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da Silva SKSM, Fuentes-Castillo DA, Ewbank AC, Sacristán C, Catão-Dias JL, Sevá AP, Lincopan N, Deem SL, Feitosa LCS, Catenacci LS. ESBL-Producing Enterobacterales at the Human-Domestic Animal-Wildlife Interface: A One Health Approach to Antimicrobial Resistance in Piauí, Northeastern Brazil. Vet Sci 2024; 11:195. [PMID: 38787167 PMCID: PMC11125940 DOI: 10.3390/vetsci11050195] [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: 03/18/2024] [Revised: 04/12/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
The use, misuse, and overuse of antimicrobials is one of the main public health threats of the 21st century. We investigated the risk factor of the presence of extended-spectrum, cephalosporin-resistant Enterobacterales in feces of non-domestic and domestic birds and other domestic animals in Piauí State, northeast Brazil. We collected a total of 387 cloacal and rectal swab samples of free-living birds, domestic birds, and domestic mammals in five municipalities: Amarante, Água Branca, Lagoa Alegre, Parnaíba, and Teresina. A total of 59/387 (15.2%) of these samples harbored extended spectrum beta-lactamase (ESBL)-producing Enterobacterales. Using the MALDI-TOF technique, we identified fifty-seven samples as Escherichia coli and two samples as Klebsiella pneumoniae. Teresina and Parnaíba had the highest prevalence of animals with resistant bacteria (32.1% and 27.1%, respectively) and highest exposure risk factor (OR of 16.06 and 8.58, respectively, and p < 0.001 for all). Multidrug-resistant, ESBL-producing Enterobacterales were observed in 72.8% of the samples (43/59). For the free-living birds, the positive samples belonged to a great kiskadee (Pitangus sulphuratus) and a semipalmated sandpiper (Calidris pusilla) in migratory and resident species, respectively. For domestic animals, the swine samples showed the highest prevalence of antimicrobial resistance. The lack of access to veterinary care and information regarding antimicrobial therapy, along with the easy access to antimicrobials without medical prescription, favors the inadequate use of antimicrobials in Piauí.
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Affiliation(s)
- Sandy Kelly S. M. da Silva
- Programa de Pós-Graduação Saúde Animal na Amazônia, Universidade Federal do Pará (UFPA), Belém 66075-110, Brazil
| | - Danny A. Fuentes-Castillo
- Departamento de Patología y Medicina Preventiva, Facultad de Ciencias Veterinarias, Universidad de Concepción (UDEC), Concepción 4070409, Chile;
| | - Ana Carolina Ewbank
- Centro de Investigación en Sanidad Animal (CISA-INIA), Consejo Superior de Investigaciones Científicas (CSIC), 28130 Valdeolmos, Spain; (A.C.E.)
| | - Carlos Sacristán
- Centro de Investigación en Sanidad Animal (CISA-INIA), Consejo Superior de Investigaciones Científicas (CSIC), 28130 Valdeolmos, Spain; (A.C.E.)
| | - José L. Catão-Dias
- Laboratório de Patologia Comparada de Animais Selvagens (LAPCOM), Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo (USP), São Paulo 05508-270, Brazil
| | - Anaiá P. Sevá
- Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz (UESC), Bahia 45662-900, Brazil
| | - Nilton Lincopan
- Laboratório de Resistência Bacteriana e Alternativas Terapêuticas, Instituto de Ciências Biomédicas, Universidade de São Paulo (USP), São Paulo 05508-220, Brazil
| | - Sharon L. Deem
- Saint Loius Zoo, Institute for Conservation Medicine, St. Louis, MO 63110, USA
| | - Lauro C. S. Feitosa
- Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciados (CIATEN) e Centro de Ciências Agrárias (CCA), Universidade Federal do Piauí (UFPI), Piauí 64049-550, Brazil;
| | - Lilian S. Catenacci
- Programa de Pós-Graduação Saúde Animal na Amazônia, Universidade Federal do Pará (UFPA), Belém 66075-110, Brazil
- Saint Loius Zoo, Institute for Conservation Medicine, St. Louis, MO 63110, USA
- Centro de Inteligência em Agravos Tropicais Emergentes e Negligenciados (CIATEN) e Centro de Ciências Agrárias (CCA), Universidade Federal do Piauí (UFPI), Piauí 64049-550, Brazil;
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Multi-Drug Resistant Plasmids with ESBL/AmpC and mcr-5.1 in Paraguayan Poultry Farms: The Linkage of Antibiotic Resistance and Hatcheries. Microorganisms 2021; 9:microorganisms9040866. [PMID: 33920558 PMCID: PMC8072826 DOI: 10.3390/microorganisms9040866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Poultry represents a common source of bacteria with resistance to antibiotics including the critically important ones. Selective cultivation using colistin, cefotaxime and meropenem was performed for 66 chicken samples coming from 12 farms in Paraguay while two breeding companies supplied the farms. A total of 62 Escherichia coli and 22 Klebsiella pneumoniae isolates were obtained and representative isolates were subjected to whole-genome sequencing. Relatively high prevalence of phylogenetic group D and F was observed in E. coli isolates and several zoonotic sequence types (STs) including ST457 (14 isolates), ST38 (5), ST10 (2), ST117 (2) or ST93 (4) were detected. Isolates from three farms, which purchased chicken from a Paraguayan hatchery showed higher prevalence of mcr-5.1 and blaCTX-M-8 compared to the other nine farms, which purchased chickens from a Brazilian hatchery. Moreover, none of the K. pneumoniae isolates were linked to the Paraguayan hatchery. ESBL/AmpC and mcr-5-carrying multi-drug resistant (MDR) plasmids were characterized, and complete sequences were obtained for eight plasmids. The study shed light on Paraguayan poultry farms as a reservoir of antibiotic resistance commonly conferred via MDR plasmids and showed linkage between resistance and origin of the chickens at the hatcheries level.
