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Akkermansia muciniphila, a member of the Verrucomicrobiota phylum, is recognized as a key gut microbe and has emerged as a potential next-generation probiotic. Assessment of antibiotic resistance in probiotics is a prerequisite for their application, while very few is studied in Akkermansia species. To address this, eight representative class A β-lactamases (36.90 %-41.30 % identity with known β-lactamases) from the Akkermansia species were screened and found to increase the minimum inhibitory concentration (MIC) of Escherichia coli to β-lactams (2-1024 fold). Secondly, four β-lactamases were successfully purified and identified as extended-spectrum β-lactamase because they exhibited hydrolase activity against β-lactams from penicillin, cephalosporins, and monobactam classes. Based on predicted three-dimensional structure, we hypothesized and validated that serine at 51 position was catalytic amino acid. Thirdly, the genomic context analysis revealed the absence of mobile genetic elements or other antibiotic resistance genes surrounding β-lactamase genes, suggesting they may not be transferable. This study provides a foundational basis for the safety evaluation of Akkermansia species as probiotics., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The emergence of RND efflux pump gene cluster tmexCD-toprJ threats the clinical use of tigecycline as a last-resort antibiotic. Co-existence of extended spectrum β-lactamases and tmexCD-toprJ can accelerate the emergence of multidrug resistant or extensively drug-resistant Pseudomonas aeruginosa, leading to the production of high-risk clones. This study identified a novel gene cluster, tmexC6D6.2-toprJ1b, on the chromosome of a high-risk ST233 XDR P. aeruginosa from Chinese retail chicken samples. Genetic feature analysis revealed that a tnfxB6-tmexC6D6.2-toprJ1b-strBA-floR-tet(G)-IS6100-sul1-aadA2-int1-intA structure formed a putative transposition unit. tmexC6D6.2-toprJ1b shared high similarity at the nucleotide level with other tmexCD-toprJ gene clusters. tnfxB6 regulator was located downstream from the tmexC6D6.2-toprJ1b gene cluster and it did not affect bacterial resistance phenotype. The expression of tmexC6D6.2-toprJ1b could reduce the growth of E. coli and bring a moderate fitness cost. Further studies are needed to decipher the mechanism of the silencing of tnfxB6 in mediating the high-level resistance of tmexC6D6.2-torpJ1b and continuously monitor the coexistence of the novel tmexCD-toprJ gene cluster and the ESBLs-related resistance genes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Animal food products are important sources of zoonotic agents, increasing the risk of exposure to antibiotic-resistant bacteria from farm to fork. Therefore, we aimed to detect and fully characterise Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli from the poultry sector in a One Health approach. From December 2021 to March 2022, 48 chicken meat samples were collected from 16 establishments in La Rioja (Northern Spain). Antibiotic susceptibility testing was assessed by the disk-diffusion method. Forty E. coli isolates were recovered from 33 of the 48 chicken meat samples tested (68.8%) when plated on MacConkey-agar. In addition, six ESBL-E. coli (6/48, 12.5%) were obtained on cefotaxime-supplemented MacConkey-agar, which were Whole-Genome Sequenced. A large diversity of clones and ESBL genes was observed, namely ST1140-E/bla CTX-M-32 (n = 1), ST752-A/bla TEM-52 (n = 1), ST117-B2/bla CTX-M-1 /bla SHV-12 (n = 2), ST10-A/bla SHV-12 (n = 1) and ST223-B1/bla SHV-12 (n = 1). Three IncI1-plasmids (pST3-CC3) were found carrying the bla SHV-12 /bla CTX-M-1 /bla CTX-M-32 genes in two genetic environments: i) IS26-smc-glpR-bla SHV-12 -IS26; and ii) wbuC-bla CTX-M-32 /bla CTX-M-1 -ISEcp1. The bla TEM-52 gene was carried on a P1-like phage-plasmid flanked by an IS4-mediated composite transposon. An IncHI2 plasmid harboured a bla SHV-12 gene flanked by an IS26-mediated composite transposon but also additional genes conferring resistance to aminoglycosides, chloramphenicol, and sulphonamides. To analyse the cross-sectoral relatedness of our ESBL-E. coli isolates, our six genomes were mapped with publicly available genomes (n = 2588) related to the STs detected, revealing that one of our genomes (X3078-ST117) displayed strong similarities (34-40 allelic differences) with few genomes belonging to ST117 from the poultry sector from Germany and USA. This study demonstrated that the proportion of ESBL-E. coli is still high in chicken meat in Spain. In addition, the ST117 clone and the IncI1-bla CTX-M-1-32 /bla SHV-12 plasmids might represent successful clones and plasmids adapted to the chicken host., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

To prevent foodborne illness, adequate cleaning and disinfection (C&D) is essential to remove pathogenic bacteria from the slaughter environment. The aim of this study was to determine the presence of Campylobacter spp., Listeria monocytogenes, and extended-spectrum beta-lactamase-producing Escherichia coli (ESBL E. coli) before and after C&D in slaughterhouses. Samples from food- and non-food contact surfaces taken before and after C&D in one red meat and one poultry slaughterhouse were analyzed for the target bacteria. Whole-genome sequencing and antimicrobial susceptibility testing were performed. In total, 484 samples were analyzed. Campylobacter spp. were isolated from 13.0% to 15.5% of samples before C&D in the red meat and poultry slaughterhouse, respectively. Listeria monocytogenes was isolated before C&D in 12.5% and 5.2% of samples in the red meat and poultry slaughterhouse, respectively. It was noted that C. jejuni was detected on multiple surfaces and