Unusually High Prevalence of Cosecretion of Ambler Class A and B Carbapenemases and Nonenzymatic Mechanisms in Multidrug-Resistant Clinical Isolates of <i>Pseudomonas aeruginosa</i> in Lebanon

Yaghi, Joseph; Fattouh, Nour; Akkawi, Charbel; Chamy, Laure El; Maroun, Richard G.; Khalil, Georges

doi:10.1089/mdr.2019.0040

Cited by 15 publications

(10 citation statements)

References 38 publications

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“…Isolates expressing various ESBLs were tested using a dual-disk potentiation method. ESBL prevalence was relatively low (24%) in 2000 but increased dramatically to 84% in 2020 [ 78 , 81 ]. Molecular analysis carried with PCR, shown in Table 2 indicated that bla SHV , bla TEM and bla CTX-M were the most predominant ESBL-encoding genes among E. coli and ESKAPE pathogens, this increasing trend was also observed for bla OXA , and bla GES ESBL traits.…”

Section: Resultsmentioning

confidence: 99%

“…Molecular analysis carried with PCR, shown in Table 2 indicated that bla SHV , bla TEM and bla CTX-M were the most predominant ESBL-encoding genes among E. coli and ESKAPE pathogens, this increasing trend was also observed for bla OXA , and bla GES ESBL traits. On the other hand, bla VIM was the most common metallo-β-lactamass resistance encoding gene which showed remarkable increase, with fewer isolates shown to express the bla NDM ESBL trait [ 77 , 78 , 79 , 80 , 81 ].…”

Section: Resultsmentioning

confidence: 99%

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Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

Nasser

Palwe²,

Bhargava

et al. 2020

Microorganisms

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The production of diverse and extended spectrum β-lactamases among Escherichia coli and ESKAPE pathogens is a growing threat to clinicians and public health. We aim to provide a comprehensive analysis of evolving trends of antimicrobial resistance and β-lactamases among E. coli and ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acine to bacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) in the Arabian region. A systematic review was conducted in Medline PubMed on papers published between January 2000 and February 2020 on countries in the Arab region showing different antibiotic resistance among E. coli and ESKAPE pathogens. A total of n = 119,144 clinical isolates were evaluated for antimicrobial resistance in 19 Arab countries. Among these clinical isolates, 74,039 belonged to E. coli and ESKAPE pathogen. Distribution of antibiotic resistance among E. coli and ESKAPE pathogens indicated that E. coli (n = 32,038) was the predominant pathogen followed by K. pneumoniae (n = 17,128), P. aeruginosa (n = 11,074), methicillin-resistant S. aureus (MRSA, n = 4370), A. baumannii (n = 3485) and Enterobacter spp. (n = 1574). There were no reports demonstrating Enterococcus faecium producing β-lactamase. Analyses revealed 19 out of 22 countries reported occurrence of ESBL (Extended-Spectrum β-Lactamase) producing E. coli and ESKAPE pathogens. The present study showed significantly increased resistance rates to various antimicrobial agents over the last 20 years; for instance, cephalosporin resistance increased from 37 to 89.5%, fluoroquinolones from 46.8 to 70.3%, aminoglycosides from 40.2 to 64.4%, mono-bactams from 30.6 to 73.6% and carbapenems from 30.5 to 64.4%. An average of 36.9% of the total isolates were reported to have ESBL phenotype during 2000 to 2020. Molecular analyses showed that among ESBLs and Class A and Class D β-lactamases, blaCTX-M and blaOXA have higher prevalence rates of 57% and 52.7%, respectively. Among Class B β-lactamases, few incidences of blaVIM 27.7% and blaNDM 26.3% were encountered in the Arab region. Conclusion: This review highlights a significant increase in resistance to various classes of antibiotics, including cephalosporins, β-lactam and β-lactamase inhibitor combinations, carbapenems, aminoglycosides and quinolones among E. coli and ESKAPE pathogens in the Arab region.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

Nasser

Palwe²,

Bhargava

et al. 2020

Microorganisms

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“…In addition, a country-wide outbreak of P. aeruginosa expressing IMP-13 was detected in Italy (290,291). Although they have not spread extensively throughout the rest of the world, they are being reported more frequently in Middle Eastern countries (292,293).…”

