scholarly journals Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System

2021 ◽  
Vol 9 (9) ◽  
pp. 1868
Author(s):  
Paz Aranega-Bou ◽  
Nicholas Ellaby ◽  
Matthew J. Ellington ◽  
Ginny Moore
Keyword(s):  
Escherichia Coli ◽  
Enterobacter Cloacae ◽  
Model System ◽  
Hospital Environment ◽  
Laboratory Model ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Before And After

Sink waste traps and drains are a reservoir for multi-drug resistant Gram-negative bacteria in the hospital environment. It has been suggested that these bacteria can migrate through hospital plumbing. Hospital waste traps were installed in a laboratory model system where sinks were connected through a common wastewater pipe. Enterobacterales populations were monitored using selective culture, MALDI-TOF identification and antibiotic resistance profiling before and after a wastewater backflow event. When transfer between sinks was suspected, isolates were compared using whole-genome sequencing. Immediately after the wastewater backflow, two KPC-producing Enterobacter cloacae were recovered from a waste trap in which Carbapenemase-producing Enterobacterales (CPE) had not been detected previously. The isolates belonged to ST501 and ST31 and were genetically indistinguishable to those colonising sinks elsewhere in the system. Following inter-sink transfer, KPC-producing E. cloacae ST501 successfully integrated into the microbiome of the recipient sink and was detected in the waste trap water at least five months after the backflow event. Seven weeks and three months after the backflow, other inter-sink transfers involving Escherichia coli ST5295 and KPC-producing E. cloacae ST501 were also observed.

scholarly journals Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System

2021 ◽  
Author(s):  
Paz Aranega-Bou ◽  
Nicholas Ellaby ◽  
Matthew J. Ellington ◽  
Ginny Moore
Keyword(s):  
Escherichia Coli ◽  
Enterobacter Cloacae ◽  
Model System ◽  
Hospital Environment ◽  
Laboratory Model ◽  
Whole Genome ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Before And After

Sink waste traps and drains are a reservoir for multi-drug resistant Gram-negative bacteria in the hospital environment. It has been suggested that these bacteria can migrate through hospital plumbing. Hospital waste traps were installed in a laboratory model system where sinks were connected through a common wastewater pipe. Enterobacterales populations were monitored using selective culture, MALDI-TOF identification and antibiotic resistance profiling before and after a wastewater backflow event. When transfer between sinks was suspected, isolates were compared using whole-genome sequencing. Immediately after the wastewater backflow, two KPC-producing Enterobacter cloacae were recovered from a waste trap in which Carbapenemase-producing Enterobacterales (CPE) had not been detected previously. The isolates belonged to ST501 and ST31 and were genetically indistinguishable to those colonising sinks elsewhere in the system. Following inter-sink transfer, KPC-producing E. cloacae ST501 successfully integrated into the microbiome of the recipient sink and was detected in the waste trap water at least six months after the backflow event. Seven weeks and three months after the backflow, other inter-sink transfers involving Escherichia coli ST5295 and KPC-producing E. cloacae ST501 were also observed.

Susceptibility of Gram-negative bacteria to the synergistic bactericidal action of serum and polymyxin B nonapeptide

1986 ◽  
Vol 32 (1) ◽  
pp. 66-69 ◽  
Author(s):  
Petri Viljanen ◽  
Helena Käyhty ◽  
Martti Vaara ◽  
Timo Vaara
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Enterobacter Cloacae ◽  
Polymyxin B ◽  
Gram Negative Bacteria ◽  
Bactericidal Action ◽  
Gram Negative ◽  
Degree Of Sensitization ◽  
Normal Human ◽  
Klebsiella Spp

Polymyxin B nonapeptide was able to sensitize Escherichia coli strains and strains of Salmonella typhimurium, Klebsiella spp., Enterobacter cloacae, Pseudomonas aeruginosa, and Haemophilus influenzae to the bactericidal action of fresh normal human serum. The degree of sensitization varied significantly within the strains. Strains of Proteus mirabilis, Neisseria gonorrhoeae, and N. meningitidis remained resistant.

scholarly journals A survey on gram-negative bacteria in saffron finches (Sicalis flaveola) from illegal wildlife trade in Brazil

2016 ◽  
Vol 53 (3) ◽  
pp. 286 ◽  
Author(s):  
Yamê Miniero Davies ◽  
Marta Brito Guimarães ◽  
Liliane Milanelo ◽  
Maria Gabriela Xavier de Oliveira ◽  
Vasco Túlio De Moura Gomes ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Klebsiella Oxytoca ◽  
Enterobacter Cloacae ◽  
Wildlife Trade ◽  
Gram Negative Bacteria ◽  
Citrobacter Freundii ◽  
Gram Negative ◽  
Illegal Wildlife Trade ◽  
Serratia Liquefaciens

