Antimicrobial Resistance in the Global Health Network: Known Unknowns and Challenges for Efficient Responses in the 21st Century

Microorganisms, Journal Year: 2023, Volume and Issue: 11(4), P. 1050 - 1050

Published: April 17, 2023

Antimicrobial resistance (AMR) is one of the Global Health challenges 21st century. The inclusion AMR on global map parallels scientific, technological, and organizational progress healthcare system socioeconomic changes last 100 years. Available knowledge about has mostly come from large institutions in high-income countries scattered studies across various fields, focused patient safety (infectious diseases), transmission pathways pathogen reservoirs (molecular epidemiology), extent problem at a population level (public health), their management cost (health economics), cultural issues (community psychology), events associated with historical periods (history science). However, there little dialogue between aspects that facilitate development, spread, evolution stakeholders (patients, clinicians, public health professionals, scientists, economic sectors, funding agencies). This study consists four complementary sections. first reviews factors have contributed to building current Healthcare system, scientific framework which traditionally been approached such novel approaching fourth globalization scenario. second discusses need reframe contexts. Given implementation policies guidelines are greatly influenced by information surveillance systems, third section, we review

Language: Английский

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Unseen Enemy: Mechanisms of Multidrug Antimicrobial Resistance in Gram-Negative ESKAPE Pathogens

Antibiotics, Journal Year: 2025, Volume and Issue: 14(1), P. 63 - 63

Published: Jan. 9, 2025

Multidrug antimicrobial resistance (AMR) represents a formidable challenge in the therapy of infectious diseases, triggered by particularly concerning gram-negative Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE) pathogens. Designated as "priority" 2017, these bacteria continue to pose significant threat 2024, during worldwide SARS-CoV-2 pandemic, where coinfections with ESKAPE members contributed worsened patient outcomes. The declining effectiveness current treatments against pathogens has led an increased disease burden increase mortality rates globally. This review explores sophisticated mechanisms driving AMR bacteria, focusing on Key bacterial contributing include limitations drug uptake, production antibiotic-degrading enzymes, alterations target sites, enhanced efflux systems. Comprehending pathways is vital for formulating innovative therapeutic strategies tackling ongoing posed resistant

Language: Английский

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Development and validation of a quick, automated, and reproducible ATR FT-IR spectroscopy machine-learning model for Klebsiella pneumoniae typing

Journal of Clinical Microbiology, Journal Year: 2024, Volume and Issue: 62(2)

Published: Jan. 29, 2024

The reliability of Fourier-transform infrared (FT-IR) spectroscopy for

Language: Английский

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Genomic analysis of extensively drug resistant (XDR) Klebsiella pneumoniae high-risk clone ST14 co-harboring blaNDM and blaOXA-48 recovered from Saudi Arabia

Journal of Infection and Public Health, Journal Year: 2024, Volume and Issue: 17(4), P. 669 - 675

Published: Feb. 22, 2024

This study presents a comprehensive genomic analysis of NDM and OXA-48-producing Klebsiella pneumoniae in the Western region Saudi Arabia, traversed by tens millions Muslims from various countries annually. significant influx visitors invariably leads to spread diversity MDR bacteria.

Language: Английский

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Decoding Klebsiella pneumoniae in poultry chain: unveiling genetic landscape, antibiotic resistance, and biocide tolerance in non-clinical reservoirs

