Molecular Epidemiology of Antimicrobial Resistance

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Antimicrobial Agents and Resistance".

Deadline for manuscript submissions: closed (31 March 2021) | Viewed by 28067

Special Issue Editors

Department of Public Health, University of Naples Federico II, Naples, Italy
Interests: genotyping; horizontal gene transfer of antimicrobial resistance; MDR Acinetobacter baumannii; MDR Klebsiella pneumoniae; molecular epidemiology of healthcare-associated infections
Special Issues, Collections and Topics in MDPI journals
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
Interests: carbapenemase-producing Klebsiella pneumoniae; ceftazidime-avibactam resistance in KPC-producing microorganisms; ceftolozane-tazobactam-resistant P. aeruginosa
Special Issues, Collections and Topics in MDPI journals
Team Resist, UMR-1184 (INSERM—Université Paris-Saclay—CEA), LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France
Interests: genetic; genomics; epidemiology; antibiotic resistance; acinetobacter; enterobacterales; horizontal gene transfer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

Antimicrobial resistance and multidrug-resistant organisms currently constitute a severe public health problem. Multidrug-resistant organisms are resistant to multiple antibiotic classes, resulting in limited therapeutic options and difficult-to-treat health-care-associated and community infections, with high morbidity and mortality rates. In particular, carbapenem-resistant (CR) Acinetobacter baumannii, CR Pseudomonas aeruginosa, CR Enterobacterales, methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus spp. are recognized by the World Health Organization as global priority pathogens of critical or high priority (doi:10.1590/S0100-15742013000100018). It is therefore evident that infections by multidrug-resistant organisms entail challenges in their detection, control, and management.

This Special Issue is dedicated to updates on the “Molecular Epidemiology of Antimicrobial Resistance”.

We invite contributors to submit original research papers, reviews, short notes, or commentaries in the following primary areas:
a) new or changing patterns in the epidemiology of multidrug-resistant organisms and antimicrobial resistances;
b) molecular determinants, genetic and genomic elements of antimicrobial resistance;
c) diagnostics and detection methods of antimicrobial resistances;
d) description of new mechanisms of resistance to antimicrobial compounds of clinical interest; and
e) management, therapeutics, and strategies for the prevention and control of infections caused by multidrug-resistant organisms.

Prof. Dr. Raffaele Zarrilli
Assist. Prof. Tommaso Giani
Assoc. Prof. Rémy A. Bonnin
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • molecular epidemiology of antimicrobial resistance
  • CR Enterobacterales
  • CR Acinetobacter baumannii
  • methicillin-resistant Staphylococcus aureus
  • diagnostics
  • mobile genetic elements
  • antimicrobial therapy

Published Papers (12 papers)

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Editorial

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2 pages, 208 KiB  
Editorial
Editorial: Special Issue “Molecular Epidemiology of Antimicrobial Resistance”
by Raffaele Zarrilli, Tommaso Giani and Rémy A. Bonnin
Microorganisms 2023, 11(3), 579; https://doi.org/10.3390/microorganisms11030579 - 24 Feb 2023
Cited by 1 | Viewed by 785
Abstract
Antimicrobial resistance and multidrug-resistant organisms currently constitute a severe public health problem [...] Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)

