Molecular epidemiology of plasmid patterns in Shigella dysenteriae type I obtained from an outbreak in West Bengal (India)

Abstract Multiple antibiotic-resistant Shigella dysenteriae type 1 isolates from a recent epidemic in West Bengal (India) showed identical plasmid patterns. All isolates were resistant to ampicillin (Am), chloramphenicol (Cm), tetracycline (Tc), streptomycin (Sm) and trimethoprim (Tp) and contained 6 plasmids, ranging from 2.5–120 kb. The Am resistance determinant was located on the 120 kb plasmid. This plasmid was unstable when the S. dysenteriae strains were grown above 37°C. The Bangladesh strains of S. dysenteriae type 1 showed identical plasmid patterns, except that many isolates were Am-sensitive and lacked the 120 kb plasmid. In strains from both Bangladesh and West Bengal, predominantly group-B plasmids conferred resistance to Cm and Tc. Comparisons of Eco R1 fragments generated from the total plasmid DNA content of each strain support the view that the plasmids present in the S. dysenteriae type 1 strains isolated from all recent epidemics in India and Bangladesh were identical.     

Level and nature of the drug resistance of Shigella flexneri]

Characteristics of antibiotic resistance of 300 strains of Shigella flexner 2a isolated from patients within 1976--1977 in the regions where these bacteria were very rare for a long period of time were studied. It was shown that most of the isolates were resistant to chloramphenicol (88.1 per cent), tetracycline (94.8 per cent), streptomycin (89.1 per cent), polymyxin M (82.4 per cent) and others. 46.5--61.6 per cent of the isolates were resistant to neomycin antibiotics. A high level of the resistance was also noted: the bactericidal effect was registered in 52.0-74.0 per cent of the cultures at a dose of 500--1000 microgram/ml. 91.4 per cent of the strains possessed multiple dug resistance, 78.8 per cent of them being simultaneously resistant to 4--7 drugs. Transmissive R-plasmids were found in 68.8 per cent of the isolates. After exposure to acridine dyes the plasmid nature of the resistance was confirmed in 72.3 per cent of the cultures. Variability of the r-determinant sets in r-plasmids was noted. Strains (64.9 per cent) carrying r-determinants Tc, Cm, Sm and Tc, Cm were more frequent. Strains with one transmissive r-determinant were usually solitary.     

Increase in drug resistance among Shigella dysenteriae,Sh flexneri,and Sh boydii.

Two thousand three hundred and seventy strains of Shigella dysenteriae, Sh flexneri, and Sh boydii isolated in England and Wales from 1974 to 1978 were tested for resistance to 12 antimicrobial drugs. Eighty per cent of strains were resistant to one or more drugs, with sulphonamide resistance occurring most frequently. Resistance to streptomycin, tetracycline, ampicillin, and chloramphenicol increased during the period, as did the incidence of multiple resistance. Most infections due to Sh dysenteriae, Sh flexneri, and Sh boydii are acquired abroad, and the increasing incidence of drug resistance among these organisms contrasts with the decreasing incidence of resistance among the indigenous Sh sonnei. These findings may indicate the need for better control of antibiotic use, particularly in developing countries.     

Antibiotic sensitivity and the characteristics of transmissive R plasmids in Shigella belonging to various species]

Sensitivity of 241 Shigella strains isolated from patients at various regions of the USSR in 1975--1978 was tested with respect to 14 antibiotics by the method of serial dilutions. 90.5 per cent of the isolates proved to be resistant to the antibacterial drugs and the greater part of 75.9 per cent of them had multiple resistance. The resistance of the Shigella was most pronounced and frequent with respect to tetracycline, streptomycin, levomycetin, as well as ampicillin and carbenicillin. Gentamicin, cephaloridin, polymyxin M, kanamycin, monomycin, neomycin and rifampicin were highly active against the Shigella. More than 50 per cent of the isolates were sensitive to levomycetin, ampicillin and carbenicillin. Differences in the frequency of the resistant strains and the spectrum of the antibiotic resistance of different Shigella subgroups (species) were observed. The study of 173 multiple resistant Shigella strains showed that about 67 per cent of the strains had a capacity for transduction of the resistance markers into the recipient cells of E. coli. The conjugative R-plasmids were most frequent in Sh. boydii and Sh. sonnei (95 and 95 per cent respectively), less frequent in Sh. flexneri and Sh. newcastle (68 and 53 per cent respectively) and least frequent in the mannitol negative Shigella (25 per cent). The capacity for transduction of R-plasmids in the strains carrying the determinants of resistance to 2 or 3 antibiotics was higher than in the strains carrying the determinant of resistance to one antibiotic. The clinical Shigella strains tested mainly had transmissive R-plasmids of fi--character (79 per cent).     

