ABSTRACT
Helicobacter pylori resistance to antibiotics is a growing problem and it increasingly leads to treatment failure. While the bacterium is present worldwide, the severity of clinical outcomes is highly dependent on the geographical origin and genetic characteristics of the strains. One of the major virulence factors identified in H. pylori is the cag pathogenicity island (cagPAI), which encodes a type IV secretion system (T4SS) used to translocate effectors into human cells. Here, we investigated the genetic variability of the cagPAI among 13 antibiotic-resistant H. pylori strains that were isolated from patient biopsies in Québec. Seven of the clinical strains carried the cagPAI, but only four could be readily cultivated under laboratory conditions. We observed variability of the sequences of CagA and CagL proteins that are encoded by the cagPAI. All clinical isolates induce interleukin-8 secretion and morphological changes upon co-incubation with gastric cancer cells and two of them produce extracellular T4SS pili. Finally, we demonstrate that molecule 1G2, a small molecule inhibitor of the Cagα protein from the model strain H. pylori 26695, reduces interleukin-8 secretion in one of the clinical isolates. Co-incubation with 1G2 also inhibits the assembly of T4SS pili, suggesting a mechanism for its action on T4SS function.
Subject(s)
Helicobacter Infections , Helicobacter pylori , Humans , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Antigens, Bacterial/genetics , Type IV Secretion Systems/genetics , Type IV Secretion Systems/metabolism , Helicobacter pylori/genetics , Helicobacter pylori/metabolism , Interleukin-8/metabolism , Helicobacter Infections/microbiologyABSTRACT
Multidrug-resistant (MDR) Shigella sonnei have become prevalent among men who have sex with men and have become a global public health concern. From June 2017 to April 2019, 32 men were infected with MDR S. sonnei acquired locally, in Montréal, which was suggestive of an outbreak. Antimicrobial susceptibility testing, whole-genome sequencing (WGS), phylogenetic analysis, antimicrobial resistance and virulence characterization, and association to international clusters were performed. The outbreak strain was ceftriaxone- and azithromycin-resistant due to the acquisition of blaCTX-M-27, and mphA and ermB genes, respectively, with reduced susceptibility to ciprofloxacin due to a single point mutation (gyrA S83L). One out of 27 patients treated with a fluoroquinolone experienced microbiological failure. Epidemiological evidence first supported by a rare unique MDR Shigella sonnei documented only in men in 2017 followed by similar pulsed-field gel electrophoresis profiles was confirmed by WGS. A core genome high-quality single-nucleotide variant (hqSNV)-based phylogeny found a median of 6 hqSNV differences among isolates. Virulence gene content was investigated, but no Shiga toxins were detected. An international cluster of highly related isolates was identified (PDS000019750.208) and belonged to the 3.7.29.1.4.1 S. sonnei genotype (Global III VN2.KH1.Aus). Genomic analysis revealed that this Montréal cluster was connected to other documented outbreaks in Australia, the United States, and the United Kingdom. This study highlights the urgent need for public health measures to focus on the prevention and the early detection of S. sonnei, since global transmission patterns of MDR strains is concerning and few antimicrobial treatment options are available. IMPORTANCE Shigella sonnei, an important foodborne pathogen, recently became a frequent sexually transmitted agent involved in large and persistent outbreaks globally among men who have sex with men. Most strains also harbor several multidrug-resistant (MDR) determinants of particular concern. This study characterizes an outbreak strain at the source of an important MDR cluster identified in Montréal in 2017. Associations were made to many high-profile international outbreaks, and the causative S. sonnei lineage of these clusters was identified, which was not evident in past reports. The worldwide occurrence of this strain is of concern since treatment with antimicrobials like ceftriaxone and azithromycin may not be effective, and rare microbiological failures have been documented in patients treated with ciprofloxacin. Our investigation highlights the threats of Shigella spp. infection and the necessity for antimicrobial susceptibility monitoring in order to mitigate S. sonnei's impact on public health and to avoid transmission to other at-risk communities.
