universidad Científica del Sur, Antigua Panamericana Sur Km 19, Villa El Salvador, 15067, Lima, Peru
| | - Angie K Castillo
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - "One Health", Universidad Científica del Sur, Antigua Panamericana Sur Km 19, Villa El Salvador, 15067, Lima, Peru
| | - Beatriz Rojo-Bezares
- Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja, Logroño, Spain
| | - María López
- Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja, Logroño, Spain
| | - Yolanda Sáenz
- Área de Microbiología Molecular, Centro de Investigación Biomédica de La Rioja, Logroño, Spain
| | - Maria J Pons
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - "One Health", Universidad Científica del Sur, Antigua Panamericana Sur Km 19, Villa El Salvador, 15067, Lima, Peru.
| | - Joaquim Ruiz
- Grupo de Investigación en Dinámicas y Epidemiología de la Resistencia a Antimicrobianos - "One Health", Universidad Científica del Sur, Antigua Panamericana Sur Km 19, Villa El Salvador, 15067, Lima, Peru.
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Kaboré B, Ouédraogo HS, Zongo O, Ouédraogo GA, Tapsoba F, Bougma S, Zongo KJ, Zeba B, Traoré Y, Sanou I, Savadogo A. Emergence of New Delhi Metallo- β-Lactamase (NDM) Genes Detected from Clinical Strains of Escherichia coli Isolated in Ouagadougou, Burkina Faso. Int J Microbiol 2023; 2023:4813225. [PMID: 37303773 PMCID: PMC10256439 DOI: 10.1155/2023/4813225] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/17/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023] Open
Abstract
The emergence and spread of carbapenem resistance in Gram-negative bacilli such as Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa through the production of carbapenemases is a global phenomenon. It threatens patient care and leads to therapeutic impasses. This study aims to genotypically determine the prevalence of the most frequent carbapenemase genes among multidrug-resistant E. coli strains isolated from patients at a biomedical analysis laboratory. A total of fifty-three unduplicated E. coli strains isolated from patient samples with a multidrug-resistant (MDR) profile were subjected to polymerase chain reaction (PCR) testing for carbapenem resistance genes. This study allowed us to identify fifteen strains carrying resistance genes among the fifty-three E. coli strains. All fifteen strains produced the metallo-β-lactamase enzymes; this represents a rate of 28.30% of study strains. Among these strains, ten carried the NDM resistance gene, NDM and VIM genes were detected in three strains and VIM was identified in two strains of E. coli. However, carbapenemases A (KPC and IMI), D (OXA-48), and IMP were not detected in the strains studied. Thus, NDM and VIM are the main carbapenemases detected in the strains in our study.
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Affiliation(s)
- Boukaré Kaboré
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Henri S. Ouédraogo
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Oumarou Zongo
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Ganamé Abasse Ouédraogo
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - François Tapsoba
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Sanogo Bougma
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Koudbi Jacob Zongo
- Department of Biochemistry and Microbiology, Faculty of Applied Science and Technology, University of Dedougou, BP 176, Dedougou, Burkina Faso
| | - Boukaré Zeba
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Yves Traoré
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
| | - Idrissa Sanou
- UFR Health Sciences, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Laboratory of Bacteriology and Virology at Tengadogo University Hospital, 11 BP 104 Ouaga CMS 11, Ouagadougou, Burkina Faso
| | - Aly Savadogo
- Department of Biochemistry and Microbiology, Laboratory of Applied Biochemistry and Immunology, University Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
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Belouad EM, Benaissa E, El Mrimar N, Bssaibis F, Maleb A, Elouennass M. Predominance of OXA-48 Carbapenemase-Producing Enterobacterales in a Moroccan Hospital. Int J Microbiol 2023; 2023:8581883. [PMID: 37250920 PMCID: PMC10219769 DOI: 10.1155/2023/8581883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 02/23/2023] [Accepted: 05/06/2023] [Indexed: 05/31/2023] Open
Abstract
Objective The emergence of carbapenemase-producing Enterobacterales (CPE) is a major concern that is increasingly reported worldwide. Our study aimed at investigating the resistance of CPE isolates in a Moroccan teaching hospital using phenotypic and genotypic methods. Methods Enterobacterales strains from March to June 2018 were collected from different clinical samples. The Enterobacterales isolates resistant to third-generation cephalosporins (3GC) and/or carbapenems were subjected to the Carba NP test and an immunochromatographic test for phenotypic detection. Detection of extended-spectrum β-lactamases (ESBL) was also performed following standards. Molecular screening of carbapenemases genes (OXA-48, NDM, blaKPC, blaIMP, blaVIM, and blaOXA-24, blaOXA-23, OXA-51, OXA-58) using conventional multiplex PCR assays was also performed on 143 isolates. Results Enterobacterales represented 52.7% with a proportion of 21.8% of bacteria resistant to 3GC and/or carbapenems. Within 143 isolates MDR to 3GC, K. pneumoniae, E. coli, and E. cloacae represent 53.1%, 40.6%, and 6.3%, respectively. These strains were isolated mainly from urinary samples (74.8%) in patients admitted to emergency and surgical units. 81.1% of strains are producing ESBL and 29% are carbapenemase producers as confirmed by the Carba NP test, immunochromatographic test, and molecular testing. OXA-48 carriers represent 83.3% of these strains, followed by NDM with 16.7%. blaKPC, blaIMP, blaVIM, and blaOXA-24, blaOXA-23, OXA-51, OXA-58 were not detected in any of these bacteria. Conclusions A high rate of CPE carrying OXA-48 among Enterobacterales resistant to 3GC and/or carbapenems isolates was found. Strict observance of hospital hygiene measures and more rational use of antibiotics are mandatory. Implantation of carbapenemases detection should be encouraged in our hospital settings to estimate the true burden of the CPE.
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Affiliation(s)
- El Mehdi Belouad
- Department of Clinical Bacteriology, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Research Team of Epidemiology and Bacterial Resistance, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Elmostafa Benaissa
- Department of Clinical Bacteriology, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Research Team of Epidemiology and Bacterial Resistance, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Nadia El Mrimar
- Research Team of Epidemiology and Bacterial Resistance, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Fatna Bssaibis
- Department of Clinical Bacteriology, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | - Adil Maleb
- Research Team of Epidemiology and Bacterial Resistance, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mostafa Elouennass
- Department of Clinical Bacteriology, Mohammed V Military Teaching Hospital, Rabat, Morocco
- Research Team of Epidemiology and Bacterial Resistance, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
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Sadeghi M, Mojtahedi A, Nikokar I, Roushan ZA. The emergence of plasmid-encoded oxacillinase and carbapenemase among uropathogenic Escherichia coli (UPEC) isolated from hospitalized patients in the North of Iran. Heliyon 2023; 9:e15386. [PMID: 37123931 PMCID: PMC10130876 DOI: 10.1016/j.heliyon.2023.e15386] [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: 12/01/2022] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 05/02/2023] Open
Abstract
Carbapenemase enzyme production is responsible for resistance to carbapenem among Gram-negative bacteria. This study aimed to detect common carbapenemase and oxacilinase genes among uropathogenic E. coli (UPEC) isolated from hospitalized patients in Rasht, north of Iran. In the present study, from 2000 urine samples, 263 UPEC strains were isolated from inpatients with urinary tract infections (UTI) in 2020. The Kirby-Bauer disk diffusion susceptibility test was used to determine the sensitivity or resistance of isolates to antimicrobial compounds. The double-disk test confirmed extended-spectrum β lactamase (ESBL) production phenotypically, and the presence and distribution of genes encoding carbapenemase and oxacilinase were investigated using polymerase chain reaction (PCR). Based on the findings, 13/263 isolates (8 ESBL and five non-ESBL) showed a non-susceptible phenotype to at least one of the studied carbapenem group antibiotics, and 121 (46%) isolates were ESBL-producers. PCR for oxacilinase and carbapenemase genes was done on all 126 isolates, including ESBL-positive and carbapenem-resistant strains, in which 10 (7.9%) and 25 (19.8%) isolates harbored OXA-1 and IMP genes, respectively. Also, OXA-2, OXA-10, OXA-48, VIM, and NDM genes were not found in any studied isolates. IMP and OXA-1 genes among carbapenemase-producing isolates indicate the possible spread of antibiotic-resistant strains. Hence, identification and control of ESBL and carbapenemase-producing strains, although with almost low frequency due to plasmid genes encoding carbapenemase, is essential for infection control.
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Affiliation(s)
- Mahsa Sadeghi
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Mojtahedi
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Corresponding author. Department of Microbiology, School of Medicine, Guilan University Campus, 7th Km of Rasht-Tehran Highway, Rasht, Guilan, Iran.
| | - Iraj Nikokar
- Medical Biotechnology Research Center, Faculty of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Atrkar Roushan
- Department of Biostatistics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Stone S, Thoms-Rodriguez CA, Cameron J, Seah C, Stephenson-Clarke S, Melano RG. New Delhi Metallo-Beta-Lactamase (NDM)-5 in Uropathogenic Klebsiella pneumoniae in a Tertiary Care Hospital in Jamaica. Microbiol Spectr 2023; 11:e0345922. [PMID: 36719202 PMCID: PMC10100667 DOI: 10.1128/spectrum.03459-22] [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: 08/31/2022] [Accepted: 12/28/2022] [Indexed: 02/01/2023] Open
Abstract
We have investigated the prevalence of carbapenemase-producing uropathogens at the University Hospital of the West Indies, Jamaica. From 64 unique urine samples collected between January and March 2020, only 2 closely related Klebsiella pneumoniae (ST11, 14 SNPs of difference; no clear epidemiological links found between patients) were carbapenemase-producers. By whole-genome sequencing (WGS), blaNDM-5 was found on ~46 kb, IncX3 plasmid. These findings highlight the necessity for continuous surveillance of these pathogens in Jamaica. IMPORTANCE As the problem of antibiotic resistance continues to be a global problem, we hope to be able to shed further insight into what is happening within the Caribbean, from which there has been a paucity of data. The ability to appropriately tackle the problem of resistance requires surveillance from all territories, including resource limited settings. In this paper, we look at a mechanism of resistance that renders some critical antibiotics useless, including carbapenems, cephalosporins, and penicillin.
