scholarly journals Environmental spreading of clinically relevant carbapenem-resistant gram-negative bacilli: the occurrence of blaKPC-or-NDM strains relates to local hospital activities

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Alex Leite Pereira ◽  
Pâmela Maria de Oliveira ◽  
Célio Faria-Junior ◽  
Everton Giovanni Alves ◽  
Glaura Regina de Castro e Caldo Lima ◽  
...  
Keyword(s):  
Sewage Treatment ◽  
Health Concern ◽  
Tertiary Level ◽  
Public Health Concern ◽  
Local Hospital ◽  
Gram Negative ◽  
Sewage Treatment Plants ◽  
Carbapenem Resistant ◽  
District Hospitals ◽  
Catchment Areas

Abstract Background Aquatic matrices impacted by sewage may shelter carbapenem-resistant (CR) Gram-negative bacilli (GNB) harboring resistance genes of public health concern. In this study, sewage treatment plants (STPs) servicing well-defined catchment areas were surveyed for the presence of CR-GNB bearing carbapenemase genes (blaKPC or blaNDM). Results A total of 325 CR-GNB were recovered from raw (RS) and treated (TS) sewage samples as well as from water body spots upstream (UW) and downstream (DW) from STPs. Klebsiella-Enterobacter (KE) group amounted to 116 isolates (35.7%). CR-KE isolates were recovered from TS, DW (35.7%) and RS samples (44.2%) (p = 0.001); but not from UW samples. KE isolates represented 65.8% of all blaKPC or blaNDM positive strains. The frequency of blaKPC-or-NDM strains was positively associated with the occurrence of district hospitals located near STPs, as well as with the number of hospitalizations and of sewer connections serviced by the STPs. blaKPC-or-NDM strains were recovered from ST samples in 7 out of 14 STPs, including four tertiary-level STPs; and from 6 out of 13 DW spots whose RS samples also had blaKPC-or-NDM strains. Conclusions Clinically relevant GNB bearing blaKPC-or-NDM resist sewage treatments and spread into environmental aquatic matrices mainly from STPs impacted by hospital activities.

scholarly journals Emergence of carbapenem-resistant ST131 Escherichia coli carrying blaOXA-244 in Germany, 2019 to 2020

2020 ◽  
Vol 25 (46) ◽  
Author(s):  
Sybille Welker ◽  
Sébastien Boutin ◽  
Thomas Miethke ◽  
Klaus Heeg ◽  
Dennis Nurjadi
Keyword(s):  
Escherichia Coli ◽  
Carbapenem Resistance ◽  
Health Concern ◽  
Gram Negative Bacteria ◽  
Public Health Concern ◽  
Gram Negative ◽  
E Coli ◽  
Carbapenem Resistant ◽  
South West ◽  
Tertiary Hospitals

The dissemination of carbapenem-producing Gram-negative bacteria is a major public health concern. We report the first detection of OXA-244-producing ST131 O16:H5 Escherichia coli in three patients from two tertiary hospitals in the south-west of Germany. OXA-244 is emerging in Europe. Because of detection challenges, OXA-244-producing E. coli may be under-reported. The emergence of carbapenem resistance in a globally circulating high-risk clone, such as ST131 E. coli is of clinical relevance and should be monitored closely.

scholarly journals Super-Cationic Peptide Dendrimers—Synthesis and Evaluation as Antimicrobial Agents

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 695
Author(s):  
Estelle J. Ramchuran ◽  
Isabel Pérez-Guillén ◽  
Linda A. Bester ◽  
René Khan ◽  
Fernando Albericio ◽  
...  
Keyword(s):  
Antibacterial Agent ◽  
Antimicrobial Agents ◽  
Health Concern ◽  
Gram Negative Bacteria ◽  
Cationic Peptide ◽  
Public Health Concern ◽  
Gram Negative ◽  
Peptide Dendrimers ◽  
Microbial Infections ◽  
Lead Candidate

Microbial infections are a major public health concern. Antimicrobial peptides (AMPs) have been demonstrated to be a plausible alternative to the current arsenal of drugs that has become inefficient due to multidrug resistance. Herein we describe a new AMP family, namely the super-cationic peptide dendrimers (SCPDs). Although all members of the series exert some antibacterial activity, we propose that special attention should be given to (KLK)2KLLKLL-NH2 (G1KLK-L2KL2), which shows selectivity for Gram-negative bacteria and virtually no cytotoxicity in HepG2 and HEK293. These results reinforce the validity of the SCPD family as a valuable class of AMP and support G1KLK-L2KL2 as a strong lead candidate for the future development of an antibacterial agent against Gram-negative bacteria.