Subject(s)
Dysentery, Bacillary , Sexual and Gender Minorities , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Azithromycin/pharmacology , Ceftriaxone/pharmacology , Ceftriaxone/therapeutic use , Ciprofloxacin/pharmacology , Ciprofloxacin/therapeutic use , Drug Resistance, Bacterial/genetics , Dysentery, Bacillary/drug therapy , Dysentery, Bacillary/epidemiology , Dysentery, Bacillary/microbiology , Genomics , Homosexuality, Male , Humans , Male , Microbial Sensitivity Tests , Phylogeny , Shigella sonnei/geneticsABSTRACT
BACKGROUND: Campylobacter species are among the most common causes of enteric bacterial infections worldwide. Men who have sex with men (MSM) are at increased risk for sexually transmitted enteric infections, including globally distributed strains of multidrug-resistant Shigella species. METHODS: This was a retrospective study of MSM-associated Campylobacter in Seattle, Washington and Montréal, Québec with phenotypic antimicrobial resistance profiles and whole genome sequencing (WGS). RESULTS: We report the isolation of 2 clonal lineages of multidrug-resistant Campylobacter coli from MSM in Seattle and Montréal. WGS revealed nearly identical strains obtained from the 2 regions over a 4-year period. Comparison with the National Center for Biotechnology Information's Pathogen Detection database revealed extensive Campylobacter species clusters carrying multiple drug resistance genes that segregated with these isolates. Examination of the genetic basis of antimicrobial resistance revealed multiple macrolide resistance determinants including a novel ribosomal RNA methyltransferase situated in a CRISPR (clustered regularly interspaced short palindromic repeats) array locus in a C. coli isolate. CONCLUSIONS: As previously reported for Shigella, specific multidrug-resistant strains of Campylobacter are circulating by sexual transmission in MSM populations across diverse geographic locations, suggesting a need to incorporate sexual behavior in the investigation of clusters of foodborne pathogens revealed by WGS data.
Subject(s)
Campylobacter Infections , Campylobacter coli , Sexual and Gender Minorities , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Campylobacter Infections/drug therapy , Campylobacter Infections/epidemiology , Campylobacter coli/genetics , Drug Resistance, Bacterial , Homosexuality, Male , Humans , Macrolides , Male , Microbial Sensitivity Tests , Quebec/epidemiology , Retrospective Studies , Washington/epidemiologyABSTRACT
We analyzed 254 Shigella species isolates collected in Québec, Canada, during 2013 and 2014. Overall, 23.6% of isolates showed reduced susceptibility to azithromycin (RSA) encoded by mphA (11.6%), ermB (1.7%), or both genes (86.7%). Shigella strains with RSA were mostly isolated from men who have sex with men (68.8% or higher) from the Montreal region. A complete sequence analysis of six selected plasmids from Shigella sonnei and different serotypes of Shigella flexneri emphasized the role of IS26 in the dissemination of RSA.
Subject(s)
Azithromycin/pharmacology , Shigella/drug effects , Shigella/pathogenicity , Anti-Bacterial Agents/pharmacology , Canada , Homosexuality, Male/statistics & numerical data , Humans , Male , Microbial Sensitivity Tests , Quebec , Shigella flexneri/drug effects , Shigella flexneri/pathogenicity , Shigella sonnei/drug effects , Shigella sonnei/pathogenicityABSTRACT
From March 2014 to December 2016, a cluster of 13 cases of Campylobacter fetus intestinal and extraintestinal infections, including 2 patients with an aortic mycotic aneurysm, caused significant morbidity. The cluster likely resulted from sexual transmission between men having sex with men living in the greater Montreal area, Quebec, Canada.
Subject(s)
Campylobacter Infections/epidemiology , Campylobacter fetus/genetics , Disease Outbreaks/statistics & numerical data , Homosexuality, Male/statistics & numerical data , Sexually Transmitted Diseases, Bacterial/epidemiology , Adult , Aged , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Campylobacter Infections/drug therapy , Campylobacter Infections/microbiology , Campylobacter Infections/transmission , Campylobacter fetus/classification , Campylobacter fetus/drug effects , Cluster Analysis , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Quebec/epidemiology , Retrospective Studies , Sexually Transmitted Diseases, Bacterial/drug therapy , Sexually Transmitted Diseases, Bacterial/microbiology , Sexually Transmitted Diseases, Bacterial/transmissionABSTRACT
Plesiomonas shigelloides, the only oxidase-positive Enterobacteriaceae, is an inhabitant of freshwater and estuary ecosystems. We report the first possible case of Plesiomonas shigelloides-induced septic abortion. This 24-year-old female was successfully treated by dilatation and curettage as well as antimicrobial therapy.
