Distribution Of Drug Resistance Research Articles

Whole Genome Sequence Dataset of Mycobacterium tuberculosis Strains from Patients of Campania Region

Tuberculosis (TB) is one of the deadliest infectious disorders in the world. To effectively TB manage, an essential step is to gain insight into the lineage of Mycobacterium tuberculosis (MTB) and the distribution of drug resistance. Although the Campania region is declared a cluster area for the infection, to contribute to the effort to understand TB evolution and transmission, still poorly known, we have generated a dataset of 159 genomes of MTB strains, from Campania region collected during 2018–2021, obtained from the analysis of whole genome sequence. The results show that the most frequent MTB lineage is the 4 according for 129 strains (81.11%). Regarding drug resistance, 139 strains (87.4%) were classified as multi susceptible, while the remaining 20 (12.58%) showed drug resistance. Among the drug-resistance strains, 8 were isoniazid-resistant MTB, 4 multidrug-resistant MTB, while only one was classified as pre-extensively drug-resistant MTB. This dataset expands the existing available knowledge on drug resistance and evolution of MTB, contributing to further TB-related genomics studies to improve the management of this disease.

Requiring Reconsideration of Differences of Aeromonas Infections Between Extra-Intestinal and Intestinal in Hospitalized Patients.

The purpose of this study is to examine the variations between extra-intestinal and intestinal infections of Aeromonas in terms of strain types, risk factors, drug susceptibility results, and the distribution of drug resistance and virulence genes. A total of 188 Aeromonas strains were identified to the species level using housekeeping genes (rpoD, gyrB, and gyrA). The risk factors for Aeromonas extra-intestinal and intestinal infection, as well as mortality, were retrospectively examined in this study. The broth microdilution method was used to investigate the antimicrobial susceptibility profiles. Touchdown polymerase chain reaction (PCR) assays and DNA sequencing were employed to confirm virulence and the presence of drug resistance genes. The housekeeping genes identified 188 strains into 7 species. Extra-intestinal isolates generally contained A. caviae and A. hydrophila, while intestinal were A. veronii (p=0.0001). Extra-intestinal infections (158/188) were the main type and accounted for 24/27 of all fatalities. Malignant tumors, hepatobiliary diseases, anemia, and hypoproteinemia were linked to infections. Poor results were associated with septic shock. Using the broth microdilution method, over 80% isolates were susceptible to most antimicrobials, except for ceftazidime (79.8%) and ceftriaxone (69.7%). Except for imipenem, intestinal strains were more susceptible to other medications than extra-intestinal. Using touch-down polymerase chain reaction testing and DNA sequencing, 6 strains, 31 strains, and a strain only had bla TEM, bla CphA, and bla VIM, respectively. Two Aeromonas hydrophila each possessed bla CphA+ bla CTXM-M-9, and bla CphA + bla CTX-M-1 + bla CTX-M-15-like + bla TEM; two Aeromonas caviae each possessed bla NDM + bla CTX-M-1 +bla CTX-M-15-like + bla TEM, and bla NDM + bla TEM. Thirty-four of the 42 strains mentioned above were isolated from extra-intestinal. Act, aexT, and ascF-G, were in intestinal more frequently, but alt, hlyA, ela, and lip were in extra-intestinal more frequently. Aeromonas inside and outside intestinal differed in their clinical characteristics, drug susceptibility, drug resistance and virulence genes.

Prevalence of multidrug resistant non-fermenters in a tertiary care centre

Background: Infections due to multidrug resistant organisms especially Gram-negative non-fermenting bacteria such as Acinetobacter baumannii and Pseudomonas aeruginosa are increasing, ultimately leading to shortage of clinically effective antibiotics. Indiscriminate use of antibiotics is the key factor influencing the prevalence and distribution of drug resistance in any community or nosocomial setting. Aims and Objectives: The objectives of the study are as follows: (1) To know the antibiotic susceptibility pattern of commonly isolated non-lactose fermenters. (2) To know the prevalence of multidrug resistant P. aeruginosa and A. baumannii. Materials and Methods: Clinical samples from various departments were processed using standard isolation and identification procedures. Only non-lactose fermenting colonies were processed further and only those isolates that were identified as P. aeruginosa and A. baumannii. were considered and their antibiotic susceptibility testing by disk diffusion method was carried out. Results were tabulated and analyzed. Results: Among 558 non-lactose fermenting Gram-negative bacilli isolates, P. aeruginosa (355) and A. baumannii. (203) were the most common isolates. Resistance to commonly used drugs such as aminoglycosides, cephalosporins and inhibitor combinations, and fluoroquinolones ranged from 40% to 65%. Carbapenem resistant isolates were around 24–25%. Multidrug resistant isolates and extensively drug resistant accounted for 17.4% and 9.1%, respectively. Conclusion: Increasing multidrug resistance and extensive drug resistance resistance among non-fermenters are on the rise leaving a very small window of treatment options. This is an alarming situation that needs strict antibiotic policy and a robust antimicrobial resistance management plan.

