Antimicrobial resistance (AMR) is a global health threat requiring urgent attention and effective strategies for containment. AMR is fueled by wastewater mismanagement and global mobility, disseminating multidrug-resistant (MDR) strains worldwide. While global estimates of AMR burden have been informative, community-level understanding has received little attention despite reports of high AMR prevalence in healthy communities. We assessed the "invasion" of antibiotic resistance genes (ARGs) into the normal human flora by characterizing AMR Escherichia coli in local wastewaters contributed by a healthy youth population. This study estimated 26% (out of 300 isolates) resistant and 59% plasmid-bearing E. coli in local wastewater. Of the 78 AMR isolates, the frequency of mono-resistance was higher against tetracycline (32%), followed by kanamycin (17%) and chloramphenicol (9%). Five isolates were potentially MDR. We further sequenced four MDRs and four sensitive strains to comprehend the genome and resistome diversity in comparison to the global wastewater E. coli (genomes from the PATRIC database). The whole-genome analysis revealed extensive genome similarity among global isolates, suggesting global dissemination and colonization of E. coli. Global wastewater resistome majorly comprised ARGs against aminoglycosides (26%), beta-lactam (17%), sulfonamide (11%), and trimethoprim (8%). Resistance to colistin, a last-resort antibiotic, was prevalent in MDRs of European and South Asian isolates. A systems approach is required to address the AMR crisis on a global scale, reduce antibiotic usage, and increase the efficiency of wastewater management and disinfection.
抗菌素耐药性(AMR)是一个全球性的健康威胁,亟需关注和有效的遏制策略。废水管理不善和全球流动性助长了抗药性的产生,并在全球范围内传播耐多药(MDR)菌株。尽管对 AMR 负担的全球估算具有参考价值,但对社区层面的了解却很少受到关注,尽管有报告称健康社区的 AMR 感染率很高。我们通过分析当地健康青少年废水中的 AMR 大肠杆菌,评估了抗生素耐药基因(ARGs)"入侵 "人体正常菌群的情况。这项研究估计当地废水中有 26%(共 300 个分离株)大肠杆菌具有抗药性,59%带有质粒。在 78 个 AMR 分离物中,对四环素(32%)产生单耐药性的频率较高,其次是卡那霉素(17%)和氯霉素(9%)。有 5 个分离株可能具有 MDR。我们对 4 株 MDR 菌株和 4 株敏感菌株进行了进一步测序,以了解其基因组和抗性组多样性,并与全球废水大肠杆菌(基因组来自 PATRIC 数据库)进行比较。全基因组分析显示,全球分离菌株之间存在广泛的基因组相似性,这表明大肠杆菌在全球范围内传播和定殖。全球废水耐药性基因组主要包括针对氨基糖苷类(26%)、β-内酰胺类(17%)、磺胺类(11%)和三甲氧苄啶(8%)的 ARGs。欧洲和南亚分离物的 MDRs 中普遍存在对可乐定(一种最后的抗生素)的耐药性。要在全球范围内解决 AMR 危机,减少抗生素的使用,提高废水管理和消毒的效率,就必须采取系统的方法。
{"title":"Resistome Diversity in <i>Escherichia coli</i> Isolates of Global Wastewaters.","authors":"Pavithra Anantharaman Sudhakari, Bhaskar Chandra Mohan Ramisetty","doi":"10.1089/mdr.2022.0296","DOIUrl":"10.1089/mdr.2022.0296","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a global health threat requiring urgent attention and effective strategies for containment. AMR is fueled by wastewater mismanagement and global mobility, disseminating multidrug-resistant (MDR) strains worldwide. While global estimates of AMR burden have been informative, community-level understanding has received little attention despite reports of high AMR prevalence in healthy communities. We assessed the \"invasion\" of antibiotic resistance genes (ARGs) into the normal human flora by characterizing AMR <i>Escherichia coli</i> in local wastewaters contributed by a healthy youth population. This study estimated 26% (out of 300 isolates) resistant and 59% plasmid-bearing <i>E. coli</i> in local wastewater. Of the 78 AMR isolates, the frequency of mono-resistance was higher against tetracycline (32%), followed by kanamycin (17%) and chloramphenicol (9%). Five isolates were potentially MDR. We further sequenced four MDRs and four sensitive strains to comprehend the genome and resistome diversity in comparison to the global wastewater <i>E. coli</i> (genomes from the PATRIC database). The whole-genome analysis revealed extensive genome similarity among global isolates, suggesting global dissemination and colonization of <i>E. coli</i>. Global wastewater resistome majorly comprised ARGs against aminoglycosides (26%), beta-lactam (17%), sulfonamide (11%), and trimethoprim (8%). Resistance to colistin, a last-resort antibiotic, was prevalent in MDRs of European and South Asian isolates. A systems approach is required to address the AMR crisis on a global scale, reduce antibiotic usage, and increase the efficiency of wastewater management and disinfection.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"37-49"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2023-10-17DOI: 10.1089/mdr.2023.0150