Frontiers in Microbiology, Journal Year: 2024, Volume and Issue: 15

Published: April 12, 2024

The rise of antibiotic resistance in the food chain is influenced by use antimicrobial agents, such as antibiotics, metals, and biocides, throughout entire farm-to-fork continuum. Besides, non-clinical reservoirs potentially contribute to transmission critical pathogens multidrug-resistant (MDR) Klebsiella pneumoniae . However, limited knowledge exists about population structure genomic diversity K. circulating conventional poultry production. We conducted a comprehensive characterization across whole chicken production (7 farms; 14 flocks + environment meat, 56 samples; 2019–2022), exploring factors beyond like copper quaternary ammonium compounds (QACs). Clonal adaptive features were characterized through cultural, molecular (FT-IR), whole-genome-sequencing (WGS) approaches. All except one flock positive for with significant increase ( p < 0.05) from early n = 1/14) pre-slaughter 11/14) stages, most 6/7) persisting meat batches. Colistin-resistant rates low (4%- 1/24 samples), while samples carried MDR strains (67%- 16/24) copper-tolerant isolates (63%- 15/24, sil pco gene clusters; MIC CuSO4 ≥ 16 mM), particularly at pre-slaughter. Benzalkonium chloride consistently exhibited activity against (MIC/MBC range 4–64 mg/L) representative independently presence or absence genes linked QACs tolerance. A polyclonal population, discriminated FT-IR WGS, included various lineages dispersed chicken’s lifecycle farm (ST29-KL124, ST11-KL106, ST15-KL19, ST1228-KL38), until (ST1-KL19, ST11-KL111, ST6405-KL109, ST6406-CG147-KL111), over years (ST631-49 KL109, ST6651-KL107, ST6406-CG147-KL111). Notably, some identical those human clinical isolates. WGS also revealed F-type multireplicon plasmids carrying (copper) co-located qacE Δ1 ± qacF (QACs) disseminated humans. In conclusion, farms their derived are diverse clones enriched metal tolerance genes, exhibiting genetic similarities strains. Further research imperative unravel influencing persistence dissemination within production, contributing improved safety risk management. This study underscores significance understanding interplay between control strategies sources effectively address spread resistance.

Language: Английский

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From Farm to Fork: Persistence of Clinically Relevant Multidrug-Resistant and Copper-Tolerant Klebsiella pneumoniae Long after Colistin Withdrawal in Poultry Production

Microbiology Spectrum, Journal Year: 2023, Volume and Issue: 11(4)

Published: July 10, 2023

Concerns about colistin-resistant bacteria in animal food-environmental-human ecosystems prompted the poultry sector to implement colistin restrictions and explore alternative trace metals/copper feed supplementation. The impact of these strategies on selection persistence Klebsiella pneumoniae whole production chain needs clarification. We assessed copper-tolerant K. occurrence chickens raised with inorganic organic copper formulas from 1-day-old chicks meat (7 farms 2019 2020), after long-term withdrawal (>2 years). Clonal diversity adaptive features were characterized by cultural, molecular, whole-genome-sequencing (WGS) approaches. Most chicken flocks (75%) carried at early preslaughter stages, a significant decrease (P < 0.05) batches (17%) sporadic water/feed contamination. High rates (>50%) colistin-resistant/mcr-negative observed among fecal samples, independently feed. samples multidrug-resistant (90%) (81%; silA pcoD positive MICCuSO4 ≥16 mM) isolates. WGS revealed accumulation resistance-associated mutations F type multireplicon plasmids carrying antibiotic resistance metal/copper tolerance genes. population was polyclonal, various lineages dispersed throughout production. ST15-KL19, ST15-KL146, ST392-KL27 IncF similar those global human clinical isolates, suggesting as reservoir/source clinically relevant genes potential risk humans through food and/or environmental exposure. Despite limited mcr spread due ban, this action ineffective controlling pneumoniae, regardless This study provides crucial insights into highlights need for continued surveillance proactive safety actions within One Health perspective. IMPORTANCE resistant last-resort antibiotics such is serious concern public health. has responded restricting use exploring supplements. However, it unclear how which extent changes chain. found high flocks, ban. isolate diversity, identical across isolates suggests source farm-to-fork mitigate risks health, stakeholders involved industry policymakers tasked regulating safety.

Language: Английский

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Molecular epidemiology and genetic dynamics of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China

Frontiers in Cellular and Infection Microbiology, Journal Year: 2025, Volume and Issue: 15

