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Nayiga S, MacPherson EE, Mankhomwa J, Nasuwa F, Pongolani R, Kabuleta R, Kesby M, Dacombe R, Hilton S, Grace D, Feasey N, Chandler CI. "Arming half-baked people with weapons!" Information enclaving among professionals and the need for a care-centred model for antibiotic use information in Uganda, Tanzania and Malawi. Glob Health Action 2024; 17:2322839. [PMID: 38441912 PMCID: PMC10916894 DOI: 10.1080/16549716.2024.2322839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The overuse of antimicrobial medicines is a global health concern, including as a major driver of antimicrobial resistance. In many low- and middle-income countries, a substantial proportion of antibiotics are purchased over-the-counter without a prescription. But while antibiotics are widely available, information on when and how to use them is not. OBJECTIVE We aimed to understand the acceptability among experts and professionals of sharing information on antibiotic use with end users - patients, carers and farmers - in Uganda, Tanzania and Malawi. METHODS Building on extended periods of fieldwork amongst end-users and antibiotic providers in the three countries, we conducted two workshops in each, with a total of 44 medical and veterinary professionals, policy makers and drug regulators, in December 2021. We carried out extensive documentary and literature reviews to characterise antibiotic information systems in each setting. RESULTS Participants reported that the general public had been provided information on medicine use in all three countries by national drug authorities, health care providers and in package inserts. Participants expressed concern over the danger of sharing detailed information on antibiotic use, particularly that end-users are not equipped to determine appropriate use of medicines. Sharing of general instructions to encourage professionally-prescribed practices was preferred. CONCLUSIONS Without good access to prescribers, the tension between enclaving and sharing of knowledge presents an equity issue. Transitioning to a client care-centred model that begins with the needs of the patient, carer or farmer will require sharing unbiased antibiotic information at the point of care.
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Affiliation(s)
- Susan Nayiga
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Eleanor E MacPherson
- Research and Innovation Services, University of Glasgow, Glasgow, UK
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - John Mankhomwa
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | | | | | - Rita Kabuleta
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Mike Kesby
- School of Geography & Sustainable Development, University of St Andrews, St Andrews, UK
| | - Russell Dacombe
- Research and Innovation Services, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Delia Grace
- Natural Resources Institute, University of Greenwich, Chatham, UK
- International Livestock Research Institute, Nairobi, Kenya
| | - Nicholas Feasey
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
- The School of Medicine, University of St Andrews, St Andrews, UK
| | - Clare I.R. Chandler
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
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Jin C, Jia C, Hu W, Xu H, Shen Y, Yue M. Predicting antimicrobial resistance in E. coli with discriminative position fused deep learning classifier. Comput Struct Biotechnol J 2024; 23:559-565. [PMID: 38274998 PMCID: PMC10809114 DOI: 10.1016/j.csbj.2023.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Escherichia coli (E. coli) has become a particular concern due to the increasing incidence of antimicrobial resistance (AMR) observed worldwide. Using machine learning (ML) to predict E. coli AMR is a more efficient method than traditional laboratory testing. However, further improvement in the predictive performance of existing models remains challenging. In this study, we collected 1937 high-quality whole genome sequencing (WGS) data from public databases with an antimicrobial resistance phenotype and modified the existing workflow by adding an attention mechanism to enable the modified workflow to focus more on core single nucleotide polymorphisms (SNPs) that may significantly lead to the development of AMR in E. coli. While comparing the model performance before and after adding the attention mechanism, we also performed a cross-comparison among the published models using random forest (RF), support vector machine (SVM), logistic regression (LR), and convolutional neural network (CNN). Our study demonstrates that the discriminative positional colors of Chaos Game Representation (CGR) images can selectively influence and highlight genome regions without prior knowledge, enhancing prediction accuracy. Furthermore, we developed an online tool (https://github.com/tjiaa/E.coli-ML/tree/main) for assisting clinicians in the rapid prediction of the AMR phenotype of E. coli and accelerating clinical decision-making.
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Affiliation(s)
- Canghong Jin
- School of Computer and Computing Science, Hangzhou City University, Hangzhou 310015, China
| | - Chenghao Jia
- Institute of Preventive Veterinary Sciences and Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou 310058, China
| | - Wenkang Hu
- School of Computer and Computing Science, Hangzhou City University, Hangzhou 310015, China
- College of Computer Science and Technology, Zhejiang University, Hangzhou 310027, China
| | - Haidong Xu
- School of Computer and Computing Science, Hangzhou City University, Hangzhou 310015, China
| | - Yanyi Shen
- School of Computer and Computing Science, Hangzhou City University, Hangzhou 310015, China
| | - Min Yue
- Institute of Preventive Veterinary Sciences and Department of Veterinary Medicine, Zhejiang University College of Animal Sciences, Hangzhou 310058, China
- Hainan Institute of Zhejiang University, Sanya 572000, China
- Zhejiang Provincial Key Laboratory of Preventive Veterinary Medicine, Hangzhou 310058, China
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China
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3
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Wang N, Zheng X, Leptihn S, Li Y, Cai H, Zhang P, Wu W, Yu Y, Hua X. Characteristics and phylogenetic distribution of megaplasmids and prediction of a putative chromid in Pseudomonas aeruginosa. Comput Struct Biotechnol J 2024; 23:1418-1428. [PMID: 38616963 PMCID: PMC11015739 DOI: 10.1016/j.csbj.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024] Open
Abstract
Research on megaplasmids that contribute to the spread of antimicrobial resistance (AMR) in Pseudomonas aeruginosa strains has grown in recent years due to the now widely used technologies allowing long-read sequencing. Here, we systematically analyzed distinct and consistent genetic characteristics of megaplasmids found in P. aeruginosa. Our data provide information on their phylogenetic distribution and hypotheses tracing the potential evolutionary paths of megaplasmids. Most of the megaplasmids we found belong to the IncP-2-type, with conserved and syntenic genetic backbones carrying modules of genes associated with chemotaxis apparatus, tellurite resistance and plasmid replication, segregation, and transmission. Extensively variable regions harbor abundant AMR genes, especially those encoding β-lactamases such as VIM-2, IMP-45, and KPC variants, which are high-risk elements in nosocomial infection. IncP-2 megaplasmids act as effective vehicles transmitting AMR genes to diverse regions. One evolutionary model of the origin of megaplasmids claims that chromids can develop from megaplasmids. These chromids have been characterized as an intermediate between a megaplasmid and a chromosome, also containing core genes that can be found on the chromosome but not on the megaplasmid. Using in silico prediction, we identified the "PABCH45 unnamed replicon" as a putative chromid in P. aeruginosa, which shows a much higher similarity and closer phylogenetic relationship to chromosomes than to megaplasmids while also encoding plasmid-like partition genes. We propose that such a chromid could facilitate genome expansion, allowing for more rapid adaptations to novel ecological niches or selective conditions, in comparison to megaplasmids.
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Affiliation(s)
- Nanfei Wang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xuan Zheng
- Department of Nephrology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Sebastian Leptihn
- HMU Health and Medical University, Am Anger 64/73 – 99084, Erfurt, Germany
- Deutsches Zentrum für Infektionsforschung (DZIF) Translational Phage-Network, Inhoffenstraße 7 – 38124, Braunschweig, Germany
- University of Southern Denmark,Department of Biochemistry and Molecular Biology, Campusvej 55 – 5230, Odense, Denmark
| | - Yue Li
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Heng Cai
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Piaopiao Zhang
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenhao Wu
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunsong Yu
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoting Hua
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
- Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Lee AWT, Ng ICF, Wong EYK, Wong ITF, Sze RPP, Chan KY, So TY, Zhang Z, Ka-Yee Fung S, Choi-Ying Wong S, Tam WY, Lao HY, Lee LK, Leung JSL, Chan CTM, Ng TTL, Zhang J, Chow FWN, Leung PHM, Siu GKH. Comprehensive identification of pathogenic microbes and antimicrobial resistance genes in food products using nanopore sequencing-based metagenomics. Food Microbiol 2024; 121:104493. [PMID: 38637066 DOI: 10.1016/j.fm.2024.104493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 04/20/2024]
Abstract
Foodborne pathogens, particularly antimicrobial-resistant (AMR) bacteria, remain a significant threat to global health. Given the limitations of conventional culture-based approaches, which are limited in scope and time-consuming, metagenomic sequencing of food products emerges as a promising solution. This method provides a fast and comprehensive way to detect the presence of pathogenic microbes and antimicrobial resistance genes (ARGs). Notably, nanopore long-read sequencing provides more accurate bacterial taxonomic classification in comparison to short-read sequencing. Here, we revealed the impact of food types and attributes (origin, retail place, and food processing methods) on microbial communities and the AMR profile using nanopore metagenomic sequencing. We analyzed a total of 260 food products, including raw meat, sashimi, and ready-to-eat (RTE) vegetables. Clostridium botulinum, Acinetobacter baumannii, and Vibrio parahaemolyticus were identified as the top three foodborne pathogens in raw meat and sashimi. Importantly, even with low pathogen abundance, higher percentages of samples containing carbapenem and cephalosporin resistance genes were identified in chicken and RTE vegetables, respectively. In parallel, our results demonstrated that fresh, peeled, and minced foods exhibited higher levels of pathogenic bacteria. In conclusion, this comprehensive study offers invaluable data that can contribute to food safety assessments and serve as a basis for quality indicators.
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Affiliation(s)
- Annie Wing-Tung Lee
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Iain Chi-Fung Ng
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Evelyn Yin-Kwan Wong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Ivan Tak-Fai Wong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Rebecca Po-Po Sze
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Kit-Yu Chan
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Tsz-Yan So
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Zhipeng Zhang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Sharon Ka-Yee Fung
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Sally Choi-Ying Wong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Wing-Yin Tam
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Hiu-Yin Lao
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Lam-Kwong Lee
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Jake Siu-Lun Leung
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Chloe Toi-Mei Chan
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Timothy Ting-Leung Ng
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Jiaying Zhang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Franklin Wang-Ngai Chow
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Polly Hang-Mei Leung
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Gilman Kit-Hang Siu
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
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5
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Montgomery DR, Rabinowitz P, Sipos Y, Wheat EE. Soil health: A common focus for one health and planetary health interventions. One Health 2024; 18:100673. [PMID: 38283832 PMCID: PMC10820383 DOI: 10.1016/j.onehlt.2023.100673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024] Open
Abstract
Proponents of both the One Health and Planetary Health paradigms have acknowledged that current methods of agricultural food production are driving many environmental changes with negative human health consequences, including climate change, deforestation, and the emergence of zoonotic disease and antimicrobial resistance. Currently, the training of human health, veterinary, and public health professionals typically does not include aspects of soil health. Much of the resultant discussion in One Health and Planetary Health circles regarding interventions to address the health impact of agricultural practices has focused on measures such as advocating for dietary change toward plant based diets and increasing food safety, biosecurity, disease surveillance and antimicrobial stewardship. A greater understanding of soil health and its relationship to agricultural practices could prove foundational to many of the problems that the One Health and Planetary Health perspectives aim to address, including antimicrobial resistance, zoonotic disease emergence, food security, and climate change. A consequent global focus on the health of soils offers a promise of specific opportunities for preventive interventions and a greater convergence between the One Health and Planetary Health approaches.
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Affiliation(s)
- David R. Montgomery
- Department of Earth and Space Sciences, University of Washington, United States of America
| | - Peter Rabinowitz
- Environmental and Occupational Health Sciences, University of Washington, United States of America
| | - Yona Sipos
- Environmental and Occupational Health Sciences, University of Washington, United States of America
| | - Eli E. Wheat
- School of Environmental and Forest Sciences, University of Washington, United States of America
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6
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Sharma G, Dey TK, Hazarika RA, Shome BR, Shome R, Singh VP, Deka RP, Grace D, Lindahl JF. Knowledge and practices related to antibiotics among poultry producers and veterinarians in two Indian states. One Health 2024; 18:100700. [PMID: 38516289 PMCID: PMC10955645 DOI: 10.1016/j.onehlt.2024.100700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/21/2024] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
Background Antibiotics are frequently utilized in livestock, particularly poultry, for therapy and growth promotion, resulting in antimicrobial resistance. Multidrug-resistant bacteria are frequent in poultry samples from India. The purpose of this study was to better understand main antibiotic consumption patterns in poultry value chains, as well as antibiotic knowledge and practices among the stakeholders. Methods A cross-sectional survey was conducted in Assam and Karnataka, India. The poultry farmers were interviewed on antibiotic usage, antibiotic knowledge, feeding practices, and preventive measures on the farm. Poultry farmers reported their veterinarians, and we also interviewed them on knowledge and practices related to antimicrobial use in poultry and antimicrobial resistance. Item response theory (IRT) was used to assess the association between the answers and demographic factors. Results This survey interviewed 62 poultry farmers and 11 veterinarians. Small poultry farms with fewer than 4000 birds were owned by 51.6% of farmers. Most poultry farmers had heard about antibiotics, and 62.9% thought they cured all diseases. If one chicken is sick, 72.6% said others should be given antibiotics to prevent the disease. All veterinarians utilized tetracyclines, aminoglycosides, and cephalexin on the poultry farms. Over half (54.5%) stated antibiotics prevent diseases, and 72.7% said they treat and prevent diseases. Some (45.5%) said antibiotics boost growth. IRT analysis showed that 8 questions assessed a knowledge scale well. Univariable analysis showed that Assam farmers and women were likely to have have more knowledge. Conclusion The poultry farmers were mostly unaware of the relation between antibiotic use and antimicrobial resistance. Despite being aware, the veterinarians agreed with use antibiotics as a prophylactic measure. It is vital that these stakeholders understand the repercussions of such widespread antibiotic use. In order to increase knowledge, frequent trainings and antimicrobial stewardship programmes with effective communication and incentives for behaviour change should be conducted.
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Affiliation(s)
- Garima Sharma
- Department of Biosciences, International Livestock Research Institute, Nairobi, Kenya
- Deparment of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Tushar Kumar Dey
- Department of Biosciences, International Livestock Research Institute, Nairobi, Kenya
- Deparment of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- National Institute of Veterinary Epidemiology and Disease Informatics, Bangalore, India
| | - Razibuddin Ahmed Hazarika
- Department of Veterinary Public Health and Epidemiology, Assam Agricultural University, Jorahat, India
| | - Bibek Ranjan Shome
- National Institute of Veterinary Epidemiology and Disease Informatics, Bangalore, India
| | - Rajeshwari Shome
- National Institute of Veterinary Epidemiology and Disease Informatics, Bangalore, India
| | - Vijay Pal Singh
- Institute of Genomics and Integrative Biology, Council of Scientific and Industrial Research, Delhi, India
| | - Ram Pratim Deka
- Department of Biosciences, International Livestock Research Institute, Nairobi, Kenya
| | - Delia Grace
- Department of Biosciences, International Livestock Research Institute, Nairobi, Kenya
- Food and Markets Department, Natural Resources Institute, Chatham, United Kingdom
| | - Johanna F. Lindahl
- Department of Biosciences, International Livestock Research Institute, Nairobi, Kenya
- Deparment of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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7
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McConn BR, Kraft AL, Durso LM, Ibekwe AM, Frye JG, Wells JE, Tobey EM, Ritchie S, Williams CF, Cook KL, Sharma M. An analysis of culture-based methods used for the detection and isolation of Salmonella spp., Escherichia coli, and Enterococcus spp. from surface water: A systematic review. Sci Total Environ 2024; 927:172190. [PMID: 38575025 DOI: 10.1016/j.scitotenv.2024.172190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/14/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024]
Abstract
Identification of methods for the standardized assessment of bacterial pathogens and antimicrobial resistance (AMR) in environmental water can improve the quality of monitoring and data collected, support global surveillance efforts, and enhance the understanding of environmental water sources. We conducted a systematic review to assemble and synthesize available literature that identified methods for assessment of prevalence and abundance of bacterial fecal indicators and pathogens in water for the purposes of monitoring bacterial pathogens and AMR. After screening for quality, 175 unique publications were identified from 15 databases, and data were extracted for analysis. This review identifies the most common and robust methods, and media used to isolate target organisms from surface water sources, summarizes methodological trends, and recognizes knowledge gaps. The information presented in this review will be useful when establishing standardized methods for monitoring bacterial pathogens and AMR in water in the United States and globally.
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Affiliation(s)
- Betty R McConn
- Oak Ridge Institute of Science and Education/U.S. Department of Agriculture (USDA), Agricultural Research Service, Beltsville, MD, United States of America
| | - Autumn L Kraft
- Oak Ridge Institute of Science and Education/U.S. Department of Agriculture (USDA), Agricultural Research Service, Beltsville, MD, United States of America
| | - Lisa M Durso
- USDA ARS Agroecoystem Management Research, Lincoln, NE, United States of America
| | - Abasiofiok M Ibekwe
- USDA ARS, Agricultural Water Efficiency and Salinity Research Unit, Riverside, CA, United States of America
| | - Jonathan G Frye
- USDA ARS, U.S. National Poultry Research Center, Poultry Microbiological Safety and Processing Research Unit, Athens, GA, United States of America
| | - James E Wells
- USDA ARS, U.S. Meat Animal Research Center, Meat Safety and Quality, Clay Center, NE, United States of America
| | - Elizabeth M Tobey
- USDA National Agricultural Library, Beltsville, MD, United States of America
| | - Stephanie Ritchie
- USDA National Agricultural Library, Beltsville, MD, United States of America
| | - Clinton F Williams
- USDA ARS, US Arid-Land Agricultural Research Center, Maricopa, AZ, United States of America
| | - Kimberly L Cook
- USDA ARS, Nutrition, Food Safety and Quality National Program Staff, Beltsville, MD, United States of America
| | - Manan Sharma
- USDA ARS Environmental Microbial and Food Safety Laboratory, Beltsville, MD, United States of America.