Subject(s)
Anti-Bacterial Agents/pharmacology , Azithromycin/pharmacology , Ciprofloxacin/pharmacology , Drug Resistance, Bacterial , Dysentery, Bacillary/epidemiology , Dysentery, Bacillary/microbiology , Shigella flexneri/drug effects , Canada/epidemiology , Coinfection , Dysentery, Bacillary/diagnosis , Dysentery, Bacillary/history , HIV Infections/drug therapy , HIV Infections/virology , History, 21st Century , Humans , Microbial Sensitivity Tests , Population Surveillance , Shigella flexneri/geneticsSubject(s)
Anti-Bacterial Agents/pharmacology , Campylobacter Infections/microbiology , Campylobacter Infections/transmission , Campylobacter coli/drug effects , Drug Resistance, Multiple, Bacterial , Homosexuality, Male , Anti-Bacterial Agents/therapeutic use , Campylobacter Infections/drug therapy , Campylobacter Infections/epidemiology , Campylobacter coli/classification , Campylobacter coli/genetics , Disease Outbreaks , Electrophoresis, Gel, Pulsed-Field , Humans , Male , Microbial Sensitivity Tests , Quebec/epidemiology , beta-Lactamases/geneticsABSTRACT
INTRODUCTION: Enterococcus pallens is one of the four yellow-pigmented members of the genus Enterococcus. To date, a single report of E. pallens isolated from a human sample has been published. CASE PRESENTATION: We report three cases of E. pallens spontaneous bacterial peritonitis in patients with liver cirrhosis that all occurred in Quebec, Canada. Ascitic fluid analysis revealed the presence of E. pallens in culture. Identification was made by classical biochemical testing and MALDI-TOF MS, as well as 16S rRNA and elongation factor (tuf) gene sequencing. Two of the three patients recovered after antimicrobial treatment. CONCLUSION: This report identifies E. pallens as a novel human pathogen that appears to possess particular but as-yet unidentified virulence factors that favour the development of peritoneal fluid infections, as previously reported for other Enterococcus species. Clinical microbiologist should be aware of this micro-organism which can be identified by phenotypic and molecular methods.
ABSTRACT
From January 2003 to December 2013, sexual transmission of 2 clades of Campylobacter jejuni subspecies jejuni isolates resulted in a prolonged outbreak among men who have sex with men living in Quebec, Canada. The outbreak isolates were acquired locally and were resistant to erythromycin and ciprofloxacin.
Subject(s)
Anti-Bacterial Agents/pharmacology , Campylobacter Infections/epidemiology , Campylobacter jejuni/isolation & purification , Ciprofloxacin/pharmacology , Disease Outbreaks , Drug Resistance, Multiple, Bacterial , Erythromycin/pharmacology , Adult , Campylobacter Infections/microbiology , Campylobacter Infections/transmission , Campylobacter jejuni/drug effects , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , Genotype , Homosexuality, Male , Humans , Male , Middle Aged , Molecular Epidemiology , Phylogeny , Quebec/epidemiology , Sequence Analysis, DNA , Sexually Transmitted Diseases, Bacterial/epidemiology , Sexually Transmitted Diseases, Bacterial/microbiology , Sexually Transmitted Diseases, Bacterial/transmission , Young AdultABSTRACT
From 2002 to 2013 in Montreal, Quebec, Canada, 38 Campylobacter coli isolates were more frequently erythromycin, tetracycline, and ciprofloxacin resistant than 440 Campylobacter jejuni subsp. jejuni isolates (18.4% versus 1.8%; P = 0.00005), of which the 148 isolates acquired abroad were more frequently erythromycin, tetracycline, and ciprofloxacin resistant than the 292 isolates acquired locally (5.4% versus 0%; P = 0.0001).
Subject(s)
Anti-Bacterial Agents/pharmacology , Campylobacter coli/drug effects , Campylobacter jejuni/drug effects , Drug Resistance, Bacterial , Campylobacter Infections/microbiology , Campylobacter coli/isolation & purification , Campylobacter jejuni/isolation & purification , Ciprofloxacin/pharmacology , Erythromycin/pharmacology , Humans , Microbial Sensitivity Tests , Quebec , Tetracycline/pharmacologyABSTRACT
During 2012-2013 in Montreal, Canada, 4 locally acquired Shigella spp. pulse types with the mph(A) gene and reduced susceptibility to azithromycin were identified from 9 men who have sex with men, 7 of whom were HIV infected. Counseling about prevention of enteric sexually transmitted infections might help slow transmission of these organisms.
Subject(s)
Anti-Bacterial Agents/pharmacology , Azithromycin/pharmacology , Drug Resistance, Bacterial , Dysentery, Bacillary/epidemiology , Dysentery, Bacillary/microbiology , Shigella/drug effects , Adult , Coinfection/epidemiology , Drug Resistance, Bacterial/genetics , Female , Genes, Bacterial , Homosexuality, Male , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Phosphotransferases (Alcohol Group Acceptor)/genetics , Public Health Surveillance , Quebec/epidemiology , Sexually Transmitted Diseases , Shigella/geneticsABSTRACT
Cupriavidus metallidurans H1130 was repeatedly isolated from different blood culture sets taken from a patient suffering from significant nosocomial septicemia. Here, we announce the H1130 genome sequence for use in comparative analyses and for exploring the adaptation and pathogenic potential of this bacterium.
