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McCarley A, Espejo ML, Harmon DE, Ruiz C. Freshwater and Marine Environments in California Are a Reservoir of Carbapenem-Resistant Bacteria. Microorganisms 2024; 12:802. [PMID: 38674746 PMCID: PMC11052360 DOI: 10.3390/microorganisms12040802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
Carbapenems are last-resort antibiotics used to treat multidrug-resistant bacterial infections. Resistance to carbapenems has been designated as an urgent threat and is increasing in healthcare settings. However, little is still known about the distribution and characteristics of carbapenem-resistant bacteria (CRB) outside of healthcare settings. Here, we surveyed the distribution of CRB in ten diverse freshwater and seawater environments in California, U.S., ranging from San Luis Obispo County to San Bernardino County, combining both direct isolation and enrichment approaches to increase the diversity of isolated CRB. From the locations surveyed, we selected 30 CRB for further characterization. These isolates were identified as members of the genera Aeromonas, Enterobacter, Enterococcus, Paenibacillus, Pseudomonas, Sphingobacterium, and Stenotrophomonas. These isolates were resistant to carbapenems, other β-lactams, and often to other antibiotics (tetracycline, gentamicin, or ciprofloxacin). We also found that nine isolates belonging to the genera Aeromonas, Enterobacter (blaIMI-2), and Stenotrophomonas (blaL1) produced carbapenemases. Overall, our findings indicate that sampling different types of aquatic environments and combining different isolation approaches increase the diversity of the environmental CRB obtained. Moreover, our study supports the increasingly recognized role of natural water systems as an underappreciated reservoir of bacteria resistant to carbapenems and other antibiotics, including bacteria carrying carbapenemase genes.
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Affiliation(s)
| | | | | | - Cristian Ruiz
- Department of Biology, California State University Northridge, Northridge, CA 91330, USA
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Javed MU, Hayat MT, Mukhtar H, Imre K. CRISPR-Cas9 System: A Prospective Pathway toward Combatting Antibiotic Resistance. Antibiotics (Basel) 2023; 12:1075. [PMID: 37370394 DOI: 10.3390/antibiotics12061075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/05/2023] [Accepted: 05/17/2023] [Indexed: 06/29/2023] Open
Abstract
Antibiotic resistance is rising to dangerously high levels throughout the world. To cope with this problem, scientists are working on CRISPR-based research so that antibiotic-resistant bacteria can be killed and attacked almost as quickly as antibiotic-sensitive bacteria. Nuclease activity is found in Cas9, which can be programmed with a specific target sequence. This mechanism will only attack pathogens in the microbiota while preserving commensal bacteria. This article portrays the delivery methods used in the CRISPR-Cas system, which are both viral and non-viral, along with its implications and challenges, such as microbial dysbiosis, off-target effects, and failure to counteract intracellular infections. CRISPR-based systems have a lot of applications, such as correcting mutations, developing diagnostics for infectious diseases, improving crops productions, improving breeding techniques, etc. In the future, CRISPR-based systems will revolutionize the world by curing diseases, improving agriculture, and repairing genetic disorders. Though all the drawbacks of the technology, CRISPR carries great potential; thus, the modification and consideration of some aspects could result in a mind-blowing technique to attain all the applications listed and present a game-changing potential.
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Affiliation(s)
| | | | - Hamid Mukhtar
- Institute of Industrial Biotechnology, Government College University, Lahore 54000, Pakistan
| | - Kalman Imre
- Department of Animal Production and Veterinary Public Health, Faculty of Veterinary Medicine, University of Life Sciences "King Mihai I" from Timişoara, 300645 Timișoara, Romania
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3
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Caliskan-Aydogan O, Alocilja EC. A Review of Carbapenem Resistance in Enterobacterales and Its Detection Techniques. Microorganisms 2023; 11:1491. [PMID: 37374993 DOI: 10.3390/microorganisms11061491] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Infectious disease outbreaks have caused thousands of deaths and hospitalizations, along with severe negative global economic impacts. Among these, infections caused by antimicrobial-resistant microorganisms are a major growing concern. The misuse and overuse of antimicrobials have resulted in the emergence of antimicrobial resistance (AMR) worldwide. Carbapenem-resistant Enterobacterales (CRE) are among the bacteria that need urgent attention globally. The emergence and spread of carbapenem-resistant bacteria are mainly due to the rapid dissemination of genes that encode carbapenemases through horizontal gene transfer (HGT). The rapid dissemination enables the development of host colonization and infection cases in humans who do not use the antibiotic (carbapenem) or those who are hospitalized but interacting with environments and hosts colonized with carbapenemase-producing (CP) bacteria. There are continuing efforts to characterize and differentiate carbapenem-resistant bacteria from susceptible bacteria to allow for the appropriate diagnosis, treatment, prevention, and control of infections. This review presents an overview of the factors that cause the emergence of AMR, particularly CRE, where they have been reported, and then, it outlines carbapenemases and how they are disseminated through humans, the environment, and food systems. Then, current and emerging techniques for the detection and surveillance of AMR, primarily CRE, and gaps in detection technologies are presented. This review can assist in developing prevention and control measures to minimize the spread of carbapenem resistance in the human ecosystem, including hospitals, food supply chains, and water treatment facilities. Furthermore, the development of rapid and affordable detection techniques is helpful in controlling the negative impact of infections caused by AMR/CRE. Since delays in diagnostics and appropriate antibiotic treatment for such infections lead to increased mortality rates and hospital costs, it is, therefore, imperative that rapid tests be a priority.
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Affiliation(s)
- Oznur Caliskan-Aydogan
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI 48824, USA
- Global Alliance for Rapid Diagnostics, Michigan State University, East Lansing, MI 48824, USA
| | - Evangelyn C Alocilja
- Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI 48824, USA
- Global Alliance for Rapid Diagnostics, Michigan State University, East Lansing, MI 48824, USA
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Abavisani M, Khayami R, Hoseinzadeh M, Kodori M, Kesharwani P, Sahebkar A. CRISPR-Cas system as a promising player against bacterial infection and antibiotic resistance. Drug Resist Updat 2023; 68:100948. [PMID: 36780840 DOI: 10.1016/j.drup.2023.100948] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/25/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
The phenomenon of antibiotic resistance (AR) and its increasing global trends and destructive waves concerns patients and the healthcare system. In order to combat AR, it is necessary to explore new strategies when the current antibiotics fail to be effective. Thus, knowing the resistance mechanisms and appropriate diagnosis of bacterial infections may help enhance the sensitivity and specificity of novel strategies. On the other hand, resistance to antimicrobial compounds can spread from resistant populations to susceptible ones. Antimicrobial resistance genes (ARGs) significantly disseminate AR via horizontal and vertical gene transfer. The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas system is a member of the bacterial immune system with the ability to remove the ARGs; therefore, it can be introduced as an effective and innovative strategy in the battle against AR. Here, we reviewed CRISPR-based bacterial diagnosis technologies. Moreover, the strategies to battle AR based on targeting bacterial chromosomes and resistance plasmids using the CRISPR-Cas system have been explained. Besides, we have presented the limitations of CRISPR delivery and potential solutions to help improve the future development of CRISPR-based platforms.
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Affiliation(s)
- Mohammad Abavisani
- Student research committee, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran; Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran
| | - Reza Khayami
- Department of Medical Genetics and Molecular Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran
| | - Melika Hoseinzadeh
- Student research committee, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran
| | - Mansoor Kodori
- Non communicable Diseases Research Center, Bam University of Medical sciences, Bam, the Islamic Republic of Iran
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India; Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Chennai, India
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran; Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, the Islamic Republic of Iran.
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Mutuku C, Melegh S, Kovacs K, Urban P, Virág E, Heninger R, Herczeg R, Sonnevend Á, Gyenesei A, Fekete C, Gazdag Z. Characterization of β-Lactamases and Multidrug Resistance Mechanisms in Enterobacterales from Hospital Effluents and Wastewater Treatment Plant. Antibiotics (Basel) 2022; 11:antibiotics11060776. [PMID: 35740182 PMCID: PMC9219941 DOI: 10.3390/antibiotics11060776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 01/11/2023] Open
Abstract
Antimicrobials in wastewater promote the emergence of antibiotic resistance, facilitated by selective pressure and transfer of resistant genes. Enteric bacteria belonging to Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Citrobacter species (n = 126) from hospital effluents and proximate wastewater treatment plant were assayed for susceptibility to four antimicrobial classes. The β-lactamase encoding genes harbored in plasmids were genotyped and the plasmids were sequenced. A multidrug resistance phenotype was found in 72% (n = 58) of E. coli isolates, 70% (n = 43) of Klebsiella species isolates, and 40% (n = 25) of Enterobacter and Citrobacter species. Moreover, 86% (n = 50) of E. coli, 77% (n = 33) of Klebsiella species, and 25% (n = 4) of Citrobacter species isolates phenotypically expressed extended spectrum β-lactamase. Regarding ESBL genes, blaCTX-M-27 and blaTEM-1 were found in E. coli, while Klebsiella species harbored blaCTX-M-15, blaCTX-M-30, or blaSHV-12. Genes coding for aminoglycoside modifying enzymes, adenylyltransferases (aadA1, aadA5), phosphotransferases (aph(6)-1d, aph(3″)-Ib), acetyltransferases (aac(3)-IIa), (aac(6)-Ib), sulfonamide/trimethoprim resistant dihydropteroate synthase (sul), dihydrofolate reductase (dfrA), and quinolone resistance protein (qnrB1) were also identified. Monitoring wastewater from human sources for acquired resistance in clinically important bacteria may provide a cheaper alternative in regions facing challenges that limit clinical surveillance.
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Affiliation(s)
- Christopher Mutuku
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
- Correspondence: (C.M.); (Z.G.)
| | - Szilvia Melegh
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Krisztina Kovacs
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Peter Urban
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Eszter Virág
- Educomat Ltd., Iskola utca 12/A, 8360 Keszthely, Hungary;
- Department of Molecular Biotechnology and Microbiology, Institute of Biotechnology, Faculty of Science and Technology, University of Debrecen, Egyetem Square 1, 4032 Debrecen, Hungary
| | - Reka Heninger
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
| | - Robert Herczeg
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Ágnes Sonnevend
- Department of Medical Microbiology and Immunology, Medical School, University of Pécs, 7622 Pécs, Hungary; (S.M.); (K.K.); (Á.S.)
| | - Attila Gyenesei
- Bioinformatics Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary; (P.U.); (R.H.); (A.G.)
| | - Csaba Fekete
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
| | - Zoltan Gazdag
- Department of General and Environmental Microbiology, Faculty of Sciences, University of Pécs, 7622 Pécs, Hungary; (R.H.); (C.F.)
- Correspondence: (C.M.); (Z.G.)
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Sriram KK, Ekedahl E, Hoang NTB, Sewunet T, Berglund B, Lundberg L, Nematzadeh S, Nilsson M, Nilsson LE, Le NK, Tran DM, Hanberger H, Olson L, Larsson M, Giske CG, Westerlund F. High diversity of bla NDM-1-encoding plasmids in Klebsiella pneumoniae isolated from neonates in a Vietnamese hospital. Int J Antimicrob Agents 2021; 59:106496. [PMID: 34921976 DOI: 10.1016/j.ijantimicag.2021.106496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 09/08/2021] [Accepted: 12/01/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The carbapenemase-encoding gene blaNDM-1 has been reported in Vietnam over the last ten years, and blaNDM-producing Enterobacteriaceae are now silently and rapidly spreading. A key factor behind dissemination of blaNDM-1 are plasmids, mobile genetic elements that commonly carry antibiotic resistance genes and spread via conjugation. Here, we characterized the diversity of blaNDM-1-encoding plasmids from neonates at a large Vietnamese hospital . METHODS 18 fecal Klebsiella pneumoniae and Klebsiella quasipneumoniae isolates collected from 16 neonates at a large pediatric hospital in Vietnam were studied with optical DNA mapping (ODM) and next-generation sequencing (NGS). We identified the plasmid(s) carrying blaNDM-1 by combining ODM with Cas9 restriction. By comparing the plasmids between isolates, we could investigate if the same plasmid was present in different patients. RESULTS Although the same plasmid was found among some isolates, ODM confirmed that there were at least 10 different plasmids encoding blaNDM-1 among the 18 isolates collected from 16 neonates, suggesting a large plasmid diversity. The ODM results were in large agreement with the NGS data. Interestingly, some isolates had two distinct plasmids encoding blaNDM-1, which could be readily detected with ODM. Thus far, the coexistence of different plasmids carrying the same carbapenem resistance gene in an isolate encoding blaNDM-1 has rarely been reported, likely due to limitations in existing plasmid characterization techniques. CONCLUSIONS Our results show that the plasmids encoding blaNDM-1 in this cohort were very diverse, suggesting a similar picture in the Vietnamese society. The study also highlights important aspects of the usefulness of ODM for plasmid analysis.