E. coli resistance to antibiotics on the material studied and the structure of the antibiotic resistance of the strains]

Standard filter paper discs were used to determine the sensitivity of 943 strains of E. coli isolated in 1970-1974 from patients' purulent-inflammatory foci with respect to benzylpenicillin, streptomycin, levomycetin, tetracycline, erythromycin and monomycin. An increase in the specific weight of the cultures resistant to the 6 drugs from 4.7 +/- 1.7 per cent in 1970 to 16.0 +/- 2.6 per cent in 1974 was observed. Strains resistant to 5--6 antibiotis were more often isolated from the urine (64.6 per cent) and the wound content (48.9 per cent) and rarer from the abdominal cavity exudate (23.1 per cent), bile (28.0 per cent) and sputum (30.1 per cent). Most often certain combinations of resistance to benzylpenicillin, streptomycin, tetracycline and erythromycin were found in the E. coli strains tested.     

Plasmid incidence rate and conjugative chloramphenicol and tetracycline resistance plasmids in Malaysian isolates of Salmonella typhi

Seven (6.1%) of 115 strains of Salmonella typhi isolated from Malaysian patients harbored a single large plasmid of 71 to 166 mD. Two of the seven plasmid-bearing strains were resistant to chloramphenicol (Cm) and tetracycline (Tc) and they transferred Cm and Tc resistance traits to Escherichia coli K12 at frequencies from 1.6 x 10(-7) to 1.9 x 10(-6). Agarose gel electrophoresis provided evidence that the resistance traits were cotransferred on a conjugative plasmid. The significance and importance of these results are discussed.     

R factors of pathogenic strains of Escherichia coli isolated from infant diarrhoea

Several drug resistance patterns were determined in 170 pathogenic strains of E. coli isolated in 6 Polish towns from infant diarrhoea. The most frequent were strains resistant to 5 different drugs: ampicillin, tetracycline, chloramphenicol, streptomycin and sulfonamide. Conjugative R factors of 30 strains of the same resistance pattern (Ap Tc Cm Sm Su) were characterised by determining their Fi(F) character, incompatibility and molecular weight.     

R-plasmids of bacteria of the genus Pseudomonas isolated from industrial sewage

A total of 132 Pseudomonas strains isolated from untreated sewage of antibiotic plants were tested. A significant number of the strains were resistant to streptomycin (77 per cent), carbenicillin (75 per cent), kanamycin (37.5 per cent) and tetracycline (23 per cent). Eighteen conjugative and 3 nonconjugative resistance plasmids were detected in 19 strains. The genes determining the resistance to streptomycin, kanamycin and tetracycline were most frequent. The frequency of the plasmid transfer between the strains of Ps. aeruginosa (PAO) varied within 10(-3)--10(-7) per donor cell. Six plasmids belonged to group Inc P-1. Four plasmids belonged to group Inc P-2, 3 plasmids to groups Inc P-3 and Inc P-5 and 1 plasmid to group Inc P-7.     

R plasmid distribution in S. typhi isolated on the territory of the left coast of the Ukraine in 1970-1982

A total of 373 strains of S. typhi isolated in 1970-1982 were tested with respect to their sensitivity to 9 antibiotics active against gram-negative bacteria. It was shown that about 1/3 of the isolates were resistant to 1-3 antibiotics. Among the resistant isolates the number of strains resistant to 4-5 and more antibiotics amounted to 12.5 per cent. The plasmid nature of the antibiotic resistance in the isolated strains of S. typhi was shown. Transmissive R plasmids were detected in 13 per cent of the strains studied. Within the last 5 years there was an increase in the proportion of strains with transmissive R plasmids in patients with sporadic typhoid fever or especially in groups of patients with the disease.     

