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Laumen JGE, Manoharan-Basil SS, Verhoeven E, Abdellati S, De Baetselier I, Crucitti T, Xavier BB, Chapelle S, Lammens C, Van Dijck C, Malhotra-Kumar S, Kenyon C. Molecular pathways to high-level azithromycin resistance in Neisseria gonorrhoeae. J Antimicrob Chemother 2021; 76:1752-1758. [DOI: 10.1093/jac/dkab084] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/28/2021] [Indexed: 01/02/2023] Open
Abstract
Abstract
Background
The prevalence of azithromycin resistance in Neisseria gonorrhoeae is increasing in numerous populations worldwide.
Objectives
To characterize the genetic pathways leading to high-level azithromycin resistance.
Methods
A customized morbidostat was used to subject two N. gonorrhoeae reference strains (WHO-F and WHO-X) to dynamically sustained azithromycin pressure. We tracked stepwise evolution of resistance by whole genome sequencing.
Results
Within 26 days, all cultures evolved high-level azithromycin resistance. Typically, the first step towards resistance was found in transitory mutations in genes rplD, rplV and rpmH (encoding the ribosomal proteins L4, L22 and L34 respectively), followed by mutations in the MtrCDE-encoded efflux pump and the 23S rRNA gene. Low- to high-level resistance was associated with mutations in the ribosomal proteins and MtrCDE efflux pump. However, high-level resistance was consistently associated with mutations in the 23S ribosomal RNA, mainly the well-known A2059G and C2611T mutations, but also at position A2058G.
Conclusions
This study enabled us to track previously reported mutations and identify novel mutations in ribosomal proteins (L4, L22 and L34) that may play a role in the genesis of azithromycin resistance in N. gonorrhoeae.
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Affiliation(s)
- J G E Laumen
- Institute of Tropical Medicine, Department of Clinical Sciences, STI Unit, Antwerp, Belgium
- University of Antwerp, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Antwerp, Belgium
| | - S S Manoharan-Basil
- Institute of Tropical Medicine, Department of Clinical Sciences, STI Unit, Antwerp, Belgium
| | - E Verhoeven
- Institute of Tropical Medicine, Department of Clinical Sciences, STI Unit, Antwerp, Belgium
- Pfizer, Puurs, Belgium
| | - S Abdellati
- Institute of Tropical Medicine, Department of Clinical Sciences, Clinical Reference Laboratory, Antwerp, Belgium
| | - I De Baetselier
- Institute of Tropical Medicine, Department of Clinical Sciences, Clinical Reference Laboratory, Antwerp, Belgium
| | - T Crucitti
- Centre Pasteur du Cameroun, Yaounde, Cameroon
| | - B B Xavier
- University of Antwerp, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Antwerp, Belgium
| | - S Chapelle
- University of Antwerp, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Antwerp, Belgium
| | - C Lammens
- University of Antwerp, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Antwerp, Belgium
| | - C Van Dijck
- Institute of Tropical Medicine, Department of Clinical Sciences, STI Unit, Antwerp, Belgium
- University of Antwerp, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Antwerp, Belgium
| | - S Malhotra-Kumar
- University of Antwerp, Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Antwerp, Belgium
| | - C Kenyon
- Institute of Tropical Medicine, Department of Clinical Sciences, STI Unit, Antwerp, Belgium
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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Kostyanev T, Nguyen MN, Markovska R, Stankova P, Xavier BB, Lammens C, Marteva-Proevska Y, Velinov T, Cantón R, Goossens H, Malhotra-Kumar S. Emergence of ST654 Pseudomonas aeruginosa co-harbouring bla NDM-1 and bla GES-5 in novel class I integron In1884 from Bulgaria. J Glob Antimicrob Resist 2020; 22:672-673. [PMID: 32585404 DOI: 10.1016/j.jgar.2020.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/06/2020] [Accepted: 06/10/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Tomislav Kostyanev
- Department of Medical Microbiology, University of Antwerp, Antwerp, Belgium; Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
| | - M N Nguyen
- Department of Medical Microbiology, University of Antwerp, Antwerp, Belgium; Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - R Markovska
- Department of Medical Microbiology, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - P Stankova
