Tracking Antimicrobial Resistance Determinants in Diarrheal Pathogens: A Cross-Institutional Pilot Study
Abstract
Infectious diarrhea affects over four billion individuals annually and causes over a million deaths each year. Though not typically prescribed for treatment of uncomplicated diarrheal disease, antimicrobials serve as a critical part of the armamentarium used to treat severe or persistent cases. Due to widespread over- and misuse of antimicrobials, there has been an alarming increase in global resistance, for which a standardized methodology for geographic surveillance would be highly beneficial. To demonstrate that a standardized methodology could be used to provide molecular surveillance of antimicrobial resistance (AMR) genes, we initiated a pilot study to test 130 diarrheal pathogens (Campylobacter spp., Escherichia coli, Salmonella, and Shigella spp.) from the USA, Peru, Egypt, Cambodia, and Kenya for the presence/absence of over 200 AMR determinants. We detected a total of 55 different determinants conferring resistance to ten different categories of antimicrobials: genes detected in ≥ 25 samples included blaTEM, tet(A), tet(B), mac(A), mac(B), aadA1/A2, strA, strB, sul1, sul2, qacEΔ1, cmr, and dfrA1. The number of determinants per strain ranged from none (several Campylobacter spp. strains) to sixteen, with isolates from Egypt harboring a wider variety and greater number of genes per isolate than other sites. Two samples harbored carbapenemase genes, blaOXA-48 or blaNDM. Genes conferring resistance to azithromycin (ere(A), mph(A)/mph(K), erm(B)), a first-line therapeutic for severe diarrhea, were detected in over 10% of all Enterobacteriaceae tested: these included >25% of the Enterobacteriaceae from Egypt and Kenya. Forty-six percent of the Egyptian Enterobacteriaceae harbored genes encoding CTX-M-1 or CTX-M-9 families of extended-spectrum β-lactamases. Overall, the data provide cross-comparable resistome information to establish regional trends in support of international surveillance activities and potentially guide geospatially informed medical care.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Aug 18, 2020
- Source ID
- 10.3390/ijms21165928
Entities
People
- Abigael N. Ombogo
- Adel Mansour
- Brent L. House
- Brook A Danboise
- Chris R. Taitt
- Christine E. Hulseberg
- Cliff O. Philip
- Drake Hamilton Tilley
- Elizabeth A. Odundo
- Erick K. Cheruiyot
- Gary J Vora
- Gavin W. Ford
- Guillermo Pimentel
- Hanan El Mohammady
- James Regeimbal
- Jennifer A. Curry
- Matthew R. Kasper
- Michael G. Prouty
- Michael J Gregory
- Momtaz Wasfy
- Paul Rios
- Samuel Y. Levin
- Tomasz Leski
- Vireak Heang
Organizations
- Office of Naval Research