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Witteveen S, Hans JB, Izdebski R, Hasman H, Samuelsen Ø, Dortet L, Pfeifer Y, Delappe N, Oteo-Iglesias J, Żabicka D, Cormican M, Sandfort M, Reichert F, Pöntinen AK, Fischer MA, Verkaik N, Pérez-Vazquez M, Pfennigwerth N, Hammerum AM, Hallstrøm S, Biedrzycka M, Räisänen K, Wielders CC, Urbanowicz P, de Haan A, Westmo K, Landman F, van der Heide HG, Lansu S, Zwittink RD, Notermans DW, Guzek A, Kondratiuk V, Salmanov A, Haller S, Linkevicius M, Gatermann S, Kohlenberg A, Gniadkowski M, Werner G, Hendrickx AP. Dissemination of extensively drug-resistant NDM-producing Providencia stuartii in Europe linked to patients transferred from Ukraine, March 2022 to March 2023. Euro Surveill 2024; 29:2300616. [PMID: 38847120 PMCID: PMC11158010 DOI: 10.2807/1560-7917.es.2024.29.23.2300616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/20/2024] [Indexed: 06/09/2024] Open
Abstract
BackgroundThe war in Ukraine led to migration of Ukrainian people. Early 2022, several European national surveillance systems detected multidrug-resistant (MDR) bacteria related to Ukrainian patients.AimTo investigate the genomic epidemiology of New Delhi metallo-β-lactamase (NDM)-producing Providencia stuartii from Ukrainian patients among European countries.MethodsWhole-genome sequencing of 66 isolates sampled in 2022-2023 in 10 European countries enabled whole-genome multilocus sequence typing (wgMLST), identification of resistance genes, replicons, and plasmid reconstructions. Five bla NDM-1-carrying-P. stuartii isolates underwent antimicrobial susceptibility testing (AST). Transferability to Escherichia coli of a bla NDM-1-carrying plasmid from a patient strain was assessed. Epidemiological characteristics of patients with NDM-producing P. stuartii were gathered by questionnaire.ResultswgMLST of the 66 isolates revealed two genetic clusters unrelated to Ukraine and three linked to Ukrainian patients. Of these three, two comprised bla NDM-1-carrying-P. stuartii and the third bla NDM-5-carrying-P. stuartii. The bla NDM-1 clusters (PstCluster-001, n = 22 isolates; PstCluster-002, n = 8 isolates) comprised strains from seven and four countries, respectively. The bla NDM-5 cluster (PstCluster-003) included 13 isolates from six countries. PstCluster-001 and PstCluster-002 isolates carried an MDR plasmid harbouring bla NDM-1, bla OXA-10, bla CMY-16, rmtC and armA, which was transferrable in vitro and, for some Ukrainian patients, shared by other Enterobacterales. AST revealed PstCluster-001 isolates to be extensively drug-resistant (XDR), but susceptible to cefiderocol and aztreonam-avibactam. Patients with data on age (n = 41) were 19-74 years old; of 49 with information on sex, 38 were male.ConclusionXDR P. stuartii were introduced into European countries, requiring increased awareness and precautions when treating patients from conflict-affected areas.
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Affiliation(s)
- Sandra Witteveen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jörg B Hans
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- German National Reference Centre for Multidrug-Resistant Gram-Negative Bacteria, Department of Medical Microbiology, Ruhr-University Bochum, Bochum, Germany
| | - Radosław Izdebski
- Departement of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | - Henrik Hasman
- National Reference Laboratory for Antimicrobial Resistance, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Ørjan Samuelsen
- Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Laurent Dortet
- French National Reference Center for Antimicrobial Resistance, INSERM UMR 1184, Paris-Saclay University, Bicêtre Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Yvonne Pfeifer
- Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | | | - Jesús Oteo-Iglesias
- Reference and Research Laboratory on Antibiotic Resistance of the National Center for Microbiology and CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Dorota Żabicka
- Departement of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | | | - Mirco Sandfort
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Felix Reichert
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Anna K Pöntinen
- Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway
- Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Martin A Fischer
- Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Nelianne Verkaik
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - María Pérez-Vazquez
- Reference and Research Laboratory on Antibiotic Resistance of the National Center for Microbiology and CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Niels Pfennigwerth
- German National Reference Centre for Multidrug-Resistant Gram-Negative Bacteria, Department of Medical Microbiology, Ruhr-University Bochum, Bochum, Germany
| | - Anette M Hammerum
- National Reference Laboratory for Antimicrobial Resistance, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Søren Hallstrøm
- National Reference Laboratory for Antimicrobial Resistance, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - Marta Biedrzycka
- Departement of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | - Kati Räisänen
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Cornelia Ch Wielders
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Paweł Urbanowicz
- Departement of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | - Angela de Haan
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Karin Westmo
- Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden
| | - Fabian Landman
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Han Gj van der Heide
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Simon Lansu
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Romy D Zwittink
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Daan W Notermans
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Aneta Guzek
- Department of Laboratory Diagnostics, Section of Microbiology, Military Institute of Medicine - National Research Institute, Warsaw, Poland
| | | | - Aidyn Salmanov
- Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
| | - Sebastian Haller
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Marius Linkevicius
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Sören Gatermann
- German National Reference Centre for Multidrug-Resistant Gram-Negative Bacteria, Department of Medical Microbiology, Ruhr-University Bochum, Bochum, Germany
| | - Anke Kohlenberg
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Marek Gniadkowski
- Departement of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | - Guido Werner
- Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany
| | - Antoni Pa Hendrickx
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Mondol SM, Islam I, Islam MR, Shakil SK, Rakhi NN, Mustary JF, Amiruzzaman, Gomes DJ, Shahjalal HM, Rahaman MM. Genomic landscape of NDM-1 producing multidrug-resistant Providencia stuartii causing burn wound infections in Bangladesh. Sci Rep 2024; 14:2246. [PMID: 38278862 PMCID: PMC10817959 DOI: 10.1038/s41598-024-51819-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/09/2024] [Indexed: 01/28/2024] Open
Abstract
The increasing antimicrobial resistance in Providencia stuartii (P. stuartii) worldwide, particularly concerning for immunocompromised and burn patients, has raised concern in Bangladesh, where the significance of this infectious opportunistic pathogen had been previously overlooked, prompting a need for investigation. The two strains of P. stuartii (P. stuartii SHNIBPS63 and P. stuartii SHNIBPS71) isolated from wound swab of two critically injured burn patients were found to be multidrug-resistant and P. stuartii SHNIBPS63 showed resistance to all the 22 antibiotics tested as well as revealed the co-existence of blaVEB-6 (Class A), blaNDM-1 (Class B), blaOXA-10 (Class D) beta lactamase genes. Complete resistance to carbapenems through the production of NDM-1, is indicative of an alarming situation as carbapenems are considered to be the last line antibiotic to combat this pathogen. Both isolates displayed strong biofilm-forming abilities and exhibited resistance to copper, zinc, and iron, in addition to carrying multiple genes associated with metal resistance and the formation of biofilms. The study also encompassed a pangenome analysis utilizing a dataset of eighty-six publicly available P. stuartii genomes (n = 86), revealing evidence of an open or expanding pangenome for P. stuartii. Also, an extensive genome-wide analysis of all the P. stuartii genomes revealed a concerning global prevalence of diverse antimicrobial resistance genes, with a particular alarm raised over the abundance of carbapenem resistance gene blaNDM-1. Additionally, this study highlighted the notable genetic diversity within P. stuartii, significant informations about phylogenomic relationships and ancestry, as well as potential for cross-species transmission, raising important implications for public health and microbial adaptation across different environments.
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Affiliation(s)
| | - Israt Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Md Rafiul Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Shahriar Kabir Shakil
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
- Department of Biotechnology and Genetic Engineering, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | | | - Jannatul Ferdous Mustary
- Microbiology Department, Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, 1000, Bangladesh
| | - Amiruzzaman
- Department of Medicine, Sir Salimullah Medical College, Dhaka, 1000, Bangladesh
| | - Donald James Gomes
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Hussain Md Shahjalal
- Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Md Mizanur Rahaman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh.
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Wang P, Li C, Yin Z, Jiang X, Li X, Mu X, Wu N, Chen F, Zhou D. Genomic epidemiology and heterogeneity of Providencia and their blaNDM-1-carrying plasmids. Emerg Microbes Infect 2023; 12:2275596. [PMID: 37874004 PMCID: PMC10796120 DOI: 10.1080/22221751.2023.2275596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/19/2023] [Indexed: 10/25/2023]
Abstract
Providencia as an opportunistic pathogen can cause serious infection, and moreover the emergence of multi-drug-resistant Providencia strains poses a potentially life-threatening risk to public health. However, a comprehensive genomic study to reveal the population structure and dissemination of Providencia is still lacking. In this study, we conducted a genomic epidemiology analysis on the 580 global sequenced Providencia isolates, including 257 ones sequenced in this study (42 ones were fully sequenced). We established a genome sequence-based species classification scheme for Providencia, redefining the conventional 11 Providencia species into seven genocomplexes that were further divided into 18 genospecies, providing an extensively updated reference for Providencia species discrimination based on the largest Providencia genome dataset to date. We then dissected the profile of antimicrobial resistance genes and the prevalence of multi-drug-resistant Providencia strains among these genocomplexes/genospecies, disclosing the presence of diverse and abundant antimicrobial resistance genes and high resistance ratios against multiple classes of drugs in Providencia. We further dissected the genetic basis for the spread of blaNDM-1 in Providencia. blaNDM-1 genes were mainly carried by five incompatible (Inc) groups of plasmids: IncC, IncW, IncpPROV114-NR, IncpCHS4.1-3, and IncpPrY2001, and the last three were newly designated in this study. By tracking the spread of blaNDM-1-carrying plasmids, IncC, IncpPROV114-NR, IncpCHS4.1-3, and IncpPrY2001 plasmids were found to be highly involved in parallel horizontal transfer or vertical clonal expansion of blaNDM-1 among Providencia. Overall, our study provided a comprehensive genomic view of species differentiation, antimicrobial resistance prevalence, and plasmid-mediated blaNDM-1 dissemination in Providencia.
