PREVALENCE OF CIPROFLOXACIN RESISTANCE IN INFLAMMATORY BOWEL DISEASE PATIENTS WITH GUT COLONIZATION WITH EXTENDED SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIA ACCORDING TO BACTERIAL PLASMID GENES

Background: The monitoring of antimicrobial resistance (AMR) in microorganisms that circulate in the environment is an important topic of scientific research and contributes to the development of action plans to combat the spread of multidrug-resistant (MDR) bacteria. As a synanthropic vector for multiple pathogens and a reservoir for AMR, flies can be used for surveillance. Methods: We collected 163 flies in the inner city of Berlin and examined them for extended-spectrum β-lactamase (ESBL)-producing Escherichia coli genotypically and phenotypically. Results: The prevalence of ESBL-producing E. coli in flies was 12.9%. Almost half (47.6%) of the ESBL-positive samples showed a co-resistance to ciprofloxacin. Resistance to carbapenems or colistin was not detected. The predominant ESBL-type was CTX-M-1, which is associated with wildlife, livestock, and companion animals as a potential major source of transmission of MDR E. coli to flies. Conclusions: This field study confirms the permanent presence of ESBL-producing E. coli in an urban fly population. For continuous monitoring of environmental contamination with multidrug-resistant (MDR) bacteria, flies can be used as indicators without much effort.

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Use of Probiotics to Reduce Infections and Death and Prevent Colonization with Extended-spectrum Beta-lactamase (ESBL) Producing Bacteria among Newborn Infants in Tanzania (ProRIDE Trial): Study Protocol for a Randomized Controlled Clinical Trial

10.21203/rs.3.rs-70753/v1 ◽

2020 ◽

Author(s):

Kanika Kuwelker ◽

Nina Langeland ◽

Iren Löhr ◽

Joshua Gidion ◽

Joel Manyahi ◽

...

Keyword(s):

Controlled Trial ◽

Newborn Infants ◽

Morbidity And Mortality ◽

World Health ◽

Resistant Bacteria ◽

Controlled Clinical Trial ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Gut Colonization ◽

Extended Spectrum

Abstract Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) has emerged as an urgent global health threat, and is by World Health Organization ranked as priority 1 among pathogens in need of new treatment. Studies have shown high mortality in Tanzanian children with ESBL-E infections. Gut colonization of ESBL-E, which is a potential risk factor of ESBL-E infections, is reported to be very high among children in Tanzania. Probiotics may potentially reduce gut colonization of multidrug-resistant bacteria. However, there is limited data on whether probiotics may reduce ESBL-E carriage in infants. The ProRIDE Trial aims to evaluate whether the use of probiotics can reduce morbidity and mortality among infants in Haydom, Tanzania, and whether this effect is mediated through prevention of ESBL-E carriage. Methods/Design: This large randomized double-blinded placebo-controlled trial aims to recruit 2000 newborn infants at Haydom Lutheran Hospital and the surrounding area in the period of November 2020 to November 2021. Participants will be enrolled from day 0-3 after birth, and randomized to receive probiotics or placebo for four weeks. Participants will be followed up for six months, during which three visits will be made to collect clinical and demographic information, as well as rectal swabs and fecal samples which will be subjected to laboratory analysis. The primary composite outcome is the prevalence of death and/or hospitalization at six months of age. Discussion: As the use of probiotics may give a more favorable gut composition, and thereby improve health and reduce morbidity and mortality, the results may have implications for future therapy guidelines in Africa and internationally. Trial Registration: www.clinicaltrials.gov , Trial identifier NCT04172012, Registered 21 November 2019

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Metagenomic Characterization of Gut Microbiota of Carriers of Extended-Spectrum Beta-Lactamase or Carbapenemase-Producing Enterobacteriaceae Following Treatment with Oral Antibiotics and Fecal Microbiota Transplantation: Results from a Multicenter Randomized Trial

Microorganisms ◽

10.3390/microorganisms8060941 ◽

2020 ◽

Vol 8 (6) ◽

pp. 941

Author(s):

Stefano Leo ◽

Vladimir Lazarevic ◽

Myriam Girard ◽

Nadia Gaïa ◽

Jacques Schrenzel ◽

...

Keyword(s):

Temporal Dynamics ◽

Fecal Microbiota Transplantation ◽

Statistical Significance ◽

Fecal Microbiota ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Gut Colonization ◽

Extended Spectrum ◽

Before And After ◽

Treatment Naïve

Background: The R-GNOSIS (Resistance in Gram-Negative Organisms: Studying Intervention Strategies) WP3 study was the first multicenter randomized clinical trial systematically investigating fecal microbiota transplantation (FMT) for intestinal decolonization of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) or carbapenemase-producing Enterobacteriaceae (CPE). Here, we characterized the temporal dynamics of fecal microbiota changes in a sub-cohort of the R-GNOSIS WP3 participants before and after antibiotics/FMT using whole metagenome shotgun sequencing. Methods: We sequenced fecal DNA obtained from 16 ESBL-E/CPE carriers having received oral colistin/neomycin followed by FMT and their corresponding seven donors. Ten treatment-naïve controls from the same trial were included. Fecal samples were collected at baseline (V0), after antibiotics but before FMT (V2) and three times after FMT (V3, V4 and V5). Results: Antibiotic treatment transiently decreased species richness and diversity and increased the abundance of antibiotic resistance determinants (ARDs). Bifidobacterium species, together with butyrate- and propionate-producing species from Lachnospiraceae and Ruminococcaceae families were significantly enriched in post-FMT microbiota of treated carriers. After FMT, the proportion of Enterobacteriaceae was lower compared to baseline but without statistical significance. Conclusions: Combined antibiotic and FMT treatment resulted in enrichment of species that are likely to limit the gut colonization by ESBL-E/CPE.

