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  1. Article ; Online: Insertion sequence disruption of adeR and ciprofloxacin resistance caused by efflux pumps and gyrA and parC mutations in Acinetobacter baumannii.

    Lopes, B S / Amyes, S G B

    International journal of antimicrobial agents

    2013  Volume 41, Issue 2, Page(s) 117–121

    Abstract: Acinetobacter baumannii is a pathogenic bacterium responsible for a wide range of infections in immunocompromised patients. This study examined the role of insertional inactivation of the adeR gene and its effect on adeABC gene expression along with ... ...

    Abstract Acinetobacter baumannii is a pathogenic bacterium responsible for a wide range of infections in immunocompromised patients. This study examined the role of insertional inactivation of the adeR gene and its effect on adeABC gene expression along with characterisation of the gyrA and parC mutations involved in ciprofloxacin resistance in three A. baumannii clinical isolates and their derivatives. Primers designed for the detection of adeSRABC detected the presence of ISAba16, which disrupted the adeR gene in strain Ab12M, and ISAba1, which disrupted the same gene in strains Ab18 and Ab209. A second copy of ISAba1 was detected upstream of the adeA gene in Ab209 leading to AdeABC pump expression. AdeIJK pump expression was seen in all of the isolates but was not as significant as AdeABC expression. Minimum inhibitory concentrations of ciprofloxacin were ≥256 mg/L for all of the isolates and a decrease of ≥8-fold was seen following addition of the efflux pump inhibitor 1-(1-naphthylmethyl)-piperazine. Fluorometric analysis also demonstrated active efflux, with upregulation of adeIJK and some genes of the adeABC operon in some strains. Sequencing of the quinolone resistance-determining region of the gyrA and parC genes revealed a Ser83→Leu change in the gyrA gene and a novel change of Ser80→Trp in the parC gene of Ab12, Ab12M and Ab209; in Ab18 there was a Ser80→Leu change in parC. This study shows the multifactorial contribution of different mechanisms in A. baumannii leading to ciprofloxacin resistance.
    MeSH term(s) Acinetobacter Infections/microbiology ; Acinetobacter baumannii/drug effects ; Acinetobacter baumannii/genetics ; Acinetobacter baumannii/isolation & purification ; Acinetobacter baumannii/metabolism ; Anti-Bacterial Agents/metabolism ; Anti-Bacterial Agents/pharmacology ; Biological Transport, Active ; Ciprofloxacin/metabolism ; Ciprofloxacin/pharmacology ; DNA Gyrase/genetics ; DNA Primers/genetics ; DNA Topoisomerase IV/genetics ; DNA, Bacterial/genetics ; Drug Resistance, Bacterial ; Humans ; Membrane Transport Proteins/genetics ; Membrane Transport Proteins/metabolism ; Microbial Sensitivity Tests ; Mutation
    Chemical Substances Anti-Bacterial Agents ; DNA Primers ; DNA, Bacterial ; Membrane Transport Proteins ; Ciprofloxacin (5E8K9I0O4U) ; DNA Topoisomerase IV (EC 5.99.1.-) ; DNA Gyrase (EC 5.99.1.3)
    Language English
    Publishing date 2013-02
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1093977-5
    ISSN 1872-7913 ; 0924-8579
    ISSN (online) 1872-7913
    ISSN 0924-8579
    DOI 10.1016/j.ijantimicag.2012.08.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Molecular characterisation and diversity in Enterobacter cloacae from Edinburgh and Egypt carrying bla(CTX-M-14) and bla(VIM-4) β-lactamase genes.

    Dimude, J U / Amyes, S G B

    International journal of antimicrobial agents

    2013  Volume 41, Issue 6, Page(s) 574–577

    Abstract: The purpose of this study was to compare the carbapenemases and extended-spectrum β-lactamases (ESBLs) associated with resistance, the genetic environment of these genes, and their location on plasmids among Enterobacter cloacae isolates from Edinburgh ( ... ...