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Affiliation(s)
- Peng Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Cuidan Li
- CAS Key Laboratory of Genome Sciences & Information, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, People’s Republic of China
| | - Zhe Yin
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Xiaoyuan Jiang
- CAS Key Laboratory of Genome Sciences & Information, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, People’s Republic of China
| | - Xinyue Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Xiaofei Mu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Nier Wu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
| | - Fei Chen
- CAS Key Laboratory of Genome Sciences & Information, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, People’s Republic of China
- University of Chinese Academy of Sciences, Beijing, People’s Republic of China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, Xinjiang, People’s Republic of China
| | - Dongsheng Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China
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Arcari G, Cecilia F, Oliva A, Polani R, Raponi G, Sacco F, De Francesco A, Pugliese F, Carattoli A. Genotypic Evolution of Klebsiella pneumoniae Sequence Type 512 during Ceftazidime/Avibactam, Meropenem/Vaborbactam, and Cefiderocol Treatment, Italy. Emerg Infect Dis 2023; 29:2266-2274. [PMID: 37877547 PMCID: PMC10617348 DOI: 10.3201/eid2911.230921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
In February 2022, a critically ill patient colonized with a carbapenem-resistant K. pneumoniae producing KPC-3 and VIM-1 carbapenemases was hospitalized for SARS-CoV-2 in the intensive care unit of Policlinico Umberto I hospital in Rome, Italy. During 95 days of hospitalization, ceftazidime/avibactam, meropenem/vaborbactam, and cefiderocol were administered consecutively to treat 3 respiratory tract infections sustained by different bacterial agents. Those therapies altered the resistome of K. pneumoniae sequence type 512 colonizing or infecting the patient during the hospitalization period. In vivo evolution of the K. pneumoniae sequence type 512 resistome occurred through plasmid loss, outer membrane porin alteration, and a nonsense mutation in the cirA siderophore gene, resulting in high levels of cefiderocol resistance. Cross-selection can occur between K. pneumoniae and treatments prescribed for other infective agents. K. pneumoniae can stably colonize a patient, and antimicrobial-selective pressure can promote progressive K. pneumoniae resistome evolution, indicating a substantial public health threat.
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5
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Capitani V, Arcari G, Oliva A, Sacco F, Menichincheri G, Fenske L, Polani R, Raponi G, Antonelli G, Carattoli A. Genome-Based Retrospective Analysis of a Providencia stuartii Outbreak in Rome, Italy: Broad Spectrum IncC Plasmids Spread the NDM Carbapenemase within the Hospital. Antibiotics (Basel) 2023; 12:antibiotics12050943. [PMID: 37237846 DOI: 10.3390/antibiotics12050943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
Providencia stuartii is a member of the Morganellaceae family, notorious for its intrinsic resistance to several antibiotics, including last-resort drugs such as colistin and tigecycline. Between February and March 2022, a four-patient outbreak sustained by P. stuartii occurred in a hospital in Rome. Phenotypic analyses defined these strains as eXtensively Drug-Resistant (XDR). Whole-genome sequencing was performed on the representative P. stuartii strains and resulted in fully closed genomes and plasmids. The genomes were highly related phylogenetically and encoded various virulence factors, including fimbrial clusters. The XDR phenotype was primarily driven by the presence of the blaNDM-1 metallo-β-lactamase alongside the rmtC 16S rRNA methyltransferase, conferring resistance to most β-lactams and every aminoglycoside, respectively. These genes were found on an IncC plasmid that was highly related to an NDM-IncC plasmid retrieved from a ST15 Klebsiella pneumoniae strain circulating in the same hospital two years earlier. Given its ability to acquire resistance plasmids and its intrinsic resistance mechanisms, P. stuartii is a formidable pathogen. The emergence of XDR P. stuartii strains poses a significant public health threat. It is essential to monitor the spread of these strains and develop new strategies for their control and treatment.