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Affiliation(s)
- Steven Stone
- The University of the West Indies, Mona, Jamaica
| | | | - Jenene Cameron
- The University Hospital of the West Indies, Mona, Jamaica
| | - Christine Seah
- Public Health Ontario Laboratory, Toronto, Ontario, Canada
| | | | - Roberto G. Melano
- Public Health Ontario Laboratory, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
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Ghadiri A, Doosti A, Shakhsi-Niaei M. Prevalence, Antimicrobial Susceptibility, and Distribution of Virulence Genes Involved in Biofilm Formation in Multidrug-Resistant Acinetobacter baumannii Isolated from Shahrekord Medical Centers, Chaharmahal and Bakhtiari, Iran. IRANIAN JOURNAL OF MEDICAL MICROBIOLOGY 2023. [DOI: 10.30699/ijmm.17.1.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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Tang B, Wang C, Sun D, Lin H, Ma J, Guo H, Yang H, Li X. In Silico Characterization of blaNDM-Harboring Conjugative Plasmids in Acinetobacter Species. Microbiol Spectr 2022; 10:e0210222. [PMID: 36301090 PMCID: PMC9769834 DOI: 10.1128/spectrum.02102-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/28/2022] [Indexed: 01/06/2023] Open
Abstract
New Delhi metallo-β-lactamase (NDM)-producing clinical strains in Acinetobacter spp. have been recently reported in many countries and have received considerable attention. The vast majority of blaNDM cases occur on conjugative plasmids, which play a vital role in disseminating blaNDM. To characterize the conjugative plasmids bearing blaNDM genes in Acinetobacter spp., we analyzed the variants of blaNDM, conjugative transfer regions, genetic contexts of blaNDM, and the phylogenetic pattern of the 62 predicted blaNDM-positive plasmids, which were selected from 1,191 plasmids of Acinetobacter species from GenBank. We identified 30 conjugative plasmids from the 62 blaNDM-harboring plasmids in Acinetobacter species, with the oriT sites similar to plasmid pNDM-YR7 in our study, genes coding for relaxases of the MOBQ family, genes encoding type IV coupling proteins (T4CPs) of the TrwB/TraD subfamily, and VirB-like type IV secretion system (T4SS) gene clusters. The genome sizes of all 30 pNDM-YR7-like plasmids ranged from 39.36 kb to 49.65 kb, with a median size of 44.56 kb. The most common species of Acinetobacter containing the blaNDM-positive conjugative plasmids was A. baumannii, followed by Acinetobacter lwoffii and Acinetobacter indicus. Notably, pNDM-YR7 is the first report on a blaNDM-positive conjugative plasmid in Acinetobacter junii. Moreover, all 30 blaNDM-positive conjugative plasmids in Acinetobacter species were found to contain genetic contexts with the structure ISAba14-aph(3')-VI-ISAba125-blaNDM-ble. Our findings provide important insights into the phylogeny and evolution of blaNDM-positive plasmids of Acinetobacter species and further address their role in acquiring and spreading blaNDM genes in Acinetobacter species. IMPORTANCE Conjugative plasmids harboring the blaNDM gene play a vital role in disseminating carbapenem resistance. In this study, we first report a conjugative plasmid, pNDM-YR7, in Acinetobacter junii. Based on the genomic characteristics of the blaNDM-positive pNDM-YR7, we performed in silico typing and comparative analysis of blaNDM-positive plasmids using the 1,191 plasmids of Acinetobacter species available in the NCBI RefSeq database. We analyzed the characteristics of blaNDM-positive plasmids, including the variants of blaNDM, genetic features associated with blaNDM, conjugative transfer regions, and the phylogenetic pattern of the blaNDM-positive plasmids. All 30 blaNDM-positive conjugative plasmids were found to contain an ISAba14-aph(3')-VI-ISAba125-blaNDM-ble region. This study provides novel insights into the phylogeny and evolution of blaNDM-harboring conjugative plasmids and contributes to the repertoire of knowledge surrounding blaNDM-positive plasmids in the genus Acinetobacter.
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Affiliation(s)
- Biao Tang
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products & Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Chenyu Wang
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Dongchang Sun
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Hui Lin
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products & Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Jiangang Ma
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products & Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Hengzhao Guo
- Department of Radiation Oncology, Zhuhai People’s Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, Guangdong, China
| | - Hua Yang
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products & Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, China
| | - Xiaobin Li
- Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital affiliated with Jinan University), Zhuhai, Guangdong, China
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Exploring the Antibiotic Resistance Profile of Clinical Klebsiella pneumoniae Isolates in Portugal. Antibiotics (Basel) 2022; 11:antibiotics11111613. [PMID: 36421258 PMCID: PMC9686965 DOI: 10.3390/antibiotics11111613] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
While antibiotic resistance is rising to dangerously high levels, resistance mechanisms are spreading globally among diverse bacterial species. The emergence of antibiotic-resistant Klebsiella pneumoniae, mainly due to the production of antibiotic-inactivating enzymes, is currently responsible for most treatment failures, threatening the effectiveness of classes of antibiotics used for decades. This study assessed the presence of genetic determinants of β-lactam resistance in 102 multi-drug resistant (MDR) K. pneumoniae isolates from patients admitted to two central hospitals in northern Portugal from 2010 to 2020. Antimicrobial susceptibility testing revealed a high rate (>90%) of resistance to most β-lactam antibiotics, except for carbapenems and cephamycins, which showed antimicrobial susceptibility rates in the range of 23.5−34.3% and 40.2−68.6%, respectively. A diverse pool of β-lactam resistance genetic determinants, including carbapenemases- (i.e., blaKPC-like and blaOXA-48-like), extended-spectrum β-lactamases (ESBL; i.e., blaTEM-like, blaCTX-M-like and blaSHV-like), and AmpC β-lactamases-coding genes (i.e., blaCMY-2-like and blaDHA-like) were found in most K. pneumoniae isolates. blaKPC-like (72.5%) and ESBL genes (37.3−74.5%) were the most detected, with approximately 80% of K. pneumoniae isolates presenting two or more resistance genes. As the optimal treatment of β-lactamase-producing K. pneumoniae infections remains problematic, the high co-occurrence of multiple β-lactam resistance genes must be seen as a serious warning of the problem of antimicrobial resistance.
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Ejaz H. Molecular characterization and antibiogram of the carbapenemase gene variants in clinical strains of Pseudomonas aeruginosa. Mol Biol Rep 2022; 49:10531-10539. [PMID: 36129599 DOI: 10.1007/s11033-022-07930-z] [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: 08/03/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Carbapenemase-producing Pseudomonas aeruginosa (CPPA) is a substantial clinical concern because it jeopardizes therapeutic choices. This study characterizes the gene variants of CPPA and report its antibiogram. METHODS CPPA was isolated prospectively from diverse clinical sources in a tertiary care setting using a routine microbiological approach. Carbapenem-resistant P. aeruginosa strains were phenotypically identified using the modified carbapenem inactivation (mCIM) method. Minimum inhibitory concentration (MIC) breakpoints of several antibacterial drug groups were determined using broth microdilution methods and the MicroScan WalkAway plus system. Carbapenemase gene variants blaNDM, blaVIM, blaOXA,blaGES, and blaIMP were amplified using polymerase chain reaction (PCR), and the purified gene products were sequenced. RESULTS Seventy-one P. aeruginosa-infected cases were found, with 47 (66.2%) carrying CPPA; 46.8% of the latter were significantly associated with intensive care units (p = 0.03). CPPA was frequently detected in wound swabs (13; 27.7%), sputum (11; 23.4%), and blood (9; 19.1%). All strains were multidrug-resistant (MDR), and several were extensively drug-resistant. MIC50 and MIC90 breakpoints of all antibiotics, except colistin, were within the resistance range. MIC90 breakpoints of aztreonam, amikacin, cefepime, and piperacillin-tazobactam were > 512 µg/mL. The multiple antibiotic resistance index (MARI) was remarkably high, with a range of 0.38-0.92. The most commonly detected carbapenemase genes were blaVIM (74%), blaNDM-1 (19%), blaOXA-23 (14.9%), and blaGES (10.6%), while 12 of 47 strains co-harbored different combinations of carbapenemase gene variants. CONCLUSION A large proportion of CPPA strains carried the blaVIM gene variant, indicating intimidating health problems and emphasizing the need for extensive surveillance and antibiotic stewardship.
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Affiliation(s)
- Hasan Ejaz
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, 72388, Al Jouf, Saudi Arabia.
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Cho YY, Kim JH, Kim H, Lee J, Im SJ, Ko KS. Comparison of Virulence between Two Main Clones (ST11 and ST307) of Klebsiella pneumoniae Isolates from South Korea. Microorganisms 2022; 10:microorganisms10091827. [PMID: 36144429 PMCID: PMC9504348 DOI: 10.3390/microorganisms10091827] [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: 08/25/2022] [Revised: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, we investigate the characteristics of two main clones of carbapenemase-producing Klebsiella pneumoniae isolates from South Korea, ST11 and ST307, including carbapenem-susceptible isolates. Antibiotic susceptibility, serotype or wzi allelic type, the presence of virulence genes, and virulence with respect to serum resistance and macrophage internalization were determined for ST11 and ST307 isolates. ST11 isolates had a wide range of characteristics, including serotype and virulence, compared with those of homogeneous ST307 isolates. The wzi14 or K14 type had higher virulence than that of other serotypes among the ST11 isolates, and the homogeneous ST307 isolates showed similar virulence level as that of the wzi14-type ST11 isolates. Our data suggest that it is necessary to monitor not only the introduction and spread of a specific clone, but also its detailed serotype.
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Affiliation(s)
- Yun Young Cho
- Department of Microbiology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
| | - Jee Hong Kim
- Department of Microbiology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
| | - Hyunkeun Kim
- Department of Microbiology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
| | - Junghwa Lee
- Department of Precision Medicine, Graduate School of Basic Medical Science, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
| | - Se Jin Im
- Department of Immunology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
- Correspondence: (S.J.I.); (K.S.K.); Tel.: +82-31-299-6125 (S.J.I.); +82-31-299-6223 (K.S.K.)
| | - Kwan Soo Ko
- Department of Microbiology, Sungkyunkwan University School of Medicine, Suwon 16419, Korea
- Correspondence: (S.J.I.); (K.S.K.); Tel.: +82-31-299-6125 (S.J.I.); +82-31-299-6223 (K.S.K.)
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Cortazzo V, Posteraro B, Menchinelli G, Liotti FM, D’Inzeo T, Fiori B, Luzzaro F, Sanguinetti M, Spanu T. Susceptibility of Meropenem-Resistant and/or Carbapenemase-Producing Clinical Isolates of Enterobacterales (Enterobacteriaceae) and Pseudomonas aeruginosa to Ceftazidime-Avibactam and Ceftolozane-Tazobactam as Assessed by In Vitro Testing Methods. Antibiotics (Basel) 2022; 11:antibiotics11081023. [PMID: 36009892 PMCID: PMC9405240 DOI: 10.3390/antibiotics11081023] [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: 07/01/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 12/04/2022] Open
Abstract
This study aimed to assess the comparability of in vitro susceptibility testing methods to ceftazidime-avibactam (CZA) and ceftolozane-tazobactam (C/T). Meropenem-resistant and/or carbapenemase-producing clinical isolates of Enterobacterales (Enterobacteriaceae) and Pseudomonas aeruginosa were tested by both bioMérieux ETEST and VITEK-2 AST-N397 card and compared with a Micronaut AST-system broth microdilution (BMD) method. CZA and C/T MICs were interpreted using EUCAST breakpoints. Of the 153 Enterobacteriaceae isolates, 55.6% and 0.0% (VITEK 2) and 56.9% and 0.0% (ETEST and BMD) were susceptible to CZA and C/T, respectively. Of 52 P. aeruginosa isolates, 50.0% and 40.4% (VITEK 2, ETEST, and BMD) were susceptible to CZA and C/T, respectively. The essential agreement (EA) was 96.1% (197/205; VITEK 2 versus BMD) and 95.6% (196/205; ETEST versus BMD) for CZA testing, whereas EA was 98.0% (201/205; VITEK 2 versus BMD) and 96.6% (198/205; ETEST versus BMD) for C/T testing. The categorical agreement (CA) was 98.0% (201/205; VITEK 2 versus BMD) and 100% (ETEST versus BMD) for CZA testing, whereas CA was 100% (VITEK 2 versus BMD) and 100% (ETEST versus BMD) for C/T testing. Categorical errors regarded four Enterobacteriaceae isolates. VITEK 2 and ETEST yielded equivalent CZA and C/T susceptibility testing results, compared to the BMD method, in such a clinical context.
