{"title":"Coexistence of seven different carbapenemase producers in a single hospital admission screening confirmed by whole-genome sequencing","authors":"","doi":"10.1016/j.jgar.2024.09.005","DOIUrl":"10.1016/j.jgar.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>To molecularly characterize several extensively drug-resistant isolates from a single hospital admission screening of a war-injured patient from Ukraine.</div></div><div><h3>Methods</h3><div>Admission screening included swabs from skin, wounds, catheters, nasopharyngeum and rectum. Bacterial identification, antimicrobial susceptibility testing and rapid multiplex PCR assays targeting resistance genes were performed during routine diagnostics. Isolates positive by PCR had their genomes sequenced using short- and long read-platforms (MiSeq and MinION) to confirm species, identify resistance genes and plasmids and investigate clonality with core-genome MLST.</div></div><div><h3>Results</h3><div>Seven Gram-negative pathogens (<em>Acinetobacter baumannii</em> (<em>n</em> = 2; ST78, ST2), <em>Klebsiella pneumoniae</em> (<em>n</em> = 2; ST395), <em>Pseudomonas aeruginosa</em> (<em>n</em> = 1; ST1047), <em>Escherichia coli</em> (<em>n</em> = 1; ST46), <em>Enterobacter cloacae</em> complex (<em>n</em> = 1; ST231)) were molecularly confirmed non-identical. Antimicrobial susceptibility testing showed resistance to carbapenems (7/7 isolates) and last-resort treatment options such as ceftazidime-avibactam (6/7 isolates) and cefiderocol (4/7 isolates). All isolates were colistin susceptible. Sequencing identified the <em>E. cloacae complex</em> as <em>Enterobacter hormaechei</em> subsp<em>. xiangfangensis</em>. Six acquired carbapenemase genes (<em>bla</em><sub>IMP-1</sub>, <em>bla</em><sub>NDM-1</sub>, <em>bla</em><sub>OXA-48</sub>, <em>bla</em><sub>NDM-5</sub>, <em>bla</em><sub>OXA-23</sub> and <em>bla</em><sub>OXA-72</sub>) were detected<em>.</em> Both <em>A. baumannii</em> isolates differed in sequence type, carbapenemases and cefiderocol susceptibility. Both <em>K. pneumoniae</em> isolates shared sequence type and some resistance genes on an IncR plasmid but were different in core-genome MLST and carbapenemases (OXA-48 or NDM-1). One vancomycin-resistant <em>Enterococcus faecium</em> was also detected (<em>VanA</em>).</div></div><div><h3>Conclusions</h3><div>War-injured patients from Ukraine may carry different clones of multidrug-resistant pathogens with limited treatment options and diverse resistance genes at risk for dissemination. Infection control measures should include early molecular characterization of isolates for detection of routes of transmission.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gijs Teunis, Maren Lanzl, Kees T Veldman, Roan Pijnacker, Fabian Landman, Jeroen Bos, Michael S M Brouwer, Jenny Schuch, Karola Waar, Eelco Franz, Antoni P A Hendrickx
{"title":"Emergence of OXA-48 carbapenemase-producing Salmonella enterica in the Netherlands, 2023.","authors":"Gijs Teunis, Maren Lanzl, Kees T Veldman, Roan Pijnacker, Fabian Landman, Jeroen Bos, Michael S M Brouwer, Jenny Schuch, Karola Waar, Eelco Franz, Antoni P A Hendrickx","doi":"10.1016/j.jgar.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.jgar.2024.09.008","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Two novel plasmids harbouring the multiresistance gene cfr in porcine Staphylococcus equorum","authors":"","doi":"10.1016/j.jgar.2024.09.004","DOIUrl":"10.1016/j.jgar.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>The emergence and transmission of the multidrug resistance gene <em>cfr</em> have raised public health concerns worldwide.</div></div><div><h3>Objectives</h3><div>Multidrug-resistant <em>Staphylococcus equorum</em> isolates can pose a threat to public health. In this study, we have characterised the whole-genome of one <em>Staphylococcus equorum</em> isolate harbouring two distinct <em>cfr</em>-carrying plasmids.</div></div><div><h3>Methods</h3><div>Antimicrobial susceptibility testing was performed by broth microdilution. Genomic DNA was sequenced using both the Illumina HiSeq X Ten and Nanopore MinION platforms. <em>De novo</em> hybrid assembly was performed by Unicycler. Genomic data were assessed by in silico prediction and bioinformatic tools.