Antimicrobial Resistance and Cytotoxicity of Citrobacter spp. in Maanshan Anhui Province, China

Liu, Liyun; Lan, Ruiting; Liu, Liqin; Wang, Yonglu; Zhang, Yushi; Wang, Yiting; Xu, Jianguo

doi:10.3389/fmicb.2017.01357

Cited by 45 publications

(88 citation statements)

References 49 publications

(84 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our analysis revealed extensive genomic diversity among both CNSC and carbapenem-susceptible Citrobacter sampled from our center. This is similar to previous analyses of CNSC from non-US centers that used more classical molecular typing methods (14, 47, 48). Among Citrobacter species , C. freundii is most commonly associated with both clinical disease (44) and multidrug-resistant phenotypes (14, 15, 49).…”

Section: Discussionsupporting

confidence: 87%

Clinical and genomic epidemiology of carbapenem-non-susceptible Citrobacter spp. at a tertiary healthcare center over two decades

Babiker

Evans

Griffith

et al. 2020

Preprint

View full text Add to dashboard Cite

22Carbapenem-non-susceptible Citrobacter spp. (CNSC) are increasingly recognized as healthcare-23 associated pathogens. Information regarding their clinical epidemiology, genetic diversity, and 24 mechanisms of carbapenem resistance is lacking. We examined microbiology records of adult 25 patients at the University of Pittsburgh Medical Center (UMPC) Presbyterian Hospital (PUH) from 26 2000-2018 for CNSC, as defined by ertapenem non-susceptibility. Over this timeframe, the 27 proportion of CNSC increased from 4% to 10% (P=0.03), as did carbapenem daily defined 28 doses/1000 patient days (6.52 to 34.5, R 2 =0.831, P<0.001), which correlated with the observed 29 increase in CNSC (lag=0 years, R 2 =0.660). Twenty CNSC isolates from 19 patients at PUH and 30 other UPMC hospitals were available for further analysis, including whole-genome short-read 31 sequencing and additional antimicrobial susceptibility testing. Of the 19 patients, nearly all 32 acquired CNSC in the healthcare setting and over half had polymicrobial cultures containing at 33 least one other organism. Among the 20 CNSC isolates, C. freundii was the predominant species 34 identified (60%). CNSC genomes were compared with genomes of carbapenem-susceptible 35Citrobacter spp. from UPMC, and with other publicly available CNSC genomes. Isolates encoding 36 carbapenemases (blaKPC-2, blaKPC-3, and blaNDM-1) were also long-read sequenced, and their 37 carbapenemase-encoding plasmid sequences were compared with one another and with publicly 38 available sequences. Phylogenetic analysis of 102 UPMC Citrobacter spp. genomes showed that 39 CNSC from our setting did not cluster together. Similarly, a global phylogeny of 64 CNSC 40 genomes showed a diverse population structure. Our findings suggest that both local and global 41 CNSC populations are genetically diverse, and that CNSC harbor carbapenemase-encoding 42 plasmids found in other Enterobacterales. 43 isolated from a specimen collected within 72 hours following hospital admission; isolates collected 91 after 72 hours were considered healthcare-associated (22). Clinical characteristics and outcomes 92 of patients with CNSC isolates that underwent further characterization were collected through 93 retrospective chart review. The primary clinical outcome was in-hospital mortality and/or transfer 94 to hospice. 95 96 CNSC isolate characterization 97 Initial species assignment was performed using standard clinical microbiology laboratory 98 methods, and was confirmed or modified after whole-genome sequencing. Carbapenem non-99 susceptibility was initially determined by standard clinical microbiology laboratory methods, and 100 was confirmed by the Kirby-Bauer disk diffusion method as per the 2017 Clinical Laboratory 101 Standards Institute (CLSI) interpretative criteria (20). Susceptibility to additional agents was 102 determined by the broth microdilution method (20). Presence of carbapenemase enzyme activity 103 was assessed by modified carbapenem inactivation (mCIM) test (23). 104 105 Genome sequencing and a...

show abstract

Section: Discussionsupporting

confidence: 87%

Clinical and genomic epidemiology of carbapenem-non-susceptible Citrobacter spp. at a tertiary healthcare center over two decades

