Introduction
Extended-spectrum beta-lactamase (ESBL) producing
Escherichia coli
have become prevalent worldwide, with
E. coli
of sequence type 131 (ST131) as the dominant genotype.
E. coli
ST131 ...predominantly exhibits the serotype O25, is associated with the ESBL CTX-M-15 and belongs to a well-defined subclade within the Fim
H
30-R clade, Fim
H
30-Rx/C2. Multidrug resistance may have fitness costs for the bacteria. The aim of the current study was to investigate the fitness burden compared to a susceptible ST131 isolate without resistance genes
in vitro
and
in vivo
and describe genetic differences between fit and less fit isolates.
Materials and methods
From a collection of clinical ESBL and non-ESBL
E. coli
isolates from urinary tract infection, we selected 16
bla
CTX–M–15
-positive isolates of ST131. The
in vitro
fitness was examined, and relative bacterial fitness (fit
t
) was determined by direct competition with a fully susceptible ST131 isolate and illustrated in percent, with <100% resulting in a lower fitness, compared to the susceptible reference isolate. The isolates were subjected to whole-genome sequencing and analyzed for resistance markers, plasmids, phage content, and serotype.
In vivo
competition was tested in a mouse colonization model.
Results
The majority (12 out of 16) of the CTX-M-15-producing isolates had a slightly lower relative fitness compared to the susceptible ST131 isolate (mean, 97.6%; range, 82.6–108%)
in vitro
. Three isolates had a better fitness than the susceptible ST131 isolate, and one isolate had an identical fitness to the susceptible ST131 isolate. The
in vitro
fitness showed no correlation to the number of plasmids, number of phages, number of resistances, or genome size. For the
in vivo
competition assays, all three ESBL-producing isolates showed better colonization of the ESBL-resistant ST131 isolates compared to the susceptible ST131 isolate.
Conclusion
This study shows that ESBL-producing ST131/
H
30-Rx are not necessarily burdened by multidrug resistance, however, have a better
in vitro
fitness than the susceptible isolate. These data contribute to the understanding of the success of ST131/
H
30-Rx, although they do not indicate ways to overcome this highly fit, virulent, and antimicrobial-resistant clone.
(
) is a Gram-negative bacterium that opportunistically causes nosocomial infections in the lung, bloodstream, and urinary tract. Extended-spectrum β-Lactamases (ESBLs)-expressed
strains are widely ...reported to cause antibiotic resistance and therapy failure. Therefore, early identification of K. pneumonia, especially ESBL-positive strains, is essential in preventing severe infections. However, clinical detection of
requires a time-consuming process in agar disk diffusion. Nucleic acid detection, like qPCR, is precise but requires expensive equipment. Recent research reveals that collateral cleavage activity of CRISPR-LbCas12a has been applied in nucleic acid detection, and the unique testing model can accommodate various testing models.
This study established a system that combined PCR with CRISPR-LbCas12a targeting the
system. Additionally, this study summarized the antibiotic-resistant information of the past five years'
clinic cases in Luohu Hospital and found that the ESBL-positive strains were growing. This study then designs a crRNA that targets
to detect ESBL-resistant
. This work is to detect
and ESBL-positive strains' nucleic acid using CRISPR-Cas12 technology. We compared PCR-LbCas12 workflow with PCR and qPCR techniques.
This system showed excellent detection specificity and sensitivity in both bench work and clinical samples. Due to its advantages, its application can meet different detection requirements in health centers where qPCR is not accessible. The antibiotic-resistant information is valuable for further research.
We report a 15 year-old Nigerian adolescent male with chronic osteomyelitis caused by an extensively drug-resistant (XDR)
strain of sequence type 773 (ST773) carrying
and an extended spectrum ...β-lactamase (ESBL)-producing
strain. The patient developed neurological side effects in the form of circumoral paresthesia with polymyxin B and asymptomatic elevation of transaminases with aztreonam (used in combination with ceftazidime-avibactam). Cefiderocol treatment for 14 weeks plus bone implantation resulted in apparent cure and avoided amputation.
