Molecular Epidemiology of Extensively-Drug Resistant Sequence Type 2 Co-Harboring and From Clinical Origin

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2021 Jun 3

PMID 34079303

Citations 12

Authors

Hasan Ejaz

Mahtab Ahmad

Sonia Younas

Kashaf Junaid

Khalid Omer Abdalla Abosalif

Abualgasim Elgaili Abdalla

Ayman Ali Mohammed Alameen

Mohammed Yagoub Mohammed Elamir

Syed Nasir Abbas Bukhari

Naveed Ahmad

Muhammad Usman Qamar

Affiliations

Soon will be listed here.

Abstract

Background: The therapeutic management of carbapenem-resistant (CR-AB) represents a serious challenge to the public health sector because these pathogens are resistant to a wide range of antibiotics, resulting in limited treatment options. The present study was planned to investigate the clonal spread of CR-AB in a clinical setting.

Methodology: A total of 174 clinical isolates were collected from a tertiary care hospitals in Lahore, Pakistan. The isolates were confirmed by VITEK 2 compact system and molecular identification of A and . Antimicrobial profile and the screening of carbapenem-resistant genes were carried out using VITEK 2 system and PCR, respectively. The molecular typing of the isolates was performed according to the Pasteur scheme.

Results: Of the 174 isolates collected, the majority were isolated from sputum samples (46.5%) and in the intensive care unit (ICU, 75%). Among these, 113/174 (64.9%) were identified as CR-AB, and 49.5% and 24.7% harbored and , respectively. A total of 11 (9.7%) isolates co-harbored , , and . Interestingly, 46.9% of the CR-AB belonged to sequence type 2 (ST2; CC1), whereas 15.9% belonged to ST1 (CC1). All of the CR-AB isolates showed extensive resistance to clinically relevant antibiotics, except colistin.

Conclusion: The study concluded CR-AB ST2 clone harboring and are widely distributed in Pakistan's clinical settings, which could result in increased mortality. Strict compliance with the National Action Plan on Antimicrobial Resistance is necessary to reduce the impacts of these strains.

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References

Perez-Oseguera A, Castro-Jaimes S, Salgado-Camargo A, Silva-Sanchez J, Garza-Gonzalez E, Castillo-Ramirez S . Complete Genome Sequence of a -Producing Strain Isolated from a Mexican Hospital. Genome Announc. 2017; 5(36). PMC: 5589538. DOI: 10.1128/genomeA.00949-17. View

Hadjadj L, Ali Syed M, Abbasi S, Rolain J, Jamil B . Diversity of Carbapenem Resistance Mechanisms in Clinical Gram-Negative Bacteria in Pakistan. Microb Drug Resist. 2020; 27(6):760-767. DOI: 10.1089/mdr.2019.0387. View

Qamar M, Walsh T, Toleman M, Tyrrell J, Saleem S, Aboklaish A . Dissemination of genetically diverse NDM-1, -5, -7 producing-Gram-negative pathogens isolated from pediatric patients in Pakistan. Future Microbiol. 2019; 14:691-704. DOI: 10.2217/fmb-2019-0012. View

Karah N, Khalid F, Nyunt Wai S, Uhlin B, Ahmad I . Molecular epidemiology and antimicrobial resistance features of Acinetobacter baumannii clinical isolates from Pakistan. Ann Clin Microbiol Antimicrob. 2020; 19(1):2. PMC: 6964048. DOI: 10.1186/s12941-019-0344-7. View

Almasaudi S . spp. as nosocomial pathogens: Epidemiology and resistance features. Saudi J Biol Sci. 2018; 25(3):586-596. PMC: 5910652. DOI: 10.1016/j.sjbs.2016.02.009. View

Sartor A, Raza M, Abbasi S, Day K, Perry J, Paterson D . Molecular epidemiology of NDM-1-producing Enterobacteriaceae and Acinetobacter baumannii isolates from Pakistan. Antimicrob Agents Chemother. 2014; 58(9):5589-93. PMC: 4135889. DOI: 10.1128/AAC.02425-14. View

Mendes R, Bell J, Turnidge J, Castanheira M, Jones R . Emergence and widespread dissemination of OXA-23, -24/40 and -58 carbapenemases among Acinetobacter spp. in Asia-Pacific nations: report from the SENTRY Surveillance Program. J Antimicrob Chemother. 2008; 63(1):55-9. DOI: 10.1093/jac/dkn434. View