Research

Jump to: Editorial, Other

13 pages, 611 KiB  
Article
Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience
by Arta Karruli, Jacopo de Cristofaro, Roberto Andini, Domenico Iossa, Mariano Bernardo, Cristiano Amarelli, Irene Mattucci, Rosa Zampino, Raffaele Zarrilli and Emanuele Durante-Mangoni
Microorganisms 2021, 9(6), 1210; https://doi.org/10.3390/microorganisms9061210 - 03 Jun 2021
Cited by 6 | Viewed by 2050
Abstract
(1) Background: The aim of this study was to assess risk factors for multidrug-resistant/extensively drug-resistant (MDR/XDR) bacterial infections in heart transplant (HT) patients within three months after surgery and its impact on patient outcome. (2) Methods: Retrospective analysis of clinical, hemato-chemical, imaging, treatment [...] Read more.
(1) Background: The aim of this study was to assess risk factors for multidrug-resistant/extensively drug-resistant (MDR/XDR) bacterial infections in heart transplant (HT) patients within three months after surgery and its impact on patient outcome. (2) Methods: Retrospective analysis of clinical, hemato-chemical, imaging, treatment and outcome data from 47 heart transplant recipients from January 2016 to December 2018. MDR/XDR infections were compared to non-MDR/XDR and noninfected patients. (3) Results: Most participants were males, median age 51 years: 35 (74.5%) developed an infection after HT; 14 (29.8%) were MDR/XDR infections. Prolonged hospital stay before HT correlated to MDR/XDR infection (p < 0.001). Sequential organ failure assessment (SOFA) score at sampling day was higher in MDR/XDR (p = 0.027). MDR/XDR were mostly blood-stream (BSI) (p = 0.043) and skin-soft tissue (SSTI) (p = 0.047) infections. Gram-negative infections were the most frequent, specifically carbapenem-resistant Klebsiella pneumoniae. Antibiotic therapy duration for MDR/XDR infections was longer (p = 0.057), eradication rate lower (p = 0.083) and hospital stay longer (p = 0.005) but not associated with a worse outcome. (4) Conclusions: MDR/XDR infections affect compromised HT recipients with a history of prolonged hospitalization, causing a lower rate of eradication and increased hospital stay. These frequently present as BSI and SSTI. We emphasize the need to prevent contamination of central venous catheters and the surgical site. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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11 pages, 1426 KiB  
Article
First Report of blaNDM-1 Bearing IncX3 Plasmid in Clinically Isolated ST11 Klebsiella pneumoniae from Pakistan
by Hazrat Bilal, Gaojian Zhang, Tayyab Rehman, Jianxion Han, Sabir Khan, Muhammad Shafiq, Xuegang Yang, Zhongkang Yan and Xingyuan Yang
Microorganisms 2021, 9(5), 951; https://doi.org/10.3390/microorganisms9050951 - 28 Apr 2021
Cited by 16 | Viewed by 2554
Abstract
The New Delhi Metallo-β-lactamase (NDM) is among the most threatening forms of carbapenemases produced by K. pneumoniae, well-known to cause severe worldwide infections. The molecular epidemiology of blaNDM-1-harboring K. pneumoniae is not well elucidated in Pakistan. Herein, we aim to [...] Read more.
The New Delhi Metallo-β-lactamase (NDM) is among the most threatening forms of carbapenemases produced by K. pneumoniae, well-known to cause severe worldwide infections. The molecular epidemiology of blaNDM-1-harboring K. pneumoniae is not well elucidated in Pakistan. Herein, we aim to determine the antibiotics-resistance profile, genes type, molecular type, and plasmid analysis of 125 clinically isolated K. pneumoniae strains from urine samples during July 2018 to January 2019 in Pakistan. A total of 34 (27.2%) K. pneumoniae isolates were carbapenemases producers, and 23 (18.4%) harbored the blaNDM-1 gene. The other carbapenemases encoding genes, i.e., blaIMP-1 (7.2%), blaVIM-1 (3.2%), and blaOXA-48 (2.4%) were also detected. The Multi Locus Sequence Typing (MLST) results revealed that all blaNDM-1-harboring isolates were ST11. The other sequence types detected were ST1, ST37, and ST105. The cluster analysis of Xbal Pulsed Field Gel Electrophoresis (PFGE) revealed variation amongst the clusters of the identical sequence type isolates. The blaNDM-1 gene in all of the isolates was located on a 45-kb IncX3 plasmid, successfully transconjugated. For the first time, blaNDM-1-bearing IncX3 plasmids were identified from Pakistan, and this might be a new primary vehicle for disseminating blaNDM-1 in Enterobacteriaceae as it has a high rate of transferability. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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7 pages, 203 KiB  
Communication
