#NDM-β-Lactamase-5–Producing #Escherichia coli in Companion #Animals, #USA (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 26, Number 2—February 2020 / Research Letter

New Delhi Metallo-β-Lactamase-5–Producing Escherichia coli in Companion Animals, United States

Stephen D. Cole, Laura Peak, Gregory H. Tyson, Renate Reimschuessel, Olgica Ceric, and Shelley C. Rankin

Author affiliations: University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania, USA (S.D. Cole, S.C. Rankin); Louisiana State University, Baton Rouge, Louisiana USA (L. Peak); US Food and Drug Administration, Silver Spring, Maryland, USA (G.H. Tyson, R. Reimscheussel, O. Ceric)

 

Abstract

We report isolation of a New Delhi metallo-β-lactamase-5–producing carbapenem-resistant Escherichia coli sequence type 167 from companion animals in the United States. Reports of carbapenem-resistant Enterobacteriaceae in companion animals are rare. We describe a unique cluster of blaNDM-5–producing E. coli in a veterinary hospital.

Keywords: Antibiotics; Drugs Resistance; Carbapenem; Beta-lactams; NDM1; USA.

——

Characterization of class 1 #integrons harboring #blaVEB-1 in #Vibrio parahaemolyticus isolated from ready-to-eat #foods in #China (Int J Food Microbiol., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Int J Food Microbiol. 2019 Dec 9;318:108473. doi: 10.1016/j.ijfoodmicro.2019.108473. [Epub ahead of print]

Characterization of class 1 integrons harboring blaVEB-1 in Vibrio parahaemolyticus isolated from ready-to-eat foods in China.

Lei T1, Zhang J1, Jiang F2, He M3, Zeng H1, Chen M1, Pang R1, Wu H1, Wu S1, Wang J4, Ding Y5, Wu Q6.

Author information: 1 Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, Guangdong Province 510070, China; State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangzhou, Guangdong Province 510070, China. 2 Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, Guangdong Province 510070, China; State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangzhou, Guangdong Province 510070, China; School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi’an, Shaanxi Province 710021, China. 3 Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, Guangdong Province 510070, China; School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi’an, Shaanxi Province 710021, China; School of Bioscience and Bioengineering, South China University of Technology, Guangzhou, Guangdong Province 510006, China. 4 College of Food Science, South China Agricultural University, Guangzhou, Guangdong Province 510642, China. 5 Department of Food Science and Technology, Jinan University, Guangzhou, Guangdong Province 510632, China. 6 Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, Guangdong Province 510070, China; State Key Laboratory of Applied Microbiology Southern China, Guangdong Provincial Key Laboratory of Microbial Culture Collection and Application, Guangdong Open Laboratory of Applied Microbiology, Guangzhou, Guangdong Province 510070, China. Electronic address: wuqp203@163.com.

 

Abstract

The aim of this study is to investigate the prevalence of integrons and integron-associated antibiotic resistance in V. parahaemolyticus strains collected from RTE foods in China, and to carry out a comprehensive analysis on the molecular characterization of V. parahaemolyticus strains carrying blaVEB-1-positive class 1 integron. Of the 51 V. parahaemolyticus strains isolated from RTE food samples, none of the isolates was found to carry integrase genes intI2 and IntI3. However, all 51 strains were positive to integrase gene intI1, and only 2 of 51 (3.92%) intI1-positive isolates yielded polymerase chain reaction (PCR) products of gene cassette amplification. Sequence data and BLAST analysis indicated the gene cassette arrays of class 1 integron in VP007 is dfrA14-blaVEB-1-aadB, while the gene cassette arrays of class 1 integron in V187 is blaVEB-1-aadB-arr2-cmlA-blaOXA-10-aadA1. Antimicrobial susceptibility testing showed that the two V. parahaemolyticus isolates harboring class 1 integrons exhibited multi-drug resistance to various antibiotics. S1-PFGE and Southern blot analysis confirmed the class 1 integron harboring blaVEB-1 gene in V187 was located on the plasmid of ~175 kb and transferrable to the recipient strain by conjugation. This is the first detection of class 1 integrons harboring the ESBL gene blaVEB-1 in V. parahaemolyticus. To the best of our knowledge, this is also the first report of VEB-producing V. parahaemolyticus from RTE foods. Our findings revealed that class 1 integron on conjugative plasmid contributes significantly to the dissemination of VEB-producing V. parahaemolyticus, which warrants further investigation because of the public health threat it poses.

