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Rao S, Linke L, Magnuson R, Jaunch L, Hyatt DR. Antimicrobial resistance and genetic diversity of Staphylococcus aureus collected from livestock, poultry and humans. One Health 2022; 15:100407. [PMID: 36277090 PMCID: PMC9582408 DOI: 10.1016/j.onehlt.2022.100407] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/13/2022] [Accepted: 06/05/2022] [Indexed: 10/30/2022] Open
Abstract
Staphylococcus aureus is one of the most prominent nosocomial, community and farm acquired bacterial infections among animals and human populations. The main purpose of our study was to identify and characterize antimicrobial resistance (AMR) among Staphylococcus aureus isolated from livestock, poultry and humans and to further identify the associated genes. Staphylococcus aureus isolates from human, bovine, swine and poultry were collected from different laboratories across the United States collected between 2003 and 2016. Antimicrobial susceptibility testing for 13 antimicrobials was performed and conventional PCR was used to detect the presence of the nuc gene, mec gene, and to detect int1 gene. Associations between the presence of mec and intl and specific AMR profiles were determined. Antimicrobial resistance was detected in all four host categories, with the highest overall rates found in swine, 100% resistant to tetracycline, 88% to penicillin and 64% clindamycin. The next highest was found among humans with 81.6% of isolates resistant to penicillin followed by 44% to clindamycin and 43% to erythromycin. Among beef cattle isolates, 63.2% were resistant to penicillin, 15.8% resistant to clindamycin and 15.8% to erythromycin. No isolates from any of the hosts were resistant to linezolid. Among poultry isolates, the highest AMR was found to clindamycin, followed by erythromycin and penicillin. Among dairy cattle, highest resistance was found to penicillin, followed by chloramphenicol and gentamicin. Dairy cattle were the only host category with isolates that are resistant to trimethoprim-sulfamethoxazole. Of the 220 isolates detected by latex agglutination, 217 were confirmed to be S. aureus via PCR of the nuc gene, 21.4% were positive for the mecA gene. Swine had the highest prevalence of the mecA gene, followed by humans, poultry and beef cattle. This study has demonstrated a high occurrence of penicillin resistance among all S. aureus isolates. There were differences observed between host species with tetracycline resistance being the highest among swine isolates and clindamycin being highest in poultry isolates. No detection of oxacillin resistance was found in isolates from dairy cattle but was found in isolates from all of the other host species, 94% of which contained the mecA gene. High occurrence of penicillin resistance in Staphylococcus aureus isolates collected from livestock, poultry and humans. Tetracycline resistance was the highest among swine isolates and clindamycin was the highest in poultry isolates. Oxacillin resistance was not detected among dairy cattle isolates but was found in isolates from other host species. Ninety four percent of the S. aureus isolates were resistant to oxacillin contained the mecA gene.
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Begmatov S, Beletsky AV, Gruzdev EV, Mardanov AV, Glukhova LB, Karnachuk OV, Ravin NV. Distribution Patterns of Antibiotic Resistance Genes and Their Bacterial Hosts in a Manure Lagoon of a Large-Scale Swine Finishing Facility. Microorganisms 2022; 10:2301. [PMID: 36422370 PMCID: PMC9692488 DOI: 10.3390/microorganisms10112301] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/01/2022] [Accepted: 11/16/2022] [Indexed: 08/26/2023] Open
Abstract
The spread of antibiotic resistance genes (ARGs) that are present in livestock manures, which are discharged into the environment, is a severe threat to human and animal health. Here, we used 16S rRNA gene profiling and metagenomic analysis to characterize microbial community composition and antibiotic resistance in a manure storage lagoon from a large-scale swine finishing facility. Manure samples were collected at intervals of two years. Both the prokaryotic community and the resistome were dominated by the Firmicutes, Proteobacteria and Bacteroidota. Metagenomic analysis of two samples revealed 726 and 641 ARGs classified into 59 and 46 AMR gene families. Besides multidrug efflux pumps, the predominating ARGs potentially encoded resistance to tetracyclines, macrolide-lincosamide-streptogramin, aminoglycosides, peptide antibiotics, rifamycin, chloramphenicol, and beta-lactams. Genes from all predominant AMR gene families were found in both samples indicating overall long-term stability of the resistome. Antibiotic efflux pumps were the primary type of ARGs in the Proteobacteria, while antibiotic target alteration or protection was the main mechanism of resistance in the Firmicutes, Actinobacteriota and Bacteroidota. Metagenome-assembled genomes (MAG) of four multidrug-resistant strains were assembled. The first MAG, assigned to Escherichia flexneri, contained 46 ARGs, including multidrug efflux pumps, modified porins, beta-lactamases, and genes conferring resistance to peptide antibiotics. The second MAG, assigned to the family Alcaligenaceae, contained 18 ARGs encoding resistance to macrolide-lincosamide-streptogramin, tetracyclines, aminoglycosides and diaminopyrimidins. Two other MAGs representing the genera Atopostipes and Prevotella, contained four and seven ARGs, respectively. All these MAGs represented minor community members and accounted for less than 0.3% of the whole metagenome. Overall, a few lineages originated from the gut but relatively rare in the manure storage lagoon, are the main source of ARGs and some of them carry multiple resistance determinants.
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Affiliation(s)
- Shahjahon Begmatov
- Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, 119071 Moscow, Russia
| | - Alexey V. Beletsky
- Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, 119071 Moscow, Russia
| | - Eugeny V. Gruzdev
- Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, 119071 Moscow, Russia
| | - Andrey V. Mardanov
- Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, 119071 Moscow, Russia
| | - Lubov B. Glukhova
- Laboratory of Biochemistry and Molecular Biology, Tomsk State University, 634050 Tomsk, Russia
| | - Olga V. Karnachuk
- Laboratory of Biochemistry and Molecular Biology, Tomsk State University, 634050 Tomsk, Russia
| | - Nikolai V. Ravin
- Institute of Bioengineering, Research Center of Biotechnology of the Russian Academy of Sciences, 119071 Moscow, Russia
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Afroze F, Das SK, Ahmed S, Sarmin M, Shaly NJ, Khan SH, Shahid ASMSB, Shahrin L, Saha H, Alam T, Faruque ASG, Shahunja KM, Chisti MJ, Ahmed T. Pathogen-specific risk of seizure in children with moderate-to-severe diarrhoea: Case control study with follow-up. Trop Med Int Health 2020; 25:1032-1042. [PMID: 32428974 DOI: 10.1111/tmi.13445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the pathogen-specific risk of seizure in under-five children hospitalised with moderate-to-severe diarrhoea (MSD) in rural settings. METHOD This was a prospective case-control study with follow-up, conducted in a sentinel facility of Global Enteric Multicenter Study in Mirzapur, a rural community of Bangladesh between 2007 and 2010. Children aged 0-59 months who presented with MSD and seizure constituted the cases whereas those who did not have seizure comprised the controls. MSD was defined if the episodes were associated with dehydration or dysentery or required hospitalisation with diarrhoea or dysentery. All enrolled children were followed up at home within 50-90 days of enrolment. A total of 64 cases and 128 randomly selected controls formed the analysable dataset. RESULTS The result of logistic regression analysis after adjusting for potential confounders revealed that shigellosis (Shigella species, OR = 5.34, 95% CI = 2.37-12.04) particularly S. flexneri (OR = 3.34, 95% CI = 1.48-7.57), S. flexneri 6 (OR = 23.24, 95% CI = 2.79-193.85), S. sonnei (OR = 6.90, 95% CI = 2.34-19.85); norovirus (OR = 6.77, 95% CI = 1.69-27.11), fever (OR = 16.75, 95% CI = 1.81-154.70) and loss of consciousness (OR = 35.25, 95% CI = 1.71-726.20) were the independent risk factors for seizure in MSD children. At enrolment, cases had lower WHZ (P = 0.006) compared to their peers, follow-up anthropometrics showed significant improvement in WHZ (P < 0.001) and WAZ (P < 0.05), whereas deterioration in HAZ (P < 0.001) in both cases and controls. CONCLUSION Childhood MSD episodes particularly due to Shigella and norovirus are often associated with seizure. Prompt identification and appropriate management of children with shigellosis may reduce occurrence and adverse consequences of seizure linked with MSD.
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Affiliation(s)
- Farzana Afroze
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sumon Kumar Das
- Mater Medical Research Institute, South Brisbane, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | | | - Monira Sarmin
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nusrat Jahan Shaly
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Soroar Hossain Khan
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Lubaba Shahrin
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Haimanti Saha
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tahmina Alam
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Abu Syed Golam Faruque
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Mohammod Jobayer Chisti
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition & Clinical Services Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Jahanbin F, Marashifard M, Jamshidi S, Zamanzadeh M, Dehshiri M, Malek Hosseini SAA, Khoramrooz SS. Investigation of Integron-Associated Resistance Gene Cassettes in Urinary Isolates of Klebsiella pneumoniae in Yasuj, Southwestern Iran During 2015-16. Avicenna J Med Biotechnol 2020; 12:124-131. [PMID: 32431797 PMCID: PMC7229451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Growing antibiotic resistance among urinary opportunistic pathogens such as Klebsiella pneumoniae (K. pneumonia) has created a worrisome condition in the treatment of the Urinary Tract Infections (UTIs) in recent years. Integrons play a significant role in the dissemination of antibiotic resistance genes. The present study was conducted to investigate class 1-3 integrons and the corresponding resistance gene cassettes in urinary K. pneumoniae isolates. METHODS In this study, from December 2015 to September 2016, a total of 196 K. pneumoniae isolates were collected from the patients with UTI referred to medical diagnostic laboratories in Yasouj, Southwestern Iran. Antibiotic susceptibility patterns of isolates were determined using 12 antibiotics by the disc diffusion method. Polymerase Chain Reaction (PCR) was used for detection of integron genes (intI1, intI2, and intI3). The variable regions of integrons were amplified by PCR and sequenced to identify the corresponding gene cassettes. RESULTS Thirty-nine different antibiotic resistance profiles were observed among K. pneumoniae isolates. Only 12.2% of K. pneumoniae isolates were found to harbor the intI1 gene. While 17 (60.7%) out of 28 Multidrug Resistance (MDR) K. pneumoniae isolates carried the intI1 gene, only 4.2% of non-MDR isolates harbored intI1 gene. Totally 7 different gene cassette arrays were found in the intI1 gene of K. pneumoniae isolates. The aadA1 was the most prominent gene cassette. Also, high frequency of dfrA containing gene cassettes was observed. CONCLUSION Continuous monitoring and characterization of integrons and their associated gene cassettes could be helpful in controlling the rising rate of antibiotic resistance.
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Affiliation(s)
- Fariba Jahanbin
- Department of Basic Sciences, Islamic Azad University, Yasuj Branch, Yasuj, Iran
| | - Masoud Marashifard
- Treatment Management of Social Security Organization of Kohgiluyeh and Boyer-Ahmad Province, Yasuj, Iran
| | - Sanaz Jamshidi
- Department of Basic Sciences, Islamic Azad University, Yasuj Branch, Yasuj, Iran
| | - Maryam Zamanzadeh
- Department of Basic Sciences, Islamic Azad University, Yasuj Branch, Yasuj, Iran
| | - Masumeh Dehshiri
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Seyed Sajjad Khoramrooz
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran, Department of Microbiology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran,Corresponding author: Seyed Sajjad Khoramrooz, Ph.D., Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran, Tel/Fax: +98 743 323 5153, E-mail: ,
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Resistance characteristics of CTX-M type Shigella flexneri in China. Biosci Rep 2019; 39:BSR20191741. [PMID: 31519769 PMCID: PMC6757185 DOI: 10.1042/bsr20191741] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/28/2019] [Accepted: 09/11/2019] [Indexed: 11/17/2022] Open
Abstract
The present study was to identify the drug resistance, resistance mechanism and the extended-spectrum β-lactamase (ESBLs) genotypes of Shigella flexneri (S. flexneri) in Jinan. Susceptibility tests were performed by MIC-determination. The genotypes of β-lactamase were identified using PCR and DNA sequencing. The resistance transfer ability of the ESBL-producing strains was examined by conjugation tests. A total of 105 S. flexneri isolates were collected, and 34 (32.4%) were ESBL-producing isolates. All ESBL-producing isolates were susceptible to cefoxitin and imipenem, and 35.3% isolates were resistant to ciprofloxacin. ESBL-producing isolates showed high level resistant to ampicillin (100%), cefotaxime (100%), tetracycline (100%), chloramphenicol (100%), trimethoprim/sulfamethoxazole (100%), ceftazidime (73.5%) and cefepime (73.5%). Three types of β-lactamase genes (blaTEM, blaOXA and blaCTX-M) were identified in all ESBL-producing isolates, and the genotypes were confirmed as blaTEM-1 (23/34), blaOXA-30 (34/34), blaCTX-M-14 (9/34) and blaCTX-M-15 (25/34) by sequencing. In conclusion, the Shigella strains isolated in Jinan are cross-resistant and multi-drug resistant. The main genotypes of ESBLs are CTX-M-14 and CTX-M-15.