Stefano Amadesi, Marta Palombo, Federica Bovo, Andrea Liberatore, Elena Vecchi, Monica Cricca, Tiziana Lazzarotto, Simone Ambretti, Paolo Gaibani
Candida auris is a concerning pathogen in health care due to its ability to spread in medical settings. In this study, we characterized the genome of three C. auris clinical isolates collected in the Emilia-Romagna region of Northeastern Italy from January 2020 to May 2021. Whole-genome sequencing was performed using Illumina iSeq 100 and Oxford Nanopore MinION systems. Genomes were assembled with Flye. Phylogenetic analysis was carried out with RaxML. The ERG11, TAC1b, and FKS1 genes were examined for known substitutions associated with resistance to azoles and caspofungin using Diamond. All three C. auris isolates belonged to clade I (South Asian lineage) and showed high minimum inhibitory concentrations for fluconazole. Two of the three isolates were closely related to the first Italian index case of C. auris occurred in the 2019 and carried similar mutations associated to azole resistance. The third isolate showed a greater phylogenetic distance from these strains and had a different genetic determinant not previously seen in Italy. Our data suggest that two C. auris clinical isolates may have been epidemiologically related to the first outbreak previously observed in Italy, while the remaining isolate may have originated from a different source. Further research is needed to understand C. auris transmission and resistance and to control its spread.
{"title":"Clonal Dissemination of <i>Candida auris</i> Clinical Isolates in Northern Italy, 2021.","authors":"Stefano Amadesi, Marta Palombo, Federica Bovo, Andrea Liberatore, Elena Vecchi, Monica Cricca, Tiziana Lazzarotto, Simone Ambretti, Paolo Gaibani","doi":"10.1089/mdr.2023.0150","DOIUrl":"10.1089/mdr.2023.0150","url":null,"abstract":"<p><p><i>Candida auris</i> is a concerning pathogen in health care due to its ability to spread in medical settings. In this study, we characterized the genome of three <i>C. auris</i> clinical isolates collected in the Emilia-Romagna region of Northeastern Italy from January 2020 to May 2021. Whole-genome sequencing was performed using Illumina iSeq 100 and Oxford Nanopore MinION systems. Genomes were assembled with Flye. Phylogenetic analysis was carried out with RaxML. The ERG<i>11</i>, <i>TAC1b</i>, and <i>FKS1</i> genes were examined for known substitutions associated with resistance to azoles and caspofungin using Diamond. All three <i>C. auris</i> isolates belonged to clade I (South Asian lineage) and showed high minimum inhibitory concentrations for fluconazole. Two of the three isolates were closely related to the first Italian index case of <i>C. auris</i> occurred in the 2019 and carried similar mutations associated to azole resistance. The third isolate showed a greater phylogenetic distance from these strains and had a different genetic determinant not previously seen in Italy. Our data suggest that two <i>C. auris</i> clinical isolates may have been epidemiologically related to the first outbreak previously observed in Italy, while the remaining isolate may have originated from a different source. Further research is needed to understand <i>C. auris</i> transmission and resistance and to control its spread.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"50-54"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41236833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The present work deals with the analysis and monitoring of bacterial resistance in using Python for the state of Gujarat, India, where occurrences of drug-resistant bacteria are prevalent. This will provide an insight into the portfolio of drug-resistant bacteria reported, which can be used to track resistance behavior and to suggest a treatment regime for the particular bacteria. The present analysis has been done using Python on Jupyter Notebook as the integrated development environment and its data analysis libraries such as Pandas, Seaborn, and Matplotlib. The data have been loaded from excel file using Pandas and cleaned to transform features into required format. Seaborn and Matplotlib have been used to create data visualizations and represent the data inexplicable manner using graphs, plots, and tables. This program can be used to study disaster epidemiology, tracking, analyzing, and surveillance of antimicrobial resistance with a proper system integration approach.
