scholarly journals Predicting Antimicrobial Resistance Using Partial Genome Alignments

mSystems ◽  
2021 ◽  
Author(s):  
D. Aytan-Aktug ◽  
M. Nguyen ◽  
P. T. L. C. Clausen ◽  
R. L. Stevens ◽  
F. M. Aarestrup ◽  
...  

Antimicrobial resistance causes thousands of deaths annually worldwide. Understanding the regions of the genome that are involved in antimicrobial resistance is important for developing mitigation strategies and preventing transmission.

mSphere ◽  
2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Shaohua Zhao ◽  
Sampa Mukherjee ◽  
Chih-Hao Hsu ◽  
Shenia Young ◽  
Cong Li ◽  
...  

ABSTRACT Genomic analyses were performed on florfenicol-resistant (FFNr) Campylobacter coli isolates recovered from cattle, and the cfr(C) gene-associated multidrug resistance (MDR) plasmid was characterized. Sixteen FFNr C. coli isolates recovered between 2013 and 2018 from beef cattle were sequenced using MiSeq. Genomes and plasmids were found to be closed for three of the isolates using the PacBio system. Single nucleotide polymorphisms (SNPs) across the genome and the structures of MDR plasmids were investigated. Conjugation experiments were performed to determine the transferability of cfr(C)-associated MDR plasmids. The spectrum of resistance encoded by the cfr(C) gene was further investigated by agar dilution antimicrobial susceptibility testing. All 16 FFNr isolates were MDR and exhibited coresistance to ciprofloxacin, nalidixic acid, clindamycin, and tetracycline. All isolates shared the same resistance genotype, carrying aph (3′)-III, hph, ΔaadE (truncated), blaOXA-61, cfr(C), and tet(O) genes plus a mutation of GyrA (T86I). The cfr(C), aph (3′)-III, hph, ΔaadE, and tet(O) genes were colocated on transferable MDR plasmids ranging in size from 48 to 50 kb. These plasmids showed high sequence homology with the pTet plasmid and carried several Campylobacter virulence genes, including virB2, virB4, virB5, VirB6, virB7, virB8, virb9, virB10, virB11, and virD4. The cfr(C) gene conferred resistance to florfenicol (8 to 32 μg/ml), clindamycin (512 to 1,024 μg/ml), linezolid (128 to 512 μg/ml), and tiamulin (1,024 μg/ml). Phylogenetic analysis showed SNP differences ranging from 11 to 2,248 SNPs among the 16 isolates. The results showed that the cfr(C) gene located in the conjugative pTet MDR/virulence plasmid is present in diverse strains, where it confers high levels of resistance to several antimicrobials, including linezolid, a critical drug for treating infections by Gram-positive bacteria in humans. This report highlights the power of genomic antimicrobial resistance surveillance to uncover the intricacies of transmissible coresistance and provides information that is needed for accurate risk assessment and mitigation strategies. IMPORTANCE Campylobacter is a leading cause of foodborne diarrheal illness worldwide, with more than one million cases each year in the United States alone. The global emergence of antimicrobial resistance in this pathogen has become a growing public health concern. Florfenicol-resistant (FFNr) Campylobacter has been very rare in the United States. In this study, we employed whole-genome sequencing to characterize 16 multidrug-resistant Campylobacter coli isolates recovered from cattle in the United States. A gene [cfr(C)] was found to be responsible for resistance not only to florfenicol but also to several other antimicrobials, including linezolid, a critical drug for treating infections by Gram-positive bacteria in humans. The results showed that cfr(C) is located in a conjugative pTet MDR/virulence plasmid. This report highlights the power of antimicrobial resistance surveillance to uncover the intricacies of transmissible coresistance and provides information that is needed for accurate risk assessment and mitigation strategies.


2021 ◽  
Author(s):  
Raghav Awasthi ◽  
Samprati Agrawal ◽  
Vaidehi Rakholia ◽  
Lovedeep Singh Dhingra ◽  
Aditya Nagori ◽  
...  

