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De la Cadena E, Mojica MF, Rojas LJ, Castro BE, García-Betancur JC, Marshall SH, Restrepo N, Castro-Caro NP, Fonseca-Carrillo M, Pallares C, Bonomo RA, Villegas MV. First report of KPC variants conferring ceftazidime-avibactam resistance in Colombia: introducing KPC-197. Microbiol Spectr 2024; 12:e0410523. [PMID: 38700337 DOI: 10.1128/spectrum.04105-23] [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: 12/04/2023] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
Resistance to ceftazidime-avibactam (CZA) due to Klebsiella pneumoniae carbapenemase (KPC) variants is increasing worldwide. We characterized two CZA-resistant clinical Klebsiella pneumoniae strains by antimicrobial susceptibility test, conjugation assays, and WGS. Isolates belonged to ST258 and ST45, and produced a KPC-31 and a novel variant KPC-197, respectively. The novel KPC variant presents a deletion of two amino acids on the Ω-loop (del_168-169_EL) and an insertion of two amino acids in position 274 (Ins_274_DS). Continued surveillance of KPC variants conferring CZA resistance in Colombia is warranted. IMPORTANCE Latin America and the Caribbean is an endemic region for carbapenemases. Increasingly high rates of Klebsiella pneumoniae carbapenemase (KPC) have established ceftazidime-avibactam (CZA) as an essential antimicrobial for the treatment of infections due to MDR Gram-negative pathogens. Although other countries in the region have reported the emergence of CZA-resistant KPC variants, this is the first description of such enzymes in Colombia. This finding warrants active surveillance, as dissemination of these variants could have devastating public health consequences.
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Affiliation(s)
- Elsa De la Cadena
- Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - María Fernanda Mojica
- Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA
- Research Service, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | - Laura J Rojas
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA
- Research Service, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | - Betsy E Castro
- Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - Juan Carlos García-Betancur
- Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - Steven H Marshall
- Research Service, VA Northeast Ohio Healthcare System, Cleveland, Ohio, USA
| | - Natalia Restrepo
- Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | | | | | - Christian Pallares
- Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
| | - Robert A Bonomo
- Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- CWRU-Cleveland VAMC Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, Ohio, USA
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, USA
- Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Proteomics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - María Virginia Villegas
- Grupo de Investigación en Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia
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García-Cedrón D, De La Cruz Noriega M, Cabanillas-Chirinos L, Otiniano NM, Rojas-Villacorta W, Salvatierra-Espinola W, Del Aguila KD, Luján-Velásquez M. Carbapenemase-Producing Bacteria Isolated from ICU Patients of a Peruvian Government Hospital during the COVID-19 Pandemic: A Descriptive Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1763. [PMID: 37893481 PMCID: PMC10608280 DOI: 10.3390/medicina59101763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/03/2023] [Accepted: 09/04/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: In Peru, the presence of antimicrobial-resistant bacteria is a constant concern in hospitals and has likely increased in frequency during the pandemic. The objective of the study was to analyze the frequency of carbapenemase-producing bacteria resistant to two carbapenems (Imipenem and Meropenem), which were isolated from Peruvian patients in the intensive care unit of the Victor Lazarte Echegaray Hospital in Trujillo (Peru) during the COVID-19 pandemic. Materials and Methods: The biological samples of the patients hospitalized in the ICU were processed in the Microbiology Diagnostic Laboratory of the Víctor Lazarte Echegaray Hospital between May 2021 and March 2022. Antimicrobial sensitivity was determined with the automated system AutoScan-4, and for the identification of the type of carbapenemase, the RESISIT-3 O.K.N K-SET cassettes were used. Results: The results show that 76 cultures (76/129) had resistance to the two carbapenems (imipenem or meropenem), where the most frequent were Klebsiella pneuomoniae (31.6%), Pseudomonas aeruginosa (26.3%), and Acinetobacter baumannii (14.5%). Pseudomonas aeruginosa cultures showed at least three carbapenemase types (KPC, NDM, and OXA-48), while A. baumannii, Escherichia coli, and Burkholderia cepacia complex presented at least two carbapenemases (NDM and OXA-48). The carbapenemase NDM was detected in Enterobacter cloacae, Morganella morganii, and Proteus mirabilis, while KPC was present in all Klebsiella pneumoniae and Klebsiella oxytoca cultures. Conclusions: The samples from patients hospitalized in the Victor Lazarte Echegaray Hospital ICU showed a high prevalence of imipenem- and meropenem-resistant bacteria. These findings are relevant and concerning from the perspective of antibiotic-resistant bacteria monitoring, control, and disinfection. Thus, an appropriate antibiotic policy must be implemented.