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Kakuta N, Nakano R, Nakano A, Suzuki Y, Masui T, Horiuchi S, Kakuta R, Tsubaki K, Ogawa M, Yano H. Molecular characteristics of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Japan: Predominance of CTX-M-15 and emergence of hypervirulent clones. Int J Infect Dis 2020; 98:281-286. [PMID: 32619765 DOI: 10.1016/j.ijid.2020.06.083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To provide data on the molecular characteristics of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae clinical isolates in Japan. METHODS A total of 100 clinical isolates of ESBL-producing K. pneumoniae collected throughout Japan between June and July 2018 were studied. ESBL genes were analyzed using PCR and DNA sequencing. Transferability of ESBL genes was investigated by conjugation experiments. Plasmid replicon types, virulence genes (rmpA, rmpA2, iucA, iroB, and peg-344) associated with hypervirulent K. pneumoniae (hvKp), and capsule types were detected using PCR. Genotyping was performed using multilocus sequence typing. RESULTS All ESBL-producing isolates carried blaCTX-M genes. The most predominant CTX-M-type identified was CTX-M-15 (n=55). We identified 24 sequence types (STs) among the CTX-M-15 producers, with ST25 (n=8) being the most common. Most of the transconjugants carrying blaCTX-M-15 contained the FIIk replicon. Of the 100 ESBL-producing isolates, 31 were hvKp defined by the presence of the virulence genes. These ESBL-producing hvKp isolates belonged to eight STs (STs 23, 25, 36, 65, 86, 268, 412, and 4492), with five capsule types (K1, K2, K20, K57, and undefined). CONCLUSIONS CTX-M-15 was the predominant ESBL among K. pneumoniae isolates from Japan. This study shows that ESBL-producing hvKp strains comprising various clones are emerging in Japan.
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Affiliation(s)
- Naoki Kakuta
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan.
| | - Ryuichi Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan.
| | - Akiyo Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan.
| | - Yuki Suzuki
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan.
| | - Takashi Masui
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan.
| | - Saori Horiuchi
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan.
| | - Risako Kakuta
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan; Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| | - Kohsuke Tsubaki
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan.
| | - Miho Ogawa
- Department of Bacteriology, BML, Inc., Saitama, Japan.
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan.
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Fuentes-Castillo D, Esposito F, Cardoso B, Dalazen G, Moura Q, Fuga B, Fontana H, Cerdeira L, Dropa M, Rottmann J, González-Acuña D, Catão-Dias JL, Lincopan N. Genomic data reveal international lineages of critical priority Escherichia coli harbouring wide resistome in Andean condors (Vultur gryphus Linnaeus, 1758). Mol Ecol 2020; 29:1919-1935. [PMID: 32335957 DOI: 10.1111/mec.15455] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/01/2020] [Accepted: 04/16/2020] [Indexed: 12/18/2022]
Abstract
Critical priority pathogens have globally disseminated beyond clinical settings, thereby threatening wildlife. Andean Condors (Vultur gryphus) are essential for ecosystem health and functioning, but their populations are globally near threatened and declining due to anthropogenic activities. During a microbiological and genomic surveillance study of critical priority antibiotic-resistant pathogens, we identified pandemic lineages of multidrug-resistant extended-spectrum β-lactamase (ESBL)-producing Escherichia coli colonizing Andean Condors admitted at two wildlife rehabilitation centres in South America. Genomic analysis revealed the presence of genes encoding resistance to hospital and healthcare agents among international E. coli clones belonging to sequence types (STs) ST162, ST602, ST1196 and ST1485. In this regard, the resistome included genes conferring resistance to clinically important cephalosporins (i.e., CTX-M-14, CTX-M-55 and CTX-M-65 ESBL genes), heavy metals (arsenic, mercury, lead, cadmium, copper, silver), pesticides (glyphosate) and domestic/hospital disinfectants, suggesting a link with anthropogenic environmental pollution. On the other hand, the presence of virulence factors, including the astA gene associated with outbreak of childhood diarrhoea and extra-intestinal disease in animals, was identified, whereas virulent behaviour was confirmed using the Galleria mellonella infection model. E. coli ST162, ST602, ST1196 and ST1485 have been previously identified in humans and food-producing animals worldwide, indicating that a wide resistome could contribute to rapid adaptation and dissemination of these clones at the human-animal-environment interface. Therefore, these results highlight that Andean Condors have been colonized by critical priority pathogens, becoming potential environmental reservoirs and/or vectors for dissemination of virulent and antimicrobial-resistant bacteria and/or their genes, in associated ecosystems and wildlife.