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Prevalence and Incidence of Antimicrobial-Resistant Organisms among Hospitalized Inflammatory Bowel Disease Patients

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2013/609230 ◽

2013 ◽

Vol 24 (4) ◽

pp. e117-e121 ◽

Cited By ~ 4

Author(s):

Alon Vaisman ◽

Kevin Pivovarov ◽

Allison McGeer ◽

Barbara Willey ◽

Bjug Borgundvaag ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Antibiotic Use ◽

Time Interval ◽

Methicillin Resistant ◽

Extended Spectrum Beta Lactamase ◽

Vancomycin Resistant Enterococci ◽

Immunosuppressive Medications ◽

Inflammatory Bowel ◽

Vancomycin Resistant

BACKGROUND: Patients with inflammatory bowel disease (IBD) experience frequent hospitalizations and use of immunosuppressive medications, which may predispose them to colonization with antimicrobial-resistant organisms (ARO).OBJECTIVE: To determine the prevalence of ARO colonization on admission to hospital and the incidence of infection during hospitalization among hospitalized IBD patients.METHODS: A chart review comparing the prevalence of colonization and incidence of infection with methicillin-resistantStaphylococcus aureus, vancomycin-resistant enterococci and extended-spectrum beta-lactamase-producingEnterobacteriaceae(ESBL) in hospitalized IBD patients with those of non-IBD controls was performed.RESULTS: On admission, there were no significant differences between IBD inpatients and controls in the prevalence of colonization of methicillin-resistantS aureus(1.0% versus 1.2%; P=0.74), vancomycin-resistant enterococci (0.2% versus 0%; P=1.0) or ESBL (4.1% versus 5.5%; P=0.33). Pooling data from historical clinic-based cohorts, IBD patients were more likely than controls to have ESBL colonization (19% versus 6.6%; P<0.05). Antibiotic use on admission was associated with ESBL colonization among IBD inpatients (OR 4.2 [95% CI 1.4 to 12.6]). The incidence of ARO infections during hospitalization was not significantly different between IBD patients and controls. Among IBD patients who acquired ARO infections during hospitalizations, the mean time interval from admission to infection was shorter for those who were already colonized with ARO on admission.CONCLUSIONS: This particular population of hospitalized IBD patients was not shown to have a higher prevalence or incidence of ARO colonization or infection compared with non-IBD inpatients.

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Use of probiotics to reduce infections and death and prevent colonization with extended-spectrum beta-lactamase (ESBL)-producing bacteria among newborn infants in Tanzania (ProRIDE Trial): study protocol for a randomized controlled clinical trial

Trials ◽

10.1186/s13063-021-05251-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Kanika Kuwelker ◽

Nina Langeland ◽

Iren Høyland Löhr ◽

Joshua Gidion ◽

Joel Manyahi ◽

...

Keyword(s):

Controlled Trial ◽

Newborn Infants ◽

Morbidity And Mortality ◽

World Health ◽

Resistant Bacteria ◽

Controlled Clinical Trial ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Gut Colonization ◽

Extended Spectrum

Abstract Background Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) has emerged as an urgent global health threat and is by the World Health Organization ranked as priority 1 among pathogens in need of new treatment. Studies have shown high mortality in Tanzanian children with ESBL-E infections. Gut colonization of ESBL-E, which is a potential risk factor of ESBL-E infections, is reported to be very high among children in Tanzania. Probiotics may potentially reduce gut colonization of multidrug-resistant bacteria. However, there is limited data on whether probiotics may reduce ESBL-E carriage in infants. The ProRIDE Trial aims to evaluate whether the use of probiotics can reduce morbidity and mortality among infants in Haydom, Tanzania, and whether this effect is associated with a reduction in ESBL-E colonization and/or infections. Methods/design This large randomized double-blinded placebo-controlled trial aims to recruit 2000 newborn infants at Haydom Lutheran Hospital and the surrounding area in the period of November 2020 to November 2021. Participants will be enrolled from days 0 to 3 after birth and randomized to receive probiotics or placebo for 4 weeks. Participants will be followed-up for 6 months, during which three visits will be made to collect clinical and demographic information, as well as rectal swabs and fecal samples which will be subjected to laboratory analysis. The primary composite outcome is the prevalence of death and/or hospitalization at 6 months of age. Discussion As the use of probiotics may give a more favorable gut composition, and thereby improve health and reduce morbidity and mortality, the results may have implications for future therapy guidelines in Africa and internationally. Trial registration ClinicalTrials.gov NCT04172012. Registered on November 21, 2019

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