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Carbapenem-resistant enterobacteriaceae

Branka Bedenić, Haris Car, Domagoj Slačanac, Mario Sviben, Marko Čačić, Amarela Lukić-Grlić, Ana Benčić, Dorotea Šijak, Marko Tripković, Nataša Beader
AIM: The aim of the study was to determine in vitro synergy and postantibiotic effect of colistin alone and combined with meropenem or vancomycin against Enterobacteriaceae producing multiple carbapenemases; combinations of two metallo-β-lactamases (MBL) or MBL with OXA-48. Colistin-resistant strain positive for OXA-48 was also included in the study. METHODS: The antibiotic susceptibility was tested by broth microdilution method. Synergy was tested by chequerboard, time-kill and 2-well method...
July 10, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Dimitria A Mathys, Dixie F Mollenkopf, Joany C Van Balen, Thomas E Wittum
The dissemination of Enterobacteriaceae expressing resistance to clinically important antibiotics such as extended-spectrum cephalosporins (ESC), carbapenems, and fluoroquinolones is of critical concern to both human and veterinary medicine. In healthcare facilities, the movement of patients, personnel, and equipment provides an opportunity for Enterobacteriaceae carrying antibiotic resistance genes to disseminate in the hospital environment where they pose a threat to patients, staff, and hospital visitors...
July 13, 2018: Vector Borne and Zoonotic Diseases
A Singh-Moodley, O Perovic
BACKGROUND: The emergence and transmission of carbapenem-resistant Enterobacteriaceae (CRE) is a concern in both the clinical and public health arenas. Reliable and accurate detection of these organisms is required for patient management and infection prevention and control purposes. In the routine laboratory, phenotypic methods are utilised for identification of CRE. OBJECTIVES: To investigate the phenotypic profiles of suspected carbapenemase-producing Enterobacteriaceae (CPE) isolates generated by the automated MicroScan Walkaway system making use of the Clinical and Laboratory Standards Institute (CLSI) guidelines, and correlate these with carbapenemase production by molecular methods...
May 25, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Danielle Vuichard Gysin, Barry Cookson, Henri Saenz, Markus Dettenkofer, Andreas F Widmer
Background: Definitions and practices regarding use of contact precautions and isolation to prevent the spread of gram-positive and gram-negative multidrug-resistant organisms (MDRO) are not uniform. Methods: We conducted an on-site survey during the European Congress on Clinical Microbiology and Infectious Diseases 2014 to assess specific details on contact precaution and implementation barriers. Results: Attendants from 32 European (EU) and 24 non-EU countries participated ( n  = 213)...
2018: Antimicrobial Resistance and Infection Control
Xiang Tang, Meng Xiao, Chao Zhuo, Yingchun Xu, Nanshan Zhong
Background: With the different situation for clinical antibiotic usage and its management in different regions and medical institutions, the antimicrobial resistance varied in different level. However, the epidemiological data of multi-drug resistant (MDR) strains from the department of respiration is limited. Thus, this study aims to investigate the epidemiology of bacteria isolated from inpatients of respiratory departments, and analyze the distribution variation of major multi-drug resistant bacteria in China...
May 2018: Journal of Thoracic Disease
Thomas Grönthal, Monica Österblad, Marjut Eklund, Jari Jalava, Suvi Nykäsenoja, Katariina Pekkanen, Merja Rantala
IntroductionCarbapenemase-producing Enterobacteriaceae (CPE) have rarely been reported in dogs, and never in animals in Finland. However, in April 2015, two meropenem-resistant Escherichia coli were identified from two dogs in one family. Both dogs suffered from chronic otitis externa . Methods: Epidemiological and molecular investigations (pulsed-field gel electrophoresis (PFGE), multilocus sequence typing) were conducted to investigate the source of infection and transmission routes. Results: In both dogs and one family member New Delhi metallo-beta-lactamase (NDM-5)-producing multidrug-resistant ST167 E...
July 2018: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Emilie Racine, Patrice Nordmann, Lucile Pantel, Matthieu Sarciaux, Marine Serri, Jessica Houard, Philippe Villain-Guillot, Anthony Demords, Carina Vingsbo Lundberg, Maxime Gualtieri
Antibacterial activity screening of a collection of Xenorhabdus strains led to the discovery of the Odilorhabdins, a new antibiotic class with broad-spectrum activity against Gram-positive and Gram-negative pathogens. Odilorhabdins inhibit bacterial translation by a new mechanism of action on ribosomes. A lead-optimization program identified NOSO-502 as a promising candidate. NOSO-502 has MIC values ranging from 0.5 to 4 μg/ml against standard Enterobacteriaceae strains and carbapenem-resistant Enterobacteriaceae (CRE) isolates that produce KPC, AmpC, or OXA enzymes and metallo-β-lactamases...
