scholarly journals Klebsiella pneumoniae Complex Harboring mcr-1, mcr-7, and mcr-8 Isolates from Slaughtered Pigs in Thailand

2021 ◽  
Vol 9 (12) ◽  
pp. 2436
Author(s):  
Nattamol Phetburom ◽  
Parichart Boueroy ◽  
Peechanika Chopjitt ◽  
Rujirat Hatrongjit ◽  
Yukihiro Akeda ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Continuous Monitoring ◽  
One Health ◽  
Public Health Issue ◽  
Resistant Bacteria ◽  
Colistin Resistance ◽  
Amoxicillin Clavulanic Acid ◽  
Monitoring And Surveillance ◽  
Slaughtered Pigs

Dissemination of the mobile colistin resistance gene mcr in Enterobacterales among humans, animals, and the environment is a public health issue. We characterized mcr genes in the Klebsiella pneumoniae complex (KpnC) isolated from slaughtered pigs in Thailand. The 280 KpnCs consisted of K. pneumoniae (85%), Klebsiella quasipneumoniae (8.21%), and Klebsiella variicola (6.79%). mcr genes were detected in 6.79% (19/280) of KpnC isolates, consisting of mcr-8 (n = 9; 3.21%), mcr-7 (n = 7; 2.50%), mcr-7 + mcr-8 (n = 2; 0.71%), and mcr-1 + mcr-7 (n = 1; 0.36%). K. pneumoniae predominantly carried the mcr-7 and mcr-8 genes, while K. variicola and K. quasipneumoniae harbored mcr-7 and mcr-8, respectively. Six of the nineteen mcr-harboring KpnC isolates exhibited colistin resistance, and five had mcr-1 or mcr-8 transferable to an Escherichia coli recipient. Antimicrobial susceptibility analysis revealed that all mcr-carrying KpnC isolates were susceptible to carbapenems, cefotaxime, cefepime, amoxicillin/clavulanic acid, piperacillin/tazobactam, amikacin, and fosfomycin, and had high resistance to azithromycin. Multilocus sequence analysis demonstrated that the mcr-harboring KpnC isolates were genetically diverse. A ‘One-Health’ approach is useful to combat antimicrobial-resistant bacteria through coordinating the human, animal, and environmental sectors. Hence, continuous monitoring and surveillance of mcr-carrying KpnCs throughout the pork supply chain is crucial for ensuring public health.

scholarly journals Stool Samples of Acute Diarrhea Inpatients as a Reservoir of ST11 Hypervirulent KPC-2-Producing Klebsiella pneumoniae

mSystems ◽  
2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Beiwen Zheng ◽  
Hao Xu ◽  
Tao Lv ◽  
Lihua Guo ◽  
Yu Xiao ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Zhejiang Province ◽  
Public Health Issue ◽  
Resistant Bacteria ◽  
Phylogenetic Tree Analysis ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Stool Samples

