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Colistin resistant klebsiella

Gonzalo De Sanctis, Augusto Ferraris, Laura Ducatenzeiler, José Benso, Lucas Fernández-Otero, Federico Angriman
BACKGROUND: The emergence of colistin resistant carbapenemase-producing Klebsiella represents a therapeutic challenge and a worldwide problem. AIM: To estimate the in-hospital mortality and identify the associated risk factors among patients with colistin-resistant carbapenemase-producing Klebsiella pneumoniae (KPC) that present with a clinical infection. METHODS: We carried a retrospective cohort study, including adult patients infected with colistin-resistant KPC hospitalized at a tertiary teaching hospital in Buenos Aires, Argentina during the year 2016...
2018: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Zhongqiang Yan, Yu Zhou, Mingmei Du, Yanling Bai, Bowei Liu, Meiliang Gong, Hongbin Song, Yigang Tong, Yunxi Liu
BACKGROUND: Following the alarming outbreak of carbapenem-resistant Klebsiella pneumonia (CRKP) in five intensive care units (ICUs) of a tertiary care hospital in China, a prospective investigation of CRKP colonized/infected patients was conducted. AIM: To describe the diffusion and transmission of CRKP among epidemiologically linked ICU patients, staff and environment. METHODS: Enhanced CRKP infected/colonized case monitoring was performed by the real-time nosocomial infection surveillance system (RT-NISS)...
December 6, 2018: Journal of Hospital Infection
M I Lespada, E Córdova, V Roca, N Gómez, M Badía, C Rodríguez
OBJECTIVE: Bacteremia caused by Klebsiella pneumoniae carbapenemase-producing strains (Kp-KPC) is associated with high mortality. The hypothesis of our work is that there was an increase in the levels of resistance to different antimicrobials in Kp-KPC isolated from bacteremia. METHODS: Retrospective and descriptive study in two periods: Period 1 (P1) 2010-2014 and period 2 (P2) 2015-2016. We included patients ≥18 years old with bacteremia caused by Kp-KPC in a General Hospital...
December 4, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Andrew J Denisuik, Lauren A Garbutt, Alyssa R Golden, Heather J Adam, Melanie Baxter, Kimberly A Nichol, Philippe Lagacé-Wiens, Andrew J Walkty, James A Karlowsky, Daryl J Hoban, Michael R Mulvey, George G Zhanel
Objectives: To describe the microbiology and antimicrobial resistance patterns of cultured samples acquired from Canadian ICUs. Methods: From 2007 to 2016, tertiary care centres from across Canada submitted 42 938 bacterial/fungal isolates as part of the CANWARD surveillance study. Of these, 8130 (18.9%) were from patients on ICUs. Susceptibility testing guidelines and MIC interpretive criteria were defined by CLSI. Results: Of the 8130 pathogens collected in this study, 58...
November 29, 2018: Journal of Antimicrobial Chemotherapy
Katarzyna Piekarska, Katarzyna Zacharczuk, Tomasz Wołkowicz, Natalia Wolaniuk, Magdalena Rzeczkowska, Rafał Gierczyński
BACKGROUND: Plasmid-mediated extended-spectrum β-lactamases (ESBLs), 16S rRNA methylases and quinolone resistance mechanisms (PMQRs) are well-known agents conferring resistance to more than 1 antimicrobial in its group. The accumulation of these agents poses, therefore, a serious risk to public health. OBJECTIVES: The objective of this study was to investigate the presence of common ß-lactamases and 16S rRNA methylases in Qnr-producing Enterobacteriaceae and their genetic relatedness...
November 30, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Dongxing Tian, Fen Pan, Chun Wang, Yan Sun, Hong Zhang
Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has caused wide global disseminations and serious clinical outcomes in pediatric patients, and the purpose of this study was to analyze drug resistance, molecular epidemiology, and clinical characteristics of CRKP from children in Shanghai, China. Methods: A retrospective study was conducted from January 2016 to December 2017, and a total of 170 CRKP isolates were collected. Antimicrobial susceptibility was determined by the broth microdilution method...
2018: Infection and Drug Resistance
M N Tarana, S M Shamsuzzaman
Pathogenic microorganisms are important cause of maternal and neonatal infections which are transmitted from colonized vagina of mother. The purpose of the present study was to detect the potential pathogens other than Group B Streptococcus in vaginal swab of pregnant women. This prospective cross sectional study was conducted from July 2013 to June 2014 at Dhaka Medical College Hospital, Dhaka, Bangladesh. A total of 224 vaginal swab samples were studied. Gram stain Nugent score was applied for all vaginal smear to detect bacterial vaginosis...
