Diversity and proliferation of metallo-β-lactamases : a clarion call for clinically effective metallo-β-lactamase inhibitors

The worldwide proliferation of life-threatening metallo-β-lactamase (MBLs)-producing Gram-negative bacteria is a serious concern to public health. MBLs are compromising the therapeutic efficacies of β-lactams, particularly carbapenems, which are last-resort antibiotics indicated for various multidrug-resistant bacterial infections. Inhibiting enzymes mediating antibiotic resistance in bacteria is one of the major promising means in overcoming bacterial resistance. Compounds having potential MBLs-inhibitory activity have been reported, but none are currently under clinical trials. The need for developing safe and efficient MBL inhibitors (MBLIs) is obvious, particularly with the continuous spread of MBLs worldwide. In this review, the emergence and escalation of MBLs in Gram-negative bacteria are dicussed. The relationship between different class B β-lactamases identified up to 2017 are represented by a phylogenetic tree and summarized. On the other hand, approved and/or clinical-phase serine β-lactamase inhibitors are recapitulated to reflect the successful advances made in developing class A β-lactamase inhibitors. Reported MBLIs, their inhibitory properties and purported mode of inhibition are herein delineated. Insights into MBLs' structural variations and the challenges involved in developing potent MBLIs are also elucidated and discussed. Currently, natural products and MBL-resistant β-lactam analogues are the most promising agents that can become clinically efficient MBLIs. A deeper comprehension of the mechanism of action and activity spectrum of the various MBLs and their inhibitors will serve as a bedrock for further investigations that can result in clinically useful MBLIs to curb this global menace.http://aem.asm.org2019-03-01hj2018Medical Microbiolog

Evaluation of antimycobacterial activity of medicinal plants used by Malian traditional medicine practitioners to treat tuberculosis

Global Tuberculosis (TB) control is facing major challenges such as occurrence of multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR). The current TB drugs are getting less effective and associated with side effects limiting their use, especially with MDR and XDR infected patients. In Mali, many medicinal plants are used against various diseases including bacterial infections. The study aimed at studying the antimycobacterial activities of 60 extracts from 22 Malian medicinal. The antibacterial activity against Mycobacterium tuberculosis H37Rv was assessed employing micro-broth dilution method. Out of 60 extracts evaluated, eleven from nine different plants were found to be active against H37Rv strain. The minimal inhibitory concentrations (MICs) ranked from 125 μg/mL to 1250 μg/mL. The most active extracts (125 μg/mL) were represented by ethanolic extract of Saba senegalensis and Vitellaria paradoxa leaves, dichloromethane extract of Cola cordifolia leaves, Strychnos spinosa and Ximenia Americana roots. Ethanolic extract of Zizyphus mauritiana, Guiera senegalensis and methanolic extract of Anthocleista djalonensis also prevented the growth of H37Rv at 250 μg/mL. The results suggest that Saba senegalensis, Vitellaria paradoxa, Cola cordifolia, Strychnos spinosa and Ximenia Americana could be potential sources of antimycobacterial molecule

1,4,7-Triazacyclononane restores the activity of β-lactam antibiotics against metallo-β-lactamase-producing Enterobacteriaceae : exploration of potential metallo-β-lactamase inhibitors

Metallo-β-lactamase (MBL)-producing Enterobacteriaceae are of grave clinical concern, particularly as there are no metallo-β-lactamase inhibitors approved for clinical use. The discovery and development of MBL inhibitors to restore the efficacy of available β-lactams are thus imperative. We investigated a zinc-chelating moiety, 1,4,7-triazacyclononane (TACN), for its inhibitory activity against clinical carbapenem-resistant Enterobacteriaceae. MICs, minimum bactericidal concentrations (MBCs), the serum effect, fractional inhibitory concentration indexes, and time-kill kinetics were determined using broth microdilution techniques according to Clinical and Laboratory Standards Institute (CSLI) guidelines. Enzyme kinetic parameters and the cytotoxic effects of TACN were determined using spectrophotometric assays. The interactions of the enzyme-TACN complex were investigated by computational studies. Meropenem regained its activity against carbapenemase-producing Enterobacteriaceae, with the MIC decreasing from between 8 and 64 mg/liter to 0.03 mg/liter in the presence of TACN. The TACN-meropenem combination showed bactericidal effects with an MBC/MIC ratio of ≤4, and synergistic activity was observed. Human serum effects on the MICs were insignificant, and TACN was found to be noncytotoxic at concentrations above the MIC values. Computational studies predicted that TACN inhibits MBLs by targeting their catalytic active-site pockets. This was supported by its inhibition constant (Ki), which was 0.044 μM, and its inactivation constant (Kinact), which was 0.0406 min−1, demonstrating that TACN inhibits MBLs efficiently and holds promise as a potential inhibitor.The South African National Research Foundation (grant no. 85595 awarded to S. Y. Essack as incentive funding for rated researchers) and the College of Health Sciences, University of Kwa-Zulu Natal.http://aem.asm.org2019-08-01hj2019Medical Microbiolog

Synthesis, in vitro evaluation, and 68Ga-radiolabeling of CDP1 toward PET/CT imaging of bacterial infection

Bacterial infections are a major concern in the human health sector due to poor diagnosis and development of multidrug-resistant strains. PET/CT provides a means for the non-invasive detection and localization of the infectious foci; however, the radiotracers available are either cumbersome to prepare or their exact contribution toward the imaging is not yet established. Human antimicrobial peptides are of interest for development as PET radiotracers as they are an integral component of the immune system, non-immunogenic toward the recipient, and show selectivity toward pathogens such as bacteria. Herein we report on the potential of LL37, a human cathelicidin antimicrobial peptide, as a radiotracer for bacterial imaging. Bifunctional chelator 1,4,7-triazacyclononane,1-glutaric acid-4,7-acetic acid was utilized to functionalize the antimicrobial peptide, which in turn was capable of chelating gallium. The synthesized natGa-CDP1 showed bacterial selectivity and low affinity toward hepatic cells, which are favorable characteristics for further preclinical application.The Department of Science and Technology, University of KwaZulu Natal, National Research Foundation and Aspen Pharmacare.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1747-0285http://wileyonlinelibrary.com/journal/cbdd2018-10-30hj2018Nuclear Medicin

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

High SARS-CoV-2 Seroprevalence among Healthcare Workers in Bamako, Mali

In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country’s weak healthcare system, and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. The study was conducted between November 2020 and June 2021. HCWs in the major hospitals where COVID-19 cases were being cared for in the capital city, Bamako, Mali, were recruited. During the study period, vaccinations were not yet available. The ELISA of the IgG against the spike protein was optimized and quantitatively measured. A total of 240 HCWs were enrolled in the study, of which seropositivity was observed in 147 cases (61.8%). A continuous increase in the seropositivity was observed, over time, during the study period, from 50% at the beginning to 70% at the end of the study. HCWs who provided direct care to COVID-19 patients and were potentially highly exposed did not have the highest seropositivity rate. Vulnerable HCWs with comorbidities such as obesity, diabetes, and asthma had even higher seropositivity rates at 77.8%, 75.0%, and 66.7%, respectively. Overall, HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a “herd” immunity level, which could be protective at some degrees. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated

Prevalence and Antimicrobial Resistance of Escherichia coli Isolated from Various Meat Types in the Tamale Metropolis of Ghana

Meats are important potential sources of foodborne pathogens including Escherichia coli. This study was conducted to determine the prevalence and antimicrobial resistance of Escherichia coli isolated from meats in the Tamale metropolis of Ghana. Isolation of Escherichia coli was done using the procedure according to the USA-FDA Bacteriological Analytical Manual. Antibiotic resistance patterns in the Escherichia coli isolates were determined by the Kirby-Bauer disk diffusion method against 8 antibiotics. The overall prevalence of Escherichia coli in the meat samples was 84.00% (189/225). Mutton (88.89%), guinea fowl (88.89%), beef (86.67%), local chicken (80.00%), and chevon (75.56%) were contaminated by Escherichia coli. The average coliform count was 4.22 cfu/cm2 and was highest in guinea fowl (4.94 log cfu/cm2) and lowest in local chicken (3.23 log cfu/cm2). The Escherichia coli isolates were highly resistant to erythromycin (85.00%), tetracycline (73.33%), and ampicillin (71.67%). The multiple antibiotic resistance (MAR) index ranged from 0.13 to 1. The Escherichia coli isolates exhibited 23 antimicrobial resistance patterns with resistant pattern TeAmpE (tetracycline-ampicillin-erythromycin) being the most common. Multidrug resistance was 68.33% (41/60) among the Escherichia coli isolates. The results showed that Escherichia coli was commonly present in the various meat types and exhibited multidrug resistances, necessitating efficient antibiotic stewardship guidelines to streamline their use in the production industry