Emergence Of Resistance Mechanisms Research Articles

Effects of kaolin particle film on Myzus persicae (Hemiptera: Aphididae) behaviour and performance

The emergence of resistance mechanisms to, and revocation of, many insecticides used in the control of the polyphagus aphid pest, Myzus persicae (Sulzer), has increased the pressure to develop novel approaches for the control of the pest in many crops. Kaolin-based particle films provide a physical barrier against insect pests and show considerable potential for controlling M. persicae. We conducted a series of laboratory experiments to investigate the mode of action of kaolin against aphids. The material appeared to have no direct effect on M. persicae; spraying adult aphids with aqueous kaolin suspension had no significant impact on their subsequent survival or reproduction on untreated plants. Similarly, when aphids were placed on kaolin-treated host-plants (Brassica oleracea), their performance (survival, growth rate and reproduction) was not significantly different from aphids on untreated plants. However, when M. persicae were given a choice between kaolin-treated and untreated (or water solvent-treated) leaf areas, both adults and nymphs exhibited a significant preference for non-kaolin-treated host-plant material. Rejection of kaolin-treated plant material occurred very rapidly (within 20 min) and this behavioural effect may be related to the efficacy of kaolin in controlling aphids under field conditions.

Emerging resistance mechanisms in French Pseudomonas aeruginosa

Emerging resistance mechanisms in French Pseudomonas aeruginosa

16S Ribosomal RNA Methylation: Emerging Resistance Mechanism against Aminoglycosides

Methylation of 16S ribosomal RNA (rRNA) has recently emerged as a new mechanism of resistance against aminoglycosides among gram-negative pathogens belonging to the family Enterobacteriaceae and glucose-nonfermentative microbes, including Pseudomonas aeruginosa and Acinetobacter species. This event is mediated by a newly recognized group of 16S rRNA methylases, which share modest similarity to those produced by aminoglycoside-producing actinomycetes. Their presence confers a high level of resistance to all parenterally administered aminoglycosides that are currently in clinical use. The responsible genes are mostly located on transposons within transferable plasmids, which provides them with the potential to spread horizontally and may in part explain the already worldwide distribution of this novel resistance mechanism. Some of these organisms have been found to coproduce extended-spectrum beta-lactamases or metallo-beta-lactamases, contributing to their multidrug-resistant phenotypes. A 2-tiered approach, consisting of disk diffusion tests followed by confirmation with polymerase chain reaction, is recommended for detection of 16S rRNA methylase-mediated resistance.

Extended double disc synergy testing reveals a low prevalence of extended-spectrum β-lactamases in Enterobacter spp. in Vienna, Austria

The aims of this study were to determine the prevalence of extended-spectrum beta-lactamases (ESBLs) in AmpC-carrying Enterobacter spp. in a tertiary care university hospital in Vienna, Austria, and to implement a cost-effective strategy to detect ESBLs in this particular genus on a routine basis. Clinical Enterobacter isolates (n=208) were investigated by means of (i) an inhibitor-potentiated diffusion test using cefpodoxime, (ii) an expanded double disc diffusion synergy test (discs of cefotaxime, ceftazidime, cefpodoxime and cefepime placed around amoxicillin/clavulanic acid), (iii) the Etest ESBL screening method and (iv) the cefoxitin-cefotaxime antagonist test. Cefepime MICs were determined by separate Etests. Of 208 isolates, 76 (37%), 18 (9%) and 92 (44%) were derepressed, partially derepressed and inducible AmpC producers, respectively. Eight (4%) ESBL-producing Enterobacter strains could be detected, all of which would have been detected using disc-based tests. Six out of eight strains were genetically not related, as assessed by random amplification of polymorphic DNA. Typing results were confirmed by means of enterobacterial repetitive intergenic consensus PCR. The MIC(90) of cefepime was not different in ESBL carriers (range 2-4 mg/L), and was especially low in inducible AmpC producers (0.125 mg/L). More than half of all Enterobacter isolates (n=110; 53%) were partly derepressed or fully inducible AmpC producers. In the absence of cefoxitin, they appeared susceptible or intermediately susceptible to cefazolin (n=8; 9%), cefuroxime (n=75; 81.5%), ceftazidime (n=91; 99%), cefotaxime (n=92; 100%), cefpodoxime (n=75; 81.5%) and cefepime (n=91; 99%). Susceptibility to third-generation cephalosporins would have been falsely assumed in more than half of all Enterobacter isolates, but ESBL in Enterobacter is currently rare in our institution. Integration of multiple double disc tests into the routine antibiogram seems a reliable approach to screen for emerging resistance mechanisms. Etests did not provide additional information in this study.