</div></div><div><h3>Results</h3><div><em>Staphylococcus equorum</em> isolate SN42 exhibited resistance or high MICs to linezolid, erythromycin, tetracycline, oxacillin, clindamycin, virginiamycin, tiamulin, chloramphenicol and florfenicol. It carried two <em>cfr</em>-harbouring plasmids: the RepA N-family plasmid pSN42–51 K and the Inc18-family plasmid pSN42–50 K. These two plasmids exhibited low structural similarities to the so far reported <em>cfr</em>-carrying plasmids. Both plasmids harboured an arsenic resistance operon, copper and cadmium resistance genes as well as the lincosamide-pleuromutilin-streptogramin A resistance gene <em>lsa</em>(B). In addition, plasmid pSN42–51 K carried two <em>erm</em>(B) genes for macrolide-lincosamide-streptogramin B resistance, the streptomycin resistance gene <em>ant(6)-Ia</em> as well as mercury resistance genes while pSN42–50 K was associated with the heavy metal translocating P-type ATPase gene <em>hmtp</em>. The co-carriage and co-existence of these antimicrobial resistance and heavy metal resistance genes increases the likelihood of co-selection of the <em>cfr</em>-carrying plasmids.</div></div><div><h3>Conclusion</h3><div>This is the first report of <em>S. equorum</em> carrying two distinct <em>cfr</em>-carrying plasmids, underscoring the need for ongoing surveillance to address the potential dissemination of multi-drug resistance in bacteria from food-producing animals to ensure food safety and public health.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to “Occurrence and characteristics of blaOXA-181 - carrying Klebsiella aerogenes from swine in China” [Journal of Global Antimicrobial Resistance 38(2024) 35–41/JGAR_2323]","authors":"","doi":"10.1016/j.jgar.2024.08.009","DOIUrl":"10.1016/j.jgar.2024.08.009","url":null,"abstract":"","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213716524001619/pdfft?md5=893228827e63500e2510674179600f1f&pid=1-s2.0-S2213716524001619-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Age and gender in drug resistance tuberculosis: A cross-sectional case study at a national tuberculosis reference hospital in Nigeria","authors":"","doi":"10.1016/j.jgar.2024.09.002","DOIUrl":"10.1016/j.jgar.2024.09.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Drug resistance in tuberculosis (TB) is a very important public health threat that should not be ignored. Understanding the gender, age, and characteristics of individuals affected by TB (without HIV, diabetes, or hepatitis B complications), particularly in terms of drug resistance or susceptibility, is crucial for effective prevention and management strategies, as most studies focus on TB/HIV co-infection.</div></div><div><h3>Methods</h3><div>A cross-sectional case study of age and gender was carried out in 140 individuals grouped into drug-resistant tuberculosis (DR-TB), drug-susceptible tuberculosis (DS-TB), and apparently healthy controls (AHCs). Data collection was through medical records and a structured questionnaire. Statistical analyses compared age, gender, and selected risk factors across the groups.</div></div><div><h3>Results</h3><div>The mean age of the DR-TB group was 32 years (SD ≈ 2). A total of 80.0% were ≤40 years of age and four times more likely to have DR-TB; 55% were male, with 1.22 times more likelihood of DR-TB in males. The mean age of the DS-TB group was 34 years (SD ≈ 12); 66.7% were ≤40 years old. The odds ratio of DS-TB in males was 2.16. Only 10% of DR-TB enrolees had BCG scars compared with 65% AHCs. A high percentage of the DR-TB group reported handling raw meat (75%) and drinking unpasteurised milk (70%) compared with the DS-TB group.</div></div><div><h3>Conclusions</h3><div>The observed gender disparities and age-related factors, particularly among the DR-TB group, highlight the importance of considering age and gender factors in DR-TB prevention, diagnosis, and treatment. Our findings also highlight the need to bridge gaps in awareness as well as for the prevention of zoonotic TB and issues around effective BCG vaccination and coverage.