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Affiliation(s)
- K K Sriram
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Elina Ekedahl
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Ngoc Thi Bich Hoang
- Department of Microbiology, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Tsegaye Sewunet
- Division of Clinical Microbiology, Department of Laboratory medicine, Karolinska Institutet, Stockholm, Sweden
| | - Björn Berglund
- Department of Biomedical and Clinical Sciences, Faculty of medicine, Linköping University, Linköping, Sweden
| | - Ludwig Lundberg
- Department of Biomedical and Clinical Sciences, Faculty of medicine, Linköping University, Linköping, Sweden; Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Shoeib Nematzadeh
- Division of Clinical Microbiology, Department of Laboratory medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maud Nilsson
- Department of Biomedical and Clinical Sciences, Faculty of medicine, Linköping University, Linköping, Sweden
| | - Lennart E Nilsson
- Department of Biomedical and Clinical Sciences, Faculty of medicine, Linköping University, Linköping, Sweden
| | - Ngai Kien Le
- Department of Surgery, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Dien Minh Tran
- Department of Infection Control, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Håkan Hanberger
- Department of Biomedical and Clinical Sciences, Faculty of medicine, Linköping University, Linköping, Sweden
| | - Linus Olson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Women and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Mattias Larsson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Christian G Giske
- Division of Clinical Microbiology, Department of Laboratory medicine, Karolinska Institutet, Stockholm, Sweden; Clinical microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Fredrik Westerlund
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
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7
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Ranjan R, Thatikonda S. β-Lactam Resistance Gene NDM-1 in the Aquatic Environment: A Review. Curr Microbiol 2021; 78:3634-3643. [PMID: 34410464 DOI: 10.1007/s00284-021-02630-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
New Delhi Metallo-β-lactamase-1 (NDM-1) offers carbapenem antibiotics resistance that creates an evolving challenge in treating bacterial infections. NDM-1-bearing strains were observed in surface waters around New Delhi in 2010 and after then identified globally. The usage of antibiotics may hasten the growth of the NDM-1-producing bacteria, which pose severe hazards to human and animal health. The emergence of the NDM-1 in the aquatic environment is turning out to be a growing concern worldwide. NDM-1 gene conferring resistance to a widespread class of antibiotics has been observed in bacteria disseminated in animal production wastewaters, hospital sewage, domestic sewage, industrial effluents, wastewater treatment plants, drinking water, surface water, and even in groundwater. This review recapitulates the currently published research studies on the prevalence and geographical distribution of the NDM-1 gene in the aquatic environment, its habitats, and healthcare risk associated with NDM-1-producing bacteria, in addition to molecular techniques employed to reveal the occurrence of the NDM-1 in the aquatic environment, including conventional polymerase chain reaction, real-time qPCR, DNA hybridization, and microarray-based methods.
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Affiliation(s)
- Rajeev Ranjan
- Department of Civil Engineering, Indian Institute of Technology Hyderabad, Sangareddy, Kandi, Telangana, 502285, India
| | - Shashidhar Thatikonda
- Department of Civil Engineering, Indian Institute of Technology Hyderabad, Sangareddy, Kandi, Telangana, 502285, India.
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Hirabayashi A, Yahara K, Mitsuhashi S, Nakagawa S, Imanishi T, Ha VTT, Nguyen AV, Nguyen ST, Shibayama K, Suzuki M. Plasmid analysis of NDM metallo-β-lactamase-producing Enterobacterales isolated in Vietnam. PLoS One 2021; 16:e0231119. [PMID: 34319973 PMCID: PMC8318238 DOI: 10.1371/journal.pone.0231119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/21/2021] [Indexed: 11/19/2022] Open
Abstract
Carbapenem-resistant Enterobacterales (CRE) represent a serious threat to public health due to the lack of treatment and high mortality. The rate of antimicrobial resistance of Enterobacterales isolates to major antimicrobials, including carbapenems, is much higher in Vietnam than in Western countries, but the reasons remain unknown due to the lack of genomic epidemiology research. A previous study suggested that carbapenem resistance genes, such as the carbapenemase gene blaNDM, spread via plasmids among Enterobacterales in Vietnam. In this study, we characterized blaNDM-carrying plasmids in Enterobacterales isolated in Vietnam, and identified several possible cases of horizontal transfer of plasmids both within and among species of bacteria. Twenty-five carbapenem-nonsusceptible isolates from a medical institution in Hanoi were sequenced on Illumina short-read sequencers, and 13 blaNDM-positive isolates, including isolates of Klebsiella pneumoniae, Escherichia coli, Citrobacter freundii, Morganella morganii, and Proteus mirabilis, were further sequenced on an Oxford Nanopore Technologies long-read sequencer to obtain complete plasmid sequences. Almost identical 73 kb IncFII(pSE11)::IncN hybrid plasmids carrying blaNDM-1 were found in a P. mirabilis isolate and an M. morganii isolate. A 112 kb IncFII(pRSB107)::IncN hybrid plasmid carrying blaNDM-1 in an E. coli isolate had partially identical sequences with a 39 kb IncR plasmid carrying blaNDM-1 and an 88 kb IncFII(pHN7A8)::IncN hybrid plasmid in a C. freundii isolate. 148-149 kb IncFIA(Hl1)::IncA/C2 plasmids and 75-76 kb IncFII(Yp) plasmids, both carrying blaNDM-1 were shared among three sequence type 11 (ST11) isolates and three ST395 isolates of K. pneumoniae, respectively. Most of the plasmids co-carried genes conferring resistance to clinically relevant antimicrobials, including third-generation cephalosporins, aminoglycosides, and fluoroquinolones, in addition to blaNDM-1. These results provide insight into the genetic basis of CRE in Vietnam, and could help control nosocomial infections.
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Affiliation(s)
- Aki Hirabayashi
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Yahara
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satomi Mitsuhashi
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - So Nakagawa
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Tadashi Imanishi
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Van Thi Thu Ha
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - An Van Nguyen
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Son Thai Nguyen
- Microbiology Department, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Keigo Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail: (KS); (MS)
| | - Masato Suzuki
- AMR Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail: (KS); (MS)
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Avershina E, Shapovalova V, Shipulin G. Fighting Antibiotic Resistance in Hospital-Acquired Infections: Current State and Emerging Technologies in Disease Prevention, Diagnostics and Therapy. Front Microbiol 2021; 12:707330. [PMID: 34367112 PMCID: PMC8334188 DOI: 10.3389/fmicb.2021.707330] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/29/2021] [Indexed: 12/20/2022] Open
Abstract
Rising antibiotic resistance is a global threat that is projected to cause more deaths than all cancers combined by 2050. In this review, we set to summarize the current state of antibiotic resistance, and to give an overview of the emerging technologies aimed to escape the pre-antibiotic era recurrence. We conducted a comprehensive literature survey of >150 original research and review articles indexed in the Web of Science using "antimicrobial resistance," "diagnostics," "therapeutics," "disinfection," "nosocomial infections," "ESKAPE pathogens" as key words. We discuss the impact of nosocomial infections on the spread of multi-drug resistant bacteria, give an overview over existing and developing strategies for faster diagnostics of infectious diseases, review current and novel approaches in therapy of infectious diseases, and finally discuss strategies for hospital disinfection to prevent MDR bacteria spread.
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Affiliation(s)
- Ekaterina Avershina
- Department of Biotechnology, Inland Norway University of Applied Sciences, Hamar, Norway
- Laboratory or Postgenomic Technologies, Izmerov Research Institute of Occupational Health, Moscow, Russia
| | - Valeria Shapovalova
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Centre for Strategic Planning of FMBA of Russia, Moscow, Russia
| | - German Shipulin
- Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Federal Medical Biological Agency, Centre for Strategic Planning of FMBA of Russia, Moscow, Russia
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10
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Prevalence and Absolute Quantification of NDM-1: a β-Lactam Resistance Gene in Water Compartment of Lakes Surrounding Hyderabad, India. JOURNAL OF APPLIED SCIENCE & PROCESS ENGINEERING 2021. [DOI: 10.33736/jaspe.3104.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
NDM-1(New Delhi Metallo-beta-lactamase-1) is considered an emerging environmental contaminant, which causes severe hazards for public health. The abuse of antimicrobials for public health and veterinary use could favor the proliferation of resistance in bacteria. In this study, screening and absolute quantification of the NDM-1 in 17 water samples collected from a different sampling location surrounding Hyderabad, India performed using a real-time quantitative polymerase chain reaction (qPCR). Absolute quantification achieved by running the isolated DNA (Deoxy-ribonucleic acid) samples from different water bodies in triplicate with the known standards of the NDM-1 and results reported as gene copy number/ng(nanogram) of template DNA. All collected samples had shown a positive signal for the NDM-1 during qPCR analysis. Among the tested samples, the highest gene copy number/ng of template DNA was observed in the Mir Alam tank (985.74). Further, based on pollution sources and observed data, a hierarchical clustering analysis was performed to categorize the different sampling locations and results presented in the form of a dendrogram.
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11
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Cherak Z, Loucif L, Moussi A, Rolain JM. Carbapenemase-producing Gram-negative bacteria in aquatic environments: a review. J Glob Antimicrob Resist 2021; 25:287-309. [PMID: 33895415 DOI: 10.1016/j.jgar.2021.03.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/04/2021] [Accepted: 03/20/2021] [Indexed: 01/05/2023] Open
Abstract
Antibiotic resistance is one of the greatest public-health challenges worldwide, especially with regard to Gram-negative bacteria (GNB). Carbapenems are the β-lactam antibiotics of choice with the broadest spectrum of activity and, in many cases, are the last-resort treatment for several bacterial infections. Carbapenemase-encoding genes, mainly carried by mobile genetic elements, are the main mechanism of resistance against carbapenems in GNB. These enzymes exhibit a versatile hydrolytic capacity and confer resistance to most β-lactam antibiotics. After being considered a clinical issue, increasing attention is being giving to the dissemination of such resistance mechanisms in the environment and especially through water. Aquatic environments are among the most significant microbial habitats on our planet, known as a favourable medium for antibiotic gene transfer, and they play a crucial role in the huge spread of drug resistance in the environment and the community. In this review, we present current knowledge regarding the spread of carbapenemase-producing isolates in different aquatic environments, which may help the implementation of control and prevention strategies against the spread of such dangerous resistant agents in the environment.
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Affiliation(s)
- Zineb Cherak
- Laboratoire de Génétique, Biotechnologie et Valorisation des Bio-ressources (GBVB), Faculté des Sciences Exactes et des Sciences de la Nature et de la Vie, Université Mohamed Khider, Biskra, Algeria
| | - Lotfi Loucif
- Laboratoire de Biotechnologie des Molécules Bioactives et de la Physiopathologie Cellulaire (LBMBPC), Département de Microbiologie et de Biochimie, Faculté des Sciences de la Nature et de la Vie, Université de Batna 2, Batna, Algeria.
| | - Abdelhamid Moussi
- Laboratoire de Génétique, Biotechnologie et Valorisation des Bio-ressources (GBVB), Faculté des Sciences Exactes et des Sciences de la Nature et de la Vie, Université Mohamed Khider, Biskra, Algeria
| | - Jean-Marc Rolain
- Aix-Marseille Université, IRD, MEPHI, Faculté de Médecine et de Pharmacie, Marseille, France; IHU Méditerranée Infection, Marseille, France; and Assistance Publique des Hôpitaux de Marseille, Marseille, France
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12
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Krivitskaya AV, Khrenova MG. Boronic Acids as Prospective Inhibitors of Metallo-β-Lactamases: Efficient Chemical Reaction in the Enzymatic Active Site Revealed by Molecular Modeling. Molecules 2021; 26:2026. [PMID: 33918209 PMCID: PMC8038151 DOI: 10.3390/molecules26072026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/08/2023] Open
Abstract
Boronic acids are prospective compounds in inhibition of metallo-β-lactamases as they form covalent adducts with the catalytic hydroxide anion in the enzymatic active site upon binding. We compare this chemical reaction in the active site of the New Delhi metallo-β-lactamase (NDM-1) with the hydrolysis of the antibacterial drug imipenem. The nucleophilic attack occurs with the energy barrier of 14 kcal/mol for imipenem and simultaneously upon binding a boronic acid inhibitor. A boron atom of an inhibitor exhibits stronger electrophilic properties than the carbonyl carbon atom of imipenem in a solution that is quantified by atomic Fukui indices. Upon forming the prereaction complex between NDM-1 and inhibitor, the lone electron pair of the nucleophile interacts with the vacant p-orbital of boron that facilitates the chemical reaction. We analyze a set of boronic acid compounds with the benzo[b]thiophene core complexed with the NDM-1 and propose quantitative structure-sroperty relationship (QSPR) equations that can predict IC50 values from the calculated descriptors of electron density. These relations are applied to classify other boronic acids with the same core found in the database of chemical compounds, PubChem, and proposed ourselves. We demonstrate that the IC50 values for all considered benzo[b]thiophene-containing boronic acid inhibitors are 30-70 μM.
