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5 results on '"Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial [Medical Subject Headings]"'

1. Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review

Author

Rodríguez-Villodres, Ángel, Martín-Gandul, Cecilia, Peñalva, Germán, Guisado-Gil, Ana Belén, Crespo-Rivas, Juan Carlos, Pachón-Ibáñez, María Eugenia, Lepe, José Antonio, Cisneros, José Miguel, [Rodríguez-Villodres,A, Martín-Gandul,C, Peñalva,G, Guisado-Gil,AB, Crespo-Rivas,JC, Pachón-Ibáñez,ME, Lepe,JA, Cisneros,JM] Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocío, Seville, Spain. [Guisado-Gil,AB] Department of Pharmacy, University Hospital Virgen del Rocío, Seville, Spain., and The study was funded by the Instituto de Salud Carlos III, the Spanish Ministry of Economy, Industry, and Competitiveness (grant number: PI17-02195) and was partially funded by the European Development Regional Fund 'A way to achieve Europe'. A.R.V. and A.B.G.G. are supported by the Subprograma Río Hortega, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spain. A.R.V. grant number: CM18/00122. A.B.G.G. grant number: CM19/00029. C.M.G. and J.C.C.R. are supported by the Instituto de Salud Carlos III (grant number: PI17-02195) and co-financed by European Development Regional Fund ‘A way to achieve Europe’ ERDF, Spanish Network for the Research in Infectious Diseases (REIPI RD16/0016/0009).G.P. is supported by the Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía, Industria y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001)- co-financed by European Development Regional Fund 'A way to achieve Europe', Operative program Intelligent Growth 2014–2020. M.E.P.I. is a postdoctoral researcher belonging to the program 'Nicolás Monardes' (C1-0038-2019), Servicio Andaluz de Salud, Junta de Andalucía, Spain. J.M.C. received funding for research from Plan Nacional de I+D+i 2013–2016 and Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de InvestigacionCooperativa, Ministry of Economy, Industry and Competitiveness, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001, RD16/0016/0009), co-financed by the European Development Regional Fund 'A way to achieve Europe'.

Subjects
Acinetobacter baumannii, Geographical Locations::Geographic Locations::Americas::North America [Medical Subject Headings], Cuidados a largo plazo, Staphylococcus aureus resistente a meticilina, Nursing homes, Check Tags::Male [Medical Subject Headings], Antimicrobial stewardship, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings], Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Moraxellaceae::Acinetobacter::Acinetobacter baumannii [Medical Subject Headings], Prevalence, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Long-Term Care [Medical Subject Headings], Geographical Locations::Geographic Locations::Asia [Medical Subject Headings], Casas de salud, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Programas de optimización del uso de los antimicrobianos, Organisms::Bacteria::Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Bacteria::Gram-Positive Endospore-Forming Rods::Staphylococcaceae::Staphylococcus::Staphylococcus aureus::Methicillin-Resistant Staphylococcus aureus [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Multidrug-resistant organism, Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Pseudomonadaceae::Pseudomonas::Pseudomonas aeruginosa [Medical Subject Headings], Long term care facilities, Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial [Medical Subject Headings], Risk factors, Chemicals and Drugs::Carbohydrates::Glycoconjugates::Glycopeptides::Vancomycin [Medical Subject Headings], Pseudomonas aeruginosa, Information Science::Information Science::Information Storage and Retrieval::Databases as Topic::Databases, Bibliographic::PubMed [Medical Subject Headings], Information Science::Information Science::Communications Media::Publications::Bibliography as Topic::Bibliometrics [Medical Subject Headings], Methicillin-resistant staphylococcus aureus, Organisms::Bacteria::Gram-Positive Bacteria::Lactobacillales::Enterococcaceae::Enterococcus [Medical Subject Headings], Prevalencia, Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Carbapenems [Medical Subject Headings], Enterococcus, Factores de riesgo, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [Medical Subject Headings]
Abstract

