Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.479
Filtrar
1.
PLoS One ; 15(3): e0230489, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32226038

RESUMEN

Surveillance of antimicrobial resistance (AMR) enables monitoring of trends in AMR prevalence. WHO recommends laboratory-based surveillance to obtain actionable AMR data at local or national level. However, laboratory-based surveillance may lead to overestimation of the prevalence of AMR due to bias. The objective of this study is to assess the difference in resistance prevalence between laboratory-based and population-based surveillance (PBS) among uropathogens in Indonesia. We included all urine samples submitted to the laboratory growing Escherichia coli and Klebsiella pneumoniae in the laboratory-based surveillance. Population-based surveillance data were collected in a cross-sectional survey of AMR in E. coli and K. pneumoniae isolated from urine samples among consecutive patients with symptoms of UTI, attending outpatient clinics and hospital wards. Data were collected between 1 April 2014 until 31 May 2015. The difference in percentage resistance (95% confidence intervals) between laboratory- and population-based surveillance was calculated for relevant antibiotics. A difference larger than +/- 5 percent points was defined as a biased result, precluding laboratory-based surveillance for guiding empirical treatment. We observed high prevalence of AMR ranging between 63.1% (piperacillin-tazobactam) and 85% (ceftriaxone) in laboratory-based surveillance and 41.3% (piperacillin-tazobactam) and 74.2% (ceftriaxone) in population-based surveillance, except for amikacin and meropenem (5.7%/9.8%; 10.8%/5.9%; [laboratory-/population-based surveillance], respectively). Laboratory-based surveillance yielded significantly higher AMR prevalence estimates than population-based surveillance. This difference was much larger when comparing surveillance data from outpatients than from inpatients. All point estimates of the difference between the two surveillance systems were larger than 5 percent points, except for amikacin and meropenem. Laboratory-based AMR surveillance of uropathogens, is not adequate to guide empirical treatment for community-based settings in Indonesia.


Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Infecciones por Escherichia coli , Escherichia coli , Infecciones por Klebsiella , Klebsiella pneumoniae , Infecciones Urinarias , Estudios Transversales , Escherichia coli/crecimiento & desarrollo , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Femenino , Humanos , Indonesia , Infecciones por Klebsiella/tratamiento farmacológico , Infecciones por Klebsiella/epidemiología , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/crecimiento & desarrollo , Klebsiella pneumoniae/aislamiento & purificación , Masculino , Pruebas de Sensibilidad Microbiana , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología
2.
Am J Trop Med Hyg ; 102(5): 1137-1143, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32157990

RESUMEN

Although there has been an increasing incidence of bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) across South East Asia, there are sparse data from the Lao PDR, where laboratory capacity for antimicrobial resistance surveillance is limited. We, therefore, retrospectively reviewed bacteremia caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae between 2010 and 2014 at Mahosot Hospital, Vientiane, Lao PDR. Clinical and laboratory data relating to all episodes of ESBL-E bacteremia were reviewed over the 5-year period and compared with non-ESBL-E bacteremia. Blood cultures positive for E. coli or K. pneumoniae were identified retrospectively from laboratory records. Clinical and laboratory data were extracted from research databases and case notes and analyzed using STATA. Between 2010 and 2014, we identified 360 patients with E. coli (n = 249) or K. pneumoniae (n = 111) bacteremia, representing 34.8% of all patients with clinically significant bacteremia. Seventy-two (20%) isolates produced ESBL; E. coli accounted for 15.3% (55/360) and K. pneumoniae for 4.7% (17/360), respectively. The incidence of ESBL-producing E. coli bacteremia rose during the study period. By multiple logistic analysis, reported antibiotic use in the previous week was significantly associated with ESBL positivity (P < 0.001, odds ratio 3.89). Although multiresistant, most ESBL-producing E. coli and K. pneumoniae remained susceptible to meropenem (65/65; 100%) and amikacin (64/65; 98.5%). We demonstrated an alarming increase in the incidence of ESBL-E as a cause of bacteremia in Vientiane during the study period. This has implications for empiric therapy of sepsis in Laos, and ongoing surveillance is essential.


Asunto(s)
Bacteriemia/microbiología , Infecciones por Escherichia coli/tratamiento farmacológico , Escherichia coli/efectos de los fármacos , Infecciones por Klebsiella/tratamiento farmacológico , beta-Lactamasas/metabolismo , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Bacteriemia/epidemiología , Escherichia coli/enzimología , Infecciones por Escherichia coli/epidemiología , Femenino , Humanos , Infecciones por Klebsiella/epidemiología , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/enzimología , Laos/epidemiología , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven , Resistencia betalactámica
3.
BMC Infect Dis ; 20(1): 98, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-32005177

