RESUMO
Helicobacter pylori resistance to antibiotics is a growing problem and it increasingly leads to treatment failure. While the bacterium is present worldwide, the severity of clinical outcomes is highly dependent on the geographical origin and genetic characteristics of the strains. One of the major virulence factors identified in H. pylori is the cag pathogenicity island (cagPAI), which encodes a type IV secretion system (T4SS) used to translocate effectors into human cells. Here, we investigated the genetic variability of the cagPAI among 13 antibiotic-resistant H. pylori strains that were isolated from patient biopsies in Québec. Seven of the clinical strains carried the cagPAI, but only four could be readily cultivated under laboratory conditions. We observed variability of the sequences of CagA and CagL proteins that are encoded by the cagPAI. All clinical isolates induce interleukin-8 secretion and morphological changes upon co-incubation with gastric cancer cells and two of them produce extracellular T4SS pili. Finally, we demonstrate that molecule 1G2, a small molecule inhibitor of the Cagα protein from the model strain H. pylori 26695, reduces interleukin-8 secretion in one of the clinical isolates. Co-incubation with 1G2 also inhibits the assembly of T4SS pili, suggesting a mechanism for its action on T4SS function.
Assuntos
Infecções por Helicobacter , Helicobacter pylori , Humanos , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Antígenos de Bactérias/genética , Sistemas de Secreção Tipo IV/genética , Sistemas de Secreção Tipo IV/metabolismo , Helicobacter pylori/genética , Helicobacter pylori/metabolismo , Interleucina-8/metabolismo , Infecções por Helicobacter/microbiologiaRESUMO
BACKGROUND: Campylobacter species are among the most common causes of enteric bacterial infections worldwide. Men who have sex with men (MSM) are at increased risk for sexually transmitted enteric infections, including globally distributed strains of multidrug-resistant Shigella species. METHODS: This was a retrospective study of MSM-associated Campylobacter in Seattle, Washington and Montréal, Québec with phenotypic antimicrobial resistance profiles and whole genome sequencing (WGS). RESULTS: We report the isolation of 2 clonal lineages of multidrug-resistant Campylobacter coli from MSM in Seattle and Montréal. WGS revealed nearly identical strains obtained from the 2 regions over a 4-year period. Comparison with the National Center for Biotechnology Information's Pathogen Detection database revealed extensive Campylobacter species clusters carrying multiple drug resistance genes that segregated with these isolates. Examination of the genetic basis of antimicrobial resistance revealed multiple macrolide resistance determinants including a novel ribosomal RNA methyltransferase situated in a CRISPR (clustered regularly interspaced short palindromic repeats) array locus in a C. coli isolate. CONCLUSIONS: As previously reported for Shigella, specific multidrug-resistant strains of Campylobacter are circulating by sexual transmission in MSM populations across diverse geographic locations, suggesting a need to incorporate sexual behavior in the investigation of clusters of foodborne pathogens revealed by WGS data.
Assuntos
Infecções por Campylobacter , Campylobacter coli , Minorias Sexuais e de Gênero , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/epidemiologia , Campylobacter coli/genética , Farmacorresistência Bacteriana , Homossexualidade Masculina , Humanos , Macrolídeos , Masculino , Testes de Sensibilidade Microbiana , Quebeque/epidemiologia , Estudos Retrospectivos , Washington/epidemiologiaRESUMO
We analyzed 254 Shigella species isolates collected in Québec, Canada, during 2013 and 2014. Overall, 23.6% of isolates showed reduced susceptibility to azithromycin (RSA) encoded by mphA (11.6%), ermB (1.7%), or both genes (86.7%). Shigella strains with RSA were mostly isolated from men who have sex with men (68.8% or higher) from the Montreal region. A complete sequence analysis of six selected plasmids from Shigella sonnei and different serotypes of Shigella flexneri emphasized the role of IS26 in the dissemination of RSA.
Assuntos
Azitromicina/farmacologia , Shigella/efeitos dos fármacos , Shigella/patogenicidade , Antibacterianos/farmacologia , Canadá , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Testes de Sensibilidade Microbiana , Quebeque , Shigella flexneri/efeitos dos fármacos , Shigella flexneri/patogenicidade , Shigella sonnei/efeitos dos fármacos , Shigella sonnei/patogenicidadeRESUMO
From March 2014 to December 2016, a cluster of 13 cases of Campylobacter fetus intestinal and extraintestinal infections, including 2 patients with an aortic mycotic aneurysm, caused significant morbidity. The cluster likely resulted from sexual transmission between men having sex with men living in the greater Montreal area, Quebec, Canada.