July 9, 2018: Antimicrobial Agents and Chemotherapy
Debby Ben-David, Samira Masarwa, Noga Fallach, Elizabeth Temkin, Ester Solter, Yehuda Carmeli, Mitchell J Schwaber
Background: Long-term care facilities (LTCFs) are a major reservoir of carbapenem-resistant Enterobacteriaceae (CRE) in healthcare facilities, contributing to rapid regional dissemination of CRE. Methods: In 2008, The Israeli National Center for Infection Control (NCIC) initiated a coordinated, comprehensive intervention in Israel's LTCFs, encompassing approximately 25,000 beds in over 300 institutions. The intervention included implementation of population-tailored contact precautions and early detection of carriers...
July 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Rong Zhang, Ning Dong, Yonglu Huang, Hongwei Zhou, Miaomiao Xie, Edward Wai-Chi Chan, Yanyan Hu, Jiachang Cai, Sheng Chen
Emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains that also exhibit resistance to tigecycline and colistin have become a major clinical concern, as these two agents are the last-resort antibiotics used for treatment of CRKP infections. A leukemia patient infected with CRKP was subjected to follow-up analysis of variation in phenotypic and genotypic characteristics of CRKP strains isolated from various specimens at different stages of treatment over a period of 3 years. Our data showed that (1) carbapenem treatment led to the emergence of CRKP in the gastrointestinal (GI) tract of the patient, which subsequently caused infections at other body sites as well as septicemia; (2) treatment with tigecycline led to the emergence of tigecycline-resistant CRKP, possibly through induction of the expression of a variant tet(A) gene located in a conjugative plasmid; (3) colistin treatment was effective in clearing CRKP from the bloodstream but led to the emergence of mcr-1-positive Enterobacteriaceae strains as well as colistin-resistant CRKP in the GI tract due to inactivation of the mgrB gene; and (4) tigecycline- and colistin-resistant CRKP could persist in the human GI tract for a prolonged period even without antibiotic selection pressure...
July 9, 2018: Emerging Microbes & Infections
Margaret M C Lam, Ryan R Wick, Kelly L Wyres, Claire L Gorrie, Louise M Judd, Adam W J Jenney, Sylvain Brisse, Kathryn E Holt
Mobile genetic elements (MGEs) that frequently transfer within and between bacterial species play a critical role in bacterial evolution, and often carry key accessory genes that associate with a bacteria's ability to cause disease. MGEs carrying antimicrobial resistance (AMR) and/or virulence determinants are common in the opportunistic pathogen Klebsiella pneumoniae, which is a leading cause of highly drug-resistant infections in hospitals. Well-characterised virulence determinants in K. pneumoniae include the polyketide synthesis loci ybt and clb (also known as pks), encoding the iron-scavenging siderophore yersiniabactin and genotoxin colibactin, respectively...
July 9, 2018: Microbial Genomics
M Abdallah, A Balshi
Providencia species are Gram-negative bacteria that belong to the Enterobacteriaceae family. They have intrinsic resistance to colistin and tigecycline, which makes treatment of the multidrug-resistant strains of Providencia challenging. Carbapenem-resistant Providencia species are increasingly reported. In this review, patients' characteristics, resistance mechanisms, treatment and infection control measures of carbapenem-resistant Providencia species in the literature are described.
September 2018: New Microbes and New Infections
Alejandro Piña-Iturbe, Diego Ulloa-Allendes, Catalina Pardo-Roa, Irenice Coronado-Arrázola, Francisco J Salazar-Echegarai, Bianca Sclavi, Pablo A González, Susan M Bueno
Genomic Islands (GIs) are DNA regions acquired through horizontal gene transfer that encode advantageous traits for bacteria. Many GIs harbor genes that encode the molecular machinery required for their excision from the bacterial chromosome. Notably, the excision/integration dynamics of GIs may modulate the virulence of some pathogens. Here, we report a novel family of GIs found in plant and animal Enterobacteriaceae pathogens that share genes with those found in ROD21, a pathogenicity island whose excision is involved in the virulence of Salmonella enterica serovar Enteritidis...
July 6, 2018: Scientific Reports
Tracy H Hazen, Roberta Mettus, Christi L McElheny, Sarah L Bowler, Sushma Nagaraj, Yohei Doi, David A Rasko
Carbapenem resistant Enterobacteriaceae are a significant public health concern, and genes encoding the Klebsiella pneumoniae carbapenemase (KPC) have contributed to the global spread of carbapenem resistance. In the current study, we used whole-genome sequencing to investigate the diversity of blaKPC -containing plasmids and antimicrobial resistance mechanisms among 26 blaKPC -containing Escherichia coli, and 13 blaKPC -containing Enterobacter asburiae, Enterobacter hormaechei, K. pneumoniae, Klebsiella variicola, Klebsiella michiganensis, and Serratia marcescens strains, which were isolated from the same patients as the blaKPC -containing E...
July 6, 2018: Scientific Reports
Xiaoming Wang, Yao Wang, Ying Zhou, Jiyun Li, Wenjuan Yin, Shaolin Wang, Suxia Zhang, Jianzhong Shen, Zhangqi Shen, Yang Wang
The rapid increase in carbapenem resistance among gram-negative bacteria has renewed focus on the importance of polymyxin antibiotics (colistin or polymyxin E). However, the recent emergence of plasmid-mediated colistin resistance determinants (mcr-1, -2, -3, -4, -5, -6, and -7), especially mcr-1, in carbapenem-resistant Enterobacteriaceae is a serious threat to global health. Here, we characterized a novel mobile colistin resistance gene, mcr-8, located on a transferrable 95,983-bp IncFII-type plasmid in Klebsiella pneumoniae...