RESUMEN

BACKGROUND: Potentially pathogenic bacteria that colonise the lower genital tract of women in labour can be passed to the baby during birth. While many babies become colonised with these bacteria after delivery, a few develop neonatal infections. The lower genital tract is a reservoir for potential pathogens and a source of infection for neonates. We determined the prevalence of vaginal colonisation of potentially pathogenic bacteria among women in labour in Central Uganda and identified potential risk factors associated with this colonisation. METHODS: We conducted a cross sectional study at three primary health care facilities and collected vaginal swabs from HIV-1 negative women in labour. Specimens were cultured on different selective microbiological media, and biochemical tests were used to classify bacterial isolates on the species level. Multivariable logistic regression analyses were used to estimate the association between relevant exposures and colonisation with potentially pathogenic bacteria. RESULTS: We recruited 1472 women in labour whose mean age was 24.6 years (standard deviation [SD] 4.9). Of these, 955 (64.9%; 95% Confidence Interval [CI] 62.4, 67%) were vaginally colonised with at least one potentially pathogenic bacterial species. The most commonly isolated species were Escherichia coli (n = 508; 34.5%), Klebsiella pneumoniae (n = 144; 9.8%) and Staphylococcus aureus (n = 121; 8.2%). Results from exploratory multivariable regression analyses indicated that having had ≥5 previous pregnancies (adjusted odds ratio [aOR] 0.59; 95% CI 0.35, 0.97) or being ≥30 years old (aOR 1.52; 95% CI 1.03, 2.23) could be associated with vaginal colonisation with any potentially pathogenic bacteria, as well as with vaginal colonisation with S. aureus (aOR 0.33; 95% CI 0.12, 0.88, and aOR 2.17; 95% CI 1.17, 4.00, respectively). Possession of domestic animals in a household (aOR 0.57; 95% CI 0.35, 0.92) could be associated with vaginal colonisation with E. coli. CONCLUSIONS: Two-thirds of HIV-1 negative women in labour were vaginally colonised by potentially pathogenic bacteria, mainly E. coli, K. pneumoniae, and S. aureus.


Asunto(s)
Infecciones por Escherichia coli/epidemiología , Infecciones por Klebsiella/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , Infecciones Estafilocócicas/epidemiología , Vagina/microbiología , Adulto , Estudios Transversales , Femenino , Seropositividad para VIH/epidemiología , Humanos , Trabajo de Parto , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Prevalencia , Atención Primaria de Salud , Factores de Riesgo , Uganda/epidemiología , Adulto Joven
4.
J Med Microbiol ; 69(3): 379-386, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32101158

RESUMEN

Introduction. Despite many ongoing surveillance projects and the recent focus on the veterinary and clinical 'One Health' aspects of antimicrobial resistance (AMR), evidence of the extent of any public health risk posed by animal reservoirs with respect to the transmission of resistant strains of Escherichia coli to humans remains varied and contentious. In the UK, the main zoonotic reservoir for the foodborne pathogen Shiga toxin-producing E. coli (STEC) is cattle and sheep. In this study, we adopt an alternative approach to the risk assessment of transmission of AMR E. coli from animals to humans, involving monitoring AMR in isolates of STEC, an established zoonotic, foodborne pathogen, from human cases of gastrointestinal disease.Aim. The aim of this study was to determine the genome-derived AMR profiles for STEC from human cases to assess the risk of transmission of multidrug-resistant STEC from ruminants to humans.Methodology. STEC belonging to 10 different clonal complexes (CCs) (n=457) isolated from human faecal specimens were sequenced and genome-derived AMR profiles were determined. Phenotypic susceptibility testing was undertaken on all isolates (n=100) predicted to be resistant to at least one class of antimicrobial.Results. Of the 457 isolates, 332 (72.7 %) lacked identifiable resistance genes and were predicted to be fully susceptible to 11 classes of antimicrobials; 125/332 (27.3 %) carried 1 or more resistance genes, of which 83/125 (66.4 %) were resistant to 3 or more classes of antibiotic. The percentage of isolates harbouring AMR determinants varied between CCs, from 4% in CC25 to 100% in CC504. Forty-six different AMR genes were detected, which conferred resistance to eight different antibiotic classes. Resistance to ampicillin, streptomycin, tetracyclines and sulphonamides was most commonly detected. Four isolates were identified as extended-spectrum ß-lactamase producers. An overall concordance of 97.7 % (n=1075/1100) was demonstrated between the phenotypic and genotypic methods.Conclusion. This analysis provided an indirect assessment of the risk of transmission of AMR gastrointestinal pathogens from animals to humans, and revealed a subset of human isolates of the zoonotic pathogen STEC were resistant to the antimicrobials used in animal husbandry. However, this proportion has not increased over the last three decades, and thismay provide evidence that guidancepromoting responsible practice has been effective.