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Affiliation(s)
- Venere Cortazzo
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (V.C.); (B.P.); (T.D.); (T.S.)
| | - Brunella Posteraro
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (V.C.); (B.P.); (T.D.); (T.S.)
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
| | - Giulia Menchinelli
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (G.M.); (F.M.L.); (B.F.)
| | - Flora Marzia Liotti
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (G.M.); (F.M.L.); (B.F.)
| | - Tiziana D’Inzeo
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (V.C.); (B.P.); (T.D.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (G.M.); (F.M.L.); (B.F.)
| | - Barbara Fiori
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (G.M.); (F.M.L.); (B.F.)
| | | | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (V.C.); (B.P.); (T.D.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (G.M.); (F.M.L.); (B.F.)
- Correspondence: ; Tel.: +39-6-3054411 (ext. 00168)
| | - Teresa Spanu
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (V.C.); (B.P.); (T.D.); (T.S.)
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (G.M.); (F.M.L.); (B.F.)
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Intestinal Carriage of Extended-spectrum β-lactamase and Carbapenemase-producing Enterobacteriaceae in Hemodialysis Patients. Jundishapur J Microbiol 2022. [DOI: 10.5812/jjm-118946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Gastrointestinal colonization with resistant pathogens is significant because they could be easily transmitted to other hosts or spread to different microbiota through mobile genetic elements. Objectives: This study assessed the prevalence of fecal carriage of extended-spectrum β-lactamase-producing and carbapenemase-producing Enterobacteriaceae (ESBL-E and CPE, respectively) among hemodialysis patients and the factors affecting its occurrence in a hospital in Tehran. Methods: From January 2018 to May 2019, 150 hemodialysis patients referred to a hospital in Tehran were sampled in this study. Stool samples of the patients were diluted in saline and cultured on MacConkey agar plates containing cefotaxime, ceftazidime, imipenem, and meropenem discs. The clinical data were analyzed to identify the risk factors using a logistic regression model. Results: The colonization rate of ESBL-E was 48.6%, while only 2% of patients were identified as the carriers of CPE (3 of 150). A higher prevalence rate was obtained for intestinal carriage of ESBL-E among hemodialysis patients aged 18 to 42 years using multivariate analysis. The prevalence rate of multidrug-resistant isolates was 73.8%. The blaCTX-M1 gene was identified as the most prevalent ESBL gene. Among carbapenemase-encoding genes, blaKPC and blaoxa-48 were found in 12 and two isolates, respectively. Conclusions: These results demonstrated a high prevalence rate of ESBLs among hemodialysis patients, although this rate was low for carbapenemases. Therefore, more control measures should be taken in hospitals to prevent the spread of antibiotic resistance genes in healthcare settings.
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Zhu Y, Fan Y, Cao X, Lu R, Chu S, Ding A. Regulation of Carbapenemase Gene Conjugation in Escherichia coli Clinical Isolates. Microb Drug Resist 2022; 28:551-558. [PMID: 35319308 DOI: 10.1089/mdr.2021.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The purpose of this study is to raise awareness of the hazards of carbapenemase epidemics and provide theoretical support for preventing the spread of carbapenemase-producing organisms. Methods: A total of 893 non-duplicate E. coil strains were recruited from three major local hospitals. The carbapenemase genotype of each imipenem-resistant strain was analyzed. Molecular typing and homology analysis of the main carbapenemase-producing strains reveal the transmission mode of resistance genes. Through the conjugation experiment, the potential spreading risk of carbapenemase genes was analyzed. Extended-spectrum beta-lactamase genes and replicon detection of the conjugant carrying plasmid were performed. The unannotated Escherichia coli bacterial small non-coding RNAs (sRNAs) interacting with sdiA were predicted through a bioinformatics tool. The sRNAs overexpression and knockout strains were constructed, and the effect of sRNA on conjugation was analyzed. Results: A total of 8 carbapenemase-producing strains were detected (0.90%, 8/893). The main carbapenemase genotype was blaKPC -2 (7 strains). Multilocus sequence typing indicated that 7 E. coli isolates belonged to ST-10, ST-101, ST-131, ST-405, ST-410, and ST-1193, ST-2562, respectively. Homologous cluster analysis revealed that the sequence types among the 7 E. coli were high diversity. The blaKPC -2 genes were successfully transferred from these isolates to EC600 by conjugation. All transconjugant cells exhibited significantly reduced susceptibility to the imipenem. IncFII was the most common conjugative plasmid type (85.7%, 6/7). Bioinformatics predicted the interaction between RydB and sdiA. Further experiments found that the interaction between RydB and sdiA improved the bacterial conjugation rate between MG1655 and EC600. The regulation effect of RydB on E. coli conjugation was not affected by the replicon type and/or harboring resistance coding genotype in conjugative plasmids. Conclusion: Our findings emphasized the epidemiological characteristics of carbapenemase-resistant E. coli. A functional phenotype of the new sRNA RydB was identified, and the regulation effect of RydB on E. coli conjugation was improved.
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Affiliation(s)
- Yihua Zhu
- Clinical Laboratory, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, P.R. China
| | - Yuping Fan
- Clinical Laboratory, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, P.R. China
| | - Xinjian Cao
- Clinical Laboratory, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, P.R. China
| | - Renfei Lu
- Clinical Laboratory, The Third Affiliated Hospital of Nantong University, Nantong, Jiangsu, P.R. China
| | - Shaopeng Chu
- Clinical Laboratory, Nantong University Affiliated Hospital, Nantong, Jiangsu, P.R. China
| | - Aimin Ding
- Department of Nursing, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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15
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Duong TTT, Tsai YM, Wen LL, Chiu HC, Chen PK, Thuy TTD, Kuo PY, Hidrosollo JH, Wang S, Zhang YZ, Lin WH, Wang MC, Kao CY. A Longitudinal Nine-Year Study of the Molecular Epidemiology of Carbapenemase-Producing Enterobacterales Isolated From a Regional Hospital in Taiwan: Predominance of Carbapenemase KPC-2 and OXA-48. Front Microbiol 2022; 13:703113. [PMID: 35359715 PMCID: PMC8963713 DOI: 10.3389/fmicb.2022.703113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Enterobacterales clinical isolates are now being resistant to clinically achievable concentrations of most commonly used antibiotics that makes treatment of hospitalized patients very challenging. We hereby determine the molecular characteristics of carbapenemase genes in carbapenem-resistant Enterobacterales (CRE) isolates in Taiwan. A total of 455 CRE isolates were identified between August 2011 to July 2020. Minimum inhibitory concentrations for selected carbapenems were tested using Vitek 2, and carbapenemase genes were determined using polymerase chain reaction in combination with sequencing. Phenotypic detection of carbapenemase was determined by modified carbapenem inactivation method (mCIM) and EDTA-modified carbapenem inactivation method (eCIM) to validate our PCR screening results. Pulsed-field gel electrophoresis (PFGE) was used to determine the clonality of carbapenemase-producing Enterobacterales (CPE) isolates, and the transferability of carbapenemase-carrying plasmids was determined by conjugation assays. A slight increase in carbapenem-resistant E. coli (CREC) was observed, however, the prevalence of carbapenem-resistant K. pneumoniae (CRKP) was steady, during 2011–2020. The dominant species among our CRE was K. pneumoniae (270/455, 59.3%), followed by E. coli (81/455, 17.8%), Morganella morganii (32/455, 7.0%), and Enterobacter cloacae (25/455, 5.5%). From 2011 to 2020, the total percentage of CPE increased steadily, accounting for 61.0% of CRE in 2020. Moreover, 122 of 455 CRE isolates (26.8%) were CPE. Among the CPE isolates, the dominant carbapenemase gene was blaOXA–48–like (54/122, 44.3%), and the second most common carbapenemase gene was blaKPC–2 (47/122, 38.5%). The sensitivity and specificity for mCIM to detect carbapenemase in the 455 isolates were both 100% in this study. The PFGE results showed that 39 carbapenemase-producing E. coli and 69 carbapenemase-producing K. pneumoniae isolates carrying blaKPC–2 and/or blaNDM–5 could be classified into 5 and 12 clusters, respectively. In conclusion, our results showed an increase in CPE isolates in Taiwan. Moreover, the distribution of carbapenemase and antimicrobial susceptibility in CPE were associated with PFGE typing.
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Affiliation(s)
- Tran Thi Thuy Duong
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Min Tsai
- Department of Clinical Laboratory, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Li-Li Wen
- Department of Clinical Laboratory, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Hui-Chuan Chiu
- Department of Clinical Laboratory, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Pek Kee Chen
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tran Thi Dieu Thuy
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Yun Kuo
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jazon Harl Hidrosollo
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shining Wang
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yen-Zhen Zhang
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Hung Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Cheng Wang
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Yen Kao
- Institute of Microbiology and Immunology, School of Life Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- *Correspondence: Cheng-Yen Kao,
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Resistant Genes and Multidrug-Resistant Bacteria in Wastewater: A Study of Their Transfer to the Water Reservoir in the Czech Republic. Life (Basel) 2022; 12:life12020147. [PMID: 35207435 PMCID: PMC8875776 DOI: 10.3390/life12020147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 01/01/2023] Open
Abstract
Wastewater is considered the most serious source of the spread of antibiotic resistance in the environment. This work, therefore, focuses on the fate and spread of antibiotic resistance genes (ARGs) in wastewater and the monitoring of multidrug-resistant strains. ARGs were monitored in the nitrification and sedimentation tanks of the wastewater treatment plant (WWTP) and in the dam into which this WWTP flows, at various times. The highest relative abundance was found for the blaTEM > tetW > blaNDM-1 > vanA resistance genes, respectively. An increased concentration of tetracycline (up to 96.00 ng/L) and ampicillin (up to 19.00 ng/L) was found in water samples compared to other antibiotics detected. The increased incidence of seven ARGs and four antibiotics was observed in the November and December sampling times. Isolated ampicillin-resistant strains showed a high degree of resistance to ampicillin (61.2% of the total isolates had a minimum inhibitory concentration (MIC) ≥ 20 mg/mL). In 87.8% of isolates, out of the total number, the occurrence of two or more ARGs was confirmed. These multidrug-resistant strains were most often identified as Aeromonas sp. This strain could represent a significant role in the spread of multidrug resistance through wastewater in the environment.