Co-Transduction of Plasmids Mediating Resistance to Tetracycline and Chloramphenicol in Staphylococcus aureus

Independent plasmids mediating resistance either to tetracycline (Tc) or chloramphenicol (Cm) were transduced successively into Staphylococcus aureus strain 8325. From this doubly resistant donor strain, Tc was co-transduced with a frequency of 40 to 50% when Cm was selected. Co-transduction of Cm was 5 to 10% with Tc selection. Plasmid elimination was infrequent and restricted to the Cm plasmid. A variant, doubly resistant strain gave 100% co-transduction of Tc and Cm and a high rate of joint elimination of both plasmid markers. Co-transduction of the plasmids from recombination-deficient donor strains was much reduced if the plasmids had been introduced separately into the donor strain, but occurred at the normal high rate if they had been introduced jointly. The plasmids were co-transformed at relatively low rates with closed circular deoxyribonucleic acid (DNA) from doubly resistant donors, but not with DNA from a mixed lysate of singly resistant strains. Our evidence favored a hypothesis of recombination-dependent, reversible linkage between the two plasmids as the basis for their co-transduction. Examination of plasmid DNA from the doubly resistant strains by ultracentrifugal and electron microscopic methods did not disclose any physical differences between singly and doubly resistant strains that might account for the observed co-transduction.     

Antibiotic resistance and its transmissibility in strains of opportunistic enterobacteria

Sensitivity of 39 opportunistic Enterobacteria strains was studied with respect to tetracycline, kanamycin, ampicillin, levomycetin, streptomycin and nevigramon. The strains were isolated from children with acute intestinal infections of obscure etiology. 38 isolates were resistant to one or more drugs. The highest number of the strains was resistant to kanamycin, ampicillin and levomycetin, i.e. 81.5, 84.2 and 84.2 per cent of the cultures respectively. Nevigramon proved to be the most effective in vitro (76.4 per cent of the sensitive strains). The ability of the strains to transfer the antibiotic resistance markers on conjugation was tested. Transmission of R plasmids was shown in 75 per cent of the isolates.     

The R-factors of multiple antibiotic resistant faecal coliforms isolated from a domestic dog

The antibiotic resistant faecal flora of a domestic dog suffering from an acute enteric infection was examined. The flora exhibited overall resistance to a wide variety of antibiotics. However, following restoration of the animal to normal health, overall resistance to ampicillin (Ap), tetracycline (Tc), chloramphenicol (Cm) and streptomycin (Sm) was lost, although low numbers of bacteria resistant to these four antimicrobial agents could still be isolated up to one year later. A total of 11 strains were purified for further study. All 11 were positively identified as Escherichia coli and shown to be resistant to various combinations of the above antibiotics, and additionally to kanamycin (Km). Each strain harboured from one to five plasmids, although only four proved capable of transferring antibiotic resistance to Escherichia coli K-12. One of the strains was found to harbour two conjugal plasmids pNJ101 (60 Md) and pNJ102 (133 Md) which coded for resistance to Cm, Tc, Ap and Cm, Tc, Km respectively. A third plasmid pNJ103 (29 Md) remains cryptic. The possession of the two plasmids pNJ101 and pNJ102 appears to be an unstable situation as variants arose harbouring one or other of the plasmids.     

Sensitivity of Corynebacterium diphtheriae isolated in Saint-Petersburg to antibacterial drugs]

One hundred and thirty strains of Corynebacterium diphtheriae isolated in St. Petersburg (42 toxigenic and 88 nontoxigenic) were tested with the method of serial dilutions in solid media for their susceptibility to 20 antibacterial drugs. The MICs of the drugs for the isolates ranged from < or = 0.015 to > or = 32.0 micrograms/ml. 13 per cent of the isolates was resistant at least to one antibacterial drug. The isolates resistant to erythromycin (11.5 per cent), lincomycin (11.5 per cent) and trimethoprim (8.5 per cent) were most frequent. 3 isolates (2.3 per cent) had multiple resistance to 8 drugs: benzylpenicillin, ampicillin, oxacillin, chloramphenicol, erythromycin, lincomycin, trimethoprim, and nitroxolin. No significant differences in the susceptibility of the toxigenic and nontoxigenic strains of C. diphtheriae were detected. Gentamicin, rifampicin, tetracycline, doxycycline and pefloxacin were the most active antibiotics.     