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Affiliation(s)
- Danny Fuentes-Castillo
- Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Fernanda Esposito
- Department of Clinical Analysis, Faculty of Pharmacy, University of São Paulo, Sao Paulo, Brazil
| | - Brenda Cardoso
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Gislaine Dalazen
- Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Quézia Moura
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Bruna Fuga
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Herrison Fontana
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Louise Cerdeira
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Milena Dropa
- School of Public Health, University of São Paulo, Sao Paulo, Brazil
| | | | - Daniel González-Acuña
- Department of Animal Sciences, Faculty of Veterinary Sciences, University of Concepción, Chillán, Chile
| | - José L Catão-Dias
- Department of Pathology, School of Veterinary Medicine and Animal Sciences, University of São Paulo, Sao Paulo, Brazil
| | - Nilton Lincopan
- Department of Clinical Analysis, Faculty of Pharmacy, University of São Paulo, Sao Paulo, Brazil.,Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Sao Paulo, Brazil
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Boudjemaa H, Allem R, Fonkou MDM, Zouagui S, Khennouchi NCEH, Kerkoud M. Molecular drivers of emerging multidrug resistance in Proteus mirabilis clinical isolates from Algeria. J Glob Antimicrob Resist 2019; 18:249-256. [PMID: 30797091 DOI: 10.1016/j.jgar.2019.01.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/04/2019] [Accepted: 01/26/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The aim of this study was to characterise the molecular drivers of multidrug resistance in Proteus mirabilis isolated from Algerian community and hospital patients. METHODS A total of 166 P. mirabilis isolates were collected from two hospitals and eight private laboratories from four cities (Khemis Miliana, Aïn Defla, Oran and Chlef) located in northwestern Algeria. All isolates were identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). Antimicrobial susceptibility testing was performed by the disk diffusion and Etest methods. Genes encoding AmpC β-lactamases, extended-spectrum β-lactamases (ESBLs), quinolone resistance and aminoglycoside-modifying enzymes (AMEs) as well as plasmid replicon typing were characterised by PCR. Clonal relationships were also determined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) typing and were compared with MALDI-TOF/MS proteomic typing. RESULTS Of the 166 P. mirabilis isolates, 14 (8.4%) exhibited resistance to important antibiotics, including amoxicillin, amoxicillin/clavulanic acid, cefotaxime, gentamicin and ciprofloxacin, of which 4/14 (28.6%) had an ESBL genotype (blaCTX-M-2) and 10 (71.4%) had an AmpC/ESBL genotype (blaCMY-2/blaTEM-1). AME genes were detected in all isolates, including ant(2'')-I, aac(3)-I, aac(6')-Ib-cr and aac(3)-IV. The qnrA gene was identified in 13 isolates (7.8%). ERIC-PCR showed one predominant clone, with eight blaCMY-2-producing isolates from UHC Oran belonging to profile A clustering together in the MALDI-TOF/MS dendrogram. CONCLUSION Here we report the first description of AME and plasmid-mediated quinolone resistance genes among ESBL- and/or AmpC β-lactamase-producing P. mirabilis isolates from community- and hospital-acquired infections in northwestern Algeria.
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Affiliation(s)
- Hadjer Boudjemaa
- Laboratory of Natural Bioresources, Department of Biology, Faculty of Natural Sciences and Life, University of Hassiba Benbouali Chlef, Box 151, 02000 Chlef, AlgeriaAlgeria.
