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Qiu Z, Kang Y, Xu C, Ma W, Li G, Jia W, Wang P. Epidemiology and molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolated from neonatal intensive care units in General Hospital of Ningxia Medical University, China, 2017-2021. Int Microbiol 2024:10.1007/s10123-024-00510-0. [PMID: 38512525 DOI: 10.1007/s10123-024-00510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/23/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES This study aimed to retrospectively investigate the epidemiology and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates from neonatal intensive care units (NICU) between 2017 and 2021. METHODS The antibacterial susceptibility of all strains was assessed using the VITEK 2 compact system. The presence of antibiotic resistance, virulence genes, sequence types (STs), capsular (K) types, and the wzi genes was determined through polymerase chain reaction (PCR). Molecular typing was performed by pulsed-field gel electrophoresis (PFGE) using the restriction enzyme XbaI. Additionally, the virulence potential of peg344-positive strains was evaluated using the string test and mouse intraperitoneal infection models. Whole-genome sequencing was conducted on the DNB system and PacBio platforms. RESULTS A total of 46 CRKP isolates were collected during the study period. Out of these, 93.47% (43/46) were identified as CRKP strains belonging to the ST76-K10 type carrying blaNDM-5. It was observed that CRKP infection resulted in more severe clinical symptoms compared to CRKP colonization. Among the CRKP strains, a hypervirulent CRKP strain called KP-63, belonging to the ST23 type, was identified. This strain exhibited high mortality in the mouse infection model and was found to possess virulence genes. Genomic alignment analysis revealed a significant similarity between the virulence plasmid from KP-63 strain (pKP-63) and pK2044 from the hypervirulent K. pneumoniae strain NTUH-2044. CONCLUSIONS There has been a potential dissemination of ST76-K10 type CRKP carrying blaNDM-5 in the NICU at Ningxia Hospital. Neonatal CRKP infection has been found to cause more severe clinical symptoms than colonization. Furthermore, we have discovered a CR-hvKP strain of ST23 with serotype K1, which exhibits a significant resemblance in its virulent plasmid to pK2044. Therefore, it is crucial to enforce effective measures to restrict the spread and hinder the evolution of CRKP within the hospital.
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Affiliation(s)
- Zhuoran Qiu
- College of Clinical Medicine, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Yuting Kang
- Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Technology Building 602, 804 Shengli Road, Yinchuan, 750004, Ningxia, China
| | - Chao Xu
- College of Clinical Medicine, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Wanting Ma
- College of Clinical Medicine, Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Gang Li
- Center of Medical Laboratory, The General Hospital of Ningxia Medical University, Technology Building 601, 804 Shengli Road, Yinchuan, 750004, Ningxia, China
| | - Wei Jia
- Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Technology Building 602, 804 Shengli Road, Yinchuan, 750004, Ningxia, China.
- Center of Medical Laboratory, The General Hospital of Ningxia Medical University, Technology Building 601, 804 Shengli Road, Yinchuan, 750004, Ningxia, China.
| | - Pengtao Wang
- Ningxia Key Laboratory of Clinical and Pathogenic Microbiology, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Technology Building 602, 804 Shengli Road, Yinchuan, 750004, Ningxia, China.
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Hamed SM, Mohamed HO, Ashour HM, Fahmy LI. Comparative genomic analysis of strong biofilm-forming Klebsiella pneumoniae isolates uncovers novel IS Ecp1-mediated chromosomal integration of a full plasmid-like sequence. Infect Dis (Lond) 2024; 56:91-109. [PMID: 37897710 DOI: 10.1080/23744235.2023.2272624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/12/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND The goal of the current study was to elucidate the genomic background of biofilm formation in Klebsiella pneumoniae. METHODS Clinical isolates were screened for biofilm formation using the crystal violet assay. Antimicrobial resistance (AMR) profiles were assessed by disk diffusion and broth microdilution tests. Biofilm formation was correlated to virulence and resistance genes screened by PCR. Draft genomes of three isolates that form strong biofilm were generated by Illumina sequencing. RESULTS Only the siderophore-coding gene iutA was significantly associated with more pronounced biofilm formation. ST1399-KL43-O1/O2v1 and ST11-KL15-O4 were assigned to the multidrug-resistant strain K21 and the extensively drug-resistant strain K237, respectively. ST1999-KL38-O12 was assigned to K57. Correlated with CRISPR/Cas distribution, more plasmid replicons and prophage sequences were identified in K21 and K237 compared to K57. The acquired AMR genes (blaOXA-48, rmtF, aac(6')-Ib and qnrB) and (blaNDM-1, blaCTX-M, aph(3')-VI, qnrS, and aac(6')-Ib-cr) were found in K237 and K21, respectively. The latter showed a novel ISEcp1-mediated chromosomal integration of replicon type IncM1 plasmid-like structure harboring blaCTX-M-14 and aph(3')-VI that uniquely interrupted rcsC. The plasmid-mediated heavy metal resistance genes merACDEPRT and arsABCDR were spotted in K21, which also exclusively carried the acquired virulence genes mrkABCDF and the hypervirulence-associated genes iucABCD-iutA, and rmpA/A2. Pangenome analysis revealed NTUH-K2044 accessory genes most frequently shared with K21. CONCLUSIONS While less virulent to Galleria mellonella than ST1999 (K57), the strong biofilm former, multidrug-resistant, NDM-producer K. pneumoniae K21 (ST1399-KL43-O1/O2v1) carries a novel chromosomally integrated plasmid-like structure and hypervirulence-associated genes and represents a serious threat to countries in the area.
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Affiliation(s)
- Samira M Hamed
- Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Hend O Mohamed
- Department of Biological Control Research, Plant Protection Research Institute, Agricultural Research Center, Giza, Egypt
| | - Hossam M Ashour
- Department of Integrative Biology, College of Arts and Sciences, University of South Florida, St. Petersburg, FL, USA
| | - Lamiaa I Fahmy
- Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
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Sah RK, Dahal P, Parajuli R, Giri GR, Tuladhar E. Prevalence of blaCTX-M and blaTEM Genes in Cefotaxime-Resistant Escherichia coli Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2024; 2024:5517662. [PMID: 38226321 PMCID: PMC10789516 DOI: 10.1155/2024/5517662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/17/2024]
Abstract
Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by Escherichia coli and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (blaCTX-M and blaTEM) in cephalosporin-resistant E. coli. Altogether, 1050 urine samples were processed to obtain 165 isolates of E. coli. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby-Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (blaCTX-M and blaTEM) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant E. coli. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as E. coli. The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the E. coli isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (blaCTX-M and blaTEM) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the blaCTX-M gene was 55.26%. The prevalence of MDR E. coli harboring the blaCTX-M and blaTEM genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.
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LeCuyer TE, Sellon RK, Byrne BA, Daniels JB, Diaz-Campos DV, Hendrix GK, Burbick CR, Besser TE, Davis MA. Multicenter molecular investigation of recurrent Escherichia coli bacteriuria in dogs. Vet Microbiol 2024; 288:109914. [PMID: 38113575 DOI: 10.1016/j.vetmic.2023.109914] [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: 05/19/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 12/21/2023]
Abstract
Escherichia coli is the most common cause of recurrent urinary tract infection (UTI) in dogs. UTI recurrence comprises of persistent, unresolved E. coli infection or reinfection with a different strain of E. coli. Differentiating between these processes is clinically important but is often impossible with routine diagnostics. We tested the hypothesis that most recurrent canine E. coli bacteriuria is due to recurrence of the same E. coli strain involved in the initial infection. Molecular typing was performed on 98 urinary E. coli isolated from dogs with recurrent bacteriuria from five veterinary diagnostic laboratories in the United States. Of the 42 dogs in this study with multiple E. coli bacteriuria observations, a single strain of E. coli caused recurrent bacteriuria in 26 (62 %) dogs, in some cases on multiple occasions for prolonged periods of time (up to eight months). A single E. coli strain was detected during both subclinical bacteriuria and clinically-apparent UTI in three dogs. Isolates with the P-fimbrial adhesin genes papA and papC were associated with recurrence by the same strain of E. coli. Multiple isolations of a single strain of E. coli associated with recurrent bacteriuria suggests that E. coli may be maintained within the urinary tract of some dogs for prolonged periods of time. In some patients, the same strain can cause both clinical UTI and subclinical bacteriuria. This indicates that in dogs, the urinary bladder may serve as a subclinical, long-term reservoir of E. coli that may cause clinical UTI in the future.
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Affiliation(s)
- Tessa E LeCuyer
- Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA, USA; Washington Animal Disease Diagnostic Laboratory, Washington State University, Pullman, WA, USA.
| | - Rance K Sellon
- Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Barbara A Byrne
- Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Joshua B Daniels
- Veterinary Clinical Sciences, College of Veterinary Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Dubraska V Diaz-Campos
- Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA, USA; Washington Animal Disease Diagnostic Laboratory, Washington State University, Pullman, WA, USA
| | - G Kenitra Hendrix
- Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA; Indiana Animal Disease Diagnostic Laboratory, West Lafayette, IN, USA
| | - Claire R Burbick
- Veterinary Diagnostic Laboratory, North Dakota State University, Fargo, ND, USA
| | - Thomas E Besser
- Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - Margaret A Davis
- Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA; Paul G. Allen School for Global Animal Health, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
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Galindo-Méndez M, Navarrete-Salazar H, Pacheco-Vásquez R, Quintas-de la Paz D, Baltazar-Jiménez I, Santiago-Luna JD, Guadarrama-Monroy L. Detection of Plasmid-Mediated Resistance against Colistin in Multi-Drug-Resistant Gram-Negative Bacilli Isolated from a Tertiary Hospital. Microorganisms 2023; 11:1996. [PMID: 37630556 PMCID: PMC10458375 DOI: 10.3390/microorganisms11081996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of this study was to determine the prevalence of plasmid-mediated colistin resistance mcr-1 to mcr-5 genes among colistin and multi-drug-resistant Gram-negative bacilli strains isolated from patients in a tertiary hospital in Toluca, Mexico. The presence of mcr genes among the 241 strains collected was assessed by PCR. In the case of mcr-carrying E. coli, further PCR tests were performed to determine the presence of blaCTX-M and whether the strains belonged to the O25b-ST131 clone. Conjugation experiments were also carried out to assess the horizontal transmission of colistin resistance. A total of twelve strains (5.0%), of which four were E. coli; four were P. aeruginosa; three were K. pneumoniae, and one E. cloacae, were found to be resistant to colistin. Of these strains, two E. coli isolates were found to carry mcr-1, and Southern blot hybridization demonstrated its presence on an approximately 60 kb plasmid. Both mcr-1-carrying E. coli strains were found to co-express blaCTX-M, belong to the O25b-ST131 clone, and horizontally transmit their colistin resistance. The results of this study confirm the presence of plasmid-mediated colistin resistance in hospitalized patients in Mexico and demonstrated that the multi-drug-resistant O25b-ST131 E. coli clone can acquire mcr genes and transmit such resistance traits to other bacteria.
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Affiliation(s)
- Mario Galindo-Méndez
- Laboratorios Galindo SC, Av Juárez 501-A, Col Centro, Oaxaca 68000, Oax, Mexico
- School of Medicine, Universidad Anáhuac Oaxaca, Blvd. Guadalupe Hinojosa de Murat 1100, San Raymundo Jalpam 71248, Oax, Mexico
| | - Humberto Navarrete-Salazar
- School of Medicine, Universidad Anáhuac Oaxaca, Blvd. Guadalupe Hinojosa de Murat 1100, San Raymundo Jalpam 71248, Oax, Mexico
| | - Reinaldo Pacheco-Vásquez
- Centro Médico ISSEMYM Toluca, Av. Baja Velocidad KM. 57.5, Carr. Mex./Tol. Col. San Jeronimo Chicahualco, Metepec 52170, Edomex, Mexico
| | - Devanhí Quintas-de la Paz
- School of Medicine, Universidad Anáhuac Oaxaca, Blvd. Guadalupe Hinojosa de Murat 1100, San Raymundo Jalpam 71248, Oax, Mexico
| | - Isabel Baltazar-Jiménez
- School of Medicine, Universidad Anáhuac Oaxaca, Blvd. Guadalupe Hinojosa de Murat 1100, San Raymundo Jalpam 71248, Oax, Mexico
| | - José David Santiago-Luna
- School of Medicine, Universidad Anáhuac Oaxaca, Blvd. Guadalupe Hinojosa de Murat 1100, San Raymundo Jalpam 71248, Oax, Mexico
| | - Laura Guadarrama-Monroy
- Centro Médico ISSEMYM Toluca, Av. Baja Velocidad KM. 57.5, Carr. Mex./Tol. Col. San Jeronimo Chicahualco, Metepec 52170, Edomex, Mexico
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LIN T, NOMURA S, SOMENO S, ABE T, NISHIYAMA M, SHIKI S, HARIMA H, ISHIHARA K. Role of multidrug resistance and co-resistance on a high percentage of streptomycin resistance in Escherichia coli isolated from chicken meats in Japan. J Vet Med Sci 2023; 85:832-836. [PMID: 37344389 PMCID: PMC10466057 DOI: 10.1292/jvms.23-0135] [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: 03/29/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023] Open
Abstract
We focused on streptomycin resistance because of the high percentage of streptomycin-resistant Escherichia coli concerning the amount used of streptomycin. Antimicrobial resistance and horizontal transfer were identified in 117 isolates of coliform bacteria from chicken meat to identify the factors that increase streptomycin resistance. Escherichia (45 isolates) was the predominant genus. Most streptomycin-resistant Escherichia isolates were resistant to other antimicrobials (17/18), suggesting that using various antimicrobials could select streptomycin-resistant Escherichia isolates. Resistance was transferred from 7 out of the 18 streptomycin-resistant isolates. The transconjugants acquired strA/strB (7/7), blaTEM (5/7), aphA1 (5/7), tetB (3/7), dfrA14 (1/7) and/or dfrA17 (1/7). The co-resistance of streptomycin resistance with other resistances would also increase streptomycin resistance.