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Lüneberg K, Amábile-Cuevas CF, Mucito-Varela E, Martínez L, Salinas E, López-Vidal Y, Siebe C, Rosas I. Metallo-beta-lactamase-producing Escherichia coli in the sewage of Mexico City: where do they come from? Can J Microbiol 2021; 68:139-145. [PMID: 34662521 DOI: 10.1139/cjm-2021-0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
While monitoring the presence of antibiotic resistance in municipal wastewater bacteria from Mexico City, five Escherichia coli isolates were found to be resistant to carbapenems, antibiotics of "last resort" used mostly in hospitals. Further analysis revealed that these carbapenem-resistant isolates carried the gene encoding a metallo-beta-lactamase, NDM-5. The gene was found to be beared by a large, ∼145 kb conjugative plasmid, which also carries putative genes encoding resistance to sulfonamides, trimethoprim, tetracycline, ciprofloxacin, and chloramphenicol (although no phenotypic chloramphenicol resistance was detected) and quaternary-ammonium compounds. The plasmid also carried gene mobility determinants, such as integron integrase and two transposases. In addition to the direct public health threat posed by the presence of such multi-resistant organisms in wastewater released into the environment and used for crop irrigation; it is particularly concerning that carbapenem-resistant E. coli is rather rare in Mexican hospitals (<1%), but was found in small, 100 mL samples of municipal wastewater. This suggests that these organisms are under-reported by clinical microbiology laboratories, underlining the usefulness of wastewater monitoring, or that there is an unknown source of such carbapenem-resistant organisms that are being dumped into the wastewater. The source of these bacteria must be assessed and controlled to prevent further spread of this multi-resistance plasmid among other environmental and clinical microorganisms.
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Affiliation(s)
- Kathia Lüneberg
- Laboratorio de Aerobiología, Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Eduardo Mucito-Varela
- Programa de Inmunología Molecular Microbiana, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Leticia Martínez
- Laboratorio de Aerobiología, Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Eva Salinas
- Laboratorio de Aerobiología, Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Yolanda López-Vidal
- Programa de Inmunología Molecular Microbiana, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Christina Siebe
- Departamento de Ciencias Ambientales y del Suelo, Instituto de Geología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Irma Rosas
- Laboratorio de Aerobiología, Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Insights into the Resistome and Phylogenomics of a ST195 Multidrug-Resistant Acinetobacter baumannii Clinical Isolate from the Czech Republic. Life (Basel) 2021; 11:life11101079. [PMID: 34685451 PMCID: PMC8537504 DOI: 10.3390/life11101079] [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: 06/04/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022] Open
Abstract
Increasing antimicrobial resistance in nosocomial pathogens, such as Acinetobacter baumannii, is becoming a serious threat to public health. It is necessary to detect β-lactamase-producing microorganisms in clinical settings to be able to control the spread of carbapenem resistance. This study was conducted to evaluate the presence of β-lactamases in a selected clinical isolate of A. baumannii of ST2P/ST195Ox and to characterize possible enzymes, as well as its β-lactam resistome, using PCR and whole-genome sequencing analysis. PCR and sequencing confirmed that the isolate harbored five bla gene alleles, namely, blaADC-73, blaTEM-1, blaOXA-23, blaOXA-58 and blaOXA-66, as well as aminoglycosides, macrolides, sulfonamides and tetracyclines resistance determinants, which were either chromosomally and/or plasmid located. Furthermore, a gene order comparison using MAUVE alignment showed multiple changes compared with the clinical isolate of Malaysian A. baumannii AC30 genome and 76 regions with high homology. This study suggests that resistance to β-lactams in this A. baumannii isolate is mainly due to an overproduction of β-lactamases in combination with other resistance mechanism (efflux pump system).
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Jannat H, Shamsuzzaman SM, Faisal MA. Emergence of OXA-833 in Proteus Species at a Tertiary Care Hospital in Dhaka, Bangladesh. Int J Appl Basic Med Res 2021; 11:258-262. [PMID: 34912691 PMCID: PMC8633693 DOI: 10.4103/ijabmr.ijabmr_153_21] [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: 02/27/2021] [Revised: 06/24/2021] [Accepted: 09/24/2021] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Proteus species are liable for multitude of infections and associated with resistance to routinely used antibiotics even to reserve drugs such as carbapenems. AIMS The aim of this study was to detect the presence of MBL producers, including blaOXA-833 gene in Proteus spp. along with their antibiotic resistance pattern. SETTINGS AND DESIGN This cross-sectional study was conducted in the Department of Microbiology of a tertiary care hospital of Bangladesh during July 2018 to June 2019. SUBJECTS AND METHODS Proteus spp. was isolated from a total of 500 samples. Antibiotic susceptibility was performed by disk-diffusion technique. Minimum inhibitory concentration (MIC) of imipenem was determined by agar dilution method. Carbapenemase producers were phenotypically detected by double disc synergy (DDS) test, combined disc (CD) assay, and modified Hodge test (MHT). Carbapenemase genes (blaKPC, blaVIM, blaIMP, blaNDM-1, blaOXA-23, blaOXA-48-like/blaOXA-833, and blaOXA-58) among imipenem-resistant Proteus spp. were detected by polymerase chain reaction (PCR). Sequencing was performed to differentiate OXA-833 from OXA-48-like gene by capillary method, and the nucleotide sequence of OXA-833 has been deposited to GenBank. RESULTS Ten (25%) imipenem-resistant isolates were detected during disk-diffusion technique, among them 60%, 70%, 50% carbapenemase producers were detected by DDS test, CD assay, MHT, respectively, and 70% by PCR. A significant increase in MIC was found between 8 and ≥128 μg/ml to imipenem. PCR revealed that 40% imipenem-resistant isolates were positive for blaNDM-1 and blaVIM followed by 20% for blaOXA-48-like/blaOXA-833 and blaOXA-23, respectively. Sequencing of blaOXA-48-like gene established the OXA-833 variant of class D carbapenemase encoding gene. CONCLUSION The results of this study showed the presence of high proportion of carbapenemase enzyme-producing Proteus spp. in Bangladesh. blaOXA-833 is emerging in Bangladesh.
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Affiliation(s)
- Hasnatul Jannat
- Department of Microbiology, Dhaka Medical College, Dhaka, Bangladesh
| | | | - Md. Abu Faisal
- Department of Microbiology, Dhaka Medical College, Dhaka, Bangladesh
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Stachurová T, Piková H, Bartas M, Semerád J, Svobodová K, Malachová K. Beta-lactam resistance development during the treatment processes of municipal wastewater treatment plants. CHEMOSPHERE 2021; 280:130749. [PMID: 33971421 DOI: 10.1016/j.chemosphere.2021.130749] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/05/2021] [Accepted: 04/29/2021] [Indexed: 05/29/2023]
Abstract
This work monitored the effect of a municipal and a village wastewater treatment plant (WWTP) technology on the fate of beta-lactam resistance genes in bacterial populations in different phases of the wastewater treatment process. In case of the municipal WWTP1, the bacteria possessing a high ampicillin resistance (minimal inhibitory concentration (MIC) values of 20 mg/mL) accumulated in the sedimentation tank, which was accompanied with a higher concentration of ampicillin in the wastewater samples (28.09 ng/L) and an increase in the relative abundance of the blaTEM gene in the bacterial population. However, an opposite trend was revealed with the blaNDM-1 gene, making the sedimentation processes of WWTP1 crucial only for the accumulation of the blaTEM gene. Similarly, the comparison with the WWTP2 showed that the accumulation of the ampicillin resistance in bacterial population probably depended on the WWTP technology and wastewater composition. Out of the four tested resistance genes (blaTEM, blaKPC, blaNDM-1, and blaOXA-48), blaTEM and blaNDM-1 genes were the only two detected in this study. According to NGS analysis of bacterial 16 S rRNA gene, Gammaproteobacteria dominated the ampicillin-resistant bacteria of the WWTP sedimentation tanks. Their relative abundance in the bacterial population also increased during the sedimentation processes in WWTP1. It could indicate the role of the bacterial taxon in ampicillin resistance accumulation in this WWTP and show that only 9.29% of the original bacterial population from the nitrification tank is involved in the documented shifts in beta-lactam resistance of the bacterial population.
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Affiliation(s)
- Tereza Stachurová
- Department of Biology and Ecology, Faculty of Science, University of Ostrava, Chittussiho 10, CZ-710 00, Ostrava, Czech Republic.
| | - Hana Piková
- Department of Biology and Ecology, Faculty of Science, University of Ostrava, Chittussiho 10, CZ-710 00, Ostrava, Czech Republic
| | - Martin Bartas
- Department of Biology and Ecology, Faculty of Science, University of Ostrava, Chittussiho 10, CZ-710 00, Ostrava, Czech Republic
| | - Jaroslav Semerád
- Institute of Microbiology of the Czech Academy of Sciences, Vídeňská 1083, CZ-142 20, Prague, Czech Republic; Institute for Environmental Studies, Faculty of Science, Charles University, Benátská 2, CZ-128 01, Prague, Czech Republic
| | - Kateřina Svobodová
- Institute of Medical Biochemistry and Laboratory Diagnostics, Clinical Microbiology and ATB Center, General University Hospital in Prague, U Nemocnice 2, CZ-128 08, Prague, Czech Republic
| | - Kateřina Malachová
- Department of Biology and Ecology, Faculty of Science, University of Ostrava, Chittussiho 10, CZ-710 00, Ostrava, Czech Republic
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Kon H, Abramov S, Frenk S, Schwartz D, Shalom O, Adler A, Carmeli Y, Lellouche J. Multiplex lateral flow immunochromatographic assay is an effective method to detect carbapenemases without risk of OXA-48-like cross reactivity. Ann Clin Microbiol Antimicrob 2021; 20:61. [PMID: 34481497 PMCID: PMC8418752 DOI: 10.1186/s12941-021-00469-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is essential to detect carriers of carbapenemase-producing Enterobacterales in order to implement infection control measures. The objectives of this study was to evaluate the NG-Test® CARBA 5 (CARBA 5) assay for detection of five carbapenemases and to assess the cross reactivity of other OXA-type carbapenemases with the OXA-48-like specific antibodies. METHODS A total of 197 Enterobacterales isolates were tested. To evaluate the cross reactivity, 73 carbapenem-resistant A. baumannii, harboring OXA-type variants, were tested. Polymerase chain reaction (PCR) served as gold standard for carbapenemase identification. RESULTS Excellent agreement was found between PCR and CARBA 5, for all but one isolate. The single false positive result (a blaSME positive S. marcescens isolate) was incorrectly positive for blaOXA-48 by CARBA 5. No cross reactivity was observed. The sensitivity and specificity were 100.0% and 98.0%, respectively. CONCLUSIONS The CARBA 5 assay is highly sensitive and specific and is recommended as a tool for the detection of the main carbapenemases of interest in clinical microbiology laboratories.
