Antibiotic resistance

A collaborative study conducted by Spanish health and research institutions has confirmed the first identification of a critical antibiotic resistance gene, New Delhi metallo-beta-lactamase-1 (NDM-1), within the Acinetobacter baumannii (Ab) strain ST85 in Spain. Published in the “Enfermedades infecciosas y microbiología clínica” English edition, this concerning finding highlights the persistent and growing threat that antibiotic resistance poses to public health.

NDM-1: A Superbug’s Weapon Against Antibiotics

NDM-1 carbapenemase is a potent enzyme that enables bacteria to resist a broad range of beta-lactam antibiotics, including carbapenems, which are often used as the last line of defense against resistant infections. The emergence of NDM-1 has been a global concern, leading to dire warnings about the waning effectiveness of critical antibiotics.

The Study in Detail

This study was initiated after the Andalusian PIRASOA infection prevention program’s referral laboratory received an isolate of carbapenem-resistant A. baumannii (CR-Ab). A dedicated team of researchers employed polymerase chain reaction (PCR) and Sanger DNA sequencing to detect the presence of carbapenemases. They employed next-generation sequencing (NGS) using the MiSeq platform by Illumina to further characterize the resistance genes.

The results of their investigation determined that the Ab isolate was resistant to carbapenems due to the presence of the NDM-1 gene. Additionally, other resistance determinants like bla OXA-94 and ADC-25 were also identified. However, it was found to remain susceptible to other antibiotics such as amikacin and tigecycline, offering limited therapeutic options.

The Implications of this Discovery

The identification of bla NDM-1 within A. baumannii represents a significant concern for Spain and the international community. NDM-1 is notorious for its rapid spread and has a profound impact on the management of bacterial infections. Its detection raises the alarm for health authorities to enforce strict antimicrobial stewardship programs and infection control measures.

Nationwide and Global Concern

A. baumannii is known for its ability to survive in hospital environments, posing a risk especially to patients with compromised immune systems. With the discovery of the ST85 clone harboring this mechanism of resistance, efforts are expected to intensify regarding surveillance and scientific research to cope with the potential outbreak and transmission of this resistant organism.

Expert Opinions and Response Actions

Felipe Fernández-Cuenca and colleagues from several Sevilla research institutions including the Hospital Universitario Virgen Macarena, IBiS, and the Spanish Network for Research in Infectious Diseases (REIPI), emphasize the urgency of comprehensive and coordinated actions at the national and international levels to contain the spread of NDM-1 producing bacteria.

The Way Forward

The study stresses the importance of implementing surveillance systems capable of rapid detection and containment of antibiotic-resistant strains. Investments in new antibiotics development and alternative treatment methods such as phage therapy are also crucial in combating multi-drug resistant infections.

DOI and References

This paramount study is accessible under the DOI: 10.1016/j.eimc.2019.03.008. The peer-reviewed article, supported by non-U.S. government entities, serves not only as a wake-up call but also as a cornerstone for future strategies in managing the ever-evolving superbugs.

References

1. Enfermedades infecciosas y microbiología clínica (English ed.). “First identification of bla NDM-1 in Acinetobacter baumannii strain ST85 in Spain.” DOI: 10.1016/j.eimc.2019.03.008
2. Nordmann, P., Naas, T., Poirel, L. (2011). “Global Spread of Carbapenemase-producing Enterobacteriaceae.” Emerging Infectious Diseases, 17(10), 1791–1798.
3. Queenan, A. M., & Bush, K. (2007). “Carbapenemases: the Versatile Beta-lactamases.” Clinical Microbiology Reviews, 20(3), 440-458.
4. Peleg, A. Y., Seifert, H., & Paterson, D. L. (2008). “Acinetobacter baumannii: Emergence of a Successful Pathogen.” Clinical Microbiology Reviews, 21(3), 538-582.
5. Walsh, T. R. (2010). “Emerging Carbapenemases: A Global Perspective.” International Journal of Antimicrobial Agents, 36, S8-S14.

Keywords

1. NDM-1 Carbapenemase
2. Acinetobacter baumannii Resistance
3. Antibiotic Resistance in Spain
4. ST85 Clone Spread
5. PCR Identification of NDM-1

With the development of this groundbreaking research, the global medical community must unite to fight the peril of antibiotic resistance. The discovery in Spain is a call to arms for aggressive monitoring, research, and the responsible use of antibiotic therapies to curb the tide of super-resistant infections.