scholarly journals Coexistence of aminoglycoside resistance genes in CTX-M-producing isolates of Klebsiella pneumoniae in Bushehr province, Iran

2021 ◽  
Author(s):  
Behrouz Latifi ◽  
Saeed Tajbakhsh ◽  
Leila Ahadi ◽  
Forough Yousefi
Keyword(s):  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Confirmatory Test ◽  
M Gene ◽  
Aminoglycoside Resistance ◽  
Genetic Groups ◽  
Genes Encoding ◽  
Resistance Patterns ◽  
Aminoglycoside Resistance Genes ◽  
Antibiotic Resistance Patterns

Background and Objectives: Increasing the rate of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae has given rise to a major healthcare issue in clinical settings over the past few years. Treatment of these strains is hardly effective since the plasmid encoding ESBL may also carry other resistance genes including aminoglycosides. The current study aimed to evaluate the prevalence of ESBL-producing K. pneumoniae and investigate the coexistence of Cefoxitamase-Munich (bla ) with aminoglycoside-modifying enzyme (AME) genes, aac(3)IIa as well as aac(6′)Ib, in CTX‑M‑producing K. pneumoniae isolated from patients in Bushehr province, Iran. Materials and Methods: A total of 212 K. pneumoniae isolates were collected and confirmed using polymerase chain re‑ action (PCR) of the malate dehydrogenase gene. Isolates were screened for production of ESBL. Phenotypic confirmatory test was performed using combined disk test. The genes encoding CTX-M groups and AME genes, aac(3)IIa and aac(6′)Ib, were investigated by PCR. Results: The ESBL phenotype was detected in 56 (26.4%) K. pneumoniae isolates. Moreover, 83.9% of ESBL-producing isolates carried the genes for CTX-M type β-lactamases, which were distributed into the two genetic groups of CTX-M-1 (97.8%)- and CTX-M-2 (2.1%)-related enzymes. Notably, among K. pneumoniae isolates containing the blaCTX‑M gene, 68.08% of isolates harbored AME genes. In addition, the coexistence of bla in 46.8% of CTX-M-producing K. pneumoniae isolates. Conclusion: This study provides evidence of a high prevalence of AME genes in CTX-M- producing K. pneumoniae iso‑ lates; therefore, in the initial empirical treatment of infections caused by ESBL-KP in regions with such antibiotic resistance patterns, aminoglycoside combination therapy should be undertaken carefully.

Prevalence of Genes Encoding Aminoglycoside-Modifying Enzymes and armA among Acinetobacter baumannii Clinical Isolates in Alexandria, Egypt

2021 ◽  
Vol 21 ◽  
Author(s):  
Amel ELsheredy ◽  
Zainab Yousif ◽  
Ebtesam Elghazzawi ◽  
Ahmed Elmenshawy ◽  
Abeer Ghazal
Keyword(s):  
Acinetobacter Baumannii ◽  
Resistance Genes ◽  
Antimicrobial Agents ◽  
Clinical Isolates ◽  
Aminoglycoside Resistance ◽  
High Propensity ◽  
Genes Encoding ◽  
Resistance Patterns ◽  
Aminoglycoside Resistance Genes ◽  
High Level

Introduction: Acinetobacter baumannii (A.baumannii ) is a ubiquitous pathogen responsible for serious infections in hospitalized patients with a high propensity to develop resistance to antimicrobial agents. The study aimed to determine the antimicrobial resistance patterns and the prevalence of aminoglycoside resistance genes among A. baumannii clinical isolates from patients in different intensive care units (ICUs) in Alexandria, Egypt. Methods: A total of 100 A. baumannii isolates collected from ICU patients were confirmed as A. baumannii by VITEK 2 and the presence of the blaOXA-51 gene has been reported. Antimicrobial susceptibility testing was performed and Multiplex PCR was done for the detection of aminoglycoside resistance genes. Results: Most of the isolates (82%) were resistant to all tested aminoglycosides; resistance was higher for kanamycin and neomycin, followed by amikacin. The predominant AMEs were aphA6 and aphA1 in 86% and 67% of the isolates, respectively; aacA4 and aacC1 were detected in 37% and 8%, respectively, while aadA1 and aadB were present in 34% and 4%, respectively. Furthermore, armA gene was detected in 83% of the isolates. Conclusion: The results of this study revealed a high level carriage of armA and AMEs which limit the usage of aminoglycoside as a treatment option for A. baumannii and makes treatment extremely difficult.

