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https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#1
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
#2
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 17, 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
#3
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
#4
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
#5
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 10, 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
#6
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
#7
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...
December 23, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28039276/the-pharmacodynamics-of-avibactam-in-combination-with-ceftaroline-or-ceftazidime-against-%C3%AE-lactamase-producing-enterobacteriaceae-studied-in-an-in-vitro-model-of-infection
#8
Alasdair MacGowan, Sharon Tomaselli, Alan Noel, Karen Bowker
OBJECTIVES: Pharmacodynamics of β-lactamase inhibitors are an area of intense interest as new β-lactam/β-lactamase inhibitor combinations enter clinical development and clinical practice. Avibactam, a non-β-lactam β-lactamase inhibitor, has been combined with ceftaroline or ceftazidime but these two combinations have not been directly compared. METHODS: Using an in vitro pharmacokinetic model we simulated human drug concentration-time courses associated with ceftaroline 600 mg every 8 h and ceftazidime 2000 mg every 8 h...
December 30, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28031433/comparison-of-phenotypic-tests-and-an-immunochromatographic-assay-and-development-of-a-new-algorithm-for-oxa-48-like-detection
#9
Florian Koroska, Stephan Göttig, Martin Kaase, Jörg Steinmann, Sören Gatermann, Julian Sommer, Thorsten Wille, Georg Plum, Axel Hamprecht
OXA-48 is the most prevalent carbapenemase in Enterobacteriaceae in Europe and the Middle East, but is frequently missed because many isolates display low minimal inhibitory concentrations (MIC) for carbapenems. Furthermore, in contrast to metallo-β-lactamases or Klebsiella pneumoniae carbapenemases (KPC), no specific inhibitor is available for the phenotypic detection of OXA-48. Molecular detection of blaOXA-48 is the gold standard, but is not available in many laboratories. Few phenotypic assays have been described, but have not been independently evaluated...
December 28, 2016: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28031201/emergence-of-ceftazidime-avibactam-resistance-due-to-plasmid-borne-blakpc-3-mutations-during-treatment-of-carbapenem-resistant-klebsiella-pneumoniae-infections
#10
Ryan K Shields, Liang Chen, Shaoji Cheng, Kalyan D Chavda, Ellen G Press, Avin Snyder, Ruchi Pandey, Yohei Doi, Barry N Kreiswirth, M Hong Nguyen, Cornelius J Clancy
Ceftazidime-avibactam is a novel β-lactam/β-lactamase inhibitor with activity against carbapenem-resistant Enterobacteriaceae (CRE) that produce Klebsiella pneumoniae carbapenemase (KPC). We report the first cases of ceftazidime-avibactam resistance to develop during treatment of CRE infections, and identify resistance mechanisms. Ceftazidime-avibactam resistant K. pneumoniae emerged in three patients after ceftazidime-avibactam treatment for 10-19 days. Whole genome sequencing (WGS) of longitudinal ceftazidime-avibactam susceptible and resistant K...
December 28, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28012683/might-real-time-pharmacokinetic-pharmacodynamic-optimisation-of-high-dose-continuous-infusion-meropenem-improve-clinical-cure-in-infections-caused-by-kpc-producing-klebsiella-pneumoniae
#11
Federico Pea, Paola Della Siega, Piergiorgio Cojutti, Assunta Sartor, Massimo Crapis, Claudio Scarparo, Matteo Bassetti
The effect of real-time pharmacokinetic/pharmacodynamic (PK/PD) optimisation of high-dose continuous-infusion meropenem on the clinical outcome of patients receiving combination antimicrobial therapy for treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp) infections was retrospectively assessed. Data for all patients with KPC-Kp-related infections who received antimicrobial combination therapy containing high-dose continuous-infusion meropenem optimised by means of therapeutic drug monitoring (TDM) were retrieved...