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Affiliation(s)
- Valerio Capitani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Gabriele Arcari
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Federica Sacco
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Gaia Menichincheri
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Linda Fenske
- Bioinformatics and Systems Biology, Justus-Liebig-University Giessen, 35390 Giessen, Germany
| | - Riccardo Polani
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Giammarco Raponi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessandra Carattoli
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
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Boralli CMDS, Paganini JA, Meneses RS, Mata CPSMD, Leite EMM, Schürch AC, Paganelli FL, Willems RJL, Camargo ILBC. Characterization of blaKPC-2 and blaNDM-1 Plasmids of a K. pneumoniae ST11 Outbreak Clone. Antibiotics (Basel) 2023; 12:antibiotics12050926. [PMID: 37237829 DOI: 10.3390/antibiotics12050926] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
The most common resistance mechanism to carbapenems is the production of carbapenemases. In 2021, the Pan American Health Organization warned of the emergence and increase in new carbapenemase combinations in Enterobacterales in Latin America. In this study, we characterized four Klebsiella pneumoniae isolates harboring blaKPC and blaNDM from an outbreak during the COVID-19 pandemic in a Brazilian hospital. We assessed their plasmids' transference ability, fitness effects, and relative copy number in different hosts. The K. pneumoniae BHKPC93 and BHKPC104 strains were selected for whole genome sequencing (WGS) based on their pulsed-field gel electrophoresis profile. The WGS revealed that both isolates belong to ST11, and 20 resistance genes were identified in each isolate, including blaKPC-2 and blaNDM-1. The blaKPC gene was present on a ~56 Kbp IncN plasmid and the blaNDM-1 gene on a ~102 Kbp IncC plasmid, along with five other resistance genes. Although the blaNDM plasmid contained genes for conjugational transfer, only the blaKPC plasmid conjugated to E. coli J53, without apparent fitness effects. The minimum inhibitory concentrations (MICs) of meropenem/imipenem against BHKPC93 and BHKPC104 were 128/64 and 256/128 mg/L, respectively. Although the meropenem and imipenem MICs against E. coli J53 transconjugants carrying the blaKPC gene were 2 mg/L, this was a substantial increment in the MIC relative to the original J53 strain. The blaKPC plasmid copy number was higher in K. pneumoniae BHKPC93 and BHKPC104 than in E. coli and higher than that of the blaNDM plasmids. In conclusion, two ST11 K. pneumoniae isolates that were part of a hospital outbreak co-harbored blaKPC-2 and blaNDM-1. The blaKPC-harboring IncN plasmid has been circulating in this hospital since at least 2015, and its high copy number might have contributed to the conjugative transfer of this particular plasmid to an E. coli host. The observation that the blaKPC-containing plasmid had a lower copy number in this E. coli strain may explain why this plasmid did not confer phenotypic resistance against meropenem and imipenem.
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Affiliation(s)
- Camila Maria Dos Santos Boralli
- Laboratory of Molecular Epidemiology and Microbiology, Department of Physics and Interdisciplinary Science, São Carlos Institute of Physics, University of São Paulo, São Carlos 13563-120, Brazil
| | | | - Rodrigo Silva Meneses
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | | | | | - Anita C Schürch
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Fernanda L Paganelli
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Rob J L Willems
- University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Ilana Lopes Baratella Cunha Camargo
- Laboratory of Molecular Epidemiology and Microbiology, Department of Physics and Interdisciplinary Science, São Carlos Institute of Physics, University of São Paulo, São Carlos 13563-120, Brazil
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Silva SMDA, Ramos BA, Sá RAQCDE, Silva MVDA, Correia MTS, Oliveira MBMDE. Investigation of factors related to biofilm formation in Providencia stuartii. AN ACAD BRAS CIENC 2022; 94:e20210765. [PMID: 36074405 DOI: 10.1590/0001-3765202220210765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/18/2021] [Indexed: 11/22/2022] Open
Abstract
Providencia stuartii is one of the Enterobacteriaceae species of medical importance commonly associated with urinary infections, which can also cause other ones, including uncommon ones, such as liver abscess and septic vasculitis. This bacterium stands out in the expression of intrinsic and acquired resistance to antimicrobials. Besides, it uses mechanisms such as biofilm for its persistence in biotic and abiotic environments. This study investigated the cellular hydrophobicity profile of clinical isolates of P. stuartii. It also analyzed genes related to the fimbrial adhesin in this species comparing with other reports described for other bacteria from Enterobacteriaceae family. The investigated isolates to form biofilm and had a practically hydrophilic cell surface profile. However, fimH and mrkD genes were not found in P. stuartii, unlike observed in other species of Enterobacteriaceae. These results show that P. stuartii has specificities regarding its potential for biofilm formation, which makes it difficult to destabilize the infectious process and increases the permanence of this pathogen in hospital units.