Assuntos
Infecções por Campylobacter/epidemiologia , Campylobacter fetus/genética , Surtos de Doenças/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Adulto , Idoso , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/transmissão , Campylobacter fetus/classificação , Campylobacter fetus/efeitos dos fármacos , Análise por Conglomerados , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Quebeque/epidemiologia , Estudos Retrospectivos , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissãoRESUMO
From January 2003 to December 2013, sexual transmission of 2 clades of Campylobacter jejuni subspecies jejuni isolates resulted in a prolonged outbreak among men who have sex with men living in Quebec, Canada. The outbreak isolates were acquired locally and were resistant to erythromycin and ciprofloxacin.
Assuntos
Antibacterianos/farmacologia , Infecções por Campylobacter/epidemiologia , Campylobacter jejuni/isolamento & purificação , Ciprofloxacina/farmacologia , Surtos de Doenças , Farmacorresistência Bacteriana Múltipla , Eritromicina/farmacologia , Adulto , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/transmissão , Campylobacter jejuni/efeitos dos fármacos , DNA Bacteriano/química , DNA Bacteriano/genética , Genótipo , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Filogenia , Quebeque/epidemiologia , Análise de Sequência de DNA , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Adulto JovemRESUMO
During 2012-2013 in Montreal, Canada, 4 locally acquired Shigella spp. pulse types with the mph(A) gene and reduced susceptibility to azithromycin were identified from 9 men who have sex with men, 7 of whom were HIV infected. Counseling about prevention of enteric sexually transmitted infections might help slow transmission of these organisms.
Assuntos
Antibacterianos/farmacologia , Azitromicina/farmacologia , Farmacorresistência Bacteriana , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/microbiologia , Shigella/efeitos dos fármacos , Adulto , Coinfecção/epidemiologia , Farmacorresistência Bacteriana/genética , Feminino , Genes Bacterianos , Homossexualidade Masculina , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Fosfotransferases (Aceptor do Grupo Álcool)/genética , Vigilância em Saúde Pública , Quebeque/epidemiologia , Infecções Sexualmente Transmissíveis , Shigella/genéticaRESUMO
From 2002 to 2013 in Montreal, Quebec, Canada, 38 Campylobacter coli isolates were more frequently erythromycin, tetracycline, and ciprofloxacin resistant than 440 Campylobacter jejuni subsp. jejuni isolates (18.4% versus 1.8%; P = 0.00005), of which the 148 isolates acquired abroad were more frequently erythromycin, tetracycline, and ciprofloxacin resistant than the 292 isolates acquired locally (5.4% versus 0%; P = 0.0001).
Assuntos
Antibacterianos/farmacologia , Campylobacter coli/efeitos dos fármacos , Campylobacter jejuni/efeitos dos fármacos , Farmacorresistência Bacteriana , Infecções por Campylobacter/microbiologia , Campylobacter coli/isolamento & purificação , Campylobacter jejuni/isolamento & purificação , Ciprofloxacina/farmacologia , Eritromicina/farmacologia , Humanos , Testes de Sensibilidade Microbiana , Quebeque , Tetraciclina/farmacologiaRESUMO
During September 2010-November 2011, a cluster of erythromycin-susceptible, tetracycline- and ciprofloxacin-resistant Campylobacter coli pulsovar 1 infections was documented, involving 10 case-patients, in Montreal, Quebec, Canada. The findings suggested sexual transmission of an enteric infection among men who have sex with men.
