Increased CPE detection in patients with COVID-19 may signal a re-emergence of these highly resistant pathogens in the wake of the global pandemic. Increased surveillance and antimicrobial stewardship efforts will be needed to mitigate their future impact.
Highlights: (1) Mutations (SNPs) in crrB induce high-level polymyxin resistance and virulence; (2) CrrB SNPs mediate the addition of both L-Ara4N and pEtN to lipid A; (3) CrrB SNPs alter carbon metabolism including the pentose phosphate pathway; (4) These changes lead to an increase in bacterial virulence at a fitness cost
Through my postdoctoral research, I have explored genomic and evolutionary characteristics of multidrug-resistant organisms (MDRO), including major public health threats such as carbapenem-resistant Enterobacterales (CRE). I have experience developing, implementing, and analyzing Ion Torrent, Illumina, and Oxford Nanopore sequencing pipelines to study the evolutionary history of MDRO, genomic determinants of multidrug resistance, and transmission and spread of resistance via mobile genetic elements. A major focus has been liver transplant recipients and other immunocompromised hosts, in whom colonizing and infectious MDRO are a major contributor to morbidity and mortality.
In a large prospective cohort of liver transplantation (LT) recipients, we identify associations between colonization by multidrug-resistant bacteria (MDRB) and microbiome dysbiosis pre- and post-LT, suggesting colonizing MDRB as an important target for microbiome-informed therapeutic approaches post-LT.
MRSA strains adapt to the host airway environment by undergoing substantial bacterial metabolic reprogramming to promote biofilm production and limit the generation of oxidants.
In this mini review, we addressed recent advances in the molecular epidemiology of multidrug-resistant *E. cloacae* complex, focusing on the global expansion of CREC.
While REL reduced IMI MICs in a majority of diverse CRE isolates, including high-risk clones, chromosomal factors had an impact on IMI-REL susceptibilities and may contribute to elevated MICs.