ABSTRACT The emergence and spread of carbapenem-resistant hypervirulent Klebsiella pneumoniae sequence type 11 (ST11-CR-HvKP) in China are a great concern in the public health community. However, the underlying mechanism that enables its wide dissemination in China remains unclear. Here, we investigated the prevalence of carriage of carbapenemase-producing Enterobacteriaceae (CPE) among inpatients with diarrhea in a teaching hospital over 1 year to identify ST11-CR-HvKP reservoirs and to understand the genetic background and plasmid profiles of these pathogens. As assessed by stool analysis, the CPE colonization rate (12.4%) among the inpatients with diarrhea was high (12.4%). Antibiotic exposure, surgical history, and CPE positivity were correlated. Genomic investigation of 65 carbapenem-resistant K. pneumoniae isolates indicated a shared bacterial population in various wards. According to maximum likelihood phylogenetic tree analysis, these isolates were partitioned into three major clades. Analysis of the wzi locus revealed three different K types (KL105, KL47, and K64) among the ST11 isolates, indicating the genetic diversity of these isolates. Genetic and sequence mapping revealed the complexity of virulence and resistance plasmid sets harbored by the isolates. These observations indicate that the dissemination of resistant bacteria is more complex than initially anticipated and possibly involves multiple K. pneumoniae ST11 lineages and a variety of virulence plasmids. Collectively, we show for the first time that stool may be a source of ST11-CR-HvKP isolates. Furthermore, the findings reveal the silent dissemination of ST11-CR-HvKP bacteria in Zhejiang Province, China. Future investigations are warranted to determine the association between rectal colonization by ST11-CR-HvKP and clinical infections. IMPORTANCE China has been experiencing a rapid increase in the number of nosocomial infections caused by carbapenem-resistant Klebsiella pneumoniae ST11 (ST11-CRKP) for decades. The emergence of hypervirulent ST11-CRKP (ST11-CR-HvKP) strains is expected to become a serious public health issue in China, considering that carbapenem resistance and virulence have converged in an epidemic clone. K. pneumoniae strains that colonize the human intestinal tract may become a reservoir of virulence and carbapenemase-encoding genes. Here, we first characterized the genotypes and antimicrobial phenotypes of ST11-CR-HvKP strains isolated from diarrheal stool samples of inpatients in Zhejiang Province, China. Active surveillance approaches based on the findings of the present study should be implemented, particularly in intensive care units, to combat the spread of ST11-CR-HvKP and to improve treatment.

scholarly journals Antibiotic residues in honey: a public health issue

2020 ◽  
Vol 9 (11) ◽  
pp. e1739119604
Author(s):  
Clara Mariana Gonçalves Lima ◽  
Flávia Michelon Dalla Nora ◽  
Siluana Katia Tischer Seraglio ◽  
Jiuliane Martins da Silva ◽  
Hercules José Marzoque ◽  
...  
Keyword(s):  
Public Health ◽  
Continuous Monitoring ◽  
Public Health Problem ◽  
Public Health Issue ◽  
Antibiotic Residues ◽  
The European Union ◽  
Cosmetic Products ◽  
Maximum Residue Limits ◽  
Rapid Tests ◽  
Trace Concentrations

Honey has numerous uses and composes formulations of many food, pharmaceutical, and cosmetic products due to its chemical, biological, and sensorial characteristics. In recent years, several reports and scientific articles claim the contamination of honey by antibiotics, a fact that is a public health problem since the ingestion of them can cause several side effects. In this sense, the purpose of this work was to carry out a literature review in international circulation databases about the contamination of honey by antibiotics in the last 10 years. It is observed in the literature that several quality control methods for evaluating this product have been developed, with the main objective of detecting trace concentrations of these compounds. In this context, the chromatographic techniques, rapid tests, immunoassays, and the use of emerging technologies that are considered sustainable for sample preparation stand out. When these methods are applied to honey samples, it is clear that the contamination of honeys by antibiotic residues has been growing every year, making it evident that programs for continuous monitoring of these residues in honeys are conducted. Also, not only has the amount of antibiotics increased, but also the diversity of assets being used. Regarding the residues present, the main antibiotics found in the evaluated samples belong to the class of tetracyclines, sulfonamides, aminoglycosides, macrolides, and amphenicols. However, few countries report maximum residue limits (MRL) allowed for these substances in honey, and in Brazil, as well as in the European Union, no MRL has been established for antibiotics in this product so far, which indicates that it is extremely important that MRL be adopted to ensure food safety for consumers.

scholarly journals Phenotypic and genotypic resistance to colistin in E. coli isolated from wild boar (Sus scrofa) hunted in Italy

