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Pariona JGM, Oliveira FA, Scoton PH, Barrón-Pastor HJ, Pariona EMM, Zaccariotto TR, Lincopan N, Levy CE. Rapid diagnostic of multidrug-resistant sepsis pathogens directly from blood culture bottles using MALDI-TOF and the EUCAST RAST. Diagn Microbiol Infect Dis 2024; 109:116247. [PMID: 38484476 DOI: 10.1016/j.diagmicrobio.2024.116247] [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: 08/23/2023] [Revised: 10/09/2023] [Accepted: 03/07/2024] [Indexed: 04/30/2024]
Abstract
In this study, rapid diagnostic of multidrug-resistant (MDR) sepsis pathogens, directly from positive blood culture (BC) bottles, was evaluated by combining MALDI-TOF and the EUCAST Rapid Antimicrobial Susceptibility Testing (RAST). Carbapenemase production in Escherichia coli and Klebsiella pneumoniae isolates was also evaluated by RAST. From 171 positive BC bottles analyzed, 79 (46 %) MDR species, including E. coli (4/34, 12 %), K. pneumoniae (33/48, 69 %), Pseudomonas aeruginosa (12/12, 100 %), Acinetobacter baumannii (15/15, 100 %), and Staphylococcus aureus (14/37, 38 %) displaying resistance to beta-lactams, fluoroquinolones, aminoglycosides, and/or trimethoprim/sulphamethoxazole, were identified. In this regard, turnaround time of direct MALDI-TOF identification and RAST was < 7 h, which was significantly (p< 0.05) lower than our routine method. Carbapenemase detection by RAST displayed 100% sensitivity and 88.7 % specificity at 8 h. This protocol could offer advantages for the treatment and clinical outcomes of septic patients, improving the rapid diagnostic of sepsis by MDR pathogens.
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Affiliation(s)
- Jesus G M Pariona
- Universidade de São Paulo, Instituto de Ciências Biomédicas II, São Paulo, Brazil.
| | - Flavio A Oliveira
- Hospital de Clínicas da Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, Brazil
| | - Patrícia Helena Scoton
- Hospital de Clínicas da Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, Brazil
| | | | - Eva M M Pariona
- Universidad Peruana Cayetano Heredia, Unidad de Investigación de Enfermedades Emergentes y Cambio Climático, Peru
| | - Tania R Zaccariotto
- Hospital de Clínicas da Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, Brazil
| | - Nilton Lincopan
- Universidade de São Paulo, Instituto de Ciências Biomédicas II, São Paulo, Brazil.
| | - Carlos E Levy
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, Brazil
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2
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Afify FA, Shata AH, Aboelnaga N, Osama D, Elsayed SW, Saif NA, Mouftah SF, Shawky SM, Mohamed AA, Loay O, Elhadidy M. Emergence of carbapenem resistant gram-negative pathogens with high rate of colistin resistance in Egypt: A cross sectional study to assess resistance trends during the COVID-19 pandemic. J Genet Eng Biotechnol 2024; 22:100351. [PMID: 38494251 PMCID: PMC10980871 DOI: 10.1016/j.jgeb.2024.100351] [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: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 03/19/2024]
Abstract
The current study investigated the temporal phenotypic and genotypic antimicrobial resistance (AMR) trends among multi-drug resistant and carbapenem-resistant Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa recovered from Egyptian clinical settings between 2020 and 2021. Bacterial identification and antimicrobial sensitivity of 111 clinical isolates against a panel of antibiotics were performed. Molecular screening for antibiotic resistance determinants along with integrons and associated gene cassettes was implemented. An alarming rate (98.2%) of these isolates were found to be phenotypically resistant to carbapenem. Although 23.9 % K. pneumoniae isolates were phenotypically resistant to colistin, no mobile colistin resistance (mcr) genes were detected. Among carbapenem-resistant isolates, blaNDM and blaOXA-48-like were the most prevalent genetic determinants and were significantly overrepresented among K. pneumoniae. Furthermore, 84.78% of K. pneumoniae isolates co-produced these two carbapenemase genes. The plasmid-mediated quinolone resistance genes (qnrS and qnrB) were detected among the bacterial species and were significantly more prevalent among K. pneumoniae. Moreover, Class 1 integron was detected in 82% of the bacterial isolates. This study alarmingly reveals elevated resistance to last-resort antibiotics such as carbapenems as well as colistin which impose a considerable burden in the health care settings in Egypt. Our future work will implement high throughput sequencing-based antimicrobial resistance surveillance analysis for characterization of novel AMR determinants. This information could be applied as a step forward to establish a robust antibiotic stewardship program in Egyptian clinical settings, thereby addressing the rising challenges of AMR.
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Affiliation(s)
- Fatma A Afify
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Ahmed H Shata
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Nirmeen Aboelnaga
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Dina Osama
- Department of Microbiology and Immunology, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Cairo, Egypt
| | - Salma W Elsayed
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt; Department of Microbiology & Immunology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Nehal A Saif
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Shaimaa F Mouftah
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt
| | - Sherine M Shawky
- Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Ahmed A Mohamed
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Omar Loay
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt
| | - Mohamed Elhadidy
- Biomedical Sciences Program, University of Science and Technology, Zewail City of Science and Technology, Giza, Egypt; Center for Genomics, Helmy Institute for Medical Sciences, Zewail City of Science and Technology, Giza, Egypt; Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt.
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3
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Soni K, Kothamasi D, Chandra R. Municipal wastewater treatment plant showing a potential reservoir for clinically relevant MDR bacterial strains co-occurrence of ESBL genes and integron-integrase genes. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 351:119938. [PMID: 38171124 DOI: 10.1016/j.jenvman.2023.119938] [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: 08/18/2023] [Revised: 11/22/2023] [Accepted: 12/23/2023] [Indexed: 01/05/2024]
Abstract
Municipal wastewater treatment plants (MWWTPs) are a milieu for co-occurrence of multiple antibiotic resistance genes (ARGs). This facilitates mixing and genetic exchange; and promotes dissemination of multidrug resistance (MDR) to wastewater bacterial communities which is hazardous for the effluent receiving environment. This study investigated the co-occurrence of extended-spectrum beta-lactamase (ESBL) genes (blaTEM, blaCTX-M, blaSHV, blaOXA), and integron-integrase genes (intI1, intI2, intI3) in MDR bacteria isolated from the Bharwara MWWTP in Lucknow, India. Thirty-one MDR bacterial colonies resistant to three or more antibiotics were isolated from three treatment stages of this MWWTP. Six of these: Staphylococcus aureus, Serratia marcescens, Salmonella enterica, Shigella sonnei, Escherichia coli, and Bacillus sp. Had co-occurrence of ESBL and integron-integrase genes. These six isolates were examined for the occurrence of MDR efflux genes (qacA, acrB) and ARGs (aac(3)-1, qnrA1, tetA, vanA) and tested for resistance against 12 different antibiotics. The highest resistance was against penicillin-G (100%) and lowest for chloramphenicol (16.66%). Bacillus sp. Isolate BWKRC6 had the highest co-occurrence of antibiotic resistance-determining genes and was resistant to all the 12 antibiotics tested. The co-occurrence of ESBL, integron-integrase, antibiotic resistance-determining and MDR efflux genes in bacteria isolated from the Bharwara MWWTP indicates that the wastewaters of this treatment plant may have become a hotspot for MDR bacteria and may present human and environmental health hazards. Therefore, there is need for a rapid action to limit the spread of this threat. Public regulatory authorities must urgently implement measures to prevent MWWTPs becoming reservoirs for evolution of antibiotic resistance genes and development of antibiotic resistance.
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Affiliation(s)
- Kuldeep Soni
- Department of Environmental Microbiology, School for Environmental Sciences, Babasaheb Bhimrao Ambedkar University (A Central University), Lucknow, 226025, Uttar Pradesh, India
| | - David Kothamasi
- Laboratory of Soil Biology and Microbial Ecology, Department of Environmental Studies, University of Delhi, Delhi, 110007, India; Strathclyde Centre for Environmental Law and Governance, University of Strathclyde, Glasgow, G4 0LT, United Kingdom
| | - Ram Chandra
- Department of Environmental Microbiology, School for Environmental Sciences, Babasaheb Bhimrao Ambedkar University (A Central University), Lucknow, 226025, Uttar Pradesh, India.
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4
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Klein Klouwenberg PMC, Altorf–van der Kuil W, van Griethuysen AJ, Hendriks M, Kuijper EJ, Notermans DW, Schoffelen AF, on behalf of the ISIS-AR study group Cohen StuartJ.W.T.1MellesD.C.2van DijkK.3AlzubaidyA.4ScholingM.5KuilS.D.6BlaauwG.J.7Altorf–van der KuilW.8BiermanS.M.8de GreeffS.C.8GroenendijkS.R.8HertroysR.8MarchalN.8MonenJ.C.M.8PolmanJ.8van den ReekW.J.8Schneeberger–van der LindenC.8SchoffelenA.F.8WieldersC.C.H.8de WitB.J.8ZoetigheidR.E.8van den BijllaardtW.9KraanE.M.10HaesekerM.B.11da SilvaJ.M.12de JongE.13MarahaB.14van GriethuysenA.J.15WintermansB.B.16van TrijpM.J.C.A.17MullerA.E.18WongM.19OttA.20BathoornE.21LokateM.21SinnigeJ.22MellesD.C.23RendersN.H.24Dorigo–ZetsmaJ.W.25BakkerL.J.25WaarK.26van der BeekM.T.27Leversteijn–van HallM.A.28van MensS.P.29SchaftenaarE.30Nabuurs–FranssenM.H.31MaatI.32SturmP.D.J.33DiederenB.M.W.34BodeL.G.M.35OngD.S.Y.36van RijnM.37PontesilliO.37DinantS.38van DamD.W.39de BrauwerE.I.G.B.39BentvelsenR.G.4041BuitingA.G.M.42VlekA.L.M.43de GraafM.44TroelstraA.45JanszA.R.46van MeerM.P.A.47de VriesJ.48MachielsJ.49Department of Medical Microbiology, Noordwest Ziekenhuisgroep, Alkmaar, the NetherlandsDepartment of Medical Microbiology, Meander Medical Center, Amersfoort, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, the NetherlandsDepartment of Medical Microbiology, Atalmedial, Amsterdam, the NetherlandsDepartment of Medical Microbiology, OLVG Lab BV, Amsterdam, the NetherlandsPublic Health Service, Public Health Laboratory, Amsterdam, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Gelre Hospitals, Apeldoorn, the NetherlandsCentre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the NetherlandsMicrovida Amphia, Laboratory for Microbiology and Infection Control, Breda, the NetherlandsDepartment of Medical Microbiology, IJsselland Hospital, Capelle aan den IJssel, the NetherlandsDepartment of Medical Microbiology, Haeseker, Reinier de Graaf Group, Delft, the NetherlandsDepartment of Medical Microbiology, Deventer Hospital, Deventer, the NetherlandsDepartment of Medical Microbiology, Slingeland Hospital, Doetinchem, the NetherlandsDepartment of Medical Microbiology, Albert Schweitzer Hospital, Dordrecht, the NetherlandsDepartment of Medical Microbiology, Gelderse Vallei Hospital, Ede, the NetherlandsDepartment of Medical Microbiology, Admiraal De Ruyter Hospital, Goes, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Groene Hart Hospital, Gouda, the NetherlandsDepartment of Medical Microbiology, Haaglanden MC, 's-Gravenhage, the NetherlandsDepartment of Medical Microbiology, Haga Hospital, 's-Gravenhage, the NetherlandsCerte, Medical Microbiology Groningen|Drenthe, Groningen, the NetherlandsDepartment of Medical Microbiology, University of Groningen, University Medical Center, Groningen, the NetherlandsRegional Public Health Laboratory Haarlem, Haarlem, the NetherlandsDepartment of Medical Microbiology, St Jansdal Hospital, Harderwijk, the NetherlandsDepartment of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the NetherlandsDepartment of Medical Microbiology, CBSL, Tergooi MC, Hilversum, the NetherlandsCerte, Medical Microbiology Friesland|NOP, Leeuwarden, the NetherlandsDepartment of Medical Microbiology, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Medical Microbiology, Eurofins Clinical Diagnostics, Leiden-Leiderdorp, the NetherlandsDepartment of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the NetherlandsDepartment of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, the NetherlandsDepartment of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, the NetherlandsDepartment of Medical Microbiology, Radboud University Medical Center, Nijmegen, the NetherlandsLaurentius Hospital, Roermond, the NetherlandsDepartment of Medical Microbiology, Bravis Hospital, Roosendaal, the NetherlandsDepartment of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Medical Microbiology and Infection Control, Franciscus Gasthuis and Vlietland, Rotterdam, the NetherlandsDepartment of Medical Microbiology, Ikazia Hospital, Rotterdam, the NetherlandsStar-SHL, Rotterdam, the NetherlandsDepartment of Medical Microbiology and Infection Control, Zuyderland Medical Centre, Sittard-Geleen, the NetherlandsDepartment of Medical Microbiology, Microvida ZorgSaam, Terneuzen, the NetherlandsDepartment of Medical Microbiology, Microvida ZorgSaam, Terneuzen, the NetherlandsDepartment of Medical Microbiology, St. Elisabeth Hospital, Tilburg, the NetherlandsDepartment of Medical Microbiology and Immunology, Diakonessenhuis, Utrecht, the NetherlandsDepartment of Medical Microbiology, Saltro Diagnostic Centre, Utrecht, the NetherlandsDepartment of Medical Microbiology, University Medical Center Utrecht, Utrecht, the NetherlandsDepartment of Medical Microbiology, Eurofins-PAMM, Veldhoven, the NetherlandsRijnstate Hospital, Laboratory for Medical Microbiology and Immunology, Velp, the NetherlandsDepartment of Medical Microbiology, VieCuri Medical Center, Venlo, the NetherlandsIsala Hospital, Laboratory of Medical Microbiology and Infectious Diseases, Zwolle, the Netherlands. False aminoglycoside resistance in Enterobacterales and non-fermenters by an automated testing system: a descriptive study. Microbiol Spectr 2023; 11:e0309323. [PMID: 38194628 PMCID: PMC10790582 DOI: 10.1128/spectrum.03093-23] [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: 08/13/2023] [Accepted: 10/03/2023] [Indexed: 01/11/2024] Open
Abstract
IMPORTANCE Antimicrobial sensitivity data are important to guide antimicrobial therapy. In microbiological laboratories, routine sensitivity measurements are typically performed with automated testing systems such as VITEK2 and Phoenix. Using data from the Dutch national surveillance system for antimicrobial resistance over a 6-year period, we found that the measured minimum inhibitory concentrations for aminoglycosides in Enterobacterales and non-fermenters were too high for the Phoenix system. In addition, we observed a yearly increase in resistance for several species measured by Phoenix. These findings might have consequences for clinical treatment of patients with sepsis.
