New Delhi Metallo-β-Lactamase and Multidrug Resistance: A Global SOS?

Bonomo, Robert A.

doi:10.1093/cid/ciq179

Cited by 74 publications

(62 citation statements)

References 22 publications

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“…In contrast, bla KPC genes were found to be more prevalent in meropenem-resistant isolates from H1a, which consisted of bacteria belonging to Enterobacteriaceae. This result is consistent with other reports where metallo-␤-lactamases was found across various bacterial species and the presence of serine-based carbapenemase was mainly restricted to Enterobacteriaceae (48,49). The detection of the bla NDM gene in a variety of bacterial species in hospital wastewaters demonstrates the ability of the bla NDM -bearing plasmid to successfully establish itself in other strains, providing other possible routes of transmission and dissemination to other bacteria within the hospital wastewater community.…”

Section: Discussionsupporting

confidence: 93%

Occurrences and Characterization of Antibiotic-Resistant Bacteria and Genetic Determinants of Hospital Wastewater in a Tropical Country

Chen

et al. 2016

Antimicrob Agents Chemother

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e Wastewater discharged from clinical isolation and general wards at two hospitals in Singapore was examined to determine the emerging trends of antibiotic resistance (AR). We quantified the concentrations of 12 antibiotic compounds by analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS), antibiotic-resistant bacteria (ARB), the class 1 integrase gene (intI1), and 16 antibiotic resistance genes (ARGs) that confer resistance to 10 different clinically relevant antibiotics. A subset of 119 antibiotic-resistant isolates were phylogenetically classified and tested for the presence of ARGs encoding resistance to ␤-lactam antibiotics (bla NDM , bla KPC , bla SHV , bla CTX-M ), amikacin [aac(6=)-Ib], co-trimoxazole (sul1, sul2, dfrA), ciprofloxacin (qnrA, qnrB), and the intI1 gene. Among these resistant isolates, 80.7% were detected with intI1 and 66.4% were found to carry at least 1 of the tested ARGs. Among 3 sampled locations, the clinical isolation ward had the highest concentrations of ARB and the highest levels of ARGs linked to resistance to ␤-lactam (bla KPC ), co-trimoxazole (sul1, sul2, dfrA), amikacin [aac(6=)-Ib], ciprofloxacin (qnrA), and intI1. We found strong positive correlations (P < 0.05) between concentrations of bacteria resistant to meropenem, ceftazidime, amikacin, co-trimoxazole, and ciprofloxacin and abundances of bla KPC , aac(6=)-Ib, sul1, sul2, dfrA, qnrA, and intI1 genes.

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Section: Discussionsupporting

confidence: 93%

Occurrences and Characterization of Antibiotic-Resistant Bacteria and Genetic Determinants of Hospital Wastewater in a Tropical Country

Chen

et al. 2016

Antimicrob Agents Chemother

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“…Since its initial identification in 2008 (25), bla NDM-1 has been identified in many countries (1,11,22), and the global distribution of this gene is imminent (20). bla NDM-1 is found in an ever-widening number of bacterial species and is strongly associated with large, highly mobile plasmids that carry numerous other antibiotic resistance genes (22,25).…”

mentioning

confidence: 99%

Complete Sequence of a Novel 178-Kilobase Plasmid Carrying bla _NDM-1 in a Providencia stuartii Strain Isolated in Afghanistan