Antimicrobial susceptibility pattern comparisons among intensive care unit and general ward Gram-negative isolates from the Meropenem Yearly Susceptibility Test Information Collection Program (USA)

The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program is a global, longitudinal antimicrobial resistance surveillance network of greater than 100 medical centers worldwide monitoring the susceptibility of bacterial pathogens to carbapenems and other broad-spectrum agents. Between 1999 and 2002, 15 US medical centers referred up to 200 nonduplicate isolates from clinical infections to a central processing laboratory. During this 4-year period, the antimicrobial activity of 11 broad-spectrum agents was assessed against 5389 bacterial isolates using Clinical and Laboratory Standards Institute (formerly National Committee for Clinical Laboratory Standards)-recommended methods with interpretive criteria. Analysis of the MIC results for pathogens isolated from patients hospitalized in intensive care units (ICUs) were compared to results from pathogens isolated in non-ICU settings. Among Enterobacteriaceae (3884 strains), the carbapenems (imipenem and meropenem) demonstrated the highest susceptibility rates (≥98.7%) and with only a 1% increase in resistance for ICU isolates compared to non-ICU organisms. Other antimicrobial agents tested demonstrated consistently higher susceptibility rates against Enterobacteriaceae isolates from ICU (89.7–98.7%) and non-ICU (93.2–99.9%) areas. For the nonfermentative Gram-negative bacilli, the rank order of the most active agents having lowest percentage resistance rates were tobramycin (15.5%) < cefepime < imipenem < piperacillin/tazobactam < ceftazidime < meropenem (21.9%) for ICU isolates, and meropenem (7.8%) < cefepime < imipenem < piperacillin/tazobactam < ceftazidime < tobramycin (12.9%) among non-ICU strains. All tested agents showed lower susceptibility rates (range, 1.0–15.3%) and higher resistance rates (range, 0.1–15.1%) for both Enterobacteriaceae and nonfermentative Gram-negative bacilli among the ICU isolates compared to the non-ICU isolates (except for ciprofloxacin against Enterobacteriaceae). Continued surveillance of these broad-spectrum antimicrobial agents in both ICU and general hospital wards appears warranted to monitor the occurrence and spread of antimicrobial resistance in pathogens causing serious infections in these care areas and the possible emergence of resistance mechanisms that could compromise empiric carbapenem therapy.

Clonal occurrences of multidrug-resistant Gram-negative bacilli: report from the Meropenem Yearly Susceptibility Test Information Collection Surveillance Program in the United States (2004)