Characterization of antimicrobial resistance patterns of Klebsiella pneumoniae isolates obtained from wound infections

2020 ◽  
Vol 20 ◽  
Author(s):  
Roya Ghanavati ◽  
Hossein Kazemian ◽  
Parisa Asadollahi ◽  
Hamid Heidari ◽  
Gholamreza Irajian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Control Strategies ◽  
Wound Infections ◽  
Aminoglycoside Resistance ◽  
Resistance Patterns ◽  
Life Threatening ◽  
Synergy Test ◽  
Aminoglycoside Resistance Genes

Background: Multidrug resistance among ESBL producing isolates has limited the administration of proper antibiotics. It is therefore important to monitor the resistance patterns of Klebsiella pneumoniae isolates and provide infection control strategies to prevent nosocomial outbreaks. This study was aimed to determine antimicrobial resistance patterns of K. pneumoniae isolates obtained from wound infections of patients in Tehran, Iran. Methods: Totally, 102 K. pneumoniae isolates were obtained from wound infections of patients in Tehran, Iran. Phenotypic ESBL and carbapenemase production was assessed using double-disc synergy test (DDST) and modified Hodge test (MHT), respectively. PCR was performed for the detection of ESBL, carbapenemase, quinolone and aminoglycoside resistance genes. Results: Forty-six (45.1%) and 23 (22.5%) isolates, out of the 102 isolates, were phenotypically detected as ESBL and carbapenemase producers, respectively. The PCR results showed that 80/102 (78.4%) and 51/102 (50%) isolates possessed at least one of the assessed ESBL and carbapenemase genes, respectively. Quinolone resistance determinants (QRDs) and aac(6')-Ib genes were found amongst 50 (49%) and 67 (65.7%) isolates, respectively. Four isolates carried the blaTEM, blaSHV, blaCTX-M, qnrB, qnrS and aac(6’)-Ib genes, simultaneously. Conclusion: Because of the presence of multiple resistance genes among some K. pneumoniae strains, antibiotic agents should be used with caution to preserve their efficacy in case of life-threatening infections.

scholarly journals High-Level Aminoglycoside Resistance in Human Clinical Klebsiella pneumoniae Complex Isolates and Characteristics of armA-Carrying IncHI5 Plasmids

2021 ◽  
Vol 12 ◽  
Author(s):  
Xueya Zhang ◽  
Qiaoling Li ◽  
Hailong Lin ◽  
Wangxiao Zhou ◽  
Changrui Qian ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Genomic Analysis ◽  
Comparative Genomic Analysis ◽  
Conjugative Plasmid ◽  
Comparative Genomic ◽  
Aminoglycoside Resistance ◽  
Life Threatening ◽  
Aminoglycoside Resistance Genes ◽  
High Level

Aminoglycosides are important options for treating life-threatening infections. However, high levels of aminoglycoside resistance (HLAR) among Klebsiella pneumoniae isolates have been observed to be increasing frequently. In this study, a total of 292 isolates of the K. pneumoniae complex from a teaching hospital in China were analyzed. Among these isolates, the percentage of HLAR strains was 13.7% (40/292), and 15 aminoglycoside resistance genes were identified among the HLAR strains, with rmtB being the most dominant resistance gene (70%, 28/40). We also described an armA-carrying Klebsiella variicola strain KP2757 that exhibited a high-level resistance to all aminoglycosides tested. Whole-genome sequencing of KP2757 demonstrated that the strain contained one chromosome and three plasmids, with all the aminoglycoside resistance genes (including two copies of armA and six AME genes) being located on a conjugative plasmid, p2757-346, belonging to type IncHI5. Comparative genomic analysis of eight IncHI5 plasmids showed that six of them carried two copies of the intact armA gene in the complete or truncated Tn1548 transposon. To the best of our knowledge, for the first time, we observed that two copies of armA together with six AME genes coexisted on the same plasmid in a strain of K. variicola with HLAR. Comparative genomic analysis of eight armA-carrying IncHI5 plasmids isolated from humans and sediment was performed, suggesting the potential for dissemination of these plasmids among bacteria from different sources. These results demonstrated the necessity of monitoring the prevalence of IncHI5 plasmids to restrict their worldwide dissemination.