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Affiliation(s)
- Alexandra V. Krivitskaya
- Bach Institute of Biochemistry, Federal Research Centre “Fundamentals of Biotechnology” of the Russian Academy of Sciences, 119071 Moscow, Russia;
| | - Maria G. Khrenova
- Bach Institute of Biochemistry, Federal Research Centre “Fundamentals of Biotechnology” of the Russian Academy of Sciences, 119071 Moscow, Russia;
- Department of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia
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Hammer-Dedet F, Jumas-Bilak E, Licznar-Fajardo P. The Hydric Environment: A Hub for Clinically Relevant Carbapenemase Encoding Genes. Antibiotics (Basel) 2020; 9:antibiotics9100699. [PMID: 33076221 PMCID: PMC7602417 DOI: 10.3390/antibiotics9100699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/31/2022] Open
Abstract
Carbapenems are β-lactams antimicrobials presenting a broad activity spectrum and are considered as last-resort antibiotic. Since the 2000s, carbapenemase producing Enterobacterales (CPE) have emerged and are been quickly globally spreading. The global dissemination of carbapenemase encoding genes (CEG) within clinical relevant bacteria is attributed in part to its location onto mobile genetic elements. During the last decade, carbapenemase producing bacteria have been isolated from non-human sources including the aquatic environment. Aquatic ecosystems are particularly impacted by anthropic activities, which conduce to a bidirectional exchange between aquatic environments and human beings and therefore the aquatic environment may constitute a hub for CPE and CEG. More recently, the isolation of autochtonous aquatic bacteria carrying acquired CEG have been reported and suggest that CEG exchange by horizontal gene transfer occurred between allochtonous and autochtonous bacteria. Hence, aquatic environment plays a central role in persistence, dissemination and emergence of CEG both within environmental ecosystem and human beings, and deserves to be studied with particular attention.
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Affiliation(s)
- Florence Hammer-Dedet
- UMR 5569 HydroSciences Montpellier, Université de Montpellier, CNRS, IRD, 34090 Montpellier, France; (F.H.-D.); (E.J.-B.)
| | - Estelle Jumas-Bilak
- UMR 5569 HydroSciences Montpellier, Université de Montpellier, CNRS, IRD, 34090 Montpellier, France; (F.H.-D.); (E.J.-B.)
- Département d’Hygiène Hospitalière, CHU Montpellier, 34090 Montpellier, France
| | - Patricia Licznar-Fajardo
- UMR 5569 HydroSciences Montpellier, Université de Montpellier, CNRS, IRD, 34090 Montpellier, France; (F.H.-D.); (E.J.-B.)
- Département d’Hygiène Hospitalière, CHU Montpellier, 34090 Montpellier, France
- Correspondence:
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14
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Ellaby N, Doumith M, Hopkins KL, Woodford N, Ellington MJ. Emergence of diversity in carbapenemase-producing Escherichia coli ST131, England, January 2014 to June 2016. ACTA ACUST UNITED AC 2020; 24. [PMID: 31530344 PMCID: PMC6749775 DOI: 10.2807/1560-7917.es.2019.24.37.1800627] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Escherichia coli ST131, a global, high-risk clone, comprises fluoroquinolone resistance (FQ-R) mutations and CTX-M extended-spectrum beta-lactamases associated with the fimH30-encoding clades, C1 and C2. Further carbapenem resistance development in ST131 is a public health concern. Aim This observational study aimed to probe the diversity of carbapenemase-producing E. coli (CP E. coli) ST131 across England. Methods ST131 isolates were identified using whole-genome sequencing (WGS) data generated for all non-duplicate CP E. coli from human samples submitted to the national reference laboratory from January 2014 to June 2016. Antimicrobial resistance (AMR) gene content and single nucleotide polymorphism (SNP) data were compared against a published ST131 phylogeny and analysed alongside patient metadata. Results Thirty-nine genetically diverse ST131 CP E. coli, from eight of nine regions, represented 10% of CP E. coli isolates sequenced. Ten and eight isolates were from the FQ-susceptible (FQ-S) clades A and B, while eight and 15 isolates belonged to the FQ-R clades C1 or C2, respectively. Seven distinct carbapenemases were identified: KPC-2 (21 isolates, 6 regions) frequently occurred among clade C2 isolates (n = 10). OXA-48-producers (10 isolates, 3 regions) were often from clade A (n = 5). NDM-1 (n = 4), NDM-5 (n = 1), VIM-1 (n = 1), VIM-4 (n = 1) and OXA-181 (n = 1) were also identified. Clade C2 isolates encoded more AMR genes than those from clades A (p = 0.02), B (p = 9.6 x 10−3) or C1 (p = 0.03). Conclusion When compared with its global predominance among ESBL-E. coli, ST131 represented a fraction of the CP E. coli received, belonging to diverse clades and encoding diverse carbapenemases. The greater accumulation of resistance genes in clade C2 isolates highlights the need for ongoing monitoring of this high-risk lineage.
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Affiliation(s)
- Nicholas Ellaby
- Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, United Kingdom
| | - Michel Doumith
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Katie L Hopkins
- Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, United Kingdom
| | - Neil Woodford
- Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, United Kingdom
| | - Matthew J Ellington
- Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, United Kingdom
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15
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Adegoke AA, Fatunla OK, Okoh AI. Critical threat associated with carbapenem-resistant gram-negative bacteria: prioritizing water matrices in addressing total antibiotic resistance. ANN MICROBIOL 2020. [DOI: 10.1186/s13213-020-01579-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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16
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Lopez NV, Farsar CJ, Harmon DE, Ruiz C. Urban and agricultural soils in Southern California are a reservoir of carbapenem-resistant bacteria. Microbiologyopen 2020; 9:1247-1263. [PMID: 32246583 PMCID: PMC7294306 DOI: 10.1002/mbo3.1034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 01/01/2023] Open
Abstract
Carbapenems are last‐resort β‐lactam antibiotics used in healthcare facilities to treat multidrug‐resistant infections. Thus, most studies on identifying and characterizing carbapenem‐resistant bacteria (CRB) have focused on clinical settings. Relatively, little is still known about the distribution and characteristics of CRBs in the environment, and the role of soil as a potential reservoir of CRB in the United States remains unknown. Here, we have surveyed 11 soil samples from 9 different urban or agricultural locations in the Los Angeles–Southern California area to determine the prevalence and characteristics of CRB in these soils. All samples tested contained CRB with a frequency of <10 to 1.3 × 104 cfu per gram of soil, with most agricultural soil samples having a much higher relative frequency of CRB than urban soil samples. Identification and characterization of 40 CRB from these soil samples revealed that most of them were members of the genera Cupriavidus, Pseudomonas, and Stenotrophomonas. Other less prevalent genera identified among our isolated CRB, especially from agricultural soils, included the genera Enterococcus, Bradyrhizobium, Achromobacter, and Planomicrobium. Interestingly, all of these carbapenem‐resistant isolates were also intermediate or resistant to at least 1 noncarbapenem antibiotic. Further characterization of our isolated CRB revealed that 11 Stenotrophomonas, 3 Pseudomonas, 1 Enterococcus, and 1 Bradyrhizobium isolates were carbapenemase producers. Our findings show for the first time that both urban and agricultural soils in Southern California are an underappreciated reservoir of bacteria resistant to carbapenems and other antibiotics, including carbapenemase‐producing CRB.
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Affiliation(s)
- Nicolas V. Lopez
- Department of BiologyCalifornia State University NorthridgeNorthridgeCAUSA
| | - Cameron J. Farsar
- Department of BiologyCalifornia State University NorthridgeNorthridgeCAUSA
| | - Dana E. Harmon
- Department of BiologyCalifornia State University NorthridgeNorthridgeCAUSA
| | - Cristian Ruiz
- Department of BiologyCalifornia State University NorthridgeNorthridgeCAUSA
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Divyashree M, Mani MK, Shama Prakash K, Vijaya Kumar D, Veena Shetty A, Shetty AK, Karunasagar I. Hospital wastewater treatment reduces NDM-positive bacteria being discharged into water bodies. WATER ENVIRONMENT RESEARCH : A RESEARCH PUBLICATION OF THE WATER ENVIRONMENT FEDERATION 2020; 92:562-568. [PMID: 31560139 DOI: 10.1002/wer.1248] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/12/2019] [Accepted: 09/19/2019] [Indexed: 05/29/2023]
Abstract
New Delhi metallo-β-lactamase-1 (NDM-1) is a novel type of metallo-β-lactamase (MBL) associated with Enterobacteriaceae constitutes an important growing public health threat. The present study aims to characterize the NDM-1 producing Gram-negative bacteria (GNB) from the effluents of two tertiary care hospitals in Mangalore, South India and to profile their antibiotic resistance pattern. A total of 134 GNB were isolated from 30 hospital wastewater samples (treated and untreated) and analyzed. High-level resistance among untreated effluent sample was found toward nalidixic acid (74.52%), followed by cefotaxime (72.64%) and ampicillin (66.03%). Among the treated effluent isolates, the high resistance was found toward ampicillin (85.71%) followed by cefotaxime (85.71%) and piperacillin-tazobactam (53.57%). From untreated effluent isolates, 9 were NDM-1 positive by PCR; no isolates from treated effluent samples harbored blaNDM-1 . Untreated hospital wastewater is found to be important reservoirs of antibiotic-resistant bacteria carrying blaNDM-1 , and the presence of such bacteria in the effluents is a matter of great concern because they can contribute the antibiotic resistance to the natural environment. However, the absence of NDM in treated effluents emphasizes the importance of effluent treatment in reducing the dissemination of antibiotic-resistant bacteria. PRACTITIONER POINTS: Hospital wastewater is the important reservoir of antibiotic-resistant bacteria especially metallo-β-lactamase producers (NDM-1). Wastewater treatment procedures in hospitals reduce the NDM isolates in the treated effluent. Thereby reduces the risk of resistance spread in the environment.
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Affiliation(s)
- Mithoor Divyashree
- Department of Biomedical Sciences, Nitte University Center for Science Education and Research (NUCSER), NITTE (Deemed to be University), Mangalore, India
| | - Madhu K Mani
- Department of Biomedical Sciences, Nitte University Center for Science Education and Research (NUCSER), NITTE (Deemed to be University), Mangalore, India
| | | | - Deekshit Vijaya Kumar
- Department of Biomedical Sciences, Nitte University Center for Science Education and Research (NUCSER), NITTE (Deemed to be University), Mangalore, India
| | - Alandur Veena Shetty
- Department of Microbiology, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangalore, India
| | | | - Indrani Karunasagar
- Department of Biomedical Sciences, Nitte University Center for Science Education and Research (NUCSER), NITTE (Deemed to be University), Mangalore, India
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Jean SS, Chang YC, Lin WC, Lee WS, Hsueh PR, Hsu CW. Epidemiology, Treatment, and Prevention of Nosocomial Bacterial Pneumonia. J Clin Med 2020; 9:jcm9010275. [PMID: 31963877 PMCID: PMC7019939 DOI: 10.3390/jcm9010275] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 12/17/2022] Open
Abstract
Septicaemia likely results in high case-fatality rates in the present multidrug-resistant (MDR) era. Amongst them are hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), two frequent fatal septicaemic entities amongst hospitalised patients. We reviewed the PubMed database to identify the common organisms implicated in HAP/VAP, to explore the respective risk factors, and to find the appropriate antibiotic choice. Apart from methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, extended-spectrum β-lactamase-producing Enterobacteriaceae spp., MDR or extensively drug-resistant (XDR)-Acinetobacter baumannii complex spp., followed by Stenotrophomonas maltophilia, Chryseobacterium indologenes, and Elizabethkingia meningoseptica are ranked as the top Gram-negative bacteria (GNB) implicated in HAP/VAP. Carbapenem-resistant Enterobacteriaceae notably emerged as an important concern in HAP/VAP. The above-mentioned pathogens have respective risk factors involved in their acquisition. In the present XDR era, tigecycline, colistin, and ceftazidime-avibactam are antibiotics effective against the Klebsiella pneumoniae carbapenemase and oxacillinase producers amongst the Enterobacteriaceae isolates implicated in HAP/VAP. Antibiotic combination regimens are recommended in the treatment of MDR/XDR-P. aeruginosa or A. baumannii complex isolates. Some special patient populations need prolonged courses (>7-day) and/or a combination regimen of antibiotic therapy. Implementation of an antibiotic stewardship policy and the measures recommended by the United States (US) Institute for Healthcare were shown to decrease the incidence rates of HAP/VAP substantially.