The Meropenem Yearly Susceptibility Test Information Collection Program is a global, longitudinal resistance surveillance network of more than 100 medical centers worldwide monitoring the susceptibility of bacterial pathogens to carbapenems and other broad-spectrum agents. Between 1999 and 2004, a total of 10–16 US medical centers referred up to 200 nonduplicate isolates from clinical infections to a central processing laboratory. Over this 6-year period, the antimicrobial activity of 12 broad-spectrum agents was assessed against 15 990 bacterial isolates using Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards) reference methods. Analysis of the MIC results by year within organism species and/or organism groups revealed a continued decrease in fluoroquinolone susceptibility (ciprofloxacin and levofloxacin), especially among indole-positive Proteae (−22.1%), Escherichia coli (−17.0%), Enterobacter species (−10.0%), and Proteus mirabilis (−7.6%) isolates. Antibiogram analysis of strains demonstrating multidrug resistance from the same institutions were further characterized by automated ribotyping and pulsed-field gel electrophoresis to determine clonality. In 2004, a total of 165 selected multidrug-resistant (MDR) strains produced 64 different ribotypes with the largest representing 31 Escherichia coli isolates from 6 medical centers. Other clusters were also identified within single medical centers among Enterobacter cloacae (6 strains), Providencia stuartii (5 strains), and Morganella morganii (4 strains). A significant clonal outbreak encompassing 40 Acinetobacter baumannii isolates from 3 centers in a single endemic region was identified in 1999 and has persisted through 2004. Continued surveillance of these broad-spectrum antimicrobial agents against MDR pathogens appears warranted to monitor the incidence and spread of resistant clones causing serious infections. Possible emergence of resistance mechanisms via clonal dissemination proves to be among the principle threats that compromise carbapenem therapy, where meropenem maintains the broadest spectrum of coverage.

Antimicrobial Activity and Spectrum Investigation of Eight Broad-Spectrum β-Lactam Drugs: A 1997 Surveillance Trial in 102 Medical Centers in the United States

Because antimicrobial agents become less effective after the emergence of resistance mechanisms in clinically prevalent pathogens, physicians must utilize local, regional, and national antimicrobial susceptibility surveillance data to assist in choices of appropriate agents. An investigation of the spectrum and potency of eight broad-spectrum β-lactam drugs (cefepime, cefotaxime, ceftazidime, ceftriaxone, imipenem, piperacillin with or without tazobactam, and ticarcillin/clavulanic acid) was performed using a common protocol and method (Etest; AB BIODISK, Solna, Sweden) in 102 clinical microbiology laboratories in the United States. A total of 9777 strains of Gram-negative bacilli were tested from late 1996 through April 1997. Quality assurance measures using three control strains observed quality control failures in 13 laboratories (usually ticarcillin/clavulanic acid or piperacillin), but only 2% of results required deletion. A total of 33.4% of Enterobacter spp. (1977 strains) were either resistant or intermediately susceptible to ceftazidime. Only imipenem (99.6% susceptible) and cefepime (99.1%) remained highly active against strains of Enterobacter, as well as Citrobacter freundii, indole-positive Proteae, and Serratia spp. Ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae were detected at rates of 10.3% and 23.8%, respectively. Although these were participant-selected strains, only imipenem and cefepime had broad-spectrum coverage (≥97.1%) against these extended-spectrum β-lactamase phenotypes. A dominant number of these extended-spectrum β-lactamase phenotypes were reported from medical centers in the Northeast, but a nationwide distribution was observed. Among the nonenteric Gram-negative bacilli (4057 strains), the rank order of susceptibility (percent inhibited at published breakpoint concentrations) was: imipenem (86.1%) > piperacillin/tazobactam (80.1%) > cefepime (77.1%) > ceftazidime = piperacillin (74.9%) > ticarcillin/clavulanic acid (61.6%) > cefotaxime (18.2%) > ceftriaxone (12.9%). The cephalosporins, cefepime and ceftazidime, had rates of resistance for the 3005 Pseudomonas aeruginosa isolates of 10.1% and 14.4%, respectively. For all Gram-negative strains tested, only two contemporary β-lactam antimicrobials exhibited >90% inhibition of strains, imipenem at 93.6% and cefepime at 90.2%. These drugs were superior to the other tested compounds (48.8–84.3%). Ticarcillin/clavulanic acid had the narrowest spectrum of activity (48.8% of isolates susceptible). These results indicate that carbapenems and a new fourth-generation cephalosporin, cefepime, possess usable in vitro potencies against current clinical strains of Gram-negative bacilli, many of which harbored resistance to other antimicrobial agents.