Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children
Amikacin is commonly used in children in combination with other agents as a last-resort treatment for severe infections caused by multidrug-resistant Gram-negative bacteria. Amikacin is also prescribed empirically in febrile neutropenia in children with cancer and in acute pulmonary exacerbations in...
محفوظ في:
| المؤلف الرئيسي: | |
|---|---|
| مؤلفون آخرون: | , , , , , |
| التنسيق: | article |
| منشور في: |
2021
|
| الموضوعات: | |
| الوصول للمادة أونلاين: | http://dx.doi.org/10.1016/j.jgar.2021.04.026 https://www.sciencedirect.com/science/article/pii/S2213716521001260 http://hdl.handle.net/10576/20677 |
| الوسوم: |
إضافة وسم
لا توجد وسوم, كن أول من يضع وسما على هذه التسجيلة!
|
| _version_ | 1857415087346679808 |
|---|---|
| author | Hassan Al, Mana |
| author2 | Sundararaju, Sathyavathi Eltai, Nahla O. Al-Hadidi, Sara H. Hasan, Mohammad Rubayet Tang, Patrick Pérez-López, Andrés |
| author2_role | author author author author author author |
| author_facet | Hassan Al, Mana Sundararaju, Sathyavathi Eltai, Nahla O. Al-Hadidi, Sara H. Hasan, Mohammad Rubayet Tang, Patrick Pérez-López, Andrés |
| author_role | author |
| dc.creator.none.fl_str_mv | Hassan Al, Mana Sundararaju, Sathyavathi Eltai, Nahla O. Al-Hadidi, Sara H. Hasan, Mohammad Rubayet Tang, Patrick Pérez-López, Andrés |
| dc.date.none.fl_str_mv | 2021-06-16T11:15:07Z 2021-09-30 |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://dx.doi.org/10.1016/j.jgar.2021.04.026 Mana, H. A., Sundararaju, S., Eltai, N. O., Al-Hadidi, S. H., Hasan, M. R., Tang, P., & Pérez-López, A. (2021). Low-level amikacin resistance induced by AAC (6')-Ib and AAC (6')-Ib-cr in ESBL-producing Enterobacterales isolated from urine in children. Journal of Global Antimicrobial Resistance. 22137165 https://www.sciencedirect.com/science/article/pii/S2213716521001260 http://hdl.handle.net/10576/20677 42-44 26 |
| dc.language.none.fl_str_mv | en |
| dc.publisher.none.fl_str_mv | Elsevier |
| dc.rights.none.fl_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | AMR CTX-M ESBL Amikacin Enterobacteriaceae |
| dc.title.none.fl_str_mv | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Amikacin is commonly used in children in combination with other agents as a last-resort treatment for severe infections caused by multidrug-resistant Gram-negative bacteria. Amikacin is also prescribed empirically in febrile neutropenia in children with cancer and in acute pulmonary exacerbations in cystic fibrosis patients. Over the past few years, however, amikacin has been increasingly used to treat urinary tract infections (UTIs) in children caused by Enterobacterales producing extended-spectrum β-lactamases (ESBLs), given the low resistance rates to this agent among ESBL-producing uropathogens worldwide. Resistance to amikacin in Enterobacterales can be caused by multiple mechanisms, including 16S rRNA methyltransferases. However, the most common cause is the aminoglycoside N-acetyltransferase AAC(6′)-Ib, which acetylates amikacin, tobramycin, kanamycin and netilmicin but spares gentamicin, while its bifunctional variant AAC(6′)-Ib-cr also modifies ciprofloxacin and norfloxacin . AAC(6′)-Ib-cr is frequently co-produced by CTX-M-type ESBL-producing isolates, particularly CTX-M-15, conferring low-level resistance to amikacin with minimum inhibitory concentrations (MICs) that do not exceed susceptible breakpoints. The study found that isolates carrying AAC(6′)-Ib-cr have on average a 2-fold higher amikacin MIC. The increased MIC may impact the ability to achieve a Cpeak/MIC > 8 assuming hypothetical peak concentrations between 20 mg/L and 30 mg/L, which could impact the antibiotic's efficacy as a theraputic agent. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | qu_4b19377347d2c8f3d3eb4c2405895350 |