scholarly journals Risk factors correlated with antibiotic-induced carbapenem resistant in Gram-negative bacilli in China: a retrospective cohort study

2020 ◽  
Author(s):  
Jing Chen ◽  
Qian Xiang ◽  
Jia-yu Wu ◽  
Min-hong Cai ◽  
Chen Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Risk Model ◽  
Length Of Hospital Stay ◽  
Health Concern ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Kaplan Meier

Abstract Background: Increasing resistance to carbapenem, particularly common in Gram-negative bacilli (GNB), has become a growing public health concern around the world. The objective of this study was to investigate risk factors associated with antibiotic-induced carbapenem resistant in Gram-negative bacilli (CR-GNB) among inpatients. Methods: A retrospective cohort study was conducted in one of the largest tertiary A-level hospitals including patients with GNB cultured from any of the clinical specimens who had been admitted for more than 2 calendar days from January 2017 to June 2019. Kaplan-Meier analysis and Cox proportional hazard model were used to estimate the hazard of CR-GNB induction by antibiotics. Results: 2490 patients including 7 cohorts were included. After cox proportional risk model analysis, carbapenems, β-lactamase inhibitors, and cephalosporins had significantly higher hazards than other types of antimicrobial (P<0.001). But even without using any antimicrobials, the hazard would increase with the length of hospital stay. On multivariate analysis, carbapenem was the most principal hazard factor for antibiotic-induced CR-GNB (hazard ratio [HR], 2.968; 95% confidence interval [CI], 1.706～5.162), followed by ICU admission (HR, 1.815; 95% CI, 1.507～2.186), cephalosporin (HR, 1.605; 95% CI, 1.288～1.999), tracheotomy (HR, 1.563; 95% CI, 1.251～1.952) and β-lactamase inhibitor (HR, 1.542; 95% CI, 1.237～1.921). However, quinolone effects on antibiotic-induced CR-GNB were not statistically significant. Conclusions: Prior carbapenem was a strong risk factor for antibiotic-induced CR-GNB, but quinolone was not associated with that. Rational use of carbapenems should be implemented and antimicrobial stewardship policies should be adjusted according to the characteristics of each hospital.

An Overview of the Activities of Cefiderocol Against Sensitive and Multidrug- Resistant (MDR) Bacteria

2020 ◽  
Vol 20 (18) ◽  
pp. 1908-1916
Author(s):  
Manaf AlMatar ◽  
Osman Albarri ◽  
Essam A. Makky ◽  
Işıl Var ◽  
Fatih Köksal
Keyword(s):  
Multidrug Resistant ◽  
Therapeutic Agents ◽  
Health Concern ◽  
Side Chain ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Public Health Concern ◽  
Gram Negative ◽  
Penicillin Binding Proteins ◽  
The Public

The need for new therapeutics and drug delivery systems has become necessary owing to the public health concern associated with the emergence of multidrug-resistant microorganisms. Among the newly discovered therapeutic agents is cefiderocol, which was discovered by Shionogi Company, Japan as an injectable siderophore cephalosporin. Just like the other β-lactam antibiotics, cefiderocol exhibits antibacterial activity via cell wall synthesis inhibition, especially in Gram negative bacteria (GNB); it binds to the penicillin-binding proteins, but its unique attribute is that it crosses the periplasmic space of bacteria owing to its siderophore-like attribute; it also resists the activity of β-lactamases. Among all the synthesized compounds with the modified C-7 side chain, cefiderocol (3) presented the best and well-balanced activity against multi-drug resistant (MDR) Gram negative bacteria, including those that are resistant to carbapenem. İn this article, an overview of the recent studies on cefiderocol was presented.

scholarly journals Distribution and Relationships of Antimicrobial Resistance Determinants among Extended-Spectrum-Cephalosporin-Resistant or Carbapenem-Resistant Escherichia coli Isolates from Rivers and Sewage Treatment Plants in India

2016 ◽  
Vol 60 (5) ◽  
pp. 2972-2980 ◽  
Author(s):  
Masato Akiba ◽  
Tsuyoshi Sekizuka ◽  
Akifumi Yamashita ◽  
Makoto Kuroda ◽  
Yuki Fujii ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Sewage Treatment ◽  
Indian States ◽  
Content Type ◽  
Sewage Treatment Plants ◽  
E Coli ◽  
Resistance Determinants ◽  
Carbapenem Resistant ◽  
Extended Spectrum