that L. monocytogenes showed potential persistence in one slaughterhouse. After C&D, L. monocytogenes was found in one sample. ESBL E. coli was not detected either before or after C&D. These findings show the possibility to remove pathogenic bacteria from slaughter and meat processing facilities, but also indicate that deficiencies in slaughter hygiene pose a risk of cross-contamination of meat., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To compare outcomes of ceftriaxone to AmpC-stable therapies in patients with bacteremia caused by low-risk AmpC harboring Enterobacterales., Methods: IRB-approved, retrospective cohort of hospitalized patients ≥18 years old with Serratia marcescens, Morganella morganii, or Providencia spp. bacteremia from 1/1/2017-2/28/2024. Patients were compared by definitive therapy with ceftriaxone vs AmpC-stable therapy (cefepime, carbapenem). The primary endpoint was 30-day all-cause mortality; secondary endpoints were clinical failure and development of ceftriaxone resistance., Results: 163 patients were included; 33.1 % received ceftriaxone, 66.9 % AmpC-stable therapies. 30-day all-cause mortality was 9.3 % ceftriaxone vs 10.1 % AmpC stable patients (P = 0.87); ceftriaxone definitive therapy was not associated with 30-day all-cause mortality (adjOR, 0.79; 95 %CI, 0.23-2.3). There were no differences in clinical failure (9.3 % vs 21.1 %, P = 0.059) or relapsing infection (5.6 % vs 9.3 %, P = 0.55) between ceftriaxone and AmpC-stable treated patients., Conclusions: Patients treated with definitive ceftriaxone for low-risk AmpC Enterobacterales bacteremia had similar outcomes to AmpC stable therapies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: In vitro activity of β-lactam enhancer/β-lactam combination zidebactam/cefepime was evaluated against carbapenem- and colistin-resistant Klebsiella pneumoniae isolates., Methods: Non duplicate K. pneumoniae (n=185), resistant to colistin as well as non-susceptible to carbapenems were collected (2018-2019) at two large tertiary care hospitals in India. Colistin resistance-conferring genes mcr1 and mcr3 were screened among 123 of 185 randomly-selected isolates. These isolates were also subjected to multi-locus sequence typing (MLST). Additionally, alterations in mgrB were screened in 109 of these 123 isolates. All the study isolates were screened for presence of carbapenemases genes. MICs of zidebactam/cefepime, colistin, carbapenems, ceftazidime/avibactam, imipenem/relebactam, amikacin and piperacillin/tazobactam were determined by reference CLSI broth dilution method., Results: Among the isolates, 65.4% (121/185) carried bla OXA-48-like gene and 27.6% isolates (51/185) carried dual carbapenemase genes; bla OXA-48-like and bla NDM . Of the remainder, 8 isolates carried bla NDM and 5 isolates lacked carbapenemases gene despite being carbapenem-resistant. None of the isolates showed presence of mcr1 and mcr3. Out of 109 isolates analysed for mgrB, 36 showed mutational changes. The MLST profile revealed at least 14 unique sequence types with ST231 being the dominant clone. All the isolates showed colistin MICs >2 mg/L and were non-susceptible to carbapenems. Zidebactam/cefepime demonstrated potent activity with MIC 50 and MIC 90 of 1 and 2 mg/L, respectively. MIC 90 s of amikacin, ceftazidime/avibactam and imipenem/relebactam were >32 mg/L., Conclusion: Zidebactam/cefepime combination was highly active against multi-clonal, carbapenem-non-susceptible and colistin-resistant K. pneumoniae isolates producing OXA-48-like (Ambler class D) or/and NDM (Ambler class B) carbapenemases, thus potentially offering a valuable treatment options for infections caused by such pan-drug resistant resistotypes. Though, zidebactam is not an inhibitor of class B and D β-lactamases, potent activity of zidebactam/cefepime combination is attributable to β-lactam enhancer mechanism., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

The increasing challenge of carbapenem antibiotics resistance caused by Pseudomonas aeruginosa is one of the global healthcare problems. P. aeruginosa is a significant opportunistic infection. For epidemiological reasons, identifying resistance genes is essential, and it is also desirable to quickly identify the techniques for producing carbapenemase enzymes. So, the study aims to determine the prevalence of beta-lactamase encoding genes (blaIMP, blaVIM, bla GIM, and bla SPM) phenotypically and genotypically in P. aeruginosa isolates to address the epidemiological spread of these genes in Baghdad city. The study identified P. aeruginosa isolates from various clinical sources by chemical characterization and VITEK 2 system, the antibiogram test, phenotypic screening carbapenem resistance by Combined disk synergy test (CDST), and conventional PCR were used to detect presence of VIM, IMP, SPM, and GIM genes. Bacterial susceptibility testing revealed (40 %) of isolates were resistant to Imipenem and (85 %) of them positive to CDST. Genotypic screening on phenotypic Metallo-β-lactamase isolates showed that (100 %) isolates contained blaVIM genes, blaGIM genes (88 %), whereas (65 %) isolates carried blaSPM genes. In this investigation, there was no evidence of blaIMP among carbapenem-resistant isolates. The study appeared high prevalence of multi-drug resistance P. aeruginosa isolates that produce carbapenemase enzymes and having β-lactamase genes in local hospitalized patients compared to global ratio. Expanding the sample size and types of enzymes screening in MDR P. aeruginosa should be the main focus in the future research., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sawsan M. Kareem reports administrative support was provided by Mustansiriyah University. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)