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Affiliation(s)
- David García-Cedrón
- Facultad de Ciencias de la Salud, Universidad César Vallejo, Trujillo 13001, Peru; (D.G.-C.); (W.S.-E.)
| | | | - Luis Cabanillas-Chirinos
- Instituto de Investigación en Ciencia y Tecnología, Universidad César Vallejo, Trujillo 13001, Peru; (L.C.-C.); (N.M.O.)
| | - Nélida Milly Otiniano
- Instituto de Investigación en Ciencia y Tecnología, Universidad César Vallejo, Trujillo 13001, Peru; (L.C.-C.); (N.M.O.)
| | | | | | - Karen Diaz Del Aguila
- Programa de Investigación Formativa, Universidad César Vallejo, Trujillo 13001, Peru;
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Identification of mcr-1 Genes and Characterization of Resistance Mechanisms to Colistin in Escherichia coli Isolates from Colombian Hospitals. Antibiotics (Basel) 2023; 12:antibiotics12030488. [PMID: 36978355 PMCID: PMC10044228 DOI: 10.3390/antibiotics12030488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
We report the presence of the mcr-1 gene among 880 Escherichia coli clinical isolates collected in 13 hospitals from 12 Colombian cities between 2016 and 2019. Seven (0.8%) isolates were colistin resistant (MIC ≥ 4 µg/mL). These colistin-resistant isolates were screened for the presence of the mcr-1 gene; five carried the gene. These five isolates were subjected to whole genome sequencing (WGS) to identify additional resistomes and their ST. In addition, antimicrobial susceptibility testing revealed that all E. coli isolates carrying mcr-1 were susceptible to third generation-cephalosporin and carbapenems, except one, which carried an extended-spectrum β-lactamase (CTX-M-55), along with the fosfomycin resistance encoding gene, fosA. WGS indicated that these isolates belonged to four distinct sequence types (ST58, ST46, ST393, and a newly described ST14315) and to phylogroups B1, A, and D. In this geographic region, the spread of mcr-1 in E. coli is low and has not been inserted into high-risk clones such as ST131, which has been present in the country longer.
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Efficacy of Vaporized Hydrogen Peroxide Combined with Silver Ions against Multidrug-Resistant Gram-Negative and Gram-Positive Clinical Isolates. Int J Mol Sci 2022; 23:ijms232415826. [PMID: 36555465 PMCID: PMC9779286 DOI: 10.3390/ijms232415826] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/19/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Antimicrobial resistance (AMR) is a serious public health problem that results in high morbidity and mortality rates. In particular, multidrug-resistant (MDR) strains circulating in hospital settings pose a major threat as they are associated with serious nosocomial infections. Therefore, regular cleaning and disinfection procedures, usually using chemical disinfectants, must be implemented in these facilities. Hydrogen peroxide (HP)-based disinfectants have proven high microbicidal activity and several comparative advantages over conventional disinfectants. We assessed the in vitro biocidal activity of an 8% HP solution combined with 30 mg/L silver ions (HP + Ag) against MDR clinical isolates of Klebsiella pneumoniae (MDRKp) and Pseudomonas aeruginosa (MDRPa), and methicillin-resistant Staphylococcus aureus (MRSA). Accordingly, the in vitro antibacterial activity was determined using the macrodilution method, and the efficacy was determined for 30 min in terms of (1) activity on bacteria in suspension and (2) activity on surfaces using vaporized HP + Ag on a 20 cm2 stainless steel surface. A strong bactericidal effect of HP + Ag was observed against MDRKp, MDRPa, and MRSA strains, with minimum inhibitory concentrations and minimum bactericidal concentrations between 362.5 and 5800 mg/L. A strong effect was observed during the 30 min of HP + Ag exposure to the resistant clinical isolates, with over 4-Log10 reduction in CFUs. Regarding the efficacy of the disinfectant on surfaces, bacterial load reductions of >99% were observed. These results suggest that HP + Ag is potentially useful as an effective disinfectant for decontaminating surfaces in hospital settings suspected of contamination with MDR bacteria.