2021 ◽  
Vol 67 (3) ◽  
Author(s):  
Giovanni Cilia ◽  
Barbara Turchi ◽  
Filippo Fratini ◽  
Valentina Virginia Ebani ◽  
Luca Turini ◽  
...  
Keyword(s):  
Wild Boar ◽  
One Health ◽  
Resistant Bacteria ◽  
Colistin Resistance ◽  
Genotypic Resistance ◽  
E Coli ◽  
Microdilution Method ◽  
Potential Reservoir ◽  
The One ◽  
Reported Data

AbstractThe One Health approach is not only focused on diseases and zoonosis control but also on antimicrobial resistance. As concern this important issue, the problem of plasmid-mediated colistin resistance recently emerged. Few studies reported data about colistin resistance and mcr genes in bacteria from wildlife. In this manuscript, 168 Escherichia coli isolated from hunted wild boar were tested; colistin resistance was evaluated by MIC microdilution method, and the presence of mcr-1 and mcr-2 genes was evaluated by PCR. Overall, 27.9% of isolates resulted resistant to colistin, and most of them showed a MIC value > 256 μg/mL. A percentage of 44.6% of tested E. coli scored positive for one or both genes. In details, 13.6% of isolated harbored mcr-1 and mcr-2 in combination; most of them exhibiting the highest MIC values. Interestingly, 19.6% of mcr-positive E. coli resulted phenotypically susceptible to colistin. Wild boar could be considered a potential reservoir of colistin-resistant bacteria. In the light of the possible contacts with domestic animals and humans, this wild species could play an important role in the diffusion of colistin resistance. Thus, the monitoring programs on wildlife should include this aspect.

scholarly journals Mobile Plasmid Mediated Transition From Colistin-Sensitive to Resistant Phenotype in Klebsiella pneumoniae

2021 ◽  
Vol 12 ◽  
Author(s):  
Baoyue Zhang ◽  
Bing Yu ◽  
Wei Zhou ◽  
Yue Wang ◽  
Ziyong Sun ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Sequencing Analysis ◽  
Direct Repeats ◽  
Colistin Resistance ◽  
Health Crisis ◽  
Carbapenem Resistant ◽  
Resistant Phenotype ◽  
New Challenges

Multidrug-resistant bacteria, including carbapenem-resistant Klebsiella pneumoniae (CRKP), are becoming an increasing health crisis worldwide. For CRKP, colistin is regarded as “the last treatment option.” In this study, we isolated a clinical CRKP strain named as K. pneumoniae R10-341. Phenotyping analysis showed that this strain could transit from a colistin-sensitive to a resistant phenotype by inserting an IS4 family ISKpn72 element into the colistin-resistance associated mgrB gene. To investigate the mechanism of this transition, we performed genome sequencing analysis of the colistin-sensitive parental strain and found that 12 copies of ISKpn72 containing direct repeats (DR) are located on the chromosome and 1 copy without DR is located on a multidrug-resistant plasmid pR10-341_2. Both types of ISKpn72 could be inserted into the mgrB gene to cause colistin-resistance, though the plasmid-derived ISKpn72 without DR was in higher efficiency. Importantly, we demonstrated that colistin-sensitive K. pneumoniae strain transferred with the ISKpn72 element also obtained the ability to switch from colistin-sensitive to colistin-resistant phenotype. Furthermore, we confirmed that the ISKpn72-containing pR10-341_2 plasmid was able to conjugate, suggesting that the ability of causing colistin-resistant transition is transferable through common conjugation. Our results point to new challenges for both colistin-resistance detection and CRKP treatment.

scholarly journals Draft Genome Sequences of Two Carbapenemase-Producing Klebsiella pneumoniae Strains Isolated from Blood Cultures

2018 ◽  
Vol 7 (8) ◽  
Author(s):  
Rémi Le Guern ◽  
Teddy Grandjean ◽  
Karine Faure ◽  
Marvin Bauduin ◽  
Eric Kipnis ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Draft Genome ◽  
Blood Cultures ◽  
Health Issue ◽  
Public Health Issue ◽  
Whole Genome ◽  
Genome Sequences ◽  
Content Type ◽  
Clinical Strains