{"title":"An Approach to Track and Analyze the Trend of Antimicrobial Resistance Using Python: A Pilot Study for Anand, Gujarat, India-May 2022-August 2023.","authors":"Priyanshu Khound, Himanshu Pandya, Rupal Patel, Naimika Patel, Siddhi A Darji, Purvi Trivedi, Vandan Mehta, Avani Raulji, Devjani Banerjee","doi":"10.1089/mdr.2023.0057","DOIUrl":"10.1089/mdr.2023.0057","url":null,"abstract":"<p><p>The present work deals with the analysis and monitoring of bacterial resistance in using Python for the state of Gujarat, India, where occurrences of drug-resistant bacteria are prevalent. This will provide an insight into the portfolio of drug-resistant bacteria reported, which can be used to track resistance behavior and to suggest a treatment regime for the particular bacteria. The present analysis has been done using Python on Jupyter Notebook as the integrated development environment and its data analysis libraries such as Pandas, Seaborn, and Matplotlib. The data have been loaded from excel file using Pandas and cleaned to transform features into required format. Seaborn and Matplotlib have been used to create data visualizations and represent the data inexplicable manner using graphs, plots, and tables. This program can be used to study disaster epidemiology, tracking, analyzing, and surveillance of antimicrobial resistance with a proper system integration approach.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"1-20"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Around the world, carbapenemase-producing Escherichia coli is becoming more prevalent. The purpose of this research was to analyze the whole plasmid sequences from YL03 isolates of the E. coli strain that produce both KPC-2 and NDM-5 carbapenemases. Materials and Methods: Whole-genome sequencing (WGS) and analysis of E. coli strain YL03, which was isolated from a wound sample, was performed by Illumina Novaseq 6000 and Pacific Biosciences Sequel (PacBio, Menlo Park, CA) sequencers. Following that, the WGS results were used to predict and analyze the YL03 genome composition and function. A complete gene sequence for YL03 with the accession number CP093551 has been uploaded to GenBank. Results: The results showed that YL03 co-carried five resistance genes, which included blaKPC-2, blaNDM-5, blaTEM-1B, blaCTX-M-14, and mdf(A). Furthermore, three resistance plasmids were found in YL03: pYL03-KPC, pYL03-NDM, and pYL03-CTX. Among them, the 53 kb-long pYL03-KPC plasmid belonging to the IncP, carried the replicase gene (repA) and the carbapenemase gene (blaKPC-2). The blaKPC-2 gene was flanked by a composite transposon-like element (Tn3-[Tn3] tnpR-ISKpn27 blaKPC--ISKpn6). Conclusions: The YL03 strain co-carried blaKPC-2 and blaNDM-5 and had a unique multidrug resistance plasmid containing blaKPC-2.
{"title":"Genomic Characterization of <i>Escherichia coli</i> Co-Producing KPC-2 and NDM-5 Carbapenemases Isolated from Intensive Care Unit in a Chinese Hospital.","authors":"Qian Xu, Haoyi Lin, Wanting Liu, Yuxia Zhong, Yingchun Zhou, Zhenbo Xu, Dingqiang Chen","doi":"10.1089/mdr.2023.0050","DOIUrl":"10.1089/mdr.2023.0050","url":null,"abstract":"<p><p><b><i>Background:</i></b> Around the world, carbapenemase-producing <i>Escherichia coli</i> is becoming more prevalent. The purpose of this research was to analyze the whole plasmid sequences from YL03 isolates of the <i>E. coli</i> strain that produce both KPC-2 and NDM-5 carbapenemases. <b><i>Materials and Methods:</i></b> Whole-genome sequencing (WGS) and analysis of <i>E. coli</i> strain YL03, which was isolated from a wound sample, was performed by Illumina Novaseq 6000 and Pacific Biosciences Sequel (PacBio, Menlo Park, CA) sequencers. Following that, the WGS results were used to predict and analyze the YL03 genome composition and function. A complete gene sequence for YL03 with the accession number CP093551 has been uploaded to GenBank. <b><i>Results:</i></b> The results showed that YL03 co-carried five resistance genes, which included <i>bla</i><sub>KPC-2</sub>, <i>bla</i><sub>NDM-5</sub>, <i>bla</i><sub>TEM-1B</sub>, <i>bla</i><sub>CTX-M-14</sub>, and <i>mdf(A)</i>. Furthermore, three resistance plasmids were found in YL03: pYL03-KPC, pYL03-NDM, and pYL03-CTX. Among them, the 53 kb-long pYL03-KPC plasmid belonging to the IncP, carried the replicase gene (<i>repA</i>) and the carbapenemase gene (<i>bla</i><sub>KPC-2</sub>). The <i>bla</i><sub>KPC-2</sub> gene was flanked by a composite transposon-like element (Tn3-[Tn3] tnpR-ISKpn27 <i>bla</i><sub>KPC-</sub>-ISKpn6). <b><i>Conclusions:</i></b> The YL03 strain co-carried <i>bla</i><sub>KPC-2</sub> and <i>bla</i><sub>NDM-5</sub> and had a unique multidrug resistance plasmid containing <i>bla</i><sub>KPC-2</sub>.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"27-36"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2023-12-22DOI: 10.1089/mdr.2023.29008.ack