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Complete genome of Escherichia coli sequence type 73 with acquired blaTEM-1 and high genotypic virulence load identified in human saliva","authors":"","doi":"10.1016/j.jgar.2024.08.011","DOIUrl":"10.1016/j.jgar.2024.08.011","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Escherichia coli</em> sequence type (ST) 73 is a pandemic lineage of the ExPEC (Extraintestinal Pathogenic <em>E. coli</em>) family associated with conserved virulence. We report the complete genome of a genomically hypervirulent <em>E. coli</em> ST73 strain isolated from the oral cavity of a patient with a diagnosis of treatment resistant schizophrenia and receiving clozapine treatment.</div></div><div><h3>Methods</h3><div><em>E. coli</em> strain GABEEC132 underwent second and third generation sequencing with Illumina and Oxford-Nanopore-Technologies (ONT) platforms. Antibiotic resistance genes (ARGs) and virulence factors (VFs) were bioinformatically identified using the NCBI-AMR-Finder-Plus database and Virulence-Factors-database (VFDB), respectively. To contextualize the genome within a broader epidemiological framework, phylogenetic analysis was conducted using representative genomes of <em>E. coli</em> ST73 O6:H1 (<em>n</em> = 55).</div></div><div><h3>Results</h3><div><em>E. coli</em> strain GABEEC132 was identified as possessing the O6:H1 serotype and classified within the B2 phylogroup. The strain exhibited a high genomic virulence load, encoding for 194 VFs. Additionally, it encoded three ARGs, including an acquired <em>blaTEM-1</em> located on a rep_cluster_2350 8 237 Kb mobilisable plasmid, presenting phenotypic resistance to ampicillin and piperacillin.</div></div><div><h3>Conclusion</h3><div>This report provides novel insights into the oral prevalence of genotypically hypervirulent and drug-resistant <em>E. coli</em> ST73, a pandemic lineage.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The frequency of AmpC overproduction, OprD downregulation and OprM efflux pump expression in Pseudomonas aeruginosa: A comprehensive meta-analysis","authors":"","doi":"10.1016/j.jgar.2024.08.014","DOIUrl":"10.1016/j.jgar.2024.08.014","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Pseudomonas aeruginosa</em> is a major opportunistic pathogen responsible for a wide range of infections. The emergence of antibiotic resistance in this pathogen poses a significant public health challenge. This study aims to conduct a comprehensive meta-analysis of studies conducted in Iran to determine the frequency of key antibiotic resistance mechanisms in <em>Pseudomonas aeruginosa</em> and their association with multidrug-resistant and extensively drug-resistant strains or pandrug-resistant strains.</div></div><div><h3>Methods</h3><div>Systematic database searches encompassing literature up to June 2023 were undertaken. The selected studies centered on OprD downregulation, efflux pump (mexAB-OprM, mexXY-OprM) expression, and AmpC overproduction. Extracted data were synthesised in a meta-analysis for pooled frequency determination of each resistance mechanism.</div></div><div><h3>Results</h3><div>In total, 24 studies were included. OprD downregulation exhibited a pooled frequency of 61%. Efflux pump component frequency ranged from 48% to 77.5%. AmpC overproduction was identified in 29.1% of isolates. Polymyxin B and colistin demonstrated lower antibiotic resistance rates, with pooled frequency of 1% and 1.6%, respectively. Conversely, resistance to other antibiotics ranged widely, with pooled frequency spanning 38.4% to 98.2%.</div></div><div><h3>Conclusions</h3><div>This study underscores the concerning frequency of diverse antibiotic resistance mechanisms in <em>Pseudomonas aeruginosa</em> strains from Iran. Concurrent OprD downregulation, mexAB, mexXY, OprM expression, and AmpC overproduction highlight the urgent need for stringent infection control and prudent antibiotic usage to curb the dissemination of these resistant strains.</div></div><div><h3>PROSPERO</h3><div>CRD42022379311</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Synthetic lincosamides iboxamycin and cresomycin are active against ocular multidrug-resistant methicillin-resistant Staphylococcus aureus carrying erm genes","authors":"","doi":"10.1016/j.jgar.2024.09.001","DOIUrl":"10.1016/j.jgar.2024.