ABSTRACT
Two Enterobacter strains 170198T and 170250T were isolated from clinical blood samples from distinct patients in a hospital in Chengdu, China, in 2022. These isolates were subjected to whole-genome sequencing. A phylogenomic tree based on 2,096 concatenated core genes showed that the two strains were clustered within the genus Enterobacter. The average nucleotide identity (ANI) and in silico DNA-DNA hybridization (isDDH) values between each of the two strains and type strains of all currently known Enterobacter species were determined. The two strains belonged to two novel species as the highest ANI and isDDH values with type strains of all currently known Enterobacter species below the cutoff for species demarcation (96% for ANI and 70% for isDDH). Then the physiological and biochemical studies demonstrated that biochemical features and the profile of whole fatty acids of strains 170198T and 170250T were largely consistent with those known Enterobacter species. Nevertheless, the two novel species can be differentiated from all other Enterobacter species by certain biochemical characteristics. In conclusion, 170198T and 170250T represent two novel species of the genus Enterobacter, for which we propose Enterobacter chinensis sp. nov. and Enterobacter rongchengensis sp. nov., as the species names. The type strains of Enterobacter chinensis sp. nov., and Enterobacter rongchengensis sp. nov. are 170198T (=GDMCC 1.3549T=JCM 35826T) and 170250T (=GDMCC 1.3670T=JCM 36189T), respectively. The two novel species have clinical significance with the ability to cause bloodstream infections.IMPORTANCEEnterobacter is a group of bacteria comprising several common opportunistic pathogens and has a complicated taxonomy. Here, we reported two novel Enterobacter species. We demonstrated that the two novel species can be differentiated from other Enterobacter species by certain phenotypic characteristics and therefore provide information for designing tests for identification. We also showed that strains of the two novel species are able to cause human bloodstream infections and carry multiple virulence factors and therefore are of clinical significance. We highlight that the virulence of Enterobacter is less studied and warrants further exploration. We believe that the findings here are valuable for enhancing the appreciation toward Enterobacter, an important pathogen.
Subject(s)
Enterobacter , Enterobacteriaceae Infections , Phylogeny , Virulence Factors , Enterobacter/genetics , Enterobacter/isolation & purification , Enterobacter/classification , Enterobacter/pathogenicity , Humans , Enterobacteriaceae Infections/microbiology , Virulence Factors/genetics , China , Fatty Acids/analysis , DNA, Bacterial/genetics , Bacterial Typing Techniques , Anti-Bacterial Agents/pharmacology , Whole Genome Sequencing , Microbial Sensitivity Tests , Nucleic Acid Hybridization , RNA, Ribosomal, 16S/genetics , Genome, Bacterial/genetics , Female , MaleABSTRACT
The objective of this study was to analyse microbiological organisms in different locations and regions for physical activity in the city of João Pessoa, Brazil. Samples were collected on various objects used, such as: mattresses, drinking fountains, gloves, cell phones and others. The samples were collected in João Pessoa-PB, following the Standard Operating Procedure-SOP/ Microbiology of a specialized laboratory. The collection took place in the five macro-regions: North, South, East, West and Center. Foreach region samples were collected in one public place (square), a private one (gym) and one school (public or private), totaling fifteen collected sites and 450 samples. The following microorganisms were studied in all analyzed surfaces: Bacillus sp, Escherichia Coli, Klebsiella sppor Enterobacter sppand Coag. Neg. Staphylococcus.All regions had a high contamination level by some microorganism. The highest rates were found in the western, central and northern regions -96, 94 and 93% respectively. The Coag. Neg.Staphylococcus presented the highest and lowest incidence rates in the South and East regions, with 43.33 and 6.67%, respectively, as well as Klebsiella sppor Enterobacter spp, which presented high levels. It is concluded that there is a microorganisms' contamination in the most varied places and regions where physical activity practices are developed, with a predominance of Coag. Neg.Staphylococcusand Klebsiella sppor Enterobacter spp. These results lead to a warning about the hygiene importance in places for physical activity practice, especially in pandemic times (COVID-19), since almost all the evaluated surfaces were contaminated.
Subject(s)
Hygiene , Fitness Centers/supply & distribution , COVID-19/pathology , Schools/supply & distribution , Bacillus/pathogenicity , Exercise/physiology , Biological Contamination , Enterobacter/pathogenicity , Environmental Microbiology , Escherichia/pathogenicity , Pandemics/statistics & numerical data , Klebsiella/pathogenicity , NoxaeABSTRACT
ABSRACT: BACKGROUND: To describe the course and intervention of an hospital-wide IMI-Producing Enterobacter ludwigii outbreak. METHODS: This was an outbreak interventional study, done at a tertiary care center in Tel-Aviv, Israel. Data was collected on the course of the outbreak and the demographic and clinical characteristics of all patients involved in the outbreak. The intervention measures included patients' cohorting, contact isolation precautions, environmental cleaning and screening of contacts. The molecular features and phylogeny of outbreak-related isolates were studied by whole-genome based analysis. RESULTS: The outbreak included 34 patients that were colonized by IMI-Producing E. ludwigii and were identified in 24 wards throughout the hospital. Colonization was identified in the first 72 h of admission in 13/34 patients (38.2%). Most patients (91.2%) were admitted from home and had relatively low level of comorbidities. The majority of them (88%) had no recent use of invasive catheters and none had previous carriage of other multi-drug resistant bacteria. All available isolates harbored the blaIMI-17 allele and belonged to Sequence-Type 385. With the exception of two isolates, all isolates were closely related with less than a 20-SNP difference between them. CONCLUSIONS: This outbreak had most likely originated in the community and subsequently disseminated inside our institution. More studies are required in order to elucidate the epidemiology of IMI-Producing E. ludwigii and the possible role of environmental sources in its dissemination.
