IntroductionCarbapenemase-producing
(CPE) have rarely been reported in dogs, and never in animals in Finland. However, in April 2015, two meropenem-resistant
were identified from two dogs in one ...family. Both dogs suffered from chronic
.
Epidemiological and molecular investigations (pulsed-field gel electrophoresis (PFGE), multilocus sequence typing) were conducted to investigate the source of infection and transmission routes.
In both dogs and one family member New Delhi metallo-beta-lactamase (NDM-5)-producing multidrug-resistant ST167
was found. Whole genome sequencing confirmed that the isolates were identical or only had one or two allelic differences. Additionally, the dogs and humans of the family carried an identical extended-spectrum beta-lactamase (ESBL) CTX-M-group 9
ST69 strain, indicating interspecies transmission. While the original source remains unclear, human-to-canine transmission is possible. No carbapenems had been administered to the dogs, but exposure to numerous other antimicrobials likely sustained the bacteria and supported its propagation in the canine host.
To our knowledge, canine clinical NDM-5
in Europe, and confirmed CPE transmission between dogs and humans have not been previously reported. The screening of veterinary
isolates for carbapenem resistance is highly recommended.
The Carba NP test was evaluated against a panel of 61 carbapenemase-producing bacterial species (15 producing class A carbapenemases, 15 producing class D carbapenemases, and 31 producing ...metallo-β-lactamases) and against 111 isolates with non-wild-type carbapenem susceptibility but not producing carbapenemase. Carbapenemase production was verified by PCR and UV-spectrophotometric measurement of imipenem hydrolysis. No false positives were seen, but there were consistent problems with the detection of OXA-48-like enzymes and also some rarer class A enzymes.
Antimicrobial resistance (AMR) is a growing concern in public health, particularly for the clinically relevant extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacteriaceae. Studies ...describing ESBL-producing
clinical samples from Finland to the genomic level and investigation of possible zoonotic transmission routes are scarce. This study characterizes ESBL-producing
from clinical samples in Finland using whole genome sequencing (WGS). Comparison is made between animal, food, and environmental sources in Finland to gain insight into potential zoonotic transmission routes and to recognize successful AMR genes, bacterial sequence types (STs), and plasmids. ESBL-producing
isolates (
= 30) obtained from the Eastern Finland healthcare district between 2018 and 2020 underwent WGS and were compared to sequences from non-human and healthy human sources (
= 67) isolated in Finland between 2012 and 2018. A majority of the clinical isolates belonged to ST131 (
= 21; 70%), of which 19 represented O25:H4 and
30 allele, and 2 O16:H5 and
41 allele. Multidrug resistance was common, and the most common
gene identified was
(
= 14; 47%) followed by
(
= 10; 33%).
was identified in 13 out of 21 isolates representing ST131, with 12 isolates belonging to a recently discovered international
ST131 C1-M27 subclade. Isolates were found to be genetically distinct from non-human sources with core genome multilocus sequence typing based analysis. Most isolates (
= 26; 87%) possessed multiple replicons, with IncF family plasmids appearing in 27 (90%) and IncI1 in 5 (17%) isolates. IncFF1:A2:B20 replicon was identified in 11, and IncFF-:A2:B20 in 4 isolates. The results indicate the ST131-C1-M27 clade gaining prevalence in Europe and provide further evidence of the concerning spread of this globally successful pathogenic clonal group. This study is the first to describe ESBL-producing
in human infections with WGS in Finland and provides important information on global level of the spread of ESBL-producing
belonging to the C1-M27 subclade. The results will help guide public health actions and guide future research.
In this study of stringently defined acute otitis media in children in Finland, amoxicillin–clavulanate was shown to significantly reduce the rate of treatment failure and the need for rescue ...treatment but was associated with more diarrhea and rash.
Acute otitis media is the most common bacterial infection during early childhood.
1
Antimicrobial agents have been the primary treatment for this infection since the 1950s, when the first studies showed that antimicrobial therapy improved the outcome.
2
,
3
Nevertheless, there is no consensus regarding the optimal management of acute otitis media.
1
Because the treatment of acute otitis media is a major reason for the use of antimicrobial agents in the outpatient setting, experts have called for these agents to be used judiciously.
4
,
5
Several guidelines for the management of acute otitis media recommend an observation period before antimicrobial therapy is even . . .