Asunto(s)
Antibacterianos/farmacología , Reservorios de Enfermedades/microbiología , Farmacorresistencia Bacteriana Múltiple/genética , Infecciones por Escherichia coli/epidemiología , Genoma Bacteriano/genética , Escherichia coli Shiga-Toxigénica/genética , Animales , Bovinos , Inglaterra/epidemiología , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/transmisión , Heces/microbiología , Genotipo , Humanos , Masculino , Salud Única , Minorías Sexuales y de Género , Ovinos , Escherichia coli Shiga-Toxigénica/aislamiento & purificación , Zoonosis
5.
N Z Med J ; 133(1510): 62-69, 2020 02 21.
Artículo en Inglés | MEDLINE | ID: mdl-32078602

RESUMEN

AIMS: National responses to antimicrobial resistance (AMR) require an understanding of the factors driving its development and spread. Research to date has primarily focused on determining individual-level risk factors for AMR-associated infections. However, additional insights may be gained by investigating exposures associated with AMR variation at the population level. METHODS: We used an ecological study design to describe the association between the incidence rate of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum ß-lactamase producing Escherichia coli (ESBL-E. coli) infection and population-level variables among 18 geographically distinct populations, defined by district health boards, in Aotearoa New Zealand. Associations were described using Spearman's correlational analysis. RESULTS: Positive correlations were found between the incidence of both MRSA and ESBL-E. coli infection and household crowding and community antimicrobial use. Positive correlations were also observed between MRSA and socioeconomic deprivation; age <5 years; Maori ethnicity; and Pacific ethnicity. For ESBL-E. coli, positive correlations were also observed with Asian ethnicity; Pacific ethnicity; and overseas-born new arrivals. European ethnicity was negatively correlated with both MRSA and ESBL-E. coli infection. CONCLUSIONS: These findings provide insight into the potential contribution of population-level exposures to MRSA and ESBL-E. coli infection in New Zealand. Exposures such as household crowding, community antimicrobial use and socioeconomic deprivation, are in principle modifiable and may present potentially novel opportunities to reduce the burden of AMR.


Asunto(s)
Infecciones por Escherichia coli/epidemiología , Escherichia coli/enzimología , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas/epidemiología , beta-Lactamasas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/transmisión , Femenino , Encuestas Epidemiológicas , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Nueva Zelanda/epidemiología , Vigilancia en Salud Pública , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/transmisión , Adulto Joven
6.
PLoS One ; 15(2): e0220428, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32101543

RESUMEN

BACKGROUND: Multidrug-resistant (MDR) E. coli with extended-spectrum ß-lactamases (ESBLs) is becoming endemic in health care settings around the world. Baseline data on virulence and antimicrobial resistance (AMR) of specific lineages of E. coli circulating in developing countries like India is currently lacking. METHODS: Whole-genome sequencing was performed for 60 MDR E. coli isolates. The analysis was performed at single nucleotide polymorphism (SNP) level resolution to identify the presence of their virulence and AMR genes. RESULTS: Genome comparison revealed the presence of ST-131 global MDR and ST410 as emerging-MDR clades of E. coli in India. AMR gene profile for cephalosporin and carbapenem resistance differed between the clades. Genotypes blaCTX-M-15 and blaNDM-5 were common among cephalosporinases and carbapenemases, respectively. For aminoglycoside resistance, rmtB was positive for 31.7% of the isolates, of which 95% were co-harboring carbapenemases. In addition, the FimH types and virulence gene profile positively correlated with the SNP based phylogeny, and also revealed the evolution of MDR clones among the study population with temporal accumulation of SNPs. The predominant clone was ST167 (blaNDM lineage) followed by ST405 (global clone ST131 equivalent) and ST410 (fast spreading high risk clone). CONCLUSIONS: This is the first report on the whole genome analysis of MDR E. coli lineages circulating in India. Data from this study will provide public health agencies with baseline information on AMR and virulent genes in pathogenic E. coli in the region.


Asunto(s)
Farmacorresistencia Bacteriana Múltiple/genética , Escherichia coli/genética , Genómica , Virulencia/genética , Secuenciación Completa del Genoma , Carbapenémicos/farmacología , Cefalosporinas/farmacología , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/genética , Infecciones por Escherichia coli/microbiología , Humanos , India , Polimorfismo de Nucleótido Simple
7.
Poult Sci ; 99(2): 1117-1123, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32029147

RESUMEN

Colibacillosis, caused by Escherichia coli, is one of the most common bacterial diseases of chickens. The high incidence and considerable economic losses associated with colibacillosis make it a significant concern worldwide. In recent years, the efficacy of colistin has been severely impacted by the emergence of plasmid-mediated colistin resistance genes, especially mcr-1. Therefore, monitoring of antibiotic resistance, particularly colistin resistance, amongst E. coli strains is vitally important to the future growth and sustainability of the poultry industry. In this study, a total of 130 E. coli strains were isolated from the livers of chickens displaying symptoms of colibacillosis in Tai'an, China. Isolates were screened for their susceptibility to various antibiotics and for the presence of mobile colistin resistance genes and other antibiotic resistance genes. Overall, 75 (57.7%) isolates showed resistance to colistin and were positive for mcr-1. The mobile colistin resistance genes, mcr-2, -3, and -4, were not detected in this study. Of the 75 mcr-1-positive isolates, all (100%) also carried tetracycline resistance genes, 71 (94.7%) also contained genes associated with ß-lactam resistance, 59 (78.7%) contained aminoglycoside resistance genes, and 57 (76%) contained sulfonamide resistance genes. This high prevalence of multidrug resistance among mcr-1-positive E. coli isolates, including the production of extended-spectrum ß-lactamases, is highly concerning. The surveillance findings presented here will be conducive to our understanding of the prevalence and characteristics of multidrug-resistance in E. coli in the Tai'an area and will provide a better scientific basis for the clinical treatment of colibacillosis in chickens.


