Emergence of Haemophilus parainfluenzae resistant to third-generation cephalosporins in Italy: potential role of PBP3 and PBP5 substitutions in high-level resistance

Abstract The aim of this study was to elucidate the epidemiology of third generation cephalosporin resistant Samonella isolates from pork of a slaughterhouse in China and the features of transferable elements carrying bla CTX-M genes. One hundred and twenty-six (7.3%) Salmonella isolates were identified; S. Derby and S. Rissen were the most two prevalent serotypes. Among these isolates 20 (15.8%) were resistant to third generation cephalosporins and nine of them carried bla CTX-M-27. S1-PFGE and replicon typing of bla CTX-M-27-carrying plasmids showed that seven were untypeable plasmids of about 104 Kb and two were IncP plasmids of about 300 Kb. Complete sequence analysis of one PBRT-untypeable plasmid showed it was a P1-like bateriophage, named SJ46, which contained a non-phage-associated region with several mobile elements, including Tn1721, ISEcp1B and IS903D. The other six 104 Kb PBRT-untypeable bla CTX-M-27-carrying plasmids also harboured the same phage-insertion region of SJ46 suggesting that they were the same P1-like bacteriophage. PFGE profiles of the parental strains revealed both potential vertical and horizontal spread of this P1-like bla CTX-M-27-containing element. Additionally, the representative gene of the P1 family bacteriophage, repL, was detected in 19.0% (24/126) of the isolates. This study indicated a potential role of P1-family bacteriophage in capture and spread of antimicrobial resistance in pathogens.

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Current antimicrobial sensitivity pattern of typhoidal salmonellae in a referral diagnostic centre

Microbiologia Medica ◽

10.4081/mm.2016.4669 ◽

2016 ◽

Vol 31 (1) ◽

Cited By ~ 1

Author(s):

Umer Shujat ◽

Aamer Ikram ◽

Inam Qadir Javaid Hashmi ◽

Shahid Ahmed Abbasi ◽

Amna Afzal ◽

...

Keyword(s):

Health Concern ◽

Third Generation ◽

Susceptibility Pattern ◽

Marked Rise ◽

Antimicrobial Sensitivity ◽

Sensitivity Pattern ◽

High Level ◽

Third Generation Cephalosporins ◽

Diagnostic Centre ◽

Level Resistance

Background: Infections caused by typhoidal salmonellae are an important public health concern in Pakistan. Inappropriate and injudicious use of fluoroquinolones has reduced their efficacy due to development of high level resistance. Aim: To ascertain the current susceptibility pattern of typhoidal salmonellae thus guiding the physicians for better management of typhoid patients. Materials and Methods: A study was conducted at our institution from January 2012 through December 2013 to investigate current susceptibility pattern of typhoidal salmonellae. Results: Out of 200 isolates, 107 (53.5%) were identified as Salmonella Typhi and 93 (46.5%) as Salmonella Paratyphi A. Sensitivities of Salmonella Typhi were as follows: ampicillin (48.6%), chloramphenicol (45.8%), co-trimoxazole (40.1%), ciprofloxacin (11.2%). Sensitivities of Salmonella Paratyphi A were: ampicillin (80.6%), chloramphenicol (89.2%), co-trimoxazole (90.3%), and ciprofloxacin (16.1%). No resistance was detected against third generation cephalosporins. Conclusions: Typhoidal salmonellae are still entirely susceptible to third generation cephalosporins in our setting. Marked rise in resistance to fluoroquinolones has reduced their empirical usage. Sensitivity of Salmonella Paratyphi A to conventional antityphoid drugs was encouraging.

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The role of prophylactic antibiotics in hepatitis B virus-related acute-on-chronic liver failure patients at risk of bacterial infection: a retrospective study

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00830-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Xiao-Qin Liu ◽