Antibiotic sensitivity of Staphylococci populating the breast skin of nursing women

Sensitivity to penicillins, tetracycline, erythromycin and lincomycin was tested in 1513 staphylococcal strains isolated from the skin of various anatomic areas of the breast of nursing mothers. It was shown that 82.9, 78.4 and 33.9 per cent of the isolated cultures were highly sensitive to lincomycin, erythromycin and methicillin respectively. Sensitivity to tetracycline and benzylpenicillin was detected in 33.1 and 19.8 per cent of the cultures respectively. The study of the resistance spectra of 1343 strains resistant to certain antibiotics revealed that 498 cultures (37.1 per cent) were polyresistant. None of the tested antibiotics could be used for selective decontamination of the breast skin with respect to S. aureus in prophylaxis of lactic mastitis.     

Drug resistance of opportunistic enterobacteria isolated from various sources]

Resistance of 159 strains of opportunistic enterobacteria to 9 antibacterial drugs was studied. The strains were isolated from man and cattle. It was shown that the overwhelming majority of the isolates (93 per cent) were polyresistant irrespective of the genus. There was a high frequency of the strains resistant to the widely used antibiotics such as chloramphenicol (73 per cent), ampicillin (73.6 per cent) and rifampicin (95.6 per cent) and sulfanilamides (99.3 per cent). Gentamicin and nalidixic acid proved to be the most active against the cultures: 11.9 and 10 per cent of the resistant strains, respectively. The strains of enterobacteria isolated from different sources had a sensitivity to the antibiotics. Multiple antibiotic resistance to at least 5 drugs, variability of the spectra and high resistance were more characteristic of the isolates from the animals. The necessity of a rational use of antibacterial drugs in veterinary is indicated.     

Antibiotic sensitivity of Proteus, Pseudomonas pyocyanea and staphyloccoci isolated from scleroma and ozena patients]

Antibiotic sensitivity of 292 strains of Proteus, 60 strains of Ps, aeruginosa, 309 strains of S. aureus and 88 strains of S. epidermidis isolated from the upper respiratory tract of patients with scleroma and ozena was studied. The cultures of Pr. mirabilis were sensitive to aminoglucosides (54.9-96.2 per cent) and Pr. morganii were sensitive to levomycetin (81.5 per cent) and neomycin (92.6 per cnet). Sensitivity of Pr. vulgaris and Pr. morganii was reliably higher (p less than 0.001) than that of Pr. mirabilis. The strains of Pr. morganii were less sensitive to monomycin (P less than 0.001) and streptomycin (p less than 0.01) as compared to the cultures of other Proteus species tested. The strains of Ps. aeruginosa were sensitive only to gentamicin (90 per cent) and neomycin (81.1 per cent). Most of the strains of S. aureus (85.4-100 per cent) were sensitive to oleadomycin, erythromycin, olemorphocycline, tetraolean, oxacillin, methicillin ceporin, lincomycin, ristomycin, kanamycin, monomycin and gentamicin. Benzylpenicillin (90.8 per cent of the sensitive strains), ampicillin (67.1 per cent), tetracycline (66.7 per cent), levomycetin (68.6 per cent) and streptomycin (38.1 per cent) were less effective. Antibacterial therapy in cases with scleroma and ozena should be directed not only against causative agents of the diseases but also against the microbes developing due to disbacteriosis. Combination of parenteral and local use of the antibiotics in the treatment of chronic clebsiellesis decreased the isolation rate of Proteus and Ps. aeruginosa in the patients.     