    Abstract The purpose of this study was to compare the carbapenemases and extended-spectrum β-lactamases (ESBLs) associated with resistance, the genetic environment of these genes, and their location on plasmids among Enterobacter cloacae isolates from Edinburgh (UK) and Egypt. Nine E. cloacae isolates were obtained from Egypt (n=3) and Edinburgh (n=6). Antimicrobial susceptibility testing was performed by agar dilution. Molecular detection of carbapenemase genes, blaCTX-M-14 and the presence of integron structures was done by PCR and sequencing. Genotyping of the strains was performed by pulsed-field gel electrophoresis (PFGE) with XbaI restriction. Plasmids were extracted to determine the location of the resistance genes. PCR sequencing revealed that all of the isolates carried the blaCTX-M-14 ESBL gene, whilst two isolates also carried the blaVIM-4 metallo-β-lactamase gene. The blaCTX-M-14 genes in two isolates were associated with the ISEcp1 transposase. Analysis of the integrons found an intI1 integron associated with the complex ISCR1. The blaVIM-4 gene was identified in the form of a gene cassette within the class 1 integron, followed downstream by the resistance genes aacA7, dfrA1 and aadA2. PFGE revealed genetic relatedness among six isolates, whereas the others were diverse although related. Plasmid analysis revealed a single plasmid carrying both blaVIM-4 and blaCTX-M-14. In conclusion, the presence of insertion sequence ISEcp1 upstream of blaCTX-M-14 suggests its involvement in the expression and mobilisation of this gene. Linked carriage of blaVIM-4 and blaCTX-M-14 on the same plasmid in E. cloacae results in resistance to all β-lactams and limits antibiotic treatment options.
    MeSH term(s) Anti-Bacterial Agents/pharmacology ; Cluster Analysis ; DNA, Bacterial/chemistry ; DNA, Bacterial/genetics ; Egypt ; Electrophoresis, Gel, Pulsed-Field ; Enterobacter cloacae/drug effects ; Enterobacter cloacae/enzymology ; Enterobacter cloacae/isolation & purification ; Enterobacteriaceae Infections/microbiology ; Gene Order ; Genetic Variation ; Genotype ; Humans ; Integrons ; Microbial Sensitivity Tests ; Plasmids/analysis ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; United Kingdom ; beta-Lactamases/genetics
    Chemical Substances Anti-Bacterial Agents ; DNA, Bacterial ; beta-lactamase CTX-M-14 (EC 3.5.2.-) ; beta-Lactamases (EC 3.5.2.6) ; metallo-beta-lactamase VIM-4, Enterobacter cloacae (EC 3.5.2.6)
    Language English
    Publishing date 2013-04-24
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article
    ZDB-ID 1093977-5
    ISSN 1872-7913 ; 0924-8579
    ISSN (online) 1872-7913
    ISSN 0924-8579
    DOI 10.1016/j.ijantimicag.2013.02.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: The rise in bacterial resistance is partly because there have been no new classes of antibiotics since the 1960s.

    Amyes, S G

    BMJ (Clinical research ed.)

    2000  Volume 320, Issue 7229, Page(s) 199–200

    MeSH term(s) Anti-Bacterial Agents/classification ; Drug Resistance, Microbial ; Humans ; Technology, Pharmaceutical
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2000-01-22
    Publishing country England
    Document type Comment ; Editorial
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8138 ; 0959-8154 ; 0959-8146 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8138 ; 0959-8154 ; 0959-8146 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.320.7229.199
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Role of ISAba1 and ISAba125 in governing the expression of blaADC in clinically relevant Acinetobacter baumannii strains resistant to cephalosporins.

    Lopes, B S / Amyes, S G B

    Journal of medical microbiology

    2012  Volume 61, Issue Pt 8, Page(s) 1103–1108

    Abstract: Acinetobacter baumannii is a multi-resistant opportunistic nosocomial pathogen responsible for several outbreaks worldwide. It can cause several infections at various sites of the body. One of the main infections caused by this bacterium is ventilator- ... ...

