Genomic epidemiology of multidrug‐resistant Gram‐negative organisms

Abstract

The emergence and spread of antibiotic-resistant Gram-negative bacteria (rGNB) across global healthcare networks presents a significant threat to public health. As the number of effective antibiotics available to treat these resistant organisms dwindles, it is essential that we devise more effective strategies for controlling their proliferation. Recently, whole-genome sequencing has emerged as a disruptive technology that has transformed our understanding of the evolution and epidemiology of diverse rGNB species, and it has the potential to guide strategies for controlling the evolution and spread of resistance. Here, we review specific areas in which genomics has already made a significant impact, including outbreak investigations, regional epidemiology, clinical diagnostics, resistance evolution, and the study of epidemic lineages. While highlighting early successes, we also point to the next steps needed to translate this technology into strategies to improve public health and clinical medicine.

In vitro synergistic activity of erythromycin and nisin against clinical Group B Streptococcus isolates

“…The rate of discovery and development of new and effective antibiotics has slowed considerably (Norrby et al ) despite the fact that the global threat of antibiotic resistance remains a significant problem, particularly for treatment of infections caused by multidrug‐resistant pathogens (Hawken and Snitkin ). Thus, there is an urgent need for alternatives to antibiotics or changes to existing treatment regimes in order to prevent further development of antimicrobial resistance and/or improve the mode of action of current antibiotics.…”

A survey of antimicrobial resistance in Enterobacteriaceae isolated from the Chesapeake Bay and adjacent upper tributaries

“…During the recent two decades, antimicrobial resistance (AR) in bacteria has been recognized as a critical public health problem (Hawken & Snitkin, 2019). Besides the fundamental utility of antibiotics in improving human health, antibiotics are widely used for treatment and prevention of infections in animals and plants, as well as for promoting growth in animal farming (Cabello, 2006;McManus, Stockwell, Sundin, & Jones, 2002;Singer et al, 2003;Smith, Harris, Johnson, Silbergeld, & Morris, 2002).…”

“…Besides the fundamental utility of antibiotics in improving human health, antibiotics are widely used for treatment and prevention of infections in animals and plants, as well as for promoting growth in animal farming (Cabello, 2006;McManus, Stockwell, Sundin, & Jones, 2002;Singer et al, 2003;Smith, Harris, Johnson, Silbergeld, & Morris, 2002). However, during the past two decades, development and spread of AR in many bacteria has been recognized with increasing frequency, and now presents a global health crisis (Hawken & Snitkin, 2019;Wattkins & Bonomo, 2016). Each year in the United States alone, approximately 2 million infections due to AR bacteria occur, resulting in at least 23,000 deaths (Centers for Disease Control & Prevention, 2013).…”

“…The economic impact of AR is tremendous and healthcare costs due to infections with AR bacteria continue to increase and pose a significant burden on societies (Wattkins & Bonomo, ). While AR has been described in almost all bacterial pathogens, AR and specifically emerging multidrug resistance (MDR) among gram‐negative bacteria represents a unique and immediate threat (Hawken & Snitkin, ; Lautenbach & Perencevich, ). Furthermore, gram‐negative bacteria and their associated AR have certainly the highest implication for human health, and would be expected to be most likely acquired from external sources.…”

Whole-Genome Sequencing To Identify Drivers of Carbapenem-Resistant Klebsiella pneumoniae Transmission within and between Regional Long-Term Acute-Care Hospitals

“…In a remarkably short time, whole-genome sequencing (WGS) has fundamentally changed the resolution at which one can study the spread of bacterial pathogens (13). Moreover, through integration of genomic data with epidemiologic metadata, the processes driving the spread of these pathogens can be more clearly understood (14).…”