Xue-Yun Zhang ◽

Yue Ying ◽

Jian-Ming Zheng ◽

Jian Sun ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Clinical Course ◽

Prophylactic Antibiotics ◽

Third Generation ◽

Chronic Liver Failure ◽

Free Survival ◽

B Virus ◽

Third Generation Cephalosporins

Abstract Background Acute-on-chronic liver failure (ACLF) is characterized by an excessive systemic inflammatory response and organ failure and has high mortality. Bacterial infections (BIs) worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients. The efficacy of third-generation cephalosporins has been challenged in recent years. The aim of this study was to characterize the difference between ACLF patients with and without BIs and to provide a reference for medical intervention. Methods A total of 140 patients with hepatitis B virus-related ACLF (HBV-ACLF) hospitalized at the Department of Infectious Diseases, Huashan Hospital, Fudan University (Shanghai, China) between May 2013 and January 2020 were enrolled. Mann-Whitney U test was used to compare the baseline characteristics of HBV-ACLF patients with and without BIs. Univariate and multivariate analyses were performed to find predictors of BIs. The characteristics of BIs and the role of prophylactic antibiotics were profiled. Results A total of 97 episodes of BIs occurred in patients during the course of HBV-ACLF. Patients with and without BIs differed in clinical characteristics. The incidence of BIs showed a positive correlation with the ACLF grade (P = 0.003) and the clinical course (P = 0.003). The 90-day transplant-free survival of patients with BIs was lower than those without BIs (P < 0.0001). Patients administered prophylactic antibiotics showed a lower incidence of BIs and had a higher transplant-free survival probability than those who did not (P = 0.046). No statistical differences in antibiotic efficacy between third-generation and other antibiotics were observed (P = 0.108). Conclusions BIs affected the clinical course and prognosis of patients with HBV-ACLF. Prophylactic antibiotics were of potential clinical importance in the prevention of BIs and improving the clinical course and prognosis in HBV-ACLF patients. Third-generation cephalosporins were qualified for use in antibiotic prophylaxis.

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Treatment of severe infections caused by penicillin-resistant pneumococci. Role of third generation cephalosporins

Infection ◽

10.1007/bf01782701 ◽

1994 ◽

Vol 22 (S3) ◽

pp. S161-S166 ◽

Cited By ~ 4

Author(s):

E. Rubinstein ◽

Bina Rubinovitch

Keyword(s):

Third Generation ◽

Severe Infections ◽

Third Generation Cephalosporins

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Potential role of ABC-assisted repositories in U.S. plutonium and high-level waste disposition

10.1063/1.49156 ◽

1995 ◽

Author(s):

David Berwald ◽

Anthony Favale ◽

Timothy Myers ◽

Jerry McDaniel

Keyword(s):

Potential Role ◽

High Level Waste ◽

High Level

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Extended-Spectrum Cephalosporinase in Acinetobacter baumannii

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00050-10 ◽

2010 ◽

Vol 54 (8) ◽

pp. 3484-3488 ◽

Cited By ~ 46

Author(s):

José-Manuel Rodríguez-Martínez ◽

Patrice Nordmann ◽

Esthel Ronco ◽

Laurent Poirel

Keyword(s):

Acinetobacter Baumannii ◽

Clinical Isolate ◽

Site Directed Mutagenesis ◽

Directed Mutagenesis ◽

Extended Spectrum ◽

Class C ◽

High Level ◽

Level Resistance

ABSTRACT An AmpC-type β-lactamase conferring high-level resistance to expanded-spectrum cephalosporins and monobactams was characterized from an Acinetobacter baumannii clinical isolate. This class C β-lactamase (named ADC-33) possessed a Pro210Arg substitution together with a duplication of an Ala residue at position 215 (inside the Ω-loop) compared to a reference AmpC cephalosporinase from A. baumannii. ADC-33 hydrolyzed ceftazidime, cefepime, and aztreonam at high levels, which allows the classification of this enzyme as an extended-spectrum AmpC (ESAC). Site-directed mutagenesis confirmed the role of both substitutions in its ESAC property.

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Motile Aeromonas as agent of infections of the foot

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-85-9-505 ◽

1995 ◽

Vol 85 (9) ◽

pp. 505-508 ◽

Cited By ~ 3

Author(s):

M Wakabongo

Keyword(s):

Second Generation ◽

Antimicrobial Agents ◽

Third Generation ◽

Beta Lactam ◽

Beta Lactam Antibiotics ◽

Taxonomic Uncertainty ◽

Post Traumatic ◽

Third Generation Cephalosporins

Motile Aeromonas infections of the foot are caused mostly by post-traumatic incidence, occurring mostly during summer months. Serious complications such as osteomyelitis and amputation can result if the infections go untreated or are inadequately treated. The role of each species of motile Aeromonas in pathogenesis and response to antimicrobial agents is not well understood because of taxonomic uncertainty. As a group, motile Aeromonas respond well to aminoglycosides, second-generation and third-generation cephalosporins, quinolones, and some beta-lactam antibiotics.

