Journal of Global Antimicrobial Resistance

Epidemiology and Resistance Profiles of Bacteria Isolated from Blood Samples in Septic Patients at Emergency Department Admission: A 6-year Single Center Retrospective Analysis from Northern Italy
Cento V, Carloni S, Sarti R, Bussini L, Asif Z, Morelli P, De Fazio F, Tordato FM, Casana M, Mondatore D, Desai A, Generali E, Pugliese N, Costantini E, Vanoni M, Cecconi M, Aliberti S, Da Rin G, Casari E, Bartoletti M and Voza A
This study aimed to investigate the microbiological and clinical heterogeneity of community-onset bloodstream infections (BSIs) and identify features to support targeted empirical antibiotic therapy in the Emergency Department (ED).
Detection of I491F and V170F rpoB Mutations Associated with Misdiagnosis of Rifampicin Resistance Among Patients with Drug-susceptible Tuberculosis Treatment Failure, Myanmar, 2022
Ei PW, Htwe MM, Nyunt MH, Mon AS, Myint Z, Nyunt WW, Win SM, Aung S, Thwe WM and Aung WW
Detecting rifampicin resistance is crucial in selecting tuberculosis (TB) treatment. Recently, several studies reported that I491F and V170F rpoB mutations, previously designated as borderline rifampicin-resistance mutations, were found with a varying prevalence. Sputum specimens from first-line tuberculosis treatment failed patients attending Tuberculosis Centers in Yangon Region during 2022 were cultured in solid media. Phenotypic drug susceptibility testing (pDST) was conducted using Mycobacterial Growth Indicator Tube (MGIT) method. Whole genome or Deeplex targeted next-generation sequencing was performed using Illumina Miseq. Mutation analysis was done by PhyResSE and SAM-TB online platforms. A total of 32 culture-positive isolates with DNA qualified for genome sequencing were included in the study. Those were diagnosed as rifampicin-susceptible by routine GeneXpert and line probe assays. Rifampicin resistance conferring mutations were found in 17/32 (53.1%) M. tuberculosis isolates; 14 (43.7%) had mutations outside the RRDR (I491F and V170F), two (6.3%) were S450L, mutation within RRDR, and one isolate (3.1%) with interim resistance mutations S428T and S441A. This study highlighted the presence of rifampicin-resistant tuberculosis strains missed by current diagnostic strategies, and are circulating as treatment-failed patients. This demonstrates a gap in current WHO-endorsed algorithms for capturing all MDR-TB strains.
Reliability of various Antimicrobial Susceptibility Testing Methods for Piperacillin/tazobactam in challenging Escherichia coli isolates
Demirocak F, Langerak D and Yusuf E
Piperacillin/tazobactam antimicrobial susceptibility testing (AST) against Enterobacterales can be challenging. The aim of this study was to assess the reproducibility of various automated (Vitek®2) and non-automated AST methods (broth microdilution (BMD), minimum inhibitory concentration (MIC) test strip, and disk diffusion) for piperacillin/tazobactam in 'challenging' E. coli isolates. We performed 20 repeated AST for seven clinical E. coli isolates: two resistant to piperacillin/ tazobactam but susceptible for amoxicillin/ clavulanic acid, four isolates with various beta-lactamases coding genes (two bla, one bla, and one with plasmidal bla), and one isolate where VITEK® 2 initially could not produce MIC measurement for piperacillin/ tazobactam (i.e. no results generated). Upon repetition, the same MIC as the mode value (i.e. the most frequent MIC value of each AST method) was found between 21% to 87% (BMD), 46% to 100% (VITEK®2), and 48% to 100 % (gradient test) of the repetitions. The range of percentage essential agreement (EA, i.e. ±1 doubling dilution from this mode value) was 53% to 100% (BMD), 63% to 100% (VITEK®2), and 100% (gradient test). Percentage categorical agreement (CA, same susceptible of resistant category using EUCAST breakpoint v 14.0) ranged from 71% to 100% (BMD), 85% to 92% (VITEK®2), 76% to 100% (gradient test) and 100% (disk diffusion). In conclusion, this study provides insights into the reliability of AST results for piperacillin/ tazobactam in challenging E. coli isolates. While the results indicate that most methods are generally reproducible, certain isolates may present inconsistent MIC results.