- Department of Medical Microbiology, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - B B Xavier
- Department of Medical Microbiology, University of Antwerp, Antwerp, Belgium; Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - C Lammens
- Department of Medical Microbiology, University of Antwerp, Antwerp, Belgium; Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Y Marteva-Proevska
- Central Laboratory of Microbiology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - T Velinov
- Central Laboratory of Microbiology, Alexandrovska University Hospital, Sofia, Bulgaria
| | - R Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - H Goossens
- Department of Medical Microbiology, University of Antwerp, Antwerp, Belgium; Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - S Malhotra-Kumar
- Department of Medical Microbiology, University of Antwerp, Antwerp, Belgium; Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Dafopoulou K, Xavier BB, Zarkotou O, Orfanidou M, Goossens H, Tsakris A, Malhotra-Kumar S, Pournaras S. Detection of colistin resistance in the highly virulent Escherichia coli ST131 H30Rx clone in Greece. J Glob Antimicrob Resist 2019; 20:31-32. [PMID: 31786358 DOI: 10.1016/j.jgar.2019.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- K Dafopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - B B Xavier
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - O Zarkotou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M Orfanidou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - H Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - A Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - S Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - S Pournaras
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Tacconelli E, Górska A, De Angelis G, Lammens C, Restuccia G, Schrenzel J, Huson DH, Carević B, Preoţescu L, Carmeli Y, Kazma M, Spanu T, Carrara E, Malhotra-Kumar S, Gladstone BP. Estimating the association between antibiotic exposure and colonization with extended-spectrum β-lactamase-producing Gram-negative bacteria using machine learning methods: a multicentre, prospective cohort study. Clin Microbiol Infect 2019; 26:87-94. [PMID: 31128285 DOI: 10.1016/j.cmi.2019.05.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/20/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of the study was to measure the impact of antibiotic exposure on the acquisition of colonization with extended-spectrum β-lactamase-producing Gram-negative bacteria (ESBL-GNB) accounting for individual- and group-level confounding using machine-learning methods. METHODS Patients hospitalized between September 2010 and June 2013 at six medical and six surgical wards in Italy, Serbia and Romania were screened for ESBL-GNB at hospital admission, discharge, antibiotic start, and after 3, 7, 15 and 30 days. Primary outcomes were the incidence rate and predictive factors of new ESBL-GNB colonization. Random forest algorithm was used to rank antibiotics according to the risk of selection of ESBL-GNB colonization in patients not colonized before starting antibiotics. RESULTS We screened 10 034 patients collecting 28 322 rectal swab samples. New ESBL-GNB colonization incidence with and without antibiotic treatment was 22/1000 and 9/1000 exposure-days, respectively. In the adjusted regression analyses, antibiotic exposure (hazard ratio (HR) 2.38; 95% CI 1.29-4.40), age 60-69 years (HR 1.19; 95% CI 1.05-1.34), and spring season (HR 1.25; 95% CI 1.14-1.38) were independently associated with new colonization. Monotherapy ranked higher als combination therapy in promoting ESBL-GNB colonization. Among monotherapy, cephalosporins ranked first followed by tetracycline (second), macrolide (fourth) and cotrimoxazole (seventh). Overall the ranking of cephalosporins was lower when used in combination. Among combinations not including cephalosporins, quinolones plus carbapenems ranked highest (eighth). Among sequential therapies, quinolones ranked highest (tenth) when prescribed within 30 days of therapy with cephalosporins. CONCLUSIONS Impact of antibiotics on selecting ESBL-GNB at intestinal level varies if used in monotherapy or combination and according to previous antibiotic exposure. These finding should be explored in future clinical trials on antibiotic stewardship interventions. CLINICAL TRIAL REGISTRATION NCT01208519.