Background: Antimicrobial resistance (AMR) is a complex multifactorial outcome of health, socio-economic and geopolitical factors. Therefore, tailored solutions for mitigation strategies could be more effective in dealing with this challenge. Knowledge-synthesis and actionable models learned upon large datasets are critical in order to diffuse the risk of entering into a post-antimicrobial era. Objective: This work is focused on learning Global determinants of AMR and predicting susceptibility of antibiotics at isolate level (Local) for WHO (world health organization) declared critically important pathogens Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Enterobacter cloacae, Staphylococcus aureus. Methods: In this study, we used longitudinal data (2004-2017) of AMR having 633820 isolates from 72 Middle and High-income countries. We integrated the Global burden of disease (GBD), Governance (WGI), and Finance data sets in order to find the unbiased and actionable determinants of AMR. We chose a Bayesian Decision Network (BDN) approach within the causal modeling framework to quantify determinants of AMR. Finally Integrating Bayesian networks with classical machine learning approaches lead to effective modeling of the level of AMR. Results: From MAR (Multiple Antibiotic Resistance) scores, we found that developing countries are at higher risk of AMR compared to developed countries, for all the critically important pathogens. Also, Principal Components Analysis(PCA) revealed that governance, finance, and disease burden variables have a strong association with AMR. We further quantified the impact of determinants in a probabilistic way and observed that heath system access and government effectiveness are strong actionable factors in reducing AMR, which was in turn confirmed by what-if analysis. Finally, our supervised machine learning models have shown decent performance, with the highest on Staphylococcus aureus. For Staphylococcus aureus, our model predicted susceptibility to Ceftaroline and Oxacillin with the highest AUROC, 0.94 and 0.89 respectively.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11958
Author(s):  
Jennifer Lord ◽  
Anthony Gikonyo ◽  
Amos Miwa ◽  
Agricola Odoi

Background Antimicrobial resistance among pathogens of public health importance is an emerging problem in sub-Saharan Africa. Unfortunately, published information on the burden and patterns of antimicrobial resistance (AMR) in this region is sparse. There is evidence that the burden and patterns of AMR vary by geography and facility. Knowledge of local epidemiology of AMR is thus important for guiding clinical decisions and mitigation strategies. Therefore, the objective of this study was to determine the burden and predictors of AMR and multidrug resistance (MDR) among bacterial pathogens isolated from specimens submitted to the diagnostic laboratory of a hospital in Nairobi, Kenya. Methods This retrospective study used laboratory records of 1,217 clinical specimens submitted for bacterial culture and sensitivity testing at the diagnostic laboratory of The Karen Hospital in Nairobi, Kenya between 2012 and 2016. Records from specimens positive for Enterobacteriaceae, Staphylococcus aureus, or Pseudomonas spp. isolates were included for analysis. Firth logistic models, which minimize small sample bias, were used to investigate determinants of AMR and MDR of the isolates. Results A total of 222 specimens had bacterial growth. Most Enterobacteriaceae isolates were resistant to commonly used drugs such as penicillin/β-lactamase inhibitor combinations (91.2%) and folate pathway inhibitors (83.7%). Resistance to extended-spectrum cephalosporins was also high (52.9%). Levels of AMR and MDR for Enterobacteriaceae were 88.5% and 51%, respectively. Among S. aureus isolates, 57.1% were AMR, while 16.7% were MDR. As many as 42.1% of the Pseudomonas spp. isolates were aminoglycoside-resistant and 15% were fluoroquinolone-resistant, but none exhibited resistance to antipseudomonal carbapenems. Half of Pseudomonas spp. isolates were AMR but none were MDR. Significant predictors of MDR among Enterobacteriaceae were organism species (p = 0.002) and patient gender (p = 0.024). Conclusions The high levels of extended-spectrum cephalosporin resistance and MDR among Enterobacteriaceae isolates are concerning. However, the relatively low levels of MDR S. aureus, and an absence of carbapenem resistance among Pseudomonas isolates, suggests that last-line drugs are still effective against S. aureus and Pseudomonas infections. These findings are relevant for guiding evidence-based treatment decisions as well as surveillance efforts and directions for future research, and contribute to the sparse literature on AMR in sub-Saharan Africa.


2021 ◽  
pp. 2662-2669
Author(s):  
Ibrahim Z. Hassan ◽  
Buks Wandrag ◽  
Johan J. Gouws ◽  
Daniel N. Qekwana ◽  
Vinny Naidoo