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Affiliation(s)
- Hadas Kon
- National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, 6 Weizmann St., 6423906, Tel-Aviv, Israel
| | - Shirin Abramov
- National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, 6 Weizmann St., 6423906, Tel-Aviv, Israel
| | - Sammy Frenk
- National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, 6 Weizmann St., 6423906, Tel-Aviv, Israel
| | - David Schwartz
- National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, 6 Weizmann St., 6423906, Tel-Aviv, Israel
| | - Ohad Shalom
- Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Amos Adler
- Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yehuda Carmeli
- National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, 6 Weizmann St., 6423906, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jonathan Lellouche
- National Institute for Antibiotic Resistance and Infection Control, Ministry of Health, 6 Weizmann St., 6423906, Tel-Aviv, Israel.
- The Miriam and Sheldon Adelson School of Medicine, Ariel University, Ariel, Israel.
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Mlynarcik P, Chudobova H, Zdarska V, Kolar M. In Silico Analysis of Extended-Spectrum β-Lactamases in Bacteria. Antibiotics (Basel) 2021; 10:antibiotics10070812. [PMID: 34356733 PMCID: PMC8300632 DOI: 10.3390/antibiotics10070812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/26/2022] Open
Abstract
The growing bacterial resistance to available β-lactam antibiotics is a very serious public health problem, especially due to the production of a wide range of β-lactamases. At present, clinically important bacteria are increasingly acquiring new elements of resistance to carbapenems and polymyxins, including extended-spectrum β-lactamases (ESBLs), carbapenemases and phosphoethanolamine transferases of the MCR type. These bacterial enzymes limit therapeutic options in human and veterinary medicine. It must be emphasized that there is a real risk of losing the ability to treat serious and life-threatening infections. The present study aimed to design specific oligonucleotides for rapid PCR detection of ESBL-encoding genes and in silico analysis of selected ESBL enzymes. A total of 58 primers were designed to detect 49 types of different ESBL genes. After comparing the amino acid sequences of ESBLs (CTX-M, SHV and TEM), phylogenetic trees were created based on the presence of conserved amino acids and homologous motifs. This study indicates that the proposed primers should be able to specifically detect more than 99.8% of all described ESBL enzymes. The results suggest that the in silico tested primers could be used for PCR to detect the presence of ESBL genes in various bacteria, as well as to monitor their spread.
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Affiliation(s)
- Patrik Mlynarcik
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic; (V.Z.); (M.K.)
- Correspondence:
| | - Hana Chudobova
- Laboratory of Growth Regulators, Faculty of Science, Institute of Experimental Botany of the Czech Academy of Sciences, Palacky University, Šlechtitelů 27, 78371 Olomouc, Czech Republic;
| | - Veronika Zdarska
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic; (V.Z.); (M.K.)
| | - Milan Kolar
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 77515 Olomouc, Czech Republic; (V.Z.); (M.K.)
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 5, 77900 Olomouc, Czech Republic
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Mlynarcik P, Dolejska M, Vagnerova I, Kutilová I, Kolar M. Detection of clinically important β-lactamases by using PCR. FEMS Microbiol Lett 2021; 368:6294906. [PMID: 34100944 DOI: 10.1093/femsle/fnab068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 06/04/2021] [Indexed: 12/14/2022] Open
Abstract
Increasing antimicrobial resistance of nosocomial pathogens is becoming a serious threat to public health. To control the spread of this resistance, it is necessary to detect β-lactamase-producing organisms in the clinical setting. The aims of the study were to design a PCR assay for rapid detection of clinically encountered β-lactamase genes described in Enterobacteriaceae and Gram-negative non-fermenting bacteria. The functionality of proposed primers was verified using eight reference strains and 17 strains from our collection, which contained 29 different β-lactamase genes. PCR products of the test strains were confirmed by Sanger sequencing. Sequence analysis was performed using bioinformatics software Geneious. Overall, 67 pairs of primers for detecting 12 members of the class C β-lactamase family, 15 members of class A β-lactamases, six gene families of subclass B1, one member each of subclasses B2, B3 and class D β-lactamases were designed, of which 43 pairs were experimentally tested in vitro. All 29 β-lactamase genes, including 10 oxacillinase subgroups, were correctly identified by PCR. The proposed set of primers should be able to specifically detect 99.7% of analyzed β-lactamase subtypes and more than 79.8% of all described β-lactamase genes.
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Affiliation(s)
- Patrik Mlynarcik
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 775 15 Olomouc, Czechia
| | - Monika Dolejska
- Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences Brno, Palackeho tr. 1946/1, 612 42 Brno, Czechia.,Central European Institute of Technology (CEITEC), University of Veterinary and Pharmaceutical Sciences Brno, Palackeho tr. 1946/1, 612 42 Brno, Czechia
| | - Iva Vagnerova
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 775 15 Olomouc, Czechia
| | - Iva Kutilová
- Central European Institute of Technology (CEITEC), University of Veterinary and Pharmaceutical Sciences Brno, Palackeho tr. 1946/1, 612 42 Brno, Czechia
| | - Milan Kolar
- Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, 775 15 Olomouc, Czechia.,Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 5, 779 00 Olomouc, Czechia
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Four-Hour Immunochromatographic Detection of Intestinal Carriage of Carbapenemase-Producing Enterobacteriaceae: a Validation Study. J Clin Microbiol 2021; 59:JCM.02973-20. [PMID: 33789958 DOI: 10.1128/jcm.02973-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/22/2021] [Indexed: 11/20/2022] Open
Abstract
The increasing incidence of carbapenemase-producing Gram-negative bacilli (C-PGNB) represents a major public health challenge. Rapid detection of digestive colonization with C-PGNB is fundamental to control their spread. We performed the validation of a rapid protocol for C-PGNB detection directly on rectal swabs. We developed a protocol combining enrichment by a rapid selective subculture of the rectal swab medium and realization of a Resist-4 O.K.N.V. K-SeT test on the bacterial pellet obtained. The limit of detection and performances of this protocol were validated in vitro on 52 C-PGNB strains spiked on a calibrated sample suspension and confirmed in clinical settings on 144 rectal swabs sampled from patients with C-PGNB digestive colonization (n = 48) and controls (patients with extended-spectrum beta-lactamase [ESBL] colonization [n = 48] and without carbapenemase/ESBL [n = 48]). The protocol detected, with 100% sensitivity, the presence of the 15 OXA-48-, 14 KPC-, 13 NDM-, and 10 VIM-producing GNB from 103 CFU/ml. The limit of detection was 2 × 102 CFU/ml. Among the 48 C-PGNB-containing rectal swabs of the validation cohort, 46 were accurately detected. False negative were observed for 1 NDM-producing Acinetobacter baumannii strain and 1 OXA-48-producing Escherichia coli strain. The 96 control swabs were negative. Sensitivity and specificity for C-PGNB detection were 97.7% (95% confidence interval [CI], 87.7 to 100) and 100% (95% CI, 96.2 to 100). The negative likelihood ratio was 0.04 (95% CI, 0.01 to 0.16). Considering a C-PGNB digestive colonization prevalence between 0.01% and 0.1%, positive and negative predictive values were 100%. Our protocol is a rapid and low-cost method detecting accurately the digestive colonization with carbapenemase-producing Enterobacteriaceae in 4 h without any requirement for specific equipment.
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High fecal carriage of bla CTX-M, bla CMY-2, and plasmid-mediated quinolone resistance genes among healthy Korean people in a metagenomic analysis. Sci Rep 2021; 11:5874. [PMID: 33712656 PMCID: PMC7955109 DOI: 10.1038/s41598-021-84974-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022] Open
Abstract
To characterize the carriage of antibiotic resistance genes (ARGs) in the gut microbiome of healthy individuals. Fecal carriage of ARGs was investigated in 61 healthy individuals aged 30 to 59 years through whole metagenome sequencing of the gut microbiome and a targeted metagenomic approach. The number of ARGs in the gut microbiome was counted and normalized per million predicted genes (GPM). In the Korean population, the resistome ranged from 49.7 to 292.5 GPM (median 89.7). Based on the abundance of ARGs, the subjects were categorised into high (> 120 GPM), middle (60‒120 GPM), and low (< 60 GPM) ARG groups. Individuals in the high ARG group tended to visit hospitals more often (P = 0.065), particularly for upper respiratory tract infections (P = 0.066), and carried more blaCTX-M (P = 0.008). The targeted metagenome approach for bla and plasmid-mediated quinolone resistance (PMQR) genes revealed a high fecal carriage rate; 23% or 13.1% of the subjects carried blaCTX-M or blaCMY-2, respectively. Regarding PMQR genes, 59% of the subjects carried PMQR, and 83% of them harboured 2‒4 PMQR genes (qnrB 44.3%, qnrS 47.5% etc.). The presence of blaCTX-M correlated with ARG abundance in the gut resistome, whereas PMQR genes were irrelevant to other ARGs (P = 0.176). Fecal carriage of blaCTX-M and PMQR genes was broad and multiplexed among healthy individuals.
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Kolar M, Htoutou Sedlakova M, Urbanek K, Mlynarcik P, Roderova M, Hricova K, Mezerova K, Kucova P, Zapletalova J, Fiserova K, Kurfurst P. Implementation of Antibiotic Stewardship in a University Hospital Setting. Antibiotics (Basel) 2021; 10:antibiotics10010093. [PMID: 33477923 PMCID: PMC7833368 DOI: 10.3390/antibiotics10010093] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/21/2023] Open
Abstract
The article describes activities of an antibiotic center at a university hospital in the Czech Republic and presents the results of antibiotic stewardship program implementation over a period of 10 years. It provides data on the development of resistance of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus to selected antibiotic agents as well as consumption data for various antibiotic classes. The genetic basis of resistance to beta-lactam antibiotics and its clonal spread were also assessed. The study showed significant correlations between aminoglycoside consumption and resistance of Escherichia coli and Klebsiella pneumoniae to gentamicin (r = 0.712, r = 0.869), fluoroquinolone consumption and resistance of Klebsiella pneumoniae to ciprofloxacin (r = 0.896), aminoglycoside consumption and resistance of Pseudomonas aeruginosa to amikacin (r = 0.716), as well as carbapenem consumption and resistance of Pseudomonas aeruginosa to meropenem (r = 0.855). Genotyping of ESBL- positive isolates of Klebsiella pneumoniae and Escherichia coli showed a predominance of CTX-M-type; in AmpC-positive strains, DHA, EBC and CIT enzymes prevailed. Of 19 meropenem-resistant strains of Klebsiella pneumoniae, two were identified as NDM-positive. Clonal spread of these strains was not detected. The results suggest that comprehensive antibiotic stewardship implementation in a healthcare facility may help to maintain the effectiveness of antibiotics against bacterial pathogens. Particularly beneficial is the work of clinical microbiologists who, among other things, approve administration of antibiotics to patients with bacterial infections and directly participate in their antibiotic therapy.
