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Hypervirulence-associated pseudo-compound transposons as fundamental mobile units driving cross-species virulence dissemination in Enterobacteriaceae.

BACKGROUND: The rapid global spread of hypervirulence in Enterobacteriaceae, particularly in carbapenem-resistant Klebsiella pneumoniae, poses a significant public health threat. However, the key genetic vehicles and mechanisms driving horizontal transfer of hypervirulence-associated genes (iucA, iroB, rmpA, rmpA2, and peg-344) remain poorly defined, limiting effective surveillance. METHODS: We performed a large-scale genomic survey of 2,869 virulence-associated plasmid sequences and 2,337 complete Enterobacteriaceae chromosomes. Using comparative genomics and evolutionary analyses, we system…

S-ketamine alleviates morphine-induced hyperalgesia via decreasing the gut Enterobacteriaceae levels: Comparison with R-ketamine.

BACKGROUND: Opioid-induced hyperalgesia (OIH) is a serious complication during the pain treatment. Ketamine has been commonly reported to tr … suggested that the distribution of gut microbiota differed among the groups. Importantly, levels of Enterobacteriaceae were increased in OIH susceptible group, while decreased after S-ketamine treatment. CONCLUSION: S-ketamine but not R-ketamine was able to alleviate morphine-induced OIH, and this mechanism is probably related to decreasing the levels of gut Entero …

Optimizing Antibiotic Treatment Duration for ESBL-Producing Enterobacteriaceae Bacteremia in ICU: A Multicentric Retrospective Cohort Study.

BACKGROUND: The optimal duration of antibiotic treatment for extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) bloodstream infections (BSI) in intensive care unit (ICU) is not established. We aim to evaluate the frequency and clinical outcomesof a short appropriate antibiotic treatment (≤7 days) (SAT) for ESBL-E BSI acquired in the ICU. We specifically assessed the rate of ESBL-E BSI relapse, and in-ICU mortality. METHOD: All patients who acquired ESBL-E BSI in three ICU in Northern France between January 2011 and June 2022 were included in a multicenter retrospective cohort…

Unravelling mutation patterns in Extended-Spectrum β-Lactamases for precision drug design against AMR in Enterobacteriaceae.

Antimicrobial resistance (AMR) presents a critical global challenge, causing over 1.27 million deaths annually, with projections reaching 10 million by 2050. Among the most concerning contributors are Enterobacteriaceae, particularly Escherichia coli and Klebsiella pneumoniae, which harbour Extended-Spectrum β-Lactamase (ESBL) genes-enzymes that hydrolyse β-lactam antibiotics and confer resistance-such as bla-CTX-M, bla-SHV, and bla-TEM. These genes confer resistance to β-lactam antibiotics, including penicillins and cephalosporins, limiting treatment options for urinary tract infections, bloo…

Clonal transmission and species-specific mechanisms of polymyxin resistance in carbapenem-resistant Enterobacteriaceae from Southwest China.

OBJECTIVES: The rapid dissemination of carbapenem-resistant Enterobacteriaceae (CRE) poses a severe global health threat due to limited treatment options. Polymyxin is currently considered a last-resort therapy for human infections caused by CRE. The increasing clinical use of polymyxin has resulted in alarming resistance rates. This study investigated the clinical characteristics, molecular epidemiological characteristics, and resistance mechanisms of polymyxin-resistant CRE (PR-CRE) in Chongqing, China. METHODS: Antimicrobial susceptibility and resistance genes were analyzed by PCR-based am…

From Screening to Strategy: Targeted Carbapenem-Resistant Enterobacteriaceae (CRE) Infection Prediction After Endoscopic Retrograde Cholangiopancreatography (ERCP).

BACKGROUND: Invariably, patients can be exposed to Carbapenem-resistant Enterobacteriaceae (CRE) through contaminated device during Endoscopic retrograde cholangiopancreatography (ERCP). We aimed to identify the risk factors and establish a model for predicting subsequent CRE infections in patients with CRE-positive bile screening after ERCP. METHODS: Patients underwent ERCP were performed with bile active screening of CRE. Medical records were reviewed to identify patient demographics, comorbidities, microbiology and antimicrobial treatments. The results were grouped according to the occurre…

Investigating a propagation of emerging carbapenemase-producing Enterobacteriaceae in Dutch broiler production pyramid through stochastic simulation.