We investigated the effect of international travel on the gut resistome of 122 healthy travelers from the Netherlands by using a targeted metagenomic approach. Our results confirm high acquisition ...rates of the extended-spectrum β-lactamase encoding gene blaCTX-M, documenting a rise in prevalence from 9.0% before travel to 33.6% after travel (p<0.001). The prevalence of quinolone resistance encoding genes qnrB and qnrS increased from 6.6% and 8.2% before travel to 36.9% and 55.7% after travel, respectively (both p<0.001). Travel to Southeast Asia and the Indian subcontinent was associated with the highest acquisition rates of qnrS and both blaCTX-M and qnrS, respectively. Investigation of the associations between the acquisitions of the blaCTX-M and qnr genes showed that acquisition of a blaCTX-M gene was not associated with that of a qnrB (p = 0.305) or qnrS (p = 0.080) gene. These findings support the increasing evidence that travelers contribute to the spread of antimicrobial drug resistance.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The epidemiology of antibiotic-resistant Enterobacteriaceae intestinal carriage in healthy US children has not been well characterized.
Children between 14 days and 14 years of age were enrolled ...during well-child visits in Oakland, California, Kansas City, Kansas, and Nashville, Tennessee, between December 2013 and March 2015. Data on recent antibiotic use by the child and travel and hospitalization history of all members of each child's household were obtained with a risk-factor survey. Stool specimens collected from the subjects were screened for extended-spectrum β-lactamase-producing (ESBL-P) bacteria using CHROMagar ESBL medium. Putative ESBL-P Escherichia coli and Klebsiella colonies underwent phenotypic confirmation by double-disk synergy testing; confirmed third-generation cephalosporin-resistant (3GCR) isolates underwent additional antibiotic-susceptibility testing.
In 519 subjects, the overall 3GCR Enterobacteriaceae carriage rate was 4.4% (n = 23) and ranged from 3.4% to 5.1% among the study sites. The ESBL-P Enterobacteriaceae carriage rate was 3.5% (n = 18). The rates of 3GCR Enterobacteriaceae carriage was highest in 1 to <2 year olds at 6.5%, and was 5.2% in <5 year-olds vs 1.7% in ≥5-year-olds (P = .11). 3GCR and ESBL-P Enterobacteriaceae carriage was associated with international travel within the previous year; 11.1% of ESBL-P Enterobacteriaceae carriers reported this history compared with 1.6% of noncarriers (P = .004). No other queried factor was found to increase risk. Of the 24 analyzed 3GCR isolates, 58% were multidrug resistant.
The 3GCR Enterobacteriaceae carriage rate exceeds 5% in healthy US children <5 years of age. International travel within the previous year increased the risk of 3GCR and ESBL-P Enterobacteriaceae carriage. In contrast, we found no differences in the rates of hospitalization or recent antibiotic exposure between carriers and noncarriers. Young children, who have the highest prevalence of colonization, might be a sentinel population to study to gain a better understanding of community sources of antibiotic-resistant Enterobacteriaceae.
BACKGROUNDDue to the recent appearance of organisms that are resistant to several drugs (multidrug-resistant) like Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL, concerns have ...remarkably increased regarding the suitable treatment of infections. The present study was an investigation into ESBL molecular characteristics among clinical isolates of Klebsiella pneumoniae and Escherichia coli resulting in urinary tract infections (UTIs) and their pattern of antimicrobial resistance in order to come up with helpful information on the epidemiology of these infections and risk factors accompanied with them. METHODSIn order to conduct the study, 20 K. pneumoniae and 48 E. coli were isolated and retrieved from thalassemia center in Erbil, Iraq during July 2016 and September 2016. The collected strains were analyzed and the profile of their antimicrobial susceptibility was specified. In order to spot β-lactamase genes (i.e. blaTEM, blaSHV, and blaCTX-M), polymerase chain reaction was conducted. RESULTSThe findings obtained from multiplex PCR assay showed that out of the collected strains of ESBL-producing E. coli, had 81% blaTEM, 16.2% blaSHV, and 32.4% blaCTX-M genes. Similarly, 64.7% blaTEM, 35.2% blaSHV, and 41.1% blaCTX-M genes existed in the isolates of K. pneumoniae. It was found that antibiotic resistance pattern of E. coli and K. pneumoniae isolates to 20 antibiotics varied widely. It was also concluded that the majority of the K. pneumoniae and E. coli isolates were multi-drug resistant (MDR). Moreover, 75% and 87.5% of respectively K. pneumoniae and E. coli isolates showed the MDR phenotypes. CONCLUSIONTEM prevalence was high among other types of ESBLs. Over all, the most active antimicrobial agents in vitro remained to be the carbapenems.