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Affiliation(s)
| | - W. Altorf–van der Kuil
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - M. Hendriks
- Department of Medical Microbiology, Gelderse Vallei Hospital, Ede, the Netherlands
| | - E. J. Kuijper
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - D. W. Notermans
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - A. F. Schoffelen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - on behalf of the ISIS-AR study groupCohen StuartJ.W.T.1MellesD.C.2van DijkK.3AlzubaidyA.4ScholingM.5KuilS.D.6BlaauwG.J.7Altorf–van der KuilW.8BiermanS.M.8de GreeffS.C.8GroenendijkS.R.8HertroysR.8MarchalN.8MonenJ.C.M.8PolmanJ.8van den ReekW.J.8Schneeberger–van der LindenC.8SchoffelenA.F.8WieldersC.C.H.8de WitB.J.8ZoetigheidR.E.8van den BijllaardtW.9KraanE.M.10HaesekerM.B.11da SilvaJ.M.12de JongE.13MarahaB.14van GriethuysenA.J.15WintermansB.B.16van TrijpM.J.C.A.17MullerA.E.18WongM.19OttA.20BathoornE.21LokateM.21SinnigeJ.22MellesD.C.23RendersN.H.24Dorigo–ZetsmaJ.W.25BakkerL.J.25WaarK.26van der BeekM.T.27Leversteijn–van HallM.A.28van MensS.P.29SchaftenaarE.30Nabuurs–FranssenM.H.31MaatI.32SturmP.D.J.33DiederenB.M.W.34BodeL.G.M.35OngD.S.Y.36van RijnM.37PontesilliO.37DinantS.38van DamD.W.39de BrauwerE.I.G.B.39BentvelsenR.G.4041BuitingA.G.M.42VlekA.L.M.43de GraafM.44TroelstraA.45JanszA.R.46van MeerM.P.A.47de VriesJ.48MachielsJ.49Department of Medical Microbiology, Noordwest Ziekenhuisgroep, Alkmaar, the NetherlandsDepartment of Medical Microbiology, Meander Medical Center, Amersfoort, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Infection and Immunity Institute, Amsterdam, the NetherlandsDepartment of Medical Microbiology, Atalmedial, Amsterdam, the NetherlandsDepartment of Medical Microbiology, OLVG Lab BV, Amsterdam, the NetherlandsPublic Health Service, Public Health Laboratory, Amsterdam, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Gelre Hospitals, Apeldoorn, the NetherlandsCentre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the NetherlandsMicrovida Amphia, Laboratory for Microbiology and Infection Control, Breda, the NetherlandsDepartment of Medical Microbiology, IJsselland Hospital, Capelle aan den IJssel, the NetherlandsDepartment of Medical Microbiology, Haeseker, Reinier de Graaf Group, Delft, the NetherlandsDepartment of Medical Microbiology, Deventer Hospital, Deventer, the NetherlandsDepartment of Medical Microbiology, Slingeland Hospital, Doetinchem, the NetherlandsDepartment of Medical Microbiology, Albert Schweitzer Hospital, Dordrecht, the NetherlandsDepartment of Medical Microbiology, Gelderse Vallei Hospital, Ede, the NetherlandsDepartment of Medical Microbiology, Admiraal De Ruyter Hospital, Goes, the NetherlandsDepartment of Medical Microbiology and Infection Prevention, Groene Hart Hospital, Gouda, the NetherlandsDepartment of Medical Microbiology, Haaglanden MC, 's-Gravenhage, the NetherlandsDepartment of Medical Microbiology, Haga Hospital, 's-Gravenhage, the NetherlandsCerte, Medical Microbiology Groningen|Drenthe, Groningen, the NetherlandsDepartment of Medical Microbiology, University of Groningen, University Medical Center, Groningen, the NetherlandsRegional Public Health Laboratory Haarlem, Haarlem, the NetherlandsDepartment of Medical Microbiology, St Jansdal Hospital, Harderwijk, the NetherlandsDepartment of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the NetherlandsDepartment of Medical Microbiology, CBSL, Tergooi MC, Hilversum, the NetherlandsCerte, Medical Microbiology Friesland|NOP, Leeuwarden, the NetherlandsDepartment of Medical Microbiology, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Medical Microbiology, Eurofins Clinical Diagnostics, Leiden-Leiderdorp, the NetherlandsDepartment of Medical Microbiology, Maastricht University Medical Centre, Maastricht, the NetherlandsDepartment of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, the NetherlandsDepartment of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, the NetherlandsDepartment of Medical Microbiology, Radboud University Medical Center, Nijmegen, the NetherlandsLaurentius Hospital, Roermond, the NetherlandsDepartment of Medical Microbiology, Bravis Hospital, Roosendaal, the NetherlandsDepartment of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the NetherlandsDepartment of Medical Microbiology and Infection Control, Franciscus Gasthuis and Vlietland, Rotterdam, the NetherlandsDepartment of Medical Microbiology, Ikazia Hospital, Rotterdam, the NetherlandsStar-SHL, Rotterdam, the NetherlandsDepartment of Medical Microbiology and Infection Control, Zuyderland Medical Centre, Sittard-Geleen, the NetherlandsDepartment of Medical Microbiology, Microvida ZorgSaam, Terneuzen, the NetherlandsDepartment of Medical Microbiology, Microvida ZorgSaam, Terneuzen, the NetherlandsDepartment of Medical Microbiology, St. Elisabeth Hospital, Tilburg, the NetherlandsDepartment of Medical Microbiology and Immunology, Diakonessenhuis, Utrecht, the NetherlandsDepartment of Medical Microbiology, Saltro Diagnostic Centre, Utrecht, the NetherlandsDepartment of Medical Microbiology, University Medical Center Utrecht, Utrecht, the NetherlandsDepartment of Medical Microbiology, Eurofins-PAMM, Veldhoven, the NetherlandsRijnstate Hospital, Laboratory for Medical Microbiology and Immunology, Velp, the NetherlandsDepartment of Medical Microbiology, VieCuri Medical Center, Venlo, the NetherlandsIsala Hospital, Laboratory of Medical Microbiology and Infectious Diseases, Zwolle, the Netherlands
- Department of pharmacy, Fundashon Mariadal, Kralendijk, Bonaire, the Netherlands
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Medical Microbiology, Gelderse Vallei Hospital, Ede, the Netherlands
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5
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Osanloo L, Zeighami H, Haghi F, Shapouri R, Shokri R. Molecular Typing of Multidrug-Resistant Acinetobacter baumannii Isolates from Clinical Specimens by ERIC-PCR and MLVA. Curr Microbiol 2023; 80:355. [PMID: 37752362 DOI: 10.1007/s00284-023-03459-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/26/2023] [Indexed: 09/28/2023]
Abstract
Acinetobacter baumannii, a Gram-negative and oxidase-negative bacterium, is a major cause of nosocomial infections, leading to high mortality rates in hospitalized patients. The use of 2 prominent molecular typing methods (i.e., enterobacterial repetitive intergenic consensus-polymerase chain reaction [ERIC-PCR] and multiple-locus variable-number tandem repeat [VNTR] analysis [MLVA]) for genotyping A. baumannii isolates has proven to be an effective approach in assessing the clonal relation of these isolates and managing their outbreaks. A total of 100 A. baumannii isolates were collected from immunocompromised patients hospitalized in the intensive care unit (ICU) of a hospital in Zanjan City, Iran. Their antibiotic resistance ability (especially aminoglycoside resistance) was studied by disc diffusion tests. The genetic typing of A. baumannii was studied using ERIC-PCR and MLVA methods. All isolates were resistant to 3 or more antibiotics and regarded as multidrug-resistant (MDR). Additionally, 32% of the isolates were resistant to all antibiotics tested, and 91% were extensively drug-resistant (XDR). The increased rate of aminoglycoside-resistant A. baumannii in ICU patients, with an increased incidence of aminoglycoside-modifying enzymes of aac (6')-Ib, ant (3″)-I, and aph (2″)-Id. ERIC-PCR has likewise shown an increased level of diversity in A. baumannii isolates. According to the ERIC-PCR patterns, isolates were classified as 4 clusters, while according to the MLVA patterns, isolates were classified as 9 distinct clusters. ERIC-PCR and MLVA assays serve as useful genotyping methods to assess the genetic variety or clonal relatedness of A. baumannii isolates.
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Affiliation(s)
- Leili Osanloo
- Department of Microbiology, Biology Research Center, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Habib Zeighami
- Department of Microbiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Fakhri Haghi
- Department of Microbiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Shapouri
- Department of Microbiology, Biology Research Center, Zanjan Branch, Islamic Azad University, Zanjan, Iran
| | - Rasoul Shokri
- Department of Microbiology, Biology Research Center, Zanjan Branch, Islamic Azad University, Zanjan, Iran
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6
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Ahmed OB, Asghar AH, Bamaga M, Bahwerth FS, Ibrahim ME. Characterization of aminoglycoside resistance genes in multidrug-resistant Klebsiella pneumoniae collected from tertiary hospitals during the COVID-19 pandemic. PLoS One 2023; 18:e0289359. [PMID: 37506109 PMCID: PMC10381092 DOI: 10.1371/journal.pone.0289359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
Since the peak of the coronavirus disease 2019 (COVID-19) pandemic, concerns around multidrug-resistant (MDR) bacterial pathogens have increased. This study aimed to characterize aminoglycoside resistance genes in MDR Klebsiella pneumoniae (K. pneumoniae) collected during the COVID-19 pandemic. A total of 220 clinical isolates of gram-negative bacteria were collected from tertiary hospitals in Makkah, Saudi Arabia, between April 2020 and January 2021. The prevalence of K. pneumoniae was 40.5%; of the 89 K. pneumoniae isolates, MDR patterns were found among 51 (57.3%) strains. The MDR isolates showed elevated resistance rates to aminoglycoside agents, including amikacin (100%), gentamicin (98%), and tobramycin (98%). PCR assays detected one or more aminoglycoside genes in 42 (82.3%) MDR K. pneumoniae strains. The rmtD gene was the most predominant gene (66.7%; 34/51), followed by aac(6')-Ib and aph(3')-Ia (45.1%; 23/51). The aac(3)-II gene was the least frequent gene (7.8%; 4/51) produced by our isolates. The rmtC gene was not detected in the studied isolates. Our findings indicated a high risk of MDR bacterial infections through the COVID-19 outbreak. Therefore, there is a need for continuous implementation of effective infection prevention control (IPC) measures to monitor the occurrence of MDR pathogens and the emergence of MDR bacterial infections through the COVID-19 outbreak.
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Affiliation(s)
- Omar B Ahmed
- Department of Environmental and Health Research, The Custodian of the Two Holy Mosques Institute for Hajj and Umrah Research, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Atif H Asghar
- Department of Environmental and Health Research, The Custodian of the Two Holy Mosques Institute for Hajj and Umrah Research, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Majid Bamaga
- Department of Environmental and Health Research, The Custodian of the Two Holy Mosques Institute for Hajj and Umrah Research, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Mutasim E Ibrahim
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Abdul-Mutakabbir JC, Griffith NC, Shields RK, Tverdek FP, Escobar ZK. Contemporary Perspective on the Treatment of Acinetobacter baumannii Infections: Insights from the Society of Infectious Diseases Pharmacists. Infect Dis Ther 2021; 10:2177-2202. [PMID: 34648177 PMCID: PMC8514811 DOI: 10.1007/s40121-021-00541-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/23/2021] [Indexed: 01/10/2023] Open
Abstract
The purpose of this narrative review is to bring together the most recent epidemiologic, preclinical, and clinical findings to offer our perspective on best practices for managing patients with A. baumannii infections with an emphasis on carbapenem-resistant A. baumannii (CRAB). To date, the preferred treatment for CRAB infections has not been defined. Traditional agents with retained in vitro activity (aminoglycosides, polymyxins, and tetracyclines) are limited by suboptimal pharmacokinetic characteristics, emergence of resistance, and/or toxicity. Recently developed and US Food and Drug Administration (FDA)-approved β-lactam/β-lactamase inhibitor agents do not provide enhanced activity against CRAB. On balance, cefiderocol and eravacycline demonstrate potent in vitro activity and are well tolerated, but clinical data for patients with CRAB infections do not yet support widespread use. Given that CRAB has the capacity to infect vulnerable patients and preferred regimens have not been identified, we advocate for combination therapy. Our preferred regimen for critically ill patients infected, or considered to be at high risk for CRAB, includes meropenem, polymyxin B, and ampicillin/sulbactam. Importantly, site of infection, severity of illness, and local epidemiology are essential factors to be considered in selecting combination therapies. Molecular mechanisms of resistance may unveil preferred combinations at individual centers; however, such data are often unavailable to treating clinicians and have not been linked to improved clinical outcomes. Combination strategies may also pose an increased risk for antibiotic toxicity and Clostridioides difficile infection, and should therefore be balanced by understanding patient goals of care and underlying health conditions. Promising therapies that are in clinical development and/or under investigation include durlobactam-sulbactam, cefiderocol combination regimens, and bacteriophage therapy, which may over time eliminate the need for the continued use of polymyxins. Future goals for CRAB management include pathogen-focused treatment paradigms that are based on molecular mechanisms of resistance, local susceptibility rates, and the availability of well-tolerated, effective treatment options.
