Resistance to critically important antimicrobials in Australian silver gulls (Chroicocephalus novaehollandiae) and evidence of anthropogenic origins

2019 ◽  
Vol 74 (9) ◽  
pp. 2566-2574 ◽  
Author(s):  
Shewli Mukerji ◽  
Marc Stegger ◽  
Alec Vincent Truswell ◽  
Tanya Laird ◽  
David Jordan ◽  
...  

Abstract Objectives Antimicrobial resistance (AMR) to critically important antimicrobials (CIAs) amongst Gram-negative bacteria can feasibly be transferred amongst wildlife, humans and domestic animals. This study investigated the ecology, epidemiology and origins of CIA-resistant Escherichia coli carried by Australian silver gulls (Chroicocephalus novaehollandiae), a gregarious avian wildlife species that is a common inhabitant of coastal areas with high levels of human contact. Methods Sampling locations were widely dispersed around the perimeter of the Australian continent, with sites separated by up to 3500 km. WGS was used to study the diversity and molecular characteristics of resistant isolates to ascertain their epidemiological origin. Results Investigation of 562 faecal samples revealed widespread occurrence of extended-spectrum cephalosporin-resistant (21.7%) and fluoroquinolone-resistant (23.8%) E. coli. Genome sequencing revealed that CIA-resistant E. coli isolates (n = 284) from gulls predominantly belonged to human-associated extra-intestinal pathogenic E. coli (ExPEC) clones, including ST131 (17%), ST10 (8%), ST1193 (6%), ST69 (5%) and ST38 (4%). Genomic analysis revealed that gulls carry pandemic ExPEC-ST131 clades (O25:H4 H30-R and H30-Rx) and globally emerging fluoroquinolone-resistant ST1193 identified among humans worldwide. Comparative analysis revealed that ST131 and ST1193 isolates from gulls overlapped extensively with human clinical isolates from Australia and overseas. The present study also detected single isolates of carbapenem-resistant E. coli (ST410-blaOXA-48) and colistin-resistant E. coli (ST345-mcr-1). Conclusions The carriage of diverse CIA-resistant E. coli clones that strongly resemble pathogenic clones from humans suggests that gulls can act as ecological sponges indiscriminately accumulating and disseminating CIA-resistant bacteria over vast distances.

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Kayode Fashae ◽  
Ines Engelmann ◽  
Stefan Monecke ◽  
Sascha D. Braun ◽  
Ralf Ehricht

Abstract Background Antimicrobial resistance (AMR) is an increasing global health concern reducing options for therapy of infections and also for perioperative prophylaxis. Many Enterobacteriaceae cannot be treated anymore with third generation cephalosporins (3GC) due to the production of certain 3GC hydrolysing enzymes (extended spectrum beta-lactamases, ESBLs). The role of animals as carriers and vectors of multi-resistant bacteria in different geographical regions is poorly understood. Therefore, we investigated the occurrence and molecular characteristics of ESBL-producing Escherichia coli (E. coli) in wild birds and slaughtered cattle in Ibadan, Nigeria. Cattle faecal samples (n = 250) and wild bird pooled faecal samples (cattle egrets, Bubulcus ibis, n = 28; white-faced whistling duck, Dendrocygna viduata, n = 24) were collected and cultured on cefotaxime-eosin methylene blue agar. Antimicrobial susceptibility was determined by agar diffusion assays and all 3GC resistant isolates were genotypically characterised for AMR genes, virulence associated genes (VAGs) and serotypes using DNA microarray-based assays. Results All 3GC resistant isolates were E. coli: cattle (n = 53), egrets (n = 87) and whistling duck (n = 4); cultured from 32/250 (12.8%), 26/28 (92.9%), 2/24(8.3%), cattle, egrets and whistling duck faecal samples, respectively. blaCTX-M gene family was prevalent; blaCTX-M15 (83.3%) predominated over blaCTX-M9 (11.8%). All were susceptible to carbapenems. The majority of isolates were resistant to at least one of the other tested antimicrobials; multidrug resistance was highest in the isolates recovered from egrets. The isolates harboured diverse repositories of other AMR genes (including strB and sul2), integrons (predominantly class 1) and VAGs. The isolates recovered from egrets harboured more AMR genes; eight were unique to these isolates including tetG, gepA, and floR. The prevalent VAGs included hemL and iss; while 14 (including sepA) were unique to certain animal isolates. E. coli serotypes O9:H9, O9:H30 and O9:H4 predominated. An identical phenotypic microarray profile was detected in three isolates from egrets and cattle, indicative of a clonal relationship amongst these isolates. Conclusion Wild birds and cattle harbour diverse ESBL-producing E. coli populations with potential of inter-species dissemination and virulence. Recommended guidelines to balance public health and habitat conservation should be implemented with continuous surveillance.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S292-S292
Author(s):  
Fatma Ben Abid ◽  
Yohei Doi ◽  
Ali S Omrani ◽  
Anand Deshmukh ◽  
Christi L McElheny ◽  
...  