Carbapenemase-producing Klebsiella pneumoniae represents an emerging public health issue. Here, we present the draft whole-genome sequences of K. pneumoniae clinical strains KPL0.1 (OXA-48 carbapenemase) and KPL0.2 (NDM-1 carbapenemase).

scholarly journals Best Practices and Innovations for Managing Codeine Misuse and Dependence

2016 ◽  
Vol 19 (3) ◽  
pp. 367 ◽  
Author(s):  
Ian J. Norman ◽  
Michael Bergin ◽  
Charles D. Parry ◽  
Marie Claire Van Hout
Keyword(s):  
Public Health ◽  
Best Practices ◽  
Product Information ◽  
Public Health Issue ◽  
Over The Counter ◽  
The Road ◽  
Scoping Reviews ◽  
Data Points ◽  
Monitoring And Surveillance ◽  
On The Road

Purpose. Promoting and ensuring safe use of codeine containing medicines remains a public health issue given the rise in reporting of misuse and dependence particularly in countries where available over–the-counter (OTC). The aim of this unique study was to identify best practices in management of opioid abuse and dependence, particularly codeine, and innovations to meet challenges surrounding safe and compliant use, patient awareness-raising, reducing health harms and enhancing successful treatment of dependence. Methods. A mixed methods approach using three data points was used that included : (1) analysis of data from existing scoping reviews to identify potential areas for innovation (2) interviews with key national stakeholders from public health, pharmaceutical, regulatory, primary care and addiction practice in three distinct regulatory regimes (Ireland, United Kingdom and South Africa); and (3) a circular email request for information on potential innovations to members of the European Medicine’s Agency European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCEPP). Data from these three sources were analysed to identify best practices and opportunities for innovation. Results. Best practices and potential innovations were identified under the nine headings: (1) manufacture; (2) product information and public education; (3) responsible prescribing; (4) monitoring and surveillance; (5) dispensing, screening and brief interventions in community pharmacies; (6) safety in the workplace and on the road; (7) internet supply of codeine and online support; (8) treatment of codeine dependence; and (9) learning resources and training for health professionals. Conclusions. Challenges ensuring availability of codeine containing medicines for legitimate therapeutic use, while minimising misuse, dependence and related health harms warrant consideration of new innovations. Most promising innovative potential lies across the products’ retail lifecycle from manufacture to prescriber and community pharmacy practitioner.This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

Recycling of domestic food waste

2018 ◽  
Vol 120 (11) ◽  
pp. 2710-2715
Author(s):  
Maika Furukawa ◽  
Naoaki Misawa ◽  
John E. Moore
Keyword(s):  
Public Health ◽  
Human Health ◽  
Food Waste ◽  
Animal Health ◽  
Public Health Issue ◽  
Resistant Bacteria ◽  
Global Public Health ◽  
Content Type ◽  
Local Council ◽  
Domestic Food

Purpose Antibiotic resistance (ABR) has now become a major global public health issue. New legislation has recently been introduced in Northern Ireland from April 2017, requiring domestic households to recycle all domestic food waste items. Resulting increases in the volume of such waste which is collected by the local council has driven technologies for the safe recycling of such material including commercial composting. Little is known about the antimicrobial resistance (AMR) profile of such composted food waste materials and hence the purpose of this paper is to characterise total AMR in bacteria isolated from such composted domestic food waste and to consider the potential public health consequences of such material. Design/methodology/approach Finished compost containing food waste material was obtained in the Spring 2017 from a local authority recycling amenity site, which freely distributes such material to the public. Total culturable populations of bacteria were isolated from the composted material and antibiotic susceptibility to six classes of antibiotics, namely florfenicol, fluoroquinolone, aminoglycoside, lincosamide, tetracycline and β-lactam was examined. Findings ABR was greatest for lincomycin > tobramycin > minocycline/amoxycillin > ciprofloxacin > florfenicol. In this study, there was one compost, which showed complete resistance to all antibiotics tested. No compost displayed complete antibiotic sensitivity. Two composts were considered pan-resistant, whilst four were considered multi-resistant. Originality/value This study showed that the total ABR profile of food waste compost is significant, with bacterial populations within the compost having ABR to several classes of antibiotics, which are important and sometimes critical to human health. The application of such materials to enrich and fertilise garden soils in significant volumes inadvertently allows for the artifical and man-made transfer of AMR bacteria and their genes to new environments, which have been hitherto niave to the presence of such AMR properties. The application of such compost horticulturally to enrich soils used to cultivate flowers, fruits and vegetables may have important consequences for human and animal health. Urgent work is now needed to quantify the fate of such antibiotic resistant bacteria from compost to their new environment and risk assessments made to estimate the carriage through to human health.

