Current Epidemiology of Multidrug-Resistant Gram-Negative Bacilli in the United States

2010 ◽  
Vol 31 (S1) ◽  
pp. S51-S54 ◽  
Author(s):  
Alexander J. Kallen ◽  
Arjun Srinivasan
Keyword(s):  
United States ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
The United States ◽  
Multidrug Resistant ◽  
Community Settings ◽  
Gram Negative ◽  
Emerging Issues

Gram-negative bacilli are an important cause of infection in healthcare and community settings. Antimicrobial resistance, including resistance to multiple antimicrobial classes, is an ongoing problem among gram-negative bacilli. This synopsis reviews the incidence of multidrug resistance among gram-negative bacilli in the United States and describes emerging issues in their epidemiology.

scholarly journals The Prevalence of Multidrug Resistance Is Higher among Bovine than Human Salmonellaenterica Serotype Newport, Typhimurium, and 4,5,12:i:− Isolates in the United States but Differs by Serotype and Geographic Region

2010 ◽  
Vol 76 (17) ◽  
pp. 5947-5959 ◽  
Author(s):  
K. Hoelzer ◽  
Y. Soyer ◽  
L. D. Rodriguez-Rivera ◽  
K. J. Cummings ◽  
P. L. McDonough ◽  
...  
Keyword(s):  
United States ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
Pacific Northwest ◽  
The United States ◽  
Multidrug Resistant ◽  
Geographic Region ◽  
Variable Number ◽  
Genetic Changes ◽  
Animal Populations

ABSTRACT Salmonella represents an important zoonotic pathogen worldwide, but the transmission dynamics between humans and animals as well as within animal populations are incompletely understood. We characterized Salmonella isolates from cattle and humans in two geographic regions of the United States, the Pacific Northwest and the Northeast, using three common subtyping methods (pulsed-field gel electrophoresis [PFGE], multilocus variable number of tandem repeat analysis [MLVA], and multilocus sequence typing [MLST]). In addition, we analyzed the distribution of antimicrobial resistance among human and cattle Salmonella isolates from the two study areas and characterized Salmonella persistence on individual dairy farms. For both Salmonella enterica subsp. enterica serotypes Newport and Typhimurium, we found multidrug resistance to be significantly associated with bovine origin of isolates, with the odds of multidrug resistance for Newport isolates from cattle approximately 18 times higher than for Newport isolates from humans. Isolates from the Northwest were significantly more likely to be multidrug resistant than those from the Northeast, and susceptible and resistant isolates appeared to represent distinct Salmonella subtypes. We detected evidence for strain diversification during Salmonella persistence on farms, which included changes in antimicrobial resistance as well as genetic changes manifested in PFGE and MLVA pattern shifts. While discriminatory power was serotype dependent, the combination of PFGE data with either MLVA or resistance typing data consistently allowed for improved subtype discrimination. Our results are consistent with the idea that cattle are an important reservoir of multidrug-resistant Salmonella infections in humans. In addition, the study provides evidence for the value of including antimicrobial resistance data in epidemiological investigations and highlights the benefits and potential problems of combining subtyping methods.

scholarly journals 130. increase in Multidrug Resistance (2011–2018) and the Emergence of Extensive Drug Resistance (2020) in shigella Sonnei in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S195-S195
Author(s):  
Naeemah Z Logan ◽  
Beth E Karp ◽  
Kaitlin A Tagg ◽  
Claire Burns-Lynch ◽  
Jessica Chen ◽  
...  
Keyword(s):  
United States ◽  
Multidrug Resistance ◽  
Disease Surveillance ◽  
Sequence Data ◽  
The United States ◽  
Multidrug Resistant ◽  
Shigella Sonnei ◽  
Short Read ◽  
Men 2 ◽  
The Us