Abstract Background There are limited data describing carbapenem-resistant Enterobacteriaceae (CRE) from the Arabian Gulf region. Our aims were to describe the clinical, microbiological and molecular characteristics of CRE infections and to characterize the gene displaying resistance to carbapenem. Methods Retrospective and prospective review of clinical, microbiological and molecular characteristics of CRE isolated between April 2015 and November 2017 at 7 tertiary hospitals in Qatar. Susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute methodology and breakpoints. Carbapenemase genes were identified using PCR. Whole-genome sequencing followed by bioinformatics analysis was performed on a subset of samples for accurate detection of resistant genes. SPSS V.21.0 was used for all statistical analyses. Results A total of 144 nonrepeating CRE strains were recovered from 137 individuals over the study period, of which 35 (24.3%) represented colonization. Klebsiella spp. (98, 68.1%) and E. coli (38, 26.4%) were the most predominant. The most prevalent carbapenemases were NDM (69, 47.9%), OXA-48 (36, 25.0%), and KPC (15, 10.4%). Sixteen (11.1%) strains possessed multiple carbapenemase genes but none were detected in 37 (25.7%) strains. Genomic analysis also detected the presence of NDM-7, NDM-5, NDM1, VIM4, and OXA48-like carbapenemase genes among 34 clinical samples. The majority of the strains were susceptible to tigecycline (124, 86.1%), fosfomycin (122, 84.7%) and amikacin (102, 70.8%). There were 109 CRE infections involving the urinary tract (40, 36.7%), bloodstream (31, 28.4%), and respiratory tract (17, 15.6%). Fifty-seven (52.3%) were males and the median age was 57 years (range 3–97). Baseline comorbidities included diabetes (57, 52.3%), chronic kidney disease (27, 24.8%), and cancer (27, 24.8%) (Table 1). Within the 30 days preceding CRE infection, 38 (34.9%) had received carbapenem therapy, 65 (59.6%) had undergone invasive procedures and 33 (30.3%) had had surgery. All-cause 30-day mortality was 29.4%. The only variable independently associated with mortality was baseline SAPS Score (Table 2). Conclusion NDM and OXA-48 are the predominant carbapenemases in Qatar. CRE infections are associated with high overall mortality. Disclosures All authors: No reported disclosures.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Si Li ◽  
Xiaonv Duan ◽  
Yuan Peng ◽  
Yongyu Rui

Abstract Background Carbapenem resistance among Acinetobacter species has become a life-threatening problem. As a last resort in the treatment of gram-negative bacteria infection, resistance to colistin is also a serious problem. The aim of study was to analyze the mechanism of resistance and perform genotyping of carbapenem-resistant Acinetobacter from clinical infection and fecal survey samples in Southern China. Methods One hundred seventy and 74 carbapenem-resistant Acinetobacter were isolated from clinical infection samples and fecal survey samples, respectively. We detected the related genes, including carbapenemase genes (blaKPC, blaIMP, blaSPM, blaVIM, blaNDM, blaOXA-23-like, blaOXA-24/40-like, blaOXA-51-like, and blaOXA-58-like), colistin resistance-related genes (mcr-1, mcr-2, mcr-3, mcr-4, and mcr-5), a porin gene (carO), efflux pump genes (adeA, adeB, adeC, adeI, adeJ, and adeK), mobile genetic element genes (intI1, intI2, intI3, tnpU, tnp513, IS26, ISAba1, and ISAba125), and the integron variable region. Genotyping was analyzed by enterobacterial repetitive intergenic consensus (ERIC)-PCR and dendrogram cluster analysis. Results Among the 244 carbapenem-resistant Acinetobacter, the common carbapenemase-positive genes included the following: blaOXA-51-like, 183 (75.00%); blaOXA-23-like, 174 (71.30%); blaNDM-1, 57 (23.40%); and blaOXA-58-like, 30 (12.30%). The coexistence of mcr-1 and blaNDM-1 in five strains of A. junii was found for the first time. Eleven distinct carO gene variants were detected in 164 (67.20%) strains, and ten novel variants, which shared 92–99% identity with sequences in the Genbank database, were first reported. Efflux system genes were present in approximately 70% of the isolates; adeABC and adeIJK were observed in 76.23 and 72.13%, respectively. Class 1 integrons were detected in 180 (73.80%) strains and revealed that four gene cassette arrays contained 11 distinct genes. The genotyping by ERIC-PCR demonstrated a high genetic diversity of non-baumannii Acinetobacter, and greater than 90% similarity to A. baumannii. Conclusions The blaNDM-1 gene was identified in up to 77% of the carbapenem-resistant Acinetobacter isolated from fecal survey samples, indicating that the gut might be a reservoir of resistant opportunistic bacteria. Intestinal bacteria can be transmitted through the fecal-hand, which is a clinical threat, thus, the monitoring of carbapenem-resistant bacteria from inpatients’ feces should be improved, especially for patients who have been using antibiotics for a long time.


