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https://www.readbyqxmd.com/read/28223379/mutations-in-blakpc-3-that-confer-ceftazidime-avibactam-resistance-encode-novel-kpc-3-variants-that-function-as-extended-spectrum-%C3%AE-lactamases
#1
Ghady Haidar, Cornelius J Clancy, Ryan K Shields, Binghua Hao, Shaoji Cheng, M Hong Nguyen
We identified four blaKPC-3 mutations in ceftazidime-avibactam resistant clinical Klebsiella pneumoniae isolates, corresponding to D179Y, T243M, D179Y/T243M, and EL165 KPC-3 variants. Using site-directed mutagenesis and transforming vectors into Escherichia coli, we conclusively demonstrated that mutant blaKPC-3 encoded enzymes that functioned as extended-spectrum β-lactamases; mutations directly conferred higher MICs of ceftazidime-avibactam MICs, and decreased MICs of carbapenems and other β-lactams. Impact was strongest for the D179Y mutant, highlighting the importance of the KPC Ω-loop...
February 21, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28219824/characterisation-of-the-first-kpc-2-producing-klebsiella-pneumoniae-st340-from-peru
#2
Gertrudis Horna, Jorge Velasquez, Nathaly Fernández, Jesus Tamariz, Joaquim Ruiz
OBJECTIVES: The aim of this study was to characterise a KPC-carrying Klebsiella pneumoniae isolate from a Peruvian hospital setting. METHODS: The identity of the isolate was confirmed by amplification and sequencing of the 16S rRNA gene, and the antibiotic resistance profile was determined by disk diffusion and automated METHODS: The sequence type (ST) and phylogenetic group were established by PCR. The presence of different β-lactamase genes was determined, including blaMBL, blaKPC, blaCTX-M, blaSHV, blaOXA-1-like, blaOXA-2-like, blaOXA-5-like, blaOXA-48-like and blaTEM and up to six different plasmid-encoded AmpC genes as well as class 1 integrons...
February 17, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28215914/fecal-carriage-of-mdros-in-a-population-of-lebanese-elderly-dynamics-and-impact-on-bacterial-fitness
#3
Caren Challita, Elias Dahdouh, Michel Attieh, Iman Dandachi, Elio Ragheb, Roy Taoutel, Carl Tanba, Ziad Daoud
Muti-Drug Resistant Organisms (MDROs) are problematic all over the world, especially in Lebanon. High fecal carriage rates of MDR Enterobacteriaceae were reported from Lebanese nursing homes. Some studies show that MDROs have a fitness cost as compared to sensitive isolates. In this study, the competitive growth of MDR Escherichia coli obtained from fecal samples from elderly is assessed. Fecal swabs from ten elderly patients from a Lebanese nursing home were obtained between June and December, 2015. Isolates were identified by API 20E and antimicrobial susceptibilities were determined...
February 16, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28210888/double-carbapenem-combination-as-salvage-therapy-for-untreatable-infections-by-kpc-2-producing-klebsiella-pneumoniae
#4
M Souli, I Karaiskos, A Masgala, L Galani, E Barmpouti, H Giamarellou
We report our experience using the double-carbapenem combination as salvage therapy for patients with untreatable infections caused by KPC-2- producing Klebsiella pneumoniae. A total of 27 patients in two institutions in Athens, Greece suffering from complicated urinary tract infections (16) with or without secondary bacteraemia (four and 12 respectively), primary (six) or catheter-related bloodstream infections (two), HAP or VAP (two) and external ventricular drainage infection (one) were treated exclusively with ertapenem and high-dose prolonged infusion meropenem because in-vitro active antimicrobials were unavailable (19) or failed (four) or were contraindicated (six)...
February 16, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28185686/outbreak-of-kpc-2-producing-enterobacteriaceae-caused-by-clonal-dissemination-of-klebsiella-pneumoniae-st307-carrying-an-incx3-type-plasmid-harboring-a-truncated-tn4401a
#5
Jung Ok Kim, Sae Am Song, Eun-Jeong Yoon, Jeong Hwan Shin, Hyukmin Lee, Seok Hoon Jeong, Kyungwon Lee
Over a 5-month period between the end of June and the beginning of November in 2015, a KPC-producing Enterobacteriaceae outbreak occurred in a general hospital in Busan, South Korea, being associated with a total of 50 clinical isolates from 47 patients. Multilocus sequence typing and pulsed-field gel electrophoresis were carried out for strain typing and whole-genome sequencing was performed to characterize the plasmids. A clonal spread of K. pneumoniae sequence type 307 (ST307) carrying a self-transferable IncX3-type plasmid harboring blaKPC-2 was responsible for the outbreak...
