Sabiha Essack
Professor Sabiha Essack (B. Pharm., M. Pharm., PhD), Professor in Pharmaceutical Sciences at the University of KwaZulu-Natal (UKZN) is the South African Research Chair in Antibiotic Resistance and One Health and a Wellcome Trust Research Fellow who completed research towards her PhD in Pharmaceutical Microbiology at St Bartholomew’s and the Royal London School of Medicine and Dentistry in the United Kingdom. She received several prestigious scholarships and bursaries from the Wellcome Trust, the Medical Research Council (MRC), the National Research Foundation (NRF) and the University of Durban-Westville during the course of her Masters and PhD studies. Her research has been published in several journals and has been presented at a number of national and international conferences.
Professor Essack began her professional career with the B. Pharm degree in 1988 and practiced as a hospital pharmacist for three years in the KwaZulu-Natal Department of Health before returning to the University of Durban-Westville in 1992 to pursue the M. Pharm and PhD degrees.
She is a C-rated researcher by the NRF, has established the Antimicrobial Research Unit at UKZN and has secured several research grants for Essential National Health Research, from the World Health Organization (WHO), the Norwegian Agency for Development Cooperation (NORAD), MRC and the NRF investigating strategies for the prevention and containment of antibiotic resistance.
Professor Essack is expert consultant on antimicrobial resistance to the WHO Africa Office, founder and co-chair of the South African Chapter of the Alliance for the Prudent Use of Antibiotics (APUA), country representative on the Global Respiratory Infections Partnership (GRIP), serves on the South African Chapter of the Global Antibiotic Resistance Partnership (GARP), the South African Antibiotic Stewardship Programme, WHO’s Technical Working Group on Health Workforce Education Assessment Tools, and is co-founder of the South African Committee of Health Sciences Deans. She is a Ministerial appointee on the Board of the Office of Health Standards Compliance, an elected member of the Academy of Sciences of South Africa (ASSAf), a peer-reviewed member of the Southern Africa FAIMER Regional Institute (SAFRI) community, member of the Bio-economy Heath Innovation Sector Coordination Committee of the Department of Science and Technology. She previously served as Ministerial appointee on the National Health Research Ethics Council, as well as on the national Department of Health, on the National Executive of the Pharmaceutical Society of South Africa, the Professional Body Reference Group of the South African Qualifications Authority (SAQA) and the Programme Accreditation Panel and Standards Development Reference Group of the Council for Higher Education (CHE).
Professor Essack is Associate Editor of the South African Journal of Epidemiology and Infection, serves on the Editorial Board of the African Journal of Microbiology Research, frequently reviews papers for several international journals as well as research proposals and rating applications for the FP7 Programme, the MRC and the NRF and is a member of the Society for Clinical Microbiology and the Federation of Infectious Diseases Societies of South Africa.
Professor Essack’s current research interests include:
• Evidence-informed strategies for the prevention and containment of antibiotic resistance based on:
o the surveillance of antibiotic use and resistance in human, animal and environmental heath (One Health),
o Risk factors for the infection/colonization by antibiotic resistant bacteria,
o Infection control, and,
o Antibiotic pharmacokinetics and pharmacodynamics.
• Molecular epidemiology of antibiotic resistance.
• Phenotypic and genotypic characterization of antibiotic resistance, including but not limited to antibiotic resistance genes, genetic determinants of resistance and clonality.
• Virulence factors and their associated genetic determinants in antibiotic-resistant bacteria.
• ESKAPE pathogens
• Health policy and health systems strengthening to optimize the management of infections in the context of antibiotic resistance and stewardship.
• Efficacy and safety of new potential antibiotic moieties
Phone: +27312608019
Address: Antimicrobial Research Unit, College of Health Sciences,
University of KwaZulu-Natal,
Private Bag X54001, Durban,
4000, South Africa
Professor Essack began her professional career with the B. Pharm degree in 1988 and practiced as a hospital pharmacist for three years in the KwaZulu-Natal Department of Health before returning to the University of Durban-Westville in 1992 to pursue the M. Pharm and PhD degrees.
She is a C-rated researcher by the NRF, has established the Antimicrobial Research Unit at UKZN and has secured several research grants for Essential National Health Research, from the World Health Organization (WHO), the Norwegian Agency for Development Cooperation (NORAD), MRC and the NRF investigating strategies for the prevention and containment of antibiotic resistance.
Professor Essack is expert consultant on antimicrobial resistance to the WHO Africa Office, founder and co-chair of the South African Chapter of the Alliance for the Prudent Use of Antibiotics (APUA), country representative on the Global Respiratory Infections Partnership (GRIP), serves on the South African Chapter of the Global Antibiotic Resistance Partnership (GARP), the South African Antibiotic Stewardship Programme, WHO’s Technical Working Group on Health Workforce Education Assessment Tools, and is co-founder of the South African Committee of Health Sciences Deans. She is a Ministerial appointee on the Board of the Office of Health Standards Compliance, an elected member of the Academy of Sciences of South Africa (ASSAf), a peer-reviewed member of the Southern Africa FAIMER Regional Institute (SAFRI) community, member of the Bio-economy Heath Innovation Sector Coordination Committee of the Department of Science and Technology. She previously served as Ministerial appointee on the National Health Research Ethics Council, as well as on the national Department of Health, on the National Executive of the Pharmaceutical Society of South Africa, the Professional Body Reference Group of the South African Qualifications Authority (SAQA) and the Programme Accreditation Panel and Standards Development Reference Group of the Council for Higher Education (CHE).
Professor Essack is Associate Editor of the South African Journal of Epidemiology and Infection, serves on the Editorial Board of the African Journal of Microbiology Research, frequently reviews papers for several international journals as well as research proposals and rating applications for the FP7 Programme, the MRC and the NRF and is a member of the Society for Clinical Microbiology and the Federation of Infectious Diseases Societies of South Africa.
Professor Essack’s current research interests include:
• Evidence-informed strategies for the prevention and containment of antibiotic resistance based on:
o the surveillance of antibiotic use and resistance in human, animal and environmental heath (One Health),
o Risk factors for the infection/colonization by antibiotic resistant bacteria,
o Infection control, and,
o Antibiotic pharmacokinetics and pharmacodynamics.
• Molecular epidemiology of antibiotic resistance.
• Phenotypic and genotypic characterization of antibiotic resistance, including but not limited to antibiotic resistance genes, genetic determinants of resistance and clonality.
• Virulence factors and their associated genetic determinants in antibiotic-resistant bacteria.
• ESKAPE pathogens
• Health policy and health systems strengthening to optimize the management of infections in the context of antibiotic resistance and stewardship.
• Efficacy and safety of new potential antibiotic moieties
Phone: +27312608019
Address: Antimicrobial Research Unit, College of Health Sciences,
University of KwaZulu-Natal,
Private Bag X54001, Durban,
4000, South Africa
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Papers by Sabiha Essack
We report on the first clinical Morganella morganii draft genomes from Africa. The isolates were found in the urine of patients presenting with urinary tract infections (UTIs). Notably, they were resistant to important clinical antibiotics, including those used to treat UTIs. Due to the common occurrence of UTIs, particularly among pregnant women for whom drug options are limited, the presence of antibiotic-resistant uropathogens such as M. morganii is a serious public health concern. We therefore characterised the resistance mechanisms and epidemiology of these isolates to provide further insights into their dissemination and background data for future studies.
Abstract
Morganella morganii is an opportunistic bacterial pathogen of the Enterobacteriaceae family that is occasionally isolated from clinical (animal and human) specimens with varying resistance profiles. Detailed genomic analyses of drug-resistant M. morganii strains are relatively limited, particularly in Africa, which is also due to their relatively low isolation rates from clinical settings. Here, we report on two multidrug-resistant clinical M. morganii isolates from urine specimens of two hospitalised patients in South Africa who presented with urinary tract infections in 2013. The isolates, M006 and E042, were only susceptible to carbapenems, amikacin and tigecycline. One strain, M006, had a novel class 1 integron, ln1484, associated with aadA7, sul1and gcuD gene cassettes and a Col3M plasmid replicase gene. The ln1484 intI1:aadA7:sul1 genes were bracketed by a TnAs3 composite transposon while a tet(B) gene was found on an IS4 family transposon. The rare blaDHA-4 and blaDHA-1 AmpC β-lactamase genes were identified on the isolates’ chromosome. The isolates were phylogenetically distant and closely related to other international strains, suggesting that they were not obtained from a single epidemiological source. Further molecular surveillance is necessary to establish the prevalence of these MDR strains in the tertiary hospital. Moreover, antibiotic stewardship and antibiotic sensitivity testing of all clinical isolates should be undertaken after empirical treatment to inform tailored therapy as well as reduce escalation of resistance and associated morbidities and mortalities.
A literature review was undertaken to ascertain the molecular basis for tigecycline and colistin resistance mechanisms and the experimental basis for the detection and delineation of this resistance particularly in carbapenemase-producing Gram-negative bacteria. Pubmed, Google Scholar and Science Direct were searched with the keywords colistin, tigecycline, resistance mechanisms and detection methods. Trans-complementation and comparative MIC studies, mass spectrometry, chromatography, spectrofluorometry, PCR, qRT-PCR and whole genome sequencing (WGS) were commonly used to determine tigecycline and colistin resistance mechanisms, specifically modifications in the structural and regulatory efflux (acrAB, OqxAB, kpgABC adeABC-FGH-IJK, mexAB-XY-oprJM and soxS, rarA robA, ramRAB marRABC, adeLRS, mexRZ and nfxb ) and lipid A (pmrHFIJFKLM, lpxA, lpxC lpxD and mgrB, pmrAB, phoPQ,) genes respectively. Mutations in the ribosomal 16S rRNA operon rrnBC, also yielded resistance to tigecycline through target site modifications. The mcr-1 gene conferring resistance to colistin was identified via WGS, trans-complementation and a murine thigh infection model studies.Common detection methods are mainly antibiotic sensitivity testing with broth microdilution while molecular identification tools are mostly PCR and WGS. Spectrofluorometry, MALDI-TOF MS, micro-array and real time multiplex PCR hold much promise for the future as new detection tools
We report on the first clinical Morganella morganii draft genomes from Africa. The isolates were found in the urine of patients presenting with urinary tract infections (UTIs). Notably, they were resistant to important clinical antibiotics, including those used to treat UTIs. Due to the common occurrence of UTIs, particularly among pregnant women for whom drug options are limited, the presence of antibiotic-resistant uropathogens such as M. morganii is a serious public health concern. We therefore characterised the resistance mechanisms and epidemiology of these isolates to provide further insights into their dissemination and background data for future studies.
Abstract
Morganella morganii is an opportunistic bacterial pathogen of the Enterobacteriaceae family that is occasionally isolated from clinical (animal and human) specimens with varying resistance profiles. Detailed genomic analyses of drug-resistant M. morganii strains are relatively limited, particularly in Africa, which is also due to their relatively low isolation rates from clinical settings. Here, we report on two multidrug-resistant clinical M. morganii isolates from urine specimens of two hospitalised patients in South Africa who presented with urinary tract infections in 2013. The isolates, M006 and E042, were only susceptible to carbapenems, amikacin and tigecycline. One strain, M006, had a novel class 1 integron, ln1484, associated with aadA7, sul1and gcuD gene cassettes and a Col3M plasmid replicase gene. The ln1484 intI1:aadA7:sul1 genes were bracketed by a TnAs3 composite transposon while a tet(B) gene was found on an IS4 family transposon. The rare blaDHA-4 and blaDHA-1 AmpC β-lactamase genes were identified on the isolates’ chromosome. The isolates were phylogenetically distant and closely related to other international strains, suggesting that they were not obtained from a single epidemiological source. Further molecular surveillance is necessary to establish the prevalence of these MDR strains in the tertiary hospital. Moreover, antibiotic stewardship and antibiotic sensitivity testing of all clinical isolates should be undertaken after empirical treatment to inform tailored therapy as well as reduce escalation of resistance and associated morbidities and mortalities.
A literature review was undertaken to ascertain the molecular basis for tigecycline and colistin resistance mechanisms and the experimental basis for the detection and delineation of this resistance particularly in carbapenemase-producing Gram-negative bacteria. Pubmed, Google Scholar and Science Direct were searched with the keywords colistin, tigecycline, resistance mechanisms and detection methods. Trans-complementation and comparative MIC studies, mass spectrometry, chromatography, spectrofluorometry, PCR, qRT-PCR and whole genome sequencing (WGS) were commonly used to determine tigecycline and colistin resistance mechanisms, specifically modifications in the structural and regulatory efflux (acrAB, OqxAB, kpgABC adeABC-FGH-IJK, mexAB-XY-oprJM and soxS, rarA robA, ramRAB marRABC, adeLRS, mexRZ and nfxb ) and lipid A (pmrHFIJFKLM, lpxA, lpxC lpxD and mgrB, pmrAB, phoPQ,) genes respectively. Mutations in the ribosomal 16S rRNA operon rrnBC, also yielded resistance to tigecycline through target site modifications. The mcr-1 gene conferring resistance to colistin was identified via WGS, trans-complementation and a murine thigh infection model studies.Common detection methods are mainly antibiotic sensitivity testing with broth microdilution while molecular identification tools are mostly PCR and WGS. Spectrofluorometry, MALDI-TOF MS, micro-array and real time multiplex PCR hold much promise for the future as new detection tools