Subject(s)
Bacterial Proteins/genetics , Cross Infection/epidemiology , Disease Outbreaks/statistics & numerical data , Enterobacter/pathogenicity , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae Infections/transmission , Hospitals/statistics & numerical data , beta-Lactamases/genetics , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Bacterial Proteins/biosynthesis , Bacterial Typing Techniques , Cross Infection/microbiology , Disease Outbreaks/prevention & control , Electrophoresis, Gel, Pulsed-Field , Enterobacter/drug effects , Enterobacter/enzymology , Enterobacter/genetics , Enterobacteriaceae Infections/drug therapy , Female , Humans , Infection Control/methods , Israel/epidemiology , Male , Microbial Sensitivity Tests , Middle Aged , Multilocus Sequence Typing , beta-Lactamases/biosynthesisABSTRACT
BACKGROUND: Enterobacter species are an important cause of healthcare-associated bloodstream infections (BSI) in children. Up to 19% of adult patients with Enterobacter BSI have recurrence of infection resistant to third-generation cephalosporins (3GCs) while on therapy with a 3GC. Data are lacking regarding the incidence of and risk factors for recurrence of infection in children with Enterobacter BSI. METHODS: We conducted a retrospective case-control study of patients aged ≤21 years old admitted to Texas Children's Hospital from January 2012 through December 2018 with Enterobacter BSI. The primary outcome was microbiologic failure from 72 hours to 30 days after the initial BSI (cases). The secondary outcome was isolation of a 3GC non-susceptible Enterobacter sp. from a patient with an initial 3GC-susceptible isolate. RESULTS: Twelve patients (6.7%) had microbiologic failure compared to 167 controls without microbiologic failure. Of the 138 patients (77.1%) with an Enterobacter sp. isolate that was initially susceptible to 3GCs, 3 (2.2%) developed a subsequent infection with a non-susceptible isolate. Predictors of microbiologic failure were having an alternative primary site of infection besides bacteremia without a focus or an urinary tract infection (OR, 9.64; 95% CI, 1.77-52.31; P < 0.01) and inadequate source control (OR, 22.16; 95% CI, 5.26-93.36; P < 0.001). CONCLUSIONS: Source of infection and adequacy of source control are important considerations in preventing microbiologic failure. In-vitro susceptibilities can be used to select an antibiotic regimen for the treatment of Enterobacter BSI in children.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Enterobacter/pathogenicity , Enterobacteriaceae Infections/drug therapy , Sepsis/drug therapy , Adolescent , Adult , Bacteremia/epidemiology , Bacteremia/microbiology , Child , Child, Preschool , Cross Infection/drug therapy , Cross Infection/epidemiology , Cross Infection/microbiology , Enterobacter/genetics , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae Infections/microbiology , Female , Humans , Infant , Male , Risk Factors , Sepsis/epidemiology , Sepsis/microbiology , Young AdultABSTRACT
BACKGROUND: High-level antibiotic consumption plays a critical role in the selection and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in the ICU. Implementation of a stewardship program including a restrictive antibiotic policy was evaluated with respect to ESBL-E acquisition (carriage and infection). METHODS: We implemented a 2-year, before-and-after intervention study including all consecutive adult patients admitted for > 48 h in the medical-surgical 26-bed ICU of Guadeloupe University Hospital (French West Indies). A conventional strategy period (CSP) including a broad-spectrum antibiotic as initial empirical treatment, followed by de-escalation (period before), was compared to a restrictive strategy period (RSP) limiting broad-spectrum antibiotics and shortening their duration. Antibiotic therapy was delayed and initiated only after microbiological identification, except for septic shock, severe acute respiratory distress syndrome and meningitis (period after). A multivariate Cox proportional hazard regression model adjusted on propensity score values was performed. The main outcome was the median time of being ESBL-E-free in the ICU. Secondary outcome included all-cause ICU mortality. RESULTS: The study included 1541 patients: 738 in the CSP and 803 in the RSP. During the RSP, less patients were treated with antibiotics (46.8% vs. 57.9%; p < 0.01), treatment duration was shorter (5 vs. 6 days; p < 0.01), and administration of antibiotics targeting anaerobic pathogens significantly decreased (65.3% vs. 33.5%; p < 0.01) compared to the CSP. The incidence of ICU-acquired ESBL-E was lower (12.1% vs. 19%; p < 0.01) during the RSP. The median time of being ESBL-E-free was 22 days (95% CI 16-NA) in the RSP and 18 days (95% CI 16-21) in the CSP. After propensity score weighting and adjusted analysis, the median time of being ESBL-E-free was independently associated with the RSP (hazard ratio, 0.746 [95% CI 0.575-0.968]; p = 0.02, and hazard ratio 0.751 [95% CI 0.578-0.977]; p = 0.03, respectively). All-cause ICU mortality was lower in the RSP than in the CSP (22.5% vs. 28.6%; p < 0.01). CONCLUSIONS: Implementation of a program including a restrictive antibiotic strategy is feasible and is associated with less ESBL-E acquisition in the ICU without any worsening of patient outcome.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Enterobacter/metabolism , Health Policy , beta-Lactamases/metabolism , Adult , Aged , Anti-Bacterial Agents/pharmacology , Antimicrobial Stewardship/methods , Cohort Studies , Endemic Diseases , Enterobacter/pathogenicity , Enterobacteriaceae Infections/drug therapy , Female , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Propensity Score , Retrospective Studies , Statistics, NonparametricABSTRACT