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Kang H, Wang L, Li Y, Lu Y, Fan W, Bi R, Qian H, Gu B. Dissemination of Multidrug-Resistant Shigella flexneri and Shigella sonnei with Class 1, Class 2, and Atypical Class 1 Integrons in China. Microb Drug Resist 2019; 25:1465-1474. [PMID: 31369341 DOI: 10.1089/mdr.2018.0229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Emergence of multidrug-resistant Shigella, a major causative agent of bacterial dysentery, has generated many concerns not only in China but also worldwide. However, the prevalence of Shigella resistance caused by integron in the nonpopular season of diarrhea is not clear. Materials and Methods: Thirty-one Shigella flexneri and 22 Shigella sonnei samples collected in December 2010 from 10 cities of China were characterized for antimicrobial susceptibility, gene cassettes, widespread of integrons, and pulsed-field gel electrophoresis (PFGE) profile. Results: Multidrug resistance (MDR) was detected in 29 (93.5%) S. flexneri and 20 (90.9%) S. sonnei isolates. Class 1 integrons were detected in 25 (80.6%) S. flexneri and in 13 (59.1%) S. sonnei isolates; class 2 integrons were detected in 26 (83.9%) S. flexneri and in 19 (86.4%) S. sonnei isolates. Interestingly, the atypical class 1 integrons were mostly detected in S. flexneri (45.2%) isolates, whereas in only 1 (4.5%) S. sonnei isolate. DNA sequencing revealed two novel cassette arrays, dfrA5 and aacA4-cmlA, of class 1 integrons in S. flexneri, and dfrA17-aadA5 in S. sonnei isolates. The cassette arrays, dfrA1-sat1-aadA1 of class 2 integron and blaoxa-30-aadA1 of atypical class 1 integron, were also identified. PFGE profiles demonstrated A6 subtype of S. flexneri strains prevalent in Shanghai, Changchun, Jinan, and Changsha; and F6 subtype of S. sonnei prevalent in Jinan, Changchun, and Shanghai. Conclusion: The dissemination of MDR Shigella strains with integrons makes it an increasing public health problem in China. Increased surveillance and the development of adequate prevention strategies are warranted.
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Affiliation(s)
- Haiquan Kang
- Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Lei Wang
- Department of Histology and Embryology, Xuzhou Medical University, Xuzhou, China
| | - Yun Li
- Institute of Clinical Pharmacology, The First Hospital, Peking University, Beijing, China
| | - Yuan Lu
- Institute of Clinical Pharmacology, The First Hospital, Peking University, Beijing, China
| | - Wenting Fan
- Medical Technology School, Xuzhou Medical University, Xuzhou, China
| | - Ruru Bi
- Medical Technology School, Xuzhou Medical University, Xuzhou, China
| | - Huimin Qian
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Bing Gu
- Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.,Medical Technology School, Xuzhou Medical University, Xuzhou, China
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Kaushik M, Kumar S, Kapoor RK, Gulati P. Integrons and antibiotic resistance genes in water-borne pathogens: threat detection and risk assessment. J Med Microbiol 2019; 68:679-692. [DOI: 10.1099/jmm.0.000972] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Megha Kaushik
- Medical Microbiology and Bioprocess Technology Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, Haryana 124001, India
| | - Sanjay Kumar
- Medical Microbiology and Bioprocess Technology Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, Haryana 124001, India
| | - Rajeev Kr. Kapoor
- Enzyme Biotechnology Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, Haryana 124001, India
| | - Pooja Gulati
- Medical Microbiology and Bioprocess Technology Laboratory, Department of Microbiology, Maharshi Dayanand University, Rohtak, Haryana 124001, India
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Integrons in Enterobacteriaceae: diversity, distribution and epidemiology. Int J Antimicrob Agents 2017; 51:167-176. [PMID: 29038087 DOI: 10.1016/j.ijantimicag.2017.10.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/29/2017] [Accepted: 10/07/2017] [Indexed: 01/03/2023]
Abstract
Integrons are versatile gene acquisition systems that allow efficient capturing of exogenous genes and ensure their expression. Various classes of integrons possessing a wide variety of gene cassettes are ubiquitously distributed in enteric bacteria worldwide. The epidemiology of integrons associated multidrug resistance in Enterobacteriaceae is rapidly evolving. In the past two decades, the incidence of integrons in enteric bacteria has increased drastically with evolution of multiple gene cassettes, novel gene arrangements and complex chromosomal integrons such as Salmonella genomic islands. This review focuses on the distribution, versatility, spread and global trends of integrons among important members of the Enterobacteriaceae, including Escherichia coli, Klebsiella, Shigella and Salmonella, which are known to cause infections globally. Such a comprehensive understanding of integron-associated antibiotic resistance, their role in the spread of such resistance traits and their clinical relevance especially with regard to each genus individually is paramount to contain the global spread of antibiotic resistance.
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Gu B, Xu T, Kang H, Xu Y, Liu G, Pan S, Qian H, Ma P. A 10-year surveillance of antimicrobial susceptibility patterns in Shigella sonnei isolates circulating in Jiangsu Province, China. J Glob Antimicrob Resist 2017; 10:29-34. [PMID: 28606485 PMCID: PMC7103933 DOI: 10.1016/j.jgar.2017.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 02/19/2017] [Accepted: 03/06/2017] [Indexed: 11/30/2022] Open
Abstract
Long-term multicentre surveillance of antimicrobial susceptibility patterns in Shigella sonnei. Epidemic clones and integron types and resistance gene cassettes were characterised. PFGE indicated large-scale clonal transmission among different cities occurred several times during 10 years. Class 1, 2 and atypical class 1 integrons were detected in S. sonnei. High prevalence of integrons and gene cassettes was related to the increasing antimicrobial resistance.
Objectives The rapid emergence of drug-resistant Shigella sonnei is a serious public health problem. This study aimed to characterise the antimicrobial resistance patterns, molecular subtypes, and integron types and resistance gene cassettes in S. sonnei from Jiangsu Province, China. Methods In total, 340 S. sonnei were collected in 2002–2011 throughout Jiangsu Province. Antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE), PCR amplification of integrons, restriction fragment length polymorphism (RFLP) and DNA sequencing of cassette regions were performed. Results Resistance rates to ampicillin (67.7%), nalidixic acid (75.2%), tetracycline (73.7%) and trimethoprim/sulfamethoxazole (68.7%) remained high. Strains from Centre and South Jiangsu showed higher resistance and multiresistance rates compared with the North. PFGE analysis indicated that large-scale clonal transmission among different cities occurred several times during 10 years. Among all strains, 55.9% (190/340) harboured class 1 integrons, 80.3% (273/340) harboured class 2 integrons and 49.4% (168/340) harboured an atypical class 1 integron. Resistance rates to nine antimicrobials in the class 1 integron-positive group were significantly higher than in the negative group (P < 0.05). Seven different gene cassettes were detected in class 1 integrons. The most prevalent type was aacA4–cmlA1 (114/286). Class 2 integrons carried the gene cassette array dfrA1–sat1–aadA1, and the atypical class 1 integron carried blaOXA-30–aadA1. Conclusions The increasing antimicrobial resistance and significant clonal transmission of S. sonnei circulating in Jiangsu were closely related to the high prevalence of integrons and gene cassettes. Long-term cross-regional monitoring of antimicrobial resistance is urgently required for S. sonnei.
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Affiliation(s)
- Bing Gu
- Medical Technology Institute of Xuzhou Medical University, Xuzhou 221004, China; Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Ting Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Haiquan Kang
- Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Yanling Xu
- Department of General Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Genyan Liu
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Shiyang Pan
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Huimin Qian
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China.
| | - Ping Ma
- Medical Technology Institute of Xuzhou Medical University, Xuzhou 221004, China; Department of Laboratory Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China.
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Afroze F, Ahmed T, Sarmin M, SMSB Shahid A, Shahunja KM, Shahrin L, Chisti MJ. Risk factors and outcome of Shigella encephalopathy in Bangladeshi children. PLoS Negl Trop Dis 2017; 11:e0005561. [PMID: 28453565 PMCID: PMC5425222 DOI: 10.1371/journal.pntd.0005561] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 05/10/2017] [Accepted: 04/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although, Shigella encephalopathy, a serious extra-intestinal complication of shigellosis, significantly increases the risks of death, data are very limited on predicting factors particularly related to electrolyte profiles in children below five years of age with Shigella encephalopathy. Our objective was to determine the clinical as well as laboratory predicting factors and outcome of children with Shigella encephalopathy. METHODOLOGY/PRINCIPAL FINDINGS In this unmatched case-control design, children aged 2-59 months having a positive stool culture for Shigella and who had their serum electrolytes been done from July 2012 to June 2015 were studied. Children with Shigella encephalopathy, defined as having abnormal mentation, constituted the cases, and those without encephalopathy constituted the controls. During the study period, we identified a total of 541 children less than five years of age, who had Shigella in their stool culture. Only 139 children fulfilled the study criteria and among them 69 were cases and 70 were controls. The cases more often had fatal outcome compared to the controls (7% vs. 0%, P = 0.02). In logistic regression analysis, the cases were independently associated with shorter duration (1.2 ± 0.4 days) of diarrhea prior to admission, dehydrating diarrhea, sepsis and hyponatremia (p<0.05 for all). Among 139 Shigella isolates, S. flexneri (88/139, 63%) and S. sonnei(34/139, 24%) were the dominant species. S. dysenteriae was not isolated throughout the study period. S.sonnei was more frequently isolated from the cases (24/69, 35%) than the controls (10/70, 14%), whereas the isolation of S. flexneri was comparable between the groups (40/69, 58% vs 48/70, 69%). A total of 94 (67.6%) isolates were resistant to trimethoprim-sulphamethoxazole, 84 (60.4%) to ciprofloxacin, 66/138 (48%) to ampicillin, 5 (3.5%) to ceftriaxone, 17 (12.2%) to mecillinum and 35 (25%) to azithromycin. CONCLUSIONS/SIGNIFICANCE The case-fatality-rate was significantly higher among the children with Shigella encephalopathy compared to those without encephalopathy. Early identification and aggressive management of simple risk factors for Shigella encephalopathy may help to reduce morbidity and deaths in such children especially in resource-limited settings.
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Affiliation(s)
- Farzana Afroze
- Nutrition & Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition & Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Monira Sarmin
- Nutrition & Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abu SMSB Shahid
- Nutrition & Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - K. M. Shahunja
- Nutrition & Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Lubaba Shahrin
- Nutrition & Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- Nutrition & Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- * E-mail:
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Falco A, Ramos Y, Franco E, Guzmán A, Takiff H. A cluster of KPC-2 and VIM-2-producing Klebsiella pneumoniae ST833 isolates from the pediatric service of a Venezuelan Hospital. BMC Infect Dis 2016; 16:595. [PMID: 27770796 PMCID: PMC5075218 DOI: 10.1186/s12879-016-1927-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 10/12/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Klebsiella pneumoniae is a bacterial pathogen that has developed resistance to multiple antibiotics and is a major cause of nosocomial infections worldwide. Carbapenemase-producing Klebsiella pneumoniae have been isolated in many hospitals in Venezuela, but they have not been well-studied. The aim of this study was to characterize carbapenem-resistant Klebsiella pneumoniae isolates from the pediatric service of a hospital located in Anzoategui State, in the eastern part of Venezuela. METHODS Nineteen Klebsiella pneumoniae strains isolated in the hospital from April to July 2014 were evaluated phenotypically and molecularly for the presence of carbapenemases blaKPC, blaIMP and blaVIM. Molecular epidemiology was performed with Repetitive Extragenic Palindromic-PCR (REP-PCR) and Multilocus Sequence Typing (MLST). They were also studied for phenotypic and molecular resistance to a quaternary ammonium compound (QAC) disinfectant. RESULTS All 19 isolates contained both bla VIM-2 and bla KPC-2 genes, and the bla KPC-2 gene was associated with Tn4401b. All isolates were phenotypically sensitive to QACs and contained qacΔE and addA2 genes typical of class 1 integrons. Analysis by REP-PCR and MLST showed that all isolates had identical profiles characteristic of sequence type ST833. CONCLUSION All 19 strains are bla VIM-2 and bla KPC-2-producing ST833 K. pneumoniae sensitive to QACs. This analysis may help to understand the routes of dissemination and confirms that QAC disinfectants can be used to help control their spread.