scholarly journals Complete Genome Sequence of a Novel Multidrug-Resistant Klebsiella pneumoniae Phage, vB_Kpn_IME260

2017 ◽  
Vol 5 (19) ◽  
Author(s):  
Shaozhen Xing ◽  
Xiangchun Pan ◽  
Qiang Sun ◽  
Guangqian Pei ◽  
Xiaoping An ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Phage Therapy ◽  
Bacterial Pathogen ◽  
Genomic Data ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Content Type ◽  
Drug Resistant Bacteria

ABSTRACT Klebsiella pneumoniae is the most common clinically important opportunistic bacterial pathogen and its infection is often iatrogenic. Its drug resistance poses a grave threat to public health. The genomic data reported here comprise an important resource for research on phage therapy in the control of drug-resistant bacteria.

scholarly journals Genomic Characterization of Colistin Heteroresistance in Klebsiella pneumoniae during a Nosocomial Outbreak

2016 ◽  
Vol 60 (11) ◽  
pp. 6837-6843 ◽  
Author(s):  
Teysir Halaby ◽  
Emre Kucukkose ◽  
Axel B. Janssen ◽  
Malbert R. C. Rogers ◽  
Dennis J. Doorduijn ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Population Analysis ◽  
Resistant Bacteria ◽  
Colistin Resistance ◽  
Sequence Element ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
Genomic Characterization ◽  
Insertion Sequence Element

ABSTRACTKlebsiella pneumoniaeis emerging as an important nosocomial pathogen due to its rapidly increasing multidrug resistance, which has led to a renewed interest in polymyxin antibiotics, such as colistin, as antibiotics of last resort. However, heteroresistance (i.e., the presence of a subpopulation of resistant bacteria in an otherwise susceptible culture) may hamper the effectiveness of colistin treatment in patients. In a previous study, we showed that colistin resistance among extended-spectrum-beta-lactamase (ESBL)-producingK. pneumoniaeisolates emerged after the introduction of selective digestive tract decontamination (SDD) in an intensive care unit (ICU). In this study, we investigated heteroresistance to colistin among ESBL-producingK. pneumoniaeisolates by using population analysis profiles (PAPs). We used whole-genome sequencing (WGS) to identify the mutations that were associated with the emergence of colistin resistance in theseK. pneumoniaeisolates. We found five heteroresistant subpopulations, with colistin MICs ranging from 8 to 64 mg/liter, which were derived from five clonally related, colistin-susceptible clinical isolates. WGS revealed the presence of mutations in thelpxM,mgrB,phoQ, andyciMgenes in colistin-resistantK. pneumoniaeisolates. In two strains,mgrBwas inactivated by an IS3-like or ISKpn14insertion sequence element. Complementation intranswith the wild-typemgrBgene resulted in these strains reverting to colistin susceptibility. The MICs for colistin-susceptible strains increased 2- to 4-fold in the presence of the mutatedphoQ,lpxM, andyciMalleles. In conclusion, the present study indicates that heteroresistantK. pneumoniaesubpopulations may be selected for upon exposure to colistin. Mutations inmgrBandphoQhave previously been associated with colistin resistance, but we provide experimental evidence for roles of mutations in theyciMandlpxMgenes in the emergence of colistin resistance inK. pneumoniae.