Outbreak of carbapenem resistant Klebsiella pneumoniae in a neurorehabilitation unit: genomic epidemiology reveals complex transmission pattern in a tertiary care hospital
Silvotti MG, Scaltriti E, Bolzoni L, Zerbi B, Tocci G, Zappavigna A, Lamberti G, Donati F, Federici F, Pongolini S and Cascio GL
Infections by Carbapenem-Resistant Enterobacterales in hospitals represent a severe threat but little is known on outbreaks in rehabilitation wards caused by Klebsiella pneumoniae producing Klebsiella pneumoniae Carbapenemase (KPC-Kp). We report an outbreak by KPC-Kp, in a Neurorehabilitation Unit in Italy, analysed through Whole-Genome Sequencing (WGS) for transmission routes reconstruction to improve management of KPC-Kp infections in rehabilitation units.
Drug-resistant tuberculosis is an important challenge in long COVID patients
Mohammadi M and Faghihi SH
Unveiling results and insights from multinational, multicenter Study of Prescribing patterns and Effectiveness of Ceftolozane/Tazobactam Real-world Analysis (SPECTRA)
Soriano A, Paterson DL, Thalhammer F, Kluge S, Viale P, Watanabe AH, Allen M, Akrich B, Wirbel S, Obi EN, Yücel E and Kaul S
Antibacterial-resistant gram-negative hospital-acquired infections result in significant morbidity and mortality. In clinical trials, ceftolozane/tazobactam (C/T) has been effective against these infections; however, real-world findings are limited.
Antimicrobial susceptibility and epidemiological types of Legionella pneumophila human isolates from Italy (1987-2020)
Scaturro M, Lanni A, Mancini F, Girolamo A, Fillo S, Ciammaruconi A, Lista F, Cocuzza CE, Musumeci R, Ginevra C, Descours G, Jarraud S, Iera J, Visca P and Ricci ML
Although antimicrobial resistance has not yet emerged as an overarching problem for Legionella pneumophila (Lp) infection, the description of clinical and environmental strains resistant to fluoroquinolones and macrolides is a cause of concern. This study aimed to investigate the antimicrobial susceptibility of Lp human isolates in Italy.
Co-existence of two bla and bla on distinct plasmids in a carbapenem-resistant Klebsiella pneumoniae from a tertiary hospital, Tanzania
Mapunda L, Mwingwa A, Kamori D, Kumburu H, van Zwetselaar M, Blomberg B and Manyahi J
To understand the mechanisms of carbapenem-resistant Klebsiella pneumoniae (CRKP) from Tanzania and characterize the genomes carrying the carbapenemase genes.
Mechanisms of bla dissemination across diverse carbapenem resistant clinical isolates
Fu Y, Morris FC, Pereira SC, Kostoulias X, Jiang Y, Vidor C, Williams G, Srikhanta Y, Macesic N, Yu Y, Lyras D and Peleg AY
The IMP-4 carbapenemase is an endemic cause of carbapenem resistance in the Asia-Pacific region. Our aim was to determine the dissemination mechanism of the bla gene.
Genomic insights into a multidrug-resistant Pandoraea apista clinical isolate carrying bla from China
Li L, Zhang Y, He F and Wu N
Pandoraea apista is notable for its multidrug resistance and is frequently identified in patients with cystic fibrosis or other chronic lung diseases, where it contributes to persistent lung infections. In this study, we describe a strain of P. apista harboring the bla, isolated from the bronchoalveolar lavage (BAL) fluid of an inpatient in China.
Fatal septicemia caused by Francisella philomiragia in an immunocompetent patient
Yun J, Hong KW and Byun JH
Clinical and molecular characteristics of KPC-producing Klebsiella pneumoniae bloodstream infections: results of a multicentre study
Brescini L, D'Achille G, Papalini C, Pallotta F, Teodori L, Pietrella D, Mencacci A, Canovari B, Pieretti B, Mingoia M, Montalti R, Morroni G, Pasticci MB and Barchiesi F
KPC-producing Klebsiella pneumoniae (KPC-Kp) is a great cause of concern and it is often associated with bloodstream infections (BSIs) and a high mortality rate. We identified the risk factors of KPC-Kp BSIs observed in three Italian hospitals and studied the epidemiology of KPC-Kp strains.
Transmitted HIV-1 Drug Resistance in Estonian Residents and Ukrainian Refugees in 2020 and 2022
Šablinskaja A, Soeorg H, Pauskar M, Jõgeda EL, Rajasaar H, Soodla P, Kallas E, Hensen K, Tabri J, Rüütel K, Päll T, Lutsar I, Huik K and Avi R
We investigated the prevalence of drug resistance mutations (DRMs) in individuals newly diagnosed with HIV-1 in Estonia in 2020 and 2022, and in Ukrainian war refugees living with HIV who arrived in Estonia in 2022.