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Affiliation(s)
- Jacinda C Abdul-Mutakabbir
- Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, CA, USA.
- Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.
| | - Nicole C Griffith
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Ryan K Shields
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Frank P Tverdek
- University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Zahra Kassamali Escobar
- University of Washington Medicine, Valley Medical Center, University of Washington School of Pharmacy, Renton, WA, USA
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8
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Alrahmany D, Omar AF, Harb G, El Nekidy WS, Ghazi IM. Acinetobacter baumannii Infections in Hospitalized Patients, Treatment Outcomes. Antibiotics (Basel) 2021; 10:antibiotics10060630. [PMID: 34070398 PMCID: PMC8229601 DOI: 10.3390/antibiotics10060630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 12/04/2022] Open
Abstract
Background Acinetobacter baumannii (AB), an opportunistic pathogen, could develop into serious infections with high mortality and financial burden. The debate surrounding the selection of effective antibiotic treatment necessitates studies to define the optimal approach. This study aims to compare the clinical outcomes of commonly used treatment regimens in hospitalized patients with AB infections to guide stewardship efforts. Material and methods: Ethical approval was obtained, 320 adult patients with confirmed AB infections admitted to our tertiary care facility within two years were enrolled. The treatment outcomes were statistically analyzed to study the relation between antibiotic regimens and 14, 28, and 90-day mortality as the primary outcomes using binary logistic regression—using R software—in addition to the length of hospitalization, adverse events due to antibiotic treatment, and 90-day recurrence as secondary outcomes. Results: Among 320 patients, 142 (44%) had respiratory tract, 105 (33%) soft tissue, 42 (13%) urinary tract, 22 (7%) bacte iemia, and other infections 9 (3%). Nosocomial infections were 190 (59%) versus community-acquired. Monotherapy was significantly associated with lower 28-day (p < 0.05, OR:0.6] and 90-day (p < 0.05, OR:0.4) mortality rates, shorter length of stay LOS (p < 0.05, Median: −12 days] and limited development of adverse events (p < 0.05, OR:0.4). Subgroup analysis revealed similar results ranging from lower odds of mortality, adverse events, and shorter LOS to statistically significant correlation to monotherapy. Meropenem (MEM) and piperacillin/tazobactam (PIP/TAZ) monotherapies showed non-significant high odd ratios of mortalities, adverse events, and disparate LOS. There was a statistical correlation between most combined therapies and adverse events, and longer LOS. Colistin based and colistin/meropenem (CST/MEM) combinations were superior in terms of 14-day mortality (p = 0.05, OR:0.4) and (p < 0.05, OR:0.4) respectively. Pip/Taz and MEM-based combined therapies were associated with statistically non-significant high odd ratios of mortalities. Tigecycline (TGC)-based combinations showed a significant correlation to mortalities (p < 0.05, OR:2.5). Conclusion: Monotherapy was associated with lower mortality rates, shorter LOS, and limited development of adverse events compared to combined therapies. Colistin monotherapy, colistin/meropenem, and other colistin combinations showed almost equivalent mortality outcomes. Patients on combined therapy were more susceptible to adverse events and comparable LOS. The possible adverse outcomes of PIP/TAZ and MEM-based therapies in the treatment of MDRAB infections and the association of TGC with a higher mortality rate raise doubts about their treatment role.
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Affiliation(s)
| | - Ahmed F. Omar
- General Medicine Department, Sohar Hospital, Sohar 311, Oman;
| | - Gehan Harb
- Gehan Harb Statistics, Cairo 11511, Egypt;
| | - Wasim S. El Nekidy
- Cleveland Clinic Abu Dhabi, Abu-Dhabi P.O. Box 112412, United Arab Emirates;
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44195, USA
| | - Islam M. Ghazi
- Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA 19104, USA
- Correspondence: ; Tel.: +1-215-596-7121; Fax: +1-215-596-8586
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9
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Ahmed OB, Asghar AH, Bahwerth FS. Increasing frequency of Aminoglycoside-Resistant Klebsiella pneumoniae during the era of pandemic COVID-19. MATERIALS TODAY. PROCEEDINGS 2021:S2214-7853(21)03943-2. [PMID: 34075332 PMCID: PMC8160573 DOI: 10.1016/j.matpr.2021.05.344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 01/10/2023]
Abstract
The emergence of multidrug resistance to aminoglycosides in K. pneumoniae isolates is a growing concern, especially during pandemic Coronavirus disease 2019 (COVID-19). The study identifies antibiotic resistance in K. pneumoniae isolated from tertiary hospitals during pandemic COVID-19. Among 220 clinical isolates, the total rate of K. pneumoniae was found to be 89 (40.5%). Phenotyping results confirmed the resistance of aminoglycoside antibiotics in 51 (23.2%) of K. pneumoniae isolates. PCR results confirmed the existence of one or more aminoglycoside genes in 82.3% of the 51 isolates. The rmtD gene was the highest-detected gene (66.7%), followed by aac(6')-Ib (45.1%), aph(3')-Ia (45.1%), rmtB (29.4%), armA (21.6%), aac(3)-II (7.8%), and rmtA (3) (11.8%). Significantly, higher resistance strains showed a higher prevalence (61.5%) of aminoglycoside genes (p < 0.05). During COVID-19, there is a higher risk of acquiring MDR bacterial infections, so the monitoring of multidrug resistant bacteria must be continuously undertaken to implement effective measures in infection control and prevention.
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Affiliation(s)
- Omar B Ahmed
- Department of Environmental and Health Research, The Custodian of the Two Holy Mosques Institute for Hajj and Umrah Research, Umm Al-Qura University, Saudi Arabia
| | - Atif H Asghar
- Department of Environmental and Health Research, The Custodian of the Two Holy Mosques Institute for Hajj and Umrah Research, Umm Al-Qura University, Saudi Arabia
| | - Fayez S Bahwerth
- King Faisal Hospital Makkah, Ministry of Health, Makkah, Saudi Arabia
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10
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The prevalence of aminoglycoside-resistant genes in Gram-negative bacteria in tertiary hospitals. APPLIED NANOSCIENCE 2021. [DOI: 10.1007/s13204-021-01887-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Abd-Elmonsef MME, Nagla S, Afandy ME, Maxwell SY. In vitro activity of plazomicin against quinolone-resistant gram-negative bacteria isolated from catheter-associated urinary tract infections. J Chemother 2021; 33:462-468. [PMID: 33810779 DOI: 10.1080/1120009x.2021.1908652] [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: 10/21/2022]
Abstract
Quinolone resistance among uropathogens is an increasing concern. Plazomicin is a new aminoglycoside that shows promising results against resistant bacteria. However, no study has yet tested its effect specifically on quinolone-resistant organisms. This study aimed to evaluate the in vitro activity of plazomicin and comparator drugs against quinolone-resistant Gram-negative isolates of catheter-associated urinary tract infections (CAUTI). Plazomicin demonstrated high inhibiting activity against Enterobacteriaceae isolates (95.9% at MIC≤ 2 mg/L), with MIC50/90 was 1/2 mg/L. High MICs values were detected against non-Enterobacteriaceae isolates (MIC50/90, 4/32 mg/L). Plazomicin had susceptibility rate of 97.2% against Enterobacteriaceae isolates carrying aminoglycosides modifying enzymes (AME) genes, while other aminoglycosides, amikacin and gentamicin showed reduced activity (32.4% and 25.4%, respectively). In conclusion, plazomicin showed potent in vitro activity against quinolone-resistant Enterobacteriaceae causing CAUTI, regardless of the AME pattern.
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Affiliation(s)
| | - Salah Nagla
- Faculty of Medicine, Department of Urology, Tanta University, Tanta, Egypt
| | - Mohamed Elsayed Afandy
- Faculty of Medicine, Department of Anesthesia and Surgical Intensive Care, Tanta University, Tanta, Egypt
| | - Sara Youssef Maxwell
- Faculty of Medicine, Department of Medical Microbiology & Immunology, Tanta University, Tanta, Egypt
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12
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Vardanega J, Maggacis R, Runnegar N, Harris PNA, Sehu MM. Discrepancy between VITEK2 and Etest aminoglycoside susceptibility testing for multidrug-resistant Acinetobacter baumannii. Pathology 2021; 53:805-808. [PMID: 33612270 DOI: 10.1016/j.pathol.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/18/2020] [Accepted: 10/26/2020] [Indexed: 10/22/2022]
Affiliation(s)
| | | | - Naomi Runnegar
- Princess Alexandra Hospital, Woolloongabba, Qld, Australia
| | - Patrick N A Harris
- UQ Centre for Clinical Research, Herston, Qld, Australia; Central Microbiology, Pathology Queensland, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
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13
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Jouybari MA, Ahanjan M, Mirzaei B, Goli HR. Role of aminoglycoside-modifying enzymes and 16S rRNA methylase (ArmA) in resistance of Acinetobacter baumannii clinical isolates against aminoglycosides. Rev Soc Bras Med Trop 2021; 54:e05992020. [PMID: 33533819 PMCID: PMC7849326 DOI: 10.1590/0037-8682-0599-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/12/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: This study aimed to determine the role of genes encoding aminoglycoside-modifying enzymes (AMEs) and 16S rRNA methylase (ArmA) in Acinetobacter baumannii clinical isolates. METHODS: We collected 100 clinical isolates of A. baumannii and identified and confirmed them using microbiological tests and assessment of the OXA-51 gene. Antibiotic susceptibility testing was carried out using disk agar diffusion and micro-broth dilution methods. The presence of AME genes and ArmA was detected by PCR and multiplex PCR. RESULTS: The most and least effective antibiotics in this study were netilmicin and ciprofloxacin with 68% and 100% resistance rates, respectively. According to the minimum inhibitory concentration test, 94% of the isolates were resistant to gentamicin, tobramycin, and streptomycin, while the highest susceptibility (20%) was observed against netilmicin. The proportion of strains harboring the aminoglycoside resistance genes was as follows: APH(3′)-VIa (aphA6) (77%), ANT(2”)-Ia (aadB) (73%), ANT(3”)-Ia (aadA1) (33%), AAC(6′)-Ib (aacA4) (33%), ArmA (22%), and AAC(3)-IIa (aacC2) (19%). Among the 22 gene profiles detected in this study, the most prevalent profiles included APH(3′)-VIa + ANT(2”)-Ia (39 isolates, 100% of which were kanamycin-resistant), and AAC(3)-IIa + AAC(6′)-Ib + ANT(3”)-Ia + APH(3′)-VIa + ANT(2”)-Ia (14 isolates, all of which were resistant to gentamicin, kanamycin, and streptomycin). CONCLUSIONS: High minimum inhibitory concentration of aminoglycosides in isolates with the simultaneous presence of AME- and ArmA-encoding genes indicated the importance of these genes in resistance to aminoglycosides. However, control of their spread could be effective in the treatment of infections caused by A. baumannii.
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Affiliation(s)
- Maryam Asadi Jouybari
- Mazandaran University of Medical Sciences, Faculty of Medicine, Molecular and Cell Biology Research Centre, Sari, Iran.,Mazandaran University of Medical Sciences, Faculty of Medicine, Department of Medical Microbiology and Virology, Sari, Iran
| | - Mohammad Ahanjan
- Mazandaran University of Medical Sciences, Faculty of Medicine, Molecular and Cell Biology Research Centre, Sari, Iran.,Mazandaran University of Medical Sciences, Faculty of Medicine, Department of Medical Microbiology and Virology, Sari, Iran
| | - Bahman Mirzaei
- Zanjan University of Medical Sciences, School of Medicine, Department of Medical Microbiology and Virology, Zanjan, Iran
| | - Hamid Reza Goli
- Mazandaran University of Medical Sciences, Faculty of Medicine, Molecular and Cell Biology Research Centre, Sari, Iran.,Mazandaran University of Medical Sciences, Faculty of Medicine, Department of Medical Microbiology and Virology, Sari, Iran
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14
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Kishk R, Soliman N, Nemr N, Eldesouki R, Mahrous N, Gobouri A, Azab E, Anani M. Prevalence of Aminoglycoside Resistance and Aminoglycoside Modifying Enzymes in Acinetobacter baumannii Among Intensive Care Unit Patients, Ismailia, Egypt. Infect Drug Resist 2021; 14:143-150. [PMID: 33519215 PMCID: PMC7838519 DOI: 10.2147/idr.s290584] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 12/18/2020] [Indexed: 12/13/2022] Open
Abstract
Background Acinetobacter baumannii is an opportunistic pathogen that rapidly develops antibiotic resistance against commonly prescribed antimicrobial agents in hospitalized patients worldwide. Aminoglycosides are commonly used in the treatment of A. baumannii health care-associated infections (HAIs). Aminoglycosides resistance mechanisms are varied and commonly involve production of aminoglycoside-modifying enzymes (AME) and efflux systems. Aim This study aimed to provide an insight into the frequency of genes encoding AME in A. baumannii strains isolated from different clinical specimens in intensive care units (ICU). Methodology A total of 52 multidrug-resistant (MDR) A. baumannii strains were isolated from ICU, Suez Canal University Hospitals. Species identification and antibiotics susceptibility testing were done by the automated system VITEK 2. The genes encoding AME were detected by PCR. Results Aminoglycosides resistance (amikacin, gentamicin and tobramycin) was observed in 35 isolates (67.3%). We found that aacC1 gene was the predominant AME resistance gene among A. baumannii isolates, detected in 14 isolates (40%), aphA6 in 11 isolates (31.4%) and addA1 in 5 isolates (14.2%). We found 5 isolates containing 2 AME genes, 3 of them with aacC1 and aphA6 and the remaining 2 with both aacC1 and aadA1 genes. Nearly, 5 isolates (14.2%) were negative for all AME resistance genes. Conclusion Our study indicated that AME encoding genes are predominant in A. baumannii strains in our region which stressed on the importance of preventive measures to control spreading of resistance genes.