ABSTRACT
During September 2010-November 2011, a cluster of erythromycin-susceptible, tetracycline- and ciprofloxacin-resistant Campylobacter coli pulsovar 1 infections was documented, involving 10 case-patients, in Montreal, Quebec, Canada. The findings suggested sexual transmission of an enteric infection among men who have sex with men.
Subject(s)
Campylobacter Infections/epidemiology , Campylobacter coli/genetics , Disease Outbreaks , HIV Infections/epidemiology , HIV/isolation & purification , Homosexuality, Male , Adult , Anti-Bacterial Agents/therapeutic use , Campylobacter Infections/drug therapy , Campylobacter Infections/microbiology , Campylobacter Infections/transmission , Campylobacter coli/isolation & purification , Ciprofloxacin/therapeutic use , Coinfection , Drug Resistance, Multiple, Bacterial , Erythromycin/therapeutic use , HIV Infections/virology , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Quebec/epidemiology , Retrospective Studies , Tetracycline/therapeutic useABSTRACT
In 2010, we observed isolates with matching pulsed-field gel electrophoresis patterns from 13 cases of ciprofloxacin-resistant Shigella sonnei in Montréal. We report on the emergence of this resistance type and a study of resistance mechanisms. The investigation suggested local transmission among men who have sex with men associated with sex venues.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Ciprofloxacin/therapeutic use , Drug Resistance, Bacterial , Dysentery, Bacillary/drug therapy , Homosexuality, Male , Shigella sonnei/drug effects , Adult , Aged , Canada/epidemiology , Disease Outbreaks , Dysentery, Bacillary/epidemiology , Dysentery, Bacillary/transmission , Electrophoresis, Gel, Pulsed-Field , Female , Humans , Male , Microbial Sensitivity Tests , Middle Aged , Molecular Typing , Sexual Behavior , Shigella sonnei/classification , Shigella sonnei/isolation & purification , Young AdultSubject(s)
Cholera/diagnosis , Cholera/microbiology , Travel , Vibrio cholerae O1/physiology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Canada , Cholera/drug therapy , Drug Resistance, Bacterial , Feces/microbiology , Female , Haiti , Humans , Microbial Sensitivity Tests , Middle Aged , Vibrio cholerae O1/drug effects , Vibrio cholerae O1/isolation & purificationABSTRACT
We describe the first case of invasive human infection (a nosocomial septicemia) caused by Cupriavidus metallidurans. This metal-resistant bacterium has not been reported to be pathogenic in humans or animals.
Subject(s)
Cupriavidus/classification , Cupriavidus/isolation & purification , Gram-Negative Bacterial Infections/diagnosis , Sepsis/diagnosis , Sepsis/microbiology , Aged , Anti-Bacterial Agents/pharmacology , Cross Infection/diagnosis , Cross Infection/microbiology , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Microbial Sensitivity Tests , Molecular Sequence Data , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNAABSTRACT
The D-zone test detects inducible clindamycin resistance in Staphylococcus spp. Two other methods not described by the Clinical and Laboratory Standards Institute (CLSI) are available to test for this resistance mechanism: an agar dilution method and new Vitek 2 cards. This study evaluated the performance of both methods in detecting inducible clindamycin resistance. Nonduplicate clinical strains of Staphylococcus spp. (111 Staphylococcus aureus and 52 coagulase-negative staphylococcus strains), intermediate or resistant to erythromycin but susceptible to clindamycin, were obtained from three hospitals in Montreal, Quebec, Canada. Molecular analysis to detect resistance genes was conducted on all strains. A Mueller-Hinton agar containing 1 mg of erythromycin and 0.5 mg of clindamycin/liter was used for the dilution method, and two inocula were tested: 10(4) and 10(5) CFU per spot. Plates were read at 24 and 48 h. The Vitek 2 AST-P580 card was used according to the manufacturer's recommendations. The results were compared to those of the D-zone test. The D-zone test was positive in 134 of 163 (82%) strains. With the 10(4) CFU inoculum, the sensitivities were 84 and 99% at 24 and 48 h, respectively. The 10(5) CFU inoculum increased the sensitivities at 24 and 48 h to 91 and 100%, respectively. The specificity was 100% for the 10(4) CFU inoculum at 24 h and 97% for the other combinations. The sensitivity and specificity for the Vitek 2 card were 93 and 100%, respectively. The performance of both the agar dilution method and the Vitek 2 card was good, but these methods were not as sensitive as the D-zone test at 24 h.