Corrigendum to "Simultaneous post-neurosurgical ventriculitis and bacteraemia by two different strains of KPC-producing K. pneumoniae successfully treated with meropenem/vaborbactam and high dose of Fosfomycin" [Journal of Global Antimicrobial Resistance 37 (2024) 86-90]
Volpicelli L, Cairoli S, Al Ismail D, Baisi F, Sacco F, Goffredo BM, Venditti M and Oliva A
ISAC News and Updates
No genetic link between E. coli isolates carrying mcr-1 in bovines and humans in France
Haenni M, Châtre P, Beyrouthy R, Drapeau A, François P, Madec JY and Bonnet R
Colistin is a last-line antibiotic used to treat severe human infections caused by carbapenemase-producing Gram-negative bacteria. In parallel, colistin has massively been used in the veterinary field so that mcr-1-positive E. coli have spread worldwide in livestock, potentially constituting a reservoir of colistin-resistant isolates that can be further transmitted to humans.
Impact of meropenem exposure on fluoroquinolone and carbapenem resistance in Pseudomonas aeruginosa infection in inpatients in a Japanese university hospital: Insights into oprD mutations and efflux pump overexpression
Yamochi T, Ugajin K, On R, Inoue S, Ikeda H, Yamochi T, Takimoto M and Tokimatsu I
In Pseudomonas aeruginosa isolates, emerging meropenem resistance beyond imipenem resistance has become a problem. In this study, we aimed to investigate the relationship between the in vivo acquisition of antimicrobial resistance in fluoroquinolone- and carbapenem-resistant P. aeruginosa clinical isolates, the underlying molecular mechanisms, and exposure to antimicrobial agents.
Antimicrobial susceptibility of gram-negative bacteria: analysis from patients in a laboratory network in Brazil
Bittencourt AA, Polis TJ, Faustino VL, Batista PM, Pereira ACPR, de Paula MDN, Rocha DADC, Daher PC and Sampaio JLM
This study aimed to describe the epidemiology and antimicrobial susceptibility patterns of gram-negative pathogens in Brazil from 2018 to 2020, addressing the gap in national data on healthcare-associated infections, using information from a private laboratory network.
Isolation and characterization of Acinetobacter phage vAbaIN10 active against carbapenem-resistant Acinetobacter baumannii (CRAB) isolates from healthcare-associated infections in Dakar, Senegal
Ndiaye I, Debarbieux L, Sow O, Sambe Ba B, Diagne MM, Cissé A, Fall C, Dieye Y, Dia N, Constantin de Magny G and Seck A
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a critical antimicrobial resistance threat and a WHO-prioritized pathogen. With intrinsic resistance to multiple antibiotics and the emergence of pan-resistant isolates, CRAB infections are challenging to treat, often relying on polymyxins, tigecycline, aminoglycosides, or combinations, though co-resistance is rising globally. Phage therapy is considered as a potential treatment for multidrug-resistant A. baumannii. This study focused on isolating and characterizing phages active against CRAB strains from healthcare-associated infections in Dakar, Senegal.
Efficacy of high doses of intravenous fosfomycin for treatment of urinary tract infection caused by KPC carbapenemase-producing Klebsiella pneumoniae: An observational study
Rodríguez-Gómez J, Gracia-Ahufinger I I, Carmona-Flores R, Guzmán-Puche J, León R, Pérez-Nadales E, Muñoz de la Rosa M, Natera AM, Castón JJ, Cano Á, Pineda-Capitán JJ, López C, De la Fuente-Martos C, Torre-Cisneros J and Martínez-Martínez L
To evaluate the efficacy of high-dose intravenous fosfomycin for the treatment of urinary tract infections (UTI) caused by KPC carbapenemase-producing Klebsiella pneumoniae (KPC-Kp). A secondary objective was to evaluate the impact of the results of fosfomycin susceptibility testing on prognosis.
Clonal dissemination of methicillin-resistant Staphylococcaceae between Algerian sheep farms
Belhout C, Fernandez JE, Butaye P and Perreten V
Sheep farming represents an important economic sector in Algeria, and the potential dissemination of methicillin-resistant Staphylococcaceae (MRS) is a critical veterinary and public health concern. This study aimed to determine the prevalence and types of MRS in ovine in Algeria and characterize them using whole-genome sequencing (WGS) analysis.