Background and Aim: Antimicrobial resistance (AMR) and recently mobilized colistin resistance (mcr-1) associated colistin resistance among Escherichia coli isolates have been attributed to the overuse of antimicrobials in livestock production. E. coli remains an important pathogen, often associated with mortality and low carcass weight in poultry medicine; therefore, the need to use antimicrobials is common. The study aimed to determine the AMR profile and presence of mcr-1 and mcr-2 genes in avian pathogenic E. coli from poultry samples tested at a bacteriology laboratory for routine diagnosis. This is a first step in understanding the effectiveness of mitigation strategies. Materials and Methods: Fifty E. coli strains were assessed for resistance against ten antimicrobial drugs using broth microdilution. All isolates with a colistin minimum inhibitory concentration (MIC) of 2 μg/mL were analyzed for the presence of mcr-1 and mcr-2 genes by employing the polymerase chain reaction. For each isolate, the following farm information was obtained: farm location, type of farm, and on-farm use of colistin. Results: Sixty-eight percent of the strains were resistant to at least one antimicrobial; 44% were multiple drug-resistant (MDR). Most E. coli isolates were resistant to doxycycline (44%), trimethoprim-sulfamethoxazole (38%), ampicillin (32%), and enrofloxacin (32%). None of the E. coli strains was resistant to colistin sulfate (MIC90 of 2 μg/mL). Only one E. coli isolate held the mcr-1 gene; none carried the mcr-2 gene. Conclusion: Resistance among E. coli isolates in this study was fairly high. Resistance to commonly used antimicrobials was observed, such as doxycycline, trimethoprim-sulfamethoxazole, and enrofloxacin. Only a single E. coli strain carried the mcr-1 gene, suggesting that mcr-1 and mcr-2 genes are common among isolates in this study. The prevalence of AMR, however, suggests that farmers must implement standard biosecurity measures to reduce E. coli burden, and antimicrobial use to prolong the efficacy life span of some of these drugs.


2020 ◽  
Author(s):  
Monira Parveen ◽  
Mahmuda Yeasmin ◽  
Md. Maruf Ahmed Molla

AbstractThere are evidences that show increased antimicrobial consumption among COVID-19 patients. This has increased the burden on worsening situation of antimicrobial resistance (AMR) throughout the world. Bangladesh, one of the countries with highest numbers of COVID-19 cases, without effective regulation of antimicrobial prescription may suffer in future with study results showing a significant proportion of participants taking antimicrobial without proper indication and prescription from physicians. Suggested mitigation strategies include – strict regulation of over the counter (OTC) antimicrobial prescription, testing biochemical marker such as procalcitonin prior to initiation of antimicrobial therapy, introduction of color coded and tightly sealed bottled antimicrobial drugs, massive campaigning on social media, effective utilization of telemedicine and finally, raising awareness among physicians and patients regarding judicial use of antimicrobial.


2020 ◽  
Author(s):  
Jonathan Bastard ◽  
Marisa Haenni ◽  
Emilie Gay ◽  
Philippe Glaser ◽  
Jean-Yves Madec ◽  
...  

AbstractThe contribution of bacteria in livestock to the global burden of antimicrobial resistance raises concerns worldwide. However, the dynamics of selection and diffusion of antimicrobial resistance in farm animals are not fully understood. Here, we used veal calf fattening farms as a model system, as they are a known reservoir of Extended Spectrum β-Lactamase-producing Escherichia coli (ESBL-EC). Longitudinal data of ESBL-EC carriage and antimicrobial use (AMU) were collected from three veal calf farms during the entire fattening process. We developed 18 agent-based mechanistic models to assess different hypotheses regarding the main drivers of ESBL-EC dynamics in calves. The models were independently fitted to the longitudinal data using Markov Chain Monte Carlo and the best model was selected. Within-farm transmission between individuals and sporadic events of contamination were found to drive ESBL-EC dynamics on farms. In the absence of AMU, the median carriage duration of ESBL-EC was estimated to be 19.6 days (95% credible interval: [12.7; 33.3]). In the best model, AMU was found to influence ESBL-EC dynamics, by affecting ESBL-EC clearance rather than acquisition. This effect of AMU was estimated to decrease gradually after the end of exposure and to disappear after 62.5 days [50.0; 76.9]. Moreover, using a simulation study, we quantified the efficacy of ESBL-EC mitigation strategies. Decreasing ESBL-EC prevalence by 50% on arrival at the fattening farm reduced prevalence at slaughter age by 33.3%. Completely eliminating the use of selective antibiotics had a strong effect on average ESBL-EC prevalence (relative reduction of 79.6%), but the effect was mild if this use was only decreased by 50% compared to baseline (relative reduction of 3.7%).


Author(s):  
Lionel Piroth ◽  
Andre Pechinot ◽  
Anne Minello ◽  
Benoit Jaulhac ◽  
Isabelle Patry ◽  
...  

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