No Estado de São Paulo, Brasil, os pássaros como os canários-da-terra têm sido uma das espécies mais frequentemente resgatadas do tráfico illegal e enviadas aos centros de vida selvagem. Em situações de estresse estas aves podem ser acometidas por infecções causadas por bactérias oportunistas. Este fato é de grande importância quando é planejada da reintrodução das aves na natureza. O presente trabalho foi delineado para avaliar o estado de saúde de canários-da-terra resgatados do tráfico ilegal. Foram colhidas soabes da traqueia e da cloaca de 100 aves resgatadas durante os anos de 2012 e 2013. Os resultados obtidos revelaram alta frequência de bactérias gram-negativas nas fezes e no orofaringe dos animais, com maior frequência para os membros da família Enterobacteriaceae (97,5%). Os gêneros mais frequentes foram Escherichia coli (46,55) e Klebsiella pneumoniae (10,4%). Outros microorganismos incluindo Enterobacter cloacae, Serratia liquefaciens, Serratia spp, Klebsiella oxytoca e Citrobacter freundii também foram isolados em menor frequencia de aves assintomáticas. A presença de estirpes de Escherichia coli enteropagênicas (EPEC) e as produtoras da toxina de Shiga confirmam o risco de zoonose e a importância para saúde pública deste tipo de ave. 

scholarly journals Escherichia Coli Isolate From Hospital Sewage Is Carrying blaNDM-1 and blaoxa-10

2021 ◽  
Author(s):  
Zimeng Hu ◽  
Weiye Chen ◽  
Genglin Guo ◽  
Chen Dong ◽  
Yun Shen ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Hospital Environment ◽  
Multi Drug Resistance ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Drug Resistant Bacteria ◽  
Hospital Sewage

Abstract Carbapenems, as the “last line of defense” against gram-negative bacteria, are increasingly being challenged by drug-resistant bacteria, especially in Enterobacteriaceae. In this study, a carbapenems resistant gram-negative bacterium, named AH001, was isolated from hospital sewage, and modified Hoge test confirmed this bacterium can produce carbapenemase. Further analysis revealed that this bacterium is multi-drug resistance, which against additional seven antibiotics. Whole-genome sequencing and analysis showed that AH001 could not be classified by existing MLST, and its serotype couldn’t be distinguished among O9, O89 or O168 in O antigen prediction. More attention should be paid to the role of environmental source Escherichia coli in the development and transfer of drug resistance in the hospital environment.

scholarly journals Antibiotic resistance and detection of plasmid mediated colistin resistance mcr-1 gene among Escherichia coli and Klebsiella pneumoniae isolated from clinical samples

Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Deepa Karki ◽  
Binod Dhungel ◽  
Srijana Bhandari ◽  
Anil Kunwar ◽  
Prabhu Raj Joshi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Klebsiella Pneumoniae ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Drug Resistant ◽  
Colistin Resistance ◽  
Gram Negative ◽  
E Coli

Abstract Background The prevalence of antimicrobial resistance (AMR) among Gram-negative bacteria is alarmingly high. Reintroduction of colistin as last resort treatment in the infections caused by drug-resistant Gram-negative bacteria has led to the emergence and spread of colistin resistance. This study was designed to determine the prevalence of drug-resistance among beta-lactamase-producing strains of Escherichia coli and Klebsiella pneumoniae, isolated from the clinical specimens received at a tertiary care centre of Kathmandu, Nepal during the period of March to August, 2019. Methods A total of 3216 different clinical samples were processed in the Microbiology laboratory of Kathmandu Model Hospital. Gram-negative isolates (E. coli and K. pneumoniae) were processed for antimicrobial susceptibility test (AST) by using modified Kirby-Bauer disc diffusion method. Drug-resistant isolates were further screened for extended-spectrum beta-lactamase (ESBL), metallo-beta-lactamase (MBL), carbapenemase and K. pneumoniae carbapenemase (KPC) production tests. All the suspected enzyme producers were processed for phenotypic confirmatory tests. Colistin resistance was determined by minimum inhibitory concentration (MIC) using agar dilution method. Colistin resistant strains were further screened for plasmid-mediated mcr-1 gene using conventional polymerase chain reaction (PCR). Results Among the total samples processed, 16.4% (529/3216) samples had bacterial growth. A total of 583 bacterial isolates were recovered from 529 clinical samples. Among the total isolates, 78.0% (455/583) isolates were Gram-negative bacteria. The most predominant isolate among Gram-negatives was E. coli (66.4%; 302/455) and K. pneumoniae isolates were 9% (41/455). In AST, colistin, polymyxin B and tigecycline were the most effective antibiotics. The overall prevalence of multidrug-resistance (MDR) among both of the isolates was 58.0% (199/343). In the ESBL testing, 41.1% (n = 141) isolates were confirmed as ESBL-producers. The prevalence of ESBL-producing E. coli was 43% (130/302) whereas that of K. pneumoniae was 26.8% (11/41). Similarly, 12.5% (43/343) of the total isolates, 10.9% (33/302) of E. coli and 24.3% of (10/41) K. pneumoniae were resistant to carbapenem. Among 43 carbapenem resistant isolates, 30.2% (13/43) and 60.5% (26/43) were KPC and MBL-producers respectively. KPC-producers isolates of E. coli and K. pneumoniae were 33.3% (11/33) and 20% (2/10) respectively. Similarly, 63.6% (21/33) of the E. coli and 50% (5/10) of the K. pneumoniae were MBL-producers. In MIC assay, 2.2% (4/179) of E. coli and 10% (2/20) of K. pneumoniae isolates were confirmed as colistin resistant (MIC ≥ 4 µg/ml). Overall, the prevalence of colistin resistance was 3.1% (6/199) and acquisition of mcr-1 was 16.6% (3/18) among the E. coli isolates. Conclusion High prevalence of drug-resistance in our study is indicative of a deteriorating situation of AMR. Moreover, significant prevalence of resistant enzymes in our study reinforces their roles in the emergence of drug resistance. Resistance to last resort drug (colistin) and the isolation of mcr-1 indicate further urgency in infection management. Therefore, extensive surveillance, formulation and implementation of effective policies, augmentation of diagnostic facilities and incorporation of antibiotic stewardship programs can be some remedies to cope with this global crisis.

