Prevalence and risk factors associated with colonization and infection of extensively drug-resistant<i>Pseudomonas aeruginosa</i>: a systematic review

Buhl, Michael; Peter, Silke; Willmann, Matthias

doi:10.1586/14787210.2015.1064310

Cited by 84 publications

(58 citation statements)

References 74 publications

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“…P. aeruginosa is an important pathogen in the nosocomial environment (Buhl et al, 2015). In this study, we characterized the full genome of six SPM-1-producing P. aeruginosa ST277 isolated from a Brazilian teaching hospital.…”

Section: Discussionmentioning

confidence: 99%

Intraclonal Genome Stability of the Metallo-β-lactamase SPM-1-producing Pseudomonas aeruginosa ST277, an Endemic Clone Disseminated in Brazilian Hospitals

et al. 2016

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Carbapenems represent the mainstay therapy for the treatment of serious P. aeruginosa infections. However, the emergence of carbapenem resistance has jeopardized the clinical use of this important class of compounds. The production of SPM-1 metallo-β-lactamase has been the most common mechanism of carbapenem resistance identified in P. aeruginosa isolated from Brazilian medical centers. Interestingly, a single SPM-1-producing P. aeruginosa clone belonging to the ST277 has been widely spread within the Brazilian territory. In the current study, we performed a next-generation sequencing of six SPM-1-producing P. aeruginosa ST277 isolates. The core genome contains 5899 coding genes relative to the reference strain P. aeruginosa PAO1. A total of 26 genomic islands were detected in these isolates. We identified remarkable elements inside these genomic islands, such as copies of the blaSPM−1 gene conferring resistance to carbapenems and a type I-C CRISPR-Cas system, which is involved in protection of the chromosome against foreign DNA. In addition, we identified single nucleotide polymorphisms causing amino acid changes in antimicrobial resistance and virulence-related genes. Together, these factors could contribute to the marked resistance and persistence of the SPM-1-producing P. aeruginosa ST277 clone. A comparison of the SPM-1-producing P. aeruginosa ST277 genomes showed that their core genome has a high level nucleotide similarity and synteny conservation. The variability observed was mainly due to acquisition of genomic islands carrying several antibiotic resistance genes.

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Section: Discussionmentioning

confidence: 99%

Intraclonal Genome Stability of the Metallo-β-lactamase SPM-1-producing Pseudomonas aeruginosa ST277, an Endemic Clone Disseminated in Brazilian Hospitals

et al. 2016

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“…A high proportion of these species of bacteria are known to show intrinsic or acquired resistance to many antimicrobial drugs, including those commonly used in initial treatment protocols for foals with sepsis. [24][25][26][27][28][29] These bacterial species were responsible for a large proportion of the HAIs in a large study in humans: Enterococcus spp., 13.9%; Klebsiella spp., 8%; Pseudomonas spp., 7.5%; Serratia spp., 2.1%; and Acinetobacter spp., 1.8%. 30 In equine medicine, there also are several reports on the role of these bacteria in HAIs.…”

Section: Isolation Frequencymentioning

confidence: 99%

Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization

Theelen

Wilson

Byrne

et al. 2020

Veterinary Internal Medicne

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Background Antimicrobial treatment protocols for foals with sepsis that do not improve clinically often are adjusted based on bacteriological and antimicrobial susceptibility testing results from samples collected at hospital admission. Objectives To evaluate whether hospitalization for ≥48 hours affects bacteriological and antimicrobial susceptibility testing results. Animals Two‐hundred sixty‐seven foals <30 days of age admitted to a neonatal intensive care unit and diagnosed with sepsis. Methods Medical records were reviewed retrospectively to identify foals with sepsis and positive bacteriological cultures. Results from samples collected at hospital admission were compared to those collected ≥48 hours after admission. Logistic regression for clustered data and exact logistic regression were used for statistical analysis. Results Three‐hundred fifty‐three unique bacterial isolates were obtained from 231 foals at hospital admission and 92 unique bacterial isolates were obtained from 57 foals after ≥48 hours of hospitalization. Relative isolation frequency after ≥48 hours of hospitalization increased for Acinetobacter spp., 0.6% versus 3.3% (odds ratio [OR], 7.63; 95% confidence interval [CI], 1.28‐45.45); Enterococcus spp., 4.8% versus 19.6% (OR, 5.37; 95% CI, 2.64‐10.90); Klebsiella spp., 5.1% versus 10.9% (OR, 2.27; 95% CI, 1.05‐4.89); Pseudomonas spp., 3.0% versus 7.6% (OR, 3.49; 95% CI, 3.49‐240.50); and Serratia spp., 3.0% versus 5.4% (OR, 20.23; 95% CI, 2.20‐186.14). Bacteria isolated after ≥48 hours of hospitalization were less susceptible to all tested antimicrobial drugs, except for imipenem. Conclusions and Clinical Importance Decreased antimicrobial susceptibility of bacteria isolated after ≥48 hours of hospitalization provides a rationale for repeated bacteriological culture and susceptibility testing in hospitalized foals with sepsis.

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“…Both substances interact with fatty acids and phosphates of lipopolysaccharide (LPS) core and lipid A moieties in the outer membrane of Gram-negative bacteria, which leads to cell lysis and death (6). The worldwide rise in infections caused by XDR P. aeruginosa (7) and other Gram-negative bacteria has given polymyxins the status of a last-resort treatment option despite their considerable neuro-and nephrotoxicity (8). Resistance to colistin has been found to be caused by the phosphoethanolamine transferase enzyme MCR-1, the gene for which is located on mobile genetic elements (9,10).…”

mentioning

confidence: 99%

Rapid and Consistent Evolution of Colistin Resistance in Extensively Drug-Resistant Pseudomonas aeruginosa during Morbidostat Culture

Dößelmann

Willmann

Steglich³

et al. 2017

Antimicrob Agents Chemother

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Colistin is a last-resort antibiotic commonly used against multidrug-resistant strains of Pseudomonas aeruginosa. To investigate the potential for in situ evolution of resistance against colistin and to map the molecular targets of colistin resistance, we exposed two P. aeruginosa isolates to colistin using a continuous-culture device known as a morbidostat. As a result, colistin resistance reproducibly increased 10-fold within 10 days and 100-fold within 20 days, along with highly stereotypic yet strain-specific mutation patterns. The majority of mutations hit the pmrAB two-component signaling system and genes involved in lipopolysaccharide (LPS) synthesis, including lpxC, pmrE, and migA. We tracked the frequencies of all arising mutations by whole-genome deep sequencing every 3 to 4 days to obtain a detailed picture of the dynamics of resistance evolution, including competition and displacement among multiple resistant subpopulations. In 7 out of 18 cultures, we observed mutations in mutS along with a mutator phenotype that seemed to facilitate resistance evolution.

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Prevalence and risk factors associated with colonization and infection of extensively drug-resistantPseudomonas aeruginosa: a systematic review

Cited by 84 publications

References 74 publications

Intraclonal Genome Stability of the Metallo-β-lactamase SPM-1-producing Pseudomonas aeruginosa ST277, an Endemic Clone Disseminated in Brazilian Hospitals

Intraclonal Genome Stability of the Metallo-β-lactamase SPM-1-producing Pseudomonas aeruginosa ST277, an Endemic Clone Disseminated in Brazilian Hospitals

Differences in isolation rate and antimicrobial susceptibility of bacteria isolated from foals with sepsis at admission and after ≥48 hours of hospitalization

Rapid and Consistent Evolution of Colistin Resistance in Extensively Drug-Resistant Pseudomonas aeruginosa during Morbidostat Culture

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