CTX-M-15 is established in most multidrug-resistant uropathogenic Enterobacteriaceae and Pseudomonaceae from hospitals in Nigeria

Ogbolu, David Olusoga; Alli, O. A. Terry; Webber, Mark A.; Oluremi, Adeolu Sunday; Oloyede, Omoboriowo Moses

doi:10.1556/1886.2017.00012

Cited by 36 publications

(24 citation statements)

References 20 publications

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“…In the current study, we demonstrated the high prevalence of CTX-M and TEM genes in community patients. e results were consistent with other studies done in the region; however, most of the studies were investigating strains isolated from hospitalized individuals with the common presence of CTX-M-15 gene [23,24]. CTX-M-producing E. coli isolates are o en coresistant to various antibiotic classes, which include co-trimoxazole, the aminoglycosides, and the fluoroquinolones [25].…”

Section: Resultssupporting

confidence: 88%

Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women

Ghaddar

Anastasiadis

Halimeh

et al. 2020

Infectious Diseases in Obstetrics and Gynecology

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Introduction. Infections caused by extended spectrum beta lactamase (ESBL) producing bacteria continue to be a challenge for choosing the appropriate therapy since they may exhibit coresistance to many other classes of antibiotics. The aim of the study was to screen pregnant women for ESBL producing bacteria in Beirut, Lebanon, to examine their phenotypic and genotypic characterization and to study the association between ESBL colonization with adverse neonatal outcomes. Method. In this cross-sectional study, vaginal samples from 308 pregnant women at 35–37 weeks of gestation were studied during a one-year period. The samples were plated on MacConkey agar and selective MacConkey agar supplemented with ceftazidime. Phenotypic confirmation of ESBL production was performed by double-disc synergy test and all isolates were screened by PCR for the resistance genes blaSHV, blaTEM, and blaCTX-M. Clonal relatedness of Escherichia coli isolates was investigated by pulsed-field gel electrophoresis. Results. In total, 59 women out of 308 (19.1%) were colonized by ESBL producing gram negative bacteria. Two babies born to mothers colonized with ESBL were diagnosed with sepsis. The susceptibility rates of isolates to other antibiotics were 39% to co-trimoxazole, 49.2% to ciprofloxacin, 91.5% to gentamicin, 18.6% to aztreonam and 35.6% to cefepime. Most of isolates were highly sensitive to meropenem and imipenem, with a susceptibility of 93.2%. PCR was performed on all E. coli isolates to detect the most common ESBL producing genes; blaCTX-M was the predominant gene (90.7%), followed by blaTEM (88.4%) and finally blaSHV (44.2%). PFGE analysis of 34 E. coli isolates revealed 22 distinct clusters showing more than 85% similarity. Conclusion. In conclusion, this study showed that Lebanon has a high prevalence of ESBL carriage in pregnant women. Further studies that include a continuous screening of pregnant women and follow up of their newborn clinical status should be conducted to foresee the risk of transmission.

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Section: Resultssupporting

confidence: 88%

Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women

Ghaddar

Anastasiadis

Halimeh

et al. 2020

Infectious Diseases in Obstetrics and Gynecology

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“…Mutant versions of CTX-M are correlated with clinically high rates of resistance and serve here as both a relevant and controlled model to determine the effect phage may have on treatment (26)(27)(28). In contrast to the previous introduction of CAT, which produced sharply defined resistance, the introduction of these beta-lactamases yielded a subtle increase of resistance against ceftazidime, with an increase in the MIC of about 2-fold ( Fig.…”

Section: The Effect Of Bacterial Antibiotic Resistance On Combined Phmentioning

confidence: 99%

Phage-Antibiotic Synergy is Driven by a Unique Combination of Antibacterial Mechanism of Action and Stoichiometry