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8
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Ntshonga P, Gobe I, Koto G, Strysko J, Paganotti GM. Biocide resistance in Klebsiella pneumoniae: a narrative review. Infect Prev Pract 2024; 6:100360. [PMID: 38571564 PMCID: PMC10988060 DOI: 10.1016/j.infpip.2024.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Klebsiella pneumoniae is among the World Health Organization's list of priority pathogens, notorious for its role in causing healthcare-associated infections and neonatal sepsis globally. Containment of K. pneumoniae transmission depends on the continued effectiveness of antimicrobials and of biocides used for topical antisepsis and surface disinfection. Klebsiella pneumoniae is known to disseminate antimicrobial resistance (AMR) through a large auxiliary genome made up of plasmids, transposons and integrons, enabling it to evade antimicrobial killing through the use of efflux systems and biofilm development. Because AMR mechanisms are also known to impart tolerance to biocides, AMR is frequently linked with biocide resistance (BR). However, despite extensive research on AMR, there is a gap in knowledge about BR and the extent to which AMR and BR mechanisms overlap remains debatable. The aim of this paper is to review and summarise the current knowledge on the determinants of BR in K. pneumoniae and highlight content areas that require further inquiry.
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Affiliation(s)
- Pearl Ntshonga
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Irene Gobe
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Garesego Koto
- School of Allied Health Professions, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Jonathan Strysko
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana
- Department of Paediatric and Adolescent Health, Princess Marina Hospital, Gaborone, Botswana
- Department of Global Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Giacomo Maria Paganotti
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana
- Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
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9
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Caudell MA, Castillo C, Santos LF, Grajeda L, Romero JC, Lopez MR, Omulo S, Ning MF, Palmer GH, Call DR, Cordon-Rosales C, Smith RM, Herzig CT, Styczynski A, Ramay BM. Risk factors for colonization with extended-spectrum cephalosporin-resistant and carbapenem-resistant Enterobacterales among hospitalized patients in Guatemala: An Antibiotic Resistance in Communities and Hospitals (ARCH) study. IJID Reg 2024; 11:100361. [PMID: 38634070 PMCID: PMC11021947 DOI: 10.1016/j.ijregi.2024.100361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
Objectives The spread of extended-spectrum cephalosporin-resistant Enterobacterales (ESCrE) and carbapenem-resistant Enterobacterales (CRE) has resulted in increased morbidity, mortality, and health care costs worldwide. To identify the factors associated with ESCrE and CRE colonization within hospitals, we enrolled hospitalized patients at a regional hospital located in Guatemala. Methods Stool samples were collected from randomly selected patients using a cross-sectional study design (March-September, 2021), and samples were tested for the presence of ESCrE and CRE. Hospital-based and household variables were examined for associations with ESCrE and CRE colonization using lasso regression models, clustered by ward (n = 21). Results A total of 641 patients were enrolled, of whom complete data sets were available for 593. Colonization with ESCrE (72.3%, n = 429/593) was negatively associated with carbapenem administration (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.11-0.42) and positively associated with ceftriaxone administration (OR 1.61, 95% CI 1.02-2.53), as was reported hospital admission within 30 days of the current hospitalization (OR 2.84, 95% CI 1.19-6.80). Colonization with CRE (34.6%, n = 205 of 593) was associated with carbapenem administration (OR 2.62, 95% CI 1.39-4.97), reported previous hospital admission within 30 days of current hospitalization (OR 2.58, 95% CI 1.17-5.72), hospitalization in wards with more patients (OR 1.05, 95% CI 1.02-1.08), hospitalization for ≥4 days (OR 3.07, 95% CI 1.72-5.46), and intubation (OR 2.51, 95% CI 1.13-5.59). No household-based variables were associated with ESCrE or CRE colonization in hospitalized patients. Conclusion The hospital-based risk factors identified in this study are similar to what has been reported for risk of health care-associated infections, consistent with colonization being driven by hospital settings rather than community factors. This also suggests that colonization with ESCrE and CRE could be a useful metric to evaluate the efficacy of infection and prevention control programs in clinics and hospitals.
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Affiliation(s)
- Mark A. Caudell
- Washington State University, Paul G. Allen School for Global Health, Pullman, USA
| | - Carmen Castillo
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
| | - Lucas F. Santos
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
| | - Laura Grajeda
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
| | - Juan Carlos Romero
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
| | - Maria Renee Lopez
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
| | - Sylvia Omulo
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
- Washington State University, Global Health-Kenya, Nairobi, Kenya
| | - Mariangeli Freitas Ning
- U.S. Centers for Disease Control and Prevention, Guatemala City, Central America Regional Office, Guatemala
| | - Guy H. Palmer
- Washington State University, Paul G. Allen School for Global Health, Pullman, USA
| | - Douglas R. Call
- Washington State University, Paul G. Allen School for Global Health, Pullman, USA
| | - Celia Cordon-Rosales
- Washington State University, Paul G. Allen School for Global Health, Pullman, USA
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
| | - Rachel M. Smith
- U.S. Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, USA
| | - Carolyn T.A. Herzig
- U.S. Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, USA
| | - Ashley Styczynski
- U.S. Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, USA
| | - Brooke M. Ramay
- Washington State University, Paul G. Allen School for Global Health, Pullman, USA
- Universidad del Valle de Guatemala, Center for Health Studies, Guatemala City, Guatemala
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10
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Maree M, Ushijima Y, Fernandes PB, Higashide M, Morikawa K. SCC mec transformation requires living donor cells in mixed biofilms. Biofilm 2024; 7:100184. [PMID: 38440091 PMCID: PMC10909703 DOI: 10.1016/j.bioflm.2024.100184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) is an important human pathogen that has emerged through the horizontal acquisition of the staphylococcal cassette chromosome mec (SCCmec). Previously, we showed that SCCmec from heat-killed donors can be transferred via natural transformation in biofilms at frequencies of 10-8-10-7. Here, we show an improved transformation assay of SCCmec with frequencies up to 10-2 using co-cultured biofilms with living donor cells. The Ccr-attB system played an important role in SCCmec transfer, and the deletion of ccrAB recombinase genes reduced the frequency ∼30-fold. SCCmec could be transferred from either MRSA or methicillin-resistant coagulase-negative staphylococci to some methicillin-sensitive S. aureus recipients. In addition, the transformation of other plasmid or chromosomal genes is enhanced by using living donor cells. This study emphasizes the role of natural transformation as an evolutionary ability of S. aureus and in MRSA emergence.
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Affiliation(s)
- Mais Maree
- Institute of Medicine, University of Tsukuba, Japan
| | | | | | - Masato Higashide
- Kotobiken Medical Laboratories, Inc., Kamiyokoba, Tsukuba, Japan
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11
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Tiwari A, Lehto KM, Paspaliari DK, Al-Mustapha AI, Sarekoski A, Hokajärvi AM, Länsivaara A, Hyder R, Luomala O, Lipponen A, Oikarinen S, Heikinheimo A, Pitkänen T. Developing wastewater-based surveillance schemes for multiple pathogens: The WastPan project in Finland. Sci Total Environ 2024; 926:171401. [PMID: 38467259 DOI: 10.1016/j.scitotenv.2024.171401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
Wastewater comprises multiple pathogens and offers a potential for wastewater-based surveillance (WBS) to track the prevalence of communicable diseases. The Finnish WastPan project aimed to establish wastewater-based pandemic preparedness for multiple pathogens (viruses, bacteria, parasites, fungi), including antimicrobial resistance (AMR). This article outlines WastPan's experiences in this project, including the criteria for target selection, sampling locations, frequency, analysis methods, and results communication. Target selection relied on epidemiological and microbiological evidence and practical feasibility. Within the WastPan framework, wastewater samples were collected between 2021 and 2023 from 10 wastewater treatment plants (WWTPs) covering 40 % of Finland's population. WWTP selection was validated for reported cases of Extended Spectrum Beta-lactamase-producing bacterial pathogens (Escherichia coli and Klebsiella pneumoniae) from the National Infectious Disease Register. The workflow included 24-h composite influent samples, with one fraction for culture-based analysis (bacteria and fungi) and the rest of the sample was reserved for molecular analysis (viruses, bacteria, antibiotic resistance genes, and parasites). The reproducibility of the monitoring workflow was assessed for SARS-CoV-2 through inter-laboratory comparisons using the N2 and N1 assays. Identical protocols were applied to same-day samples, yielding similar positivity trends in the two laboratories, but the N2 assay achieved a significantly higher detection rate (Laboratory 1: 91.5 %; Laboratory 2: 87.4 %) than the N1 assay (76.6 %) monitored only in Laboratory 2 (McNemar, p < 0.001 Lab 1, = 0.006 Lab 2). This result indicates that the selection of monitoring primers and assays may impact monitoring sensitivity in WBS. Overall, the current study recommends that the selection of sampling frequencies and population coverage of the monitoring should be based on pathogen-specific epidemiological characteristics. For example, pathogens that are stable over time may need less frequent annual sampling, while those that are occurring across regions may require reduced sample coverage. Here, WastPan successfully piloted WBS for monitoring multiple pathogens, highlighting the significance of one-litre community composite wastewater samples for assessing community health. The infrastructure established for COVID-19 WBS is valuable for monitoring various pathogens. The prioritization of the monitoring targets optimizes resource utilization. In the future legislative support in target selection, coverage determination, and sustained funding for WBS is recomended.
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Affiliation(s)
- Ananda Tiwari
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio and Helsinki, Finland.
| | - Kirsi-Maarit Lehto
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
| | - Dafni K Paspaliari
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio and Helsinki, Finland; ECDC Fellowship Programme, Public Health Microbiology path (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Ahmad I Al-Mustapha
- University of Helsinki, Faculty of Veterinary Medicine, Helsinki, Finland; Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria.
| | - Anniina Sarekoski
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio and Helsinki, Finland; University of Helsinki, Faculty of Veterinary Medicine, Helsinki, Finland.
| | - Anna-Maria Hokajärvi
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio and Helsinki, Finland.
| | - Annika Länsivaara
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
| | - Rafiqul Hyder
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
| | - Oskari Luomala
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio and Helsinki, Finland.
| | - Anssi Lipponen
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio and Helsinki, Finland.
| | - Sami Oikarinen
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
| | - Annamari Heikinheimo
- University of Helsinki, Faculty of Veterinary Medicine, Helsinki, Finland; Finnish Food Authority, Seinäjoki, Finland.
| | - Tarja Pitkänen
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio and Helsinki, Finland; University of Helsinki, Faculty of Veterinary Medicine, Helsinki, Finland.
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12
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Vougat Ngom R, Jajere SM, Ayissi GJ, Tanyienow A, Moffo F, Watsop HM, Mimboe LM, Mouiche MM, Schüpbach-Regula G, Carmo LP. Unveiling the landscape of resistance against high priority critically important antimicrobials in food-producing animals across Africa: A scoping review. Prev Vet Med 2024; 226:106173. [PMID: 38503073 DOI: 10.1016/j.prevetmed.2024.106173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/10/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
The rapid population growth in Africa is associated with an increasing demand for livestock products which in turn can lead to antimicrobial use. Antimicrobial usage in animals contributes to the emergence and selection of resistant bacteria which constitutes a serious public health threat. This study aims to review and summarize the available information on highest priority critically important antimicrobials (HPCIAs) resistance in livestock production in Africa. This work will help to inform future policies for controlling antimicrobial resistance (AMR) in the food production chain. A scoping review was conducted according to the Cochrane handbook and following PRISMA 2020 guidelines for reporting. Primary research studies published after 1999 and reporting resistance of Escherichia coli, Enterococcus spp, Staphylococcus aureus, Salmonella spp, and Campylobacter spp to HPCIAs in poultry, cattle, pigs, goats, and sheep in Africa were searched in four databases. A total of 312 articles were included in the review. The majority of the studies (40.7) were conducted in North African countries. More than 49.0% of included studies involved poultry and 26.2% cattle. Cephalosporins and quinolones were the most studied antimicrobial classes. Of the bacteria investigated in the current review, E. coli (41.7%) and Salmonella spp (24.9%) represented the most commonly studied. High levels of resistance against erythromycin in E. coli were found in poultry (MR 96.1%, IQR 83.3-100.0%), cattle (MR 85.7%, IQR 69.2-100.0%), and pigs (MR 94.0%, IQR 86.2-94.0%). In sheep, a high level of resistance was observed in E. coli against nalidixic acid (MR 87.5%, IQR 81.3-93.8%). In goats, the low level of sensibility was noted in S. aureus against streptomycin (MR 86.8%, IQR 19.4-99.0%). The study provides valuable information on HPCIAs resistance in livestock production in Africa and highlights the need for further research and policies to address the public health risk of AMR. This will likely require an investment in diagnostic infrastructure across the continent. Awareness on the harmful impact of AMR in African countries is a requirement to produce more effective and sustainable measures to curb AMR.
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Affiliation(s)
- Ronald Vougat Ngom
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Saleh M Jajere
- Faculty of Veterinary Medicine, University of Maiduguri, Borno State, Nigeria
| | - Gaspard Ja Ayissi
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Akenghe Tanyienow
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Frédéric Moffo
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Hippolyte M Watsop
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Leina M Mimboe
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Mohamed Mm Mouiche
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | | - Luís Pedro Carmo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Norwegian Veterinary Institute, Elizabeth Stephansens vei 1, Ås 1433, Norway
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13
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Scarpellini R, Vélez De Mendizábal LL, Quevedo-Caraballo S, Blanco JL, García ME, Pérez-Sancho M, Portero Fuentes M, Penelo S, Esposito E, Mondo E, Piva S. Active surveillance of antimicrobial resistance in companion animals: A pilot study in a Spanish Veterinary Teaching Hospital. Comp Immunol Microbiol Infect Dis 2024; 108:102169. [PMID: 38579648 DOI: 10.1016/j.cimid.2024.102169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/22/2024] [Accepted: 03/31/2024] [Indexed: 04/07/2024]
Abstract
The role of small animal veterinary hospitals in the onset and dissemination of antimicrobial-resistant organisms (AMROs) is still not clear, and the implementation of an internal surveillance systems is a cost-effective tool to better understand their impact. The aim of this study was to describe a pilot program of active surveillance in a Spanish Veterinary Teaching Hospital, developed to estimate the detection frequency of AMROs in the commensal flora of patients and in the environment. Surveillance was focused on Methicillin-resistant Staphylococci (MRS), third generation cephalosporins resistant gram-negative bacteria (3GCR-GNB), and carbapenems-resistant gram-negative bacteria (CR-GNB). Oral and perirectal swabs were collected in the same dogs and cats hospitalized > 48 h, at their admission and before their discharge. Out of 50 patients sampled, 24% (12/50) were carriers at admission of at least one of the three investigated AMROs. Twenty-eight percent of patients (14/50) acquired at least one AMRO during the hospital stay. MRS detection frequency at admission was 12% (6/50), while acquisition was 6% (3/50). 3GCR-GNB detection frequency was 14% at admission (7/50) and acquisition 22% (11/50), while CR-GNB detection frequency was 2% at admission (1/50) and acquisition 2% (1/50). Environmental surveillance (98 samples) showed a total detection frequency of 22.4% for MRS (22/98), 2% for 3GCR-GNB and CR-GNB (2/98). Clinical staff' shoe soles showed high detection frequency for MRS (50%). 3GCR Escherichia coli was the most isolated species in patients (n = 17). The results show how active surveillance can be used as a tool to assess the impact of AMROs in veterinary hospitals to subsequently build up tailored control plans based on specific issues.
