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      Contribution of efflux to colistin heteroresistance in a multidrug resistant Acinetobacter baumannii clinical isolate

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          Global spread of carbapenem-resistant Acinetobacter baumannii.

          We have investigated the molecular epidemiology and distribution of carbapenemase genes in 492 imipenem-non-susceptible Acinetobacter baumannii worldwide isolates (North and Latin America, Europe, Asia, South Africa and Australia). MICs were determined by broth microdilution and Etest. The presence of carbapenemase-encoding genes was investigated by PCR. Molecular epidemiology was performed by repetitive sequence-based PCR (rep-PCR; DiversiLab), sequence-type multiplex PCR and PFGE. Imipenem non-susceptibility was associated with ISAba1 upstream of the intrinsic bla(OXA-51-like) or the acquired carbapenemase bla(OXA-23-like), bla(OXA-40-like) or bla(OXA-58-like). Isolates were grouped into eight distinct clusters including European clones I, II and III. European clone II was the largest (246 isolates) and most widespread group (USA, pan-Europe, Israel, Asia, Australia and South Africa). The global dissemination of eight carbapenem-resistant lineages illustrates the success this organism has had in epidemic spread. The acquired OXA enzymes are widely distributed but are not the sole carbapenem resistance determinant in A. baumannii.
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            Distribution of repetitive DNA sequences in eubacteria and application to finerpriting of bacterial enomes

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              Resistance to polymyxins in Gram-negative organisms.

              Polymyxins have recently been re-introduced into the therapeutic arsenal to combat infections caused by multidrug-resistant Gram-negative bacteria. However, the emergence of strains resistant to these last-resort drugs is becoming a critical issue in a growing number of countries. Both intrinsic and transferable mechanisms of polymyxin resistance have been characterised. These mechanisms as well as the epidemiological data regarding four relevant bacterial pathogens (Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa) are considered in this review. A special focus is made on plasmid-mediated resistance and the spread of mcr genes.

                Author and article information

                Journal of Medical Microbiology
                Microbiology Society
                June 01 2018
                June 01 2018
                : 67
                : 6
                : 740-749
                [1 ] 1​Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisboa, Portugal
                [2 ] †​Present address: Instituto Nacional de Investigação Agrária e Veterinária, I.P, Lisboa, Portugal.
                [3 ] 2​iMed.ULisboa, Instituto de Investigação do Medicamento, Faculdade de Farmácia, Universidade de Lisboa, Lisboa, Portugal
                [4 ] 3​School of Food Science and Environmental Health, College of Sciences and Health, Dublin Institute of Technology, Dublin, Ireland
                [5 ] 4​Department of Microbiology, Moyne Institute of Preventive Medicine, School of Genetics and Microbiology, Trinity College Dublin, Dublin, Ireland
                [6 ] 5​Serviço de Patologia Clínica, Laboratório de Microbiologia Clínica e Biologia Molecular – Hospital de Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
                © 2018


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