Asunto(s)
Pollos , Farmacorresistencia Bacteriana Múltiple/genética , Infecciones por Escherichia coli/veterinaria , Escherichia coli/efectos de los fármacos , Enfermedades de las Aves de Corral/epidemiología , Animales , China/epidemiología , Escherichia coli/genética , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Proteínas de Escherichia coli/genética , Pruebas de Sensibilidad Microbiana/veterinaria , Enfermedades de las Aves de Corral/microbiología , Prevalencia
8.
PLoS One ; 15(2): e0228388, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045422

RESUMEN

BACKGROUND: Amphenicols have been widely used in the pig industry in China, leading to varying degrees of drug resistance. METHODS: The systematic review was performed according to PRISMA (Preferred Reported Items for Systematic Reviews and Meta-Analysis) recommendations on studies investigating the prevalence of amphenicol-resistant Escherichia coli (E. coli) isolated from pig in mainland China from 2000 to 2018, a random-effects model was selected, then followed by meta-analysis. RESULTS: A total of 103 articles were included in the study. The results of the meta-analysis revealed that the pooled summarized prevalence of resistance to chloramphenicol (CAP) was 72.31% (95% confidence interval (95% CI) = 67.12%-77.23%) and to florfenicol (FF) was 58.64% (95% CI = 52.48%-64.67%). During the past 18 years, the resistance rate to CAP remained high initially but then declined rapidly after 2012, whereas the resistance rate to FF plateaued (54.13%-59.60%) from 2000-2018. In different parts of China, the rate of resistance to amphenicols among E. coli isolates was fairly consistent, with the exception of the north and northwest regions. CONCLUSIONS: In 2002, the veterinary use of CAP was prohibited and its resistance levels in E. coli isolated from pigs was initially maintained at a high level but then showed an obvious downward trend in recent years. Resistance to commonly used FF remained at a high but stable level.


Asunto(s)
Cloranfenicol/farmacología , Farmacorresistencia Bacteriana , Infecciones por Escherichia coli/veterinaria , Escherichia coli/aislamiento & purificación , Enfermedades de los Porcinos/epidemiología , Animales , Antibacterianos/farmacología , China/epidemiología , Escherichia coli/efectos de los fármacos , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Porcinos , Enfermedades de los Porcinos/tratamiento farmacológico , Enfermedades de los Porcinos/microbiología
9.
BMC Infect Dis ; 20(1): 72, 2020 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-31973703

RESUMEN

BACKGROUND: Hospital infection control requires timely detection and identification of organisms, and their antimicrobial susceptibility. We describe a hybrid modeling approach to evaluate whole genome sequencing of pathogens for improving clinical decisions during a 2017 hospital outbreak of OXA-181 carbapenemase-producing Escherichia coli and the associated economic effects. METHODS: Combining agent-based and discrete-event paradigms, we built a hybrid simulation model to assess hospital ward dynamics, pathogen transmission and colonizations. The model was calibrated to exactly replicate the real-life outcomes of the outbreak at the ward-level. Seven scenarios were assessed including genome sequencing (early or late) and no sequencing (usual care). Model inputs included extent of microbiology and sequencing tests, patient-level data on length of stay, hospital ward movement, cost data and local clinical knowledge. The main outcomes were outbreak size and hospital costs. Model validation and sensitivity analyses were performed to address uncertainty around data inputs and calibration. RESULTS: An estimated 197 patients were colonized during the outbreak with 75 patients detected. The total outbreak cost was US$318,654 with 6.1% of total costs spent on sequencing. Without sequencing, the outbreak was estimated to result in 352 colonized patients costing US$531,109. Microbiology tests were the largest cost component across all scenarios. CONCLUSION: A hybrid simulation approach using the advantages of both agent-based and discrete-event modeling successfully replicated a real-life bacterial hospital outbreak as a foundation for evaluating clinical outcomes and efficiency of outbreak management. Whole genome sequencing of a potentially serious pathogen appears effective in containing an outbreak and minimizing hospital costs.


Asunto(s)
Proteínas Bacterianas/metabolismo , Infección Hospitalaria/microbiología , Brotes de Enfermedades , Infecciones por Escherichia coli/epidemiología , Escherichia coli/genética , Genoma Bacteriano/genética , beta-Lactamasas/metabolismo , Proteínas Bacterianas/genética , Simulación por Computador , Infección Hospitalaria/epidemiología , Escherichia coli/enzimología , Infecciones por Escherichia coli/microbiología , Hospitales , Humanos , Modelos Estadísticos , Secuenciación Completa del Genoma , beta-Lactamasas/genética
10.
PLoS One ; 15(1): e0227604, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31935253