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Affiliation(s)
- E Tacconelli
- Division of Infectious Disease, Department of Internal Medicine I, Tübingen University Hospital, Tübingen, Germany; Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Italy.
| | - A Górska
- Algorithms in Bioinformatics, University of Tübingen and International Max Planck Research School, Tübingen, Germany
| | - G De Angelis
- Institute of Microbiology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Lammens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - G Restuccia
- Department of Anaesthesiology and Intensive Care Medicine, University of Catania, Catania, Italy
| | - J Schrenzel
- Bacteriology Laboratory, Service of Infectious Diseases, University of Geneva Hospitals and Medical Faculty, Geneva, Switzerland
| | - D H Huson
- Algorithms in Bioinformatics, University of Tübingen and International Max Planck Research School, Tübingen, Germany
| | - B Carević
- Department for Hospital Epidemiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - L Preoţescu
- National Institute for Infectious Diseases, University of Medicine 'Carol Davila', Bucharest, Romania
| | - Y Carmeli
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; National Centre for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
| | - M Kazma
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; National Centre for Infection Control, Israel Ministry of Health, Tel Aviv, Israel
| | - T Spanu
- Institute of Microbiology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy
| | - E Carrara
- Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Italy
| | - S Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - B P Gladstone
- Division of Infectious Disease, Department of Internal Medicine I, Tübingen University Hospital, Tübingen, Germany
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De Backer S, Xavier B, Vanjari L, Coppens J, Lammens C, Vemu L, Carevic B, Hryniewicz W, Jorens P, Kumar-Singh S, Lee A, Harbarth S, Schrenzel J, Tacconelli E, Goossens H, Malhotra-Kumar S. Remarkable geographical variations between India and Europe in carriage of the staphylococcal surface protein-encoding sasX/sesI and in the population structure of methicillin-resistant Staphylococcus aureus belonging to clonal complex 8. Clin Microbiol Infect 2019; 25:628.e1-628.e7. [DOI: 10.1016/j.cmi.2018.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/10/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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Stewardson AJ, Vervoort J, Adriaenssens N, Coenen S, Godycki-Cwirko M, Kowalczyk A, Huttner BD, Lammens C, Malhotra-Kumar S, Goossens H, Harbarth S. Effect of outpatient antibiotics for urinary tract infections on antimicrobial resistance among commensal Enterobacteriaceae: a multinational prospective cohort study. Clin Microbiol Infect 2018; 24:972-979. [PMID: 29331548 DOI: 10.1016/j.cmi.2017.12.026] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/18/2017] [Accepted: 12/31/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We quantified the impact of antibiotics prescribed in primary care for urinary tract infections (UTIs) on intestinal colonization by ciprofloxacin-resistant (CIP-RE) and extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE), while accounting for household clustering. METHODS Prospective cohort study from January 2011 to August 2013 at primary care sites in Belgium, Poland and Switzerland. We recruited outpatients requiring antibiotics for suspected UTIs or asymptomatic bacteriuria (exposed patients), outpatients not requiring antibiotics (non-exposed patients), and one to three household contacts for each patient. Faecal samples were tested for CIP-RE, ESBL-PE, nitrofurantoin-resistant Enterobacteriaceae (NIT-RE) and any Enterobacteriaceae at baseline (S1), end of antibiotics (S2) and 28 days after S2 (S3). RESULTS We included 300 households (205 exposed, 95 non-exposed) with 716 participants. Most exposed patients received nitrofurans (86; 42%) or fluoroquinolones (76; 37%). CIP-RE were identified in 16% (328/2033) of samples from 202 (28%) participants. Fluoroquinolone treatment caused transient suppression of Enterobacteriaceae (S2) and subsequent two-fold increase in CIP-RE prevalence at S3 (adjusted prevalence ratio (aPR) 2.0, 95% CI 1.2-3.4), with corresponding number-needed-to-harm of 12. Nitrofurans had no impact on CIP-RE (aPR 1.0, 95% CI 0.5-1.8) or NIT-RE. ESBL-PE were identified in 5% (107/2058) of samples from 71 (10%) participants, with colonization not associated with antibiotic exposure. Household exposure to CIP-RE or ESBL-PE was associated with increased individual risk of colonization: aPR 1.8 (95% CI 1.3-2.5) and 3.4 (95% CI 1.3-9.0), respectively. CONCLUSIONS These findings support avoidance of fluoroquinolones for first-line UTI therapy in primary care, and suggest potential for interventions that interrupt household circulation of resistant Enterobacteriaceae.