Babiker

Evans

Griffith

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Despite the fact that this method was 186 unable to identify complete previously reported sequence types (STs), the detection of partial allele 187 combinations allowed us to infer the presence of several genotypes of clinical importance. In sewage samples 188 we found three alleles of Citrobacter freundii whose combination determines the ST-209, which has been 189 detected from isolates recovered from diarrheal patients [20]. Also, we detected three alleles from Escherichia 190 coli defining the clonal complex ST-131, which is a globally disseminated multidrug-resistant clone 191 associated with human extraintestinal (urinary and bloodstream) infections [21].…”

mentioning

confidence: 82%

City-wide metagenomics uncover antibiotic resistance reservoirs in urban beach and sewage waters

Fresia

Antelo

Salazar

et al. 2018

Preprint

View full text Add to dashboard Cite

41Background: Microbial communities present in environmental waters constitute a reservoir for antibiotic-42 resistant pathogens that impact human health. For this reason a diverse variety of water environments are 43 being analyzed using metagenomics to uncover public health threats. However, the composition of these 44 communities along the coastal environment of a whole city where sewage and beach waters are mixed, is 45 poorly understood. 47Results: We shotgun-sequenced 20 coastal areas from the city of Montevideo (capital of Uruguay) including 48 beach and sewage water samples to characterize bacterial communities and their virulence and antibiotic 49 resistance repertories. We found that sewage and beach environments presented significantly different 50 bacterial communities. Sewage waters harbored a higher prevalence and a more diverse repertory of virulence 51 and antibiotic resistant genes mainly from well-known enterobacteria, including carbapenemases and 52 extended-spectrum betalactamases reported in hospital infections in Montevideo. Additionally, we were able 53 to genotype the presence of both globally-disseminated pathogenic clones as well as emerging antibiotic-54 resistant bacteria in sewage waters. 56Conclusions: Our study represents the first in using metagenomics to jointly analyze beaches and the sewage 57 system from an entire city, allowing us to characterize antibiotic-resistant pathogens circulating in urban 58 waters. The data generated in this initial study represent a baseline metagenomic exploration to guide future 59 longitudinal (time-wise) studies, whose systematic implementation will provide useful epidemiological 60 information to improve public health surveillance. 61 62

show abstract

“…C. freundii is the most commonly isolated Citrobacter species causing diarrhea and other infections [7,8], while C. youngae and C. braakii are rarely reported to cause infections. Some C. freundii strains caused food poisoning or diarrhea in humans which were found to carry virulent factors, such as Shiga-like toxins, heat-stable toxins, or virulence islands [9,10]. C. youngae can cause peritonitis [11].…”

Section: Introductionmentioning

confidence: 99%

Lineage, Antimicrobial Resistance and Virulence of Citrobacter spp

et al. 2020

Self Cite

View full text Add to dashboard Cite

Citrobacter spp. are opportunistic human pathogens which can cause nosocomial infections, sporadic infections and outbreaks. In order to determine the genetic diversity, in vitro virulence properties and antimicrobial resistance profiles of Citrobacter spp., 128 Citrobacter isolates obtained from human diarrheal patients, foods and environment were assessed by multilocus sequence typing (MLST), antimicrobial susceptibility testing and adhesion and cytotoxicity testing to HEp-2 cells. The 128 Citrobacter isolates were typed into 123 sequence types (STs) of which 101 were novel STs, and these STs were divided into five lineages. Lineages I and II contained C. freundii isolates; Lineage III contained all C. braakii isolates, while Lineage IV and V contained C. youngae isolates. Lineages II and V contained more adhesive and cytotoxic isolates than Lineages I, III, and IV. Fifty-one of the 128 isolates were found to be multidrug-resistant (MDR, ≥3) and mainly distributed in Lineages I, II, and III. The prevalence of quinolone resistance varied with Lineage III (C. braakii) having the highest proportion of resistant isolates (52.6%), followed by Lineage I (C. freundii) with 23.7%. Seven qnrB variants, including two new alleles (qnrB93 and qnrB94) were found with Lineage I being the main reservoir. In summary, highly cytotoxic MDR isolates from diarrheal patients may increase the risk of severe disease.

show abstract

Antimicrobial Resistance and Cytotoxicity of Citrobacter spp. in Maanshan Anhui Province, China

Cited by 45 publications

References 49 publications

Clinical and genomic epidemiology of carbapenem-non-susceptible Citrobacter spp. at a tertiary healthcare center over two decades

Clinical and genomic epidemiology of carbapenem-non-susceptible Citrobacter spp. at a tertiary healthcare center over two decades

City-wide metagenomics uncover antibiotic resistance reservoirs in urban beach and sewage waters

Lineage, Antimicrobial Resistance and Virulence of Citrobacter spp

Contact Info

Product

Resources

About