Copyright © 2019 Elsevier B.V. All rights reserved.

KEYWORDS: Antibiotic resistance; Class 1 integron; RTE food; Vibrio parahaemolyticus; bla(VEB-1)

PMID: 31863965 DOI: 10.1016/j.ijfoodmicro.2019.108473

Keywords: Antibiotics; Drugs Resistance; Beta-lactams; Vibrio spp.; Food Safety; China.

——

#Transmission of #ESBL-producing #Escherichia coli between #broilers and #humans on broiler #farms (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Transmission of ESBL-producing Escherichia coli between broilers and humans on broiler farms

Angela H A M van Hoek, Cindy Dierikx, Thijs Bosch, Leo Schouls, Engeline van Duijkeren, Michael Visser

Journal of Antimicrobial Chemotherapy, dkz507, https://doi.org/10.1093/jac/dkz507

Published: 04 December 2019

 

Abstract

Background

ESBL and AmpC β-lactamases are an increasing concern for public health. Studies suggest that ESBL/pAmpC-producing Escherichia coli and their plasmids carrying antibiotic resistance genes can spread from broilers to humans working or living on broiler farms. These studies used traditional typing methods, which may not have provided sufficient resolution to reliably assess the relatedness of these isolates.

Methods

Eleven suspected transmission events among broilers and humans living/working on eight broiler farms were investigated using whole-genome short-read (Illumina) and long-read sequencing (PacBio). Core genome MLST (cgMLST) was performed to investigate the occurrence of strain transmission. Horizontal plasmid and gene transfer were analysed using BLAST.

Results

Of eight suspected strain transmission events, six were confirmed. The isolate pairs had identical ESBL/AmpC genes and fewer than eight allelic differences according to the cgMLST, and five had an almost identical plasmid composition. On one of the farms, cgMLST revealed that the isolate pairs belonging to ST10 from a broiler and a household member of the farmer had 475 different alleles, but that the plasmids were identical, indicating horizontal transfer of mobile elements rather than strain transfer. Of three suspected horizontal plasmid transmission events, one was confirmed. In addition, gene transfer between plasmids was found.

Conclusions

The present study confirms transmission of strains as well as horizontal plasmid and gene transfer between broilers and farmers and household members on the same farm. WGS is an important tool to confirm suspected zoonotic strain and resistance gene transmission.

Issue Section: ORIGINAL RESEARCH

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Beta-lactams; E. Coli; Poultry; Human.

——

LMB-1 producing #Citrobacter freundii from #Argentina, a novel player in the field of MBLs (Int J Antimicrob Agents, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Int J Antimicrob Agents. 2019 Nov 27. pii: S0924-8579(19)30328-0. doi: 10.1016/j.ijantimicag.2019.11.014. [Epub ahead of print]

LMB-1 producing Citrobacter freundii from Argentina, a novel player in the field of MBLs.

Dabos L1, Rodriguez CH2, Nastro M2, Dortet L3, Bonnin R4, Famiglietti A2, Iorga BI5, Vay C2, Naas T6.