December 8, 2016: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27980379/epidemiology-and-biomolecular-characterization-of-carbapenem-resistant-klebsiella-pneumoniae-in-an-italian-hospital
#12
REVIEW
M L Cristina, M Sartini, G Ottria, E Schinca, N Cenderello, M P Crisalli, P Fabbri, G Lo Pinto, D Usiglio, A M Spagnolo
OBJECTIVE: To describe the occurrence of CRKP infections in a tertiary care hospital and to analyse the allelic profiles of the clinical strains involved and the most frequent carbapenemases. DESIGN: The study analyzed cases of infection due to CRKP in the period 2013-2014; 147 cases were recorded, most of which (82.31%) were in-hospital infections. SETTING: A hospital in northern Italy. METHODS: We retrospectively collected: data on patient characteristics and the microbiological characteristics of CRKP...
September 2016: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/27934829/does-the-presence-of-klebsiella-pneumoniae-carbapenemase-and-new-delhi-metallo-%C3%AE-lactamase-1-genes-in-pathogens-lead-to-fatal-outcome
#13
P Mathur, S Sagar, S Kumar, V Sharma, D Gupta, S Lalwani, R Rani, A Muruganantham
INTRODUCTION: Infections due to multidrug-resistant (MDR) pathogens are a medical challenge. There is considerable apprehension among clinicians regarding pathogens reported as carrying New Delhi metallo-β-lactamase-1 (NDM) and Klebsiella pneumoniae carbapenemase (KPC) genes from their patients. In the face of extremely high rates of antimicrobial resistance, it is essential to gauge the clinical significance of isolation of pathogens carrying these genes from clinical samples. This study compares the outcome of patients infected with pathogens carrying NDM/KPC genes versus those without these genes...
October 2016: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27927163/phenotypic-and-molecular-detection-of-the-bla-kpc-gene-in-clinical-isolates-from-inpatients-at-hospitals-in-s%C3%A3-o-luis-ma-brazil
#14
Patricia Cristina Saldanha Ribeiro, Andrea Souza Monteiro, Sirlei Garcia Marques, Sílvio Gomes Monteiro, Valério Monteiro-Neto, Martina Márcia Melo Coqueiro, Ana Cláudia Garcia Marques, Rosimary de Jesus Gomes Turri, Simone Gonçalves Santos, Maria Rosa Quaresma Bomfim
BACKGROUND: Bacteria that produce Klebsiella pneumoniae carbapenemases (KPCs) are resistant to broad-spectrum β-lactam antibiotics. The objective of this study was to phenotypically and genotypically characterize the antibiotic susceptibility to carbapenems of 297 isolates recovered from clinical samples obtained from inpatients at 16 hospitals in São Luis (Maranhão, Brazil). METHODS: The study was conducted using phenotypic tests and molecular methods, including polymerase chain reaction (PCR), sequencing and enterobacterial repetitive intergenic consensus (ERIC)-PCR...
December 7, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27919898/a-prolonged-outbreak-of-kpc-3-producing-enterobacter-cloacae-and-klebsiella-pneumoniae-driven-by-multiple-mechanisms-of-resistance-transmission-at-a-large-academic-burn-center
#15
Hajime Kanamori, Christian M Parobek, Jonathan J Juliano, David van Duin, Bruce A Cairns, David J Weber, William A Rutala
Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter cloacae have been recently recognized in the United States. Whole-genome sequencing (WGS) has become a useful tool for analysis of outbreaks and for determining transmission networks of multidrug-resistant organisms in healthcare settings, including carbapenem-resistant Enterobacteriaceae (CRE). We experienced a prolonged outbreak of CRE of E. cloacae and K. pneumoniae over a three-year period at a large academic burn center despite rigorous infection control measures...
December 5, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27890667/investigation-of-carbapenem-resistance-and-the-first-identification-of-klebsiella-pneumoniae-carbapenemase-kpc-enzyme-among-escherichia-coli-isolates-in-turkey-a-prospective-study
#16
Mert Ahmet Kuskucu, Asiye Karakullukcu, Mailihaba Ailiken, Barıs Otlu, Bilgul Mete, Gokhan Aygun
BACKGROUND: The aim of this study was to determine the presence of carbapenem resistance and carbapenemase production in Escherichia coli isolates from clinical samples in Turkey. METHODS: The prospective study included a total of 4.052 Escherichia coli isolates collected from patients admitted to a hospital from March 2011 to May 2012. We used ertapenem disc for screening carbapenemase production, and the confirmation was performed by using Etest. The resistance mechanisms and genetic relatedness of the carbapenem resistant strains were investigated by using PCR (polymerase chain reaction) and pulsed-field gel electrophoresis (PFGE), respectively...
