Carbapenem-Resistant Enterobacteriaceae in Urinary Tract Infections: From Biological Insights to Emerging Therapeutic Alternatives

Bologna, Eugenio; Licari, Leslie Claire; Manfredi, Celeste; Ditonno, Francesco; Cirillo, Luigi; Fusco, Giovanni Maria; Abate, Marco; Passaro, Francesco; Di Mauro, Ernesto; Crocetto, Felice; Pandolfo, Savio Domenico; Aveta, Achille; Cilio, Simone; Di Filippo, Isabella; Barone, Biagio; Franco, Antonio; Arcaniolo, Davide; La Rocca, Roberto; Pinchera, Biagio; Napolitano, Luigi

doi:10.3390/medicina60020214

Cited by 6 publications

(1 citation statement)

References 98 publications

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“…The emergence and spread of antimicrobial resistance (AMR) among Enterobacteriaceae play significant roles to global public health. These bacteria are responsible for a wide range of infections, including urinary tract infections (UTIs), hospital-acquired and ventilator-associated pneumonia (HAP/VAP), complicated intra-abdominal infections (cIAIs), and bloodstream infections (BSIs) [ 1 ]. AMR is a critical issue that contributes to significant morbidity and mortality worldwide.…”

Section: Introductionmentioning

confidence: 99%

Genomic Characterization of Multidrug-Resistant Enterobacteriaceae Clinical Isolates from Southern Thailand Hospitals: Unraveling Antimicrobial Resistance and Virulence Mechanisms

Yaikhan,

Suwannasin,

Singkhamanan

et al. 2024

Antibiotics

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The emergence and spread of antimicrobial resistance (AMR) among Enterobacteriaceae pose significant threats to global public health. In this study, we conducted a short-term surveillance effort in Southern Thailand hospitals to characterize the genomic diversity, AMR profiles, and virulence factors of Enterobacteriaceae strains. We identified 241 carbapenem-resistant Enterobacteriaceae, of which 12 were selected for whole-genome sequencing (WGS) and genome analysis. The strains included Proteus mirabilis, Serratia nevei, Klebsiella variicola, Klebsiella aerogenes, Klebsiella indica, Klebsiella grimontii, Phytobacter ursingii, Phytobacter palmae, Kosakonia spp., and Citrobacter freundii. The strains exhibited high levels of multidrug resistance, including resistance to carbapenem antibiotics. Whole-genome sequencing revealed a diverse array of antimicrobial resistance genes (ARGs), with strains carrying genes for ß-lactamase, efflux pumps, and resistance to other antibiotic classes. Additionally, stress response, metal tolerance, and virulence-associated genes were identified, highlighting the adaptability and pathogenic potential of these strains. A plasmid analysis identified several plasmid replicons, including IncA/C2, IncFIB(K), and Col440I, as well as several plasmids identical to those found globally, indicating the potential for the horizontal gene transfer of ARGs. Importantly, this study also identified a novel species of Kosakonia spp. PSU27, adding to the understanding of the genetic diversity and resistance mechanisms of Enterobacteriaceae in Southern Thailand. The results reported in this study highlight the critical importance of implementing effective antimicrobial management programs and developing innovative treatment approaches to urgently tackle AMR.

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Section: Introductionmentioning

confidence: 99%

Genomic Characterization of Multidrug-Resistant Enterobacteriaceae Clinical Isolates from Southern Thailand Hospitals: Unraveling Antimicrobial Resistance and Virulence Mechanisms

Yaikhan,

Suwannasin,

Singkhamanan

et al. 2024

Antibiotics

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The emergence of Fluoroquinolone resistant and Extended-spectrum beta-lactamase-producingSalmonella spp.isolated from Poultry in Pakistan