Author(s):  
Johanna M. Vanegas ◽  
Lorena Salazar-Ospina ◽  
Gustavo A. Roncancio ◽  
Julián Builes ◽  
Judy Natalia Jiménez

ABSTRACT The emergence of resistance mechanisms not only limits the therapeutic options for common bacterial infections but also worsens the prognosis in patients who have conditions that increase the risk of bacterial infections. Thus, the effectiveness of important medical advances that seek to improve the quality of life of patients with chronic diseases is threatened. We report the simultaneous colonization and bacteremia by multidrug-resistant bacteria in two hemodialysis patients. The first patient was colonized by carbapenem- and colistin-resistant Klebsiella pneumoniae, carbapenem-resistant Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus (MRSA). The patient had a bacteremia by MRSA, and molecular typing methods confirmed the colonizing isolate was the same strain that caused infection. The second case is of a patient colonized by extended-spectrum beta-lactamases (ESBL)-producing Escherichia coli and carbapenem-resistant Pseudomonas aeruginosa. During the follow-up period, the patient presented three episodes of bacteremia, one of these caused by ESBL-producing E. coli. Molecular methods confirmed colonization by the same clone of ESBL-producing E. coli at two time points, but with a different genetic pattern to the strain isolated from the blood culture. Colonization by multidrug-resistant bacteria allows not only the spread of these microorganisms, but also increases the subsequent risk of infections with limited treatments options. In addition to infection control measures, it is important to establish policies for the prudent use of antibiotics in dialysis units.


2020 ◽  
Vol 10 (03) ◽  
pp. 426-430
Author(s):  
Suhad Hadi Mohammed ◽  
Maysaa Saleh Mahdi ◽  
Mohanad Mohsin Ahmed ◽  
Ali Najm Al-Deen ◽  
Nargis Fadhil ◽  
...  

Determining the bacterial causative agents of infections by identifying their antimicrobial patterns will enable health institutions to limit the unnecessary use of antibiotics, and take active ways in preventing the spread of drug-resistant bacteria. This study aimed to identify the most common bacterial isolates responsible for infection and their antibiotic resistance rates. The results showed that Escherichia coli, Staphylococcus aureus (S aureus), and Pseudomonas aeruginosa (P. aeruginosa) represent the most common bacteria isolated with a percentage of 23.9, 18.8, and 16.2%, respectively. High resistance rates were found for the most common bacterial isolates. Other important findings are the presence of extended-spectrum B-lactamase (ESBL) producing bacteria and the appearance of hetero-resistance phenomenon. Moreover, the bacterial infection is mainly occurring in men. No significant correlation was observed in the type of isolated bacteria with patient admission status. E. coli strains were found to be highly resistant to amoxicillin-clavulanic acid, ceftriaxone (88.9%), ceftazidime (85.2%), trimethoprim-sulfamethoxazole (74.1%), and ciprofloxacin (59.3%). Whereas, the highest sensitivity rates were seen with meropenem antibiotic (92.6%). Concerning S. aureus isolates, 100, and approximately 91% of resistant rates were seen to penicillin and cefoxitin, respectively [methicillin-resistant S. aureus (MRSA)]. Approximately 50% of MRSA were vancomycin-resistant S. aureus (VRSA). Resistant rates of P. aeruginosa isolates to gentamycin and ciprofloxacin were 47.1%, amikacin 41.2%, and levofloxacin 35.3%. In conclusion, the current study might reveal that the isolated bacteria could be of critical priority carbapenem-resistant P. aeruginosa, and carbapenem-resistant and 3rd generation cephalosporin-resistant E. coli. In addition, the isolation of high priority bacteria includes vancomycin-resistant methicillin-resistant S. aureus.