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Affiliation(s)
- Aura Falco
- Laboratorio de Genética Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela
| | - Yusibeska Ramos
- Laboratorio B, Dirección de Energía y Ambiente, Instituto de Estudios Avanzados, Caracas, Venezuela
| | - Esther Franco
- Servicio de Laboratorio Clínico del anexo pediátrico "Dr. Rafael Tobías Guevara" del Complejo Hospitalario Universitario "Dr. Luis Razetti", Barcelona, Venezuela
| | - Alegría Guzmán
- Servicio de Laboratorio Clínico del anexo pediátrico "Dr. Rafael Tobías Guevara" del Complejo Hospitalario Universitario "Dr. Luis Razetti", Barcelona, Venezuela
| | - Howard Takiff
- Laboratorio de Genética Molecular, Centro de Microbiología y Biología Celular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela.
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Barbu EM, Cady KC, Hubby B. Phage Therapy in the Era of Synthetic Biology. Cold Spring Harb Perspect Biol 2016; 8:cshperspect.a023879. [PMID: 27481531 DOI: 10.1101/cshperspect.a023879] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
For more than a century, bacteriophage (or phage) research has enabled some of the most important discoveries in biological sciences and has equipped scientists with many of the molecular biology tools that have advanced our understanding of replication, maintenance, and expression of genetic material. Phages have also been recognized and exploited as natural antimicrobial agents and nanovectors for gene therapy, but their potential as therapeutics has not been fully exploited in Western medicine because of challenges such as narrow host range, bacterial resistance, and unique pharmacokinetics. However, increasing concern related to the emergence of bacteria resistant to multiple antibiotics has heightened interest in phage therapy and the development of strategies to overcome hurdles associated with bacteriophage therapeutics. Recent progress in sequencing technologies, DNA manipulation, and synthetic biology allowed scientists to refactor the entire bacterial genome of Mycoplasma mycoides, thereby creating the first synthetic cell. These new strategies for engineering genomes may have the potential to accelerate the construction of designer phage genomes with superior therapeutic potential. Here, we discuss the use of phage as therapeutics, as well as how synthetic biology can create bacteriophage with desirable attributes.
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Affiliation(s)
| | - Kyle C Cady
- Synthetic Genomics, La Jolla, California 92037
| | - Bolyn Hubby
- Synthetic Genomics, La Jolla, California 92037
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Miranda A, Ávila B, Díaz P, Rivas L, Bravo K, Astudillo J, Bueno C, Ulloa MT, Hermosilla G, Del Canto F, Salazar JC, Toro CS. Emergence of Plasmid-Borne dfrA14 Trimethoprim Resistance Gene in Shigella sonnei. Front Cell Infect Microbiol 2016; 6:77. [PMID: 27489797 PMCID: PMC4951496 DOI: 10.3389/fcimb.2016.00077] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 07/05/2016] [Indexed: 11/24/2022] Open
Abstract
The most common mechanism of trimethoprim (TMP)-resistance is the acquisition of dihydrofolate reductase enzyme resistant to this drug. Previous molecular characterization of TMP-genes resistance in Chilean isolates of Shigella sonnei searching for dfrA1 and dfrA8, showed solely the presence of dfrA8 (formerly dhfrIIIc). However, these genetic markers were absent in S. sonnei strains further isolated during an outbreak in 2009. To identify the TMP-resistance gene in these strains, a genomic DNA library from a TMP-resistant (TMPR) S. sonnei representative strain for the outbreak was used to clone, select and identify a TMP-resistance marker. The TMPR clone was sequenced by primer walking, identifying the presence of the dfrA14 gene in the sul2-strA'-dfrA14-‘strA-strB gene arrangement, harbored in a native 6779-bp plasmid. The same plasmid was isolated by transforming with a ~4.2 MDa plasmid extracted from several TMPRS. sonnei strains into Escherichia coli. This plasmid, named pABC-3, was present only in dfrA14-positive strains and was homologous to a previously described pCERC-1, but different due to the absence of an 11-bp repetitive unit. The distribution of dfrA1, dfrA8, and dfrA14 TMP-resistance genes was determined in 126 TMPRS. sonnei isolates. Most of the strains (96%) carried only one of the three TMP-resistance genes assessed. Thus, all strains obtained during the 2009-outbreak harbored only dfrA14, whereas, dfrA8 was the most abundant gene marker before outbreak and, after the outbreak dfrA1 seems have appeared in circulating strains. According to PFGE, dfrA14-positive strains were clustered in a genetically related group including some dfrA1- and dfrA8-positive strains; meanwhile other genetic group included most of the dfrA8-positive strains. This distribution also correlated with the isolation period, showing a dynamics of trimethoprim genetic markers prevalent in Chilean S. sonnei strains. To our knowledge, dfrA14 gene associated to a small non-conjugative plasmid was detected for the first time in Shigella. Apparently, the strain causing the outbreak must have been introduced, changing drastically the genetic distribution of trimethoprim resistance in Chilean S. sonnei strains.
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Affiliation(s)
- Alfonso Miranda
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Bárbara Ávila
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Patricia Díaz
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Lina Rivas
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Karen Bravo
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Javier Astudillo
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Constanza Bueno
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - María T Ulloa
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Germán Hermosilla
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Felipe Del Canto
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Juan C Salazar
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Cecilia S Toro
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
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Molecular characterization and analysis of high-level multidrug-resistance of Shigella flexneri serotype 4s strains from China. Sci Rep 2016; 6:29124. [PMID: 27374009 PMCID: PMC4931504 DOI: 10.1038/srep29124] [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: 12/10/2015] [Accepted: 06/13/2016] [Indexed: 12/19/2022] Open
Abstract
To conduct the first comprehensive analysis of Shigella flexneri serotype 4s, a novel serotype found in 2010, we identified 24 serotype 4s isolates from 1973 shigellosis cases in China (2002–2014). The isolates were characterized by single nucleotide polymorphism (SNP) phylogenetic analysis, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) to determine their genetic relatedness, and analysed further for their antimicrobial susceptibilities and antimicrobial resistance determinants. The PFGE and SNP phylogenetic analyses suggest that S. flexneri serotype 4s strains are derived from multiple serotypes, including two predominant serotypes in China: serotype X variant and serotype II. Three new sequence types were identified by MLST. All isolates were resistant to ticarcillin, ampicillin and tetracycline, with high-level resistance to third-generation cephalosporins. Notably, all the isolates were multidrug resistant (MDR), with the highest levels of resistance observed for eight antimicrobials classes. Most isolates contain various antimicrobial resistance determinants. In conclusion, we found that serotype 4s isolates have multiple evolutionary sources, diverse biochemical characteristics and genomes, and highly prevalent multidrug resistance and antimicrobial-resistant determinants. With few clinical treatment options, continuous monitoring and timely intervention against this emerging MDR serotype is essential. The possibility that serotype 4s will become the next predominant serotype exists.
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Malek MM, Amer FA, Allam AA, El-Sokkary RH, Gheith T, Arafa MA. Occurrence of classes I and II integrons in Enterobacteriaceae collected from Zagazig University Hospitals, Egypt. Front Microbiol 2015; 6:601. [PMID: 26157425 PMCID: PMC4477160 DOI: 10.3389/fmicb.2015.00601] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 06/01/2015] [Indexed: 12/30/2022] Open
Abstract
Integrons are genetic units characterized by the ability to capture and incorporate gene cassettes, thus can contribute to the emergence and transfer of antibiotic resistance. The objectives of this study were: (1) to investigate the presence and distribution of class I and class II integrons and the characteristics of the gene cassettes they carry in Enterobacteriaceae isolated from nosocomial infections at Zagzig University Hospital in Egypt, (2) to determine their impact on resistance, and (3) to identify risk factors for the existence of integrons. Relevant samples and full clinical history were collected from 118 inpatients. Samples were processed; isolated microbes were identified and tested for antibiotic susceptibilities. Integrons were detected by polymerase chain reaction (PCR) and were characterized into class I or II by restriction fragment length polymorphism (RFLP). Integron-positive isolates were subjected to another PCR to detect gene cassette, followed by gene cassette sequencing. Risk factors were analyzed by logistic regression analysis. Seventy-six Enterobacteriaceae isolates were recognized, 41 of them (53.9%) were integron-positive; 39 strains carried class I and 2 strains carried class II integrons. Integrons had gene cassettes encoding different combinations and types of resistance determinants. Interestingly, blaOXA129 gene was found and ereA gene was carried on class I integrons. The same determinants were carried within isolates of the same species as well as isolates of different species. The presence of integrons was significantly associated with multidrug resistance (MDR). No risk factors were associated for integron carriage. We conclude that integrons carrying gene cassettes encoding antibiotic resistance are significantly present among Enterobacteriaceae causing nosocomial infection in our hospital. Risk factors for acquisition remain to be identified.
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Affiliation(s)
- Mai M. Malek
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Fatma A. Amer
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Ayman A. Allam
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Rehab H. El-Sokkary
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Tarek Gheith
- Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig UniversityCairo, Egypt
| | - Mohamed A. Arafa
- Pediatrics Department, Faculty of Medicine, Zagazig UniversityZagazig, Egypt
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Farshad S, Ranjbar R, Hosseini M. Molecular Genotyping of Shigella sonnei Strains Isolated From Children With Bloody Diarrhea Using Pulsed Field Gel Electrophoresis on the Total Genome and PCR-RFLP of IpaH and IpaBCD Genes. Jundishapur J Microbiol 2014; 8:e14004. [PMID: 25789126 PMCID: PMC4350046 DOI: 10.5812/jjm.14004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 12/12/2013] [Accepted: 12/25/2013] [Indexed: 11/25/2022] Open
Abstract
Background: Identification, understanding of antibiotic sensitivity patterns and molecular characterization of genetic elements of Shigella species are important because of both epidemiological and clinical indications in developing countries. Objectives: The aim of this study was to analyze molecular epidemiology of Shigella isolates recovered from children with diarrhea in Shiraz (Southern Iran), using IpaH and IpaBCD PCR-restriction fragment length polymorphism (RFLP), and to determine pulsed field gel electrophoresis (PFGE) patterns of total DNA of the S. sonnei isolates to find the clonality among these strains. Patients and Methods: A total of 82 clinical strains of Shigella spp., S. sonnei (n = 61), S. flexneri (n = 16), Shigella boydii (n = 3) and S. dysenteriae (n = 2) isolated from the stool samples of 719 patients, aged two months to 14 years, with positive occult blood (OB) test were characterized based on their IpaH and IpaBCD genes PCR-RFLP patterns. Genomic DNAs of S. sonnei strains were analyzed by PFGE. Results: All Shigella isolates were positive for both invasive genes and showed homogeneous profiles for such genes except for two S. sonnei strains, which had IpaH bands with different sizes and PCR-RFLP profiles. Forty palsotypes were determined among the 41 S. sonnei strains. Sample patterns were divided into two groups based on the drawn dendrogram with a similarity range of 70% to 100%. Conclusions: The results revealed that the strains under study could be epidemically related. It seems that an alternative subtyping method is needed to study the relationship among clinical S. sonnei strains and their transmission. Here, we reported for the first time, two strains of S. sonnei with a different PCR-RFLP pattern for IpaH gene.
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Affiliation(s)
- Shohreh Farshad
- Professor Alborzi Clinical Microbiology Research Center, Nemazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Shohreh Farshad, Professor Alborzi Clinical Microbiology Research Center, Nemazi Hospital, Shiraz University of Medical Sciences, P. O. Box: 7193711351, Shiraz, IR Iran. Tel: +98-7116474304, Fax: +98-7116474303, E-mail:
| | - Reza Ranjbar
- Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Marziyeh Hosseini
- Professor Alborzi Clinical Microbiology Research Center, Nemazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Kacmaz B, Unaldi O, Sultan N, Durmaz R. Drug resistance profiles and clonality of sporadic Shigella sonnei isolates in Ankara, Turkey. Braz J Microbiol 2014; 45:845-9. [PMID: 25477917 PMCID: PMC4204968 DOI: 10.1590/s1517-83822014000300013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 03/14/2014] [Indexed: 12/27/2023] Open
Abstract
The aims of this study were to investigate drug resistance rates, types of extended spectrum beta lactamases (ESBLs), and molecular epidemiological characteristics of 43 Shigella sonnei isolates. Ampicillin-sulbactam, amoxicillin-clavulanate, chloramphenicol, and ciprofloxacin were the most active antibiotics. Five isolates harbored bla SHV-12, bla(TEM-1) and bla(CTX-M-15). More than 90% of the isolates had an indistinguishable pulsotype.