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Affiliation(s)
- Shio-Shin Jean
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Emergency Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medicine University, Taipei 110, Taiwan
- Correspondence: ; Tel.: +886-2-29307930 (ext. 1262)
| | - Yin-Chun Chang
- Division of Thoracic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan; (Y.-C.C.); (W.-C.L.)
| | - Wei-Cheng Lin
- Division of Thoracic Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan; (Y.-C.C.); (W.-C.L.)
| | - Wen-Sen Lee
- Division of Infectious Diseases, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan;
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100, Taiwan;
- Department Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100, Taiwan
| | - Chin-Wan Hsu
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Emergency Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medicine University, Taipei 110, Taiwan
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Huang M, He P, Munir S, Wu Y, Li X, He P, He Y. Ecology and etiology of bacterial top rot in maize caused by Klebsiella pneumoniae KpC4. Microb Pathog 2019; 139:103906. [PMID: 31786257 DOI: 10.1016/j.micpath.2019.103906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 10/25/2022]
Abstract
Klebsiella pneumoniae is an important opportunistic pathogen in humans and animals. Recently, K. pneumoniae KpC4 was identified as a causative agent of bacterial top rot in maize, which has been observed in many areas of Yunnan province, China. KpC4 is potentially dangerous to humans and livestock due to its cross-kingdom infection ability. Our study revealed the disease cycle of maize bacterial top rot caused by KpC4 and the ecological adaptability and host range of KpC4. We found same pathogenicity in maize between KpC4, the environmental strains E1, E4 (K1 serotype), E5, and the clinical strain K. pneumoniae 138 (Kp138). Alternative hosts of K. pneumoniae include not only humans and animals but also a variety of plants (such as maize, banana and sorghum). One of the survival strategies of K. pneumoniae is ecological adaptability, which is an essential factor for KpC4 to be able to cause bacterial top rot in maize. K. pneumoniae, for example, could survive in large numbers (2.34 ± 0.22 × 103 cfu/g) not only in the maize leaves (2.34 ± 0.22 × 103 cfu/g) under natural light, but persist in dried maize plant debris (1.51 × 104 cfu/g) for at least 6 months. K. pneumoniae strains from different sources can generally induce infection in susceptible hosts. Thus, this study revealed the ecological basis of KpC4 cross-kingdom infections, laying the foundation for the study of the mechanisms underlying cross-kingdom infections involving this type of human/animal opportunistic pathogen.
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Affiliation(s)
- Min Huang
- College of Plant Protection, Yunnan Agricultural University, Kunming, 650201, Yunnan, China; College of Agriculture and Life Sciences, Urban Modern Agriculture Engineering Research Center, Kunming University, Kunming, 650214, China
| | - Pengfei He
- College of Plant Protection, Yunnan Agricultural University, Kunming, 650201, Yunnan, China
| | - Shahzad Munir
- College of Plant Protection, Yunnan Agricultural University, Kunming, 650201, Yunnan, China
| | - Yixin Wu
- College of Plant Protection, Yunnan Agricultural University, Kunming, 650201, Yunnan, China
| | - Xingyu Li
- College of Plant Protection, Yunnan Agricultural University, Kunming, 650201, Yunnan, China
| | - Pengbo He
- College of Plant Protection, Yunnan Agricultural University, Kunming, 650201, Yunnan, China
| | - Yueqiu He
- College of Plant Protection, Yunnan Agricultural University, Kunming, 650201, Yunnan, China.
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Mills MC, Lee J. The threat of carbapenem-resistant bacteria in the environment: Evidence of widespread contamination of reservoirs at a global scale. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 255:113143. [PMID: 31541827 DOI: 10.1016/j.envpol.2019.113143] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 08/19/2019] [Accepted: 08/29/2019] [Indexed: 05/10/2023]
Abstract
Environmental reservoirs of antibiotic resistance (AR) are a growing concern that are gathering more attention as potential sources for human infection. Carbapenem-resistant Enterobacteriaceae (CRE) are extremely dangerous, as carbapenems are often drugs of last resort that are used to treat multi-drug resistant infections. Among the genes capable of conferring carbapenem resistance to bacteria, the most transferrable are those that produce carbapenemase, an enzyme that hydrolyzes carbapenems and other β-lactam antibiotics. The goal of this review was to comprehensively identify global environmental reservoirs of carbapenemase-producing genes, as well as identify potential routes of transmission to humans. The genes of interest were Klebsiella pneumoniae carbapenemase (KPC), New Delhi Metallo-β-lactamase (NDM), Oxacillinase-48-type carbapenemases (OXA-48), and Verona Integron-Mediated Metallo-β-lactamase (VIM). Carbapenemase genes have been reported in the environment on almost every continent. Hospital and municipal wastewater, drinking water, natural waterways, sediments, recreational waters, companion animals, wildlife, agricultural environments, food animals, and retail food products were identified as current reservoirs of carbapenemase-producing bacteria and genes. Humans have been recorded as carrying CRE, without recent admittance to a hospital or long-term care facility in France, Egypt, and China. CRE infections from the environment have been reported in patients in Montpellier, France and Cairo, Egypt. This review demonstrates the need for 1) comprehensive monitoring of AR not only in waterways, but also other types of environmental matrices, such as aerosol, dusts, periphyton, and surfaces in indoor environments; and 2) action to reduce the prevalence and mitigate the effects of these potentially deadly resistance genes. In order to develop an accurate quantitative model for environmental dimensions of AR, longitudinal sampling and quantification of AR genes and bacteria are needed, using a One Health approach.
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Affiliation(s)
- Molly C Mills
- College of Public Health, Division of Environmental Health Sciences, The Ohio State University, Columbus, OH, United States; Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, United States
| | - Jiyoung Lee
- College of Public Health, Division of Environmental Health Sciences, The Ohio State University, Columbus, OH, United States; Environmental Sciences Graduate Program, The Ohio State University, Columbus, OH, United States; Department of Food Science & Technology, The Ohio State University, Columbus, OH, United States.
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21
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Emergence of New Delhi Metallo-Beta-Lactamase (NDM) and Klebsiella pneumoniae Carbapenemase (KPC) Production by Escherichia coli and Klebsiella pneumoniae in Southern Vietnam and Appropriate Methods of Detection: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9757625. [PMID: 31179337 PMCID: PMC6507273 DOI: 10.1155/2019/9757625] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/07/2019] [Accepted: 03/31/2019] [Indexed: 01/12/2023]
Abstract
Carbapenemase-producing Enterobacteriaceae (CPE) are well known to cause many serious infections resulting in increasing mortality rate, treatment cost, and prolonged hospitalization. Among the widely recognized types of carbapenemases, New Delhi β-lactamase (NDM) and Klebsiella pneumoniae carbapenemase (KPC) are the most important enzymes. However, in Vietnam, there are only scattered reports of CPE due to the lack of simple and affordable methods that are suitable to laboratory conditions. This study aims to survey the characteristics of carbapenem-resistant E. coli and K. pneumoniae (CR-E/K) at two hospitals in Southern Vietnam and perform some simple methods to detect the two enzymes. A total of 100 CR-E/K strains were collected from clinical isolates of Gia Dinh People's Hospital and Dong Nai General Hospital, Vietnam, from November 2017 to May 2018. The patient-related information was also included in the analysis. We conducted real-time polymerase chain reaction (PCR), Modified Hodge Test (MHT), and combined disk test (CDT) on all isolates. Carbapenemase-encoding genes were detected in 47 isolates (36 NDM, 10 KPC, and one isolate harboring both genes). The E. coli strain carrying simultaneously these two genes was the first case reported here. Most of isolates were collected from patients in ICU, Infectious Disease Department, and Department of Urologic Surgery. Urine and sputum were two common specimens. The true positive rate (sensitivity, TPR) and specificity (SPC) of the imipenem–EDTA (ethylen diamine tetra acetic acid) for NDM detection and the imipenem–PBA (phenylboronic acid) for KPC detection on E. coli were 93.8%, 97.1% and 66.7%, 95.7%, respectively. Meanwhile, the imipenem–EDTA for NDM detection and the imipenem–PBA for KPC detection among K. pneumonia achieved 90.5%, 100% and 100%, 92.9% TPR and SPC, respectively. However, MHT showed low sensitivity and specificity. Our findings showed that CP-E/K were detected with high prevalence in the two hospitals. We suggest that CDT can be used as a low-priced and accurate method of detection.
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Harmon DE, Miranda OA, McCarley A, Eshaghian M, Carlson N, Ruiz C. Prevalence and characterization of carbapenem-resistant bacteria in water bodies in the Los Angeles-Southern California area. Microbiologyopen 2019; 8:e00692. [PMID: 29987921 PMCID: PMC6460273 DOI: 10.1002/mbo3.692] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 01/15/2023] Open
Abstract
Carbapenems are β-lactam antibiotics used in healthcare settings as last resort drugs to treat infections caused by antibiotic-resistant bacteria. Carbapenem-resistant bacteria are increasingly being isolated from healthcare facilities; however, little is known about their distribution or prevalence in the environment, especially in the United States, where their distribution in water environments from the West Coast has not been studied before. The aim of this study was to determine the prevalence of carbapenem-resistant bacteria and carbapenemase genes in water bodies from the Los Angeles area (California, USA). All samples that were analyzed contained carbapenem-resistant bacteria with a frequency of between 0.1 and 324 carbapenem-resistant cfu per 100 mls of water. We identified 76 carbapenem-resistant or -intermediate isolates, most of which were also resistant to noncarbapenem antibiotics, as different strains of Enterobacter asburiae, Aeromonas veronii, Cupriavidus gilardii, Pseudomonas, and Stenotrophomonas species. Of them, 52 isolates were carbapenemase-producers. Furthermore, PCR and sequence analysis to identify the carbapenemase gene of these carbapenemase-producing isolates revealed that all Enterobacter asburiae isolates had a blaIMI-2 gene 100% identical to the reference sequence, and all Stenotrophomonas maltophlia isolates had a blaL1 gene 83%-99% identical to the reference blaL1 . Our findings indicate that water environments in Southern California are an important reservoir of bacteria-resistant to carbapenems and other antibiotics, including bacteria carrying intrinsic and acquired carbapenemase genes.
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Affiliation(s)
- Dana E. Harmon
- Department of BiologyCalifornia State University NorthridgeNorthridgeCalifornia
| | - Osvaldo A. Miranda
- Department of BiologyCalifornia State University NorthridgeNorthridgeCalifornia
| | - Ashley McCarley
- Department of BiologyCalifornia State University NorthridgeNorthridgeCalifornia
| | - Michelle Eshaghian
- Department of BiologyCalifornia State University NorthridgeNorthridgeCalifornia
| | - Natasha Carlson
- Department of BiologyCalifornia State University NorthridgeNorthridgeCalifornia
| | - Cristian Ruiz
- Department of BiologyCalifornia State University NorthridgeNorthridgeCalifornia
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Das UN, Singh AS, Lekshmi M, Nayak BB, Kumar S. Characterization of bla NDM-harboring, multidrug-resistant Enterobacteriaceae isolated from seafood. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:2455-2463. [PMID: 30471059 DOI: 10.1007/s11356-018-3759-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 11/13/2018] [Indexed: 06/09/2023]
Abstract
Carbapenem-resistant Enterobacteriaceae (CRE) have evolved into a major challenge to antibiotic therapy worldwide. The problem is more confounding when wider dissemination of CRE occurs in the community and the environment. In this study, six blaNDM-harboring Enterobacteriaceae, four Klebsiella pneumoniae, and two Escherichia coli, isolated from seafood, were characterized with respect to their antibiotic resistance and the genetic factors responsible for these resistances. The isolates were resistant to all β-lactam antibiotics, quinolones, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline and were susceptible to colistin, polymixin B, fosfomycin, and tigecycline. Four isolates harbored New Delhi metallo β-lactamase (blaNDM-5 genes, while one isolate each harbored blaNDM-1 and blaNDM-2 genes, respectively. The blaNDM genes in all the isolates were flanked by an upstream, truncated ISAba125, and downstream bleMBL-trpF genes. Conjugation experiments showed that the NDM plasmids were readily transmissible. Further, the two blaNDM-positive E. coli isolates belonged to the multidrug-resistant ST131 clone. This study highlights the growing danger of seafood as carriers of multidrug-resistant bacteria leading to their wider dissemination in the community.