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Affiliation(s)
- Milan Kolar
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
| | - Miroslava Htoutou Sedlakova
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
- Correspondence: ; Tel.: +420-585-639-511
| | - Karel Urbanek
- Department of Pharmacology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic;
| | - Patrik Mlynarcik
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
| | - Magdalena Roderova
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
| | - Kristyna Hricova
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
| | - Kristyna Mezerova
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
| | - Pavla Kucova
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
| | - Jana Zapletalova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic;
| | - Katerina Fiserova
- Department of Microbiology, University Hospital Olomouc, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic; (M.K.); (P.M.); (M.R.); (K.H.); (K.M.); (P.K.); (K.F.)
| | - Pavel Kurfurst
- Department of Foreign Languages, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic;
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Tang B, Yang H, Jia X, Feng Y. Coexistence and characterization of Tet(X5) and NDM-3 in the MDR-Acinetobacter indicus of duck origin. Microb Pathog 2020; 150:104697. [PMID: 33347964 DOI: 10.1016/j.micpath.2020.104697] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/07/2020] [Accepted: 12/13/2020] [Indexed: 12/30/2022]
Abstract
Tigecycline and carbapenem are last-resort antibiotics for serious infections caused by pathogens with multi-drug resistance (MDR). Whereas, bacterial pathogens with co-resistance to tigecycline and carbapenem are poorly addressed. Here we report a tigecycline- and carbapenem-resistant Acinetobacter indicus strain HY20 of duck origin, which co-produces Tet(X5) and NDM-3. Tet(X5) is harbored by a novel plasmid pAI01 (116,992 bp long), which carries 10 antimicrobial resistance genes (AMRs), and heavy metal resistance system cobalt-zinc-cadmium (czc) gene cluster. Unlike that tet(X5) is located in the res-tet(X5)-xerD segment of plasmid, the chromosomal blaNDM-3 is flanked by insertion ISAba125. Collectively, our result represents an example of co-carriage of tet(X5) and blaNDM-3, heightening the importance of AMR surveillance needed in poultry production.
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Affiliation(s)
- Biao Tang
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products & Institute of Quality and Standard for Agro-products, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, 310021, China; Department of Pathogen Biology & Microbiology and Department of General Intensive Care Unit of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China
| | - Hua Yang
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products & Institute of Quality and Standard for Agro-products, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, 310021, China
| | - Xu Jia
- Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, Sichuan, 610500, China
| | - Youjun Feng
- Department of Pathogen Biology & Microbiology and Department of General Intensive Care Unit of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China; Non-coding RNA and Drug Discovery Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, Sichuan, 610500, China; College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang, 310058, China.
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Talebi M, Najar-Peerayeh S, Bakhshi B. Hidden carbapenem resistance in the community- and hospital-associated OXA-48 gene-carrying uropathogenic Escherichia coli. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Tsai YM, Wang S, Chiu HC, Kao CY, Wen LL. Combination of modified carbapenem inactivation method (mCIM) and EDTA-CIM (eCIM) for phenotypic detection of carbapenemase-producing Enterobacteriaceae. BMC Microbiol 2020; 20:315. [PMID: 33069233 PMCID: PMC7568406 DOI: 10.1186/s12866-020-02010-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Carbapenemase-resistant Enterobacteriaceae (CRE) cause many serious infections resulting in increasing treatment cost, prolonged hospitalization, and mortality rate. Reduced expression and/or mutations of porins and the presence of carbapenemase promote Enterobacteriaceae survival under carbapenem treatments. Development of accurate methods for the detection of antimicrobial resistance is required not only for therapy but also to monitor the spread of resistant bacteria or resistance genes throughout the hospital and community. In this study, we aimed to evaluate the phenotypic methods, Modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and EDTA-CIM (eCIM) for the detection of carbapenemase-producing Enterobacteriaceae (CPE). Results The results showed that mCIM had a sensitivity of 100% and a specificity of 100%, whereas the MHT had a sensitivity of 84.8% and a specificity of 97.8% for the 195 CRE isolates tested (105 CPE and 90 non-CPE isolates). The sensitivity of the mCIM/eCIM to detect metallo-carbapenemases in this study was 89.3% and the specificity was 98.7% as compared to the genotypic PCR detection. Conclusions These findings indicate that the mCIM combined with eCIM is useful for detecting and distinguishing different types of carbapenemase in Enterobacteriaceae.
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Affiliation(s)
- Ya-Min Tsai
- Department of Clinical Laboratory, En Chu Kong Hospital, No. 399, Fuxing Rd., Sanxia Dist, New Taipei City, 23702, Taiwan
| | - Shining Wang
- Institute of Microbiology and Immunology, School of Life Science, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan
| | - Hui-Chuan Chiu
- Department of Clinical Laboratory, En Chu Kong Hospital, No. 399, Fuxing Rd., Sanxia Dist, New Taipei City, 23702, Taiwan
| | - Cheng-Yen Kao
- Institute of Microbiology and Immunology, School of Life Science, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 112, Taiwan.
| | - Li-Li Wen
- Department of Clinical Laboratory, En Chu Kong Hospital, No. 399, Fuxing Rd., Sanxia Dist, New Taipei City, 23702, Taiwan.
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Mehrbakhsh P, Basharkhah Y, Bahkshi A, Kamarposhti LTN, Bolori S. Prevalence of OXA-type Class D β-lactamases Among Clinical Isolates of Klebsiella Pneumoniae in Multiple Centers of Tehran, Iran. Infect Disord Drug Targets 2020; 21:558-563. [PMID: 32942981 DOI: 10.2174/1871526520999200917152502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/20/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Drug- and multidrug-resistant Klebsiella pneumoniae isolates have been found worldwide. Treatment failures against carbapenems and extended-spectrum cephalosporins, the currently recommended drugs, contribute to consider K. pneumoniae infections as untreatable infections. The emergence and spread of oxacillinases (OXAs) with carbapenem-hydrolyzing properties are a major concern and seriously become a public health problem worldwide. The present study was aimed to explore the blaOXA genes among clinical isolates of K. pneumoniae in some clinical settings in Tehran, Iran. METHODS A total of 90 K. pneumoniae isolates were collected from different clinical samples at hospitals in Tehran during the year 2016 and 2018. Antimicrobial susceptibility testing was performed on bacterial isolates using the Kirby-Bauer disc diffusion method on Mueller Hinton agar plates. PCR experiments were carried out to detect the presence of the blaOXA genes, including blaOXA- 1, blaOXA-2, blaOXA-4, blaOXA10, and blaOXA-48-like, using specific primers. RESULTS The antibiotics susceptibility results showed that 41% of the K. pneumoniae isolates were resistant to imipenem and meropenem. Resistance rates for cephalosporin agents, including cefpodoxime, ceftazidime, cefuroxime, cefotaxime, and cefepime, were measured as 72.3%, 67.8%, 67.7%, 65.5%, and 60%, respectively. In the present study, 51.1% of isolates were classified as multidrug-resistant K. pneumoniae strains. The molecular assays showed that 56.6% of isolates harbored blaOXA-2. In addition, blaOXA-4, blaOXA-1, blaOXA-10, and blaOXA-48-like genes were also found in 16.7%, 5.6%, 1.1%, and 1.1% of isolates, respectively. CONCLUSION The spread of blaOXAs, especially blaOXA-48-like, among K. pneumoniae isolates indicated the inadequate dissemination control of multidrug-resistant bacteria in the Iranian hospital environment. There is a reason to assume that OXA producing K. pneumoniae will limit clinical therapeutic options in the future and pose threats to national public health among the Iranian population.
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Affiliation(s)
- Pariya Mehrbakhsh
- Department of Biology, Faculty of basic sciences, East Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Yalda Basharkhah
- Department of Biology, Faculty of basic sciences, Ahar Branch, Islamic Azad University, Iran
| | - Ashraf Bahkshi
- Department of Microbiology and Immunology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Shahin Bolori
- Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Vasconcelos NG, Queiroz JHFDS, da Silva KE, Vasconcelos PCDP, Croda J, Simionatto S. Synergistic effects of Cinnamomum cassia L. essential oil in combination with polymyxin B against carbapenemase-producing Klebsiella pneumoniae and Serratia marcescens. PLoS One 2020; 15:e0236505. [PMID: 32701970 PMCID: PMC7377461 DOI: 10.1371/journal.pone.0236505] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/07/2020] [Indexed: 12/16/2022] Open
Abstract
Multidrug resistance prompts the search for new sources of antibiotics with new targets at bacteria cell. To investigate the antibacterial activity of Cinnamomum cassia L. essential oil (CCeo) alone and in combination with antibiotics against carbapenemase-producing Klebsiella pneumoniae and Serratia marcescens. The antimicrobial susceptibility of the strains was determined by Vitek® 2 and confirmed by MALDI-TOF/TOF. The antibacterial activity of CCeo and its synergism with antibiotics was determined using agar disk diffusion, broth microdilution, time-kill, and checkboard methods. The integrity of the bacterial cell membrane in S. marcescens was monitored by protein leakage assay. CCeo exhibited inhibitory effects with MIC = 281.25 μg.mL-1. The association between CCeo and polymyxin B showed a decrease in terms of viable cell counts on survival curves over time after a 4 hour-treatment with a FIC index value of 0.006. Protein leakage was observed with increasing concentrations for CCeo and CCeo + polymyxin B treatments. CCeo showed antibacterial activity against the studied strains. When associated with polymyxin B, a synergistic effect was able to inhibit bacterial growth rapidly and consistently, making it a potential candidate for the development of an alternative treatment and drug delivery system for carbapenemase-producing strains.
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Affiliation(s)
- Nathalie Gaebler Vasconcelos
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados—UFGD, Dourados, Mato Grasso do Sul, Brazil
- Hospital Universitário de Dourados, Universidade Federal da Grande Dourados—UFGD, Dourados, Mato Grosso do Sul, Brazil
| | | | - Késia Esther da Silva
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados—UFGD, Dourados, Mato Grasso do Sul, Brazil
| | | | - Julio Croda
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados—UFGD, Dourados, Mato Grasso do Sul, Brazil
- Fundação Oswaldo Cruz, Campo Grande, Mato Grosso do Sul, Brazil
- Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Simone Simionatto
- Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados—UFGD, Dourados, Mato Grasso do Sul, Brazil
- * E-mail:
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Santos AL, dos Santos AP, Ito CRM, de Queiroz PHP, de Almeida JA, de Carvalho Júnior MAB, de Oliveira CZ, Avelino MAG, Wastowski IJ, Gomes GPLA, Souza ACSE, Vasconcelos LSNDOL, Santos MDO, da Silva CA, Carneiro LC. Profile of Enterobacteria Resistant to Beta-Lactams. Antibiotics (Basel) 2020; 9:E410. [PMID: 32679663 PMCID: PMC7400480 DOI: 10.3390/antibiotics9070410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/04/2022] Open
Abstract
A serious emerging problem worldwide is increased antimicrobial resistance. Acquisition of coding genes for evasion methods of antimicrobial drug mechanisms characterizes acquired resistance. This phenomenon has been observed in Enterobacteriaceae family. Treatment for bacterial infections is performed with antibiotics, of which the most used are beta-lactams. The aim of this study was to correlate antimicrobial resistance profiles in Enterobacteriaceae by phenotypic methods and molecular identification of 14 beta-lactamase coding genes. In this study, 70 exclusive isolates from Brazil were used, half of which were collected in veterinary clinics or hospitals Phenotypic methodologies were used and real-time PCR was the molecular methodology used, through the Sybr Green system. Regargding the results found in the tests it was observed that 74.28% were resistant to ampicillin, 62.85% were resistant to amoxicillin associated with clavalunate. The mechanism of resistance that presented the highest expression was ESBL (17.14%). The genes studied that were detected in a greater number of species were blaGIM and blaSIM (66.66% of the samples) and the one that was amplified in a smaller number of samples was blaVIM (16.66%). Therefore, high and worrying levels of antimicrobial resistance have been found in enterobacteria, and a way to minimize the accelerated emergence of their resistance includes developing or improving techniques that generate diagnoses with high efficiency and speed.