December 27, 2016: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28185222/trimethoprim-sulfamethoxazole-therapy-for-patients-with-carbapenemase-producing-klebsiella-pneumoniae-infections-retrospective-single-center-case-series
#6
Rita Murri, Barbara Fiori, Teresa Spanu, Ilaria Mastrorosa, Francesca Giovannenze, Francesco Taccari, Claudia Palazzolo, Giancarlo Scoppettuolo, Giulio Ventura, Maurizio Sanguinetti, Roberto Cauda, Massimo Fantoni
OBJECTIVE: The objective of the study was to evaluate the efficacy and tolerability of trimethoprim-sulfamethoxazole (also known as co-trimoxazole, TMPS) to treat Klebsiella pneumoniae (Kp)-K. pneumoniae carbapenemase (KPC) infections. METHODS: Clinical data of patients with a TMPS-susceptible Kp-KPC infection were collected as a case series. RESULTS: We report clinical outcomes and tolerability for 14 patients infected by Kp-KPC strains susceptible to TMPS, including three bloodstream infections...
February 9, 2017: Infection
https://www.readbyqxmd.com/read/28167556/the-importance-of-clonal-complex-258-and-incfk2-like-plasmids-among-a-global-collection-of-klebsiella-pneumoniae-with-blakpcs
#7
Gisele Peirano, Patricia A Bradford, Krystyna M Kazmierczak, Liang Chen, Barry N Kreiswirth, Johann D D Pitout
This study was designed to determine the global distribution of clonal complex (CC) 258 and IncFIIK2-like plasmids with blaKPC among 522 global KPC-producing K. pneumoniae CC258 (i.e. ST258 [clades I and II], ST11, ST512) and ST147 were statistically associated with IncFIIK2-like KPC-containing plasmids and may possess an epidemiological advantage over isolates that harboured non-IncF KPC-harboring plasmids.
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28167551/genomic-characterization-of-two-kpc-producing-klebsiella-isolates-collected-in-1997-from-new-york-city
#8
Brandon Eilertson, Liang Chen, Kalyan D Chavda, Barry N Kreiswirth
Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae have now become a global public health threat. However, the origin of this pandemic and characterization of pre-2003 blaKPC-harboring plasmids remain unknown. Here we used next generation sequencing to characterize two KPC-2-producing K. pneumoniae and K. michiganensis isolates, collected from a New York City hospital in 1997. Although identified in two different Klebsiella species, the blaKPC-2 gene is harbored by Tn4401b transposon on two highly similar IncN plasmids...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28167549/polymyxin-b-based-triple-combinations-wage-war-against-kpc-2-producing-klebsiella-pneumoniae-new-dosing-strategies-for-old-allies
#9
Zackery P Bulman, Michael J Satlin, Liang Chen, Barry N Kreiswirth, Beom Soo Shin, Thomas J Walsh, Patricia N Holden, Alan Forrest, Roger L Nation, Jian Li, Brian T Tsuji
Pharmacodynamics of a polymyxin B, meropenem and rifampin triple combination were examined against Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) ST258. In time-kill experiments against three KPC-Kp isolates, triple combination generated 8.14, 8.19 and 8.29 log10CFU/mL reductions within 24h. In the hollow fiber infection model, the triple combination caused maximal killing of 5.16 log10CFU/mL at 78h and time required for regrowth was more than doubled versus 2-drug combinations...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28167547/bacteremia-due-to-carbapenem-resistant-enterobacteriaceae-cre-a-multicenter-clinical-and-molecular-epidemiologic-analysis-in-the-nation-s-epicenter-for-cre
#10
Michael J Satlin, Liang Chen, Gopi Patel, Angela Gomez-Simmonds, Gregory Weston, Angela C Kim, Susan K Seo, Marnie E Rosenthal, Steven J Sperber, Stephen G Jenkins, Camille L Hamula, Anne-Catrin Uhlemann, Michael H Levi, Bettina C Fries, Yi-Wei Tang, Stefan Juretschko, Albert D Rojtman, Tao Hong, Barun Mathema, Michael R Jacobs, Thomas J Walsh, Robert A Bonomo, Barry N Kreiswirth
Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or transplantation...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28152085/a-putative-multi-replicon-plasmid-co-harboring-beta-lactamase-genes-blakpc-2-blactx-m-14-and-blatem-1-and-trimethoprim-resistance-gene-dfra25-from-a-klebsiella-pneumoniae-sequence-type-st-11-strain-in-china
#11
Yu Tang, Pinghua Shen, Wei Liang, Jialin Jin, Xiaofei Jiang
The global emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae poses a major public health threat requiring immediate and aggressive action. Some older generation antibiotics, such as trimethoprim, serve as alternatives for treatment of infections. Here, we determined the complete nucleotide sequence of plasmid pHS091147, which co-harbored the carbapenemase (blaKPC-2) and trimethoprim resistance genes (dfrA25) from a Klebsiella pneumoniae sequence type (ST) 11 clone recovered in Shanghai, China...