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Affiliation(s)
- Rania Kishk
- Microbiology and Immunology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nourhan Soliman
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nader Nemr
- Endemic and Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Raghda Eldesouki
- Genetics Unit, Histology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Nageh Mahrous
- Endemic and Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Adil Gobouri
- Department of Chemistry, College of Science, Taif University, Taif 21944, Saudi Arabia
| | - Ehab Azab
- Department of Biotechnology, College of Science, Taif University, Taif 21944, Saudi Arabia
| | - Maha Anani
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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15
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Sung JY, Kwon PS. Spreading of Aminoglycoside-Modifying Enzymes among Escherichia coli Isolated from Clinical Specimens in Chungcheong Province. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2020. [DOI: 10.15324/kjcls.2020.52.2.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong, Korea
| | - Pil Seung Kwon
- Department of Clinical Laboratory Science, Wonkwang Health Science University, Iksan, Korea
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16
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Antibiotic Resistance Profiles, Molecular Mechanisms and Innovative Treatment Strategies of Acinetobacter baumannii. Microorganisms 2020; 8:microorganisms8060935. [PMID: 32575913 PMCID: PMC7355832 DOI: 10.3390/microorganisms8060935] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 12/18/2022] Open
Abstract
Antibiotic resistance is one of the biggest challenges for the clinical sector and industry, environment and societal development. One of the most important pathogens responsible for severe nosocomial infections is Acinetobacter baumannii, a Gram-negative bacterium from the Moraxellaceae family, due to its various resistance mechanisms, such as the β-lactamases production, efflux pumps, decreased membrane permeability and altered target site of the antibiotic. The enormous adaptive capacity of A. baumannii and the acquisition and transfer of antibiotic resistance determinants contribute to the ineffectiveness of most current therapeutic strategies, including last-line or combined antibiotic therapy. In this review, we will present an update of the antibiotic resistance profiles and underlying mechanisms in A. baumannii and the current progress in developing innovative strategies for combating multidrug-resistant A. baumannii (MDRAB) infections.
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17
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Singh M, De Silva PM, Al-Saadi Y, Switala J, Loewen PC, Hausner G, Chen W, Hernandez I, Castillo-Ramirez S, Kumar A. Characterization of Extremely Drug-Resistant and Hypervirulent Acinetobacter baumannii AB030. Antibiotics (Basel) 2020; 9:antibiotics9060328. [PMID: 32560407 PMCID: PMC7345994 DOI: 10.3390/antibiotics9060328] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022] Open
Abstract
Acinetobacter baumannii is an important nosocomial bacterial pathogen. Multidrug-resistant isolates of A. baumannii are reported worldwide. Some A. baumannii isolates display resistance to nearly all antibiotics, making treatment of infections very challenging. As the need for new and effective antibiotics against A. baumannii becomes increasingly urgent, there is a need to understand the mechanisms of antibiotic resistance and virulence in this organism. In this work, comparative genomics was used to understand the mechanisms of antibiotic resistance and virulence in AB030, an extremely drug-resistant and hypervirulent strain of A. baumannii that is a representative of a recently emerged lineage of A. baumannii International Clone V. In order to characterize AB030, we carried out a genomic and phenotypic comparison with LAC-4, a previously described hyper-resistant and hypervirulent isolate. AB030 contains a number of antibiotic resistance- and virulence-associated genes that are not present in LAC-4. A number of these genes are present on mobile elements. This work shows the importance of characterizing the members of new lineages of A. baumannii in order to determine the development of antibiotic resistance and virulence in this organism.
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Affiliation(s)
- Manu Singh
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - P. Malaka De Silva
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Yasser Al-Saadi
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Jacek Switala
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Peter C. Loewen
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Georg Hausner
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Wangxue Chen
- Human Health Therapeutics, National Research Council Canada, 100 Sussex Drive, Ottawa, ON K1A 0R6, Canada;
| | - Ismael Hernandez
- Programa de Genómica Evolutiva, Centro de Ciencias Génomicas, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico; (I.H.); (S.C.-R.)
| | - Santiago Castillo-Ramirez
- Programa de Genómica Evolutiva, Centro de Ciencias Génomicas, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico; (I.H.); (S.C.-R.)
| | - Ayush Kumar
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
- Correspondence:
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18
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Vázquez-López R, Solano-Gálvez SG, Juárez Vignon-Whaley JJ, Abello Vaamonde JA, Padró Alonzo LA, Rivera Reséndiz A, Muleiro Álvarez M, Vega López EN, Franyuti-Kelly G, Álvarez-Hernández DA, Moncaleano Guzmán V, Juárez Bañuelos JE, Marcos Felix J, González Barrios JA, Barrientos Fortes T. Acinetobacter baumannii Resistance: A Real Challenge for Clinicians. Antibiotics (Basel) 2020; 9:antibiotics9040205. [PMID: 32340386 PMCID: PMC7235888 DOI: 10.3390/antibiotics9040205] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 12/21/2022] Open
Abstract
Acinetobacter baumannii (named in honor of the American bacteriologists Paul and Linda Baumann) is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients with central venous catheters. A. baumannii has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non-baumannii species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. A. baumannii can cause a variety of infections; most involve the respiratory tract, especially ventilator-associated pneumonia, but bacteremia and skin wound infections have also been reported, the latter of which has been prominently observed in the context of war-related trauma. Cases of meningitis associated with A. baumannii have been documented. The most common risk factor for the acquisition of MDR A baumannii is previous antibiotic use, following by mechanical ventilation, length of ICU/hospital stay, severity of illness, and use of medical devices. Current efforts focus on addressing all the antimicrobial resistance mechanisms described in A. baumannii, with the objective of identifying the most promising therapeutic scheme. Bacteriophage- and artilysin-based therapeutic approaches have been described as effective, but further research into their clinical use is required.
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Affiliation(s)
- Rosalino Vázquez-López
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
- Correspondence: or ; Tel.: +52-56-270210 (ext. 7302)
| | - Sandra Georgina Solano-Gálvez
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de Mexico 04510, Mexico;
| | - Juan José Juárez Vignon-Whaley
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - Jorge Andrés Abello Vaamonde
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - Luis Andrés Padró Alonzo
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - Andrés Rivera Reséndiz
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - Mauricio Muleiro Álvarez
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - Eunice Nabil Vega López
- Medical IMPACT, Infectious Diseases Department, Mexico City 53900, Mexico; (E.N.V.L.); (G.F.-K.)
| | - Giorgio Franyuti-Kelly
- Medical IMPACT, Infectious Diseases Department, Mexico City 53900, Mexico; (E.N.V.L.); (G.F.-K.)
| | - Diego Abelardo Álvarez-Hernández
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - Valentina Moncaleano Guzmán
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - Jorge Ernesto Juárez Bañuelos
- Departamento de Microbiología del Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico; (J.J.J.V.-W.); (J.A.A.V.); (L.A.P.A.); (A.R.R.); (M.M.Á.); (D.A.Á.-H.); (V.M.G.); (J.E.J.B.)
| | - José Marcos Felix
- Coordinación Ciclos Clínicos Medicina, FCS, Universidad Anáhuac México Norte, Huixquilucan 52786, Mexico;
| | - Juan Antonio González Barrios
- Laboratorio de Medicina Genómica, Hospital Regional “1º de Octubre”, ISSSTE, Av. Instituto Politécnico Nacional 1669, Lindavista, Gustavo A. Madero, Ciudad de Mexico 07300, Mexico;
| | - Tomás Barrientos Fortes
- Dirección Sistema Universitario de Salud de la Universidad Anáhuac México (SUSA), Huixquilucan 52786, Mexico;
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Özdemir R, Tuncer Y. Detection of antibiotic resistance profiles and aminoglycoside-modifying enzyme (AME) genes in high-level aminoglycoside-resistant (HLAR) enterococci isolated from raw milk and traditional cheeses in Turkey. Mol Biol Rep 2020; 47:1703-1712. [PMID: 31989429 DOI: 10.1007/s11033-020-05262-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 01/04/2020] [Accepted: 01/18/2020] [Indexed: 12/29/2022]
Abstract
The aim of this study was isolation and identification of the high-level aminoglycoside-resistant (HLAR) enterococci in raw milk and dairy products and to analyze their antibiotic resistance and the presence of aminoglycoside-modifying enzyme (AME) genes. A total of 59 HLAR enterococci were isolated from raw milk and traditional cheese samples. Thirty-nine of the 59 HLAR enterococci were isolated on streptomycin-containing agar medium, while the other 20 HLAR strains were isolated on gentamicin containing agar medium. The 59 HLAR enterococci were identified as 26 E. faecalis (44.07%), 18 E. faecium (30.51%), 13 E. durans (22.03%), and two E. gallinarum (3.39%) by species-specific PCR. Disk diffusion tests showed that teicoplanin were the most effective antibiotics used in this study, while 89.83% of isolates were found to be resistant to tetracycline. High rates of multiple antibiotic resistance were detected in HLAR isolates. Minimum inhibitory concentration (MIC) values of HLAR enterococci against streptomycin and gentamicin were found in the range of 64 to > 4096 µg/mL. Forty-seven (79.66%) of the 59 HLAR enterococci were found to be both high-level streptomycin-resistant (HLSR) and high-level gentamicin-resistant (HLGR) by MIC tests. However, no correlation was found between the results of the disk diffusion and MIC tests for gentamicin and streptomycin in some HLAR strains. The aph(3')-IIIa (94.92%) was found to be most prevalent AME gene followed by ant(4')-Ia (45.76%), ant(6')-Ia (20.34%) and aph(2'')-Ic (10.17%). None of the isolates contained the aac(6')-Ie-aph(2'')-Ia, aph(2'')-Ib or aph(2'')-Id genes. None of the AME-encoding genes were identified in E. durans RG20.1, E. faecalis RG22.4, or RG26.1. In conclusion, HLAR enterococci strains isolated in this study may act as reservoirs in the dissemination of antibiotic resistance genes.
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Affiliation(s)
- Rahime Özdemir
- Department of Food Engineering, Faculty of Engineering, Süleyman Demirel University, Isparta, Turkey
| | - Yasin Tuncer
- Department of Food Engineering, Faculty of Engineering, Süleyman Demirel University, Isparta, Turkey.
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20
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Polotto M, Casella T, Tolentino FM, Mataruco MM, Porto NKM, Binhardi MFB, Nogueira MCL. Investigation of carbapenemases and aminoglycoside modifying enzymes of Acinetobacter baumannii isolates recovered from patients admitted to intensive care units in a tertiary-care hospital in Brazil. Rev Soc Bras Med Trop 2019; 53:e20190044. [PMID: 31859941 PMCID: PMC7083385 DOI: 10.1590/0037-8682-0094-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/13/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Acinetobacter baumannii are opportunistic bacteria, highly
capable of acquiring antimicrobial resistance through the production of
carbapenemases and aminoglycoside modifying enzymes (AMEs). METHODS: Carbapenemase and AME genes were investigated in A.
baumannii recovered from inpatients of a Brazilian hospital. RESULTS: The key genes found were blaOXA-51-like, the association ISAba1- blaOXA-23-like, and the AME genes aph(3´)-VI, aac(6´)-Ib,
aac(3)-Ia, and aph(3´)-Ia. Different clusters
spread through the institution wards. CONCLUSIONS: The dissemination of blaOXA-23-like and AME-carrying A. baumannii
through the hospital highlights the need for improved preventive measures to
reduce the spread of infection.
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Affiliation(s)
- Milena Polotto
- Instituto Adolfo Lutz, Centro de Laboratório Regional de São José do Rio Preto, São José do Rio Preto, SP, Brasil.,Faculdade de Medicina de São José do Rio Preto, Centro de Investigação de Microrganismos, São José do Rio Preto, SP, Brasil
| | - Tiago Casella
- Faculdade de Medicina de São José do Rio Preto, Centro de Investigação de Microrganismos, São José do Rio Preto, SP, Brasil
| | - Fernanda Modesto Tolentino
- Instituto Adolfo Lutz, Centro de Laboratório Regional de São José do Rio Preto, São José do Rio Preto, SP, Brasil.,Faculdade de Medicina de São José do Rio Preto, Centro de Investigação de Microrganismos, São José do Rio Preto, SP, Brasil
| | | | - Naiady Konno Madela Porto
- Faculdade de Medicina de São José do Rio Preto, Centro de Investigação de Microrganismos, São José do Rio Preto, SP, Brasil
| | | | - Mara Corrêa Lelles Nogueira
- Faculdade de Medicina de São José do Rio Preto, Centro de Investigação de Microrganismos, São José do Rio Preto, SP, Brasil
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21
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Lorenzin G, Scaltriti E, Gargiulo F, Caccuri F, Piccinelli G, Gurrieri F, Caruso A, De Francesco MA. Extensively drug-resistant Acinetobacter baumannii isolated from intensive care units in northern Italy: a genomic approach to characterize new sequence types. Future Microbiol 2019; 14:1281-1292. [PMID: 31638422 DOI: 10.2217/fmb-2019-0083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: This study aims to characterize clinical strains of Acinetobacter baumannii with an extensively drug-resistant phenotype. Methods: VITEK® 2, Etest® method and broth microdilution method for colistin were used. PCR analysis and multilocus sequence typing Pasteur scheme were performed to identify bla-OXA genes and genetic relatedness, respectively. Whole-genome sequencing analysis was used to characterize three isolates. Results: All the isolates were susceptible only to polymyxins. blaOXA-23-like gene was the only acquired carbapenemase gene in 88.2% of the isolates. Multilocus sequence typing identified various sequence types: ST2, ST19, ST195, ST577 and ST632. Two new sequence types, namely, ST1279 and ST1280, were detected by whole-genome sequencing. Conclusion: This study showed that carbapenem-resistant A. baumannii isolates causing infections in intensive care units almost exclusively produce OXA-23, underlining their frequent spread in Italy.