Detection of KPC, NDM and VIM-Producing Organisms Directly from Rectal Swabs by a Multiplex Lateral Flow Immunoassay
by Alexandra Vasilakopoulou, Polyxeni Karakosta, Sophia Vourli, Eleni Kalogeropoulou and Spyros Pournaras
Microorganisms 2021, 9(5), 942; https://doi.org/10.3390/microorganisms9050942 - 27 Apr 2021
Cited by 12 | Viewed by 1902
Abstract
We report a preliminary evaluation of the NG-Test CARBA 5 immunochromatographic assay for detecting carbapenemases directly from rectal swabs on the same day of sampling. Thirty fecal swabs were examined for carbapenemase-producing organisms (CPOs) by conventional culture, PCR, and NG-Test CARBA 5. Each [...] Read more.
We report a preliminary evaluation of the NG-Test CARBA 5 immunochromatographic assay for detecting carbapenemases directly from rectal swabs on the same day of sampling. Thirty fecal swabs were examined for carbapenemase-producing organisms (CPOs) by conventional culture, PCR, and NG-Test CARBA 5. Each sample was tested by the immunochromatographic assay five times, including direct testing and incubation in trypticase soy broth for 1, 2, 3, and 4 h. Twenty patients yielded CPOs by culture. Immunochromatographic and PCR results were concordant and detected the same 25 carbapenemases (11 KPC, 8 VIM, and 6 NDM). In five cases, we detected co-carriage of KPC and VIM. Compared with PCR, the sensitivity of NG-Test CARBA 5 for the detection of KPC, VIM, and NDM was 80% without incubation, 88% with one hour, 92% with two, and 100% with three hours incubation, while specificity was 100% for all time points. All samples containing adequate fecal content were detected by NG-Test CARBA 5 concordantly with PCR, without incubation. NG-Test CARBA 5 is a reliable test that rapidly detects the presence of carbapenemases at the same day of sampling, directly from rectal swabs. It thus provides early information to guide antimicrobial treatment and infection control interventions. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
23 pages, 3919 KiB  
Article
Detection of a New Resistance-Mediating Plasmid Chimera in a blaOXA-48-Positive Klebsiella pneumoniae Strain at a German University Hospital
by Julian Schwanbeck, Wolfgang Bohne, Ufuk Hasdemir, Uwe Groß, Yvonne Pfeifer, Boyke Bunk, Thomas Riedel, Cathrin Spröer, Jörg Overmann, Hagen Frickmann and Andreas E. Zautner
Microorganisms 2021, 9(4), 720; https://doi.org/10.3390/microorganisms9040720 - 31 Mar 2021
Cited by 5 | Viewed by 2513
Abstract
Mobile genetic elements, such as plasmids, facilitate the spread of antibiotic resistance genes in Enterobacterales. In line with this, we investigated the plasmid-resistome of seven blaOXA-48 gene-carrying Klebsiella pneumoniae isolates, which were isolated between 2013 and 2014 at the University Medical Center [...] Read more.
Mobile genetic elements, such as plasmids, facilitate the spread of antibiotic resistance genes in Enterobacterales. In line with this, we investigated the plasmid-resistome of seven blaOXA-48 gene-carrying Klebsiella pneumoniae isolates, which were isolated between 2013 and 2014 at the University Medical Center in Göttingen, Germany. All isolates were subjected to complete genome sequencing including the reconstruction of entire plasmid sequences. In addition, phenotypic resistance testing was conducted. The seven isolates comprised both disease-associated isolates and colonizers isolated from five patients. They fell into two clusters of three sequence type (ST)101 and two ST11 isolates, respectively; and ST15 and ST23 singletons. The seven isolates harbored various plasmids of the incompatibility (Inc) groups IncF, IncL/M, IncN, IncR, and a novel plasmid chimera. All blaOXA-48 genes were encoded on the IncL/M plasmids. Of note, distinct phenotypical resistance patterns associated with different sets of resistance genes encoded by IncL/M and IncR plasmids were observed among isolates of the ST101 cluster in spite of high phylogenetic relatedness of the bacterial chromosomes, suggesting nosocomial transmission. This highlights the importance of plasmid uptake and plasmid recombination events for the fast generation of resistance variability after clonal transmission. In conclusion, this study contributes a piece in the puzzle of molecular epidemiology of resistance gene-carrying plasmids in K. pneumoniae in Germany. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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22 pages, 7747 KiB  
Article
Epidemic HI2 Plasmids Mobilising the Carbapenemase Gene blaIMP-4 in Australian Clinical Samples Identified in Multiple Sublineages of Escherichia coli ST216 Colonising Silver Gulls