Published: Feb. 14, 2025

Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CRhvKP) poses a significant global health threat due to its enhanced virulence and resistance. This study analyzed 5,036 publicly available K. genomes from China (2005–2023), identifying 1,538 CRhvKP genomes, accounting for 44.6% of carbapenem-resistant isolates 69.5% isolates. Predominant carbapenemases included bla KPC (92.1%), with an increasing prevalence NDM OXA-48-like genes. Most (93.6%) carried both aerobactin yersiniabactin The genetic background showed high diversity, characterized by 36 sequence types (STs) 22 capsule types, high-risk endemic STs such as ST11, ST15, ST23 being predominant. demonstrated virulence, whereas ST11 more resistance genes but minimal presence iroBCDN A core genome MLST analysis revealed that 89.0% clustered into 131 clonal groups, indicating widespread dissemination, particularly in eastern China. CR hv plasmids, primarily IncF, IncH, IncR distinct community structures, plasmids demonstrating higher mobility diversity. Crucially, we identified 40 CR-hv convergent across five STs, likely resulting plasmid fusions, which have become increasingly prevalent over the last decade. Furthermore, chromosomal integration KPC-2 was detected, underscoring stable inheritance these traits. Class 1 Integrons were present 84.5% strains, most notably least ST23. These integrons harbored confer various antibiotics, including IMP VIM , their content varying different STs. highlights complexity, rapid China, emphasizing urgent need genomic surveillance targeted interventions mitigate posed multidrug-resistant strains.

Language: Английский

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The fitness connection of antibiotic resistance

Frontiers in Microbiology, Journal Year: 2025, Volume and Issue: 16

Published: April 10, 2025

More than three decades ago multidrug-resistant (MDR) clones of the pathogens: Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Clostridioides difficile, Enterococcus faecium, Pseudomonas aeruginosa and Acinetobacter baumannii have started to disseminate across wide geographical areas. A characteristic feature all these MDR lineages is carriage some mutations in quinolone resistance-determining regions (QRDRs) DNA gyrase topoisomerase IV which besides conferring resistance fluoroquinolones are associated with a fitness benefit. Several lines evidence strongly suggest that extra conferred by facilitated dissemination international lineages. pathogens require energy cover cost excess antibiotic gene cargo. However, generated upgraded metabolic activity was demonstrated increase uptake antibiotics enhancing susceptibility. Accordingly, bacteria need additional positive schemes which, similarly QRDR advantage, will not compromise resistance. Some these, clone-specific effects large genomes, low-cost plasmids, transfer plasmid genes chromosome, application weak promoters integrons various techniques for economic control integrase enzyme including highly sophisticated system A. baumannii. These impacts - among others confer advantage promoting spread pathogens. even potential combined effect without limit virulence-related or less relevant cargoes often be sacrificed permit acquisition high-priority determinants. Accordingly major clone strains usually virulent susceptible isolates. In summary, approach research very useful since status seem profoundly impact capacity healthcare setting.

Language: Английский

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Integrative genomics would strengthen AMR understanding through ONE health approach

Heliyon, Journal Year: 2024, Volume and Issue: 10(14), P. e34719 - e34719

Published: July 1, 2024

Emergence of drug-induced antimicrobial resistance (AMR) forms a crippling health and economic crisis worldwide, causing high mortality from otherwise treatable diseases infections. Next Generation Sequencing (NGS) has significantly augmented detection culture independent microbes, potential AMR in pathogens elucidation mechanisms underlying it. Here, we review recent findings evolution aided by integrated genomic investigation strategies inclusive bacteria, virus, fungi alleles. While monitoring is dominated data hospital-related infections, surveillance both biotic abiotic components involved global emergence persistence. Identification pathogen-intrinsic as well environmental and/or host factors through robust genomics/bioinformatics, along with type frequency antibiotic usage will greatly facilitate prediction regional patterns evolution. Genomics-enabled be crucial - shaping policies within the One Health framework to combat this concern.

Language: Английский

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Great Plasticity in a Great Pathogen: Capsular Types, Virulence Factors and Biofilm Formation in ESBL-Producing Klebsiella pneumoniae from Pediatric Infections in Uruguay

Antibiotics, Journal Year: 2024, Volume and Issue: 13(2), P. 170 - 170

Published: Feb. 9, 2024

is widely recognized as an opportunistic hospital and community pathogen. It one of the priority microorganisms included in ESKAPE group, its antibiotic resistance related to extended-spectrum β-lactamases (ESBL) a global public health concern. The multi-drug (MDR) phenotype, combination with pathogenicity factors, could enhance ability this pathogen cause clinical infections. aim study was characterize factors biofilm formation ESBL-producing

Language: Английский

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