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Ochoa AM, García MI, Cienfuegos A, Vásquez-Jaramillo L. Isolation of Escherichia coli and Klebsiella pneumoniae strains producing extended spectrum β-lactamases from dog urine of the Metropolitan Area of the Aburrá Valley Antioquia-Colombia. REVISTA DE LA FACULTAD DE MEDICINA VETERINARIA Y DE ZOOTECNIA 2022. [DOI: 10.15446/rfmvz.v69n3.103805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Escherichia coli and Klebsiella pneumoniae are the most common pathogens causing urinary tract infections in humans and animals. Close contact between humans and companion animals can facilitate the spread of multidrugresistant pathogens between both species. Objective: To characterize extended-spectrum β-lactamases (ESBL) -producing E. coli and K. pneumoniae isolated from dogs with urinary tract infections in the metropolitan area of Valle del Aburrá (Antioquia, Colombia). Methods: Three-hundred seventy-one urine samples collected from March 2018 to March 2019 in a veterinary clinical laboratory were analyzed. E. coli and K. pneumoniae isolates were detected in chromogenic agar and identified by biochemical tests. Susceptibility testing was performed by disc diffusion and ESBL production was evaluated by the double disk test in all isolates. MIC determination of ESBL-positive isolates were performed on the automated VITEK®2 system. Multiple PCR was used for the detection of CTX-M beta-lactamases (group 1, 2, 9 and 8/25), SHV, TEM and AmpC of plasmid origin in ESBL-positive isolates. Results: In total 22 out 371 isolates were positive for ESBL production by double disc test, 11 E. coli (ESBL-Ec) and 11 K. pneumoniae (ESBL-Kp). The multiple PCR detected CTX-M group 1 in the 22 ESBL-positive isolates. Multi-drug resistance was observed in all ESBL-producing isolates Conclusions: A high frequency of antibiotic multi-resistance was found in ESBL-Ec and ESBL-Kp. The main ESBL detected was CTX-M group 1, which also prevails in human isolates.
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Robledo J, Maldonado N, Robledo C, Ceballos Naranjo L, Hernández Galeano V, Pino JJ. Changes in Antimicrobial Resistance and Etiology of Blood Culture Isolates: Results of a Decade (2010-2019) of Surveillance in a Northern Region of Colombia. Infect Drug Resist 2022; 15:6067-6079. [PMID: 36277243 PMCID: PMC9581729 DOI: 10.2147/idr.s375206] [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: 06/01/2022] [Accepted: 09/09/2022] [Indexed: 11/05/2022] Open
Abstract
Background Bloodstream infections (BSI) are important causes of morbidity and mortality worldwide. Antimicrobial surveillance is essential for identifying emerging resistance and generating empirical treatment guides, the purpose of this study is to analyze trends in antimicrobial susceptibility of BSI from 2010 to 2019 in healthcare institutions from Medellin and nearby towns in Colombia. Methods A Whonet database was analyzed from the GERMEN antimicrobial surveillance network; frequency and antibiotic susceptibility trends were calculated on more frequent microorganisms using Mann Kendall and Sen’s Slope Estimator Test. Results 61,299 isolates were included; the three microorganisms more frequent showed a significant increasing trend through time E. coli (Sen’s Slope estimator = 0.7 p = <0.01) S. aureus (Sen’s Slope estimator = 0.60 p = <0.01) and K. pneumonia (Sen’s Slope estimator = 0.30 p = <0.01). E. coli showed a significant increase trend in cefepime and ceftazidime resistance, while K. pneumoniae showed a significant increase in resistance to cefepime, ciprofloxacin, and gentamicin. P. aeruginosa increases its susceptibility to all analyzed antibiotics and S. aureus to oxacillin. No increasing trend was observed for carbapenem resistance. Conclusion An upward trends was observed in more frequent microorganisms and resistance to third and fourth-generation cephalosporins for E. coli and K pneumoniae; in contrast, not increasing trends in antibiotic resistance was observed for P. aeruginosa and S. aureus. The essential role of AMR-surveillance programs is to point out and identify these trends, which should improve antibiotic resistance control.