by Hassan Tarabai, Ethan R. Wyrsch, Ibrahim Bitar, Monika Dolejska and Steven P. Djordjevic
Microorganisms 2021, 9(3), 567; https://doi.org/10.3390/microorganisms9030567 - 10 Mar 2021
Cited by 21 | Viewed by 4163
Abstract
Escherichia coli ST216, including those that carry blaKPC-2, blaFOX-5, blaCTX-M-15 and mcr-1, have been linked to wild and urban-adapted birds and the colonisation of hospital environments causing recalcitrant, carbapenem-resistant human infections. Here we sequenced 22 multiple-drug resistant [...] Read more.
Escherichia coli ST216, including those that carry blaKPC-2, blaFOX-5, blaCTX-M-15 and mcr-1, have been linked to wild and urban-adapted birds and the colonisation of hospital environments causing recalcitrant, carbapenem-resistant human infections. Here we sequenced 22 multiple-drug resistant ST216 isolates from Australian silver gull chicks sampled from Five Islands, of which 21 carried nine or more antibiotic resistance genes including blaIMP-4 (n = 21), blaTEM-1b (n = 21), aac(3)-IId (n = 20), mph(A) (n = 20), catB3 (n = 20), sul1 (n = 20), aph(3”)-Ib (n = 18) and aph(6)-Id (n = 18) on FIB(K) (n = 20), HI2-ST1 (n = 11) and HI2-ST3 (n = 10) plasmids. We show that (i) all HI2 plasmids harbour blaIMP-4 in resistance regions containing In809 flanked by IS26 (HI2-ST1) or IS15DI (HI2-ST3) and diverse metal resistance genes; (ii) HI2-ST1 plasmids are highly related to plasmids reported in diverse Enterobacteriaceae sourced from humans, companion animals and wildlife; (iii) HI2 were a feature of the Australian gull isolates and were not observed in international ST216 isolates. Phylogenetic analyses identified close relationships between ST216 from Australian gull and clinical isolates from overseas. E. coli ST216 from Australian gulls harbour HI2 plasmids encoding resistance to clinically important antibiotics and metals. Our studies underscore the importance of adopting a one health approach to AMR and pathogen surveillance. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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10 pages, 1430 KiB  
Communication
High Prevalence of Carbapenemase-Producing Acinetobacter baumannii in Wound Infections, Ghana, 2017/2018
by Mathieu Monnheimer, Paul Cooper, Harold K. Amegbletor, Theresia Pellio, Uwe Groß, Yvonne Pfeifer and Marco H. Schulze
Microorganisms 2021, 9(3), 537; https://doi.org/10.3390/microorganisms9030537 - 05 Mar 2021
Cited by 12 | Viewed by 2267
Abstract
Three years after a prospective study on wound infections in a rural hospital in Ghana revealed no emergence of carbapenem-resistant bacteria we initiated a new study to assess the prevalence of multidrug-resistant pathogens. Three hundred and one samples of patients with wound infections [...] Read more.
Three years after a prospective study on wound infections in a rural hospital in Ghana revealed no emergence of carbapenem-resistant bacteria we initiated a new study to assess the prevalence of multidrug-resistant pathogens. Three hundred and one samples of patients with wound infections were analysed for the presence of resistant bacteria in the period August 2017 till March 2018. Carbapenem-resistant Acinetobacter (A.) baumannii were further characterized by resistance gene sequencing, PCR-based bacterial strain typing, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST “Oxford scheme”). A. baumanni was detected in wound infections of 45 patients (15%); 22 isolates were carbapenem-resistant. Carbapenemases NDM-1 and/or OXA-23 were detected in all isolates; two isolates harboured additionally OXA-420. PFGE and MLST analyses confirmed the presence of one A. baumannii strain in 17 patients that was assigned to the worldwide spread sequence type ST231 and carried NDM-1 and OXA-23. Furthermore, two new A. baumannii STs (ST2145 and ST2146) were detected in two and three patients, respectively. Within three years the prevalence of carbapenem-resistant A. baumannii increased dramatically in the hospital. The early detection of multidrug-resistant bacteria and prevention of their further spread are only possible if continuous surveillance and molecular typing will be implemented. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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12 pages, 7793 KiB  
Article
Genomic Characterization of Clinical Extensively Drug-Resistant Acinetobacter pittii Isolates
by Peechanika Chopjitt, Nuntiput Putthanachote, Ratchadaporn Ungcharoen, Rujirat Hatrongjit, Parichart Boueroy, Yukihiro Akeda, Kazunori Tomono, Shigeyuki Hamada and Anusak Kerdsin
Microorganisms 2021, 9(2), 242; https://doi.org/10.3390/microorganisms9020242 - 25 Jan 2021
