Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study
Karthikeyan Kumarasamy,Mark Toleman,Timothy R. Walsh,Jay Bagaria,Fafhana Butt,Ravikumar Balakrishnan,Uma Chaudhary,Michel Doumith,Christian G. Giske,Seema Irfan,Padma Krishnan,Anil Kumar,Sunil Maharjan,Shazad Mushtaq,Tabassum Noorie,David L. Paterson,A. Pearson,Claire Perry,Rachel Pike,Bhargavi Rao,Ujjwayini Ray,Jayanta B. Sarma,Madhu Sharma,Elizabeth Sheridan,M A Thirunarayan,Jane F. Turton,Supriya Upadhyay,Marina Warner,William Welfare,David M. Livermore,Neil Woodford +30 more
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TLDR
The prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK is investigated, and co-ordinated international surveillance is needed.Abstract:
Summary Background Gram-negative Enterobacteriaceae with resistance to carbapenem conferred by New Delhi metallo-β-lactamase 1 (NDM-1) are potentially a major global health problem. We investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae in India, Pakistan, and the UK. Methods Enterobacteriaceae isolates were studied from two major centres in India—Chennai (south India), Haryana (north India)—and those referred to the UK's national reference laboratory. Antibiotic susceptibilities were assessed, and the presence of the carbapenem resistance gene bla NDM-1 was established by PCR. Isolates were typed by pulsed-field gel electrophoresis of XbaI-restricted genomic DNA. Plasmids were analysed by S1 nuclease digestion and PCR typing. Case data for UK patients were reviewed for evidence of travel and recent admission to hospitals in India or Pakistan. Findings We identified 44 isolates with NDM-1 in Chennai, 26 in Haryana, 37 in the UK, and 73 in other sites in India and Pakistan. NDM-1 was mostly found among Escherichia coli (36) and Klebsiella pneumoniae (111), which were highly resistant to all antibiotics except to tigecycline and colistin. K pneumoniae isolates from Haryana were clonal but NDM-1 producers from the UK and Chennai were clonally diverse. Most isolates carried the NDM-1 gene on plasmids: those from UK and Chennai were readily transferable whereas those from Haryana were not conjugative. Many of the UK NDM-1 positive patients had travelled to India or Pakistan within the past year, or had links with these countries. Interpretation The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed. Funding European Union, Wellcome Trust, and Wyeth.read more
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Real-time PCR assay and a synthetic positive control for the rapid and sensitive detection of the emerging resistance gene New Delhi Metallo-β-lactamase-1 (bla(NDM-1)).
TL;DR: This study describes a real-time PCR assay as well as two conventional PCR assays to detect blaNDM-1, a proof of principle for the usefulness of rapidly synthesized genes serving as positive controls for novel diagnostic PCR Assays of emerging pathogens during the initial phase after their discovery when biological isolates are still rare and not commonly available.
Journal ArticleDOI
Enterobacteriaceae isolates carrying the New Delhi metallo-β-lactamase gene in Yemen.
Alima Gharout-Sait,Samer-Ahmed Alsharapy,Lucien Brasme,Abdelaziz Touati,Rachida Kermas,Sofiane Bakour,Thomas Guillard,Christophe de Champs +7 more
TL;DR: To the best of the authors' knowledge, this is the first report of NDM-1-producing Enterobacteriaceae isolates in Yemen.
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Clinical review: Probiotics in critical care.
TL;DR: The use of probiotics in the critical care setting is examined, some of the proposed mechanisms of action are looked at, their potential benefits and drawbacks are discussed and differences in administration techniques are discussed.
Journal ArticleDOI
Multiple-omic data analysis of Klebsiella pneumoniae MGH 78578 reveals its transcriptional architecture and regulatory features
Joo-Hyun Seo,Jay Sung-Joong Hong,Jay Sung-Joong Hong,Donghyuk Kim,Byung-Kwan Cho,Byung-Kwan Cho,Tzu-Wen Huang,Tzu-Wen Huang,Shih-Feng Tsai,Bernhard O. Palsson,Pep Charusanti +10 more
TL;DR: A systems biology approach is taken to annotate the K. pneumoniae MGH 78578 genome at the structural and operational levels to provide new insight into fundamental genome-level biology for this important human pathogen.
Journal ArticleDOI
A quantum mechanics/molecular mechanics study on the hydrolysis mechanism of New Delhi metallo-β-lactamase-1.
Kongkai Zhu,Junyan Lu,Zhongjie Liang,Xiangqian Kong,Fei Ye,Lu Jin,Heji Geng,Heji Geng,Yong Chen,Mingyue Zheng,Hualiang Jiang,Jun-Qian Li,Cheng Luo,Cheng Luo +13 more
TL;DR: This study provides detailed insights into the catalytic mechanism of NDM-1 hydrolyzing meropenem β-lactam antibiotics and offers clues for the discovery of new antibiotics against N DM-1 positive strains in clinical studies.
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