New Perspectives in Controlling the Spread of Multi-Drug Resistance Organisms (MDROs)

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 8046

Special Issue Editor


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Guest Editor
Infection Control Unit, French-Muslim Hospital, Avicenna, 93000 Bobigny, France
Interests: infection control; antimicrobial resistance; antimircrobial stewardship; health acquired infection; environmental contamination
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Special Issue Information

Dear Colleagues,

The evolution of multi-drug resistance organisms in the world and the difficulty of controlling the phenomenon must lead us to consider, evaluate, and propose alternatives to the infection control measures.

Most of the proposed control policies are based on a search for new strategies and recommendations to contact isolated patients who are identified as carriers or infected with MDRO. The recent pandemic related to COVID-19 has shown the limits of these policies and leads us to initiate a debate on new ways and means of prevention.

In this issue, we propose to address important questions that would allow us to consider MDRO control in our hospitals differently, such as:

  • What are the lessons to be drawn from the COVID-19 pandemic and the spread of MDRO?
  • Are MDRO organisms the same or different in terms of risk?
  • Are contact isolations mandatory to control the spread of MDRO?
  • Are adverse events related to contact isolation?
  • What is the role of microbiota in acquisition and clearance of MDRO?
  • Is it necessary to control the risk related to the environment? If so, when and how?
  • Is decolonisation useful? When? For what organisms? How?

Prof. Dr. Jean-Ralph Zahar
Guest Editor

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Published Papers (5 papers)