Simulating resistant bacteria transmission in livestock informs surveillance strategies for emerging threats like Carbapenem-resistant Enterobacteriaceae (CPE), aiding targeted surveillance and detecting CPE through active methods. We employed a simulation model to assess three potential scenarios for introducing CPE: 1) a single import of live animals, 2) the use of contaminated feed, and 3) multiple imports of live animals. Employing the SimInf package, we constructed a population model for broiler production, encompassing rearing farms, multiplier farms, hatcheries, and broiler farms. Subse…

Carbapenem Versus Non-carbapenem Therapy in Hematology Patients: Extended-Spectrum Beta-Lactamase Positive Enterobacteriaceae Colonization Impact.

BackgroundExtended-spectrum beta-lactamase-producing Enterobacteriacea (ESBL-E) infections are a major source of mortality and morbidity in patients with hematologic cancers. One of the most significant risk factors for bacterial illness is prior colonization with resistant germs. Empiric usage of carbapenems is recommended for the treatment of infections in patients with a positive colonization history.ObjectivesWe aimed to determine the outcome of empirical carbapenem (de-escalation) versus non-carbapenem (escalation) therapy in adult hematology patients who have rectal extended-spectrum bet

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… Introduction Infections due to extended-spectrum beta-lactamase-producing Enterobacteriacea (ESBL-E) are an important cause of mortality and morbidity in patients with hematologic cancer. … Table 4 Outcome of prospective infections due to extended spectrum beta-lactamase producing Enterobacteriaceae in case and control groups M: male, F: female, ESBL-E: extended-spectrum beta-lactamase-producing Enterobacteriaceae , NHL: non-Hodgkin Lymphoma, ALL: acute lymphoblastic leukemia, AML: acute …

Isolation and Characterization of Multidrug-resistant Enterobacteriaceae from Kitchen Sponges: An Under-recognized Public Health Problem.

BACKGROUND: The domestic kitchen is increasingly being recognized as one of the most important areas with regards to the incidences of foodborne diseases. Kitchen sponges may play a role in foodborne illnesses through cross-contamination as they provide a suitable environment for bacterial pathogen growth and transmission. OBJECTIVES: This study was designed to isolate, characterize, and determine the antibiogram of Enterobacteriaceae contaminating household kitchen sponges in Abakaliki metropolis, Nigeria. MATERIALS AND METHODS: A total of 50 household kitchen sponges were randomly collecte…

Study of Plasmid-Mediated Extended-Spectrum Beta-Lactamase-Producing Clinical Strains of Enterobacteriaceae From Tabuk Region.

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae threaten infection treatment globally. This study aims to assess ESBLs-E prevalence and multidrug-resistant organisms (MDR) in clinical specimens from Tabuk, KSA. METHODS: A cross-sectional research was carried out in March-May 2023. A collective of 90 Enterobacteriaceae isolates were identified from clinical specimens. The specimen was identified by standard methods. The Enterobacteriaceae member was screed for ESBL production by screening and confirmatory as per the Clinical and Laboratory Standards Institute (…

Extended-spectrum β-lactamase-producing Enterobacteriaceae from ready-to-eat foods: Genetic diversity and antibiotic susceptibility.

Ready-to-eat (RTE) foods are widely marketed in China and are important components of everyday diet. In this study, a total of 2000 RTE food samples were analyzed, 252 (12.60%) of which were positive for Enterobacteriaceae, and 48 were identified as containing extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolates. Furthermore, the antimicrobial resistance patterns of these isolates to 14 antimicrobial agents revealed that most isolates were resistant to aminoglycosides and β-lactam antibiotics. The TEM-type gene was prevalent in our isolates (79.17%). The isolates (n = 48) w…

Enterobacteriaceae and Bacteroidaceae provide resistance to travel-associated intestinal colonization by multi-drug resistant Escherichia coli.

Previous studies have shown high acquisition risks of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) among international travelers visiting antimicrobial resistance (AMR) hotspots. Although antibiotic use and travelers' diarrhea have shown to influence the ESBL-E acquisition risk, it remains largely unknown whether successful colonization of ESBL-E during travel is associated with the composition, functional capacity and resilience of the traveler's microbiome. The microbiome of pre- and post-travel fecal samples from 190 international travelers visiting Africa or Asia …

Epidemiology of extended-spectrum beta-lactamase producing Enterobacteriaceae in Qatar: A 3-year hospital-based study.

