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Patel B, Yadav VK, Desai R, Patel S, Amari A, Choudhary N, Osman H, Patel R, Balram D, Lian KY, Sahoo DK, Patel A. Bacteriogenic synthesis of morphologically diverse silver nanoparticles and their assessment for methyl orange dye removal and antimicrobial activity. PeerJ 2024; 12:e17328. [PMID: 38770094 PMCID: PMC11104345 DOI: 10.7717/peerj.17328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 04/11/2024] [Indexed: 05/22/2024] Open
Abstract
Nanotechnology and nanoparticles have gained massive attention in the scientific community in recent years due to their valuable properties. Among various AgNPs synthesis methods, microbial approaches offer distinct advantages in terms of cost-effectiveness, biocompatibility, and eco-friendliness. In the present research work, investigators have synthesized three different types of silver nanoparticles (AgNPs), namely AgNPs-K, AgNPs-M, and AgNPs-E, by using Klebsiella pneumoniae (MBC34), Micrococcus luteus (MBC23), and Enterobacter aerogenes (MBX6), respectively. The morphological, chemical, and elemental features of the synthesized AgNPs were analyzed by using UV-Vis spectroscopy (UV-Vis), Fourier transform-infrared spectroscopy (FTIR), X-ray diffraction (XRD), field emission scanning electron microscope (FESEM) and energy-dispersive spectroscopy (EDX). UV-Vis absorbance peaks were obtained at 475, 428, and 503 nm for AgNPs-K, AgNPs-M, and AgNPs-E, respectively. The XRD analysis confirmed the crystalline nature of the synthesized AgNPs, having peaks at 26.2°, 32.1°, and 47.2°. At the same time, the FTIR showed bands at 599, 963, 1,693, 2,299, 2,891, and 3,780 cm-1 for all the types of AgNPs indicating the presence of bacterial biomolecules with the developed AgNPs. The size and morphology of the AgNPs varied from 10 nm to several microns and exhibited spherical to porous sheets-like structures. The percentage of Ag varied from 37.8% (wt.%) to 61.6%, i.e., highest in AgNPs-K and lowest in AgNPs-M. Furthermore, the synthesized AgNPs exhibited potential for environmental remediation, with AgNPs-M exhibiting the highest removal efficiency (19.24% at 120 min) for methyl orange dye in simulated wastewater. Further, all three types of AgNPs were evaluated for the removal of methyl orange dye from the simulated wastewater, where the highest dye removal percentage was 19.24% at 120 min by AgNPs-M. Antibacterial potential of the synthesized AgNPs assessment against both Gram-positive (GPB) Bacillus subtilis (MBC23), B. cereus (MBC24), and Gram-negative bacteria Enterococcus faecalis (MBP13) revealed promising results, with AgNPs-M, exhibiting the largest zone of inhibition (12 mm) against GPB B. megaterium. Such investigation exhibits the potential of the bacteria for the synthesis of AgNPs with diverse morphology and potential applications in environmental remediation and antibacterial therapy-based synthesis of AgNPs.
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Affiliation(s)
- Bhakti Patel
- Department of Life Sciences, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Virendra Kumar Yadav
- Department of Life Sciences, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Reema Desai
- Department of Life Sciences, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Shreya Patel
- Department of Life Sciences, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Abdelfattah Amari
- Department of Chemical Engineering, College of Engineering, King Khalid University, Abha, Saudi Arabia
| | - Nisha Choudhary
- Department of Life Sciences, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Haitham Osman
- Department of Chemical Engineering, College of Engineering, King Khalid University, Abha, Saudi Arabia
| | - Rajat Patel
- Department of Life Sciences, Hemchandracharya North Gujarat University, Patan, Gujarat, India
| | - Deepak Balram
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Kuang-Yow Lian
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Dipak Kumar Sahoo
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa, United States
| | - Ashish Patel
- Department of Life Sciences, Hemchandracharya North Gujarat University, Patan, Gujarat, India
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Guedes M, Gathara D, López-Hernández I, Pérez-Crespo PMM, Pérez-Rodríguez MT, Sousa A, Plata A, Reguera-Iglesias JM, Boix-Palop L, Dietl B, Blanco JS, Castillo CA, Galán-Sánchez F, Kindelán CN, Jover-Saenz A, Aguirre JG, Alemán AA, Ciordia TM, Del Arco Jiménez A, Fernandez-Suarez J, Lopez-Cortes LE, Rodríguez-Baño J. Differences in clinical outcomes of bloodstream infections caused by Klebsiella aerogenes, Klebsiella pneumoniae and Enterobacter cloacae: a multicentre cohort study. Ann Clin Microbiol Antimicrob 2024; 23:42. [PMID: 38711045 DOI: 10.1186/s12941-024-00700-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Klebsiella aerogenes has been reclassified from Enterobacter to Klebsiella genus due to its phenotypic and genotypic similarities with Klebsiella pneumoniae. It is unclear if clinical outcomes are also more similar. This study aims to assess clinical outcomes of bloodstreams infections (BSI) caused by K. aerogenes, K. pneumoniae and Enterobacter cloacae, through secondary data analysis, nested in PRO-BAC cohort study. METHODS Hospitalized patients between October 2016 and March 2017 with monomicrobial BSI due to K. aerogenes, K. pneumoniae or E. cloacae were included. Primary outcome was a composite clinical outcome including all-cause mortality or recurrence until 30 days follow-up. Secondary outcomes were fever ≥ 72 h, persistent bacteraemia, and secondary device infection. Multilevel mixed-effect Poisson regression was used to estimate the association between microorganisms and outcome. RESULTS Overall, 29 K. aerogenes, 77 E. cloacae and 337 K. pneumoniae BSI episodes were included. Mortality or recurrence was less frequent in K. aerogenes (6.9%) than in E. cloacae (20.8%) or K. pneumoniae (19.0%), but statistical difference was not observed (rate ratio (RR) 0.35, 95% CI 0.08 to 1.55; RR 0.42, 95% CI 0.10 to 1.71, respectively). Fever ≥ 72 h and device infection were more common in K. aerogenes group. In the multivariate analysis, adjusted for confounders (age, sex, BSI source, hospital ward, Charlson score and active antibiotic therapy), the estimates and direction of effect were similar to crude results. CONCLUSIONS Results suggest that BSI caused by K. aerogenes may have a better prognosis than E. cloacae or K. pneumoniae BSI.
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Affiliation(s)
- Mariana Guedes
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Departamento de Medicina, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Seville, Spain.
- Infection and Antimicrobial Resistance Control and Prevention Unit, Hospital Epidemiology Centre, Centro Hospitalar Universitário São João, Porto, Portugal.