Assuntos
Infecções por Campylobacter/epidemiologia , Campylobacter coli/genética , Surtos de Doenças , Infecções por HIV/epidemiologia , HIV/isolamento & purificação , Homossexualidade Masculina , Adulto , Antibacterianos/uso terapêutico , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/transmissão , Campylobacter coli/isolamento & purificação , Ciprofloxacina/uso terapêutico , Coinfecção , Farmacorresistência Bacteriana Múltipla , Eritromicina/uso terapêutico , Infecções por HIV/virologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Quebeque/epidemiologia , Estudos Retrospectivos , Tetraciclina/uso terapêuticoRESUMO
Multidrug-resistant (MDR) Shigella sonnei have become prevalent among men who have sex with men and have become a global public health concern. From June 2017 to April 2019, 32 men were infected with MDR S. sonnei acquired locally, in Montréal, which was suggestive of an outbreak. Antimicrobial susceptibility testing, whole-genome sequencing (WGS), phylogenetic analysis, antimicrobial resistance and virulence characterization, and association to international clusters were performed. The outbreak strain was ceftriaxone- and azithromycin-resistant due to the acquisition of blaCTX-M-27, and mphA and ermB genes, respectively, with reduced susceptibility to ciprofloxacin due to a single point mutation (gyrA S83L). One out of 27 patients treated with a fluoroquinolone experienced microbiological failure. Epidemiological evidence first supported by a rare unique MDR Shigella sonnei documented only in men in 2017 followed by similar pulsed-field gel electrophoresis profiles was confirmed by WGS. A core genome high-quality single-nucleotide variant (hqSNV)-based phylogeny found a median of 6 hqSNV differences among isolates. Virulence gene content was investigated, but no Shiga toxins were detected. An international cluster of highly related isolates was identified (PDS000019750.208) and belonged to the 3.7.29.1.4.1 S. sonnei genotype (Global III VN2.KH1.Aus). Genomic analysis revealed that this Montréal cluster was connected to other documented outbreaks in Australia, the United States, and the United Kingdom. This study highlights the urgent need for public health measures to focus on the prevention and the early detection of S. sonnei, since global transmission patterns of MDR strains is concerning and few antimicrobial treatment options are available. IMPORTANCE Shigella sonnei, an important foodborne pathogen, recently became a frequent sexually transmitted agent involved in large and persistent outbreaks globally among men who have sex with men. Most strains also harbor several multidrug-resistant (MDR) determinants of particular concern. This study characterizes an outbreak strain at the source of an important MDR cluster identified in Montréal in 2017. Associations were made to many high-profile international outbreaks, and the causative S. sonnei lineage of these clusters was identified, which was not evident in past reports. The worldwide occurrence of this strain is of concern since treatment with antimicrobials like ceftriaxone and azithromycin may not be effective, and rare microbiological failures have been documented in patients treated with ciprofloxacin. Our investigation highlights the threats of Shigella spp. infection and the necessity for antimicrobial susceptibility monitoring in order to mitigate S. sonnei's impact on public health and to avoid transmission to other at-risk communities.
Assuntos
Disenteria Bacilar , Minorias Sexuais e de Gênero , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Azitromicina/farmacologia , Ceftriaxona/farmacologia , Ceftriaxona/uso terapêutico , Ciprofloxacina/farmacologia , Ciprofloxacina/uso terapêutico , Farmacorresistência Bacteriana/genética , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/microbiologia , Genômica , Homossexualidade Masculina , Humanos , Masculino , Testes de Sensibilidade Microbiana , Filogenia , Shigella sonnei/genéticaAssuntos
Antibacterianos/farmacologia , Infecções por Campylobacter/microbiologia , Infecções por Campylobacter/transmissão , Campylobacter coli/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla , Homossexualidade Masculina , Antibacterianos/uso terapêutico , Infecções por Campylobacter/tratamento farmacológico , Infecções por Campylobacter/epidemiologia , Campylobacter coli/classificação , Campylobacter coli/genética , Surtos de Doenças , Eletroforese em Gel de Campo Pulsado , Humanos , Masculino , Testes de Sensibilidade Microbiana , Quebeque/epidemiologia , beta-Lactamases/genéticaAssuntos
Antibacterianos/farmacologia , Azitromicina/farmacologia , Ciprofloxacina/farmacologia , Farmacorresistência Bacteriana , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/microbiologia , Shigella flexneri/efeitos dos fármacos , Canadá/epidemiologia , Coinfecção , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/história , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , História do Século XXI , Humanos , Testes de Sensibilidade Microbiana , Vigilância da População , Shigella flexneri/genéticaRESUMO
In 2010, we observed isolates with matching pulsed-field gel electrophoresis patterns from 13 cases of ciprofloxacin-resistant Shigella sonnei in Montréal. We report on the emergence of this resistance type and a study of resistance mechanisms. The investigation suggested local transmission among men who have sex with men associated with sex venues.
Assuntos
Antibacterianos/uso terapêutico , Ciprofloxacina/uso terapêutico , Farmacorresistência Bacteriana , Disenteria Bacilar/tratamento farmacológico , Homossexualidade Masculina , Shigella sonnei/efeitos dos fármacos , Adulto , Idoso , Canadá/epidemiologia , Surtos de Doenças , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/transmissão , Eletroforese em Gel de Campo Pulsado , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem Molecular , Comportamento Sexual , Shigella sonnei/classificação , Shigella sonnei/isolamento & purificação , Adulto JovemRESUMO
We describe the first case of invasive human infection (a nosocomial septicemia) caused by Cupriavidus metallidurans. This metal-resistant bacterium has not been reported to be pathogenic in humans or animals.