RESUMEN

BACKGROUND: Knowledge on the molecular epidemiology of Escherichia coli causing E. coli bacteremia (ECB) in the Netherlands is mostly based on extended-spectrum beta-lactamase-producing E. coli (ESBL-Ec). We determined differences in clonality and resistance and virulence gene (VG) content between non-ESBL-producing E. coli (non-ESBL-Ec) and ESBL-Ec isolates from ECB episodes with different epidemiological characteristics. METHODS: A random selection of non-ESBL-Ec isolates as well as all available ESBL-Ec blood isolates was obtained from two Dutch hospitals between 2014 and 2016. Whole genome sequencing was performed to infer sequence types (STs), serotypes, acquired antibiotic resistance genes and VG scores, based on presence of 49 predefined putative pathogenic VG. RESULTS: ST73 was most prevalent among the 212 non-ESBL-Ec (N = 26, 12.3%) and ST131 among the 69 ESBL-Ec (N = 30, 43.5%). Prevalence of ST131 among non-ESBL-Ec was 10.4% (N = 22, P value < .001 compared to ESBL-Ec). O25:H4 was the most common serotype in both non-ESBL-Ec and ESBL-Ec. Median acquired resistance gene counts were 1 (IQR 1-6) and 7 (IQR 4-9) for non-ESBL-Ec and ESBL-Ec, respectively (P value < .001). Among non-ESBL-Ec, acquired resistance gene count was highest among blood isolates from a primary gastro-intestinal focus (median 4, IQR 1-8). Median VG scores were 13 (IQR 9-20) and 12 (IQR 8-14) for non-ESBL-Ec and ESBL-Ec, respectively (P value = .002). VG scores among non-ESBL-Ec from a primary urinary focus (median 15, IQR 11-21) were higher compared to non-ESBL-Ec from a primary gastro-intestinal (median 10, IQR 5-13) or hepatic-biliary focus (median 11, IQR 5-18) (P values = .007 and .04, respectively). VG content varied between different E. coli STs. CONCLUSIONS: Non-ESBL-Ec and ESBL-Ec blood isolates from two Dutch hospitals differed in clonal distribution, resistance gene and VG content. Also, resistance gene and VG content differed between non-ESBL-Ec from different primary foci of ECB.


Asunto(s)
Escherichia coli/genética , Escherichia coli/metabolismo , beta-Lactamasas/metabolismo , Antibacterianos/farmacología , Bacteriemia/tratamiento farmacológico , Bacteriemia/etiología , Farmacorresistencia Bacteriana/genética , Escherichia coli/enzimología , Infecciones por Escherichia coli/epidemiología , Humanos , Pruebas de Sensibilidad Microbiana , Epidemiología Molecular , Países Bajos , Prevalencia , Virulencia/genética
11.
Nat Commun ; 11(1): 228, 2020 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-31932601

RESUMEN

Antibiotic use and bacterial transmission are responsible for the emergence, spread and persistence of antimicrobial-resistant (AR) bacteria, but their relative contribution likely differs across varying socio-economic, cultural, and ecological contexts. To better understand this interaction in a multi-cultural and resource-limited context, we examine the distribution of antimicrobial-resistant enteric bacteria from three ethnic groups in Tanzania. Household-level data (n = 425) was collected and bacteria isolated from people, livestock, dogs, wildlife and water sources (n = 62,376 isolates). The relative prevalence of different resistance phenotypes is similar across all sources. Multi-locus tandem repeat analysis (n = 719) and whole-genome sequencing (n = 816) of Escherichia coli demonstrate no evidence for host-population subdivision. Multivariate models show no evidence that veterinary antibiotic use increased the odds of detecting AR bacteria, whereas there is a strong association with livelihood factors related to bacterial transmission, demonstrating that to be effective, interventions need to accommodate different cultural practices and resource limitations.


Asunto(s)
Antibacterianos/farmacología , Bacterias/aislamiento & purificación , Farmacorresistencia Bacteriana , Microbiología Ambiental , Microbioma Gastrointestinal , Animales , Bacterias/clasificación , Bacterias/efectos de los fármacos , Bacterias/genética , Farmacorresistencia Bacteriana/efectos de los fármacos , Farmacorresistencia Bacteriana/genética , Escherichia coli/clasificación , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/etnología , Infecciones por Escherichia coli/microbiología , Heces/microbiología , Microbioma Gastrointestinal/genética , Genoma Bacteriano/genética , Genotipo , Humanos , Pruebas de Sensibilidad Microbiana , Filogenia , Prevalencia , Tanzanía/epidemiología
12.
J Med Microbiol ; 69(1): 96-103, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31769400

RESUMEN

Enteroaggregative Escherichia coli (EAEC), a highly heterogeneous pathotype of E. coli classified as typical and atypical, are an emerging cause of acute and persistent diarrhea. We aimed to investigate whether population living in rural geographic areas, impacts in the heterogeneity, dissemination and antimicrobial susceptibility of EAEC strains. EAEC isolates (n=73) were analysed for the presence of 23 putative virulence factors, plasmid and antimicrobial resistance profiles, biofilm formation, pulsedfield gel electrophoresis (PFGE) and by multilocus sequence typing (MLST). The agg3A, agg4A, agn43, aap, shf, astA, pet, pic/set1A and sat genes, biofilm forming and antimicrobial resistance were statistically associated with typical EAEC. A low frequency of all isolates was resistant or showed a multidrug-resistance profile. No isolate showed the same plasmid profile. In total, 58 different pulsotypes were observed. Sixteen isolates analysed by MLST belonged to 15 different sequence types (ST) and showed a different PFGE pattern and virulence-gene profile. The fact that the communities are semi-isolated did not impact on the peculiar heterogeneity of EAEC, being characterized as epidemiologically independent strains.