    Abstract Acinetobacter baumannii is a multi-resistant opportunistic nosocomial pathogen responsible for several outbreaks worldwide. It can cause several infections at various sites of the body. One of the main infections caused by this bacterium is ventilator-associated pneumonia in patients in intensive care units. Treating these infections is becoming difficult because of the high resistance to antimicrobial agents. This study compared the expression of the chromosomally encoded bla(ADC) gene in isolates having ISAba1, ISAba125 and no insertion upstream of the bla(ADC) gene in A. baumannii clinical isolates. It showed that the expression of bla(ADC) was six times greater when ISAba125 was present upstream of the gene in comparison with the constitutively expressed bla(ADC) gene with no insertion present upstream. The study indicated that ISAba125 has better promoters than ISAba1 and this is responsible for the overexpression of the bla(ADC) gene as they share considerable homology to the well-established Escherichia coli promoters. The -10 box of ISAba125 formed a fusion promoter with the -35 box of the bla(ADC) gene causing the bla(ADC) gene to be significantly overexpressed. The ability to upregulate the expression of bla(ADC) with the assistance of different insertion elements such as ISAba1 and ISAba125 has become an important factor in A. baumannii resistance to cephalosporins.
    MeSH term(s) Acinetobacter Infections/microbiology ; Acinetobacter baumannii/drug effects ; Acinetobacter baumannii/enzymology ; Acinetobacter baumannii/genetics ; Acinetobacter baumannii/isolation & purification ; Anti-Bacterial Agents/pharmacology ; Cephalosporins/pharmacology ; DNA Transposable Elements ; DNA, Bacterial/chemistry ; DNA, Bacterial/genetics ; Gene Expression Profiling ; Gene Expression Regulation, Bacterial ; Gene Order ; Humans ; Molecular Sequence Data ; Promoter Regions, Genetic ; Sequence Analysis, DNA ; beta-Lactam Resistance ; beta-Lactamases/biosynthesis ; beta-Lactamases/genetics
    Chemical Substances Anti-Bacterial Agents ; Cephalosporins ; DNA Transposable Elements ; DNA, Bacterial ; beta-Lactamases (EC 3.5.2.6)
    Language English
    Publishing date 2012-04-12
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 218356-0
    ISSN 1473-5644 ; 0022-2615
    ISSN (online) 1473-5644
    ISSN 0022-2615
    DOI 10.1099/jmm.0.044156-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Klebsiella pneumoniae susceptibility to biocides and its association with cepA, qacΔE and qacE efflux pump genes and antibiotic resistance.

    Abuzaid, A / Hamouda, A / Amyes, S G B

    The Journal of hospital infection

    2012  Volume 81, Issue 2, Page(s) 87–91

    Abstract: Background: Although antiseptics are some of the most widely used antibacterials in hospitals, there is very little information on reduced susceptibility to these biocides and its relationship with resistance to antibiotics.: Aim: To determine the ... ...

    Abstract Background: Although antiseptics are some of the most widely used antibacterials in hospitals, there is very little information on reduced susceptibility to these biocides and its relationship with resistance to antibiotics.
    Aim: To determine the relationship between reduced susceptibility to biocides and the carriage of antiseptic resistance genes, cepA, qacΔE and qacE, as well as identifying the role of efflux pumps in conferring reduced susceptibility.
    Methods: Susceptibility was assessed for five biocides: chlorhexidine, benzalkonium chloride, Trigene, MediHex-4, Mediscrub; and for 11 antibiotics against 64 isolates of Klebsiella pneumoniae. Susceptibility to all compounds was tested by the agar double dilution method (DDM) and the effect of efflux pumps on biocides determined by repeating the susceptibility studies in the presence of the efflux pump inhibitor carbonyl cyanide m-chlorophenyl hydrazone (CCCP). The presence of the cepA, qacΔE and qacE genes was identified by polymerase chain reaction.
    Findings: The bacteria were not widely antibiotic resistant though a few showed reduced susceptibility to cefoxitin, chloramphenicol and rifampicin and later-generation cephalosporins but not to carbapenems. Biocide susceptibility, tested by DDM, showed that 50, 49 and 53 strains had reduced susceptibility to chlorhexidine, Trigene and benzalkonium chloride, respectively. The antiseptic resistance genes cepA, qacΔE and qacE were found in 56, 34 and one isolates respectively and their effects as efflux pumps were determined by CCCP (10 mg/L), which decreased the minimum inhibitory concentrations (MICs) of chlorhexidine and Medihex-4 by 2-128-fold but had no impact on the MICs of benzalkonium chloride, Trigene and Mediscrub.
    Conclusion: There was a close link between carriage of efflux pump genes, cepA, qacΔE and qacE genes and reduced biocide susceptibility, but not antibiotic resistance, in K. pneumoniae clinical isolates.
    MeSH term(s) Biological Transport ; Disinfectants/metabolism ; Disinfectants/pharmacology ; Drug Resistance, Bacterial ; Genes, Bacterial ; Humans ; Klebsiella pneumoniae/drug effects ; Klebsiella pneumoniae/genetics ; Klebsiella pneumoniae/metabolism ; Membrane Transport Proteins/genetics ; Membrane Transport Proteins/metabolism ; Microbial Sensitivity Tests
    Chemical Substances Disinfectants ; Membrane Transport Proteins
    Language English
    Publishing date 2012-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 779366-2
    ISSN 1532-2939 ; 0195-6701
    ISSN (online) 1532-2939
    ISSN 0195-6701
    DOI 10.1016/j.jhin.2012.03.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: A potential key role for alpha-haemolysin of