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Affiliation(s)
- Thein LIN
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
- International Innovative Agricultural Science Course,
Department of Agriculture, Graduate School of Agriculture, Tokyo University of Agriculture
and Technology, Tokyo, Japan
| | - Shizuka NOMURA
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Suzuka SOMENO
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Takahiro ABE
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Miyuki NISHIYAMA
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Shunya SHIKI
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Hayato HARIMA
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Kanako ISHIHARA
- Laboratory of Veterinary Public Health, Faculty of
Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
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Famojuro OB, Adesanya IO, Ajewole JO, Famojuro TI. Genotypic characterization of extended spectrum beta-lactamase in gram negative bacterial contaminants of some door handles in Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun state. Afr Health Sci 2023; 23:208-218. [PMID: 38223573 PMCID: PMC10782325 DOI: 10.4314/ahs.v23i2.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
Background Nosocomial infections due to cross-transmission by microorganisms from inanimate surfaces have become a recognized public health problem. Objectives This research was carried out to detect bacterial contaminants of door handles and their production of extended spectrum beta-lactamase (ESBL) in Olabisi Onabanjo University Teaching Hospital. Methods Seventy door handles from twenty-seven sections of Olabisi Onabanjo University Teaching Hospital were swabbed and inoculated on different culture media. The isolates were identified using standard microbiological procedures. Susceptibility of the isolates to eleven antibiotics was determined by Kirby- Bauer disc diffusion test. Phenotypic detection of ESBL was determined by modified double disc synergy test (MDDST) followed by PCR amplification of ESBL- encoding genes. Results Forty-four (62.9%) out of 70 door swabs were positive for bacterial growth. S . aureus was the most common isolate (22.9%). Multidrug resistance was observed in 15(79.0%) and 20(69%) of Gram positive and Gram-negative isolates, respectively. Coagulase negative staphylococci, E. coli, Acinetobacter and Shigella species were totally resistant to ceftazidime (100%). PCR amplification of ESBL-genes revealed the presence of blaTEM blaCTX -M and blaSHV in 4(14.3%), 2(7.2%) and 1(3.6%) isolate, respectively. Conclusion This study revealed that door handles of different sections in hospital environment were contaminated by multidrug resistant Gram-negative bacteria encoding ESBL genes.
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Affiliation(s)
- Oluwatoyin Bola Famojuro
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Ogun state
| | - Ifeoluwa Omolola Adesanya
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Ogun state
| | - Jerome Olu Ajewole
- Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun state
| | - Tayo Ibukun Famojuro
- Department of Pharmacognosy, Faculty of Pharmaceutical Sciences, Bingham University, Karu Nasarawa state
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Kamala K, Sivaperumal P. Predominance of multi-drug resistant extended spectrum β lactamase producing bacteria from marine fishes. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 323:121314. [PMID: 36813100 DOI: 10.1016/j.envpol.2023.121314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
The present study aimed to determine the extended spectrum beta lactamase (ESBL) genes in the bacteria from fresh exportable fish samples collected along South east coast of India, Chennai. ESBL genes are the base for the antibiotic resistance in pathogens and it transmitted from one to other species. Totally 2670 isolates were isolated from 293 fish samples which belong to 31 species dominated by Aeromonas, Klebsiella, Serratia, Leclerica, Proteus, Enterobacter, Acinetobacter, Haemophilus, Escherichia, Shigella sp. Out of 2670 isolates, 1958 isolates have multi drug resistant capacity with ESBL genes of blaCTX, blaSHV, blaTEM and blaAmpC and 712 isolates are not detected ESBL genes. The present study revealed that, the contamination of fresh fish sample with pathogenic bacteria resistant to multiple antibiotics can incriminate seafood as a potential carrier and accentuate an immediate need to prevent environmental infectivity and distribution. Further, hygienic facilitated markets should be developed with ensured quality of seafood.
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Affiliation(s)
- Kannan Kamala
- Department of Physiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 600077, India
| | - Pitchiah Sivaperumal
- Marine Biomedical Research Lab & Environmental Toxicology Unit, Cellular and Molecular Research Centre, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, 600077, India.
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Tseng CH, Liu CW, Liu PY. Extended-Spectrum β-Lactamases (ESBL) Producing Bacteria in Animals. Antibiotics (Basel) 2023; 12:antibiotics12040661. [PMID: 37107023 PMCID: PMC10135299 DOI: 10.3390/antibiotics12040661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/22/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023] Open
Abstract
Animals have been identified as potential reservoirs and vectors of resistance genes, with studies showing that Gram-negative bacteria can acquire resistance through the horizontal transmission of resistance genes on plasmids. It is important to understand the distribution of antimicrobial-resistant bacteria and their drug-resistant genes in animals. Previous review articles mostly focused on a single bacterium or a single animal. Our objective is to compile all ESBL-producing bacteria isolated from various animals in recent years and provide a comprehensive viewpoint. Using a thorough PubMed literature search spanning from 1 January 2020 to 30 June 2022, studies exploring extended-spectrum beta-lactamase (ESBL) producing bacteria in animals were included. ESBL-producing bacteria are present in animals from various countries around the world. The most common sources of these bacteria were farm animals, and the most frequently isolated bacteria were Escherichia coli and Klebsiella pneumoniae. The most detected ESBL genes were blaTEM, blaSHV, and blaCTX-M. The presence of ESBL-producing bacteria in animals highlights the importance of the One Health approach to address the issue of antibiotic resistance. Further research is needed to better understand the epidemiology and mechanisms of the spread of ESBL-producing bacteria in animal populations and their potential impact on human and animal health.
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Intestinal Colonization of Preterm Neonates with Carbapenem Resistant Enterobacteria at Hospital Discharge. Antibiotics (Basel) 2023; 12:antibiotics12020284. [PMID: 36830195 PMCID: PMC9952716 DOI: 10.3390/antibiotics12020284] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Our aim was to investigate gut colonization with carbapenem-resistant Enterobacterales (CRE) in the population of preterm neonates at discharge from a tertiary care center in Serbia. The study included 350 randomly selected neonates/infants discharged in the period April 2018-May 2019. CRE colonization was present in 88/350 (25.1%) of patients. Klebsiella pneumoniae producing KPC and OXA-48 carbapenemase were detected in 45 and 42 subjects, respectively, while NDM producing Escherichia coli was identified in one patient only. All OXA-48 strains harbored blaCTX-M-15, while both blaTEM and blaSHV were present in all but one KPC-producing strain. CRE isolates exhibited a multidrug resistance pattern with uniform fluoroquinolone resistance, universal susceptibility to colistin, and variable susceptibility to aminoglycosides. Administration of carbapenems was common (~50%) and it was strongly associated with colonization, as well as the combinational therapeutic regimens that included meropenem, contrary to ampicillin-sulbactam/colistin therapy and prolonged course of the initial therapy (ampicillin/amikacin ≥ 7 days). Other risk factors for CRE carriage were level of immaturity, admission to neonatal intensive care unit, prolonged hospitalization and invasive procedures. Although the rate of clinically and/or laboratory proven systemic infections was significantly higher among colonized patients, CRE infection was confirmed in one patient only (1.1%) that was colonized with NDM E. coli. Clonal relatedness of CRE isolates was high, with seven and eight clusters detected among KPC (N = 30) and OXA-48 (N = 37) producing strains, respectively. The follow up of the 31 KPC-colonized patients after discharge from hospital revealed common decolonization within one month (~68%). In conclusion, our results demonstrated a high rate of CRE colonization that is most likely related to carbapenem consumption and lack of screening as important infection prevention practice.
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Shahkolahi S, Shakibnia P, Shahbazi S, Sabzi S, Badmasti F, Asadi Karam MR, Habibi M. Detection of ESBL and AmpC producing Klebsiella pneumoniae ST11 and ST147 from urinary tract infections in Iran. Acta Microbiol Immunol Hung 2022; 69:303-313. [PMID: 36112491 DOI: 10.1556/030.2022.01808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
In the present study a total of 200 Klebsiella pneumoniae isolates were collected from patients with urinary tract infections (UTIs) in Tehran, Iran. Antibiotic resistance was determined by disk diffusion and broth dilution methods. Detection of extended-spectrum β-lactamases (ESBLs) and AmpCs was performed using phenotypic tests. Polymerase chain reaction (PCR) was applied to detect the ESBL, AmpC, and integron genes. Analysis of AmpC and cassette arrays of integron genes was performed using DNA sequencing. Plasmids were analyzed by PCR-based replicon typing and conjugation. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were applied to explore the genomic relatedness among the isolates. The highest levels of resistance were observed against ampicillin (100%), followed by piperacillin (57.5%), ceftazidime (46%), trimethoprim/sulfamethoxazole (44%), ciprofloxacin (32.5%), and imipenem (19%). Approximately, 66.5% of isolates harbored at least one of the beta-lactamase genes (blaTEM, blaSHV, blaCTX-M, and blaOXA-1). In addition, 22.5% of isolates carried at least one of the AmpC genes including blaDHA and blaCIT. Integron class I was the most prevalent integron among resistant isolates. According to the results of replicon typing, IncFII, IncL/M, and IncA/C were the most frequent replicons, respectively. All selected isolates were able to transfer blaCTX-M, also two isolates transferred the blaDHA-1 gene to Escherichia coli K12 through conjugation. Finally, 21 isolates were categorized into 4 pulsotypes and 11 unique clusters in PFGE. MLST identified ST147 and ST11 sequence types but ST147 was the most prevalent in the current study.
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Affiliation(s)
| | - Pegah Shakibnia
- 2Department of Microbiology, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Shahla Shahbazi
- 1Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
| | - Samira Sabzi
- 1Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
| | - Farzad Badmasti
- 3Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
| | | | - Mehri Habibi
- 1Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
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Genetic and Antimicrobial Resistance Profiles of Mammary Pathogenic E. coli (MPEC) Isolates from Bovine Clinical Mastitis. Pathogens 2022; 11:pathogens11121435. [PMID: 36558768 PMCID: PMC9781227 DOI: 10.3390/pathogens11121435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Mammary pathogenic E. coli (MPEC) is one of the main pathogens of environmental origin responsible for causing clinical mastitis worldwide. Even though E. coli are strongly associated with transient or persistent mastitis and the economic impacts of this disease, the virulence factors involved in the pathogenesis of MPEC remain unknown. Our aim was to characterize 110 MPEC isolates obtained from the milk of cows with clinical mastitis, regarding the virulence factor-encoding genes present, adherence patterns on HeLa cells, and antimicrobial resistance profile. The MPEC isolates were classified mainly in phylogroups A (50.9%) and B1 (38.2%). None of the isolates harbored genes used for diarrheagenic E. coli classification, but 26 (23.6%) and 4 (3.6%) isolates produced the aggregative or diffuse adherence pattern, respectively. Among the 22 genes investigated, encoding virulence factors associated with extraintestinal pathogenic E. coli pathogenesis, fimH (93.6%) was the most frequent, followed by traT (77.3%) and ompT (68.2%). Pulsed-field gel electrophoresis analysis revealed six pulse-types with isolates obtained over time, thus indicating persistent intramammary infections. The genes encoding beta-lactamases detected were as follows: blaTEM (35/31.8%); blaCTX-M-2/blaCTX-M-8 (2/1.8%); blaCTX-M-15 and blaCMY-2 (1/0.9%); five isolates were classified as extended spectrum beta-lactamase (ESBL) producers. As far as we know, papA, shf, ireA, sat and blaCTX-M-8 were detected for the first time in MPEC. In summary, the genetic profile of the MPEC studied was highly heterogeneous, making it impossible to establish a common genetic profile useful for molecular MPEC classification. Moreover, the detection of ESBL-producing isolates is a serious public health concern.
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Tapia-Arreola AK, Ruiz-Garcia DA, Rodulfo H, Sharma A, De Donato M. High Frequency of Antibiotic Resistance Genes (ARGs) in the Lerma River Basin, Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113988. [PMID: 36360888 PMCID: PMC9657182 DOI: 10.3390/ijerph192113988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/24/2022] [Accepted: 10/24/2022] [Indexed: 05/31/2023]
Abstract
The spread of beta-lactamase-producing bacteria is of great concern and the environment has been found to be a main source of contamination. Herein, it was proposed to determine the frequency of antimicrobial-resistant-Gram-negative bacteria throughout the Lerma River basin using phenotypic and molecular methods. Resistant bacteria were isolated with chromogenic media and antimicrobial susceptibility tests were used to characterize their resistance. ARGs for beta-lactams, aminoglycosides, and quinolones were detected by PCR. Species were identified by Sanger sequencing the 16S rRNA gene and the representative genomes of MDR strains were sequenced by NGS. A high variation in the number of isolates was observed in the 20 sampled sites, while observing a low diversity among the resistant bacteria. Of the 12 identified bacterial groups, C. freundii, E. coli, and S. marcescens were more predominant. A high frequency of resistance to beta-lactams, quinolones, and aminoglycosides was evidenced, where the blaCTX,qnrB, qnrS y, and aac(6')lb-cr genes were the most prevalent. C. freundii showed the highest frequency of MDR strains. Whole genome sequencing revealed that S. marcescens and K. pneumoniae showed a high number of shared virulence and antimicrobial resistance genes, while E. coli showed the highest number of unique genes. The contamination of the Lerma River with MDR strains carrying various ARGs should raise awareness among environmental authorities to assess the risks and regulations regarding the optimal hygienic and sanitary conditions for this important river that supports economic activities in the different communities in Mexico.