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Affiliation(s)
- Sivoneide M DA Silva
- Universidade Federal de Pernambuco, Centro de Biociências, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, Brazil
| | - Bárbara A Ramos
- Universidade Federal de Pernambuco, Centro de Biociências, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, Brazil
| | - Rafael A Q C DE Sá
- Universidade Federal de Pernambuco, Centro de Biociências, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, Brazil
| | - Márcia V DA Silva
- Universidade Federal de Pernambuco, Centro de Biociências, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, Brazil
| | - Maria T S Correia
- Universidade Federal de Pernambuco, Centro de Biociências, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, Brazil
| | - Maria B M DE Oliveira
- Universidade Federal de Pernambuco, Centro de Biociências, Departamento de Bioquímica, Av. Prof. Moraes Rego, 1235, Cidade Universitária, 50670-901 Recife, PE, Brazil
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8
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Association of Proteus mirabilis and Providencia stuartii Infections with Diabetes. Medicina (B Aires) 2022; 58:medicina58020271. [PMID: 35208593 PMCID: PMC8880118 DOI: 10.3390/medicina58020271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 01/13/2023] Open
Abstract
Background and Objectives: Proteus and Providencia are related genera of opportunistic pathogens belonging to the Morganellaceae family, often a cause of infections in the immunocompromised hosts, such as diabetic patients. Their clinical significance has increased due to their intrinsic resistance to polymyxins, which is often associated with acquired resistance mechanisms. In this study we evaluated the infections caused by Proteus mirabilis and Providencia stuartii in two groups of patients, with diabetes (group 1) and without diabetes (group 2) admitted to the intensive care unit and surgical wards. The infections were investigated in terms of infection type, risk factors, clinical course, predictive factors for unfavourable outcomes and antibiotic resistance profile. Materials and Methods: An observational, retrospective, cross-sectional study was conducted, comprising all patients infected with these pathogens. Bacterial identification and antibiotic sensitivity testing were performed using the Vitek2C automated system. Results: Comparison of the two groups showed that the statistically significant common infectious risk factors were found less frequently among diabetic patients when compared with non-diabetic patients, and that antimicrobial resistance was significantly lower in the diabetic patient group. However, survival rates did not differ between the two groups, drawing attention to the implications of diabetes as comorbidity. Additionally, with regard to the antibiotic resistance profile, 38.89% of P. stuartii strains isolated from diabetic patients belonged to the difficult-to-treat (DTR) phenotype, contributing to the severity of these infections compared with those caused by P. mirabilis, of which 32% were wild type strains and 0% were DTR phenotype. The DTR/extended spectrum beta-lactamase producing P. stuartii isolates more than doubled the risk of mortality, while the presence of nasogastric nutrition tripled the risk. Conclusions: P. stuartii infections that occurred in diabetic patients proved to be more difficult to treat, the majority of them being healthcare-associated bacteremias.
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de Oliveira MS, Oshiro-Junior JA, Dantas MM, da Fonsêca NF, Ramos HA, da Silva JVB, de Medeiros ACD. An Overview of the Antimicrobial Activity of Polymeric Nanoparticles Against Enterobacteriaceae. Curr Pharm Des 2021; 27:1311-1322. [PMID: 33121399 DOI: 10.2174/1381612826666201029095327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 09/26/2020] [Indexed: 11/22/2022]
Abstract
Bacterial resistance is considered one of the most important public health problems of the century, due to the ability of bacteria to rapidly develop resistance mechanisms, which makes it difficult to treat infections, leading to a high rate of morbidity and mortality. Based on this, several options are being sought as an alternative to currently available treatments, with a particular focus on nanotechnology. Nanomaterials have important potential for use in medical interventions aimed at preventing, diagnosing and treating numerous diseases by directing the delivery of drugs. This review presents data on the use of polymeric nanoparticles having in vitro and in vivo activity against bacteria belonging to the Enterobacteriaceae family.
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Affiliation(s)
- Maísa Soares de Oliveira
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - João Augusto Oshiro-Junior
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Mariana Morais Dantas
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Naara Felipe da Fonsêca
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Hilthon Alves Ramos
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - João Victor Belo da Silva
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
| | - Ana Claudia Dantas de Medeiros
- Laboratorio de Desenvolvimento e Ensaios de Medicamentos, Centro de Ciencias Biologicas e da Saude, Universidade Estadual da Paraiba, Av. das Baraunas, 351, Campina Grande, PB, 58429-500, Campina Grande, Paraiba, Brazil
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Tickler IA, Shettima SA, Dela Cruz CM, Le VM, Dewell S, Sumner J, Tenover FC. Characterization of carbapenem-resistant gram-negative bacterial isolates from Nigeria by whole genome sequencing. Diagn Microbiol Infect Dis 2021; 101:115422. [PMID: 34111650 DOI: 10.1016/j.diagmicrobio.2021.115422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/13/2021] [Accepted: 04/26/2021] [Indexed: 01/08/2023]
Abstract
This study characterized the mechanisms of carbapenem resistance in gram-negative bacteria isolated from patients in Yola, Nigeria. Whole genome sequencing (WGS) was performed on 66 isolates previously identified phenotypically as carbapenem-non-susceptible. The patterns of beta-lactamase resistance genes identified were primarily species-specific. However, blaNDM-7 and blaCMY-4 were detected in all Escherichia coli and most Providencia rettgeri isolates; blaNDM-7 was also detected in 1 Enterobacter cloacae. The E. coli and E. cloacae isolates also shared blaOXA-1, while blaOXA-10 was found in all P. rettgeri, one Pseudomonas aeruginosa and 1 E. coli. Except for Stenotrophomonas maltophilia isolates, which only contained blaL1, most species carried multiple beta-lactamase genes, including those encoding extended-spectrum beta-lactamases, AmpC and OXA in addition to a carbapenemase gene. Carbapenemase genes were either class B or class D beta-lactamases. No carbapenemase gene was detected by WGS in 13.6% of isolates.