| | - David Gathara
- London School of Hygiene and Tropical Medicine, MARCH Centre, London, UK
| | - Inmaculada López-Hernández
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Departamento de Medicina, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Seville, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - María Teresa Pérez-Rodríguez
- Unidad de Enfermedades Infecciosas, Departamento de Medicina Interna, Complexo Hospitalario Universitario de Vigo/Galicia Sur Health Research Institute, Vigo, Spain
| | - Adrian Sousa
- Unidad de Enfermedades Infecciosas, Departamento de Medicina Interna, Complexo Hospitalario Universitario de Vigo/Galicia Sur Health Research Institute, Vigo, Spain
| | - Antonio Plata
- Servicio de Enfermedades Infecciosas, Hospital Regional Universitario de Málaga, IBIMA Málaga, Málaga, Spain
| | - Jose María Reguera-Iglesias
- Servicio de Enfermedades Infecciosas, Hospital Regional Universitario de Málaga, IBIMA Málaga, Málaga, Spain
| | - Lucía Boix-Palop
- Servicio de Enfermedades Infecciosas, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Beatriz Dietl
- Servicio de Enfermedades Infecciosas, Hospital Universitari Mútua de Terrassa, Barcelona, Spain
| | - Juan Sevilla Blanco
- Unidad de Enfermedades Infecciosas y Microbiologia Clinica, Hospital Universitario Jerez De La Frontera, Jerez De La Frontera, Cádiz, Spain
| | - Carlos Armiñanzas Castillo
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla-IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Fátima Galán-Sánchez
- Unidad de Gestión Clínica de Microbiología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Clara Natera Kindelán
- Unidad de Enfermedades Infecciosas, Hospital Universitario Reina Sofia, Cordoba, Spain
| | - Alfredo Jover-Saenz
- Unidad de Infección Nosocomial, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | | | - Ana Alemán Alemán
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Hospital Universitario de Burgos, Burgos, Spain
| | - Teresa Marrodán Ciordia
- Departamento de Microbiología Clínica, Complejo Asistencial Universitario de León (CAULE), León, Spain
| | - Alfonso Del Arco Jiménez
- Grupo Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Spain
| | - Jonathan Fernandez-Suarez
- Unidad de Microbiología, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Luis Eduardo Lopez-Cortes
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Departamento de Medicina, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Seville, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Rodríguez-Baño
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Departamento de Medicina, Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Hospital Universitario Virgen Macarena, Universidad de Sevilla, Seville, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
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Nicolau-Guillaumet N, Dortet L, Jacquemin A, Mourvillier B, Muggeo A, Guillard T. Lack of detection of Klebsiella aerogenes sub-species in lung infection by the BioFire® FilmArray® Pneumonia Panel plus. Clin Microbiol Infect 2024; 30:688-690. [PMID: 38368943 DOI: 10.1016/j.cmi.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/12/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Nathan Nicolau-Guillaumet
- Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, Laboratoire de bactériologie-Virologie-Hygiène hospitalière-Parasitologie-Mycologie, P3Cell, U 1250, Reims, France
| | - Laurent Dortet
- Team 'Resist', INSERM Unit 1184, Faculty of Medicine, Université Paris-Saclay, Service de Bactériologie-Hygiène, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Bacteriology-Hygiene Unit, Assistance Publique-Hôpitaux de Paris, AP-HP Paris-Saclay, Bicêtre Hospital, Le Kremlin-Bicêtre, France; Associated French National Reference Center for Antibiotic Resistance, Carbapenemase-Producing Enterobacterales, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Aymeric Jacquemin
- Team 'Resist', INSERM Unit 1184, Faculty of Medicine, Université Paris-Saclay, Service de Bactériologie-Hygiène, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Bruno Mourvillier
- Medical Intensive Care Unit, University Hospital of Reims, Université de Reims Champagne-Ardenne, CardioVir, France
| | - Anaëlle Muggeo
- Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, Laboratoire de bactériologie-Virologie-Hygiène hospitalière-Parasitologie-Mycologie, P3Cell, U 1250, Reims, France
| | - Thomas Guillard
- Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, Laboratoire de bactériologie-Virologie-Hygiène hospitalière-Parasitologie-Mycologie, P3Cell, U 1250, Reims, France.
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Li X, Li C, Zhou L, Wang Q, Yao J, Zhang X, Yu Y, Li R, Zhou H, Tu Y. Global phylogeography and genomic characterization of bla KPC and bla NDM-positive clinical Klebsiella aerogenes isolates from China, 2016-2022. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171560. [PMID: 38458455 DOI: 10.1016/j.scitotenv.2024.171560] [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: 12/20/2023] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
Carbapenem-resistant Klebsiella aerogenes (CRKA), being one of the members of carbapenem-resistant Enterobacteriaceae (CRE), has caused great public health concern, but with fewer studies compared to other CRE members. Furthermore, studies on phylogenetic analysis based on whole genome Single-Nucleotide Polymorphism (SNP) of CRKA were limited. Here, 20 CRKA isolates (11 blaKPC-2-bearing and 9 blaNDM-1/5-harboring) were characterized by antimicrobial susceptibility testing, conjugation assay, whole genome sequencing (WGS) and bioinformatics analysis. Additionally, the phylogeographic relationships of K. aerogenes were further investigated from public databases. All isolates were multidrug-resistant (MDR) bacteria, and they demonstrated susceptibility to colistin. Most blaKPC-2 or blaNDM-1/5-carrying plasmids were found to be conjugative. Phylogenetic analysis revealed the clonal dissemination of K. aerogenes primarily occurred within clinical settings. Notably, some strains in this study showed the potential for clonal transmission, sharing few SNPs between K. aerogenes and KPC- and/or NDM-positive K. aerogenes isolated from various countries. The STs of K. aerogenes strains had significant diversity. WGS analysis showed that the IncFIIK plasmid was the most prevalent carrier of blaKPC-2, and, blaNDM-1/5 were detected on the IncX3 plasmids. The Tn6296 and Tn3000 transposons were most common vehicles for facilitating the transmission of blaKPC-2 and blaNDM-1/5, respectively. This study highlights the importance of continuous screening and surveillance by WGS for analysis of drug-resistant strains in hospital settings, and provide clinical information that supports epidemiological and public health research on human pathogens.
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Affiliation(s)
- Xi Li
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - Changan Li
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu 225009, China
| | - Longjie Zhou
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - Qiaojun Wang
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu 225009, China
| | - Jiayao Yao
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - Xiaofan Zhang
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - Yunsong Yu
- Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China
| | - Ruichao Li
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu 225009, China.
| | - Hua Zhou
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
| | - Yuexing Tu
- Department of Critical Care Medicine, Tongde Hospital of Zhejiang Province, #234 Gucui Road, Hangzhou, Zhejiang 310012, China.
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Takei K, Ogawa M, Sakata R, Kanamori H. Molecular Epidemiology of Carbapenem-Resistant Klebsiella aerogenes in Japan. Int J Mol Sci 2024; 25:4494. [PMID: 38674079 PMCID: PMC11049973 DOI: 10.3390/ijms25084494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/07/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Information regarding Klebsiella aerogenes haboring carbapenemase in Japan is limited. A comprehensive nationwide survey was conducted from September 2014 to December 2022, and 67 non-duplicate strains of carbapenem-resistant K. aerogenes were isolated from 57 healthcare facilities in Japan. Through genetic testing and whole-genome sequencing, six strains were found to possess carbapenemases, including imipenemase (IMP)-1, IMP-6, New Delhi metallo-β-lactamase (NDM)-1, and NDM-5. The strain harboring blaNDM-5 was the novel strain ST709, which belongs to the clonal complex of the predominant ST4 in China. The novel integron containing blaIMP-1 featured the oxacillinase-101 gene, which is a previously unreported structure, with an IncN4 plasmid type. However, integrons found in the strains possessing blaIMP-6, which were the most commonly identified, matched those reported domestically in Klebsiella pneumoniae, suggesting the prevalence of identical integrons. Transposons containing blaNDM are similar or identical to the transposon structure of K. aerogenes harboring blaNDM-5 previously reported in Japan, suggesting that the same type of transposon could have been transmitted to K. aerogenes in Japan. This investigation analyzed mobile genetic elements, such as integrons and transposons, to understand the spread of carbapenemases, highlighting the growing challenge of carbapenem-resistant Enterobacterales in Japan and underscoring the critical need for ongoing surveillance to control these pathogens.