McGann

Hang

Clifford

et al. 2012

Antimicrob Agents Chemother

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bIn response to global concerns over the spread of the New Delhi metallo-␤-lactamase gene 1, bla NDM-1 , a monthly surveillance program was initiated in September 2010. All carbapenem-resistant Gram-negative strains forwarded to our facility are screened for this gene. To date, 321 carbapenem-resistant isolates, encompassing 11 bacterial species, have been tested. In February 2011, two strains of Providencia stuartii, submitted from a military hospital in Afghanistan, tested positive for bla NDM-1 . Both strains were identical by pulsed-field gel electrophoresis (PFGE). bla NDM-1 was carried on a large plasmid, pMR0211, which was sequenced by emulsion PCR and pyrosequencing. pMR0211 is 178,277 bp in size and belongs to incompatibility group A/C. The plasmid consists of a backbone with considerable homology to pAR060302 from Escherichia coli, and it retains many of the antibiotic resistance genes associated with it. The plasmid also shares common elements with the pNDM-HK plasmid, including bla NDM-1 , armA, and sul1. However, gene orientation is reversed, and a 3-kb fragment from this region is absent from pMR0211. pMR0211 also contains additional genes, including the aminoglycoside-modifying enzyme loci aadA and aac(6=), the quinolone resistance gene qnrA, a gene with highest homology to a U32 family peptidase from Shewanella amazonensis, and the bla OXA-10 gene. The finding of this gene in an intrinsically colistin-resistant species such as Providencia stuartii is especially worrisome, as it renders the organism resistant to nearly every available antibiotic. The presence of multiple insertion sequences and transposons flanking the region containing the bla NDM-1 gene further highlights the potential mobility associated with this gene.

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“…The variation of these NDM types results from mutation within the gene encoding the β-lactamase [64]. #NDM-1 has drawn atention since the gene encoding these MBLs is located in a mobile genetic element and the patern of spread proves to be more complex [65]. NDM can coexist with other antibiotic-resistant genes.…”

Section: Factors and Mechanisms Involved In Resistance To β-Lactam Anmentioning

confidence: 99%

Toxicity of β-Lactam Antibiotics: Pathophysiology, Molecular Biology and Possible Recovery Strategies

Bozcal¹,

Dagdeviren²

2017

Poisoning - From Specific Toxic Agents to Novel Rapid and Simplified Techniques for Analysis

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Beta (β)-lactam antibiotics are wide-spectrum antibiotics used for various bacterial infections. The aim of this chapter is to summarize the knowledge about the toxicity of β-lactam antibiotics and issues associated to their inappropriate use. This review has highlighted that β-lactam antibiotics are a group of products that have a chemical structure characterized by a β-lactam ring and are one of the most common antibacterial agents. However, due to the inappropriate use including abuse and misuse, resistance to the β-lactam antibiotics is currently a global crisis. Moreover, even when used appropriately, they have been linked to triggering allergic reactions like urticaria, bronchoconstriction, also severe conditions like immune-mediated haemolytic anaemia and intravascular haemolysis. It is known that some β-lactam antibiotics are neurotoxic, some are nephrotoxic, some are genotoxic and some are toxic to urogenital system. Several factors are involved in the occurrence of toxic efects including the dosage and renal status. Several strategies are possible to overcome β-lactam antibiotics-triggered toxicity, including rational prescribing, substitution combination and phage therapy which seems promising. Public health education for clinical teams and patients is essential in ensuring that this group of antibiotics are retained in therapeutics.

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New Delhi Metallo-β-Lactamase and Multidrug Resistance: A Global SOS?

Cited by 74 publications

References 22 publications

Occurrences and Characterization of Antibiotic-Resistant Bacteria and Genetic Determinants of Hospital Wastewater in a Tropical Country

Occurrences and Characterization of Antibiotic-Resistant Bacteria and Genetic Determinants of Hospital Wastewater in a Tropical Country

Complete Sequence of a Novel 178-Kilobase Plasmid Carrying bla _NDM-1 in a Providencia stuartii Strain Isolated in Afghanistan

Toxicity of β-Lactam Antibiotics: Pathophysiology, Molecular Biology and Possible Recovery Strategies

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New Delhi Metallo-β-Lactamase and Multidrug Resistance: A Global SOS?

Cited by 74 publications

References 22 publications

Occurrences and Characterization of Antibiotic-Resistant Bacteria and Genetic Determinants of Hospital Wastewater in a Tropical Country

Occurrences and Characterization of Antibiotic-Resistant Bacteria and Genetic Determinants of Hospital Wastewater in a Tropical Country

Complete Sequence of a Novel 178-Kilobase Plasmid Carrying bla NDM-1 in a Providencia stuartii Strain Isolated in Afghanistan

Toxicity of β-Lactam Antibiotics: Pathophysiology, Molecular Biology and Possible Recovery Strategies

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Complete Sequence of a Novel 178-Kilobase Plasmid Carrying bla _NDM-1 in a Providencia stuartii Strain Isolated in Afghanistan