Elderly people confined to chronic care facilities face an increased risk of acquiring infections by multidrug-resistant organisms (MDROs). This review presents the current knowledge of the prevalence and risk factors for colonization by MDROs in long-term care facilities (LTCF), thereby providing a useful reference to establish objectives for implementing successful antimicrobial stewardship programs (ASPs). We searched in PubMed and Scopus for studies examining the prevalence of MDROs and/or risk factors for the acquisition of MDROs in LTCF. One hundred and thirty-four studies published from 1987 to 2020 were included. The prevalence of MDROs in LTCF varies between the different continents, where Asia reported the highest prevalence of extended-spectrum ß-lactamase (ESBL) Enterobacterales (71.6%), carbapenem resistant (CR) Enterobacterales (6.9%) and methicillin-resistant Staphylococcus aureus (MRSA) (25.6%) and North America the highest prevalence to MDR Pseudomonas aeruginosa (5.4%), MDR Acinetobacter baumannii (15.0%), vancomycin-resistant Enterococcus spp. (VRE) (4.0%), and Clostridioides difficile (26.1%). Furthermore, MDRO prevalence has experienced changes over time, with increases in MDR P. aeruginosa and extended spectrum ß-lactamase producing Enterobacterales observed starting in 2015 and decreases of CR Enterobacterales, MDR A. baumannii, VRE, MRSA and C. difficile. Several risk factors have been found, such as male sex, chronic wounds, the use of medical devices, and previous antibiotic use. The last of these aspects represents one of the most important modifiable factors for reducing colonization with MDROs through implementing ASPs in LTCF. Yes

Published
2021

2. Genomic analysis of 40 prophages located in the genomes of 16 carbapenemase-producing clinical strains of Klebsiella pneumoniae

Author

Elisenda Miró, Luis Martínez-Martínez, Elena Pérez-Nadales, Jesús Oteo-Iglesias, Julián Torre-Cisneros, Antón Ambroa, Felipe Fernández-Cuenca, Lucia Blasco, Rocio Trastoy, Ines Bleriot, Álvaro Pascual, Germán Bou, Ferran Navarro, María Tomás, Laura Fernandez-Garcia, Olga Pacios, Instituto de Salud Carlos III, European Commission, Xunta de Galicia, Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), Red de Investigación Cooperativa en Investigación en Patología Infecciosa (España), Xunta de Galicia (España), [Bleriot,I, Trastoy,R, Blasco,L, Ambroa,A, Fernández-García,L, Pacios,O, Bou,G, Tomas,M] Microbiology Department, Research Institute Biomedical A Coruña (INIBIC), Hospital A Coruña (CHUAC), University of A Coruña. (UDC), A Coruña, Spain. [Bleriot,I, Fernández-Cuenca,F, Oteo-Iglesias,J, Navarro,F, Miró,E, Pascual,A, Martínez-Martínez,L, Tomas,M] Study Group on Mechanisms of Action and Resistance to Antimicrobials (GEMARA), Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), Madrid. [Fernández-Cuenca,F, Pascual,A] Clinical Unit for Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena. Deparment of Microbiology and Medicine, University of Seville, Seville, Spain. [Fernández-Cuenca,F, Perez-Nadales,E, Torre-Cisneros,J, Tomas,M] Spanish Network for the Research in Infectious Diseases, REIPI, Seville, Spain. [Perez-Nadales,E, Martínez-Martínez,L] 5Microbiology Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University Hospital Reina Sofía, University of Córdoba, Cordoba, Spain. [Oteo-Iglesias,J] Reference and Research Laboratory for Antibiotic Resistance and Health Care Infections, National Centre for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain. [Navarro,F, Miró,E] Microbiology Department, Sant Pau Hospital, Autonomous University of Barcelona (Bellaterra), Barcelona, Spain., and This study was funded by grant PI16/01163 awarded to M.T. within the State Plan for R+D+I 2013–2016 (National Plan for Scientific Research, Technological Development and Innovation 2008–2011), and co-financed by the ISCIII-Deputy General Directorate for Evaluation and Promotion of Research – European Regional Development Fund ‘A Way of Making Europe’ and Instituto de Salud Carlos III FEDER, Spanish Network for the Research in Infectious Diseases (REIPI) (RD16/0016/0001, RD16/0016/0006 and RD16/0016/0008) and by the Study Group on Mechanisms of Action and Resistance to Antimicrobials (GEMARA) (Spanish Society of Infectious Diseases and Clinical Microbiology – SEIMC