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Affiliation(s)
- A J Stewardson
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Department of Medicine (Austin Health), University of Melbourne, Melbourne, Australia; Department of Infectious Diseases, Monash University and Alfred Health, Melbourne, Australia.
| | - J Vervoort
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - N Adriaenssens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Centre for General Practice, Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium
| | - S Coenen
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Centre for General Practice, Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium
| | - M Godycki-Cwirko
- Faculty of Health Sciences, Division of Public Health, Medical University of Lodz, Łódź, Poland; Centre for Family and Community Medicine, Medical University of Lodz, Łódź, Poland
| | - A Kowalczyk
- Centre for Family and Community Medicine, Medical University of Lodz, Łódź, Poland
| | - B D Huttner
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Division of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Lammens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - S Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - H Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - S Harbarth
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; Division of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
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Xavier BB, Lammens C, Butaye P, Goossens H, Malhotra-Kumar S. Complete sequence of an IncFII plasmid harbouring the colistin resistance genemcr-1isolated from Belgian pig farms. J Antimicrob Chemother 2016; 71:2342-4. [DOI: 10.1093/jac/dkw191] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kostyanev T, Strateva T, Xavier BB, Marteva-Proevska Y, Lammens C, Markova B, Goossens H, Malhotra-Kumar S. Detection and characterization of two NDM-1-producingKlebsiella pneumoniaestrains from Bulgaria. J Antimicrob Chemother 2016; 71:1428-30. [DOI: 10.1093/jac/dkv471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bahrami S, Lee AS, Harbarth S, Malhotra-Kumar S, Brun-Buisson C, Durand-Zaleski I. Workload associated with mrsa control in surgery: a prospective study alongside a controlled clinical trial. Antimicrob Resist Infect Control 2015. [PMCID: PMC4475084 DOI: 10.1186/2047-2994-4-s1-p188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sabirova JS, Hernalsteens JP, De Backer S, Xavier BB, Moons P, Turlej-Rogacka A, De Greve H, Goossens H, Malhotra-Kumar S. Fatty acid kinase A is an important determinant of biofilm formation in Staphylococcus aureus USA300. BMC Genomics 2015; 16:861. [PMID: 26502874 PMCID: PMC4623894 DOI: 10.1186/s12864-015-1956-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/25/2015] [Indexed: 01/09/2023] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA)-USA300 is notorious for its ability to cause community- and healthcare-acquired infections, which are even more difficult to treat when associated with a biofilm phenotype. We aimed to characterize the genetic determinants of biofilm formation in a USA300 skin abscess isolate (UAS391) that formed prolific biofilms. Methods USA300 S. aureus strains, TCH1516 and FPR3757, were found to be closely related based on whole genome mapping (Argus™ Optical Mapping System, Opgen Inc, Gaithersburg, USA) to UAS391 (96.3-99.1 % similarity, P=0.0151), however differed markedly in biofilm formation (P=0.0001) on a dynamic assay (BioFlux 200, Fluxion Biosciences, USA). Comparison of whole genome sequences of these strains identified differences in a total of 18 genes. Corresponding Tn (bursa aurealis-bearing) knockout mutants in these target genes were obtained from a publicly available mutant library of the same clonal lineage (USA300-JE2) and were characterized phenotypically for biofilm formation. Tn mutants showing significant differences in biofilm formation were utilized for transduction into a plasmid-cured erythromycin-sensitive derivative of UAS391 and for complementation experiments. All strains were tested on the dynamic assay, and 17h-biofilms were stained (SYTO9, Life Technologies) and fluorescence intensity quantified by microscopy (Zeiss, ImageJ). Gene expression levels in Tn and transduced