Predictive Factors of HIV-1 Drug Resistance and Its Distribution among Female Sex Workers in the Democratic Republic of the Congo (DRC).

The predictive factors of HIV-1 drug resistance and its distribution are poorly documented in female sex workers (FSWs) in the Democratic Republic of the Congo (DRC). However, the identification of predictive factors can lead to the development of improved and effective antiretroviral therapy (ART). The objective of the current study was to determine the predictive factors of HIV-1 drug resistance and its distribution based on FSWs in the studied regions in the Democratic Republic of the Congo (DRC). HIV-positive FSWs who were diagnosed as part of the DRC Integrated Biological and Behavioral Surveillance Survey (IBBS) were included in this study. A total of 325 FSWs participated. The HIV-1 viral load (VL) was measured according to the Abbott m2000sp and m2000rt protocols. The homogeneity chi-square test was conducted to determine the homogeneity of HIV-1 drug resistance distribution. Using a significance level of 0.05, multivariate analyses were performed to identify factors associated with HIV-1 drug resistance to ART. HIV drug resistance mutation (HIVDRM) distribution was homogeneous in the three study regions (p = 0.554) but differed based on the HIV-1 VLs of the FSWs. FSWs with high HIV-1 VLs harbored more HIVDRMs (p = 0.028) of predominantly pure HIV-1 strains compared with those that had low HIV-1 VLs. Sexually transmitted infection (STI) history (aOR [95%CI] = 8.51 [1.62, 44.74]), high HIV-1 VLs (aOR [95%CI] = 5.39 [1.09, 26.74]), and HIV-1–syphilis coinfection (aOR [95%CI] = 9.71 [1.84, 51.27]) were associated with HIV drug resistance among FSWs in the DRC. A history of STIs (e.g., abnormal fluid) in the 12 months prior to the survey, a high HIV-1 VL, and HIV-1–syphilis coinfection were associated with HIV-1 drug resistance among FSWs in the DRC. Efforts should be made to systematically test for other infections which increase the HIV-1 VL, in the case of HIV-1 coinfection, in order to maintain ART effectiveness across the DRC.

Antimicrobial resistance in fecal Escherichia coli isolated from poultry chicks in northern Iran

BackgroundThe use of antibiotics in food-producing animals has raised concerns about the spread of resistant bacteria. Antimicrobial resistance is achieved by horizontal gene transfer between bacteria or mobile gene elements in humans, animals and the environment.The present study was conducted to determine the prevalence and genetic diversity of antibiotic resistance in poultry-isolated E. coli in northern Iran. Materials and methodsOverall, 206 E. coli isolates were collected from the cloacal swabs of healthy Ross broiler chickens at 20–45 days of age from individual commercial broilers farms from August to December 2019. The antimicrobial susceptibility assessment was tested using disc diffusion for 20 antibiotics. PCRs were performed for investigating the respective antimicrobial resistance genes. ResultsAmong 206 fecal E. coli isolates, 89.81% were resistance to at least one antimicrobials tested, and 70.87% showed MDR phenotype. The highest resistance was related to Flumequine and Chlortetracycline. In accordance with phenotypic assay, tetA, tetB, qnrS and qnrB encoding for tetracyclines and quinolones resistance were the most predominant genes. IMP, VIM, GIM and SPM β-lactamase-encoding genes and colistin resistance-associated mcr genes were not detected in any phenotypically non susceptible isolates. ConclusionThe presence of different classes of resistance genes in poultry isolated E. coli strains suggests the importance of poultry-source E. coli in the distribution of drug resistance in humans in northern Iran.

Detection of acrA, acrB, aac(6')-Ib-cr, and qepA genes among clinical isolates of Escherichia coli and Klebsiella pneumoniae.

