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Carbapenem-resistant enterobacteriaceae

Saoussen Oueslati, Delphine Girlich, Laurent Dortet, Thierry Naas
As carbapenemase-producing Gram-negative bacilli (CP-GNB) (Enterobacteriaceae, Pseudomonadaceae and Acinetobacter spp.) are becoming a major public health issue, there is an urgent need for accurate and fast diagnostic tests. Amplidiag® Carba-R+VRE assay is a multiplex nucleic acid-based in-vitro diagnostic test intended for the detection of CP-GNB and vancomycin resistant enterococci (VRE) from cultured colonies.We have evaluated its ability to detect carbapenemases genes in 100 well-characterized GNB, and in 200 consecutive enterobacterial isolates with reduced susceptibility to carbapenems and that were referred to the French National Reference Center for carbapenem-resistance...
January 5, 2018: Journal of Clinical Microbiology
Sae-Rom Chae, Anna Q Yaffee, Mark K Weng, D Cal Ham, Kimberly Daniels, Amanda B Wilburn, Kimberly A Porter, Andrea H Flinchum, Sandra Boyd, Alicia Shams, Maroya S Walters, Alexander Kallen
No abstract text is available yet for this article.
January 5, 2018: MMWR. Morbidity and Mortality Weekly Report
Jingxian Liu, Jing Yu, Feng Chen, Jiajia Yu, Patricia Simner, Pranita Tamma, Ying Liu, Lisong Shen
The aim of this study was to investigate the characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) collected during an outbreak in a Chinese teaching hospital and to provide insights into the prevention and control of nosocomial infection. We collected unique CRKP clinical isolates from 2009 to 2013. Antibiotic-resistant genes were identified by polymerase chain reaction (PCR) and sequencing. The isolates were typed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST)...
December 27, 2017: European Journal of Clinical Microbiology & Infectious Diseases
Ian Marr, Nevio Sarmento, Matt O'Brien, Karl Lee, Celia Gusmao, Gloria de Castro, Sonja Janson, Steven Y C Tong, Rob W Baird, Joshua R Francis
OBJECTIVES: High rates of antimicrobial resistance are seen throughout Southeast Asia. Limited antimicrobial resistance data exists for Timor-Leste, which is situated on the south-eastern portion of the Malay Archipelago. The purpose of this study was to identify antimicrobial resistance in bacteria isolated from urine and skin swabs from patients in Dili, Timor-Leste. METHODS: Urine and skin swabs were collected from symptomatic patients and processed for bacterial culture in Timor-Leste...
December 22, 2017: Journal of Global Antimicrobial Resistance
Yanina Dubrovskaya, Marco R Scipione, Justin Siegfried, Shin-Pung Jen, Vinh Pham, John Papadopoulos, Arnold Decano, Tyler Lewis, Arash Dabestani
Purpose: Leveraging pharmacy personnel resources for the purpose of antimicrobial stewardship program (ASP) operations presents a challenging task. We describe our experience integrating all pharmacists into an ASP, and evaluate the impact on ASP interventions, antimicrobial utilization, rate of selected hospital-onset infections and readmission. Summary: During a study period (January 1 to December 31, 2015), a total of 14 552 ASP-related pharmacy interventions were performed (ASP clinical pharmacotherapy specialists [CPS] n = 4025; non-ASP CPS n = 4888; hospital pharmacists n = 5639)...
