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Michael J Satlin, Liang Chen, Gopi Patel, Angela Gomez-Simmonds, Gregory Weston, Angela C Kim, Susan K Seo, Marnie E Rosenthal, Steven J Sperber, Stephen G Jenkins, Camille L Hamula, Anne-Catrin Uhlemann, Michael H Levi, Bettina C Fries, Yi-Wei Tang, Stefan Juretschko, Albert D Rojtman, Tao Hong, Barun Mathema, Michael R Jacobs, Thomas J Walsh, Robert A Bonomo, Barry N Kreiswirth
Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or transplantation...
February 6, 2017: Antimicrobial Agents and Chemotherapy
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
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
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
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 has 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 health care settings, including carbapenem-resistant Enterobacteriaceae (CRE). We experienced a prolonged outbreak of CRE E. cloacae and K. pneumoniae over a 3-year period at a large academic burn center despite rigorous infection control measures...
February 2017: Antimicrobial Agents and Chemotherapy
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
Silvia Angeletti, Alessandra Lo Presti, Eleonora Cella, Marta Fogolari, Lucia De Florio, Etleva Dedej, Aletheia Blasi, Teresa Milano, Stefano Pascarella, Raffaele Antonelli Incalzi, Roberto Coppola, Giordano Dicuonzo, Massimo Ciccozzi
K. pneumoniae isolates carrying blaKPC-3 gene were collected to perform Bayesian phylogenetic and selective pressure analysis and to apply homology modeling to the KPC-3 protein. A dataset of 44 blakpc-3 gene sequences from clinical isolates of K. pneumoniae was used for Bayesian phylogenetic, selective pressure analysis and homology modeling. The mean evolutionary rate for blakpc-3 gene was 2.67×10(-3) substitution/site/year (95% HPD: 3.4×10(-4-)5.59×10(-)(3)). The root of the Bayesian tree dated back to the year 2011 (95% HPD: 2007-2012)...
December 2016: Infection, Genetics and Evolution
D Vubil, R Figueiredo, T Reis, C Canha, L Boaventura, G J DA Silva
To date, only a few sporadic cases of infections due to Klebsiella pneumoniae carbapenemase (KPC) producers have been reported in Portugal. Here, we report for the first time an outbreak of K. pneumoniae KPC-3 producers in a tertiary-care hospital during 2013. Twenty-seven ertapenem-resistant K. pneumoniae were identified in patients at a tertiary-care hospital during 2013 isolated predominantly from urine (48·1%) and blood (25·9%) cultures. All isolates were highly resistant to β-lactam antibiotics and most showed intermediate resistance to imipenem...
February 2017: Epidemiology and Infection
A Sorlózano-Puerto, D Esteva-Fernández, J Oteo-Iglesias, J M Navarro-Marí, J Gutiérrez-Fernández
OBJECTIVE: We describe the characterization of a new isolated in Spain of Klebsiella pneumoniae ST258 producing KPC-3, carbapenems non-susceptible, recovered from a sample of urine from a patient with urinary tract infection and no history of carbapenems exposure. METHODS: After the isolation, identification of K. pneumoniae was performed by biochemical tests and mass spectrometry. The carbapenems susceptibility testing was performed by microdilution and E-test in cation-adjusted Mueller-Hinton...
September 2016: Archivos Españoles de Urología
Viola Conte, Monica Monaco, Tommaso Giani, Fortunato D'Ancona, Maria Luisa Moro, Fabio Arena, Marco Maria D'Andrea, Gian Maria Rossolini, Annalisa Pantosti
OBJECTIVES: The spread of carbapenem-resistant Enterobacteriaceae (CRE) represents one of the most worrisome problems for clinical medicine worldwide. In Italy, the Antibiotic-Resistance-Istituto Superiore di Sanità surveillance network, in collaboration with the Committee for Antimicrobial Agents of the Italian Society of Clinical Microbiologists, promoted a study to investigate the carbapenem-resistance mechanisms, clonal relatedness and capsular typing of a recent collection of carbapenem-resistant Klebsiella pneumoniae (CR-KP)...
