Multidrug and co-resistance patterns of non-fermenting Gram-negative bacilli involved in ventilator-associated pneumonia carrying class 1 integron in the North of Iran

Bagheri-Nesami, Masoumeh; Rezai, Mohammad Sadegh; Ahangarkani, Fatemeh; Rafiei, Alireza; Nikkhah, Attieh; Eslami, Gohar; Shafahi, Kheironesa; Hajalibeig, Azin; Khajavi, Rezvan

doi:10.18683/germs.2017.1117

Cited by 9 publications

(8 citation statements)

References 18 publications

(17 reference statements)

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“…In a worrying study of MDRAB antibiotic susceptibility, it was reported that the colistin resistance rate increased to 35.7% in Iran [19]. In the present study, while all isolates in 2015 were sensitive to colistin, colistin resistance was found to be at 3.8% in 2016.…”

Section: Discussioncontrasting

confidence: 37%

“…In a study reported from Palestine, 40 isolates were obtained from NICU in 2004-2005, and 77.5% of them were found to be resistant to trimethoprim/sulfamethoxazole [13]. In 2 recent studies conducted in Iran and India, the trimethoprim/sulfamethoxazole resistance rate was detected as 92.5% and 73.3%, respectively [19,20]. In a recent survey describing secular trends in the resistance of 39,230 A. baumannii isolates in the United States from 2003 to 2012, it was stated that the rate of resistance to trimethoprim/sulfamethoxazole varied between 52.5-57.5% during the study period, and the total resistance rate was 55.3% [16].…”

Section: Discussionmentioning

confidence: 99%

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Susceptibility Patterns of Multidrug-Resistant Acinetobacter baumannii

2020

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Objectives To investigate the antimicrobial resistance patterns of multidrug-resistant Acinetobacter baumannii (MDRAB) in patients in pediatric intensive care units (PICU) in order to determine a guide for the empirical antibiotic treatment of MDRAB. Methods The authors retrospectively evaluated the medical records of patients with MDRAB infections in the PICU during a follow-up period, between January 2015 and January 2017. The identification of A. baumannii was performed using a BD Phoenix 100 Automated Microbiology System. A BD Phoenix NMIC/ID-400 commercial kit was used to test antibiotic susceptibility. All data was entered into Microsoft Excel, and the data was analyzed using SPSS version 23.0. Results The mean age of the patients was 8.1 ± 6.2 y. In all, 46 isolates were obtained from 33 patients. The most effective antimicrobial agents were colistin, trimethoprim/sulfamethoxazole, and tigecycline. Nevertheless, with the exception of colistin, no antibiotic was associated with a susceptibility rate of >45% for the isolates. Low sensitivities in 2015 to tigecycline, aminoglycosides, levofloxacin, and carbapenems had been lost in 2016. Conclusions Many drugs that were previously effective against MDRAB, have lost their effectiveness. Currently, there is no effective drug to fight MDRAB, apart from colistin. Thus, it is clear that new drugs and treatment protocols should be developed urgently.

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Section: Discussioncontrasting

confidence: 37%

Section: Discussionmentioning

confidence: 99%

Susceptibility Patterns of Multidrug-Resistant Acinetobacter baumannii

2020

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“…us, the class 1 integron was related to intI1, but no significant difference was found in the carrying rate between the pandrug resistance phenotype and multidrug resistance phenotype (P > 0.05). Class 2 and 3 integrons were not detected in any of the strains, which agreed with previous reports [15][16][17][18]. erefore, class 2 and 3 integrons were not related to quinolone resistance in the tested strains.…”

Section: Discussionsupporting

confidence: 92%

Detection of 5 Kinds of Genes Related to Plasmid-Mediated Quinolone Resistance in Four Species of Nonfermenting Bacteria with 2 Drug Resistant Phenotypes