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Lima T, Fernandes L, Matias M, Mateus A, Silveira E, Domingues S, Pomba C, Da Silva GJ. Longitudinal Study Detects the Co-Carriage of ESBL and mcr-1 and -4 Genes in Escherichia coli Strains in a Portuguese Farrow-to-Finish Swine Herd. Animals (Basel) 2022; 12:ani12172209. [PMID: 36077929 PMCID: PMC9454694 DOI: 10.3390/ani12172209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Cephalosporins and polymyxins are employed in antimicrobial protocols to control and treat neonatal infections and post-weaning diarrhoea in swine operations. We conducted a longitudinal study to evaluate the colonization and transmission of antibiotic–resistant Escherichia coli in sows and their piglets in a farrow-to-finish operation, focusing on characterization of Extended Spectrum Beta-Lactamase (ESBL) and mcr genes, virulence traits and genetic relatedness. A total of 293 E. coli isolates were obtained from faecal samples collected in five time points. At birth blaCTX-M-1group cluster was detected in E. coli isolates from 9 sows and 49 piglets (73.41%), while in the following four’ piglets sampling moments it was detected in 91.8%, 57.6%, 71.4% and 97.4%. The gene mcr-1 was detected in E. coli from one sow and from three piglets from different litters at birth and increased in the first weeks of piglet life (68.85%, 100%, 90% and 8.1%). A new mcr-4 allele, mcr-4.7, was identified in 3.28%, 28.57%, 7.5% of E. coli isolates. Most mcr-positive E. coli isolates (96,7%) carried blaCTX-M-1Group genes and 93,33% carried both mcr-4 and mcr-1. CTX-M-1 and CTX-M-32 were the most predominant ESBLs. Plasmids belonged to IncI1, IncF and IncN groups. Most isolates belong to phylogenetic group B1; PAI IV536 marker was detected in nine isolates. The strains were kept in the different stages of the piglets’ life. The use of ceftiofur and colistin may explain the high prevalence and co-selection of blaCTX-M-1Group and mcr-1 and/or -4 genes, contributing to the maintenance of resistant and virulent isolates throughout the pig life cycle that may reach the food chain.
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Affiliation(s)
- Tiago Lima
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Laura Fernandes
- Centre for Interdisciplinary Research in Animal Health, Laboratory of Antibiotic Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
| | - Marta Matias
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
| | - Ana Mateus
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
| | - Eduarda Silveira
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Department of Veterinary Medicine, Veterinary School Vasco Da Gama, 3020-210 Coimbra, Portugal
| | - Sara Domingues
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
| | - Constança Pomba
- Centre for Interdisciplinary Research in Animal Health, Laboratory of Antibiotic Resistance, CIISA, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisboa, Portugal
- Correspondence: (C.P.); (G.J.D.S.); Tel.: +351-213-652-037 (C.P.); +351-239-488-460 (G.J.D.S.)
| | - Gabriela Jorge Da Silva
- Faculty of Pharmacy, University of Coimbra, 3000-458 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, 3004-517 Coimbra, Portugal
- Correspondence: (C.P.); (G.J.D.S.); Tel.: +351-213-652-037 (C.P.); +351-239-488-460 (G.J.D.S.)
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Kochan TJ, Nozick SH, Medernach RL, Cheung BH, Gatesy SWM, Lebrun-Corbin M, Mitra SD, Khalatyan N, Krapp F, Qi C, Ozer EA, Hauser AR. Genomic surveillance for multidrug-resistant or hypervirulent Klebsiella pneumoniae among United States bloodstream isolates. BMC Infect Dis 2022; 22:603. [PMID: 35799130 PMCID: PMC9263067 DOI: 10.1186/s12879-022-07558-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Klebsiella pneumoniae strains have been divided into two major categories: classical K. pneumoniae, which are frequently multidrug-resistant and cause hospital-acquired infections in patients with impaired defenses, and hypervirulent K. pneumoniae, which cause severe community-acquired and disseminated infections in normal hosts. Both types of infections may lead to bacteremia and are associated with significant morbidity and mortality. The relative burden of these two types of K. pneumoniae among bloodstream isolates within the United States is not well understood. METHODS We evaluated consecutive K. pneumoniae isolates cultured from the blood of hospitalized patients at Northwestern Memorial Hospital (NMH) in Chicago, Illinois between April 2015 and April 2017. Bloodstream isolates underwent whole genome sequencing, and sequence types (STs), capsule loci (KLs), virulence genes, and antimicrobial resistance genes were identified in the genomes using the bioinformatic tools Kleborate and Kaptive. Patient demographic, comorbidity, and infection information, as well as the phenotypic antimicrobial resistance of the isolates were extracted from the electronic health record. Candidate hypervirulent isolates were tested in a murine model of pneumonia, and their plasmids were characterized using long-read sequencing. We also extracted STs, KLs, and virulence and antimicrobial resistance genes from the genomes of bloodstream isolates submitted from 33 United States institutions between 2007 and 2021 to the National Center for Biotechnology Information (NCBI) database. RESULTS Consecutive K. pneumoniae bloodstream isolates (n = 104, one per patient) from NMH consisted of 75 distinct STs and 51 unique capsule loci. The majority of these isolates (n = 58, 55.8%) were susceptible to all tested antibiotics except ampicillin, but 17 (16.3%) were multidrug-resistant. A total of 32 (30.8%) of these isolates were STs of known high-risk clones, including ST258 and ST45. In particular, 18 (17.3%) were resistant to ceftriaxone (of which 17 harbored extended-spectrum beta-lactamase genes) and 9 (8.7%) were resistant to meropenem (all of which harbored a carbapenemase genes). Four (3.8%) of the 104 isolates were hypervirulent K. pneumoniae, as evidenced by hypermucoviscous phenotypes, high levels of virulence in a murine model of pneumonia, and the presence of large plasmids similar to characterized hypervirulence plasmids. These isolates were cultured from patients who had not recently traveled to Asia. Two of these hypervirulent isolates belonged to the well characterized ST23 lineage and one to the re-emerging ST66 lineage. Of particular concern, two of these isolates contained plasmids with tra conjugation loci suggesting the potential for transmission. We also analyzed 963 publicly available genomes of K. pneumoniae bloodstream isolates from locations within the United States. Of these, 465 (48.3%) and 760 (78.9%) contained extended-spectrum beta-lactamase genes or carbapenemase genes, respectively, suggesting a bias towards submission of antibiotic-resistant isolates. The known multidrug-resistant high-risk clones ST258 and ST307 were the predominant sequence types. A total of 32 (3.3%) of these isolates contained aerobactin biosynthesis genes and 26 (2.7%) contained at least two genetic features of hvKP strains, suggesting elevated levels of virulence. We identified 6 (0.6%) isolates that were STs associated with hvKP: ST23 (n = 4), ST380 (n = 1), and ST65 (n = 1). CONCLUSIONS Examination of consecutive isolates from a single center demonstrated that multidrug-resistant high-risk clones are indeed common, but a small number of hypervirulent K. pneumoniae isolates were also observed in patients with no recent travel history to Asia, suggesting that these isolates are undergoing community spread in the United States. A larger collection of publicly available bloodstream isolate genomes also suggested that hypervirulent K. pneumoniae strains are present but rare in the USA; however, this collection appears to be heavily biased towards highly antibiotic-resistant isolates (and correspondingly away from hypervirulent isolates).
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Affiliation(s)
- Travis J Kochan
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Sophia H Nozick
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Rachel L Medernach
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Division of Infectious Diseases, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Bettina H Cheung
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Samuel W M Gatesy
- Division of Infectious Diseases, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Marine Lebrun-Corbin
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Sumitra D Mitra
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Natalia Khalatyan
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Fiorella Krapp
- Division of Infectious Diseases, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Chao Qi
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Egon A Ozer
- Division of Infectious Diseases, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Center for Pathogen Genomics and Microbial Evolution, Havey Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alan R Hauser
- Department of Microbiology-Immunology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.,Division of Infectious Diseases, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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Rectal and Tracheal Carriage of Carbapenemase Genes and Class 1 and 2 Integrons in Patients in Neurosurgery Intensive Care Unit. Antibiotics (Basel) 2022; 11:antibiotics11070886. [PMID: 35884140 PMCID: PMC9312170 DOI: 10.3390/antibiotics11070886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022] Open
Abstract
The spread of multidrug-resistant Gram-negative bacteria, which is associated with the distribution of beta-lactamase genes and class 1 and 2 integrons, is a global problem. In this study, in the Moscow neurosurgery intensive care unit (neuro-ICU), the high prevalence of the above-stated genes was found to be associated with intestinal and tracheal carriage. Seven-point prevalence surveys, which included 60 patients in the neuro-ICU, were conducted weekly in the period from Oct. to Nov. 2019. A total of 293 clinical samples were analyzed, including 146 rectal and 147 tracheal swabs; 344 Gram-negative bacteria isolates were collected. Beta-lactamase genes (n = 837) were detected in the isolates, including beta-lactamase blaTEM (n = 162), blaSHV (n = 145), cephalosporinase blaCTX–M (n = 228), carbapenemase blaNDM (n = 44), blaKPC (n = 25), blaOXA–48 (n = 126), blaOXA–51–like (n = 54), blaOXA–40-like (n = 43), blaOXA–23-like (n = 8), and blaVIM (n = 2), as well as class 1 (n = 189) and class 2 (n = 12) integrons. One extensively drug-resistant Klebsiella pneumoniae strain (sequence type ST39 and capsular type K23), simultaneously carried beta-lactamase genes, blaSHV–40 and blaTEM–1B, three carbapenemase genes, blaNDM, blaKPC, and blaOXA–48, the cephalosporinase gene blaCTX–M, and two class 1 integrons. Before this study, such heavily armed strains have not been reported, suggesting the ongoing evolution of antibiotic resistance.
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17
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Maharjan R, Bastola A, Adhikari N, Rijal KR, Banjara MR, Ghimire P, Shrestha UT. Multidrug-resistant bacteria with ESBL genes: a growing threat among people living with HIV/AIDS in Nepal. BMC Infect Dis 2022; 22:526. [PMID: 35672713 PMCID: PMC9171981 DOI: 10.1186/s12879-022-07503-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacterial opportunistic infections are common in people living with HIV/AIDS (PLHA). Besides HIV-TB co-infection, lower respiratory tract infections (LRTIs) due to multidrug-resistant (MDR) bacteria cause significant morbidity and mortality among PLHA. This study identified bacterial co-infection of the lower respiratory tract and detected plasmid-mediated blaTEM and blaCTX-M genes among Extended-Spectrum β-Lactamase (ESBL) producing isolates from sputum samples in PLHA. METHODS A total of 263 PLHA with LRTIs were enrolled in this study, out of which, 50 were smokers, 70 had previous pulmonary tuberculosis, and 21 had CD4 count < 200 cells/µl. Sputum samples collected from PLHA were processed with standard microbiological methods to identify the possible bacterial pathogens. The identified bacterial isolates were assessed for antibiotic susceptibility pattern using modified Kirby Bauer disk diffusion method following Clinical Laboratory Standard Institute (CLSI) guidelines. In addition, plasmid DNA was extracted from MDR and ESBL producers for screening of ESBL genes; blaCTX-M and blaTEM by conventional PCR method using specific primers. RESULTS Of 263 sputum samples, 67 (25.48%) showed bacterial growth. Among different bacterial pathogens, Klebsiella pneumoniae, (17; 25.37%) was the most predominant, followed by Haemophillus influenzae, (14; 20.90%) and Escherichia coli, (12; 17.91%). A higher infection rate (4/8; 50%) was observed among people aged 61-70 years, whereas no infection was observed below 20 years. About 30.0% (15/50) of smokers, 32.86% (23/70) cases with previous pulmonary tuberculosis, and 52.38% (11/21) with CD4 count < 200 cells/µl had bacterial LRTIs. Among 53 bacterial isolates excluding H. influenzae, 28 isolates were MDR and 23 were ESBL producers. All ESBL producers were sensitive to colistin and polymyxin B. Among ESBL producers, 47.83% (11/23) possessed blaCTX-M, 8.6% (2/23) were positive for blaTEM gene, and 43.48% (10/23) possessed both ESBL genes. CONCLUSION The increasing rate of MDR bacterial infections, mainly ESBL producers of LRTIs causes difficulty in disease management, leading to high morbidity and mortality of PLHA. Hence, it is crucial to know the antibiogram pattern of the isolates to recommend effective antimicrobial therapy to treat LRTIs in PLHA.