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Affiliation(s)
- Jaime Robledo
- Laboratorio Médico de Referencia, Medellín, Colombia,Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia,Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia,Grupo GERMEN, Medellín, Colombia,Correspondence: Jaime Robledo, Unidad de Bacteriología y Micobacterias, Corporación para Investigaciones Biológicas, Carrera 72A No. 78B-141, Medellín, Colombia, Tel +57-4-6051808, Email
| | - Natalia Maldonado
- Grupo GERMEN, Medellín, Colombia,UGC Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Carlos Robledo
- Laboratorio Médico de Referencia, Medellín, Colombia,Grupo GERMEN, Medellín, Colombia
| | | | | | - Juan Jose Pino
- Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia
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Bastidas-Caldes C, Romero-Alvarez D, Valdez-Vélez V, Morales RD, Montalvo-Hernández A, Gomes-Dias C, Calvopiña M. Extended-Spectrum Beta-Lactamases Producing Escherichia coli in South America: A Systematic Review with a One Health Perspective. Infect Drug Resist 2022; 15:5759-5779. [PMID: 36204394 PMCID: PMC9531622 DOI: 10.2147/idr.s371845] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Carlos Bastidas-Caldes
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
- Doctoral Program in Public and Animal Health, Faculty of Veterinary Medicine, University of Extremadura, Cáceres, Spain
- Correspondence: Carlos Bastidas-Caldes, One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, 170124, Ecuador, Tel +593 983 174949, Email
| | - Daniel Romero-Alvarez
- One Health Reserch Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
- Biodiversity Institute and Department of Ecology & Evolutionary Biology, The University of Kansas, Lawrence, KS, USA
| | - Victor Valdez-Vélez
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Roberto D Morales
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Andrés Montalvo-Hernández
- One Health Research Group, Faculty of Engineering and Applied Sciences, Universidad de las Américas, Quito, Ecuador
| | - Cicero Gomes-Dias
- Department of Basic Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Manuel Calvopiña
- One Health Reserch Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
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Montoya-Urrego D, Tellez-Carrasquilla S, Vanegas JM, Quiceno JNJ. High frequency of colonization by extended-spectrum beta-lactamase-producing Gram-negative bacilli in hemodialysis patients and their household contacts in Colombia: dissemination between the community and the hospital. Epidemiol Health 2022; 44:e2022069. [PMID: 36097808 PMCID: PMC9943636 DOI: 10.4178/epih.e2022069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/27/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Increasing colonization by beta-lactam-resistant Gram-negative bacilli (BR-GNB) represents a risk for infections and bacterial resistance spread, both in hospitals and the community. Hemodialysis patients and their household contacts regularly transit between these environments. This study investigated the clinical and epidemiological characteristics of BR-GNB colonization in hemodialysis patients and their household contacts, as well as the genetic relationship between their isolates. METHODS A cross-sectional study was conducted on hemodialysis patients at a hospital-associated dialysis center in Medellín, Colombia and their household contacts. Clinical and epidemiological information was collected. Colonization was assessed from stool or rectal swab samples. Bacterial identification and susceptibility were determined using chromogenic media and Vitek-2. Molecular characterization included beta-lactamase detection by polymerase chain reaction, multiple-locus sequence typing (MLST), pulsed-field gel electrophoresis, and identification of Escherichia coli phylogroups by the Clermont protocol. RESULTS This study included 36 hemodialysis patients and 90 household contacts. Colonization by BR-GNB occurred in 58.3% of patients and 22.2% of household contacts. The main beta-lactamase detected was CTX-M group-1 (40.5%). In 3 of the 9 homes that had more than 1 colonized individual, a genetic relationship was found. MLST showed a high diversity in E. coli isolates, and the most frequent phylogroups were B1 and B2. CONCLUSIONS These results show a high frequency of colonization and the presence of potentially pathogenic BR-GBN both in hospitals and the community. This highlights the importance of populations who move between those 2 environments, and the need to prevent the spread of bacterial resistance outside hospitals.
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Affiliation(s)
- Daniela Montoya-Urrego
- Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - Sara Tellez-Carrasquilla
- Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - Johanna M. Vanegas
- Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia,Grupo de Investigación en Salud Pública, Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Judy Natalia Jiménez Quiceno
- Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia,Correspondence: Judy Natalia Jiménez Quiceno Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Calle 67 No. 53-108, Medellín 050010, Colombia E-mail:
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Bonilla-Caballero MA, Lozano-Puentes MP, Ospina MA, Varón-López M. First report of multidrug-resistant Salmonella Infantis in broiler litter in Tolima, Colombia. Vet World 2022; 15:1557-1565. [PMID: 35993060 PMCID: PMC9375208 DOI: 10.14202/vetworld.2022.1557-1565] [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: 12/11/2021] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aim: Salmonella has been identified as one of the most widely distributed zoonotic pathogens in broiler litter. Multidrug-resistant strains have been isolated from salmonellosis outbreaks, compromising the success of their treatment. This study aimed to isolate and identify Salmonella spp. serovars in healthy broiler litter in Tolima (Colombia), determine their resistance to different antimicrobials, and detect genes associated with b-lactam resistance that could be useful to control Salmonella spp. in poultry. Materials and Methods: In total, 45 broiler litter samples were collected. Salmonella spp. was isolated and identified using selective and differential culture media and biochemical tests. Molecular confirmation of the pathogen was performed with the invA gene and serotyping by Kauffman–White scheme. Antimicrobial susceptibility to 15 antibiotics was determined by Kirby–Bauer method. In cefotaxime-resistant strains, blaCTX-M-F, blaCTX-M-1, blaCMY, and blaTEM genes were evaluated by polymerase chain reaction (PCR). Results: In total, 817 presumptive strains were obtained from xylose lysine deoxycholate and SalmonellaShigella agars and subcultured on xylose-lysine-tergitol 4 and MacConkey agars, from which 150 strains were isolated; 29 of these strains were presumptive for Salmonella spp. after performing biochemical tests and 16 were confirmed by PCR as Salmonella Infantis (15) and Gallinarum (1). All strains were found to be multiresistant to antibiotics, showing three different profiles and isolates resistant to cefotaxime, and the blaCTX-M gene was detected. Conclusion: This is the first study to isolate S. Infantis from broiler litter in Colombia. All isolates exhibited resistance to the evaluated antimicrobials, suggesting the misuse of antimicrobials in small- and medium-sized poultry farms. The presence of Salmonella enterica serovar Infantis is a public health problem. Thus, regular monitoring of poultry litter is recommended, as these bacteria can be transmitted to humans through animal products or contaminated environments.