ABSTRACTTo determine the distribution and relationship of antimicrobial resistance determinants among extended-spectrum-cephalosporin (ESC)-resistant or carbapenem-resistantEscherichia coliisolates from the aquatic environment in India, water samples were collected from rivers or sewage treatment plants in five Indian states. A total of 446E. coliisolates were randomly obtained. Resistance to ESC and/or carbapenem was observed in 169 (37.9%)E. coliisolates, which were further analyzed. These isolates showed resistance to numerous antimicrobials; more than half of the isolates exhibited resistance to eight or more antimicrobials. TheblaNDMgene was detected in 14/21 carbapenem-resistantE. coliisolates:blaNDM-1in 2 isolates,blaNDM-5in 7 isolates, andblaNDM-7in 5 isolates. TheblaCTX-Mgene was detected in 112 isolates (66.3%):blaCTX-M-15in 108 isolates andblaCTX-M-55in 4 isolates. We extracted 49 plasmids from selected isolates, and their whole-genome sequences were determined. Fifty resistance genes were detected, and 11 different combinations of replicon types were observed among the 49 plasmids. The network analysis results suggested that the plasmids sharing replicon types tended to form a community, which is based on the predicted gene similarity among the plasmids. Four communities each containing from 4 to 17 plasmids were observed. Three of the four communities contained plasmids detected in different Indian states, suggesting that the interstate dissemination of ancestor plasmids has already occurred. Comparison of the DNA sequences of theblaNDM-positive plasmids detected in this study with known sequences of related plasmids suggested that various mutation events facilitated the evolution of the plasmids and that plasmids with similar genetic backgrounds have widely disseminated in India.

Superbugs: Antibiotic Resistance Is Becoming a Major Public Health Concern

2016 ◽  
Vol 29 (2) ◽  
pp. 130-133 ◽  
Author(s):  
Patricia T. Alpert
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Clostridium Difficile ◽  
Current Treatment ◽  
Health Concern ◽  
Treatment Modalities ◽  
Public Health Concern ◽  
Carbapenem Resistant ◽  
Control And Prevention ◽  
Carbapenem Resistant Enterobacteriaceae

Antibiotic resistance has led to the development of so-called “superbugs” that no longer respond to the current treatment modalities. The array of antibiotics available to treat these infections is dwindling with very few antibiotics in the pipeline. This article discussed the pathogens the Centers for Disease Control and Prevention (CDC) has placed in their urgent category: (1) Clostridium difficile, (2) Carbapenem-resistant Enterobacteriaceae, and (3) Neisseria gonorrhoeae. In addition, a few suggestions for prevention of resistance are offered.

scholarly journals Detection of NDM-1, VIM-1 and AIM-type metallo-beta-lactamase genes in Gram-negative bacteria isolated from clinical samples in Tamil Nadu

2020 ◽  
Author(s):  
Prasanth Manohar ◽  
Aemy Joseph ◽  
B Karthika ◽  
Pradeep AnuPriya ◽  
Swetha S Mani ◽  
...  
Keyword(s):  
Tamil Nadu ◽  
Health Concern ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Study Region ◽  
Gram Negative ◽  
Phenotypic Resistance ◽  
Carbapenem Resistant ◽  
Synergy Test

AbstractThe distribution of carbapenem-resistant Gram-negative bacteria has become an increasing public health concern in India. The aim of this study was to investigate the prevalence of carbapenem-resistant bacteria isolated from the clinical samples in Tamil Nadu, India. A total of 126 non-repetitive Gram-negative bacteria were taken for this study. The susceptibility to meropenem was determined by Minimum Inhibitory Concentration (MIC) by broth micro-dilution. The phenotypic resistance screening such as MHT (Modified Hodge test), EDTA disk synergy and CIM (carbapenem inactivation method) were performed. A multiplex PCR was used for the detection of carbapenemase-encoding genes. Among the 126 isolates studied, 82 (65.07%) meropenem-resistant isolates were identified by MIC. A total of 18 (21.9%) isolates were found to be positive for Metallo-β-Lactamase production through EDTA synergy test. None of the isolates were carbapenemase producer by MHT and CIM. The isolates identified with resistance genes (8/82) were blaNDM-1 in two Klebsiella sp., two P. aeruginosa and one A. baumannii, blaVIM-1 in one P. aeruginosa and blaAIM-1 in one P. aeruginosa and one A. baumannii. The study showed the distribution and increase of carbapenem-resistant bacteria in the study region. Therefore, constant monitoring and effective elimination should be focused to reduce the spread of carbapenem-resistant isolates.