Cited by 9 | Viewed by 2281
Abstract
Carbapenem-resistant Acinetobacter pittii (CRAP) is a causative agent of nosocomial infections. This study aimed to characterize clinical isolates of CRAP from a tertiary hospital in Northeast Thailand. Six isolates were confirmed as extensively drug-resistant Acinetobacter pittii (XDRAP). The blaNDM-1 gene was detected [...] Read more.
Carbapenem-resistant Acinetobacter pittii (CRAP) is a causative agent of nosocomial infections. This study aimed to characterize clinical isolates of CRAP from a tertiary hospital in Northeast Thailand. Six isolates were confirmed as extensively drug-resistant Acinetobacter pittii (XDRAP). The blaNDM-1 gene was detected in three isolates, whereas blaIMP-14 and blaIMP-1 were detected in the others. Multilocus sequence typing with the Pasteur scheme revealed ST220 in two isolates, ST744 in two isolates, and ST63 and ST396 for the remaining two isolates, respectively. Genomic characterization revealed that six XDRAP genes contained antimicrobial resistance genes: ST63 (A436) and ST396 (A1) contained 10 antimicrobial resistance genes, ST220 (A984 and A864) and ST744 (A56 and A273) contained 9 and 8 antimicrobial resistance genes, respectively. The single nucleotide polymorphism (SNP) phylogenetic tree revealed that the isolates A984 and A864 were closely related to A. pittii YB-45 (ST220) from China, while A436 was related to A. pittii WCHAP100020, also from China. A273 and A56 isolates (ST744) were clustered together; these isolates were closely related to strains 2014S07-126, AP43, and WCHAP005069, which were isolated from Taiwan and China. Strict implementation of infection control based upon the framework of epidemiological analyses is essential to prevent outbreaks and contain the spread of the pathogen. Continued surveillance and close monitoring with molecular epidemiological tools are needed. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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8 pages, 1542 KiB  
Communication
The Amino Acid Changes T55A, A273P and R277C in the Beta-Lactamase CTX-M-14 Render E. coli Resistant to the Antibiotic Nitrofurantoin, a First-Line Treatment of Urinary Tract Infections
by Yasir Edowik, Thomas Caspari and Hugh Merfyn Williams
Microorganisms 2020, 8(12), 1983; https://doi.org/10.3390/microorganisms8121983 - 13 Dec 2020
Cited by 6 | Viewed by 1933
Abstract
The antibiotic nitrofurantoin is a furan flanked by a nitro group and a hydantoin ring. It is used to treat lower urinary tract infections (UTIs) that have a lifetime incidence of 50−60% in adult women. UTIs are typically caused by uropathogenic Escherichia coli [...] Read more.
The antibiotic nitrofurantoin is a furan flanked by a nitro group and a hydantoin ring. It is used to treat lower urinary tract infections (UTIs) that have a lifetime incidence of 50−60% in adult women. UTIs are typically caused by uropathogenic Escherichia coli (UPEC), which are increasingly expressing extended-spectrum beta-lactamases (ESBL), rendering them multi-drug resistant. Nitrofurantoin is a first-line treatment for gram-negative ESBL-positive UTI patients, given that resistance to it is still rare (0% to 4.4%). Multiplex PCR of β-lactamase genes of the blaCTX-M groups 1, 2, 9 and 8/25 from ESBL-positive UTI patients treated at three referral hospitals in North Wales (UK) revealed the presence of a novel CTX-M-14-like gene harbouring the missense mutations T55A, A273P and R277C. While R277 is close to the active site, T55 and A273 are both located in external loops. Recombinant expression of CTX-M-14 and the mutated CTX-M-14 in the periplasm of E. coli revealed a significant increase in the Minimum Inhibitory Concentration (MIC) for nitrofurantoin from ≥6 μg/mL (CTX-M-14) to ≥512 μg/mL (mutated CTX-M-14). Consistent with this finding, the mutated CTX-M protein hydrolysed nitrofurantoin in a cell-free assay. Detection of a novel nitrofurantoin resistance gene indicates an emerging clinical problem in the treatment of gram-negative ESBL-positive UTI patients. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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15 pages, 3476 KiB  
Article
In Vitro and In Vivo Evaluations of β-Lactam/β-Lactamase Mono- and Combined Therapies against Carbapenem-Nonsusceptible Enterobacteriaceae in Taiwan
by Tsung-Ying Yang, Ya-Ju Hsieh, Li-Ting Kao, Guan-Hong Liu, Shao-Hsuan Lian, Liang-Chun Wang, I-Ling Lin, Yu-Tzu Lin, Sheng-Fan Wang, Sung-Pin Tseng and Po-Liang Lu
Microorganisms 2020, 8(12), 1981; https://doi.org/10.3390/microorganisms8121981 - 12 Dec 2020
Cited by 4 | Viewed by 1926