September 1, 2016: Journal of Antimicrobial Chemotherapy
Ping-Feng Wu, Chien Chuang, Chin-Fang Su, Yi-Tsung Lin, Yu-Jiun Chan, Fu-Der Wang, Yin-Ching Chuang, L Kristopher Siu, Chang-Phone Fung
Carbapenem resistance in Klebsiella pneumoniae is important because of its increasing prevalence and limited therapeutic options. To investigate the clinical and microbiological characteristics of patients infected or colonized with carbapenem non-susceptible K. pneumoniae (CnsKP) in Taiwan, we conducted a retrospective study at Taipei Veterans General Hospital from January 2012 to November 2013. Carbapenem non-susceptibility was defined as a minimum inhibitory concentration (MIC) of ≥2 mg/L for imipenem or meropenem...
September 2, 2016: Scientific Reports
Jesús Oteo, María Pérez-Vázquez, Verónica Bautista, Adriana Ortega, Pilar Zamarrón, David Saez, Sara Fernández-Romero, Noelia Lara, Raquel Ramiro, Belén Aracil, José Campos
OBJECTIVES: We analysed the microbiological traits and population structure of KPC-producing Enterobacteriaceae isolates collected in Spain between 2012 and 2014. We also performed a comparative WGS analysis of the three major KPC-producing Klebsiella pneumoniae clones detected. METHODS: Carbapenemase and ESBL genes were sequenced. The Institut Pasteur MLST scheme was used. WGS data were used to construct phylogenetic trees, to identify the determinants of resistance and to de novo assemble the genome of one representative isolate of each of the three major K...
August 15, 2016: Journal of Antimicrobial Chemotherapy
Belén Aracil-García, Jesús Oteo-Iglesias, Óscar Cuevas-Lobato, Noelia Lara-Fuella, Isabel Pérez-Grajera, Sara Fernández-Romero, María Pérez-Vázquez, José Campos
INTRODUCTION: An analysis was made about the evolution of resistance to 3rd generation cephalosporins, imipenem, and other antibiotics in invasive isolates of Klebsiella pneumoniae (K. pneumoniae) according to the Spanish EARS-Net database (2010-2014). METHODS: Forty-two hospitals from 16 Autonomous Communities with an approximate population coverage of 33% participated. RESULTS: A total 7,140 pneumoniae corresponding to the same number of patients were studied...
July 25, 2016: Enfermedades Infecciosas y Microbiología Clínica
Marion Smith, Bram Diederen, Jelle Scharringa, Maurine Leversteijn-van Hall, Ad C Fluit, James Cohen Stuart
Rapid and accurate detection of carbapenemase-producing Enterobacteriaceae is pivotal for adequate antibiotic therapy and infection control. The Cepheid Xpert Carba-R assay detects and identifies the most prevalent carbapenemases (KPC, VIM, IMP, NDM and OXA-48), using automated real-time PCR. The test performance of the Xpert Carba-R was evaluated with 129 well-characterized non-repeat Enterobacteriaceae isolates, suspected for carbapenemase production, i.e. with meropenem MICs >0.25 mg l-1. The isolate collection contained 100 carbapenemase-producing isolates (36 KPC-2 or KPC-3, 20 VIM-1, 4 KPC-2 plus VIM-1, 5 NDM-1, 2 IMP-1, 1 IMP-28, 1 IMP-1 plus VIM-1 and 31 OXA-48 like) and 29 negative control isolates producing extended-spectrum β-lactamase and/or AmpC β-lactamases...
September 2016: Journal of Medical Microbiology
Carla Rodrigues, Jan Bavlovič, Elisabete Machado, José Amorim, Luísa Peixe, Ângela Novais
KPC-3-producing bacteria are endemic in many countries but only recently became apparent their wide distribution in different Portuguese hospitals. The aim of this study is to characterize genetic backgrounds associated with bla KPC-3 among Klebsiella pneumoniae isolates recently identified on non-hospitalized patients in Portugal. Twenty KPC-producing K. pneumoniae identified between October 2014 and November 2015 in three different community laboratories were characterized. Isolates were mainly from patients from long-term care facilities (n = 11) or nursing homes (n = 6), most of them (75%) previously hospitalized in different Portuguese hospitals...
