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Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries

Antimicrobial resistance in neonatal sepsis is rising, yet mechanisms of resistance that often spread between species via mobile genetic elements, ultimately limiting treatments in low- and middle-income countries (LMICs), are poorly characterized. The Burden of Antibiotic Resistance in Neonates fro...

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Autores principales: Sands, Kirsty, Carvalho, Maria J., Portal, Edward, Thomson, Kathryn, Dyer, Calie, Akpulu, Chinenye, Andrews, Robert, Ferreira, Ana, Gillespie, David, Hender, Thomas, Hood, Kerenza, Mathias, Jordan, Milton, Rebecca, Nieto, Maria, Taiyari, Khadijeh, Chan, Grace J., Bekele, Delayehu, Solomon, Semaria, Basu, Sulagna, Chattopadhyay, Pinaki, Mukherjee, Suchandra, Iregbu, Kenneth, Modibbo, Fatima, Uwaezuoke, Stella, Zahra, Rabaab, Shirazi, Haider, Muhammad, Adil, Mazarati, Jean-Baptiste, Rucogoza, Aniceth, Gaju, Lucie, Mehtar, Shaheen, Bulabula, Andre N. H., Whitelaw, Andrew, Walsh, Timothy R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007471/
https://www.ncbi.nlm.nih.gov/pubmed/33782558
http://dx.doi.org/10.1038/s41564-021-00870-7
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author Sands, Kirsty
Carvalho, Maria J.
Portal, Edward
Thomson, Kathryn
Dyer, Calie
Akpulu, Chinenye
Andrews, Robert
Ferreira, Ana
Gillespie, David
Hender, Thomas
Hood, Kerenza
Mathias, Jordan
Milton, Rebecca
Nieto, Maria
Taiyari, Khadijeh
Chan, Grace J.
Bekele, Delayehu
Solomon, Semaria
Basu, Sulagna
Chattopadhyay, Pinaki
Mukherjee, Suchandra
Iregbu, Kenneth
Modibbo, Fatima
Uwaezuoke, Stella
Zahra, Rabaab
Shirazi, Haider
Muhammad, Adil
Mazarati, Jean-Baptiste
Rucogoza, Aniceth
Gaju, Lucie
Mehtar, Shaheen
Bulabula, Andre N. H.
Whitelaw, Andrew
Walsh, Timothy R.
author_facet Sands, Kirsty
Carvalho, Maria J.
Portal, Edward
Thomson, Kathryn
Dyer, Calie
Akpulu, Chinenye
Andrews, Robert
Ferreira, Ana
Gillespie, David
Hender, Thomas
Hood, Kerenza
Mathias, Jordan
Milton, Rebecca
Nieto, Maria
Taiyari, Khadijeh
Chan, Grace J.
Bekele, Delayehu
Solomon, Semaria
Basu, Sulagna
Chattopadhyay, Pinaki
Mukherjee, Suchandra
Iregbu, Kenneth
Modibbo, Fatima
Uwaezuoke, Stella
Zahra, Rabaab
Shirazi, Haider
Muhammad, Adil
Mazarati, Jean-Baptiste
Rucogoza, Aniceth
Gaju, Lucie
Mehtar, Shaheen
Bulabula, Andre N. H.
Whitelaw, Andrew
Walsh, Timothy R.
author_sort Sands, Kirsty
collection PubMed
description Antimicrobial resistance in neonatal sepsis is rising, yet mechanisms of resistance that often spread between species via mobile genetic elements, ultimately limiting treatments in low- and middle-income countries (LMICs), are poorly characterized. The Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) network was initiated to characterize the cause and burden of antimicrobial resistance in neonatal sepsis for seven LMICs in Africa and South Asia. A total of 36,285 neonates were enrolled in the BARNARDS study between November 2015 and December 2017, of whom 2,483 were diagnosed with culture-confirmed sepsis. Klebsiella pneumoniae (n = 258) was the main cause of neonatal sepsis, with Serratia marcescens (n = 151), Klebsiella michiganensis (n = 117), Escherichia coli (n = 75) and Enterobacter cloacae complex (n = 57) also detected. We present whole-genome sequencing, antimicrobial susceptibility and clinical data for 916 out of 1,038 neonatal sepsis isolates (97 isolates were not recovered from initial isolation at local sites). Enterobacterales (K. pneumoniae, E. coli and E. cloacae) harboured multiple cephalosporin and carbapenem resistance genes. All isolated pathogens were resistant to multiple antibiotic classes, including those used to treat neonatal sepsis. Intraspecies diversity of K. pneumoniae and E. coli indicated that multiple antibiotic-resistant lineages cause neonatal sepsis. Our results will underpin research towards better treatments for neonatal sepsis in LMICs.