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Affiliation(s)
- Raffaele Scarpellini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia (BO) 40006, Italy.
| | - Laura Leal Vélez De Mendizábal
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, av. Puerta de Hierro s/n, Madrid 28040, Spain; Complutense University of Madrid, Faculty of Veterinary Medicine, Veterinary Teaching Hospital, av. Puerta de Hierro s/n, Madrid 28040, Spain
| | - Sergio Quevedo-Caraballo
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, av. Puerta de Hierro s/n, Madrid 28040, Spain; Complutense University of Madrid, Faculty of Veterinary Medicine, Veterinary Teaching Hospital, av. Puerta de Hierro s/n, Madrid 28040, Spain
| | - José L Blanco
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, av. Puerta de Hierro s/n, Madrid 28040, Spain; Complutense University of Madrid, Faculty of Veterinary Medicine, Veterinary Teaching Hospital, av. Puerta de Hierro s/n, Madrid 28040, Spain
| | - Marta E García
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, av. Puerta de Hierro s/n, Madrid 28040, Spain; Complutense University of Madrid, Faculty of Veterinary Medicine, Veterinary Teaching Hospital, av. Puerta de Hierro s/n, Madrid 28040, Spain
| | - Marta Pérez-Sancho
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, av. Puerta de Hierro s/n, Madrid 28040, Spain; VISAVET Health Surveillance Centre, Complutense University of Madrid, av. Puerta de Hierro s/n, Madrid 28040, Spain
| | - Miriam Portero Fuentes
- Complutense University of Madrid, Faculty of Veterinary Medicine, Veterinary Teaching Hospital, av. Puerta de Hierro s/n, Madrid 28040, Spain
| | - Silvia Penelo
- Complutense University of Madrid, Faculty of Veterinary Medicine, Veterinary Teaching Hospital, av. Puerta de Hierro s/n, Madrid 28040, Spain
| | - Erika Esposito
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia (BO) 40006, Italy
| | - Elisabetta Mondo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia (BO) 40006, Italy
| | - Silvia Piva
- Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Via Tolara di Sopra 50, Ozzano Emilia (BO) 40006, Italy
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14
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Yeary J, Hacker L, Liang SY. Managing Antimicrobial Resistance in the Emergency Department. Emerg Med Clin North Am 2024; 42:461-483. [PMID: 38641399 DOI: 10.1016/j.emc.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
(Basic awareness and understanding of antimicrobial resistance and prevailing mechanisms can aid emergency physicians in providing appropriate care to patients with infections due to a multidrug-resistant organism (MDRO). Empiric treatment of MDRO infections should be approached with caution and guided by the most likely pathogens based on differential diagnosis, severity of the illness, suspected source of infection, patient-specific factors, and local antibiotic susceptibility patterns. Newer broad-spectrum antibiotics should be reserved for critically ill patients where there is a high likelihood of infection with an MDRO.).
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Affiliation(s)
- Julianne Yeary
- Department of Pharmacy, Barnes Jewish Hospital, 1 Barnes Jewish Place, St Louis, MO 63110, USA.
| | - Larissa Hacker
- Department of Pharmacy, UW Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Stephen Y Liang
- Department of Emergency Medicine and Division of Infectious Diseases, John T. Milliken Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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15
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Lobo CB, Molina RDI, Moreno Mochi P, Vargas JM, Jure MÁ, Juárez Tomás MS. Safety attributes of Pseudomonas sp. P26, an environmental microorganism with potential application in contaminated environments. Environ Pollut 2024; 348:123818. [PMID: 38508367 DOI: 10.1016/j.envpol.2024.123818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/19/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
Currently, the selection of non-pathogenic microorganisms that lack clinically relevant antimicrobial resistance is crucial to bioaugmentation strategies. Pseudomonas sp. P26 (P26) is an environmental bacterium of interest due to its ability to remove aromatic compounds from petroleum, but its safety characteristics are still unknown. The study aimed to: a) determine P26 sensitivity to antimicrobials, b) investigate the presence of quinolone and β-lactam resistance genes, c) determine the presence of virulence factors, and d) evaluate the effect of P26 on the viability of Galleria mellonella (an invertebrate animal model). P26 antimicrobial sensitivity was determined in vitro using the Kirby-Bauer agar diffusion method and the VITEK 2 automated system (BioMerieux®). Polymerase Chain Reaction was employed for the investigation of genes associated with quinolone resistance, extended-spectrum β-lactamases, and carbapenemases. Hemolysin and protease production was determined in human blood agar and skimmed-milk agar, respectively. In the in vivo assay, different doses of P26 were injected into Galleria mellonella larvae and their survival was monitored daily. Control larvae injected with Pseudomonas putida KT2440 (a strain considered as safe) and Pseudomonas aeruginosa PA14 (a pathogenic strain) were included. Pseudomonas sp. P26 was susceptible to most evaluated antimicrobials, except for trimethoprim-sulfamethoxazole. No epidemiologically relevant genes associated with quinolone and β-lactam resistance were identified. Hemolysin and protease production was only evidenced in the virulent strain (PA14). Furthermore, the results obtained in the in vivo experiment demonstrated that inocula less than 108 CFU/mL of P26 and P. putida KT2440 did not significantly affect larval survival, whereas larvae injected with the lowest dose of the pathogenic strain P. aeruginosa PA14 experienced instant mortality. The results suggest that Pseudomonas sp. P26 is a safe strain for its application in environmental bioremediation processes. Additional studies will be conducted to ensure the safety of this bacterium against other organisms.
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Affiliation(s)
- Constanza Belén Lobo
- Planta Piloto de Procesos Industriales Microbiológicos (PROIMI), CONICET, San Miguel de Tucumán, Tucumán, Argentina.
| | - Rocío Daniela Inés Molina
- Planta Piloto de Procesos Industriales Microbiológicos (PROIMI), CONICET, San Miguel de Tucumán, Tucumán, Argentina.
| | - Paula Moreno Mochi
- Laboratorio de Bacteriología Certificado (LABACER), Cátedra de Bacteriología, Instituto de Microbiología Luis Verna, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Tucumán, Argentina.
| | - Juan Martín Vargas
- Laboratorio de Bacteriología Certificado (LABACER), Cátedra de Bacteriología, Instituto de Microbiología Luis Verna, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Tucumán, Argentina.
| | - María Ángela Jure
- Laboratorio de Bacteriología Certificado (LABACER), Cátedra de Bacteriología, Instituto de Microbiología Luis Verna, Facultad de Bioquímica, Química y Farmacia, Universidad Nacional de Tucumán, San Miguel de Tucumán, Tucumán, Argentina.
| | - María Silvina Juárez Tomás
- Planta Piloto de Procesos Industriales Microbiológicos (PROIMI), CONICET, San Miguel de Tucumán, Tucumán, Argentina.
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16
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Guo X, Zhang X, Yu M, Cheng Z, Feng Y, Chen B. Iron decoration in binary graphene oxide and copper iron sulfide nanocomposites boosting catalytic antibacterial activity in acidic microenvironment against antimicrobial resistance. J Colloid Interface Sci 2024; 661:802-814. [PMID: 38330653 DOI: 10.1016/j.jcis.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/21/2024] [Accepted: 02/02/2024] [Indexed: 02/10/2024]
Abstract
The strong antimicrobial resistance (AMR) of multidrug-resistant (MDR) bacteria and biofilm, especially the biofilm with extracellular polymeric substance (EPS) protection and persister cells, not only renders antibiotics ineffective but also causes chronic infections and makes the infectious tissue difficult to repair. Considering the acidic properties of bacterial infection microenvironment and biofilm, herein, a binary graphene oxide and copper iron sulfide nanocomposite (GO/CuFeSx NC) is synthesized by a surfactant free strategy and utilized as an alternative smart nanozyme to fight against the MDR bacteria and biofilm. For the GO/CuFeSx NC, the iron decoration facilitates the well distribution of bimetallic CuFeSx NPs on the GO surfaces compared to monometallic CuS NPs, providing synergistically enhanced peroxidase (POD)-like activity in acidic medium (pH 4 ∼ 5) and intrinsic strong near infrared (NIR) light responsive photothermal activity, while the ultrathin and sharp structure of 2D GO nanosheet allows the GO/CuFeSx NC to strongly interact with the bacteria and biofilm, facilitating the catalytic and photothermal attacks on the bacterial surfaces. In addition, the GO in GO/CuFeSx NC exhibits a "Pseudo-Photo-Fenton" effect to promote the ROS generation. Therefore, the GO/CuFeSx NC can effectively kill bacteria and biofilm both in vitro and in vivo, finally eliminating the infections and accelerating the tissue repair when treating the biofilm-infected wound. This work paves a new way to the design of novel nanozyme for smart antibacterial therapy against antimicrobial resistance.
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Affiliation(s)
- Xiaobin Guo
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, 137 South LiYuShan Road, Urumqi, Xinjiang 830054, China
| | - Xiaogang Zhang
- Department of Orthopaedics, First Affiliated Hospital of Xinjiang Medical University, 137 South LiYuShan Road, Urumqi, Xinjiang 830054, China
| | - Min Yu
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China
| | - Zerui Cheng
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China
| | - Yonghai Feng
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China.
| | - Binghai Chen
- Department of Urology, Affiliated Hospital of Jiangsu University, 438 Jiefang Road, Zhenjiang 212001, China; Institute of Translational Medicine of Jiangsu University, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, China.
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Shmoury AH, Hanna W, Zakhour J, Zahreddine NK, Kanj SS. Epidemiology and microbiology of catheter-associated urinary tract infections: A 14-year surveillance study at a tertiary care center in Lebanon. J Infect Public Health 2024; 17:825-832. [PMID: 38537577 DOI: 10.1016/j.jiph.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are the most common device-associated healthcare-acquired infections and pose a significant burden on patients and healthcare systems worldwide. However, there is a paucity of data on CAUTI epidemiology and microbiology in the Middle East and North Africa (MENA) region, including Lebanon. METHODS This 14-year retrospective cohort study was conducted at a tertiary care center in Lebanon. It analyzed data on all adult patients diagnosed with CAUTI between January 2009 and December 2022 in intensive care units (ICUs) and between June 2011 and December 2022 in regular units. Incidence rates, urinary catheter utilization ratios, and microbiological profiles were collected and analyzed. RESULTS A total of 620 CAUTI cases were identified during the study period. The overall CAUTI rate was 2.4 per 1000 catheter-days, with higher rates in ICUs (3.2 per 1000 catheter-days) compared to regular units (1.4 per 1000 catheter-days). No significant changes in the rates were noted despite implementing many interventions. The most common pathogens were Gram-negative bacteria, with Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae being predominant. Multidrug-resistant organisms represented 48% of all isolates. Enterobacterales were largely extended-spectrum β-lactamase (ESBL) producing, and most Acinetobacter baumannii isolates showed multidrug resistance. CONCLUSIONS This study provides important insights into CAUTI epidemiology and microbiology in a tertiary care center in Lebanon, addressing the knowledge gap in this area in the MENA region. Despite implementing prevention measures, CAUTI rates remained stable over the 14-year period. The findings highlight the need for continuous improvement in infection prevention practices, diagnostic stewardship, and antimicrobial stewardship, especially given the rising threat of antimicrobial resistance. These results can serve as a guide for the development of targeted preventive strategies to reduce the burden of CAUTIs, particularly in low- and middle-income countries where antimicrobial resistance is a major issue.
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Affiliation(s)
- Abdel Hadi Shmoury
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Wael Hanna
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Johnny Zakhour
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nada Kara Zahreddine
- Infection Control and Prevention Program, American University of Beirut Medical Center, Beirut, Lebanon
| | - Souha S Kanj
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon; Center for Infectious Diseases Research, American University of Beirut Medical Center, Beirut, Lebanon.
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18
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Rossi CC, Ahmad F, Giambiagi-deMarval M. Staphylococcus haemolyticus: An updated review on nosocomial infections, antimicrobial resistance, virulence, genetic traits, and strategies for combating this emerging opportunistic pathogen. Microbiol Res 2024; 282:127652. [PMID: 38432015 DOI: 10.1016/j.micres.2024.127652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/30/2024] [Accepted: 02/17/2024] [Indexed: 03/05/2024]
Abstract
Staphylococcus haemolyticus, a key species of the Staphylococcus genus, holds significant importance in healthcare-associated infections, due to its notable resistance to antimicrobials, like methicillin, and proficient biofilms-forming capabilities. This coagulase-negative bacterium poses a substantial challenge in the battle against nosocomial infections. Recent research has shed light on Staph. haemolyticus genomic plasticity, unveiling genetic elements responsible for antibiotic resistance and their widespread dissemination within the genus. This review presents an updated and comprehensive overview of the clinical significance and prevalence of Staph. haemolyticus, underscores its zoonotic potential and relevance in the one health framework, explores crucial virulence factors, and examines genetics features contributing to its success in causing emergent and challenging infections. Additionally, we scrutinize ongoing studies aimed at controlling spread and alternative approaches for combating it.
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Affiliation(s)
- Ciro César Rossi
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal de Viçosa, MG, Brazil.
| | - Faizan Ahmad
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal de Viçosa, MG, Brazil
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19
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Tree M, Lam TJGM, Townsend K, McDougall S, Beggs DS, Barnes AL, Robertson ID, Aleri JW. A scoping review of antimicrobial resistance in the Australian dairy cattle industry. Prev Vet Med 2024; 226:106161. [PMID: 38460345 DOI: 10.1016/j.prevetmed.2024.106161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Quantification of antimicrobial resistance (AMR) is beneficial to inform policies and direct prudent antimicrobial use. AIM This study aimed to assess the current published evidence of AMR from passive and active ad hoc surveillance activities within the Australian dairy cattle industry. METHODS Following a scoping review framework 373 articles published before January 2023 were retrieved using the keyword search function from two online databases (PubMed® and Web of Science™ Core Collection). The duplicate articles were removed and the title, abstract, and full text of the remaining articles were reviewed following the study objectives and inclusion criteria (location, subject/theme, and data). Data from the remaining articles were extracted, summarised, interpreted and the study quality assessed using the Grades of Recommendations, Assessment, Development, and Evaluation guidelines. RESULTS A total of 29 articles dating from the 1960 s until 2022 were identified to meet the study criteria (passive: n = 15; active: n = 14). Study characteristics such as sampling type, sampling method, and AMR assessment were all common characteristics from both passive and active surveillance articles, being milk samples, individual sampling, and phenotypic assessment respectively. Passive surveillance articles had a wider range in both the type of bacteria and the number of antimicrobials investigated, while active surveillance articles included a higher number of bacterial isolates and sampling from healthy populations. There was an overall low level of clinical AMR across all articles. Higher prevalence of non-wildtype Escherichia coli, Salmonella spp., and Staphylococcus spp., although limited in data, was suggested for commonly used Australian veterinary antimicrobials for these bacteria. The prevalence of phenotypic AMR varied due to the health and age status of the sampled animals. The articles reviewed in this study suggest the prevalence of AMR genes was higher for commonly used antimicrobials, although genes were not always related to the phenotypic AMR profile. CONCLUSIONS Published evidence of AMR in the Australian dairy cattle industry is limited as demonstrated by only 29 articles included in this review following selection criteria screening. However, collectively these articles provide insight on industry AMR prevalence. For example, the suggestion of non-wildtype bacteria within the Australian dairy cattle indicating a risk of emerging or increasing industry AMR. Therefore, further surveillance is required to monitor the development of future AMR risk within the industry. Additionally, evidence suggesting that animals varying in health and age differ in prevalence of AMR imply a requirement for further research into animal population demographics to reduce potential bias in data collated in both national and global surveillance activities.
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Affiliation(s)
- Michele Tree
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia.
| | - Theo J G M Lam
- GD Animal Health, Deventer, and Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, the Netherlands
| | - Kristy Townsend
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia
| | - Scott McDougall
- Cognosco, Anexa Veterinary Services, PO Box 21, Morrinsville 3340, New Zealand; School of Veterinary Science, Massey University, Private Bag 11 222, Palmerston North 4442, New Zealand
| | - David S Beggs
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, VIC 3030, Australia
| | - Anne L Barnes
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia
| | - Ian D Robertson
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia
| | - Josh W Aleri
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia; Centre for Animal Production and Health, Future Foods Institute, Murdoch University, 90 South Street, Murdoch, WA 6150, Australia.
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20
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Dominski BH, Raitz MDF, Provenzi MA, Silveira ACDO, Sincero TCM, Ferreira FA. Characterization of Methicillin-resistant Staphylococcus aureus (MRSA) isolated in Santa Catarina (SC), Brazil. Diagn Microbiol Infect Dis 2024; 109:116244. [PMID: 38452557 DOI: 10.1016/j.diagmicrobio.2024.116244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
The study investigated the characteristics of Methicillin-resistant Staphylococcus aureus (MRSA) isolated in Santa Catarina. Findings revealed prevalent SCCmecII and IV, multiresistance, Leucocidin ED genes, and one ST105 isolate. The results indicated that the in-state MRSA isolates showed the same characteristics as the out-of-state isolates among the investigated features.
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Affiliation(s)
- Bruno Hech Dominski
- Laboratório de Genética Molecular Bacteriana (GeMBac), Departamento de Microbiologia, Imunologia e Parasitologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina (UFSC), Campus Universitário Reitor João David Ferreira Lima, Trindade, Florianópolis, SC 88040-960, Brazil
| | - Maria de Fátima Raitz
- Laboratório de Genética Molecular Bacteriana (GeMBac), Departamento de Microbiologia, Imunologia e Parasitologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina (UFSC), Campus Universitário Reitor João David Ferreira Lima, Trindade, Florianópolis, SC 88040-960, Brazil
| | - Marcel Afonso Provenzi
- Laboratório de Genética Molecular Bacteriana (GeMBac), Departamento de Microbiologia, Imunologia e Parasitologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina (UFSC), Campus Universitário Reitor João David Ferreira Lima, Trindade, Florianópolis, SC 88040-960, Brazil
| | - Alessandro Conrado de Oliveira Silveira
- Departamento de Ciências Farmacêuticas, Fundação Universidade Regional de Blumenau (FURB). Rua Antônio da Veiga, 140. Itoupava Seca, Blumenau, SC 89030-903, Brazil
| | - Thais Cristine Marques Sincero
- Laboratório de Microbiologia Molecular Aplicada (MIMA); Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina (UFSC), Campus Universitário Reitor João David Ferreira Lima, Trindade, Florianópolis, SC 88040-960, Brazil
| | - Fabienne Antunes Ferreira
- Laboratório de Genética Molecular Bacteriana (GeMBac), Departamento de Microbiologia, Imunologia e Parasitologia, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina (UFSC), Campus Universitário Reitor João David Ferreira Lima, Trindade, Florianópolis, SC 88040-960, Brazil.