mutants were studied by quantitative reverse transcriptase PCR (StepOnePlusTM, Applied Biosystems®). Results Comparison of the sequenced genomes of TCH1516, FPR3757 and UAS391 yielded a limited number of variant genes (n=18) that were hypothesized to account for the observed difference in biofilm-forming capacity. Screening of Tn mutants disrupted in these target genes identified one mutant (NE229) bearing a transposon insertion in SAUSA300_1119 (fakA), which exhibited increased biofilm formation similar to UAS391 (P=0.9320). Transduction experiments confirmed that fakA::Tn corresponded to 1.9- to 4.6-fold increase in biofilm formation depending on the USA300 strain background (P≤0.0007), while complementation of the TCH1516 wild-type fakA allele in UAS391 resulted in a 4.3-fold reduction in biofilm formation (P<0.0001). Conclusions This sequential approach, consisting of strain typing, genome comparison and functional genomics, identified fakA, a recently described fatty acid kinase in S. aureus that is essential for phospholipid synthesis and also impacts the transcription of numerous virulence factors, as a negative regulator of biofilm formation in S. aureus USA300. Electronic supplementary material The online version of this article (doi:10.1186/s12864-015-1956-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J S Sabirova
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.,Viral Genetics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - J-P Hernalsteens
- Viral Genetics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - S De Backer
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - B B Xavier
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - P Moons
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - A Turlej-Rogacka
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - H De Greve
- Structural Biology Brussels, Vrije Universiteit Brussel, Brussels, Belgium.,Structural and Molecular Microbiology, Structural Biology Research Center, VIB, Brussels, Belgium
| | - H Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - S Malhotra-Kumar
- Department of Medical Microbiology, Campus Drie Eiken, University of Antwerp, S6, Universiteitsplein 1, B-2610, Wilrijk, Belgium.
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Stewardson A, Gaïa N, François P, Malhotra-Kumar S, Delémont C, Martinez de Tejada B, Schrenzel J, Harbarth S, Lazarevic V. Collateral damage from oral ciprofloxacin versus nitrofurantoin in outpatients with urinary tract infections: a culture-free analysis of gut microbiota. Clin Microbiol Infect 2015; 21:344.e1-11. [DOI: 10.1016/j.cmi.2014.11.016] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 01/25/2023]
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Papagiannitsis CC, Izdebski R, Baraniak A, Fiett J, Herda M, Hrabák J, Derde LPG, Bonten MJM, Carmeli Y, Goossens H, Hryniewicz W, Brun-Buisson C, Gniadkowski M, Grabowska A, Nikonorow E, Dautzenberg MJ, Adler A, Kazma M, Navon-Venezia S, Malhotra-Kumar S, Lammens C, Legrand P, Annane D, Chalfine A, Giamarellou H, Petrikkos GL, Nardi G, Balode A, Dumpis U, Stammet P, Arag I, Esteves F, Muzlovic I, Tomic V, Mart AT, Lawrence C, Salomon J, Paul M, Lerman Y, Rossini A, Salvia A, Samso JV, Fierro J. Survey of metallo-β-lactamase-producing Enterobacteriaceae colonizing patients in European ICUs and rehabilitation units, 2008–11. J Antimicrob Chemother 2015; 70:1981-8. [DOI: 10.1093/jac/dkv055] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/07/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- C. C. Papagiannitsis
- National Medicines Institute, Warsaw, Poland
- Faculty of Medicine in Plzeň, Charles University in Prague, Plzeň, Czech Republic
| | - R. Izdebski
- National Medicines Institute, Warsaw, Poland
| | - A. Baraniak
- National Medicines Institute, Warsaw, Poland
| | - J. Fiett
- National Medicines Institute, Warsaw, Poland
| | - M. Herda
- National Medicines Institute, Warsaw, Poland
| | - J. Hrabák
- Faculty of Medicine in Plzeň, Charles University in Prague, Plzeň, Czech Republic
| | - L. P. G. Derde
- University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Y. Carmeli
- Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
