Carbapenem-resistant &lt;em&gt;Acinetobacter baumannii&lt;/em&gt; and &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt;: characterization of carbapenemase genes and E-test evaluation of colistin-based combinations

Ramadan, Ronnie; Gebriel, Manar G; Kadry, Heba M.; Mosallem, Ahmed

doi:10.2147/idr.s170233

Cited by 55 publications

(39 citation statements)

References 38 publications

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“…On the other hand, our findings were different from another study that was conducted in Zagazig hospital in Egypt, which reported that blaOXA-23 was the most prevalent (90%) followed by, blaNDM (66.7%) then blaGES (50%) in CR A. baumannii , respectively. 38 However, genes coding for blaVIM, blaGES, blaNDM and blaIMP were identified in 50%, 40.9%, 27.3% and 18.2% of CR P. aeruginosa , respectively. 38 The difference between the respective study and our study could be attributed to other factors such as geographical and patient factors.…”

Section: Discussionmentioning

confidence: 99%

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<p>Carbapenemase Producers Among Extensive Drug-Resistant Gram-Negative Pathogens Recovered from Febrile Neutrophilic Patients in Egypt</p>

Mabrouk

Abdellatif

El-Ansary

et al. 2020

IDR

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Purpose This study aimed to detect the prevalence of carbapenemase producers (CPs) among extensive drug-resistant (XDR)-carbapenemase producing Gram-negative bacteria (GNB) recovered from various clinical specimens of hospitalized neutrophilic febrile patients in two major tertiary care hospitals in Egypt. Methods Standard methods were used to evaluate the antimicrobial susceptibility of clinical isolates according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Phenotypic and genotypic analysis of CPs were carried out and statistically analyzed using standard methods. Results Three hundred and forty-two GNB were obtained from 342 clinical specimens during the period of the study, where 162 (47%) were enterobacterial isolates, including, 63 (18.4%) Escherichia coli , 87 (25.4%) Klebsiella spp., 5 (1.46%) Enterobacter cloacae , 5 (1.46%) Salmonella spp. and 2 (0.6%) Proteus and 180 (53%) were non-fermentative bacilli including, 129 (37.7%), Acinetobacter baumannii , and 51 (14.9%), Pseudomonas spp. Out of the 342 GNB, 188 (54.9%) isolates were multi-drug resistant (MDR). Of these, 52 (27.6%) were XDR as well as CPs as confirmed phenotypically. The MIC of imipenem against the XDR GNB against showed either low (11 isolates; 21.1%; MIC range =4–32 µg/mL) or high levels of resistance (41 isolates; 78.8%; MIC range = 64-≥1024). The most prevalent carbapenem resistance (CR) genes were blaKPC (63.5%) followed by blaOXA -48 (55.7%) and blaVIM (28.8%). No significant association could be observed between the MIC level and the presence of CR genes ( P value >0.05). Conclusion High prevalence of MDR (54.9%) and XDR (27.6%) GNB pathogens associated with high levels of resistance to carbapenems were observed. All XDR GNB were CPs and tested positive for at least one of the CR genes. However, most of them (78.8%) showed a high level of CR (MIC range = 64-≥1024) with no significant association with the CR genes.

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Section: Discussionmentioning

confidence: 99%

“… 38 However, genes coding for blaVIM, blaGES, blaNDM and blaIMP were identified in 50%, 40.9%, 27.3% and 18.2% of CR P. aeruginosa , respectively. 38 The difference between the respective study and our study could be attributed to other factors such as geographical and patient factors.…”

Section: Discussionmentioning

confidence: 99%

<p>Carbapenemase Producers Among Extensive Drug-Resistant Gram-Negative Pathogens Recovered from Febrile Neutrophilic Patients in Egypt</p>

Mabrouk

Abdellatif

El-Ansary

et al. 2020

IDR

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“…Published studies reveal that bacteria can acquire antibiotic resistance in the existence of drug efflux pumps; new findings indicate that these systems, by removing various compounds, contribute to bacteria that has had time to acquire resistance to the various classes of antibiotics, including β-lactams, tetracyclines, aminoglycosides, cephalosporins and fluoroquinolones [21], [27]. MDR and XDR strains have been recognized as a major concern in different hospital areas, particularly the intensive care unit [18], [19], [28]. According to US Food and Drug Administration–published guidelines as well as the results of previous studies, a few antibiotics such as tigecycline, minocycline and colistin can be used for the treatment of MDR A. baumannii [12], [13], but tigecycline resistance is increasingly being reported [16].…”

Section: Discussionmentioning

confidence: 99%

Role of efflux pumps in reduced susceptibility to tigecycline in Acinetobacter baumannii