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21
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Bydalek F, Webster G, Barden R, Weightman AJ, Kasprzyk-Hordern B, Wenk J. Microbial community and antimicrobial resistance niche differentiation in a multistage, surface flow constructed wetland. Water Res 2024; 254:121408. [PMID: 38442607 DOI: 10.1016/j.watres.2024.121408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 03/07/2024]
Abstract
Free-living (FL) and particulate-associated (PA) communities are distinct bacterioplankton lifestyles with different mobility and dissemination routes. Understanding spatio-temporal dynamics of PA and FL fractions will allow improvement to wastewater treatment processes including pathogen and AMR bacteria removal. In this study, PA, FL and sediment community composition and antimicrobial resistance gene (ARG; tetW, ermB, sul1, intI1) dynamics were investigated in a full-scale municipal wastewater free-water surface polishing constructed wetland. Taxonomic composition of PA and FL microbial communities shifted towards less diverse communities (Shannon, Chao1) at the CW effluent but retained a distinct fraction-specific composition. Wastewater treatment plant derived PA communities introduced the bulk of AMR load (70 %) into the CW. However, the FL fraction was responsible for exporting over 60 % of the effluent AMR load given its high mobility and the effective immobilization (1-3 log removal) of PA communities. Strong correlations (r2>0.8, p < 0.05) were observed between the FL fraction, tetW and emrB dynamics, and amplicon sequence variants (ASVs) of potentially pathogenic taxa, including Bacteroides, Enterobacteriaceae, Aeromonadaceae, and Lachnospiraceae. This study reveals niche differentiation of microbial communities and associated AMR in CWs and shows that free-living bacteria are a primary escape route of pathogenic and ARG load from CWs under low-flow hydraulic conditions.
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Affiliation(s)
- Franciszek Bydalek
- Department of Chemical Engineering, University of Bath, Claverton Down, Bath BA2 7AY, UK; Water Innovation and Research Centre (WIRC), University of Bath, Bath BA2 7AY, UK; GW4 NERC CDT in Freshwater Biosciences and Sustainability, Cardiff University, Cardiff CF10 3AX, UK; Organisms and Environment Division, School of Biosciences, Microbiomes, Microbes and Informatics Group, Cardiff University, Cardiff CF10 3AX, UK
| | - Gordon Webster
- Organisms and Environment Division, School of Biosciences, Microbiomes, Microbes and Informatics Group, Cardiff University, Cardiff CF10 3AX, UK
| | | | - Andrew J Weightman
- Organisms and Environment Division, School of Biosciences, Microbiomes, Microbes and Informatics Group, Cardiff University, Cardiff CF10 3AX, UK
| | - Barbara Kasprzyk-Hordern
- Water Innovation and Research Centre (WIRC), University of Bath, Bath BA2 7AY, UK; Department of Chemistry, University of Bath, Bath BA2 7AY, UK
| | - Jannis Wenk
- Department of Chemical Engineering, University of Bath, Claverton Down, Bath BA2 7AY, UK; Water Innovation and Research Centre (WIRC), University of Bath, Bath BA2 7AY, UK.
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22
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Hermans LE, Centner CM, Morel CM, Mbamalu O, Bonaconsa C, Ferreyra C, Lindahl O, Mendelson M. Point-of-care diagnostics for infection and antimicrobial resistance in sub-Saharan Africa: A narrative review. Int J Infect Dis 2024; 142:106907. [PMID: 38141961 DOI: 10.1016/j.ijid.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/25/2023] Open
Abstract
OBJECTIVES Sub-Saharan African (SSA) countries are severely impacted by antimicrobial resistance (AMR). Due to gaps in access to diagnostics in SSA, the true extent of AMR remains unknown. This diagnostic gap affects patient management and leads to significant antimicrobial overuse. This review explores how point-of-care (POC) testing for pathogen identification and AMR may be used to close the diagnostic gap in SSA countries. METHODS A narrative review exploring current clinical practice and novel developments in the field of POC testing for infectious diseases and AMR. RESULTS POC assays for identification of various pathogens have been successfully rolled out in SSA countries. While implementation studies have mostly highlighted impressive test performance of POC assays, there is limited data on the impact of implementation on clinical outcomes and cost-effectiveness. We did not encounter local studies of host-directed POC assays relevant to AMR. Novel POC assays using real-time polymerase chain reaction, isothermal amplification, microfluidics, and other technologies are in various stages of development. CONCLUSIONS Available literature shows that POC testing for AMR applications is implementable in SSA and holds the potential to reduce the diagnostic gap. Implementation will require effective regulatory pathways, incorporation of POC testing in clinical and laboratory guidelines, and adequate value capture in existing health financing models.
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Affiliation(s)
- Lucas Etienne Hermans
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
| | - Chad M Centner
- Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Chantal M Morel
- Department of Business Studies, Uppsala University, Uppsala, Sweden; Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany; University of Bern, KPM Center for Public Management, Bern, Switzerland
| | - Oluchi Mbamalu
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Candice Bonaconsa
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Cecilia Ferreyra
- Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Olof Lindahl
- Department of Business Studies, Uppsala University, Uppsala, Sweden
| | - Marc Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa
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23
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Broom J, Broom A, Kenny K, Konecny P, Post JJ. Regulating antimicrobial use within hospitals: A qualitative study. Infect Dis Health 2024; 29:81-90. [PMID: 38216402 DOI: 10.1016/j.idh.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES To examine how regulatory structures and processes focused on antimicrobial stewardship and antimicrobial resistance are experienced by hospital managers and clinicians. METHODS Forty-two hospital managers and clinicians working within accreditation and antimicrobial stewardship teams in three Australian hospitals participated in individual in-depth interviews. Thematic analysis was performed. RESULTS Thematic analysis revealed participants' experiences of hospital antimicrobial regulation and their perceptions of what would be required for meaningful antimicrobial optimisation. Theme 1: Experience of regulation of antimicrobials within hospitals: Participants described an increased profile of antimicrobial resistance with inclusion in regulatory requirements, but also the risks of bureaucratic manoeuvring to meet standards rather than governance-inducing systemic changes. Theme 2: Growth of accreditation processes and hospitals over time: Both regulatory requirements and hospitals were described as evolving over time, each manoeuvring in response to each other (e.g. development of short notice accreditation). Theme 3: Perceived requirements for change: Participants perceived a need for top-down buy-in, resource prioritisation, complex understanding of power and influence on clinician behaviour, and a critical need for medical engagement. CONCLUSIONS This study around antimicrobials shows the tension and dynamic relationship between regulatory processes and hospital responses, bringing to light the enduring balance of a system that positions itself to meet regulatory requirements and emerging "demands", without necessarily addressing the key underlying concerns. Antimicrobial resistance-related solutions are perceived as likely to require further resourcing and buy-in across multiple levels, engagement across professional streams and require strategies that consider complex systems change in order for regulatory structures to have potency.
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Affiliation(s)
- Jennifer Broom
- Sunshine Coast University Hospital, Sunshine Coast Hospital and Health Service, 6 Doherty Street, Birtinya, QLD, Australia; University of Queensland, Brisbane, QLD, Australia.
| | - Alex Broom
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Camperdown, NSW, Australia.
| | - Katherine Kenny
- Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Camperdown, NSW, Australia.
| | - Pamela Konecny
- Department of Infectious Diseases, Immunology & Sexual Health, St George Hospital, Kogarah, Sydney, Australia; School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Jeffrey J Post
- School of Clinical Medicine, University of New South Wales, Sydney, Australia; Department of Infectious Diseases, Prince of Wales Hospital and Community Health Services, Randwick, NSW, Australia.
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Sfragano PS, Reynoso EC, Rojas-Ruíz NE, Laschi S, Rossi G, Buchinger M, Torres E, Palchetti I. A microfluidic card-based electrochemical assay for the detection of sulfonamide resistance genes. Talanta 2024; 271:125718. [PMID: 38301374 DOI: 10.1016/j.talanta.2024.125718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
Most electroanalytical detection schemes for DNA markers require considerable time and effort from expert personnel to thoroughly follow the analysis and obtain reliable outcomes. This work aims to present an electrochemical assay performed inside a small card-based platform powered by microfluidic manipulation, requiring minimal human intervention and consumables. The assay couples a sample/signal dual amplification and DNA-modified magnetic particles for the detection of DNA amplification products. Particularly, the sul1 and sul4 genes involved in the resistance against sulfonamide antibiotics were analyzed. As recognized by the World Health Organization, antimicrobial resistance threatens global public health by hampering medication efficacy against infections. Consequently, analytical methods for the determination of such genes in environmental and clinical matrices are imperative. Herein, the resistance genes were extracted from E. coli cells and amplified using an enzyme-assisted isothermal amplification at 37 °C. The amplification products were analyzed in an easily-produced, low-cost, card-based set-up implementing a microfluidic system, demanding limited manual work and small sample volumes. The target amplicon was thus captured and isolated using versatile DNA-modified magnetic beads injected into the microchannel and exposed to the various reagents in a continuously controlled microfluidic flow. After the optimization of the efficiency of each phase of the assay, the platform achieved limits of detections of 44.2 pmol L-1 for sul1 and 48.5 pmol L-1 for sul4, and was able to detect down to ≥500-fold diluted amplification products of sul1 extracted from E. coli living cells in around 1 h, thus enabling numerous end-point analyses with a single amplification reaction.
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Affiliation(s)
| | - Eduardo Canek Reynoso
- Department of Chemistry "Ugo Schiff", University of Florence, 50019, Sesto Fiorentino, Italy; Posgrado en Ciencias Ambientales, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, 72570, Mexico
| | - Norma Elena Rojas-Ruíz
- Centro de Investigaciones en Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, 72000, Mexico
| | - Serena Laschi
- Department of Chemistry "Ugo Schiff", University of Florence, 50019, Sesto Fiorentino, Italy
| | - Giulia Rossi
- Department of Chemistry "Ugo Schiff", University of Florence, 50019, Sesto Fiorentino, Italy
| | - Martin Buchinger
- Department of Chemistry "Ugo Schiff", University of Florence, 50019, Sesto Fiorentino, Italy
| | - Eduardo Torres
- Centro de Química, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla, 72570, Mexico.
| | - Ilaria Palchetti
- Department of Chemistry "Ugo Schiff", University of Florence, 50019, Sesto Fiorentino, Italy.
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Leopold M, Kabicher A, Pap IJ, Ströbele B, Zarfel G, Farnleitner AH, Kirschner AKT. A comparative study on antibiotic resistant Escherichia coli isolates from Austrian patients and wastewater-influenced Danube River water and biofilms. Int J Hyg Environ Health 2024; 258:114361. [PMID: 38552533 DOI: 10.1016/j.ijheh.2024.114361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/04/2024] [Accepted: 03/22/2024] [Indexed: 04/06/2024]
Abstract
Antimicrobial resistance (AMR) poses a major threat to human health worldwide. AMR can be introduced into natural aquatic ecosystems, for example, from clinical facilities via wastewater emissions. Understanding AMR patterns in environmental populations of bacterial pathogens is important to elucidate propagation routes and develop mitigation strategies. In this study, AMR patterns of Escherichia coli isolates from urinary tract infections and colonised urinary catheters of inpatients and outpatients were compared to isolates from the Danube River within the same catchment in Austria to potentially link environmental with clinical resistance patterns. Susceptibility to 20 antibiotics was tested for 697 patient, 489 water and 440 biofilm isolates. The resistance ratios in patient isolates were significantly higher than in the environmental isolates and higher resistance ratios were found in biofilm in comparison to water isolates. The role of the biofilm as potential sink of resistances was reflected by two extended-spectrum beta-lactamase (ESBL) producing isolates in the biofilm while none were found in water, and by higher amoxicillin/clavulanic acid resistance ratios in biofilm compared to patient isolates. Although, resistances to last-line antibiotics such as carbapenems and tigecycline were found in the patient and in the environmental isolates, they still occurred at low frequency.
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Affiliation(s)
- Melanie Leopold
- Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Krems, Austria; Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics, Technische Universität Wien, Vienna, Austria
| | - Angelika Kabicher
- Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Krems, Austria; Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics, Technische Universität Wien, Vienna, Austria
| | - Ildiko-Julia Pap
- Clinical Institute for Hygiene and Microbiology, University Clinic St. Pölten, Austria
| | - Barbara Ströbele
- Clinical Institute for Hygiene and Microbiology, University Clinic St. Pölten, Austria
| | - Gernot Zarfel
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Austria
| | - Andreas H Farnleitner
- Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Krems, Austria; Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics, Technische Universität Wien, Vienna, Austria
| | - Alexander K T Kirschner
- Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Krems, Austria; Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University Vienna, Austria.
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Orszulik ST. The quality of antimicrobial susceptibility test discs and implications for clinical outcomes. Diagn Microbiol Infect Dis 2024; 109:116237. [PMID: 38428376 DOI: 10.1016/j.diagmicrobio.2024.116237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
Disc diffusion remains the main technique for evaluating antibiotic activity in clinical microbiology laboratories. However, the assay protocol endorsed by the FDA, DIN, and WHO is invalid. Despite decades of research and practice in this field, the quantitative quality of manufactured discs is largely unknown, potentially leading to adverse clinical outcomes. The usual standards expected for new medical devices in terms of quality control, QA, and evidence-based assessment of outcomes are almost completely lacking. Recent data indicate that a large proportion of discs do not meet the specifications, and that disc diffusion is a poor predictor of clinical outcomes. In addition, lack of harmonisation between EUCAST and CLSI, despite many years of effort, strongly suggests that there are serious flaws in these systems. This area lacks scientific rigour, which may have also contributed to adverse clinical outcomes and the emergence of antimicrobial resistance.
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Affiliation(s)
- Stefan T Orszulik
- De La Rue Currency, Overton, Basingstoke, Hampshire, United Kingdom.
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Calabro C, Sadhu R, Xu Y, Aprea M, Guarino C, Cazer CL. Longitudinal antimicrobial susceptibility trends of canine Staphylococcus pseudintermedius. Prev Vet Med 2024; 226:106170. [PMID: 38493570 DOI: 10.1016/j.prevetmed.2024.106170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/19/2024]
Abstract
Antimicrobial resistance within Staphylococcus pseudintermedius poses a significant risk for the treatment of canine pyoderma and as a reservoir for resistance and potential zoonoses, but few studies examine long-term temporal trends of resistance. This study assesses the antimicrobial resistance prevalence and minimum inhibitory concentration (MIC) trends in S. pseudintermedius (n=1804) isolated from canine skin samples at the Cornell University Animal Health Diagnostic Center (AHDC) between 2007 and 2020. Not susceptible (NS) prevalence, Cochran-Armitage tests, logrank tests, MIC50 and MIC90 quantiles, and survival analysis models were used to evaluate resistance prevalence and temporal trends to 23 antimicrobials. We use splines as predictors in accelerated failure time (AFT) models to model non-linear temporal trends in MICs. Multidrug resistance was common among isolates (47%), and isolates had moderate to high NS prevalence to the beta-lactams, chloramphenicol, the fluoroquinolones, gentamicin, the macrolides/lincosamides, the tetracyclines, and trimethoprim-sulfamethoxazole. However, low levels of NS to amikacin, rifampin, and vancomycin were observed. Around one third of isolates (38%) were found to be methicillin resistant S. pseudintermedius (MRSP), and these isolates had a higher prevalence of NS to all tested antimicrobials than methicillin susceptible isolates. Amongst the MRSP isolates, one phenotypically vancomycin resistant isolate (MIC >16 µg/mL) was identified, but genomic sequence data was unavailable. AFT models showed increasing MICs across time to the beta-lactams, chloramphenicol, the fluoroquinolones, gentamicin, and the macrolides/lincosamides, and decreasing temporal resistance (decreasing MICs) to doxycycline was observed amongst isolates. Notably, ATF modeling showed changes in MIC distributions that were not identified using Cochran-Armitage tests on prevalence, MIC quantiles, and logrank tests. Increasing resistance amongst these S. pseudintermedius isolates highlights the need for rational, empirical prescribing practices and increased antimicrobial resistance (AMR) surveillance to maintain the efficacy of current therapeutic agents. AFT models with non-linear predictors may be a useful, breakpoint-independent, surveillance tool alongside other modeling methods and antibiograms.