scholarly journals Antibiotic Resistance and Production of Extended Spectrum β-Lactamases by Clinical Gram-negative Bacteria in Benin

2019 ◽  
pp. 1-13
Author(s):  
Wassiyath Moussé ◽  
Haziz Sina ◽  
Ibrahima A. Mama-Sirou ◽  
Eugénie Anago ◽  
Durand Dah-Nouvlessounon ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Enterobacter Cloacae ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Enterobacter Agglomerans ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
University Center ◽  
Extended Spectrum

Aims: The aim of this work was to determine the resistance profile and to investigate the production of extended spectrum β-lactamases (ESBL) by clinically relevant Gram-negative Bacillus (GNB) strains. Methodology: About 191 strains were isolated from 1823 samples collected at the HKM National Hospital and University Center of Cotonou (Benin). Species identification was done with the Api 20th gallery. Two methods were used to search for β-lactamase production: the liquid acidimetric test for penicillinases and double halo method for ESBL. The susceptibility to conventional antibiotic molecules was investigated by the disk diffusion method. Polymerase Chain Reaction (PCR) was used to identify blaTEM and blaSHV genes in the β-lactamases. Results: A prevalence of 10.48% of GNB was recorded. Among the isolated strains, 51.31% came from samples collected from in-patients and 48.69% from out-patients’ samples. The most contaminated samples were urine (43.98%), pus (34.58%) and blood (9.42%). Majority of the isolated species included: Klebsiella pneumoniae (28.27%), Acinetobacter spp. (18.32%), Pseudomonas aeruginosa (15.72%), Escherichia coli (14.15%) and Enterobacter cloacae (12.04%). More than the half (57.07%) of the strains produced penicillinases; whereas 16.76% were ESBL-producers and these occurred only among Klebsiella pneumoniae, Enterobacter cloacae, Escherichia coli and Enterobacter agglomerans. The ESBL-producing strains were cross-resistant to beta-lactams. Imipenem is the most effective antibiotic on all isolated strains. ESBL-producing GNB strains possessed both the blaTEM gene and the blaSHV gene in a proportion of 25%; 37.5% of the strains had only the blaTEM gene and 12.5% of the strains had only the blaSHV gene. Conclusion: ESBL-producing strains of K. pneumonia in the hospital environment were the major carriers of blaTEM and blaSHV. Given this situation, it is necessary to continue research to identify resistance genes.

scholarly journals Antimicrobial susceptibility of multi-drug and extensively-drug-resistant Escherichia coli to ceftolozane-tazobactam and ceftazidime-avibactam: An in vitro study*

2020 ◽  
Vol 74 ◽  
pp. 77-83
Author(s):  
Patrycja Zalas-Więcek ◽  
Eugenia Gospodarek-Komkowska
Keyword(s):  
Escherichia Coli ◽  
Therapeutic Options ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
In Vitro Susceptibility ◽  
Gram Negative ◽  
E Coli ◽  
Extensively Drug Resistant