This study was carried out to investigate the risks of simultaneous exposure to pesticide residues and bacteria contaminants in locally produced fresh vegetables and vegetables in Tanzania. A total of 613 samples were analyzed for pesticide residues, out of which 250 were also analyzed for bacterial contamination. Overall, 47.5% had pesticide residues, 74.2% exceeded Maximum Residue Levels (MRLs). Organophosphorus (95.2%), organochlorines (24.0%), pyrethroids (17.3%), and carbamates (9.2%) residues dominated. MRL values were mostly exceeded in tomatoes, onions, watermelons, cucumbers, Chinese cabbage, and sweet paper. Tetramethrin (0.0329-1.3733 mg/kg), pirimiphos-methyl (0.0003-1.4093 mg/kg), permethrin (0.0009-2.4537 mg/kg), endosulfan (beta) (0.0008-2.3416 mg/kg), carbaryl (0.0215-1.5068 mg/kg), profenofos (0.0176-2.1377 mg/kg), chlorpyrifos (0.0004-1.2549 mg/kg) and dieldrin (0.0011-0.5271 mg/kg) exceeded MRLs. The prevalence of bacteria contamination was high (63.2%). Enterobacter (55.6%) Pseudomonas aeruginosa (32.4%), E. coli (28.2%), Citrobacter (26.8%), Klebsiella oxytoca (14.8%), and Salmonella (7.7%) were isolated. Furthermore, 46.4% tested positive for both pesticide residues and bacterial contaminants. Vegetables from farms (60.7%) contained more dual contaminants than market-based vegetables (41.8%). This may have resulted from excessive pesticide use and unhygienic handling of fresh fruits and vegetables at production level. Binary logistic regression showed that fresh fruits and vegetables with pesticide residues were 2.231 times more likely to have bacteria contaminants (OR: 2.231; 95% CI: 0.501, 8.802). The contamination levels of pesticide residues and bacterial contaminants could be perceived as a serious problem as most fresh fruits and vegetables recorded values of pesticide residues far above the MRLs with pathogenic bacteria isolated in higher proportions. MRLs was higher in most vegetables consumed raw or semi-cooked such as watermelons, carrots, cucumber, tomatoes, onion and sweet paper. There is an urgent need to develop pesticide monitoring and surveillance systems at farmer level, educating farmers and promoting the use of greener pesticides to mitigate the health effects of pesticides and bacterial contaminants.
Subject(s)
Food Contamination/analysis , Fruit/adverse effects , Pesticides/adverse effects , Vegetables/adverse effects , Citrobacter/isolation & purification , Citrobacter/pathogenicity , Enterobacter/isolation & purification , Enterobacter/pathogenicity , Fruit/chemistry , Fruit/microbiology , Humans , Hydrocarbons, Chlorinated/adverse effects , Hydrocarbons, Chlorinated/chemistry , Klebsiella oxytoca/isolation & purification , Klebsiella oxytoca/pathogenicity , Pesticide Residues/adverse effects , Pesticide Residues/chemistry , Pesticides/chemistry , Pseudomonas aeruginosa/isolation & purification , Pseudomonas aeruginosa/pathogenicity , Pyrethrins/adverse effects , Pyrethrins/chemistry , Salmonella/isolation & purification , Salmonella/pathogenicity , Vegetables/chemistry , Vegetables/microbiologyABSTRACT
OBJETIVO: Identificar la colonización por ESKAPES y las características clínicas de los pacientes hospitalizados en una Unidad de Cuidados Intensivos para Adultos de un hospital mixto en Paraná. MÉTODO: Investigación de campo, descriptiva, documental y experimental con enfoque cuantitativo, desarollada en una Unidad de Cuidados Intensivos adultos de un hospital mixto en el suroeste de Paraná, Brasil. La población del estudio consistió en pacientes con ingreso de 48 horas en la Unidad de Cuidados Intensivos, de abril a agosto de 2018 y de abril a agosto de 2019. La muestra totalizó 102 individuos. Para la recopilación de datos clínicos, se utilizó un Checklist y para el análisis microbiológico se recogieron muestras de las cavidades nasales y orales y la secreción traqueal. El análisis de los datos clínicos se produjo a través del software Statistical Package for the Social Sciences. Se realizaron pruebas de frecuencia y chi-cuadrado, teniendo en cuenta la p < 0,05 significativa. RESULTADOS: Se evaluaron un total de 102 pacientes ingresados en la Unidad de Cuidados Intensivos durante el período estudiado. De ellos, 57 (55,8%) fueron colonizados por microorganismos patógenos. En cuanto a la colonización por microorganismos, predominan Staphylococcus aureus (61,4%), seguido de Klebsiella pneumoniae (40,4%), Pseudomonas aeruginosa (26,3%) y Staphylococcus epidermidis (21,1%). Cabe destacar que Klebsiella pneumoniae y Staphylococcus aureus estuvieron presentes en las tres regiones evaluadas. CONCLUSIÓN: El estudio identificó la presencia de colonización en pacientes en estado crítico estudiados, siendo esta colonización, en su mayoría, por bacterias resistentes pertenecientes al grupo ESKAPE