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Burns A, Shore AC, Brennan GI, Coleman DC, Egan J, Fanning S, Galligan MC, Gibbons JF, Gutierrez M, Malhotra-Kumar S, Markey BK, Sabirova JS, Wang J, Leonard FC. A longitudinal study of Staphylococcus aureus colonization in pigs in Ireland. Vet Microbiol 2014; 174:504-513. [PMID: 25465665 DOI: 10.1016/j.vetmic.2014.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 02/08/2023]
Abstract
The emergence of methicillin-resistant Staphylococcus aureus (MRSA) in livestock has refocused attention on S. aureus colonization and transmission in pigs. This study investigated the effect of the S. aureus colonization status of a sow on the colonization status of her piglets, and whether pigs carry the same strain of S. aureus throughout production. Nasal swabs were collected from the piglets of six healthy sows two days after birth and two days before and two days after they were moved into each production stage. The average prevalence of S. aureus colonization varied between 26% and 73%. The odds of being S. aureus positive were almost 12 times higher for piglets born to nasal-positive sows than for those born to nasal-negative sows, and three times higher again for piglets born to sows that were both nasal- and vaginal-positive. Isolates recovered from piglets immediately after birth were indistinguishable from those of the dam as determined by phenotypic and molecular typing, including microarray analysis and optical mapping. All isolates belonged to clonal complex 9 and the majority exhibited a novel spa type, t10449. The findings show that the S. aureus colonization status of the sow influences the colonization status of her piglets in the early production stages but strains carried by pigs change over time. Multiresistant S. aureus was detected, in particular post-weaning. Results suggest that sow status and management practices, including mixing of pigs and antimicrobial usage at weaning, should be considered when implementing control measures for S. aureus on a farm.
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Affiliation(s)
- A Burns
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - A C Shore
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Ireland; Department of Clinical Microbiology, School of Medicine, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland
| | - G I Brennan
- Department of Clinical Microbiology, School of Medicine, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland
| | - D C Coleman
- Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Ireland
| | - J Egan
- National Reference Laboratory for Antimicrobial Resistance (Food, Feed and Animal Health), Department of Agriculture, Food and the Marine, Backweston Laboratories, Celbridge, Co. Kildare, Ireland
| | - S Fanning
- School of Public Health, Physiotherapy and Population Science, Science Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - M C Galligan
- School of Mathematical Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - J F Gibbons
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - M Gutierrez
- National Reference Laboratory for Antimicrobial Resistance (Food, Feed and Animal Health), Department of Agriculture, Food and the Marine, Backweston Laboratories, Celbridge, Co. Kildare, Ireland
| | - S Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - B K Markey
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - J S Sabirova
- Laboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - J Wang
- School of Public Health, Physiotherapy and Population Science, Science Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - F C Leonard
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
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Adler A, Baraniak A, Izdebski R, Fiett J, Salvia A, Samso JV, Lawrence C, Solomon J, Paul M, Lerman Y, Schwartzberg Y, Mordechai E, Rossini A, Fierro J, Lammens C, Malhotra-Kumar S, Goossens H, Hryniewicz W, Brun-Buisson C, Gniadkowski M, Carmeli Y. A multinational study of colonization with extended spectrum β-lactamase-producing Enterobacteriaceae in healthcare personnel and family members of carrier patients hospitalized in rehabilitation centres. Clin Microbiol Infect 2014; 20:O516-23. [PMID: 24450778 DOI: 10.1111/1469-0691.12560] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/05/2013] [Accepted: 12/15/2013] [Indexed: 11/28/2022]
