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Kpc klebsiella

Rafael De León-Borrás, Julio Álvarez-Cardona, Jorge A Vidal, Humberto M Guiot
A 36-year-old man was admitted to the intensive care unit due to diabetic ketoacidosis and pneumonia requiring mechanical ventilation. Three weeks after admission, he developed a refractory bacteremia with Klebsiella pneumoniae carbapenemase-producing bacteria (KPC). He remained febrile and with bacteremia for six weeks despite therapy with polymyxin B, carbapenems, and amikacin. Imaging studies looking for deep-seated infection revealed vertebral L1-L2 diskitis and osteomyelitis with pre-vertebral abscess and bilateral psoas pyomyositis that were not amenable for drainage...
June 2018: Puerto Rico Health Sciences Journal
Mario Tumbarello, Enrico Maria Trecarichi, Alberto Corona, Francesco Giuseppe De Rosa, Matteo Bassetti, Cristina Mussini, Francesco Menichetti, Claudio Viscoli, Caterina Campoli, Mario Venditti, Andrea De Gasperi, Alessandra Mularoni, Carlo Tascini, Giustino Parruti, Carlo Pallotto, Simona Sica, Ercole Concia, Rosario Cultrera, Gennaro De Pascale, Alessandro Capone, Spinello Antinori, Silvia Corcione, Elda Righi, Angela Raffaella Losito, Margherita Digaetano, Francesco Amadori, Daniele Roberto Giacobbe, Giancarlo Ceccarelli, Ernestina Mazza, Francesca Raffaelli, Teresa Spanu, Roberto Cauda, Pierluigi Viale
Background: Ceftazidime-avibactam (CAZ-AVI) has been approved in Europe for the treatment of complicated intra-abdominal and urinary-tract infections, as well as hospital-acquired pneumonia, and for Gram-negative infections with limited treatment options. CAZ-AVI displays in vitro activity against KPC-enzyme producers, but clinical-trial data on its efficacy in this setting are lacking. Methods: We retrospectively reviewed 138 cases of infections caused by Klebsiella pneumoniae carbapenemase-producing (KPC-Kp) in adults who received CAZ-AVI in compassionate-use programs in Italy...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Fangyou Yu, Jingnan Lv, Siqiang Niu, Hong Du, Yi-Wei Tang, Robert A Bonomo, Barry N Kreiswirth, Liang Chen
Carbapenem-resistant and hypervirulent Klebsiella pneumoniae (CR-hvKp) strains have emerged while antimicrobial treatment options remain limited. Herein, we tested the in vitro activity of ceftazidime-avibactam and other comparator antibiotics against 65 CR-hvKp isolates. Ceftazidime-avibactam, colistin and tigecycline are highly active in vitro against CR-hvKp isolates (MIC90 ≤ 1μg/ml), including KPC-2-producing ST11 CR-hvKp. Based upon previous clinical experience and the in vitro data presented herein, we posit that ceftazidime-avibactam is a considered therapeutic option against CR-hvKp infections...
June 11, 2018: Antimicrobial Agents and Chemotherapy
Angela Gomez-Simmonds, Stephania Stump, Marla J Giddins, Medini K Annavajhala, Anne-Catrin Uhlemann
Treatment options for carbapenem-resistant Enterobacteriaceae (CRE) are limited. While Klebsiella pneumoniae harboring bla KPC account for most CRE, recent evidence points to increasing diversification of CRE. We determined whether CRE species and antibiotic resistance genotype influence response to relebactam (REL), a novel beta-lactamase inhibitor with class A/C activity, combined with imipenem(IMI)/cilastatin. We carried out broth microdilution testing to IMI alone or in the presence of 4 μg/mL REL in 154 clinical isolates collected at a New York City hospital with high prevalence of bla KPC including Enterobacter spp...