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Affiliation(s)
- Kentarou Takei
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
| | - Miho Ogawa
- Department of Bacteriology, BML Inc., Kawagoe 350-1101, Japan
| | - Ryuji Sakata
- Department of Bacteriology, BML Inc., Kawagoe 350-1101, Japan
| | - Hajime Kanamori
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
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Miliotis G, McDonagh F, Singh NK, O'Connor L, Tuohy A, Morris D, Venkateswaran K. Genomic analysis reveals the presence of emerging pathogenic Klebsiella lineages aboard the International Space Station. Microbiol Spectr 2023; 11:e0189723. [PMID: 37966203 PMCID: PMC10715203 DOI: 10.1128/spectrum.01897-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/27/2023] [Indexed: 11/16/2023] Open
Abstract
IMPORTANCE The International Space Station (ISS) is a unique, hermetically sealed environment, subject to environmental pressures not encountered on Earth, including microgravity and radiation (cosmic ionising/UV). While bacteria's adaptability during spaceflight remains elusive, recent research suggests that it may be species and even clone-specific. Considering the documented spaceflight-induced suppression of the human immune system, a deper understanding of the genomics of potential human pathogens in space could shed light on species and lineages of medical astromicrobiological significance. In this study, we used hybrid assembly methods and comparative genomics to deliver a comprehensive genomic characterization of 10 Klebsiella isolates retrieved from the ISS. Our analysis unveiled that Klebsiella quasipneumoniae ST138 demonstrates both spatial and temporal persistence aboard the ISS, showing evidence of genomic divergence from its Earth-based ST138 lineage. Moreover, we characterized plasmids from Klebsiella species of ISS origin, which harbored genes for disinfectant resistance and enhanced thermotolerance, suggestin possible adaptive advantages. Furthermore, we identified a mobile genetic element containing a hypervirulence-associated locus belonging to a Klebsiella pneumoniae isolate of the "high-risk" ST101 clone. Our work provides insights into the adaptability and persistence of Klebsiella species during spaceflight, highlighting the importance of understanding the dynamics of potential pathogenic bacteria in such environments.
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Affiliation(s)
- Georgios Miliotis
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland
| | - Francesca McDonagh
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland
| | - Nitin Kumar Singh
- Biotechnology and Planetary Protection Group, NASA Jet Propulsion Laboratory, California Institute of Technology, Pasadena, California, USA
| | - Louise O'Connor
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland
| | - Alma Tuohy
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland
| | - Dearbháile Morris
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland
| | - Kasthuri Venkateswaran
- Biotechnology and Planetary Protection Group, NASA Jet Propulsion Laboratory, California Institute of Technology, Pasadena, California, USA
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Takei K, Ogawa M, Sakata R, Kanamori H. Epidemiological Characteristics of Carbapenem-Resistant Enterobacterales in Japan: A Nationwide Analysis of Data from a Clinical Laboratory Center (2016-2022). Pathogens 2023; 12:1246. [PMID: 37887763 PMCID: PMC10609946 DOI: 10.3390/pathogens12101246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/07/2023] [Accepted: 10/14/2023] [Indexed: 10/28/2023] Open
Abstract
In Japan, nationwide epidemiological surveys on carbapenem-resistant Enterobacterales (CREs), including comprehensive information, are scarce, with most data available only through public reports. This study analyzed data on the Enterobacterales family collected from nationwide testing centers between January 2016 and December 2022, focusing on isolates that met the criteria for CRE in Japan based on drug susceptibility. We investigated 5,323,875 Enterobacterales isolates of 12 different species; among 4696 (0.09%) CRE strains, the proportion of major CRE isolates was as follows: Escherichia coli, 31.3%; Klebsiella pneumoniae, 28.0%; Enterobacter cloacae, 18.5%; and Klebsiella aerogenes, 6.7%. Moreover, over a 7-year period, Providencia rettgeri, E. cloacae, K. aerogenes, and K. pneumoniae demonstrated relatively high CRE percentages of 0.6% (156/26,185), 0.47% (869/184,221), 0.28% (313/110,371), and 0.17% (1314/780,958), respectively. The number of CRE strains isolated from different samples was as follows: urine, 2390; respiratory specimens, 1254; stool, 425; blood, 252; others, 375. In the broader context, including colonization, the predominant isolates of CREs collected at nationwide testing centers are E. coli and K. pneumoniae. Furthermore, recently, attention has been directed toward less common CRE species, such as Klebsiella oxytoca and Providencia rettgeri, and thus, it might be necessary to continue monitoring these less common species.
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Affiliation(s)
- Kentarou Takei
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
| | - Miho Ogawa
- Department of Bacteriology, BML Inc., Kawagoe 350-1101, Japan
| | - Ryuji Sakata
- Department of Bacteriology, BML Inc., Kawagoe 350-1101, Japan
| | - Hajime Kanamori
- Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
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8
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Laupland KB, Edwards F, Harris PNA, Paterson DL. Significant clinical differences but not outcomes between Klebsiella aerogenes and Enterobacter cloacae bloodstream infections: a comparative cohort study. Infection 2023; 51:1445-1451. [PMID: 36881325 PMCID: PMC10545569 DOI: 10.1007/s15010-023-02010-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/21/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Although Klebsiella aerogenes (formerly Enterobacter aerogenes) and Enterobacter cloacae share many phenotypic characteristics, controversy exists as to whether they cause clinically distinguishable infections. The objective of this study was to determine the comparative incidence, determinants, and outcomes of K. aerogenes and E. cloacae bloodstream infections (BSI). METHODS Population-based surveillance was conducted among residents aged ≥ 15 years of Queensland, Australia during 2000-2019. RESULTS Overall 695 and 2879 incident K. aerogenes and E. cloacae BSIs were identified for incidence rates of 1.1 and 4.4 per 100,000 population, respectively. There was a marked increase in incidence associated with older age and with males with both species. Patients with K. aerogenes BSIs were older, were more likely male, to have community-associated disease, and to have a genitourinary source of infection. In contrast, E. cloacae were more likely to have co-morbid diagnoses of liver disease and malignancy and be associated with antimicrobial resistance. Enterobacter cloacae were significantly more likely to have repeat episodes of BSI as compared to K. aerogenes. However, no differences in length of stay or all cause 30-day case-fatality were observed. CONCLUSION Although significant demographic and clinical differences exist between K. aerogenes and E. cloacae BSI, they share similar outcomes.
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Affiliation(s)
- Kevin B Laupland
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Level 3 Ned Hanlon Building, Butterfield Street, Brisbane, QLD, 4029, Australia.
- Queensland University of Technology (QUT), Brisbane, QLD, Australia.
| | - Felicity Edwards
- Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Patrick N A Harris
- Faculty of Medicine, University of Queensland, UQ Center for Clinical Research, Brisbane, Australia
- Department of Microbiology, Pathology Queensland, Brisbane, Australia
| | - David L Paterson
- Faculty of Medicine, University of Queensland, UQ Center for Clinical Research, Brisbane, Australia
- Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Pospišil M, Car H, Elveđi-Gašparović V, Beader N, Herljević Z, Bedenić B. Bloodstream Infections by AmpC-Producing Enterobacterales: Risk Factors and Therapeutic Outcome. Pathogens 2023; 12:1125. [PMID: 37764933 PMCID: PMC10535069 DOI: 10.3390/pathogens12091125] [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: 07/20/2023] [Revised: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Bloodstream infections associated with AmpC-producing Enterobacterales are severe medical conditions which, without prompt and effective treatment, may have dire ramifications. This study aimed to assess whether certain comorbidities and previous surgical procedures coincide with resistance determinants of AmpC-producing Enterobacterales associated with bloodstream infections. Antibiotic resistance patterns and therapy outcome were also determined. The patients' data obtained revealed that the prevalence of recent surgical procedures, solid organ tumors, metabolic diseases, kidney and liver failure, and hematological malignancies do not differ between resistant and susceptible isolates of AmpC-producing Enterobacterales. Furthermore, no difference was reported in mortality rates. Regarding antibiotic resistance, 34.52% of isolates were confirmed to be resistant (AmpC hyperproduction, ESBL, or carbapenemase). More than one in five AmpC hyperproducers were reported amid Providencia spp., K. aerogenes, E. cloacae, and C. freundii. strains. Carbapenemases were mostly noted in Providencia spp. followed by M. morganii and K. aerogenes strains. Serratia marcescens had the highest proportion of ESBLsof ESBLs. Resistance to expanded-spectrum cephalosporins of Providencia spp. and K. aerogenes strains exceeded 50%, and resistance to meropenem over 10% was observed only in C. freundii strains. Enterobacterales' ever-growing resistance to antibiotics is becoming quite a challenge for clinicians and new treatment options are required.