scholarly journals The Molecular Epidemiology of Resistance to Antibiotics among Klebsiella pneumoniae Isolates in Azerbaijan, Iran

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Mehdi Kashefieh ◽  
Hassan Hosainzadegan ◽  
Shabnam Baghbanijavid ◽  
Reza Ghotaslou
Keyword(s):  
Drug Resistance ◽  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Resistance Genes ◽  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Aminoglycoside Resistance ◽  
State Hospitals ◽  
Aminoglycoside Resistance Genes ◽  
Hospital Acquired

Introduction. Klebsiella pneumoniae (K. pneumoniae) is one of the leading causes of hospital-acquired and community-acquired infections in the world. This study was conducted to investigate the molecular epidemiology of drug resistance in clinical isolates of K. pneumoniae in Azerbaijan, Iran. Materials and Methods. A total of 100 nonduplicated isolates were obtained from the different wards of Azerbaijan state hospitals, Iran, from 2019 to 2020. Antibiotic susceptibility testing was done. The DNA was extracted, and the PCR for evaluation of the resistance genes was carried out. Results. The highest antibiotic resistance was shown to ampicillin (96%), and the highest susceptibility was shown to tigecycline (9%), and 85% of isolates were multidrug resistant. The most frequent ESBL gene in the tested isolates was blaSHV-1 in 58%, followed by blaCTXM-15 (55%) and blaSHV-11(42%). The qepA, oqxB, and oqxA genes were found to be 95%, 87.5%, and 70%, respectively. We detected tetB in 42%, tetA in 32%, tetD in 21%, and tetC in 16%. Seventy isolates were resistant to co-trimoxazole, and the rate of resistance genes was sul1 in 71%, followed by sul2 (43%), dfr (29%), and sul3 (7%). The most common aminoglycoside resistance genes were ant3Ia, aac6Ib, aph3Ib, and APHs in 44%, 32%, 32%, and 31.4%, respectively. The most frequent resistance gene to fosfomycin was fosA (40%) and fosX (40%) followed by fosC (20%). Conclusion. The results of this study indicate the high frequency of drug resistance among K. pneumoniae isolated from hospitals of Azerbaijan state. The present study shows the presence of high levels of drug-resistant genes in various antibiotics, which are usually used in the treatment of infections due to K. pneumoniae.

scholarly journals Complement Susceptibility in Relation to Genome Sequence of RecentKlebsiella pneumoniaeIsolates from Thai Hospitals

mSphere ◽  
2018 ◽  
Vol 3 (6) ◽  
Author(s):  
Jessica Loraine ◽  
Eva Heinz ◽  
Jessica De Sousa Almeida ◽  
Oleksandr Milevskyy ◽  
Supayang P. Voravuthikunchai ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Single Gene ◽  
Multidrug Resistant ◽  
Side Chains ◽  
Content Type ◽  
Genes Encoding ◽  
Resistance Patterns ◽  
Tertiary Hospitals ◽  
Population Structures ◽  
Antibiotic Resistance Patterns

ABSTRACTThe capacity to resist the bactericidal action of complement (C′) is a strong but poorly understood virulence trait inKlebsiellaspp. Killing requires activation of one or more C′ pathways, assembly of C5b-9 membrane attack complexes (MACs) on the surface of the outer membrane (OM), and penetration of MACs into the target bilayer. We interrogated whole-genome sequences of 164Klebsiellaisolates from three tertiary hospitals in Thailand for genes encoding surface-located macromolecules considered to play a role in determination of C′ resistance. Most isolates (154/164) were identified asKlebsiella pneumoniae, and the collection conformed to previously established population structures and antibiotic resistance patterns. The distribution of sequence types (STs) and capsular (K) types were also typical of global populations. The majority (64%) of isolates were resistant to C′, and the remainder were either rapidly or slowly killed. All isolates carried genes encoding capsular polysaccharides (K antigens), which have been strongly linked to C′ resistance. In contrast to previous reports, there were no differences in the amount of capsule produced by C′-resistant isolates compared to C′-susceptible isolates, nor was there any correlation between serum reactivity and the presence of hypermucoviscous capsules. Similarly, there were no correlations between the presence of genes specifying lipopolysaccharide O-side chains or major OM proteins. Some virulence factors were found more frequently in C′-resistant isolates but were considered to reflect clonal ST expansion. Thus, no single gene accounts for the C′ resistance of the isolates sequenced in this study.IMPORTANCEMultidrug-resistantKlebsiella pneumoniaeis responsible for an increasing proportion of nosocomial infections, and emerging hypervirulentK. pneumoniaeclones now cause severe community-acquired infections in otherwise healthy individuals. These bacteria are adept at circumventing immune defenses, and most survive and grow in serum; their capacity to avoid C′-mediated destruction is correlated with their invasive potential. Killing of Gram-negative bacteria occurs following activation of the C′ cascades and stable deposition of C5b-9 MACs onto the OM. ForKlebsiella, studies with mutants and conjugants have invoked capsules, lipopolysaccharide O-side chains, and OM proteins as determinants of C′ resistance, although the precise roles of the macromolecules are unclear. In this study, we sequenced 164Klebsiellaisolates with different C′ susceptibilities to identify genes involved in resistance. We conclude that no single OM constituent can account for resistance, which is likely to depend on biophysical properties of the target bilayer.