Section: Carbapenemase-producing Bacteriamentioning

confidence: 99%

Epidemiology of β-Lactamase-Producing Pathogens

Bush

Bradford²

2020

Clin Microbiol Rev

532

440

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SUMMARY β-Lactam antibiotics have been widely used as therapeutic agents for the past 70 years, resulting in emergence of an abundance of β-lactam-inactivating β-lactamases. Although penicillinases in Staphylococcus aureus challenged the initial uses of penicillin, β-lactamases are most important in Gram-negative bacteria, particularly in enteric and nonfermentative pathogens, where collectively they confer resistance to all β-lactam-containing antibiotics. Critical β-lactamases are those enzymes whose genes are encoded on mobile elements that are transferable among species. Major β-lactamase families include plasmid-mediated extended-spectrum β-lactamases (ESBLs), AmpC cephalosporinases, and carbapenemases now appearing globally, with geographic preferences for specific variants. CTX-M enzymes include the most common ESBLs that are prevalent in all areas of the world. In contrast, KPC serine carbapenemases are present more frequently in the Americas, the Mediterranean countries, and China, whereas NDM metallo-β-lactamases are more prevalent in the Indian subcontinent and Eastern Europe. As selective pressure from β-lactam use continues, multiple β-lactamases per organism are increasingly common, including pathogens carrying three different carbapenemase genes. These organisms may be spread throughout health care facilities as well as in the community, warranting close attention to increased infection control measures and stewardship of the β-lactam-containing drugs in an effort to control selection of even more deleterious pathogens.

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“…Embora, o gene blaKPC tenha sido identificado em isolados de Klebsiella spp desde então, já foram documentadas nas Americas (Castanheira et al, 2020, Cuaical-Ramos et al, 2019 incluindo o Brasil (Firmo et al, 2020, Araújo et al, 2018. A carbapenemase blaVIM foi predominante, seguida de blaKPC e blaNDM em infecção da corrente sanguinea em um estudo Grego A coexistência simultânea de diversas β-lactamases também foram detectados no Egito (Benmahmod et al, 2019), no Iran (Kiaei et al, 2019), no Líbano (Yaghi et al, 2020).…”

Section: Discussionunclassified

Epidemiologia molecular de bacilos Gram-negativos multidroga resistente produtores de carbapenemases isoladas de diferentes sítios de infecção

Soares

Silva

Júnior

et al. 2021

RSD

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A resistência a carbapenemases em bacilos gram-negativas (BGN) tornou-se um problema mundial, elevando a taxa de morbidade e mortalidade. O método automatizado foi utilizado para identificação e suscetibilidade dos isolados. E o método molecular foi aplicado na detecção de bacilos gram-negativas (BGN) produtoras de carbapenemase. Um total de 205 BGN foram recuperados a partir de diferentes amostras clínicas, resistentes a carbapenemases. Os genes de resistência blaKPC (57,5%), blaVIM (30,2%), blaGES (17%), blaNDM (15%) e blaSPM (2,4%) foram recuperados a partir de isolados clínicos. O gene blaIMP não foi detectado em nenhum dos isolados. É preocupante que Pseudomonas aeruginosa e Acinetobacter baumannii representem a maioria dos isolados (61,6%) recuperados de infecções de diferentes sítios, com alta resistência a carbapenêmicos, carregando simultaneamente os genes blaKPC, blaGES e blaVIM, assim como encontrados também em Enterobactericeae. A carbapenemase mais prevalente foi blaKPC e blaVIM, seguida de blaNDM dentre os isolados multidroga resistentes. Esses resultados são um ameaça à saúde pública, configurando altas taxas de resistência, limitando as opções terapêuticas.

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Unusually High Prevalence of Cosecretion of Ambler Class A and B Carbapenemases and Nonenzymatic Mechanisms in Multidrug-Resistant Clinical Isolates of Pseudomonas aeruginosa in Lebanon

Cited by 15 publications

References 38 publications

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

Epidemiology of β-Lactamase-Producing Pathogens

Epidemiologia molecular de bacilos Gram-negativos multidroga resistente produtores de carbapenemases isoladas de diferentes sítios de infecção

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