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Affiliation(s)
- Giovanni Lorenzin
- Institute of Microbiology, Department of Molecular & Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy.,Institute of Microbiology & Virology, Department of Biomedical, Surgical & Dental Sciences, University of Milan, Italy
| | - Erika Scaltriti
- Risk Analysis & Genomic Epidemiology Unit, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Parma, Italy
| | - Franco Gargiulo
- Institute of Microbiology, Department of Molecular & Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy
| | - Francesca Caccuri
- Institute of Microbiology, Department of Molecular & Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy
| | - Giorgio Piccinelli
- Institute of Microbiology, Department of Molecular & Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy
| | - Francesca Gurrieri
- Institute of Microbiology, Department of Molecular & Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy
| | - Arnaldo Caruso
- Institute of Microbiology, Department of Molecular & Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy
| | - Maria Antonia De Francesco
- Institute of Microbiology, Department of Molecular & Translational Medicine, University of Brescia-Spedali Civili, Brescia, Italy
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22
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Zou H, He JT, He BN, Lao TY, Liu F, Guan XY. Sensitivity assessment of denitrifying bacteria against typical antibiotics in groundwater. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2019; 21:1570-1579. [PMID: 31407763 DOI: 10.1039/c9em00275h] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The effects of antibiotics on nitrate denitrification in groundwater have acquired growing concern. Denitrification is a microbially mediated process. The effects of antibiotics on denitrification were mainly reflected in denitrifying bacteria. However, little is known about the relationship between antibiotics and denitrifying bacteria. Based on this, both direct antimicrobial susceptibility testing and microbial batch-culture experiments were conducted to assess the influences of typical antibiotics on denitrifying groundwater bacteria, mainly Pseudomonas (46.17%). Denitrifying bacteria, screened from a long-term groundwater denitrification environment, were tested for sensitivity to five typical antibiotics in groundwater: sulfamethoxazole (SMX), erythromycin (ERY), enrofloxacin (ENR), clindamycin (CLI), and tetracycline (TCY). The results showed that the sensitivity of denitrifying bacteria to antibiotics is mainly related to the type and concentration of antibiotics. For antibiotic types, the order of sensitivity by quantitative assessment is ENR > TCY > SMX > ERY > CLI. Fluoroquinolones (FQs) represented by ENR were selected to explore their concentration effects. The influences on denitrifying bacteria were divided into the high concentration effect (500 μg L-1 to 100 mg L-1) and the low concentration effect (100 ng L-1 to 10 μg L-1) with about 100 μg L-1 as a boundary. Exposure to high concentrations had significant inhibitory effects on bacterial growth and exhibited dose dependency, especially for ciprofloxacin (CIP). The low concentration effect was independent of concentration, which may be stimulation or inhibition. The stimulation mainly occurred due to ENR-exposure. For inhibitory effects, Lomefloxacin (LOM) was more effective than other FQs. Especially for inhibition at ng-level exposure, LOM and norfloxacin (NOR) exposures led to the highest and lowest inhibition rates, respectively.
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Affiliation(s)
- Hua Zou
- School of Water Resources and Environment, Beijing Key Laboratory of Water Resources and Environmental Engineering, MOE Key Laboratory of Groundwater Circulation and Environmental Evolution, China University of Geosciences (Beijing), Beijing 100083, P. R. China.
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23
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Hammer P, Jordan J, Jacobs C, Klempt M. Characterization of coagulase-negative staphylococci from brining baths in Germany. J Dairy Sci 2019; 102:8734-8744. [PMID: 31421877 DOI: 10.3168/jds.2018-15610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 06/19/2019] [Indexed: 12/17/2022]
Abstract
Brining is an important step in cheese making, and using brine baths for this purpose is common practice in German dairies. Time of brining, brine concentration, and composition of the complex and heterogeneous microbiota, including coagulase-negative staphylococci (CNS), contribute to the ripening and taste of cheese. As well as producing staphylococcal enterotoxins, some CNS show antibiotic resistance; therefore, we isolated 52 strains of presumptive CNS from cheese brines from 13 factories in Germany. Species identification by sodA gene sequencing revealed that 50 isolates were CNS: 31 Staphylococcus saprophyticus, 4 Staphylococcus carnosus, 4 Staphylococcus equorum, 3 Staphylococcus sciuri, 2 Staphylococcus hominis, and 2 Staphylococcus warneri. One isolate each was identified as Staphylococcus epidermidis, Staphylococcus pasteurii, Staphylococcus succinus, and Staphylococcus xylosus. Further subtyping of the Staph. saprophyticus isolates to the subspecies level revealed the presence of 6 Staph. saprophyticus ssp. saprophyticus. Using pulsed-field gel electrophoresis with the identified Staph. saprophyticus strains, 12 independent clones were identified, resulting in the exclusion of 18 strains from further testing. In 19 of the remaining 32 CNS isolates, resistance to antibiotics was observed. Resistance was found against oxacillin (17), penicillin (5), and cefoxitin (1). Four isolates expressed resistance to both oxacillin and penicillin. No resistance was found to enrofloxacin, tetracycline, gentamicin, or erythromycin. Then, PCR analysis for antibiotic resistance genes was performed for 22 different genes. Only genes blaZ and blaTEM were found in 7 isolates. These isolates were selected for challenge tests with different concentrations of lactic acid and NaCl to examine whether expression of antibiotic resistance was influenced by these stressors. An increase in the minimal inhibitory concentration from 0 to 2.0 µg/mL was seen for trimethoprim/sulfamethoxazole only in one isolate of Staph. saprophyticus at an increased lactic acid concentration. Finally, all isolates were tested for genetic determinants (entA, entB, entC, entD, and entE) of the most common staphylococcal enterotoxins; none of these genes were detected. We found no indication for unacceptable risks originating from the isolated CNS.
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Affiliation(s)
- P Hammer
- Department of Safety and Quality of Milk and Fish Products, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, 24103 Kiel, Germany.
| | - J Jordan
- Department of Safety and Quality of Milk and Fish Products, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, 24103 Kiel, Germany
| | - C Jacobs
- Department of Safety and Quality of Milk and Fish Products, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, 24103 Kiel, Germany
| | - M Klempt
- Department of Safety and Quality of Milk and Fish Products, Max Rubner-Institut, Federal Research Institute of Nutrition and Food, 24103 Kiel, Germany
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24
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Tahbaz S, Azimi L, Lari A. Characterization of aminoglycoside resistance mechanisms in Acinetobacter Baumannii isolates from burn wound colonization. ANNALS OF BURNS AND FIRE DISASTERS 2019; 32:115-121. [PMID: 31528151 PMCID: PMC6733215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/22/2019] [Indexed: 06/10/2023]
Abstract
Clinical isolates of Acinetobacter baumannii have a tendency to develop antimicrobial resistance against commonly prescribed antimicrobial agents, including aminoglycoside agents, particularly in hospitalized patients worldwide. Resistance mechanisms of the bacterium to aminoglycosides are diverse and commonly involve production of aminoglycoside-modifying enzymes and efflux systems. The aim of this study was to investigate the frequency of gene encoding aminoglycoside-modifying enzymes and expression level of adeB efflux gene in A. baumannii isolates recovered from burn wound colonization. A total of 47 clinical isolates of A. baumannii were obtained from burned patients admitted to the Burns Teaching Hospital, Tehran, in 2018. Standard antimicrobial susceptibility screening was performed to determine resistance pattern. A polymerase chain reaction (PCR) assay was performed to determine aminoglycoside-modifying genes ACC(6'), aph(3')-Via, aph(3')-IIb, aadA1, aphA1 and aph6. Semi-quantitative RT-PCR was also carried out to quantify the expression level of the adeB gene. According to the results of the present study, the acc(6') was the predominant aminoglycoside-modifying enzyme gene (80.9%), followed by aph(3')-via, aph6, aph(3')-IIb and aphA1, which was detected in 59.6%, 42.6%, 14.9% and 14.9% of isolates, respectively. None of the A. baumannii isolates harboured the aadA1 gene. The up regulation of adeB gene expression was observed in 63.8% of strains. Moreover, we indicated that there is a relationship between adeB expression and high resistance to gentamicin. Our results revealed that aminoglycoside resistance could be explained by the production of one or a combination of known aminoglycoside-modifying enzymes rather than overexpression of adeB.
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Affiliation(s)
- S.V. Tahbaz
- Department of Microbiology, Islamic Azad University, North Tehran Branch, Tehran, Iran
| | - L. Azimi
- Pediatric Infections Research Centre, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A.R. Lari
- Department of Microbiology, Iran University of Medical Sciences, Tehran, Iran
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25
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Tolentino FM, Bueno MFC, Franscisco GR, Barcelos DDDP, Lobo SM, Tomaz FMMB, da Silva NS, de Andrade LN, Casella T, Darini ALDC, Polotto M, de Oliveira Garcia D, Nogueira MCL. Endemicity of the High-Risk Clone Klebsiella pneumoniae ST340 Coproducing QnrB, CTX-M-15, and KPC-2 in a Brazilian Hospital. Microb Drug Resist 2019; 25:528-537. [DOI: 10.1089/mdr.2018.0006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Fernanda Modesto Tolentino
- Instituto Adolfo Lutz, São José do Rio Preto, Brazil
- Universidade Estadual Paulista “Júlio de Mesquita Filho,” São José do Rio Preto, Brazil
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | | | | | - Diego Diniz de Paula Barcelos
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | - Suzana Margareth Lobo
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | - Francieli Maira Moreira Batista Tomaz
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | - Natal Santos da Silva
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
- Laboratório de Modelagens Matemática e Estatística em Medicina, União das Faculdades dos Grandes Lagos, São José do Rio Preto, São Paulo, Brazil
| | - Leonardo Neves de Andrade
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Tiago Casella
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
- Setor de Microbiologia Clínica, Laboratório Central, Hospital de Base, São José do Rio Preto, Brazil
| | - Ana Lucia da Costa Darini
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Milena Polotto
- Instituto Adolfo Lutz, São José do Rio Preto, Brazil
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
| | | | - Mara Correa Lelles Nogueira
- Centro de Investigação de Microrganismos - Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, Brazil
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26
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Abo-State MAM, Saleh YES, Ghareeb HM. Prevalence and sequence of aminoglycosides modifying enzymes genes among E.coli and Klebsiella species isolated from Egyptian hospitals. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2019. [DOI: 10.1016/j.jrras.2018.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mervat Aly Mohamed Abo-State
- Department of Radiation Microbiology, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority(EAEA), Cairo, Egypt
| | | | - Hazem Mahmmoud Ghareeb
- National Center for Nuclear Safety and Radiation, Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt
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27
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Fernández-Cuenca F, Tomás M, Caballero-Moyano FJ, Bou G, Pascual Á. Reporting antimicrobial susceptibilities and resistance phenotypes in Acinetobacter spp: a nationwide proficiency study. J Antimicrob Chemother 2019; 73:692-697. [PMID: 29244131 DOI: 10.1093/jac/dkx464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/07/2017] [Indexed: 01/30/2023] Open
Abstract
Objectives To evaluate the proficiency of Spanish microbiology laboratories with respect to the antimicrobial susceptibility testing (AST) of Acinetobacter spp. Methods Eight Acinetobacter spp. with different resistance mechanisms were sent to 48 Spanish centres which were asked to report: (i) the AST system used; (ii) MICs; (iii) breakpoints used (CLSI versus EUCAST); (iv) clinical category; and (v) resistance mechanisms inferred. Minor, major and very major errors (mE, ME and VME, respectively) were determined. Results The greatest percentages of discrepancies were: (i) by AST method: 18.5% Etest, 14.3% Vitek 2 and Sensititre; (ii) by breakpoints: 20.5% (CLSI) and 10.8% (EUCAST); and (iii) by antimicrobial agent: ampicillin/sulbactam (56.2% CLSI), minocycline (40.7% CLSI), tobramycin (38.7% CLSI, 16.8% EUCAST), imipenem (27.8% CLSI, 30.0% EUCAST) and meropenem (25.4% CLSI, 20.8% EUCAST). Categorical error rates: (i) by AST method ranged from 30.0% (Phoenix) to 100% (Sensititre and disc diffusion) for mE, 0.0% (Etest, Sensititre, disc diffusion) to 40% (Phoenix) for ME, and 0.0% (Sensititre and disc diffusion) to 30% (Phoenix) for VME; (ii) by breakpoints: mE (80.1% CLSI, 58.4% EUCAST), ME (3.5% CLSI, 12.4% EUCAST) and VME (16.4% CLSI, 29.2% EUCAST); and (iii) by antimicrobial agent: mE (100% levofloxacin/CLSI, 100% levofloxacin and meropenem/EUCAST), ME (35.3% colistin/CLSI, 25.0% colistin/EUCAST) and VME (64.7% colistin/CLSI, 86.7% gentamicin/EUCAST). Conclusions Clinical microbiology laboratories must improve their ability to determine antimicrobial susceptibilities of Acinetobacter spp. isolates. Higher discrepancies using CLSI when compared with EUCAST are mainly due to mE and to a much lesser extent to ME or VME.
