scholarly journals Multidrug Resistant CTX-M-ProducingEscherichia coli: A Growing Threat among HIV Patients in India

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Kesavaram Padmavathy ◽  
Krishnan Padma ◽  
Sikhamani Rajasekaran
Keyword(s):  
Multidrug Resistance ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Hiv Patients ◽  
E Coli ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Third Generation Cephalosporins ◽  
Highly Virulent ◽  
Esbl Producers

Extended Spectrumβ-Lactamases (ESBLs) confer resistance to third-generation cephalosporins and CTX-M types have emerged as the most prominent ESBLs worldwide. This study was designed to determine the prevalence of CTX-M positive ESBL-producing urinaryE. coliisolates from HIV patients and to establish the association of multidrug resistance, phylogeny, and virulence profile with CTX-M production. A total of 57 ESBL producers identified among 76E. colistrains isolated from HIV patients from South India were screened forblaCTX-M, AmpC production, multidrug resistance, and nine virulence associated genes (VAGs),fimH,pap,afa/dra,sfa/foc,iutA,fyuA,iroN,usp,andkpsMII.The majority (70.2%) of the ESBL producers harboredblaCTX-Mand were AmpC coproducers. Among the CTX-M producers, 47.5% were found to be UPEC, 10% harbored as many as 7 VAGs, and 45% possessedkpsMII. Multidrug resistance (CIPRSXTRGENR) was significantly more common among the CTX-M producers compared to the nonproducers (70% versus 41.2%). However, 71.4% of the multidrug resistant CTX-M producers exhibited susceptibility to nitrofurantoin thereby making it an effective alternative to cephalosporins/fluoroquinolones. The emergence of CTX-M-producing highly virulent, multidrug resistant uropathogenicE. coliis of significant public health concern in countries like India with a high burden of HIV/AIDS.

scholarly journals Diversity of Plasmids and Genes Encoding Resistance to Extended-Spectrum β-Lactamase in Escherichia coli from Different Animal Sources

2021 ◽  
Vol 9 (5) ◽  
pp. 1057
Author(s):  
Abasiofiok Ibekwe ◽  
Lisa Durso ◽  
Thomas F. Ducey ◽  
Adelumola Oladeinde ◽  
Charlene R. Jackson ◽  
...  
Keyword(s):  
The United States ◽  
Multidrug Resistant ◽  
Dairy Manure ◽  
E Coli ◽  
Extended Spectrum ◽  
Drug Classes ◽  
Genes Encoding ◽  
Synergy Testing ◽  
Third Generation Cephalosporins ◽  
Esbl Producers

Antimicrobial resistance associated with the spread of plasmid-encoded extended-spectrum β-lactamase (ESBL) genes conferring resistance to third generation cephalosporins is increasing worldwide. However, data on the population of ESBL producing E. coli in different animal sources and their antimicrobial characteristics are limited. The purpose of this study was to investigate potential reservoirs of ESBL-encoded genes in E. coli isolated from swine, beef, dairy, and poultry collected from different regions of the United States using whole-genome sequencing (WGS). Three hundred isolates were typed into different phylogroups, characterized by BOX AIR-1 PCR and tested for resistance to antimicrobials. Of the 300 isolates, 59.7% were resistant to sulfisoxazole, 49.3% to tetracycline, 32.3% to cephalothin, 22.3% to ampicillin, 20% to streptomycin, 16% to ticarcillin; resistance to the remaining 12 antimicrobials was less than 10%. Phylogroups A and B1 were most prevalent with A (n = 92, 30%) and B1 (87 = 29%). A total of nine E. coli isolates were confirmed as ESBL producers by double-disk synergy testing and multidrug resistant (MDR) to at least three antimicrobial drug classes. Using WGS, significantly higher numbers of ESBL-E. coli were detected in swine and dairy manure than from any other animal sources, suggesting that these may be the primary animal sources for ESBL producing E. coli. These isolates carry plasmids, such as IncFIA(B), IncFII, IncX1, IncX4, IncQ1, CollRNAI, Col440I, and acquired ARGs aph(6)-Id, aph(3″)-Ib, aadA5, aph(3′)-Ia, blaCTX-M-15, blaTEM-1B, mphA, ermB, catA1, sul1, sul2, tetB, dfrA17. One of the E. coli isolates from swine with ST 410 was resistant to nine antibiotics and carried more than 28 virulence factors, and this ST has been shown to belong to an international high-risk clone. Our data suggests that ESBL producing E. coli are widely distributed in different animal sources, but swine and dairy cattle may be their main reservoir.