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Affiliation(s)
- Caroline Calabro
- Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY, USA; Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Ritwik Sadhu
- Department of Statistics and Data Science, Cornell University, Ithaca, NY, USA
| | - Yuchen Xu
- Department of Statistics and Data Science, Cornell University, Ithaca, NY, USA
| | - Melissa Aprea
- Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Cassandra Guarino
- Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Casey L Cazer
- Department of Public and Ecosystem Health, Cornell University College of Veterinary Medicine, Ithaca, NY, USA; Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
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Kenyon C. Doxycycline post-exposure prophylaxis could theoretically select for resistance to various antimicrobials in 19 pathobionts: an in silico analysis. Int J Infect Dis 2024; 142:106974. [PMID: 38395219 DOI: 10.1016/j.ijid.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/14/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES Doxycycline post exposure prophylaxis (PEP) has been shown to reduce the incidence of bacterial STIs. However, if there is genetic linkage between resistance to tetracycline and other antimicrobials, then it could also select for resistance to these other antimicrobials. We therefore undertook to evaluate if there is an association between the minimum inhibitory concentrations (MICs) of tetracycline and other antimicrobials in 19 clinically important bacterial species. METHODS Mixed-effects linear regression was used to assess if minocycline MICs were associated with the MICs of eight other antimicrobials (ceftriaxone, ampicillin, oxacillin, vancomycin, erythromycin, levofloxacin, amikacin, and trimethoprim-sulfamethoxazole) in 19 bacterial species in the Antimicrobial Testing Leadership and Surveillance (ATLAS) database. RESULTS With the notable exception of vancomycin, where no association was found, strong positive associations were typically found between the MICs of minocycline and each of the eight antimicrobials in each of the species assessed. For example, the minocycline MICs of all the Gram-positive species were positively associated with ampicillin, ceftriaxone, oxacillin and erythromycin MICs (all P-values < 0.001). The only exceptions were ampicillin for Streptococcus pyogenes and ceftriaxone for S. dysgalactiae, where no significant associations were found. Similarly in the Gram-negative species, the minocycline MICs of all the species except Haemophilus influenzae and Stenotrophomonas maltophilia were positively associated with the MICs of ceftriaxone, ampicillin, levofloxacin and amikacin (all P-values < 0.001). CONCLUSIONS There is a theoretical risk that doxycycline PEP could select for resistance not only to tetracyclines but to a range of other antimicrobials in each of the 19 pathobionts assessed.
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Affiliation(s)
- Chris Kenyon
- STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa.
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Lokhande AS, Maurya V, Rani K, Parashar P, Gaind R, Tandon V, Devarajan PV. Polydispersity-mediated high efficacy of an in-situ aqueous nanosuspension of PPEF.3HCl in methicillin resistant Staphylococcus aureus sepsis model. Int J Pharm 2024; 655:123982. [PMID: 38460770 DOI: 10.1016/j.ijpharm.2024.123982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
Recently, World Health Organization declared antimicrobial resistance as the third greatest threat to human health. Absence of known cross-resistance, new class, new target, and a new mode of action are few major strategies being undertaken by researches to combat multidrug resistant pathogen. PPEF.3HCl, a bisbenzimidazole was developed as highly potent antibacterial agent against ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens, targeting topoisomerase IA. The present work encompasses a radical on-site generation of In-situ nanosuspension of PPEF.3HCl with enhanced efficacy against methicillin resistant S. aureus in septicemia model. We have generated instantaneously a PPEF.3HCl nanosuspension (IsPPEF.3HCl-NS) by mixing optimized monophasic PPEF.3HCl preconcentrate in propylene glycol into an aqueous medium comprising tween 80 as stabilizer. The IsPPEF.3HCl-NS showed precipitation efficiency of > 90 %, average particle size < 500 nm, retained upto 5 h, a negative zeta potential and bi/trimodal particle size distribution. Differential scanning calorimetry, X-ray diffraction confirmed partial amorphization and transmission electron microscopy revealed spherical particles. IsPPEF.3HCl-NS was non-hemolytic and exhibited good stability in serum. More significantly, it exhibited a ∼ 1.6-fold increase in macrophage uptake compared to free PPEF.3HCl in the RAW 264.7 macrophage cell line. Confocal microscopy revealed accumulation of IsPPEF.3HCl-NS within the lysosomal compartment and cell cytosol, proposing high efficacy. In terms of antimicrobial efficacy, IsPPEF.3HCl-NS outperforms free PPEF.3HCl against clinical methicillin sensitive and resistant S. aureus strains. In a pivotal experiment, IsPPEF.3HCl-NS exhibited over 83 % survival at 8 mg/kg.bw and an impressive reduction of ∼ 4-5 log-fold in bacterial load, primarily in the kidney, liver and spleen of septicemia mice. IsPPEF.3HCl-NS prepared by the In-situ approach, coupled with enhanced intramacrophage delivery and superior efficacy, positions IsPPEF.3HCl-NS as a pioneering and highly promising formulation in the battle against antimicrobial resistance.
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Affiliation(s)
- Amit S Lokhande
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N. P. Marg, Matunga, Mumbai 400019, Maharashtra, India
| | - Vikas Maurya
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India
| | - Komal Rani
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India
| | - Palak Parashar
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India
| | - Rajni Gaind
- Vardhaman Medical College Hospital, Safdarjung Hospital, New Delhi 110029, India
| | - Vibha Tandon
- Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi 110067, India; CSIR-Indian Institute of Chemical Biology, Kolkata, West Bengal 700032, India.
| | - Padma V Devarajan
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, N. P. Marg, Matunga, Mumbai 400019, Maharashtra, India.
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Dos Santos LA, Cayô R, Valiatti TB, Gales AC, de Araújo LFB, Rodrigues FM, de Carvalho TS, Vaz MAB, Campanharo M. Biodiversity of carbapenem-resistant bacteria in clinical samples from the Southwest Amazon region (Rondônia/Brazil). Sci Rep 2024; 14:9383. [PMID: 38654061 DOI: 10.1038/s41598-024-59733-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Brazil is recognized for its biodiversity and the genetic variability of its organisms. This genetic variability becomes even more valuable when it is properly documented and accessible. Understanding bacterial diversity through molecular characterization is necessary as it can improve patient treatment, reduce the length of hospital stays and the selection of resistant bacteria, and generate data for health and epidemiological surveillance. In this sense, in this study, we aimed to understand the biodiversity and molecular epidemiology of carbapenem-resistant bacteria in clinical samples recovered in the state of Rondônia, located in the Southwest Amazon region. Retrospective data from the Central Public Health Laboratories (LACEN/RO) between 2018 and 2021 were analysed using the Laboratory Environment Manager Platform (GAL). Seventy-two species with carbapenem resistance profiles were identified, of which 25 species carried at least one gene encoding carbapenemases of classes A (blaKPC-like), B (blaNDM-like, blaSPM-like or blaVIM-like) and D (blaOXA-23-like, blaOXA-24-like, blaOXA-48-like, blaOXA-58-like or blaOXA-143-like), among which we will highlight Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, Serratia marcescens, and Providencia spp. With these results, we hope to contribute to the field by providing epidemiological molecular data for state surveillance on bacterial resistance and assisting in public policy decision-making.
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Affiliation(s)
- Levy Assis Dos Santos
- Federal University of Rondônia Foundation (UNIR), Postgraduate Program in Conservation and Use of Natural Resources (PPGReN), Porto Velho, RO, Brazil.
- Central Public Health Laboratory of Rondônia (LACEN/RO), Medical Biology Center, Porto Velho, RO, Brazil.
| | - Rodrigo Cayô
- Laboratory ALERTA, Department of Medicine, Paulista School of Medicine (EPM), Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
- Laboratory of Bacteriology and Immunology (LIB), Department of Biological Sciences (DCB), Institute of Environmental, Chemical and Pharmaceutical Sciences (ICAQF), Federal University of São Paulo (UNIFESP), Diadema, SP, Brazil
| | - Tiago Barcelos Valiatti
- Laboratory ALERTA, Department of Medicine, Paulista School of Medicine (EPM), Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ana Cristina Gales
- Laboratory ALERTA, Department of Medicine, Paulista School of Medicine (EPM), Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Larissa Fatarelli Bento de Araújo
- Federal University of Rondônia Foundation (UNIR), Postgraduate Program in Conservation and Use of Natural Resources (PPGReN), Porto Velho, RO, Brazil
| | - Fernando Marques Rodrigues
- Central Public Health Laboratory of Rondônia (LACEN/RO), Medical Biology Center, Porto Velho, RO, Brazil
| | - Tatiane Silva de Carvalho
- Central Public Health Laboratory of Rondônia (LACEN/RO), Medical Biology Center, Porto Velho, RO, Brazil
| | - Marcos André Braz Vaz
- Department of Informatics and Statistics, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Marcela Campanharo
- Federal University of Rondônia Foundation (UNIR), Postgraduate Program in Conservation and Use of Natural Resources (PPGReN), Porto Velho, RO, Brazil
- Department of Agricultural and Biological Sciences (DCAB), Federal University of Espirito Santo, São Mateus, ES, Brazil
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Furlan JPR, Rosa RDS, Ramos MS, Santos LDRD, Savazzi EA, Stehling EG. Emergence of carbapenem-resistant Klebsiella pneumoniae species complex from agrifood system: detection of ST6326 co-producing KPC-2 and NDM-1. J Sci Food Agric 2024. [PMID: 38651793 DOI: 10.1002/jsfa.13555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Klebsiella pneumoniae species complex (KpSC) is an important disseminator of carbapenemase-encoding genes, mainly blaKPC-2 and blaNDM-1, from hospitals to the environment. Consequently, carbapenem-resistant strains can be spread through the agrifood system, raising concerns about food safety. Therefore, this study aimed to isolate carbapenem-resistant KpSC strains from agricultural and environmental sectors and characterize them by phenotypic, molecular, and genomic analyses. RESULTS K. pneumoniae and Klebsiella quasipneumoniae strains isolated from soils with lemon, guava, and fig cultivation, and surface waters displayed an extensive drug resistance profile and carried blaKPC-2, blaNDM-1, or both. In addition to carbapenemase-encoding genes, KpSC strains harbor a broad resistome (antimicrobial resistance and metal tolerance) and present putative hypervirulence. Soil-derived K. pneumoniae strains were assigned as high-risk clones (ST11 and ST307) and harbored the blaKPC-2 gene associated with Tn4401b and Tn3-like elements on IncN-pST15 and IncX5 plasmids. In surface waters, the coexistence of blaKPC-2 and blaNDM-1 genes was identified in the K. pneumoniae ST6326, a new carbapenem-resistant regional Brazilian clone. In this case, blaKPC-2 with Tn4401a isoform and blaNDM-1 associated with a Tn125-like transposon were located on different plasmids. In addition, K. quasipneumoniae ST526 presented the blaNDM-1 gene associated with a Tn3000 transposon on an IncX3 plasmid. CONCLUSION These findings alert for the transmission of carbapenemase-positive KpSC across the agricultural and environmental sectors, raising critical food safety and environmental issues. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- João Pedro Rueda Furlan
- Department of Clinical Analyses, Toxicology and Food Science, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rafael da Silva Rosa
- Department of Clinical Analyses, Toxicology and Food Science, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Micaela Santana Ramos
- Department of Clinical Analyses, Toxicology and Food Science, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lucas David Rodrigues Dos Santos
- Department of Clinical Analyses, Toxicology and Food Science, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Eliana Guedes Stehling
- Department of Clinical Analyses, Toxicology and Food Science, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Rwigi D, Nyerere AK, Diakhate MM, Kariuki K, Tickell KD, Mutuma T, Tornberg SN, Soge OO, Walson JL, Singa B, Kariuki S, Pavlinac PB, Mogeni P. Phenotypic and molecular characterization of β-lactamase-producing Klebsiella species among children discharged from hospital in Western Kenya. BMC Microbiol 2024; 24:135. [PMID: 38654237 DOI: 10.1186/s12866-024-03284-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/31/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The emergence and spread of β-lactamase-producing Klebsiella spp. has been associated with a substantial healthcare burden resulting in therapeutic failures. We sought to describe the proportion of phenotypic resistance to commonly used antibiotics, characterize β-lactamase genes among isolates with antimicrobial resistance (AMR), and assess the correlates of phenotypic AMR in Klebsiella spp. isolated from stool or rectal swab samples collected from children being discharged from hospital. METHODS We conducted a cross-sectional study involving 245 children aged 1-59 months who were being discharged from hospitals in western Kenya between June 2016 and November 2019. Whole stool or rectal swab samples were collected and Klebsiella spp. isolated by standard microbiological culture. β-lactamase genes were detected by PCR whilst phenotypic antimicrobial susceptibility was determined using the disc diffusion technique following standard microbiology protocols. Descriptive analyses were used to characterize phenotypic AMR and carriage of β-lactamase-producing genes. The modified Poisson regression models were used to assess correlates of phenotypic beta-lactam resistance. RESULTS The prevalence of β-lactamase carriage among Klebsiella spp. isolates at hospital discharge was 62.9% (154/245). Antibiotic use during hospitalization (adjusted prevalence ratio [aPR] = 4.51; 95%CI: 1.79-11.4, p < 0.001), longer duration of hospitalization (aPR = 1.42; 95%CI: 1.14-1.77, p < 0.002), and access to treated water (aPR = 1.38; 95%CI: 1.12-1.71, p < 0.003), were significant predictors of phenotypically determined β-lactamase. All the 154 β-lactamase-producing Klebsiella spp. isolates had at least one genetic marker of β-lactam/third-generation cephalosporin resistance. The most prevalent genes were blaCTX-M 142/154 (92.2%,) and blaSHV 142/154 (92.2%,) followed by blaTEM 88/154 (57.1%,) and blaOXA 48/154 (31.2%,) respectively. CONCLUSION Carriage of β-lactamase producing Klebsiella spp. in stool is common among children discharged from hospital in western Kenya and is associated with longer duration of hospitalization, antibiotic use, and access to treated water. The findings emphasize the need for continued monitoring of antimicrobial susceptibility patterns to inform the development and implementation of appropriate treatment guidelines. In addition, we recommend measures beyond antimicrobial stewardship and infection control within hospitals, improved sanitation, and access to safe drinking water to mitigate the spread of β-lactamase-producing Klebsiella pathogens in these and similar settings.
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Affiliation(s)
- Doreen Rwigi
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
- Center for Microbiology Research (CMR), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
| | - Andrew K Nyerere
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Mame M Diakhate
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Kevin Kariuki
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Center for Microbiology Research (CMR), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Kirkby D Tickell
- Department of Global Health, University of Washington, Seattle, Washington, USA
- The Childhood Acute Illness & Nutrition (CHAIN) Network, Nairobi, Kenya
| | - Timothy Mutuma
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Center for Microbiology Research (CMR), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | | | - Olusegun O Soge
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Judd L Walson
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- The Childhood Acute Illness & Nutrition (CHAIN) Network, Nairobi, Kenya
- Department of Pediatrics, University of Washington, Seattle, Washington, USA
- Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| | - Benson Singa
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Samuel Kariuki
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
- Center for Microbiology Research (CMR), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Patricia B Pavlinac
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Polycarp Mogeni
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
- Department of Global Health, University of Washington, Seattle, Washington, USA.
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Nayak S, Akshay SD, Deekshit VK, Raj JM, Maiti B. Exposure to imipenem at sub-minimum inhibitory concentration leads to altered expression of major outer membrane proteins in Acinetobacter baumannii. J Appl Microbiol 2024:lxae105. [PMID: 38653725 DOI: 10.1093/jambio/lxae105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
AIMS Acinetobacter baumannii is a nosocomial pathogen known to be multidrug-resistant (MDR), especially to drugs of carbapenem classes. Several factors contribute to resistance, including efflux pumps, β-lactamases, alteration of target sites, and permeability defects. In addition, outer membrane proteins (OMPs) like porins are involved in the passage of antibiotics, and their alteration could lead to resistance development. This study aimed to explore the possible involvement of porins and OMPs in developing carbapenem resistance due to differential expression. METHODS AND RESULTS The antibiotic-susceptible and MDR isolates of A. baumannii were first studied for differences in their transcriptional levels of OMP expression and OMP profiles. The antibiotic-susceptible isolates were further treated with imipenem, and it found that the omp genes were differentially expressed. Six of the nine genes studied were upregulated at 1 h of exposure to imipenem. Their expression gradually decreased with time, further confirmed by their OMP profile and two-dimensional gel electrophoresis. CONCLUSIONS This study could identify OMPs that were differentially expressed on exposure to imipenem. Hence, this study provides insights into the role of specific OMPs in antibiotic resistance in A. baumannii.