November 2016: Travel Medicine and Infectious Disease
https://www.readbyqxmd.com/read/27872078/polymyxin-b-in-combination-with-rifampin-and-meropenem-against-polymyxin-b-resistant-kpc-producing-klebsiella-pneumoniae
#17
John Diep, David M Jacobs, Rajnikant Sharma, Jenna Covelli, Dana R Bowers, Thomas A Russo, Gauri G Rao
Safe and effective therapies are urgently needed to treat polymyxin-resistant KPC-producing K. pneumoniae and suppress the emergence of resistance. We investigated the pharmacodynamics of polymyxin B, rifampin, and meropenem alone and as polymyxin B-based double and triple combinations against KPC-producing K. pneumoniae The rate and extent of killing with polymyxin B (1-128mg/L), rifampin (2-16mg/L), and meropenem (10-120mg/L) were evaluated against polymyxin B-susceptible (PB(S)) and -resistant (PB(R)) clinical isolates using 48h static time-kills...
November 21, 2016: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27866944/occurrence-of-carbapenemase-producing-klebsiella-pneumoniae-and-escherichia-coli-in-the-european-survey-of-carbapenemase-producing-enterobacteriaceae-euscape-a-prospective-multinational-study
#18
Hajo Grundmann, Corinna Glasner, Barbara Albiger, David M Aanensen, Chris T Tomlinson, Arjana Tambić Andrasević, Rafael Cantón, Yehuda Carmeli, Alexander W Friedrich, Christian G Giske, Youri Glupczynski, Marek Gniadkowski, David M Livermore, Patrice Nordmann, Laurent Poirel, Gian M Rossolini, Harald Seifert, Alkiviadis Vatopoulos, Timothy Walsh, Neil Woodford, Dominique L Monnet
BACKGROUND: Gaps in the diagnostic capacity and heterogeneity of national surveillance and reporting standards in Europe make it difficult to contain carbapenemase-producing Enterobacteriaceae. We report the development of a consistent sampling framework and the results of the first structured survey on the occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in European hospitals. METHODS: National expert laboratories recruited hospitals with diagnostic capacities, who collected the first ten carbapenem non-susceptible clinical isolates of K pneumoniae or E coli and ten susceptible same-species comparator isolates and pertinent patient and hospital information...
November 17, 2016: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/27846056/mother-to-child-transmission-of-kpc-carbapenemase-producing-klebsiella-pneumoniae-at-birth
#19
Paolo Bonfanti, Roberto Bellù, Luigi Principe, Ilaria Caramma, Manuela Condò, Tommaso Giani, Gian Maria Rossolini, Francesco Luzzaro
We report on a mother-to-child transmission of KPC carbapenemase-producing Klebsiella pneumoniae at birth followed by subsequent cases in the NICU. Molecular analysis of isolates showed production of KPC-3 enzyme. The only potential risk factor identified for the mother was previous activity as a caregiver. Present findings suggest consideration of pro-active surveillance in pregnant women with risk factors for colonization.
November 11, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27835839/characterisation-of-carbapenem-resistant-enterobacteriaceae-from-the-southwestern-ohio-northern-kentucky-and-southeastern-indiana-region
#20
Joel E Mortensen, Barbara DeBurger, Eleanor A Powell, Jeanna DiFranco-Fisher, Laura Koeth, Scott J Weissman
Although carbapenem-resistant Enterobacteriaceae (CRE) have been recognised worldwide, there are important gaps in regional prevalence data. This study sought to determine the occurrence and type of CRE in the Cincinnati tri-state region. Clinical microbiology laboratories in the region screened patient stool and rectal swab samples using chromogenic screening agar. Isolates of Enterobacteriaceae resistant to carbapenems were characterised using molecular methods. Area institutions screened 1939 patient samples...
December 2016: Journal of Global Antimicrobial Resistance
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