Abstract
Increasing carbapenem resistance rates worldwide underscored the urgent need of novel antimicrobials. Ceftazidime–avibactam and aztreonam–avibactam combinations are developed to combat carbapenem resistance, but biological and geographic variations must be considered for antibiotic susceptibility patterns varied. Thus, we sought to assess the susceptibilities of [...] Read more.
Increasing carbapenem resistance rates worldwide underscored the urgent need of novel antimicrobials. Ceftazidime–avibactam and aztreonam–avibactam combinations are developed to combat carbapenem resistance, but biological and geographic variations must be considered for antibiotic susceptibility patterns varied. Thus, we sought to assess the susceptibilities of ceftazidime–avibactam and aztreonam–avibactam against 660 carbapenem-nonsusceptible Enterobacteriaceae isolates (472 Klebsiella pneumoniae and 188 Escherichia coli) collected during an earlier Taiwan surveillance study. Agar dilution method was used to determine ceftazidime–avibactam and aztreonam–avibactam susceptibility. Metallo-carbapenemase’s contribution to resistance were investigated with EDTA addition. The in vivo efficacies were evaluated using a Caenorhabditis elegans model. High susceptibility rates were observed for ceftazidime–avibactam and aztreonam–avibactam against the 472 carbapenem-nonsusceptible K. pneumoniae (CnsKP) (85.2% and 95.3%, respectively) and 188 carbapenem-nonsusceptible E. coli (CnsEC) isolates (91.5% and 94.1%, respectively). For non-metallo-carbapenemase producers, the susceptibility rates for ceftazidime–avibactam were 93.6% for CnsKP and 97.7% for CnsEC, whereas only 7.1% CnsKP and 11.1% CnsEC in metallo-carbapenemase producers were susceptible to ceftazidime–avibactam. Of all isolates, 95.3% CnsKP and 94.1% CnsEC were susceptible to aztreonam–avibactam. In C. elegans model, ceftazidime–avibactam and aztreonam–avibactam revealed effective against a blaKPC-producing K. pneumoniae isolate in vivo. Our results propose a positive therapeutic approach for both combinations against carbapenem-nonsusceptible Enterobacteriaceae in Taiwan. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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12 pages, 1705 KiB  
Article
A Possible Role of Insertion Sequence IS1216V in Dissemination of Multidrug-Resistant Elements MESPM1 and MES6272-2 between Enterococcus and ST59 Staphylococcus aureus
by Yu-Tzu Lin, Sung-Pin Tseng, Wei-Wen Hung, Chen-Chia Chang, You-Han Chen, Ya-Ting Jao, Yen-Hsu Chen, Lee-Jene Teng and Wei-Chun Hung
Microorganisms 2020, 8(12), 1905; https://doi.org/10.3390/microorganisms8121905 - 30 Nov 2020
Cited by 6 | Viewed by 1682
Abstract
Sequence type 59 (ST59) is the dominant type of community-associated methicillin-resistant Staphylococcus aureus (MRSA) in Taiwan. Previously, we reported that ST59 MRSA harbors enterococcal IS1216V-mediated multidrug-resistant composite transposons MESPM1 or MES6272-2. The MES were found to have a [...] Read more.
Sequence type 59 (ST59) is the dominant type of community-associated methicillin-resistant Staphylococcus aureus (MRSA) in Taiwan. Previously, we reported that ST59 MRSA harbors enterococcal IS1216V-mediated multidrug-resistant composite transposons MESPM1 or MES6272-2. The MES were found to have a mosaic structure, largely originating in enterococci and partly native to S. aureus. The current study aimed to track the origin of the MES and how they disseminated from enterococci to ST59 S. aureus. A total of 270 enterococcal isolates were analyzed, showing that two ST64 Enterococcus faecalis isolated in 1992 and 11 clonal complex 17 Enterococcus faecium harbored MESPM1-like and MES6272-2-like structures, respectively. Sequence analysis revealed that ST64 E. faecalis strain N48 acquired the MESPM1-like structure on the plasmid pEflis48. The pEflis48 harbored the enterococci-originated region (erythromycin, kanamycin, and streptomycin resistances) and the S.aureus-originated region (chloramphenicol resistance) of MESPM1 but was separated by the replication region of the plasmid. Homologous recombination between the two direct repeats of IS1216V resulted in excision of the replication region of the plasmid to regenerate MESPM1. The p4780-1 and pV19 of E. faecium carried MES6272-2-like structures with IS1216V, albeit with multiple insertions by other insertion sequences. The findings show that IS1216V plays important roles in bidirectional gene transfer of multidrug resistance between enterococci and S. aureus. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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Other