Introduction
The rise in extended-spectrum beta-lactamase (ESBL)-producing
Enterobacteriaceae
in dairy cattle farms poses a risk to human health as they can spread to humans through the food chain, ...including raw milk. This study was designed to determine the status, antimicrobial resistance, and pathogenic potential of ESBL-producing -
E. coli
and -
Klebsiella
spp. isolates from bulk tank milk (BTM).
Methods
Thirty-three BTM samples were collected from 17 dairy farms and screened for ESBL-
E. coli
and -
Klebsiella
spp. on CHROMagar ESBL plates. All isolates were confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and subjected to antimicrobial susceptibility testing and whole genome sequencing (WGS).
Results
Ten presumptive ESBL-producing bacteria, eight
E. coli
, and two
K. pneumoniae
were isolated. The prevalence of ESBL-
E. coli
and -
K. pneumoniae
in BTM was 21.2% and 6.1%, respectively. ESBL-
E. coli
were detected in 41.2% of the study farms. Seven of the ESBL-
E. coli
isolates were multidrug resistant (MDR). The two ESBL-producing
K. pneumoniae
isolates were resistant to ceftriaxone. Seven ESBL-
E. coli
strains carry the
bla
CTX-M
gene, and five of them co-harbored
bla
TEM-1
. ESBL-
E. coli
co-harbored
bla
CTX-M
with other resistance genes, including
qnr
B
19
,
tet
(A),
aad
A1,
aph(3’’)
-Ib,
aph(6)
-Id),
floR
,
sul2
, and chromosomal mutations (
gyrA, gyrB, parC, parE, and pmrB
). Most
E. coli
resistance genes were associated with mobile genetic elements, mainly plasmids. Six sequence types (STs) of
E. coli
were detected. All ESBL-
E. coli
were predicted to be pathogenic to humans. Four STs (three ST10 and ST69) were high-risk clones of
E. coli
. Up to 40 virulence markers were detected in all
E. coli
isolates. One of the
K. pneumoniae
was ST867; the other was novel strain.
K. pneumoniae
isolates carried three types of beta-lactamase genes (
bla
CTX-M
,
bla
TEM-1
and
bla
SHV
). The novel
K. pneumoniae
ST also carried a novel IncFII(K) plasmid ST.
Conclusion
Detection of high-risk clones of MDR ESBL-
E. coli
and ESBL-
K. pneumoniae
in BTM indicates that raw milk could be a reservoir of potentially zoonotic ESBL-
E. coli
and -
K. pneumoniae
.
•Records covering 793,954 E. coli isolates from 1022 clinical laboratories.•ESBL-E.coli rates compared before and after the lockdown in march 2020 in france.•ESBL-E.coli rates in primary cares ...decreased from 3.1% before to 2.9% (p < 0.001).•Sustainable reduction in ESBL-E.coli rates (−0.07%/month, p < 0.001) after the lockdown.•In nursing homes, the reduction rate accelerated from −0.04 to −0.22%/month.
We investigated the impact of the COVID-19 and national pandemic response on the epidemiology of Extended Spectrum Beta-Lactamase producing E. coli (ESBL-E.coli) in France.