scholarly journals Preponderance of blaKPC-Carrying Carbapenem-Resistant Enterobacterales Among Fecal Isolates From Community Food Handlers in Kuwait

2021 ◽  
Vol 12 ◽  
Author(s):  
Ola H. Moghnia ◽  
Vincent O. Rotimi ◽  
Noura A. Al-Sweih
Keyword(s):  
Health Concern ◽  
Food Handlers ◽  
Gene Characterization ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Significant Public Health Concern ◽  
The Family ◽  
Significant Public Health ◽  
Molecular Mode ◽  
Sequence Types

Carbapenem-resistant Enterobacterales (CRE) are pathogens that have been found in several countries, with a significant public health concern. Characterizing the mode of resistance and determining the prevailing clones are vital to the epidemiology of CRE in our community. This study was conducted to characterize the molecular mode of resistance and to determine the clonality of the CRE fecal isolates among community food handlers (FHs) vs. infected control patients (ICPs) in Kuwait. Fecal CRE isolates obtained from FHs and ICPs from September 2016 to September 2018 were analyzed for their resistance genes. Gene characterization was carried out by polymerase chain reaction (PCR) assays and sequencing. Clonality of isolates was established by multilocus sequence typing (MLST). Of the 681 and 95 isolates of the family Enterobacterales isolated from FHs and ICPs, 425 (62.4%) and 16 (16.8%) were Escherichia coli, and 18 (2.6%) and 69 (72.6%) were Klebsiella pneumoniae, respectively. A total of 36 isolates were CRE with a prevalence of 5.3% among FH isolates and 87 (91.6%) among the ICPs. Of these, carbapenemase genes were detected in 22 (61.1%) and 65 (74.7%) isolates, respectively (p < 0.05). The detected specific genes among FHs and ICPs were positive for blaKPC 19 (86.4%) and 35 (40.2%), and blaOXA 10 (45.5%) and 59 (67.8%), in addition to blaNDM 2 (9.1%) and 32 (36.8%), respectively. MLST assays of the E. coli and K. pneumoniae isolates revealed considerable genetic diversity and polyclonality as well as demonstrated multiple known ST types and eight novel sequence types. The study revealed a relatively high number of CRE harboring predominantly blaKPC-mediated CRE among the community FH isolates vs. predominant blaOXA genes among the ICPs. Those heterogeneous CRE isolates raise concerns and mandate more efforts toward molecular surveillance. A multinational study is recommended to monitor the spread of genes mediating CRE in the community of Arabian Peninsula countries.

Isolation frequency of uropathogenic strains and search for ESBL producing Enterobacteriaceae isolated from patients with UTI in Bechar (Algeria)

2020 ◽  
Vol 18 ◽  
Author(s):  
Elhassan Benyagoub ◽  
Miaad K. Alkhudhairy ◽  
S. Mohamed Benchaib ◽  
Abdelmadjid Zaalan ◽  
Youcef Mekhfi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Multidrug Resistance ◽  
Health Sector ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Klebsiella Spp