Abstract Background Multidrug-resistant (MDR) Shigella sonnei infections are a serious public health threat, and outbreaks are common among men who have sex with men (MSM). In February 2020, Australia’s Department of Health notified CDC of extensively drug-resistant (XDR) S. sonnei in 2 Australian residents linked to a cruise that departed from Florida. We describe an international outbreak of XDR S. sonnei and report on trends in MDR among S. sonnei in the United States. Methods Health departments (HDs) submit every 20th Shigella isolate to CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory for susceptibility testing. We defined MDR as decreased susceptibility to azithromycin (MIC ≥32 µg/mL) with resistance to ampicillin, ciprofloxacin, and cotrimoxazole, and XDR as MDR with additional resistance to ceftriaxone. We used PulseNet, the national subtyping network for enteric disease surveillance, to identify US isolates related to the Australian XDR isolates by short-read whole genome sequencing. We screened these isolates for resistance determinants (ResFinder v3.0) and plasmid replicons (PlasmidFinder) and obtained patient histories from HDs. We used long-read sequencing to generate closed plasmid sequences for 2 XDR isolates. Results NARMS tested 2,781 S. sonnei surveillance isolates during 2011–2018; 80 (2.9%) were MDR, including 1 (0.04%) that was XDR. MDR isolates were from men (87%), women (9%), and children (4%). MDR increased from 0% in 2011 to 15.3% in 2018 (Figure). In 2020, we identified XDR isolates from 3 US residents on the same cruise as the Australians. The US residents were 41–42 year-old men; 2 with available information were MSM. The US and Australian isolates were highly related (0–1 alleles). Short-read sequence data from all 3 US isolates mapped to the blaCTX-M-27 harboring IncFII plasmids from the 2 Australian isolates with >99% nucleotide identity. blaCTX-M-27 genes confer ceftriaxone resistance. Increase in Percentage of Shigella sonnei Isolates with Multidrug Resistance* in the United States, 2011–2018† Conclusion MDR S. sonnei is increasing and is most often identified among men. XDR S. sonnei infections are emerging and are resistant to all recommended antibiotics, making them difficult to treat without IV antibiotics. This outbreak illustrates the alarming capacity for XDR S. sonnei to disseminate globally among at-risk populations, such as MSM. Disclosures All Authors: No reported disclosures

scholarly journals Need for Annual Surveillance of Antimicrobial Resistance in Streptococcus pneumoniae in the United States: 2-Year Longitudinal Analysis

2001 ◽  
Vol 45 (4) ◽  
pp. 1037-1042 ◽  
Author(s):  
Daniel F. Sahm ◽  
James A. Karlowsky ◽  
Laurie J. Kelly ◽  
Ian A. Critchley ◽  
Mark E. Jones ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
The United States ◽  
Multidrug Resistant ◽  
Fluoroquinolone Resistance ◽  
Resistance Patterns ◽  
Changing Patterns ◽  
Resistance To Penicillin

ABSTRACT Although changing patterns in antimicrobial resistance inStreptococcus pneumoniae have prompted several surveillance initiatives in recent years, the frequency with which these studies are needed has not been addressed. To approach this issue, the extent to which resistance patterns change over a 1-year period was examined. In this study we analyzed S. pneumoniaeantimicrobial susceptibility results produced in our laboratory with isolates obtained over 2 consecutive years (1997–1998 and 1998–1999) from the same 96 institutions distributed throughout the United States. Comparison of results revealed increases in resistant percentages for all antimicrobial agents studied except vancomycin. For four of the agents tested (penicillin, cefuroxime, trimethoprim-sulfamethoxazole, and levofloxacin), the increases were statistically significant (P < 0.05). Resistance to the fluoroquinolone remained low in both years (0.1 and 0.6%, respectively); in contrast, resistance to macrolides was consistently greater than 20%, and resistance to trimethoprim-sulfamethoxazole increased from 13.3 to 27.3%. Multidrug resistance, concurrent resistance to three or more antimicrobials of different chemical classes, also increased significantly between years, from 5.9 to 11%. The most prevalent phenotype was resistance to penicillin, azithromycin (representative macrolide), and trimethoprim-sulfamethoxazole. Multidrug-resistant phenotypes that included fluoroquinolone resistance were uncommon; however, two phenotypes that included fluoroquinolone resistance not found in 1997–1998 were encountered in 1998–1999. This longitudinal surveillance study of resistance inS. pneumoniae revealed that significant changes do occur in just a single year and supports the need for surveillance at least on an annual basis, if not continuously.