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Affiliation(s)
- Uday Narayan Das
- QC Laboratory, Post Harvest Technology Department, ICAR-Central Institute of Fisheries Education (CIFE), Mumbai, 400061, India
| | - Asem Sanjit Singh
- QC Laboratory, Post Harvest Technology Department, ICAR-Central Institute of Fisheries Education (CIFE), Mumbai, 400061, India
| | - Manjusha Lekshmi
- QC Laboratory, Post Harvest Technology Department, ICAR-Central Institute of Fisheries Education (CIFE), Mumbai, 400061, India
| | - Binaya Bhusan Nayak
- QC Laboratory, Post Harvest Technology Department, ICAR-Central Institute of Fisheries Education (CIFE), Mumbai, 400061, India
| | - Sanath Kumar
- QC Laboratory, Post Harvest Technology Department, ICAR-Central Institute of Fisheries Education (CIFE), Mumbai, 400061, India.
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Haller L, Chen H, Ng C, Le TH, Koh TH, Barkham T, Sobsey M, Gin KYH. Occurrence and characteristics of extended-spectrum β-lactamase- and carbapenemase- producing bacteria from hospital effluents in Singapore. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 615:1119-1125. [PMID: 29751417 DOI: 10.1016/j.scitotenv.2017.09.217] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/17/2017] [Accepted: 09/20/2017] [Indexed: 05/09/2023]
Abstract
One of the most important resistance mechanisms in Gram-negative bacteria today is the production of enzymes causing resistance to cephalosporin and carbapenem antibiotics. The spread of extended-spectrum β-lactamases (ESBL)- and carbapenemase- producing Gram-negative bacteria is an emerging global public health problem. The aim of the present study was to (i) assess the prevalence of carbapenem-resistant bacteria (CRB) and ESBL-producing strains in sewage effluents from two major hospitals in Singapore, (ii) characterize the isolated strains and (iii) identify some of the ESBL and carbapenemase genes responsible for the resistance. CHROMagar ESBL and KPC plates were used to rapidly screen for ESBL-producing bacteria and those expressing reduced susceptibility to carbapenems, respectively. The abundance of ESBL-producers and CRB in hospital wastewater ranged between 103 and 106CFU/mL. Out of the 66 isolates picked from ESBL and KPC plates, 95%, 82%, 82% and 76% were resistant to ceftriaxone, ceftazidime (3rd generation cephalosporin family), ertapenem and meropenem (carbapenem family), respectively. Among the resistant isolates, the most predominant taxa identified were Pseudomonas spp. (28.2%), Klebsiella spp. (28.2%), Enterobacter spp. (18.3%) and Citrobacter spp. (11.3%). PCR and sequencing analysis showed that the predominant β-lactamase genes were blaSHV (41.1%) followed by blaNDM-1 (35.6%), blaCTX (35.6%) and blaKPC (28.8%). The results of this study show a high prevalence of bacteria resistant to modern extended-spectrum cephalosporins and carbapenems and the presence of ESBL- and carbapenemase producers in hospital effluents. These findings support the need to improve management of hospital wastewater in order to minimize the spread of antimicrobial resistant microorganisms from this source.
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Affiliation(s)
- Laurence Haller
- Department of Civil & Environmental Engineering, National University of Singapore, E1A-07-03, 1 Engineering Drive 2, 117576, Singapore
| | - Hongjie Chen
- Department of Civil & Environmental Engineering, National University of Singapore, E1A-07-03, 1 Engineering Drive 2, 117576, Singapore
| | - Charmaine Ng
- Department of Civil & Environmental Engineering, National University of Singapore, E1A-07-03, 1 Engineering Drive 2, 117576, Singapore
| | - Thai Hoang Le
- Department of Civil & Environmental Engineering, National University of Singapore, E1A-07-03, 1 Engineering Drive 2, 117576, Singapore
| | - Tse Hsien Koh
- Department of Pathology, Singapore, General Hospital, Outram Road, Singapore 169608
| | - Timothy Barkham
- Department of Laboratory Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433
| | - Mark Sobsey
- Department of Environmental Sciences and Engineering, School of Public Health, University of North Carolina CB# 7431, Chapel Hill, N.C. 27599, USA
| | - Karina Yew-Hoong Gin
- Department of Civil & Environmental Engineering, National University of Singapore, E1A-07-03, 1 Engineering Drive 2, 117576, Singapore; NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, 117411, Singapore.
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25
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Potential Dissemination of ARB and ARGs into Soil Through the Use of Treated Wastewater for Agricultural Irrigation: Is It a True Cause for Concern? ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-3-319-66260-2_7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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26
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Tafoukt R, Touati A, Leangapichart T, Bakour S, Rolain JM. Characterization of OXA-48-like-producing Enterobacteriaceae isolated from river water in Algeria. WATER RESEARCH 2017; 120:185-189. [PMID: 28486169 DOI: 10.1016/j.watres.2017.04.073] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 04/16/2017] [Accepted: 04/29/2017] [Indexed: 05/10/2023]
Abstract
The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a significant problem for healthcare worldwide. The prevalence of carbapenem-resistant Enterobacteriaceae (CPE) in water environments in Algeria are unknown. The aim of this study was to screen for the presence of CPE isolates in the Soummam River in Bejaia, Algeria. Isolates of Enterobacteriaceae recovered from twelve samples of river water and showing reduced susceptibility to carbapenems were included in this study. The isolates were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Isolates were subjected to antimicrobial susceptibility testing and the modified Carba NP test. Carbapenemase and extended-spectrum β-lactamase (ESBL) determinants were studied by PCR amplification and sequencing. The clonal relatedness between isolates was studied by Multilocus Sequence Typing (MLST) method. A total of 20 carbapenem-resistant Enterobacteriaceae strains were included in this study, identified as Escherichia coli (n = 12), Klebsiella pneumoniae (n = 3), Raoultella ornithinolytica (n = 3), Citrobacter freundii (n = 1) and Citrobacter braakii (n = 1). Carbapenemase genes identified in this study included blaOXA-48, observed in 17 isolates (9 E. coli, 3 K. pneumoniae, 3 R. ornithinolytica, 1 C. freundii and 1 C. braakii), and blaOXA-244, a variant of blaOXA-48, was found in three E. coli isolates. MLST showed that 12 E. coli strains belonged to six different sequence types (ST559, ST38, ST212, ST3541, 1972 and ST2142), and we identified three different STs in K. pneumoniae isolates, including ST133, ST2055, and a new sequence type: ST2192. This study showed the presence of OXA-48-like-producing Enterobacteriaceae in water environments and highlighted the potential role of aquatic environments as reservoirs of clinically relevant antimicrobial-resistant bacteria, with the potential to spread throughout the community.
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Affiliation(s)
- Rima Tafoukt
- Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, 06000 Bejaia, Algeria; Unité de Recherche sur les Maladies Infectieuses et Tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Abdelaziz Touati
- Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, 06000 Bejaia, Algeria
| | - Thongpan Leangapichart
- Unité de Recherche sur les Maladies Infectieuses et Tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Sofiane Bakour
- Unité de Recherche sur les Maladies Infectieuses et Tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
| | - Jean-Marc Rolain
- Unité de Recherche sur les Maladies Infectieuses et Tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France.
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Multiple Antibiotic-Resistant, Extended Spectrum-β-Lactamase (ESBL)-Producing Enterobacteria in Fresh Seafood. Microorganisms 2017; 5:microorganisms5030053. [PMID: 28867789 PMCID: PMC5620644 DOI: 10.3390/microorganisms5030053] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/16/2017] [Accepted: 08/25/2017] [Indexed: 01/04/2023] Open
Abstract
Members of the family Enterobacteriaceae include several human pathogens that can be acquired through contaminated food and water. In this study, the incidence of extended spectrum β-lactamase (ESBL)-producing enterobacteria was investigated in fresh seafood sold in retail markets. The ESBL-positive phenotype was detected in 169 (78.60%) isolates, with Escherichia coli being the predominant species (53), followed by Klebsiella oxytoca (27), and K. pneumoniae (23). More than 90% of the isolates were resistant to third generation cephalosporins, cefotaxime, ceftazidime, and cefpodoxime. Sixty-five percent of the isolates were resistant to the monobactam drug aztreonam, 40.82% to ertapenem, and 31.36% to meropenem. Resistance to at least five antibiotics was observed in 38.46% of the isolates. Polymerase Chain Reaction (PCR) analysis of ESBL-encoding genes detected blaCTX, blaSHV, and blaTEM genes in 76.92%, 63.3%, and 44.37% of the isolates, respectively. Multiple ESBL genes were detected in majority of the isolates. The recently discovered New Delhi metallo-β-lactamase gene (blaNDM-1) was detected in two ESBL+ isolates. Our study shows that secondary contamination of fresh seafood with enteric bacteria resistant to multiple antibiotics may implicate seafood as a potential carrier of antibiotic resistant bacteria and emphasizes an urgent need to prevent environmental contamination and dissemination of such bacteria.
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28
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Chandar B, Poovitha S, Ilango K, MohanKumar R, Parani M. Inhibition of New Delhi Metallo-β-Lactamase 1 (NDM-1) Producing Escherichia coli IR-6 by Selected Plant Extracts and Their Synergistic Actions with Antibiotics. Front Microbiol 2017; 8:1580. [PMID: 28878746 PMCID: PMC5572277 DOI: 10.3389/fmicb.2017.01580] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 08/03/2017] [Indexed: 11/13/2022] Open
Abstract
Improper use of antibiotics has led to a great concern in the development of pathogenic microbial resistance. New Delhi metallo-β-lactamase 1 (NDM-1) producing bacteria are resistant to most of the β-lactam antibiotics, and so far, no new compounds have been clinically tested against these bacteria. In this study, ethanol extracts from the leaves of 240 medicinal plant species were screened for antibacterial activity against an NDM-1 Escherichia coli strain. The extracts that showed antibacterial activity were then tested for minimum inhibitory concentrations (MICs) and zones of inhibition. The extract from Combretum albidum G. Don, Hibiscus acetosella Welw. ex Hiern, Hibiscus cannabinus L., Hibiscus furcatus Willd., Punica granatum L., and Tamarindus indica L. showed bactericidal activity between 5 and 15 mg/ml and the MIC was between 2.56 and 5.12 mg/ml. All six plant extracts inhibited activity of the NDM-1 enzyme in vitro, and the IC50 value ranged between 0.50 and 1.2 ng/μl. Disruption of bacterial cell wall integrity by the plant extracts was clearly visible with scanning electron microscopy. Increases in membrane permeability caused 79.4–89.7% bacterial cell deaths as investigated by fluorescence-activated cell sorting. All the plant extracts showed synergistic effects when combined with colistin [fractional inhibitory concentration (ΣFIC) = 0.125–0.375], meropenem (ΣFIC = 0.09–0.313), and tetracycline (ΣFIC = 0.125–0.313). Thus, the plant extracts can be fractionated for the identification of active compounds, which could be used as new antibacterial compounds for the development of drugs against NDM-1 E. coli in addition to their use in combination therapy.
