Analysis of β-Lactamase Resistance Determinants in Enterobacteriaceae from Chicago Children: a Multicenter Survey

Logan, Latania K.; Hujer, Andrea M.; Marshall, Steven H.; Domitrovic, Tatiana; Rudin, Susan D.; Zheng, Xiaotian; Qureshi, Nadia K.; Hayden, Mary K.; Scaggs, Felicia A.; Karadkhele, Anand; Bonomo, Robert A.

doi:10.1128/aac.00098-16

Cited by 35 publications

(44 citation statements)

References 32 publications

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“…Other plasmid replicon groups, such as IncN, IncP, IncX, IncU, IncI, A/C, IncR, and L/M, are also occasionally reported in KPC‐producing K. pneumoniae . Moreover, these plasmid replicon groups are also associated with K. pneumoniae strains producing other carbapenemases.…”

Section: Plasmid Biology and Incompatibility Groupsmentioning

confidence: 99%

Plasmid evolution in carbapenemase‐producing Enterobacteriaceae: a review

Kopotsa

Sekyere

Mbelle

2019

Annals of the New York Academy of Sciences

178

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Carbapenem‐resistant Enterobacteriaceae (CRE) have been listed by the WHO as high‐priority pathogens owing to their high association with mortalities and morbidities. Resistance to multiple β‐lactams complicates effective clinical management of CRE infections. Using plasmid typing methods, a wide distribution of plasmid replicon groups has been reported in CREs around the world, including IncF, N, X, A/C, L/M, R, P, H, I, and W. We performed a literature search for English research papers, published between 2013 and 2018, reporting on plasmid‐mediated carbapenem resistance. A rise in both carbapenemase types and associated plasmid replicon groups was seen, with China, Canada, and the United States recording a higher increase than other countries. blaKPC was the most prevalent, except in Angola and the Czech Republic, where OXA‐181 (n = 50, 88%) and OXA‐48–like (n = 24, 44%) carbapenemases were most prevalent, respectively; blaKPC‐2/3 accounted for 70% (n = 956) of all reported carbapenemases. IncF plasmids were found to be responsible for disseminating different antibiotic resistance genes worldwide, accounting for almost 40% (n = 254) of plasmid‐borne carbapenemases. blaCTX‐M, blaTEM, blaSHV, blaOXA‐1/9, qnr, and aac‐(6′)‐lb were mostly detected concurrently with carbapenemases. Most reported plasmids were conjugative but not present in multiple countries or species, suggesting limited interspecies and interboundary transmission of a common plasmid. A major limitation to effective characterization of plasmid evolution was the use of PCR‐based instead of whole‐plasmid sequencing–based plasmid typing.

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Section: Plasmid Biology and Incompatibility Groupsmentioning

confidence: 99%

Plasmid evolution in carbapenemase‐producing Enterobacteriaceae: a review

Kopotsa

Sekyere

Mbelle

2019

Annals of the New York Academy of Sciences

178

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“…Genomic DNA from Enterobacteriaceae isolates was purified from isolates confirmed with an ESBL phenotype (DNeasy blood and tissue kit, Qiagen, Inc. Valencia, CA). DNA Microarray (Check-MDR CT101 and CT103XL; Check-Points, Wageningen, Netherlands) and polymerase chain reaction (PCR) was performed to assess and confirm the presence of bla genes in isolates as previously described and according to manufacturer protocol 13,17 . Isolates found to be positive solely for beta-lactamase genes belonging to CTX-M-9-grp were included in the analysis.…”

Section: Beta-lactam Resistance Determinantsmentioning

confidence: 99%

“…Unlike the clonal ST131 E. coli strains, CTX-M-9-group genes are associated with multiple strain types and horizontal gene transfer via mobile genetic elements likely plays an important role in their dissemination 12 . While studies of ESBL-Ent in U.S. children and internationally have reported infections due to CTX-M-9-group-producing Enterobacteriaceae (CTX-M-9-grp-Ent) 10,13 , pediatric studies have not focused on the clinical and molecular epidemiology and impact of infections specifically due to CTX-M-9-grp-Ent.…”

Section: Introductionmentioning

confidence: 99%

“…In previous investigations, the genetic basis for beta-lactam resistance in Enterobacteriaceae isolates recovered from children cared for by multiple centers in the Chicago area was determined 13 . Subsequently, subgroups of children with infections due to similar resistance determinants, (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Subsequently, subgroups of children with infections due to similar resistance determinants, (e.g. plasmid-mediated fluoroquinolone, ESBL, and carbapenem resistance genes) were analyzed in order to determine genotypes, host factors, and exposures associated with specific MDR Enterobacteriaceae strains 13,14 . A prior analysis of children with plasmid-mediated fluoroquinolone-resistant (PMFQR)-Ent infections that there are genetic and geospatial community links to MDR in our pediatric population was found 15 .…”