Antibiotic sensitivity of nonfermenting gram-negative bacteria

Antibiotic resistance of 132 strains of nonfermenting gram-negative bacteria (NGNB) was studied. 43, 20, 17, 14 and 12 of them belonged to Acinetobacter calcoaceticus (anitratus and lwoffi), Pseudomonas cepacia, Alcaligenes faecalis, P. stutzeri and P. maltophilia, respectively. With rare exceptions all the strains were resistant to benzylpenicillin, oxacillin, lincomycin, ampicillin and cephaloridine. Sensitivity to the other antibiotics varied within wide ranges. Amikacin (94.3 per cent) and tobramycin (90.8 per cent), as well as polymyxin, rifampicin and gentamicin (71.7-66.9 per cent) had the highest effect. The majority of the antibiotics had higher activity (p less than 0.01) against the tested NGNB as compared to their activity against P. aeruginosa. Antibioticograms of every of the tested species of NGNB revealed that P. cepacia and P. stutzeri were the most resistant species. The biovars of Acinetobacter varied in their antibiotic resistance: A. subsp. lwoffi was more sensitive to the majority of the antibiotics though some of them, i.e. doxycycline, carbenicillin, and polymyxin were more active against A. subsp. anitratus.     

Development and Transduction of Rsistance to Novobiocin and Nikkol-SNP 7.5 A (an Anionic Surfactant) in Staphylococcus aureus

The susceptibility to Novobiocin (NB) and Nikkol-SNP 7.5 A (NS), an anionic surfactant, was studied in 458 strains of coagulase-positive Staphylococcus aureus isolated from clinical sources. Twenty three (4.9%) of these strains were resistant to NB with minimum inhibition concentration (MIC) of 1.6 μg per ml or more, 97 (21.2%) resistant to NS with MIC of 6.25 mg per ml or more, and 17 (3.7%) resistant to both drugs. Cross-resistance to NB and NS was found in 74 per cent of 23 NB-resistant strains and 17.5 per cent of 97 NS-resistant strains. Nearly one half of NS-resistant strains belonged to phase group I, while the remainder were non-typable. The majority of the NB-resistant strains were not phage typable. In S. aureus strain PS 53 used for propagating phage 53, resistance to 25 mg per ml of NS was attained rapidly by single step without accompanying that to NB, whereas resistance to 25 μg per ml of NB developed gradually by three successive steps and was accompanied by a rapid development of resistance to NS first by two steps. The transduction experiments in strain PS 53 showed that resistance to NB and NS was jointly transduced and the genetic loci responsible for resistance to both drugs are closely linked.     

Characterization and transferability of Clostridium perfringens plasmids.

Two strains of Clostridium perfringens resistant to clindamycin (Cl), chloramphenicol (Cm), erythromycin (Em), and tetracycline (Tc) were isolated in France in 1974 and 1975. For one of these strains, curing experiments and molecular characterization of the extrachromosomal DNA clearly demonstrate the existence of two plasmids, plP401 (54 kilobases) and plP402 (63 kilobases), which, respectively, code for Tc Cm and Em Cl resistance. With mixed cultures, the Tc Cm plasmid is transferable to sensitive strains of C. perfringens; a segregation of these markers is frequently observed during mating experiments. In contrast, the transfer of the naturally occurring plasmid Em Cl does not occur at a significant rate. In performing transfer experiments in axenic mice, we obtained a Cl^r Em^r Tc^r transcipient whose chromosomal properties are those of a hybrid. When used in mating as a parental strain, this strain promotes chromosomal gene exchange. The role of the plasmid in this phenomenon is discussed, these transcipients being generally Cl^r Em^r Tc^r. The plasmid transfer is not limited to antibiotic resistance plasmids, the transferability of a bacteriocinogenic plasmid, plP404, harbored by C. perfringens BP6K-N5 being shown also. The transfer mechanism remains to be proved; it might be a conjugation process, a cell-to-cell contact being necessary for the transfer.     

Infectious Drug Resistance Among Clinically Isolated Escherichia coli

Of 398 strains of clinically isolated Escherichia coli from three Birmingham, Alabama, hospitals, 38% were found to be resistant to one or more drugs tested. Fifty-seven per cent of the resistant strains transferred all or a part of their resistance pattern to sensitive cells during mixed cultivation. Of the 152 resistant strains, 29.1% were singly resistant, and 70.5% were resistant to more than one drug. Of the multiply resistant strains, 61% transferred all or a part of their pattern. Strains isolated from Veterans Hospital patients demonstrated higher percentages of resistance than strains isolated from Children's Hospital patients. An extremely low incidence of infective drug resistance was noted among E. coli isolated from the stools of healthy hospital employees.