OBJECTIVE: To identify colonization by ESKAPES and clinical characteristics of patients admitted in Adult Intensive Care Unit of a mixed hospital in Paraná. METHOD: Field research, descriptive, documentary and experimental quantitative approach, developed in adult Intensive Care Unit of a mixed hospital in Southwest Paraná, Brazil. The study population consisted of patients with admission from 48 hours in the Intensive Care Unit, from April to August 2018 and April to August 2019. The sample has 102 individuals. For the collection of clinical data, a checklist was used and for microbiological analysis the sample was collected from nasal and oral cavities and tracheal secretion. The analysis of clinical data occurred through the Statistical Package for the Social Sciences software. Descriptive frequency and chi-square test, considering significant p <0,05. RESULTS: A total of 102 patients admitted to the Intensive Care Unit during the period studied were evaluated. On these ones, 57 (55,8%) were colonized by pathogenic microorganisms. Regarding the colonization of microorganisms, there was predominance of Staphylococcus aureus (61,4%), followed by Klebsiella pneumoniae (40,4%), Pseudomonas aeruginosa (26,3%) and Staphylococcus epidermidis (21,1%). It is noteworthy that Klebsiella pneumoniae and Staphylococcus aureus were present in the three regions evaluated. CONCLUSION: The study identified the presence of colonization in critically ill patients studied, being this colonization, mostly, resistant bacteria belonging to the ESKAPE group
OBJETIVO: Identificar a colonização por ESKAPES e características clínicas de pacientes internados em uma Unidade de Terapia Intensiva Adulto de um hospital misto do Paraná. MÉTODO: Pesquisa de campo, descritiva, documental e experimental com abordagem quantitativa, desenvolvida em uma Unidade de Terapia Intensiva adulto de um hospital misto do Sudoeste do Paraná, Brasil. A população do estudo constituiu-se pelos pacientes com admissão a partir de 48 horas na Unidade de Terapia Intensiva, no período de abril a agosto de 2018 e de abril a agosto de 2019. A amostra totalizou 102 indivíduos. Para a coleta de dados clínicos foi utilizado um Checklist e para a análise microbiológica foram coletadas amostras das cavidades nasal e oral e secreção traqueal. A análise dos dados ocorreu por meio do software Statistical Package for the Social Sciences. Realizou-se frequência descritiva e teste de qui-quadrado, considerando significativo p <0,05. RESULTADOS: Foram avaliados 102 pacientes admitidos na Unidade de Terapia Intensiva durante o período pesquisado. Destes, 57 (55,8%) estavam colonizados por microrganismos patogênicos. Em relação à colonização de microrganismos, houve predominância de Staphylococcus aureus (61,4%), seguido por Klebsiella pneumoniae (40,4%), Pseudomonas aeruginosa (26,3%) e Staphylococcus epidermidis (21,1%). Vale ressaltar que, Klebsiella pneumoniae e Staphylococcus aureus estiveram presentes nas três regiões avaliadas. CONCLUSÃO: O estudo identificou a presença de colonização nos pacientes criticamente enfermos pesquisados, sendo essa colonização, em sua maioria, por bactérias resistentes pertencentes ao grupo ESKAPE
Subject(s)
Humans , Colony Count, Microbial/methods , Drug Resistance, Bacterial/immunology , Acinetobacter baumannii/pathogenicity , Pseudomonas aeruginosa/pathogenicity , Klebsiella pneumoniae/pathogenicity , Enterobacter/pathogenicity , Drug Approval/organization & administration , Drugs, Investigational/administration & dosage , Drug Resistance, Multiple/immunology , Cross Infection/microbiology , Intensive Care Units/statistics & numerical dataABSTRACT
Non-Escherichia coli Enterobacterales (NECE) can colonize the human gut and may present virulence determinants and phenotypes that represent severe heath concerns. Most information is available for virulent NECE strains, isolated from patients with an ongoing infection, while the commensal NECE population of healthy subjects is understudied. In this study, 32 NECE strains were isolated from the feces of 20 healthy adults. 16S rRNA gene sequencing and mass spectrometry attributed the isolates to Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, Enterobacter aerogenes, Enterobacter kobei, Citrobacter freundii, Citrobacter amalonaticus, Cronobacter sp., and Hafnia alvei, Morganella morganii, and Serratia liquefaciens. Multiplex PCR revealed that K. pneumoniae harbored virulence genes for adhesins (mrkD, ycfM, and kpn) and enterobactin (entB) and, in one case, also for yersiniabactin (ybtS, irp1, irp2, and fyuA). Virulence genes were less numerous in the other NECE species. Biofilm formation was spread across all the species, while curli and cellulose were mainly produced by Citrobacter and Enterobacter. Among the most common antibiotics, amoxicillin-clavulanic acid was the sole against which resistance was observed, only Klebsiella strains being susceptible. The NECE inhabiting the intestine of healthy subjects have traits that may pose a health threat, taking into account the possibility of horizontal gene transfer.