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Affiliation(s)
- Brinda Chandar
- Genomics Laboratory, Department of Genetic Engineering, School of Bioengineering, SRM UniversityKattankulathur, India
| | - Sundar Poovitha
- Genomics Laboratory, Department of Genetic Engineering, School of Bioengineering, SRM UniversityKattankulathur, India
| | - Kaliappan Ilango
- Interdisciplinary Institute of Indian System of Medicine, SRM UniversityKattankulathur, India
| | - Ramasamy MohanKumar
- Interdisciplinary Institute of Indian System of Medicine, SRM UniversityKattankulathur, India
| | - Madasamy Parani
- Genomics Laboratory, Department of Genetic Engineering, School of Bioengineering, SRM UniversityKattankulathur, India
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29
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Ludden C, Reuter S, Judge K, Gouliouris T, Blane B, Coll F, Naydenova P, Hunt M, Tracey A, Hopkins KL, Brown NM, Woodford N, Parkhill J, Peacock SJ. Sharing of carbapenemase-encoding plasmids between Enterobacteriaceae in UK sewage uncovered by MinION sequencing. Microb Genom 2017; 3:e000114. [PMID: 29026655 PMCID: PMC5605956 DOI: 10.1099/mgen.0.000114] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 04/11/2017] [Indexed: 12/30/2022] Open
Abstract
Dissemination of carbapenem resistance among pathogenic Gram-negative bacteria is a looming medical emergency. Efficient spread of resistance within and between bacterial species is facilitated by mobile genetic elements. We hypothesized that wastewater contributes to the dissemination of carbapenemase-producing Enterobacteriaceae (CPE), and studied this through a cross-sectional observational study of wastewater in the East of England. We isolated clinically relevant species of CPE in untreated and treated wastewater, confirming that waste treatment does not prevent release of CPE into the environment. We observed that CPE-positive plants were restricted to those in direct receipt of hospital waste, suggesting that hospital effluent may play a role in disseminating carbapenem resistance. We postulated that plasmids carrying carbapenemase genes were exchanged between bacterial hosts in sewage, and used short-read (Illumina) and long-read (MinION) technologies to characterize plasmids encoding resistance to antimicrobials and heavy metals. We demonstrated that different CPE species (Enterobacter kobei and Raoultella ornithinolytica) isolated from wastewater from the same treatment plant shared two plasmids of 63 and 280 kb. The former plasmid conferred resistance to carbapenems (blaOXA-48), and the latter to numerous drug classes and heavy metals. We also report the complete genome sequence for Enterobacter kobei. Small, portable sequencing instruments such as the MinION have the potential to improve the quality of information gathered on antimicrobial resistance in the environment.
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Affiliation(s)
- Catherine Ludden
- 1London School of Hygiene and Tropical Medicine, London, UK.,2Wellcome Trust Sanger Institute, Cambridge, UK
| | - Sandra Reuter
- 3Department of Medicine, University of Cambridge, Cambridge, UK
| | - Kim Judge
- 2Wellcome Trust Sanger Institute, Cambridge, UK.,3Department of Medicine, University of Cambridge, Cambridge, UK
| | - Theodore Gouliouris
- 3Department of Medicine, University of Cambridge, Cambridge, UK.,4Clinical Microbiology and Public Health Laboratory, Public Health England, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Beth Blane
- 3Department of Medicine, University of Cambridge, Cambridge, UK
| | - Francesc Coll
- 1London School of Hygiene and Tropical Medicine, London, UK.,2Wellcome Trust Sanger Institute, Cambridge, UK
| | | | - Martin Hunt
- 2Wellcome Trust Sanger Institute, Cambridge, UK
| | - Alan Tracey
- 2Wellcome Trust Sanger Institute, Cambridge, UK
| | - Katie L Hopkins
- 5Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK
| | - Nicholas M Brown
- 4Clinical Microbiology and Public Health Laboratory, Public Health England, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Neil Woodford
- 5Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) Reference Unit, National Infection Service, Public Health England, London, UK
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30
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Almakki A, Maure A, Pantel A, Romano-Bertrand S, Masnou A, Marchandin H, Jumas-Bilak E, Licznar-Fajardo P. NDM-5-producing Escherichia coli in an urban river in Montpellier, France. Int J Antimicrob Agents 2017; 50:123-124. [DOI: 10.1016/j.ijantimicag.2017.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 10/19/2022]
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31
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New Delhi metallo-β-lactamase-1 (NDM-1) Escherichia coli isolated from household vacuum cleaner-Oregon, 2013. IDCases 2017; 9:56-58. [PMID: 28660132 PMCID: PMC5484987 DOI: 10.1016/j.idcr.2017.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/11/2017] [Indexed: 11/29/2022] Open
Abstract
The first Oregon case of New Delhi metallo-β-lactamase-1 (NDM-1)-producing Escherichia coli was reported during November 2013. Epidemiologic investigation revealed only local outpatient medical care and no travel outside Oregon for both the patient and his household contact. Environmental sampling discovered a matching isolate from the patient’s household vacuum cleaner, suggesting environmental persistence.
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32
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Ojer-Usoz E, González D, Vitas AI. Clonal Diversity of ESBL-Producing Escherichia coli Isolated from Environmental, Human and Food Samples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMID: 28644413 PMCID: PMC5551114 DOI: 10.3390/ijerph14070676] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study presents a comprehensive approach of a clonal diversity analysis of 448 Extended-spectrum β-lactamase (ESBL)-producing E. coli isolated from environmental, human and food samples in Spain. The phenotypic confirmation of ESBL production was performed by disc diffusion and microdilution methods, while Polymerase Chain Reaction (PCR) and sequencing were used for the molecular characterization of β-lactamase genes (blaCTX-M, blaSHV, blaTEM, blaOXA). Clonal relationship of isolates was determined by multi-locus sequence typing (MLST). Multidrug resistant strains were present in all the studied niches, with percentages above 50.0%. The most prevalent β-lactamase genes were blaCTXM-14 (26%) and blaCTXM-1 (21.4%), followed by blaSHV-12, blaCTX-M-15 and blaTEM-42. MLST isolates were grouped into 26 clonal complexes (CC) and 177 different sequence types (ST) were detected. Despite the high clonal diversity observed, CC10 was the prevalent and the only CC detected in all niches, while other complexes as CC131 were mainly associated to human isolates. The observed prevalence and diversity of these resistant bacteria across the different environments encourages a One Health approach to prevent and control ESBL dissemination between environment and consumers.
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Affiliation(s)
- Elena Ojer-Usoz
- Department of Microbiology and Parasitology, University of Navarra, 31080 Pamplona, Spain.
| | - David González
- Department of Microbiology and Parasitology, University of Navarra, 31080 Pamplona, Spain.
| | - Ana Isabel Vitas
- Department of Microbiology and Parasitology, University of Navarra, 31080 Pamplona, Spain.
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33
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Hsu LY, Apisarnthanarak A, Khan E, Suwantarat N, Ghafur A, Tambyah PA. Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia. Clin Microbiol Rev 2017; 30:1-22. [PMID: 27795305 PMCID: PMC5217790 DOI: 10.1128/cmr.masthead.30-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.
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Affiliation(s)
- Li-Yang Hsu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Tan Tock Seng Hospital, Singapore
| | | | - Erum Khan
- Aga Khan University, Karachi, Pakistan
| | - Nuntra Suwantarat
- Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
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34
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Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia. Clin Microbiol Rev 2016. [PMID: 27795305 DOI: 10.1128/cmr.00042-16] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.
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35
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Tran DN, Tran HH, Matsui M, Suzuki M, Suzuki S, Shibayama K, Pham TD, Van Phuong TT, Dang DA, Trinh HS, Loan CT, Nga LTV, van Doorn HR, Wertheim HFL. Emergence of New Delhi metallo-beta-lactamase 1 and other carbapenemase-producing Acinetobacter calcoaceticus-baumannii complex among patients in hospitals in Ha Noi, Viet Nam. Eur J Clin Microbiol Infect Dis 2016; 36:219-225. [PMID: 27714593 PMCID: PMC5253155 DOI: 10.1007/s10096-016-2784-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
Abstract
Acinetobacter baumannii is an important cause of multidrug-resistant hospital acquired infections in the world. Here, we investigate the presence of NDM-1 and other carbapenemases among carbapenem-resistant A. baumannii isolated between August 2010 and December 2014 from three large hospitals in Hanoi, Vietnam. We identified 23/582 isolates (4 %) (11 from hospital A, five from hospital B, and seven from hospital C) that were NDM-1 positive, and among them 18 carried additional carbapenemase genes, including seven isolates carrying NDM-1, IMP-1, and OXA-58 with high MICs for carbapenems. Genotyping indicated that NDM-1 carrying A. baumannii have expanded clonally in these hospitals. Five new STs (ST1135, ST1136, ST1137, ST1138, and ST1139) were identified. One isolate carried NDM-1 on a plasmid belonging to the N-repA replicon type; no NDM-1-positive plasmids were identified in the other isolates. We have shown the extent of the carbapenem resistance and the local clonal spread of A. baumannii carrying NDM-1 in these hospitals; coexistence of NDM-1 and IMP-1 is reported for the first time from Vietnam here, and this will further seriously limit future therapeutic options.
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Affiliation(s)
- D N Tran
- National Institute of Hygiene and Epidemiology, Yersin 1, Hanoi, Vietnam
| | - H H Tran
- National Institute of Hygiene and Epidemiology, Yersin 1, Hanoi, Vietnam.
| | - M Matsui
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - M Suzuki
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - S Suzuki
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - K Shibayama
- Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - T D Pham
- National Institute of Hygiene and Epidemiology, Yersin 1, Hanoi, Vietnam
| | - T T Van Phuong
- National Institute of Hygiene and Epidemiology, Yersin 1, Hanoi, Vietnam
| | - D A Dang
- National Institute of Hygiene and Epidemiology, Yersin 1, Hanoi, Vietnam
| | | | - C T Loan
- Saint Paul Hospital, Hanoi, Vietnam
| | | | - H R van Doorn
- Oxford University Clinical Research Unit, Hanoi, Vietnam; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK
| | - H F L Wertheim
- Oxford University Clinical Research Unit, Hanoi, Vietnam; Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK.,Department of Clinical Microbiology, Radboud UMC, Nijmegen, Netherlands
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Jean SS, Hsueh PR. Distribution of ESBLs, AmpC β-lactamases and carbapenemases among Enterobacteriaceae isolates causing intra-abdominal and urinary tract infections in the Asia-Pacific region during 2008-14: results from the Study for Monitoring Antimicrobial Resistance Trends (SMART). J Antimicrob Chemother 2016; 72:166-171. [PMID: 27703058 DOI: 10.1093/jac/dkw398] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/15/2016] [Accepted: 08/19/2016] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To investigate the antimicrobial resistance and assess the molecular characteristics of β-lactamases (ESBLs, AmpC β-lactamases and carbapenemases) among Enterobacteriaceae isolates that caused intra-abdominal infections (IAIs) in patients hospitalized in the Asia-Pacific region during 2008-14. METHODS Multiplex PCR was used to detect the specific types of β-lactamase in 2893 isolates with MICs of ertapenem >0.5 mg/L. In-hospital acquisition times for most isolates were also delineated. RESULTS Among 2728 (94.3%) isolates proven with β-lactamase production, the rates of non-susceptibility to imipenem were low (average = 7.9%) among IAI Enterobacteriaceae isolates from all Asia-Pacific countries except Vietnam (17.7%) and the Philippines (10.2%). A stepwise and significant increase in annual rates of carbapenemase production among these isolates was noted. CTX-M-15 and CTX-M-14 were the dominant ESBL variants in most IAI Enterobacteriaceae species. The most abundant AmpC β-lactamase variants were blaCMY-2 among isolates of Escherichia coli and blaDHA-1 among isolates of Klebsiella pneumoniae. In addition, the IAI Enterobacteriaceae isolates harbouring a blaCMY-2 or blaDHA-1 allele were associated with high community-acquired rates (38.0% and 42.6%, respectively). AmpC ACT and MIR variants were mostly detected in Enterobacter species. The blaNDM-1,4,5,7-harbouring isolates of E. coli, K. pneumoniae and Enterobacter cloacae were most commonly identified among IAI isolates from Vietnam and the Philippines. Also of note, blaOXA-48-harbouring IAI Enterobacteriaceae isolates were detected exclusively in Vietnam. CONCLUSIONS The high resistance burden in Vietnam and the Philippines warrants aggressive control policies to combat the worsening trend in antimicrobial resistance among Enterobacteriaceae species causing IAIs.