Author information: 1 EA7361 “Structure, dynamic, function and expression of broad spectrum β-lactamases”, Paris-Sud University, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint research Unit EERA « Evolution and Ecology of Resistance to Antibiotics », Institut Pasteur-APHP-University Paris Sud, Paris, France. 2 Departamento de Bioquímica Clinica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina. 3 EA7361 “Structure, dynamic, function and expression of broad spectrum β-lactamases”, Paris-Sud University, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint research Unit EERA « Evolution and Ecology of Resistance to Antibiotics », Institut Pasteur-APHP-University Paris Sud, Paris, France; Department of Bacteriology-Hygiene, Bicêtre Hospital, APHP, Le Kremlin-Bicêtre, France; French National Reference Center for Antibiotic Resistance, Le Kremlin-Bicêtre, France. 4 EA7361 “Structure, dynamic, function and expression of broad spectrum β-lactamases”, Paris-Sud University, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint research Unit EERA « Evolution and Ecology of Resistance to Antibiotics », Institut Pasteur-APHP-University Paris Sud, Paris, France; French National Reference Center for Antibiotic Resistance, Le Kremlin-Bicêtre, France. 5 CNRS, UMR3525, Paris, France. 6 EA7361 “Structure, dynamic, function and expression of broad spectrum β-lactamases”, Paris-Sud University, Faculty of Medicine, Le Kremlin-Bicêtre, France; Joint research Unit EERA « Evolution and Ecology of Resistance to Antibiotics », Institut Pasteur-APHP-University Paris Sud, Paris, France; Department of Bacteriology-Hygiene, Bicêtre Hospital, APHP, Le Kremlin-Bicêtre, France; French National Reference Center for Antibiotic Resistance, Le Kremlin-Bicêtre, France. Electronic address: thierry.naas@aphp.fr.

 

Abstract

Carbapenemase-producing Enterobacterales expressing OXA-48, KPC, NDM, VIM or IMP enzymes are increasingly reported worldwide. We have characterized LMB-1, a novel metallo-β-latamase (MBL) of Ambler class B3 from Citrobacter freundii 164 (Cf164) clinical isolate from Buenos Aires, Argentina. Cf164 displayed reduced susceptibility to carbapenems but gave inconsistent results with carbapenemase confirmatory tests, suggesting the presence of a weak carbapenemase. Analysis of WGS of Cf164 using Resfinder revealed four β-lactamase genes coding for CTX-M-8, PER-2, TEM-1 and CMY-150, a novel chromosomally-encoded CMY variant. Kinetic parameters of purified CMY-150 did not reveal any carbapenemase activity. However, CMY-150 conferred to E. coli higher MIC values for ceftazidime and aztreonam as compared to CMY-2. The in-house developed β-lactamase search software (ResMINER) in WGS data, revealed a novel subclass B3 MBL named LMB-1. LMB-1 conferred to E. coli, resistance to penicillins, to expanded-spectrum cephalosporins and reduced susceptibility to carbapenems. The blaLMB-1 gene was located on a 176-kb IncA/C2 plasmid. LMB-1 shared 99% of amino acid sequence identity with the MBL encoded in the chromosome of Rheinheimera pacifica, it’s likely progenitor. Despite repeated attempts, LMB-1 could not be purified, thus only specific activities could evidence hydrolysis of carbapenems. Here we report CMY-150, a novel CMY-2 variant that confers increased ceftazidime and aztreonam MICs to E. coli and the first description of LMB-1 in Argentina. This work underlines the need for several CPE confirmatory tests, as this novel enzyme might have been missed using only one.

Copyright © 2019 Elsevier Ltd. All rights reserved.

KEYWORDS: CPE; Carbapenemase; Class B3 MBL; Metallo-beta-lactamase

PMID: 31785341 DOI: 10.1016/j.ijantimicag.2019.11.014

Keywords: Antibiotics; Drugs Resistance; E. Coli; Citrobacter freundii; Carbapenem; Beta-lactams; Argentina.

——

High heterogeneity of #MDR #Enterobacteriaceae #fecal levels in hospitalized patients is partially driven by intravenous #betalactams (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

High heterogeneity of multidrug-resistant Enterobacteriaceae fecal levels in hospitalized patients is partially driven by intravenous beta-lactams.