Asunto(s)
Diarrea/epidemiología , Diarrea/microbiología , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Escherichia coli/clasificación , Escherichia coli/genética , Heterogeneidad Genética , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Tipificación de Secuencias Multilocus , Plásmidos/análisis , Población Rural
13.
Res Vet Sci ; 128: 49-58, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31710964

RESUMEN

Bats are a poorly understood reservoir of pathogenic and multi-drug resistant microorganisms; therefore, the aim of the study was to analyze the presence of drug resistance among E. coli isolated from the species of bats occurring naturally in Poland. The strategy of isolation and identification of resistant strains from pooled and single-animal samples was based on selective media with cefotaxime, chloramphenicol, kanamycin and tetracycline, the use of the ADSRRS-fingerprinting method for genomic differentiation of isolates, and the classical methods of evaluation of phenotypic and genotypic resistance. Of the 78 isolated isolates confirmed as E. coli, there were 38 genetically distinct strains resistant at least to one antimicrobial. 71% of these strains met the multi-drug resistance criterion. Moreover, two different multidrug resistant strains were isolated from three single samples. The highest resistance was observed in the case of ampicillin (66%), kanamycin (84%), sulfamethoxazole/trimetoprim (61%/55% respectively), and streptomycin (50%), which in most cases was confirmed by the presence of an adequate gene. Two isolates from single hosts produced extended-spectrum beta-lactamases (blaCTX-M-3, blaCTX-M-15, blaTEM-1). With the exception of tetracycline resistance, which was dominant among isolates from single animals, no significant differences in the resistance of the strains from both groups of samples were observed. Bats should not be neglected as another environmental reservoir and as an unpredictable source of potential pathogenic and multidrug resistant bacteria and should be extensively studied to predict the direction of the development and range of spreading resistance.


Asunto(s)
Antibacterianos/farmacología , Quirópteros/microbiología , Reservorios de Enfermedades/veterinaria , Farmacorresistencia Bacteriana Múltiple , Infecciones por Escherichia coli/epidemiología , Escherichia coli/efectos de los fármacos , Animales , Reservorios de Enfermedades/microbiología , Infecciones por Escherichia coli/microbiología , Polonia
14.
Lett Appl Microbiol ; 70(3): 203-209, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31837237

RESUMEN

Ready-to-eat food contamination with ESBL-producing Escherichia coli is a growing health concern. Some of these strains also are epidemic clones and can cause community-associated infections that are difficult to treat. In this study, the occurrence of ESBL-producing E. coli contaminated ready-to-eat street food in Quito, Ecuador was evaluated. In total, 150 samples were collected randomly in the most crowded sites of the city. In all, 34 samples (34/150; 22·6%) were positive for total thermotolerant (44·5°C) coliforms resistant to cefotaxime. MALDI-TOF analysis identified that the E. coli was found in 20 food samples (20/34; 59%). ESBL gene blaCTX-M-55 was identified in nine isolates, blaCTX-M-15 in six isolates, blaCTX-M-14 in two isolates, and one isolate each harboured blaCTX-M-24 , blaCTX-M-65 , blaCTX-M-55 and blaCTX-M-8 . Phylogenetic groups like A and B1 were the most common, followed by groups D and B2. MLST analysis identified 12 different sequence types (STs), the most common was ST162. Recognized epidemic clonal groups ST410, ST131 and ST744 were encountered. Ready-to-eat street food is a potential way of spreading ESBL-producing E. coli epidemic clones in Quito, Ecuador. SIGNIFICANCE AND IMPACT OF THE STUDY: This study identified ESBL-producing Escherichia coli epidemic clones: ST131, ST410 and ST744 in ready-to-eat street food samples. Street food is a possible way to spread harm multidrug-resistant (MDR) E. coli strains in the community. Studies to identify the contamination sources of this kind of food are needed to tackle MDR E. coli dissemination.


