Carriage trends and fitness cost of MDROs in Lebanese nursing homes

Introduction: Nowadays, medical treatments efficiency is challenged by multi drug resistant organisms (MDROs). Lebanese nursing homes’ residents revealed high fecal carriage rates of MDR Enterobacteriacea. Previous studies claim that bacteria with resistant genes experience fitness cost. This study...

Full description

Saved in:
Bibliographic Details
Main Authors: Caren Challita, Nourhane Hafza, Elias Dahdouh, Michel Attieh, Iman Dandachi, Ziad Daoud
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2018-02-01
Series:Journal of Infection in Developing Countries
Subjects:
Online Access:https://jidc.org/index.php/journal/article/view/9996
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850148872880390144
author Caren Challita
Nourhane Hafza
Elias Dahdouh
Michel Attieh
Iman Dandachi
Ziad Daoud
author_facet Caren Challita
Nourhane Hafza
Elias Dahdouh
Michel Attieh
Iman Dandachi
Ziad Daoud
author_sort Caren Challita
collection DOAJ
description Introduction: Nowadays, medical treatments efficiency is challenged by multi drug resistant organisms (MDROs). Lebanese nursing homes’ residents revealed high fecal carriage rates of MDR Enterobacteriacea. Previous studies claim that bacteria with resistant genes experience fitness cost. This study assesses the competitive growth of MDR Escherichia coli and Klebsiella pneumoniae. Methodology: Fecal swabs were collected, during six consecutive months, from ten elderly residing in a Lebanese nursing home. All isolates were subject to API 20E (bioMerieux, Marcy L’ Etoile, France) and antimicrobial susceptibility (Kirby–Bauer method) testing. Phenotypically, ESBL (extended spectrum β-lactamase), MBL (metallo β-lactamase), AmpC and KPC (Klebsiella pneumoniae carbapenemase) were detected using EDTA, PBA, cloxacillin, and DDSTs (Biorad, Hercules, USA). Selected ESBL producing E. coli and K. pneumoniae underwent multiplex PCR analysis. Intra and inter-species in-vitro competition assays were conducted in multiple combinations. Results: Among 117 collected isolates, E. coli was predominant (71.8%); 7.7% were ESBL and 5.1% AmpC producers. With E. coli intra-species assays, sensitive isolates out-competed all others, followed by ESBL, AmpC, and OXA-48 (oxacillin) producers. Inter-species assays, demonstrated a decreased fitness of ESBL producing K. pneumoniae in presence of sensitive E. coli. While out-competing ESBL producing E. coli required 2 sensitive K. pneumoniae isolates. Conclusion: This study highlights resistant E. coli and K. pneumoniae frequency decrease in presence of sensitive isolates, endorsing the fitness cost hypothesis.  Hence, competing supplementary species reproducing gut flora, would ensure further steps in the fight against MDROs.
format Article
id doaj-art-7ad2ca38d71b442793621565ff1db694
institution OA Journals
issn 1972-2680
language English
publishDate 2018-02-01
publisher The Journal of Infection in Developing Countries
record_format Article
series Journal of Infection in Developing Countries
spelling doaj-art-7ad2ca38d71b442793621565ff1db6942025-08-20T02:27:06ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802018-02-011202.110.3855/jidc.9996Carriage trends and fitness cost of MDROs in Lebanese nursing homesCaren Challita0Nourhane Hafza1Elias Dahdouh2Michel Attieh3Iman Dandachi4Ziad Daoud5Faculty of Medicine, Clinical Microbiology Lab, University of Balamand, LebanonFaculty of Sciences, University of Balamand, LebanonFaculty of Veterinary, Department of Animal Health, Complutense University of Madrid, Madrid, SpainFaculty of Medicine, Clinical Microbiology Lab, University of Balamand, LebanonFaculty of Medicine, Clinical Microbiology Lab, University of Balamand, LebanonFaculty of Medicine, Clinical Microbiology Lab, University of Balamand, Lebanon Introduction: Nowadays, medical treatments efficiency is challenged by multi drug resistant organisms (MDROs). Lebanese nursing homes’ residents revealed high fecal carriage rates of MDR Enterobacteriacea. Previous studies claim that bacteria with resistant genes experience fitness cost. This study assesses the competitive growth of MDR Escherichia coli and Klebsiella pneumoniae. Methodology: Fecal swabs were collected, during six consecutive months, from ten elderly residing in a Lebanese nursing home. All isolates were subject to API 20E (bioMerieux, Marcy L’ Etoile, France) and antimicrobial susceptibility (Kirby–Bauer method) testing. Phenotypically, ESBL (extended spectrum β-lactamase), MBL (metallo β-lactamase), AmpC and KPC (Klebsiella pneumoniae carbapenemase) were detected using EDTA, PBA, cloxacillin, and DDSTs (Biorad, Hercules, USA). Selected ESBL producing E. coli and K. pneumoniae underwent multiplex PCR analysis. Intra and inter-species in-vitro competition assays were conducted in multiple combinations. Results: Among 117 collected isolates, E. coli was predominant (71.8%); 7.7% were ESBL and 5.1% AmpC producers. With E. coli intra-species assays, sensitive isolates out-competed all others, followed by ESBL, AmpC, and OXA-48 (oxacillin) producers. Inter-species assays, demonstrated a decreased fitness of ESBL producing K. pneumoniae in presence of sensitive E. coli. While out-competing ESBL producing E. coli required 2 sensitive K. pneumoniae isolates. Conclusion: This study highlights resistant E. coli and K. pneumoniae frequency decrease in presence of sensitive isolates, endorsing the fitness cost hypothesis.  Hence, competing supplementary species reproducing gut flora, would ensure further steps in the fight against MDROs. https://jidc.org/index.php/journal/article/view/9996fecal carriagefitness costmultidrug-resistantnursing home
spellingShingle Caren Challita
Nourhane Hafza
Elias Dahdouh
Michel Attieh
Iman Dandachi
Ziad Daoud
Carriage trends and fitness cost of MDROs in Lebanese nursing homes
Journal of Infection in Developing Countries
fecal carriage
fitness cost
multidrug-resistant
nursing home
title Carriage trends and fitness cost of MDROs in Lebanese nursing homes
title_full Carriage trends and fitness cost of MDROs in Lebanese nursing homes
title_fullStr Carriage trends and fitness cost of MDROs in Lebanese nursing homes
title_full_unstemmed Carriage trends and fitness cost of MDROs in Lebanese nursing homes
title_short Carriage trends and fitness cost of MDROs in Lebanese nursing homes
title_sort carriage trends and fitness cost of mdros in lebanese nursing homes
topic fecal carriage
fitness cost
multidrug-resistant
nursing home
url https://jidc.org/index.php/journal/article/view/9996
work_keys_str_mv AT carenchallita carriagetrendsandfitnesscostofmdrosinlebanesenursinghomes
AT nourhanehafza carriagetrendsandfitnesscostofmdrosinlebanesenursinghomes
AT eliasdahdouh carriagetrendsandfitnesscostofmdrosinlebanesenursinghomes
AT michelattieh carriagetrendsandfitnesscostofmdrosinlebanesenursinghomes
AT imandandachi carriagetrendsandfitnesscostofmdrosinlebanesenursinghomes
AT ziaddaoud carriagetrendsandfitnesscostofmdrosinlebanesenursinghomes