2017: PloS One
https://www.readbyqxmd.com/read/28143787/clonal-or-not-clonal-investigating-hospital-outbreaks-of-kpc-producing-klebsiella-pneumoniae-with-whole-genome-sequencing
#12
Etienne Ruppé, Flaminia Olearo, Daniela Pires, Damien Baud, Gesuele Renzi, Abdessalam Cherkaoui, Daniel Goldenberger, Angela Huttner, Patrice François, Stephan Harbarth, Jacques Schrenzel
OBJECTIVES: Whole-genome sequencing (WGS) is a promising tool for identifying transmission pathways in outbreaks caused by multidrug-resistant bacteria. However, it is uncertain how the data produced by WGS can be best integrated into epidemiological investigations. METHODS: We tested various genomic analyses to identify clonal groups in two distinct outbreaks of KPC-producing Klebsiella pneumoniae that occurred in Switzerland in 2013 and 2015. In blinded fashion, we sequenced 12 strains involved in the 2 outbreaks, respectively, and six that were epidemiologically unrelated...
January 28, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28132768/bacteremia-and-other-body-site-infection-caused-by-hypervirulent-and-classic-klebsiella-pneumoniae
#13
Hua Wu, Dongdong Li, Haijian Zhou, Yunfang Sun, Ling Guo, Dingxia Shen
OBJECTIVES: To investigate bacteremia and other body site infection caused by hypervirulent Klebsiella pneumoniae (hvKP), a recently recognized pathogen of invasive infection, and classic Klebsiella pneumoniae (cKP), a very common organism associated with many kinds of nosocomial infection. METHODS: Clinical information obtained from patients with both bacteremia and other body site infections caused by hvKP and/or cKP was retrospectively reviewed. Homo-hvKP (or homo-cKP) was defined as homologous hvKP (or cKP) strains from different body sites in each individual patient according to string test, virulence gene amplification and PFGE pattern...
March 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#14
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28096418/multi-institute-analysis-of-carbapenem-resistance-reveals-remarkable-diversity-unexplained-mechanisms-and-limited-clonal-outbreaks
#15
Gustavo C Cerqueira, Ashlee M Earl, Christoph M Ernst, Yonatan H Grad, John P Dekker, Michael Feldgarden, Sinéad B Chapman, João L Reis-Cunha, Terrance P Shea, Sarah Young, Qiandong Zeng, Mary L Delaney, Diane Kim, Ellena M Peterson, Thomas F O'Brien, Mary Jane Ferraro, David C Hooper, Susan S Huang, James E Kirby, Andrew B Onderdonk, Bruce W Birren, Deborah T Hung, Lisa A Cosimi, Jennifer R Wortman, Cheryl I Murphy, William P Hanage
Carbapenem-resistant Enterobacteriaceae (CRE) are among the most severe threats to the antibiotic era. Multiple different species can exhibit resistance due to many different mechanisms, and many different mobile elements are capable of transferring resistance between lineages. We prospectively sampled CRE from hospitalized patients from three Boston-area hospitals, together with a collection of CRE from a single California hospital, to define the frequency and characteristics of outbreaks and determine whether there is evidence for transfer of strains within and between hospitals and the frequency with which resistance is transferred between lineages or species...
January 31, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28089736/antibacterial-activity-of-limonium-brasiliense-baicuru-against-multidrug-resistant-bacteria-using-a-statistical-mixture-design
#16
Andressa Blainski, Barbara Gionco, Admilton G Oliveira, Galdino Andrade, Ieda S Scarminio, Denise B Silva, Norberto P Lopes, João C P Mello
ETHNOPHARMACOLOGICAL RELEVANCE: Limonium brasiliense (Boiss.) Kuntze (Plumbaginaceae) is commonly known as "baicuru" or "guaicuru" and preparations of its dried rhizomes have been populary used in the treatment of premenstrual syndrome and menstrual disorder, and as an antiseptic in genito-urinary infections. This study evaluated the potential antibacterial activity of rhizome extracts against multidrug-resistant bacterial strains using statistical mixture design. MATERIALS AND METHODS: The statistical design of four components (water, methanol, acetone and ethanol) produced 15 different extracts and also a confirmatory experiment, which was performed using water:acetone (3:7, v/v)...