2016: Frontiers in Microbiology
Vincenzo Di Pilato, Fabio Arena, Carlo Tascini, Antonio Cannatelli, Lucia Henrici De Angelis, Simona Fortunato, Tommaso Giani, Francesco Menichetti, Gian Maria Rossolini
A novel mcr variant, named mcr-1.2, encoding a Gln3-to-Leu functional variant of MCR-1, was detected in a KPC-3-producing ST512 Klebsiella pneumoniae isolate collected in Italy from a surveillance rectal swab from a leukemic child. The mcr-1.2 gene was carried on a transferable IncX4 plasmid whose structure was very similar to that of mcr-1-bearing plasmids previously found in Escherichia coli and K. pneumoniae strains from geographically distant sites (Estonia, China, and South Africa).
September 2016: Antimicrobial Agents and Chemotherapy
Yunliang Zhang, Xiaoyan Lin, Karen Bush
Eravacycline is a novel, fully synthetic fluorocycline antibiotic of the tetracycline class being developed for the treatment of complicated urinary tract infections and complicated intra-abdominal infections. Eravacycline has activity against many key Gram-negative pathogens, including Enterobacteriaceae resistant to carbapenems, cephalosporins, fluoroquinolones and β-lactam/β-lactamase inhibitor combinations, including strains that are multidrug-resistant. Carbapenem-resistant Enterobacteriaceae (CRE) isolates from 2010 to 2013 (n=110) were characterized for carbapenemase genes by PCR and sequencing...
August 2016: Journal of Antibiotics
Carolina Venditti, Laura Villa, Alessandro Capone, Daniela Fortini, Silvia D'Arezzo, Carla Nisii, Eugenio Bordi, Vincenzo Puro, Mario Antonini, Alessandra Carattoli, Maria Adriana Cataldo, Nicola Petrosillo, Antonino Di Caro
We describe the interspecies transmission of the plasmid-mediated blaKPC-3 gene, which confers carbapenem resistance, between clinically relevant gram-negative bacteria in a single patient. A KPC-3 producing Enterobacter aerogenes was isolated from a hospitalized patient previously colonized and then infected by a Klebsiella pneumoniae ST101 carrying the blaKPC-3 gene. The strains showed identical plasmids. Since intense horizontal exchanges among bacteria can occur in the gut, clinicians should be aware that patients colonized by carbapenem-resistant K...
October 2016: New Microbiologica
Krystyna M Kazmierczak, Douglas J Biedenbach, Meredith Hackel, Sharon Rabine, Boudewijn L M de Jonge, Samuel K Bouchillon, Daniel F Sahm, Patricia A Bradford
The Klebsiella pneumoniae carbapenemase (KPC), first described in the United States in 1996, is now a widespread global problem in several Gram-negative species. A worldwide surveillance study collected Gram-negative pathogens from 202 global sites in 40 countries during 2012 to 2014 and determined susceptibility to β-lactams and other class agents by broth microdilution testing. Molecular mechanisms of β-lactam resistance among carbapenem-nonsusceptible Enterobacteriaceae and Pseudomonas aeruginosa were determined using PCR and sequencing...
August 2016: Antimicrobial Agents and Chemotherapy
Tsukasa Ito-Horiyama, Yoshikazu Ishii, Akinobu Ito, Takafumi Sato, Rio Nakamura, Norio Fukuhara, Masakatsu Tsuji, Yoshinori Yamano, Keizo Yamaguchi, Kazuhiro Tateda
To better understand the antibacterial activity of S-649266 against carbapenemase producers, its stability against clinically relevant carbapenemases was investigated. The catalytic efficiencies (kcat/Km) of IMP-1, VIM-2, and L1 for S-649266 were 0.0048, 0.0050, and 0.024 μM(-1) s(-1), respectively, which were more than 260-fold lower than that for meropenem. Only slight hydrolysis of S-649266 against KPC-3 was observed. NDM-1 hydrolyzed meropenem 3-fold faster than S-649266 at 200 μM.
July 2016: Antimicrobial Agents and Chemotherapy
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