{"title":"Acknowledgment of Reviewers 2023.","authors":"","doi":"10.1089/mdr.2023.29008.ack","DOIUrl":"10.1089/mdr.2023.29008.ack","url":null,"abstract":"","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":"30 1","pages":"61-62"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139432357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2023-10-23DOI: 10.1089/mdr.2023.0054
Greta Bellinzona, Cristina Merla, Marta Corbella, Elizabeth Nagy Iskandar, Elena Seminari, Angela Di Matteo, Stefano Gaiarsa, Greta Petazzoni, Davide Sassera, Fausto Baldanti, Aurora Piazza, Patrizia Cambieri
In this study, we present two cases of Klebsiella pneumoniae, one KPC-33- and one NDM-1-producing, showing resistance to cefiderocol and ceftazidime/avibactam, collected in the intensive care unit of a hospital in Northern Italy from two patients who had recently undergone lung transplantation. Whole-genome sequencing was performed to investigate the molecular features of these strains.
{"title":"Concomitant Resistance to Cefiderocol and Ceftazidime/Avibactam in Two Carbapenemase-Producing <i>Klebsiella pneumoniae</i> Isolates from Two Lung Transplant Patients.","authors":"Greta Bellinzona, Cristina Merla, Marta Corbella, Elizabeth Nagy Iskandar, Elena Seminari, Angela Di Matteo, Stefano Gaiarsa, Greta Petazzoni, Davide Sassera, Fausto Baldanti, Aurora Piazza, Patrizia Cambieri","doi":"10.1089/mdr.2023.0054","DOIUrl":"10.1089/mdr.2023.0054","url":null,"abstract":"<p><p>In this study, we present two cases of <i>Klebsiella pneumoniae</i>, one KPC-33- and one NDM-1-producing, showing resistance to cefiderocol and ceftazidime/avibactam, collected in the intensive care unit of a hospital in Northern Italy from two patients who had recently undergone lung transplantation. Whole-genome sequencing was performed to investigate the molecular features of these strains.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"21-26"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49691457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.1089/mdr.2023.29008.ack
{"title":"Acknowledgment of Reviewers 2023.","authors":"","doi":"10.1089/mdr.2023.29008.ack","DOIUrl":"https://doi.org/10.1089/mdr.2023.29008.ack","url":null,"abstract":"","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Pavoni, Luigi Principe, Claudio Foschi, Elisa Meroni, Elena Briozzo, Tiziana Lazzarotto, Simone Ambretti, Stefano Di Bella
{"title":"Antimicrobial Resistance of Genital Mycoplasma and Ureaplasma: A Multicentre Study Over a 5-Year Period in Italy (2017–2021)","authors":"Matteo Pavoni, Luigi Principe, Claudio Foschi, Elisa Meroni, Elena Briozzo, Tiziana Lazzarotto, Simone Ambretti, Stefano Di Bella","doi":"10.1089/mdr.2023.0202","DOIUrl":"https://doi.org/10.1089/mdr.2023.0202","url":null,"abstract":"","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":"31 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138590222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sylvain Merle, Stéphane Bland, L. Bénejat, A. Ducournau, Quentin Jehanne, Emilie Bessède, Marine Jauvain, Fréderic Heluwaert, P. Lehours
{"title":"Description of a Case of Helicobacter pylori Infection with In Vitro Resistance to Tetracycline: An Exceptional Event with No Consequences?","authors":"Sylvain Merle, Stéphane Bland, L. Bénejat, A. Ducournau, Quentin Jehanne, Emilie Bessède, Marine Jauvain, Fréderic Heluwaert, P. Lehours","doi":"10.1089/mdr.2023.0247","DOIUrl":"https://doi.org/10.1089/mdr.2023.0247","url":null,"abstract":"","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":"51 16","pages":""},"PeriodicalIF":2.6,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138591704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-09-21DOI: 10.1089/mdr.2023.0056