Background: Emergence of multidrug-resistant uropathogenic strains mainly the global spread of extended-spectrum betalactamase (ESBL) genes accompanied both by uncontrolled use of antibacterial agents and a considerable decrease in their activities makes the monitoring of the resistance pattern one of necessary means that could help the medical practitioners to choose the best treatment. For this purpose and during four months from March 1 to June 30 (2019), an experimental study has been carried out on urine specimens of 123 inpatients (IP) and outpatients (OP) at infectious disease service Boudjemaa TOURABI Public Hospital of Bechar (Algeria), aiming the detection of ESBL-producing Enterobacteriaceae uropathogenic strains. Methods: Firstly, the antibiotic susceptibility testing has been carried out by using the disk diffusion method to determine not only the multidrug resistance patterns, but also the multiple antibiotic resistance indexes of uropathogenic strains isolated from clinical IP and OP samples. Secondly, the ESBL detection was done by using the following methods: synergy tests based on the synergy between a thirdgeneration cephalosporin and clavulanate, double-disc synergy test (DDST) and phenotypic tests on a cloxacillin-containing agar. Results: As a result, 56 patients had a urinary tract infection (UTI) in overall 123 patients; a frequency of 45,52%. Through a UTI’s frequency of 64,7%, the female gender was the most affected. All age groups were affected by UTI, with a mean age of 38,47±19,97 years old. Knowing that UTIs’ patients having ages ranged from 16 to 49 years old were most affected compared to other ages’ groups, with a frequency of 66,6 and 50% for female and male gender, respectively. The microbial strains represented by the bacteria group were predominant, ie (98,22%) followed by yeasts (1,78%), where Gram-negative bacilli showed (96,36%) of the uropathogenic agents, so (3,64%) were Gram-positive bacteria. The antibiotic resistance profile of isolated Enterobacteriaceae showed very high resistance rates for the species of Escherichia coli, Klebsiella spp, and Proteus spp to aminopenicillins, cephalosporins, and less against carbapenems and other drug groups. E. coli had presented the highest multidrug resistance followed by Klebsiella spp with a MAR index ranged from 0,53 to 0,82. Within this range, a total of 28 isolate (25 E. coli, 2 Klebsiella spp, and 1 Proteus mirabilis) had shown resistance against 9 to 14 out of the 17 tested antibiotics. The rate of ESBL-producing Enterobacteriaceae strains was 23,07 and 55,26% for inpatients and outpatients respectively, where E.coli was the most important ESBL producers out of all isolated strains. Conclusion: An alarming ESBLs rate for outpatients which is usually higher among inpatients with UTI, who receive several classes of antibiotics. Such condition should be considered as a major public health concern, and measures must be taken to establish the sources and drivers of this issue. Thus, the findings of this research pushes health sector stakeholders as well as scientific communities to act on reducing the transmission of the multidrug-resistant strains that threatens several classes of life-saving antibiotics.

scholarly journals Multidrug-Resistant, Including Extended-Spectrum Beta Lactamase-Producing and Quinolone-Resistant, Escherichia coli Isolated from Poultry and Domestic Pigs in Dar es Salaam, Tanzania

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 406
Author(s):  
Zuhura I. Kimera ◽  
Fauster X. Mgaya ◽  
Gerald Misinzo ◽  
Stephen E. Mshana ◽  
Nyambura Moremi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistant ◽  
Antibiotics Resistance ◽  
Beta Lactamase ◽  
Domestic Pigs ◽  
Extended Spectrum Beta Lactamase ◽  
Phenotypic Profile ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

We determined the phenotypic profile of multidrug-resistant (MDR) Escherichia coli isolated from 698 samples (390 and 308 from poultry and domestic pigs, respectively). In total, 562 Enterobacteria were isolated. About 80.5% of the isolates were E. coli. Occurrence of E. coli was significantly higher among domestic pigs (73.1%) than in poultry (60.5%) (p = 0.000). In both poultry and domestic pigs, E. coli isolates were highly resistant to tetracycline (63.5%), nalidixic acid (53.7%), ampicillin (52.3%), and trimethoprim/sulfamethoxazole (50.9%). About 51.6%, 65.3%, and 53.7% of E. coli were MDR, extended-spectrum beta lactamase-producing enterobacteriaceae (ESBL-PE), and quinolone-resistant, respectively. A total of 68% of the extended-spectrum beta lactamase (ESBL) producers were also resistant to quinolones. For all tested antibiotics, resistance was significantly higher in ESBL-producing and quinolone-resistant isolates than the non-ESBL producers and non-quinolone-resistant E. coli. Eight isolates were resistant to eight classes of antimicrobials. We compared phenotypic with genotypic results of 20 MDR E. coli isolates, ESBL producers, and quinolone-resistant strains and found 80% harbored blaCTX-M, 15% aac(6)-lb-cr, 10% qnrB, and 5% qepA. None harbored TEM, SHV, qnrA, qnrS, qnrC, or qnrD. The observed pattern and level of resistance render this portfolio of antibiotics ineffective for their intended use.

scholarly journals Genomic Characterization of New Variant of Hydrogen Sulfide (H2S)-Producing Escherichia coli with Multidrug Resistance Properties Carrying the mcr-1 Gene in China