| identifier_str_mv | Mana, H. A., Sundararaju, S., Eltai, N. O., Al-Hadidi, S. H., Hasan, M. R., Tang, P., & Pérez-López, A. (2021). Low-level amikacin resistance induced by AAC (6')-Ib and AAC (6')-Ib-cr in ESBL-producing Enterobacterales isolated from urine in children. Journal of Global Antimicrobial Resistance. 22137165 42-44 26 |
| language_invalid_str_mv | en |
| network_acronym_str | qu |
| network_name_str | Qatar University repository |
| oai_identifier_str | oai:qspace.qu.edu.qa:10576/20677 |
| publishDate | 2021 |
| publisher.none.fl_str_mv | Elsevier |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| spelling | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in childrenHassan Al, ManaSundararaju, SathyavathiEltai, Nahla O.Al-Hadidi, Sara H.Hasan, Mohammad RubayetTang, PatrickPérez-López, AndrésAMRCTX-MESBLAmikacinEnterobacteriaceaeAmikacin is commonly used in children in combination with other agents as a last-resort treatment for severe infections caused by multidrug-resistant Gram-negative bacteria. Amikacin is also prescribed empirically in febrile neutropenia in children with cancer and in acute pulmonary exacerbations in cystic fibrosis patients. Over the past few years, however, amikacin has been increasingly used to treat urinary tract infections (UTIs) in children caused by Enterobacterales producing extended-spectrum β-lactamases (ESBLs), given the low resistance rates to this agent among ESBL-producing uropathogens worldwide. Resistance to amikacin in Enterobacterales can be caused by multiple mechanisms, including 16S rRNA methyltransferases. However, the most common cause is the aminoglycoside N-acetyltransferase AAC(6′)-Ib, which acetylates amikacin, tobramycin, kanamycin and netilmicin but spares gentamicin, while its bifunctional variant AAC(6′)-Ib-cr also modifies ciprofloxacin and norfloxacin . AAC(6′)-Ib-cr is frequently co-produced by CTX-M-type ESBL-producing isolates, particularly CTX-M-15, conferring low-level resistance to amikacin with minimum inhibitory concentrations (MICs) that do not exceed susceptible breakpoints. The study found that isolates carrying AAC(6′)-Ib-cr have on average a 2-fold higher amikacin MIC. The increased MIC may impact the ability to achieve a Cpeak/MIC > 8 assuming hypothetical peak concentrations between 20 mg/L and 30 mg/L, which could impact the antibiotic's efficacy as a theraputic agent.This work was funded by Sidra Internal Research Funding Grant [Project ID: SIRF_200040] to AP-L, and a Qatar University Grant [No. QUUG-BRC-2017-2] to NOE.Elsevier2021-06-16T11:15:07Z2021-09-30Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1016/j.jgar.2021.04.026Mana, H. A., Sundararaju, S., Eltai, N. O., Al-Hadidi, S. H., Hasan, M. R., Tang, P., & Pérez-López, A. (2021). Low-level amikacin resistance induced by AAC (6')-Ib and AAC (6')-Ib-cr in ESBL-producing Enterobacterales isolated from urine in children. Journal of Global Antimicrobial Resistance.22137165https://www.sciencedirect.com/science/article/pii/S2213716521001260http://hdl.handle.net/10576/2067742-4426enhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/206772024-11-20T10:16:40Z |
| spellingShingle | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children Hassan Al, Mana AMR CTX-M ESBL Amikacin Enterobacteriaceae |
| status_str | publishedVersion |
| title | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children |
| title_full | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children |
| title_fullStr | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children |
| title_full_unstemmed | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children |
| title_short | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children |
| title_sort | Low-level amikacin resistance induced by AAC(6′)-Ib and AAC(6′)-Ib-cr in extended-spectrum β-lactamase (ESBL)-producing Enterobacterales isolated from urine in children |
| topic | AMR CTX-M ESBL Amikacin Enterobacteriaceae |
| url | http://dx.doi.org/10.1016/j.jgar.2021.04.026 https://www.sciencedirect.com/science/article/pii/S2213716521001260 http://hdl.handle.net/10576/20677 |