| | - Rachida Allem
- Laboratory of Natural Bioresources, Department of Biology, Faculty of Natural Sciences and Life, University of Hassiba Benbouali Chlef, Box 151, 02000 Chlef, AlgeriaAlgeria
| | - Maxime Descartes Mbogning Fonkou
- MEPHI, UMR, IRD, Aix-Marseille Université, Marseille, France; INSERM U1095, Facultés de Médecine et de Pharmacie, Marseille, France
| | - Souad Zouagui
- Laboratoire Central de Microbiologie du CHU d'Oran, 76 boulevard docteur Benzerdjeb (Ex Plateau), Oran, Algeria
| | - Nour Chems El Houda Khennouchi
- Laboratoire de Microbiologie et Biochimie Appliquée, Département de Biochimie, Faculté des Sciences, Université Badji Mokhtar, Annaba, Algeria
| | - Mohamed Kerkoud
- Laboratory of Natural Bioresources, Department of Biology, Faculty of Natural Sciences and Life, University of Hassiba Benbouali Chlef, Box 151, 02000 Chlef, AlgeriaAlgeria; Laboratoire de diag-gene, 8 rue lenotre, Angers, France
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Rui Y, Lu W, Li S, Cheng C, Sun J, Yang Q. Integrons and insertion sequence common region 1 (ISCR1) of carbapenem-non-susceptible Gram-negative bacilli in fecal specimens from 5000 patients in southern China. Int J Antimicrob Agents 2018; 52:571-576. [DOI: 10.1016/j.ijantimicag.2018.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 05/22/2018] [Accepted: 06/16/2018] [Indexed: 11/30/2022]
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Müller A, Jansen W, Grabowski NT, Monecke S, Ehricht R, Kehrenberg C. ESBL- and AmpC-producing Escherichia coli from legally and illegally imported meat: Characterization of isolates brought into the EU from third countries. Int J Food Microbiol 2018; 283:52-58. [DOI: 10.1016/j.ijfoodmicro.2018.06.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/25/2018] [Accepted: 06/11/2018] [Indexed: 11/16/2022]
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Saraiva MMS, Moreira Filho ALB, Freitas Neto OC, Silva NMV, Givisiez PEN, Gebreyes WA, Oliveira CJB. Off-label use of ceftiofur in one-day chicks triggers a short-term increase of ESBL-producing E. coli in the gut. PLoS One 2018; 13:e0203158. [PMID: 30204766 PMCID: PMC6133352 DOI: 10.1371/journal.pone.0203158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 08/15/2018] [Indexed: 11/19/2022] Open
Abstract
This trial was designed to evaluate the off-label use of ceftiofur with Marek's vaccine in one-day-old broiler chicks, a prophylactic treatment that has been done in some commercial hatcheries, on the emergence of extended-spectrum beta-lactamase producing Escherichia coli (ESBL-E. coli). A total of 168 chicks (Cobb500®) were used in a completely randomized design. Birds were assigned to two treatments (Marek's vaccine plus saline vs Marek's vaccine plus ceftiofur) and six repetitions, with 14 animals each. Cloacal swabs were collected from 1 to 14 days post-hatch. The majority (86%; p<0.0001) of the ESBL-producing isolates harboring blaCTX-M and blaSHV genes originated from animals receiving the antimicrobial. None of the isolates were positive for plasmid-mediated AmpC betalactamase genes (blaACC, blaCMY-2, blaDHA, blaFOX, blaMOX and blaMIR). These findings indicate that the off-label use of ceftiofur with Marek's vaccine is associated with the short-term increase in ESBL-producing Escherichia coli in the gut of chicks.
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Affiliation(s)
- Mauro M. S. Saraiva
- Department of Animal Science, Center for Agricultural Sciences, Federal University of Paraiba (CCA/UFPB), Areia, Paraíba, Brazil
| | - Alexandre L. B. Moreira Filho
- Department of Animal Science, Center for Agricultural Sciences, Federal University of Paraiba (CCA/UFPB), Areia, Paraíba, Brazil
- National Institute for Research on Antimicrobial Resistance (INPRA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Oliveiro C. Freitas Neto
- Department of Veterinary Sciences, Center for Agricultural Sciences, Federal University of Paraiba (CCA/UFPB), Areia, Paraíba, Brazil
| | - Núbia M. V. Silva
- Department of Animal Science, Center for Agricultural Sciences, Federal University of Paraiba (CCA/UFPB), Areia, Paraíba, Brazil
| | - Patrícia E. N. Givisiez
- Department of Animal Science, Center for Agricultural Sciences, Federal University of Paraiba (CCA/UFPB), Areia, Paraíba, Brazil
| | - Wondwossen A. Gebreyes
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Global One Health Initiative (GOHi), The Ohio State University, Columbus, Ohio, United States of America
| | - Celso J. B. Oliveira
- Department of Animal Science, Center for Agricultural Sciences, Federal University of Paraiba (CCA/UFPB), Areia, Paraíba, Brazil
- National Institute for Research on Antimicrobial Resistance (INPRA), Porto Alegre, Rio Grande do Sul, Brazil
- Global One Health Initiative (GOHi), The Ohio State University, Columbus, Ohio, United States of America
- * E-mail: ,
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Moura Q, Cerdeira L, Fernandes MR, Vianello MA, Lincopan N. Novel class 1 integron (In1390) harboring bla GES-5 in a Morganella morganii strain recovered from a remote community. Diagn Microbiol Infect Dis 2018; 91:345-347. [PMID: 29628289 DOI: 10.1016/j.diagmicrobio.2018.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 02/16/2018] [Accepted: 03/05/2018] [Indexed: 11/25/2022]
Abstract
Antimicrobial resistance in Morganella morganii has been mainly acquired via plasmids and class 1 integrons. We hereby report acquisition of blaGES-5 by a M. morganii isolated in a remote community from the Amazon region. Genomic analysis revealed that blaGES-5 was harbored by a novel class 1 integron designated as In1390.
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Affiliation(s)
- Quézia Moura
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
| | - Louise Cerdeira
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Miriam R Fernandes
- Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Nilton Lincopan
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil; Department of Clinical Analysis, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.