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Affiliation(s)
- Felipe Fernández-Cuenca
- Unidad Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Universitario Virgen Macarena, Sevilla, Spain.,Departamento de Microbiología, Universidad de Sevilla, Sevilla, Spain.,Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla (IBIs), Sevilla, Spain
| | - María Tomás
- Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Microbiología, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.,Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - Francisco-Javier Caballero-Moyano
- Unidad Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Universitario Virgen Macarena, Sevilla, Spain.,Departamento de Microbiología, Universidad de Sevilla, Sevilla, Spain
| | - Germán Bou
- Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Microbiología, Complexo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.,Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
| | - Álvaro Pascual
- Unidad Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Universitario Virgen Macarena, Sevilla, Spain.,Departamento de Microbiología, Universidad de Sevilla, Sevilla, Spain.,Spanish Network for the Research in Infectious Diseases (REIPIRD12/0015), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla (IBIs), Sevilla, Spain
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High Prevalence of Extensively Drug-resistant Acinetobacter baumannii at a Children Hospital in Bolivia. Pediatr Infect Dis J 2018; 37:1118-1123. [PMID: 29474260 DOI: 10.1097/inf.0000000000001962] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Acinetobacter baumannii causes serious hospital-acquired infections and has been positioned as a priority organism by the World Health Organization. This study includes 36 A. baumannii isolates from a children hospital recovered between March 2014 and May 2015 in Cochabamba. The majority of the isolates were recovered from blood cultures (n = 10, 31.3%) and respiratory samples (n = 11, 34.4%); 53% of the patients were younger than 1 month old. Most of these isolates (n = 30, 80.6%) were extremely drug resistant and 8.3% were multidrug resistant. The circulation of 2 predominant clones including 25 isolates was determined by pulsed-field gel electrophoresis; 9 of the isolates were considered sporadic strains. The isolates grouped in the predominant clones and 5 of the unrelated sporadic strains were single-locus variant or double locus variant of clonal complex (CC110), belonging to international clone 7; the rest of the isolates were single-locus variant or double locus variant of another clonal complex. All the carbapenem-resistant isolates (88.9%) carried the blaOXA-23-like in a similar structure to Tn2008 located on the chromosome, and the aac(3)-IIa gene was present in all the aminoglycoside-resistant isolates (86.1%). Strong biofilm producers were found among these isolates, being the strongest ones those recovered from the hospital environment, catheter, blood and cerebrospinal fluid (CSF) all of them belonged to the unrelated sporadic strains. The present study demonstrated the predominance and spread of closely related extremely drug-resistant A. baumannii isolates, what confers increasing risk to children and is of major concern because of the kind of infections and the lack of therapeutic alternatives to treat them.
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Salimizand H, Zomorodi AR, Mansury D, Khakshoor M, Azizi O, Khodaparast S, Baseri Z, Karami P, Zamanlou S, Farsiani H, Amini Y, Moradi B, Meshkat Z, Salimizand H, Hasanzadeh S, Sadeghian H. Diversity of aminoglycoside modifying enzymes and 16S rRNA methylases in Acinetobacter baumannii and Acinetobacter nosocomialis species in Iran; wide distribution of aadA1 and armA. INFECTION GENETICS AND EVOLUTION 2018; 66:195-199. [PMID: 30292703 DOI: 10.1016/j.meegid.2018.09.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/12/2018] [Accepted: 09/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Acinetobacter baumannii-calcoaceticus complex (ABC) make a great burden on health-care systems due to hospital-acquired infections and antibacterial resistance. Aminoglycoside in combination with other antibacterials used as treatment options. However, ABC species overcome this class of antibacterials in different ways. This study provides a comprehensive report on the distribution of aminoglycoside modifying enzymes (AMEs) and 16S rRNA methylase in Acinetobacter baumannii and Acinetobacter nosocomialis isolated from various provinces in Iran. METHODS During six month of study, from eight referral centers in seven provinces across the country, Iran, 178 A. baumannii and 43 A. nosocomialis isolates were collected. The minimum inhibitory concentration of amikacin, gentamicin, netilmicin, kanamycin and tobramycin were measured by microbroth dilution method. AMEs and 16S rRNA methylase variants were sought by PCR. RESULTS High rates of resistance were seen in all centers. MIC50 and MIC90 for all A. baumannii and A. nosocomialis isolates from different centers were > 512 mg/L. The most frequent AME was ant(3″)-Ia (aadA1) in both of A. baumannii (74.1%) and A. nosocomialis (86%). armA was detected in A. baumannii and A. nosocomialis at the frequency of 41.6% and 67.4%, respectively. rmtA, B, C, D, aac(3)-Ia (aacC1) and aac(6')-Im were not detected, neither in A. baumannii nor A. nosocomialis. Moreover, aac(6')-Ih was only found in A. baumannii isolates. The distribution of some of the ARGs was limited to a definite center. CONCLUSION The overall high-level carriage of ARGs in Acinetobacter species may limited usage of this class of antibacterials as a treatment option.
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Affiliation(s)
- Himen Salimizand
- Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; Department of Microbiology, Faculty of Medicine, Kurdistan University of medical Sciences, Sanandaj, Iran
| | - Abolfazl Raafati Zomorodi
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi university of Mashhad, Mashhad, Iran
| | - Davood Mansury
- Student Research Committee, Faculty of Medicine, Mashhad, University of Medical Sciences, Mashhad, Iran; Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, Medical School, Mashhad University of medical Sciences, Mashhad, Iran
| | - Mostafa Khakshoor
- Microbiology Department, Faculty of science, Islamic Azad University of Tonekabon, Iran
| | - Omid Azizi
- Department of Laboratory Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Sepideh Khodaparast
- Department of bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Molecular laboratory, Shariati hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohre Baseri
- Molecular laboratory, Shariati hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pezhman Karami
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sajjad Zamanlou
- Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Farsiani
- Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, Medical School, Mashhad University of medical Sciences, Mashhad, Iran
| | - Yousef Amini
- Department of Microbiology, Medical school, Zahedan University of medical Sciences, Zahedan, Iran; Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Bagher Moradi
- Esfarayen University of Medical Sciences, Esfarayen, Iran
| | - Zahra Meshkat
- Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, Medical School, Mashhad University of medical Sciences, Mashhad, Iran
| | - Hana Salimizand
- Department of Biology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Sepideh Hasanzadeh
- Student Research Committee, Faculty of Medicine, Mashhad, University of Medical Sciences, Mashhad, Iran; Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, Medical School, Mashhad University of medical Sciences, Mashhad, Iran
| | - Hamid Sadeghian
- Antimicrobial Resistance Research Center, Avicenna Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Laboratory Sciences, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
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30
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Jiang H, Cao L, Shen Q, Qu L, Jiang Y, Qu T, Zhang J, Lu Y, Li B, Zhu C, Liu G, Wang R, Chen M, Wang Y, Wang Y, Feng S, Wang J, Yu Y, Wu J, Chen J. Whole-Genome Analysis of an Extensive Drug-Resistant Acinetobacter Baumannii ST195 Isolate from a Recipient After DCD Renal Transplantation in China. Kidney Blood Press Res 2017; 42:1247-1257. [PMID: 29248914 DOI: 10.1159/000485928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/03/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Infection with Acinetobacter baumannii was emerging as one of the leading causes of mortality after donation after cardiac death transpalantion. METHODS We reported a case of a recipient who underwent DCD renal transplantation and later got infected by A.baumannii. Etests were done to verify the susceptibility test results in clinic. Whole-genome analysis was applied to investigate the resistant mechanism at gene level. RESULTS The pathogen was isolated from his draining liquid the day after the surgery, and susceptibility test reavealed that it was sensitive to tigecycline. However, the isolate obtained from the draining liquid became tigecycline-resistant after fifteen-day administration of tigecycline. The Susceptibility tests showed that the pathogen recovered from tigecycline resistance and became intermediated to tigecycline. Whole-Genome analysis revealed the genetic level change leading to tigecycline resistance and we identified the location of mutation by comparing the whole genome sequence of the isolates. Three loci were figured out which may contribute to drug resistance, including genes encoding HTH domain protein, MFS transporter and AdeS. CONCLUSION Understanding the genetic characteristics associated with drug resistance mechanism and antimicrobial profiles of pathogen is important in controlling infection outbreak and preventing serious complications and gives a new insight into the development of antimicrobial agents.
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Affiliation(s)
- Hong Jiang
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Luxi Cao
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Qixia Shen
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Lihui Qu
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Yan Jiang
- Microbiology Laboratory, Sir Runrun Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Tingting Qu
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Jian Zhang
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Yingying Lu
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Bingjue Li
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Chaohong Zhu
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Guangjun Liu
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Rending Wang
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Miao Chen
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Yucheng Wang
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Yanfei Wang
- Microbiology Laboratory, Sir Runrun Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Shi Feng
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Junwen Wang
- Department of Health Sciences Research and Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Biomedical Informatics, Arizona State University, Scottsdale, Arizona, USA
| | - Yunsong Yu
- Microbiology Laboratory, Sir Runrun Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jianyong Wu
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
| | - Jianghua Chen
- Kidney Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Kidney Disease Immunology Laboratory, The Third Grade Laboratory, State Administration Of Traditional Chinese Medicine Of PR China, Hangzhou, China.,Key Laboratory of Multiple Organ Transplantation, Ministry Of Health, Hangzhou, China.,Key Laboratory of Nephropathy, Zhejiang Province, Hangzhou, China
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Complete sequences of two novel bla NDM-1-harbouring plasmids from two Acinetobacter towneri isolates in China associated with the acquisition of Tn125. Sci Rep 2017; 7:9405. [PMID: 28839253 PMCID: PMC5571222 DOI: 10.1038/s41598-017-09624-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/24/2017] [Indexed: 12/01/2022] Open
Abstract
Two novel New Delhi metallo-β-lactamase-1 (NDM-1)-positive plasmids containing a complete composite transposon, Tn125, from two respective Acinetobacter towneri isolates were characterized. Plasmid pNDM-GJ01 (30,293 bp) isolated from A. towneri G165 did not show homology to any known plasmid structure, except for the transposon Tn125 containing blaNDM-1. A novel repB gene and two XRE-type transcriptional regulators were found in pNDM-GJ01. Plasmid pNDM-GJ02 (62,011 bp) isolated from A. towneri G295 showed the highest homology to pBJAB0715 (41% coverage, 99% nucleotide identity). In addition to the blaNDM-1-harbouring transposon Tn125, pNDM-GJ02 also had an IS26-composite transposon, which contains ISCR1 and two class 1 integrons carrying different cassette arrays. Both clinical isolates were highly resistant to β-lactams and susceptible to tigecycline and colistin. Ten other resistance genes were detected in G295, and one other resistance gene was detected in G165. No transconjugant was obtained from any of the donors by broth and filter mating. The emergence of these two novel plasmids carrying NDM-1 in Acinetobacter spp., pNDM-GJ01 and pNDM-GJ02, suggests Tn125 mobile integration.
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32
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Bacot-Davis VR, Bassenden AV, Sprules T, Berghuis AM. Effect of solvent and protein dynamics in ligand recognition and inhibition of aminoglycoside adenyltransferase 2″-Ia. Protein Sci 2017; 26:1852-1863. [PMID: 28734024 DOI: 10.1002/pro.3224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/24/2017] [Accepted: 07/03/2017] [Indexed: 01/15/2023]
Abstract
The aminoglycoside modifying enzyme (AME) ANT(2″)-Ia is a significant target for next generation antibiotic development. Structural studies of a related aminoglycoside-modifying enzyme, ANT(3″)(9), revealed this enzyme contains dynamic, disordered, and well-defined segments that modulate thermodynamically before and after antibiotic binding. Characterizing these structural dynamics is critical for in situ screening, design, and development of contemporary antibiotics that can be implemented in a clinical setting to treat potentially lethal, antibiotic resistant, human infections. Here, the first NMR structural ensembles of ANT(2″)-Ia are presented, and suggest that ATP-aminoglycoside binding repositions the nucleotidyltransferase (NT) and C-terminal domains for catalysis to efficiently occur. Residues involved in ligand recognition were assessed by site-directed mutagenesis. In vitro activity assays indicate a critical role for I129 toward aminoglycoside modification in addition to known catalytic D44, D46, and D48 residues. These observations support previous claims that ANT aminoglycoside sub-class promiscuity is not solely due to binding cleft size, or inherent partial disorder, but can be controlled by ligand modulation on distinct dynamic and thermodynamic properties of ANTs under cellular conditions. Hydrophobic interactions in the substrate binding cleft, as well as solution dynamics in the C-terminal tail of ANT(2″)-Ia, advocate toward design of kanamycin-derived cationic lipid aminoglycoside analogs, some of which have already shown antimicrobial activity in vivo against kanamycin and gentamicin-resistant P. aeruginosa. This data will drive additional in silico, next generation antibiotic development for future human use to combat increasingly prevalent antimicrobial resistance.
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Affiliation(s)
- Valjean R Bacot-Davis
- McGill University, Biochemistry, 3649 Promenade Sir William Osler Room 470, Montreal, QC H3A 0G4, Canada
| | - Angelia V Bassenden
- McGill University, Biochemistry, 3649 Promenade Sir William Osler Room 470, Montreal, QC H3A 0G4, Canada
| | - Tara Sprules
- McGill University, Biochemistry, 3649 Promenade Sir William Osler Room 470, Montreal, QC H3A 0G4, Canada.,Quebec/Eastern Canada NMR Centre, Pulp & Paper Research Centre, 3420 University St. Room 023, Montreal, QC H3A 2A7, Canada
| | - Albert M Berghuis
- McGill University, Biochemistry, 3649 Promenade Sir William Osler Room 470, Montreal, QC H3A 0G4, Canada
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Distribution of Aminoglycoside Resistance Genes Among Acinetobacter Baumannii Strains Isolated From Burn Patients in Tehran, Iran. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2017. [DOI: 10.5812/pedinfect.57263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wenzler E, Goff DA, Humphries R, Goldstein EJC. Anticipating the Unpredictable: A Review of Antimicrobial Stewardship and Acinetobacter Infections. Infect Dis Ther 2017; 6:149-172. [PMID: 28260148 PMCID: PMC5446362 DOI: 10.1007/s40121-017-0149-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Indexed: 11/29/2022] Open
Abstract
Acinetobacter remains one of the most challenging pathogens in the field of infectious diseases owing primarily to the uniqueness and multiplicity of its resistance mechanisms. This resistance often leads to devastatingly long delays in time to appropriate therapy and increased mortality for patients afflicted with Acinetobacter infections. Selecting appropriate empiric and definitive antibacterial therapy for Acinetobacter is further complicated by the lack of reliability in commercial antimicrobial susceptibility testing devices and limited breakpoint interpretations for available agents. Existing treatment options for infections due to Acinetobacter are limited by a lack of robust efficacy and safety data along with concerns regarding appropriate dosing, pharmacokinetic/pharmacodynamic targets, and toxicity. Antimicrobial stewardship programs are essential to combat this unpredictable pathogen through use of infection prevention, rapid diagnostics, antibiogram-optimized treatment regimens, and avoidance of overuse of antimicrobials. The drug development pipeline includes several agents with encouraging in vitro activity against Acinetobacter, but their place in therapy and contribution to the armamentarium against this pathogen remain to be defined. The objective of this review is to highlight the unique challenge of treating infections due to Acinetobacter and summarize recent literature regarding optimal antimicrobial treatment for this pathogen. The drug development pipeline is also explored for future potentially effective treatment options.