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Affiliation(s)
- Mayra A. Bonilla-Caballero
- Department of Biology, Research Group on Plant and Microbial Biotechnology - GEBIUT, Faculty of Sciences, University of Tolima, PO Box 730006299, Ibagué, Colombia
| | - María P. Lozano-Puentes
- Department of Biology, Research Group on Plant and Microbial Biotechnology - GEBIUT, Faculty of Sciences, University of Tolima, PO Box 730006299, Ibagué, Colombia
| | - María A. Ospina
- Department of Biology, Research Group on Plant and Microbial Biotechnology - GEBIUT, Faculty of Sciences, University of Tolima, PO Box 730006299, Ibagué, Colombia
| | - Maryeimy Varón-López
- Department of Biology, Research Group on Plant and Microbial Biotechnology - GEBIUT, Faculty of Sciences, University of Tolima, PO Box 730006299, Ibagué, Colombia
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Comparative Evaluation of Phenotypic Synergy Tests versus RESIST-4 O.K.N.V. and NG Test Carba 5 Lateral Flow Immunoassays for the Detection and Differentiation of Carbapenemases in Enterobacterales and Pseudomonas aeruginosa. Microbiol Spectr 2022; 10:e0108021. [PMID: 35107384 PMCID: PMC8809327 DOI: 10.1128/spectrum.01080-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The spread of carbapenem-resistant Pseudomonas aeruginosa and carbapenemase-producing Enterobacterales (CPE) has dramatically impacted morbidity and mortality. COVID-19 pandemic has favored the selection of these microorganisms because of the excessive and prolonged use of broad-spectrum antibiotics and the outbreaks related to patient transfer between hospitals and inadequate personal protective equipment. Therefore, early CPE detection is considered essential for their control. We aimed to compare conventional phenotypic synergy tests and two lateral flow immunoassays for detecting carbapenemases in Enterobacterales and P. aeruginosa. We analyzed 100 carbapenem-resistant Gram-negative bacilli isolates, 80 Enterobacterales, and 20 P. aeruginosa (86 isolates producing KPC, NDM, OXA-48, IMP, and VIM carbapenemases and 14 non-carbapenemase-producing isolates). We performed a modified Hodge test, boronic acid and ethylenediaminetetraacetic acid (EDTA) synergy tests, and two lateral flow immunoassays: RESIST-4 O.K.N.V. (Coris Bioconcept) and NG Test Carba 5 (NG Biotech). In total, 76 KPC, seven VIM, one NDM, one OXA-48, and one isolate coproducing KPC + NDM enzymes were included. The concordance of different methods estimated by the Kappa index was 0.432 (standard error: 0.117), thus showing a high variability with the synergy tests with boronic acid and EDTA and reporting 16 false negatives that were detected by the two immunochromatographic methods. Co-production was only detected using immunoassays. Conventional phenotypic synergy tests with boronic acid and EDTA for detecting carbapenemases are suboptimal, and their routine use should be reconsidered. These tests depend on the degree of enzyme expression and the distance between disks. Lateral flow immunoassay tests are a rapid and cost-effective tool to detect and differentiate carbapenemases, improving clinical outcomes through targeted therapy and promoting infection prevention measures. IMPORTANCE Infections due to multidrug-resistant pathogens are a growing problem worldwide. The production of carbapenemases in Pseudomonas aeruginosa and Enterobacterales cause a high impact on the mortality of infected patients. Therefore, it is of great importance to have methods that allow the early detection of these multi-resistant microorganisms, achieving the confirmation of the type of carbapenemase present, with high sensitivity and specificity, with the aim of improving epidemiological control, dissemination, the clinical course to through targeted antibiotic therapy and promoting infection control in hospitals.