Subjects
Prophages, Profagos, comparative genomics, phylogeny, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Siphoviridae, Genomic analysis, Genome Size, prophages, Drug Resistance, Multiple, Bacterial, Tamaño del genoma, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Enterobacteriaceae Infections::Klebsiella Infections [Medical Subject Headings], Phylogeny, Genetics, Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Amidohydrolases::beta-Lactamases [Medical Subject Headings], biology, General Medicine, bioinformatics, Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial [Medical Subject Headings], Klebsiella pneumoniae, Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Computational Biology [Medical Subject Headings], Phenomena and Processes::Genetic Phenomena::Genetic Structures::Genome::Genome Size [Medical Subject Headings], Biología computacional, Phenomena and Processes::Genetic Phenomena::Genetic Processes::Biological Evolution::Evolution, Molecular [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Sequence Analysis::Molecular Sequence Annotation [Medical Subject Headings], Phenomena and Processes::Genetic Phenomena::Genetic Structures::Genome::Genome, Microbial::Genome, Viral [Medical Subject Headings], Genómica, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Bacterial Proteins [Medical Subject Headings], Bioinformatics, Genome, Viral, Bacterial genome size, Superinfection exclusion, beta-Lactamases, Evolution, Molecular, Podoviridae, Organisms::Bacteria::Proteobacteria::Gammaproteobacteria::Enterobacteriaceae::Klebsiella::Klebsiella pneumoniae [Medical Subject Headings], Bacterial Proteins, Caudovirales, Lysogenic cycle, Humans, Prophage, Comparative genomics, Computational Biology, Molecular Sequence Annotation, biology.organism_classification, Klebsiella Infections, genomic analysis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Bacteriological Techniques::Bacterial Typing Techniques::Molecular Typing::Multilocus Sequence Typing [Medical Subject Headings], Phenomena and Processes::Genetic Phenomena::Phylogeny [Medical Subject Headings], Multilocus sequence typing, Organisms::Viruses::Bacteriophages::Prophages [Medical Subject Headings], Multilocus Sequence Typing
Abstract

Klebsiella pneumoniae is the clinically most important species within the genus Klebsiella and, as a result of the continuous emergence of multi-drug resistant (MDR) strains, the cause of severe nosocomial infections. The decline in the effectiveness of antibiotic treatments for infections caused by MDR bacteria has generated particular interest in the study of bacteriophages. In this study, we characterized a total of 40 temperate bacteriophages (prophages) with a genome range of 11.454–84.199 kb, predicted from 16 carbapenemase-producing clinical strains of K. pneumoniae belonging to different sequence types, previously identified by multilocus sequence typing. These prophages were grouped into the three families in the order Caudovirales (27 prophages belonging to the family Myoviridae, 10 prophages belonging to the family Siphoviridae and 3 prophages belonging to the family Podoviridae). Genomic comparison of the 40 prophage genomes led to the identification of four prophages isolated from different strains and of genome sizes of around 33.3, 36.1, 39.6 and 42.6 kb. These prophages showed sequence similarities (query cover >90 %, identity >99.9 %) with international Microbe Versus Phage (MVP) (http://mvp.medgenius.info/home) clusters 4762, 4901, 3499 and 4280, respectively. Phylogenetic analysis revealed the evolutionary proximity among the members of the four groups of the most frequently identified prophages in the bacterial genomes studied (33.3, 36.1, 39.6 and 42.6 kb), with bootstrap values of 100 %. This allowed the prophages to be classified into three clusters: A, B and C. Interestingly, these temperate bacteriophages did not infect the highest number of strains as indicated by a host-range assay, these results could be explained by the development of superinfection exclusion mechanisms. In addition, bioinformatic analysis of the 40 identified prophages revealed the presence of 2363 proteins. In total, 59.7 % of the proteins identified had a predicted function, mainly involving viral structure, transcription, replication and regulation (lysogenic/lysis). Interestingly, some proteins had putative functions associated with bacterial virulence (toxin expression and efflux pump regulators), phage defence profiles such as toxin–antitoxin modules, an anti-CRISPR/Cas9 protein, TerB protein (from terZABCDE operon) and methyltransferase proteins, This study was funded by grant PI16/01163 awarded to M.T. within the State Plan for R+D+I 2013–2016 (National Plan for Scientific Research, Technological Development and Innovation 2008–2011), and co-financed by the ISCIII-Deputy General Directorate for Evaluation and Promotion of Research – European Regional Development Fund ‘A Way of Making Europe’ and Instituto de Salud Carlos III FEDER, Spanish Network for the Research in Infectious Diseases (REIPI) (RD16/0016/0001, RD16/0016/0006 and RD16/0016/0008) and by the Study Group on Mechanisms of Action and Resistance to Antimicrobials (GEMARA) (Spanish Society of Infectious Diseases and Clinical Microbiology – SEIMC; http://www.seimc.org/). R.T. and L.F.-G. were financially supported by grants from the SEIMC and the Deputacion Provincial da Coruña (Xunta de Galicia), respectively