Antibiotics ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 80 ◽  
Author(s):  
Silpak Biswas ◽  
Mohammed Elbediwi ◽  
Guimin Gu ◽  
Min Yue
Keyword(s):  
Escherichia Coli ◽  
Hydrogen Sulfide ◽  
Multidrug Resistance ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Colistin Resistance ◽  
New Variant ◽  
Genomic Characterization ◽  
Human Infections

Colistin is considered to be a ‘last-resort’ antimicrobial for the treatment of multidrug-resistant Gram-negative bacterial infections. Identification of Enterobacteriaceae, carrying the transferable colistin resistance gene mcr-1, has recently provoked a global health concern. This report presents the first detection of a hydrogen sulfide (H2S)-producing Escherichia coli variant isolated from a human in China, with multidrug resistance (MDR) properties, including colistin resistance by the mcr-1 gene, which could have great implications for the treatment of human infections.

scholarly journals Association of Living Arrangement Conditions and Socioeconomic Differentials with Anemia Status among Women in Rural Bangladesh

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ghose Bishwajit ◽  
Sanni Yaya ◽  
Shangfeng Tang ◽  
Akmal Hossain ◽  
Yang Fan ◽  
...  
Keyword(s):  
Dietary Habits ◽  
Living Arrangement ◽  
Health Concern ◽  
Adult Women ◽  
Household Characteristics ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Women And Children ◽  
Health Survey Data ◽  
Socioeconomic Differentials

In Bangladesh, iron deficiency is the most common cause of anemia and remains a significant public health concern. Being a high anemia prevalent country, numerous efforts have been made to confront the issue especially among women and children by both local and international actors. Though the situation has substantially improved in recent years, a staggering number of adult women are currently living with anemia. The etiology of anemia is a multifactorial problem and has been proposed to be associated with various household, societal, economic, cultural factors apart from dietary habits. However, evidence regarding the household arrangements and socioeconomic determinants of anemia is scarce, especially in the context of Bangladesh. To this end, we utilized the 2011 demographic and health survey data to explore the association between anemia status and selected demographic, socioeconomic, and household characteristics. Our result showed significant correlation of anemia with both sociodemographic and household characteristics. Among the sociodemographic variables the following were found to be significantly associated with anemia status: age (p=0.014; OR = 1.195; 95% CI = 1.036–1.378) and microcredit membership (p=0.014; OR = 1.19; 95% CI = 1.037–1.386). Regarding the household arrangements, women utilizing biomass fuel for cooking (p<0.019; OR = 1.82; 95% CI = 0.981–2.460) were more likely to be anemic.

scholarly journals Medication Errors: Scope and prevention strategies

2012 ◽  
Vol 1 (2) ◽  
pp. 54 ◽  
Author(s):  
Luigi Brunetti ◽  
Dong-Churl Suh
Keyword(s):  
Medication Error ◽  
Medication Errors ◽  
Health Concern ◽  
Prevention Strategies ◽  
Error Prevention ◽  
Integration Of Technology ◽  
Significant Public Health Concern ◽  
Significant Public Health ◽  
Safety Systems ◽  
Improve Patient

Background: Medication errors are a significant public health concern.  Although significant advances have been made, errors are still relatively common and represent an opportunity for healthcare improvement.Methodology/Principal Findings: Since the publication of To Err is Human, medication errors have been under tremendous scrutiny.  Organizations have moved towards a non-punitive approach to evaluating errors.  This approach to medication errors has aided in identifying common pathways to medication errors and improving understanding regarding the anatomy of a medication error.  As a result, prevention strategies have been developed to target common themes contributing to errors.  Error prevention strategies may target common contributors of medication errors, broadly grouped as performance lapses, lack of knowledge, and lack or failure of safety systems.  Strategies to thwart medication errors range from process improvement to integration of technology in the health care environment.Conclusions/Significance:  Organizations should devote resources to address medication error prevention strategies in an effort to improve patient outcomes and decrease morbidity and mortality associated with medication errors.

scholarly journals Internet Mindfulness Meditation Intervention (IMMI) Program with iMINDr Application Support for Older Adults with Depression Symptoms: A Feasibility Study

