| Autor: |
Taitt CR; US Naval Research Laboratory, Center for Biomolecular Science & Engineering, Washington, DC 20375, USA., Leski TA; US Naval Research Laboratory, Center for Biomolecular Science & Engineering, Washington, DC 20375, USA., Prouty MG; US Naval Medical Research Unit No. 2-Phnom Penh, Blvd Kim Il Sung, Khan Toul Kork, Phnom Penh, Cambodia., Ford GW; US Naval Medical Research Unit No. 2-Phnom Penh, Blvd Kim Il Sung, Khan Toul Kork, Phnom Penh, Cambodia., Heang V; US Naval Medical Research Unit No. 2-Phnom Penh, Blvd Kim Il Sung, Khan Toul Kork, Phnom Penh, Cambodia., House BL; US Naval Medical Research Unit No. 3, Naval Air Station Sigonella, 95030 Sigonella, Italy., Levin SY; US Naval Medical Research Unit No. 3, Naval Air Station Sigonella, 95030 Sigonella, Italy., Curry JA; US Naval Medical Research Unit No. 3, Naval Air Station Sigonella, 95030 Sigonella, Italy., Mansour A; US Naval Medical Research Unit No. 3, Naval Air Station Sigonella, 95030 Sigonella, Italy., Mohammady HE; US Naval Medical Research Unit No. 3, Naval Air Station Sigonella, 95030 Sigonella, Italy., Wasfy M; US Naval Medical Research Unit No. 3, Naval Air Station Sigonella, 95030 Sigonella, Italy., Tilley DH; US Naval Medical Research Unit No. 6 Peru, Lima 07001, Peru., Gregory MJ; US Naval Medical Research Unit No. 6 Peru, Lima 07001, Peru., Kasper MR; US Naval Medical Research Unit No. 6 Peru, Lima 07001, Peru., Regeimbal J; US Naval Medical Research Unit No. 6 Peru, Lima 07001, Peru., Rios P; US Naval Medical Research Unit No. 6 Peru, Lima 07001, Peru., Pimentel G; US Naval Medical Research Unit No. 6 Peru, Lima 07001, Peru., Danboise BA; US Army Medical Research Directorate-Africa/Kenya, Kericho 20200, Kenya., Hulseberg CE; US Army Medical Research Directorate-Africa/Kenya, Kericho 20200, Kenya., Odundo EA; US Army Medical Research Directorate-Africa/Kenya, Kericho 20200, Kenya., Ombogo AN; US Army Medical Research Directorate-Africa/Kenya, Kericho 20200, Kenya., Cheruiyot EK; US Army Medical Research Directorate-Africa/Kenya, Kericho 20200, Kenya., Philip CO; US Army Medical Research Directorate-Africa/Kenya, Kericho 20200, Kenya., Vora GJ; US Naval Research Laboratory, Center for Biomolecular Science & Engineering, Washington, DC 20375, USA. |
| Abstrakt: |
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 bla TEM , tet (A), tet (B), mac (A), mac (B), aadA1/A2 , strA , strB , sul1 , sul2 , qacE Δ1, 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, bla OXA-48 or bla NDM . 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. |