The distribution of drug resistance among clinical isolates of Escherichia coli and Klebsiella pneumoniae has limited the therapeutic options. The aim of this study was to report the prevalence of quinolone resistance genes among E. coli and K. pneumoniae clinical strains isolated from three educational hospitals of Tehran, Iran. A total of 100 strains of E. coli from Labbafinejad and Taleghani Hospitals and 100 strains of K. pneumoniae from Mofid Children and Taleghani Hospitals were collected between January 2013 and May 2014. Antimicrobial susceptibility tests were done by disk diffusion method based on Clinical and Laboratory Standards Institute guidelines. Detection of qepA, aac(6')-Ib-cr, acrA, and acrB genes was done by polymerase chain reaction (PCR). In this study, fosfomycin and imipenem against E. coli and fosfomycin and tigecycline against K. pneumoniae had the best effect in antimicrobial susceptibility tests. PCR assay using specific primers demonstrated that the prevalence of qepA, aac(6')-Ib-cr, acrA, and acrB genes among the 100 E. coli isolates was 0 (0%), 87 (87%), 92 (92%), and 84 (84%), respectively. The prevalence of qepA, aac(6')-Ib-cr, acrA, and acrB genes among the 100 K. pneumoniae isolates was 4 (4%), 85 (85%), 94 (94%), and 87 (87%), respectively. The distribution of qepA, aac(6')-Ib-cr, acrA, and acrB resistance determinants in E. coli and K. pneumoniae is a great concern. Therefore, infection control and prevention of spread of drug-resistant bacteria need careful management of medication and identification of resistant isolates.

Distribution of drug resistance among enterococci and Salmonella from poultry and cattle in Ethiopia

Enterococci and Salmonella were isolated from feces of chicken in intensive poultry farms and cattle which are maintained following traditional practices. Their resistance to different antibiotics was also determined. A total of 298 enterococcal isolates consisting of Enterococcus faecium (49.6%), Enterococcus durans (26.9%), Enterococcus hirea (11.9%), and Enterococcus faecalis (11.5%) were obtained. Among the enterococci, resistance to erythromycin (Ery), clindamicin (Cli), amoxicillin (Amo), ampicillin (Amp), and cephalothin (Cep) was high. Resistance to vancomycin (Van) was detected in all enterococcal species. Over 80% of the isolates showed multiple drug resistance. The most dominant patterns in poultry were Amo/Amp/Cep/Pen and Amo/Amp/Cep/Cli/Pen/Van. Among isolates from cattle, Amo/Amp/Cep/Cli/Ery/Pen/Van and Amo/Amp/Cli/Ery/Pen/Van constituted the most dominant multiple resistance patterns. A total of 51 Salmonella isolates were obtained from poultry (43/280) and cattle (8/450). About 70% of the isolates had varying resistance to the tested antibiotics. Multiple drug resistance was observed in over 30% of the Salmonella isolates. The most frequent resistance pattern was Amo/Amp/Cip/Gen/Str in cattle and Amo/Amp/Cep/Cip/Gen/Kan/Str in poultry. Enteroccoccal and Salmonella isolates showed multiple resistance to those antibiotics used in human and veterinary medicine. The high frequency of isolation of resistant enterococci is indicative of the wide dissemination of antibiotic resistant bacteria in the farm environment.

Feasibility of Detecting Human Immunodeficiency Virus Type 1 Drug Resistance in DNA Extracted from Whole Blood or Dried Blood Spots

Due to high cost, availability of human immunodeficiency virus type 1 (HIV-1) drug resistance testing in resource-poor settings is still limited. We therefore evaluated the usefulness of viral DNA extracted from either whole blood or dried blood spots (DBS). Samples were collected from 50 patients receiving therapy and 10 therapy-naïve patients. Amplification and sequencing of RNA and DNA was performed using an in-house assay. Protease (PR) and reverse transcriptase (RT) sequences of plasma viral RNA were obtained for 96.6% and 89.7%, respectively, of the 29 patients with a detectable viral load. For cellular viral DNA, useful PR and RT sequences were obtained for 96.6% and 93.1% of the whole-blood-cell samples and for 93.1% and 93.1% of the DBS samples, respectively. For the 31 patients with an undetectable viral load, PR and RT sequences were obtained for 67.7% and 61.3% of the whole-blood-cell DNA preparations and for 54.8% and 58.1% of the DBS DNA preparations, respectively. A good correlation between RNA and DNA sequences was found; most discordances were caused by the detection of mixed amino acids. Of the RT drug-resistant mutations, 13 (38.2%) were seen in RNA only, 6 (17.6%) in DNA only, and 15 (44.1%) in both. Repeated amplification and sequencing of DNA extracts revealed a lack of reproducibility for the detection of drug resistance mutations in a number of samples, indicating a possible founder effect. In conclusion, this study shows the feasibility of genotypic drug resistance testing on whole blood cells or DBS and its possible usefulness for HIV-1 subtyping or examining the overall distribution of drug resistance in a population. For individual patients, RNA sequencing was shown to be superior to DNA sequencing, especially for patients who experienced early treatment failure. The use of DNA extracted from whole blood or DBS for the detection of archived drug resistance mutations deserves further study.