Ming

Chen

Xiaoting

2020

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Objective. This study aimed to detect 5 kinds of genes related to plasmid-mediated quinolone resistance in four species of nonfermenting bacteria with 2 drug resistance phenotypes (multidrug resistance and pandrug resistance), which were Acinetobacter baumannii (Ab), Pseudomonas aeruginosa (Pa), Stenotrophomonas maltophilia (Sm), and Elizabethkingia meningoseptica (Em). Methods. The Phoenix NMIC/ID-109 panel and API 20NE panel were applied to 19 isolated strains, including 6 Ab strains (2 strains with multidrug resistance and 4 strains with pandrug resistance), 6 Pa strains (3 strains with multidrug resistance and 3 strains with pandrug resistance), 4 Sm strains (2 strains with multidrug resistance and 2 strains with pandrug resistance), and 3 Cm strains (2 strains with multidrug resistance and 1 strain with pandrug resistance). After strain identification and drug susceptibility test, PCR was applied to detect 5 genes related to plasmid-mediated quinolone resistance. The genes detected were quinolone resistance A (qnrA), aminoglycoside acetyltransferase ciprofloxacin resistance variant, acc(6′)-Ib-cr, and 3 integrons (intI1, intI2, and intI3). The amplified products were analyzed by 1% agarose gel electrophoresis and sequenced. Sequence alignment was carried out using the bioinformatics technique. Results. Of 19 strains tested, 8 strains carried acc(6′)-Ib-cr and 6 of them were of pandrug resistance phenotype (3 Ab strains, 2 Pa strains, and 1 Sm strain). The carrying rate of acc(6′)-Ib-cr was 60.0% for strains of pandrug resistance (6/10). Two strains were of multidrug resistance (1 Ab strain and 1 Pa strain), and the carrying rate of acc(6′)-Ib-cr was 22.0% (2/9). The carrying rate was significantly different between strains of multidrug resistance and pandrug resistance (P<0.05). The class 1 integron was detected in 11 strains, among which 6 strains were of pandrug resistance (3 Ab strains, 2 Pa strains, and 1 Sm strain). The carrying rate of the class 1 integron was 60.0% (6/10). Five strains were of multidrug resistance (3 Pa strains, 1 Ab strain, and 1 Em strain), and the carrying rate was 55.6% (5/9). The carrying rate of the class 1 integron was not significantly different between strains of multidrug resistance and pandrug resistance (P>0.05). Both acc(6′)-Ib-cr and intI1 were detected in 6 strains, which were negative for qnrA, intI2, and intI3. Conclusion. Quinolone resistance of isolated strains was related to acc(6′)-Ib-cr and intI1 but not to qnrA, intI2, or intI3. The carrying rate of acc(6′)-Ib-cr among the strains of pandrug resistance was much higher than that among the strains of multidrug resistance. But, the strains of two drug resistant phenotypes were not significantly different in the carrying rate of intI1. The detection rates of the two genes were high and similar in Ab and Pa strains. 1 Em strain carried the class 1 integron.

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“…Similar proportions were described in previously published studies from Spain, Iran, and Tunisia [48][49][50]. In this study, the rate of class 1 integrons among CR isolates was 73%, while in reports from Iran, this index was higher (86-95%) [51,52]. In our study, class 1 integrons were detected in 76% of MDR P. aeruginosa, 70% of MDR K. pneumoniae, 68% of MDR A. baumannii, and 34% MDR of E. coli.…”

Section: Discussionsupporting

confidence: 90%

Rectal and Tracheal Carriage of Carbapenemase Genes and Class 1 and 2 Integrons in Patients in Neurosurgery Intensive Care Unit

et al. 2022

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The spread of multidrug-resistant Gram-negative bacteria, which is associated with the distribution of beta-lactamase genes and class 1 and 2 integrons, is a global problem. In this study, in the Moscow neurosurgery intensive care unit (neuro-ICU), the high prevalence of the above-stated genes was found to be associated with intestinal and tracheal carriage. Seven-point prevalence surveys, which included 60 patients in the neuro-ICU, were conducted weekly in the period from Oct. to Nov. 2019. A total of 293 clinical samples were analyzed, including 146 rectal and 147 tracheal swabs; 344 Gram-negative bacteria isolates were collected. Beta-lactamase genes (n = 837) were detected in the isolates, including beta-lactamase blaTEM (n = 162), blaSHV (n = 145), cephalosporinase blaCTX–M (n = 228), carbapenemase blaNDM (n = 44), blaKPC (n = 25), blaOXA–48 (n = 126), blaOXA–51–like (n = 54), blaOXA–40-like (n = 43), blaOXA–23-like (n = 8), and blaVIM (n = 2), as well as class 1 (n = 189) and class 2 (n = 12) integrons. One extensively drug-resistant Klebsiella pneumoniae strain (sequence type ST39 and capsular type K23), simultaneously carried beta-lactamase genes, blaSHV–40 and blaTEM–1B, three carbapenemase genes, blaNDM, blaKPC, and blaOXA–48, the cephalosporinase gene blaCTX–M, and two class 1 integrons. Before this study, such heavily armed strains have not been reported, suggesting the ongoing evolution of antibiotic resistance.

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Multidrug and co-resistance patterns of non-fermenting Gram-negative bacilli involved in ventilator-associated pneumonia carrying class 1 integron in the North of Iran

Abstract: ConclusionThe high prevalence of multidrug resistance and incidence of class 1 integron is a therapeutic concern. Employing antibiotic stewardship in hospitals could prevent the dissemination of MDR bacteria.

Cited by 9 publications

References 18 publications

Susceptibility Patterns of Multidrug-Resistant Acinetobacter baumannii

Susceptibility Patterns of Multidrug-Resistant Acinetobacter baumannii

Detection of 5 Kinds of Genes Related to Plasmid-Mediated Quinolone Resistance in Four Species of Nonfermenting Bacteria with 2 Drug Resistant Phenotypes

Rectal and Tracheal Carriage of Carbapenemase Genes and Class 1 and 2 Integrons in Patients in Neurosurgery Intensive Care Unit

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