Subject(s)
Amoxicillin-Potassium Clavulanate Combination/pharmacology , Anti-Bacterial Agents/pharmacology , Drug Resistance, Multiple, Bacterial/genetics , Enterobacteriaceae/drug effects , Gastrointestinal Microbiome/drug effects , beta-Lactamase Inhibitors/pharmacology , Citrobacter/drug effects , Citrobacter/genetics , Citrobacter/pathogenicity , Cronobacter/drug effects , Cronobacter/genetics , Cronobacter/pathogenicity , Enterobacter/drug effects , Enterobacter/genetics , Enterobacter/pathogenicity , Enterobacteriaceae/genetics , Enterobacteriaceae/pathogenicity , Gastrointestinal Microbiome/genetics , Healthy Volunteers , Humans , Klebsiella/drug effects , Klebsiella/genetics , Klebsiella/pathogenicity , Microbial Sensitivity Tests , RNA, Ribosomal, 16S/genetics , Virulence/genetics , Virulence Factors/geneticsABSTRACT
In insects, diet plays an important role in growth and development. Insects can vary their diet composition based on their physiological needs. In this study we tested the influence of diet composition involving varying concentrations of macronutrients and zinc on the immune-tolerance following parasite and pathogen exposure in Spodoptera litura larvae. We also tested the insecticidal potential of Mesorhabditis belari, Enterobacter hormaechei and its secondary metabolites on Spodoptera litura larvae. The results shows macronutrient composition does not directly affect the larval tolerance to nematode infection. However, Zinc supplemented diet improved the immune tolerance. While larvae exposed to bacterial infection performed better on carbohydrate rich diet. Secondary metabolites from bacteria produced an immune response in dose dependent mortality. The study shows that the larvae maintained on different diet composition show varied immune tolerance which is based on the type of infection.
Subject(s)
Enterobacter/physiology , Pest Control, Biological , Rhabditoidea/physiology , Spodoptera/immunology , Analysis of Variance , Animals , Biological Assay , Carbohydrates/administration & dosage , Chromatography, High Pressure Liquid , Diet , Enterobacter/immunology , Enterobacter/pathogenicity , Gas Chromatography-Mass Spectrometry , Immune Tolerance , Larva/immunology , Lethal Dose 50 , Proteins/administration & dosage , Rhabditoidea/immunology , Rhabditoidea/pathogenicity , Spectroscopy, Fourier Transform Infrared , Spodoptera/physiology , Symbiosis , Virulence , Zinc/administration & dosageABSTRACT
The genus Enterobacter is a member of the ESKAPE group, which contains the major resistant bacterial pathogens. First described in 1960, this group member has proven to be more complex as a result of the exponential evolution of phenotypic and genotypic methods. Today, 22 species belong to the Enterobacter genus. These species are described in the environment and have been reported as opportunistic pathogens in plants, animals, and humans. The pathogenicity/virulence of this bacterium remains rather unclear due to the limited amount of work performed to date in this field. In contrast, its resistance against antibacterial agents has been extensively studied. In the face of antibiotic treatment, it is able to manage different mechanisms of resistance via various local and global regulator genes and the modulation of the expression of different proteins, including enzymes (ß-lactamases, etc.) or membrane transporters, such as porins and efflux pumps. During various hospital outbreaks, the Enterobacter aerogenes and E. cloacae complex exhibited a multidrug-resistant phenotype, which has stimulated questions about the role of cascade regulation in the emergence of these well-adapted clones.
Subject(s)
Enterobacter/classification , Enterobacter/drug effects , Enterobacteriaceae Infections/microbiology , Animals , Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial/genetics , Enterobacter/pathogenicity , Enterobacteriaceae Infections/pathology , HumansABSTRACT
Background & objectives: Plasmid has led to increase in resistant bacterial pathogens through the exchange of antimicrobial resistance (AMR) genetic determinants through horizontal gene transfer. Baseline data on the occurrence of plasmids carrying AMR genes are lacking in India. This study was aimed to identify the plasmids associated with AMR genetic determinants in ESKAPE pathogens. Methods: A total of 112 ESKAPE isolates including Escherichia coli (n=37), Klebsiella pneumoniae (n=48, including 7 pan-drug susceptible isolates), Acinetobacter baumannii (n=8), Pseudomonas aeruginosa (n=1) and Staphylococcus aureus (n=18) were analyzed in the study. Isolates were screened for antimicrobial susceptibility and whole genome sequencing of isolates was performed using Ion Torrent (PGM) sequencer. Downstream data analysis was done using PATRIC, ResFinder, PlasmidFinder and MLSTFinder databases. All 88 whole genome sequences (WGS) were deposited at GenBank. Results: Most of the study isolates showed resistant phenotypes. As analyzed from WGS, the isolates included both known and unknown sequence types. The plasmid analysis revealed the presence of single or multiple plasmids in the isolates. Plasmid types such as IncHI1B(pNDM-MAR), IncFII(pRSB107), IncFIB(Mar), IncFIB(pQil), IncFIA, IncFII(K), IncR, ColKP3 and ColpVC were present in K. pneumoniae. In E. coli, IncFIA, IncFII, IncFIB, Col(BS512), IncL1, IncX3 and IncH were present along with other types. S. aureus harboured seven different plasmid groups pMW2 (rep 5), pSAS1 (rep 7), pDLK1 (rep 10), pUB110 (rep US12), Saa6159 (rep 16), pKH12 (rep 21) and pSA1308 (rep 21). The overall incidence of IncF type plasmids was 56.5 per cent followed by Col type plasmids 18.3 per cent and IncX 5.3 per cent. Other plasmid types identified were <5 per cent. Interpretation & conclusions: Results from the study may serve as a baseline data for the occurrence of AMR genes and plasmids in India. Information on the association between phenotypic and genotypic expression of AMR was deciphered from the data. Further studies on the mechanism of antibiotic resistance dissemination are essential for enhancing clinical lifetime of antibiotics.