Macrolide resistance mechanisms in<i>Enterobacteriaceae</i>: Focus on azithromycin

Gomes, Cláudia; Martínez-Puchol, Sandra; Palma, Noemí; Horna, Gertrudis; Ruiz-Roldán, Lidia; Pons, María J.; Ruiz, Joaquı́m

doi:10.3109/1040841x.2015.1136261

Cited by 104 publications

(115 citation statements)

References 251 publications

(347 reference statements)

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“…It should be noted that EreB enzyme confers resistance to almost all members of the macrolide class, with the exception of telithromycin, a semisynthetic erythromycin derivative, which belongs to a new class of antibiotics called ketolides [22]. In contrast, the EreA enzyme does not hydrolyze azithromycin and also telithromycin [23].…”

Section: Enzymatic Inactivation or Modification Of Antibioticsmentioning

confidence: 99%

Multidrug-Resistant Bacterial Foodborne Pathogens: Impact on Human Health and Economy

Mancilla-Becerra¹,

Lías-Macías²,

Ramírez-Jiménez³

et al. 2020

Pathogenic Bacteria

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The drug abuse known to occur during growth of animals intended for food production, because of their use as either a prophylactic or therapeutic treatment, promotes the emergence of bacterial drug resistance. It has been reported that at least 25% of the foodborne isolates show drug resistance to one or more classes of antimicrobials (FAO 2018). There are diverse mechanisms that promote drug resistance. It is known that the use of sub-therapeutic doses of antibiotics in animals intended for food production promotes mutations of some chromosomal genes such as gyrA-parC and mphA, which are responsible for quinolone and azithromycin resistance, respectively. Also, the horizontal transfer of resistance genes as groups ("cassettes") or plasmids makes the spread of resistance to different bacterial genera possible, among which there could be pathogens. The World Health Organization considers the emergence of multidrug-resistant pathogenic bacteria as a health problem, since the illnesses caused by them complicate the treatment and increase the morbidity and mortality rates. The complication in the illness treatment caused by a multidrug-resistant pathogen causes economic losses to patients for the payment of long stays in hospitals and also causes economic losses to companies due to the absenteeism of their workers.

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Section: Enzymatic Inactivation or Modification Of Antibioticsmentioning

confidence: 99%

Multidrug-Resistant Bacterial Foodborne Pathogens: Impact on Human Health and Economy

Mancilla-Becerra¹,

Lías-Macías²,

Ramírez-Jiménez³

et al. 2020

Pathogenic Bacteria

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“…The resistance of enterobacteriaceae to antibiotics has been steadily increasing [7]. The resistance of pathogens to cloxacillin [8,9], aztreonam [10,11] and ceftazidime [12,13] has been widely reported.…”

Section: Introductionmentioning

confidence: 99%

Chitin Oligosaccharide (COS) Reduces Antibiotics Dose and Prevents Antibiotics-Caused Side Effects in Adolescent Idiopathic Scoliosis (AIS) Patients with Spinal Fusion Surgery

Zhou

et al. 2017

Marine Drugs

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Antibiotics are always considered for surgical site infection (SSI) in adolescent idiopathic scoliosis (AIS) surgery. However, the use of antibiotics often causes the antibiotic resistance of pathogens and side effects. Thus, it is necessary to explore natural products as drug candidates. Chitin Oligosaccharide (COS) has anti-inflammation and anti-bacteria functions. The effects of COS on surgical infection in AIS surgery were investigated. A total of 312 AIS patients were evenly and randomly assigned into control group (CG, each patient took one-gram alternative Azithromycin/Erythromycin/Cloxacillin/Aztreonam/Ceftazidime or combined daily), experiment group (EG, each patient took 20 mg COS and half-dose antibiotics daily), and placebo group (PG, each patient took 20 mg placebo and half-dose antibiotics daily). The average follow-up was one month, and infection severity and side effects were analyzed. The effects of COS on isolated pathogens were analyzed. SSI rates were 2%, 3% and 8% for spine wounds and 1%, 2% and 7% for iliac wound in CG, EG and PG (p < 0.05), respectively. COS reduces the side effects caused by antibiotics (p < 0.05). COS improved biochemical indexes and reduced the levels of interleukin (IL)-6 and tumor necrosis factor (TNF) alpha. COS reduced the antibiotics dose and antibiotics-caused side effects in AIS patients with spinal fusion surgery by improving antioxidant and anti-inflammatory activities. COS should be developed as potential adjuvant for antibiotics therapies.