    Smith, I D M / Milto, K M / Doherty, C J / Amyes, S G B / Simpson, A H R W / Hall, A C

    Bone & joint research

    2018  Volume 7, Issue 7, Page(s) 457–467

    Abstract: Objectives: Staphylococcus aureus: Methods: Bovine cartilage explants were cultured with isogenic : Results: Hla-producing mutants caused substantial chondrocyte death compared with the toxin-deficient control (Hla-Hlb-Hlg-), whilst mutants ... ...

    Abstract Objectives: Staphylococcus aureus
    Methods: Bovine cartilage explants were cultured with isogenic
    Results: Hla-producing mutants caused substantial chondrocyte death compared with the toxin-deficient control (Hla-Hlb-Hlg-), whilst mutants producing Hlb and Hlg in the absence of Hla induced minimal chondrocyte death. Coronal studies established that Hla-induced chondrocyte death started in the superficial zone of cartilage and spread to deeper layers, whereas Hlb and Hlg toxins were without significant effect.
    Conclusion: This study identified Hla as a highly potent
    Language English
    Publishing date 2018-08-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 2669244-2
    ISSN 2046-3758
    ISSN 2046-3758
    DOI 10.1302/2046-3758.77.BJR-2017-0165.R1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Resistance to beta-lactams--the permutations.

    Amyes, S G B

    Journal of chemotherapy (Florence, Italy)

    2003  Volume 15, Issue 6, Page(s) 525–535

    Abstract: The beta-lactam family of antimicrobials, in particular penicillins and cephalosporins, is the mainstay of treatment for community-acquired infections. However, the emergence of resistant isolates to these agents has raised concerns regarding the ... ...

    Abstract The beta-lactam family of antimicrobials, in particular penicillins and cephalosporins, is the mainstay of treatment for community-acquired infections. However, the emergence of resistant isolates to these agents has raised concerns regarding the continued efficacy of existing therapies. Resistance to beta-lactams is most commonly expressed by the microbial production of beta-lactamases that hydrolyze the beta-lactam ring. Three further resistance mechanisms include conformational changes in penicillin-binding proteins (PBPs); permeability changes in the outer membrane; and active efflux of the antimicrobial. In addition to the pre-requisite efficacy and tolerability profiles, new beta-lactams should address these four resistance mechanisms. Overcoming resistance may be a serendipitous event or arrived at by design. A unique synthetic beta-lactam class, which demonstrates promise in terms of its activity against the range of bacteria responsible for community-acquired infections and its inherent stability to hydrolysis by beta-lactamases, is the penems. This discrete class of hybrid molecules combines properties from the penicillin (penam) and cephalosporin (cephem) beta-lactam classes. Faropenem is an example of a penem with a broad spectrum of activity designed to address these resistance issues.
    MeSH term(s) Biological Availability ; Community-Acquired Infections/drug therapy ; Community-Acquired Infections/microbiology ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Resistance, Multiple, Bacterial ; Humans ; Microbial Sensitivity Tests ; Sensitivity and Specificity ; beta-Lactam Resistance ; beta-Lactams/pharmacokinetics ; beta-Lactams/therapeutic use
    Chemical Substances beta-Lactams
    Language English
    Publishing date 2003-12
    Publishing country England
    Document type Comparative Study ; Journal Article ; Review
    ZDB-ID 1036294-0
    ISSN 1973-9478 ; 1120-009X
    ISSN (online) 1973-9478
    ISSN 1120-009X
    DOI 10.1179/joc.2003.15.6.525
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Carbapenems: do they have a future?

    Hamouda, A / Findlay, J / Amyes, S G B

    Journal of medical microbiology

    2011  Volume 60, Issue Pt 9, Page(s) 1229–1230

    MeSH term(s) Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Bacteria/drug effects ; Bacterial Infections/drug therapy ; Bacterial Infections/microbiology ; Carbapenems/pharmacology ; Carbapenems/therapeutic use ; Humans ; beta-Lactam Resistance
    Chemical Substances Anti-Bacterial Agents ; Carbapenems
    Language English
    Publishing date 2011-06-30
    Publishing country England
    Document type Editorial
    ZDB-ID 218356-0
    ISSN 1473-5644 ; 0022-2615
    ISSN (online) 1473-5644
    ISSN 0022-2615
    DOI 10.1099/jmm.0.031013-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Carbapenem resistance in clinical isolates of Pseudomonas aeruginosa.