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spelling pubmed-80074712021-04-12 Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries Sands, Kirsty Carvalho, Maria J. Portal, Edward Thomson, Kathryn Dyer, Calie Akpulu, Chinenye Andrews, Robert Ferreira, Ana Gillespie, David Hender, Thomas Hood, Kerenza Mathias, Jordan Milton, Rebecca Nieto, Maria Taiyari, Khadijeh Chan, Grace J. Bekele, Delayehu Solomon, Semaria Basu, Sulagna Chattopadhyay, Pinaki Mukherjee, Suchandra Iregbu, Kenneth Modibbo, Fatima Uwaezuoke, Stella Zahra, Rabaab Shirazi, Haider Muhammad, Adil Mazarati, Jean-Baptiste Rucogoza, Aniceth Gaju, Lucie Mehtar, Shaheen Bulabula, Andre N. H. Whitelaw, Andrew Walsh, Timothy R. Nat Microbiol Article Antimicrobial resistance in neonatal sepsis is rising, yet mechanisms of resistance that often spread between species via mobile genetic elements, ultimately limiting treatments in low- and middle-income countries (LMICs), are poorly characterized. The Burden of Antibiotic Resistance in Neonates from Developing Societies (BARNARDS) network was initiated to characterize the cause and burden of antimicrobial resistance in neonatal sepsis for seven LMICs in Africa and South Asia. A total of 36,285 neonates were enrolled in the BARNARDS study between November 2015 and December 2017, of whom 2,483 were diagnosed with culture-confirmed sepsis. Klebsiella pneumoniae (n = 258) was the main cause of neonatal sepsis, with Serratia marcescens (n = 151), Klebsiella michiganensis (n = 117), Escherichia coli (n = 75) and Enterobacter cloacae complex (n = 57) also detected. We present whole-genome sequencing, antimicrobial susceptibility and clinical data for 916 out of 1,038 neonatal sepsis isolates (97 isolates were not recovered from initial isolation at local sites). Enterobacterales (K. pneumoniae, E. coli and E. cloacae) harboured multiple cephalosporin and carbapenem resistance genes. All isolated pathogens were resistant to multiple antibiotic classes, including those used to treat neonatal sepsis. Intraspecies diversity of K. pneumoniae and E. coli indicated that multiple antibiotic-resistant lineages cause neonatal sepsis. Our results will underpin research towards better treatments for neonatal sepsis in LMICs. Nature Publishing Group UK 2021-03-29 2021 /pmc/articles/PMC8007471/ /pubmed/33782558 http://dx.doi.org/10.1038/s41564-021-00870-7 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Sands, Kirsty
Carvalho, Maria J.
Portal, Edward
Thomson, Kathryn
Dyer, Calie
Akpulu, Chinenye
Andrews, Robert
Ferreira, Ana
Gillespie, David
Hender, Thomas
Hood, Kerenza
Mathias, Jordan
Milton, Rebecca
Nieto, Maria
Taiyari, Khadijeh
Chan, Grace J.
Bekele, Delayehu
Solomon, Semaria
Basu, Sulagna
Chattopadhyay, Pinaki
Mukherjee, Suchandra
Iregbu, Kenneth
Modibbo, Fatima
Uwaezuoke, Stella
Zahra, Rabaab
Shirazi, Haider
Muhammad, Adil
Mazarati, Jean-Baptiste
Rucogoza, Aniceth
Gaju, Lucie
Mehtar, Shaheen
Bulabula, Andre N. H.
Whitelaw, Andrew
Walsh, Timothy R.
Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries
title Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries
title_full Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries
title_fullStr Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries
title_full_unstemmed Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries
title_short Characterization of antimicrobial-resistant Gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries
title_sort characterization of antimicrobial-resistant gram-negative bacteria that cause neonatal sepsis in seven low- and middle-income countries
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007471/
https://www.ncbi.nlm.nih.gov/pubmed/33782558
http://dx.doi.org/10.1038/s41564-021-00870-7
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