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Affiliation(s)
- Riju Maharjan
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Anup Bastola
- Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal
| | - Nabaraj Adhikari
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Prakash Ghimire
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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Mutuku C, Melegh S, Kovacs K, Urban P, Virág E, Heninger R, Herczeg R, Sonnevend Á, Gyenesei A, Fekete C, Gazdag Z. Characterization of β-Lactamases and Multidrug Resistance Mechanisms in Enterobacterales from Hospital Effluents and Wastewater Treatment Plant. Antibiotics (Basel) 2022; 11:antibiotics11060776. [PMID: 35740182 PMCID: PMC9219941 DOI: 10.3390/antibiotics11060776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 01/11/2023] Open
Abstract
Antimicrobials in wastewater promote the emergence of antibiotic resistance, facilitated by selective pressure and transfer of resistant genes. Enteric bacteria belonging to Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Citrobacter species (n = 126) from hospital effluents and proximate wastewater treatment plant were assayed for susceptibility to four antimicrobial classes. The β-lactamase encoding genes harbored in plasmids were genotyped and the plasmids were sequenced. A multidrug resistance phenotype was found in 72% (n = 58) of E. coli isolates, 70% (n = 43) of Klebsiella species isolates, and 40% (n = 25) of Enterobacter and Citrobacter species. Moreover, 86% (n = 50) of E. coli, 77% (n = 33) of Klebsiella species, and 25% (n = 4) of Citrobacter species isolates phenotypically expressed extended spectrum β-lactamase. Regarding ESBL genes, blaCTX-M-27 and blaTEM-1 were found in E. coli, while Klebsiella species harbored blaCTX-M-15, blaCTX-M-30, or blaSHV-12. Genes coding for aminoglycoside modifying enzymes, adenylyltransferases (aadA1, aadA5), phosphotransferases (aph(6)-1d, aph(3″)-Ib), acetyltransferases (aac(3)-IIa), (aac(6)-Ib), sulfonamide/trimethoprim resistant dihydropteroate synthase (sul), dihydrofolate reductase (dfrA), and quinolone resistance protein (qnrB1) were also identified. Monitoring wastewater from human sources for acquired resistance in clinically important bacteria may provide a cheaper alternative in regions facing challenges that limit clinical surveillance.
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Affiliation(s)
- Christopher Mutuku
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
- Correspondence: (C.M.); (Z.G.)
| | - Szilvia Melegh
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Krisztina Kovacs
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Peter Urban
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Eszter Virág
- Educomat Ltd., Iskola utca 12/A, 8360 Keszthely, Hungary;
- Department of Molecular Biotechnology and Microbiology, Institute of Biotechnology, Faculty of Science and Technology, University of Debrecen, Egyetem Square 1, 4032 Debrecen, Hungary
| | - Reka Heninger
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
| | - Robert Herczeg
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Ágnes Sonnevend
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Attila Gyenesei
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Csaba Fekete
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
| | - Zoltan Gazdag
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
- Correspondence: (C.M.); (Z.G.)
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19
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Belas A, Marques C, Menezes J, da Gama LT, Cavaco-Silva P, Pomba C. ESBL/ pAmpC-Producing Escherichia coli Causing Urinary Tract Infections in Non-Related Companion Animals and Humans. Antibiotics (Basel) 2022; 11:antibiotics11050559. [PMID: 35625203 PMCID: PMC9137695 DOI: 10.3390/antibiotics11050559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022] Open
Abstract
Urinary tract infections (UTI) caused by Escherichia coli are frequently diagnosed in humans and companion animals. Extended-spectrum beta-lactamase (ESBL)- and cephalosporinase (pAmpC)-producing Escherichia coli are worldwide-disseminated and frequently multidrug-resistant, hence leading to treatment failure and public health concerns. This study aimed to characterize and compare ESBL/pAmpC-producing E. coli strains causing community-acquired UTI in companion animals and non-related humans. Third-generation cephalosporin (3GC)-resistant E. coli (companion animals n = 35; humans n = 85) isolated from patients with UTI were tested against 14 antimicrobials following CLSI guidelines. PCR-based assays were used to detect the major E. coli phylogenetic groups, pathogenicity associated-islands (PAIs), virulence genes, and ESBLs/pAmpC resistance genes. ESBL/pAmpC-producing E. coli isolates were typed by multi-locus sequence typing (MLST) and PCR. E. coli strains from companion animals and humans shared two MDR high-risk clonal lineages: ST131 and ST648. To the best of our knowledge, this study reports the first description of E. coli ST131 clade C1-M27 and the clonal lineage ST131 clade A in humans with community-acquired UTI in Portugal. Considering that companion animals with UTI are generally treated at home by the owners, measures should be implemented to avoid the spread of multidrug-resistant high-risk clones to humans and their household environment.
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Affiliation(s)
- Adriana Belas
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal or (A.B.); or (C.M.); (J.M.); (L.T.d.G.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
| | - Cátia Marques
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal or (A.B.); or (C.M.); (J.M.); (L.T.d.G.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisbon, Portugal
| | - Juliana Menezes
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal or (A.B.); or (C.M.); (J.M.); (L.T.d.G.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Luís Telo da Gama
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal or (A.B.); or (C.M.); (J.M.); (L.T.d.G.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Patrícia Cavaco-Silva
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, 2829-511 Caparica, Portugal;
- Technophage, 1649-028 Lisboa, Portugal
| | - Constança Pomba
- Centre for Interdisciplinary Research in Animal Health (CIISA), Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal or (A.B.); or (C.M.); (J.M.); (L.T.d.G.)
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Correspondence:
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Gelalcha BD, Ensermu DB, Agga GE, Vancuren M, Gillespie BE, D'Souza DH, Okafor CC, Kerro Dego O. Prevalence of Antimicrobial Resistant and Extended-Spectrum Beta-Lactamase-producing Escherichia coli in Dairy Cattle Farms in East Tennessee. Foodborne Pathog Dis 2022; 19:408-416. [PMID: 35451874 DOI: 10.1089/fpd.2021.0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Antimicrobials have been widely used in dairy farms to prevent and control dairy cattle diseases since 1960s. This led to the emergence of antimicrobial resistant bacteria (ARB) that, along with their antimicrobial resistance genes (ARGs), can spread from dairy farms to humans. Therefore, regular antimicrobial resistance (AMR) monitoring is important to implement proper mitigation measures. The objective of this study was to determine the prevalence of AMR and extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli in dairy cattle. A cross-sectional study was conducted in four dairy cattle farms (A-D) in East Tennessee. A total of 80 samples consisting of 20 samples each of bulk tank milk, feces, dairy cattle manure-amended soil, and prairie soil adjacent to the farms were collected and cultured for the isolation of E. coli. Tetracycline (TETr)-, third-generation cephalosporin (TGCr)- and nalidixic acid (NALr)-resistant E. coli (n = 88) were isolated and identified on agar media supplemented with TET, cefotaxime, and NAL, respectively. TGCr E. coli were tested for ESBLs and other coselected ARGs. TETr (74%, n = 88) was the most common, followed by TGCr (20%) and NALr (8%). Farms had significant (p < 0.001) differences: the highest prevalence of TGCr (55%) and TETr (100%) were observed in farm D, while all NALr isolates were from farm C. Over 83% of TGCr isolates (n = 18) harbored ESBL gene blaCTX-M. Majority (78%) of the E. coli isolates were multidrug-resistant (MDR), being positive for beta-lactams (blaCTX-M), TETs tet(A), tet(B), tet(M)), sulfonamides (sul2), aminoglycosides (strA), and phenicols (floR). This study indicated the widespread occurrence of MDR ESBLs-E. coli in dairy cattle farms. AMR surveillance of more dairy farms and identification of farm-level risk factors are important to mitigate the occurrence and spread of ARB of significant public health importance, such as ESBLs-E. coli.
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Affiliation(s)
- Benti D Gelalcha
- Department of Animal Science, The University of Tennessee Institute of Agriculture, Knoxville, Tennessee, USA
| | - Desta B Ensermu
- Department of Animal Science, The University of Tennessee Institute of Agriculture, Knoxville, Tennessee, USA
| | - Getahun E Agga
- Food Animal Environmental Systems Research Unit, Agricultural Research Service, United States Department of Agriculture, Bowling Green, Kentucky, USA
| | - Molly Vancuren
- Department of Animal Science, The University of Tennessee Institute of Agriculture, Knoxville, Tennessee, USA
| | - Barbara E Gillespie
- Department of Animal Science, The University of Tennessee Institute of Agriculture, Knoxville, Tennessee, USA
| | - Doris H D'Souza
- Department of Food Science, The University of Tennessee Institute of Agriculture, Knoxville, Tennessee, USA
| | - Chika C Okafor
- Department of Biomedical & Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Tennessee, USA
| | - Oudessa Kerro Dego
- Department of Animal Science, The University of Tennessee Institute of Agriculture, Knoxville, Tennessee, USA
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21
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Wang X, Zhang Y, Li C, Li G, Wu D, Li T, Qu Y, Deng W, He Y, Penttinen P, Zhang H, Huang Y, Zhao K, Zou L. Antimicrobial resistance of Escherichia coli, Enterobacter spp., Klebsiella pneumoniae and Enterococcus spp. isolated from the feces of giant panda. BMC Microbiol 2022; 22:102. [PMID: 35421931 PMCID: PMC9008915 DOI: 10.1186/s12866-022-02514-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/01/2022] [Indexed: 11/26/2022] Open
Abstract
Background Escherichia coli, Enterobacter spp., Klebsiella pneumoniae and Enterococcus spp., common gut bacteria in giant pandas, include opportunistic pathogens. The giant panda is an endangered species, classified as vulnerable by the World Wildlife Foundation. Continuous monitoring for the emergence of antimicrobial resistance (AMR) among bacterial isolates from giant pandas is vital not only for their protection but also for public health. Results A total of 166 E. coli, 68 Enterobacter spp., 116 K. pneumoniae and 117 Enterococcus spp. isolates were collected from fecal samples of 166 giant pandas. In the antimicrobial susceptibility tests, 144 E. coli isolates, 66 Enterobacter spp. isolates, 110 K. pneumoniae isolates and 43 Enterococcus spp. isolates were resistant to at least one antimicrobial. The resistant isolates carried antimicrobial resistance genes (ARGs), including sul3, blaTEM, blaSHV and tetA. The differences in the prevalence of the bla types implied that the genetic basis for β-lactam resistance among the E. coli, Enterobacter spp. and K. pneumoniae isolates was different. The strain K. pneumoniae K85 that was resistant to sixteen antimicrobials was selected for whole genome sequencing. The genome contained Col440I, IncFIBK and IncFIIK plasmids and altogether 258 ARGs were predicted in the genome; 179 of the predicted ARGs were efflux pump genes. The genetic environment of the β-lactamase genes blaCTX-M-3 and blaTEM-1 in the K. pneumoniae K85 genome was relatively similar to those in other sequenced K. pneumoniae genomes. In comparing the giant panda age groups, the differences in the resistance rates among E. coli, K. pneumoniae and Enterobacter spp. isolates suggested that the infections in giant pandas of different age should be treated differently. Conclusions Antimicrobial resistance was prevalent in the bacterial isolates from the giant pandas, implying that the gut bacteria may pose serious health risks for captive giant pandas. The resistance genes in the genome of K. pneumoniae K85 were associated with insertion sequences and integron-integrase genes, implying a potential for the further spread of the antimicrobial resistance. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-022-02514-0.
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22
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Novikova IE, Sadeeva ZZ, Shakirzyanova RA, Alyabieva NM, Lazareva AV, Karaseva OV, Vershinina MG, Fisenko AP. The using of the polymerase chain reaction for the detection of resistance genes in gram-negative bacteria in routine practice in a pediatric hospital. Klin Lab Diagn 2022; 67:180-185. [PMID: 35320635 DOI: 10.51620/0869-2084-2022-67-3-180-185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective - assessment of RT-PCR for the detection of carbapenem-resistance genes in gram-negative bacteria. A total, 499 strains of gram-negative microorganisms isolated in two pediatric hospitals in 2019-2020 were studied. Species identification was performed using MALDI-ToF mass-spectrometry (Bruker Daltonics, Germany). Meropenem and imipenem minimal inhibitory concentration (MIC) was determined by E-test method (BioMerieux, France). The presence of acquired carbapenemase genes of IMP, NDM, VIM, KPC, OXA-48, OXA-23, OXA-40, OXA-58-groups was determined by RT-PCR. Klebsiella pneumoniae (34%), Escherichia coli (4%), Serratia marcescens (6%) and other members of Enterobacterales (6%), also gram-negative non-glucose-fermenting bacteria Acinetobacter baumannii (14%), Pseudomonas aeruginosa (36%) were found among selected strains. Carbapenemase production was found in 385 isolates (77%). The main mechanism determining carbapenem resistance in P. aeruginosa was the production of blaVIM (100%). A. baumanii strains harbored OXA-23 (55%) and OXA-40 (45%) carbapenemases. The major determinant of carbapenem resistance in K. pneumoniae isolates was OXA-48 carbapenemase, detected in 63% strains, 13% of the strains possessed blaNDM-group, 16% isolates had a combination of blaNDM-group and blaOXA-48-like. Carbapenemase of KPC-group was found in 8% K. pneumoniae strains. OXA-48 carbapenemase prevailed (95%) among S. marcescens strains. Most of E. coli isolates harbored metallo-beta-lactamase NDM (89%). Other members of Enterobacterales most often had OXA-48 carbapenemase (57%), 39% of the isolates carried blaNDM-group. In one strain, a combination of blaNDM-group and blaOXA-48-like was discovered. RT-PCR is a fast and reliable method for the detection of acquired carbapenemases and can be recommended for routine use in bacteriological laboratories.