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Affiliation(s)
- Andressa Liberal Santos
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | - Adailton Pereira dos Santos
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | - Célia Regina Malveste Ito
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | - Pedro Henrique Pereira de Queiroz
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | - Juliana Afonso de Almeida
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | - Marcos Antonio Batista de Carvalho Júnior
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | | | - Melissa Ameloti G. Avelino
- Medicine College, Federal University of Goiás, 235 Street, Goiânia 74690-900, Brazil; (M.A.G.A.); (M.d.O.S.)
| | | | - Giselle Pinheiro Lima Aires Gomes
- Department of Biology, Federal University of Tocantins, Square 109 North, NS15 Avenue, ALCNO-14-Plano Director North, Palmas 77001-090, Brazil;
| | | | - Lara Stefânia Netto de Oliveira Leão Vasconcelos
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | - Mônica de Oliveira Santos
- Medicine College, Federal University of Goiás, 235 Street, Goiânia 74690-900, Brazil; (M.A.G.A.); (M.d.O.S.)
| | - Carla Afonso da Silva
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
| | - Lilian Carla Carneiro
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, 235 Street, Goiânia 74605-050, Brazil; (A.L.S.); (A.P.d.S.); (C.R.M.I.); (P.H.P.d.Q.); (J.A.d.A.); (M.A.B.d.C.J.); (L.S.N.d.O.L.V.); (C.A.d.S.)
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Dehbashi S, Tahmasebi H, Alikhani MY, Keramat F, Arabestani MR. Distribution of Class B and Class A β-Lactamases in Clinical Strains of Pseudomonas aeruginosa: Comparison of Phenotypic Methods and High-Resolution Melting Analysis (HRMA) Assay. Infect Drug Resist 2020; 13:2037-2052. [PMID: 32636657 PMCID: PMC7335274 DOI: 10.2147/idr.s255292] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background There are various phenotypic methods for identifying class B and class A β-lactamase enzymes in Pseudomonas aeruginosa. The purpose of this study was to compare the sensitivity and specificity of different phenotypic methods with HRMA assay to detect β-lactamase-producing P. aeruginosa strains. Methods Eighty-eight of P. aeruginosa isolates were collected from different specimens. Conventional double-disk test (DDT) and EDTA-imipenem microbiological (EIM) were performed to detect ESBL and MBL-producing strains, respectively. Meanwhile, the Modified Hodge test and Carba-NP test were performed on all carbapenem-resistant strains. HRMA method and sensitivity and specificity of primers were determined based on the melt curve temperature range. In all comparisons, PCR was considered as the gold standard. Results Of the 402 isolates collected from different clinical specimens, 88 isolates of P. aeruginosa were identified. However, 43 strains were (48.88%) ESBL-producing, and 7 strains (7.95%) were MBL-producing. Also, using the Modified Hodge test and Carba-NP method, 11 (12.5%) and 19 (21.59%) strains were carbapenemase-producing, respectively. The results of the HRMA test revealed that genes coding for bla SHV, bla TEM, bla KPC, bla IMP, bla VIM, and bla GES were detected in 44.31%, 22.72%, 13.63%, 14.7%, 5.6%, and 2.27% of P. aeruginosa isolates. Nonetheless, for bla KPC and bla GES genes, sensitivity and specificity of the Carba-NP test were 90.47%, 94.87%, and 83.36%, 94.80%, respectively. However, sensitivity and specificity of MHT was 91.66%, 98.70%, and 77.77%, 96.42%, respectively. For bla SHV and bla TEM genes, sensitivity and specificity of DDT were 95.55%, 95.55%, and 86%, 83.50%, respectively. However, sensitivity and specificity of EMI were 77.77%, 97.59%, and 91.66%, 97.43% for bla VIM and bla IMP, respectively. Conclusion The HRMA is a powerful, accurate, closed-tube, rapid method for detecting β-lactamase genes in P. aeruginosa. The high sensitivity and specificity of this method, along with phenotypic tests, play a useful role in increasing the predictive value of clinical reports.
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Affiliation(s)
- Sanaz Dehbashi
- Microbiology Department, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamed Tahmasebi
- Microbiology Department, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Yousef Alikhani
- Microbiology Department, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fariba Keramat
- Brucellosis Research Center, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Arabestani
- Microbiology Department, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Ranjbar R, Zayeri S, Mirzaie A. Development of multiplex PCR for rapid detection of metallo-β-lactamase genes in clinical isolates of Acinetobacter baumannii. IRANIAN JOURNAL OF MICROBIOLOGY 2020; 12:107-112. [PMID: 32494344 PMCID: PMC7244819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND OBJECTIVES Acinetobacter baumannii has been known as a major pathogen causing nosocomial infections. The aim of this study was to develop multiplex PCR for rapid and simultaneous detection of metallo-β-lactamase (MBL) genes in clinical isolates of A. baumannii. MATERIALS AND METHODS In this study, we used three sets of primers to amplify the MBL genes including bla OXA-48 , bla OXA-23 and bla NDM . The multiplex PCR assay was optimized for rapid and simultaneous detection of MBL genes in A. baumannii strains recovered from clinical samples. RESULTS A. baumannii strains recovered from clinical samples were subjected to the study. The multiplex PCR produced 3 bands of 501 bp for bla OXA-23 , 744 bp for bla OXA-48 and 623 bp for bla NDM genes. In addition to, no any cross-reactivity was observed in multiplex PCR. CONCLUSION Based on obtained data, the multiplex PCR had a good specificity without any cross reactivity and it appears that the multiplex PCR is reliable assay for simultaneous detection of MBL genes in A. baumannii strains.
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Affiliation(s)
- Reza Ranjbar
- Corresponding author: Reza Ranjbar, PhD, Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran., Tel: +98-21-88039883, Fax: +98-21-88039883,
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Malekjamshidi MR, Zandi H, Eftekhar F. Prevalence of Extended-Spectrum β-lactamase and Integron Gene Carriage in Multidrug-Resistant Klebsiella Species Isolated from Outpatients in Yazd, Iran. IRANIAN JOURNAL OF MEDICAL SCIENCES 2020; 45:23-31. [PMID: 32038056 PMCID: PMC6983277 DOI: 10.30476/ijms.2019.45334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Community-acquired infections by multidrug-resistant (MDR), extended-spectrum β-lactamase (ESBL) producing Klebsiella species (Klebsiella spp.) is of major concern worldwide. Antibiotic resistance, production of extended-spectrum β-lactamases (ESBLs), and carbapenemases, as well as the presence of classes 1, 2, and 3 integrons in outpatient isolates of Klebsiella collected from Yazd central laboratory, Yazd, Iran Methods: We collected 250 Klebsiella isolates from Yazd central laboratory between August 2015 and October 2017. Antibiotic susceptibility was determined against
18 antibiotics by disc diffusion, and multidrug-resistant isolates were tested for ESBL production by the phenotypic confirmatory test according to CLSI 2017 protocols.
The amplification of β-lactamase genes blaSHV, blaTEM, blaCTX-M,
blaOXA-48, blaKPC, and blaNDM, classes 1, 2,
and 3 integrase genes, was carried out using specific primers and polymerase chain reaction (PCR) Results: Of the 250 Klebsiella outpatient isolates, 3.6% were K. oxytoca and the rest were K. pneumoniae. Disc diffusion showed that 21 (8.4%) isolates were MDR,
19 (90.4%) of which were ESBL producers including one K. oxytoca. The most prevalent β-lactamase gene was blaSHV followed by blaTEM
and blaCTX-M, but blaOXA-48, blaKPC,
and blaNDM were not detected. Class 1 integron was detected in 18 out of 21 MDR isolates (85.7%), but classes 2 and 3 were not observed. Two isolates were resistant
to carbapenems and harbored blaSHV, blaTEM, and blaCTX-M, as well as class 1 integron. Conclusion: ESBL production and the presence of multiple β-lactamase genes in MDR community isolates of Klebsiella spp. can have significant implications in terms of the spread of these opportunistic pathogens.
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Affiliation(s)
- Mohammad Reza Malekjamshidi
- Departments of Microbiology, Faculty of Life Sciences and Technology, Shahid Beheshti University, Tehran, Iran
| | - Hengameh Zandi
- Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fereshteh Eftekhar
- Departments of Microbiology, Faculty of Life Sciences and Technology, Shahid Beheshti University, Tehran, Iran
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Spreading of extended-spectrum β-lactamase-producing Escherichia coli ST131 and Klebsiella pneumoniae ST11 in patients with pneumonia: a molecular epidemiological study. Chin Med J (Engl) 2020; 132:1894-1902. [PMID: 31408445 PMCID: PMC6708689 DOI: 10.1097/cm9.0000000000000368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Supplemental Digital Content is available in the text Background: Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are the important pathogens causing pneumonia. This study aimed to investigate the clinical characteristics and molecular epidemiology of ESBL-producing E. coli and K. pneumoniae causing pneumonia at a large teaching hospital in China. Methods: We collected patient's clinical data and ESBL-producing E. coli and K. pneumoniae strains causing pneumonia (from December 2015 to June 2016) at a hospital in Wuhan. The susceptibilities, multi-locus sequence typing, homologous analysis, ESBL genes by polymerase chain reaction and sequencing were determined. Results: A total of 59 ESBL-producing strains (31 E. coli and 28 K. pneumoniae) isolated from patients with pneumonia were analyzed. The majority of strains were isolated from patients were with hospital-acquired pneumonia (37/59, 62.7%), followed by community-acquired pneumonia (13/59, 22.0%), and ventilator-related pneumonia (9/59, 15.3%). The E. coli ST131 (9 isolates, 29.0%) and K. pneumoniae ST11 (5 isolates, 17.9%) were the predominant sub-types. The most prevalent ESBL gene was CTX-M-14, followed by SHV-77, CTX-M-3, SHV-11, and CTX-M-27. At least 33 (55.9%) of the ESBL-producing strains carried two or more ESBL genes. The ISEcp1 and IS26 were found upstream of all blaCTX-M (CTX-Ms) and of most blaSHV (SHVs) (57.6%), respectively. Moreover, three ESBL-producing K. pneumoniae ST11 strains which were resistant to carbapenems carried the blaNDM-1 and blaKPC-2, two of which also bearing blaOXA-48 were resistant to all antibiotics (including Tigecycline). Conclusions: Hospital-acquired pneumonia is more likely correlated with ESBL-producing E. coli and K. pneumoniae. ESBL-producing E. coli ST131 and multi-drug resistance ESBL-producing, as well as New Delhi metallo-β-lactamase-1 (NDM-1) and Klebsiella pneumoniae carbapenemases-2 (KPC-2) bearing K. pneumoniae ST11 are spreading in patients with pneumonia in hospital.