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5 pages, 240 KiB  
Case Report
Compassionate Use of Cefiderocol to Treat a Case of Prosthetic Joint Infection Due to Extensively Drug-Resistant Enterobacter hormaechei
by Soline Siméon, Laurent Dortet, Frédérique Bouchand, Anne-Laure Roux, Rémy A. Bonnin, Clara Duran, Jean-Winoc Decousser, Simon Bessis, Benjamin Davido, Grégory Sorriaux and Aurélien Dinh
Microorganisms 2020, 8(8), 1236; https://doi.org/10.3390/microorganisms8081236 - 13 Aug 2020
Cited by 23 | Viewed by 2576
Abstract
We report the case of a 67-year old man with a right knee prosthetic joint infection due to extensively drug-resistant Enterobacter hormaechei. The resistance phenotype was due to the overproduction of the intrinsic cephalosporinase (ACT-5) associated with the production of three acquired [...] Read more.
We report the case of a 67-year old man with a right knee prosthetic joint infection due to extensively drug-resistant Enterobacter hormaechei. The resistance phenotype was due to the overproduction of the intrinsic cephalosporinase (ACT-5) associated with the production of three acquired β-lactamases (CTX-M-15, TEM-1B and OXA-1), and a putative membrane decreased permeability. He was first treated with colistin-tigecyclin due to adverse drug reactions; treatment was switched to cefiderocol for a 12-week antibiotic duration, with a favorable outcome. Full article
(This article belongs to the Special Issue Molecular Epidemiology of Antimicrobial Resistance)
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