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Affiliation(s)
- I E Novikova
- Federal State Autonomous Institution «National Medical Research Center of Children's Health» of the Ministry of Health
| | - Z Z Sadeeva
- Federal State Autonomous Institution «National Medical Research Center of Children's Health» of the Ministry of Health
| | - R A Shakirzyanova
- Federal State Autonomous Institution «National Medical Research Center of Children's Health» of the Ministry of Health
| | - N M Alyabieva
- Federal State Autonomous Institution «National Medical Research Center of Children's Health» of the Ministry of Health
| | - A V Lazareva
- Federal State Autonomous Institution «National Medical Research Center of Children's Health» of the Ministry of Health
| | - O V Karaseva
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma/CRIEPST (Publicity funded health facility of Moscow City Health Department)
| | - M G Vershinina
- Federal State Autonomous Institution «National Medical Research Center of Children's Health» of the Ministry of Health
| | - A P Fisenko
- Federal State Autonomous Institution «National Medical Research Center of Children's Health» of the Ministry of Health
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Antibiotic resistance, virulence, and phylogenetic analysis of Escherichia coli strains isolated from free-living birds in human habitats. PLoS One 2022; 17:e0262236. [PMID: 35020771 PMCID: PMC8754294 DOI: 10.1371/journal.pone.0262236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022] Open
Abstract
Wild birds can be colonized by bacteria, which are often resistant to antibiotics and have various virulence profiles. The aim of this study was to analyze antibiotic resistance mechanisms and virulence profiles in relation to the phylogenetic group of E. coli strains that were isolated from the GI tract of wildfowl. Out of 241 faecal samples, presence of E. coli resistant to a cephalosporin (ESBL/AmpC) was estimated for 33 isolates (13,7%). Based on the analysis of the coexistence of 4 genes encoding ESBLs/AmpC (blaCTX-M, blaTEM,blaSHV, blaAmpC) and class 1 and 2 integrons genes (intI1, intI2) a subset of two resistance profiles was observed among the investigated E. coli isolates carrying blaAmpC, blaSHV, and blaCTX-M, blaTEM, class 1 and 2 integrons, respectively. The E. coli isolates were categorized into 4 phylogenetic groups A (39.4%), B2 (24.25%), D (24.25%) and B1 (12.1%). The pathogenic B2 and D groups were mainly typical for the Laridae family. Among the 28 virulence factors (Vfs) detected in pathogenic phylogenetic groups B2 and D, 7 were exclusively found in those groups (sfa, vat, tosA, tosB, hly, usp, cnf), while 4 VFs (fecA, fyuA, irp2, kspMTII) showed a statistically significant association (P≤0.05) with phylogroups A and B1. Our results indicated that strains belonging to commensal phylogroups A/B1 possess extensive iron acquisition systems (93,9%) and autotransporters (60,6%), typical for pathogens, hence we suggest that these strains evolve towards higher levels of virulence. This study, which is a point assessment of the virulence and drug resistance potential of wild birds, confirms the importance of taking wild birds as a reservoir of strains that pose a growing threat to humans. The E. coli analyzed in our study derive from different phylogenetic groups and possess an arsenal of antibiotic resistance genes and virulence factors that contribute to their ability to cause diseases.
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Dávalos-Almeyda M, Guerrero A, Medina G, Dávila-Barclay A, Salvatierra G, Calderón M, Gilman RH, Tsukayama P. Antibiotic Use and Resistance Knowledge Assessment of Personnel on Chicken Farms with High Levels of Antimicrobial Resistance: A Cross-Sectional Survey in Ica, Peru. Antibiotics (Basel) 2022; 11:antibiotics11020190. [PMID: 35203794 PMCID: PMC8868202 DOI: 10.3390/antibiotics11020190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
Poultry farming represents Peru’s primary food animal production industry, where antimicrobial growth promoters are still commonly used, exerting selective pressure on intestinal microbial populations. Consumption and direct animal-to-human transmission have been reported, and farmworkers are at high risk of colonization with resistant bacteria. We conducted a cross-sectional survey among 54 farmworkers to understand their current antimicrobial resistance (AMR) awareness in Ica, Peru. To gain insight into the potential work-related risk of exposure to bacteria, we also measured the AMR rates in Escherichia coli isolated among 50 broiler chickens. Farmworkers were unaware of antimicrobial resistance (31.5%) or antibiotic resistance (16.7%) terms. Almost two-thirds (61%) consumed antibiotics during the previous month, and only 42.6% received a prescription from a healthcare professional. A total of 107 E. coli chicken isolates were obtained, showing a high frequency of multidrug-resistant (89.7%) and extended-spectrum beta-lactamase (ESBL) production (71.9%). Among ESBL-producer isolates, 84.4% carried the blaCTX-M gene. Results identified gaps in knowledge that reflect the need for interventions to increase antimicrobial awareness among poultry farmworkers. The high AMR rates among E. coli isolates highlight the need to reduce antimicrobial use in poultry farms. Our findings reveal a critical need for effective policy development and antimicrobial stewardship interventions in poultry production in Ica, Peru.
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Affiliation(s)
- María Dávalos-Almeyda
- School of Veterinary Medicine, Universidad Nacional San Luis Gonzaga, Ica 11004, Peru; (M.D.-A.); (A.G.); (G.M.)
| | - Agustín Guerrero
- School of Veterinary Medicine, Universidad Nacional San Luis Gonzaga, Ica 11004, Peru; (M.D.-A.); (A.G.); (G.M.)
| | - Germán Medina
- School of Veterinary Medicine, Universidad Nacional San Luis Gonzaga, Ica 11004, Peru; (M.D.-A.); (A.G.); (G.M.)
| | - Alejandra Dávila-Barclay
- Microbial Genomics Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (A.D.-B.); (G.S.)
| | - Guillermo Salvatierra
- Microbial Genomics Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (A.D.-B.); (G.S.)
| | - Maritza Calderón
- Infectious Diseases Research Laboratories, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima 15102, Peru;
| | - Robert H. Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21218, USA;
| | - Pablo Tsukayama
- Microbial Genomics Laboratory, Department of Cellular and Molecular Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (A.D.-B.); (G.S.)
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, Saffron Walden CB10 1RQ, UK
- Correspondence:
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Sadeghi M, Sedigh Ebrahim-Saraie H, Mojtahedi A. Prevalence of ESBL and AmpC genes in E. coli isolates from urinary tract infections in the north of Iran. New Microbes New Infect 2022; 45:100947. [PMID: 34984104 PMCID: PMC8693013 DOI: 10.1016/j.nmni.2021.100947] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 10/02/2021] [Accepted: 11/03/2021] [Indexed: 12/26/2022] Open
Abstract
Beta-lactam resistance in Gram-negative bacteria, especially Escherichia coli, is a main clinical problem. It is often caused by the production of β-lactamases, particularly extended-spectrum β-lactamases (ESBLs) or AmpC enzymes. This study was undertaken to characterize ESBL and AmpC producers among Escherichia coli isolates from urine samples. During six months, 263 E. coli isolates were detected by standard biochemical tests. The isolates were screened for ESBL production by the double-disk synergy test using Ceftazidime (30 μg) and Cefotaxime (30 μg) disks and confirmed by combined disk diffusion test using Clavulanic acid. AmpC production was confirmed by an AmpC disk test based on filter paper disks impregnated with EDTA. The presence of genes encoding TEM, SHV, CTX-M, CIT, FOX, MOX, ACC, and EBC were detected by PCR. 263 E. coli isolates were selected for the combined disk (Ceftazidime, Cefotaxime, and Clavulanic acid) assay in the disk agar diffusion test. In the combined disk assay, among 263 isolates, 121 (46%) isolates were detected as ESBLs, and none of the isolates were AmpC producers. PCR performed on all ESBL producers and blaSHV, blaTEM, and blaCTX-M were detected in 42 (34.7%), 44 (36.4%), and 47 (38.8%) cases, respectively. Also, from 48 Isolates with zone diameters of less than or equal to 18 mm to Cefoxitin, 7 (14.6%), 4 (8.3%), and 9 (18.8%) cases contained MOX, EBC, and CIT genes, respectively. DHA, FOX, and ACC genes were not detected in any sample. Since pathogens evolve in the hospital setting, updating local data, such as this research, offers scientific evidence to improve the outcome of nosocomial infections.
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Affiliation(s)
- M. Sadeghi
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - H. Sedigh Ebrahim-Saraie
- Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - A. Mojtahedi
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Detection and characterisation of extended-spectrum and plasmid-mediated AmpC β-lactamase produced by Escherichia coli isolates found at poultry farms in Bosnia and Herzegovina. Arh Hig Rada Toksikol 2021; 72:305-314. [PMID: 34985844 PMCID: PMC8785107 DOI: 10.2478/aiht-2021-72-3560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/01/2021] [Indexed: 11/20/2022] Open
Abstract
Extended-spectrum β-lactamases (ESBLs) hydrolyse extended-spectrum cephalosporins (ESC) and aztreonam. As ESBL-producing organisms have been identified in food producing animals, the aim of our study was to detect and analyse such Escherichia coli isolates from poultry. Antibiotic susceptibility of the isolates was determined with disk-diffusion and broth microdilution methods. ESBLs were detected with the double-disk synergy and inhibitor-based test with clavulanic acid. The transferability of cefotaxime resistance was determined with conjugation experiments, and genes encoding ESBLs, plasmid-mediated AmpC β-lactamases, and quinolone resistance determinants identified by polymerase chain reaction. The study included 108 faecal samples (cloacal swabs) from 25 different poultry farms in the Zenica-Doboj Canton, Bosnia and Herzegovina. Of these, 75 (69.4 %) were positive for E. coli, of which 27 were resistant to cefotaxime, amoxicillin, cefazoline, and cefriaxone, and susceptible to imipenem, meropenem, ertapenem, and amikacin. All 27 cefotaxime-resistant isolates were positive in double-disk synergy and combined disk tests. Eighteen isolates transferred cefotaxime resistance to E. coli recipient. Twenty-one isolates were positive for the bla CTX-M-1 cluster genes and seven for bla CTX-M-15. Fourteen were positive for the bla TEM genes. The most frequent plasmid incompatibility group was IncFIB, whereas IncFIA and Inc HI1 were present in only a few isolates. Two different sequence types (STs) were identified: ST117 and ST155. The emergence of ESBL-producing E. coli in farm animals presents a public health threat, as they can colonise the intestine and cause infections in humans.
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Bhattacharyya D, Banerjee J, Habib M, Thapa G, Samanta I, Nanda PK, Dutt T, Sarkar K, Bandyopadhyay S. Elucidating the resistance repertoire, biofilm production, and phylogenetic characteristics of multidrug-resistant Escherichia coli isolated from community ponds: A study from West Bengal, India. WATER ENVIRONMENT RESEARCH : A RESEARCH PUBLICATION OF THE WATER ENVIRONMENT FEDERATION 2021; 94:e1678. [PMID: 34907618 DOI: 10.1002/wer.1678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
This study details about the phenotypic and molecular characteristics of multidrug-resistant (MDR) Escherichia coli in the fresh community pond water (n = 257) collected from three districts of West Bengal, India. In total, 57 isolates were MDR of which 38 emerged as extended spectrum and 7 as AmpC-type β-lactamase producers in phenotypic assay. Among β-lactamase genes, blaCTXM-1was predominant (87.71%) followed by blaAmpC (77.2%) and blaTEM-1 (22.8%). Six MDR strains carried metallo-β-lactamase (MBL, blaNDM-1) gene. Tissue culture plate assay confirmed strong biofilm (SP) production in four MDR and one non-MDR isolates. In PCR-based replicon typing (PBRT), multiple plasmids of diverse replicon types (Frep, FIB, I1, FIA, K/B, HI1, and Y) were identified. The enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR)-based phylogenetic analysis revealed a high degree of genetic divergence among the MDR isolates. Multiplex PCR-based phylogrouping categorized 11 isolates as virulent (B2/D/F), which carried blaCTXM-1 gene and three had blaNDM-1 gene. Relative transcriptional activity of AcrAB efflux pump was significantly elevated among the SP and MBL producers. The presence of MDR E. coli isolates, particularly those resistant to carbapenem, in pond water used for daily domestic and household work, is a cause of concern as these pathogens may sneak into human food chain causing life-threatening infections. PRACTITIONER POINTS: Multidrug-resistant biofilm producing E. coli isolated from community pond water. A few of them were carbapenem-resistant and belonged to virulent (B2/D) types. Expression of AcrAB efflux pumps was found significantly elevated among biofilm producers and carbapenem-resistant population.
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Affiliation(s)
- Debaraj Bhattacharyya
- ICAR-Indian Veterinary Research Institute, Kolkata, India
- Department of Microbiology, University of Kalyani, Kalyani, India
| | | | - Md Habib
- ICAR-Indian Veterinary Research Institute, Kolkata, India
| | | | - Indranil Samanta
- Department of Veterinary Microbiology, Faculty of Veterinary and Animal Sciences, West Bengal University of Animal & Fishery Sciences, Kolkata, India
| | | | - Triveni Dutt
- Division of Livestock Production and Management, ICAR-Indian Veterinary Research Institute, Izatnagar, India
| | - Keka Sarkar
- Department of Microbiology, University of Kalyani, Kalyani, India
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AL-Mahfoodh WJM, Pekacar FS, Abbas AH. The molecular study for evaluation the antibiotic resistance of Escherichia coli and Klebsiella pneumoniae bacteria isolated from urinary tract infection patients. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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ESBL/AmpC-Producing Enterobacteriaceae Fecal Colonization in Dogs after Elective Surgery. MICROBIOLOGY RESEARCH 2021. [DOI: 10.3390/microbiolres12040067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to evaluate the presence and load of ESBL/AmpC-producing Enterobacteriaceae fecal carriage in healthy dogs. Fecal samples were collected from dogs submitted to surgical procedures (n = 25). Fecal samples were collected before surgery (BS) and after surgery (AS). β-lactamases were detected by PCR. Statistical analyses were performed with SAS software (v.9.4); a p value ≤ 0.05 was considered statistically significant. The ESBL/AmpC-producing Enterobacteriaceae bacteria species detected in this study were E. coli, K. pneumoniae and E. cloacae. TEM, and CTX-M-1 group genes were the most frequent β-lactamases detected. The number of dogs colonized with 3GC-resistant Enterobacteriaceae bacteria was significantly higher in the AS (63.6%, n = 14/22) group compared to in the BS group (20.0%, n = 5/25, p = 0.0033). The ESBL/AmpC-producing bacteria fecal load was significantly higher in the AS group compared to in the BS (p = 0.025) group. This study shows that 3GC-resistant Enterobacteriaceae and ESBLs/AmpC producers in the veterinary clinical practice are a concern and highlights the need to implement preventive measures to minimize their spread.