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Rakov C, Ben Porat S, Alkalay-Oren S, Yerushalmy O, Abdalrhman M, Gronovich N, Huang L, Pride D, Coppenhagen-Glazer S, Nir-Paz R, Hazan R. Targeting Biofilm of MDR Providencia stuartii by Phages Using a Catheter Model. Antibiotics (Basel) 2021; 10:antibiotics10040375. [PMID: 33918377 PMCID: PMC8065852 DOI: 10.3390/antibiotics10040375] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 01/29/2023] Open
Abstract
Providencia spp. are emerging pathogens mainly in nosocomial infections. Providencia stuartii in particular is involved in urinary tract infections and contributes significantly to the high incidence of biofilm-formation in catheterized patients. Furthermore, recent reports suggested a role for multiple drug resistant (MDR) P. stuartii in hospital-associated outbreaks which leads to excessive complications resulting in challenging treatments. Phage therapy is currently one of the most promising solutions to combat antibiotic-resistant infections. However, the number of available phages targeting Providencia spp. is extremely limited, restricting the use of phage therapy in such cases. In the present study, we describe the isolation and characterization of 17 lytic and temperate bacteriophages targeting clinical isolates of Providencia spp. as part of the Israeli Phage Bank (IPB). These phages, isolated from sewage samples, were evaluated for host range activity and effectively eradicated 95% of the tested bacterial strains isolated from different geographic locations and displaying a wide range of antibiotic resistance. Their lytic activity is demonstrated on agar plates, planktonic cultures, and biofilm formed in a catheter model. The results suggest that these bacteriophages can potentially be used for treatment of antibiotic-resistant Providencia spp. infections in general and of urinary tract infections in particular.
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Affiliation(s)
- Chani Rakov
- Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (C.R.); (S.B.P.); (S.A.-O.); (O.Y.); (N.G.); (S.C.-G.)
| | - Shira Ben Porat
- Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (C.R.); (S.B.P.); (S.A.-O.); (O.Y.); (N.G.); (S.C.-G.)
| | - Sivan Alkalay-Oren
- Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (C.R.); (S.B.P.); (S.A.-O.); (O.Y.); (N.G.); (S.C.-G.)
| | - Ortal Yerushalmy
- Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (C.R.); (S.B.P.); (S.A.-O.); (O.Y.); (N.G.); (S.C.-G.)
| | - Mohanad Abdalrhman
- Hadassah-Hebrew University Medical Center, Department of Clinical Microbiology and Infectious Diseases, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.); (R.N.-P.)
| | - Niv Gronovich
- Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (C.R.); (S.B.P.); (S.A.-O.); (O.Y.); (N.G.); (S.C.-G.)
| | - Lina Huang
- Department of Pathology, University of California, San Diego, CA 92093, USA; (L.H.); (D.P.)
| | - David Pride
- Department of Pathology, University of California, San Diego, CA 92093, USA; (L.H.); (D.P.)
| | - Shunit Coppenhagen-Glazer
- Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (C.R.); (S.B.P.); (S.A.-O.); (O.Y.); (N.G.); (S.C.-G.)
| | - Ran Nir-Paz
- Hadassah-Hebrew University Medical Center, Department of Clinical Microbiology and Infectious Diseases, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (M.A.); (R.N.-P.)
| | - Ronen Hazan
- Institute of Dental Sciences, School of Dentistry, Hebrew University of Jerusalem, Jerusalem 91120, Israel; (C.R.); (S.B.P.); (S.A.-O.); (O.Y.); (N.G.); (S.C.-G.)