Published
2020

3. Global dissemination of a multidrug resistant Escherichia coli clone

Author

Mark A. Schembri, Gordon Dougan, Minh-Duy Phan, Jesús Rodríguez-Baño, David L. Paterson, Danilo Gomes Moriel, Elizabeth Skippington, Álvaro Pascual, Nicola K. Petty, Brian M. Forde, Scott A. Beatson, Johann D. D. Pitout, Benjamin A. Rogers, Mark R. Davies, Kate M. Peters, Timothy R. Walsh, Mathew Upton, Mitchell Stanton-Cook, Nouri L. Ben Zakour, Makrina Totsika, [Petty,NK, Ben Zakour,NL, Stanton-Cook,M, Skippington,E, Totsika,M, Forde,BM, Phan,BM, Gomes Moriel,D, Peters,KM, Davies,M, Paterson,DL, Schembri,MA, Beatson,SA] Australian Infectious Diseases Research Centre, Brisbane, Australia. [Petty,NK, Beatson,SA] School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia. [Petty,NK] The ithree institute, University of Technology Sydney, Sydney, Australia. [Davies,M, Dougan,G] Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom. [Rogers,BA, Paterson,DL] University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital Campus, The University of Queensland, Brisbane, Australia. [Rodriguez-Baño,J, Pascual,A] Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Seville, Spain, Departmentos de Medicina y Microbiología, Universidad de Sevilla, Seville, Spain. [Pitout,JDD] Division of Microbiology, Calgary Laboratory Services, Calgary, Canada, Department of Pathology and Laboratory Medicine, and Department of Microbiology and Infectious Diseases, University of Calgary, Calgary, Canada. [Upton,M] School of Biomedical and Healthcare Sciences, Plymouth University, Plymouth, United Kingdom. [Walsh,TR] School of Medicine, Cardiff University, Cardiff, United Kingdom., Universidad de Sevilla. Departamento de Medicina, and Universidad de Sevilla. Departamento de Microbiología

Subjects
medicine.disease_cause, Genome, Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 2-Ring::Quinolines::Quinolones::Fluoroquinolones [Medical Subject Headings], Bacterial evolution, Drug Resistance, Multiple, Bacterial, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Likelihood Functions [Medical Subject Headings], Phenomena and Processes::Genetic Phenomena::Genetic Structures::Genome::Genome, Microbial::Genome, Bacterial [Medical Subject Headings], Phylogeny, Genetics, Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Genetics::Genetics, Population::Phylogeography [Medical Subject Headings], Likelihood Functions, Multidisciplinary, Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Amidohydrolases::beta-Lactamases [Medical Subject Headings], Genomics, Biological Sciences, Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae::Escherichia::Escherichia coli [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial [Medical Subject Headings], Phylogeography, Farmacorresistencia bacteriana múltiple, Disciplines and Occupations::Natural Science Disciplines::Biological Science Disciplines::Biology::Computational Biology [Medical Subject Headings], Fluoroquinolonas, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Sequence Analysis::Sequence Analysis, DNA [Medical Subject Headings], Fluoroquinolones, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Models, Theoretical::Models, Biological::Models, Genetic [Medical Subject Headings], Sequence analysis, Molecular Sequence Data, Virulence, Biology, Polymorphism, Single Nucleotide, beta-Lactamases, Antibiotic resistance, Species Specificity, medicine, Phenomena and Processes::Biological Phenomena::Species Specificity [Medical Subject Headings], Escherichia coli, Secuencia de bases, Phenomena and Processes::Genetic Phenomena::Genetic Variation::Polymorphism, Genetic::Polymorphism, Single Nucleotide [Medical Subject Headings], Molecular epidemiology, Base Sequence, Models, Genetic, Computational Biology, Sequence Analysis, DNA, Genomic epidemiology, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Sequence Alignment [Medical Subject Headings], Multiple drug resistance, Phenomena and Processes::Chemical Phenomena::Biochemical Phenomena::Molecular Structure::Base Sequence [Medical Subject Headings], Information Science::Information Science::Information Services::Documentation::Molecular Sequence Data [Medical Subject Headings], Phenomena and Processes::Genetic Phenomena::Phylogeny [Medical Subject Headings], Mobile genetic elements, Sequence Alignment, Genome, Bacterial
Abstract