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Andrade LN, Novais Â, Stegani LMM, Ferreira JC, Rodrigues C, Darini ALC, Peixe L. Virulence genes, capsular and plasmid types of multidrug-resistant CTX-M(-2, -8, -15) and KPC-2-producing Klebsiella pneumoniae isolates from four major hospitals in Brazil. Diagn Microbiol Infect Dis 2018; 91:164-168. [PMID: 29459053 DOI: 10.1016/j.diagmicrobio.2018.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/06/2017] [Accepted: 01/08/2018] [Indexed: 01/20/2023]
Abstract
We performed a single-month snapshot study of the population diversity of multidrug resistant (MDR) Klebsiella pneumoniae isolates producing carbapenemases and/or extended-spectrum β-lactamases from four major hospitals in Brazil. Isolates produced diverse ESBL (CTX-M-2, -8, -15, SHV-2), KPC-2 or both (CTX-M-2 and KPC-2), linked to specific genetic backgrounds and plasmids from a few families (IncR, IncFIIk, IncL/M) that were shared among clonal lineages within and between hospitals. A high clonal diversity was identified, among isolates from the same ST (ST11, ST15, ST101 or ST340). Diverse capsular types (n=13 K-types) were identified, most of which linked to specific ST (ST11 and K27 or K64, ST101 and K17, ST340 and KL151, ST15 and K24 or ST17 and KL112). Isolates shared a common set of virulence genes (ureA, fimH, uge, wabG, mrkD, entB) and occasionally ybtS (42%) and kfuBC (18%). Our data suggest intra- and inter-hospital spread of common genetic structures and international MDR K. pneumoniae clones.
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Affiliation(s)
- Leonardo Neves Andrade
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Ângela Novais
- UCIBIO@REQUIMTE, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Lenita Maria Marcato Stegani
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Joseane Cristina Ferreira
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Carla Rodrigues
- UCIBIO@REQUIMTE, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Ana Lucia Costa Darini
- Universidade de São Paulo (USP) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto (FCFRP), Ribeirão Preto, SP, Brazil
| | - Luisa Peixe
- UCIBIO@REQUIMTE, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal.
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Kanafani ZA, Fadlallah SM, Assaf S, Anouti K, Kissoyan KAB, Sfeir J, Nawar T, Yasmin M, Matar GM. Sites of colonization in hospitalized patients with infections caused by extended-spectrum beta-lactamase organisms: a prospective cohort study. Antimicrob Resist Infect Control 2017; 6:46. [PMID: 28515902 PMCID: PMC5433240 DOI: 10.1186/s13756-017-0207-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/10/2017] [Indexed: 11/23/2022] Open
Abstract
Background The objective of this study was to determine whether patients infected with extended-spectrum beta-lactamase (ESBL)-producing organisms are colonized at multiple body sites. Methods This was a prospective cohort study at a tertiary care center in Beirut, Lebanon. Hospitalized patients with infections caused by ESBL-producing organisms were included. Cultures were obtained from the primary site of infection as well as from other sites (skin, nasopharynx, urine, rectum). Molecular analysis was performed on isolates to determine clonal relatedness. Results One hundred patients were included in the study. Only 22 patients had positive cultures from sites other than the primary site of infection. The most common ESBL gene was CTX-M-15 followed by TEM-1. In 11 of 22 patients, isolates collected from the same patient were 100% genetically related, while in the remaining patients, genomic relatedness ranged from 42.9% to 97.1%. Conclusions Colonization at sites other than the primary site of infection was not common among our patient population infected with ESBL-producing organisms. The dynamics of transmission of these bacterial strains should be studied in further prospective studies to determine the value of routine active surveillance and the need for expanded precautions in infected and colonized patients.
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Affiliation(s)
- Zeina A Kanafani
- Department of Internal Medicine, American University of Beirut, PO Box 11-0236/11D, Cairo Street, Riad El Solh, Beirut, 1107 2020 Lebanon
| | - Sukayna M Fadlallah
- Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut, Beirut, Lebanon
| | - Sarah Assaf
- Department of Internal Medicine, American University of Beirut, PO Box 11-0236/11D, Cairo Street, Riad El Solh, Beirut, 1107 2020 Lebanon
| | - Khalil Anouti
- Department of Internal Medicine, American University of Beirut, PO Box 11-0236/11D, Cairo Street, Riad El Solh, Beirut, 1107 2020 Lebanon
| | - Kohar Annie B Kissoyan
- Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut, Beirut, Lebanon
| | - Jad Sfeir
- Department of Internal Medicine, American University of Beirut, PO Box 11-0236/11D, Cairo Street, Riad El Solh, Beirut, 1107 2020 Lebanon
| | - Tamara Nawar
- Department of Internal Medicine, American University of Beirut, PO Box 11-0236/11D, Cairo Street, Riad El Solh, Beirut, 1107 2020 Lebanon
| | - Mohamad Yasmin
- Department of Internal Medicine, American University of Beirut, PO Box 11-0236/11D, Cairo Street, Riad El Solh, Beirut, 1107 2020 Lebanon
| | - Ghassan M Matar
- Department of Experimental Pathology, Immunology and Microbiology, American University of Beirut, Beirut, Lebanon
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12