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Pumipuntu N, Pumipuntu S. Detection of antimicrobial resistance genes of carbapenem-resistant Enterobacteriaceae in Escherichia coli isolated from the water supply of smallholder dairy farms in Saraburi and Maha Sarakham, Thailand. ACTA ACUST UNITED AC 2020. [DOI: 10.14202/ijoh.2020.1-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Aim: The problem of antimicrobial resistance of bacteria in both humans and animals is an important public health concern globally, which is likely to increase, including in Thailand, where carbapenem-resistant Enterobacteriaceae (CRE), such as Escherichia coli, are of particular concern. They are pathogens found in the gastrointestinal tract of humans and other animals as well as in the environment. They may cause opportunistic infection and are often resistant to antibiotics in various fields especially in animal husbandry, such as pets or livestock farms. This study aimed to investigate the occurrence of carbapenem-resistant E. coli from water samples of smallholder dairy farms in Saraburi and Maha Sarakham, Thailand.
Materials and Methods: Sixty-four water samples were collected from 32 dairy farms in Kaeng Khoi district, Muak Lek district, and Wang Muang district of Saraburi Province, and Kantharawichai district and Mueang district of Maha Sarakham Province, Thailand. All samples were cultured and isolated for E. coli by biochemical tests. All E. coli isolates were tested for drug susceptibility using imipenem, meropenem, and drug resistance genes of carbapenemases such as blaNDM, blaIMP, and blaOXA48 of drug-resistant E. coli isolates detected by polymerase chain reaction (PCR) technique.
Results: A total of 182 E. coli isolates were found (140 and 42 isolates from Saraburi and Maha Sarakham, respectively). Drug sensitivity tests found that two isolates of E. coli from water in Kaeng Khoi were resistant to imipenem; therefore, the incidence of E. coli resistance to carbapenem was 1.43% of Saraburi Province. On the other hand, there was no incidence of drug-resistant E. coli in Maha Sarakham. In addition, the detection of the drug-resistant gene of E. coli in both isolates by PCR showed the expression of blaNDM.
Conclusion: This study reports E. coli resistance to antimicrobial drugs on livestock farms. It can be considered to be the first report of E. coli CRE detection in a dairy farm at Saraburi, which should be the subject of further extended study.
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Affiliation(s)
- Natapol Pumipuntu
- One Health Research Unit, Faculty of Veterinary Sciences, Mahasarakham University, Maha Sarakham 44000, Thailand
| | - Sangkom Pumipuntu
- Department of Educational Technology and Communications, Faculty of Education, Mahasarakham University, Maha Sarakham 44000, Thailand
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Amin M, Navidifar T, Shooshtari FS, Rashno M, Savari M, Jahangirmehr F, Arshadi M. Association Between Biofilm Formation, Structure, and the Expression Levels of Genes Related to biofilm formation and Biofilm-Specific Resistance of Acinetobacter baumannii Strains Isolated from Burn Infection in Ahvaz, Iran. Infect Drug Resist 2019; 12:3867-3881. [PMID: 31853190 PMCID: PMC6914661 DOI: 10.2147/idr.s228981] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/15/2019] [Indexed: 12/18/2022] Open
Abstract
Background The ability of biofilm formation is an effective way for Acinetobacter baumannii survival from stressed conditions. This present study was aimed to evaluate the association between biofilm formation, structure, the expression levels of genes related to biofilm formation and biofilm-specific resistance of A. baumannii strains isolated from burn infections in Ahvaz, Iran. Methods In this study, we assessed the antibiotic susceptibilities, ERIC-PCR typing, capacity of biofilm formation and biofilm structure of 64 A. baumannii isolates collected from burn infections. The distribution and the expression levels of genes involved in the biofilm formation including bap, ompA, abaI, pgaA and csuE were assessed by PCR and real-time PCR, respectively. Results We classified A. baumannii isolates in 14 clonal types of ERIC-PCR. Most A. baumannii isolates were resistant to all antibiotics tested except to tigecycline and colistin and had the biofilm formation capability but with different capacities. There was a significant inverse relationship between resistance to antibiotic agents and biofilm formation. The biofilm matrix of 50 strains consisted of polysaccharides together with DNA or proteins. The genes involved in the biofilm formation were detected in both biofilm-forming and non-biofilm forming; however, the expression levels of these genes were higher in biofilm producers compared with non-producers. Conclusion The biofilm cells exhibited dramatically decreased susceptibility to antibiotic agents; hence, they have great significance for public health. Therefore, the determination of antibiotic susceptibilities in biofilm and planktonic mode, molecular typing, and capacity of biofilm formation in clinical setting is essential.
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Affiliation(s)
- Mansour Amin
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Tahereh Navidifar
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farkhondeh Saleh Shooshtari
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Infertility Research and Treatment Center of Jahad Daneshgahi, Ahvaz, Khuzestan, Iran
| | - Mohammad Rashno
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Savari
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Jahangirmehr
- Pain Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mania Arshadi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mlynarcik P, Bardon J, Htoutou Sedlakova M, Prochazkova P, Kolar M. Identification of novel OXA-134-like β-lactamases in Acinetobacter lwoffii and Acinetobacter schindleri isolated from chicken litter. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:141-146. [DOI: 10.5507/bp.2018.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/22/2018] [Indexed: 11/23/2022] Open
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40
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Zaki M, El-Halaby H, Elmansoury E, Zeid M, Khaled K, Nomir M. Genetic Study of Extended Spectrum Beta-Lactamase and Carbapenemase Producing Escherichia Coli Causing Sepsis among Egyptian Children. Open Microbiol J 2019. [DOI: 10.2174/1874285801913010128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background:
Treatment failure of sepsis caused by Escherichia coli (E. Coli) is a leading cause of death of infants and children in intensive care units.
Objective:
To detect the prevalence of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-genes between E. coli isolates from infants and children with septicemia and to identify their antibiotic sensitivity pattern.
Methods:
This is a cross-sectional study performed on 88 patients with sepsis. The isolated E. coli were identified by Gram stain and biochemically by the Microscan automated system. ESBL and carbapenemase producing E. coli were isolated on double disk diffusion and EDTA double disk, respectively. Polymerase chain reaction for ESBL and carbapenemase producing E. coli genes were performed. Bacterial susceptibility to antibiotics was tested. The initial results were measured through the 30-days of hospital admission. IRB approved the study.
Results:
Of 88 patients with sepsis, 49 and 30 strains were ESBL producing and carbapenemase producing E. coli; respectively. Neither risk factors for infection nor clinical picture can differentiate between ESBL and carbapenemase producing E. coli. The most frequently detected gene of ESBL producing E. coli was SHV, it was more sensitive to Piperacillin/Tazobactam (90%) and cefepime (86.7%) while for carbapenemase-producing E. coli; IMP was the most frequent, its sensitivity was high to Piperacillin/Tazobactam and Ciprofloxacin (52.6% each).
Conclusion:
The commonest gene of ESBL producing E. coli is SHV whereas for carbapenemase-producing E. coli is IMP. Piperacillin/Tazobactam is the candidate drug to start in children with septicemia and suspected ESBL or carbapenemase-producing E. coli infection.
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Amin M, Navidifar T, Saleh Shooshtari F, Goodarzi H. Association of the genes encoding Metallo-β-Lactamase with the presence of integrons among multidrug-resistant clinical isolates of Acinetobacter baumannii. Infect Drug Resist 2019; 12:1171-1180. [PMID: 31190906 PMCID: PMC6526166 DOI: 10.2147/idr.s196575] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 04/11/2019] [Indexed: 12/21/2022] Open
Abstract
Background: Metallo-β-Lactamases (MBL) are usually encoded on the gene cassettes harboring integrons and disseminated easily among Acinetobacter baumannii isolates. This study was aimed to investigate the association of the genes encoding MBL with the presence of class 1 and 2 integrons among multidrug-resistant (MDR) A.baumannii isolates. Methodology: A total of 85 non-duplicated A.baumannii isolates were collected and evaluated for the amplification of blaOXA-51. The presence of genes encoding MBLs, including blaIMP, blaVIM, blaSIM, blaSPM, blaGIM, blaDIM and blaNDM, as well as intI 1 and intI 2 was evaluated by PCR. Also, the production of MBLs was screened phenotypically by the combination of EDTA and meropenem. Results: In this study, 77 out of 85 isolates were MDR. Also, 34 isolates had only intI 1, 10 had only intI 2 and 15 had both intI 1 and intI 2. The phenotypic detection of MBLs was found in 30 isolates, among which blaVIM was as the most common the gene encoding MBL followed by blaIMP, blaSPM and blaSIM. The gene cassettes analysis revealed that class 1 integron is often responsible for transferring the genes harboring MBLs. Conclusion: The production of MBLs among A. baumannii strains is one of the main mechanisms of resistance to carbapenems. Therefore, the development of inexpensive screening methods for the phenotypic detection of MBLs in clinical laboratories settings is essential. Also, our data revealed that the class 1 integron is often responsible for the dissemination of the MBL genes among A. baumannii isolates.
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Affiliation(s)
- Mansour Amin
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Tahereh Navidifar
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farkhondeh Saleh Shooshtari
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hamed Goodarzi
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Dehbashi S, Tahmasebi H, Arabestani MR. Association between Beta-lactam Antibiotic Resistance and Virulence Factors in AmpC Producing Clinical Strains of P. aeruginosa. Osong Public Health Res Perspect 2018; 9:325-333. [PMID: 30584496 PMCID: PMC6296806 DOI: 10.24171/j.phrp.2018.9.6.06] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives The purpose of this study was to determine the presence of IMP and OXA genes in clinical strains of Pseudomonas aeruginosa (P. aeruginosa) that are carriers of the ampC gene. Methods In this study, 105 clinical isolates of P. aeruginosa were collected. Antibiotic resistance patterns were determined using the disk diffusion method. The strains carrying AmpC enzymes were characterized by a combination disk method. Multiplex-PCR was used to identify resistance and virulence genes, chi-square test was used to determine the relationship between variables. Results Among 105 isolates of P. aeruginosa, the highest antibiotic resistance was to cefotaxime and aztreonam, and the least resistance was to colictin and ceftazidime. There were 49 isolates (46.66%) that showed an AmpC phenotype. In addition, the frequencies of the resistance genes were; OXA48 gene 85.2%, OXA199, 139 3.8%, OXA23 3.8%, OXA2 66.6%, OXA10 3.8%, OXA51 85.2% and OXA58 3.8%. The IMP27 gene was detected in 9 isolates (8.57%) and the IMP3.34 was detected in 11 isolates (10.47%). Other genes detected included; lasR (17.1%), lasB (18%) and lasA (26.6%). There was a significant relationship between virulence factors and the OX and IMP genes (p ≤ 0.05). Conclusion The relationship between antibiotic resistance and virulence factors observed in this study could play an important role in outbreaks associated with P. aeruginosa infections.
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Affiliation(s)
- Sanaz Dehbashi
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamed Tahmasebi
- Department of Microbiology, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Reza Arabestani
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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