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Affiliation(s)
- Mladen Pospišil
- Krapina-Zagorje County Community Health Centre, 49245 Stubica, Croatia;
| | - Haris Car
- Zagreb Health School, 10000 Zagreb, Croatia;
| | - Vesna Elveđi-Gašparović
- Department of Gynecology and Obstetrics, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Department of Gynecology and Obstetrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Nataša Beader
- BIMIS—Biomedical Research Center Šalata, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Clinical Department for Clinical and Molecular Microbiology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Zoran Herljević
- Clinical Department for Clinical and Molecular Microbiology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Branka Bedenić
- BIMIS—Biomedical Research Center Šalata, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
- Clinical Department for Clinical and Molecular Microbiology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
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10
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Ye J, Jin L, Li Y, Xu H, Lin Y, Zhou T, Zheng B, Wang M, Wang Z. Complete-genome sequencing and comparative genomic characterization of bla NDM-5 carrying Citrobacter freundii isolates from a patient with multiple infections. BMC Genomics 2023; 24:506. [PMID: 37649002 PMCID: PMC10466682 DOI: 10.1186/s12864-023-09579-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 08/11/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The emergence and wide spread of carbapenemase-producing Enterobacteriaceae (CPE) poses a growing threat to global public health. However, clinically derived carbapenemase-producing Citrobacter causing multiple infections has rarely been investigated. Here we first report the isolation and comparative genomics of two blaNDM-5 carrying Citrobacter freundii (C. freundii) isolates from a patient with bloodstream and urinary tract infections. RESULTS Antimicrobial susceptibility testing showed that both blaNDM-5 carrying C. freundii isolates were multidrug-resistant. Positive modified carbapenem inactivation method (mCIM) and EDTA-carbapenem inactivation method (eCIM) results suggested metallo-carbapenemase production. PCR and sequencing confirmed that both metallo-carbapenemase producers were blaNDM-5 positive. Genotyping and comparative genomics analyses revealed that both isolates exhibited a high level of genetic similarity. Plasmid analysis confirmed that the blaNDM-5 resistance gene is located on IncX3 plasmid with a length of 46,161 bp, and could successfully be transferred to the recipient Escherichia coli EC600 strain. A conserved structure sequence (ISAba125-IS5-blaNDM-5-trpF-IS26-umuD-ISKox3) was found in the upstream and downstream of the blaNDM-5 gene. CONCLUSIONS The data presented in this study showed that the conjugative blaNDM-5 plasmid possesses a certain ability to horizontal transfer. The dissemination of NDM-5-producing C. freundii isolates should be of close concern in future clinical surveillance. To our knowledge, this is the first study to characterize C. freundii strains carrying the blaNDM-5 gene from one single patient with multiple infections.
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Affiliation(s)
- Jianzhong Ye
- Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Lulu Jin
- Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, No. 60 Wuning West Road, Dongyang, 322100, Zhejiang Province, China
| | - Yaling Li
- Department of Health Screening Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310000, Zhejiang, China
| | - Hao Xu
- Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
- State Key Laboratory for Diagnosis and Treatment of Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesSchool of Medicine, National Clinical Research Center for Infectious Diseasesthe First Affiliated HospitalZhejiang University, No. 79 Qingchun Road, Shangcheng District, Hangzhou, 310000, Zhejiang Province, China
| | - Yishuai Lin
- Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Tieli Zhou
- Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Beiwen Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesSchool of Medicine, National Clinical Research Center for Infectious Diseasesthe First Affiliated HospitalZhejiang University, No. 79 Qingchun Road, Shangcheng District, Hangzhou, 310000, Zhejiang Province, China.
| | - Maofeng Wang
- Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, No. 60 Wuning West Road, Dongyang, 322100, Zhejiang Province, China.
| | - Zhongyong Wang
- Department of Clinical Laboratory, Key Laboratory of Clinical Laboratory Diagnosis and Translational Research of Zhejiang Province, the First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Street, Ouhai District, Wenzhou, 325000, Zhejiang Province, China.
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11
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Mazumder R, Hussain A, Bhadra B, Phelan J, Campino S, Clark TG, Mondal D. Case report: A successfully treated case of community-acquired urinary tract infection due to Klebsiella aerogenes in Bangladesh. Front Med (Lausanne) 2023; 10:1206756. [PMID: 37435536 PMCID: PMC10330784 DOI: 10.3389/fmed.2023.1206756] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
Klebsiella aerogenes, a nosocomial pathogen, is increasingly associated with extensive drug resistance and virulence profiles. It is responsible for high morbidity and mortality. This report describes the first successfully treated case of community-acquired urinary tract infection (UTI) caused by Klebsiella aerogenes in an elderly housewife with Type-2 diabetes (T2D) from Dhaka, Bangladesh. The patient was empirically treated with intravenous ceftriaxone (500 mg/8 h). However, she did not respond to the treatment. The urine culture and sensitivity tests, coupled with bacterial whole-genome sequencing (WGS) and analysis, revealed the bacteria to be K. aerogenes which was extensively drug-resistant but was susceptible to carbapenems and polymyxins. Based on these findings, meropenem (500 mg/8 h) was administered to the patient, who then responded to the treatment and recovered successfully without having a relapse. This case raises awareness of the importance of diagnosis of not-so-common etiological agents, correct identification of the pathogens, and targeted antibiotic therapy. In conclusion, correctly identifying etiological agents of UTI using WGS approaches that are otherwise difficult to diagnose could help improve the identification of infectious agents and improve the management of infectious diseases.
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Affiliation(s)
- Razib Mazumder
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Arif Hussain
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Bithika Bhadra
- Department of Biochemistry and Microbiology, North South University, Dhaka, Bangladesh
| | - Jody Phelan
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Susana Campino
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Taane G. Clark
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dinesh Mondal
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
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12
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Shi Q, Huang C, Chen W, Wu S, Ji J, Ying C, Wu H, Xiao Y. Cefepime, not Piperacillin/Tazobactam use, for empirical treatment of bloodstream infections caused by Enterobacter spp.: Results from a population pharmacokinetic/pharmacodynamic analysis. Eur J Pharm Sci 2023; 180:106334. [PMID: 36402309 DOI: 10.1016/j.ejps.2022.106334] [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: 05/22/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE There is a paucity of published data to evaluate the efficacy and safety of imipenem, cefepime and piperacillin/tazobactam dosing regimens against bloodstream infections caused by Klebsiella aerogenes (BSIs-Kae) and Enterobacter cloacae complex (BSIs-Ecc) in patients with various degrees of renal function. METHODS Pathogens were isolated from China's blood bacterial resistant investigation network. The dosing regimens of imipenem, cefepime and piperacillin were simulated with intermittent infusion and extended infusion. Monte Carlo simulation was performed to calculate the probability of target attainment and a cumulative fraction of response (CFR) against BSIs-Kae/Ecc. RESULTS In total, 203 BSIs-Kae, and 785 BSIs-Ecc were isolated from the surveillance network. Imipenem showed the highest in vitro activity against BSIs-Kae/Ecc, followed by cefepime (85%) and piperacillin/tazobactam (70-80%). The MIC90 values of imipenem, cefepime and piperacillin/tazobactam aginst BSIs-Kae and BSIs-Ecc were 1/1 mg/L, 16/16 mg/L, and 64/128 mg/L, respectively. The simulation results showed imipenem achieved the highest CFRs in patients with normal or decreased renal function, with values of 91-99%, followed by FEP (88-96%), without risk of excessive dosing. However, the intermittent and extended dosing regimens of piperacillin/tazobactam were unlikely to provide adequate exposure for empirical management of BSIs-Kae/Ecc (CFRs, 50-80%), regardless of renal function. Besides, the traditional intermittent piperacillin/tazobactam dosing regimens were highly likely to contribute to suboptimal therapeutic exposure when MIC was close to clinical breakpoints. CONCLUSIONS Cefepime, not piperacillin/tazobactam, can be a reasonable carbapenem-sparing option in empirically treating BSIs-Kae/Ecc.