Ana Djukovic, Eva M. González-Barberá, Jaime Sanz, Alejandro Artacho, Iván Peñaranda, Beatriz Herrera, María Jose Garzón, Miguel Salavert, Jose Luis López-Hontangas, Karina B. Xavier, Bernhard Kuster, Laurent Debrauwer, Jean-Marc Rolain, Miguel Sanz, Joao Xavier, Carles Ubeda

DOI: 10.1128/AAC.01415-19

 

ABSTRACT

Multidrug-resistant Enterobacteriaceae (MRE) colonize the intestine asymptomatically from where they can breach into the bloodstream and cause life-threatening infections, especially in heavily colonized patients. Despite the clinical relevance of MRE colonization levels, we know little about how they vary in hospitalized patients and the clinical factors that determine those levels. Here we conducted one of the largest studies of MRE fecal levels by tracking longitudinally 133 acute leukemia patients and monitoring their MRE levels over time through extensive culturing. MRE were defined as Enterobactericeae species that acquired non-susceptibility to ≥1 agent in ≥3 antimicrobial categories. In addition, due to the selective media used, the MRE had to be resistant to third-generation cephalosporins. MRE were detected in 60% of the patients, but their fecal levels varied considerably among patients and within the same patient (>6 and 4 orders of magnitude, respectively). Multivariate analysis of clinical metadata revealed an impact of intravenous beta-lactams (i.e. meropenem and piperacillin-tazobactam), which significantly diminished the fecal MRE levels in hospitalized patients. Consistent with a direct action of beta-lactams, we found an effect only when the patient was colonized with strains sensitive to the administered beta-lactam (p<0.001) but not with non-susceptible strains. We report previously unobserved inter and intra-individual heterogeneity in MRE fecal levels, suggesting that quantitative surveillance is more informative than qualitative surveillance of hospitalized patients. In addition, our study highlights the relevance of incorporating antibiotic treatment and susceptibility data of gut colonizing pathogens for future clinical studies and in clinical decision-making.

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Beta-lactams; Cephalosporins; Enterobacteriaceae.

——

Long-term #impact of an #educational #antimicrobial #stewardship programme in primary care on #infections caused by #ESBL #Escherichia coli in the community… (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Long-term impact of an educational antimicrobial stewardship programme in primary care on infections caused by extended-spectrum β-lactamase-producing Escherichia coli in the community: an interrupted time-series analysis

Germán Peñalva, MSEd, Rocío Fernández-Urrusuno, PhD, José María Turmo, MD, Rocío Hernández-Soto, PhD, Ignacio Pajares, MD, Lucía Carrión, MD, Inmaculada Vázquez-Cruz, PhD, Blanca Botello, MD, Beatriz García-Robredo, PhD, Manuel Cámara-Mestres, PharmD, Juan Carlos Domínguez-Camacho, PharmD, Manuel María Aguilar-Carnerero, PharmD, José Antonio Lepe, PhD, Marina de Cueto, PhD, María Carmen Serrano-Martino, PhD, María Carmen Domínguez-Jiménez, PhD, Ana Domínguez-Castaño, MD, José Miguel Cisneros, PhD on behalf of the PIRASOA-FIS team †

Published: November 22, 2019 / DOI: https://doi.org/10.1016/S1473-3099(19)30573-0

 

Summary

Background

There is little evidence on the ecological effect and sustainability of antimicrobial stewardship programmes (ASPs) in primary-care settings. We aimed to determine whether a multimodal, educational ASP would be sustainable in the long-term and reduce the incidence of infections caused by extended-spectrum β-lactamase-producing Escherichia coli in the community by optimising antibiotic use.

Methods

We did this quasi-experimental intervention study in 214 primary health centres of four primary health-care districts in Andalusia, Spain. Local multidisciplinary teams, comprised of general practitioners, paediatricians, primary-care pharmacists, and epidemiologists, were created in each district and implemented a multimodal, education-based ASP. The core activity of the programme consisted of regular one-to-one educational interviews between a reference interviewing physician and prescribing physicians from each centre on the appropriateness of their most recent (same or preceding day) antibiotic prescriptions based on a structured questionnaire. Appropriate prescribing was defined as compliance of all checklist items with the reference guidelines. An average of five educational interviews were scheduled per prescriber per study year. We did an interrupted time-series analysis to assess the effect of the intervention on quarterly antibiotic use (prescription and collection by the patient) and quality of prescriptions (as defined daily doses per 1000 inhabitants per day) and incidence per 1000 inhabitants of E coli producing extended-spectrum β-lactamase (ESBL) isolated from urine samples.