Individual microbiology records from clinical laboratories were analyzed between 1 January 2019 to 31 December 2020. The ESBL-E.coli rates from clinical samples of patients in primary care and nursing home residents were compared before and after the general lockdown in March 2020, according to demographic and geographical characteristics. Interrupted time series analyses were performed to detect measurable changes in the trend of ESBL-E.coli rates.
Records covering 793,954 E. coli isolates from 1022 clinical laboratories were analyzed. In primary care, 3.1% of E. coli isolates from clinical samples were producing ESBL before March 2020 and 2.9% since May 2020 (p < 0.001). The proportion of ESBL-E.coli decreased significantly among urine cultures, females, age categories 5–19, 40–64, > 65 year-old, and in the North, West, East and South-East regions. In nursing home, the ESBL-E.coli rate was 9.3% (monthly rate min-max: 6.5–10.5%) before March 2020 and 8.3% (7.2–9.1%) since May 2020 (p < 0.001). The reduction rate accelerated from -0.04%/month to -0.22%/month from May 2020 (p < 0.001).
Investigation of factors that led to the decreased proportion of ESBL-E.coli during the COVID-19 pandemic is urgently needed.
•Prevalence of colistin resistance was 76.9% in pigs suffering post-weaning diarrhoea (PWD) in Spain.•mcr-1, mcr-4 and mcr-5 were detected in 26.4%, 72.8% and 3.6%, respectively.•Co-occurrence of ...mcr-1, mcr-4 and mcr-5 was found in five isolates.•Two novel mcr-4 variants were identified.•ST10-A (CH11-24) clonal group plays a key role in the spread of mcr-4.
Colistin is an antimicrobial polypeptide commonly employed for controlling and treating neonatal and post-weaning diarrhoea (PWD) diseases caused by Enterotoxigenic and Shiga toxin-producing Escherichia coli (ETEC and STEC). The plasmid-mediated colistin resistance gene, mcr-1 was first described in late 2015 and, since then, multiple studies have reported its global distribution. In addition, five different mcr genes have been identified. The aim of this study was to characterise the colistin-resistant E. coli clonal groups implicated in PWD in farms of intensive pig production. Of 186 ETEC and STEC isolated in Spain from 2006 to 2017, 76.9% showed resistance to colistin. Of those, 102 were mcr-4 carriers, 37 mcr-1 and 5 mcr-5, with co-occurrence of mcr-1/mcr-4, mcr-1/mcr-5 and mcr-4/mcr-5 in five isolates. Three different mcr-4 variants were detected, including the new mcr-4.4 and mcr-4.5 described here. Interestingly, the clonal group ST10-A (CH11-24) appears to be primarily responsible for the spread of mcr-4. In summary, our results show that the pig industry is an important reservoir of colistin-resistant E. coli, carriers of other additional risk genes, such as blaESBL. These food-producing animals might be spreading a cocktail of multiple resistances, posing a worrisome threat to human health.
Abstract Increasing antimicrobial resistance in urinary tract infections (UTI) is a concern. To evaluate resistance trends, 3498 Escherichia coli UTI isolates were collected from 2010 to 2014 in the ...Study for Monitoring Antimicrobial Resistance Trends (SMART) in Canada and United States (US). ESBL phenotype and susceptibility were determined using CLSI microdilution and breakpoints. US ESBL rates increased in 2010–2014 (7.8–18.3%, P < 0.0001), especially among hospital-associated (HA) infections, males, and older patients (≥65 years). Overall, ESBL rates in Canada showed no significant trend (10.4-13.0%. P = 0.079), and were lower than US rates in recent years, but increased significantly among community-associated (CA) infections, females, and older patients. In the US, but not Canada, susceptibility to cephalosporins and fluoroquinolones among 2013–2014 isolates was significantly lower in isolates from HA than CA UTI, males than females, and ≥65- than <65-year-olds. These observations confirm increasing resistance in E. coli . Subgroup analyses like these may help direct empirical therapy.
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