Ardehali

Azimi

Fallah

et al. 2019

New Microbes and New Infections

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Acinetobacter baumannii is an important human pathogen responsible for a various type of infections. These bacterial strains are generally resistant to numerous antibiotics. Therefore, eradication of such strains is problematic and related to high mortality. We investigated the effect of cyanide 3-chlorophenylhydrazone (CCCP) efflux pump inhibitor in tigecycline-resistant strains of Acinetobacter baumannii. In a cross-sectional study, from July until the end of February 2017, eighty isolates of A. baumannii were recovered. Antimicrobial susceptibility testing against tigecycline was performed by the disc diffusion method and determination of minimum inhibitory concentration by broth microdilution method, according to Clinical and Laboratory Standards Institute guidelines. Active efflux pumps were detected by CCCP as an efflux pumps inhibitor, and the gene expression of some of the resistance/nodulation/division (RND)-type efflux pumps was measured by semiquantitative RT-PCR (qRT-PCR). Antibiotic susceptibility tests in this study showed that 78 of 80 A. baumannii isolates were resistant to tigecycline. The results of phenotypic detection of efflux pumps revealed that 23.07% of tigecycline-resistant A. baumannii isolates can contain active efflux pumps. On the basis of conventional PCR, genes coding for adeF and adeJ were detected in 76 (98%) A. baumannii isolates. The results of qRT-PCR showed that the transcript level of the adeJ gene increased in 66.6% A. baumannii isolates with CCCP-positive tests and was correlated with tigecycline resistance. The results of this study indicate that RND-type efflux pumps appear to play a significant role in the tigecycline resistance of A. baumannii.

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“…In 2013, the United States CDC declared that carbapenem-resistant Enterobacteriaceae (CRE), 4) as well as drug-resistant Neisseria gonorrhoeae and Clostridium difficile are an urgent threat to public health. 5) Furthermore, WHO recently published its "priority list of antibiotic-resistant bacteria for R&D." 6) This list classified carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, 7) and carbapenem-resistant extended spectrum β-lactamase (ESBL)-producing Enterobacteriaceae as "Priority 1: critical." 8,9) This list demonstrates that the development of antibiotics active against MDR Gram-negative bacteria, particularly carbapenemaseproducing organisms, is key to preventing future catastrophic pandemic outbreaks.…”

Section: Introductionmentioning

confidence: 99%

Potent Antibiotics Active against Multidrug-Resistant Gram-Negative Bacteria

Otsuka

2020

Chem. Pharm. Bull.

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The emergence of multidrug-resistant (MDR) Gram-negative bacteria has become a global problem. Among MDR Gram-negative bacteria, carbapenem-resistant Enterobacteriaceae (CRE), MDR Pseudomonas aeruginosa, and MDR Acinetobacter baumannii have limited treatment options and present serious threats. Therefore, strong countermeasures must be taken against these bacteria immediately. Accordingly, the focus of this review is on recent advances in the development of promising antibacterial agents against MDR Gram-negative bacteria. These agents include novel tetracyclines, polymyxins, β-lactams, β-lactam/βlactamase inhibitors, aminoglycosides, and peptide mimetics that have been recently approved or have shown promising results in clinical and preclinical development. This review summarizes these potent antibiotics in terms of their development status, mode of action, spectra of activity, and structure-activity relationship. Key words antibiotic; drug candidate; Gram-negative bacteria; carbapenem-resistant 2. Novel Tetracycline-class Antibiotics for MDR Gramnegative Bacteria Tetracycline antibiotics derived from natural products do not contain substituents at the C-7, C-8, and C-9 positions. However, the development of totally synthetic methods to synthesize tetracyclines has made it possible to modify these three positions, 21,22) providing novel and fully synthetic tetracyclines such as XERAVA and TP-6076, developed by Tetraphase Pharmaceuticals Inc. (Fig. 1). The introduction of an electron-withdrawing group at the C-7 position, and substitution at the C-9 position, significantly improved the antimicrobial activity of these synthetic tetracyclines. 23,24) XERAVA (eravacycline, TP-434) 25-27) was the first fully synthetic fluorocycline produced by Michael-Dieckmann reaction. 28) XERAVA was approved by the U.S. Food and Drug Administration (FDA) in August 27, 2018 for the treatment of

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Carbapenem-resistant <em>Acinetobacter baumannii</em> and <em>Pseudomonas aeruginosa</em>: characterization of carbapenemase genes and E-test evaluation of colistin-based combinations

Cited by 55 publications

References 38 publications

<p>Carbapenemase Producers Among Extensive Drug-Resistant Gram-Negative Pathogens Recovered from Febrile Neutrophilic Patients in Egypt</p>

<p>Carbapenemase Producers Among Extensive Drug-Resistant Gram-Negative Pathogens Recovered from Febrile Neutrophilic Patients in Egypt</p>

Role of efflux pumps in reduced susceptibility to tigecycline in Acinetobacter baumannii

Potent Antibiotics Active against Multidrug-Resistant Gram-Negative Bacteria

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