2021 ◽  
Vol 06 (04) ◽  
pp. 1-1
Author(s):  
Lutvija Hrnjic ◽  
◽  
Nina Fry ◽  
Helané Wahbeh ◽  
◽  
...  
Keyword(s):  
Older Adults ◽  
Mindfulness Meditation ◽  
Well Being ◽  
Health Concern ◽  
Depression Symptoms ◽  
Attrition Rates ◽  
Significant Public Health Concern ◽  
Before And After ◽  
Significant Public Health ◽  
Potential Applications

The growing population of older adults with depression is a significant public health concern, and effective treatments are necessary. Mindfulness meditation intervention offers effective treatment for depression, but little research has been conducted on the older population. This study aimed to evaluate if the combination of the Internet Mindfulness Meditation Intervention (IMMI) plus iMINDr application improves well-being in older adults with depressive symptoms. Potential participants were recruited online. IMMI included a one-hour online session once a week, a daily 30-minute home practice of guided meditation using the iMINDr app, and a workbook. Measures were collected online before and after the six-week intervention period. Online session adherence was tracked. Thirty-eight participants completed all study requirements and are included in the analysis. Participants showed clinically and statistically significant improvements in depression symptoms, well-being, positive and negative affect, sleep quality, and pain intensity. Participants took 9.9 ± 3.5 weeks to complete the course. High attrition rates mainly were related to participants' motivation to complete the course and stress levels. There were no significant demographic differences between participants and depression symptoms. Potential applications and limitations are discussed. Internet Mindfulness Meditation Intervention (IMMI) was effective in treating depression symptoms in older adults.

scholarly journals Retail Chicken Carcasses as a Reservoir of Antimicrobial- Resistant Escherichia coli

2020 ◽  
Author(s):  
Nahla Omer Eltai ◽  
Hadi M. Yassine ◽  
Sara H. Al-Hadidi ◽  
Tahra ElObied ◽  
Asmaa A. Al Thani ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Growth Promotion ◽  
Multidrug Resistant ◽  
Chicken Meat ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Inappropriate Use ◽  
Esbl Producers

The dissemination of antimicrobial resistance (AMR) bacteria has been associated with the inappropriate use of antibiotics in both humans and animals and with the consumption of food contaminated with resistant bacteria. In particular, the use of antibiotics as prophylactic and growth promotion purposes in food-producing animals has rendered many of the antibiotics ineffective. The increased global prevalence of AMR poses a significant threat to the safety of the world’s food supply. Objectives: This study aims at determining the prevalence of antibiotic-resistant Escherichia coli (E. coli) isolated from local and imported retail chicken meat in Qatar. Methodology: A total of 270 whole chicken carcasses were obtained from three different hypermarket stores in Qatar. A total of 216 E. coli were isolated and subjected to antibiotic susceptibility testing against 18 relevant antibiotics using disc diffusion and micro- dilution methods. Furthermore, extended-spectrum β-lactamase (ESBL) production was determined via a double-disc synergetic test. Isolates harboring colistin resistance were confirmed using multiplex-PCR and DNA sequencing. Results: Nearly 89% (192/216) of the isolates were resistant to at least one antibiotics. In general, isolates showed relatively higher resistance to sulfamethoxazole (62%), tetracycline (59.7%), ampicillin and trimethoprim (52.3%), ciprofloxacin (47.7%), cephalothin, and colistin (31.9%). On the other hand, less resistance was recorded against amoxicillin/clavulanic acid (6%), ceftriaxone (5.1%), nitrofurantoin (4.2%) and piperacillin/tazobactam (4.2%), cefepime (2.3%), meropenem (1.4%), ertapenem (0.9%), and amikacin (0.9%). Nine isolates (4.2%) were ESBL producers. Furthermore, 63.4% were multidrug-resistant (MDR). The percentage of MDR, ESBL producers, and colistin-resistant isolates was significantly higher among local isolates compared to imported chicken samples. Conclusion: We reported a remarkably high percentage of the antibiotic-resistant E. coli in chicken meat sold at retail in Qatar. The high percentage of MDR and colistin isolates is troublesome to the food safety of raw chicken meat and the potential of antibiotic resistance spread to public health. Our findings support the need for the implementation of one health approach to address the spread of antimicrobial resistance and the need for a collaborative solution.

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