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Epidemic Clostridium difficile-Associated Diarrhea: Role of Second- and Third-Generation Cephalosporins

Infection Control and Hospital Epidemiology ◽

10.2307/30145537 ◽

1994 ◽

Vol 15 (2) ◽

pp. 88-94 ◽

Cited By ~ 36

Author(s):

David E. Nelson ◽

Steven B. Auerbach ◽

Aldona L. Baltch ◽

Ethel Desjardin ◽

Consuelo Beck-Sague ◽

...

Keyword(s):

Clostridium Difficile ◽

Third Generation ◽

Clostridium Difficile Associated Diarrhea ◽

Third Generation Cephalosporins

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Role of β-Lactamases and Porins in Resistance to Ertapenem and Other β-Lactams in Klebsiella pneumoniae

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.48.8.3203-3206.2004 ◽

2004 ◽

Vol 48 (8) ◽

pp. 3203-3206 ◽

Cited By ~ 127

Author(s):

George A. Jacoby ◽

Debra M. Mills ◽

Nancy Chow

Keyword(s):

Klebsiella Pneumoniae ◽

Outer Membrane ◽

Type Strain ◽

Wild Type Strain ◽

Outer Membrane Proteins ◽

Wild Type ◽

Resistant Mutants ◽

High Level ◽

Level Resistance

ABSTRACT High-level resistance to ertapenem was produced by β-lactamases of groups 1, 2f, and 3 in a strain of Klebsiella pneumoniae deficient in Omp35 and Omp36. From a wild-type strain producing ACT-1 β-lactamase, ertapenem-resistant mutants for which the ertapenem MICs were up to 128 μg/ml and expression of outer membrane proteins was diminished could be selected.

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A Novel Complex Mutant β-Lactamase, TEM-68, Identified in a Klebsiella pneumoniae Isolate from an Outbreak of Extended-Spectrum β-Lactamase-Producing Klebsiellae

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.44.6.1499-1505.2000 ◽

2000 ◽

Vol 44 (6) ◽

pp. 1499-1505 ◽

Cited By ~ 46

Author(s):

Janusz Fiett ◽

Andrzej Pałucha ◽

Beata Mia˛czyńska ◽

Maria Stankiewicz ◽

Hanna Przondo-Mordarska ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

University Hospital ◽

Pediatric Hospitals ◽

Extended Spectrum ◽

Novel Complex ◽

High Level ◽

Inhibitor Resistance ◽

The University ◽

Level Resistance

ABSTRACT Twenty-two Klebsiella pneumoniae and two K. oxytoca extended-spectrum β-lactamase (ESBL)-producing isolates were collected in 1996 from patients in two pediatric wards of the University Hospital in Wrocław, Poland. Molecular typing has revealed that the K. pneumoniae isolates represented four different epidemic strains. Three kinds of enzymes with ESBL activity (pI values of 5.7, 6.0, and 8.2) were identified. The pI 6.0 β-lactamases belonged to the TEM family, and sequencing of thebla TEM genes amplified from representative isolates revealed that these enzymes were TEM-47, previously identified in K. pneumoniae isolates from pediatric hospitals in Łódź and Warsaw. One of the TEM-47-producing strains from Wrocław was very closely related to the isolates from the other cities, and this indicated countrywide spread of the epidemic strain. The pI 5.7 β-lactamase was produced by a single K. pneumoniae isolate for which, apart from oxyimino-β-lactams, the MICs of β-lactam–inhibitor combinations were also remarkably high. Sequencing revealed that this was a novel TEM β-lactamase variant, TEM-68, specified by the following combination of mutations: Gly238Ser, Glu240Lys, Thr265Met, and Arg275Leu. The new enzyme has most probably evolved from TEM-47 by acquiring the single substitution of Arg275, which before was identified only twice in enzymes with inhibitor resistance (IR) activity. TEM-68 was shown to be a novel complex mutant TEM β-lactamase (CMT-2) which combines strong ESBL activity with relatively weak IR activity and, when expressed inK. pneumoniae, is able to confer high-level resistance to a wide variety of β-lactams, including inhibitor combinations. This data confirms the role of the Arg275Leu mutation in determining IR activity and documents the first isolation of K. pneumoniae producing the complex mutant enzyme.

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