July 4, 2018: Emerging Microbes & Infections
Peng-Yan Bai, Shang-Shang Qin, Wen-Chao Chu, Yi Yang, De-Yun Cui, Yong-Gang Hua, Qian-Qian Yang, En Zhang
Bacterial infections cause various life-threatening diseases and have become a serious public health problem due to the emergence of drug-resistant strains. Thus, novel antibiotics with excellent antibacterial activity and low cytotoxicity are urgently needed. Here, three series of novel cationic deacetyl linezolid amphiphiles bearing one lipophilic alkyl chain and one non-peptidic amide bond were synthesized and tested for antimicrobial activities. Several compounds showed excellent antibacterial activity toward drug-sensitive bacteria such as gram-negative bacteria Escherichia coli (E...
June 23, 2018: European Journal of Medicinal Chemistry
Sandra Pulss, Inka Stolle, Ivonne Stamm, Ursula Leidner, Carsten Heydel, Torsten Semmler, Ellen Prenger-Berninghoff, Christa Ewers
The increasing spread of carbapenemase-producing Enterobacteriaceae (CPE) poses a serious threat to public health. Recent studies suggested animals as a putative source of such bacteria. We investigated 19,025 Escherichia coli , 1607 Klebsiella spp. and 570 Enterobacter spp. isolated from livestock, companion animal, horse, and pet samples between 2009 and 2016 in our routine diagnostic laboratory for reduced susceptibility to carbapenems (CP) by using meropenem-containing media. Actively screened CP non-susceptible strains as well as 367 archived ESBL/AmpC-β-lactamase-producing Enterobacteriaceae were then tested for the presence of CP genes by PCRs...
2018: Frontiers in Microbiology
Toshiaki Aoki, Hidenori Yoshizawa, Kenji Yamawaki, Katsuki Yokoo, Jun Sato, Shinya Hisakawa, Yasushi Hasegawa, Hiroki Kusano, Masayuki Sano, Hideki Sugimoto, Yasuhiro Nishitani, Takafumi Sato, Masakatsu Tsuji, Rio Nakamura, Toru Nishikawa, Yoshinori Yamano
The structure-activity relationship (SAR) for a novel series of catechol conjugated siderophore cephalosporins is described with their in vitro activities against multi-drug resistant Gram-negative pathogens including Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia and Enterobacteriaceae. Cefiderocol (3) was one of the best molecules which displayed well-balanced and potent activities against multi-drug resistant Gram-negative pathogens including carbapenem resistant bacteria among the prepared compounds with the modified C-7 side chain and the modified C-3 side chain...
June 8, 2018: European Journal of Medicinal Chemistry
Kevin L Schwartz, Shaun K Morris
PURPOSE OF REVIEW: The rise in antimicrobial resistance is an urgent public health threat which, in the absence of intervention, may result in a post-antibiotic era limiting the effectiveness of antibiotics to treat both common and serious infections. Globalization and human migration have profoundly contributed to the spread of drug-resistant bacteria. In this review, we summarize the recent literature on the importance of travelers in the spread of drug-resistant bacterial organisms...
June 29, 2018: Current Infectious Disease Reports
François Caméléna, Aurélie Cointe, Vincent Mathy, Claire Hobson, Catherine Doit, Béatrice Bercot, Dominique Decré, Isabelle Podglajen, Laurent Dortet, Audrey Monjault, Philippe Bidet, Stéphane Bonacorsi, André Birgy
The dissemination of carbapenemase-producing Enterobacteriaceae (CPE) is a major threat to public health. Rapid and accurate detection of CPE is essential to initiate appropriate antimicrobial treatment and to establish infection control measures. The carbapenem inactivation method (CIM) was recently described with good sensitivity and specificity but a detection time of 20 hours. In this study, we evaluated the performances of a new version, the CIMplus that allows the detection of carbapenemase in 8 hours and the characterization of the carbapenemase classes, according to Ambler classification, in 20 hours...
June 27, 2018: Journal of Clinical Microbiology
Laurent Poirel, Marta Aires-de-Sousa, Patrick Kubyda, Nicolas Kieffer, Patrice Nordmann
Occurrence of resistance to last-resort antibiotics was evaluated among Enterobacteriaceae isolates recovered from hospitalized children in a remote African archipelago, São Tomé and Príncipe, where there is limited access to those antibiotics. Fifty patients were screened for colonization by carbapenem-, pan-aminoglycoside-, or polymyxin-resistant Enterobacteriaceae. A total of 36 isolates (including 30 Escherichia coli and 4 Klebsiella pneumoniae ) were recovered from 23 patients, including 26 isolates harboring the bla OXA-181 carbapenemase gene, a single isolate harboring the 16S rRNA methylase gene rmtB encoding pan-resistance to aminoglycosides, and 8 isolates co-harboring both genes...
June 25, 2018: Antimicrobial Agents and Chemotherapy
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