Aim: <i>Escherichia coli</i> is one of the Gram-negative bacteria, known to cause many nosocomial infections. Multi-drug (MDR) and extensively-drug resistant (XDR). <i>E. coli</i> are of particular note, due to significant limitations in antibiotic therapy. Ceftolozane-tazobactam and ceftazidime-avibactam are novel therapeutic options against Gram-negative bacteria; hence the aim of this study was to evaluate and compare the <i> in vitro </i> activity of ceftolozane-tazobactam and ceftazidime-avibactam against MDR and XDR clinical <i>E. coli</i> isolates. Material/Methods: The study included 100 non-replicate <i>E. coli</i> isolates derived from clinical samples of patients hospitalized in teaching hospitals. Bacteria were identified by applying mass spectrometry in the MALDI Biotyper system (Bruker). ESBL (bla<sub>CTX-M-1group</sub>, bla<sub>CTX-M-9group</sub>) and carbapenemase (bla<sub>KPC</sub>, bla<sub>VIM</sub>, bla<sub>NDM</sub>, bla<sub>OXA-48</sub>, bla<sub>OXA-181</sub>) genes were detected using the eazyplex® SuperBug CRE test, based on a loop-mediated isothermal amplification (LAMP). The in vitro susceptibility to ceftolozane-tazobactam and ceftazidime-avibactam was tested using validated MIC Test strips (Liofilchem). Results: All 84 extended-spectrum β-lactamase-producing (ESBL) <i>E. coli</i> isolates were susceptible to ceftazidime-avibactam and 83 to ceftolozane-tazobactam. Among 17 <i>E. coli</i> isolates with resistance to at least one of the carbapenems, three (17.6%) were susceptible to ceftolozane-tazobactam and ceftazidime-avibactam. All 14 blaVIM gene-positive <i>E. coli</i> isolates were resistant to both ceftolozane-tazobactam and ceftazidime-avibactam. Both antibiotics were active against bla<sub>CTX-M-9group</sub> and bla<sub>OXA-48</sub> gene-positive <i>E. coli</i> isolates, but they were not active against bla<sub>CTX-M-1group</sub> and bla<sub>VIM</sub> gene-positive isolates. Conclusions: Ceftolozane-tazobactam and ceftazidime-avibactam are alternative, non-carbapenem therapeutic options for ESBL-positive <i>E. coli</i> strains, and they are promising in the treatment of carbapenem-resistant <i>E. coli</i> strains, but not for those carrying the metallo-β-lactamase enzymes. Both drug combinations have comparable activity against ESBL, however, lower MIC values were found for ceftazidime-avibactam.

Rapid susceptibility testing of multi-drug resistant Escherichia coli and Klebsiella by glucose metabolization monitoring

2019 ◽  
Vol 57 (8) ◽  
pp. 1271-1279 ◽  
Author(s):  
Maximilian Kittel ◽  
Peter Findeisen ◽  
Beniam Ghebremedhin ◽  
Thomas Miethke ◽  
Alexander Grundt ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Therapy ◽  
Susceptibility Testing ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Maldi Tof Ms ◽  
E Coli ◽  
Maldi Tof ◽  
Tof Ms

Abstract Background The increasing number of multi-drug resistant (MDR) bacteria provides enormous challenges for choosing an appropriate antibiotic therapy in the early phase of sepsis. While bacterial identification has been greatly accelerated by the introduction of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), the antibiotic susceptibility testing (AST) remains time-consuming. Here, we present a rapid susceptibility testing method for testing Gram-negative bacteria, exemplarily validated for Escherichia coli and Klebsiella spp. Methods Gram-negative isolates (E. coli and Klebsiella spp.) were either taken as single colonies from agar plates (n=136) or directly extracted and identified from positive blood cultures (n=42) using MALDI-TOF MS. Bacteria were incubated in glucose-supplemented Luria broths (LBs) each containing one antibiotic (ceftazidime, piperacillin, imipenem and ciprofloxacin), routinely used to classify Gram-negative bacteria in Germany. To determine susceptibility the dynamics of glucose utilization in bacterial suspensions were quantitatively measured in the presence or absence of antibiotics designated liquid-AST (L-AST). Results The L-AST can be run on clinical-chemistry analyzers and integrated into laboratory routines. It yields critical resistance information within 90–150 min downstream of a MS-based identification. The results showed a high concordance with routine susceptibility testing, with less than 1% very major errors (VME) and 3.51% major errors (ME) for 178 assessed isolates. Analysis of turnaround time (TAT) for 42 clinical samples indicated that L-AST results could be obtained 34 h earlier than the routine results. Conclusions As exemplified for E. coli and Klebsiella spp., L-AST provides substantial acceleration of susceptibility testing following MALDI-TOF MS identification. The assay is a simple and low-cost method that can be integrated into clinical laboratory to allow for 24/7 AST. This approach could improve antibiotic therapy.

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