scholarly journals Longitudinal Assessment of Antipneumococcal Susceptibility in the United States

2002 ◽  
Vol 46 (8) ◽  
pp. 2651-2655 ◽  
Author(s):  
Mark E. Jones ◽  
James A. Karlowsky ◽  
Renée Blosser-Middleton ◽  
Ian A. Critchley ◽  
Elena Karginova ◽  
...  
Keyword(s):  
United States ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
The United States ◽  
Longitudinal Assessment ◽  
Amoxicillin Clavulanate ◽  
Resistance To Penicillin

ABSTRACT The prevalence of antimicrobial resistance among 4,940 U.S. pneumococcal isolates collected during 1999 was as follows: penicillin, 16.2%; amoxicillin-clavulanate, 12.2%; cefuroxime, 28.1%; ceftriaxone, 3.6%; trimethoprim-sulfamethoxazole, 30.3%; azithromycin, 21.4%; levofloxacin, 0.6%; and moxifloxacin, 0.1%. Compared to the previous 1997-1998 study (Jones et al., Antimicrob. Agents Chemother. 44:2645-2652, 2000), increases were noted for resistance to penicillin (3.7%; P < 0.001), amoxicillin-clavulanate (3.9%; P < 0.001), cefuroxime (5.7%; P < 0.001), azithromycin (2.4%; P = 0.014), trimethoprim-sulfamethoxazole (15.4%; P < 0.001), and levofloxacin (0.3%; P = 0.017). Resistance to ceftriaxone (0.1%; P = 0.809) and moxifloxacin (0.03%; P = 0.570) decreased. Concurrently, multidrug resistance increased (P < 0.001) from 6.3% to 11.3%.

scholarly journals Antimicrobial Resistance in Salmonella in the United States from 1948 to 1995

2016 ◽  
Vol 60 (4) ◽  
pp. 2567-2571 ◽  
Author(s):  
Daniel A. Tadesse ◽  
Aparna Singh ◽  
Shaohua Zhao ◽  
Mary Bartholomew ◽  
Niketta Womack ◽  
...  
Keyword(s):  
United States ◽  
Retrospective Study ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
Salmonella Enterica ◽  
Antimicrobial Agents ◽  
The United States ◽  
Content Type ◽  
The Past ◽  
The 1950S

ABSTRACTWe conducted a retrospective study of 2,149 clinicalSalmonellastrains to help document the historical emergence of antimicrobial resistance. There were significant increases in resistance to older drugs, including ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline, which were most common inSalmonella entericaserotype Typhimurium. An increase in multidrug resistance was observed for each decade since the 1950s. These data help show howSalmonellaevolved over the past 6 decades, after the introduction of new antimicrobial agents.

scholarly journals Multidrug Resistance Dynamics in Salmonella in Food Animals in the United States: An Analysis of Genomes from Public Databases

2021 ◽  
Author(s):  
João Pires ◽  
Jana S. Huisman ◽  
Sebastian Bonhoeffer ◽  
Thomas P. Van Boeckel
Keyword(s):  
United States ◽  
Multidrug Resistance ◽  
Next Generation Sequencing ◽  
Antimicrobial Resistance ◽  
The United States ◽  
Next Generation ◽  
Exponential Increase ◽  
Food Animals ◽  
Public Repositories ◽  
Generation Sequencing

Next-generation sequencing has led to an exponential increase in the number of genomes deposited in public repositories. This growing volume of information presents opportunities to track the prevalence of genes conferring antimicrobial resistance (AMR), a growing threat to the health of humans and animals.

scholarly journals Antimicrobial Resistance and Genomic Characterization of Salmonella Dublin Isolates in Cattle from the United States.