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Affiliation(s)
- Birgul Kacmaz
- Central Microbiology Laboratory Medical Faculty Gazi University Ankara Turkey Central Microbiology Laboratory, Medical Faculty, Gazi University, Ankara, Turkey
| | - Ozlem Unaldi
- Molecular Microbiology Research and Application Laboratory National Public Health Agency Ankara Turkey Molecular Microbiology Research and Application Laboratory, National Public Health Agency, Ankara, Turkey
| | - Nedim Sultan
- Department of Clinical Microbiology Medical Faculty Gazi University Ankara Turkey Department of Clinical Microbiology, Medical Faculty, Gazi University, Ankara, Turkey
| | - Riza Durmaz
- Molecular Microbiology Research and Application Laboratory National Public Health Agency Ankara Turkey Molecular Microbiology Research and Application Laboratory, National Public Health Agency, Ankara, Turkey. ; Department of Clinical Microbiology Medical Faculty Kirikkale University Kirikkale Turkey Department of Clinical Microbiology, Medical Faculty, Kirikkale University, Kirikkale, Turkey
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Ruekit S, Wangchuk S, Dorji T, Tshering KP, Pootong P, Nobthai P, Serichantalergs O, Poramathikul K, Bodhidatta L, Mason CJ. Molecular characterization and PCR-based replicon typing of multidrug resistant Shigella sonnei isolates from an outbreak in Thimphu, Bhutan. BMC Res Notes 2014; 7:95. [PMID: 24555739 PMCID: PMC3936901 DOI: 10.1186/1756-0500-7-95] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 02/14/2014] [Indexed: 11/19/2022] Open
Abstract
Background Shigella species are an important cause of diarrhea in developing countries. These bacteria normally acquire their antibiotic resistance via several different mobile genetic elements including plasmids, transposons, and integrons involving gene cassettes. During a diarrhea surveillance study in Thimphu, Bhutan in June and July, 2011, Shigella sonnei were isolated more frequently than expected. This study describes the antibiotic resistance of these S. sonnei isolates. Methods A total of 29 S. sonnei isolates from Thimphu, Bhutan was characterized for antimicrobial susceptibility by disc diffusion assay and minimum inhibitory concentration (MIC) assay. All isolates were tested by pulsed-field gel electrophoresis (PFGE) with restriction enzyme XbaI and were tested for plasmid. The plasmid patterns and the PFGE patterns were analyzed by Bionumerics software. DNA sequencing was performed on amplified products for gyraseA gene and class 1 and class 2 integrons. S. sonnei isolates were classified for incompatibility of plasmids by PCR-based replicon typing (PBRT). Results These S. sonnei were resistant to multiple drugs like ciprofloxacin, nalidixic acid, trimethoprim-sulfamethoxazole, streptomycin, and tetracycline but susceptible to azithromycin. All isolates had class 2 integrons dfrA1, sat1 and aadA1 genes. Two point mutations in Gyrase A subunit at position Ser83Leu and Asp87Gly were detected in these quinolone resistant isolates. The plasmid and PFGE patterns of S. sonnei isolates suggested a clonal relationship of the isolates. All isolates carried common ColE plasmid. ColE plasmid co-resided with B/O plasmid (nine isolates) or I1 plasmid (one isolate). Conclusions The characteristics of 29 S. sonnei isolates from Thimphu, Bhutan in June and July, 2011 are identical in PFGE, plasmid and resistance pattern. This study suggests that these recent S. sonnei isolates are clonally related and multidrug-resistant.
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Affiliation(s)
- Sirigade Ruekit
- Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand.
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Ud-Din AIMS, Wahid SUH, Latif HA, Shahnaij M, Akter M, Azmi IJ, Hasan TN, Ahmed D, Hossain MA, Faruque ASG, Faruque SM, Talukder KA. Changing trends in the prevalence of Shigella species: emergence of multi-drug resistant Shigella sonnei biotype g in Bangladesh. PLoS One 2013; 8:e82601. [PMID: 24367527 PMCID: PMC3867351 DOI: 10.1371/journal.pone.0082601] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/26/2013] [Indexed: 11/18/2022] Open
Abstract
Shigellosis, caused by Shigella species, is a major public health problem in Bangladesh. To determine the prevalence and distribution of different Shigella species, we analyzed 10,827 Shigella isolates from patients between 2001 and 2011. S. flexneri was the predominant species isolated throughout the period. However, the prevalence of S. flexneri decreased from 65.7% in 2001 to 47% in 2011, whereas the prevalence of S. sonnei increased from 7.2% in 2001 to 25% in 2011. S. boydii and S. dysenteriae accounted for 17.3% and 7.7% of the isolates respectively throughout the period. Of 200 randomly selected S. sonnei isolates for extensive characterization, biotype g strains were predominant (95%) followed by biotype a (5%). Resistance to commonly used antibiotics including trimethoprim-sulfamethoxazole, nalidixic acid, ciprofloxacin, mecillinam and ampicillin was 89.5%, 86.5%, 17%, 10.5%, and 9.5%, respectively. All isolates were susceptible to ceftriaxone, cefotaxime, ceftazidime and imipenem. Ninety-eight percent of the strains had integrons belonging to class 1, 2 or both. The class 1 integron contained only dfrA5 gene, whereas among class 2 integron, 16% contained dhfrAI-sat1-aadA1-orfX gene cassettes and 84% harbored dhfrA1-sat2 gene cassettes. Plasmids of ∼5, ∼1.8 and ∼1.4 MDa in size were found in 92% of the strains, whereas only 33% of the strains carried the 120 MDa plasmid. PFGE analysis showed that strains having different integron patterns belonged to different clusters. These results show a changing trend in the prevalence of Shigella species with the emergence of multidrug resistant S. sonnei. Although S. flexneri continues to be the predominant species albeit with reduced prevalence, S. sonnei has emerged as the second most prevalent species replacing the earlier dominance by S. boydii and S. dysenteriae in Bangladesh.
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Affiliation(s)
- Abu I. M. S. Ud-Din
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Syeda U. H. Wahid
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Hasan A. Latif
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Shahnaij
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahmuda Akter
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ishrat J. Azmi
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Trisheeta N. Hasan
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Dilruba Ahmed
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad A. Hossain
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abu S. G. Faruque
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shah M. Faruque
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kaisar A. Talukder
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- * E-mail:
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Structural diversity of class 1 integrons and their associated gene cassettes in Klebsiella pneumoniae isolates from a hospital in China. PLoS One 2013; 8:e75805. [PMID: 24098729 PMCID: PMC3786929 DOI: 10.1371/journal.pone.0075805] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 08/20/2013] [Indexed: 12/02/2022] Open
Abstract
Background Klebsiella pneumoniae strains carrying class 1 integrons are becoming more common worldwide, and their role in the dissemination of drug resistance is significant. The aim of this study was to characterize the structural diversity of class 1 integrons and their associated gene cassettes in K. pneumoniae isolates from hospital settings. Methodology/Principal Findings We analyzed a total of 176 K. pneumoniae isolates in a tertiary-care hospital in Beijing, China for the period of November 1, 2010-October 31, 2011. The presence of class 1 integrons and gene cassettes was analyzed by PCR and sequencing. The prevalence of class 1 integrons was 51.1% (90/176). Fourteen different gene cassettes and 10 different gene cassette arrays were detected. dfrA and aadA cassettes were predominant and cassette combination dfrA1-orfC was most frequently found (13.6%, 24/176). Strong association between resistance to a variety of drugs (both phenotypes and the associated genes) and the presence of class 1 integrons was observed. In addition, we also identified an association between some previously identified prevalent sequence types (such as ST11, ST15, ST147, ST562, and ST716) and the presence of class 1 integrons. Conclusions/Significance Data from this study demonstrated that class 1 integrons are highly diverse and are associated with a variety of drug resistance phenotypes, drug resistance genes, as well as genotypes among K. pneumoniae isolates. Continuous monitoring of gene cassettes in class 1 integrons is warranted to improve the understanding and control of drug resistance among hospital settings.
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DEJLI J, NADA RA, MANSOUR A, EL-MONIEM AA, WASFY MO, KLENA JD. Comparative analysis of Shigella sonnei biotype g isolated from paediatric populations in Egypt, 1999-2005. Epidemiol Infect 2013; 141:1614-24. [PMID: 22989417 PMCID: PMC9151601 DOI: 10.1017/s0950268812002002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 07/16/2012] [Accepted: 08/13/2012] [Indexed: 11/06/2022] Open
Abstract
Strain characteristics of 51 Shigella sonnei isolates obtained from children seeking medical care (MC) and 48 isolates recovered during a prospective diarrhoea birth cohort (BC) study were compared. Biochemical characterization and antibiotic susceptibility testing determined that all S. sonnei isolates were biotype g and multidrug-resistant. Plasmid profiling identified 15 closely related patterns and XbaI pulsed-field gel electrophoresis confirmed the high degree of genetic similarity between isolates. All S. sonnei isolates harboured ipaH and class II integrase genes and 84∙3 and 80% of the MC and BC isolates, respectively carried the sen gene. Neither the class I integrase nor the set gene was detected. Our results indicate that S. sonnei isolates associated with severe diarrhoea were indistinguishable from those associated with mild diarrhoea. Additional genetic tests with greater discrimination might offer an opportunity to determine genetic differences within the globally disseminating biotype g clone.
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MESH Headings
- Anti-Bacterial Agents/pharmacology
- Bacterial Typing Techniques
- Child, Preschool
- DNA, Bacterial/drug effects
- DNA, Bacterial/genetics
- DNA, Bacterial/metabolism
- Disk Diffusion Antimicrobial Tests
- Drug Resistance, Multiple, Bacterial
- Dysentery, Bacillary/epidemiology
- Dysentery, Bacillary/microbiology
- Egypt/epidemiology
- Electrophoresis, Gel, Pulsed-Field
- Feces/microbiology
- Female
- Humans
- Infant
- Male
- Microbial Sensitivity Tests
- Phylogeny
- Plasmids/drug effects
- Plasmids/genetics
- Plasmids/metabolism
- Polymerase Chain Reaction
- Prospective Studies
- Restriction Mapping
- Shigella sonnei/classification
- Shigella sonnei/drug effects
- Shigella sonnei/genetics
- Shigella sonnei/isolation & purification
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Affiliation(s)
- J. DEJLI
- Clinical Trials and Military Studies Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - R. A. NADA
- Clinical Trials and Military Studies Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - A. MANSOUR
- Clinical Trials and Military Studies Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | | | - M. O. WASFY
- International Emerging Infections Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
| | - J. D. KLENA
- Clinical Trials and Military Studies Program, U.S. Naval Medical Research Unit No. 3, Cairo, Egypt
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22
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Sambe-Ba B, Seck A, Wane AA, Fall-Niang NK, Gassama-Sow A. [Sensitivity to antibiotics and genetic support to resistance of Shigella flexneri strains isolated in Dakar from 2001 to 2010]. ACTA ACUST UNITED AC 2013; 106:89-94. [PMID: 23483461 DOI: 10.1007/s13149-013-0283-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 02/12/2013] [Indexed: 10/27/2022]
Abstract
Diarrheal diseases remain a leading cause of death with 14.7 million deaths in 2001 and 26% of global mortality worldwide according to WHO. Shigella species are prevalent in tropical areas; they are present all the year, with epidemic outbreaks in rainy season. Between 2001 and 2010 one hundred ninety (190) strains of Shigella flexneri isolated from National Senegalese Enterobacteriaceae Center located at the Pasteur Institute in Dakar were studied. Susceptibility was performed by antibiogram following the CASFM recommendations. Detection and characterization of integrons and resistance genes was done by PCR using specific primers and sequencing. Antibiotic susceptibility showed high percentage resistance to tetracycline: 95%, cotrimoxazole 60%, ampicillin 55%. Nineteen strains were cephalosporin resistant (10%). Two isolates were resistant to quinolones and one was imipenem resistant. Genes tet, dfr, cat, bla tem1 , bla oxa30 , bla shv , bla CTX-M , blakpc,bla IMP , gyrA, gyrB, parC and parE were detected on isolates. Integrons harbored genes resistance. The class 1 integron predominated followed by class 2 integron. Genes bla oxa30 , aadA1/aadA2 dfrA1, dfrA7 were found on class 1 integron. Class 2 integron showed three different types cassettes. No class 3 integron was detected. Genes dfrA1, dfrA7, sat, and aadA1 were harbouring by integrons. Antibiotic susceptibility showed that Shigella flexneri strains are resistant to the first line drugs used to treat shigellosis in Senegal. Resistance to 3rd generation of cephalosporins and fluoroquinolones emerged and is of great concern. These molecules must be used with caution in the treatment of shigellosis.