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Affiliation(s)
- Srajana Nayak
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research, Department of Bio and Nano Technology, Deralakatte, Mangaluru-575018, Karnataka, India
| | - Sadanand Dangari Akshay
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research, Department of Bio and Nano Technology, Deralakatte, Mangaluru-575018, Karnataka, India
| | - Vijaya Kumar Deekshit
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research, Department of Infectious Diseases & Microbial Genomics, Deralakatte, Mangaluru-575018, Karnataka, India
| | - Juliet Mohan Raj
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research, Department of Infectious Diseases & Microbial Genomics, Deralakatte, Mangaluru-575018, Karnataka, India
| | - Biswajit Maiti
- Nitte (Deemed to be University), Nitte University Centre for Science Education and Research, Department of Bio and Nano Technology, Deralakatte, Mangaluru-575018, Karnataka, India
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Govindaraju G, Rajaiah B, Ramakrishnan S, Thangaraju D, Chandrasekar P, Abiramalatha T. Changing Patterns of Organisms Causing Neonatal Sepsis and Their Antimicrobial Sensitivity Profile in a Tertiary Center - A Prospective Study. Indian J Pediatr 2024:10.1007/s12098-024-05116-y. [PMID: 38647868 DOI: 10.1007/s12098-024-05116-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To identify the profile of organisms causing neonatal sepsis and their antibiotic susceptibility pattern in recent years. METHODS In this prospective study, authors included neonates with blood culture proven sepsis. Antibiotic resistance patterns that were identified were extended spectrum β-lactamase, AmpC β-lactamase and possible carbapenamase producer. Xpert CARBA-R test was performed to identify genes causing carbapenem resistance. RESULTS There were 210 neonates with 216 episodes of blood culture proven sepsis. Klebsiella pneumoniae (n = 85) and Escherichia coli (n = 19) were the most common gram-negative organisms. Coagulase negative Staphylococcus (n = 11) and Staphylococcus aureus (n = 7) were the most common gram positive organisms. There were 17 episodes of fungal sepsis with Candida albicans (n = 6) being the most common. Sixty-five out of 216 (30%) organisms were multidrug resistant. Among the Klebsiella isolates, 32/85 (37.6%) were possible carbapenamase producers. Xpert CARBA-R performed for 13 infants showed that all were positive for New Delhi metallo-β-lactamase. Among the 19 Escherichia coli, 10/19 (37.6%) were multidrug resistant and 1/19 (5.3%) was a possible carbapenamase producer. CONCLUSIONS The authors found a significant increase in New Delhi metallo-β-lactamase positive Klebsiella pneumoniae causing neonatal sepsis in last three years. Regular monitoring of resistance patterns and prudent use of antimicrobials are imperative in regulating the shadow pandemic of multi-drug resistant neonatal sepsis.
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Affiliation(s)
- Gayathiri Govindaraju
- Neonatal Intensive Care Unit, Kovai Medical Center and Hospital (KMCH), Coimbatore, 641014, India
| | - Balakrishnan Rajaiah
- Neonatal Intensive Care Unit, Kovai Medical Center and Hospital (KMCH), Coimbatore, 641014, India
| | - Srinivas Ramakrishnan
- Neonatal Intensive Care Unit, Kovai Medical Center and Hospital (KMCH), Coimbatore, 641014, India
| | - Deepak Thangaraju
- Department of Microbiology, Kovai Medical Center and Hospital (KMCH), Coimbatore, 641014, India
| | - Preethi Chandrasekar
- Neonatal Intensive Care Unit, Kovai Medical Center and Hospital (KMCH), Coimbatore, 641014, India
| | - Thangaraj Abiramalatha
- Neonatal Intensive Care Unit, Kovai Medical Center and Hospital (KMCH), Coimbatore, 641014, India.
- KMCH Research Foundation, Coimbatore, 641014, India.
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Rauseo J, Spataro F, Pescatore T, Patrolecco L. Multiresidue determination and predicted risk assessment of emerging contaminants in sediments from Kongsfjorden, Svalbard. Sci Total Environ 2024; 922:171156. [PMID: 38417527 DOI: 10.1016/j.scitotenv.2024.171156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/19/2024] [Accepted: 02/19/2024] [Indexed: 03/01/2024]
Abstract
The present work provides the first data on the occurrence of different classes of pharmaceuticals and personal care products (PPCPs) in surface marine sediments from an Arctic fjord (Kongsfjorden, Svalbard Islands, Norway). The target compounds included: ciprofloxacin; enrofloxacin; amoxicillin; erythromycin; sulfamethoxazole; carbamazepine; diclofenac; ibuprofen; acetylsalicylic acid; paracetamol; caffeine; triclosan; N,N-diethyl-meta-toluamide; 17β-estradiol; 17α-ethinyl estradiol and estrone. Sampling was performed in the late summer, when high sedimentation rates occur, and over 5 years (2018-2022). Based on the environmental concentrations (MECs) found of emerging contaminants and the relative predicted no-effect concentrations (PNECs), an environmental risk assessment (ERA) for sediments was performed, including the estimation of the Risk Quotients (RQs) of selection and propagation of antimicrobial resistance (AMR) in this Arctic marine ecosystem. Sediments were extracted by Pressurized Liquid Extraction (PLE) and the extracts were purified by Solid Phase Extraction (SPE). Analytical determination was conducted with liquid chromatography-high-resolution mass spectrometry (HPLC-HRMS). PPCPs were detected in the sediments along the fjord in all the years investigated, with overall concentrations similar in most cases to those reported in urbanized areas of the planet and ranging from a minimum of 6.85 ng/g for triclosan to a maximum of 684.5 ng/g for ciprofloxacin. This latter was the only antibiotic detected but was the most abundant compound (32 %) followed by antipyretics (16 %), hormones (14 %), anti-inflammatories (13 %), insect repellents (11 %), stimulants (9 %), and disinfectants (5 %). Highest concentrations of all PPCPs detected were found close to the Ny-Ålesund research village, where human activities and the lack of appropriate wastewater treatment technologies were recognized as primary causes of local contamination. Finally, due to the presence in the sediments of the PPCPs investigated, the ERA highlights a medium (0.1 < RQ < 1) to high risk (RQ > 1) for organisms living in this Arctic marine ecosystem, including high risk of the spread of AMR.
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Affiliation(s)
- Jasmin Rauseo
- Institute of Polar Sciences, National Research Council (ISP-CNR), Strada Provinciale 35d, km 0.700, 00010 Montelibretti, Rome, Italy
| | - Francesca Spataro
- Institute of Polar Sciences, National Research Council (ISP-CNR), Strada Provinciale 35d, km 0.700, 00010 Montelibretti, Rome, Italy.
| | - Tanita Pescatore
- Institute of Polar Sciences, National Research Council (ISP-CNR), Strada Provinciale 35d, km 0.700, 00010 Montelibretti, Rome, Italy
| | - Luisa Patrolecco
- Institute of Polar Sciences, National Research Council (ISP-CNR), Strada Provinciale 35d, km 0.700, 00010 Montelibretti, Rome, Italy
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Cellone I, Russi N, Calvinho LF, Signorini M, Molineri A. Effects of feeding pasteurized waste milk or saleable milk to calves on weight, health and fecal Escherichia coli antimicrobial resistance. J DAIRY RES 2024:1-7. [PMID: 38639043 DOI: 10.1017/s0022029924000219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
The aim of this study was to compare the effects of feeding pasteurized waste milk or saleable milk to calves on weight, health and emergence of antimicrobial resistance in Escherichia coli strains isolated from those calves. An experimental study under field conditions on a commercial pasture-based Argentinian dairy farm was carried out. Forty Holstein calves were assigned randomly to either pasteurized waste milk (PWM) or non-pasteurized saleable milk (SM). The antimicrobial agents (AM) used on the farm, both to treat or prevent diseases, were recorded. The passive immunity level, calf live weight, AM presence in milk, clinical examination of calves, and E. coli isolation and identification, were performed. A total of 258 E. coli strains were isolated from fecal samples (132 isolates from SM calves and 126 from PWM calves at six sampling times). All E. coli isolated were used to perform AM susceptibility tests (disc diffusion and agar dilution). No differences were observed between groups in health parameters, average daily gain or prevalence of resistant E. coli strains to any AM evaluated throughout the study. Peaks of trimethoprim, sulfamethoxazole and enrofloxacin minimum inhibitory concentration (MIC) were observed at 30 d in E. coli from both groups of calves, whilst additional peaks to tetracyclin and ampicillin were observed only in SM calves. All MIC apart from gentamicin decreased at 75 and 90 d of age (during the weaning period). Gentamicin MIC behaved differently, having no peaks and increasing at 90 d only in PWM group. In conclusion, we found no evidence that emergence of antibiotic resistance is related to the consumption of pasteurized waste milk.
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Affiliation(s)
- Ivana Cellone
- Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral, Kreder 2805, Esperanza 3080, Santa Fe, Argentina
| | - Norma Russi
- Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral, Kreder 2805, Esperanza 3080, Santa Fe, Argentina
| | - Luis F Calvinho
- Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral, Kreder 2805, Esperanza 3080, Santa Fe, Argentina
- Instituto de Investigación de la Cadena Láctea (IDICaL, INTA-CONICET) - EEA Rafaela INTA, Ruta Nacional 34 Km 227, Rafaela 2300, Santa Fe, Argentina
| | - Marcelo Signorini
- Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral, Kreder 2805, Esperanza 3080, Santa Fe, Argentina
- Instituto de Investigación de la Cadena Láctea (IDICaL, INTA-CONICET) - EEA Rafaela INTA, Ruta Nacional 34 Km 227, Rafaela 2300, Santa Fe, Argentina
| | - Ana Molineri
- Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral, Kreder 2805, Esperanza 3080, Santa Fe, Argentina
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Hala S, Malaikah M, Huang J, Bahitham W, Fallatah O, Zakri S, Antony CP, Alshehri M, Ghazzali RN, Ben-Rached F, Alsahafi A, Alsaedi A, AlAhmadi G, Kaaki M, Alazmi M, AlhajHussein B, Yaseen M, Zowawi HM, Alghoribi MF, Althaqafi AO, Al-Amri A, Moradigaravand D, Pain A. The emergence of highly resistant and hypervirulent Klebsiella pneumoniae CC14 clone in a tertiary hospital over 8 years. Genome Med 2024; 16:58. [PMID: 38637822 PMCID: PMC11025284 DOI: 10.1186/s13073-024-01332-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/08/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Klebsiella pneumoniae is a major bacterial and opportunistic human pathogen, increasingly recognized as a healthcare burden globally. The convergence of resistance and virulence in K. pneumoniae strains has led to the formation of hypervirulent and multidrug-resistant strains with dual risk, limiting treatment options. K. pneumoniae clones are known to emerge locally and spread globally. Therefore, an understanding of the dynamics and evolution of the emerging strains in hospitals is warranted to prevent future outbreaks. METHODS In this study, we conducted an in-depth genomic analysis on a large-scale collection of 328 multidrug-resistant (MDR) K. pneumoniae strains recovered from 239 patients from a single major hospital in the western coastal city of Jeddah in Saudi Arabia from 2014 through 2022. We employed a broad range of phylogenetic and phylodynamic methods to understand the evolution of the predominant clones on epidemiological time scales, virulence and resistance determinants, and their dynamics. We also integrated the genomic data with detailed electronic health record (EHR) data for the patients to understand the clinical implications of the resistance and virulence of different strains. RESULTS We discovered a diverse population underlying the infections, with most strains belonging to Clonal Complex 14 (CC14) exhibiting dominance. Specifically, we observed the emergence and continuous expansion of strains belonging to the dominant ST2096 in the CC14 clade across hospital wards in recent years. These strains acquired resistance mutations against colistin and extended spectrum β-lactamase (ESBL) and carbapenemase genes, namely blaOXA-48 and blaOXA-232, located on three distinct plasmids, on epidemiological time scales. Strains of ST2096 exhibited a high virulence level with the presence of the siderophore aerobactin (iuc) locus situated on the same mosaic plasmid as the ESBL gene. Integration of ST2096 with EHR data confirmed the significant link between colonization by ST2096 and the diagnosis of sepsis and elevated in-hospital mortality (p-value < 0.05). CONCLUSIONS Overall, these results demonstrate the clinical significance of ST2096 clones and illustrate the rapid evolution of an emerging hypervirulent and MDR K. pneumoniae in a clinical setting.
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Affiliation(s)
- Sharif Hala
- Pathogen Genomics Laboratory, Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, 23955-6900, Jeddah, Makkah, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Mohammed Malaikah
- Pathogen Genomics Laboratory, Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, 23955-6900, Jeddah, Makkah, Saudi Arabia
- Laboratory of Infectious Disease Epidemiology, Biological and Environmental Science and Engineering (BESE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Jiayi Huang
- Laboratory of Infectious Disease Epidemiology, Biological and Environmental Science and Engineering (BESE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
- KAUST Computational Bioscience Research Center (CBRC), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
| | - Wesam Bahitham
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Omniya Fallatah
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Samer Zakri
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Chakkiath Paul Antony
- Pathogen Genomics Laboratory, Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, 23955-6900, Jeddah, Makkah, Saudi Arabia
- International Institute for Zoonosis Control, Hokkaido University, Sapporo, 001-0020, Japan
| | - Mohammed Alshehri
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Raeece Naeem Ghazzali
- Pathogen Genomics Laboratory, Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, 23955-6900, Jeddah, Makkah, Saudi Arabia
| | - Fathia Ben-Rached
- Pathogen Genomics Laboratory, Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, 23955-6900, Jeddah, Makkah, Saudi Arabia
| | - Abdullah Alsahafi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Asim Alsaedi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Ghadeer AlAhmadi
- King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Mai Kaaki
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Meshari Alazmi
- KAUST Computational Bioscience Research Center (CBRC), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia
- College of Computer Science and Engineering, University of Hail, Hail, Saudi Arabia
| | - Baraa AlhajHussein
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Muhammad Yaseen
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Hosam M Zowawi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
- The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, Australia
| | - Majed F Alghoribi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Abdulhakeem O Althaqafi
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Abdulfattah Al-Amri
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Infectious Disease Research Department, King Abdullah International Medical Research Centre, Jeddah, Saudi Arabia
- Ministry of National Guard Health Affairs, Riyadh, Western Region, Saudi Arabia
| | - Danesh Moradigaravand
- Laboratory of Infectious Disease Epidemiology, Biological and Environmental Science and Engineering (BESE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia.
- KAUST Computational Bioscience Research Center (CBRC), King Abdullah University of Science and Technology (KAUST), Thuwal, Saudi Arabia.
| | - Arnab Pain
- Pathogen Genomics Laboratory, Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, 23955-6900, Jeddah, Makkah, Saudi Arabia.
- The University of Queensland, UQ Centre for Clinical Research, Herston, QLD, Australia.
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Montrucchio G, Balzani E, Sales G, Vaninetti A, Grillo F, Trompeo AC, Zanierato M, Fanelli V, Corcione S, De Rosa FG, Curtoni A, Costa C, Brazzi L. Multidrug-resistant pathogens and ventilator-associated pneumonia in critically ill COVID-19 and non-COVID-19 patients: a prospective observational monocentric comparative study. Respir Res 2024; 25:168. [PMID: 38637766 PMCID: PMC11027225 DOI: 10.1186/s12931-024-02779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has increased the incidence of ventilator-associated pneumonia (VAP) among critically ill patients. However, a comparison of VAP incidence in COVID-19 and non-COVID-19 cohorts, particularly in a context with a high prevalence of multidrug-resistant (MDR) organisms, is lacking. MATERIAL AND METHODS We conducted a single-center, mixed prospective and retrospective cohort study comparing COVID-19 patients admitted to the intensive care unit (ICU) of the "Città della Salute e della Scienza" University Hospital in Turin, Italy, between March 2020 and December 2021 (COVID-19 group), with a historical cohort of ICU patients admitted between June 2016 and March 2018 (NON-COVID-19 group). The primary objective was to define the incidence of VAP in both cohorts. Secondary objectives were to evaluate the microbial cause, resistance patters, risk factors and impact on 28 days, ICU and in-hospital mortality, duration of ICU stay, and duration of hospitalization). RESULTS We found a significantly higher incidence of VAP (51.9% - n = 125) among the 241 COVID-19 patients compared to that observed (31.2% - n = 78) among the 252 NON-COVID-19 patients. The median SOFA score was significantly lower in the COVID-19 group (9, Interquartile range, IQR: 7-11 vs. 10, IQR: 8-13, p < 0.001). The COVID-19 group had a higher prevalence of Gram-positive bacteria-related VAP (30% vs. 9%, p < 0.001), but no significant difference was observed in the prevalence of difficult-to-treat (DTR) or MDR bacteria. ICU and in-hospital mortality in the COVID-19 and NON-COVID-19 groups were 71% and 74%, vs. 33% and 43%, respectively. The presence of COVID-19 was significantly associated with an increased risk of 28-day all-cause hospital mortality (Hazard ratio, HR: 7.95, 95% Confidence Intervals, 95% CI: 3.10-20.36, p < 0.001). Tracheostomy and a shorter duration of mechanical ventilation were protective against 28-day mortality, while dialysis and a high SOFA score were associated with a higher risk of 28-day mortality. CONCLUSION COVID-19 patients with VAP appear to have a significantly higher ICU and in-hospital mortality risk regardless of the presence of MDR and DTR pathogens. Tracheostomy and a shorter duration of mechanical ventilation appear to be associated with better outcomes.
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Affiliation(s)
- Giorgia Montrucchio
- Department of Surgical Sciences, University of Turin, Turin, Italy.
- Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, Turin, Italy.
| | - Eleonora Balzani
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Gabriele Sales
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Anna Vaninetti
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Francesca Grillo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Anna Chiara Trompeo
- Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Marinella Zanierato
- Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Vito Fanelli
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Silvia Corcione
- Department of Medical Sciences, University of Turin, Turin, Italy
- Tufts University School of Medicine, Boston, MA, 02111, USA
| | | | - Antonio Curtoni
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
- Microbiology and Virology Laboratory, Città Della Salute e Della Scienza Hospital, Corso Dogliotti 14, Turin, 10126, Italy
| | - Cristina Costa
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
- Microbiology and Virology Laboratory, Città Della Salute e Della Scienza Hospital, Corso Dogliotti 14, Turin, 10126, Italy
| | - Luca Brazzi
- Department of Surgical Sciences, University of Turin, Turin, Italy
- Department of Anesthesia, Intensive Care and Emergency, Città della Salute e della Scienza Hospital, Turin, Italy
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Das S, Pandey AK, Morris DE, Anderson R, Lim V, Wie CC, Yap IKS, Alattraqchi AG, Simin H, Abdullah R, Yeo CC, Clarke SC, Cleary DW. Respiratory carriage of hypervirulent Klebsiella pneumoniae by indigenous populations of Malaysia. BMC Genomics 2024; 25:381. [PMID: 38632538 PMCID: PMC11025145 DOI: 10.1186/s12864-024-10276-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
Klebsiella pneumoniae is a Gram-negative Enterobacteriaceae that is classified by the World Health Organisation (WHO) as a Priority One ESKAPE pathogen. South and Southeast Asian countries are regions where both healthcare associated infections (HAI) and community acquired infections (CAI) due to extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant K. pneumoniae (CRKp) are of concern. As K. pneumoniae can also exist as a harmless commensal, the spread of resistance genotypes requires epidemiological vigilance. However there has been no significant study of carriage isolates from healthy individuals, particularly in Southeast Asia, and specially Malaysia. Here we describe the genomic analysis of respiratory isolates of K. pneumoniae obtained from Orang Ulu and Orang Asli communities in Malaysian Borneo and Peninsular Malaysia respectively. The majority of isolates were K. pneumoniae species complex (KpSC) 1 K. pneumoniae (n = 53, 89.8%). Four Klebsiella variicola subsp. variicola (KpSC3) and two Klebsiella quasipneumoniae subsp. similipneumoniae (KpSC4) were also found. It was discovered that 30.2% (n = 16) of the KpSC1 isolates were ST23, 11.3% (n = 6) were of ST65, 7.5% (n = 4) were ST13, and 13.2% (n = 7) were ST86. Only eight of the KpSC1 isolates encoded ESBL, but importantly not carbapenemase. Thirteen of the KpSC1 isolates carried yersiniabactin, colibactin and aerobactin, all of which harboured the rmpADC locus and are therefore characterised as hypervirulent. Co-carriage of multiple strains was minimal. In conclusion, most isolates were KpSC1, ST23, one of the most common sequence types and previously found in cases of K. pneumoniae infection. A proportion were hypervirulent (hvKp) however antibiotic resistance was low.
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Affiliation(s)
- Souradeep Das
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Anish K Pandey
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
| | - Denise E Morris
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Rebecca Anderson
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Victor Lim
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Chong Chun Wie
- Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Ivan Kok Seng Yap
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Ahmed Ghazi Alattraqchi
- Centre for Research in Infectious Diseases and Biotechnology (CeRIDB), Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, 20400, Kuala Terengganu, Terengganu, Malaysia
| | - Hafis Simin
- Faculty of Applied Social Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300, Kuala Nerus, Terengganu, Malaysia
| | - Ramle Abdullah
- Centre of Excellence in National Indigenous Pedagogy, Institute of Teacher Education Tengku, Ampuan Afzan Campus, Pahang, Malaysia
| | - Chew Chieng Yeo
- Centre for Research in Infectious Diseases and Biotechnology (CeRIDB), Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, 20400, Kuala Terengganu, Terengganu, Malaysia
| | - Stuart C Clarke
- Faculty of Medicine, Institute for Life Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton Foundation NHS Trust, Southampton, UK
- Institute for Research, Development and Innovation, International Medical University, Kuala Lumpur, Malaysia
- Global Health Research Institute, University of Southampton, Southampton, UK
| | - David W Cleary
- Institute of Microbiology and Infection, College of Medical and Dental Sciences, University of Birmingham, University of Birmingham, UK.
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Guo R, Fang X, Shang K, Wen J, Ding K. Induction of ferroptosis: A new strategy for the control of bacterial infections. Microbiol Res 2024; 284:127728. [PMID: 38643523 DOI: 10.1016/j.micres.2024.127728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/30/2024] [Revised: 04/07/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
The continued rise of drug-resistant bacterial infections heightens a threat of a pandemic of antimicrobial resistance to the global health. The urgency of infection control against antimicrobial-resistant bacteria is evident. Ferroptosis, a newly defined form of iron-dependent cell death characterized by lipid peroxidation, has garnered substantial interest since this programmed cell death was associated with pathophysiological processes of many diseases. Exploring whether ferroptosis could be utilized in infectious diseases holds significant importance for discovering novel antimicrobial approaches. Recent years have witnessed significant progress with respect to elucidating the mechanisms that govern ferroptosis induction and its roles in bacterial pathogenesis and host-pathogen interactions. In this review, we discuss the mechanisms of targeting ferroptosis and/or iron homeostasis for the control of antimicrobial-resistant bacterial infections. These implications may inform and enable effective therapeutic strategies against pathogen infection and provide novel insights into the potential applications of ferroptosis to address the global bacterial resistance crisis.
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Affiliation(s)
- Rongxian Guo
- Laboratory of Functional Microbiology and Animal Health, College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471003, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Xin Fang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Ke Shang
- Laboratory of Functional Microbiology and Animal Health, College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471003, China
| | - Jiachen Wen
- Key Laboratory of Structure-Based Drugs Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China.
| | - Ke Ding
- Laboratory of Functional Microbiology and Animal Health, College of Animal Science and Technology, Henan University of Science and Technology, Luoyang 471003, China.
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Deddefo A, Mamo G, Asfaw M, Edao A, Hiko A, Fufa D, Jafer M, Sombo M, Amenu K. Occurrence, antimicrobial susceptibility, and resistance genes of Staphylococcus aureus in milk and milk products in the Arsi highlands of Ethiopia. BMC Microbiol 2024; 24:127. [PMID: 38627609 PMCID: PMC11020821 DOI: 10.1186/s12866-024-03288-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND In Ethiopia, milk production and handling practices often lack proper hygiene measures, leading to the potential contamination of milk and milk products with Staphylococcus aureus (S. aureus), including methicillin-resistant strains, posing significant public health concerns. This study aimed to investigate the occurrence, antimicrobial susceptibility profiles and presence of resistance genes in S. aureus strains isolated from milk and milk products. METHODS A cross-sectional study was conducted in the Arsi highlands, Oromia, Ethiopia from March 2022 to February 2023. A total of 503 milk and milk product samples were collected, comprising 259 raw milk, 219 cottage cheese, and 25 traditional yogurt samples. S. aureus isolation and coagulase-positive staphylococci enumeration were performed using Baird-Parker agar supplemented with tellurite and egg yolk. S. aureus was further characterized based on colony morphology, Gram stain, mannitol fermentation, catalase test, and coagulase test. Phenotypic antimicrobial resistance was assessed using the Kirby-Bauer disc diffusion method, while the polymerase chain reaction (PCR) was employed for confirming the presence of S. aureus and detecting antimicrobial resistance genes. RESULTS S. aureus was detected in 24.9% of the milk and milk products, with the highest occurrence in raw milk (40.9%), followed by yogurt (20%), and cottage cheese (6.4%). The geometric mean for coagulase-positive staphylococci counts in raw milk, yogurt, and cottage cheese was 4.6, 3.8, and 3.2 log10 CFU/mL, respectively. Antimicrobial resistance analysis revealed high levels of resistance to ampicillin (89.7%) and penicillin G (87.2%), with 71.8% of the isolates demonstrating multidrug resistance. Of the 16 S. aureus isolates analyzed using PCR, all were found to carry the nuc gene, with the mecA and blaZ genes detected in 50% of these isolates each. CONCLUSION This study revealed the widespread distribution of S. aureus in milk and milk products in the Arsi highlands of Ethiopia. The isolates displayed high resistance to ampicillin and penicillin, with a concerning level of multidrug resistance. The detection of the mecA and blaZ genes in selected isolates is of particular concern, highlighting a potential public health hazard and posing a challenge to effective antimicrobial treatment. These findings highlight the urgent need to enhance hygiene standards in milk and milk product handling and promote the rational use of antimicrobial drugs. Provision of adequate training for all individuals involved in the dairy sector can help minimize contamination. These measures are crucial in addressing the threats posed by S. aureus, including methicillin-resistant strains, and ensuring the safety of milk and its products for consumers.
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Affiliation(s)
- Abiot Deddefo
- College of Agriculture and Environmental Sciences, Arsi University, P.O. Box 193, Asella, Ethiopia.
- College of Veterinary Medicine and Agriculture, Addis Ababa University, P.O. Box 34, Bishoftu, Ethiopia.
| | - Gezahegne Mamo
- College of Veterinary Medicine and Agriculture, Addis Ababa University, P.O. Box 34, Bishoftu, Ethiopia
| | - Minda Asfaw
- College of Agriculture and Environmental Sciences, Arsi University, P.O. Box 193, Asella, Ethiopia
| | - Adem Edao
- College of Veterinary Medicine, Haramaya University, P.O. Box 138, Haramaya, Ethiopia
| | - Adem Hiko
- College of Veterinary Medicine, Haramaya University, P.O. Box 138, Haramaya, Ethiopia
| | - Dereje Fufa
- Asella Regional Veterinary Laboratory, P.O. Box 212, Asella, Ethiopia
| | - Mohammed Jafer
- College of Veterinary Medicine, Haramaya University, P.O. Box 138, Haramaya, Ethiopia
| | - Melaku Sombo
- National Animal Health Institute, P.O. Box 04, Sebeta, Ethiopia
| | - Kebede Amenu
- College of Veterinary Medicine and Agriculture, Addis Ababa University, P.O. Box 34, Bishoftu, Ethiopia
- Animal and Human Health Programme, International Livestock Research Institute (ILRI), P.O. Box 5689, Addis Ababa, Ethiopia
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Zheng Z, Ye L, Xiong W, Hu Q, Chen K, Sun R, Chen S. Prevalence and genomic characterization of the Bacillus cereus group strains contamination in food products in Southern China. Sci Total Environ 2024; 921:170903. [PMID: 38354793 DOI: 10.1016/j.scitotenv.2024.170903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/16/2024]
Abstract
The Bacillus cereus group, as one of the important opportunistic foodborne pathogens, is considered a risk to public health due to foodborne diseases and an important cause of economic losses to food industries. This study aimed to gain essential information on the prevalence, phenotype, and genotype of B. cereus group strains isolated from various food products in China. A total of 890 strains of B. cereus group bacteria from 1181 food samples from 2020 to 2023 were identified using the standardized detection method. These strains were found to be prevalent in various food types, with the highest contamination rates observed in cereal flour (55.8 %) and wheat/rice noodles (45.7 %). The tested strains exhibited high resistance rates against penicillin (98.5 %) and ampicillin (98.9 %). Strains isolated from cereal flour had the highest rate of meropenem resistance (7.8 %), while strains from sausages were most resistant to vancomycin (16.8 %). A total of 234 out of the 891 B. cereus group strains were randomly selected for WGS analysis, 18.4 % of which displayed multidrug resistance. The species identification by WGS analysis revealed the presence of 10 distinct species within the B. cereus group, with B. cereus species being the most prevalent. The highest level of species diversity was observed in sausages. Notably, B. anthracis strains lacking the anthrax toxin genes were detected in flour-based food products and sausages. A total of 20 antibiotic resistance genes have been identified, with β-lactam resistance genes (bla1, bla2, BcI, BcII, and blaTEM-116) being the most common. The B. tropicus strains exhibit the highest average number of virulence genes (23.4). The diarrheal virulence genes nheABC, hblACD, and cytK were found in numerous strains. Only 4 of the 234 (1.7 %) sequenced strains contain the ces gene cluster linked to emetic symptoms. These data offer valuable insights for public health policymakers on addressing foodborne B. cereus group infections and ensuring food safety.
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Affiliation(s)
- Zhiwei Zheng
- State Key Lab of Chemical Biology and Drug Discovery, Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong; Shenzhen Key Lab for Biological Safety Control, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Lianwei Ye
- State Key Lab of Chemical Biology and Drug Discovery, Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong; Shenzhen Key Lab for Biological Safety Control, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China; Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Wenguang Xiong
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China
| | - Qiao Hu
- State Key Lab of Chemical Biology and Drug Discovery, Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong; Shenzhen Key Lab for Biological Safety Control, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China; Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Kaichao Chen
- State Key Lab of Chemical Biology and Drug Discovery, Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong; Shenzhen Key Lab for Biological Safety Control, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Ruanyang Sun
- State Key Lab of Chemical Biology and Drug Discovery, Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong; Shenzhen Key Lab for Biological Safety Control, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China
| | - Sheng Chen
- State Key Lab of Chemical Biology and Drug Discovery, Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong; Shenzhen Key Lab for Biological Safety Control, The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, China.
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Xiao X, He M, Ma L, Lv W, Huang K, Yang H, Li Y, Zou L, Xiao Y, Wang W. Insights into microbial contamination and antibiotic resistome traits in pork wholesale market: An evaluation of the disinfection effect of sodium hypochlorite. J Hazard Mater 2024; 468:133811. [PMID: 38382341 DOI: 10.1016/j.jhazmat.2024.133811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 02/23/2024]
Abstract
Chlorine and its derivatives, such as sodium hypochlorite (NaClO) and chlorine dioxide, are frequently employed as disinfectants throughout the pork supply chain in China. Nevertheless, the extensive use of NaClO has the potential to cause the creation of 'chlorine-tolerant bacteria' and accelerate the evolution of antibiotic resistance. This study evaluated the efficacy of NaClO disinfection by examining alterations in the microbiome and resistome of a pork wholesale market (PWM), and bacteria isolation and analysis were performed to validate the findings. As expected, the taxonomic compositions of bacteria was significantly different before and after disinfection. Notably, Salmonella enterica (S. enterica), Salmonella bongori (S. bongori), Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa) were observed on all surfaces, indicating that the application of NaClO disinfection treatment in PWM environments for pathogenic bacteria is limited. Correlations were identified between antibiotic resistance genes (ARGs) associated with aminoglycosides (aph(3'')-I, aph(6')-I), quinolone (qnrB, abaQ), polymyxin (arnA, mcr-4) and disinfectant resistance genes (emrA/BD, mdtA/B/C/E/F). Furthermore, correlations were found between risk Rank I ARGs associated with aminoglycoside (aph(3')-I), tetracycline (tetH), beta_lactam (TEM-171), and disinfectant resistance genes (mdtB/C/E/F, emrA, acrB, qacG). Importantly, we found that Acinetobacter and Salmonella were the main hosts of disinfectant resistance genes. The resistance mechanisms of the ARGs identified in PWM were dominated by antibiotic deactivation (38.7%), antibiotic efflux (27.2%), and antibiotic target protection (14.4%). The proportion of genes encoding efflux pumps in the PWM resistome increased after disinfection. Microbial cultures demonstrated that the traits of microbial contamination and antibiotic resistane were consistent with those observed by metagenomic sequencing. This study highlights the possibility of cross-resistance between NaClO disinfectants and antibiotics, which should not be ignored.
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Affiliation(s)
- Xingning Xiao
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, MOA Laboratory of Quality & Safety Risk Assessment for Agro-products (Hangzhou), Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Miao He
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, MOA Laboratory of Quality & Safety Risk Assessment for Agro-products (Hangzhou), Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, China; College of Food and Pharmaceutical Sciences, Ningbo University, Ningbo, China
| | - Lingyan Ma
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, MOA Laboratory of Quality & Safety Risk Assessment for Agro-products (Hangzhou), Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Wentao Lv
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, MOA Laboratory of Quality & Safety Risk Assessment for Agro-products (Hangzhou), Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Kang Huang
- Biological Systems Engineering, Washington State University, Pullman, USA
| | - Hua Yang
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, MOA Laboratory of Quality & Safety Risk Assessment for Agro-products (Hangzhou), Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Yanbin Li
- Department of Biological & Agricultural Engineering, University of Arkansas, Fayetteville, AR 72701, USA
| | - Likou Zou
- College of Resources and Environment, Sichuan Agricultural University, Chengdu, China.
| | - Yingping Xiao
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, MOA Laboratory of Quality & Safety Risk Assessment for Agro-products (Hangzhou), Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, China.
| | - Wen Wang
- State Key Laboratory for Managing Biotic and Chemical Threats to the Quality and Safety of Agro-products, MOA Laboratory of Quality & Safety Risk Assessment for Agro-products (Hangzhou), Institute of Agro-product Safety and Nutrition, Zhejiang Academy of Agricultural Sciences, Hangzhou, China.
