Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries.

Africa / epidemiology Anti-Bacterial Agents / pharmacology Asia / epidemiology Bacterial Proteins / genetics Developing Countries Drug Resistance, Multiple, Bacterial / drug effects Genetic Variation Genome, Bacterial / genetics Gram-Negative Bacteria / drug effects Gram-Negative Bacterial Infections / drug therapy Humans Infant, Newborn Neonatal Sepsis / drug therapy Phylogeny Plasmids / genetics beta-Lactamases / genetics

Journal

Nature microbiology
ISSN: 2058-5276
Titre abrégé: Nat Microbiol
Pays: England
ID NLM: 101674869

Informations de publication

Date de publication:
04 2021
Historique:
received: 21 01 2020
accepted: 22 01 2021
entrez: 30 3 2021
pubmed: 31 3 2021
medline: 27 7 2021
Statut: ppublish

Résumé

Antimicrobial resistance in neonatal sepsis is rising, yet mechanisms of resistance that often spread between species via mobile genetic elements, ultimately limiting treatments in low- and middle-income countries (LMICs), are poorly characterized. The Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) network was initiated to characterize the cause and burden of antimicrobial resistance in neonatal sepsis for seven LMICs in Africa and South Asia. A total of 36,285 neonates were enrolled in the BARNARDS study between November 2015 and December 2017, of whom 2,483 were diagnosed with culture-confirmed sepsis. Klebsiella pneumoniae (n = 258) was the main cause of neonatal sepsis, with Serratia marcescens (n = 151), Klebsiella michiganensis (n = 117), Escherichia coli (n = 75) and Enterobacter cloacae complex (n = 57) also detected. We present whole-genome sequencing, antimicrobial susceptibility and clinical data for 916 out of 1,038 neonatal sepsis isolates (97 isolates were not recovered from initial isolation at local sites). Enterobacterales (K. pneumoniae, E. coli and E. cloacae) harboured multiple cephalosporin and carbapenem resistance genes. All isolated pathogens were resistant to multiple antibiotic classes, including those used to treat neonatal sepsis. Intraspecies diversity of K. pneumoniae and E. coli indicated that multiple antibiotic-resistant lineages cause neonatal sepsis. Our results will underpin research towards better treatments for neonatal sepsis in LMICs.

Identifiants

DOI: 10.1038/s41564-021-00870-7 PMID: 33782558 PMC: PMC8007471
pubmed: 33782558
doi: 10.1038/s41564-021-00870-7
pii: 10.1038/s41564-021-00870-7
pmc: PMC8007471
doi:

Substances chimiques

Anti-Bacterial Agents 0
Bacterial Proteins 0
beta-Lactamases EC 3.5.2.6
carbapenemase EC 3.5.2.6

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

512-523

Subventions

Organisme : Medical Research Council
ID : MR/P007295/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S013768/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S013768/2
Pays : United Kingdom

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Auteurs

Kirsty Sands (K)

Division of Infection and Immunity, Cardiff University, Cardiff, UK. kirsty.sands@zoo.ox.ac.uk.
Department of Zoology, University of Oxford, Oxford, UK. kirsty.sands@zoo.ox.ac.uk.
ORCID: 0000-0001-5049-4481

Maria J Carvalho (MJ)

Division of Infection and Immunity, Cardiff University, Cardiff, UK. mjcarvalho@ua.pt.
Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal. mjcarvalho@ua.pt.
ORCID: 0000-0001-6819-927X

Edward Portal (E)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.

Kathryn Thomson (K)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.

Calie Dyer (C)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.
Centre for Trials Research, Cardiff University, Cardiff, UK.

Chinenye Akpulu (C)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.
National Hospital Abuja, Abuja, Nigeria.
54gene, Lagos, Nigeria.

Robert Andrews (R)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.

Ana Ferreira (A)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.

David Gillespie (D)

Centre for Trials Research, Cardiff University, Cardiff, UK.
ORCID: 0000-0002-6934-2928

Thomas Hender (T)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.
ORCID: 0000-0002-5987-5923

Kerenza Hood (K)

Centre for Trials Research, Cardiff University, Cardiff, UK.