October 2017: Hospital Pharmacy
Evelina Tacconelli, Elena Carrara, Alessia Savoldi, Stephan Harbarth, Marc Mendelson, Dominique L Monnet, Céline Pulcini, Gunnar Kahlmeter, Jan Kluytmans, Yehuda Carmeli, Marc Ouellette, Kevin Outterson, Jean Patel, Marco Cavaleri, Edward M Cox, Chris R Houchens, M Lindsay Grayson, Paul Hansen, Nalini Singh, Ursula Theuretzbacher, Nicola Magrini
BACKGROUND: The spread of antibiotic-resistant bacteria poses a substantial threat to morbidity and mortality worldwide. Due to its large public health and societal implications, multidrug-resistant tuberculosis has been long regarded by WHO as a global priority for investment in new drugs. In 2016, WHO was requested by member states to create a priority list of other antibiotic-resistant bacteria to support research and development of effective drugs. METHODS: We used a multicriteria decision analysis method to prioritise antibiotic-resistant bacteria; this method involved the identification of relevant criteria to assess priority against which each antibiotic-resistant bacterium was rated...
December 21, 2017: Lancet Infectious Diseases
María Díez-Aguilar, María-Carmen Conejo, María-Isabel Morosini, Núria Tormo Palop, Concepción Gimeno, Rafael Cantón, Álvaro Pascual
A nationwide study was developed to evaluate the ability of 60 Spanish clinical microbiology laboratories to predict the underlying β-lactam resistance mechanisms of 12 Enterobacteriaceae strains (CCS01-CCS12). Results obtained by two reference laboratories were compared with those reported by the participants that used their own routine susceptibility testing methodology. CLSI interpretive criteria were used in 53.3% of the centres, while 46.7% used EUCAST. The overall categorical agreement (CA) was 85.5%...
December 21, 2017: International Journal of Antimicrobial Agents
Laura F Mataseje, David A Boyd, Jeffrey Fuller, David Haldane, Linda Hoang, Brigitte Lefebvre, Roberto G Melano, Susan Poutanen, Paul Van Caeseele, Michael R Mulvey
Objectives: Since the first identification of the OXA-48 carbapenemase in 2001, Enterobacteriaceae harbouring OXA-48-like enzymes have been reported globally. Here, we applied WGS to characterize the molecular epidemiology of these bacterial isolates. Methods: Enterobacteriaceae non-susceptible to carbapenems isolated from patients between 2011 and 2014 were voluntarily submitted to the Canadian National Microbiology Laboratory where they were screened for carbapenemase genes...
December 18, 2017: Journal of Antimicrobial Chemotherapy
Marko Jelić, Jasenka Škrlin, Danijela Bejuk, Iva Košćak, Iva Butić, Marija Gužvinec, Arjana Tambić-Andrašević
Here, we report a retrospective study conducted to elucidate emergence, epidemiology, and molecular mechanisms of resistance underlying the early spread of OXA-48 carbapenemase-producing Enterobacteriaceae in Croatia. Retrospective screening for OXA-48 producers was performed on a collection of 296 nonrepetitive, carbapenem-nonsusceptible enterobacterial isolates collected from January 2011 to December 2012 from 40 participating centers in Croatia. Antimicrobial susceptibility profiles and production of carbapenemases were assessed phenotypically...
December 21, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Ágnes Sonnevend, Nour Yahfoufi, Akela Ghazawi, Wafaa Jamal, Vincent Rotimi, Tibor Pál
Carbapenem-resistant Enterobacteriaceae encountered in countries of the Arabian Peninsula usually produce OXA-48-like and New Delhi metallo-beta-lactamases (NDM) carbapenemases. However, a temporary increase in VIM-4-producing, clonally unrelated Enterobacteriaceae strains was described earlier in a Kuwaiti hospital. We investigated the genetic support of blaVIM-4 in six Klebsiella pneumoniae strains, one Escherichia coli, and one Enterobacter cloacae strain and compared it to that of VIM-4-producing isolates from other countries of the region...
2017: Infection and Drug Resistance
Marla J Giddins, Nenad Macesic, Medini K Annavajhala, Stephania Stump, Sabrina Khan, Thomas H McConville, Monica Mehta, Angela Gomez-Simmonds, Anne-Catrin Uhlemann
Ceftazidime-avibactam (CAZ/AVI) is a promising novel treatment for carbapenem-resistant Enterobacteriaceae (CRE). Despite improved treatment outcomes compared to aminoglycoside- and colistin-based regimens, rapid evolution of CAZ/AVI resistance during treatment has previously been reported in Klebsiella pneumoniae ST258 blaKPC-3 harboring isolates. Here, we report the step-wise evolution and isolation of two phenotypically distinct CAZ/AVI resistant Klebsiella pneumoniae phenotypes from a patient with pancreatitis...
