Predictive Modeling of Phenotypic Antimicrobial Susceptibility of Selected Beta-Lactam Antimicrobials from Beta-Lactamase Resistance Genes

The outcome of bacterial infection management relies on prompt diagnosis and effective treatment, but conventional antimicrobial susceptibility testing can be slow and labor-intensive. Therefore, this study aims to predict phenotypic antimicrobial susceptibility of selected beta-lactam antimicrobial...

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Bibliographic Details
Main Authors: Md. Kaisar Rahman, Ryan B. Williams, Samuel Ajulo, Gizem Levent, Guy H. Loneragan, Babafela Awosile
Format: Article
Language:English
Published: MDPI AG 2024-02-01
Series:Antibiotics
Subjects:
Online Access:https://www.mdpi.com/2079-6382/13/3/224
Description
Summary:The outcome of bacterial infection management relies on prompt diagnosis and effective treatment, but conventional antimicrobial susceptibility testing can be slow and labor-intensive. Therefore, this study aims to predict phenotypic antimicrobial susceptibility of selected beta-lactam antimicrobials in the bacteria of the family Enterobacteriaceae from different beta-lactamase resistance genotypes. Using human datasets extracted from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program conducted by Pfizer and retail meat datasets from the National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS), we used a robust or weighted least square multivariable linear regression modeling framework to explore the relationship between antimicrobial susceptibility data of beta-lactam antimicrobials and different types of beta-lactamase resistance genes. In humans, in the presence of the <i>bla</i><sub>CTX-M-1</sub>, <i>bla</i><sub>CTX-M-2</sub>, <i>bla</i><sub>CTX-M-8/25</sub>, and <i>bla</i><sub>CTX-M-9</sub> groups, MICs of cephalosporins significantly increased by values between 0.34–3.07 μg/mL, however, the MICs of carbapenem significantly decreased by values between 0.81–0.87 μg/mL. In the presence of carbapenemase genes (<i>bla</i><sub>KPC</sub>, <i>bla</i><sub>NDM</sub>, <i>bla</i><sub>IMP</sub>, and <i>bla</i><sub>VIM</sub>), the MICs of cephalosporin antimicrobials significantly increased by values between 1.06–5.77 μg/mL, while the MICs of carbapenem antimicrobials significantly increased by values between 5.39–67.38 μg/mL. In retail meat, MIC of ceftriaxone increased significantly in the presence of <i>bla</i><sub>CMY-2</sub>, <i>bla</i><sub>CTX-M-1</sub>, <i>bla</i><sub>CTX-M-55</sub>, <i>bla</i><sub>CTX-M-65</sub>, and <i>bla</i><sub>SHV-2</sub> by 55.16 μg/mL, 222.70 μg/mL, 250.81 μg/mL, 204.89 μg/mL, and 31.51 μg/mL respectively. MIC of cefoxitin increased significantly in the presence of <i>bla</i><sub>CTX-M-65</sub> and <i>bla</i><sub>TEM-1</sub> by 1.57 μg/mL and 1.04 μg/mL respectively. In the presence of <i>bla</i><sub>CMY-2</sub>, MIC of cefoxitin increased by an average of 8.66 μg/mL over 17 years. Compared to <i>E. coli</i> isolates, MIC of cefoxitin in <i>Salmonella enterica</i> isolates decreased significantly by 0.67 μg/mL. On the other hand, MIC of ceftiofur increased in the presence of <i>bla</i><sub>CTX-M-1</sub>, <i>bla</i><sub>CTX-M-65</sub>, <i>bla</i><sub>SHV-2</sub>, and <i>bla</i><sub>TEM-1</sub> by 8.82 μg/mL, 9.11 μg/mL, 8.18 μg/mL, and 1.04 μg/mL respectively. In the presence of <i>bla</i><sub>CMY-2</sub>, MIC of ceftiofur increased by an average of 10.20 μg/mL over 14 years. The ability to predict antimicrobial susceptibility of beta-lactam antimicrobials directly from beta-lactamase resistance genes may help reduce the reliance on routine phenotypic testing with higher turnaround times in diagnostic, therapeutic, and surveillance of antimicrobial-resistant bacteria of the family Enterobacteriaceae.
ISSN:2079-6382