Escherichia coli sequence type 131 (ST131) is a globally disseminated, multidrug resistant (MDR) clone responsible for a high proportion of urinary tract and bloodstream infections. The rapid emergence and successful spread of E. coli ST131 is strongly associated with several factors, including resistance to fluoroquinolones, high virulence gene content, the possession of the type 1 fimbriae FimH30 allele, and the production of the CTX-M-15 extended spectrum β-lactamase (ESBL). Here, we used genome sequencing to examine the molecular epidemiology of a collection of E. coli ST131 strains isolated from six distinct geographical locations across the world spanning 2000-2011. The global phylogeny of E. coli ST131, determined from whole-genome sequence data, revealed a single lineage of E. coli ST131 distinct from other extraintestinal E. coli strains within the B2 phylogroup. Three closely related E. coli ST131 sublineages were identified, with little association to geographic origin. The majority of single-nucleotide variants associated with each of the sublineages were due to recombination in regions adjacent to mobile genetic elements (MGEs). The most prevalent sublineage of ST131 strains was characterized by fluoroquinolone resistance, and a distinct virulence factor and MGE profile. Four different variants of the CTX-M ESBL-resistance gene were identified in our ST131 strains, with acquisition of CTX-M-15 representing a defining feature of a discrete but geographically dispersed ST131 sublineage. This study confirms the global dispersal of a single E. coli ST131 clone and demonstrates the role of MGEs and recombination in the evolution of this important MDR pathogen. Australian National Health and Medical Research Council (NHMRC); the Australian Infectious Diseases Research Centre; ARC Discovery Early Career Researcher Award; Ministerio de Economía y Competitividad, Instituto de Salud Carlos III, the Spanish Network for Research in Infectious Diseases; Fondo de Investigación Sanitaria and Junta de Andalucía. Yes

Published
2014

4. Contribution of efflux pumps, porins, and β-lactamases to multidrug resistance in clinical isolates of Acinetobacter baumannii

Author

Jerónimo Pachón, María Tomás, Germán Bou, Carlos Rumbo, Luis Martínez-Martínez, María M. López, Jesús Rodríguez-Baño, José Miguel Cisneros, C. Ruiz de Alegría, Almudena Jiménez Pascual, Felipe Fernández-Cuenca, Eva Gato, Jordi Vila, Antimicrobials (GEIH-GEMARA) from the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC), The Spanish Network for Research in Infectious Diseases (REIPI), [Rumbo,C, Gato,E, López,M, Bou,G, Tomás,M] Department of Microbiology, Complejo Hospitalario Universitario a Coruña-INIBIC, La Coruña, Spain.[Ruiz de Alegría,C, Martínez-Martínez,L] Department of Clinical Microbiology, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain.[Fernández-Cuenca,F, Rodríguez-Baño,J, Pascual,A] Clinical Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen Macarena, Seville, Spain.[Vila,J] Department of Clinical Microbiology, Hospital Clinic-CRESIB, School of Medicine, University of Barcelona, Barcelona, Spain.[Cisneros,JM] Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain., Research in our laboratories is financially supported by grants from the Instituto de Salud Carlos III, the Spanish Network for Research in Infectious Diseases (REIPI RD 06/0008/0025), the Fondo de Investigaciones Sanitarias (PI08/1368 and PS09/00687 to G.B. and PI10/00056 to M.T.), SERGAS (PS07/90), and the Xunta de Galicia (07CSA050916PR). C.R. is funded by a doctoral grant (PFIS) from the Instituto de Salud Carlos III, and M.T. is supported by the Instituto de Salud Carlos III (program Miguel Servet), both from the Ministerio de Economia y Competitividad., and Universidad de Sevilla. Departamento de Medicina