October 2018: Mymensingh Medical Journal: MMJ
Georgios Meletis, Lemonia Skoura
The global spread of carbapenemase-encoding genes among Gram-negative nosocomial pathogens, has led to the revival of polymyxins. Colistin and polymyxin B, despite their serious adverse effects, have become last resort treatment options for multi- or even extensively-drug-resistant bacterial infections due to Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. Their use however has been followed by an increase in polymyxin resistance rates and the spread of transferable resistance genes limiting further the treatment options and contributing to the emergence of pan-drug-resistance...
November 26, 2018: Recent Patents on Anti-infective Drug Discovery
Uday Narayan Das, Asem Sanjit Singh, Manjusha Lekshmi, Binaya Bhusan Nayak, Sanath Kumar
Carbapenem-resistant Enterobacteriaceae (CRE) have evolved into a major challenge to antibiotic therapy worldwide. The problem is more confounding when wider dissemination of CRE occurs in the community and the environment. In this study, six blaNDM -harboring Enterobacteriaceae, four Klebsiella pneumoniae, and two Escherichia coli, isolated from seafood, were characterized with respect to their antibiotic resistance and the genetic factors responsible for these resistances. The isolates were resistant to all β-lactam antibiotics, quinolones, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline and were susceptible to colistin, polymixin B, fosfomycin, and tigecycline...
November 23, 2018: Environmental Science and Pollution Research International
Miranda E Pitt, Minh Duc Cao, Mark S Butler, Soumya Ramu, Devika Ganesamoorthy, Mark A T Blaskovich, Lachlan J M Coin, Matthew A Cooper
Background: Polymyxin B and E (colistin) have been pivotal in the treatment of XDR Gram-negative bacterial infections; however, resistance has emerged. A structurally related lipopeptide, octapeptin C4, has shown significant potency against XDR bacteria, including polymyxin-resistant strains, but its mode of action remains undefined. Objectives: We sought to compare and contrast the acquisition of resistance in an XDR Klebsiella pneumoniae (ST258) clinical isolate in vitro with all three lipopeptides to potentially unveil variations in their mode of action...
November 14, 2018: Journal of Antimicrobial Chemotherapy
Cesira Giordano, Simona Barnini
Carbapenemase-producing Klebsiella pneumoniae has become a worldwide recognized cause of nosocomial infections and requires urgent public health attention. The main reason of this concern is the increasing resistance to all the last-resort antibiotics, including colistin. The ideal methodology for colistin susceptibility testing still remains undefined. However, the emergence of colistin as one of the last-option treatments requires a reliable method to determine the susceptibility profile of resistant isolates...
November 12, 2018: Journal of Microbiological Methods
Thomas Büdel, Mathieu Clément, Odette J Bernasconi, Luigi Principe, Vincent Perreten, Francesco Luzzaro, Andrea Endimiani
The emergence of the colistin-resistant (COL-R) Enterobacteriaceae represents a worrying health issue. However, only a portion of these strains may carry the plasmid-mediated mcr colistin resistance genes. We evaluated the ability of both ethylenediaminetetraacetic acid (EDTA)-based and dipicolinic acid (DPA)-based broth microdilution (BMD) tests to detect mcr-1 to mcr-5 producers. Of 92 Enterobacteriaceae (85 COL-R), 44 mcr-positive strains (39 Escherichia coli, 3 Klebsiella pneumoniae, and 2 Salmonella spp...
November 15, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Xu Huang, Xiangjun Cheng, Pengfei Sun, Chenjie Tang, Fang Ni, Genyan Liu
BACKGROUND: The emergence of carbapenem-resistant Klebsiella pneumoniae (CR-KP) has become a significant problem worldwide and also being a major threat to children and newborns. Here we report an outbreak of NDM-1-producing K. pneumoniae in a neonatal unit. RESULTS: Six CR-KP strains, isolated from neonates with symptoms of infection, were identified using a VITEK-2 compact system, and the clinical data were retrieved from the electronic case records. In vitro susceptibility testing with broth dilution method showed that all six K...
November 14, 2018: BMC Microbiology
Chaitra Shankar, Susmitha Karunasree, Abi Manesh, Balaji Veeraraghavan
AIM: Klebsiella pneumoniae carbapenemase (KPC) is a class A carbapenemase endemic in the United States, China, South America, and Europe but is rarely reported from India. A single report of KPC-9 from K. pneumoniae in Israel has been published. K. pneumoniae has been classified into three phylogenetic groups: group 1 consists of K. pneumoniae and its subspecies, group 2 consists of Klebsiella quasipneumoniae and its subspecies, and group 3 consists of Klebsiella variicola. This is the first report of whole-genome sequencing of colistin-resistant K...