Abstract
The study aims were: (i) to define the prevalence of and risk factors for colonization by extended spectrum β-lactamase (ESBL) -producing Enterobacteriaceae (EPE) among healthcare workers (HCWs) and family members (FMs) of EPE-colonized patients in rehabilitation units and (ii) to compare EPE isolates from these three groups. The study included 286 FMs of 194 EPE-carrying patients identified in five rehabilitation units located in Israel, Italy, France and Spain. The EPE were detected in rectal swabs from 26 (9%) of 286 FMs screened. In multivariate analyses, older age of FM, greater mean number of hours spent with the patient, being a daughter or a female spouse of a patient, and chronic lung disease of the patient were significantly associated with carriage in the FM. Escherichia coli was the most common organism (76%), followed by Klebsiella pneumoniae (19%). Isolates were typed by pulsed field gel electrophoresis and multilocus sequence typing, and ESBLs were identified by PCR sequencing. A comparison of paired species isolates from FMs and their respective patient showed that 17 of 23 strains were indistinguishable. EPE were detected in 35 (3.5%, E. coli = 34) of the 1001 HCWs screened. Feeding patients was associated with EPE carriage by HCWs. Only 7 of 23 E. coli subclones cultured from HCWs were also represented among 376 patient-derived ESBL-producing E. coli isolates from the same rehabilitation units. In Spain, a higher proportion of HCWs and FMs were ESBL carriers than elsewhere (p <0.05). In conclusion, the molecular and epidemiological data suggest that FMs are at higher risk of EPE acquisition from their relative patients than HCWs.
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Affiliation(s)
- A Adler
- Division of Epidemiology, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel
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15
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Adler A, Gniadkowski M, Baraniak A, Izdebski R, Fiett J, Hryniewicz W, Malhotra-Kumar S, Goossens H, Lammens C, Lerman Y, Kazma M, Kotlovsky T, Carmeli Y, MOSAR. Transmission dynamics of ESBL-producing Escherichia coli clones in rehabilitation wards at a tertiary care centre. Clin Microbiol Infect 2012; 18:E497-505. [DOI: 10.1111/j.1469-0691.2012.03999.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Pan A, Lee A, Cooper B, Chalfine A, Daikos GL, Garilli S, Goossens H, Malhotra-Kumar S, Martínez JA, Patroni A, Harbarth S. Risk factors for previously unknown meticillin-resistant Staphylococcus aureus carriage on admission to 13 surgical wards in Europe. J Hosp Infect 2012. [PMID: 23201397 DOI: 10.1016/j.jhin.2012.09.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Early identification of meticillin-resistant Staphylococcus aureus (MRSA) carriers may be helpful for clinical and epidemiological reasons. AIM To identify and compare risk factors of previously unknown MRSA carriage on admission to 13 surgical wards in France, Greece, Italy, and Spain. METHODS The study was a prospective observational cohort study which enrolled consecutive patients screened for MRSA on admission to surgical wards. Sociodemographic data, comorbidities and possible risk factors for MRSA were recorded. A multivariate logistic regression model was used to predict probabilities of previously unknown MRSA colonization on admission based on patient characteristics. Prediction rules for MRSA carriage were developed and evaluated using the c-statistic. FINDINGS Of 2901 patients enrolled, admission screening identified 111 (3.8%) new MRSA carriers. Independent risk factors for MRSA carriage were urinary catheterization (odds ratio: 4.4; 95% confidence interval: 2.0-9.9), nursing home residency (3.8; 1.9-7.7), chronic skin disease (2.9; 1.5-5.8), wounds/ulcers (2.4; 1.5-4.0), recent hospitalization (2.2; 1.5-3.3), diabetes (1.6, 1.02-2.5), and age >70 years (1.5; 1.03-2.3). However, risk factors varied between centres. The c-statistic for the common prediction rule for all centres was 0.64, indicating limited predictive power. CONCLUSIONS Risk profiles for MRSA carriers vary between surgical wards in European countries. Identifying local risk factors is important, as a common European prediction rule was found to be of limited clinical value.