Section: Introductionmentioning

confidence: 99%

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The Clinical and Molecular Epidemiology of CTX-M-9 Group Producing Enterobacteriaceae infections in children

Logan

Medernach

Domitrovic³

et al. 2018

Preprint

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Background:The pandemic of extended-spectrum-beta-lactamase (ESBL)-producing-Enterobacteriaceae (Ent) is strongly linked to the dissemination of CTX-M-type-ESBL-Ent. We sought to define the epidemiology of infections in children due to an emerging resistance type, CTX-M-9-group-producing-Ent (CTX-M-9-grp-Ent). Methods:A multi-centered case-control analysis of Chicago children with CTX-M-9-grp-Ent infections was performed. Cases were defined as children possessing extended-spectrumcephalosporin-resistant (ESC-R) infections. PCR and DNA analysis assessed beta-lactamase (bla) genes, multi-locus sequence types (MLST) and phylogenetic grouping of E. coli. Controls were children with ESC-susceptible (ESC-S)-Ent infections matched 3:1 by age, source, and hospital. The clinical-epidemiologic predictors of CTX-M-9-grp-Ent infection were assessed. Results: Of 356 ESC-R-Ent isolates from children (median age 4.1 years), CTX-M-9-group was the solely detected bla gene in 44(12.4%). The predominant species was E. coli (91%) of virulent phylogroups D(60%) and B2(40%). MLST revealed multiple strain types. On multivariable analysis, CTX-M-9-grp-Ent occurred more often in E. coli (OR 7.0), children of non-black-white-Hispanic race (OR 6.5), and outpatients (OR 4.5) which was a very unexpected finding for infections due to antibiotic-resistant bacteria. Residents of South Chicago were 6.7 times more likely to have CTX-M-9-grp-Ent infections than those in the reference region (West), while residence in Northwestern Chicago was associated with an 81% decreased risk. Other demographic, comorbidity, invasive-device, and antibiotic use differences were not found.Conclusions: CTX-M-9-grp-Ent infection is strikingly associated with patient residence and is occurring in children without traditional in-patient exposure risk factors. This suggests that among children, the community environment may be a key contributor in the spread of these resistant pathogens. of participating institutions for collection, shipping, and cultivation of organisms. We thank the team of curators of the Institut Pasteur MLST and whole-genome MLST databases for curating the data and making them publicly available at

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Multidrug-resistant organisms in urinary tract infections in children

et al. 2019

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The global spread of multidrug-resistant organisms has led to an increase in urinary tract infections (UTIs) in children that are difficult to treat. This review explores the current literature regarding multidrug-resistant UTIs in childhood and proposes an approach to management. Multidrug-resistant organisms include a wide range of potential urinary tract pathogens and, while most literature on drug resistance in UTIs during childhood has focused on extended-spectrum beta-lactamase producing organisms, in this review, we have included a discussion of multidrug resistance including and beyond beta-lactamase production. We provide definitions for multidrug-resistant organisms in line with current consensus guidelines and summarise clinically relevant mechanisms of resistance. Additionally, in this review, we outline the global epidemiology of multidrug-resistant UTIs in children, summarising published prevalence rates, which range from 5 to 90% in different settings. Finally, we also critically review the evidence on risk factors for colonisation and infection of the urinary tract with multidrug-resistant organisms, including prior antibiotic use, hospitalisation and underlying urological malformations. We also highlight multidrug-resistant UTI occurring in children without any identifiable risk factors, reflecting an increasing prevalence of colonisation with these organisms in the general community. Taken as a whole, this emphasises a need for careful and evidence-based use of antibiotics when treating UTIs in children and, to aide clinicians, we have outlined here potential management strategies for when infection with a multidrug-resistant organism is suspected or confirmed.

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Analysis of β-Lactamase Resistance Determinants in Enterobacteriaceae from Chicago Children: a Multicenter Survey

Cited by 35 publications

References 32 publications

Plasmid evolution in carbapenemase‐producing Enterobacteriaceae: a review

Plasmid evolution in carbapenemase‐producing Enterobacteriaceae: a review

The Clinical and Molecular Epidemiology of CTX-M-9 Group Producing Enterobacteriaceae infections in children

Multidrug-resistant organisms in urinary tract infections in children

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