June 11, 2018: Antimicrobial Agents and Chemotherapy
Wenjun Sui, Haijian Zhou, Pengcheng Du, Lijun Wang, Tian Qin, Mei Wang, Hongyu Ren, Yanfei Huang, Jing Hou, Chen Chen, Xinxin Lu
Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of nosocomial infections worldwide. The transmission route of CRKP isolates within an outbreak is rarely described. This study aimed to reveal the molecular characteristics and transmission route of CRKP isolates within an outbreak of nosocomial infection. Methods: Collecting case information, active screening and targeted environmental monitoring were carried out. The antibiotic susceptibility, drug-resistant genes, molecular subtype and whole genome sequence of CRKP strains were analyzed...
2018: Antimicrobial Resistance and Infection Control
Fabio Arena, Federica Vannetti, Vincenzo Di Pilato, Laura Fabbri, Olga Lorenza Colavecchio, Tommaso Giani, Chiara Marraccini, Roberto Pupillo, Claudio Macchi, Francesco Converti, Gian Maria Rossolini
BACKGROUND: Long-term acute care rehabilitation facilities (LTACRFs) are affected by Carbapenem-resistant Enterobacteriaceae (CRE) in endemic areas. However, the contribution of different subpopulations of patients has not been investigated in these settings. AIM: To study the CRE epidemiology in an LTACRF, and the effect of an infection control intervention. METHODSMATERIALS-METHODS: A surveillance program was implemented in a large Italian LTACRF...
June 4, 2018: Journal of Hospital Infection
Chih-Ming Chen, Ming-Kai Guo, Se-Chin Ke, Yi-Pei Lin, Chia-Ru Li, Hong Thuy Vy Nguyen, Lii-Tzu Wu
PURPOSE: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as a major challenge for global healthcare systems. The objectives of this study were to determine the nosocomial spread of CRKP clones and analyse the molecular characteristics of CRKP in our hospital. METHODOLOGY: Ninety-eight non-duplicated clinical CRKP isolates were collected from March 2014-June 2015. Clinical, demographic and microbiological data of patients with CRKP were reviewed. Pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing were applied to investigate the genetic relationship between the 98 isolates...
June 6, 2018: Journal of Medical Microbiology
María E Pachón-Ibáñez, Gema Labrador-Herrera, Tania Cebrero-Cangueiro, Caridad Díaz, Younes Smani, José P Del Palacio, Jesús Rodríguez-Baño, Alvaro Pascual, Jerónimo Pachón, M Carmen Conejo
Despite the relevance of carbapenemase-producing Klebsiella pneumoniae (CP-Kp) infections there are a scarce number of studies to evaluate in vivo the efficacy of combinations therapies. The bactericidal activity of colistin, rifampin, and its combination was studied (time-kill curves) against four clonally unrelated clinical isolates of CP-Kp, producing VIM-1, VIM-1 plus DHA-1(acquired AmpC β-lactamase), OXA-48 plus CTX-M-15 (extended spectrum β-lactamase) and KPC-3, respectively, with colistin MICs of 0...
2018: Frontiers in Microbiology
Radim Knob, Robert L Hanson, Olivia B Tateoka, Ryan L Wood, Israel Guerrero-Arguero, Richard A Robison, William G Pitt, Adam T Woolley
Fast determination of antibiotic resistance is crucial in selecting appropriate treatment for sepsis patients, but current methods based on culture are time consuming. We are developing a microfluidic platform with a monolithic column modified with oligonucleotides designed for sequence-specific capture of target DNA related to the Klebsiella pneumoniae carbapenemase (KPC) gene. We developed a novel single-step monolith fabrication method with an acrydite-modified capture oligonucleotide in the polymerization mixture, enabling fast monolith preparation in a microfluidic channel using UV photopolymerization...
May 21, 2018: Journal of Chromatography. A
Lisia Miglioli Galvão, Anna Paula Romero de Oliveira, Aline Santos Ibanês, Jussimara Monteiro, Fernanda Inoue, Daniel Chagas Dantas, Flavio Sanchez, Daniel Wagner Santos, Cely Saad Abboud
Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation. A 59-year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation. On day 5 post-operation, blood cultures from the donor were positive for colistin-resistant carbapenemase-producing K. pneumoniae (ColR KPC-Kp) susceptible only to amikacin. Recipient blood cultures were also positive for ColR KPC-Kp with the same sensitivity profile as the donor isolate with an identical PFGE pattern...
