Surveillance; Carbapenemases; Household; Community; Enterobacteriaceae; KPC; Whole-genome sequencing; Plasmid; E. coli; MDR; Transmission; Gut; Global; Surveillance; ESBL; Colonization; Intestinal; Stools; CTX-M; E. coli; multidrug-resistant; Prevalence; Colistin; Whole-plasmid sequencing; NDM
Campos-Madueno Edgar I., Moser Aline I., Jost Géraldine, Maffioli Carola, Bodmer Thomas, Perreten Vincent, Endimiani Andrea (2022), Carbapenemase-producing Klebsiella pneumoniae strains in Switzerland: Human and non-human settings may share high-risk clones, in Journal of Global Antimicrobial Resistance
Moser Aline I, Campos-Madueno Edgar I, Sendi Parham, Perreten Vincent, Keller Peter M, Ramette Alban, Endimiani Andrea (2021), Repatriation of a patient with COVID-19 contributed to the importation of an emerging carbapenemase producer, in Journal of global antimicrobial resistance
, 27, 267-272.
Moser Aline, Keller Peter, Campos-Madueno Edgar I., Poirel Laurent, Nordmann Patrice, Endimiani Andrea (2021), A Patient With Multiple Carbapenemase Producers Including an Unusual Citrobacter sedlakii Hosting an IncC blaNDM-1- and armA-carrying Plasmid, in Pathogens and Immunity
, 6(2), 119-134.
Moser Aline I., Kuenzli Esther, Campos-Madueno Edgar I., Büdel Thomas, Rattanavong Sayaphet, Vongsouvath Manivanh, Hatz Christoph, Endimiani Andrea (2021), Antimicrobial-Resistant Escherichia coli Strains and Their Plasmids in People, Poultry, and Chicken Meat in Laos, in Frontiers in Microbiology
, 12, 1-15.
Campos-Madueno Edgar I., Moser Aline I., Risch Martin, Bodmer Thomas, Endimiani Andrea (2021), Exploring the global spread of Klebsiella grimontii isolates possessing blaVIM-1 and mcr-9, in Antimicrobial Agents and Chemotherapy
Background and rationaleThe rising prevalence of infections due to multidrug-resistant Enterobacterales (MDR-Ent) represents a serious concern. Hospitalized people and subjects in the community may carry such pathogens at gut level contributing to their spread. However, international travel is recognized as the major risk factor for acquiring MDR-Ent. Overall, carriers of MDR-Ent are at risk to develop difficult-to-treat infections and can transmit such pathogens to other people in contact with them (e.g., in the household, HH). People from Western countries who live for long periods in areas with high prevalence of MDR-Ent might present the same frequency of gut colonization as for travelers, thus having similar risks of infection and transmission to other subjects. However, data regarding this relevant epidemiological aspect are lacking. Moreover, while information about MDR-Ent gut colonization in people in community is available from European countries, the same aspect is scarcely explored in poorer countries. This epidemiological bias also directly generates a lack of data regarding the molecular features (e.g., sequence types; plasmids; antimicrobial resistance genes, ARGs) of MDR-Ent that are emerging in such areas and could be imported in low prevalence countries (e.g., Switzerland).Thanks to the support of the Federal Department of Foreign Affairs (FDFA), in this project we will analyze the stools of ~750 volunteers including the Swiss embassies’ employees (EEs) who work around the world at the 102 Swiss embassies and their relatives/partners (Rs/Ps). To study transmission rates and epidemiological impact for Switzerland, we will also analyze 75 hosting HHs (including local residents) where EEs return temporarily (e.g., for vacation) with their Rs/Ps. All volunteers will provide fecal samples and epidemiological questionnaires at different time points. Specific aims:Aim 1: Molecular features of MDR-Ent colonizing the intestinal tract of EEs and Rs/Ps. We will use an improved selective culture-based approach to detect the MDR-Ent in the stools of the ~750 EEs/Rs/Ps (screening 1). Overall, ~280 MDR-Ent will be phenotypically (MICs) and molecularly (whole-genome/plasmid sequencing, WGS/WPS) characterized. Aim 2: Colonization status of EEs and Rs/Ps at return and analysis of MDR-Ent transmission in the Swiss HHs. After screening 1, we will select 75 groups (including EE/Rs/Ps of which at least one is carrier of MDR-Ent) to be rescreened just before a trip to Switzerland; at the same time, the hosting householders (HHHrs) in Switzerland will be tested (screening 2). After the return of the EEs/Rs/Ps to the foreign country, stools of all subjects will be collected and analyzed again (screening 3). WGS/WPS will be performed on the ~310 MDR-Ent isolated from the stools of EEs/Rs/Ps and HHHrs obtained at screening 2 and 3.Aim 3: Metagenomic approaches to detect novel ARGs and to define the hidden resistome. Functional metagenomics will be executed on the stools of the 75 EEs obtained at screening 2. For 15 groups (out of the 75 of aim 2), shotgun metagenomics will be performed on the stools obtained from all subjects at screening 2 and 3 (~100 samples).Expected results and impact of the studyWe will explore the extent of MDR-Ent gut colonization among EEs and Rs/Ps and the factors associated with this condition. The different molecular features of MDR-Ent will be defined, therefore providing important insights regarding the clones and/or plasmids that could be imported and spread in Switzerland in the near future. We will also delineate the rate of transmission of MDR-Ent and/or plasmids from the EEs/Rs/Ps to the HHHrs. This will have key implications on the possible countermeasures that may be applied to prevent importation and transmission in the Swiss HHs. By taking into account the functional metagenomic results novel ARGs and/or mobile genetic elements (MGEs; e.g., plasmids) will be identified in cultured strains. This will help defining the natural bacterial species that harbor such genes. Finally, the shotgun metagenomic analyses will provide essential information about ARG content and abundance (hidden resistome) that cannot be obtained with the culture approaches.