Assuntos
Cupriavidus/classificação , Cupriavidus/isolamento & purificação , Infecções por Bactérias Gram-Negativas/diagnóstico , Sepse/diagnóstico , Sepse/microbiologia , Idoso , Antibacterianos/farmacologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/microbiologia , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Infecções por Bactérias Gram-Negativas/microbiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , RNA Ribossômico 16S/genética , Análise de Sequência de DNARESUMO
The D-zone test detects inducible clindamycin resistance in Staphylococcus spp. Two other methods not described by the Clinical and Laboratory Standards Institute (CLSI) are available to test for this resistance mechanism: an agar dilution method and new Vitek 2 cards. This study evaluated the performance of both methods in detecting inducible clindamycin resistance. Nonduplicate clinical strains of Staphylococcus spp. (111 Staphylococcus aureus and 52 coagulase-negative staphylococcus strains), intermediate or resistant to erythromycin but susceptible to clindamycin, were obtained from three hospitals in Montreal, Quebec, Canada. Molecular analysis to detect resistance genes was conducted on all strains. A Mueller-Hinton agar containing 1 mg of erythromycin and 0.5 mg of clindamycin/liter was used for the dilution method, and two inocula were tested: 10(4) and 10(5) CFU per spot. Plates were read at 24 and 48 h. The Vitek 2 AST-P580 card was used according to the manufacturer's recommendations. The results were compared to those of the D-zone test. The D-zone test was positive in 134 of 163 (82%) strains. With the 10(4) CFU inoculum, the sensitivities were 84 and 99% at 24 and 48 h, respectively. The 10(5) CFU inoculum increased the sensitivities at 24 and 48 h to 91 and 100%, respectively. The specificity was 100% for the 10(4) CFU inoculum at 24 h and 97% for the other combinations. The sensitivity and specificity for the Vitek 2 card were 93 and 100%, respectively. The performance of both the agar dilution method and the Vitek 2 card was good, but these methods were not as sensitive as the D-zone test at 24 h.
Assuntos
Antibacterianos/farmacologia , Clindamicina/farmacologia , Farmacorresistência Bacteriana , Staphylococcus aureus/efeitos dos fármacos , Animais , DNA Bacteriano/genética , Eritromicina/farmacologia , Genes Bacterianos , Hospitais , Humanos , Testes de Sensibilidade Microbiana/métodos , Quebeque , Sensibilidade e Especificidade , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificaçãoRESUMO
With disk diffusion, the following zone diameters are suggested to be resistant and susceptible breakpoints, respectively: for susceptibility testing of Campylobacter coli, no inhibition zone and 15 mm or more for erythromycin, and 20 mm or less and 25 mm or more for ciprofloxacin, in the absence or presence of an inhibition zone around the nalidixic acid disk; and for susceptibility testing of C. coli and Campylobacter jejuni, 20 mm or less and 26 mm or more for tetracycline.
Assuntos
Antibacterianos/farmacologia , Campylobacter coli/efeitos dos fármacos , Campylobacter jejuni/efeitos dos fármacos , Testes de Sensibilidade Microbiana/métodos , Ciprofloxacina/farmacologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão/métodos , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão/normas , Eritromicina/farmacologia , Humanos , Testes de Sensibilidade Microbiana/normas , Tetraciclina/farmacologiaRESUMO
From 1997 to 2006, in the province of Quebec, Canada, 15 isolates of Streptococcus pseudoporcinus from 1 urine and 14 vaginorectal cultures were recovered from the genitourinary tract of pregnant women. All these women originated from the Caribbean or sub-Saharan Africa (P=0.00045 compared with a suitable control group). The S. pseudoporcinus isolates were compared to eight isolates of Streptococcus porcinus identified in Quebec from 1995 to 2006, all from animals, of which five were swine. 16S rRNA gene sequencing was required to differentiate between S. pseudoporcinus and S. porcinus animal isolates.
Assuntos
Doenças Urogenitais Femininas/microbiologia , RNA Ribossômico 16S/análise , Infecções Estreptocócicas/epidemiologia , Streptococcus/efeitos dos fármacos , Sistema Urogenital/microbiologia , Canadá/epidemiologia , Feminino , Humanos , Testes de Sensibilidade Microbiana , RNA Bacteriano/genética , RNA Ribossômico 16S/genética , Infecções Estreptocócicas/microbiologia , Streptococcus/classificação , Streptococcus/genética , Streptococcus/isolamento & purificaçãoRESUMO
Plesiomonas shigelloides, the only oxidase-positive Enterobacteriaceae, is an inhabitant of freshwater and estuary ecosystems. We report the first possible case of Plesiomonas shigelloides-induced septic abortion. This 24-year-old female was successfully treated by dilatation and curettage as well as antimicrobial therapy.