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Affiliation(s)
- Eric Wenzler
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.
| | - Debra A Goff
- Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Romney Humphries
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Ellie J C Goldstein
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,R M Alden Research Laboratory, Santa Monica, CA, USA
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Plazomicin Activity against 346 Extended-Spectrum-β-Lactamase/AmpC-Producing Escherichia coli Urinary Isolates in Relation to Aminoglycoside-Modifying Enzymes. Antimicrob Agents Chemother 2017; 61:AAC.02454-16. [PMID: 27919895 DOI: 10.1128/aac.02454-16] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 11/29/2016] [Indexed: 11/20/2022] Open
Abstract
The activity of plazomicin and clinically relevant aminoglycosides was tested against 346 extended-spectrum-β-lactamase/AmpC-producing Escherichia coli urinary isolates, and the results were correlated with the presence of aminoglycoside-modifying enzymes (AMEs). Data showed that plazomicin was very active against all ESBL/AmpC-producing E. coli urinary isolates. Its activity was not related to the AME genes studied.
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Wang H, Wang J, Yu P, Ge P, Jiang Y, Xu R, Chen R, Liu X. Identification of antibiotic resistance genes in the multidrug-resistant Acinetobacter baumannii strain, MDR-SHH02, using whole-genome sequencing. Int J Mol Med 2016; 39:364-372. [PMID: 28035408 PMCID: PMC5358717 DOI: 10.3892/ijmm.2016.2844] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 12/07/2016] [Indexed: 01/28/2023] Open
Abstract
This study aimed to investigate antibiotic resistance genes in the multidrug-resistant (MDR) Acinetobacter baumannii (A. baumanii) strain, MDR-SHH02, using whole-genome sequencing (WGS). The antibiotic resistance of MDR-SHH02 isolated from a patient with breast cancer to 19 types of antibiotics was determined using the Kirby-Bauer method. WGS of MDR-SHH02 was then performed. Following quality control and transcriptome assembly, functional annotation of genes was conducted, and the phylogenetic tree of MDR-SHH02, along with another 5 A. baumanii species and 2 Acinetobacter species, was constructed using PHYLIP 3.695 and FigTree v1.4.2. Furthermore, pathogenicity islands (PAIs) were predicted by the pathogenicity island database. Potential antibiotic resistance genes in MDR-SHH02 were predicted based on the information in the Antibiotic Resistance Genes Database (ARDB). MDR-SHH02 was found to be resistant to all of the tested antibiotics. The total draft genome length of MDR-SHH02 was 4,003,808 bp. There were 74.25% of coding sequences to be annotated into 21 of the Clusters of Orthologous Groups (COGs) of protein terms, such as 'transcription' and 'amino acid transport and metabolism'. Furthermore, there were 45 PAIs homologous to the sequence MDRSHH02000806. Additionally, a total of 12 gene sequences in MDR-SHH02 were highly similar to the sequences of antibiotic resistance genes in ARDB, including genes encoding aminoglycoside-modifying enzymes [e.g., aac(3)-Ia, ant(2″)-Ia, aph33ib and aph(3′)-Ia], β-lactamase genes (bl2b_tem and bl2b_tem1), sulfonamide-resistant dihydropteroate synthase genes (sul1 and sul2), catb3 and tetb. These results suggest that numerous genes mediate resistance to various antibiotics in MDR-SHH02, and provide a clinical guidance for the personalized therapy of A. baumannii-infected patients.
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Affiliation(s)
- Hualiang Wang
- Department of Molecular Biology Laboratory, Shanghai Centre for Clinical Laboratory, Shanghai 200126, P.R. China
| | - Jinghua Wang
- Department of Microbiology Laboratory, Shanghai Centre for Clinical Laboratory, Shanghai 200126, P.R. China
| | - Peijuan Yu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Ping Ge
- Department of Microbiology Laboratory, Shanghai Centre for Clinical Laboratory, Shanghai 200126, P.R. China
| | - Yanqun Jiang
- Department of Clinical Laboratory, The Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200233, P.R. China
| | - Rong Xu
- Department of Microbiology Laboratory, Shanghai Centre for Clinical Laboratory, Shanghai 200126, P.R. China
| | - Rong Chen
- Department of Microbiology Laboratory, Shanghai Centre for Clinical Laboratory, Shanghai 200126, P.R. China
| | - Xuejie Liu
- Department of Microbiology Laboratory, Shanghai Centre for Clinical Laboratory, Shanghai 200126, P.R. China
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Wang Y, Shen M, Yang J, Dai M, Chang Y, Zhang C, Luan G, Ling B, Jia X. Prevalence of carbapenemases among high-level aminoglycoside-resistant Acinetobacter baumannii isolates in a university hospital in China. Exp Ther Med 2016; 12:3642-3652. [PMID: 28101158 PMCID: PMC5228107 DOI: 10.3892/etm.2016.3828] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 09/01/2016] [Indexed: 11/28/2022] Open
Abstract
The prevalence of aminoglycoside resistant enzymes has previously been reported and extended-spectrum β-lactamase among Acinetobacter baumannii. To track the risk of multidrug-resistant A. baumannii, the present study aimed to determine the prevalence of carbapenemases in high-level aminoglycoside resistant A. baumannii over two years. A total of 118 strains of A. baumannii were consecutively collected in the First Affiliated Hospital of Chengdu Medical College, Chengdu, China. These isolates were investigated on the genetic basis of their resistance to aminoglycosides. The results showed that 75 (63.56%) isolates were high-level resistant to aminoglycosides, including gentamicin and amikacin (minimum inhibitory concentration, ≥256 µg/ml). Aminoglycoside-resistant genes ant(2″)-Ia, aac(6′)-Ib, aph(3′)-Ia, aac(3)-Ia, aac(3)-IIa, armA, rmtA, rmtB, rmtC, rmtD, rmtE, rmtF, rmtG, rmtH and npmA, and carbapenem-resistant genes blaOXA-23, blaOXA-24, blaOXA-51, blaOXA-58, blaSIM, blaIMP, blaNDM-1 and blaKPC, were analyzed using polymerase chain reaction. The positive rate of ant(2″)-Ia, aac(6′)-Ib, aph(3′)-Ia, aac(3)-Ia and aac(3)-IIa was 66.95, 69.49, 42.37, 39.83 and 14.41%, respectively. armA was present in 72.0% (54/75) of A. baumannii isolates with high-level resistance to aminoglycosides. The remaining nine 16S ribosomal RNA methlyase genes (rmtA, rmtB, rmtC, rmtD, rmtE, rmtF, rmtG, rmtH and npmA) and aminoglycoside-modifying enzyme gene aac(6′)-Ib-cr were not detected. Among the 54 armA-positive isolates, the prevalence of the carbapenem resistant blaOXA-23 and blaOXA-51 genes was 79.63 and 100%, respectively. armA, ant(2″)-Ia and aac(6′)-Ib were positive in 43 isolates. The results of multilocus sequence typing revealed 31 sequence types (STs) in all clinical strains. Among these STs, the high-level aminoglycoside-resistant A. baumannii ST92, which mostly harbored blaOXA-23, was the predominant clone (29/75). In conclusion, A. baumannii harboring carbapenemases and aminoglycoside-resistant enzymes are extremely prevalent in western China, emphasizing the need to adopt surveillance programs to solve the therapeutic challenges that this presents.
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Affiliation(s)
- Yanhong Wang
- Non-Coding RNA and Drug Discovery Laboratory, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Min Shen
- Non-Coding RNA and Drug Discovery Laboratory, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Jingni Yang
- Non-Coding RNA and Drug Discovery Laboratory, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Min Dai
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Yaowen Chang
- Small Molecule Drugs Sichuan Key Laboratory, Institute of Materia Medica, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Chi Zhang
- Small Molecule Drugs Sichuan Key Laboratory, Institute of Materia Medica, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Guangxin Luan
- Non-Coding RNA and Drug Discovery Laboratory, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Baodong Ling
- Small Molecule Drugs Sichuan Key Laboratory, Institute of Materia Medica, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
| | - Xu Jia
- Non-Coding RNA and Drug Discovery Laboratory, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China
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Lim J, Lee G, Choi Y, Kim J. An Analysis of the Antibiotic Resistance Genes of Multi-Drug Resistant (MDR) Acinetobacter baumannii. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2016. [DOI: 10.15324/kjcls.2016.48.3.217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jina Lim
- Department of Biomedical Laboratory Science, Yonsei University, Wonju 26493, Korea
| | - Gyusang Lee
- MAKRI (Military National Defense) KIA Recovery and Identification), Department of Identification, Scientific Staff, Seoul 06984, Korea
| | - Yeonim Choi
- Department of Biomedical Laboratory Science, Songho College, Hoengseong 25242, Korea
| | - Jongbae Kim
- Department of Biomedical Laboratory Science, Yonsei University, Wonju 26493, Korea
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Biofilm formation in clinical isolates of nosocomial Acinetobacter baumannii and its relationship with multidrug resistance. Asian Pac J Trop Biomed 2016. [DOI: 10.1016/j.apjtb.2016.04.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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García-Salguero C, Rodríguez-Avial I, Picazo JJ, Culebras E. Can Plazomicin Alone or in Combination Be a Therapeutic Option against Carbapenem-Resistant Acinetobacter baumannii? Antimicrob Agents Chemother 2015; 59:5959-66. [PMID: 26169398 PMCID: PMC4576036 DOI: 10.1128/aac.00873-15] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 07/06/2015] [Indexed: 12/26/2022] Open
Abstract
Nosocomial pathogens can be associated with a variety of infections, particularly in intensive care units (ICUs) and in immunocompromised patients. Usually these pathogens are resistant to multiple drugs and pose therapeutic challenges. Among these organisms, Acinetobacter baumannii is one of the most frequent being encountered in the clinical setting. Carbapenems are very useful to treat infections caused by these drug-resistant Gram-negative bacilli, but carbapenem resistance is increasing globally. Combination therapy is frequently given empirically for hospital-acquired infections in critically ill patients and is usually composed of an adequate beta-lactam and an aminoglycoside. The purpose of this study was to evaluate the in vitro activity of plazomicin against carbapenem-resistant Acinetobacter baumannii. Amikacin was used as a comparator. The activity of plazomicin in combination with several different antibiotics was tested by disk diffusion, the checkerboard method, and time-kill studies. Synergy was consistently observed with carbapenems (meropenem and/or imipenem) along with plazomicin or amikacin. When the aminoglycosides were combined with other classes of antibiotics, synergy was observed in some cases, depending on the strain and the antibiotic combination; importantly, there was no antagonism observed in any case. These findings indicate the potential utility of plazomicin in combination with other antibiotics (mainly carbapenems) for the treatment of A. baumannii infections, including those caused by carbapenem-resistant isolates.
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Affiliation(s)
| | | | - Juan J Picazo
- Microbiology Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Esther Culebras
- Microbiology Department, Hospital Clínico San Carlos, Madrid, Spain
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Viehman JA, Nguyen MH, Doi Y. Treatment options for carbapenem-resistant and extensively drug-resistant Acinetobacter baumannii infections. Drugs 2015; 74:1315-33. [PMID: 25091170 DOI: 10.1007/s40265-014-0267-8] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Acinetobacter baumannii is a leading cause of healthcare-associated infections worldwide. Because of various intrinsic and acquired mechanisms of resistance, most β-lactam agents are not effective against many strains, and carbapenems have played an important role in therapy. Recent trends show many infections are caused by carbapenem-resistant or even extensively drug-resistant (XDR) strains, for which effective therapy is not well established. Evidence to date suggests that colistin constitutes the backbone of therapy, but the unique pharmacokinetic properties of colistin have led many to suggest the use of combination antimicrobial therapy. However, the combination of agents and dosing regimens that delivers the best clinical efficacy while minimizing toxicity is yet to be defined. Carbapenems, sulbactam, rifampin and tigecycline have been the most studied in the context of combination therapy. Most data regarding therapy for invasive, resistant A. baumannii infections come from uncontrolled case series and retrospective analyses, though some clinical trials have been completed and others are underway. Early institution of appropriate antimicrobial therapy is shown to consistently improve survival of patients with carbapenem-resistant and XDR A. baumannii infection, but the choice of empiric therapy in these infections remains an open question. This review summarizes the most current knowledge regarding the epidemiology, mechanisms of resistance, and treatment considerations of carbapenem-resistant and XDR A. baumannii.
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Affiliation(s)
- J Alexander Viehman
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh Medical Center, S319 Falk Medical Building, 3601 Fifth Avenue, Pittsburgh, PA, 15213, USA
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Atasoy AR, Ciftci IH, Petek M. Modifying enzymes related aminoglycoside: analyses of resistant Acinetobacter isolates. Int J Clin Exp Med 2015; 8:2874-2880. [PMID: 25932248 PMCID: PMC4402895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/06/2015] [Indexed: 06/04/2023]
Abstract
Enzymatic modification of aminoglycosides by nucleotidyltransferases, acetyltransferases and/or phosphotransferases accounts for the majority of aminoglycoside-resistant Acinetobacter isolates. In this study, we investigated the relationship between aminoglycoside resistance and the presence of aminoglycoside-modifying enzymes in Acinetobacter baumannii clinical isolate groups with different resistance profiles. Thirty-two clinical A. baumannii isolates were included in this study. Acinetobacter isolates were divided into 4 groups according to results of susceptibility testing. The presence of genes encoding the following aminoglycoside-modifying enzymes; aph (3')-V1, aph (3')-Ia, aac (3)-Ia, aac (3) IIa, aac (6')-Ih, aac (6')-Ib and ant (2')-Ia responsible for resistance was investigated by PCR in all strains. The acetyltransferase (aac (6')-Ib, aac (3)-Ia) and phosphotransferase (aph (3')-Ia) gene regions were identified in the first group, which comprised nine imipenem, meropenem, and gentamicin-resistant isolates. The acetyltransferase (aac (6')-Ib, aac (3)-Ia), phosphotransferase (aph (3')-VI) and nucleotidyltransferase (ant2-Ia) gene regions were identified in the second group, which was composed of nine imipenem-resistant, meropenem-resistant and gentamicin-sensitive isolates. The acetyltransferase (aac (3)-Ia) and phosphotransferase (aph (3')-Ia) regions were identified in the fourth group, which comprised eight imipenem-sensitive, meropenem-sensitive and gentamicin-resistant isolates. Modifying enzyme gene regions were not detected in the third group, which was composed of six imipenem, meropenem and gentamicin-sensitive isolates. Our data are consistent with previous reports, with the exception of four isolates. Both acetyltransferases and phosphotransferases were widespread in A. baumannii clinical isolates in our study. However, the presence of the enzyme alone is insufficient to explain the resistance rates. Therefore, the association between the development of resistance and the presence of the enzyme and other components should be investigated further.