2021 ◽  
Vol 15 (07) ◽  
pp. 934-342
Author(s):  
Charbel Al-Bayssari ◽  
Tania Nawfal Dagher ◽  
Samar El Hamoui ◽  
Fadi Fenianos ◽  
Nehman Makdissy ◽  
...  

Introduction: The increasing incidence of infections caused by multidrug-resistant bacteria is considered a global health problem. This study aimed to investigate this resistance in Gram-negative bacteria isolated from patients hospitalized in North-Lebanon. Methodology: All isolates were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was achieved using disk diffusion, E-test and Broth microdilution methods. Phenotypic detection of carbapenemase was carried out using the CarbaNP test. RT-PCR, standard-PCR and sequencing were performed to detect resistance genes and oprD gene. Conjugal transfer was carried out between our isolates and Escherichia coli J53 to detect the genetic localization of resistance genes. MLST was conducted to determine the genotype of each isolate. Results: Twenty-three carbapenem-resistant Enterobacterales of which eight colistin-resistant Escherichia coli, and Twenty carbapenem-resistant Pseudomonas aeruginosa were isolated. All isolates showed an imipenem MIC greater than 32 mg/mL with MICs for colistin greater than 2 mg/L for E. coli isolates. All the Enterobacterales isolates had at least one carbapenemase-encoding gene, with E. coli isolates coharboring blaNDM-4 and mcr-1 genes. Moreover, 16/20 Pseudomonas aeruginosa harbored the blaVIM-2 gene and 18/20 had mutations in the oprD gene. MLST revealed that the isolates belonged to several clones. Conclusions: We report here the first description in the world of clinical E. coli isolates coharboring blaNDM-4 and mcr-1 genes, and K. pneumoniae isolates producing NDM-6 and OXA-48 carbapenemases. Also, we describe the emergence of NDM-1-producing E. cloacae in Lebanon. Screening for these isolates is necessary to limit the spread of resistant microorganisms in hospitals.


Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 954
Author(s):  
Zhenbao Ma ◽  
Zhenling Zeng ◽  
Jiao Liu ◽  
Chang Liu ◽  
Yu Pan ◽  
...  

Carbapenem resistance has posed potential harmful risks to human and animals. The objectives of this study were to understand the prevalence of blaNDM-5 in pigs and investigate the molecular characteristics of NDM-5-producing Escherichia coli isolates in Guangdong province in China. Carbapenem-resistant E. coli isolates were isolated from pigs and obtained using MacConkey plates containing 0.5 mg/L meropenem. Conjugation assay and antimicrobial susceptibility testing were conducted for the isolates and their transconjugants. Whole-genome sequence (WGS) was used to analyze the plasmid genetic feature. A total of five blaNDM-5-carrying E. coli isolates were obtained in the present investigations. They belonged to five ST types. The blaNDM-5 genes were found to be in IncX3 and IncHI2 plasmid. The IncX3 plasmid was 46,161 bp in size and identical to other reports. IncHI2 plasmid was 246,593 bp in size and similar to other IncHI2-ST3 plasmids. It consisted of a typical IncHI2 plasmid backbone region and a multiresistance region (MRR). The blaNDM-5 was closely associated with the IS3000-ISAba125-blaNDM-5-bleMBL-trpF-tat-IS26 unit. We first reported the blaNDM-5-carrying IncHI2 in E. coli isolates recovered from pigs and revealed the molecular characterization. Continued surveillance for the dissemination of blaNDM-5 among food-producing animals is required.


2021 ◽  
Author(s):  
Tatsuya Nakayama ◽  
Le Thi Hien ◽  
Ngo Thanh Phong ◽  
Doan Nguyen Minh Tran ◽  
Oanh Thi Hoang Nguyen ◽  
...  