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Molecular characterization of multiresistant enterobacteria in two departments of the Peruvian jungle. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2021; 41:180-187. [PMID: 34669288 PMCID: PMC8724863 DOI: 10.7705/biomedica.5720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Indexed: 11/21/2022]
Abstract
Introducción. La aparición de enterobacterias multirresistentes y productoras de betalactamasas de espectro extendido (BLEE) en pacientes de consulta externa con infecciones urinarias, representa un problema de salud pública en Perú. Objetivos. Caracterizar molecularmente enterobacterias multirresistentes aisladas de pacientes con diagnóstico de infección urinaria y procedentes de dos departamentos de la selva peruana. Materiales y métodos. Se hizo un estudio descriptivo, observacional y retrospectivo de 61 aislamientos de urocultivo procedentes de la selva peruana durante 2017 y 2018. Los perfiles de resistencia se identificaron utilizando el sistema automatizado MicroScan™ y para la detección de los genes blaTEM , blaCTX-M , blaSHV se empleó una reacción en cadena de la polimerasa (PCR) convencional. Resultados. Las enterobacterias positivas para BLEE más frecuentes por departamento fueron Escherichia coli en Madre de Dios (25%, 10/40) y Ucayali (76,2%, 16/21). En ambos departamentos, el gen blaCTX-M fue el más frecuente (25/61; 41), seguido por blaTEM (15/61; 24,6%) y blaSHV (10/61; 16,4%). En el perfil de sensibilidad antimicrobiana, se detectó 72,6% de resistencia contra ampicilina, 82,3 % contra cefalotina y 88,7% contra nitrofurantoína. Conclusiones. El porcentaje de cepas de enterobacterias multirresistentes productoras de BLEE en ambos departamentos fue del 57,4% y el gen bla CTX-M fue el más frecuente.
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Rodríguez EA, Ramirez D, Balcázar JL, Jiménez JN. Metagenomic analysis of urban wastewater resistome and mobilome: A support for antimicrobial resistance surveillance in an endemic country. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 276:116736. [PMID: 33618114 DOI: 10.1016/j.envpol.2021.116736] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 05/10/2023]
Abstract
In developing countries, where high levels of antimicrobial resistance are observed in hospitals, the surveillance of this phenomenon in wastewater treatment plants (WWTPs) and the environment is very limited, especially using cutting-edge culture-independent methods. In this study, the composition of bacterial communities, the resistome and mobilome (the pool of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs), respectively) at a WWTP were determined using shotgun metagenomics and culture-based approaches. Wastewater samples were collected at four sampling points of a WWTP in Antioquia, Colombia. A total of 24 metagenomes were analyzed. Specifically, there were marked differences in bacterial community composition, resistome, and mobilome, according to the WWTP sampling points. Bacterial families of clinical importance such as Moraxellaceae, Aeromonadaceae, and Enterobacteriaceae were mainly detected in the WWTP influent and effluent samples. Genes encoding resistance to macrolide-lincosamide-streptogramin, β-lactams, and those conferring multidrug resistance (e.g., acrB, adeG, and mexD) were the most abundant. Moreover, some clinically important ARGs such as blaKPC-2 and blaCTX-M, and others not reported locally, such as blaTEM-196, blaGES-23, blaOXA-10, mcr-3, and mcr-5 were frequently detected. Co-occurrence network analyses indicated a significant association of ARGs such as blaOXA-58 and blaKPC genes with Aeromonadaceae and Enterobacteriaceae. Among the markers of MGEs, intI1 and ISCR8 were the most frequently detected. Altogether, this work reveals the importance of shotgun metagenomics and culture-based approaches in antimicrobial resistance studies. The findings also support that WWTPs are hotspots for antimicrobial resistance, whose analysis constitutes a powerful tool to predict the impact of antimicrobial resistance in a population.
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Affiliation(s)
- Erika A Rodríguez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, 050010, Medellín, Colombia.
| | - Diego Ramirez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, 050010, Medellín, Colombia; Grupo de Investigación en Gestión y Modelación Ambiental, Universidad de Antioquia, 050010, Medellín, Colombia
| | - José L Balcázar
- Catalan Institute for Water Research (ICRA), 17003, Girona, Spain; University of Girona, 17004, Girona, Spain
| | - J Natalia Jiménez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, 050010, Medellín, Colombia.