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Affiliation(s)
- Ali Riza Atasoy
- Department of Medical Microbiology, Sakarya University Faculty of MedicineSakarya, Turkey
| | - Ihsan Hakki Ciftci
- Department of Medical Microbiology, Sakarya University Faculty of MedicineSakarya, Turkey
| | - Mustafa Petek
- Environmental Engineering, Fatih University Faculty of Engineeringİstanbul, Turkey
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Emergence of the first levofloxacin-resistant strains of Streptococcus agalactiae isolated in Italy. Antimicrob Agents Chemother 2015; 59:2466-9. [PMID: 25666148 DOI: 10.1128/aac.05127-14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Of 901 group B streptococcus strains analyzed, 13 (1.4%) were resistant to levofloxacin (MICs of >32 μg/ml for seven isolates, 2 μg/ml for four isolates, and 1.5 μg/ml for four isolates). Mutations in the quinolone resistance-determining regions (QRDRs) of gyrase and topoisomerase IV were identified. A double mutation involving the Ser-81 change to Leu for gyrA and the Ser-79 change to Phe or to Tyr for parC was linked to a high level of fluoroquinolone resistance. In addition, two other mutational positions in parC were observed, resulting in an Asp-83-to-Tyr substitution and an Asp-83-to-Asn substitution. Different mutations were also observed in gyrB, with unknown significance. Most levofloxacin-resistant GBS strains were of serotype Ib and belonged to sequence type 19 (ST19) and clonal complex 19 (CC-19). Most of them exhibited the epsilon gene.
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A novel New Delhi metallo-β-lactamase variant, NDM-14, isolated in a Chinese Hospital possesses increased enzymatic activity against carbapenems. Antimicrob Agents Chemother 2015; 59:2450-3. [PMID: 25645836 DOI: 10.1128/aac.05168-14] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel New Delhi metallo-β-lactamase (NDM) variant, NDM-14, was identified in clinical isolate Acinetobacter lwoffii JN49-1, which was recovered from an intensive care unit patient at a local hospital in China. NDM-14, which differs from other existing enzymes by an amino acid substitution at position 130 (Asp130Gly), possesses enzymatic activity toward carbapenems that is greater than that of NDM-1. Kinetic data indicate that NDM-14 has a higher affinity for imipenem and meropenem.
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Doi Y, Murray GL, Peleg AY. Acinetobacter baumannii: evolution of antimicrobial resistance-treatment options. Semin Respir Crit Care Med 2015; 36:85-98. [PMID: 25643273 DOI: 10.1055/s-0034-1398388] [Citation(s) in RCA: 193] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The first decade of the 20th century witnessed a surge in the incidence of infections due to several highly antimicrobial-resistant bacteria in hospitals worldwide. Acinetobacter baumannii is one such organism that turned from an occasional respiratory pathogen into a major nosocomial pathogen. An increasing number of A. baumannii genome sequences have broadened our understanding of the genetic makeup of these bacteria and highlighted the extent of horizontal transfer of DNA. Animal models of disease combined with bacterial mutagenesis have provided some valuable insights into mechanisms of A. baumannii pathogenesis. Bacterial factors known to be important for disease include outer membrane porins, surface structures including capsule and lipopolysaccharide, enzymes such as phospholipase D, iron acquisition systems, and regulatory proteins. A. baumannii has a propensity to accumulate resistance to various groups of antimicrobial agents. In particular, carbapenem resistance has become commonplace, accounting for the majority of A. baumannii strains in many hospitals today. Carbapenem-resistant strains are often resistant to all other routinely tested agents. Treatment of carbapenem-resistant A. baumannii infection therefore involves the use of combinations of last resort agents such as colistin and tigecycline, but the efficacy and safety of these approaches are yet to be defined. Antimicrobial-resistant A. baumannii has high potential to spread among ill patients in intensive care units. Early recognition and timely implementation of appropriate infection control measures is crucial in preventing outbreaks.
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Affiliation(s)
- Yohei Doi
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Gerald L Murray
- Department of Microbiology, Monash University, Melbourne, Australia
| | - Anton Y Peleg
- Department of Microbiology, Monash University, Melbourne, Australia
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Van TD, Dinh QD, Vu PD, Nguyen TV, Pham CV, Dao TT, Phung CD, Hoang HTT, Tang NT, Do NT, Nguyen KV, Wertheim H. Antibiotic susceptibility and molecular epidemiology of Acinetobacter calcoaceticus-baumannii complex strains isolated from a referral hospital in northern Vietnam. J Glob Antimicrob Resist 2014; 2:318-321. [PMID: 25540720 PMCID: PMC4270437 DOI: 10.1016/j.jgar.2014.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/12/2014] [Accepted: 05/15/2014] [Indexed: 10/28/2022] Open
Abstract
Acinetobacter calcoaceticus-baumannii complex is a common cause of hospital-acquired infections (HAIs) globally, remarkable for its high rate of antibiotic resistance, including to carbapenems. There are few data on the resistance of A. baumannii in Vietnam, which are essential for developing evidence-based treatment guidelines for HAIs. Antibiotic susceptibility testing was conducted by VITEK®2, and pulsed-field gel electrophoresis (PFGE) was performed on 66 clinical A. baumannii complex isolates recovered during 2009 at the National Hospital of Tropical Diseases (NHTD), a referral hospital in Hanoi, Vietnam. Basic demographic and clinical data were collected and analysed using descriptive statistics. Most isolates came from lower respiratory tract specimens (59; 89.4%) from intensive care unit (ICU) patients [64/65 (98.5%) with available data] who had been admitted to NHTD for ≥2 days [42/46 (91.3%) with available data]. More than 90% of the isolates were resistant to the tested β-lactamase/β-lactamase inhibitors, cephalosporins, carbapenems, fluoroquinolones and trimethoprim/sulfamethoxazole. Moreover, 25.4% (16/63) were resistant to all tested β-lactams, quinolones and aminoglycosides. All isolates remained sensitive to colistin and 58.7% were susceptible to tigecycline. Of the 66 isolates, 49 could be classified into eight PFGE types (A-H). Every PFGE type, except D, had cluster(s) of three or more isolates with a temporal relationship. In conclusion, these data suggest a significant rise in A. baumannii antibiotic resistance in Vietnam. Clustering within PFGE types supports cross-transmission of A. baumannii within the ICU at NHTD. Increased research and resources in optimising treatment, infection control and antibiotic stewardship are needed.
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Affiliation(s)
| | - Quynh-Dao Dinh
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hanoi, Viet Nam
| | - Phu Dinh Vu
- National Hospital of Tropical Diseases, Hanoi, Viet Nam
| | | | - Ca Van Pham
- National Hospital of Tropical Diseases, Hanoi, Viet Nam
| | | | - Cam Dac Phung
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | - Nga Thi Tang
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Nga Thuy Do
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hanoi, Viet Nam
| | | | - Heiman Wertheim
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, Hanoi, Viet Nam ; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK
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Aliakbarzade K, Farajnia S, Karimi Nik A, Zarei F, Tanomand A. Prevalence of Aminoglycoside Resistance Genes in Acinetobacter baumannii Isolates. Jundishapur J Microbiol 2014; 7:e11924. [PMID: 25632323 PMCID: PMC4295313 DOI: 10.5812/jjm.11924] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 08/05/2013] [Accepted: 09/10/2013] [Indexed: 11/29/2022] Open
Abstract
Background: Acinetobacter baumannii is one of the major causes of nosocomial infections and is resistant to most available antibiotics. Aminoglycosides remain as drugs of choice for treatment of Acinetobacter infections yet resistance to aminoglycosides has increased in the recent years. Objectives: The present study investigated the prevalence of genes encoding aminoglycoside-modifying enzymes in A. baumannii strains isolated from patients of Tabriz city, northwest of Iran. Materials and Methods: A total of 103 Acinetobacter isolates were collected from Imam Reza Hospital of Tabriz University of medical sciences. Antimicrobial susceptibility patterns of the isolates to different antimicrobial agents including cephalosporins, gentamicin, amikacin, tobramycin, colistin and polymyxin, were evaluated by the disc diffusion method. The frequency of aminoglycoside modifying enzymes encoding genes aacC1, aphA6, aadA1 and aadB was analyzed by the PCR method. Results: Antimicrobial susceptibility analysis showed that the highest resistance was towards beta−lactam antibiotics including cephalosporins whereas the highest sensitivity was observed towards colistin (77%) and polymyxin (84%). The resistance rate to aminoglycosides was 81%, 86% and 63% for amikacin, gentamicin and tobramycin, respectively. The PCR results showed that among the 103 A. baumannii isolates, 56 (65.11 %) were positive for aacC1, 52 (60.46 %) for aphA6, 24 (27.9 %) for aadA1 and 16 (18.6 %) for aadB resistant genes. Conclusions: The results of this study indicated that the genes encoding aminoglycoside-modifying enzymes are prevalent in A. baumannii isolates in the study region, which highlighted the necessity of considering preventive measures to control dissemination of these resistance genes.
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Affiliation(s)
- Katayun Aliakbarzade
- Department of Microbiology, Science and Research Branch, Islamic Azad University of Kerman, IR Iran
| | - Safar Farajnia
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding author: Safar Farajnia, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98−9143018589 Fax: +98-4113363231, E-mail:
| | - Ashraf Karimi Nik
- Department of Microbiology, Science and Research Branch, Islamic Azad University of Kerman, IR Iran
| | - Farzaneh Zarei
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Asghar Tanomand
- Tuberculosis and Lung Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
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Role of efflux pumps: MexAB-OprM and MexXY(-OprA), AmpC cephalosporinase and OprD porin in non-metallo-β-lactamase producing Pseudomonas aeruginosa isolated from cystic fibrosis and burn patients. INFECTION GENETICS AND EVOLUTION 2014; 24:187-92. [DOI: 10.1016/j.meegid.2014.03.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 03/09/2014] [Accepted: 03/19/2014] [Indexed: 11/21/2022]
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Carbapenem-resistant Enterobacteriaceae and Acinetobacter baumannii: assessing their impact on organ transplantation. Curr Opin Organ Transplant 2014; 15:676-82. [PMID: 20930636 DOI: 10.1097/mot.0b013e3283404373] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW This review highlights the impact of carbapenem-resistant Enterobacteriaceae and carbapenem-resistant Acinetobacter baumannii on patients who have undergone organ transplantation and explores both available and potential agents to treat infections caused by these multidrug-resistant (MDR) pathogens. RECENT FINDINGS Few antimicrobials exist to treat carbapenem-resistant Gram-negative infections, and resistance to salvage therapies is escalating. Organ transplantation appears to be a risk factor for infections with Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae. Isolation of these MDR bacteria is increasing and may be associated with allograft failure and mortality. In the majority of cases, aminoglycosides, polymyxins, and tigecycline have been employed to treat these infections. Anecdotal successes exist but these antibiotics may be unreliable. Few novel agents are in development. SUMMARY Bacterial infections remain a leading cause of posttransplantation morbidity and mortality. Carbapenem resistance is a significant threat to allograft and patient survival. With few antimicrobials being developed, transplant centers may be forced to make decisions regarding surveillance, empiric antimicrobial regimens, and transplant candidacy in the setting of carriage of MDR pathogens. There is an urgent need for collaborative studies to address the clinical impact of these infections on transplantation.
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Antibiotic resistance and expression of resistance-nodulation-division pump- and outer membrane porin-encoding genes in Acinetobacter species isolated from Canadian hospitals. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2014; 24:17-21. [PMID: 24421787 DOI: 10.1155/2013/696043] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Bacterial pathogens belonging to the genus Acinetobacter cause serious infections in immunocompromised individuals that are very difficult to treat due to their extremely high resistance to many antibiotics. OBJECTIVE To investigate the role of resistance-nodulation-division (RND) pumps and porins in the antibiotic resistance of Acinetobacter species collected from Canadian hospitals. METHODS Clinical isolates of Acinetobacter species collected from Canadian hospitals were analyzed for the expression of genes encoding RND pumps (adeB, adeG, adeJ, AciBau_2746 and AciBau_2436) and outer membrane porins (carO, 33 kDa porin and oprD) using quantitative reverse transcription (qRT) polymerase chain reaction. Species identification of the isolates was performed using a multiplex polymerase chain reaction method for gyrB. RESULTS The expression of RND pump-encoding genes was widespread in the clinical isolates of Acinetobacter species, with each of the isolates expressing at least one RND pump. adeG was found to be overexpressed in all of the isolates, while adeB was found to be overexpressed in only two isolates. Among the porin-encoding genes, the expression of carO was considerably downregulated among the majority of isolates. CONCLUSION The present study was the first to analyze the expression of RND pump- and porin-encoding genes in the clinical isolates of Acinetobacter species from Canadian hospitals. The overexpression of genes encoding RND pumps and the downregulation of genes encoding porins was common in clinical isolates of Acinetobacter species from Canadian hospitals, with the AdeFGH pump being the most commonly expressed RND pump.
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