December 20, 2017: Antimicrobial Agents and Chemotherapy
Camilla Sticchi, Marisa Alberti, Stefania Artioli, Marina Assensi, Ivana Baldelli, Angela Battistini, Silvia Boni, Giovanni Cassola, Elio Castagnola, Mauro Cattaneo, Nadia Cenderello, Maria Luisa Cristina, Anna Maria De Mite, Paola Fabbri, Francesca Federa, Daniele Roberto Giacobbe, Daniela La Masa, Carolina Lorusso, Karine Marioni, VitaMaria Masi, Bruno Mentore, Silvana Montoro, Andrea Orsi, Doranna Raiteri, Rosamaria Riente, Ines Samengo, Claudio Viscoli, Roberto Carloni
BACKGROUND: In the light of the importance of monitoring healthcare-associated infections (HAI) and the consumption of antibiotics, a regional point prevalence survey was conducted in Liguria between March and April 2016. AIM: The aim of the study was to measure the overall prevalence of HAI and describe the use of antibiotics in all public hospitals. METHODS: Data on risk factors and use of antibiotics were collected for each hospitalised patient...
December 15, 2017: Journal of Hospital Infection
Neil Woodford, Li Xu-McCrae, Shazad Mushtaq, Houdini Ho Tin Wu, Matthew J Ellington, Owen Lancaster, Frances Davies, Hugo Donaldson, G Gopal Rao, Anita Verma, David W Wareham, Holly Ciesielczuk, Gregory G Stone, Paurus M Irani, Simon Bracher, Peter M Hawkey
Objectives: Although carbapenem susceptibility testing has been recommended for all Enterobacteriaceae from clinical specimens, for practical reasons a carbapenem is not included in many primary antibiotic panels for urine specimens. The 'iCREST' study sought carbapenemase-producing Enterobacteriaceae (CPE) in routine urine specimens yielding Gram-negative growth in five diagnostic laboratories in the UK. We sought also to compare locally and centrally determined MICs of meropenem and ceftazidime/avibactam...
December 15, 2017: Journal of Antimicrobial Chemotherapy
Ya Hu, Lu Liu, Xiaoxia Zhang, Yu Feng, Zhiyong Zong
We determined the in vitro susceptibility of four aminoglycosides, which are not of the 4,6-disubstituted deoxystreptamine (DOS) subclass against a collection of carbapenem-resistant Enterobacteriaceae (CRE). CRE clinical strains (n = 134) were collected from multiple hospitals in China and carried blaNDM (blaNDM-1, blaNDM-5 or blaNDM-7; n = 66), blaKPC-2 (n = 62) or blaIMP-4 (n = 7; including one carrying blaNDM-1 and blaIMP-4). MICs of neomycin, paromomycin, streptomycin and apramycin as well as three 4,6-disubstituted DOS aminoglycosides (amikacin, gentamicin and tobramycin) were determined using the broth microdilution with breakpoints defined by the Clinical Laboratory Standards Institute (for amikacin, gentamicin and tobramycin), US Food and Drug Administration (streptomycin), the National Antimicrobial Resistance Monitoring System (apramycin) or la Société Française de Microbiologie (neomycin and paromomycin)...
2017: Frontiers in Microbiology
Ester Solter, Amos Adler, Bina Rubinovitch, Elizabeth Temkin, David Schwartz, Debby Ben-David, Samira Masarwa, Yehuda Carmeli, Mitchell J Schwaber
Since 2006, Israel has been confronting an outbreak of carbapenem-resistant Enterobacteriaceae (CRE), and in 2007 Israel implemented a national strategy to contain spread. The intervention was initially directed toward acute-care hospitals and later expanded to include an established reservoir of carriage in long-term-care hospitals. It included regular reporting of CRE cases to a central registry and daily oversight of management of the outbreak at the institutional level. Microbiological methodologies were standardized in clinical laboratories nationwide...