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Dynamics of bla KPC-2 Dissemination from Non-CG258 Klebsiella pneumoniae to Other Enterobacterales via IncN Plasmids in an Area of High Endemicity. Antimicrob Agents Chemother 2020; 64:AAC.01743-20. [PMID: 32958711 DOI: 10.1128/aac.01743-20] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/15/2020] [Indexed: 02/06/2023] Open
Abstract
Carbapenem-resistant Enterobacterales (CRE) pose a significant threat to global public health. The most important mechanism for carbapenem resistance is the production of carbapenemases. Klebsiella pneumoniae carbapenemase (KPC) represents one of the main carbapenemases worldwide. Complex mechanisms of bla KPC dissemination have been reported in Colombia, a country with a high endemicity of carbapenem resistance. Here, we characterized the dynamics of dissemination of bla KPC gene among CRE infecting and colonizing patients in three hospitals localized in a highly endemic area of Colombia (2013 and 2015). We identified the genomic characteristics of KPC-producing Enterobacterales recovered from patients infected/colonized and reconstructed the dynamics of dissemination of bla KPC-2 using both short and long read sequencing. We found that spread of bla KPC-2 among Enterobacterales in the participating hospitals was due to intra- and interspecies horizontal gene transfer (HGT) mediated by promiscuous plasmids associated with transposable elements that was originated from a multispecies outbreak of KPC-producing Enterobacterales in a neonatal intensive care unit. The plasmids were detected in isolates recovered in other units within the same hospital and nearby hospitals. The gene "epidemic" was driven by IncN-pST15-type plasmids carrying a novel Tn4401b structure and non-Tn4401 elements (NTEKPC) in Klebsiella spp., Escherichia coli, Enterobacter spp., and Citrobacter spp. Of note, mcr-9 was found to coexist with bla KPC-2 in species of the Enterobacter cloacae complex. Our findings suggest that the main mechanism for dissemination of bla KPC-2 is HGT mediated by highly transferable plasmids among species of Enterobacterales in infected/colonized patients, presenting a major challenge for public health interventions in developing countries such as Colombia.
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Angles-Yanqui E, Huaringa-Marcelo J, Sacsaquispe-Contreras R, Pampa-Espinoza L. [Panorama of carbapenemases in PeruUm panorama das carbapenemases presentes no Peru]. Rev Panam Salud Publica 2020; 44:e61. [PMID: 32973907 PMCID: PMC7498286 DOI: 10.26633/rpsp.2020.61] [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: 11/04/2019] [Accepted: 04/07/2020] [Indexed: 02/06/2023] Open
Abstract
Objetivo. Describir los genotipos de las carbapenemasas reportadas de aislamientos microbiológicos de pacientes en Perú. Métodos. Se realizó una búsqueda sistemática de la literatura biomédica publicada desde el 1 enero de 2000 hasta el 15 de setiembre de 2019 en las bases de datos PubMed, SCOPUS, Biblioteca Virtual de Salud, Biblioteca Virtual de CONCYTEC, Google Scholar y otras fuentes de publicaciones de resúmenes o póster en congresos nacionales o internacionales sobre carbapenemasas con confirmación genotípica; la selección y extracción de datos fue por pares. Resultados. Se incluyeron 14 estudios en los que se realizó la caracterización genotípica de 313 carbapenemasas. Ciento tres de estos reportes pertenecían a estudios efectuados en enterobacterias; de estos, 74 fueron en Klebsiella pneumoniae, 11 en Proteus mirabilis, 7 en Enterobacter cloacae y 11 en otras. Sesenta y una de estas 103 corresponden a blaNDM, 39 a blaKPC y 3 a blaIMP. Según su estructura molecular, 64 son metalobetalactamasas y 39 son serinbetalactamasas. En Pseudomonas aeruginosa se incluyeron 84 reportes, 79 corresponden a blaIMP, 4 a blaVIM, y 1 a blaGES. En Acinetobacter baumannii 126 reportes, 55 corresponden a blaOXA-23, 66 a blaOXA24, 3 a blaNDM y 2 a blaOXA-143. Conclusiones. Existe un número escaso de publicaciones respecto a carbapenemasas de pacientes en Perú; los reportes genotípicos provienen en su mayoría de hospitales de la capital del país. Esta es la primera revisión que intenta conocer los tipos de carbapenemasas reportadas en enterobacterias, P. aeruginosa y A. baumannii.