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>Antimicrobial resistance is a global pandemic that poses a major threat to vision health as ocular bacteria, especially methicillin-resistant <em>Staphylococcus aureus</em> (MRSA), are becoming increasingly resistant to first-line therapies. Here we evaluated the antimicrobial activity of new synthetic lincosamides in comparison to currently used antibiotics against clinical ocular MRSA isolates.</div></div><div><h3>Methods</h3><div>Antimicrobial susceptibility testing was performed by broth microdilution for two novel synthetic lincosamides (iboxamycin and cresomycin) and eight comparator antibiotics against a collection of 50 genomically characterised ocular MRSA isolates, including isolates harbouring <em>erm</em> genes (<em>n</em> = 25).</div></div><div><h3>Results</h3><div>Both drugs were active against widespread MRSA clonal complexes CC8 and CC5. The MIC<sub>50</sub> and MIC<sub>90</sub> of iboxamycin were 0.06 and 2 mg/L, respectively. Cresomycin (MIC<sub>50</sub> = 0.06 mg/L) also displayed good activity with an <em>in vitro</em> potency four-fold higher (MIC<sub>90</sub> = 0.5 mg/L) than iboxamycin. In isolates harbouring <em>erm</em> genes, MIC<sub>90</sub> were >16, 2, and 0.5 mg/L for clindamycin, iboxamycin, and cresomycin, respectively. The <em>in vitro</em> potencies of iboxamycin and cresomycin were similar or higher than that of comparator agents and were not impacted by multidrug-resistance phenotypes or by the presence of <em>erm</em> genes when compared with clindamycin.</div></div><div><h3>Conclusions</h3><div>Our results demonstrate that iboxamycin and cresomycin display potent <em>in vitro</em> activity against ocular MRSA isolates, including multidrug-resistant isolates harbouring <em>erm</em> genes.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Easy analysis of bacterial whole-genome sequencing data for clinical microbiologists using open-source Galaxy platform: Characterization of ESBL-producing Enterobacterales from bloodstream infections","authors":"","doi":"10.1016/j.jgar.2024.08.012","DOIUrl":"10.1016/j.jgar.2024.08.012","url":null,"abstract":"<div><h3>Objectives</h3><div>Clinical microbiologists require easy-to-use open access tools with graphical interfaces to perform bacterial whole-genome sequencing (WGS) in routine practice. This study aimed to build a bioinformatics pipeline on the open-source Galaxy platform, facilitating comprehensive and reproducible analysis of bacterial WGS data in a few steps. We then used it to characterize our local epidemiology of ESBL-producing <em>Enterobacterales</em> isolated from patients with bacteremia.</div></div><div><h3>Methods</h3><div>We built a bioinformatics pipeline consisting of the following sequential tools: Fastp (input data trimming); FastQC (read quality control); SPAdes (genome assembly); Quast (quality control of genome assembly); Prokka (gene annotation); Staramr (ResFinder database) and ABRicate (CARD database) for antimicrobial resistance (AMR) gene screening and molecular strain typing. Paired-end short read WGS data from all ESBL-producing <em>Enterobacterales</em> strains isolated from patients with bacteremia over one year were analysed.</div></div><div><h3>Results</h3><div>The Galaxy platform does not require command line tools. The bioinformatics pipeline was constructed within one hour. It only required uploading fastq files and facilitated systematization of <em>de novo</em> assembly of genomes, MLST typing, and AMR gene screening in one step. Among the 66 ESBL-producing strains analysed, the two most frequent ESBL genes were <em>bla</em><sub>CTX−M-15</sub> (62.1%) and <em>bla</em><sub>CTX−M-27</sub> (13.6%).</div></div><div><h3>Conclusions</h3><div>The open-access Galaxy platform provides a graphical interface and easy-to-use tools suitable for routine use in clinical microbiology laboratories without bioinformatics specialists. We believe that this platform will facilitate fast and low-cost analysis of bacterial WGS data, especially in resource-limited settings.</div></div>","PeriodicalId":15936,"journal":{"name":"Journal of global antimicrobial resistance","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}