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Affiliation(s)
- B Sambe-Ba
- Institut Pasteur de Dakar, 36, avenue Pasteur, BP 220, Dakar, Sénégal
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23
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Yang H, Chen G, Zhu Y, Liu Y, Cheng J, Hu L, Ye Y, Li J. Surveillance of antimicrobial susceptibility patterns among Shigella species isolated in China during the 7-year period of 2005-2011. Ann Lab Med 2013; 33:111-5. [PMID: 23482897 PMCID: PMC3589635 DOI: 10.3343/alm.2013.33.2.111] [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: 08/14/2012] [Revised: 09/11/2012] [Accepted: 11/20/2012] [Indexed: 12/01/2022] Open
Abstract
Background Shigella is a frequent cause of bacterial dysentery in the developing world. Treatment with antibiotics is recommended for shigellosis, but the options are limited due to globally emerging resistance. This study was conducted to determine the frequency and pattern of antimicrobial susceptibility of Shigella in China. Methods We studied the antimicrobial resistance profiles of 308 Shigella spp. strains (260 S. flexneri, 40 S. sonnei, 5 S. boydii, and 3 S. dysenteriae) isolated from fecal samples of patients (age, from 3 months to 92 yr) presenting with diarrhea in different districts of Anhui, China. The antimicrobial resistance of strains was determined by the agar dilution method according to the CSLI guidelines. Results The most common serogroup in the Shigella isolates was S. flexneri (n=260, 84.4%), followed by S. sonnei (n=40, 13.0%). The highest resistance rate was found for nalidixic acid (96.4%), followed by ampicillin (93.2%), tetracycline (90.9%), and trimethoprim/sulfamethoxazole (80.8%). Among the isolates tested, 280 (91.0%) were multidrug resistant (resistant to ≥2 agents). The most common resistance pattern was the combination of ampicillin, tetracycline, and trimethoprim/sulfamethoxazole (70.8%). Resistance to ampicillin and tetracycline were more common among S. flexneri than among S. sonnei isolates. Conclusions S. flexneri is predominant in Anhui, China, and its higher antimicrobial resistance rate compared with that of S. sonnei is a cause for concern. Continuous monitoring of resistance patterns is necessary to control the spread of resistance in Shigella. The recommendations for antimicrobial treatment must be updated regularly based on surveillance results.
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Affiliation(s)
- Haifei Yang
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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24
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Qu F, Bao C, Chen S, Cui E, Guo T, Wang H, Zhang J, Wang H, Tang YW, Mao Y. Genotypes and antimicrobial profiles of Shigella sonnei isolates from diarrheal patients circulating in Beijing between 2002 and 2007. Diagn Microbiol Infect Dis 2012; 74:166-70. [PMID: 22858547 PMCID: PMC7127854 DOI: 10.1016/j.diagmicrobio.2012.06.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 06/12/2012] [Accepted: 06/25/2012] [Indexed: 11/16/2022]
Abstract
Shigella sonnei has become the dominant serotype causing shigellosis in Asian countries in recent years. In this study, we characterize the increasing trend of antibiotic resistance profiles and genotypes of S. sonnei isolates in the Beijing area. From January 2002 to December 2007, a total of 1108 Shigella isolates including 362 S. sonnei were recovered from diarrhea patients at the 302nd Hospital in Beijing. While the frequency of S. flexneri gradually decreased, S. sonnei gradually increased and became the dominant species. A total of 362 S. sonnei isolates were further analyzed for their antimicrobial profiles and 272 revived isolates were selected for genotyping analysis, respectively. High-level antimicrobial resistances were observed in sulfamethoxazole/trimethoprim (94.5%), ampicillin (40.3%), piperacillin (36.5%), and ceftriaxone (12.8%) with significant single- and multiple-drug resistance increase trends from 2002 to 2007 (P = 0.0000). Pulsed-field gel electrophoresis analysis indicated that 263 (96.7%) S. sonnei belonged to 1 clonal genotype A, which were further divided into A1–A6 subtypes. While subtype A2 was dominant in the early stage of study years, subtype A4 started to emerge and increased significantly in later years. Antimicrobial resistance rates are statistically different among the 6 subtypes (P = 0.0000), and A4 possessed the highest resistance rates to ampicillin (83.7%) and piperacillin (81.4%). Subtype A3 was highly clustered in inpatients compared to other subtypes (P = 0.0145). This study indicates that a clonal S. sonnei strain has become dominant in the Beijing area, and subtype A4 is responsible for increased antibiotic resistance.
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Affiliation(s)
- Fen Qu
- Clinical Diagnostic Center, 302nd Hospital of the People's Liberation Army, Beijing 100039, China
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25
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A school outbreak of Shigella sonnei infection in China: clinical features, antibiotic susceptibility and molecular epidemiology. Indian Pediatr 2011; 49:287-90. [PMID: 21992857 DOI: 10.1007/s13312-012-0043-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Accepted: 05/31/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To describe the clinical features of infection, and the antibiotic susceptibility of epidemic strains, and investigate plasmid maps and integrons of the isolates from an outbreak of Shigella sonnei infection at an elementary school in southwest China. STUDY DESIGN Cross-sectional study. SETTING An elementary school and five hospitals in Chengdu in southwest China. RESULTS There were 1,134 students in the school. 937 (82.6%) students had signs and symptoms. Of the 568 (60.6%, 568/937) hospitalized students, 93.3% 86.8%, 72.4%, and 28.9% of the hospitalized patients had diarrhea, fever, abdominal pain, and vomiting, respectively. S. sonnei strains were isolated from the stool samples of 36.0% (337/937) students. All of the outbreak isolates had the same high-level antimicrobial resistance and plasmid profiles, which were different from that of sporadic strains. All the outbreak S. sonnei isolates were positive for the integrin gene and contained class 2 integron; however, two outbreak isolates contained class 1 and class 2 integrons. CONCLUSIONS Diarrhea, fever, and abdominal pain were the three most common clinical manifestations observed in patients infected with S. sonnei. High-level antibiotic resistance was observed among Shigella species.
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26
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Ahmed AM, Shimamoto T. Molecular characterization of antimicrobial resistance in Gram-negative bacteria isolated from bovine mastitis in Egypt. Microbiol Immunol 2011; 55:318-27. [PMID: 21338385 DOI: 10.1111/j.1348-0421.2011.00323.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to characterize the genetic basis of multidrug resistance in Gram-negative bacteria isolated from bovine mastitis cases in Egypt. Multidrug resistance phenotypes were found in 34 of 112 (30.4%) Gram-negative bacterial isolates, which harbored at least one antimicrobial resistance gene. The most prevalent multidrug-resistant (MDR) species were Enterobacter cloacae (8 isolates, 7.1%), Klebsiella pneumoniae (7 isolates, 6.3%), Klebsiella oxytoca (7 isolates, 6.3%), Escherichia coli (5 isolates, 4.5%), and Citrobacter freundii (3 isolates, 2.7%). The most commonly observed resistance phenotypes were against ampicillin (97.0%), streptomycin (94.1%), tetracycline (91.2%), trimethoprim-sulfamethoxazole (88.2%), nalidixic acid (85.3%), and chloramphenicol (76.5%). Class 1 integrons were detected in 28 (25.0%) isolates. The gene cassettes within class 1 integrons included those encoding resistance to trimethoprim (dfrA1, dfrA5, dfrA7, dfrA12, dfrA15, dfrA17, and dfrA25), aminoglycosides (aadA1, aadA2, aadA5, aadA7, aadA12, aadA22, and aac(3)-Id), chloramphenicol (cmlA), erythromycin (ereA2), and rifampicin (arr-3). Class 2 integrons were identified in 6 isolates (5.4%) with three different profiles. Furthermore, the β-lactamase encoding genes, bla(TEM), bla(SHV), bla(CTX-M), and bla(OXA), the plasmid-mediated quinolone resistance genes, qnr and aac(6)-Ib-cr, and the florfenicol resistance gene, floR, were also identified. To the best of our knowledge, the results identified class 2 integrons, qnr and aac(6)-Ib-cr from cases of mastitis for the first time. This is the first report of molecular characterization for antimicrobial resistance in Gram-negative bacteria isolated from bovine mastitis in Africa.
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Affiliation(s)
- Ashraf M Ahmed
- Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Kafr El-Sheikh University, Kafr El-Sheikh, Egypt
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27
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Ke X, Gu B, Pan S, Tong M. Epidemiology and molecular mechanism of integron-mediated antibiotic resistance in Shigella. Arch Microbiol 2011; 193:767-74. [PMID: 21842348 DOI: 10.1007/s00203-011-0744-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 07/27/2011] [Accepted: 08/02/2011] [Indexed: 01/15/2023]
Abstract
Integrons are gene capture and expression systems that are characterized by the presence of an integrase gene. This encodes an integrase, a recombined site, and a promoter. They are able to capture gene cassettes from the environment and incorporate them using site-specific recombination. The role of integrons and gene cassettes in the dissemination of multidrug resistance in Gram-negative bacteria is significant. In Shigella species, antimicrobial resistance is often associated with the presence of class 1 and class 2 integrons that contain resistance gene cassettes. Multiple and complex expression regulation mechanisms involving mobile genetic elements in integrons have been developed in the evolution of Shigella strains. Knowledge of the epidemiology and molecular mechanisms of antimicrobial resistance in this important pathogen is essential for the implementation of intervention strategies. This review was conducted to introduce the structures and functions of integrons in Shigella species and mechanisms that control integron-mediated events linked to antibiotic resistance.
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Affiliation(s)
- Xing Ke
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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28
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Chang CY, Lu PL, Lin CC, Lee TM, Tsai MY, Chang LL. Integron types, gene cassettes, antimicrobial resistance genes and plasmids of Shigella sonnei isolates from outbreaks and sporadic cases in Taiwan. J Med Microbiol 2011; 60:197-204. [DOI: 10.1099/jmm.0.022517-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
This study analysed the presence, location and transferability of integrons and antibiotic resistance genes in 103 Shigella sonnei outbreak isolates and in 32 sporadic isolates from Taiwan. Multiple antimicrobial resistance was common in both outbreak (95 %) and sporadic (97 %) isolates. Class 1 integrons were present in 34 outbreak isolates (33 %) and in six sporadic isolates (19 %). This study is the first, to our knowledge, to identify an atypical sul3-associated class 1 integron carrying the estX-psp-aadA2-cmlA-aadA1-qacH cassette array in Shigella. Class 2 integrons carrying the dfr1-sat2-aadA1 cassette array were predominant in outbreak isolates (90 %) but were not present in sporadic isolates. Other antimicrobial resistance genes not associated with integrons were found to encode resistance to ampicillin (bla
TEM), chloramphenicol (cat1), sulfonamide (sul2) and tetracycline (tetA and tetB). The most common plasmid size was 130 kb (observed in 43 and 97 % of 1998 outbreak and sporadic isolates, respectively). In conclusion, the plasmid location of resistance genes and horizontal plasmid transfer promote the spread of multiple resistance genes in outbreak and sporadic isolates of S. sonnei.