Carbapenemase-producing
Enterobacterales
(CPE) pose an increasing threat to patient safety and healthcare systems globally. We present molecular epidemiology of CPE in Finland during 2012–2018 with ...detailed characteristics of CPE strains causing clusters during the same time period. All Finnish clinical microbiology laboratories send
Enterobacterales
isolates with reduced susceptibility to carbapenems or isolates producing carbapenemase to the reference laboratory for further characterization by whole genome sequencing (WGS). In total, 231 CPE strains from 202 patients were identified during 2012–2018. Of the strains, 59% were found by screening and 32% from clinical specimens, the latter were most commonly urine. Travel and/or hospitalization history abroad was reported for 108/171 strains (63%). The most common species were
Klebsiella pneumoniae
(45%),
Escherichia coli
(40%), and
Citrobacter freundii
(6%), and the most common carbapenemase genes
bla
NDM-like
(35%),
bla
OXA-48-like
(33%), and
bla
KPC-like
(31%). During 2012–2018, the annual number of CPE strains increased from 9 to 70 and different sequence types from 7 to 33, and
bla
OXA-48-like
genes became the most prevalent. Of the clusters, 3/8 were linked to traveling or hospitalization abroad and 5/8 were caused by
K. pneumoniae
clone clonal complex 258. Most of the clusters were caused by
K. pneumoniae
producing KPC. High variety among different sequence types indicates that majority of CPE cases detected in Finland are likely imported from foreign countries. Nearly one-third of the cases are not found by screening suggesting that there is hidden transmission occurring in the healthcare settings.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Multi-drug resistance is emerging in
, which is the third most common carbapenemase-producing (CP)
in humans in Finland due to recent outbreaks. The objective of this study was to determine if ...wastewater surveillance (WWS) could detect CP
strains causing infections in humans. Selective culturing was used to isolate CP
from the hospital environment, hospital wastewater, and untreated municipal wastewater in Helsinki, Finland, between 2019 and 2022. Species were identified using MALDI-TOF, and presumptive CP
isolates were subjected to antimicrobial susceptibility testing and further characterized by whole genome sequencing. A genomic comparison was conducted to compare isolates collected from the hospital environment, untreated municipal wastewater, and a selection of isolates from human specimens from two hospitals in the same city. We also examined the persistence of CP
in the hospital environment and the impact of our attempts to eradicate it. Overall, 27
-carrying
were detected in the hospital environment (ST18;
= 23 and ST8;
= 4), while 13
-carrying
(ST8) and five
-carrying (ST421)
were identified in untreated municipal wastewater. CP
was not identified in hospital wastewater. We found three clusters (cluster distance threshold ≤ 10 allelic difference) after comparing the recovered isolates and a selection of isolates from human specimens. The first cluster consisted of ST18 isolates from the hospital environment (
= 23) and human specimens (
= 4), the second consisted of ST8 isolates from the hospital environment (
= 4), untreated municipal wastewater (
= 6), and human specimens (
= 2), and the third consisted of ST421 isolates from the untreated municipal wastewater (
= 5). Our results support previous studies suggesting that the hospital environment could act as a source of transmission of CP
in clinical settings. Furthermore, the eradication of CP Enterobacteriaceae from the hospital environment is challenging. Our findings also showed that CP
is persistent throughout the sewerage system and demonstrate the potential of WWS for detecting CP
.
Abstract Purpose To characterise and compare twenty-eight Finnish Clostridium difficile RT027-like isolates, selected based on the presence of 18 bp deletion in the tcdC gene and toxin gene profile ...(A, B, binary), with eleven RT027 isolates from different Finnish geographical areas and time periods. Methods Twenty-eight C. difficile RT027-like isolates and 11 RT027 comparative strains were characterised by capillary-electrophoresis (CE) ribotyping, multi-locus variable tandem-repeats analysis (MLVA), multi-locus sequence typing (MLST), and sequencing of tcdC and gyrA gene fragments. Susceptibility to moxifloxacin was determined by E-test. Results Of 28 RT027-like isolates, seven RTs (016, 034, 075, 080, 153, 176 and 328), three WEBRIBO types (411, 475, AI-78) and three new profiles (F1–F3) were identified. MLVA revealed six clonal complexes (RTs 016, 027, 176 and F3). MLST showed eleven sequence types (1, 41, 47, 67, 95, 191,192, 223, 229, 264 and new ST). Twenty-two isolates (RTs 016, 080, 176, 328, F1, F2, F3 and WRTAI-78) carried Δ117 in the tcdC gene. Isolates of RTs 016, 027 and 176 were moxifloxacin resistant and harboured Thr82Ile in the GyrA. Conclusion Our results show a high diversity within 28 Finnish RT027-like C. difficile isolates, with twelve CE-ribotyping profiles and eleven STs. MLVA revealed the regional spread of RTs 016, 027, 176 and F3. The presence of Δ117 in the tcdC gene in eight non-027 RTs highlights the importance of careful interpretation of the results from molecular systems targeting this site in the genome of C. difficile and the need of strain typing for epidemiological purposes.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
For over a century, a fundamental objective in infection biology research has been to understand the molecular processes contributing to the origin and perpetuation of epidemics. Divergent hypotheses ...have emerged concerning the extent to which environmental events or pathogen evolution dominates in these processes. Remarkably few studies bear on this important issue. Based on population pathogenomic analysis of 1,200 Streptococcus pyogenes type emm89 infection isolates, we report that a series of horizontal gene transfer events produced a new pathogenic genotype with increased ability to cause infection, leading to an epidemic wave of disease on at least two continents. In the aggregate, these and other genetic changes substantially remodeled the transcriptomes of the evolved progeny, causing extensive differential expression of virulence genes and altered pathogen-host interaction, including enhanced immune evasion. Our findings delineate the precise molecular genetic changes that occurred and enhance our understanding of the evolutionary processes that contribute to the emergence and persistence of epidemically successful pathogen clones. The data have significant implications for understanding bacterial epidemics and for translational research efforts to blunt their detrimental effects.
The confluence of studies of molecular events underlying pathogen strain emergence, evolutionary genetic processes mediating altered virulence, and epidemics is in its infancy. Although understanding these events is necessary to develop new or improved strategies to protect health, surprisingly few studies have addressed this issue, in particular, at the comprehensive population genomic level. Herein we establish that substantial remodeling of the transcriptome of the human-specific pathogen Streptococcus pyogenes by horizontal gene flow and other evolutionary genetic changes is a central factor in precipitating and perpetuating epidemic disease. The data unambiguously show that the key outcome of these molecular events is evolution of a new, more virulent pathogenic genotype. Our findings provide new understanding of epidemic disease.
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