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“…Because antimicrobial resistance has increased over time and in many areas these antimicrobial agents are losing their usefulness, azithromycin and fluoroquinolones have become first line drugs for the treatment of ETEC infections. Azithromycin, an antimicrobial agent belonging to the macrolide family, owns a favourable membrane permeability, making it very effective in treating enterobacteria infection [10,11]. Amounts of studies revealed that although several Enterobacteriaceae have developed resistance to azithromycin, the overall level of resistance is absolutely low.…”

mentioning

confidence: 99%

“…(1) overexpression of efflux pump, (2) peptidyl tRNA hydrolase overexpression, (3) chromosomal mutations such as changes in ribosomal proteins and 23S rRNA mutations, (4) methylation mediated by methylases encoded by erm genes (especially ermA and ermB), (5) macrolides-inactivation, mediated by esterases encoded by the ereA and ereB genes and/or phosphotransferases encoded by mphA and mphB [10][11][12][13][14]. Among these mechanisms, macrolide resistance gene mphA was reported to play an important role in developing resistance to azithromycin, and Enterobacteriaceae with MIC values more than 256 mg/L of azithromycin often carry mphA [10,15].…”

mentioning

confidence: 99%

A new plasmid carrying mphA causes prevalence of azithromycin resistance in enterotoxigenic Escherichia coli serogroup O6

Xiang¹,

Wang²,

Chai³

et al. 2020

Preprint

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Background: At present, azithromycin has become an effective treatment for severe diarrhea caused by Enterotoxigenic Escherichia coli (ETEC) infection. However, enterobacteria have begun to develop resistance to azithromycin and have attracted attention in recent years. This study conducted to described the emergence of a high proportion of azithromycin-resistant ETEC serogroup O6 strains in Shanghai and to analyzed the mechanisms of azithromycin resistance.Results: Strains from adult diarrhea patients with ETEC serogroup O6 infections were collected by Shanghai Diarrhea Surveillance Network and the Foodborne Surveillance Network from 2016 to 2018. We tested 30 isolates of ETEC O6 serogroup, 26 of which were resistant to azithromycin. Phylogenetic analysis revealed that these ETEC serogroup O6 strains have formed an independent dominant clone. S1-PFGE and southern blotting revealed the presence of the mphA gene on the 103kb plasmid. Illumina and Nanopore sequencing and plasmid coverage analysis further confirmed that azithromycin-resistant strains carried a novel IncFII plasmid harboring mphA and blaTEM-1 resistance genes.Conclusions: This is the first study to report a high proportion of azithromycin resistance in a particular ETEC serogroup due to a specific plasmid carrying mphA. Our findings indicate the rapid spread of azithromycin resistance, highlighting the urgency of stringent surveillance and control measure.

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Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Cited by 104 publications

References 251 publications

Multidrug-Resistant Bacterial Foodborne Pathogens: Impact on Human Health and Economy

Multidrug-Resistant Bacterial Foodborne Pathogens: Impact on Human Health and Economy

Chitin Oligosaccharide (COS) Reduces Antibiotics Dose and Prevents Antibiotics-Caused Side Effects in Adolescent Idiopathic Scoliosis (AIS) Patients with Spinal Fusion Surgery

A new plasmid carrying mphA causes prevalence of azithromycin resistance in enterotoxigenic Escherichia coli serogroup O6

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