Shan-Jian Chen, Wei-Qing Zhang, Yu-Lan Lin, Yong-Bin Zeng, Shou-Tao Chen, Shu Wu, Zhen Xun, Bin Yang
Intestinal colonization with carbapenem-resistant Enterobacterales (CRE) has been shown as a significant risk factor for subsequent CRE infections, especially in intensive care units (ICUs). The aim of this study was to determine the prevalence of intestinal CRE colonization among ICU patients in a Chinese tertiary hospital. Fecal sample screenings for CRE were performed on ICU patients weekly. Antibiotic-susceptibility profile of CRE strains was determined using the Vitek-2 analysis system and broth microdilution method. The carbapenemases of all isolates were determined by phenotypes and genotypes. Clonal relatedness was analyzed by pulsed-field gel electrophoresis (PFGE). Whole-genome sequencing was used to identify the multilocus sequence type (ST), plasmid replicons, and insertion sequences (ISs) of isolates. The overall colonization rate of CRE was 40.4% (82/203). A total of 84 CRE strains were detected, mostly with Klebsiella pneumoniae (92.9%). Antibiotic susceptibility testing profile revealed that 84 CRE strains were resistant to most antibiotics except for tigecycline and colistin. The carbapenemase-encoding genes including blaKPC-2, blaNDM-1, and blaIMP-4 were detected, and blaKPC-2 was the predominant genotype (90.8%). A total of 9 STs were identified among 84 CRE strains, and ST11 was the most common type (83.3%). A variety of mobile genetic elements, including plasmids and ISs, were detected via online tool prediction. PFGE analysis of the 78 K. pneumoniae strains showed 8 different pulsotypes, and pulsotype A was highly prevalent. This study found that the prevalence of CRE colonization was alarmingly high in the ICU, and that effective infection control measures are urgently needed to prevent the dissemination of CRE.
{"title":"High Prevalence of Carbapenem-Resistant Enterobacterales Colonization Among Intensive Care Unit Patients in a Tertiary Hospital, China.","authors":"Shan-Jian Chen, Wei-Qing Zhang, Yu-Lan Lin, Yong-Bin Zeng, Shou-Tao Chen, Shu Wu, Zhen Xun, Bin Yang","doi":"10.1089/mdr.2023.0056","DOIUrl":"10.1089/mdr.2023.0056","url":null,"abstract":"<p><p>Intestinal colonization with carbapenem-resistant Enterobacterales (CRE) has been shown as a significant risk factor for subsequent CRE infections, especially in intensive care units (ICUs). The aim of this study was to determine the prevalence of intestinal CRE colonization among ICU patients in a Chinese tertiary hospital. Fecal sample screenings for CRE were performed on ICU patients weekly. Antibiotic-susceptibility profile of CRE strains was determined using the Vitek-2 analysis system and broth microdilution method. The carbapenemases of all isolates were determined by phenotypes and genotypes. Clonal relatedness was analyzed by pulsed-field gel electrophoresis (PFGE). Whole-genome sequencing was used to identify the multilocus sequence type (ST), plasmid replicons, and insertion sequences (ISs) of isolates. The overall colonization rate of CRE was 40.4% (82/203). A total of 84 CRE strains were detected, mostly with <i>Klebsiella pneumoniae</i> (92.9%). Antibiotic susceptibility testing profile revealed that 84 CRE strains were resistant to most antibiotics except for tigecycline and colistin. The carbapenemase-encoding genes including <i>bla</i><sub>KPC-2</sub>, <i>bla</i><sub>NDM-1</sub>, and <i>bla</i><sub>IMP-4</sub> were detected, and <i>bla</i><sub>KPC-2</sub> was the predominant genotype (90.8%). A total of 9 STs were identified among 84 CRE strains, and ST11 was the most common type (83.3%). A variety of mobile genetic elements, including plasmids and ISs, were detected via online tool prediction. PFGE analysis of the 78 <i>K. pneumoniae</i> strains showed 8 different pulsotypes, and pulsotype A was highly prevalent. This study found that the prevalence of CRE colonization was alarmingly high in the ICU, and that effective infection control measures are urgently needed to prevent the dissemination of CRE.</p>","PeriodicalId":18701,"journal":{"name":"Microbial drug resistance","volume":" ","pages":"568-575"},"PeriodicalIF":2.6,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}