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The Relationship between Antibiotic Susceptibility and pH in the Case of Uropathogenic Bacteria. Antibiotics (Basel) 2021; 10:antibiotics10121431. [PMID: 34943643 PMCID: PMC8697967 DOI: 10.3390/antibiotics10121431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/17/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022] Open
Abstract
Urinary tract infections (UTIs) are common bacterial infections caused mainly by enteric bacteria. Numerous virulence factors assist bacteria in the colonization of the bladder. Bacterial efflux pumps also contribute to bacterial communication and to biofilm formation. In this study, the phenotypic and genetic antibiotic resistance of clinical UTI pathogens such as Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis were determined by disk diffusion method and polymerase chain reaction (PCR). Following this, different classes of antibiotics were evaluated for their antibacterial activity at pH 5, 6, 7 and 8 by a microdilution method. Gentamicin (GEN) was the most potent antibacterial agent against E. coli strains. The effect of GEN on the relative expression of marR and sdiA genes was evaluated by quantitative PCR. The slightly acidic pH (pH 6) and GEN treatment induced the upregulation of marR antibiotic resistance and sdiA QS activator genes in both E. coli strains. Consequently, bacteria had become more susceptible to GEN. It can be concluded that antibiotic activity is pH dependent and so the artificial manipulation of urinary pH can contribute to a more effective therapy of multidrug resistant bacterial infections.
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Outbreak of CTX-M-15 Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae ST394 in a French Intensive Care Unit Dedicated to COVID-19. Pathogens 2021; 10:pathogens10111426. [PMID: 34832582 PMCID: PMC8618658 DOI: 10.3390/pathogens10111426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Infections caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) are constantly rising worldwide and are often reported as causative agent of outbreaks in intensive care units (ICUs). During the first wave of the COVID-19 pandemic, bacterial cross-transmission was thought unlikely to occur due to the reinforcement of hygiene measures and prevention control. However, we report here an ESBL-producing K. pneumoniae (ST394) isolate responsible for a nosocomial outbreak in an ICU dedicated to COVID-19 patients.
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Phylogenetic diversity and mutational analysis of New Delhi Metallo-β-lactamase (NDM) producing E. coli strains from pediatric patients in Pakistan. Saudi J Biol Sci 2021; 28:5875-5883. [PMID: 34588903 PMCID: PMC8459064 DOI: 10.1016/j.sjbs.2021.06.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/25/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022] Open
Abstract
The evolution of NDM genes (blaNDM) in E. coli is accounted for expansive multidrug resistance (MDR), causing severe infections and morbidities in the pediatric population. This study aimed to analyze the phylogeny and mutations in NDM variants of E. coli recovered from the pediatric population. Carbapenem-resistant clinical strains of E. coli were identified using microbiological phenotypic techniques. PCR technique used to amplify the blaNDM genes, identified on agarose gel, and analyzed by DNA sequencing. The amino acid substitutions were examined for mutations after aligning with wild types. Mutational and phylogenetic analysis was performed using Lasergene, NCBI blastn, Clustal Omega, and MEGA software, whereas PHYRE2 software was used for the protein structure predictions. PCR amplification of the blaNDM genes detected 113 clinical strains of E. coli with the contribution of blaNDM-1 (46%), blaNDM-4 (3.5%), and blaNDM-5 (50%) variants. DNA sequencing of blaNDM variants showed homology to the previously described blaNDM-1, blaNDM-4, and blaNDM-5 genes available at GenBank and NCBI database. In addition, the mutational analysis revealed in frame substitutions of Pro60Ala and Pro59Ala in blaNDM-4 and blaNDM-5, respectively. The blaNDM-1 was ortholog with related sequences of E. coli available at GenBank. The phylogenetic analysis indicated that the NDM gene variants resemble other microbes reported globally with some new mutational sites.
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Halaji M, Shahidi S, Ataei B, Atapour A, Feizi A, Havaei SA. Molecular epidemiology of bla CTX-M gene-producing uropathogenic Escherichia coli among Iranian kidney transplant patients: clonal dissemination of CC131 and CC10. Ann Clin Microbiol Antimicrob 2021; 20:65. [PMID: 34496873 PMCID: PMC8424993 DOI: 10.1186/s12941-021-00470-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 08/31/2021] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to investigate the phylogenetic characterization and virulence traits of uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTPs) as well as non-KTPs and analyze the clonal distribution of Extended spectrum β-lactamases (ESBLs)-producing UPEC containing blaCTX-M gene. Methods To this end, we determined virulence marker and the phylogenetic characterization of UPEC in non-KTPs (n = 65) and KTPs (n = 46). The non-KTPs were considered the control group of the study. Also, according to the Achtman scheme, we performed multilocus sequence typing to assess the relationship between twenty-nine of ESBL-producing isolates containing blaCTX-M gene. Results According to the results of PCR assay, the prevalence of virulence factor genes ranged from 0% (cnf and papG III) to 93.7% (fimH). Also, KTP isolates significantly differed from non-KTP isolates only in terms of the prevalence of pap GI elements. Moreover, the most frequent UPEC isolates were in phylogenetic group B2, followed by group D (18.9%), and group A (13.5%). Furthermore, except for phylogenetic group C, there was no significant correlation between phylogenetic distribution in KTPs and non-KTPs. Additionally, MLST analysis of blaCTX-M carrying isolates identified 18 unique sequence types (ST) the most common of which was ST131 (24.1%), followed by ST1193 (10.3%), while fourteen STs were detected only once. Conclusions The results further revealed significant differences between the UPEC isolates from KTPs and non-KTPs regarding the phylogroups C and PAI gene. Based on MLST analysis, we also observed a relatively high diversity in UPEC isolates obtained from KTPs and non-KTPs. Moreover, clonal complex (CC) 131 and ST131 were found to be the most prevalent clones and ST types, respectively. Besides, for the first time, ST8503 were reported in KTPs. These results suggested regular studies on characterization of UPEC isolates among KTPs. Supplementary Information The online version contains supplementary material available at 10.1186/s12941-021-00470-7.
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Affiliation(s)
- Mehrdad Halaji
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Gurung R, Adhikari S, Adhikari N, Sapkota S, Rana JC, Dhungel B, Thapa Shrestha U, Banjara MR, Ghimire P, Rijal KR. Efficacy of Urine Dipstick Test in Diagnosing Urinary Tract Infection and Detection of the blaCTX-M Gene among ESBL-Producing Escherichia coli. Diseases 2021; 9:diseases9030059. [PMID: 34562966 PMCID: PMC8482205 DOI: 10.3390/diseases9030059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/18/2021] [Accepted: 08/26/2021] [Indexed: 01/24/2023] Open
Abstract
A urine dipstick test used for prompt diagnosis of urinary tract infection (UTI) is a rapid and cost-effective method. The main objective of this study was to compare the efficacy of the urine dipstick test with culture methods in screening for UTIs along with the detection of the blaCTX-M gene in extended spectrum β-lactamase (ESBL)-producing Escherichia coli. A total of 217 mid-stream urine samples were collected from UTI-suspected patients attending Bharatpur Hospital, Chitwan, and tested by dipstick test strip (COMBI-10SL, Germany) prior to the culture. E. coli isolates were identified by standard microbiological procedures and subjected to antimicrobial susceptibility testing by Kirby Bauer disc diffusion method following CLSI guideline. Primary screening of ESBL-producing E. coli isolates was conducted using ceftriaxone, cefotaxime and ceftazidime discs and phenotypically confirmed by combined disk diffusion test. Plasmid DNA of ESBL-producing strains was extracted by phenol-chloroform method and subjected to PCR for detection of the blaCTX-M gene. Out of 217 urine samples, 48 (22.12%) showed significant bacteriuria. Among 46 (21.20%) Gram negative bacteria recovered, the predominant one was E. coli 37 (77.08%) of which 33 (89.19%) were multidrug resistant (MDR). E. coli isolates showed a higher degree of resistance towards cefazolin (62.16%) while 81.08% of the isolates were sensitive towards amikacin followed by nitrofurantoin (70.27%). Among 14 (37.84%) phenotypically confirmed ESBL isolates, only eight (21.62%) isolates carried the blaCTX-M gene. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of urine dipstick test were 43.75%, 77.51%, 35.59% and 82.91%, respectively. Besides, the use of dipstick test strip for screening UTI was associated with many false positive and negative results as compared to the gold standard culture method. Hence, dipstick nitrite test alone should not be used as sole method for screening UTIs.
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Affiliation(s)
- Rubina Gurung
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
| | - Sanjib Adhikari
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
| | - Nabaraj Adhikari
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
| | - Sanjeep Sapkota
- Department of Microbiology, Birendra Multiple Campus, Tribhuvan University, Bharatpur 44200, Chitwan, Nepal;
| | - Jid Chani Rana
- Department of Microbiology, Bharatpur Hospital, Bharatpur 44200, Chitwan, Nepal;
| | - Binod Dhungel
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
| | - Upendra Thapa Shrestha
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
| | - Prakash Ghimire
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur 44600, Kathmandu, Nepal; (R.G.); (S.A.); (N.A.); (B.D.); (U.T.S.); (M.R.B.); (P.G.)
- Correspondence: or
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Fursova NK, Astashkin EI, Ershova ON, Aleksandrova IA, Savin IA, Novikova TS, Fedyukina GN, Kislichkina AA, Fursov MV, Kuzina ES, Biketov SF, Dyatlov IA. Multidrug-Resistant Klebsiella pneumoniae Causing Severe Infections in the Neuro-ICU. Antibiotics (Basel) 2021; 10:antibiotics10080979. [PMID: 34439029 PMCID: PMC8389041 DOI: 10.3390/antibiotics10080979] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was the identification of genetic lineages and antimicrobial resistance (AMR) and virulence genes in Klebsiella pneumoniae isolates associated with severe infections in the neuro-ICU. Susceptibility to antimicrobials was determined using the Vitek-2 instrument. AMR and virulence genes, sequence types (STs), and capsular types were identified by PCR. Whole-genome sequencing was conducted on the Illumina MiSeq platform. It was shown that K. pneumoniae isolates of ST14K2, ST23K57, ST39K23, ST76K23, ST86K2, ST218K57, ST219KL125/114, ST268K20, and ST2674K47 caused severe systemic infections, including ST14K2, ST39K23, and ST268K20 that were associated with fatal incomes. Moreover, eight isolates of ST395K2 and ST307KL102/149/155 were associated with manifestations of vasculitis and microcirculation disorders. Another 12 K. pneumoniae isolates of ST395K2,KL39, ST307KL102/149/155, and ST147K14/64 were collected from patients without severe systemic infections. Major isolates (n = 38) were XDR and MDR. Beta-lactamase genes were identified: blaSHV (n = 41), blaCTX-M (n = 28), blaTEM (n = 21), blaOXA-48 (n = 21), blaNDM (n = 1), and blaKPC (n = 1). The prevalent virulence genes were wabG (n = 41), fimH (n = 41), allS (n = 41), and uge (n = 34), and rarer, detected only in the genomes of the isolates causing severe systemic infections-rmpA (n = 8), kfu (n = 6), iroN (n = 5), and iroD (n = 5) indicating high potential of the isolates for hypervirulence.
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Affiliation(s)
- Nadezhda K. Fursova
- Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia; (E.I.A.); (T.S.N.)