    Walsh, F / Amyes, S G B

    Journal of chemotherapy (Florence, Italy)

    2007  Volume 19, Issue 4, Page(s) 376–381

    Abstract: The objectives of this study were to identify the carbapenem resistance mechanisms of clinical Pseudomonas aeruginosa isolates. The strains resistant to imipenem had lost only the OprD protein, the isolates resistant to imipenem and meropenem had both ... ...

    Abstract The objectives of this study were to identify the carbapenem resistance mechanisms of clinical Pseudomonas aeruginosa isolates. The strains resistant to imipenem had lost only the OprD protein, the isolates resistant to imipenem and meropenem had both loss of the OprD porin and reduced minimum inhibitory concentrations (MICs) in the presence of efflux pump inhibitors. In the isolates in which efflux had been identified (n=2) only 1 isolate had a mutation in the mexR gene corresponding to a glutamine to a stop codon change at amino acid 106. This has not been previously identified. There were no significant changes in the mexT genes. No mutations previously associated with the upregulation of the carbapenem efflux pumps in in vitro generated resistant isolates were identified in any of the clinical isolates. Therefore, the resistance mechanisms identified by development of carbapenem resistance in vitro are not sufficient to understand carbapenem resistance development in clinical isolates.
    MeSH term(s) Amino Acid Sequence ; Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics ; Base Sequence ; Carbapenems/pharmacology ; Codon, Terminator/genetics ; Drug Resistance, Bacterial/genetics ; Glutamine/genetics ; Humans ; Imipenem/pharmacology ; Microbial Sensitivity Tests ; Molecular Sequence Data ; Mutation ; Porins/genetics ; Pseudomonas aeruginosa/drug effects ; Pseudomonas aeruginosa/genetics ; Pseudomonas aeruginosa/isolation & purification ; Repressor Proteins/genetics ; Sequence Analysis, DNA ; Thienamycins/pharmacology
    Chemical Substances Anti-Bacterial Agents ; Bacterial Proteins ; Carbapenems ; Codon, Terminator ; MexR protein, Pseudomonas aeruginosa ; Porins ; Repressor Proteins ; Thienamycins ; Glutamine (0RH81L854J) ; OprD protein, Pseudomonas aeruginosa (148412-32-2) ; Imipenem (71OTZ9ZE0A) ; meropenem (FV9J3JU8B1)
    Language English
    Publishing date 2007-08
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1036294-0
    ISSN 1973-9478 ; 1120-009X
    ISSN (online) 1973-9478
    ISSN 1120-009X
    DOI 10.1179/joc.2007.19.4.376
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Strategies and options for minimizing resistance emergence in pulmonary infections.

    Amyes, S G

    Chest

    1998  Volume 113, Issue 3 Suppl, Page(s) 228S–232S

    Abstract: The early-onset hospital pulmonary gram-negative infections may respond to ciprofloxacin and co-amoxiclav without significant resistance development. Penicillin-resistant Streptococcus pneumoniae may be treated with macrolides, fluoroquinolones, and ... ...

    Abstract The early-onset hospital pulmonary gram-negative infections may respond to ciprofloxacin and co-amoxiclav without significant resistance development. Penicillin-resistant Streptococcus pneumoniae may be treated with macrolides, fluoroquinolones, and glycopeptides. The late-onset hospital pathogens all seem to have developed resistance to cephalosporins, so greater reliance is now made on the fluoroquinolones and carbapenems when aminoglycoside therapy is considered undesirable.
    MeSH term(s) Acinetobacter/drug effects ; Anti-Infective Agents/therapeutic use ; Carbapenems/therapeutic use ; Cephalosporins/pharmacology ; Cross Infection ; Drug Resistance, Microbial ; Fluoroquinolones ; Hospitals ; Humans ; Lung Diseases/drug therapy ; Macrolides/pharmacology ; Microbial Sensitivity Tests ; Penicillin Resistance ; Respiratory Tract Infections/drug therapy ; Scotland ; Streptococcus pneumoniae/drug effects
    Chemical Substances Anti-Infective Agents ; Carbapenems ; Cephalosporins ; Fluoroquinolones ; Macrolides
    Language English
    Publishing date 1998-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1378/chest.113.3_supplement.228s
    Database MEDical Literature Analysis and Retrieval System OnLINE

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