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Sangare SA, Rondinaud E, Maataoui N, Maiga AI, Guindo I, Maiga A, Camara N, Dicko OA, Dao S, Diallo S, Bougoudogo F, Andremont A, Maiga II, Armand-Lefevre L. Very high prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in bacteriemic patients hospitalized in teaching hospitals in Bamako, Mali. PLoS One 2017; 12:e0172652. [PMID: 28245252 PMCID: PMC5330466 DOI: 10.1371/journal.pone.0172652] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 02/07/2017] [Indexed: 11/19/2022] Open
Abstract
The worldwide dissemination of extended-spectrum beta-lactamase producing Enterobacteriaceae, (ESBL-E) and their subset producing carbapenemases (CPE), is alarming. Limited data on the prevalence of such strains in infections from patients from Sub-Saharan Africa are currently available. We determined, here, the prevalence of ESBL-E/CPE in bacteriemic patients in two teaching hospitals from Bamako (Mali), which are at the top of the health care pyramid in the country. During one year, all Enterobacteriaceae isolated from bloodstream infections (E-BSI), were collected from patients hospitalized at the Point G University Teaching Hospital and the pediatric units of Gabriel Touré University Teaching Hospital. Antibiotic susceptibility testing, enzyme characterization and strain relatedness were determined. A total of 77 patients had an E-BSI and as many as 48 (62.3%) were infected with an ESBL-E. ESBL-E BSI were associated with a previous hospitalization (OR 3.97 95% IC [1.32; 13.21]) and were more frequent in hospital-acquired episodes (OR 3.66 95% IC [1.07; 13.38]). Among the 82 isolated Enterobacteriaceae, 58.5% were ESBL-E (20/31 Escherichia coli, 20/26 Klebsiella pneumoniae and 8/15 Enterobacter cloacae). The remaining (5 Salmonella Enteritidis, 3 Morganella morganii 1 Proteus mirabilis and 1 Leclercia adecarboxylata) were ESBL negative. CTX-M-1 group enzymes were highly prevalent (89.6%) among ESBLs; the remaining ones being SHV. One E. coli produced an OXA-181 carbapenemase, which is the first CPE described in Mali. The analysis of ESBL-E relatedness suggested a high rate of cross transmission between patients. In conclusion, even if CPE are still rare for the moment, the high rate of ESBL-BSI and frequent cross transmission probably impose a high medical and economic burden to Malian hospitals.
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Affiliation(s)
- Samba Adama Sangare
- Bacteriology Laboratory, Centre Hospitalier Universitaire Gabriel Touré, Bamako, Mali
- Bacteriology Laboratory, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Emilie Rondinaud
- Bacteriology Laboratory, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Naouale Maataoui
- Bacteriology Laboratory, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Almoustapha Issiaka Maiga
- Bacteriology Laboratory, Centre Hospitalier Universitaire Gabriel Touré, Bamako, Mali
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Ibrehima Guindo
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
- Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Aminata Maiga
- Bacteriology Laboratory, Centre Hospitalier Universitaire du Point G, Bamako, Mali
| | - Namory Camara
- Bacteriology Laboratory, Centre Hospitalier Universitaire Gabriel Touré, Bamako, Mali
| | - Oumar Agaly Dicko
- Bacteriology Laboratory, Centre Hospitalier Universitaire du Point G, Bamako, Mali
| | - Sounkalo Dao
- Faculté de Médecine et d’Odonto- stomatologie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Souleymane Diallo
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
- Centre d’Infectiologie Charles Mérieux, Bamako, Mali
| | - Flabou Bougoudogo
- Faculté de Pharmacie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
- Institut National de Recherche en Santé Publique, Bamako, Mali
| | - Antoine Andremont
- Bacteriology Laboratory, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Ibrahim Izetiegouma Maiga
- Bacteriology Laboratory, Centre Hospitalier Universitaire du Point G, Bamako, Mali
- Faculté de Médecine et d’Odonto- stomatologie, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali
| | - Laurence Armand-Lefevre
- Bacteriology Laboratory, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France
- INSERM, IAME, UMR 1137, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
- * E-mail:
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13
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Moura Q, Fernandes MR, Silva KC, Monte DF, Esposito F, Dropa M, Noronha C, Moreno AM, Landgraf M, Negrão FJ, Lincopan N. Virulent nontyphoidal Salmonella producing CTX-M and CMY-2 β-lactamases from livestock, food and human infection, Brazil. Virulence 2017; 9:281-286. [PMID: 28102761 PMCID: PMC5955470 DOI: 10.1080/21505594.2017.1279779] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Quézia Moura
- a Department of Microbiology , Institute of Biomedical Sciences, Universidade de São Paulo , São Paulo , Brazil
| | - Miriam R Fernandes
- b Department of Clinical Analysis , School of Pharmacy, Universidade de São Paulo , São Paulo , Brazil
| | - Ketrin C Silva
- c School of Veterinary Medicine, Universidade de São Paulo , São Paulo , Brazil
| | - Daniel F Monte
- d Food and Experimental Nutrition Department , School of Pharmacy & Food Research Center, Universidade de São Paulo , São Paulo , Brazil
| | - Fernanda Esposito
- b Department of Clinical Analysis , School of Pharmacy, Universidade de São Paulo , São Paulo , Brazil
| | - Milena Dropa