- Correspondence:
| | - Evgenii I. Astashkin
- Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia; (E.I.A.); (T.S.N.)
| | - Olga N. Ershova
- Department of Clinical Epidemiology, National Medical Research Center of Neurosurgery Named after Academician N.N. Burdenko, 125047 Moscow, Russia; (O.N.E.); (I.A.A.); (I.A.S.)
| | - Irina A. Aleksandrova
- Department of Clinical Epidemiology, National Medical Research Center of Neurosurgery Named after Academician N.N. Burdenko, 125047 Moscow, Russia; (O.N.E.); (I.A.A.); (I.A.S.)
| | - Ivan A. Savin
- Department of Clinical Epidemiology, National Medical Research Center of Neurosurgery Named after Academician N.N. Burdenko, 125047 Moscow, Russia; (O.N.E.); (I.A.A.); (I.A.S.)
| | - Tatiana S. Novikova
- Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia; (E.I.A.); (T.S.N.)
| | - Galina N. Fedyukina
- Department of Immunobiochemistry of Pathogenic Microorganisms, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia; (G.N.F.); (S.F.B.)
| | - Angelina A. Kislichkina
- Department of Culture Collection, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia;
| | - Mikhail V. Fursov
- Department of Training and Improvement of Specialists, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia; (M.V.F.); (E.S.K.)
| | - Ekaterina S. Kuzina
- Department of Training and Improvement of Specialists, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia; (M.V.F.); (E.S.K.)
| | - Sergei F. Biketov
- Department of Immunobiochemistry of Pathogenic Microorganisms, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia; (G.N.F.); (S.F.B.)
| | - Ivan A. Dyatlov
- Department of Administration, State Research Center for Applied Microbiology and Biotechnology, Territory “Kvartal A”, 142279 Obolensk, Russia;
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From the Urinary Catheter to the Prevalence of Three Classes of Integrons, β-Lactamase Genes, and Differences in Antimicrobial Susceptibility of Proteus mirabilis and Clonal Relatedness with Rep-PCR. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9952769. [PMID: 34212042 PMCID: PMC8211507 DOI: 10.1155/2021/9952769] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/28/2021] [Accepted: 05/31/2021] [Indexed: 12/18/2022]
Abstract
Introduction Proteus mirabilis is a biofilm-forming agent that quickly settles on the urinary catheters and causing catheter-associated urinary tract infections. Thus, the spread of multidrug-resistant P. mirabilis isolates, with the ability to form a biofilm that carries integron, extended-spectrum β-lactamases (ESBLs), and plasmid-mediated colistin resistance genes (mcr), represents a severe threat to managing nosocomial infectious diseases. This study is aimed at surveying the prevalence of ESBL, integrase, and mcr genes of P. mirabilis, isolated from the catheter, to assess the differences in their antimicrobial susceptibility and clonal dissemination. Method Microtiter plate assay was adopted to measure biofilm formation. The antimicrobial susceptibility was assessed by the disk diffusion method. Antimicrobial resistance genes (intI1, intI2, intI3, blaTEM, blaCTX-M, blaSHV, mcr1, and mcr2) were detected by PCR. All of the isolates were characterized by repetitive sequence-based PCR. Result From 385 collected catheters in patients admitted to the intensive care unit (ICU), 40 P. mirabilis were isolated. All of the isolates could form a biofilm. Proteus spp. had intrinsic resistance to tetracycline (95%) and nitrofurantoin (92.5%), which explains the high resistance prevalence. The most widely resistant antibiotic was trimethoprim-sulfamethoxazole (75%). Thirty-three (82.5%) isolates were classified as multidrug resistance (MDR). The prevalence of intI1 and intI2 genes was 60% and 25%, respectively. In 6 (15%) isolates, both genes were detected. The most frequent ESBL gene detected in all of the isolates was blaTEM. Also, no detection for mcr1 and mcr2 antibiotic resistance genes was reported. Rep-PCR identified 39(GTG)5 types (G1–G39) of 40 isolates that 38 isolates had unique patterns. Conclusion In this study, 82.5% of isolates were MDR with high antibiotic resistance to trimethoprim-sulfamethoxazole. The intI1 and blaTEM were the most prevalent genes in the integrase and ESBL gene family. High diversity was seen in the isolates with Rep-PCR. The increasing rate of MDR isolates with a high prevalence of resistance genes could be alarming and demonstrate the need for hygienic procedures to prevent the increased antibiotic resistance rate in the future.
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Genetic Determinants of Resistance among ESBL-Producing Enterobacteriaceae in Community and Hospital Settings in East, Central, and Southern Africa: A Systematic Review and Meta-Analysis of Prevalence. ACTA ACUST UNITED AC 2021; 2021:5153237. [PMID: 34122680 PMCID: PMC8192179 DOI: 10.1155/2021/5153237] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/17/2020] [Accepted: 05/29/2021] [Indexed: 12/25/2022]
Abstract
Background The world prevalence of community and hospital-acquired extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is increasing tremendously. Bacteria harboring ESBLs are currently the number one critical pathogens posing a major threat to human health. Objective To provide a summary of molecular evidence on the prevalence of ESBL-producing Enterobacteriaceae (ESBL-E) and associated genes at community and hospital settings in East, Central, and Southern African countries. Methods We conducted a systematic literature search on PubMed and Google Scholar databases for the available molecular studies on ESBL-E in hospitals and community settings in East, Central, and Sothern Africa (ECSA). Published studies in English language involving gene characterization of ESBLs from human samples in hospital and community settings were included in the review, inception to November 2019. A random effect meta-analysis was performed to estimate the prevalence of ESBL-E. Results A total of 27 studies involving molecular characterization of resistance genes from 20,225 ESBL-E isolates were included in the analysis. Seventy-four percent of all studies were hospital based, 15% were based in community settings, and others were done in both hospital and community settings. Of all the studies, 63% reported E. coli as the dominant isolate among ESBL-E recovered from clinical samples and Klebsiella pneumoniae was reported dominant isolates in 33% of all studies. A random pooled prevalence of ESBL-E was 38% (95% CI = 24–53%), highest in Congo, 92% (95% CI = 90–94%), and lowest in Zimbabwe, 14% (95% CI = 9–20%). Prevalence was higher in hospital settings 41% (95% CI = 23–58%) compared to community settings 34% (95% CI = 8–60%). ESBL genes detected from clinical isolates with ESBL-E phenotypes in ECSA were those of Ambler molecular class A [1] that belongs to both functional groups 2be and 2d of Bush and Jacob classification of 2010 [2]. Majority of studies (n = 22, 81.5%) reported predominance of blaCTX-M gene among isolates, particularly CTX-M-15. Predictors of ESBL-E included increased age, hospital admissions, previous use of antibiotics, and paramedical use of herbs. Conclusion Few studies have been conducted at a molecular level to understand the genetic basis of increased resistance among members of ESBL-E in ECSA. Limited molecular studies in the ECSA region leave a gap in estimating the burden and risk posed by the carriage of ESBL genes in these countries. We found a high prevalence of ESBL-E most carrying CTX-M enzyme in ECSA with a greater variation between countries. This could be an important call for combined (regional or global) efforts to combat the problem of antimicrobial resistance (AMR) in the region. Antibiotic use and hospital admission increased the carriage of ESBL-E, while poor people contributed little to the increase of AMR due to lack of access and failure to meet the cost of healthcare compared to high income individuals.
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Frequency of CTX-M gene isolated from E. coli in patients with suspected urinary tract infection in Semnan. GENE REPORTS 2021. [DOI: 10.1016/j.genrep.2021.101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kuznetsova MV, Gizatullina JS. Epidemiological characteristics of uropatogenic isolates of Escherichia coli in hospitals. Klin Lab Diagn 2021; 66:248-256. [PMID: 33878248 DOI: 10.51620/0869-2084-2021-66-4-248-256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of the study was to evaluate the genetic affinity of uropathogenic E. coli cultures (UPEC) and to identify the major types of extended spectrum beta-lactamases (ESBL) found among nosocomial isolates. A molecular typing of UPEC (n=93) isolated from patients with urinary tract infections (UTI) who were hospitalised in nine medical facilities (MO) in Perm was performed. It was found that 69.89% of the cultures had individual RAPD/ERIC profiles, the remaining 30.10% were distributed among 13 genome groups. Most frequently blaCTX-M-1 was detected individually or in combination with other beta-lactamase genes (n=23, 79.31% of ESBL phenotype-positive isolates), genes were detected in seventeen cases (58.62%) blaTEM and/or blaOXA, the blaCMY fragment was found in only three isolates (10.34%), blaSHV was missing in this isolates. It was shown that in two thirds of the cases the pathogens of the infection process are representatives of the endogenous intestinal microbiota of the patients, in other cases an exogenous infection occurs. The proportion of "circulating" (possibly hospital) isolates in the spectrum of UTI increased in the series: therapy departments - surgery departments - intensive care units. In addition, in multidisciplinary hospitals there are conditions for cross-infections of patients, but the epidemiological chains of episodes of UTI are short and concise. It has been shown that the probability of infection with E. coli producing CTX-M or OXA enzymes is significantly higher in the intensive care unit than in surgery or therapy departments. The data obtained complement the understanding of the epidemiology of UTI caused by E. coli and can be used as an aid in the planning and implementation of methods for the prevention and control of nosocomial UTI.
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Affiliation(s)
- M V Kuznetsova
- Institute of Ecology and Genetic of Microorganisms Ural Branch Russian Academy of Sciences
| | - J S Gizatullina
- Institute of Ecology and Genetic of Microorganisms Ural Branch Russian Academy of Sciences
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Kanashenko ME, Mitzevich IP, Kartsev NN, Astashkin EI, Detusheva EV, Khramov MV, Svetoch EA, Fursova NK. A study of antibiotic and disinfectant susceptibility of Elizabethkingia meningoseptica. Klin Lab Diagn 2021; 66:242-247. [PMID: 33878247 DOI: 10.51620/0869-2084-2021-66-4-242-247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
For the local health service, Elizabethkingia meningoseptica remains a relatively new and little-known pathogen, whereas in many countries of Europe, Asia and other continents it is considered as a potential causative agent of nosocomial infections, especially in premature infants and immunocompromised patients. An analysis of the literature data, as well as our results indicate that E. meningoseptica should be considered as a potential pathogen, which is characterized by a unique profile of susceptibility to antimicrobial agents (AMP) and disinfectants. This article presents the results of a study of susceptibility to AMP and disinfectants of three isolates of E. meningoseptica, isolated during an investigation of an outbreak in one of the perinatal centers of the Russian Federation, where three cases of sepsis with a fatal outcome in premature infants caused by co-infection with Acinetobacter baumannii and E. meningoseptica were recorded between January and February 2016.
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Affiliation(s)
- M E Kanashenko
- State Research Center for Applied Microbiology and Biotechnology
| | - I P Mitzevich
- State Research Center for Applied Microbiology and Biotechnology
| | - N N Kartsev
- State Research Center for Applied Microbiology and Biotechnology
| | - E I Astashkin
- State Research Center for Applied Microbiology and Biotechnology
| | - E V Detusheva
- State Research Center for Applied Microbiology and Biotechnology
| | - M V Khramov
- State Research Center for Applied Microbiology and Biotechnology
| | - E A Svetoch
- State Research Center for Applied Microbiology and Biotechnology
| | - N K Fursova
- State Research Center for Applied Microbiology and Biotechnology
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Tolentino FM, De Almeida IAZC, Dos Santos CCM, Teixeira ISDC, Silva SIDLE, Nogueira MCL, Arroyo MG, Faim WR, De Almeida MTG, Peresi JTM. Phenotypic and genotypic profile of the antimicrobial resistance of bacterial isolates and evaluation of physical and chemical potability indicators in groundwater in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:186-201. [PMID: 31293171 DOI: 10.1080/09603123.2019.1640354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 07/02/2019] [Indexed: 06/09/2023]
Abstract
The aquatic environment has received increasing attention regarding the evolution of bacterial resistance, either as a source of resistance genes or as a matrix for the dissemination of these genes. We evaluated the physicochemical, microbiological and antimicrobial resistance characteristics of 160 samples from alternative water well solutions. According to Ordinance 2914/2011 - MS, 44 (27.5%) samples were considered unsafe if at least one physicochemical parameter exceeded permissible limits. Escherichia coli were found in 30.6% of the unregistered housing estates (UHE) and 1.9% of the local sanitary surveillance system (RW). The total of 158 bacterial strains were isolated from 13 (25%) RW and 68 (63%) UHE, 132 of which (83.5%) were obtained from UHE samples. In the investigation of resistance genes, tetA, qnrS and qnrB genes were detected in three, one and eight isolates, respectively. Our results emphasize the importance of constant surveillance and control of the quality of water supplies.
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Affiliation(s)
- Fernanda Modesto Tolentino
- Instituto Adolfo Lutz - Centro de Laboratório Regional de São José do Rio Preto - Rua Alberto Sufredine Bertone , São José do Rio Preto-SP, Brasil
| | | | - Cecilia Cristina Marques Dos Santos
- Instituto Adolfo Lutz - Centro de Laboratório Regional de São José do Rio Preto - Rua Alberto Sufredine Bertone , São José do Rio Preto-SP, Brasil
| | - Inara Siqueira De Carvalho Teixeira
- Instituto Adolfo Lutz - Centro de Laboratório Regional de São José do Rio Preto - Rua Alberto Sufredine Bertone , São José do Rio Preto-SP, Brasil
| | - Sonia Izaura De Lima E Silva
- Instituto Adolfo Lutz - Centro de Laboratório Regional de São José do Rio Preto - Rua Alberto Sufredine Bertone , São José do Rio Preto-SP, Brasil
| | - Mara Correa Lelles Nogueira
- Centro de Pesquisas de Micro-organismos da Faculdade de Medicina de São José do Rio Preto , São José do Rio Preto-SP, Brasil
| | - Máira Gazzola Arroyo
- Centro de Pesquisas de Micro-organismos da Faculdade de Medicina de São José do Rio Preto , São José do Rio Preto-SP, Brasil
| | - Wilson Roberto Faim
- Secretaria Municipal de Saúde e Higiene - Vigilância Sanitária de São José do Rio Preto , São José do Rio Preto-SP, Brasil
| | | | - Jacqueline Tanury Macruz Peresi
- Instituto Adolfo Lutz - Centro de Laboratório Regional de São José do Rio Preto - Rua Alberto Sufredine Bertone , São José do Rio Preto-SP, Brasil
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42
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Detection of TEM and CTX-M Genes in Escherichia coli Isolated from Clinical Specimens at Tertiary Care Heart Hospital, Kathmandu, Nepal. Diseases 2021; 9:diseases9010015. [PMID: 33562276 PMCID: PMC7931013 DOI: 10.3390/diseases9010015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/19/2021] [Accepted: 02/04/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Antimicrobial resistance (AMR) among Gram-negative pathogens, predominantly ESBL-producing clinical isolates, are increasing worldwide. The main aim of this study was to determine the prevalence of ESBL-producing clinical isolates, their antibiogram, and the frequency of ESBL genes (blaTEM and blaCTX-M) in the clinical samples from patients. Methods: A total of 1065 clinical specimens from patients suspected of heart infections were collected between February and August 2019. Bacterial isolates were identified on colony morphology and biochemical properties. Thus, obtained clinical isolates were screened for antimicrobial susceptibility testing (AST) using modified Kirby–Bauer disk diffusion method, while ESBL producers were identified by using a combination disk diffusion method. ESBL positive isolates were further assessed using conventional polymerase chain reaction (PCR) to detect the ESBL genes blaTEM and blaCTX-M. Results: Out of 1065 clinical specimens, 17.8% (190/1065) showed bacterial growth. Among 190 bacterial isolates, 57.4% (109/190) were Gram-negative bacteria. Among 109 Gram-negative bacteria, 40.3% (44/109) were E. coli, and 30.2% (33/109) were K. pneumoniae. In AST, 57.7% (n = 63) Gram-negative bacterial isolates were resistant to ampicillin and 47.7% (n = 52) were resistant to nalidixic acid. Over half of the isolates (51.3%; 56/109) were multidrug resistant (MDR). Of 44 E. coli, 27.3% (12/44) were ESBL producers. Among ESBL producer E. coli isolates, 58.4% (7/12) tested positive for the blaCTX-M gene and 41.6% (5/12) tested positive for the blaTEM gene. Conclusion: Half of the Gram-negative bacteria in our study were MDR. Routine identification of an infectious agent followed by AST is critical to optimize the treatment and prevent antimicrobial resistance.