BACKGROUND: The incidence of ESBL infections is exponentially increasing with variable prevalence among geographical areas and treatment settings. Identifying local prevalence rate and patient-related factors will help in earlier recognition and initiation of appropriate antibiotics treatment of patients with ESBL infections. METHODS: Retrospective analysis of all positive cultures for ESBL producing Enterobacteriaceae collected in Al-Khor hospital from January 2010 to December 2012. ESBL bacterial isolates reported as cephalosporin-resistant or ESBL using the automated VITEK Gram-Negative Su…

Mortality-Related Risk Factors and Novel Antimicrobial Regimens for Carbapenem-Resistant Enterobacteriaceae Infections: A Systematic Review.

OBJECTIVE: Carbapenem-resistant Enterobacteriaceae (CRE) has become a significant public health problem in the last decade. We aimed to explore the risk factors of mortality in patients with CRE infections and to focus on the current evidence on antimicrobial regimens for CRE infections, particularly from the perspective of mortality. METHODS: A systematic literature review was performed by searching the databases of EMBASE, PubMed, and the Cochrane Library to identify studies that evaluated mortality-related risk factors and antimicrobial regimens for CRE infections published from 2012 to 20…

Characterization of Oral Enterobacteriaceae Prevalence and Resistance Profile in Chronic Kidney Disease Patients Undergoing Peritoneal Dialysis.

Chronic Kidney Disease (CKD) is a growing public-health concern worldwide. Patients exhibit compromised immunity and are more prone to infection than other populations. Therefore, oral colonization by clinically relevant members of the Enterobacteriaceae family, major agents of both nosocomial and dialysis-associated infections with frequent prevalence of antibiotic resistances, may constitute a serious risk. Thus, this study aimed to assess the occurrence of clinically relevant enterobacteria and their antibiotic resistance profiles in the oral cavity of CKD patients undergoing peritoneal dia…

Tigecycline Therapy for Infections Caused by Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Critically Ill Patients.

: We aimed to evaluate tigecycline on the clinical effectiveness in treating complicated skin and soft tissue infections (cSSTI), complicated intra-abdominal infections (cIAI), and pneumonia, caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, as data are limited. From three medical centers in Taiwan, we retrospectively studied the cSSTI, cIAI, and/or pneumonia caused by ESBL-producing Enterobacteriaceae. Among the 71 patients, including 39 patients infected with Klebsiella pneumoniae, 30 infected with Escherichia coli and others, the clinical success rate of tigecycli…

Diverse aminoglycoside phosphotransferase types conferring aminoglycoside resistance in Enterobacteriaceae: A single-centre study from Northeast India.

The present study investigates the molecular basis of aph-mediated aminoglycoside resistance and their transmission dynamics in a tertiary care hospital of Northeast India. Two hundred forty one isolates (230 Escherichia coli and 11 Klebsiella pneumoniae) were collected and screened for aminoglycoside resistance genes. Various aph types were amplified using polymerase chain reaction (PCR) assay. Plasmid incompatibilty, horizontal transferability and ERIC-PCR based typing were carried out for all the positive isolates. Among them, 67 isolates showed the presence of aph gene. Aph (3")-IIIa and a

High admission prevalence of fluoroquinolone resistance in third-generation cephalosporin-resistant Enterobacteriaceae in German university hospitals.

OBJECTIVES: Fluoroquinolone resistance (FQR) in third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE) presents serious limitations to antibiotic therapy. The aim of this study was to investigate whether the FQR proportion among 3GCRE differs between community-acquired (CA) and hospital-acquired (HA) isolates. METHODS: In a prospective observational study covering 2014 and 2015, we monitored the occurrence of 3GCRE in adult hospitalized patients in six German university hospitals. 3GCRE clinical isolates were subdivided into CA and HA. Multivariable analysis identified factors as…

Epidemiology, Antimicrobial Resistance, and Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae in Clinical Bovine Mastitis in Tunisia.

Bovine mastitis is a major disease in dairy cattle that causes high economic losses annually. Staphylococci, streptococci, and coliforms are among the major pathogens responsible for such infections. While data on bovine mastitis are numerous in Europe where the efficacy of farm management was monitored, those are scarce in African countries. In this study, we reported the occurrence of Escherichia coli (118/372, 31.7%) and Klebsiella pneumoniae (77/372, 20.7%), two environmental pathogens known to cause bovine mastitis. Resistance phenotypes were frequently identified for tetracycline (E. col