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Affiliation(s)
- Chung-Yu Chang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
- Department of Microbiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
| | - Po-Liang Lu
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan, ROC
- Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan, ROC
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
| | - Chung-Che Lin
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
- Department of Microbiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
| | - Tsong-Ming Lee
- Department of Food Science and Technology, Tajen University, 20 Weisin Road, Sin-er Village, Yanpu Township, Pingtung County 907, Taiwan, ROC
| | - Mei-Yin Tsai
- Department of Microbiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
| | - Lin-Li Chang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
- Department of Microbiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC
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Madiyarov RS, Bektemirov AM, Ibadova GA, Abdukhalilova GK, Khodiev AV, Bodhidatta L, Sethabutr O, Mason CJ. Antimicrobial resistance patterns and prevalence of class 1 and 2 integrons in Shigella flexneri and Shigella sonnei isolated in Uzbekistan. Gut Pathog 2010; 2:18. [PMID: 21143880 PMCID: PMC3017001 DOI: 10.1186/1757-4749-2-18] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 12/09/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Shigella is a frequent cause of bacterial dysentery in the developing world. Treatment with effective antibiotics is recommended for shigellosis, but options become limited due to globally emerging resistance. One of the mechanisms for the development of resistance utilizes integrons. This study described the antibiotic susceptibility and the presence of class 1 and 2 integrons in S. flexneri and S. sonnei isolated in Uzbekistan. RESULTS We studied 31 isolates of S. flexneri and 21 isolates of S. sonnei isolated in Uzbekistan between 1992 and 2007 for the susceptibility or resistance to ampicillin (Am), chloramphenicol (Cl), tetracycline (Te), co-trimoxazole (Sxt), kanamycin (Km), streptomycin (Str), gentamicin (Gm), cefazolin (Czn), cefoperazone (Cpr), cefuroxime (Cur), ceftazidime (Ctz), nalidixic acid (NA) and ciprofloxacin (Cip). Am/Str/Cl/Te and Am/Str/Cl/Te/Sxt resistance patterns were found most frequently in S. flexneri. Single isolates were resistant to aminoglycoside, quinolones and cephalosporins. The resistance patterns were different in the two species. Integrons were detected in 93.5% of S. flexneri (29/31) and 81.0% of S. sonnei (17/21) isolates. In addition, 61.3% of S. flexneri (19/31) isolates and 19.0% of S. sonnei (4/21) isolates carried both classes of integrons. In 29.0% of S. flexneri (9/31) isolates, only class 1 integrons were identified. In S. flexneri isolates, the presence of class 1 integrons was associated with resistance to ampicillin and chloramphenicol. Only Class 2 integrons were present in 61.9% of S. sonnei (13/21) isolates. CONCLUSIONS Our study documents antibiotic resistance among Shigella spp. in Uzbekistan. Ninety percent of Shigella strains were resistant to previously used antibiotics. Differences among S. flexneri and S. sonnei isolates in patterns of antimicrobial resistance to routinely used shigellosis antibiotics were observed. The majority of S. flexneri were resistant to ampicillin, chloramphenicol, tetracycline and streptomycin. Class 1 and 2 integrons were widely present in these Shigella strains. Resistance to ampicillin/chloramphenicol was associated with the presence of class 1 integrons. Though several mechanisms are possible, the resistance of Shigella isolates to ampicillin/chloramphenicol may be associated with the expression of genes within class 1 integrons.
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Affiliation(s)
- Ruslan S Madiyarov
- Research Institute of Epidemiology, Microbiology and Infectious Diseases, Tashkent 100133, Republic of Uzbekistan.
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30
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Al-Nimri S, Miller WA, Byrne BA, Guibert G, Chen L. A unified approach to molecular epidemiology investigations: tools and patterns in California as a case study for endemic shigellosis. BMC Infect Dis 2009; 9:184. [PMID: 19930709 PMCID: PMC2788569 DOI: 10.1186/1471-2334-9-184] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 11/24/2009] [Indexed: 12/03/2022] Open
Abstract
Background Shigellosis causes diarrheal disease in humans from both developed and developing countries, and multi-drug resistance is an emerging problem. The objective of this study is to present a unified approach that can be used to characterize endemic and outbreak patterns of shigellosis using use a suite of epidemiologic and molecular techniques. The approach is applied to a California case study example of endemic shigellosis at the population level. Methods Epidemiologic patterns were evaluated with respect to demographics, multi-drug resistance, antimicrobial resistance genes, plasmid profiles, and pulsed-field gel electrophoresis (PFGE) fingerprints for the 43 Shigella isolates obtained by the Monterey region health departments over the two year period from 2004-2005. Results The traditional epidemiologic as well as molecular epidemiologic findings were consistent with endemic as compared to outbreak shigellosis in this population. A steady low level of cases was observed throughout the study period and high diversity was observed among strains. In contrast to most studies in developed countries, the predominant species was Shigella flexneri (51%) followed closely by S. sonnei (49%). Over 95% of Shigella isolates were fully resistant to three or more antimicrobial drug subclasses, and 38% of isolates were resistant to five or more subclasses. More than half of Shigella strains tested carried the tetB, catA, or blaTEM genes for antimicrobial resistance to tetracycline, chloramphenicol, and ampicillin, respectively. Conclusion This study shows how epidemiologic patterns at the host and bacterial population levels can be used to investigate endemic as compared to outbreak patterns of shigellosis in a community. Information gathered as part of such investigations will be instrumental in identifying emerging antimicrobial resistance, for developing treatment guidelines appropriate for that community, and to provide baseline data with which to compare outbreak strains in the future.
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Affiliation(s)
- Sawsan Al-Nimri
- Pathology, Microbiology & Immunology Department, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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31
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Angelini M, Stehling EG, Moretti ML, da Silveira WD. Molecular epidemiology of Shigella spp strains isolated in two different metropolitam areas of southeast Brazil. Braz J Microbiol 2009; 40:685-92. [PMID: 24031415 PMCID: PMC3768556 DOI: 10.1590/s1517-838220090003000034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 09/24/2008] [Accepted: 05/03/2009] [Indexed: 11/22/2022] Open
Abstract
Shigella spp., the human pathogen responsible for shigellosis, is highly infectious even at low levels. The incidence rate of shigellosis varies with geographical distribution, location human development index, and age groups, being higher among children aged under 5 years. In Brazil, a few works indicate that shigellosis cases are underestimated, with S. flexneri and S. sonnei strains being the major agents responsible for the shigellosis cases. The present study used pulsed field gel electrophoresis (PFGE) to investigate the molecular epidemiology of 119 strains of S. sonnei and S. flexneri isolated from shigellosis cases that occurred in the metropolitan areas of Ribeirão Preto and Campinas Cities, São Paulo Sate, southeast Brazil. The results indicated (i) the existence of just a few strain clusters for both species, but with genotype variability with either a high speed of genetic change or constant introduction of several genotypes, considering the intense migration to these two metropolitan areas, and (ii) the prevalence of specific genotypes in each geographical area, which suggests the successful adaptation of some genotypes to the local environmental conditions. Our results indicate the need of more efficacious sanitary barriers to prevent Shigella spp. outbreaks and epidemics.
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Affiliation(s)
- Michelle Angelini
- Departamento de Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Campinas , São Paulo , Brasil
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32
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Ahmed AM, Shimabukuro H, Shimamoto T. Isolation and Molecular Characterization of Multidrug-Resistant Strains of Escherichia coli and Salmonella from Retail Chicken Meat in Japan. J Food Sci 2009; 74:M405-10. [DOI: 10.1111/j.1750-3841.2009.01291.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Surveillance of antibiotic susceptibility patterns among Shigella sonnei strains isolated in Belgium during the 18-year period 1990 to 2007. J Clin Microbiol 2009; 47:1379-85. [PMID: 19321731 DOI: 10.1128/jcm.02460-08] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study was conducted to determine the frequency and pattern of antimicrobial susceptibility of Shigella sonnei, the predominant species causing shigellosis in Belgium. Between 1990 and 2007, a total of 7,307 strains, mainly (98.2%) isolated from stools, were diagnosed by peripheral laboratories before being confirmed as Shigella strains by serotyping by the National Reference Center of Salmonella and Shigella. A significant increase in resistances to tetracycline, streptomycin, trimethoprim, sulfonamides, and cotrimoxazole (i.e., trimethoprim in combination with sulfonamides) was observed during this period. Since 1998, resistance to nalidixic acid also increased to reach a peak (12.8%) of resistant isolates in 2004. Concomitantly, multidrug resistance (MDR) in this species emerged in 2007, with 82% of total isolates being MDR. However, during this 18-year period, all isolates remained fully susceptible to ciprofloxacin and gentamicin. The work includes the molecular characterization of mechanisms of resistance to ampicillin, tetracycline, chloramphenicol, and cotrimoxazole and class 1 and class 2 integrons. S. sonnei acquired antimicrobial resistance to traditional antibiotics (ampicillin and tetracycline) by horizontal gene transfer, while the genetic stability of transposons was responsible for a high (89%) proportion of resistance to a commonly prescribed antibiotic (cotrimoxazole). Therefore, cotrimoxazole should no longer be considered appropriate as empirical therapy for treatment of shigellosis in Belgium when antibiotics are indicated. Rates of resistance to nalidixic acid should also be attentively monitored to detect any shift in fluoroquinolone resistance, because it represents the first line among antibiotics used in the treatment of shigellosis.
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34
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Ranjbar R, Aleo A, Giammanco GM, Dionisi AM, Sadeghifard N, Mammina C. Genetic relatedness among isolates of Shigella sonnei carrying class 2 integrons in Tehran, Iran, 2002-2003. BMC Infect Dis 2007; 7:62. [PMID: 17587439 PMCID: PMC1914347 DOI: 10.1186/1471-2334-7-62] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 06/22/2007] [Indexed: 11/26/2022] Open
Abstract
Background Shigella spp. are major cause of diarrhoeal disease in both developing and developed countries. Shigella sonnei is the serogroup of Shigella most frequently responsible for sporadic and epidemic enteritis in developed countries. In recent years the emergence and spread of S. sonnei biotype g carrying class 2 integron have been frequently reported in many countries. Recently, S. sonnei has been reported as the prevalent serogroup of Shigella in Iran. The present study was carried out to investigate phenotypic and genetic characteristics of Shigella sonnei isolates identified in the years 2002 and 2003 in Tehran, Iran. Methods Biotyping, drug susceptibility testing, pulsed field gel electrophoresis (PFGE) and analysis of class 2 integrons have been carried out on 60 S. sonnei isolates, including 57 sporadic isolates from paediatric cases of shigellosis occurring in 2002 and 2003, two sporadic isolates recovered in 1984 and the ATCC 9290 strain. Results Biotype g and resistance to streptomycin, sulfamethoxazole-trimethoprim and tetracycline were exhibited by 54 of the 57 recent isolates. Of the 54 biotype g isolates, 28 exhibited a class 2 integron of 2161 bp, and 24 a class 2 integron of 1371 bp, respectively. Class 2 integrons were not detected in four isolates only, including the two endemic isolates recovered in 1984 and two strains from recent sporadic cases. PFGE divided the strains into eight pulsotypes labeled A to H, three major pulsotypes – A to C – including the large majority of the recent sporadic S. sonnei isolates. Pulsotypes A and C were the most prevalent groups, accounting for 41.6% and 35.0%, respectively, of the isolates under study. Conclusion The results suggest that biotype g, class 2 integron carrying S. sonnei are prevalent in our geographic area. S. sonnei isolated in the years 2002 and 2003 could be attributed to a few predominant clusters including, respectively, strains with pulsotypes B and C carrying a 2161 bp class 2 integron, and those having pulsotype A and a 1371 bp class 2 integron. A few epidemic clones are responsible for the apparently endemic occurrence of shigellosis in Tehran, Iran.
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Affiliation(s)
- Reza Ranjbar
- Research Center of Molecular Biology, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Aurora Aleo
- Dipartimento di Igiene e Microbiologia "G. D'Alessandro", Università di Palermo, Via del Vespro 133, I-90127 Palermo, Italy
| | - Giovanni M Giammanco
- Dipartimento di Igiene e Microbiologia "G. D'Alessandro", Università di Palermo, Via del Vespro 133, I-90127 Palermo, Italy
| | - Anna Maria Dionisi
- Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Viale Regina Elena 299, I-00161Rome, Italy
| | - Nourkhoda Sadeghifard
- Department of Microbiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Caterina Mammina
- Dipartimento di Igiene e Microbiologia "G. D'Alessandro", Università di Palermo, Via del Vespro 133, I-90127 Palermo, Italy
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Machado E, Ferreira J, Novais A, Peixe L, Cantón R, Baquero F, Coque TM. Preservation of integron types among Enterobacteriaceae producing extended-spectrum beta-lactamases in a Spanish hospital over a 15-year period (1988 to 2003). Antimicrob Agents Chemother 2007; 51:2201-4. [PMID: 17404002 PMCID: PMC1891394 DOI: 10.1128/aac.01389-06] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The variable presence of integrons among extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae species (0 to 66%) is described. Association between bla(ESBL) and integrons occurred when these are linked to specific ESBL-type genes (In60 bearing ISCR1 and bla(CTX-M-9)) or when ESBL genes were superimposed onto selected plasmids carrying integrons. Some integrons were identical to those found during decades worldwide, illustrating the preservation of the genetic elements carrying them.