Liu

Green

Min

et al. 2020

Preprint

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The continued rise in antibiotic resistance is precipitating a medical crisis. Bacteriophage (phage) has been hailed as one possible therapeutic option to augment the efficacy of antibiotics.However, only a handful of studies have addressed the synergistic relationship between phage and antibiotics. Here, we report a comprehensive analysis of phage-antibiotic interaction that evaluates synergism, additivism, and antagonism for all classes of antibiotics across clinically achievable stoichiometries. We combined an optically-based real-time microtiter plate readout with a matrix-like heatmap of treatment potencies to measure phage and antibiotic synergy (PAS), a process we term synography. Phage-antibiotic synography was performed against a pandemic drug-resistant clonal group of E. coli (ExPEC) with antibiotic levels blanketing the minimum inhibitor concentration (MIC) across seven orders of viral titers. Our results suggest that, under certain conditions, phages provide an adjuvating effect by lowering the MIC for drugresistant strains. Furthermore, synergistic and antagonistic interactions are highly dependent on the mechanism of bacterial inhibition by the class of antibiotic paired to the phage, and when synergism is observed, it suppresses the emergence of resistant cells. Host conditions that simulate the infection environment, including serum and urine, suppress PAS in a bacterial growth-dependent manner. Lastly, phage burst size seems to be a significant driver of synergism.Collectively, this data suggests lytic phages can resuscitate an ineffective antibiotic for previously resistant bacteria, while also synergize with antibiotics in a class-dependent manner, processes that may be dampened by lower bacterial growth rates found in host environments. Significance StatementBacteriophage (phage) therapy is a promising approach to combat the rise of multi-drug resistant bacteria. Currently, the preferred clinical modality is to pair phage with an antibiotic, a practice thought to improve efficacy. However, antagonism between phage and antibiotics has been reported, the choice of phage and antibiotic is not often empirically determined, and the effect of the host factors on the effectiveness is unknown. Here, we interrogate phage-antibiotic interactions across antibiotics with different mechanisms of action. Our results suggest that phage can lower the working MIC for bacterial strains already resistant to the antibiotic, is dependent on the antibiotic class and stoichiometry of the pairing, and is dramatically influenced by the host microenvironment.

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“…It therefore appears that blaCTX-M15 is the most frequently found ESBL in our study. Several other studies have shown that blaCTX-M15 is the enzyme most commonly found in strains circulating in the hospital environment as well as within the community [36]. The emergence and spread and spread of ESBLs in West African countries are therefore linked to the global expansion of the CTX-M15 type [37].…”

Section: Discussionmentioning

confidence: 99%

Molecular characterization of Enterobacteriaceae producing β-lactamase and methicillin-resistant staphylococci isolated from the hospital environment and catheters in two public hospitals in Benin

Gbotche¹,

Dougnon²,

Chabi³

et al. 2020

Preprint

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Background: Antimicrobial resistance is a real public health problem. All over the world, it has a considerable impact in hospitals. The present study aims to analyze the presence of resistance genes and bacterial ecology in two hospitals in Benin. Methods: To do this, 146 environmental and catheter samples were collected at the University Hospital Center of Abomey-Calavi / So-Ava and at the Beninese Army Hospital. These samples were inoculated on Mannitol Salt and Eosin Methylene Blue agars. The colonies obtained were identified and their sensitivity to antibiotics was tested, using the usual bacteriological techniques. Four resistance genes encoding the production of extended spectrum beta-lactamases (blaCTX-M1, blaCTX-M2, blaCTX-M9, blaCTX-M15) have been searched in the genome of enterobacteriaceae strains. At the level of staphylococci, the gene coding for methicillin resistance (mecA) was sought.Results: At the end of this study, 69 strains of enterobacteria and 60 of staphylococci were identified. A predominance of Staphylococcus aureus (25.6%) followed by Enterobacter cloacae (21.0%) and coagulase negative staphylococci (21.0%) was noted. These bacterial strains showed to be multidrug-resistant, particularly to beta-lactams, fluoroquinolones, aminoglycosides and macrolides. Beta-lactamases were identified in the genome of bacterial strains with a predominance of blaCTX-M15 (42.8%). The frequency of the mecA gene in staphylococci was 50%.Conclusions: These results show the magnitude of the antimicrobial resistance situation in hospitals. They can be used to support advocacy for urgent action at the national level, especially with regard to the management and efficient use of antimicrobials in Benin.

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CTX-M-15 is established in most multidrug-resistant uropathogenic Enterobacteriaceae and Pseudomonaceae from hospitals in Nigeria

Cited by 36 publications

References 20 publications

Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women

Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women

Phage-Antibiotic Synergy is Driven by a Unique Combination of Antibacterial Mechanism of Action and Stoichiometry

Molecular characterization of Enterobacteriaceae producing β-lactamase and methicillin-resistant staphylococci isolated from the hospital environment and catheters in two public hospitals in Benin

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