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Affiliation(s)
- Shio-Shin Jean
- Emergency Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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Singh AS, Lekshmi M, Nayak BB, Kumar SH. Isolation of Escherichia coli harboring blaNDM-5 from fresh fish in India. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2016; 49:822-823. [DOI: 10.1016/j.jmii.2014.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 08/04/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
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38
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Le NK, HF W, Vu PD, Khu DTK, Le HT, Hoang BTN, Vo VT, Lam YM, Vu DTV, Nguyen TH, Thai TQ, Nilsson LE, Rydell U, Nguyen KV, Nadjm B, Clarkson L, Hanberger H, Larsson M. High prevalence of hospital-acquired infections caused by gram-negative carbapenem resistant strains in Vietnamese pediatric ICUs: A multi-centre point prevalence survey. Medicine (Baltimore) 2016; 95:e4099. [PMID: 27399106 PMCID: PMC5058835 DOI: 10.1097/md.0000000000004099] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There is scarce information regarding hospital-acquired infections (HAIs) among children in resource-constrained settings. This study aims to measure prevalence of HAIs in Vietnamese pediatric hospitals.Monthly point prevalence surveys (PPSs) in 6 pediatric intensive care units (ICUs) in 3 referral hospitals during 1 year.A total of 1363 cases (1143 children) were surveyed, 59.9% male, average age 11 months. Admission sources were: other hospital 49.3%, current hospital 36.5%, and community 15.3%. Reasons for admission were: infectious disease (66%), noninfectious (20.8%), and surgery/trauma (11.3%). Intubation rate was 47.8%, central venous catheter 29.4%, peripheral venous catheter 86.2%, urinary catheter 14.6%, and hemodialysis/filtration 1.7%. HAI was diagnosed in 33.1% of the cases: pneumonia (52.2%), septicemia (26.4%), surgical site infection (2%), and necrotizing enterocolitis (2%). Significant risk factors for HAI included age under 7 months, intubation and infection at admission. Microbiological findings were reported in 212 cases (43%) with 276 isolates: 50 Klebsiella pneumoniae, 46 Pseudomonas aeruginosa, and 39 Acinetobacter baumannii, with carbapenem resistance detected in 55%, 71%, and 65%, respectively. Staphylococcus aureus was cultured in 18 cases, with 81% methicillin-resistant Staphylococcus aureus. Most children (87.6%) received antibiotics, with an average of 1.6 antibiotics per case. Colistin was administered to 96 patients, 93% with HAI and 49% with culture confirmed carbapenem resistance.The high prevalence of HAI with carbapenem resistant gram-negative strains and common treatment with broad-spectrum antibiotics and colistin suggests that interventions are needed to prevent HAI and to optimize antibiotic use.
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Affiliation(s)
- Ngai Kien Le
- National Hospital of Pediatrics, Hanoi
- Correspondence: Le Kien Ngai, National Hospital of Pediatrics, Hanoi, Vietname-mail: ); Mattias Larsson, Karolinska Institutet, Stockholm, Sweden (e-mail: )
| | - Wertheim HF
- Oxford University Clinical Research Unit, Vietnam; Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, UK
- Department of Medical Microbiology, RCI, Radboudumc, Nijmegen, Netherlands
| | - Phu Dinh Vu
- National Hospital for Tropical Diseases, Hanoi
| | | | | | | | | | | | - Dung Tien Viet Vu
- Oxford University Clinical Research Unit, Vietnam; Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, UK
| | | | | | | | | | | | - Behzad Nadjm
- Oxford University Clinical Research Unit, Vietnam; Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, UK
| | | | | | - Mattias Larsson
- Oxford University Clinical Research Unit, Vietnam; Nuffield Department of Medicine, Centre for Tropical Medicine, University of Oxford, UK
- Karolinska Institutet, Stockholm, Sweden
- Correspondence: Le Kien Ngai, National Hospital of Pediatrics, Hanoi, Vietname-mail: ); Mattias Larsson, Karolinska Institutet, Stockholm, Sweden (e-mail: )
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39
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Diep TT, Nguyen NTN, Nguyen TNC, An HK, Nguyen TQ, Nguyen VH, Nguyen TV, Nguyen TNA, Izumiya H, Ohnishi M, Yamashiro T, Nguyen LTP. Isolation of New Delhi metallo-β-lactamase 1-producing Vibrio cholerae non-O1, non-O139 strain carrying ctxA, st and hly genes in southern Vietnam. Microbiol Immunol 2016; 59:262-7. [PMID: 25683557 DOI: 10.1111/1348-0421.12248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 10/24/2022]
Abstract
Vibrio cholerae non-O1, non-O139 (VC_NAG) organisms are universally present in the aquatic environment and regarded as non-pathogenic bacteria. However, considering that they do occasionally induce gastroenteritis, a study of their virulence and antibiotic resistance genes is important. The presence of enteropathogenic genes, including ctxA, VC_NAG-specific heat-stable toxin gene (st), hemolysin (hly), and zona occludens toxin (zot) was determined by PCR in 100 VC_NAG strains isolated in southern Vietnam in 2010-2013 from 94 environmental and six human origins. These 100 VC_NAG strains were also tested phenotypically and genotypically for the presence of the New Delhi metallo-β-lactamase (NDM-1). Of the 100 VC_NAG strains tested, six were positive for ctxA; five from the environment and one of human origin. The st gene was detected in 17 isolates, 15 and two of which were of environmental and human origins, respectively. Gene hly was detected in 19 VC_NAG strains examined, two of which were isolated from humans and 17 from environments. The zot gene was not detected in any of the strains tested. Three VC_NAG strains of environmental origin were confirmed to produce NDM-1 and the blaNDM-1 gene was detected in those strains by PCR. Of note, one of the three NDM-1-producing VC_NAG strains was confirmed to carry ctxA, st and hly genes concurrently. This is the first report of isolation of NDM-1-producing VC_NAG strains in Vietnam.
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Affiliation(s)
- Tai The Diep
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Nhi Thi Ngoc Nguyen
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Thi Ngoc Cat Nguyen
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Huy Khac An
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Truong Quang Nguyen
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Vu Hoang Nguyen
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Thuong Van Nguyen
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Thu Ngoc Anh Nguyen
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
| | - Hidemasa Izumiya
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama Shinjuku, Tokyo, 162-8640, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama Shinjuku, Tokyo, 162-8640, Japan
| | - Tetsu Yamashiro
- Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan.,Vietnam Research Station, Institute of Tropical Medicine, Nagasaki University, c/o National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hanoi, Vietnam
| | - Lan Thi Phuong Nguyen
- Laboratory of Bacteria Microbiology and Immunology Department, Pasteur Institute of Ho Chi Minh City, 167 Pasteur Street District 3, Ho Chi Minh City, Vietnam
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40
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Tada T, Miyoshi-Akiyama T, Shimada K, Nga TTT, Thu LTA, Son NT, Ohmagari N, Kirikae T. Dissemination of clonal complex 2 Acinetobacter baumannii strains co-producing carbapenemases and 16S rRNA methylase ArmA in Vietnam. BMC Infect Dis 2015; 15:433. [PMID: 26471294 PMCID: PMC4608321 DOI: 10.1186/s12879-015-1171-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 10/01/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Acinetobacter baumannii strains co-producing carbapenemase and 16S rRNA methylase are highly resistant to carbapenems and aminoglycosides. METHODS Ninety-three isolates of multidrug-resistant A. baumannii were obtained from an intensive care unit in a hospital in Vietnam. Antimicrobial susceptibility tests and whole genome sequencing were performed. Multilocus sequence typing and the presence of drug resistant genes were determined and a maximum-likelihood phylogenetic tree was constructed by SNP alignment of whole genome sequencing data. RESULTS The majority of isolates belonged to clonal complex 2 (ST2, ST570 and ST571), and carried carbapenemase encoding genes bla OXA-23 and bla OXA-66. Two isolates encoded carbapenemase genes bla NDM-1 and bla OXA-58 and the 16S rRNA methylase encoding gene armA and did not belong to clonal complex 2 (ST16). CONCLUSION A. baumannii isolates producing 16S rRNA methylase ArmA and belonging to clonal complex 2 are widespread, and isolates co-producing NDM-1 and ArmA are emerging, in medical settings in Vietnam.
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Affiliation(s)
- Tatsuya Tada
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan.
| | - Tohru Miyoshi-Akiyama
- Pathogenic Microbe Laboratory, Research Institute, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan.
| | - Kayo Shimada
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan.
| | | | | | | | - Norio Ohmagari
- Disease Control and Prevention Center, Division of Infectious Diseases, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Teruo Kirikae
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan.
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41
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Tacão M, Correia A, Henriques IS. Low Prevalence of Carbapenem-Resistant Bacteria in River Water: Resistance Is Mostly Related to Intrinsic Mechanisms. Microb Drug Resist 2015; 21:497-506. [DOI: 10.1089/mdr.2015.0072] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Marta Tacão
- Biology Department and CESAM, University of Aveiro, Aveiro, Portugal
- Biology Department and iBiMED, University of Aveiro, Aveiro, Portugal
| | - António Correia
- Biology Department and CESAM, University of Aveiro, Aveiro, Portugal
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Rashid M, Rakib MM, Hasan B. Antimicrobial-resistant and ESBL-producing Escherichia coli in different ecological niches in Bangladesh. Infect Ecol Epidemiol 2015; 5:26712. [PMID: 26193990 PMCID: PMC4507753 DOI: 10.3402/iee.v5.26712] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 05/22/2015] [Accepted: 05/26/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The rapid and wide-scale environmental spread of multidrug-resistant bacteria in different ecosystems has become a serious issue in recent years. OBJECTIVES To investigate the epidemiology of antimicrobial resistance and extended spectrum beta-lactamase (ESBL) in Bangladeshi wild birds and aquatic environments, samples were taken from Open Bill Stork (Anastomus oscitans) (OBS) and the nearby water sources. METHODS Water and fresh fecal samples were collected from several locations. All samples were processed and cultured for Escherichia coli and tested for antibiotic susceptibility against commonly used antibiotics. ESBL producers were characterized at genotypic level using polymerase chain reaction (PCR), sequencing, multilocus sequence typing, and rep-PCR. RESULTS AND DISCUSSION A total of 76 E. coli isolates from the 170 OBS and 8 E. coli isolates from three river sources were isolated. In total, 29% of E. coli isolated from OBS and all of the E. coli isolated from water sources were resistant to at least one of the tested antimicrobials. Resistant phenotypes were observed with all antimicrobials except tigecycline, gentamicin, imipenem, and chloramphenicol. Multidrug resistance was observed in 2.6% of OBS and 37.5% of the water isolates. Also, 1.2% of the ESBL-producing E. coli were isolated from OBS, whereas 50% of the E. coli isolated from water sources were ESBL producers possessing the CTX-M-15 gene. The most concerning aspect of our findings was the presence of human-associated E. coli sequence types in the water samples, for example, ST156-complex156, ST10-complex10 and ST46. CONCLUSION This study reports the presence of multidrug-resistant ESBL-producing E. coli in OBSs and nearby aquatic sources in Bangladesh.
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Affiliation(s)
- Mahmudur Rashid
- Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mufti Mahmud Rakib
- Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Badrul Hasan
- Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala Biomedical Centre (BMC), Uppsala University, Uppsala, Sweden; ;
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Sun F, Yin Z, Feng J, Qiu Y, Zhang D, Luo W, Yang H, Yang W, Wang J, Chen W, Xia P, Zhou D. Production of plasmid-encoding NDM-1 in clinical Raoultella ornithinolytica and Leclercia adecarboxylata from China. Front Microbiol 2015; 6:458. [PMID: 26052314 PMCID: PMC4439573 DOI: 10.3389/fmicb.2015.00458] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/27/2015] [Indexed: 12/17/2022] Open
Abstract
Raoultella ornithinolytica YNKP001 and Leclercia adecarboxylata P10164, which harbor conjugative plasmids pYNKP001-NDM and pP10164-NDM, respectively, were isolated from two different Chinese patients, and their complete nucleotide sequences were determined. Production of NDM-1 enzyme by these plasmids accounts for the carbapenem resistance of these two strains. This is the first report of bla NDM in L. adecarboxylata and third report of this gene in R. ornithinolytica. pYNKP001-NDM is very similar to the IncN2 NDM-1-encoding plasmids pTR3, pNDM-ECS01, and p271A, whereas pP10164-NDM is similar to the IncFIIY bla NDM-1-carrying plasmid pKOX_NDM1. The bla NDM-1 genes of pYNKP001-NDM and pP10164-NDM are embedded in Tn125-like elements, which represent two distinct truncated versions of the NDM-1-encoding Tn125 prototype observed in pNDM-BJ01. Flanking of these two Tn125-like elements by miniature inverted repeat element (MITE) or its remnant indicates that MITE facilitates transposition and mobilization of bla NDM-1 gene contexts.