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Research

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12 pages, 275 KiB  
Article
Emergence of NDM-1-Producing Pseudomonas aeruginosa Nosocomial Isolates in Attica Region of Greece
by Olga Pappa, Christina Louka, Kleon Karadimas, Evangelia Maikousi, Angeliki Tzoukmani, Michalis Polemis, Anna-Danai Panopoulou, Ioannis Daniil, Stella Chryssou, Kassiani Mellou, Jette S. Kjeldgaard, Olympia Zarkotou, Costas Papagiannitsis and Kyriaki Tryfinopoulou
Microorganisms 2024, 12(9), 1753; https://doi.org/10.3390/microorganisms12091753 - 23 Aug 2024
Viewed by 951
Abstract
Here, we report on the emergence and spread of multidrug-resistant NDM-1-producing P. aeruginosa isolates from patients hospitalized in the Attica region, Greece, in 2022 to provide data on their resistome, their virulome, the genetic environment of blaNDM-1, and their molecular epidemiology. [...] Read more.
Here, we report on the emergence and spread of multidrug-resistant NDM-1-producing P. aeruginosa isolates from patients hospitalized in the Attica region, Greece, in 2022 to provide data on their resistome, their virulome, the genetic environment of blaNDM-1, and their molecular epidemiology. A total of 17 carbapenem-resistant P. aeruginosa isolates identified as NDM-producers by immunochromatography at the hospital level were sent to the Central Public Health Laboratory, in the frame of the laboratory surveillance of carbapenem-resistant pathogens, for further characterization. The initial screening for genetic AMR determinants was carried out by PCR and the MDR Direct Flow Chip assay. Typing was performed by MLST and DLST, the latter in a subset of isolates. Further analysis was performed by whole-genome sequencing (WGS) of six isolates from both hospitals to analyze their entire genomes and elucidate their genetic relatedness. All isolates were allocated to international high-risk clones, sixteen to ST773 and one to ST308. Five ST773 and the sole ST308 isolate were found to harbor the blaNDM-1 gene, along with various other ARGs integrated into their chromosomes, as well as with a wide variety of virulence genes. The blaNDM-1 gene was located in the integrative and conjugative elements ICE6600-like and ICETn43716385 in ST773 and ST308 isolates, respectively. Single-nucleotide polymorphism analysis of the five ST773 isolates indicated their clonal spread in both hospitals. These results suggested that two different molecular events contributed to the emergence of NDM-1-producing P. aeruginosa isolates in Athenian hospitals, highlighting the need for ongoing surveillance. Full article
24 pages, 7053 KiB  
Article
Phenotypic and Genotypic Characterization of Recently Isolated Multidrug-Resistant Acinetobacter baumannii Clinical and Aquatic Strains and Demonstration of Silver Nanoparticle Potency
by Irina Gheorghe-Barbu, Viorica Maria Corbu, Corneliu Ovidiu Vrancianu, Ioana Cristina Marinas, Marcela Popa, Andreea Ștefania Dumbravă, Mihai Niță-Lazăr, Ionut Pecete, Andrei Alexandru Muntean, Mircea Ioan Popa, Liliana Marinescu, Denisa Ficai, Anton Ficai and Ilda Czobor Barbu
Microorganisms 2023, 11(10), 2439; https://doi.org/10.3390/microorganisms11102439 - 28 Sep 2023
Cited by 3 | Viewed by 1755
Abstract
This study aims to demonstrate the effectiveness of silver nanoparticles (Ag NPs) on multidrug-resistant (MDR) Acinetobacter baumannii (AB) strains isolated from the clinical and aquatic environment. Three types of Ag NPs were investigated for their antimicrobial, antibiofilm, and antivirulence properties on a total [...] Read more.
This study aims to demonstrate the effectiveness of silver nanoparticles (Ag NPs) on multidrug-resistant (MDR) Acinetobacter baumannii (AB) strains isolated from the clinical and aquatic environment. Three types of Ag NPs were investigated for their antimicrobial, antibiofilm, and antivirulence properties on a total number of 132 AB strains isolated in the same temporal sequence from intra-hospital infections (IHIs), wastewater (WW), and surface water (SW) samples between 2019 and 2022 from different Romanian locations and characterized at the phenotypic and genotypic levels. The comparative analysis of the antimicrobial resistance (AR) profiles according to the isolation source and the geographical location demonstrated a decrease in MDR level in AB recovered from WW samples in 2022 from north-eastern/central/southern regions (N-E/C-W/analyzed strains S): 87.5/60/32.5%. The AB strains were lecithinase, caseinase, amylase, and lipase producers, had variable biofilm formation ability, and belonged to six genotypes associated with the presence of different virulence genes (ompA, csuE, bap, and bfmS). The Ag NPs synthesized with the solvothermal method exhibited an inhibitory effect on microbial growth, the adherence capacity to the inert substratum, and on the production of soluble virulence factors. We report here the first description of a powerful antibacterial agent against MDR AB strains circulating between hospitals and anthropically polluted water in Romania. Full article
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12 pages, 275 KiB  
Article
Bloodstream Infections: Comparison of Diagnostic Methods and Therapeutic Consequences between a Hospital in a Resource-Limited Setting and Two French Hospitals
by Racha Eid, Jean-Ralph Zahar, Chahrazed Ait Ali, Assaf Mizrahi, Racha Ibrahim, Emeline Banh, Habib Halouani, Françoise Jauréguy, Benoit Pilmis and Rindala Saliba
Microorganisms 2023, 11(9), 2136; https://doi.org/10.3390/microorganisms11092136 - 23 Aug 2023
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Abstract
In recent years, the diagnosis of bloodstream infections has been complemented by rapid microbiological methods, unattainable to most clinical laboratories in resource-limited settings. We evaluated the impact of their shortage on antibiotic therapy adequacy. We conducted a prospective multicenter cohort study including 150 [...] Read more.
In recent years, the diagnosis of bloodstream infections has been complemented by rapid microbiological methods, unattainable to most clinical laboratories in resource-limited settings. We evaluated the impact of their shortage on antibiotic therapy adequacy. We conducted a prospective multicenter cohort study including 150 adult Gram-negative bacilli bacteremia episodes, evenly distributed across three university hospitals: one in Lebanon, a resource-limited setting, and two in France, a resource-rich setting. Previous colonization by multidrug-resistant organisms (MDRO) was significantly more prevalent among the Lebanese than the French group of patients (16/50 vs. 5/100; p < 0.01). Bloodstream infections by carbapenemase-producing Enterobacterales and other MDRO were higher among the Lebanese than the French group of patients (25/50 vs. 12/100; p < 0.01). For the French group, rapid identification of species and mechanisms of resistance significantly shortened turnaround time for definitive laboratory diagnosis and increased antibiotic therapy adequacy. No statistically significant differences were noted in targeted antibiotic therapy between the two groups. This study suggests that, in settings where bacterial resistance is prevalent, rapid microbiological methods have not provided any additional value. The clinical and economic impact of rapid microbiological methods will likely depend on local CPE, VRE, and other MDRO epidemiology and are areas for future research. Full article
14 pages, 1443 KiB  
Article
Molecular Characterization and Prevalence of Antimicrobial-Resistant Escherichia coli Isolates Derived from Clinical Specimens and Environmental Habitats
by Chrysoula Dioli, Olga Pappa, Eirini Siatravani, Spyridoula Bratakou, Apostolos Tatsiopoulos, Panagiota Giakkoupi, Vivi Miriagou and Apostolos Beloukas
Microorganisms 2023, 11(6), 1399; https://doi.org/10.3390/microorganisms11061399 - 26 May 2023
Cited by 6 | Viewed by 2190
Abstract
Antibiotic-resistant bacteria (ARB) are present in wastewaters as their elimination during treatment in wastewater treatment plants (WWTPs) is often impossible. Water plays an important role in the spread of these microorganisms among humans, animals and the environment. This study aimed to assess the [...] Read more.
Antibiotic-resistant bacteria (ARB) are present in wastewaters as their elimination during treatment in wastewater treatment plants (WWTPs) is often impossible. Water plays an important role in the spread of these microorganisms among humans, animals and the environment. This study aimed to assess the antimicrobial resistance patterns, resistance genes and molecular genotypes by means of phylogenetic groups of E. coli isolates in aquatic habitats, including sewage and receiving water bodies, as well as clinical settings in the Boeotia regional district of Greece. The highest resistance rates among both environmental and clinical isolates were observed to be for penicillins, ampicillin and piperacillin. Resistance patterns related to extended spectrum β-lactamases (ESBL) production and ESBL genes were also detected in both environmental and clinical isolates. Phylogenetic group B2 was predominant in clinical settings and the second most frequent among wastewaters, whereas group A was dominant in all environmental isolates. In conclusion, the studied river water and wastewaters may serve as reservoirs of resistant E. coli isolates that pose potential threats to both human and animal health. Full article
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Review