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Affiliation(s)
- Eddie Angles-Yanqui
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia Lima Perú Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Jorge Huaringa-Marcelo
- Facultad de Ciencias de la Salud, Universidad Científica del Sur Lima Perú Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Perú
| | | | - Luis Pampa-Espinoza
- Instituto Nacional de Salud Lima Perú Instituto Nacional de Salud, Lima, Perú
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Mojica MF, De La Cadena E, Correa A, Appel TM, Pallares CJ, Villegas MV. Evaluation of Allplex™ Entero-DR assay for detection of antimicrobial resistance determinants from bacterial cultures. BMC Res Notes 2020; 13:154. [PMID: 32178721 PMCID: PMC7075001 DOI: 10.1186/s13104-020-04997-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/05/2020] [Indexed: 12/18/2022] Open
Abstract
Objective To evaluate the sensitivity and specificity of the Allplex™ Entero-DR, a quantitative PCR-based method, for the detection of β-lactamase-encoding genes and vancomycin-resistance determinants in 156 previously characterized Gram-negative bacilli and Enterococcus spp. from bacterial cultures. Result The method had 100% sensitivity and between 92 and 100% of specificity for identifying blaKPC, blaVIM, blaIMP, blaNDM, blaOXA-48-like, blaCTX-M and vanA. In nine isolates, unspecific amplifications were detected. The Ct of these false positives was above 33. The Ct of the correctly identified bla and van genes did not surpass 28 and 30, respectively. None of the clinical isolates included as negative controls yielded any amplification. Therefore, the Allplex™ Entero-DR assay is a highly accurate test for the detection of important antibiotic resistance determinants. With this assay, reliable results can be obtained within 3 h. However, according to our data, samples with Ct values greater than 33 should be considered with caution.
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Affiliation(s)
- María Fernanda Mojica
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Ak. 9 #131a-02, Bogotá, DC, Colombia.,Infectious Diseases Department, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.,Research Service, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, USA
| | - Elsa De La Cadena
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Ak. 9 #131a-02, Bogotá, DC, Colombia.
| | - Adriana Correa
- Universidad Santiago de Cali, Cali, Colombia.,Centro Médico Imbanaco, Cali, Colombia
| | - Tobias Manuel Appel
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Ak. 9 #131a-02, Bogotá, DC, Colombia
| | - Christian José Pallares
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Ak. 9 #131a-02, Bogotá, DC, Colombia.,Centro Médico Imbanaco, Cali, Colombia
| | - María Virginia Villegas
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Ak. 9 #131a-02, Bogotá, DC, Colombia.,Centro Médico Imbanaco, Cali, Colombia
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Aristizábal-Hoyos AM, Rodríguez EA, Arias L, Jiménez JN. High clonal diversity of multidrug-resistant and extended spectrum beta-lactamase-producing Escherichia coli in a wastewater treatment plant. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2019; 245:37-47. [PMID: 31150908 DOI: 10.1016/j.jenvman.2019.05.073] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/17/2019] [Accepted: 05/19/2019] [Indexed: 05/29/2023]
Abstract
Increasing beta-lactam resistance has led to the exploration of different places, such as wastewater treatment plants (WWTPs) which have been considered to be reservoirs and sources of bacterial resistance. This work aims to determine the presence of beta-lactamase-producing-Enterobacteriaceae in different points of a WWTP in Colombia. Six samplings were carried out in 2017 in the raw influent, aeration tanks, recycled sludge and final effluent of a WWTP. The beta-lactamase-producing-Enterobacteriaceae were detected and identified using phenotypic and molecular methods. Of the 353 isolates included, 28.3% corresponded to enterobacteria. The most frequent microorganisms were Escherichia coli (83%), Citrobacter freundii (11%) and Enterobacter cloacae complex (4%). The 97% of enterobacteriaceae had at least one beta-lactamase, and the most prevalent were the blaTEM (43.8%) and blaCTX-M-1group (35.8%) which were detected specially in recycled sludge and final effluent sample points. High percentage of multidrug resistance (to beta-lactams and non-beta-lactam antibiotics) was detected in E. coli (63.2%). Additionally, the typing by PFGE and MLST showed high genotypic diversity and the presence of the successful ST131 clone, globally spread. This work highlights the strong role of E. coli as a vector for the dissemination of resistance and the beta-lactamases in aquatic environments.
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Affiliation(s)
- A M Aristizábal-Hoyos
- Línea de Epidemiología Molecular Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia; Grupo de Bioprocesos Microbianos, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - E A Rodríguez
- Línea de Epidemiología Molecular Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - L Arias
- Grupo de Bioprocesos Microbianos, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia
| | - J N Jiménez
- Línea de Epidemiología Molecular Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia.
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