January 13, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28081233/differences-in-inflammatory-response-induced-by-two-representatives-of-clades-of-the-pandemic-st258-klebsiella-pneumoniae-clonal-lineage-producing-kpc-type-carbapenemases
#17
Giuseppe Castronovo, Ann Maria Clemente, Alberto Antonelli, Marco Maria D'Andrea, Michele Tanturli, Eloisa Perissi, Sara Paccosi, Astrid Parenti, Federico Cozzolino, Gian Maria Rossolini, Maria Gabriella Torcia
ST258-K. pneumoniae (ST258-KP) strains, the most widespread multidrug-resistant hospital-acquired pathogens, belong to at least two clades differing in a 215 Kb genomic region that includes the cluster of capsule genes. To investigate the effects of the different capsular phenotype on host-pathogen interactions, we studied representatives of ST258-KP clades, KKBO-1 and KK207-1, for their ability to activate monocytes and myeloid dendritic cells from human immune competent hosts. The two ST258-KP strains strongly induced the production of inflammatory cytokines...
2017: PloS One
https://www.readbyqxmd.com/read/28072891/molecular-epidemiology-and-resistome-analysis-of-multidrug-resistant-st11-klebsiella-pneumoniae-strain-containing-multiple-copies-of-extended-spectrum-%C3%AE-lactamase-genes-using-whole-genome-sequencing
#18
Roshan DSouza, Naina Adren Pinto, Insik Hwang, Hwang Younjee, YoungLag Cho, Hyunsoo Kim, Dongeun Yong, Jongrak Choi, Kyungwon Lee, Yunsop Chong
The aim of this work was to investigate the mechanism responsible for multidrug resistance in ST11 Klebsiella pneumoniae YMC 2013/7/B3993 containing multiple copies of ESBL genes using multiple parallel sequencing technology. In-depth analysis of the strain revealed multiple copies of ESBL genes, 2 copies of blaSHV-12 and 1 copy of blaCTX-M-15. Furthermore, 1 copy of blaOXA-9 and 3 copies of blaTEM-1 were found. The insertion of Tn1331 was detected, which consisted of blaOXA-9, blaTEM-1, aac(6')-lb-cr, and aadA1 genes...
January 2017: New Microbiologica
https://www.readbyqxmd.com/read/28069649/antimicrobial-activity-of-ceftazidime-avibactam-when-tested-against-gram-negative-bacteria-isolated-from-patients-hospitalized-with-pneumonia-in-united-states-medical-centers-2011-2015
#19
Helio S Sader, Mariana Castanheira, Robert K Flamm
Bacterial isolates were collected from patients hospitalized with pneumonia (PHP), including ventilator-associated (VAP), from 76 USA medical centers in 2011-2015. The Gram-negative organisms (n=11,185; including 1,097 from VAP) were tested for susceptibility against ceftazidime-avibactam and comparators by broth microdilution method. β-lactamase-encoding genes were screened using a microarray based assay on selected isolates. Pseudomonas aeruginosa and Klebsiella spp. were the most common Gram-negatives isolated from PHP and VAP...
January 9, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28040408/polymyxin-b-in-combination-with-meropenem-against-carbapenemase-producing-klebsiella-pneumoniae-pharmacodynamics-and-morphological-changes
#20
Rajnikant Sharma, Saloni Patel, Cely Abboud, John Diep, Neang S Ly, Jason M Pogue, Keith S Kaye, Jian Li, Gauri G Rao
Combination therapy provides a useful therapeutic approach to overcome resistance until new antibiotics become available. In this study, the pharmacodynamics, including the morphological effects, of polymyxin B (PMB) and meropenem alone and in combination against KPC-producing Klebsiella pneumoniae clinical isolates was examined. Ten clinical isolates were obtained from patients undergoing treatment for mediastinitis. KPCs were identified and MICs were measured using microbroth dilution. Time-kill studies were conducted over 24 h with PMB (0...
February 2017: International Journal of Antimicrobial Agents
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