Asunto(s)
Farmacorresistencia Bacteriana Múltiple/genética , Infecciones por Escherichia coli/transmisión , Escherichia coli/efectos de los fármacos , Escherichia coli/genética , Comida Rápida/microbiología , beta-Lactamasas/genética , Antibacterianos/farmacología , Ecuador/epidemiología , Infecciones por Escherichia coli/epidemiología , Contaminación de Alimentos/análisis , Humanos , Tipificación de Secuencias Multilocus , Filogenia
15.
Infection ; 48(2): 223-230, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31758437

RESUMEN

PURPOSE: The recurrence of multi-drug resistant (MDR) pathogens to the latest antibiotics and the limited development of new antibacterial agents have reduced the options for the treatment of severe infections. The reintroduction of old antibiotics, such as colistin, represents an effective strategy, since the latest antibiotics are over-consumed and ineffective against MDR pathogens. In 2015, Liu (Lancet Infect Dis 16:161-168, 2016) reported Escherichia coli (E. coli) isolates carrying plasmid-mediated colistin resistance gene mcr-1. The first of mcr-1 positive colistin-resistant (col-R) E. coli from a human blood culture was observed in 2012 in Latin America, while in Italy was reported for the first time by our center in 2016. The present study aimed to describe the prevalence of mcr-1 positive col-R strains in E. coli-related bloodstream infection among patients hospitalized in Fondazione IRCCS Policlinico San Matteo in Pavia, Italy, from 2012 to 2018, including the three cases already published. METHODS: All col-R E. coli strains isolated from blood cultures collected during the study period were analyzed. The minimal inhibitory concentration of colistin was determined using broth microdilution and detection of mcr-1 and mcr-2 genes was performed by PCR. The sequence type of E. coli mcr-1 positive was determined according to Multilocus sequence typing. RESULTS: Out of 1557 samples, 14 strains (0.90%) were col-R. and positive for the presence of the mcr-1 gene, with no mcr-2 detected. The most common ST was ST10 (n = 3), followed by ST410 (n = 2). The remaining strains exhibited different MLST profiles, indicating that they were genetically unrelated. CONCLUSIONS: Proper reporting of the presence of mcr-1 genes is an essential component to anticipate the spread of colistin resistance. This public health issue is particularly alarming in Italy due to the consistent circulation of MDR bacteria.


Asunto(s)
Infecciones por Escherichia coli/microbiología , Proteínas de Escherichia coli/genética , Escherichia coli/genética , Enfermedades Hematológicas/microbiología , Hospitalización/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Colistina/farmacología , Farmacorresistencia Bacteriana/genética , Escherichia coli/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/epidemiología , Femenino , Enfermedades Hematológicas/epidemiología , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
18.
PLoS One ; 14(12): e0220265, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31821338

RESUMEN

Urinary tract infections (UTIs) caused by Escherichia coli have been historically managed with oral antibiotics including the cephalosporins, fluoroquinolones and trimethoprim-sulfamethoxazole. The use of these agents is being compromised by the increase in extended spectrum ß-lactamase (ESBL)-producing organisms, mostly caused by the emergence and clonal expansion of E. coli multilocus sequence typing (ST) 131. In addition, ESBL isolates show co-resistance to many of oral agents. Management of UTIs caused by ESBL and fluoroquinolone-resistant organisms is becoming increasingly challenging to treat outside of the hospital setting with clinicians having to resort to intravenous agents. The aim of this study was to assess the prevalence of ESBL phenotypes and genotypes among UTI isolates of E. coli collected in the US during 2017 as well as the impact of co-resistance to oral agents such as the fluoroquinolones and trimethoprim-sulfamethoxazole. The national prevalence of ESBL phenotypes of E. coli was 15.7% and was geographically distributed across all nine Census regions. Levofloxacin and trimethoprim-sulfamethoxazole-resistance rates were ≥ 24% among all isolates and this co-resistance phenotype was considerably higher among isolates showing an ESBL phenotype (≥ 59.2%) and carrying blaCTX-M-15 (≥ 69.5%). The agents with the highest potency against UTI isolates of E. coli, including ESBL isolates showing cross-resistance across oral agents, were the intravenous carbapenems. The results of this study indicate that new oral options with the spectrum and potency similar to the intravenous carbapenems would address a significant unmet need for the treatment of UTIs in an era of emergence and clonal expansion of ESBL isolates resistant to several classes of antimicrobial agents, including oral options.


Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Infecciones por Escherichia coli/microbiología , Escherichia coli/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Infecciones Urinarias/microbiología , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/epidemiología , Humanos , Pruebas de Sensibilidad Microbiana , Factores de Tiempo , Estados Unidos/epidemiología , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/epidemiología
19.
BMC Infect Dis ; 19(1): 1037, 2019 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-31818261