Subjects
Acinetobacter baumannii, Aminoglicósidos, Porinas, Tigecycline, Drug resistance, Quinolones, Carbapenémicos, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Polycyclic Hydrocarbons, Aromatic::Naphthacenes::Tetracyclines [Medical Subject Headings], Drug Resistance, Multiple, Bacterial, polycyclic compounds, Pharmacology (medical), Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Carrier Proteins::Membrane Transport Proteins::ATP-Binding Cassette Transporters [Medical Subject Headings], Phylogeny, Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Amidohydrolases::beta-Lactamases [Medical Subject Headings], Minocycline, Anti-Bacterial Agents, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Microbial Sensitivity Tests [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial [Medical Subject Headings], Infectious Diseases, Tetracyclines, Gentamicin, Efflux, Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Carbapenems [Medical Subject Headings], Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [Medical Subject Headings], medicine.drug, Acinetobacter Infections, beta-Lactamasas, Tetraciclinas, CL 331002, Porins, Microbial Sensitivity Tests, Biology, beta-Lactamases, Microbiology, Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Moraxellaceae Infections::Acinetobacter Infections [Medical Subject Headings], Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Moraxellaceae::Acinetobacter::Acinetobacter baumannii [Medical Subject Headings], Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 2-Ring::Quinolines::Quinolones [Medical Subject Headings], Antibiotic resistance, Mechanisms of Resistance, medicine, Humans, Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Proteins::Carrier Proteins::Membrane Transport Proteins::Ion Channels::Porins [Medical Subject Headings], Pharmacology, Chemicals and Drugs::Carbohydrates::Glycosides::Aminoglycosides [Medical Subject Headings], Gene Expression Regulation, Bacterial, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, bacterial infections and mycoses, Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Cephalosporins [Medical Subject Headings], Multiple drug resistance, Aminoglycosides, Carbapenems, Quinolonas, Phenomena and Processes::Genetic Phenomena::Phylogeny [Medical Subject Headings], bacteria, ATP-Binding Cassette Transporters
Abstract

We investigated the mechanisms of resistance to carbapenems, aminoglycosides, glycylcyclines, tetracyclines, and quinolones in 90 multiresistant clinical strains of Acinetobacter baumannii isolated from two genetically unrelated A. baumannii clones: clone PFGE-ROC-1 (53 strains producing the OXA-58 β-lactamase enzyme and 18 strains with the OXA-24 β-lactamase) and clone PFGE-HUI-1 (19 strains susceptible to carbapenems). We used real-time reverse transcriptase PCR to correlate antimicrobial resistance (MICs) with expression of genes encoding chromosomal β-lactamases (AmpC and OXA-51), porins (OmpA, CarO, Omp33, Dcap-like, OprB, Omp25, OprC, OprD, and OmpW), and proteins integral to six efflux systems (AdeABC, AdeIJK, AdeFGH, CraA, AbeM, and AmvA). Overexpression of the AdeABC system (level of expression relative to that by A. baumannii ATCC 17978, 30- to 45-fold) was significantly associated with resistance to tigecycline, minocycline, and gentamicin and other biological functions. However, hyperexpression of the AdeIJK efflux pump (level of expression relative to that by A. baumannii ATCC 17978, 8- to 10-fold) was significantly associated only with resistance to tigecycline and minocycline (to which the TetB efflux system also contributed). TetB and TetA(39) efflux pumps were detected in clinical strains and were associated with resistance to tetracyclines and doxycycline. The absence of the AdeABC system and the lack of expression of other mechanisms suggest that tigecycline-resistant strains of the PFGE-HUI-1 clone may be associated with a novel resistance-nodulation-cell efflux pump (decreased MICs in the presence of the inhibitor Phe-Arg β-naphthylamide dihydrochloride) and the TetA(39) system.