November 14, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Qi Wang, Xiaojuan Wang, Juan Wang, Pengwen Ouyang, Chunmei Jin, Ruobing Wang, Yawei Zhang, Longyang Jin, Hongbin Chen, Zhanwei Wang, Feifei Zhang, Bin Cao, Liangyi Xie, Kang Liao, Bing Gu, Chunxia Yang, Zhiwu Liu, Xiaobo Ma, Liang Jin, Xiaoqian Zhang, Sijin Man, Wei Li, Fengyan Pei, Xiuli Xu, Yan Jin, Ping Ji, Hui Wang
Background: Carbapenem-resistant Enterobacteriaceae (CRE) strains are a major threat to global health. The development of effective control measures requires more detailed phenotypic and genotypic characterization of CRE. Methods: CRE isolates were collected from 65 hospitals in 25 provinces across China between January 1, 2012, and December 31, 2016. The isolates were characterized by antimicrobial susceptibility testing and multilocus sequence typing. Genes encoding carbapenemases, mobilized colistin resistance (mcr-1), and β-lactamases were detected by polymerase chain reaction and DNA sequencing...
November 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Cong Shen, Siyuan Feng, Hongtao Chen, Min Dai, David L Paterson, Xiaobin Zheng, Xingui Wu, Lan-Lan Zhong, Yan Liu, Yong Xia, Rui Ma, Xi Huang, Guo-Bao Tian
Objectives: mcr-1-mediated colistin resistance in bacteria is concerning, as colistin is used in treating multidrug-resistant bacterial infections. And mcr-1-producing bacteria have been identified in multiple sources. Up to 248 million people use public transportation daily in China, however; public transportation hasn't been studied as a potential source of community-based transmission of mcr-1. Herein we investigated mcr-1-producing isolates from public transportation and explored the genomic characteristics of them...
November 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Yang Lu, Yu Feng, Alan McNally, Zhiyong Zong
Hypervirulent Klebsiella pneumoniae strains are usually susceptible to many antimicrobial agents including colistin. Here we report the isolation and characterization of several colistin-resistant hypervirulent K. pneumoniae clinical strains. K. pneumoniae strains recovered from blood samples were collected at a university hospital in China. MICs of colistin were determined using microdilution. Colistin-resistant strains were subjected to whole genome sequencing to reveal their clonal background, antimicrobial resistance determinants and virulence factors...
2018: Frontiers in Microbiology
Tania Cebrero-Cangueiro, Rocío Álvarez-Marín, Gema Labrador-Herrera, Younes Smani, Elisa Cordero-Matía, Jerónimo Pachón, María Eugenia Pachón-Ibáñez
Enterobacteriaceae cause different types of community- and hospital-acquired infections. Moreover, the spread of multidrug-resistant Enterobacteriaceae is a public health problem and the World Health Organization pointed them among the pathogens in which the search of new antibiotics is critical. The objective of this study was to analyze the in vitro activity of pentamidine alone and in combination with gentamicin, tobramycin, amikacin, tigecycline, rifampicin, or doripenem against eight clinical strains of carbapenemase-producing and/or colistin-resistant Enterobacteriaceae: five carbapenemase-producing Klebsiella pneumoniae , one carbapenemase-producing Escherichia coli , and two colistin-resistant Enterobacter cloacae ...
2018: Frontiers in Cellular and Infection Microbiology
Cátia Caneiras, Filipa Calisto, Gabriela Jorge da Silva, Luis Lito, José Melo-Cristino, Aida Duarte
Herein, we describe a case report of carbapenem-resistant Acinetobacter baumannii and Klebsiella pneumoniae isolates that were identified from the same patient at a Tertiary University Hospital Centre in Portugal. Antimicrobial susceptibility and the molecular characterization of resistance and virulence determinants were performed. PCR screening identified the presence of the resistance genes bla KPC-3 , bla TEM-1 and bla SHV-1 in both isolates. The KPC-3 K. pneumoniae isolate belonged to the ST-14 high risk clone and accumulated an uncommon resistance and virulence profile additional to a horizontal dissemination capacity...
November 6, 2018: Antibiotics
Serap Süzük Yıldız, Banu Kaşkatepe, Hüsniye Şimşek, Fatma Mutlu Sarıgüzel
When the problem with carbapenem-resistant Enterobacteriaceae (CRE) increases, the older antimicrobial agents such as colistin and fosfomycin are used for the treatment of these infections. In this study, the broth microdilution method for colistin and the agar dilution method for fosfomycin were used for a total of 147 multidrug-resistant (MDR) or extensively drug-resistant (XDR) strains of CRE. The study included Klebsiella pneumoniae (91.16%), Escherichia coli (7.48%), Enterobacter cloacae (0.68%), and Serratia marcescens (0...
November 7, 2018: Acta Microbiologica et Immunologica Hungarica
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