December 15, 2017: Infection Control and Hospital Epidemiology
Andrew S Jarrell, Rachel M Kruer, Loredana Diana Berescu, Peter J Pronovost, Julie B Trivedi
PURPOSE: Multidrug-resistant (MDR) Gram-negative infection increases risk of mortality, other complications, and costs. The objective of this study was to determine the prevalence of and identify factors associated with in-hospital mortality among critically ill surgical patients. MATERIALS AND METHODS: This case-control study included critically ill surgical patients from 2011 to 2014 who had a carbapenem-resistant Enterobacteriaceae (CRE), MDR P. aeruginosa, or MDR Acinetobacter spp...
November 24, 2017: Journal of Critical Care
Warangkhana Wanla, Wasan Katip, Sakon Supakul, Porntipa Apiwatnakorn, Sompong Khamsarn
Background: Gram-negative bacteria are becoming increasingly resistant to carbapenems and are related to the use of carbapenems. Thus, the main objective of this study was to compare the appropriateness of prescribing carbapenem before and after using an antimicrobial restriction system without infectious diseases consultation. Materials and methods: A retrospective cross-sectional before and after study was conducted in Lamphun Hospital to limit the prescription of carbapenems...
2017: International Journal of General Medicine
Jeanette W P Teo, Marimuthu Kalisvar, Indumathi Venkatachalam, Ng Oon Tek, Raymond T P Lin, Sophie Octavia
The world-wide distribution of plasmid-mediated colistin resistance determinants (mcr-1, mcr-2, mcr-3 and mcr-4) coupled to an emerging observation that colistin resistance is more prevalent in carbapenem-resistant Enterobacteriaceae (CRE) (1, 2) present a daunting challenge in combatting antimicrobial resistance. Undoubtedly, next-generation sequencing approaches have expedited the discovery of mobile colistin resistance determinants (3).….
December 13, 2017: Journal of Clinical Microbiology
George G Zhanel, Courtney K Lawrence, Heather Adam, Frank Schweizer, Sheryl Zelenitsky, Michael Zhanel, Philippe R S Lagacé-Wiens, Andrew Walkty, Andrew Denisuik, Alyssa Golden, Alfred S Gin, Daryl J Hoban, Joseph P Lynch, James A Karlowsky
Relebactam (formerly known as MK-7655) is a non-β-lactam, bicyclic diazabicyclooctane, β-lactamase inhibitor that is structurally related to avibactam, differing by the addition of a piperidine ring to the 2-position carbonyl group. Vaborbactam (formerly known as RPX7009) is a non-β-lactam, cyclic, boronic acid-based, β-lactamase inhibitor. The structure of vaborbactam is unlike any other currently marketed β-lactamase inhibitor. Both inhibitors display activity against Ambler class A [including extended-spectrum β-lactamases (ESBLs), Klebsiella pneumoniae carbapenemases (KPCs)] and class C β-lactamases (AmpC)...
December 12, 2017: Drugs
David M Livermore, Danièle Meunier, Katie L Hopkins, Michel Doumith, Robert Hill, Rachel Pike, Peter Staves, Neil Woodford
Background: Ceftazidime/avibactam combines an established oxyimino-cephalosporin with the first diazabicyclooctane β-lactamase inhibitor to enter clinical use. We reviewed its activity against Gram-negative isolates, predominantly from the UK, referred for resistance investigation in the first year of routine testing, beginning in July 2015. Methods: Isolates were as received from referring laboratories; there is a bias to submit those with suspected carbapenem resistance...
December 8, 2017: Journal of Antimicrobial Chemotherapy
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