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Affiliation(s)
- Qingyi Shi
- Department of Immunology and Rheumatology, Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Chen Huang
- Department of Respiratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Weizhuang Chen
- Department of Respiratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Shibo Wu
- Department of Respiratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Jinru Ji
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chaoqun Ying
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Hongcheng Wu
- Department of Respiratory Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China..
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Chou A, Sucgang R, Hamill RJ, Zechiedrich L, Trautner BW. Mortality difference from Klebsiella aerogenes vs Enterobacter cloacae bloodstream infections. Access Microbiol 2023; 5:acmi000421. [PMID: 36919079 PMCID: PMC10008348 DOI: 10.1099/acmi.0.000421] [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: 02/11/2022] [Accepted: 10/17/2022] [Indexed: 03/02/2023] Open
Abstract
Members of the order Enterobacterales, including Escherichia coli , Klebsiella species and Enterobacter species, are important pathogens in healthcare-associated infections. Higher mortality has been reported from infections due to Klebsiella pneumoniae than from E. coli , but prior studies comparing Enterobacter aerogenes (recently renamed Klebsiella aerogenes ) bacteraemia and Enterobacter cloacae complex bacteraemia have yielded conflicting results regarding whether clinical outcomes differ. We found bacteraemia with K. aerogenes was independently associated with greater risk of 30-day mortality than bacteraemia with Enterobacter cloacae complex.
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Affiliation(s)
- Andrew Chou
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd, Suite 01Y, Houston, Texas, USA.,Medical Care Line, Infectious Disease Section, Michael E. DeBakey VA Medical Center, Houston, Texas, 2002 Holcombe Blvd 111G/4B370, Houston, Texas, USA.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.,Margaret M. and Albert B. Alkek Department of Medicine Section of Infectious Disease, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
| | - Richard Sucgang
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.,Center for Health Data Science and Analytics, Houston Methodist Hospital, 6565 Fannin St, Houston, Texas, USA
| | - Richard J Hamill
- Medical Care Line, Infectious Disease Section, Michael E. DeBakey VA Medical Center, Houston, Texas, 2002 Holcombe Blvd 111G/4B370, Houston, Texas, USA.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.,Margaret M. and Albert B. Alkek Department of Medicine Section of Infectious Disease, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
| | - Lynn Zechiedrich
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.,Verna and Marrs McLean Department of Biochemistry and Molecular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.,Department of Pharmacology and Chemical Biology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
| | - Barbara W Trautner
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd, Suite 01Y, Houston, Texas, USA.,Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.,Section of Health Services Research, Departments of Medicine and Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
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14
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Genetic Diversity of Virulent Polymyxin-Resistant Klebsiella aerogenes Isolated from Intensive Care Units. Antibiotics (Basel) 2022; 11:antibiotics11081127. [PMID: 36009996 PMCID: PMC9405322 DOI: 10.3390/antibiotics11081127] [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: 08/01/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/18/2022] Open
Abstract
This study evaluated the scope and genetic basis of polymyxin-resistant Klebsiella aerogenes in Brazil. Eight polymyxin-resistant and carbapenemase-producing K. aerogenes strains were isolated from patients admitted to the ICU of a tertiary hospital. Bacterial species were identified by automated systems and antimicrobial susceptibility profile was confirmed using broth microdilution. The strains displayed a multidrug resistant profile and were subjected to whole-genome sequencing. Bioinformatic analysis revealed a variety of antimicrobial resistance genes, including the blaKPC-2. No plasmid-mediated colistin resistance gene was identified. Nonetheless, nonsynonymous mutations in mgrB, pmrA, pmrB, and eptA were detected, justifying the colistin resistance phenotype. Virulence genes encoding yersiniabactin, colibactin, and aerobactin were also found, associated with ICEKp4 and ICEKp10, and might be related to the high mortality observed among the patients. In fact, this is the first time ICEKp is identified in K. aerogenes in Brazil. Phylogenetic analysis grouped the strains into two clonal groups, belonging to ST93 and ST16. In summary, the co-existence of antimicrobial resistance and virulence factors is deeply worrying, as it could lead to the emergence of untreatable invasive infections. All these factors reinforce the need for surveillance programs to monitor the evolution and dissemination of multidrug resistant and virulent strains among critically ill patients.
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15
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Gu H, Cai Q, Dai X, Wang H, Xu W, Cao X, Ye Y. A case report of Klebsiella aerogenes-caused lumbar spine infection identified by metagenome next-generation sequencing. BMC Infect Dis 2022; 22:616. [PMID: 35840919 PMCID: PMC9288078 DOI: 10.1186/s12879-022-07583-0] [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: 03/01/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The early clinical diagnosis of spinal infections in elderly patients with recessive or atypical symptoms is difficult. Klebsiella aerogenes is a common opportunistic bacterium that can infect the respiratory tract, urinary tract, and even the central nervous system. However, whether it can infect the lumbar spine has not been previously described. CASE PRESENTATION In this paper, we report the case of a 69-year-old female patient with osteoporosis who was initially diagnosed with hemolytic anemia. Later, she was diagnosed with K. aerogenes infection of the lumbar spine based on imaging combined with blood culture and metagenome next-generation sequencing (mNGS) detection. After precise medication, the lumbar degeneration was improved. CONCLUSIONS Bacterial infection should therefore be considered in cases of lumbar degenerative disease in middle-aged and elderly patients.
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Affiliation(s)
- Huajie Gu
- Department of Emergency Intensive Care Unit, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, China
| | - Qingqing Cai
- Genoxor Medical Science and Technology Inc., Shanghai, China
| | - Xiaoyong Dai
- Department of Emergency Intensive Care Unit, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, China
| | - Huanhuan Wang
- Department of Emergency Intensive Care Unit, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, China
| | - Wenying Xu
- Department of Radiology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xuejie Cao
- Genoxor Medical Science and Technology Inc., Shanghai, China
| | - Youwen Ye
- Department of Emergency Intensive Care Unit, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Shanghai, China.
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Two Newly Isolated Enterobacter-Specific Bacteriophages: Biological Properties and Stability Studies. Viruses 2022; 14:v14071518. [PMID: 35891499 PMCID: PMC9319786 DOI: 10.3390/v14071518] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022] Open
Abstract
In an era of antibiotic therapy crisis caused by spreading antimicrobial resistance, and when recurrent urinary tract infections constitute a serious social and medical problem, the isolation and complex characterization of phages with a potential therapeutic application represents a promising solution. It is an inevitable, and even a necessary direction in the development of current phage research. In this paper, we present two newly isolated myoviruses that show lytic activity against multidrug-resistant clinical isolates of Enterobacter spp. (E. cloacae, E. hormaechei, and E. kobei), the genomes of which belong to a poorly represented phage group. Both phages were classified as part of the Tevenvirinae subfamily (Entb_43 was recognized as Karamvirus and Entb_45 as Kanagawavirus). Phage lytic spectra ranging from 40 to 60% were obtained. The most effective phage-to-bacteria ratios (MOI = 0.01 and MOI = 0.001) for both the phage amplification and their lytic activity against planktonic bacteria were also estimated. Complete adsorption to host cells were obtained after about 20 min for Entb_43 and 10 min for Entb_45. The phage lysates retained their initial titers even during six months of storage at both −70 °C and 4 °C, whereas storage at 37 °C caused a complete loss in their activity. We showed that phages retained their activity after incubation with solutions of silver and copper nanoparticles, which may indicate possible synergistic antibacterial activity. Moreover, a significant reduction in phage titers was observed after incubation with a disinfectant containing octenidinum dihydrochloridum and phenoxyethanol, as well as with 70% ethanol. The observed maintenance of phage activity during incubation in a urine sample, along with other described properties, may suggest a therapeutic potential of phages at the infection site after intravesical administration.