- Correspondence: ; Tel.: +972-26758588
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Rus M, Licker M, Musuroi C, Seclaman E, Muntean D, Cirlea N, Tamas A, Vulpie S, Horhat FG, Baditoiu L. Distribution of NDM1 Carbapenemase-Producing Proteeae Strains on High-Risk Hospital Wards. Infect Drug Resist 2020; 13:4751-4761. [PMID: 33408490 PMCID: PMC7781034 DOI: 10.2147/idr.s280977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/11/2020] [Indexed: 12/31/2022] Open
Abstract
Background Carbapenem-resistant Proteeae (CRP) is a group of multidrug-resistant (MDR) microorganisms that raise special treatment problems due to their intrinsic resistance to colistin. In this study, our aim is to provide a phenotypic and molecular characterization of the carbapenemases secreted by CRP strains isolated from inpatients from an intensive care unit (ICU) and surgical wards, as well as the identification of the risk factors involved in their acquisition. Methods An observational, cross-sectional study was performed which included all Proteeae strains isolated in samples from inpatients on high-risk wards of the largest university hospital in Western Romania, from July 2017 to April 2019. Meropenem-resistant strains (N=65) with MIC ≥16 µg/mL were subjected to a singleplex PCR assay for the detection of blaNDM, blaVIM and blaCTX-M genes. The analysis of risk factors was performed by logistic regression. Results Out of 8317 samples that were processed, 400 Proteeae strains were isolated: 64% belonging to the genus Proteus, 26.75% to the genus Providencia and 9.25% to the genus Morganella. Most CRP strains (N=56) were of MBL type, and 55 had the blaNDM gene as the prevalent gene substrate. P. stuartii was the main species that provided the circulating MDR strains. Most CRP strains came from patients admitted to ICU, being isolated mainly from bronchial aspirates and blood cultures. Multivariate analysis revealed 3 independent risk factors – mechanical ventilation>96h (HR: 40.51 [13.65–120.25], p <0.001), tracheostomy (HR: 2.65 [1.14–6.17], p = 0.024) and prolonged antibiotic therapy (HR: 1.01 [1.00–1.02], p = 0.03). Conclusion There is a significant increase in the incidence of CR P. stuartii strains, the MBL-blaNDM type being predominant. These strains presented various other resistance mechanisms, being often extremely difficult to treat and led to an excess of lethality of 27.16%.
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Affiliation(s)
- Maria Rus
- Department of Microbiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,"Pius Brinzeu" County Clinical Emergency Hospital, Timisoara, Romania
| | - Monica Licker
- Department of Microbiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,"Pius Brinzeu" County Clinical Emergency Hospital, Timisoara, Romania.,Multidisciplinary Research Center on Antimicrobial Resistance, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Corina Musuroi
- "Pius Brinzeu" County Clinical Emergency Hospital, Timisoara, Romania
| | - Edward Seclaman
- Department of Biochemistry, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania
| | - Delia Muntean
- Department of Microbiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,"Pius Brinzeu" County Clinical Emergency Hospital, Timisoara, Romania.,Multidisciplinary Research Center on Antimicrobial Resistance, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Natalia Cirlea
- "Pius Brinzeu" County Clinical Emergency Hospital, Timisoara, Romania
| | - Alina Tamas
- "Pius Brinzeu" County Clinical Emergency Hospital, Timisoara, Romania
| | - Silvana Vulpie
- "Pius Brinzeu" County Clinical Emergency Hospital, Timisoara, Romania
| | - Florin George Horhat
- Department of Microbiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,Multidisciplinary Research Center on Antimicrobial Resistance, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Luminita Baditoiu
- Multidisciplinary Research Center on Antimicrobial Resistance, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,Department of Epidemiology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania
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Molecular epidemiology and the clinical impact of carbapenemase-producing Enterobacterales isolates among adult patients: aspects from a Romanian non-teaching hospital. REV ROMANA MED LAB 2020. [DOI: 10.2478/rrlm-2020-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Introduction: A dramatic increase of infections induced by carbapenemase-producing Enterobacterales (CPE) has been registered worldwide. The aim of this study was to evaluate the molecular epidemiology and the clinical impact of CPE strains isolated from adult inpatients.
Material and methods: A one-year, single-center, retrospective observational study including 34 consecutive patients with 37 non-duplicate CPE strains recovered from clinical specimens was accomplished. The Vitek 2 Compact, M.I.C.Evaluator strips, the modified carbapenem inactivation method (mCIM), and the combination disks test (KPC, MBL, OXA-48 Confirm kit, Rosco Diagnostica) were applied as phenotypic tests. A multiplex polymerase chain reaction (PCR) assay was used for detection of blaKPC, blaNDM, and blaOXA-48-like genes. The clonality was assessed with pulsed-field gel electrophoresis (PFGE).
Results: Klebsiella pneumoniae (n=25) was the most frequent CPE encountered. The carbapenemase types were NDM (n=13), KPC (n=12), and OXA-48-like (n=12). Two distinct clonal clusters were identified among the 12 KPC positive strains. All CPE isolates exhibited non-susceptibility to carbapenems, cephalosporins, ciprofloxacin. Respiratory tract infections (n=16) and hospitalization in the intensive care unit (ICU) (n=14) were dominant. The most common comorbidity was congestive heart failure (n=11). Monotherapy was the main strategy adopted (n=15). Death occurred in 18 patients.
Conclusions: Our analysis underscores the scarcity of antibiotic solutions and high mortality. Monotherapy for urinary tract infections (UTIs) is beneficial. Inter- or intrahospital dissemination of successful epidemic clones is proved. The adequate CPE infections control programs and antimicrobial policies are essential..
