Relationship between Virulence and Resistance among Gram-Negative Bacteria

Cepas, Virginio; Soto, Sara M.

doi:10.3390/antibiotics9100719

Cited by 69 publications

(53 citation statements)

References 71 publications

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“…Enhanced virulence or AMR frequently has been reported to have a fitness cost on bacteria but their relationship changes according to different bacterial species, the resistance and virulence genes involved and the host's immune system [42,43]. Some antibiotics, such as ceftazidime, cefotaxime and quinolones, have been reported to enhance the increase of the deletion and transposition of DNA regions that are specific for VFs [42]. By contrast, a positive correlation has been shown between AMR and virulence with the use of other antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales

et al. 2021

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Mortality in neonates with Gram-negative bloodstream infections has remained unacceptably high. Very few data are available on the impact of resistance profiles, virulence factors, appropriateness of empirical treatment and clinical characteristics on patients’ mortality. A survival analysis to investigate 28-day mortality probability and predictors was performed including (I) infants <90 days (II) with an available Enterobacterales blood isolate with (III) clinical, treatment and 28-day outcome data. Eighty-seven patients were included. Overall, 299 virulence genes were identified among all the pathogens. Escherichia coli had significantly more virulence genes identified compared with other species. A strong positive correlation between the number of resistance and virulence genes carried by each isolate was found. The cumulative probability of death obtained by the Kaplan-Meier survival analysis was 19.5%. In the descriptive analysis, early age at onset, gestational age at onset, culture positive for E. coli and number of classes of virulence genes carried by each isolate were significantly associated with mortality. By Cox multivariate regression, none of the investigated variables was significant. This pilot study has demonstrated the feasibility of investigating the association between neonatal sepsis mortality and the causative Enterobacterales isolates virulome. This relationship needs further exploration in larger studies, ideally including host immunopathological response, in order to develop a tailor-made therapeutic strategy.

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Section: Discussionmentioning

confidence: 99%

Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales

et al. 2021

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“…NF-GNB presents both a high antimicrobial resistance rate and high production of virulence factors, such as biofilms, as confirmed in the present series, which potentially could explain the low observed resolution rate. In addition, important virulence factors are present in NF-GNB, particularly Pseudomonas species, which induce bacterial adhesion, destruction of cell membranes, and inhibition of the macrophage response, in addition to other actions 16 – 19 , 27 , 28 .…”

Section: Discussionmentioning

confidence: 99%

“…are the most isolated NF-GNB and of greatest clinical importance. Pseudomonas species virulence factors enable them to invade tissues, proliferate rapidly, generate biofilms, quickly develop antibiotic resistance and provide those species with great motility 16 – 19 . Acinetobacter species have been an increasing concern in PD due to their alarming rate of antibiotic resistance development; in particular, the Acinetobacter baumannii complex 13 can form biofilms and colonize catheters 22 .…”

Section: Introductionmentioning

confidence: 99%

Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis

Santos

Hernandes

Montelli

et al. 2021

Sci Rep

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Peritonitis due to gram-negative bacilli (GNB), particularly nonfermenting GNB (NF-GNB), is a serious complication of peritoneal dialysis with a low resolution rate. Beyond the patient’s condition, microbiological properties such as antimicrobial resistance, biofilm production and other virulence factors can explain the poor outcomes. This study aimed to evaluate the influence of patient condition, microbiological characteristics, including biofilm production, and treatment on peritonitis outcome. We reviewed the records of 62 index episodes caused by NF-GNB that occurred between 1997 and 2015 in our center. The etiologies were species of Pseudomonas (51.6%), Acinetobacter (32.2%), and other NF-GNB (16.1%). There was a high (72.9%) proportion of biofilm producer lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low resolution rate (< 45%) among the episodes attributable to them. Preexisting exit-site infection was independently associated with nonresolution. No other factor, including biofilm production, was associated with the outcome. The higher in vitro susceptibility of Pseudomonas compared to other NF-GNB that presented a similar resolution rate suggests that bacterial virulence factors such as biofilms can act in concert, thereby worsening the outcome.

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“…Considering the daily isolated gram-positive bacteria may have relatively low virulence, we further tested a highly virulent mucoid serotype 3 S. pneumoniae strain and a hypervirulent S. agalactiae strain isolated earlier, of which we had to reduce the bacteria number to 2.25×10 5 CFU and 1.5×10 7 CFU respectively to keep the inoculated mice live to 24 h endpoint. However, no visible alveolar damage occurred either in both groups after treatment, even though 50% mice died within 24 hours or developed seizure, sepsis and multiple organ infection (Figure S1B).…”

Section: Gram-positive Bacteria Lung Infectionmentioning

confidence: 99%

“…Microorganisms like bacteria or virus, evolves rapidly in response to environment for better adaption and survival [4–6]. Compared to the type strains or standard strains preserved and studied in lab for decades, clinical isolates nowadays are exhibiting significant differences in phenotype, drug resistance and invasiveness[7–9]. However, virulence of this “new generation” of bacteria in causing lung injury have not been comparatively explored.…”

Section: Introductionmentioning

confidence: 99%

Clinical Strains of Pseudomonas aeruginosa secret LasB protease to induce hemorrhagic diffused alveolar damage and acute lung injury in mice

Zhu

Xie

et al. 2021

Preprint

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Background: Acute lung injury and acute respiratory distress syndrome are most often caused by bacterial pneumonia, characterized by severe dyspnea and high mortality. Knowledge about the lung injury effects of current clinical bacteria strains is lacking. The aim of this study was to investigate the ability of representative pathogenic bacteria isolated from patients to cause ALI/ARDS in mice and identify the virulent factors. Method: 7 major bacteria species were isolated from clinical sputum and instilled in to mice airway unilaterally. Histology study was used to judge the lung injury effect. Virulence genes were examined by PCR. Sequence type of P. aeruginosa strains were identified by MLST. LC-MS/MS was used to identify the suspicious protein bands. LasB was purified through DEAE-cellulose column and its toxicity was tested both in vitro and in vivo. Results: Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus agalactiae, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli were randomly separated and tested 3 times. Among them, gram-negative bacteria are more potential than gram-positive bacteria to cause acute lung injury. However, P. aeruginosa is the only pathogen which induced diffused alveolar damage, hemorrhage and hyaline membrane in the lung of mice. The lung injury effect is associated to the excreted matrix metalloproteinase LasB of P. aeruginosa. Purified LasB recapitulated hemorrhagic acute lung injury identical to P. aeruginosa infection in vivo. We found this was due to the powerful degradation effect of LasB on both lung extracellular matrix and key proteins in coagulation cascade without inducing cellular apoptosis. Conclusion: P. aeruginosa strains are most capable to induce ALI/ARDS among major clinical pathogenic bacteria, this ability is specifically attributed to their LasB production.

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Relationship between Virulence and Resistance among Gram-Negative Bacteria

Cited by 69 publications

References 71 publications

Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales

Antibiotic Susceptibility, Virulome, and Clinical Outcomes in European Infants with Bloodstream Infections Caused by Enterobacterales

Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis

Clinical Strains of Pseudomonas aeruginosa secret LasB protease to induce hemorrhagic diffused alveolar damage and acute lung injury in mice

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