Abstract Although the spread of plasmid-mediated antibiotic-resistant bacteria is a public health concern, food contamination with plasmid-mediated antibiotic-resistant Escherichia coli has not been well investigated in Vietnam. The aim of this study was to describe the prevalence of colistin-resistant, carbapenem-resistant and endemic blaCTX−M in extended-spectrum β-lactamase (ESBL)-producing E. coli isolates. Colistin- and carbapenem-resistant ESBL-producing E. coli were isolated from chickens in Vietnam and Japan. The results showed that 52% and 93% of Vietnamese chicken was isolated with colistin-resistant and AmpC/ESBL-producing E. coli, respectively, while 52.7% of Japanese chickens were isolated with AmpC/ESBL-producing E. coli. Carbapenem-resistant E. coli has not been isolated in Vietnam or Japan. Genotyping revealed that colistin-resistant E. coli harboured mcr-1, and most of the AmpC/ESBL-related genes were blaCTX−M−55 and blaCTX−M−65 together with blaTEM in Vietnamese chickens, and blaCMY−2 in Japanese chickens. Multidrug resistance analysis showed that ESBL-producing E. coli isolates were more resistant to quinolones, streptomycin, and chloramphenicol compared with colistin-resistant E. coli isolates from Vietnam, suggesting selection in ESBL-producing E. coli for multiple antibiotic resistance genes. In conclusion, colistin-resistant E. coli was detected in about half of the chicken meat samples, the majority of which were found to harbour mcr-1. The high prevalence of ESBL-producing E. coli has remained constant across the last five years, and the predominant blaCTX−M for ESBL-producing E. coli was found to be blaCTX−M−55 or blaCTX−M−65, with the coexistence of blaTEM in Vietnam. Our results can be implemented in monitoring systems to combat the development of antimicrobial resistance.


2016 ◽  
Vol 10 (06) ◽  
pp. 592-599 ◽  
Author(s):  
Rito Santo Pereira ◽  
Vanessa Cordeiro Dias ◽  
Alessandra Barbosa Ferreira-Machado ◽  
Juliana Alves Resende ◽  
André Netto Bastos ◽  
...  

Introduction: Bacterial resistance is a growing concern in the nosocomial environment in which Klebsiella pneumoniae and Enterobacter aerogenes play an important role due to their opportunism and carbapenemase-production. This work aimed to evaluate physiological and molecular characteristics of carbapenem-resistant K. pneumoniae and E. aerogenes isolated in a Brazilian tertiary hospital. Methodology: In total, 42 carbapenem-resistant bacteria isolated from clinical specimens were included (21 K. pneumoniae and 21 E. aerogenes). Drug-sensitive K. pneumoniae (n = 27) were also included. Antimicrobial susceptibility and biocide tolerance patterns, hemolytic activity, tolerance to oxidative stress, and aggregative ability were assessed. Genetic markers related to carbapenem resistance, or ESBL-production were screened by PCR. Results: Compared to drug-sensitive strains, carbapenem-resistant K. pneumoniae were more tolerant to biocides and to oxidative stress, and they displayed an increase in biofilm formation. The genetic markers blaKPC (95.2%) and blaTEM (90.5%) were the most frequent. Among the carbapenem-resistant E. aerogenes strains, blaKPC, and blaTEM were detected in all bacteria. Drug-sensitive E. aerogenes were not isolated in the same period. blaSHV, blaVIM, and blaCTX markers were also observed among carbapenem-resistant bacteria. Conclusions: Results suggest that carbapenemase-producing enterobacteria might show peculiar characteristics regarding their physiology associated with their environmental persistency, virulence, and multidrug resistance. The observed phenomenon may have implications not only for antimicrobial chemotherapy, but also for the prognosis of infectious diseases and infection control.


2020 ◽  
Vol 18 (6) ◽  
pp. 899-910
Author(s):  
Taro Urase ◽  
Mitsuhiro Okazaki ◽  
Hirofumi Tsutsui

Abstract The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide health threat. Monitoring of these resistant bacteria in the environment can provide regional prevalence reflecting both healthy and infected populations, although the quantitative monitoring of those resistant bacteria, especially CRE, is difficult due to their low proportion in the total Enterobacteriaceae population and the possible interference by autochthonous species with intrinsic resistance. In this study, these resistant bacteria in treated wastewater were quantified at 12 different treatment plants. The proportions of cefotaxime-resistant and ESBL-producing E. coli in the total E. coli population in the chlorinated effluents in Tokyo were 5.7 and 5.3%, respectively. The estimated proportion of CRE was 0.007% with the constituting species of Klebsiella spp. and Enterobacter spp., although the conditions during the first incubation may have affected the estimation even after the correction by the proportion of resistant population in the isolates. The observed resistant proportions in this study were lower than those in the surveillance on nosocomial infection not only for inpatients but also for outpatients, and higher than those in the veterinary monitoring.


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