Current Malaria Status and Distribution of Drug Resistance in East and Southeast Asia with Special Focus to Thailand

Malaria is the world's most important parasitic infection ranking among the major health and developmental challenges. Despite years of continual efforts, malaria is still one of the major causes of morbidity and mortality affecting third-world countries and still a threat to over 2 billion people, representing approximately 40% of the world's population in about 100 countries (Rollback Malaria 2005). During the "eradication era", half a century ago, malaria was eliminated or effectively suppressed in many parts of the world, particularly subtropical regions. The disease is now on the rise again since it is appearing in areas where it had disappeared. The disaster can largely be attributed to antimalarial drug resistance in most malaria endemic countries. Geographical distribution of the disease is worldwide, being found in tropical areas, throughout sub-Saharan Africa and to a lesser extent in South Africa, Southeast Asia, the Pacific Islands, India and Central and South America. Best estimates currently describe the annual global burden of malaria as 300-500 million cases and 1-2 million deaths. Over 90% of the disease burden is in sub-Saharan Africa. The malaria burden differs according to age and gender; almost all deaths occur in African children under 5 years of age (Snow et al. 2001). Pregnant women in Africa (especially primigravidae) are at high risk, and are the major adult risk group in the continent. An increasing number of imported cases of malaria have been reported particularly as a result of increasing worldwide travel to regions where there is ongoing risk of malaria transmission. Nowadays, cases of malaria acquired by international travelers from developed countries probably number 25,000 cases per year, with 10,000 of them reported annually and approximately 150 deaths per year.

In vitro susceptibility testing for the new ketolide antibacterial telithromycin — influence of methodologic factors

Antimicrobial susceptibility testing of common bacterial pathogens responsible for community-acquired respiratory tract infections is essential for monitoring the prevalence and distribution of drug resistance and for detecting new patterns of resistance at both the global and local levels. However, a number of factors may affect antimicrobial susceptibility testing results (including the test method used, the composition and pH of test media, the size and age of bacterial inocula, and incubation conditions), thus making comparison of data among studies problematic. This review summarizes the impacts of these factors on in vitro susceptibility test results for telithromycin, the first ketolide antibacterial agent approved for clinical use in the treatment of community-acquired respiratory tract infections.

Antibiotic surveillance of Streptococcus pneumoniae in Mississipi.

A survey of antimicrobial resistance in S. pneumoniae isolates collected from representative geographic regions of Mississippi during two different respiratory seasons was conducted to determine rates and distribution of drug resistance. A total of 318 S. pneumoniae isolates was collected from July 1999 to March 2000, and 171 isolates were collected from July 2001 to March 2002. The minimum inhibitory concentration for 12 antibiotics was determined by the micro dilution method. A total of 28 hospitals through out the state of Mississippi participated in the submission of S. pneumoniae isolates felt to be clinically relevant and reported to the attending physician. Specimens were transported to a central laboratory via state health department courier. Isolates were obtained from hospital inpatients as well as outpatients seen in local clinics. Changes in the percentage of isolates resistant to the tested antibiotics and patient demographics were collected. Pediatric isolates accounted for 36% and 28%, respectively, in 2000 and 2002. The relative percentage of total respiratory isolates remained for each year. Resistance to penicillin increased in pediatric (58% vs. 71%) and adult (40% vs. 52%) as did resistance to ceftriaxone (pediatric 14% vs. 31%; adult 9% vs. 25%) from 2000 to 2002. The majority of isolates were resistant to multiple antibiotics in both years tested. The results of this study are comparable to those from other national studies of antimicrobial resistance in S. pneumoniae demonstrating increasing resistance to multiple classes of antibiotics quantitatively and qualitatively.