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Schmiege D, Haselhoff T, Thomas A, Kraiselburd I, Meyer F, Moebus S. Small-scale wastewater-based epidemiology (WBE) for infectious diseases and antibiotic resistance: A scoping review. Int J Hyg Environ Health 2024; 259:114379. [PMID: 38626689 DOI: 10.1016/j.ijheh.2024.114379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/12/2024] [Revised: 03/25/2024] [Accepted: 04/08/2024] [Indexed: 04/18/2024]
Abstract
Wastewater analysis can serve as a source of public health information. In recent years, wastewater-based epidemiology (WBE) has emerged and proven useful for the detection of infectious diseases. However, insights from the wastewater treatment plant do not allow for the small-scale differentiation within the sewer system that is needed to analyze the target population under study in more detail. Small-scale WBE offers several advantages, but there has been no systematic overview of its application. The aim of this scoping review is to provide a comprehensive overview of the current state of knowledge on small-scale WBE for infectious diseases, including methodological considerations for its application. A systematic database search was conducted, considering only peer-reviewed articles. Data analyses included quantitative summary and qualitative narrative synthesis. Of 2130 articles, we included 278, most of which were published since 2020. The studies analyzed wastewater at the building level (n = 203), especially healthcare (n = 110) and educational facilities (n = 80), and at the neighborhood scale (n = 86). The main analytical parameters were viruses (n = 178), notably SARS-CoV-2 (n = 161), and antibiotic resistance (ABR) biomarkers (n = 99), often analyzed by polymerase chain reaction (PCR), with DNA sequencing techniques being less common. In terms of sampling techniques, active sampling dominated. The frequent lack of detailed information on the specification of selection criteria and the characterization of the small-scale sampling sites was identified as a concern. In conclusion, based on the large number of studies, we identified several methodological considerations and overarching strategic aspects for small-scale WBE. An enabling environment for small-scale WBE requires inter- and transdisciplinary knowledge sharing across countries. Promoting the adoption of small-scale WBE will benefit from a common international conceptualization of the approach, including standardized and internationally accepted terminology. In particular, the development of good WBE practices for different aspects of small-scale WBE is warranted. This includes the establishment of guidelines for a comprehensive characterization of the local sewer system and its sub-sewersheds, and transparent reporting to ensure comparability of small-scale WBE results.
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Affiliation(s)
- Dennis Schmiege
- Institute for Urban Public Health (InUPH), University Hospital Essen, University of Duisburg-Essen, 45130, Essen, Germany.
| | - Timo Haselhoff
- Institute for Urban Public Health (InUPH), University Hospital Essen, University of Duisburg-Essen, 45130, Essen, Germany
| | - Alexander Thomas
- Institute for Artificial Intelligence in Medicine (IKIM), University Hospital Essen, University of Duisburg-Essen, 45131, Essen, Germany
| | - Ivana Kraiselburd
- Institute for Artificial Intelligence in Medicine (IKIM), University Hospital Essen, University of Duisburg-Essen, 45131, Essen, Germany
| | - Folker Meyer
- Institute for Artificial Intelligence in Medicine (IKIM), University Hospital Essen, University of Duisburg-Essen, 45131, Essen, Germany
| | - Susanne Moebus
- Institute for Urban Public Health (InUPH), University Hospital Essen, University of Duisburg-Essen, 45130, Essen, Germany
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Simão FA, Almeida MM, Rosa HS, Marques EA, Leão RS. Genetic determinants of antimicrobial resistance in polymyxin B resistant Pseudomonas aeruginosa isolated from airways of patients with cystic fibrosis. Braz J Microbiol 2024:10.1007/s42770-024-01311-3. [PMID: 38619733 DOI: 10.1007/s42770-024-01311-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/21/2024] [Indexed: 04/16/2024] Open
Abstract
Pseudomonas aeruginosa is the main pathogen associated with pulmonary exacerbation in patients with cystic fibrosis (CF). CF is a multisystemic genetic disease caused by mutations in the cystic fibrosis transmembrane conductance regulator gene, which mainly affects pulmonary function. P. aeruginosa isolated from individuals with CF in Brazil is not commonly associated with multidrug resistance (MDR), especially when compared to global occurrence, where the presence of epidemic clones, capable of expressing resistance to several drugs, is often reported. Due to the recent observations of MDR isolates of P. aeruginosa in our centers, combined with these characteristics, whole-genome sequencing was employed for analyses related to antimicrobial resistance, plasmid identification, search for phages, and characterization of CF clones. All isolates in this study were polymyxin B resistant, exhibiting diverse mutations and reduced susceptibility to carbapenems. Alterations in mexZ can result in the overexpression of the MexXY efflux pump. Mutations in oprD, pmrB, parS, gyrA and parC may confer reduced susceptibility to antimicrobials by affecting permeability, as observed in phenotypic tests. The phage findings led to the assumption of horizontal genetic transfer, implicating dissemination between P. aeruginosa isolates. New sequence types were described, and none of the isolates showed an association with epidemic CF clones. Analysis of the genetic context of P. aeruginosa resistance to polymyxin B allowed us to understand the different mechanisms of resistance to antimicrobials, in addition to subsidizing the understanding of possible relationships with epidemic strains that circulate among individuals with CF observed in other countries.
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Affiliation(s)
- Felipe A Simão
- Laboratório de Microbiologia da Fibrose Cística, Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mila M Almeida
- Laboratório de Microbiologia da Fibrose Cística, Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heloísa S Rosa
- Laboratório de Microbiologia da Fibrose Cística, Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elizabeth A Marques
- Laboratório de Microbiologia da Fibrose Cística, Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Robson S Leão
- Laboratório de Microbiologia da Fibrose Cística, Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
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Sahuquillo-Arce J, Suárez-Urquiza P, Hernández-Cabezas A, Tofan L, Chouman-Arcas R, García-Hita M, Sabalza-Baztán O, Sellés-Sánchez A, Lozano-Rodríguez N, Martí-Cuñat J, López-Hontangas J. Actinotignum schaalii infection: Challenges in diagnosis and treatment. Heliyon 2024; 10:e28589. [PMID: 38590897 PMCID: PMC10999919 DOI: 10.1016/j.heliyon.2024.e28589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/17/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Actinotignum schaalii affects elderly people and is associated with individuals with urological-related predispositions, but can be found in a variety of locations, such as cutaneous, intraabdominal, genitourinary and surgical infections. Disseminated infections occur less frequently and are by and large related to urinary tract colonisation. This pathogen is often neglected due to growth requirements, especially in urinary tract infections. We present 107 Actinotignum schaalii isolated from genitourinary samples (80.4%), from skin and soft tissue infections (13.1%), from bone and deep tissue infection (4.7%) and from blood cultures (1.9%). The automated system Alfred 60/AST was paramount for the isolation of 77.6% of the UTI. All the isolates tested were susceptible to penicillin, ampicillin, linezolid, vancomycin, teicoplanin, rifampicin and tetracycline. In conclusion, we present a large series of Actinotignum schaalii infections. This pathogen is hard to isolate, and is resistant to commonly used empirical antimicrobials.
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Affiliation(s)
- J.M. Sahuquillo-Arce
- Servicio de Microbiología, Hospital Doctor Moliner, Serra, Spain
- Grupo de Investigación de Infecciones Respiratorias, IIS La Fe, Valencia, Spain
| | - P. Suárez-Urquiza
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - A. Hernández-Cabezas
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - L. Tofan
- Servicio de Análisis Clínicos, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - R. Chouman-Arcas
- Servicio de Microbiología, Hospital Francesc de Borja, Gandia, Spain
| | - M. García-Hita
- Servicio de Microbiología, Hospital de la Vega Lorenzo Guirao, Cieza, Spain
| | - O. Sabalza-Baztán
- Servicio de Microbiología, Hospital General Universitari de Castelló, Castellón de la Plana, Spain
| | | | - N. Lozano-Rodríguez
- Servicio de Microbiología, Hospital General Universitari de Castelló, Castellón de la Plana, Spain
| | - J. Martí-Cuñat
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - J.L. López-Hontangas
- Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Yihunie FB, Belete MA, Fentahun G, Dubie T. Molecular detection and antibiogram of Shiga toxin-producing Escherichia coli (STEC) from raw milk in and around Bahir Dar town dairy farms, Ethiopia. Heliyon 2024; 10:e28839. [PMID: 38601628 PMCID: PMC11004750 DOI: 10.1016/j.heliyon.2024.e28839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 03/16/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
Illnesses associated with consuming infected milk and milk products are a widespread problem in low and middle-income countries. Shiga toxin-producing Escherichia coli (STEC) is a bacterium commonly found in raw milk and causes foodborne diseases ranging from mild diarrhea to severe hemorrhagic colitis and hemolytic uremic syndrome. This study aimed to investigate the virulence gene and antimicrobial resistance profiles of Shiga toxin-producing E. coli strains isolated from raw milk in dairy farms in and around Bahir Dar town. Raw milk samples (n = 128) collected from December 2021 to July 2022 were cultured, and E. coli strains were isolated using standard methods. Shiga toxin-producing E. coli strains were identified genotypically by the presence of the virulence markers using a single-plex polymerase chain reaction. The antibiotic susceptibility testing of Shiga toxin-producing E. coli isolates was done by the agar disk diffusion method. In total, 32 E. coli isolates were recovered from milk samples from lactating animals. PCR screening of these isolates resulted in 19 (59.3%) positives for Shiga toxin-producing E. coli. The stx2 gene was detected in 53% of cases, followed by stx1 (31%) and eae (16%. The STEC isolates were highly sensitive to ciprofloxacin (94.7%) and kanamycin (89.5%), while exhibiting significant resistance to amoxicillin (89.5%) and streptomycin (73.7%). The present study points out the occurrence of virulent and antibiotic-resistant Shiga toxin-producing E. coli strains in raw milk that could pose a potential risk to public health. Further analysis by whole genome sequencing is necessary for an in-depth assessment and understanding of their virulence and resistance factors. Moreover, large-scale studies are needed to identify the prevalence and potential risk factors and to prevent the spread of antibiotic-resistant STEC strains in the milk production chain.
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Affiliation(s)
| | - Mequanint Addisu Belete
- Department of Veterinary Laboratory Technology, College of Agriculture and Natural Resource, Debre Markos University, Debre Markos, Ethiopia
- Institute of Biotechnology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gizachew Fentahun
- College of Veterinary Medicine and Animal Science, Samara University, Semera, Ethiopia
| | - Teshager Dubie
- College of Veterinary Medicine and Animal Science, Samara University, Semera, Ethiopia
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Gan M, Zhang Y, Yan G, Wang Y, Lu G, Wu B, Chen W, Zhou W. Antimicrobial resistance prediction by clinical metagenomics in pediatric severe pneumonia patients. Ann Clin Microbiol Antimicrob 2024; 23:33. [PMID: 38622723 PMCID: PMC11020437 DOI: 10.1186/s12941-024-00690-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a major threat to children's health, particularly in respiratory infections. Accurate identification of pathogens and AMR is crucial for targeted antibiotic treatment. Metagenomic next-generation sequencing (mNGS) shows promise in directly detecting microorganisms and resistance genes in clinical samples. However, the accuracy of AMR prediction through mNGS testing needs further investigation for practical clinical decision-making. METHODS We aimed to evaluate the performance of mNGS in predicting AMR for severe pneumonia in pediatric patients. We conducted a retrospective analysis at a tertiary hospital from May 2022 to May 2023. Simultaneous mNGS and culture were performed on bronchoalveolar lavage fluid samples obtained from pediatric patients with severe pneumonia. By comparing the results of mNGS detection of microorganisms and antibiotic resistance genes with those of culture, sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS mNGS detected bacterial in 71.7% cases (86/120), significantly higher than culture (58/120, 48.3%). Compared to culture, mNGS demonstrated a sensitivity of 96.6% and a specificity of 51.6% in detecting pathogenic microorganisms. Phenotypic susceptibility testing (PST) of 19 antibiotics revealed significant variations in antibiotics resistance rates among different bacteria. Sensitivity prediction of mNGS for carbapenem resistance was higher than penicillins and cephalosporin (67.74% vs. 28.57%, 46.15%), while specificity showed no significant difference (85.71%, 75.00%, 75.00%). mNGS also showed a high sensitivity of 94.74% in predicting carbapenem resistance in Acinetobacter baumannii. CONCLUSIONS mNGS exhibits variable predictive performance among different pathogens and antibiotics, indicating its potential as a supplementary tool to conventional PST. However, mNGS currently cannot replace conventional PST.
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Affiliation(s)
- Mingyu Gan
- Center for Molecular Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China
| | - Yanyan Zhang
- Department of Neonatology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Gangfeng Yan
- Department of Critical Care Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China
| | - Yixue Wang
- Department of Critical Care Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China
| | - Guoping Lu
- Department of Critical Care Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China
| | - Bingbing Wu
- Center for Molecular Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China
| | - Weiming Chen
- Department of Critical Care Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China.
| | - Wenhao Zhou
- Center for Molecular Medicine, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, People's Republic of China.
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510005, China.
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49
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Yi S, Song H, Kim WH, Lee S, Guk JH, Woo J, Cho S. Dynamics of microbiota and antimicrobial resistance in on-farm dairy processing plants using metagenomic and culture-dependent approaches. Int J Food Microbiol 2024; 417:110704. [PMID: 38640816 DOI: 10.1016/j.ijfoodmicro.2024.110704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/19/2024] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
On-farm dairy processing plants, which are situated close to farms and larger dairy processing facilities, face unique challenges in maintaining environmental hygiene. This can impact various stages of dairy processing. These plants operate on smaller scales and use Low-Temperature-Long-Time (LTLT) pasteurization, making them more susceptible to microbial contamination through direct and indirect contact. Antimicrobial-resistant bacteria found on dairy farms pose risks to human health by potentially transferring resistance via dairy products. Our study aimed to investigate microbial distribution and antimicrobial resistance at four key stages: the farm, pre-pasteurization, post-pasteurization, and processing environments. We assessed microbial distribution by quantifying indicator bacteria and conducting metagenomic analysis. Antimicrobial resistance was examined by identifying resistance phenotypes and detecting resistance genes in bacterial isolates and metagenomes. Our results showed that the indicator bacteria were detected at all stages of on-farm dairy processing. We observed a significant reduction in aerobic microbes and coliforms post-pasteurization. However, contamination of the final dairy products increased, suggesting potential cross-contamination during post-pasteurization. Metagenomic analysis revealed that Pseudomonas, a representative psychrotrophic bacterium, was predominant in both the farm (24.1 %) and pre-pasteurization (65.9 %) stages, indicating microbial transfer from the farms to the processing plants. Post-pasteurization, Pseudomonas and other psychrotrophs like Acinetobacter and Enterobacteriaceae remained dominant. Core microbiota analysis identified 74 genera in total, including 13 psychrotrophic bacteria, across all stages. Of the 59 strains isolated from these plants, 49 were psychrotrophic. Antimicrobial resistance analysis showed that 74.6 % (44/59) of isolates were resistant to at least one antibiotic, with cefoxitin-, ampicillin-, amoxicillin-, and ticarcillin-resistant bacteria present at all stages. Identical antimicrobial resistance patterns were observed in isolates from serial stages of the same farm and season, suggesting bacterial transmission across stages. Additionally, 27.1 % (16/59) of isolates carried plasmid-mediated resistance genes, which were also detected in the metagenomes of non-isolated samples, indicating potential antimicrobial resistance gene transmission and their presence in uncultured bacteria. These findings reveal the persistence of antimicrobial-resistant psychrotrophic bacteria in on-farm dairy processing plants, which pose potential health risks via dairy consumption. Our study underscores the importance of both culture-dependent and culture-independent methods to fully understand their distribution and impact.
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Affiliation(s)
- Saehah Yi
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Hyokeun Song
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Woo-Hyun Kim
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Soomin Lee
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Jae-Ho Guk
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - JungHa Woo
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea
| | - Seongbeom Cho
- College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, South Korea.
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50
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Srivastava A, Verma N, Kumar V, Apoorva P, Agarwal V. Biofilm inhibition/eradication: exploring strategies and confronting challenges in combatting biofilm. Arch Microbiol 2024; 206:212. [PMID: 38616221 DOI: 10.1007/s00203-024-03938-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/04/2024] [Accepted: 03/20/2024] [Indexed: 04/16/2024]
Abstract
Biofilms are complex communities of microorganisms enclosed in a self-produced extracellular matrix, posing a significant threat to different sectors, including healthcare and industry. This review provides an overview of the challenges faced due to biofilm formation and different novel strategies that can combat biofilm formation. Bacteria inside the biofilm exhibit increased resistance against different antimicrobial agents, including conventional antibiotics, which can lead to severe problems in livestock and animals, including humans. In addition, biofilm formation also imposes heavy economic pressure on industries. Hence it becomes necessary to explore newer alternatives to eradicate biofilms effectively without applying selection pressure on the bacteria. Excessive usage of antibiotics may also lead to an increase in the number of resistant strains as bacteria employ an advanced antimicrobial resistance mechanism. This review provides insight into multifaceted technologies like quorum sensing inhibition, enzymes, antimicrobial peptides, bacteriophage, phytocompounds, and nanotechnology to neutralize biofilms without developing antimicrobial resistance (AMR). Furthermore, it will pave the way for developing newer therapeutic agents to deal with biofilms more efficiently.
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Affiliation(s)
- Anmol Srivastava
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, 211004, Uttar Pradesh, India
| | - Nidhi Verma
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, 211004, Uttar Pradesh, India
| | - Vivek Kumar
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, 211004, Uttar Pradesh, India
| | - Pragati Apoorva
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, 211004, Uttar Pradesh, India
| | - Vishnu Agarwal
- Department of Biotechnology, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, 211004, Uttar Pradesh, India.
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