Phenotypic and genotypic characterization of antibiotic resistance in military hospital-associated bacteria from war injuries in the Eastern Ukraine conflict between 2014 and 2020.
Acinetobacter baumannii
/ genetics
Anti-Bacterial Agents
/ pharmacology
Bacterial Proteins
/ genetics
Drug Resistance, Microbial
Drug Resistance, Multiple, Bacterial
/ genetics
Hospitals, Military
Humans
Klebsiella pneumoniae
/ genetics
Microbial Sensitivity Tests
Phenotype
RNA, Ribosomal, 16S
Retrospective Studies
Ukraine
United States
beta-Lactamases
/ genetics
Bacterial multiple drug resistance
Military
Phenotype
Ukraine
Whole-genome sequencing
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
13
12
2020
revised:
18
03
2021
accepted:
21
03
2021
pubmed:
1
4
2021
medline:
19
8
2021
entrez:
31
3
2021
Statut:
ppublish
Résumé
Infections from the recent conflict in Ukraine have been poorly investigated. To describe the phenotypic and genotypic mechanisms of antibiotic resistance in pathogens associated with war injuries in the Ukraine conflict. This report describes a retrospective multi-centre microbiological survey conducted in four Ukrainian military hospitals between 2014 and 2020. The phenotypes of 813 organisms obtained from 1061 tests of 162 patients were analysed. Fifty-two isolates underwent whole-genome sequencing. Resistance was highest in Acinetobacter baumannii, with 92.5% ((48/52) 95% confidence interval (CI) 81.8-97.9) resistant to fluoroquinolones, 83.0% ((43/52) 95% CI 70.2-91.9) resistant to aminoglycosides, and 67.9% ((37/52) 95% CI 53.7-80.1) resistant to carbapenems. In contrast, resistance to carbapenems was 55.6% ((30/52) 95% CI 41.4-69.1) in Pseudomonas aeruginosa, 42.9% in Escherichia coli ((12/28) 95% CI 24.5-62.8), and 32.8% in Klebsiella pneumoniae ((20/34) 95% CI 21.3-46.0). Multi-drug-resistant strains harboured an abundance of antibiotic resistance genes. K. pneumoniae co-produced class A and D β-lactamases, in one case with blaNDM-1 and rmtC 16S rRNA methyltransferase. A. baumannii carried class A and D β-lactamases but not metallo-β-lactamases; in four isolates, carbapenemases were present with the RmtASE gene armA. P. aeruginosa harboured a wide range of class A and D β-lactamases along with metallo-β-lactamases, as well as the RmtB4 RmtASE gene. Gram-positive cocci were generally sensitive to the tested antibiotics. The incidence of resistance among the studied pathogens was higher than that in Ukrainian civilian hospitals and European countries. The discovery of P. aeruginosa, A. baumannii, and K. pneumoniae co-producing carbapenemases and RmtASEs is of particular importance, and hospitals should be vigilant for their emergence.
Sections du résumé
BACKGROUND
BACKGROUND
Infections from the recent conflict in Ukraine have been poorly investigated.
AIM
OBJECTIVE
To describe the phenotypic and genotypic mechanisms of antibiotic resistance in pathogens associated with war injuries in the Ukraine conflict.
METHODS
METHODS
This report describes a retrospective multi-centre microbiological survey conducted in four Ukrainian military hospitals between 2014 and 2020. The phenotypes of 813 organisms obtained from 1061 tests of 162 patients were analysed. Fifty-two isolates underwent whole-genome sequencing.
FINDINGS
RESULTS
Resistance was highest in Acinetobacter baumannii, with 92.5% ((48/52) 95% confidence interval (CI) 81.8-97.9) resistant to fluoroquinolones, 83.0% ((43/52) 95% CI 70.2-91.9) resistant to aminoglycosides, and 67.9% ((37/52) 95% CI 53.7-80.1) resistant to carbapenems. In contrast, resistance to carbapenems was 55.6% ((30/52) 95% CI 41.4-69.1) in Pseudomonas aeruginosa, 42.9% in Escherichia coli ((12/28) 95% CI 24.5-62.8), and 32.8% in Klebsiella pneumoniae ((20/34) 95% CI 21.3-46.0). Multi-drug-resistant strains harboured an abundance of antibiotic resistance genes. K. pneumoniae co-produced class A and D β-lactamases, in one case with blaNDM-1 and rmtC 16S rRNA methyltransferase. A. baumannii carried class A and D β-lactamases but not metallo-β-lactamases; in four isolates, carbapenemases were present with the RmtASE gene armA. P. aeruginosa harboured a wide range of class A and D β-lactamases along with metallo-β-lactamases, as well as the RmtB4 RmtASE gene. Gram-positive cocci were generally sensitive to the tested antibiotics.
CONCLUSION
CONCLUSIONS
The incidence of resistance among the studied pathogens was higher than that in Ukrainian civilian hospitals and European countries. The discovery of P. aeruginosa, A. baumannii, and K. pneumoniae co-producing carbapenemases and RmtASEs is of particular importance, and hospitals should be vigilant for their emergence.
Identifiants
pubmed: 33789157
pii: S0195-6701(21)00141-9
doi: 10.1016/j.jhin.2021.03.020
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Bacterial Proteins
0
RNA, Ribosomal, 16S
0
beta-Lactamases
EC 3.5.2.6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
69-76Informations de copyright
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