scholarly journals Emergence of blaNDM-1 and blaVIM producing Gram-negative bacilli in ventilator-associated pneumonia at AMR Surveillance Regional Reference Laboratory in India

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256308
Author(s):  
Mithlesh Kumari ◽  
Sheetal Verma ◽  
Vimala Venkatesh ◽  
Prashant Gupta ◽  
Piyush Tripathi ◽  
...  
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Antibiotic Resistance Genes ◽  
Health Concern ◽  
Reference Laboratory ◽  
Ventilator Associated Pneumonia ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Resistance Patterns ◽  
Prior Surgery

Introduction Ventilator-associated pneumonia (VAP) may be a life threatening nosocomial infection encountered in intensive care units. Currently the emergence of carbapenem-resistant Gram-negative pathogens has become worrisome threat worldwide. Material and methods Endotracheal aspirates samples were collected from patients who were under mechanical ventilation for > 48 h. The bacterial isolates were identified by MALDI-TOF-MS and antibiotic susceptibility testing performed. All carbapenem resistant isolates were tested by Modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and EDTA-CIM (eCIM) and PCR were performed to detect blaIMP, blaVIM and blaNDM producing MBL genes. Results VAP occurred in 172/353(48.7%), 23.3% had early-onset VAP and 76.7% had late-onset VAP. Males (69.2%) were found to suffer more from VAP. Prior antibiotic therapy, CPI>6, prior surgery and tracheostomy were associated with VAP. The mortality in VAP (58.1%) contrasted with non-VAP (40%). 99/169 (58.6%) Gram-negative isolates were resistant to carbapenems. Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae were common pathogens found in late onset VAP, whereas K. pneumoniae, A. baumannii and Staphylococcus aureus were common in early onset VAP. The PCR results detected blaNDM in 37/172(21.5%) and blaVIM in 30/172(17.4%); 15/172(8.7%) isolates carried both genes. Conclusion The blaNDM-1 and blaVIM genes are the main antibiotic-resistance genes that induce resistance patterns to carbapenems in VAP, highlighting CRE strains of potential public health concern and therapeutic challenge. Diagnostic laboratories in India must get on high caution for early MBL detection as it may limit the wide dispersal of MBL genes.

scholarly journals First Report of the mcr-1 colistin Resistance Gene Identified in Escherichia coli Isolated from a Clinical Sample in Naples in 2020

2020 ◽  
Author(s):  
BIAGIO SANTELLA ◽  
CARLA ZANNELLA ◽  
CHIARA DEL VECCHIO ◽  
ANNALISA CHIANESE ◽  
VERONICA FOLLIERO ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Resistance Gene ◽  
Clinical Sample ◽  
Resistance Mechanism ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Colistin Resistance ◽  
Gram Negative ◽  
E Coli ◽  
Carbapenem Resistant

Abstract Background: The emergence of a novel plasmid-mediated colistin resistance mechanism, encoded by the mcr-1 gene, represents a major public health concern. The mechanism of resistance to colistin, mediated by plasmids, is a serious problem, both for its ability to be transferred to other species, and for infections caused by carbapenem-resistant Gram-negative, in which colistin is used as an antimicrobial drug of last line for the treatment of these infections. The present study highlights the first isolation and genetic evaluation of detecting plasmid-mediated resistance to colistin in a multidrug-resistant (MDR) Escherichia coli (E. coli) isolated from a clinical sample in the metropolitan city of Naples, Italy. Results: Colistin-resistant E. coli isolate was identified in August 2020 from the blood culture of a male patient with multiple comorbidities. The minimum inhibitory concentration (MIC) of colistin was 8 mg/L. In addition to colistin, the isolate was resistant to third-generation cephalosporins (cefotaxime and ceftazidime), penicillin (amoxicillin and piperacillin), aminoglycosides (gentamicin and tobramycin), and fluoroquinolones (ciprofloxacin and levofloxacin). However, it showed susceptibility to carbapenems (ertapenem, imipenem, and meropenem), tetracyclines (tigecycline), and piperacillin-tazobactam. The results of the PCR confirmed the presence of the mcr-1 resistance gene. Conclusion: This study confirms the presence of resistance to colistin mediated by the mcr-1 gene in a clinical isolate of E. coli. Although resistance to colistin caused by the mcr-1 gene is not common in our region, it should not be ignored. Therefore, further surveillance studies are recommended to monitor the spread of plasmid-mediated colistin resistance genes in Gram-negative MDR bacteria.

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