Published
2013

5. Trends in yearly prevalence of third-generation cephalosporin and fluoroquinolone resistant Enterobacteriaceae infections and antimicrobial use in Spanish hospitals, Spain, 1999 to 2010

Author

Asensio A, Elena Espejo, Fernandez-Crehuet J, Ramos A, Vaque-Rafart J, Bishopberger C, Hernandez Navarrete M, Calbo-Torrecillas F, Campayo J, Estudio de Prevalencia de las Infecciones Nosocomiales en Espana (EPINE) Working Group, Estudio de Prevalencia de las Infecciones Nosocomiales en España (EPINE) Working Group, [Asensio,A] Department of Preventive Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain. [Álvarez-Espejo,T, Ramos,A] Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Madrid, Spain. [Fernández-Crehuet,J] Department of Preventive Medicine, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain. [Vaque-Rafart,J] Department of Preventive Medicine, Hospital Vall d´Hebron, Barcelona, Spain. [Bishopberger,C] Department of Preventive Medicine, Hospitales El Escorial/Guadarrama, San Lorenzo del Escorial, Madrid, Spain. [Hernández Navarrete,MJ] Department of Preventive Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain. [Calbo-Torrecillas,F] Department of Preventive Medicine, Hospital Universitario Carlos Haya, Málaga, Spain. [Campayo,J] Department of Preventive Medicine, Hospital General Universitario Reina Sofía, Murcia, Spain. [Cantón,R] Department of Microbiology, CIBER in Epidemiology and Public Health (CIBERESP), Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain., and Supported by the Fondo para la investigación. Spanish Ministry of Health, grant Pl07/90255

Subjects
Named Groups::Persons::Age Groups::Adult::Young Adult [Medical Subject Headings], Infección Hospitalaria, España, Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], Utilización de Medicamentos, Check Tags::Male [Medical Subject Headings], Cefalosporinas, Health Care::Health Services Administration::Organization and Administration::Pharmacy Administration::Drug Utilization [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Infection::Community-Acquired Infections [Medical Subject Headings], Chemicals and Drugs::Heterocyclic Compounds::Heterocyclic Compounds, 2-Ring::Quinolines::Quinolones::Fluoroquinolones [Medical Subject Headings], Phenomena and Processes::Physiological Phenomena::Pharmacological Phenomena::Drug Resistance::Drug Resistance, Microbial::Drug Resistance, Bacterial::beta-Lactam Resistance::Cephalosporin Resistance [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Named Groups::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Infecciones por Enterobacteriaceae, Named Groups::Persons::Age Groups::Child [Medical Subject Headings], Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae [Medical Subject Headings], Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospitals [Medical Subject Headings], Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings], Farmacorresistencia Bacteriana Múltiple, Named Groups::Persons::Age Groups::Child::Child, Preschool [Medical Subject Headings], Infecciones Comunitarias Adquiridas, Chemicals and Drugs::Organic Chemicals::Amides::Lactams::beta-Lactams::Cephalosporins [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Enterobacteriaceae Infections [Medical Subject Headings], Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Bacterial Physiological Phenomena::Drug Resistance, Bacterial::Drug Resistance, Multiple, Bacterial [Medical Subject Headings], Antibacterianos, Check Tags::Female [Medical Subject Headings], Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Vital Statistics::Morbidity [Medical Subject Headings], Information Science::Information Science::Information Storage and Retrieval::Databases as Topic::Databases, Factual [Medical Subject Headings], Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings], Fluoroquinolonas, Named Groups::Persons::Age Groups::Infant [Medical Subject Headings], Prevalencia, Fluoroquinolones, Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents [Medical Subject Headings]
Abstract

Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp. are a major cause of infections in hospitalised patients. The aim of our study was to evaluate rates and trends of resistance to third-generation cephalosporins and fluoroquinolones in infected patients, the trends in use for these antimicrobials, and to assess the potential correlation between both trends. The database of national point prevalence study series of infections and antimicrobial use among patients hospitalised in Spain over the period from 1999 to 2010 was analysed. On average 265 hospitals and 60,000 patients were surveyed per year yielding a total of 19,801 E. coli, 3,004 K. pneumoniae and 3,205 Enterobacter isolates. During the twelve years period, we observed significant increases for the use of fluoroquinolones (5.8%-10.2%, p

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