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Cross Infection/drug therapy , Drug Resistance, Multiple, Bacterial/genetics , Plasmids/genetics , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/genetics , Acinetobacter baumannii/pathogenicity , Anti-Bacterial Agents/adverse effects , Cross Infection/epidemiology , Cross Infection/genetics , Cross Infection/microbiology , Enterobacter/drug effects , Enterobacter/genetics , Enterobacter/pathogenicity , Enterococcus faecium/drug effects , Enterococcus faecium/genetics , Enterococcus faecium/pathogenicity , Gene Transfer, Horizontal/genetics , Humans , India/epidemiology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/genetics , Klebsiella pneumoniae/pathogenicity , Plasmids/drug effects , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/genetics , Pseudomonas aeruginosa/pathogenicity , Staphylococcus aureus/drug effects , Staphylococcus aureus/genetics , Staphylococcus aureus/pathogenicity , beta-Lactamases/geneticsABSTRACT
Background and objectives: Urinary tract infections (UTIs) are the third most common infections in humans, representing a significant factor of morbidity, both among outpatients and inpatients. The pathogenic role of Citrobacter, Enterobacter, and Serratia species (CES bacteria) has been described in UTIs. CES bacteria present a therapeutic challenge due to the various intrinsic and acquired resistance mechanisms they possess. Materials and Methods: The aim of this study was to assess and compare the resistance trends and epidemiology of CES pathogens in UTIs (RECESUTI) in inpatients and outpatients during a 10-year study period. To evaluate the resistance trends of isolated strains, several antibiotics were chosen as indicator drugs based on local utilization data. 578 CES isolates were obtained from inpatients and 554 from outpatients, representing 2.57 ± 0.41% of all positive urine samples for outpatients and 3.02 ± 0.40% for inpatients. E. cloacae was the most prevalent species. Results: The ratio of resistant strains to most of the indicator drugs was higher in the inpatient group and lower in the second half of the study period. ESBL-producing isolates were detected in 0-9.75% from outpatient and 0-29.09% from inpatient samples. Conclusions: Resistance developments of CES bacteria, coupled with their intrinsic non-susceptibility to several antibiotics, severely limits the number of therapeutic alternatives, especially for outpatients.
Subject(s)
Citrobacter/pathogenicity , Enterobacter/pathogenicity , Serratia/pathogenicity , Urinary Tract Infections/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Drug Resistance, Bacterial/drug effects , Female , Humans , Hungary/epidemiology , Infant , Male , Middle Aged , Retrospective Studies , Statistics, Nonparametric , Surveys and Questionnaires , Urinary Tract Infections/epidemiology , Urinary Tract Infections/physiopathologyABSTRACT
Enterobacter sp. J49 is a plant growth promoting endophytic strain that promotes the growth of peanut and maize crops. This strain promotes plant growth by different mechanisms with the supply of soluble phosphorus being one of the most important. Enterobacter sp. J49 not only increases the phosphorus content in the plant but also in the soil favoring the nutrition of other plants usually used in rotation with these crops. The aims of this study were to analyze the genome sequence of Enterobacter sp. J49 in order to deepen our knowledge regarding its plant growth promoting traits and to establish its phylogenetic relationship with other species of Enterobacter genus. Genome sequence of Enterobacter sp. J49 is a valuable source of information to continuing the research of its potential industrial production as a biofertilizer of peanut, maize and other economically important crops.
Subject(s)
Endophytes/genetics , Enterobacter/genetics , Genome, Bacterial , Arachis/microbiology , Endophytes/pathogenicity , Enterobacter/pathogenicity , Zea mays/microbiologyABSTRACT
A 60-year-old woman with a history of dilated cardiomyopathy underwent heart transplantation. One month post discharge, she presented to clinic with low-grade fever and productive cough. Her chest radiograph showed air-fluid levels in the pericardial silhouette. Transthoracic echocardiogram showed a large complex pericardial collection with no evidence of cardiac tamponade. The patient was urgently taken to the operating room for exploration. A large "egg-shaped" mass in the pericardium measuring 10 × 12 cm with gaseous material was aspirated. As the posterior wall of the mass was firmly adhered to the right atrium, the capsule was incompletely excised. We present the case of a potentially life-threatening complication post transplantation that required surgical debridement and life-long antibiotic suppressive therapy. To our knowledge, this is the first report of purulent pericardial collection caused by Enterobacter cancerogenous. Further research is required to better understand the biology of this microorganism and the role it may play as a pathogen in immunocompromised patients following solid organ transplantation.