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Affiliation(s)
- Elisabete Machado
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. Carretera de Colmenar, km. 9.1. Madrid 28034, Spain
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Zheng XY, Wen Y, Yin CH, Wang J. Integrons and gene cassettes in antibiotic-resistant Shigella. Shijie Huaren Xiaohua Zazhi 2007; 15:855-859. [DOI: 10.11569/wcjd.v15.i8.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
With the widespread use of antibiotics, the question of drug resistance, especially multi-drug resistance, in Shigella is increasingly serious. As a new drug-resistant mechanism, integron system, which has the ability of capturing and expressing foreign genes, is attracting more and more attention. According to the difference of integrase, integrons can be divided into six types, of which type 1, 2 and 3 integrons are studied most and have been proved to be correlated with the drug resistance of bacteria. Recent studies indicated that type 2 integron is most commonly found in Shigella. In this article, we reviewed the conception and structure of integrons and gene cassettes as well as their correlations with the drug resistance of Shigella.
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Dubois V, Parizano MP, Arpin C, Coulange L, Bezian MC, Quentin C. High genetic stability of integrons in clinical isolates of Shigella spp. of worldwide origin. Antimicrob Agents Chemother 2007; 51:1333-40. [PMID: 17242143 PMCID: PMC1855518 DOI: 10.1128/aac.01109-06] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Over a 12-year period, 68 Shigella strains (31 S. sonnei, 30 S. flexneri, 4 S. dysenteriae, and 3 S. boydii strains) were collected in a French University Hospital from the stools of patients who generally had a recent history of travel to various parts of the world (91%), particularly Africa (67%). These strains were often resistant (streptomycin, spectinomycin, trimethoprim, tetracycline, and sulfonamides, 66 to 84%; ampicillin and chloramphenicol, 34 to 38%; nalidixic acid, 4%) and even multiresistant (87%), and they generally carried integrons (81%) of class 1 (21%), class 2 (47%), or both (13%). Class 1 integrons were associated with ampicillin resistance due to the production of an OXA-30 beta-lactamase in S. flexneri and S. dysenteriae. Class 2 integrons were associated with trimethoprim resistance in S. sonnei. Class 1 and class 2 integrons were inserted within transposons Tn21 and Tn7, respectively, themselves located on the bacterial chromosome, except in one strain. Class 1 integrons showed an atypical organization consisting of the insertion sequence IS1 at the 3' end instead of the typical 3' conserved segment and two blaOXA-30 and aadA1 gene cassettes, despite the absence of epidemiological relationships between the strains, and an apparently functional integrase. Class 2 integrons showed the same albeit classical organization with the three dfrA1, sat, and aadA1 gene cassettes. Occasionally, the 3' end was deleted and the aadA1 gene cassette was unexpressed. Thus, integrons contributed only in part to the multidrug resistance of the Shigella strains. The highly conserved organization of integrons might be related to their location within mobile genetic superstructures.
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Affiliation(s)
- Véronique Dubois
- Laboratoire de Microbiologie, Faculté de Pharmacie, Université de Bordeaux 2, 146 rue Léo Saignat, 33076 Bordeaux Cedex, and Laboratoire de Bactériologie, Hôpital Saint André, France.
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Ahmed AM, Furuta K, Shimomura K, Kasama Y, Shimamoto T. Genetic characterization of multidrug resistance in Shigella spp. from Japan. J Med Microbiol 2006; 55:1685-1691. [PMID: 17108272 DOI: 10.1099/jmm.0.46725-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study characterized the genetic basis of antimicrobial resistance of a number of Shigella spp. isolated from humans from 2000 to 2004 in Hiroshima prefecture, Japan. A total of 26 isolates of Shigella spp. were included in this study. Antimicrobial susceptibility tests revealed high levels of resistance, especially to ampicillin, streptomycin, trimethoprim, tetracycline, nalidixic acid and ciprofloxacin. PCR and DNA sequencing were used for screening and characterization of antibiotic-resistance determinants. PCR sequencing analysis revealed the presence of only one type of class 1 integron in one isolate of Shigella sonnei. This class 1 integron was 1904 bp and contained two gene cassettes: a probable esterase/lipase (estX) and aadA1, which confers resistance to streptomycin and spectinomycin. Two types of class 2 integron were identified in this study. One was the classic type (2158 bp) and carried the three conserved resistance gene cassettes of the class 2 integron, dfrA1, sat1 and aadA1, which confer resistance to trimethoprim, streptothricin and streptomycin/spectinomycin, respectively. This type was detected in both Shigella sonnei (14 isolates) and Shigella flexneri (five isolates). The other type was shorter (1313 bp) and carried only two gene cassettes, dfrA1 and sat1. This integron was detected in a single isolate of Shigella sonnei. PFGE patterns showed limited diversity within clusters of the same species. Furthermore, an extended-spectrum beta-lactamase gene, bla(OXA-30), which confers resistance to ampicillin, was characterized in all isolates of Shigella flexneri except the oldest strain, which was isolated in 2000. Southern blot hybridization and conjugation experiments showed that bla(OXA-30) was located in the chromosome.
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Affiliation(s)
- Ashraf M Ahmed
- Department of Microbiology, Faculty of Veterinary Medicine, Kafr El-Sheikh University, Kafr El-Sheikh 33516, Egypt
- Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima 739-8528, Japan
| | - Kimi Furuta
- Division of Biological Science, Hiroshima City Institute of Public Health, Hiroshima 733-8650, Japan
| | - Kei Shimomura
- Division of Biological Science, Hiroshima City Institute of Public Health, Hiroshima 733-8650, Japan
| | - Yoshio Kasama
- Division of Biological Science, Hiroshima City Institute of Public Health, Hiroshima 733-8650, Japan
| | - Tadashi Shimamoto
- Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima 739-8528, Japan
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Farshad S, Sheikhi R, Japoni A, Basiri E, Alborzi A. Characterization of Shigella strains in Iran by plasmid profile analysis and PCR amplification of ipa genes. J Clin Microbiol 2006; 44:2879-83. [PMID: 16891506 PMCID: PMC1594633 DOI: 10.1128/jcm.00310-06] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To characterize Shigella clinical strains, we studied 82 Shigella strains recovered from 719 stool samples of patients with bloody diarrhea in Shiraz, Iran, over the period from April to October 2003. Serological assay classified the Shigella isolates as follows: 61 (74.39%) Shigella sonnei isolates, 16 (19.51%) Shigella flexneri isolates, 3 (3.65%) Shigella boydii isolates, and 2 (2.43%) Shigella dysenteriae isolates. In an antibiogram test, all Shigella strains were susceptible to ceftazidime, ciprofloxacin, and ceftriaxone. They showed high degrees of sensitivity to nalidixic acid, gentamicin, cephalothin, and amikacin. Approximately 90.24% of the Shigella isolates were resistant to co-trimoxazole. The plasmid profile patterns of all strains were determined by a modified alkaline lysis method. The average number of plasmid bands for each strain was 9.5. By plasmid profile analysis we identified 56 genotypes among all isolates and 42, 14, 3, and 2 genotypes among the S. sonnei, S. flexneri, S. boydii, and S. dysenteriae strains, respectively. PCR assays showed that all isolates were positive for two virulence genes, ipaBCD and ipaH. In conclusion, these data mandate local monitoring of drug resistance and its consideration in the empirical therapy of Shigella infections. These results also demonstrate that plasmid profile analysis is more reliable than antibiotic susceptibility pattern analysis for the identification of Shigella epidemic strains isolated in Iran.
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Affiliation(s)
- Shohreh Farshad
- Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Nemazi Hospital, Shiraz 71937-11351, Iran.
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Talukder KA, Islam Z, Dutta DK, Islam MA, Khajanchi BK, Azmi IJ, Iqbal MS, Hossain MA, Faruque ASG, Nair GB, Sack DA. Antibiotic resistance and genetic diversity of Shigella sonnei isolated from patients with diarrhoea between 1999 and 2003 in Bangladesh. J Med Microbiol 2006; 55:1257-1263. [PMID: 16914657 DOI: 10.1099/jmm.0.46641-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Shigella sonnei is a significant cause of diarrhoeal infection in both developing and industrialized countries. From 1999 to 2003, 445 strains of Shigella sonnei were isolated from patients admitted to the diarrhoea treatment centre of the International Center for Diarrhoeal Disease Research, Bangladesh. More than 60% of the isolates were resistant to nalidixic acid, 89% to sulfamethoxazole-trimethoprim and 9.5% to ampicillin. In addition, 4% of strains were resistant to multiple antibiotics (AmpR TetR SxtR StrR) and 4.2% of strains were sensitive to all antibiotics tested. None of the strains were positive for the set1 gene, whereas 46% were positive for the sen gene. Forty-six per cent of the strains (stored at -70 degrees C) harboured the 120 MDa invasive plasmid and representative strains produced keratoconjunctivitis in the guinea pig eye. In addition, three plasmids of approximately 5, 1.8 and 1.4 MDa were found to be present in more than 90% of the strains. A self-transmissible, middle-ranged plasmid (35-80 MDa) carrying the multiple antibiotic resistance gene was found in some strains. PFGE analysis of the strains identified five unique types with many subtypes, which were characterized into four unique types by ribotyping analysis. It can be concluded that endemic strains of Shigella sonnei isolated from patients in Bangladesh are diverse in their genetic pattern.
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Affiliation(s)
- Kaisar A Talukder
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - Zhahirul Islam
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - Dilip K Dutta
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - M Aminul Islam
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - Bijay K Khajanchi
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - Ishrat J Azmi
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - Mohd S Iqbal
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - M A Hossain
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - A S G Faruque
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - G Balakrish Nair
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
| | - David A Sack
- ICDDR, B, Centre for Health and Population Research, GPO Box-128, Dhaka-1000, Bangladesh
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PICHEL M, GONZÁLEZ FRAGA S, TERRAGNO R, MULKI J, GENTILE A, KREMER C, MOLA A, NOSEDA R, BINSZTEIN N. Short report: analysis of clonal relationship among Shigella sonnei isolates circulating in Argentina. Epidemiol Infect 2006; 135:681-7. [PMID: 16999876 PMCID: PMC2870610 DOI: 10.1017/s0950268806007230] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Thirty-five isolates of Shigella sonnei from patients with diarrhoea in three geographic regions of Argentina were examined for genetic diversity by pulsed-field gel electrophoresis (PFGE) and plasmid profile. PFGE of XbaI and BlnI DNA digests confirmed the occurrence of outbreaks in two regions caused by two separate predominant clones of S. sonnei. The third region was characterized by three circulating clones, one of which was possibly associated with an outbreak. Similar plasmids were found in distinct clones and in one outbreak clone five different plasmid profiles were identified. Antimicrobial resistance of the isolates varied from fully susceptible to the agents tested, to resistance to cotrimoxazole, ampicillin and ciprofloxacin. Antibiotic resistance did not correlate with plasmid content. This information will form the basis for active surveillance of shigellosis in Argentina and elsewhere in the region through the PulseNet International Network.
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Affiliation(s)
- M. PICHEL
- Departamento Bacteriología, Instituto Nacional de Enfermedades Infecciosas – ANLIS ‘Carlos G. Malbran’, Buenos Aires, Argentina
| | - S. GONZÁLEZ FRAGA
- Departamento Bacteriología, Instituto Nacional de Enfermedades Infecciosas – ANLIS ‘Carlos G. Malbran’, Buenos Aires, Argentina
| | - R. TERRAGNO
- Departamento Bacteriología, Instituto Nacional de Enfermedades Infecciosas – ANLIS ‘Carlos G. Malbran’, Buenos Aires, Argentina
| | - J. MULKI
- Servicio Microbiología, Hospital del Niño Jesús de Praga, Salta, Argentina
| | - A. GENTILE
- Coordinación de Gestión Epidemiológica de Salta, Ministerio de Salud Pública, Salta, Argentina
| | - C. KREMER
- Laboratorio de Microbiología, Hospital Provincial Neuquén ‘Dr. Eduardo Castro Rendón’, Neuquén, Argentina
| | - A. M. MOLA
- Laboratorio de Microbiología, Hospital Zonal Materno Infantil ‘Argentina Diego’, Azul, Argentina
| | | | - N. BINSZTEIN
- Departamento Bacteriología, Instituto Nacional de Enfermedades Infecciosas – ANLIS ‘Carlos G. Malbran’, Buenos Aires, Argentina
- *Author for correspondence: Dr N. Binsztein, Instituto Nacional de Enfermedades Infecciosas – ANLIS ‘Carlos G. Malbran’, Departamento Bacteriología, Av. Vélez Sarsfield 563, Buenos Aires – C1282AFF, Argentina. ()
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De Lappe N, Doran G, Connor JO, Mammina C, Cormican M. Use of pulsed-field gel electrophoresis for comparison of similar but distinguishable isolates of Shigella sonnei collected in Ireland and Italy. J Clin Microbiol 2006; 44:3808-10. [PMID: 16928969 PMCID: PMC1594758 DOI: 10.1128/jcm.01286-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Comparison of pulsed-field gel electrophoresis patterns (generated with XbaI and BlnI) of Shigella sonnei isolates from Ireland and Italy suggests that two possibly distantly related lineages are present in both countries. Smaller, more closely related groups, including isolates from Ireland and Italy, were also noted. These groups raise the possibility that the dissemination of clonal groups of S. sonnei may have occurred in recent years.