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The Predominance of Klebsiella aerogenes among Carbapenem-Resistant Enterobacteriaceae Infections in Japan. Pathogens 2022; 11:pathogens11070722. [PMID: 35889968 PMCID: PMC9323708 DOI: 10.3390/pathogens11070722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 02/04/2023] Open
Abstract
The emergence of carbapenem-resistant Enterobacteriaceae (CRE) is an important public health issue worldwide, not only due to the potential of these pathogens for widespread dissemination, but also due to the limited antimicrobial therapy options, and the elevated mortality rates associated with these infections. As with other multidrug-resistant organisms (MDROs), active surveillance via timely testing, early diagnosis, and contact isolation is an important strategy to control the occurrence and spread of CRE bacteria. Here we summarize the epidemiology of CRE infections in Japan from 2015 to 2019. Data were extracted from a public dataset collected by the nationwide surveillance system via the National Institute of Infectious Diseases (NIID) of Japan. The annual number of reported CRE infections has remained relatively stable, with a tendency to increase in the last two years (1671 cases reported in 2015 and 2333 cases reported in 2019). The majority of patients who presented CRE infections over this five year period were older than 65 years (~80%, mean age 75), 60% of them were men, and mortality rates were around 3.5%. Importantly, about 60% of infections are caused by both Enterobacter cloacae and Klebsiella aerogenes (previously known as Enterobacter aerogenes), the former being the most common pathogen in 2015 and 2016 (~30%), and the latter the leading pathogen since 2017 (~40%). The most common carbapenemase isolated was the IMP carbapenemase type. Further studies are needed to determine the prevalence of CRE colonization, especially in the healthcare setting, and to elucidate the mechanisms behind the local predominance of Klebsiella aerogenes and Enterobacter cloacae.
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Mudenur C, Boruah P, Kumar A, Katiyar V. Prodigiosin-Loaded Poly(lactic acid) to Combat the Biofilm-Associated Infections. ACS APPLIED BIO MATERIALS 2022; 5:2143-2151. [PMID: 35467829 DOI: 10.1021/acsabm.1c01187] [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: 11/29/2022]
Abstract
Poly(lactic acid) (PLA) is an emerging biobased implant material. Despite its biocompatibility and the aseptic procedures followed during orthopedic surgery, bacterial infection remains an obstacle to implementing PLA-based implants. To tackle this issue, prodigiosin-incorporated PLA has been developed, which possesses improved hydrophobicity with a contact angle of 111 ± 1.5°. The degradation temperature of the prodigiosin is 215 °C, which is more than the melting temperature of PLA, which supports the processability and sterilization of the PLA-based implants without any toxic gases. Further, prodigiosin improves the transparency of PLA and acts as a nucleation site. The spherulite density increases three times compared to that of neat PLA. The inherent methoxy group of prodigiosin is an active site responsible for the inhibition of bacterial attack and biofilm formation. The in vitro study on biofilm formation shows excellent inhibition activity against implant-associated pathogens such as Klebsiella aerogenes and Staphylococcus aureus.
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Affiliation(s)
- Chethana Mudenur
- Department of Chemical Engineering, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
| | - Pankaj Boruah
- Department of Chemical Engineering, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
| | - Amit Kumar
- Department of Chemical Engineering, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
| | - Vimal Katiyar
- Department of Chemical Engineering, Indian Institute of Technology Guwahati, Guwahati 781039, Assam, India
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Dong M, Chen D, Che L, Gu N, Yin M, Du X, Shen J, Yan S. Biotoxicity Evaluation of a Cationic Star Polymer on a Predatory Ladybird and Cooperative Pest Control by Polymer-Delivered Pesticides and Ladybird. ACS APPLIED MATERIALS & INTERFACES 2022; 14:6083-6092. [PMID: 35072467 DOI: 10.1021/acsami.1c24077] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although employing nanocarriers for gene/drug delivery shows great potential in agricultural fields, the biotoxicity of nanocarriers is a major concern for large-scale applications. Herein, we synthesized a cationic star polymer (SPc) as a pesticide nanocarrier/adjuvant to evaluate its safety against a widely used predatory ladybird (Harmonia axyridis). The application of SPc at extremely high concentrations nearly did not influence the hatching of ladybird eggs but it led to the death of ladybird larvae at lethal concentration 50 (LC50) values of 43.96 and 19.85 mg/mL through the soaking and feeding methods, respectively. The oral feeding of SPc downregulated many membrane protein genes and lysosome genes significantly, and the cell membrane and nucleus in gut tissues were remarkably damaged by SPc application, revealing that the lethal mechanism might be SPc-mediated membrane damage. Furthermore, the oral feeding of SPc increased the relative abundance of Serratia bacteria in ladybird guts to result in bacterial infection. Coapplication of ladybird and SPc-loaded thiamethoxam/matrine achieved desired control efficacies of more than 80% against green peach aphids, revealing that the coapplication could overcome the slow-acting property of ladybirds. To our knowledge, this is the first attempt to investigate the polymer-mediated lethal mechanism toward natural enemies and explore the possibility of coapplying SPc-loaded pesticides and natural enemies for pest management.
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Affiliation(s)
- Min Dong
- Department of Plant Biosecurity and MOA Key Lab of Pest Monitoring and Green Management, College of Plant Protection, China Agricultural University, Beijing 100193, P. R. China
| | - Dingming Chen
- Department of Plant Biosecurity and MOA Key Lab of Pest Monitoring and Green Management, College of Plant Protection, China Agricultural University, Beijing 100193, P. R. China
| | - Lin Che
- Department of Plant Biosecurity and MOA Key Lab of Pest Monitoring and Green Management, College of Plant Protection, China Agricultural University, Beijing 100193, P. R. China
| | - Na Gu
- Department of Plant Biosecurity and MOA Key Lab of Pest Monitoring and Green Management, College of Plant Protection, China Agricultural University, Beijing 100193, P. R. China
| | - Meizhen Yin
- State Key Lab of Chemical Resource Engineering, Beijing Lab of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, P. R. China
| | - Xiangge Du
- Department of Plant Biosecurity and MOA Key Lab of Pest Monitoring and Green Management, College of Plant Protection, China Agricultural University, Beijing 100193, P. R. China
| | - Jie Shen
- Department of Plant Biosecurity and MOA Key Lab of Pest Monitoring and Green Management, College of Plant Protection, China Agricultural University, Beijing 100193, P. R. China
| | - Shuo Yan
- Department of Plant Biosecurity and MOA Key Lab of Pest Monitoring and Green Management, College of Plant Protection, China Agricultural University, Beijing 100193, P. R. China
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Rachmawati N, Powell SM, Triwibowo R, Nichols DS, Ross T, Tamplin ML. Modelling growth and histamine formation of Klebsiella aerogenes TI24 isolated from Indonesian pindang. Int J Food Microbiol 2022; 362:109459. [PMID: 34861562 DOI: 10.1016/j.ijfoodmicro.2021.109459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 09/24/2021] [Accepted: 10/24/2021] [Indexed: 10/20/2022]
Abstract
Indonesian salted-boiled fish (pindang) is a popular traditional food in Indonesia, which is made from Scombroid fish such as tuna and mackerel. As with other traditionally prepared fish products, pindang has important economic and social values, especially for those living in the coastal areas of Indonesia. However, pindang is a major cause of histamine fish poisoning (HFP) for consumers. Klebsiella aerogenes T124, a relatively high histamine-producing isolate from pindang, was used to describe lag time (λ), growth rate (μmax), maximum population density (Nmax), and histamine production in histidine broth and artificially contaminated Grey mackerel. Broth was adjusted to 1.5, 6, 10 and 20% w/v NaCl; mackerel was treated with 6% w/w NaCl, a level common to Indonesian industry practice, or not treated with additional NaCl. Samples were incubated at 10, 15, 20 and 30 °C. In broth, μmax and Nmax were significantly affected by temperature and NaCl, respectively, with λ influenced by both parameters. In control fish, μmax was significantly affected by temperature and NaCl, except at 10 and 15 °C; for 6% NaCl treatment, growth was only observed at 20 and 30 °C. Under similar incubation conditions for broth and fish, histamine formation was markedly affected by NaCl concentration. In broth, -5.1 to -6.6 log μg of histamine was produced per CFU, versus -4.6 to -6.6 log μg per CFU in fish. This study demonstrated that mackerel treated with 6% NaCl and stored at 10-15 °C prevents growth of K. aerogenes strain TI24 and formation of toxic levels of histamine.