scholarly journals Deciphering MCR-2 Colistin Resistance

mBio ◽  
2017 ◽  
Vol 8 (3) ◽  
Author(s):  
Jian Sun ◽  
Yongchang Xu ◽  
Rongsui Gao ◽  
Jingxia Lin ◽  
Wenhui Wei ◽  
...  
Keyword(s):  
Public Health ◽  
Lipid A ◽  
Multidrug Resistant ◽  
Zinc Binding ◽  
Resistant Bacteria ◽  
Colistin Resistance ◽  
Gram Negative ◽  
Resistance Protein ◽  
Catalytic Motif ◽  
Potential Challenge

ABSTRACT Antibiotic resistance is a prevalent problem in public health worldwide. In general, the carbapenem β-lactam antibiotics are considered a final resort against lethal infections by multidrug-resistant bacteria. Colistin is a cationic polypeptide antibiotic and acts as the last line of defense for treatment of carbapenem-resistant bacteria. Very recently, a new plasmid-borne colistin resistance gene, mcr-2, was revealed soon after the discovery of the paradigm gene mcr-1, which has disseminated globally. However, the molecular mechanisms for MCR-2 colistin resistance are poorly understood. Here we show a unique transposon unit that facilitates the acquisition and transfer of mcr-2. Evolutionary analyses suggested that both MCR-2 and MCR-1 might be traced to their cousin phosphoethanolamine (PEA) lipid A transferase from a known polymyxin producer, Paenibacillus. Transcriptional analyses showed that the level of mcr-2 transcripts is relatively higher than that of mcr-1. Genetic deletions revealed that the transmembrane regions (TM1 and TM2) of both MCR-1 and MCR-2 are critical for their location and function in bacterial periplasm, and domain swapping indicated that the TM2 is more efficient than TM1. Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) confirmed that all four MCR proteins (MCR-1, MCR-2, and two chimeric versions [TM1-MCR-2 and TM2-MCR-1]) can catalyze chemical modification of lipid A moiety anchored on lipopolysaccharide (LPS) with the addition of phosphoethanolamine to the phosphate group at the 4′ position of the sugar. Structure-guided site-directed mutagenesis defined an essential 6-residue-requiring zinc-binding/catalytic motif for MCR-2 colistin resistance. The results further our mechanistic understanding of transferable colistin resistance, providing clues to improve clinical therapeutics targeting severe infections by MCR-2-containing pathogens. IMPORTANCE Carbapenem and colistin are the last line of refuge in fighting multidrug-resistant Gram-negative pathogens. MCR-2 is a newly emerging variant of the mobilized colistin resistance protein MCR-1, posing a potential challenge to public health. Here we report transfer of the mcr-2 gene by a unique transposal event and its possible origin. Distribution of MCR-2 in bacterial periplasm is proposed to be a prerequisite for its role in the context of biochemistry and the colistin resistance. We also define the genetic requirement of a zinc-binding/catalytic motif for MCR-2 colistin resistance. This represents a glimpse of transferable colistin resistance by MCR-2. IMPORTANCE Carbapenem and colistin are the last line of refuge in fighting multidrug-resistant Gram-negative pathogens. MCR-2 is a newly emerging variant of the mobilized colistin resistance protein MCR-1, posing a potential challenge to public health. Here we report transfer of the mcr-2 gene by a unique transposal event and its possible origin. Distribution of MCR-2 in bacterial periplasm is proposed to be a prerequisite for its role in the context of biochemistry and the colistin resistance. We also define the genetic requirement of a zinc-binding/catalytic motif for MCR-2 colistin resistance. This represents a glimpse of transferable colistin resistance by MCR-2.

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