- e Public Health Laboratory, School of Public Health, Universidade de São Paulo , São Paulo , Brazil
| | - César Noronha
- f State Center for Clinical Analysis , São Paulo, São Paulo , Brazil
| | - Andrea M Moreno
- c School of Veterinary Medicine, Universidade de São Paulo , São Paulo , Brazil
| | - Mariza Landgraf
- d Food and Experimental Nutrition Department , School of Pharmacy & Food Research Center, Universidade de São Paulo , São Paulo , Brazil
| | - Fábio J Negrão
- g Health Sciences Research Laboratory, School of Health Sciences, Universidade Federal da Grande Dourados , Dourados , Brazil
| | - Nilton Lincopan
- a Department of Microbiology , Institute of Biomedical Sciences, Universidade de São Paulo , São Paulo , Brazil.,b Department of Clinical Analysis , School of Pharmacy, Universidade de São Paulo , São Paulo , Brazil
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14
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Fernandes SA, Camargo CH, Francisco GR, Bueno MFC, Garcia DO, Doi Y, Casas MRT. Prevalence of Extended-Spectrum β-Lactamases CTX-M-8 and CTX-M-2-Producing Salmonella Serotypes from Clinical and Nonhuman Isolates in Brazil. Microb Drug Resist 2016; 23:580-589. [PMID: 27828759 DOI: 10.1089/mdr.2016.0085] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We characterized extended-spectrum β-lactamases (ESBL) enzymes among Salmonella strains isolated in Brazil from 2009 to 2014. Salmonella recovered from both clinical and nonhuman (food, poultry, and environment) sources were subjected to antimicrobial susceptibility testing. β-lactamases genes were detected by polymerase chain reaction/sequencing; plasmid profiles and transferability were assessed by S1-pulsed field gel electrophoresis (PFGE). Genetic diversity was evaluated by XbaI-PFGE. Out of 630 Salmonella strains screened, 46 displayed ESBL phenotype, distributed across 11 different serotypes. blaCTX-M-8 and blaCTX-M-2 genes were detected at frequencies of 47% and 41%, respectively. blaSHV-5 and blaSHV-2 were also detected but in lower frequencies (4%, 2%). blaTEM-1 gene was detected in 22% of the strains. Most of the ESBL genes were transferable by conjugation, and the respective blaESBL gene was detected in the recipient strain, indicating the location of ESBL determinants on transferable plasmids. XbaI-PFGE revealed genomic diversity of Salmonella Typhimurium bearing blaCTX-M-2, blaCTX-M-8, blaTEM-1, and blaSHV-2 genes. Salmonella Muenchen (harboring blaCTX-M-2) and Salmonella Corvallis (blaCTX-M-8 and blaSHV-5) showed clonal relatedness within respective serotypes. Our findings underscore the occurrence of diverse ESBL genes in several Salmonella serotypes, reinforcing the need for continuous surveillance of resistance genes circulating in human and nonhuman sources.
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Affiliation(s)
| | | | | | | | | | - Yohei Doi
- 2 Division of Infectious Diseases, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
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15
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Sampaio JLM, Gales AC. Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins. Braz J Microbiol 2016; 47 Suppl 1:31-37. [PMID: 27825605 PMCID: PMC5156504 DOI: 10.1016/j.bjm.2016.10.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 10/07/2016] [Accepted: 10/07/2016] [Indexed: 12/22/2022] Open
Abstract
During the last 30 years there has been a dissemination of plasmid-mediated β-lactamases in Enterobacteriaceae in Brazil. Extended spectrum β-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo-β-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials.
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Affiliation(s)
- Jorge Luiz Mello Sampaio
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Departamento de Análises Clínicas e Toxicológicas, São Paulo, SP, Brazil; Fleury Medicina e Saúde, Seção de Microbiologia, São Paulo, SP, Brazil.
| | - Ana Cristina Gales
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina Interna, São Paulo, Brazil.
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16
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Liakopoulos A, Mevius D, Ceccarelli D. A Review of SHV Extended-Spectrum β-Lactamases: Neglected Yet Ubiquitous. Front Microbiol 2016; 7:1374. [PMID: 27656166 PMCID: PMC5011133 DOI: 10.3389/fmicb.2016.01374] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 08/19/2016] [Indexed: 12/29/2022] Open
Abstract
β-lactamases are the primary cause of resistance to β-lactams among members of the family Enterobacteriaceae. SHV enzymes have emerged in Enterobacteriaceae causing infections in health care in the last decades of the Twentieth century, and they are now observed in isolates in different epidemiological settings both in human, animal and the environment. Likely originated from a chromosomal penicillinase of Klebsiella pneumoniae, SHV β-lactamases currently encompass a large number of allelic variants including extended-spectrum β-lactamases (ESBL), non-ESBL and several not classified variants. SHV enzymes have evolved from a narrow- to an extended-spectrum of hydrolyzing activity, including monobactams and carbapenems, as a result of amino acid changes that altered the configuration around the active site of the β -lactamases. SHV-ESBLs are usually encoded by self-transmissible plasmids that frequently carry resistance genes to other drug classes and have become widespread throughout the world in several Enterobacteriaceae, emphasizing their clinical significance.