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13 pages, 1321 KiB  
Review
Multidrug and Toxic Compound Extrusion Transporters: Ubiquitous Multifaceted Proteins in Microbes, Plants, and Their Interactions
by Chiara Pastacaldi, Dario Gaudioso and Stefania Tegli
Microorganisms 2024, 12(12), 2433; https://doi.org/10.3390/microorganisms12122433 - 27 Nov 2024
Viewed by 429
Abstract
In recent years, membrane transporters have attracted considerable interest regarding their involvement in the molecular dialogue occurring between microbes and their hosts. In particular, the multidrug and toxic compound extrusion (MATE) transporters form a family of integral membrane proteins, mainly involved in the [...] Read more.
In recent years, membrane transporters have attracted considerable interest regarding their involvement in the molecular dialogue occurring between microbes and their hosts. In particular, the multidrug and toxic compound extrusion (MATE) transporters form a family of integral membrane proteins, mainly involved in the efflux of toxic and xenobiotic compounds. They are present in all living organisms, both prokaryotes and eukaryotes, where they have a wide array of extremely different roles. In plants, MATE proteins are involved in many important physiological processes, such as plant development, as well as the active transport of several secondary metabolites. In microorganisms, they are mainly implicated in the efflux of toxic compounds and thus contribute to drug resistance. Conversely, information about the actual role of MATE transporters in the interaction between plants and microorganisms, including phytopathogens, is still limited, according to the number of publications available on this topic. Indeed, an understanding of their roles in the plant–pathogen interaction could be essential to increase the knowledge of their molecular conversation and to provide data for the design and development of innovative and sustainable anti-infective strategies to control and manage plant pathogens. Full article
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