IJAA Editor's Choice
The Editor's Choice articles, chosen by Editor Jean-Marc Rolain and Scientific Assistant, Sophie Barron, are available to read for free for a limited time only!
"Multi-drug resistant Klebsiella pneumoniae are emerging pathogens these last years, mostly in hospital settings. Some clones of K. pneumoniae such as the well-known CC258 clonal complex, the CG14 or the CG147 have been widely described to carry multi-drug resistance and to spread worldwide. The ST307 clone is a multi-drug resistant clone associated with ESBL beta-lactamase, carbapenemases and/or colistin resistance that has emerged in hospital settings in the mid 1990’s. In this retrospective study from 2012 to 2017, Shamina et al. observed this clone became dominant in Moscow among carbapenemase K. pneumoniae producers (CarbR-Kp). CarbR-Kp mostly carry a blaOXA-48 gene and acquired colistin resistance in 45% of cases. This resistance was mostly caused by the alteration of the mgrB gene. Interestingly in ST307 isolates, mgrB gene was truncated by a small mobile genetic element MITE at the position +74, known to be a hotspot recombination for insertion sequence (IS). This study still demonstrates the ability of some clones to acquire numerous resistance factors and to spread worldwide. Understanding the factors explaining these faculties will be key to understanding the epidemiology of resistance and clones."
"ß-lactamases constitute a wide family of enzymes that are interestingly found in bacteria but also in other fields of life. In this study, authors tend to understand the mechanism of resistance to ß-lactams in Acanthamoeba castellanii. They first showed that ß-lactams influence the encystation process in this amoeba, by decreasing the percentage of cyst. But Acanthamoaeba can protect its encystation process by producing a ß-lactamases. This ß-lactamases have six isoforms in amoeba, suggesting an evolution has occurred in this genus. Interestingly, the gene was successfully expressed in Escherichia coli, leading resistance to cefotaxime, cefuroxime, penicillin and meropenem. These findings suggest that this family of gene gives an advantage for surviving not only in bacteria. These ß-lactamases may play other role in amoeba explaining its conservation in this organism."
1. Update and recent advances on azole resistance mechanisms in Aspergillus(Perez-Cantero et al)
"Aspergillus spp., mainly represented by Aspergillus fumigatus, is the most frequent filamentous fungi encountered in human infectious disease. Invasive aspergillosis affects immunocompromised patient, mostly suffering from solid or hematological malignancies or treated with chemotherapy, corticosteroid or transplantation. The main treatment for such affection relies on the use of voriconazole, an azole drug or amphotericin B. These last year, azole resistance in Aspergillus has alarmingly increased, not only in A. fumigatus, raising concern of therapeutic impasse and an increase of mortality. Detection of these resistance became important to adapt treatment of such infection. In this work, Capilla et al., reviewed mechanisms of azole resistance that have been described to date in literature, in A. fumigatus and other frequently encountered Aspergillus. They highlight for the need of more studies on this field, with a higher number of isolates tested to better understand these molecular mutations on therapeutic failure. This review may contribute to the development of molecular and/or phenotypic techniques for the detection of the most frequent resistances leading to faster adaptation of the treatment or to the highlighting of new pathways/targets for the development of new active therapy."
"Carbapenem-resistant Klebsiella pneumoniae infections treatment are a current challenge for clinicians. The use of monotherapy or combination therapy and the choice of antibiotic therapy are issues that have already been raised in the literature, with studies conducted that are difficult to compare and statistically not very robust. In this context, Agyeman et al. performed a systematic review of literature to identify treatment strategies that made consensus through the different studies and questions that are still unresolved. Base on their findings, they insist on the need of well-designed randomized clinical trials to defined the most appropriate antibiotic therapy to choose for CRKP infections."