scholarly journals Molecular Identification of Aminoglycoside-Modifying Enzymes and Plasmid-Mediated Quinolone Resistance Genes among Klebsiella pneumoniae Clinical Isolates Recovered from Egyptian Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Mohamed F. El-Badawy ◽  
Wael M. Tawakol ◽  
Shaymaa W. El-Far ◽  
Ibrahim A. Maghrabi ◽  
Saleh A. Al-Ghamdi ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Quinolone Resistance ◽  
Clinical Isolates ◽  
Phylogenetic Groups ◽  
Aminoglycoside Resistance ◽  
Inappropriate Use ◽  
Genes Encoding

Inappropriate use of antibiotics in clinical settings is thought to have led to the global emergence and spread of multidrug-resistant pathogens. The goal of this study was to investigate the prevalence of genes encoding aminoglycoside resistance and plasmid-mediated quinolone resistance among clinical isolates of Klebsiella pneumoniae. All K. pneumoniae isolates were phenotypically identified using API 20E and then confirmed genotypically through amplification of the specific K. pneumoniae phoE gene. All isolates were genotyped by the enterobacterial repetitive intergenic consensus polymerase chain reaction technique (ERIC-PCR). Antibiotic susceptibility testing was done by a modified Kirby-Bauer method and broth microdilution. All resistant or intermediate-resistant isolates to either gentamicin or amikacin were screened for 7 different genes encoding aminoglycoside-modifying enzymes (AMEs). In addition, all resistant or intermediate-resistant isolates to either ciprofloxacin or levofloxacin were screened for 5 genes encoding the quinolone resistance protein (Qnr), 1 gene encoding quinolone-modifying enzyme, and 3 genes encoding quinolone efflux pumps. Biotyping using API 20E revealed 13 different biotypes. Genotyping demonstrated that all isolates were related to 2 main phylogenetic groups. Susceptibility testing revealed that carbapenems and tigecycline were the most effective agents. Investigation of genes encoding AMEs revealed that acc(6′)-Ib was the most prevalent, followed by acc(3′)-II, aph(3′)-IV, and ant(3′′)-I. Examination of genes encoding Qnr proteins demonstrated that qnrB was the most prevalent, followed by qnrS, qnrD, and qnrC. It was found that 61%, 26%, and 12% of quinolone-resistant K. pneumoniae isolates harbored acc(6′)-Ib-cr, oqxAB, and qebA, respectively. The current study demonstrated a high prevalence of aminoglycoside and quinolone resistance genes among clinical isolates of K. pneumoniae.

scholarly journals 849. Whole Genome Sequencing Analysis of Klebsiella pneumoniae Isolates Reveals Diversity in Genetic Antibiotic Resistance Patterns

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S464-S466
Author(s):  
Ryan Beaver ◽  
Hosoon Choi ◽  
Chetan Jinadatha ◽  
Keith S Kaye ◽  
Piyali Chatterjee ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Veterans Affairs ◽  
Whole Genome ◽  
Department Of Veterans Affairs ◽  
Material Support ◽  
Resistance Patterns ◽  
Antibiotic Resistance Patterns ◽  
Research Grant