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Affiliation(s)
- A Pan
- Istituti Ospitalieri di Cremona, Cremona, Italy.
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17
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Van Heirstraeten L, Leten G, Lammens C, Goossens H, Malhotra-Kumar S. Increase in fluoroquinolone non-susceptibility among clinical Streptococcus pyogenes in Belgium during 2007-10. J Antimicrob Chemother 2012; 67:2602-5. [DOI: 10.1093/jac/dks281] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Lee A, Carmeli Y, Chalfine A, Derde L, Malhotra-Kumar S, Martínez JA, Salomon J, Torres A, Vidal J, Harbarth S. Prevalence and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission to different hospital sectors in two European countries. BMC Proc 2011. [PMCID: PMC3239498 DOI: 10.1186/1753-6561-5-s6-o81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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19
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Pan A, Lee A, Cooper B, Chalfine A, Daikos G, Garilli S, Malhotra-Kumar S, Martinez JA, Patroni A, Harbarth S. Risk factors for previously unknown methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission to 13 surgical wards in Europe. BMC Proc 2011. [PMCID: PMC3239502 DOI: 10.1186/1753-6561-5-s6-o85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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20
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Gazin M, Lammens C, Goossens H, Malhotra-Kumar S. Evaluation of GeneOhm VanR and Xpert vanA/vanB molecular assays for the rapid detection of vancomycin-resistant enterococci. Eur J Clin Microbiol Infect Dis 2011; 31:273-6. [PMID: 21667270 DOI: 10.1007/s10096-011-1306-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 05/13/2011] [Indexed: 11/28/2022]
Abstract
Rapid diagnosis is critical for treating and preventing infections due to vancomycin-resistant enterococci (VRE). We assessed the performance of GeneOhm VanR and Xpert vanA/vanB assays that detect vanA and vanB, the two most important genes encoding vancomycin resistance, utilizing 50 stool samples from renal dialysis patients, as well as well-characterized VRE strains. Stool samples were screened for the presence of VRE by culture followed by polymerase chain reaction (PCR) for the detection of van genes in isolates. Furthermore, the direct detection of vanA/vanB from aerobically and anaerobically pre-enriched stools was performed by in-house PCR sequencing. GeneOhm was less sensitive (43.5% vs. 73.9%) and more specific (100% vs. 92.6%) than Xpert in detecting vanA from stool samples. vanB detection by GeneOhm was more sensitive than Xpert (100% vs. 87.5%), but equally non-specific (20.6% vs. 14.7%). A further estimation on log-serial dilutions of VRE strains showed that Xpert was more sensitive at detecting VRE at low concentrations (10-100 colony forming units [cfu]/ml).
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Affiliation(s)
- M Gazin
- National Reference Centre for Enterococcus spp., Department of Medical Microbiology, Vaccine and Infectious Disease Institute, Universiteit Antwerpen, Antwerp, Belgium
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Goossens H, Malhotra-Kumar S, Eraksoy H, Unal S, Grabein B, Masterton R, Mendes C, Garcia-Rodriguez JA, Russo G, Jones RN. Results of two worldwide surveys into physician awareness and perceptions of extended-spectrum β-lactamases. Clin Microbiol Infect 2004; 10:760-2. [PMID: 15301682 DOI: 10.1111/j.1469-0691.2004.00957.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An omnibus survey of microbiologists (n = 400) and a survey of participants (n = 49) in the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) programme were conducted to determine the awareness and prevalence of extended-spectrum beta-lactamases (ESBLs), and the regularity and method of screening. Of the omnibus survey participants, 69% screened regularly for ESBLs, compared with 83% of MYSTIC participants. In both surveys, ESBLs were more common in Klebsiella pneumoniae (73% and 79%, respectively) and Escherichia coli (63% and 81%, respectively) than in other bacteria. The surveys demonstrated that awareness of, and testing for, ESBLs is inconsistent.
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Affiliation(s)
- H Goossens
- Department of Microbiology, University Hospital, Antwerp, Belgium.
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