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Affiliation(s)
- Novalia Rachmawati
- Tasmanian Institute of Agriculture, University of Tasmania, Hobart, Australia; Research and Development Centre for Marine and Fisheries Product Processing and Biotechnology, Ministry of Marine Affairs and Fisheries, Jakarta, Indonesia.
| | - Shane M Powell
- Tasmanian Institute of Agriculture, University of Tasmania, Hobart, Australia
| | - Radestya Triwibowo
- Tasmanian Institute of Agriculture, University of Tasmania, Hobart, Australia; Research and Development Centre for Marine and Fisheries Product Processing and Biotechnology, Ministry of Marine Affairs and Fisheries, Jakarta, Indonesia
| | - David S Nichols
- Central Science Laboratory, University of Tasmania, Hobart, Australia
| | - Tom Ross
- Tasmanian Institute of Agriculture, University of Tasmania, Hobart, Australia
| | - Mark L Tamplin
- Tasmanian Institute of Agriculture, University of Tasmania, Hobart, Australia
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21
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Jeon M, Huh K, Ko JH, Cho SY, Huh HJ, Lee NY, Kang CI, Chung DR, Peck KR. Difference in the Clinical Outcome of Bloodstream Infections Caused by Klebsiella aerogenes and Enterobacter cloacae Complex. Open Forum Infect Dis 2021; 8:ofab390. [PMID: 34409124 PMCID: PMC8364985 DOI: 10.1093/ofid/ofab390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/19/2021] [Indexed: 12/22/2022] Open
Abstract
Background The difference in clinical outcomes between Klebsiella aerogenes (formerly Enterobacter aerogenes) bacteremia (KAB) and Enterobacter cloacae complex bacteremia (ECB) is controversial. Methods We compared the clinical outcomes of patients with KAB and ECB and examined the risk factors associated with mortality. We conducted a retrospective case-control study of hospitalized patients with monobacterial KAB and ECB between January 2011 and June 2020. The primary outcome measure was 30-day all-cause mortality. Multiple logistic regression and propensity-score (PS) matching were used to identify independent risk factors for mortality. The models included demographic characteristics, comorbidities, recent healthcare contact, patient status at the onset of bacteremia, and severity of infection as covariates. Results A total of 282 patients with KAB or ECB were included, among whom 194 patients were selected after PS matching. The 30-day all-cause mortality rate was higher in the ECB group than in the KAB group (24.1% vs 10.6%, P = .003). In a multivariable model, ECB was an independent risk factor for 30-day mortality in both overall and PS-matched cohorts (adjusted odds ratio, 3.528; 95% confidence interval, 1.614–7.714; P = .002). Stay in the intensive care unit at the onset of bacteremia and higher Pitt bacteremia score were found to be independent risk factors for 30-day mortality. Conclusions In our study, mortality was significantly higher in patients with ECB than in those with KAB. Further studies are warranted to clarify the virulence mechanisms of E cloacae complex.
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Affiliation(s)
- Minji Jeon
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Jae-Hoon Ko
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Sun Young Cho
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Republic of Korea
| | - Nam Yong Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Republic of Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong, Gangnam-gu, Seoul, Republic of Korea
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22
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Stokes W, Peirano G, Matsumara Y, Nobrega D, Pitout JDD. Population-based surveillance of Enterobacter cloacae complex causing blood stream infections in a centralized Canadian region. Eur J Clin Microbiol Infect Dis 2021; 41:119-125. [PMID: 34258687 DOI: 10.1007/s10096-021-04309-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/08/2021] [Indexed: 11/30/2022]
Abstract
Active population-based surveillance determined clinical factors, susceptibility patterns, incidence rates (IR), and genomics among Enterobacter cloacae complex (n = 154) causing blood stream infections in a centralized Canadian region (2015-2017). The annual population IR was 1.2/100,000 (95% CI 0.9-16) in 2015, 1.4/100,000 (95% CI 1.1-1.9) in 2016, and 1.5/100,000 (95% CI 1.2-2.0) in 2017, affecting mainly elderly males with underlying comorbid conditions in the hospital setting. E. cloacae complex was dominated by polyclonal subspecies (i.e., E. hormaechei subsp. steigerwaltii, subsp. hoffmanni and subsp. xiangfangesis). Antimicrobial resistant determinants were rare. This study provided novel information about Enterobacter genomics in a well-defined human population.
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Affiliation(s)
- William Stokes
- Alberta Precision Laboratories, Calgary, Alberta, Canada.,Cummings School of Medicine, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, T2L 2K8, Canada.,Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada.,Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Gisele Peirano
- Alberta Precision Laboratories, Calgary, Alberta, Canada.,Cummings School of Medicine, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, T2L 2K8, Canada
| | | | | | - Johann D D Pitout
- Alberta Precision Laboratories, Calgary, Alberta, Canada. .,Cummings School of Medicine, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, T2L 2K8, Canada. .,University of Pretoria, Pretoria, Gauteng, South Africa.
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23
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Li Y, Wang Q, Xiao X, Li R, Wang Z. Emergence of bla NDM-9-bearing tigecycline-resistant Klebsiella aerogenes of chicken origin. J Glob Antimicrob Resist 2021; 26:66-68. [PMID: 34051402 DOI: 10.1016/j.jgar.2021.04.028] [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] [Received: 01/29/2020] [Revised: 03/12/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES The aim of this study was to characterise a tigecycline-resistant blaNDM-9-bearing Klebsiella aerogenes strain (HNHF1) of chicken origin. METHODS Strain HNHF1 was characterised by phenotypic antimicrobial susceptibility testing, PCR, conjugation assays, S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), whole-genome sequencing and bioinformatics analysis. RESULTS The blaNDM-9 gene was located on an IncHI2 plasmid (pHNHF1_NDM-9) carrying various antimicrobial resistance genes. Moreover, the genetic context ΔISAba125-blaNDM-9-bleMBL-trpF is similar to other blaNDM-bearing genetic contexts. TA cloning experiments showed that tet(A) variants may play a partial role in high-level tigecycline resistance in HNHF1. CONCLUSION This is the first report of a tigecycline-resistant blaNDM-9-bearing IncHI2 plasmid in a K. aerogenes ST4 isolate of animal origin, which poses a great threat to public health. Further comprehensive surveillance is needed.