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Affiliation(s)
- N De Lappe
- National Salmonella Reference Laboratory, Medical Microbiology Department, National University of Ireland--Galway, Newcastle Road, Galway, Ireland.
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Mammina C, Aleo A, Romani C, Nastasi A. Shigella sonnei biotype G carrying class 2 integrons in southern Italy: a retrospective typing study by pulsed field gel electrophoresis. BMC Infect Dis 2006; 6:117. [PMID: 16846516 PMCID: PMC1538607 DOI: 10.1186/1471-2334-6-117] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2006] [Accepted: 07/17/2006] [Indexed: 11/27/2022] Open
Abstract
Background Emergence and global dissemination of multiresistant strains of enteric pathogens is a very concerning problem from both epidemiological and Public Health points of view. Shigella sonnei is the serogroup of Shigella most frequently responsible for sporadic and epidemic enteritis in developed countries. The dissemination is associated most often to human to human transmission, but foodborne episodes have also been described. In recent years the circulation of multiresistant strains of S. sonnei biotype g carrying a class 2 integron has been reported in many countries worldwide. In southern Italy a strain with similar properties has been responsible for a large community outbreak occurred in 2003 in Palermo, Sicily. The objective of this study was to date the emergence of the biotype g strain carrying the class 2 integron in southern Italy and to evaluate the genetic heterogeneity of biotype g S. sonnei isolated throughout an extended interval of time. Methods A total of 31 clinical isolates of S. sonnei biotype g identified in southern Italy during the years 1971–2000 were studied. The strains were identified at the serogroup level, characterized by biochemical tests and submitted to antimicrobial susceptibility testing. Molecular typing was performed by pulsed field gel electrophoresis (PFGE) after digestion of DNA by XbaI. Carriage of class 2 integrons was investigated by polymerase chain reaction (PCR) with specific primers and confirmed by restriction endonuclease analysis of amplicons. Results The 15 isolates of S. sonnei biotype g identified in the decade 1971–1980 showed highly heterogeneous drug resistance profiles and pulsotypes. None of the isolates was simultaneous resistant to streptomycin and trimethoprim and none was class 2 integron positive. On the contrary, this resistance phenotype and class 2 integron carriage were very common among the 16 strains of biotype g identified in the following two decades. Moreover, all the more recent isolates, but one, showed closely related pulsotypes. Conclusion Although our findings refer to a limited geographic area, they provide a snapshot of integron acquisition by an enteric pathogen responsible for several outbreaks in the years 2001–2003 in Italy. Molecular typing, indeed, suggests that the emergence of biotype g class 2 integron carrying S. sonnei in southern Italy should be backdated to at least the late 1980s. In the following decades, the circulation of biotype g appears to be sustained by multiresistant highly related strains. Similar trend are described in several countries, but the questions about mechanism of emergence and worldwide spread of this pathogen remain open.
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Affiliation(s)
- Caterina Mammina
- Centre for Enteric Pathogens of southern Italy (CEPIM), Department of Hygiene and Microbiology "G. D'Alessandro", University, Via del Vespro 133, 90127 Palermo, Italy
| | - Aurora Aleo
- Centre for Enteric Pathogens of southern Italy (CEPIM), Department of Hygiene and Microbiology "G. D'Alessandro", University, Via del Vespro 133, 90127 Palermo, Italy
| | - Cristina Romani
- Department of Public Health, University, Via G.B. Morgagni 54, Florence, Italy
| | - Antonino Nastasi
- Department of Public Health, University, Via G.B. Morgagni 54, Florence, Italy
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Pan JC, Ye R, Meng DM, Zhang W, Wang HQ, Liu KZ. Molecular characteristics of class 1 and class 2 integrons and their relationships to antibiotic resistance in clinical isolates of Shigella sonnei and Shigella flexneri. J Antimicrob Chemother 2006; 58:288-96. [PMID: 16766536 DOI: 10.1093/jac/dkl228] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To analyse the gene cassettes and determine the roles of class 1 and class 2 integrons in antibiotic-resistant strains of Shigella sonnei (n=31) and Shigella flexneri (n=33). METHODS Various molecular techniques, including PCR and Southern-blotting analysis, were used to analyse various markers of class 1 and class 2 integrons in these 64 S. sonnei and S. flexneri isolates collected in Hangzhou, China. The gene cassette arrays in integrons were identified by DNA sequencing and/or restriction fragment length polymorphism. Two genomic DNA fragments, one containing intI1 from a S. flexneri isolate that contains intI1 but lacks 3'-conserved region and another containing intI2 from a S. sonnei isolate, were cloned into pUC19 vectors and sequenced. The links between integron gene cassette arrays and antibiotic resistance were analysed. RESULTS Class 2 integrons were present in 80.6% (25/31) of the S. sonnei isolates and 87.9% (29/33) of the S. flexneri isolates. All of these integron 2-positive isolates contained constant gene cassette arrays of dfrA1+sat1+aadA1 which confer resistance to trimethoprim and streptomycin. It was demonstrated that the class 2 integron was located in the Tn7 region inside the attTn7 locus downstream of glmS in Shigella. Class 1 integrons were found in 9.4% (6/64) of Shigella spp. isolates. An atypical class 1 integron without a 3'-conserved segment on the Shigella chromosome, termed Shigella atypical class 1 integron (SAI), was present in 84.9% (28/33) of S. flexneri isolates. The SAI contained two gene cassettes, bla(OXA30) and aadA1; however, the SAI conferred resistance to ampicillin, but not to streptomycin, in Escherichia coli host. The bla(OXA30) and aadA1 cassettes of the SAI seemed to be always coordinately excised or integrated. CONCLUSIONS Multiple and complex mechanisms involving mobile genetic elements in class 1 and class 2 integrons and antibiotic resistance have been developed in the evolution of Shigella strains.
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Affiliation(s)
- Jing-Cao Pan
- Microbiology Laboratory, Hangzhou Center for Disease Control and Prevention Hangzhou 310006, People's Republic of China.
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Affiliation(s)
- Ashraf M Ahmed
- Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8528, Japan
| | - Fumio Kawaguchi
- Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8528, Japan
| | - Tadashi Shimamoto
- Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-8528, Japan
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Valverde A, Cantón R, Galán JC, Nordmann P, Baquero F, Coque TM. In117, an unusual In0-like class 1 integron containing CR1 and bla(CTX-M-2) and associated with a Tn21-like element. Antimicrob Agents Chemother 2006; 50:799-802. [PMID: 16436750 PMCID: PMC1366881 DOI: 10.1128/aac.50.2.799-802.2006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An unusual In0-like class 1 integron containing a common region that includes the putative recombinase gene named orf513 (CR1) and bla(CTX-M-2) was characterized from Escherichia coli. The integron contained an unusual gene cassette array, estX-aadA1, embedded between the 5'-conserved segment (5'-CS) and 3'-CS1 regions and was flanked by mer-Tn21 sequences downstream of the tni truncated module. This element constitutes one of the few examples of CR1-bearing class 1 integrons that has been fully characterized.
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Mammina C, Pontello M, Dal Vecchio A, Nastasi A. Identification of Shigella sonnei biotype g isolates carrying class 2 integrons in Italy (2001 to 2003). J Clin Microbiol 2005; 43:2467-70. [PMID: 15872285 PMCID: PMC1153732 DOI: 10.1128/jcm.43.5.2467-2470.2005] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Phenotyping and genotyping have been carried out on 64 epidemic and sporadic isolates of Shigella sonnei identified in Italy in the years 2001 to 2003. Class 2 integron carriage has been also investigated. Isolates from four of the five outbreaks and four of six sporadic cases were biotype g, pulsed-field gel electrophoresis type B, and class 2 integron positive, suggesting emergence and spread of an epidemic clone in Italy.
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Affiliation(s)
- Caterina Mammina
- Dipartimento di Igiene e Microbiologia G. D'Alessandro, Via del Vespro 133, 0127 Palermo, Italy.
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Kim SH, Wei CI, An H. Molecular characterization of multidrug-resistant Proteus mirabilis isolates from retail meat products. J Food Prot 2005; 68:1408-13. [PMID: 16013378 DOI: 10.4315/0362-028x-68.7.1408] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sixty-four multidrug-resistant isolates of Proteus mirabilis were collected from retail meat products in Oklahoma. The isolates showed four different patterns of antibiotic resistance based on their resistant phenotype and genotypes. Most of these isolates were resistant to ampicillin, tetracycline, gentamycin, and kanamycin. Class 1 integrons were detected as a common carrier of the antibiotic-resistant genes, such as aadA1, aadB, and aadA2. A few isolates (9%) contained class 2 integrons with three gene cassettes included: dhfr1, sat1, and aadA1. These isolates were even resistant to nalidixic acid due to mutations in gyrA and parC. All ampicillin-resistant isolates contained blaTEM-1. Plasmids that contained class 1 or 2 integrons and blaTEM-1 were able to be transferred from P. mirabilis isolates into Escherichia coli by conjugation, indicating that conjugal transfer could contribute to the dissemination of antibiotic resistance genes between the Enterobacteriaceae species.
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Affiliation(s)
- Shin-Hee Kim
- Department of Nutritional Sciences, College of Human Environmental Sciences, Oklahoma State University, Stillwater, Oklahoma 74078, USA.
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Lee YS, Liu MC, Ko CF, Lu CH, Tseng YH. Molecular epidemiology of Shigella flexneri in a long-stay psychiatric nursing center during 2001 to 2003. J Clin Microbiol 2005; 43:1353-60. [PMID: 15750107 PMCID: PMC1081245 DOI: 10.1128/jcm.43.3.1353-1360.2005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
With six separate wards accommodating more than 1,600 patients, V Nursing Center (VNC) is a long-stay psychiatric nursing center in eastern Taiwan. During 2001 to 2003, 39 shigellosis cases occurred in VNC. Different from the notion that most cases of shigellosis are caused by Shigella sonnei, all except one of these cases were caused by S. flexneri, with the remaining one caused by an S. sonnei isolate. O-antigen serotyping showed that the 38 S. flexneri strains were of either type 1a (n = 20) or 4a (n = 18), two less prevalent serotypes in Taiwan. NotI-based pulsed-field gel electrophoresis analyses performed with 8 type 1a non-VNC strains and 9 type 4a non-VNC strains isolated from 1996 to 2003 for comparison divided the 28 type 1a strains and the 27 type 4a strains into 7 and 10 subtypes, designated subtypes P1A to P1G and subtypes P4A to P4J, respectively. Subtypes P1A and P4A, which appeared in three consecutive years in VNC as well as outside of VNC, are the most prevalent subtypes. Analyses of the relatedness of the VNC strains on the basis of the banding patterns grouped the type 1a and 4a strains into four and five clusters, respectively. All except one of the type 1a strains had 95% similarity, indicating that they had a common parent, whereas the type 4a strains had similarities that ranged from 77 to 93%, suggesting that they were of diverse origins. In two of the outbreaks, less related subtypes of the type 4a strains were found in the same VNC wards in consecutive years, suggesting the possible existence of different subtypes in VNC all the time. Antibiotic susceptibility testing showed that all except one of the S. flexneri strains were sensitive to at least seven antibiotics; the remaining isolate was sensitive to three antibiotics. The data from the latter tests should be helpful for selection of proper treatments for S. flexneri infections in Taiwan.
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Affiliation(s)
- Yeong-Sheng Lee
- Center for Research and Development, Chungtai Institute of Health Sciences and Technology, Taichung 406, Taiwan
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