Antunes N, Fisher J . Acquired Class D β-Lactamases. Antibiotics (Basel). 2016; 3(3):398-434. PMC: 4790369. DOI: 10.3390/antibiotics3030398. View

Aslam B, Wang W, Arshad M, Khurshid M, Muzammil S, Rasool M . Antibiotic resistance: a rundown of a global crisis. Infect Drug Resist. 2018; 11:1645-1658. PMC: 6188119. DOI: 10.2147/IDR.S173867. View

10.

Elbediwi M, Li Y, Paudyal N, Pan H, Li X, Xie S . Global Burden of Colistin-Resistant Bacteria: Mobilized Colistin Resistance Genes Study (1980-2018). Microorganisms. 2019; 7(10). PMC: 6843232. DOI: 10.3390/microorganisms7100461. View

11.

Qamar M, Ejaz H, Walsh T, Shah A, Al Farraj D, ALKufeidy R . Clonal relatedness and plasmid profiling of extensively drug-resistant New Delhi metallo-β-lactamase-producing clinical isolates. Future Microbiol. 2021; 16:229-239. DOI: 10.2217/fmb-2020-0315. View

12.

Kuo S, Huang W, Huang T, Wang H, Lai J, Chen T . Molecular Epidemiology of Emerging - and -Carrying Acinetobacter baumannii in Taiwan. Antimicrob Agents Chemother. 2018; 62(3). PMC: 5826164. DOI: 10.1128/AAC.01215-17. View

13.

Mulani M, Kamble E, Kumkar S, Tawre M, Pardesi K . Emerging Strategies to Combat ESKAPE Pathogens in the Era of Antimicrobial Resistance: A Review. Front Microbiol. 2019; 10:539. PMC: 6452778. DOI: 10.3389/fmicb.2019.00539. View

14.

Qamar M, Saleem S, Toleman M, Saqalein M, Waseem M, Nisar M . In vitro and in vivo activity of Manuka honey against NDM-1-producing Klebsiella pneumoniae ST11. Future Microbiol. 2017; 13:13-26. DOI: 10.2217/fmb-2017-0119. View

15.

Hasan B, Perveen K, Olsen B, Zahra R . Emergence of carbapenem-resistant Acinetobacter baumannii in hospitals in Pakistan. J Med Microbiol. 2013; 63(Pt 1):50-55. DOI: 10.1099/jmm.0.063925-0. View

16.

Chen Y, Guo P, Huang H, Huang Y, Wu Z, Liao K . Detection of co-harboring OXA-58 and NDM-1 carbapenemase producing genes resided on a same plasmid from an clinical isolate in China. Iran J Basic Med Sci. 2019; 22(1):106-111. PMC: 6437464. DOI: 10.22038/ijbms.2018.28934.6994. View

17.

Khurshid M, Rasool M, Siddique M, Azeem F, Naeem M, Sohail M . Molecular mechanisms of antibiotic co-resistance among carbapenem resistant Acinetobacter baumannii. J Infect Dev Ctries. 2020; 13(10):899-905. DOI: 10.3855/jidc.11410. View

18.

Thirapanmethee K, Srisiri-A-Nun T, Houngsaitong J, Montakantikul P, Khuntayaporn P, Chomnawang M . Prevalence of OXA-Type β-Lactamase Genes among Carbapenem-Resistant Clinical Isolates in Thailand. Antibiotics (Basel). 2020; 9(12). PMC: 7761801. DOI: 10.3390/antibiotics9120864. View

19.

Qamar M, Lopes B, Hassan B, Khurshid M, Shafique M, Nisar M . The present danger of New Delhi metallo-β-lactamase: a threat to public health. Future Microbiol. 2021; 15(18):1759-1778. DOI: 10.2217/fmb-2020-0069. View

20.

Qamar M, Nahid F, Walsh T, Kamran R, Zahra R . Prevalence and clinical burden of NDM-1 positive infections in pediatric and neonatal patients in Pakistan. Pediatr Infect Dis J. 2015; 34(4):452-4. DOI: 10.1097/INF.0000000000000582. View