Genetic mechanisms and correlated risk factors of antimicrobial-resistant ESKAPEE pathogens isolated in a tertiary hospital in Malaysia

Ngoi, Soo Tein; Chong, Chun Wie; Ponnampalavanar, Sasheela; Tang, Soo Nee; Idris, Nuryana; Jabar, Kartini Abdul; Gregory, Michael J.; Husain, Tupur; Teh, Cindy Shuan Ju

doi:10.1186/s13756-021-00936-5

Cited by 8 publications

(7 citation statements)

References 64 publications

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“…Among all the ESKAPE pathogens, OXA was highly prevalent on the chromosomes of A. baumannii (~1.5 copies) per genome, followed by P. aeruginosa and K. pneumoniae . Our results exhibited complete concordance with a recent study, which also reported presence of a large number of blaOXAs in A. baumannii, K. pneumoniae and P. aeruginosa [ 32 ].…”

Section: Resultssupporting

confidence: 93%

Investigating the OXA Variants of ESKAPE Pathogens

2021

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ESKAPE pathogens are the leading cause of nosocomial infections. The Global Priority List of WHO has categorized ESKAPE as priority 1 and 2 pathogens. Even though several mechanisms contribute to antimicrobial resistance, OXA β-lactamase has emerged as a new threat in combating nosocomial infections. In the present study we have investigated the presence of OXA and their variants, copy number, distribution on chromosomes/plasmids, subfamilies, phylogenetic relationships, amino acid identities and variabilities in ESKAPE pathogens. Our results revealed that a total of 929 OXA were present in 2258 completely assembled genomes, which could be further subdivided into 16 sub-families. Among all the ESKAPE pathogens, OXA were highly prevalent in A. baumannii, followed by P. aeruginosa and K. pneumoniae but completely absent in E. faecium and S. aureus while, only a few copies were found in Enterobacter spp. Most of the OXA variants belonged to the OXA-51-like subfamily (200 proteins), followed by OXA-50-like subfamily (189 proteins), OXA-23-like subfamily (156 proteins) and OXA-1-like subfamily (154 proteins). OXA-51-like, OXA-213-like, OXA-134-like, OXA-58-like, OXA-24-like and OXA-20-like subfamilies were present exclusively in A. baumannii. Phylogenetic tree of the subfamilies revealed that OXA-1-like and OXA-33-like, OXA-51-like and OXA-213-like and, OXA-5-like and OXA-10-like belonged to the same branches with amino acid identities as 100%, 97.10% and 80.90% respectively. This indicates that the members of these subfamily-pairs might have evolved from the same ancestor or have recently diverged. Thus, a judicious use of carbapenems is warranted to curtail the rise of new OXA enzymes and preserve them. This is the first detailed report about the OXA of ESKAPE pathogens.

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Section: Resultssupporting

confidence: 93%

Investigating the OXA Variants of ESKAPE Pathogens

2021

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“…Many studies have focused specifically on the Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , Enterobacter spp., and Escherichia coli pathogens that are highly resistant to last-resort drugs and extensively described in different microbial reservoirs [9] . Additionally, MRSA has been reported to be both human- and animal-associated with a high risk for zoonotic transmission 10 , 11 .…”

Section: Microbial Reservoirs Of Antimicrobial Resistancementioning

confidence: 99%

Reservoirs of antimicrobial resistance in the context of One Health

Despotovic

Nies

Busi

et al. 2023

Current Opinion in Microbiology

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“…Multi-drug resistant Enterobacterales strains are one of the greatest public health threats, often causing severe infections, such as bloodstream infections, pneumoniae, and abdominal infections. 14,20 However, data from Shanxi in patients infected with MDR-E is scarce, and the available literature has revealed the risk factors of Gram-negative bacteria infection. Therefore, we reported the mortality risk factors of the patients infected with MDRE pathogens isolated from a tertiary hospital located in Shanxi, China.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18][19] The most encountered ESBL genes among E. coli and KP are blaTEM, blaSHV, and blaCTXM. 20 One study from the Netherlands showed that from 1990 to 2015, fecal colonization rates of ESBL-producing Enterobacterales were estimated to be 14% in healthy populations, increasing by about 5% per year. 21 Moreover, MDRE strains could carry three or more resistance genes and have a broader spectrum of drug resistance than CRE.…”

Section: Introductionmentioning

confidence: 99%

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Mortality Risk Factors and Prognostic Analysis of Patients with Multi-Drug Resistant Enterobacterales Infection

Wang¹,

Li²,

Kang³

et al. 2022

IDR

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Background:The data from the China Network Antibacterial Surveillance Center (http://www.chinets.com) showed that the prevalence of Escherichia coli (E. coli), Klebsiella pneumoniae (KP), and Enterobacter cloacae (ecl), was 18.96%, 14.12%, and 2.74% in 2022, respectively. The resistance rates of E. coli and KP to 3rd or 4th generation cephalosporins were 51.7% and 22.1%, to carbapenems was 1.7% and 3.9%, to quinolones was 55.9% in Shanxi. The generation of extended-spectrum beta-lactamases (ESBLs) is a major mechanism resulting in drug resistance in Enterobacterales. To determine the mortality risk factors of multi-drug resistant Enterobacterales (MDRE) and multi-drug resistant Klebsiella pneumoniae (MDR-KP) infection. Methods: 91 MDR strains from 91 patients were collected from 2015 to 2019 in the second hospital of Shanxi Medical University. The mortality risk factors for the MDRE infections and clinical outcomes were analyzed by univariable and multivariable analysis. The independent predictors of 30-day mortality were analyzed through the Cox regression analysis including the variables with a value <0.2. Results: The majority of patients were admitted to ICUs. Pulmonary infection was a major infection (43.96%, 40/91). Thirty-three (36.26%, 33/91) strains of MDR-KP were only detected in 2018. The proportion of multi-drug resistant Escherichia coli (MDR E. coli) and multi-drug resistant Enterobacter cloacae (MDR ecl) were 16.48% (15/91) and 17.58% (16/91), respectively. The presence of cerebrovascular diseases (OR, 4.046; 95%Cl,; P=0.008) and central venous catheterization (OR, 4.543; 95%Cl, P=0.015) were associated with mortality in patients with MDRE infections. Endotracheal intubation (OR, 4.654; 95%Cl,; P=0.008) was an independent mortality risk factor for patients infected with MDR-KP strains. Patients who received aminoglycoside antibiotics (P=0.057) had a higher 30-day survival rate. The β-lactam antibiotics were the major agent in the clinic. Conclusion:This study implies that patients with cerebrovascular diseases, central venous catheterization, and endotracheal intubation are at risk of carrying MDR isolates.

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Genetic mechanisms and correlated risk factors of antimicrobial-resistant ESKAPEE pathogens isolated in a tertiary hospital in Malaysia

Cited by 8 publications

References 64 publications

Investigating the OXA Variants of ESKAPE Pathogens

Investigating the OXA Variants of ESKAPE Pathogens

Reservoirs of antimicrobial resistance in the context of One Health

Mortality Risk Factors and Prognostic Analysis of Patients with Multi-Drug Resistant Enterobacterales Infection

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