Abstract Background Klebsiella pneumoniae is among the leading causes of healthcare-associated infections (HAI). Multidrug-resistant (MDR) Klebsiella variants are difficult to treat and have been reported with increasing frequency in hospitals. Whole genome multi-locus sequence typing (wg-MLST) of K. pneumoniae HAI isolates was used to compare antibiotic resistance genetic patterns against epidemiologic typing. Figure 1. Prevalence of ABX resistance genes for each drug class. Figure 2. Prevalence of ABX resistance genes by hospital. Methods Forty-six clinical bacterial HAI isolates were collected from patients admitted to two disparate tertiary care hospitals in Detroit, Michigan between 2017 and 2019. Data output from wg-MLST was de novo assembled using SPAdes (version 3.7.1) assembler on the Bionumerics calculation engine. Minimum spanning tree (MST) analysis categorized isolates into unique MLST Pasteur serotypes (ST). Antimicrobial resistance genes and/or chromosomal mutations were identified using the ResFinder Database (version 3.2). K. pneumoniae isolates were compared for antibiotic-resistance patterns by hospital, unit, and ST. Figure 3. Hospital 1 clusters and strains that detected gene qnr1, arranged by unit for visual comparison. Figure 4. Sample of clinically significant genes and prevalence, excluding SHV family of genes for simplicity. Results There was significant genetic diversity among the isolates, and no predominant strain was identified. MST analysis revealed 17 unique strains. Only six strains had genetically unique resistance genes detected in more than one isolate, and only three of six were hospital-specific; none were unit-specific. Out of the 75 unique resistance genes detected, only 8 genes had a prevalence >50%: oqxA (100%), oqxB (100%), fosA (89%), blaCTX-M-15 (76%), aac(6’)-Ib-cr (61%), blaTEM-1B (52%), blaOXA-1 (52%), and catB3 (52%). No colistin resistance genes were detected. Of the remaining 69 low-prevalence resistance genes, only 8 hospital-specific genes were detected in more than one isolate (qnrB1, blaSHV-1, blaSHV-110, ac(6’)-Ib3, blaCTX-M-3, blaSHV-36, blaSHV-80, blaSHV-178) with a prevalence range of 4%-22%. Conclusion Our genetic analysis of antibiotic resistance patterns and wg-MLST revealed significant heterogeneity among the isolates, indicating no common source of transmission for either hospital. Although K. pneumoniae is a very common nosocomial pathogen, etiologic analysis suggests diverse community strains (e.g., gut colonization) may actually be responsible for previously-designated HAI. Disclosures Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support) Mark Stibich, PhD MHS, Xenex Disinfection Services, Inc (Board Member, Employee)

Antibiotic resistance patterns of Pseudomonas spp. isolated from faecal wastes in the environment and contaminated surface water

2020 ◽  
Vol 96 (2) ◽  
Author(s):  
Mathilde Camiade ◽  
Josselin Bodilis ◽  
Naouel Chaftar ◽  
Wassila Riah-Anglet ◽  
Johan Gardères ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Enteric Bacteria ◽  
Resistance Pattern ◽  
Pathogenic Species ◽  
Pseudomonas Species ◽  
Class 1 ◽  
Resistance Patterns ◽  
Faecal Bacteria ◽  
Antibiotic Resistance Patterns

ABSTRACT The Pseudomonas genus, which includes environmental and pathogenic species, is known to present antibiotic resistances, and can receive resistance genes from multi-resistant enteric bacteria released into the environment via faecal rejects. This study was aimed to investigate the resistome of Pseudomonas populations that have been in contact with these faecal bacteria. Thus, faecal discharges originating from human or cattle were sampled (from 12 points and two sampling campaigns) and 41 Pseudomonas species identified (316 isolates studied). The resistance phenotype to 25 antibiotics was determined in all isolates, and we propose a specific antibiotic resistance pattern for 14 species (from 2 to 9 resistances). None showed resistance to aminoglycosides, tetracycline, or polymyxins. Four species carried a very low number of resistances, with none to β-lactams. Interestingly, we observed the absence of the transcriptional activator soxR gene in these four species. No plasmid transfer was highlighted by conjugation assays, and a few class 1 but no class 2 integrons were detected in strains that may have received resistance genes from Enterobacteria. These results imply that the contribution of the Pseudomonas genus to the resistome of an ecosystem first depends on the structure of the Pseudomonas populations, as they may have very different resistance profiles.

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