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Liu J, Wang R, Fang M. Clinical and drug resistance characteristics of Providencia stuartii infections in 76 patients. J Int Med Res 2020; 48:300060520962296. [PMID: 33081537 PMCID: PMC7588764 DOI: 10.1177/0300060520962296] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To investigate the clinical and drug resistance characteristics of Providencia stuartii infections in the Huainan region of Anhui and provide a reference for the clinical selection of antimicrobial agents. METHODS This single-center retrospective analysis included 76 patients with P. stuartii infection in Huainan during the period from October 2018 to March 2020. The hospital department in which the patients were treated and the drug susceptibility characteristics of the P. stuartii isolates were recorded. RESULTS Among the 76 patients, the lung was the most common site of infection, and intensive care unit was the main hospital department. Extended spectrum beta-lactamase screening revealed expression by all 76 isolates of P. stuartii. Of the 76 isolates, 92.1% exhibited multiple drug resistance or extensive drug resistance. P. stuartii isolates were sensitive to cefepime and imipenem, but not to other beta-lactam antibiotics. Twenty isolates were resistant to all 21 types of antibiotics. Of the 20 patients infected with extensively drug-resistant isolates, nine (45%) died. CONCLUSIONS Drug resistance is increasing in P. stuartii. The antimicrobial agent imipenem may be effective for treatment of P. stuartii infections. Fluoroquinolones, aminoglycosides, and fourth-generation cephalosporins are suitable options for antibiotic therapy.
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Affiliation(s)
- Jiachang Liu
- Department of Respiratory Medicine, First Affiliated Hospital of Anhui University of Science & Technology, Huainan, China
| | - Ruikai Wang
- Department of Respiratory Medicine, First Affiliated Hospital of Anhui University of Science & Technology, Huainan, China
| | - Ming Fang
- Department of Respiratory Medicine, First Affiliated Hospital of Anhui University of Science & Technology, Huainan, China
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Hoard A, Montaña S, Moriano A, Fernandez JS, Traglia GM, Quiroga C, Franchi A, Cohen E, Corigliano C, Almuzara M, Ramirez MS. Genomic Analysis of two NDM-1 Providencia stuartii Strains Recovered from a Single Patient. Curr Microbiol 2020; 77:4029-4036. [PMID: 33048176 DOI: 10.1007/s00284-020-02242-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/01/2020] [Indexed: 12/18/2022]
Abstract
In the last years, an increasing number of untreatable infections caused by drug-resistant microbes have impacted the health care system. Worldwide, infections caused by carbapenem-resistant (CR) Gram-negative bacilli have dramatically increased. Among the CR-Gram-negative bacilli, those producing carbapenemases, such as NDM-1, are the main concern. Different Enterobacterales harboring NDM-1 have been reported lately. Providencia stuartii, a member of the Morganellaceae family, is ubiquitous in the environment, but is also known to cause nosocomial infections. Here we describe the genomic analysis of two NDM-1- producing P. stuartii strains recovered from the same patient as well as other carbapenem resistant strains recovered from the same hospital. As a result of the genomic analysis thirteen resistance genes, including three to β-lactams (blaOXA-1, blaTEM-1, blaNDM-1), four to aminoglycosides (aphA6, aac(3)-IId, aac(2')-Ia, aac(6')-Ib-cr5), one to sulfonamides (sul1), two to chloramphenicol (catB3, catA3), one to rifampicin, one to bleomycin (ble), and one to tetracycline (tet(B)) were found. Moreover, a variety of mobile genetic elements, such as insertion sequences, plasmids and phage- related sequences, were found within P. stuartii genomes. The spread of carbapenem-resistant isolates remains a significant clinical and public health concern. Therefore, we considered that the detection of CR isolates is an essential step in addressing this problem.
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Affiliation(s)
- Amparo Hoard
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA
| | - Sabrina Montaña
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia Y Bioquímica, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Alessandro Moriano
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA
| | - Jennifer S Fernandez
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA
| | - German M Traglia
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Facultad de Farmacia Y Bioquímica, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Cecilia Quiroga
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas Y Tecnológicas, Instituto de Investigaciones en Microbiología Y Parasitología Médica (IMPAM), Facultad de Medicina, Paraguay 2155- C1121ABG, Buenos Aires, Argentina
| | - Agustina Franchi
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, Provincia de Buenos Aires, San Martín, Argentina
| | - Emilia Cohen
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, Provincia de Buenos Aires, San Martín, Argentina
| | - Cecilia Corigliano
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, Provincia de Buenos Aires, San Martín, Argentina
| | - Marisa Almuzara
- Laboratorio de Bacteriologia, Hospital Interzonal de Agudos Eva Perón, Provincia de Buenos Aires, San Martín, Argentina
| | - Maria Soledad Ramirez
- Center for Applied Biotechnology Studies, Department of Biological Science, California State University Fullerton, Fullerton, CA, USA.
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