Jordan Mathias (J)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.

Rebecca Milton (R)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.
Centre for Trials Research, Cardiff University, Cardiff, UK.

Maria Nieto (M)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.
ORCID: 0000-0001-6188-5947

Khadijeh Taiyari (K)

Centre for Trials Research, Cardiff University, Cardiff, UK.

Grace J Chan (GJ)

Division of Medical Critical Care, Boston Children's Hospital, Boston, MA, USA.
Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Delayehu Bekele (D)

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Obstetrics and Gynecology, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
ORCID: 0000-0002-9243-2622

Semaria Solomon (S)

Department of Microbiology, Immunology and Parasitology, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Sulagna Basu (S)

Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India.

Pinaki Chattopadhyay (P)

Department of Neonatology, Institute of Postgraduate Medical Education & Research, Kolkata, India.

Suchandra Mukherjee (S)

Department of Neonatology, Institute of Postgraduate Medical Education & Research, Kolkata, India.

Kenneth Iregbu (K)

National Hospital Abuja, Abuja, Nigeria.

Fatima Modibbo (F)

National Hospital Abuja, Abuja, Nigeria.
54gene, Lagos, Nigeria.

Stella Uwaezuoke (S)

Federal Medical Centre - Jabi, Abuja, Nigeria.

Rabaab Zahra (R)

Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan.

Haider Shirazi (H)

Pakistan Institute of Medical Sciences, Islamabad, Pakistan.

Adil Muhammad (A)

Department of Microbiology, Quaid-i-Azam University, Islamabad, Pakistan.

Jean-Baptiste Mazarati (JB)

The National Reference Laboratory, Rwanda Biomedical Centre, Kigali, Rwanda.

Aniceth Rucogoza (A)

The National Reference Laboratory, Rwanda Biomedical Centre, Kigali, Rwanda.

Lucie Gaju (L)

The National Reference Laboratory, Rwanda Biomedical Centre, Kigali, Rwanda.

Shaheen Mehtar (S)

Unit of IPC, Stellenbosch University, Cape Town, South Africa.
Infection Control Africa Network, Cape Town, South Africa.
ORCID: 0000-0002-3165-5566

Andre N H Bulabula (ANH)

Infection Control Africa Network, Cape Town, South Africa.
Department of Global Health, Stellenbosch University, Cape Town, South Africa.

Andrew Whitelaw (A)

Division of Medical Microbiology, Stellenbosch University, Cape Town, South Africa.
National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa.
ORCID: 0000-0001-9070-5247

Timothy R Walsh (TR)

Division of Infection and Immunity, Cardiff University, Cardiff, UK.
Ineos Oxford Institute for Antimicrobial Research, Department of Zoology, Oxford, UK.
ORCID: 0000-0003-4315-4096

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Classifications MeSH

questionsmedicales.fr › Régions géographiques › Afrique › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Régions géographiques › Asie › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines bactériennes › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Sciences sociales › Internationalité › Coopération internationale › Pays en voie de développement › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Phénomènes physiologiques › Phénomènes pharmacologiques et toxicologiques › Phénomènes pharmacologiques › Résistance aux substances › Multirésistance aux médicaments › Multirésistance bactérienne aux médicaments › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Phénomènes génétiques › Variation génétique › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Phénomènes génétiques › Structures génétiques › Génome › Génome microbien › Génome bactérien › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Bactéries › Bactéries à Gram négatif › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Infection › Infections bactériennes et mycoses › Infections bactériennes › Infections bactériennes à Gram négatif › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Nouveau-né › Characterization of antimicrobial-resistant...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Inflammation › Sepsie › Sepsis néonatal › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Sciences de l'information › Phylogenèse › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Phénomènes génétiques › Structures génétiques › Plasmides › Characterization of antimicrobial-resistant...
questionsmedicales.fr › Enzymes et coenzymes › Enzymes › Hydrolases › Amidohydrolases › bêta-Lactamases › Characterization of antimicrobial-resistant...