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Affiliation(s)
- Yan Li
- College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu Province, P.R. China; Institute of Comparative Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China
| | - Qian Wang
- College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu Province, P.R. China; Institute of Comparative Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China
| | - Xia Xiao
- College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu Province, P.R. China
| | - Ruichao Li
- College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu Province, P.R. China; Institute of Comparative Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China.
| | - Zhiqiang Wang
- College of Veterinary Medicine, Yangzhou University, Yangzhou, Jiangsu Province, P.R. China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, Jiangsu Province, P.R. China.
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The Changing Face of the Family Enterobacteriaceae (Order: " Enterobacterales"): New Members, Taxonomic Issues, Geographic Expansion, and New Diseases and Disease Syndromes. Clin Microbiol Rev 2021; 34:34/2/e00174-20. [PMID: 33627443 DOI: 10.1128/cmr.00174-20] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The family Enterobacteriaceae has undergone significant morphogenetic changes in its more than 85-year history, particularly during the past 2 decades (2000 to 2020). The development and introduction of new and novel molecular methods coupled with innovative laboratory techniques have led to many advances. We now know that the global range of enterobacteria is much more expansive than previously recognized, as they play important roles in the environment in vegetative processes and through widespread environmental distribution through insect vectors. In humans, many new species have been described, some associated with specific disease processes. Some established species are now observed in new infectious disease settings and syndromes. The results of molecular taxonomic and phylogenetics studies suggest that the current family Enterobacteriaceae should possibly be divided into seven or more separate families. The logarithmic explosion in the number of enterobacterial species described brings into question the relevancy, need, and mechanisms to potentially identify these taxa. This review covers the progression, transformation, and morphogenesis of the family from the seminal Centers for Disease Control and Prevention publication (J. J. Farmer III, B. R. Davis, F. W. Hickman-Brenner, A. McWhorter, et al., J Clin Microbiol 21:46-76, 1985, https://doi.org/10.1128/JCM.21.1.46-76.1985) to the present.
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Complete Genome Sequence of Klebsiella aerogenes Siphophage Solomon. Microbiol Resour Announc 2021; 10:10/3/e01419-20. [PMID: 33478993 PMCID: PMC8407766 DOI: 10.1128/mra.01419-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Klebsiella aerogenes is a bacterium that can cause a variety of infections. Phage-based biotechnologies may be useful for controlling antibiotic-resistant strains of this bacterium. The characterization of K. aerogenes phage Solomon is described here. Solomon has a 51,775-bp genome, with structural components closely resembling those of Escherichia coli siphophage T1. Klebsiella aerogenes is a bacterium that can cause a variety of infections. Phage-based biotechnologies may be useful for controlling antibiotic-resistant strains of this bacterium. The characterization of K. aerogenes phage Solomon is described here. Solomon has a 51,775-bp genome, with structural components closely resembling those of Escherichia coli siphophage T1.
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Identification of Nasal Gammaproteobacteria with Potent Activity against Staphylococcus aureus: Novel Insights into the "Noncarrier" State. mSphere 2021; 6:6/1/e01015-20. [PMID: 33408227 PMCID: PMC7802429 DOI: 10.1128/msphere.01015-20] [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] [Indexed: 02/07/2023] Open
Abstract
Nasal carriage of Staphylococcus aureus is a risk factor for infection, but it is not yet understood why some individuals carry nasal S. aureus persistently, intermittently, or seemingly not at all when tested via culture methods. This study compared the nasal microbiomes of established S. aureus carriers and noncarriers, identified species associated with noncarriage, and tested them for anti-S. aureus activity using assays developed to model the nutrient-limited nasal mucosa. Staphylococcus aureus nasal carriage provides the bacterial reservoir for opportunistic infection. In comparing the nasal microbiomes of culture-defined persistent S. aureus carriers versus noncarriers, we detected S. aureus DNA in all noses, including those with an established history of S. aureus negativity based on culture. Colonization with Gammaproteobacteria, including Klebsiella aerogenes, Citrobacter koseri, Moraxella lincolnii, and select Acinetobacter spp., was associated with S. aureus noncarriage. We next developed physiological competition assays for testing anti-S. aureus activity of isolated nasal species, utilizing medium modeling the nutrient-limited fluid of the nasal mucosa, polarized primary nasal epithelia, and nasal secretions. K. aerogenes from the nose of an S. aureus noncarrier demonstrated >99% inhibition of S. aureus recovery in all assays, even when S. aureus was coincubated in 9-fold excess. Secreted S. aureus inhibitory proteins from K. aerogenes and M. lincolnii were heat-stable and <30 kDa, fitting the profile of antimicrobial peptides. C. koseri, Acinetobacter haemolyticus, Acinetobacter junii, and Acinetobacter schindleri inhibited S. aureus recovery on nasal epithelia in a contact-dependent manner, while several other species either had no effect or promoted S. aureus growth. Collectively, this project is one of the first to identify resident nasal microbial species that impede S. aureus survival, and it implies that detectable nasal S. aureus results from shifts in microbial community composition. IMPORTANCE Nasal carriage of Staphylococcus aureus is a risk factor for infection, but it is not yet understood why some individuals carry nasal S. aureus persistently, intermittently, or seemingly not at all when tested via culture methods. This study compared the nasal microbiomes of established S. aureus carriers and noncarriers, identified species associated with noncarriage, and tested them for anti-S. aureus activity using assays developed to model the nutrient-limited nasal mucosa. We determined that all nostril swabs contain S. aureus DNA, even swabs from hosts considered to be long-term noncarriers. Select members of the Gammaproteobacteria class were more prevalent in noncarrier than carrier nostrils and demonstrated potent activity against multiple strains of S. aureus. The results described here provide a better understanding of how the nasal microbiome controls S. aureus growth and viability and may be useful in the design of improved S. aureus decolonization strategies.
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Newly Named Klebsiella aerogenes (formerly Enterobacter aerogenes) Is Associated with Poor Clinical Outcomes Relative to Other Enterobacter Species in Patients with Bloodstream Infection. J Clin Microbiol 2020; 58:JCM.00582-20. [PMID: 32493786 DOI: 10.1128/jcm.00582-20] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/26/2020] [Indexed: 12/17/2022] Open
Abstract
Enterobacter aerogenes was recently renamed Klebsiella aerogenes This study aimed to identify differences in clinical characteristics, outcomes, and bacterial genetics among patients with K. aerogenes versus Enterobacter species bloodstream infections (BSI). We prospectively enrolled patients with K. aerogenes or Enterobacter cloacae complex (Ecc) BSI from 2002 to 2015. We performed whole-genome sequencing (WGS) and pan-genome analysis on all bacteria. Overall, 150 patients with K. aerogenes (46/150 [31%]) or Ecc (104/150 [69%]) BSI were enrolled. The two groups had similar baseline characteristics. Neither total in-hospital mortality (13/46 [28%] versus 22/104 [21%]; P = 0.3) nor attributable in-hospital mortality (9/46 [20%] versus 13/104 [12%]; P = 0.3) differed between patients with K. aerogenes versus Ecc BSI, respectively. However, poor clinical outcome (death before discharge, recurrent BSI, and/or BSI complication) was higher for K. aerogenes than Ecc BSI (32/46 [70%] versus 42/104 [40%]; P = 0.001). In a multivariable regression model, K. aerogenes BSI, relative to Ecc BSI, was predictive of poor clinical outcome (odds ratio 3.3; 95% confidence interval 1.4 to 8.1; P = 0.008). Pan-genome analysis revealed 983 genes in 323 genomic islands unique to K. aerogenes isolates, including putative virulence genes involved in iron acquisition (n = 67), fimbriae/pili/flagella production (n = 117), and metal homeostasis (n = 34). Antibiotic resistance was largely found in Ecc lineage 1, which had a higher rate of multidrug resistant phenotype (23/54 [43%]) relative to all other bacterial isolates (23/96 [24%]; P = 0.03). K. aerogenes BSI was associated with poor clinical outcomes relative to Ecc BSI. Putative virulence factors in K. aerogenes may account for these differences.
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