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Affiliation(s)
- Fengjun Sun
- Department of Pharmacy, Southwest Hospital, The Third Military Medical University Chongqing, China
| | - Zhe Yin
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China
| | - Jiao Feng
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China ; Laboratory Animal Center, Academy of Military Medical Sciences Beijing, China
| | - Yefeng Qiu
- Laboratory Animal Center, Academy of Military Medical Sciences Beijing, China
| | - Defu Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China
| | - Wenbo Luo
- Department of Pharmacy, Southwest Hospital, The Third Military Medical University Chongqing, China ; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China
| | - Huiying Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China
| | - Wenhui Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China
| | - Jie Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China
| | - Weijun Chen
- Beijing Institute of Genomics, Chinese Academy of Sciences Beijing, China
| | - Peiyuan Xia
- Department of Pharmacy, Southwest Hospital, The Third Military Medical University Chongqing, China
| | - Dongsheng Zhou
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology Beijing, China
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Tran HH, Ehsani S, Shibayama K, Matsui M, Suzuki S, Nguyen MB, Tran DN, Tran VP, Tran DL, Nguyen HT, Dang DA, Trinh HS, Nguyen TH, Wertheim HFL. Common isolation of New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae in a large surgical hospital in Vietnam. Eur J Clin Microbiol Infect Dis 2015; 34:1247-54. [PMID: 25732142 PMCID: PMC4426131 DOI: 10.1007/s10096-015-2345-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/01/2015] [Indexed: 01/08/2023]
Abstract
This study sought to monitor the presence of carbapenem-resistant Enterobacteriaceae (CRE) and the proportion New Delhi metallo-beta-lactamase 1 (NDM-1)-producing bacteria between August 2010 and December 2012 in a surgical hospital in Vietnam. We identified 47 CRE strains from a total of 4,096 Enterobacteriaceae isolates (1.1 %) that were NDM-1-positive from 45 patients admitted to 11 different departments, with the majority being from the urology department. The NDM-1 gene was found in seven different species. Genotyping revealed limited clonality of NDM-1-positive isolates. Most of the isolates carried the NDM-1 gene on a plasmid and 17.8 % (8/45) of those were readily transferable. We found five patients at admission and one patient at discharge with NDM-1-positive bacteria in their stool. From 200 screening environmental hospital samples, five were confirmed to be NDM-1-positive and included Acinetobacter species (n = 3) and Enterobacter aerogenes (n = 2). The results reveal that NDM-1-producing Enterobacteriaceae are commonly isolated in patients admitted to a Vietnamese surgical hospital and are also detected in the hospital environment.
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Affiliation(s)
- H H Tran
- National Institute of Hygiene and Epidemiology, Yersin Street 1, Hanoi, Vietnam,
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Wang X, Lu M, Shi Y, Ou Y, Cheng X. Discovery of novel new Delhi metallo-β-lactamases-1 inhibitors by multistep virtual screening. PLoS One 2015; 10:e0118290. [PMID: 25734558 PMCID: PMC4348537 DOI: 10.1371/journal.pone.0118290] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 01/12/2015] [Indexed: 01/21/2023] Open
Abstract
The emergence of NDM-1 containing multi-antibiotic resistant "Superbugs" necessitates the needs of developing of novel NDM-1inhibitors. In this study, we report the discovery of novel NDM-1 inhibitors by multi-step virtual screening. From a 2,800,000 virtual drug-like compound library selected from the ZINC database, we generated a focused NDM-1 inhibitor library containing 298 compounds of which 44 chemical compounds were purchased and evaluated experimentally for their ability to inhibit NDM-1 in vitro. Three novel NDM-1 inhibitors with micromolar IC50 values were validated. The most potent inhibitor, VNI-41, inhibited NDM-1 with an IC50 of 29.6 ± 1.3 μM. Molecular dynamic simulation revealed that VNI-41 interacted extensively with the active site. In particular, the sulfonamide group of VNI-41 interacts directly with the metal ion Zn1 that is critical for the catalysis. These results demonstrate the feasibility of applying virtual screening methodologies in identifying novel inhibitors for NDM-1, a metallo-β-lactamase with a malleable active site and provide a mechanism base for rational design of NDM-1 inhibitors using sulfonamide as a functional scaffold.
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Affiliation(s)
- Xuequan Wang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Meiling Lu
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Yang Shi
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Yu Ou
- School of Life Science and Technology, China Pharmaceutical University, Nanjing, People’s Republic of China
| | - Xiaodong Cheng
- Department of Integrative Biology & Pharmacology, The University of Texas Health Science Center, Houston, United States of America
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46
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Dissemination of NDM metallo-β-lactamase genes among clinical isolates of Enterobacteriaceae collected during the SMART global surveillance study from 2008 to 2012. Antimicrob Agents Chemother 2014; 59:826-30. [PMID: 25403666 DOI: 10.1128/aac.03938-14] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The prevalence of carbapenemase enzymes continues to increase. Among the Ambler class B enzymes is the New Delhi metallo-β-lactamase (NDM). This particular enzyme is capable of hydrolyzing nearly all β-lactam antimicrobial agents and has spread rapidly, becoming a global problem. Therapeutic treatment options for patients infected with isolates which produce this enzyme are difficult to manage, as cross-resistance to other antimicrobial classes is common. The Study for Monitoring Antimicrobial Resistance Trends (SMART) is a global surveillance study evaluating the antimicrobial susceptibilities of numerous Gram-negative bacterial species recovered from people with intra-abdominal and urinary tract infections. The Clinical and Laboratory Standards Institute methods and a molecular analysis identified 134 isolates of Enterobacteriaceae (nine species) and one Acinetobacter sp. with blaNDM genes. These isolates were collected in nine countries, and >95% of the isolates possessed the NDM-1 variant. The MIC90 values were >4 mg/liter and >8 mg/liter for ertapenem and imipenem, respectively. No tested β-lactam or β-lactamase inhibitor combination had activity against these isolates. Resistance to amikacin (79.9%) and levofloxacin (82.8%) was common. Nearly all the isolates encoded additional enzymes, including AmpC cephalosporinases and extended-spectrum β-lactamases. There is an urgent need for infection control and continued global monitoring of isolates which harbor the NDM enzyme, as evidenced by recent outbreaks.
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47
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Temkin E, Adler A, Lerner A, Carmeli Y. Carbapenem-resistant Enterobacteriaceae: biology, epidemiology, and management. Ann N Y Acad Sci 2014; 1323:22-42. [PMID: 25195939 DOI: 10.1111/nyas.12537] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduced in the 1980s, carbapenem antibiotics have served as the last line of defense against multidrug-resistant Gram-negative organisms. Over the last decade, carbapenem-resistant Enterobacteriaceae (CRE) have emerged as a significant public health threat. This review summarizes the molecular genetics, natural history, and epidemiology of CRE and discusses approaches to prevention and treatment.
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Affiliation(s)
- Elizabeth Temkin
- Division of Epidemiology and Preventive Medicine, Tel Aviv Sourasky Medical Center, Israel
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48
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Manenzhe RI, Zar HJ, Nicol MP, Kaba M. The spread of carbapenemase-producing bacteria in Africa: a systematic review. J Antimicrob Chemother 2014; 70:23-40. [PMID: 25261423 DOI: 10.1093/jac/dku356] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Carbapenems are the last line of defence against ever more prevalent MDR Gram-negative bacteria, but their efficacy is threatened worldwide by bacteria that produce carbapenemase enzymes. The epidemiology of bacteria producing carbapenemases has been described in considerable detail in Europe, North America and Asia; however, little is known about their spread and clinical relevance in Africa. METHODS We systematically searched in PubMed, EBSCOhost, Web of Science, Scopus, Elsevier Masson Consulte and African Journals Online, international conference proceedings, published theses and dissertations for studies reporting on carbapenemase-producing bacteria in Africa. We included articles published in English or French up to 28 February 2014. We calculated the prevalence of carbapenemase producers only including studies where the total number of isolates tested was at least 30. RESULTS Eighty-three studies were included and analysed. Most studies were conducted in North Africa (74%, 61/83), followed by Southern Africa (12%, 10/83), especially South Africa (90%, 9/10), West Africa (8%, 7/83) and East Africa (6%, 6/83). Carbapenemase-producing bacteria were isolated from humans, the hospital environment and community environmental water samples, but not from animals. The prevalence of carbapenemase-producing isolates in hospital settings ranged from 2.3% to 67.7% in North Africa and from 9% to 60% in sub-Saharan Africa. CONCLUSIONS Carbapenemase-producing bacteria have been described in many African countries; however, their prevalence is poorly defined and has not been systematically studied. Antibiotic stewardship and surveillance systems, including molecular detection and genotyping of resistant isolates, should be implemented to monitor and reduce the spread of carbapenemase-producing bacteria.
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Affiliation(s)
- Rendani I Manenzhe
- Division of Medical Microbiology, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Mark P Nicol
- Division of Medical Microbiology, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Institute for Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - Mamadou Kaba
- Division of Medical Microbiology, Department of Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Institute for Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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49
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Nhu NTK, Lan NPH, Campbell JI, Parry CM, Thompson C, Tuyen HT, Hoang NVM, Tam PTT, Le VM, Nga TVT, Nhu TDH, Van Minh P, Nga NTT, Thuy CT, Dung LT, Yen NTT, Van Hao N, Loan HT, Yen LM, Nghia HDT, Hien TT, Thwaites L, Thwaites G, Chau NVV, Baker S. Emergence of carbapenem-resistant Acinetobacter baumannii as the major cause of ventilator-associated pneumonia in intensive care unit patients at an infectious disease hospital in southern Vietnam. J Med Microbiol 2014; 63:1386-1394. [PMID: 25038137 PMCID: PMC4170484 DOI: 10.1099/jmm.0.076646-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Ventilator-associated pneumonia (VAP) is a serious healthcare-associated infection that affects up to 30 % of intubated and mechanically ventilated patients in intensive care units (ICUs) worldwide. The bacterial aetiology and corresponding antimicrobial susceptibility of VAP is highly variable, and can differ between countries, national provinces and even between different wards in the same hospital. We aimed to understand and document changes in the causative agents of VAP and their antimicrobial susceptibility profiles retrospectively over an 11 year period in a major infectious disease hospital in southern Vietnam. Our analysis outlined a significant shift from Pseudomonas aeruginosa to Acinetobacter spp. as the most prevalent bacteria isolated from quantitative tracheal aspirates in patients with VAP in this setting. Antimicrobial resistance was common across all bacterial species and we found a marked proportional annual increase in carbapenem-resistant Acinetobacter spp. over a 3 year period from 2008 (annual trend; odds ratio 1.656, P = 0.010). We further investigated the possible emergence of a carbapenem-resistant Acinetobacter baumannii clone by multiple-locus variable number tandem repeat analysis, finding a blaOXA-23-positive strain that was associated with an upsurge in the isolation of this pathogen. We additionally identified a single blaNDM-1-positive A. baumannii isolate. This work highlights the emergence of a carbapenem-resistant clone of A. baumannii and a worrying trend of antimicrobial resistance in the ICU of the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam.
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Affiliation(s)
- Nguyen Thi Khanh Nhu
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen Phu Huong Lan
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - James I Campbell
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Christopher M Parry
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Corinne Thompson
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Ha Thanh Tuyen
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen Van Minh Hoang
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Pham Thi Thanh Tam
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Vien Minh Le
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco, CA, USA.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Vu Thieu Nga
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Do Hoang Nhu
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Pham Van Minh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen Thi Thu Nga
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Cao Thu Thuy
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Le Thi Dung
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | | | - Nguyen Van Hao
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Huynh Thi Loan
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Lam Minh Yen
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ho Dang Trung Nghia
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.,School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Tinh Hien
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Louise Thwaites
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Nguyen Van Vinh Chau
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Stephen Baker
- The London School of Hygiene and Tropical Medicine, London, UK.,Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, UK.,The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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50
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Chandran S, Diwan V, Tamhankar A, Joseph B, Rosales-Klintz S, Mundayoor S, Lundborg C, Macaden R. Detection of carbapenem resistance genes and cephalosporin, and quinolone resistance genes along with oqxAB
gene in Escherichia coli
in hospital wastewater: a matter of concern. J Appl Microbiol 2014; 117:984-95. [DOI: 10.1111/jam.12591] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/07/2014] [Accepted: 06/25/2014] [Indexed: 01/22/2023]
Affiliation(s)
- S.P. Chandran
- Division of Infectious Diseases; St. John's Research Institute; Bangalore India
- Department of Microbiology; St. John's Medical College; Bangalore India
| | - V. Diwan
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
- Department of Public Health and Environment; R.D. Gardi Medical College; Ujjain India
- International Center for Health Research; R.D. Gardi Medical College; Ujjain India
| | - A.J. Tamhankar
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
- Department of Environmental Medicine; Indian Initiative for Management of Antibiotic Resistance (IIMAR); R D Gardi Medical College; Ujjain India
| | - B.V. Joseph
- Departments of Biotechnology; Christ University; Bangalore India
| | - S. Rosales-Klintz
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
| | - S. Mundayoor
- Mycobacterial Research Group; Department of Molecular Microbiology; Rajiv Gandhi Centre for Biotechnology; Thiruvananthapuram India
| | - C.S. Lundborg
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
| | - R. Macaden
- Division of Infectious Diseases; St. John's Research Institute; Bangalore India
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