Subject(s)
Enterobacteriaceae Infections/microbiology , Heart Transplantation/adverse effects , Pericarditis/microbiology , Pneumopericardium/diagnosis , Pneumopericardium/etiology , Echocardiography , Enterobacter/isolation & purification , Enterobacter/pathogenicity , Enterobacteriaceae Infections/complications , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/drug therapy , Female , Humans , Immunocompromised Host , Middle Aged , Pericarditis/diagnosis , Pericarditis/diagnostic imaging , Pneumopericardium/diagnostic imaging , Pneumopericardium/microbiologyABSTRACT
Lower respiratory tract infections (LRTIs) is an umbrella term that covers a wide spectrum of diseases, comprising mild and severe, acute and chronic conditions. A wide spectrum of pathogens can be implicated, from viruses to pyogenic and atypical bacteria. A special place should be reserved for slow growing bacteria (Mycobacteria spp., Nocardia spp.) and parasites (i.e., hydatic cysts caused by Echinococcus granulosus). OBJECTIVE: The objective of this study is to observe, analyze and establish the drug susceptibility patterns for Enterococcus spp., Staphylococcus aureus, Klebsiella spp., Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. (the ESKAPE pathogens) in the "Marius Nasta" Institute for Pulmonary Medicine (MNIPM), Bucharest, Romania. MATERIALS AND METHODS: A retrospective healthcare record based study was undertaken to establish the drug susceptibility patterns. We assessed all antibiograms of the ESKAPE pathogens isolated from respiratory samples from adult inpatients hospitalized between 2010-2015 at the MNIPM. RESULTS: We analyzed 2859 isolates (61% of the 4683 ESKAPE isolates). P. aeruginosa was the most frequent pathogen, while Enterococcus spp. and Enterobacter spp. were practically non-present. The antibiotic profile of P. aeruginosa isolates presented more resistance in the Intensive Care Unit (ICU)÷Surgery wards, probably resulting from antibiotic pressure. The other non-fermenter, A. baumannii, while less frequent (and the only pathogen more frequent in the surgery department) had an even more resistant profile, to almost all antibiotics, with the exception of Colistin. Methicillin-resistant S. aureus (MRSA) accounted for about 60% of all isolates, more in the ICU÷Surgery ward. K. pneumoniae presents a less resistance and shows more stability when analyzing the antibiogram pattern in the Medical wards. DISCUSSION: For methodological or procedural reasons, Enterococcus spp. and Enterobacter spp. were underrepresented in the study. Interventional programs comprising antibiotic stewardship and active surveillance need to be implemented to alleviate the antibiotic profile. Further research needs to focus on more detailed characterization of the molecular mechanisms leading to the high resistance detailed herein. CONCLUSIONS: This study adds to the body of literature reporting the antibiotic resistance landscape in Romania, for these highly resistant pathogens.
Subject(s)
Acinetobacter baumannii/pathogenicity , Enterobacter/pathogenicity , Enterococcus/pathogenicity , Klebsiella/pathogenicity , Pseudomonas aeruginosa/pathogenicity , Respiratory Center/microbiology , Staphylococcus aureus/pathogenicity , Tertiary Care Centers/standards , History, 21st Century , Humans , Retrospective Studies , RomaniaABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Urinary Tract Infections/microbiology , Enterobacter/pathogenicity , Enterobacteriaceae Infections/microbiology , Adenocarcinoma/complications , Prostatic Neoplasms/complications , Enterobacter/classificationABSTRACT
OBJECTIVES: Bloodstream infections (BSIs) are a major cause of paediatric morbidity and mortality worldwide. This study describes the epidemiology and antimicrobial resistance of Gram-negative bacteria (GNB) from BSIs in children admitted to an Iranian paediatric hospital. METHODS: Clinical and microbiological data of patients with positive blood cultures were collected from March 2011 to September 2016. Standard laboratory methods were used for blood culture and bacterial identification. Antimicrobial sensitivity was evaluated by the Kirby-Bauer disk diffusion and broth microdilution methods. RESULTS: Of 2325 bacterial pathogens isolated from blood cultures, 41.1% (n=956) were GNB. Most clinical isolates (n=208; 21.8%) were identified in the cardiac intensive care unit. Predominant bacterial isolates were Klebsiella pneumoniae subsp. pneumoniae (n=263; 27.5%), Escherichia coli (n=192; 20.1%), Serratia marcescens (n=151; 15.8%), Pseudomonas aeruginosa (n=111; 11.6%) and Enterobacter spp. (n=100; 10.5%). Enterobacter isolates showed a high level of ampicillin resistance. Escherichia coli were highly resistant to chloramphenicol (100%), cefixime (100%), ceftriaxone (100%) and ampicillin (96%). Cefixime had the least efficacy against Haemophilus spp. (100% resistant). All K. pneumoniae (100%) were ampicillin-resistant. All S. marcescens were ceftazidime-resistant. No Acinetobacter baumannii were resistant to colistin. All P. aeruginosa were resistant to cefotaxime and trimethoprim/sulfamethoxazole. CONCLUSIONS: These results demonstrate the increasing trend in antibiotic resistance among GNB associated with BSI in children, emphasising the importance of continuous screening and surveillance programmes for detection of antibiotic resistance in BSI pathogens for selection of appropriate treatment regimens.