May 25, 2018: Brazilian Journal of Infectious Diseases
Giulia Errico, Carlo Gagliotti, Monica Monaco, Lucia Masiero, Paolo Gaibani, Simone Ambretti, Maria Paola Landini, Silvia D'Arezzo, Antonino Di Caro, Saverio Giuseppe Parisi, Giorgio Palù, Francesca Vespasiano, Filomena Morsillo, Maria Luisa Moro, Francesco Procaccio, Andrea Ricci, Paolo Antonio Grossi, Annalisa Pantosti, Alessandro Nanni Costa
OBJECTIVE: A prospective cohort study was conducted in Italy in order to describe the microbiological aspects of colonization/infection by carbapenemase producing Enterobacteriaceae (CPE) in donors and recipients of lung and liver transplants and the possible CPE transmission from donors to recipients. METHODS: Between 15 January 2014-14 January 2015 all recipients of solid organ transplants (SOT) at 10 lung and 8 liver transplantation centres (TCs) and the corresponding donors were enrolled...
May 22, 2018: Clinical Microbiology and Infection
Yen-Hua Huang, Sheng-Hua Chou, Syun-Wun Liang, Chung-En Ni, Yi-Tsung Lin, Yi-Wei Huang, Tsuey-Ching Yang
Background: Carbapenemase-producing Klebsiella pneumoniae causes high mortality owing to the limited therapeutic options available. Here, we investigated an emergent carbapenem-resistant K. pneumoniae strain with hypervirulence found among KPC-2-producing strains in Taiwan. Methods: KPC-producing K. pneumoniae strains were collected consecutively from clinical specimens at the Taipei Veterans General Hospital between January 2012 and December 2014. Capsular types and the presence of rmpA/rmpA2 were analysed, and PFGE and MLST performed using these strains...
May 24, 2018: Journal of Antimicrobial Chemotherapy
Qiong Chen, Jia-Wei Zhou, Sheng-Hai Wu, Xiao-Hua Meng, Dao-Jun Yu, Xian-Jun Wang
Bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) strains have been a severe problem with high clinical costs and high mortality rates. The bla KPC-2 -producing CRKP strain XPY20 was collected from the blood of a patient. The genome characteristics and antimicrobial resistance mechanisms were determined using next-generation sequencing.
May 24, 2018: Genome Announcements
Melina Lorraine Ferreira, Bruna Fuga Araújo, Iara Rossi Gonçalves, Sabrina Royer, Paola Amaral Campos, Luiz Gustavo Machado, Deivid William Fonseca Batistão, Cristiane Silveira Brito, Paulo P Gontijo-Filho, Rosineide Marques Ribas
Carbapenemase-producing organisms are pandemic and a significant threat to public health. We investigated the clonal relatedness of colistin-resistant Klebsiella pneumoniae strains producing KPC-type carbapenemase (KPC-KP) causing subsequent infections or colonization. Moreover, we aimed to gain insight into the ability of biofilm production in K. pneumoniae strains producing carbapenemase. Twenty-two consecutive KPC-KP and one KPC-negative strain was identified from an adult intensive care unit in Brazil. Seventy-five percent of isolates that harbored the blaKPC gene exhibited genetic relatedness by pulsed-field gel electrophoresis, and none presented the plasmid-mediated mcr-1 and blaNDM genes...