Findings

The study was done between January, 2012, and December, 2017, in a pre-intervention period of 2012–13 and an intervention period of 2014–17. Throughout the study period, there were 1387 physicians (1116 general practicioners and 271 paediatricians) in the included health centres serving a mean population of 1 937 512 people (299 331 children and 1 638 181 adults). 24 150 educational interviews were done over the 4 years. Inappropriate antibiotic prescribing was identified in 1794 (36·5%) of 4917 educational interviews in 2014 compared with 1793 (26·9%) of 6665 in 2017 (p<0·0001). The intervention was associated with a sustained reduction in the use of ciprofloxacin (relative effect −15·9%, 95% CI −23·9 to −8·0) and cephalosporins (−22·6%, −35·9 to −9·2), and a sustained increase in the use of amoxicillin (22·2%, 6·4 to 38·0) and fosfomycin trometamol (6·1%, 2·6 to 9·6). The incidence density of ESBL-producing E coli decreased by −0·028 cases per 1000 inhabitants (95% CI −0·034 to −0·021) after the start of the programme, reversing the pre-intervention increase and leading to a relative reduction of −65·6% (−68·2 to −63·0) 4 years later.

Interpretation

Our data suggest that implementation of a multimodal ASP in primary care that is based on individual educational interviews improves the use of antibiotics and results in a sustained significant reduction of infections by ESBL-producing E coli in the community. This information should encourage the implementation of ASPs in primary care.

Funding

Instituto de Salud Carlos III, Spanish Government (PI14/01523).

Keywords: Antibiotics; Drugs Resistance; Society; Spain; E. Coli; Beta-lactams.

——

Heterogeneity of #penicillin-non-susceptible group B #streptococci isolated from a single patient in #Germany (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Heterogeneity of penicillin-non-susceptible group B streptococci isolated from a single patient in Germany

Mark van der Linden, Rafael Mamede, Natascha Levina, Peter Helwig, Pedro Vila-Cerqueira, João André Carriço, José Melo-Cristino, Mário Ramirez, Elisabete R Martins

Journal of Antimicrobial Chemotherapy, dkz465, https://doi.org/10.1093/jac/dkz465

Published: 18 November 2019

 

Abstract

Objectives

Streptococcus agalactiae [group B streptococci (GBS)] have been considered uniformly susceptible to penicillin. However, increasing reports from Asia and North America are documenting penicillin-non-susceptible GBS (PRGBS) with mutations in pbp genes. Here we report, to the best of our knowledge, the first two PRGBS isolates recovered in Europe (AC-13238-1 and AC-13238-2), isolated from the same patient.

Methods

Two different colony morphologies of GBS were noted from a surgical abscess drainage sample. Both were serotyped and antimicrobial susceptibility testing was performed by different methodologies. High-throughput sequencing was done to compare the isolates at the genomic level, to identify their capsular type and ST, to evaluate mutations in the pbp genes and to compare the isolates with the genomes of other PRGBS isolates sharing the same serotype and ST.

Results

Isolates AC-13238-1 and AC-13238-2 presented MICs above the EUCAST and CLSI breakpoints for penicillin susceptibility. Both shared the capsular type Ia operon and ST23. Genomic analysis uncovered differences between the two isolates in seven genes, including altered pbp genes. Deduced amino acid sequences revealed critical substitutions in PBP2X in both isolates. Comparison with serotype Ia clonal complex 23 PRGBS from the USA reinforced the similarity between AC-13238-1 and AC-13238-2, and their divergence from the US strains.

Conclusions

Our results support the in-host evolution of β-lactam-resistant GBS, with two PRGBS variants being isolated from one patient.

Topic: mutation – penicillin – heterogeneity – amino acid sequence – asia – genes – genome – germany – lactams – operon – surgical procedures, operative – streptococcus group b – antimicrobial susceptibility test – abscess drainage – malnutrition-inflammation-cachexia syndrome – serotype

Issue Section: ORIGINAL RESEARCH

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Streptococcus agalactiae; Beta-lactams; Penicillin; Germany.

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