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Affiliation(s)
- Apostolos Liakopoulos
- Department of Bacteriology and Epidemiology, Central Veterinary Institute of Wageningen UR Lelystad, Netherlands
| | - Dik Mevius
- Department of Bacteriology and Epidemiology, Central Veterinary Institute of Wageningen URLelystad, Netherlands; Faculty of Veterinary Medicine, Utrecht UniversityUtrecht, Netherlands
| | - Daniela Ceccarelli
- Department of Bacteriology and Epidemiology, Central Veterinary Institute of Wageningen UR Lelystad, Netherlands
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17
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Suleyman G, Perri M, Vager D, Samuel L, Zervos MJ, Alangaden G, Tibbetts RJ. Characterization of Salmonella Isangi possessing a CTX-M15 ESBL associated with an outbreak in a US Hospital. Diagn Microbiol Infect Dis 2016; 85:386-390. [DOI: 10.1016/j.diagmicrobio.2016.03.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/08/2016] [Accepted: 03/17/2016] [Indexed: 10/22/2022]
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18
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Rocha FR, Pinto VPT, Barbosa FCB. The Spread of CTX-M-Type Extended-Spectrum β-Lactamases in Brazil: A Systematic Review. Microb Drug Resist 2016; 22:301-11. [DOI: 10.1089/mdr.2015.0180] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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19
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Dropa M, Lincopan N, Balsalobre LC, Oliveira DE, Moura RA, Fernandes MR, da Silva QM, Matté GR, Sato MIZ, Matté MH. Genetic background of novel sequence types of CTX-M-8- and CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae from public wastewater treatment plants in São Paulo, Brazil. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:4953-4958. [PMID: 26782324 DOI: 10.1007/s11356-016-6079-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/06/2016] [Indexed: 05/29/2023]
Abstract
The release of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae to the environment is a public health issue worldwide. The aim of this study was to investigate the genetic background of genes encoding ESBLs in wastewater treatment plants (WWTPs) in São Paulo, southeastern Brazil. In 2009, during a local surveillance study, seven ESBL-producing Enterobacteriaceae strains were recovered from five WWTPs and screened for ESBL genes and mobile genetic elements. Multilocus sequence typing (MLST) was carried out, and wild plasmids were transformed into electrocompetent Escherichia coli. S1-PFGE technique was used to verify the presence of high molecular weight plasmids in wild-type strains and in bla ESBL-containing E. coli transformants. Strains harbored bla CTX-M-8, bla CTX-M-15, and/or bla SHV-28. Sequencing results showed that bla CTX-M-8 and bla CTX-M-15 genes were associated with IS26. MLST revealed new sequence types for E. coli (ST4401, ST4402, ST4403, and ST4445) and Klebsiella pneumoniae (ST1574), except for one K. pneumoniae from ST307 and Enterobacter cloacae from ST131. PCR and S1-PFGE results showed CTX-M-producing E. coli transformants carried heavy plasmids sizing 48.5-209 kb, which belonged to IncI1, IncF, and IncM1 incompatibility groups. This is the first report of CTX-M-8 and SHV-28 enzymes in environmental samples, and the present results demonstrate the plasmid-mediated spread of CTX-M-encoding genes through five WWTPs in São Paulo, Brazil, suggesting WWTPs are hotspots for the transfer of ESBL genes and confirming the urgent need to improve the management of sewage in order to minimize the dissemination of resistance genes to the environment.
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Affiliation(s)
- Milena Dropa
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil.
| | - Nilton Lincopan
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Avenida Professor Lineu Prestes, 1374, Butantã, 05508-900, São Paulo, SP, Brazil
- Department of Clinical Analysis, School of Pharmacy, University of São Paulo, Avenida Professor Lineu Prestes, 580, Butantã, 05434-070, São Paulo, SP, Brazil
| | - Livia C Balsalobre
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
| | - Danielle E Oliveira
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
| | - Rodrigo A Moura
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Avenida Professor Lineu Prestes, 1374, Butantã, 05508-900, São Paulo, SP, Brazil
| | - Miriam Rodriguez Fernandes
- Department of Clinical Analysis, School of Pharmacy, University of São Paulo, Avenida Professor Lineu Prestes, 580, Butantã, 05434-070, São Paulo, SP, Brazil
| | - Quézia Moura da Silva
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, Avenida Professor Lineu Prestes, 1374, Butantã, 05508-900, São Paulo, SP, Brazil
| | - Glavur R Matté
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
| | - Maria I Z Sato
- Environmental Company of São Paulo State (CETESB), Avenida Professor Frederico Hermann Jr, 345, Pinheiros, 05489-900, São Paulo, SP, Brazil
| | - Maria H Matté
- Public Health Laboratory, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira César, 01146-904, São Paulo, SP, Brazil
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