RESUMEN

BACKGROUND: Shigella spp. and entero-invasive E. coli (EIEC) use the same invasive mechanism to cause diarrheal diseases. Public health regulations apply only to Shigella spp. infections, but are hampered by the lack of simple methods to distinguish them from EIEC. In the last decades, molecular methods for detecting Shigella spp. and EIEC were implemented in medical microbiological laboratories (MMLs). However, shigellosis cases identified with molecular techniques alone are not notifiable in most countries. Our study investigates the impact of EIEC versus Shigella spp. infections and molecular diagnosed shigellosis versus culture confirmed shigellosis for re-examination of the rationale for the current public health regulations. METHODS: In this multicenter cross-sectional study, fecal samples of patients suspected for gastro-enteritis, referred to 15 MMLs in the Netherlands, were screened by PCR for Shigella spp. or EIEC. Samples were cultured to discriminate between the two pathogens. We compared risk factors, symptoms, severity of disease, secondary infections and socio-economic consequences for (i) culture-confirmed Shigella spp. versus culture-confirmed EIEC cases (ii) culture positive versus PCR positive only shigellosis cases. RESULTS: In 2016-2017, 777 PCR positive fecal samples with patient data were included, 254 of these were culture-confirmed shigellosis cases and 32 were culture-confirmed EIEC cases. EIEC cases were more likely to report ingestion of contaminated food and were less likely to be men who have sex with men (MSM). Both pathogens were shown to cause serious disease although differences in specific symptoms were observed. Culture-negative but PCR positive cases were more likely report travel or ingestion of contaminated food and were less likely to be MSM than culture-positive cases. Culture-negative cases were more likely to suffer from multiple symptoms. No differences in degree of secondary infections were observed between Shigella spp. and EIEC, and culture-negative and culture-positive cases. CONCLUSIONS: No convincing evidence was found to support the current guidelines that employs different measures based on species or detection method. Therefore, culture and molecular detection methods for Shigella spp. and EIEC should be considered equivalent for case definition and public health regulations regarding shigellosis. Differences were found regarding risks factors, indicating that different prevention strategies may be required.


Asunto(s)
Disentería Bacilar/epidemiología , Disentería Bacilar/microbiología , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Adolescente , Adulto , Técnicas Bacteriológicas/métodos , Estudios Transversales , Diarrea/microbiología , Disentería Bacilar/etiología , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Escherichia coli/patogenicidad , Infecciones por Escherichia coli/etiología , Heces/microbiología , Femenino , Gastroenteritis/microbiología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Reacción en Cadena de la Polimerasa , Salud Pública , Shigella/genética , Shigella/aislamiento & purificación , Shigella/patogenicidad , Adulto Joven
20.
PLoS One ; 14(12): e0225697, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31791047

RESUMEN

Antibiotic use in beef cattle is a risk factor for the expansion of antimicrobial-resistant Salmonella populations. However, actual changes in the quantity of Salmonella in cattle feces following antibiotic use have not been investigated. Previously, we observed an overall reduction in Salmonella prevalence in cattle feces associated with both ceftiofur crystalline-free acid (CCFA) and chlortetracycline (CTC) use; however, during the same time frame the prevalence of multidrug-resistant Salmonella increased. The purpose of this analysis was to quantify the dynamics of Salmonella using colony counting (via a spiral-plating method) and hydrolysis probe-based qPCR (TaqMan® qPCR). Additionally, we quantified antibiotic-resistant Salmonella by plating to agar containing antibiotics at Clinical & Laboratory Standards Institute breakpoint concentrations. Cattle were randomly assigned to 4 treatment groups across 16 pens in 2 replicates consisting of 88 cattle each. Fecal samples from Days 0, 4, 8, 14, 20, and 26 were subjected to quantification assays. Duplicate qPCR assays targeting the Salmonella invA gene were performed on total community DNA for 1,040 samples. Diluted fecal samples were spiral plated on plain Brilliant Green Agar (BGA) and BGA with ceftriaxone (4 µg/ml) or tetracycline (16 µg/ml). For comparison purposes, indicator non-type-specific (NTS) E. coli were also quantified by direct spiral plating. Quantity of NTS E. coli and Salmonella significantly decreased immediately following CCFA treatment. CTC treatment further decreased the quantity of Salmonella but not NTS E. coli. Effects of antibiotics on the imputed log10 quantity of Salmonella were analyzed via a multi-level mixed linear regression model. The invA gene copies decreased with CCFA treatment by approximately 2 log10 gene copies/g feces and remained low following additional CTC treatment. The quantities of tetracycline or ceftriaxone-resistant Salmonella were approximately 4 log10 CFU/g feces; however, most of the samples were under the quantification limit. The results of this study demonstrate that antibiotic use decreases the overall quantity of Salmonella in cattle feces in the short term; however, the overall quantities of antimicrobial-resistant NTS E. coli and Salmonella tend to remain at a constant level throughout.


Asunto(s)
Antibacterianos/efectos adversos , Infecciones por Escherichia coli/veterinaria , Escherichia coli/aislamiento & purificación , Salmonelosis Animal/epidemiología , Salmonella/aislamiento & purificación , Animales , Antibacterianos/administración & dosificación , Proteínas Bacterianas/genética , Bovinos , Cefalosporinas/administración & dosificación , Cefalosporinas/efectos adversos , Clortetraciclina/administración & dosificación , Clortetraciclina/efectos adversos , Recuento de Colonia Microbiana , ADN Bacteriano/aislamiento & purificación , Farmacorresistencia Bacteriana Múltiple , Escherichia coli/efectos de los fármacos , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Heces/microbiología , Enfermedades Transmitidas por los Alimentos/prevención & control , Humanos , Estudios Longitudinales , Masculino , Pruebas de Sensibilidad Microbiana , Prevalencia , Carne Roja/microbiología , Salmonella/efectos de los fármacos , Salmonella/genética , Salmonelosis Animal/tratamiento farmacológico , Salmonelosis Animal/microbiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA