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https://www.readbyqxmd.com/read/29029188/an-analysis-of-the-epidemic-of-kpc-producing-klebsiella-pneumoniae-convergence-of-two-evolutionary-mechanisms-creates-the-perfect-storm
#1
Laura J Rojas, George M Weinstock, Elsa De La Cadena, Lorena Diaz, Rafael Rios, Blake M Hanson, Joseph S Brown, Purva Vats, Daniel S Phillips, Hoan Nguyen, Kristine M Hujer, Adriana Correa, Mark D Adams, Federico Perez, Erica Sodergren, Apurva Narechania, Paul J Planet, Maria V Villegas, Robert A Bonomo, Cesar A Arias
Background: Carbapenem resistance is a critical health care challenge worldwide. Particularly concerning is the widespread dissemination of Klebsiella pneumoniae carbapenemase (KPC). K. pneumoniae harboring blaKPC (KPC-Kpn) is endemic in many areas including United States, where the epidemic was primarily mediated by the clonal dissemination of Kpn ST258. We postulated that the spread of blaKPC in other regions occurs by different and more complex mechanisms. To test this, we investigated the evolution and dynamics of spread of KPC-Kpn in Colombia, where KPC became rapidly endemic after emerging in 2005...
September 27, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29021086/genomic-characterization-of-an-extensively-drug-resistant-kpc-2-producing-klebsiella-pneumoniae-st855-cc258-only-susceptible-to-ceftazidime-avibactam-isolated-in-brazil
#2
Caio Augusto Martins Aires, Michael J Rybak, Juwon Yim, Polyana Silva Pereira, Cláudio M Rocha-de-Souza, Rodolpho Mattos Albano, Valdelucia Oliveira Cavalcanti, Ana Paula D'Alincourt Carvalho-Assef, Marisa Zenaide Ribeiro Gomes, Marise Dutra Asensi
In this study, we describe the genetic features of an XDR KPC-2-producing Klebsiella pneumoniae isolate by using whole-genome sequencing, its clinical-epidemiological context and susceptibility against antimicrobial combinations. The isolate belongs to clonal complex 258 and harbors several acquired genes and mutations associated with antimicrobial resistance.
August 25, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29020404/colistin-vs-ceftazidime-avibactam-in-the-treatment-of-infections-due-to-carbapenem-resistant-enterobacteriaceae
#3
David van Duin, Judith J Lok, Michelle Earley, Eric Cober, Sandra S Richter, Federico Perez, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Yohei Doi, Keith S Kaye, Vance G Fowler, David L Paterson, Robert A Bonomo, Scott Evans
Background: The efficacy of ceftazidime-avibactam - a cephalosporin-β-lactamase inhibitor combination with in vitro activity against Klebsiella pneumoniae carbapenemase (KPC)-producing carbapenem-resistant Enterobacteriaceae (CRE) - as compared to colistin remains unknown. Methods: Patients initially treated with either ceftazidime-avibactam or colistin for CRE infections were selected from the Consortium on resistance against carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE), a prospective, multicenter, observational study...
September 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29020228/the-impact-of-a-carbapenem-resistant-enterobacteriaceae-outbreak-on-facilitating-development-of-a-national-infrastructure-for-infection-control-in-israel
#4
Mitchell J Schwaber, Yehuda Carmeli
In 2006 the Israeli healthcare system faced an unprecedented outbreak of carbapenem-resistant Enterobacteriaceae, primarily involving KPC-producing Klebsiella pneumoniae clonal complex CC258. This public health crisis exposed major gaps in infection control. In response, Israel established a national infection control infrastructure. The steps taken to build this infrastructure and benefits realized from its creation are described here.
July 19, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28968012/-antimicrobial-susceptibility-profile-in-urinary-pathogens-causing-community-acquired-infections-in-diabetic-patients-in-colombia
#5
Laura Cristina Nocua-Báez, Jorge Alberto Cortés, Aura Lucía Leal, Gerson Fitzgerald Arias, María Victoria Ovalle-Guerro, Sandra Yamile Saavedra-Rojas, Giancarlo Buitrago, Javier Antonio Escobar-Pérez, Betsy Castro-Cardozo
INTRODUCTION: Urinary tract infection is the most common pathology in diabetic patients, and an important determinant of morbidity and mortality among them. The increasing resistance of uropathogens acquired in the community to commonly used antibiotics is alarming. OBJECTIVE: To identify the profile of antibiotic susceptibility of uropathogens responsible for communityacquired infections among diabetic patients in hospitals in Colombia. MATERIALS AND METHODS: We conducted a descriptive study in a subgroup of diabetic patients in the framework of a larger study in adults with urinary tract infection acquired in the community...
September 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28961916/structural-modification-of-lps-in-colistin-resistant-kpc-producing-klebsiella-pneumoniae
#6
Lisa M Leung, Vaughn S Cooper, David A Rasko, Qinglan Guo, Marissa P Pacey, Christi L McElheny, Roberta T Mettus, Sung Hwan Yoon, David R Goodlett, Robert K Ernst, Yohei Doi
Background: Colistin resistance in Klebsiella pneumoniae typically involves inactivation or mutations of chromosomal genes mgrB , pmrAB or phoPQ , but data regarding consequent modifications of LPS are limited. Objectives: To examine the sequences of chromosomal loci implicated in colistin resistance and the respective LPS-derived lipid A profiles using 11 pairs of colistin-susceptible and -resistant KPC-producing K. pneumoniae clinical strains. Methods: The strains were subjected to high-throughput sequencing with Illumina HiSeq...
August 18, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28961793/covert-dissemination-of-carbapenemase-producing-klebsiella-pneumoniae-kpc-in-a-successfully-controlled-outbreak-long-and-short-read-whole-genome-sequencing-demonstrate-multiple-genetic-modes-of-transmission
#7
Jessica Martin, Hang T T Phan, Jacqueline Findlay, Nicole Stoesser, Louise Pankhurst, Indre Navickaite, Nicola De Maio, David W Eyre, Giles Toogood, Nicolas M Orsi, Andrew Kirby, Nicola Young, Jane F Turton, Robert L R Hill, Katie L Hopkins, Neil Woodford, Tim E A Peto, A Sarah Walker, Derrick W Crook, Mark H Wilcox
Background: Carbapenemase-producing Enterobacteriaceae (CPE), including KPC-producing Klebsiella pneumoniae (KPC -Kpn ), are an increasing threat to patient safety. Objectives: To use WGS to investigate the extent and complexity of carbapenemase gene dissemination in a controlled KPC outbreak. Materials and methods: Enterobacteriaceae with reduced ertapenem susceptibility recovered from rectal screening swabs/clinical samples, during a 3 month KPC outbreak (2013-14), were investigated for carbapenemase production, antimicrobial susceptibility, variable-number-tandem-repeat profile and WGS [short-read (Illumina), long-read (MinION)]...
August 7, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28951106/in-vitro-interaction-of-ceftazidime-avibactam-in-combination-with-different-antimicrobials-against-kpc-producing-klebsiella-pneumoniae-clinical-isolates
#8
Paolo Gaibani, Russell E Lewis, Silvia L Volpe, Maddalena Giannella, Caterina Campoli, Maria Paola Landini, PierLuigi Viale, Maria Carla Re, Simone Ambretti
OBJECTIVES: Combination therapy has been recommended when using ceftazidime-avibactam for the treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp), but the optimal combination is unknown. Here, we evaluated six common antimicrobial agents (ertapenem, imipenem, meropenem, gentamicin, tigecycline or ciprofloxacin) for synergy with a recently approved cephalosporin-β-lactamase inhibitor combination, Ceftazidime-Avibactam (CAZ-AVI). METHODS: We tested different antimicrobial combinations against thirteen KPC-Kp, including CAZ-AVI -susceptible (n=11) and -resistant (n=2) clinical isolates...
September 22, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28947474/pharmacokinetics-pharmacodynamics-of-cb-618-in-combination-with-cefepime-ceftazidime-ceftolozane-and-meropenem-the-pharmacological-basis-for-a-stand-alone-%C3%AE-lactamase-inhibitor
#9
Paul G Ambrose, Brian D VanScoy, Michael Trang, Jennifer McCauley-Miller, Haley Conde, Sujata M Bhavnani, Dylan C Alexander, Lawrence V Friedrich
A major challenge in treating patients is the selection of the "right" antibiotic regimen. Given that the optimal β-lactam-β-lactamase inhibitor pair is dependent upon the spectrum of β-lactamase enzymes produced and the frequency of resistance to the β-lactamase inhibitor, it might be useful if a stand-alone were available for the clinician to pair with the "right" β-lactam rather than only in a fixed combination. In this communication, we describe a one-compartment in vitro infection model studies conducted to identify the magnitude of the pharmacokinetic-pharmacodynamic (PK-PD) index for a β-lactamase inhibitor, CB-618, that would restore the activity of four β-lactam partner agents (cefepime, ceftazidime, ceftolozane, and meropenem) with varying dose (1 or 2 g) and dosing intervals (8 or 12 h)...
September 25, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28935481/stalking-a-lethal-superbug-by-whole-genome-sequencing-and-phylogenetics-influence-on-unraveling-a-major-hospital-outbreak-of-carbapenem-resistant-klebsiella-pneumoniae
#10
Thorsten Kaiser, Knut Finstermeier, Madlen Häntzsch, Sarah Faucheux, Martin Kaase, Tim Eckmanns, Sven Bercker, Udo X Kaisers, Norman Lippmann, Arne C Rodloff, Joachim Thiery, Christoph Lübbert
BACKGROUND: From July 2010-April 2013, Leipzig University Hospital experienced the largest outbreak of a Klebsiella pneumoniae carbapenemase 2 (KPC-2)-producing Klebsiella pneumoniae (KPC-2-Kp) strain observed in Germany to date. After termination of the outbreak, we aimed to reconstruct transmission pathways by phylogenetics based on whole-genome sequencing (WGS). METHODS: One hundred seventeen KPC-2-Kp isolates from 89 outbreak patients, 5 environmental KPC-2-Kp isolates, and 24 K pneumoniae strains not linked to the outbreak underwent WGS...
September 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28893689/management-of-kpc-producing-klebsiella-pneumoniae-infections
#11
REVIEW
M Bassetti, D R Giacobbe, H Giamarellou, C Viscoli, G L Daikos, G Dimopoulos, F G De Rosa, E J Giamarellos-Bourboulis, G M Rossolini, E Righi, I Karaiskos, M Tumbarello, D P Nicolau, P L Viale, G Poulakou
BACKGROUND: Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) has become one of the most important contemporary pathogens, especially in endemic areas. AIMS: our aim was to provide practical suggestion for physicians dealing with the management of KPC-KP infections in critically ill patients, based on expert opinions. SOURCES: PubMed search for relevant publications related to the management of KPC-KP infections. CONTENTS: a panel of experts developed a list of 12 questions to be addressed...
September 9, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28887199/temporal-evolution-of-polymyxin-b-resistant-klebsiella-pneumoniae-clones-recovered-from-blood-cultures-in-a-teaching-hospital-during-a-7-year-period
#12
Graziela Braun, Rodrigo Cayô, Adriana Pereira Matos, Juliane de Mello Fonseca, Ana Cristina Gales
The polymyxins have become one of the last resorts to treat serious infections caused by KPC-2-producing Klebsiella pneumoniae worldwide. However, the increase of polymyxin consumption has favored the emergence of resistance to these compounds. In this study we observed an increase in the polymyxin B resistance rates from 0 to 30.6% among 224 K. pneumoniae isolates recovered from blood cultures between 2009 and 2015. Only gentamicin, tigecycline and fosfomycin remained active against the polymyxin B-resistant K...
September 5, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28886559/sewage-treatment-effluents-in-delhi-a-key-contributor-of-%C3%AE-lactam-resistant-bacteria-and-genes-to-the-environment
#13
Manisha Lamba, Shaikh Ziauddin Ahammad
Rapid emergence of antibiotic resistance (AR) in developing countries is posing a greater health risk and increasing the global disease burden. Lack of access to safe drinking water, poor sanitation and inadequate sewage treatment facilities in these countries are fueling the problem associated with emergence of AR. Rapid proliferation of AR mediated by treated and untreated discharges from sewage treatment plants (STPs) is a prime public health concern. This study aims to understand the occurrence, fate, and routes of proliferation of carbapenem (KPC) and extended spectrum β-lactam (ESBL) resistant bacteria, and selected resistant genes in the samples collected from different unit operations in 12 STPs in New Delhi over two seasons...
August 28, 2017: Chemosphere
https://www.readbyqxmd.com/read/28874377/high-level-resistance-to-colistin-mediated-by-various-mutations-in-the-crrb-gene-among-carbapenemase-producing-klebsiella-pneumoniae
#14
Aurélie Jayol, Patrice Nordmann, Adrian Brink, Maria-Virginia Villegas, Véronique Dubois, Laurent Poirel
Mutations in the crrAB genes encoding a two-component regulator involved in modifications of the lipopolysaccharide were searched for among a collection of colistin-resistant Klebsiella pneumoniae isolates. Four isolates respectively producing carbapenemases NDM-1, OXA-181, or KPC-2 showed mutated CrrB proteins compared to wild-type strains. Complementation assays with a wild-type CrrB protein restored the susceptibility to colistin in all cases, confirming the involvement of the identified substitutions in the resistance phenotype...
September 5, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28844719/evaluation-of-a-rapid-immunochromatographic-test-for-detection-of-distinct-variants-of-klebsiella-pneumoniae-carbapenemase-kpc-in-enterobacteriaceae
#15
Ana C Ramos, Ana C Gales, Jussimara Monteiro, Suzane Silbert, Thomás Chagas-Neto, Antonia M O Machado, Cecilia G Carvalhaes
The rapid detection of KPC-producing Enterobacteriaceae by microbiology laboratories has been required for infectious control programs. Herein we evaluated the performance of a novel immunochromatographic test for detecting KPC-2-, KPC-3-, KPC-4-, KPC-6-, KPC-7-, KPC-8-, and KPC-11-producing isolates and the influence of different growth media on the test performance.
November 2017: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/28844390/photodynamic-inactivation-of-multiresistant-bacteria-kpc-using-zinc-ii-phthalocyanines
#16
Mariana Miretti, Romina Clementi, Tomas C Tempesti, María T Baumgartner
The worldwide increase in antibiotic resistance has led to search of alternatives anti-microbial therapies such as photodynamic inactivation. The aim of this paper was to evaluate the photodynamic activity in vitro of a neutral and two cationic Zn phthalocyanines. Their photokilling activity was tested on Escherichia coli ATCC 25922 and Klebsiella pneumoniae Carbapenemase (KPC)-producing. After treating bacteria with phthalocyanines, the cultures were irradiated with white light. As a result, the bacteria were inactivated in presence of cationic phthalocyanines...
September 15, 2017: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/28840351/activity-of-temocillin-and-15-other-agents-including-fosfomycin-and-colistin-against-enterobacteriaceae-in-hong-kong
#17
Margaret Ip, Christopher K Lai, Kitty S C Fung, K-Tak Wong, Chendi Zhu, Sebastien Van de Velde, Dominic N Tsang, Peter Hawkey
Limited data are available on temocillin susceptibilities in Enterobacteriaceae from Asian countries where antimicrobial resistance is prevalent. The in vitro activities of temocillin and 15 commonly used antimicrobials against 613 non-duplicate blood (n = 310) and urine (with clinically significant bacteriuria; n = 303) isolates of Enterobacteriaceae from patients who attended 3 out of 7 clusters of public hospitals of the Hospital Authority, Hong Kong, during 2015/2016 were tested. Minimum inhibitory concentrations (MICs) were determined by Clinical and Laboratory Standards Institute (CLSI) microbroth dilution (agar dilution with fosfomycin)...
August 25, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28837596/membrane-active-macromolecules-kill-antibiotic-tolerant-bacteria-and-potentiate-antibiotics-towards-gram-negative-bacteria
#18
Divakara S S M Uppu, Mohini M Konai, Paramita Sarkar, Sandip Samaddar, Isabel C M Fensterseifer, Celio Farias-Junior, Paramanandam Krishnamoorthy, Bibek R Shome, Octávio L Franco, Jayanta Haldar
Chronic bacterial biofilms place a massive burden on healthcare due to the presence of antibiotic-tolerant dormant bacteria. Some of the conventional antibiotics such as erythromycin, vancomycin, linezolid, rifampicin etc. are inherently ineffective against Gram-negative bacteria, particularly in their biofilms. Here, we report membrane-active macromolecules that kill slow dividing stationary-phase and antibiotic tolerant cells of Gram-negative bacteria. More importantly, these molecules potentiate antibiotics (erythromycin and rifampicin) to biofilms of Gram-negative bacteria...
2017: PloS One
https://www.readbyqxmd.com/read/28827526/measuring-and-modelling-the-response-of-klebsiella-pneumoniae-kpc-prey-to-bdellovibrio-bacteriovorus-predation-in-human-serum-and-defined-buffer
#19
Michelle Baker, David Negus, Dhaarini Raghunathan, Paul Radford, Chris Moore, Gemma Clark, Mathew Diggle, Jess Tyson, Jamie Twycross, R Elizabeth Sockett
In worldwide conditions of increasingly antibiotic-resistant hospital infections, it is important to research alternative therapies. Bdellovibrio bacteriovorus bacteria naturally prey on Gram-negative pathogens, including antibiotic-resistant strains and so B. bacteriovorus have been proposed as "living antibiotics" to combat antimicrobially-resistant pathogens. Predator-prey interactions are complex and can be altered by environmental components. To be effective B. bacteriovorus predation needs to work in human body fluids such as serum where predation dynamics may differ to that studied in laboratory media...
August 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28827415/antimicrobial-activity-of-ceftazidime-avibactam-tested-against-multidrug-resistant-enterobacteriaceae-and-pseudomonas-aeruginosa-isolates-from-united-states-medical-centers-2013-2016
#20
Helio S Sader, Mariana Castanheira, Dee Shortridge, Rodrigo E Mendes, Robert K Flamm
The in vitro activity of ceftazidime-avibactam and many comparator agents was determined against various resistant subsets of organisms selected among 36,380 Enterobacteriaceae and 7,868 Pseudomonas aeruginosa. Isolates were consecutively collected from 94 US hospitals, and all isolates were tested for susceptibility by reference broth microdilution methods in a central monitoring laboratory (JMI Laboratories). Enterobacteriaceae isolates resistant to carbapenems (CRE) and/or ceftazidime-avibactam (MIC ≥16 μg/mL) were evaluated for the presence of genes encoding ESBLs, KPC, NDM, and transferable AmpC enzymes...
August 21, 2017: Antimicrobial Agents and Chemotherapy
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