2021 ◽  
Author(s):  
Mariela Srednik ◽  
Kristina Lantz ◽  
Jessica A Hicks ◽  
Brenda R Morningstar-Shaw ◽  
Tonya A Mackie ◽  
...  
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Systemic Disease ◽  
The United States ◽  
Multidrug Resistant ◽  
Severe Illness ◽  
Valuable Insight ◽  
Antimicrobial Drugs ◽  
Salmonella Dublin ◽  
Genomic Characterization

Salmonella enterica subspecies enterica serovar Dublin is a host-adapted serotype in cattle, associated with enteritis and systemic disease. While rare in humans, it can cause severe illness, including bacteremia, with hospitalization and death. In the United States, S. Dublin has become one of the most multidrug-resistant serotypes . The objective of this study was to characterize S. Dublin isolates from sick cattle by analyzing phenotypic and genotypic antimicrobial resistance (AMR) profiles, the presence of plasmids, and phylogenetic relationships. S. Dublin isolates (n=140) were selected from submissions to the NVSL for Salmonella serotyping (2014 – 2017) from 21 states. Isolates were tested for susceptibility against 14 class-representative antimicrobial drugs. Resistance profiles were determined using the ABRicate with Resfinder and NCBI databases, AMRFinder and PointFinder. Plasmids were detected using ABRicate with PlasmidFinder. Phylogeny was determined using vSNP. We found 98% of the isolates were resistant to more than 4 antimicrobials . Only 1 isolate was pan-susceptible and had no predicted AMR genes. All S. Dublin isolates were susceptible to azithromycin and meropenem. They showed 96% resistance to sulfonamides, 97% to tetracyclines, 95% to aminoglycosides and 85% to beta-lactams . The most common AMR genes were: sulf2 and tetA (98.6%), aph(3'')-Ib and aph(6)-Id (96.4%), floR (94.3%), and blaCMY-2 (85.7%). All quinolone resistant isolates presented mutations in gyr A. Ten plasmid types were identified among all isolates with IncA/C2, IncX1, and IncFII(S) being the most frequent. The S. Dublin isolates show low genomic genetic diversity. This study provided antimicrobial susceptibility and genomic insight into S . Dublin clinical isolates from cattle in the U.S. Further sequence analysis integrating food and human origin S . Dublin isolates may provide valuable insight on increased virulence observed in humans.

scholarly journals Trends in Susceptibility of Escherichia coli from Intra-Abdominal Infections to Ertapenem and Comparators in the United States According to Data from the SMART Program, 2009 to 2013

2015 ◽  
Vol 59 (6) ◽  
pp. 3606-3610 ◽  
Author(s):  
Sibylle H. Lob ◽  
Krystyna M. Kazmierczak ◽  
Robert E. Badal ◽  
Meredith A. Hackel ◽  
Samuel K. Bouchillon ◽  
...  
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Statistical Significance ◽  
The United States ◽  
Multidrug Resistant ◽  
Content Type ◽  
E Coli ◽  
Smart Data ◽  
Abdominal Infections

ABSTRACTAntimicrobial resistance inEnterobacteriaceae, including resistance to carbapenems, is increasing worldwide. However, using U.S. Study for Monitoring Antimicrobial Resistance Trends (SMART) data for 2009 to 2013, no statistically significant decreasing susceptibility trends were found overall forEscherichia coliisolates from patients with intra-abdominal infections. In the subset of isolates from community-associated infections, susceptibility to levofloxacin decreased significantly and the increasing rate of multidrug-resistantE. coliapproached statistical significance. In 2013, ertapenem, imipenem, and amikacin showed the highest susceptibility rates (≥99%) and fluoroquinolones the lowest (<70%). The 10 non-ertapenem-susceptible isolates (0.3% of allE. coliisolates) encoded one or more carbapenemases, extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, or non-ESBL β-lactamases.

Sign in / Sign up

Export Citation Format

Share Document