May 24, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Chaitra Shankar, Baby Abirami Shankar, Abi Manesh, Balaji Veeraraghavan
This study characterizes KPC-2 producing Klebsiella pneumoniae belonging to ST101. Whole genome sequencing using the Ion Torrent PGM platform with 400 bp chemistry was performed. blaKPC-2 was found on an IncFIIK plasmid associated with ISKpn6 and ISKpn7 without Tn4401. This is the first report of KPC-2 K. pneumoniae from bacteremia in India. The isolate also coded for other resistance genes such as aadA1, aadA2, armA, aac(3)-Ild, aac(6')-Ild for aminoglycoside; blaSHV-11, blaTEM-1B, blaOXA-9, for β-lactams and aac(6')-Ild, oqxA, oqxB, qnrB1 for fluoroquinolones...
May 22, 2018: Journal of Medical Microbiology
Gregory Balabanian, Michael Rose, Nyla Manning, David Landman, John Quale
Imipenem with relebactam is a novel β-lactam-β-lactamase inhibitor that has activity against most KPC-producing Enterobacteriaceae. Using 10 isolates of KPC-possessing Klebsiella pneumoniae, we assessed the relationship between imipenem-relebactam minimum inhibitory concentrations (MICs) and mechanisms known to contribute to antimicrobial resistance. The effect of adding a second agent was assessed by time-kill experiments. Mutations affecting the genes encoding porins ompK35 and ompK36 and identification of β-lactamases were assessed by PCR...
May 21, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Piergiorgio Cojutti, Assunta Sartor, Matteo Bassetti, Claudio Scarparo, Federico Pea
OBJECTIVE: To assess MIC distribution for meropenem and the other antibiotics with Gram-negative activity against KPC-Kp clinical isolates collected at our hospital in 2013-2016. METHODS: Susceptibility of KPC-Kp strains was tested by broth microdilution method, using customized 96-well plates, and was interpreted according to the EUCAST recommendations. RESULTS: Among 169 consecutive KPC-Kp clinical isolates 26.6% were susceptible to meropenem...
May 15, 2018: Journal of Global Antimicrobial Resistance
Menglan Zhou, Danchen Wang, Timothy Kudinha, Qiwen Yang, Shuying Yu, Ying-Chun Xu
Objectives: To evaluate the performance of four phenotypic methods in the detection of carbapenemase-producing Enterobacteriaceae (CPE) in China. Methods: We evaluated the performance of four carbapenemase detection methods, the modified Hodge test (MHT), Carba NP test, meropenem hydrolysis assay (MHA) with 1 and 2-hour incubation, and modified carbapenem inactivation method (mCIM) with meropenem, imipenem, and ertapenem, on 342 carbapenem-resistant Enterobacteriaceae (CRE) in China. Polymerase chain reaction was used as the gold standard...
May 16, 2018: Journal of Clinical Microbiology
Ka Lip Chew, Michelle K L Tay, Bernadette Cheng, Raymond T P Lin, Sophie Octavia, Jeanette W P Teo
Newly approved Food and Drug Administration (FDA) β-lactam-β-lactamase inhibitor (βL-βLI) inhibitor combinations such as ceftazidime-avibactam and meropenem-vaborbactam are potent inhibitors of class A carbapenemase (typified by KPC [ Klebsiella pneumoniae carbapenemase]-like) (1, 2) but are ineffective against carbapenemase-producing Enterobacteriaceae (CPE) producing class B metallo-β-lactamases (MβLs) such as New Delhi metallo-β-lactamase (NDM) (1-4).….
May 14, 2018: Antimicrobial Agents and Chemotherapy
Min-Chi Lu, Hui-Ling Tang, Chien-Shun Chiou, Yao-Chen Wang, Ming-Ko Chiang, Yi-Chyi Lai
OBJECTIVES: The global spread of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a massive threat to human health. We here investigated the clonal relatedness of CR-Kp strains in central Taiwan. METHODS: CR-Kp were prospectively collected from inpatients referred to Chung Shan Medical University Hospital (CSMUH) during Sep. 2011 to Dec. 2015. The presence of carbapenemase genes, including blaKPC-2 , blaVIM-1 , blaNDM-1 , and blaOXA-48 was analyzed with PCR and sequence determination...
May 9, 2018: International Journal of Antimicrobial Agents
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