Subject(s)
Bacteremia/epidemiology , Bacteremia/microbiology , Drug Resistance, Bacterial , Gram-Negative Bacteria/isolation & purification , Gram-Negative Bacteria/pathogenicity , Hospitals, Pediatric , Referral and Consultation , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/isolation & purification , Acinetobacter baumannii/pathogenicity , Anti-Bacterial Agents/pharmacology , Bacteremia/diagnosis , Drug Resistance, Bacterial/drug effects , Enterobacter/drug effects , Enterobacter/isolation & purification , Enterobacter/pathogenicity , Escherichia coli/drug effects , Escherichia coli/isolation & purification , Escherichia coli/pathogenicity , Female , Gram-Negative Bacteria/classification , Gram-Negative Bacteria/drug effects , Humans , Iran/epidemiology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/pathogenicity , Male , Microbial Sensitivity Tests , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/isolation & purification , Pseudomonas aeruginosa/pathogenicity , Serratia marcescens/drug effects , Serratia marcescens/isolation & purification , Serratia marcescens/pathogenicityABSTRACT
Class 1 integrons have played a major role in the global dissemination of antibiotic resistance. Reconstructing the history of class 1 integrons might help us control further spread of antibiotic resistance by understanding how human activities influence microbial evolution. Here we describe a class 1 integron that represents an intermediate stage in the evolutionary history of clinical integrons. It was embedded in a series of nested transposons, carried on an IncP plasmid resident in Enterobacter, isolated from the surface of baby spinach leaves. Based on the structure of this integron, we present a modified hypothesis for integron assembly, where the ancestral clinical class 1 integron was captured from a betaproteobacterial chromosome to form a Tn402-like transposon. This transposon then inserted into a plasmid-borne Tn21-like ancestor while in an environmental setting, possibly a bacterium resident in the phyllosphere. We suggest that the qacE gene cassette, conferring resistance to biocides, together with the mercury resistance operon carried by Tn21, provided a selective advantage when this bacterium made its way into the human commensal flora via food. The integron characterized here was located in Tn6007, which along with Tn6008, forms part of the larger Tn6006 transposon, itself inserted into another transposable element to form the Tn21-like transposon, Tn6005. This element has previously been described from the human microbiota, but with a promoter mutation that upregulates integron cassette expression. This element we describe here is from an environmental bacterium, and supports the hypothesis that the ancestral class 1 integron migrated into anthropogenic settings via foodstuffs. Selection pressures brought about by early antimicrobial agents, including mercury, arsenic and disinfectants, promoted its initial fixation, the acquisition of promoter mutations, and subsequent dissemination into various species and pathogens.
Subject(s)
DNA Transposable Elements/genetics , Drug Resistance, Bacterial/genetics , Foodborne Diseases/genetics , Integrons/genetics , Enterobacter/drug effects , Enterobacter/genetics , Enterobacter/pathogenicity , Evolution, Molecular , Foodborne Diseases/microbiology , Humans , Mutation , Plasmids/genetics , Promoter Regions, Genetic , Sequence Analysis, DNAABSTRACT
Outpatient urine samples are among the most commonly processed in a microbiology laboratory, which involves a high economic burden. The aim of this study was compare cost and efficiency to process uropathogens between MicroScan system (2010-2011) versus a chromogenic medium and the disk diffusion method (2013-2014). In the first period, a total 9918 bacterial populations were isolated from urine samples. Annual estimated costs during 2010 and 2011 for processing were EUR 53,818 and EUR 57,306, respectively (EUR 111,124 total). In the second period, a total 11,728 bacterial isolates were processed, with annual estimated costs of EUR 21,078 and EUR 23,248, respectively (EUR 44,326 total). We included the cost for a laboratory technician (252h worked per year), estimated at EUR 2500 per year. The mean estimated savings were EUR 66,797 (60%).The identification by chromogenic media and antibiotic susceptibility patterns by disk diffusion method was similar to MicroScan in both study periods. Only some isolated Citrobacter spp., Enterobacter spp., Morganella morganii, and Providencia spp. were misidentified. The strategy reported here did not affect the quality of the results and yielded substantial cost savings.
Subject(s)
Bacteria/drug effects , Bacteria/isolation & purification , Community-Acquired Infections/microbiology , Microbial Sensitivity Tests/economics , Urinary Tract Infections/microbiology , Anti-Bacterial Agents/pharmacology , Chromogenic Compounds/chemistry , Chromogenic Compounds/economics , Citrobacter/drug effects , Citrobacter/isolation & purification , Citrobacter/pathogenicity , Cost Savings , Disk Diffusion Antimicrobial Tests/economics , Drug Resistance, Bacterial , Enterobacter/drug effects , Enterobacter/isolation & purification , Enterobacter/pathogenicity , Humans , Microbial Sensitivity Tests/methods , Urine/microbiologyABSTRACT
OBJECT: This surveillance aimed to investigate the antimicrobial resistance profiles of Enterobacteriaceae pathogens in Southern China during 2001-2015. METHODS: A total of 6858 Enterobacteriaceae isolates were collected, including 4276 E. coli, 1992 K. pneumoniae and 590 Enterobacter spp. Disk diffusion method and minimum inhibitory concentrations method were used for susceptibility testing, with results interpreted by the CLSI (2015). RESULTS: Urinary tract remained the dominant isolated site among E. coli (49.88%), whereas 53.26% K. pneumoniae and 45.25% Enterobacter spp. were from Sputum. The carbapenems maintained the highest antimicrobial activity (resistance rates <15%), followed by piperacillin-tazobactam and amikacin. Gentle increases were obtained in carbapenems-resistant K. pneumoniae and Enterobacter spp. (eg. from 4.5% to 11.2% and 3.2% to 14.5% in imipenem, repestively). The third-generation cephalosporins showed high and stable resistance among Enterobacteriaceae pathogens during the studied period, with ceftazidime as the most active third-generation cephalosporin against Enterobacteriaceae. Isolates from ICU department showed higher or similar resistance rates among Enterobacteriaceae pathogens compared to other wards. CONCLUSION: Carbapenems are the most potent antibiotic agents against Enterobacteriaceae pathogens. Due to the complicated susceptibility profiles, prescribing guidelines should be based on the knowledge of antibiogram of pathogens.