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Genotyping and Virulence Analysis of Drug Resistant Clinical Klebsiella pneumoniae Isolates in Egypt. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.3.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Klebsiella pneumoniae is a highly drug-resistant human pathogen responsible for a variety of serious infections. Integrons, mobile genetic elements capable of integrating antibiotic resistance genes, and the capsule are important virulence factors that increase bacteria resistance to phagocytosis and antimicrobial agents. Molecular typing is an effective tool for identifying the likely etiology of infection. This study aimed to investigate the presence of the rmpA, wcaG, intI1, intI2, and intI3 virulence genes in clinical Klebsiella pneumoniae isolates, and explore their molecular genotypes by using ERIC-PCR. Fifty Klebsiella pneumoniae strains were isolated from various specimens. Antimicrobial resistance was evaluated by using the disc diffusion method. Five genes were amplified by conventional PCR. Genotyping was performed molecularly by using ERIC-PCR. Forty-seven isolates were multi-drug resistant. In all, 18%, 36%, and 98% of the 50 K. pneumoniae isolates were positive for rmpA, wcaG, and intI1 genes, respectively; however, all isolates were negative for intI2 and intI3 genes. Dendogram analysis of the ERIC-PCR results showed 49 distinct patterns, arranged in five clusters. Our study demonstrates high levels of antibiotic resistance and virulence among clinical isolates of K. pneumoniae. Such resistance reflects a growing problem for public health. Further, the presence of integrons increases the horizontal spread of antibiotic resistance and virulence genes among bacterial isolates. The ERIC-PCR technique is an effective method for molecular typing and epidemiological studies of hospital-acquired infections.
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Prevalence of Extended-Spectrum β-Lactamases in E. coli of Rats in the Region North East of Gabon. Vet Med Int 2020; 2020:5163493. [PMID: 32733665 PMCID: PMC7383316 DOI: 10.1155/2020/5163493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/24/2020] [Accepted: 07/02/2020] [Indexed: 11/17/2022] Open
Abstract
Antibiotic resistance occurs in the environment by multiplication and the spread of multidrug-resistant bacteria that would be due to an improper and incorrect use of antibiotics in human and veterinary medicine. The aim of this study was to establish the prevalence of E.coli producing Extended-Spectrum beta-Lactamase (ESBL) antibiotics from rats and gregarious animals in a semirural area of Gabon and to evaluate the origin of a resistance distribution in the environment from animal feces. The bacterial culture was carried out, and the identification of E. coli strains on a specific medium and the antibiotic susceptibility tests allowed establishing the prevalence. Characterization of resistance genes was performed by gene amplification after DNA extraction. On 161 feces collected in rats, 32 strains were isolated, and 11 strains of E. coli produced ESBL with a prevalence of 34.37%. Molecular tests showed that CTX-M genes 214 bp were identified in rats. The presence of CTX-M genes could have a human origin. So, the rats can carry ESBL-producing Enterobacteriaceae which poses a risk to human health and pets in this region of Gabon.
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Halaji M, Shahidi S, Atapour A, Ataei B, Feizi A, Havaei SA. Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic Escherichia coli Among Iranian Kidney Transplant Patients. Infect Drug Resist 2020; 13:1429-1437. [PMID: 32523361 PMCID: PMC7237106 DOI: 10.2147/idr.s248572] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/05/2020] [Indexed: 12/21/2022] Open
Abstract
Introduction The aim of this study was to investigate the antimicrobial susceptibility pattern and the presence of ESBLs among the uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTP) and community-acquired urinary tract infections (UTIs) using phenotypic and molecular methods. Materials and Methods A total of 111 pure cultures of UPEC isolates were collected from 65 and 46 of non-KTP and KTPs with UTIs. The pattern and ESBL production of the strains were evaluated. PCR reaction to detect the presence of bla SHV, bla TEM, and bla CTX-M genes was performed. Results The results revealed that most of UPEC isolates obtained from KTPs and control group were resistant to trimethoprim/sulfamethoxazole (84.8% vs 46.2%), while carbapenems (100% sensitivity) were the most effective against UPEC isolates. ESBL-producing strains were significantly more frequent in KTPs compared with control group (43.5% vs 23.1%, P = 0.021). The molecular results revealed that 53.2% (59/111), 45% (50/111), and 5.4% (6/111) of isolates harbored bla CTX-M, bla TEM, and bla SHV genes, respectively. Of the genes investigated, bla CTX-M and bla TEM genes were significantly higher among KTP than the control group. Conclusion Our results showed a high proportion of multidrug-resistant and ESBL-producing isolates, which most of them harbor blaCTX-M. A significant high co-resistance to different classes of antibiotics was reported from ESBL-producing UPEC from KTPs, which remains a serious clinical challenge.
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Affiliation(s)
- Mehrdad Halaji
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Asghar Havaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Halaji M, Shahidi S, Atapour A, Ataei B, Feizi A, Havaei SA. <p>Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic <em>Escherichia coli</em> Among Iranian Kidney Transplant Patients</p>. Infect Drug Resist 2020. [DOI: 10.2147/idr.s248572 and 21=21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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47
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Comparison of Commensal and Clinical Isolates for Diversity of Plasmids in Escherichia coli and Klebsiella pneumoniae. Antimicrob Agents Chemother 2020; 64:AAC.02064-19. [PMID: 32122890 DOI: 10.1128/aac.02064-19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/24/2020] [Indexed: 01/23/2023] Open
Abstract
In this study, the plasmid content of clinical and commensal strains was analyzed and compared. The replicon profile was similar in both populations, except for L, M, A/C, and N (detected only in clinical strains) and HI1 (only in commensal strains). Although I1 and F were the most frequent replicons, only IncI1, sequence type 12 (ST12) was associated with bla CMY-2 in both populations. In contrast, the widespread resistant IncF plasmids were not linked to a single epidemic plasmid.
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Supershed Escherichia coli O157:H7 Has Potential for Increased Persistence on the Rectoanal Junction Squamous Epithelial Cells and Antibiotic Resistance. Int J Microbiol 2020; 2020:2368154. [PMID: 32351572 PMCID: PMC7178529 DOI: 10.1155/2020/2368154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/24/2020] [Accepted: 03/17/2020] [Indexed: 11/18/2022] Open
Abstract
Supershedding cattle shed Escherichia coli O157:H7 (O157) at ≥ 104 colony-forming units/g feces. We recently demonstrated that a supershed O157 (SS-O157) strain, SS-17, hyperadheres to the rectoanal junction (RAJ) squamous epithelial (RSE) cells which may contribute to SS-O157 persistence at this site in greater numbers, thereby increasing the fecal O157 load characterizing the supershedding phenomenon. In order to verify if this would be the signature adherence profile of any SS-O157, we tested additional SS-O157 isolates (n = 101; each from a different animal) in the RSE cell adherence assay. Similar to SS-17, all 101 SS-O157 exhibited aggregative adherence on RSE cells, with 56% attaching strongly (>10 bacteria/cell; hyperadherent) and 44% attaching moderately (1–10 bacteria/cells). Strain typing using Polymorphic Amplified Typing Sequences (PATS) analysis assigned the 101 SS-O157 into 5 major clades but not to any predominant genotype. Interestingly, 69% of SS-O157 isolates were identical to human O157 outbreak strains based on pulsed field gel electrophoresis profiles (CDC PulseNet Database), grouped into two clades by PATS distinguishing them from remaining SS-O157, and were hyperadherent on RSE cells. A subset of SS-O157 isolates (n = 53) representing different PATS and RSE cell adherence profiles were analyzed for antibiotic resistance (AR). Several SS-O157 (30/53) showed resistance to sulfisoxazole, and one isolate was resistant to both sulfisoxazole and tetracycline. Minimum inhibitory concentration (MIC) tests confirmed some of the resistance observed using the Kirby–Bauer disk diffusion test. Each SS-O157 isolate carried at least 10 genes associated with AR. However, genes directly associated with AR were rarely amplified: aac (3)-IV in 2 isolates, sul2 in 3 isolates, and tetB in one isolate. The integrase gene, int, linked with integron-based AR acquisition/transmission, was identified in 92% of SS-O157 isolates. Our results indicate that SS-O157 isolates could potentially persist longer at the bovine RAJ but exhibit limited resistance towards clinical antibiotics.
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Brkić S, Božić D, Stojanović N, Vitorović T, Topalov D, Jovanović M, Stepanović M, Ćirković I. Antimicrobial Susceptibility and Molecular Characterization of Carbapenemase-Producing Enterobacter spp. Community Isolates in Belgrade, Serbia. Microb Drug Resist 2020; 26:378-384. [DOI: 10.1089/mdr.2019.0224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Snežana Brkić
- Institute for Laboratory Diagnostics “Konzilijum,” Belgrade, Serbia
| | - Dragana Božić
- Department of Microbiology and Immunology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Nena Stojanović
- City Institute of Public Health of Belgrade, Belgrade, Serbia
| | - Teodora Vitorović
- University Hospital Center “Dr Dragiša Mišović-Dedinje,” Belgrade, Serbia
| | - Drina Topalov
- Institute for Laboratory Diagnostics “Konzilijum,” Belgrade, Serbia
| | | | | | - Ivana Ćirković
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
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Halimeh FB, Rafei R, Diene S, Mikhael M, Mallat H, Achkar M, Dabboussi F, Hamze M, Rolain JM. Challenges in identification of enteroinvasive Escherichia coli and Shigella spp. in Lebanon. Acta Microbiol Immunol Hung 2020; 67:100-106. [PMID: 32223306 DOI: 10.1556/030.2020.01102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 12/23/2019] [Indexed: 02/01/2023]
Abstract
This study aimed to evaluate the routine identification tools available in Lebanon for differentiation of Escherichia coli and Shigella spp. The identification of 43 isolates defined as Shigella spp. by Api 20E was accessed using MALDI-TOF, serological testing, duplex PCR targeting ipaH (present in Shigella spp. and enteroinvasive E. coli "EIEC") and lacY (found in E. coli including EIEC but not Shigella spp.) as well as gyrB gene sequencing. Antibiotic susceptibility was investigated as well as Shiga-toxin production. All isolates were identified as E. coli by MALDI-TOF while the PCR showed a disparate group of 26 EIEC, 11 Shigella spp., 5 E. coli and 1 inactive E. coli. However, the sequencing of gyrB gene, which was recently described as a suitable marker for distinguishing E. coli and Shigella spp., identified all isolates as E. coli. Antibiotic resistance was noticeable against ß-lactams, rifampicin, trimethoprim-sulfamethoxazole, gentamicin, and ciprofloxacin. The most common variants of beta-lactamase genes were blaTEM-1, blaCTX-M-15, and blaCTX-M-3. A great discordance between the used methods in identification was revealed herein. An accurate identification technique able to distinguish E. coli from Shigella spp. in routine laboratories is a pressing need in order to select the appropriate treatment and assess the epidemiology of these bacteria.
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Affiliation(s)
- Fatima Bachir Halimeh
- 1Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
- 2Aix Marseille University, IRD, APHM, MEPHI, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, 19-21 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
| | - Rayane Rafei
- 1Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Seydina Diene
- 2Aix Marseille University, IRD, APHM, MEPHI, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, 19-21 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
| | - Mary Mikhael
- 1Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Hassan Mallat
- 1Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Marcel Achkar
- 3Laboratory of Clinical Biology, NINI Hospital, Tripoli, Lebanon
| | - Fouad Dabboussi
- 1Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Monzer Hamze
- 1Laboratoire Microbiologie Santé et Environnement (LMSE), Doctoral School of Science and Technology, Faculty of Public Health, Lebanese University, Tripoli, Lebanon
| | - Jean-Marc Rolain
- 2Aix Marseille University, IRD, APHM, MEPHI, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, 19-21 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France
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