Irfan,

Uzair,

Khan

et al. 2024

Preprint

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The rise of antimicrobial-resistant and Extended Spectrum Beta Lactamases producing Salmonella strains in poultry is a severe health threat worldwide, particularly in developing countries like Pakistan. The current study aimed to investigate the isolation and identification of Cefotaxime and Ciprofloxacin-Resistant Salmonella strains originating from poultry. During this study, 78 (26.0%) Salmonella strains were isolated from 300 diverse poultry samples. The isolated 78 Salmonella strains were identified as S. pullorum, S. gallinarum, S. enteritidis, S. enterica, S. paratyphi, S. typhimurium, S. typhi, S. arizonae, and 19% other Salmonella spp. by API 20E method. The antibiotic susceptibility profile showed that 61% of MDR Salmonella strains were isolated from diverse poultry samples. MDR rates were high in serovars S. enterica, S. typhimurium, S. enteritidis, S. arizonae, and S. gallinarum. Co-resistant to cefotaxime and ciprofloxacin in 56.4% of Salmonella strains was observed. Among 44 phenotypically ESBL-positive Salmonella strains, 36 (81.8%) carried bla CTX-M and 38 (86%) carried bla CTX-M-1. A High incidence rate of bla CTX-M and bla-CTX-M-1 was observed among S. enteritidis (19% and 21%), S. enterica (11% and 16%), S. typhimurium (13% and16%) and S. typhi (3% and 5%). Among 29 phenotypically MBL-positive Salmonella strains, 13 (44.8%) carried bla VIM and 6 (20.6%) carried bla IMP. The 67% prevalence of gyr A was observed in fluoroquinolone-resistant Salmonella strains. The most prevalent fluoroquinolone strains were S. enteritidis (19%), S. typhimurium (19%), S. typhi (13%), and S. gallinarum (12%). Fluoroquinolone-resistant, MBL, and ESBL-producing Salmonella strains from poultry are a matter of great concern for both livestock and public health, demonstrating the dissemination risk of these microorganisms through the food chain.

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Efficacy of lyophilized Lactobacillus sakei as a potential candidate for preventing carbapenem-resistant Klebsiella infection

Tajdozian,

Seo,

Jeong

et al. 2024

Ann Microbiol

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Background Antimicrobial resistance is considered one of the greatest threats to human health, according to the World Health Organization (WHO). Gram-negative bacteria, especially carbapenem-resistant Enterobacteriaceae (CRE), have become a significant concern in antimicrobial-resistant bacteria’s global emergence and spread. Among CRE pathogens, carbapenem-resistant Klebsiella pneumoniae (CRKP) has recently been reported as a highly infectious strain associated with high mortality and morbidity in adults and immunocompromised patients. Additionally, CRKP-related infections are challenging to treat, as carbapenems are the last resort of antibiotics. Therefore, developing novel drugs with different mechanisms of action from existing drugs is urgently required to defeat this lethal menace. Under such circumstances, probiotics can be therapeutic candidates for inhibiting pathogens. Thus, our research team has been focusing on probiotics for a long time to develop potential anti-CRKP drug agents. Methods After extensive efforts, we finally found a novel probiotic strain, Lactobacillus sakei PMC104, suitable for treating CRKP infection. It was isolated from kimchi. As part of our expansion into therapeutic development, we evaluated the L. sakei strain effect against CRKP pathogens in both in vitro and in vivo experiments. Moreover, we conducted media optimization at food grade and then established a scale-up process on a pilot scale. Subsequently, a lyophilizate was obtained and used in a mouse model infected with CRKP. Results Data demonstrated that the L. sakei strain has an inhibitory effect against CRKP infection both in in vitro and in vivo experiments and also increases the level of short-chain fatty acids in the feces of mice after receiving L. sakei strain treatment for 10 days. Furthermore, treatment with L. sakei powder remarkably diminished body weight loss, mortality, and illness severity in CRKP-infected mice, showing a preventive effect of our PMC 104 against CRKP infection. Discussion Our results demonstrate the potential therapeutic effect of our candidate probiotic strain against CRKP, suggesting that L. sakei PMC 104 could be considered an antimicrobial candidate for treating CRKP infections. However, extensive studies, including additional toxicity tests and clinical trials, are still essential to develop it as a new anti-CRKP therapeutic agent.

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Carbapenem-Resistant Enterobacteriaceae in Urinary Tract Infections: From Biological Insights to Emerging Therapeutic Alternatives

Cited by 6 publications

References 98 publications

Genomic Characterization of Multidrug-Resistant Enterobacteriaceae Clinical Isolates from Southern Thailand Hospitals: Unraveling Antimicrobial Resistance and Virulence Mechanisms

Genomic Characterization of Multidrug-Resistant Enterobacteriaceae Clinical Isolates from Southern Thailand Hospitals: Unraveling Antimicrobial Resistance and Virulence Mechanisms

The emergence of Fluoroquinolone resistant and Extended-spectrum beta-lactamase-producingSalmonella spp.isolated from Poultry in Pakistan

Efficacy of lyophilized Lactobacillus sakei as a potential candidate for preventing carbapenem-resistant Klebsiella infection

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