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https://www.readbyqxmd.com/read/28396547/resistance-to-ceftazidime-avibactam-in-klebsiella-pneumoniae-due-to-porin-mutations-and-the-increased-expression-of-kpc-3
#1
Romney M Humphries, Peera Hemarajata
We reported the first clinical case of a ceftazidime-avibactam resistant KPC-3-producing Klebsiella pneumoniae (1), from a patient with no prior history of ceftazidime-avibactam therapy.….
April 10, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28389354/treating-complicated-carbapenem-resistant-enterobacteriaceae-infections-with-ceftazidime-avibactam-a-retrospective-study-with-molecular-strain-characterisation
#2
Fiorella Krapp, Jennifer L Grant, Sarah H Sutton, Egon A Ozer, Viktorija O Barr
Ceftazidime/avibactam (CAZ/AVI) is the first antimicrobial agent with activity against carbapenem-resistant Enterobacteriaceae (CRE) approved by the US Food and Drug Administration (FDA). Notably, human clinical outcome data for this indication are limited. Therefore, a retrospective study was performed to evaluate the clinical outcomes and bacterial genomic characteristics of patients hospitalised at a tertiary medical centre with CRE infections treated for the first time with CAZ/AVI. From a total of 44 patients with CRE infections, 6 patients were treated with CAZ/AVI...
April 4, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28333331/multiregional-dissemination-of-kpc-producing-klebsiella-pneumoniae-st258-st512-genotypes-in-poland-2010-14
#3
Anna Baraniak, Radoslaw Izdebski, Dorota Zabicka, Katarzyna Bojarska, Sandra Górska, Elzbieta Literacka, Janusz Fiett, Waleria Hryniewicz, Marek Gniadkowski
Objectives: In 2008-09, the KPC carbapenemase epidemiology in Poland was dominated by a Klebsiella pneumoniae ST258 KPC-2 outbreak in Warsaw and its administrative region. The aim of this study was to analyse the situation in 2010-14, with a focus on new outbreaks in other parts of the country. Methods: KPCs were detected in all suspected isolates by PCR. The detailed study was performed on 173 isolates from 2010 to 2012, and included PFGE and MLST, PCR identification of K...
March 9, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28295617/carbapenemases-producing-klebsiella-pneumoniae-in-hospitals-of-two-regions-of-southern-italy
#4
Carla Calia, Carlo Pazzani, Marta Oliva, Maria Scrascia, Piero Lovreglio, Carmen Capolongo, Anna Maria Dionisi, Adriana Chiarelli, Rosa Monno
Carbapenem-resistant Klebsiella pneumoniae infections are reported with increasing frequency elsewhere in the world, representing a worrying phenomenon for global health. In Italy, there are hotspot data on the diffusion and type of carbapenemase-producing Enterobacteriaceae and K. pneumoniae in particular, with very few data coming from Apulia and Basilicata, two regions of Southern Italy. This study was aimed at characterizing by phenotypic and genotypic methods carbapenem-resistant K. pneumoniae isolated from several Hospitals of Apulia and Basilicata, Southern Italy...
March 15, 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28242667/in-vitro-selection-of-meropenem-resistance-among-ceftazidime-avibactam-resistant-meropenem-susceptible-klebsiella-pneumoniae-isolates-with-variant-kpc-3-carbapenemases
#5
Ryan K Shields, M Hong Nguyen, Ellen G Press, Liang Chen, Barry N Kreiswirth, Cornelius J Clancy
Ceftazidime-avibactam resistance is mediated by blaKPC-3 mutations, which restore carbapenem susceptibility. We subjected blaKPC-3 mutant (n=5) and wild-type (n=2) K. pneumoniae isolates to serial meropenem passage. Meropenem MICs against all isolates increased. Ompk36 porin mutations evolved in 5 isolates, including those with wild-type blaKPC-3 In different passage lineages, blaKPC-3 mutations reverted to wild-type, were replaced by new mutations, or were retained. Carbapenem treatment of ceftazidime-avibactam resistant K...
February 27, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28223379/mutations-in-blakpc-3-that-confer-ceftazidime-avibactam-resistance-encode-novel-kpc-3-variants-that-function-as-extended-spectrum-%C3%AE-lactamases
#6
Ghady Haidar, Cornelius J Clancy, Ryan K Shields, Binghua Hao, Shaoji Cheng, M Hong Nguyen
We identified four blaKPC-3 mutations in ceftazidime-avibactam resistant clinical Klebsiella pneumoniae isolates, corresponding to D179Y, T243M, D179Y/T243M, and EL165 KPC-3 variants. Using site-directed mutagenesis and transforming vectors into Escherichia coli, we conclusively demonstrated that mutant blaKPC-3 encoded enzymes that functioned as extended-spectrum β-lactamases; mutations directly conferred higher MICs of ceftazidime-avibactam MICs, and decreased MICs of carbapenems and other β-lactams. Impact was strongest for the D179Y mutant, highlighting the importance of the KPC Ω-loop...
February 21, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28167547/multicenter-clinical-and-molecular-epidemiological-analysis-of-bacteremia-due-to-carbapenem-resistant-enterobacteriaceae-cre-in-the-cre-epicenter-of-the-united-states
#7
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 had undergone transplantation...
April 2017: Antimicrobial Agents and Chemotherapy
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
#8
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 to 19 days. Whole-genome sequencing (WGS) of longitudinal ceftazidime-avibactam-susceptible and -resistant K...
March 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27980379/epidemiology-and-biomolecular-characterization-of-carbapenem-resistant-klebsiella-pneumoniae-in-an-italian-hospital
#9
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/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
#10
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
#11
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
https://www.readbyqxmd.com/read/27846056/mother-to-child-transmission-of-kpc-carbapenemase-producing-klebsiella-pneumoniae-at-birth
#12
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 neonatal intensive care unit. 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 proactive surveillance in pregnant women with risk factors for colonization.
February 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27815135/klebsiella-pneumoniae-blakpc-3-nosocomial-epidemic-bayesian-and-evolutionary-analysis
#13
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
https://www.readbyqxmd.com/read/27788691/outbreak-of-kpc-3-producing-st15-and-st348-klebsiella-pneumoniae-in-a-portuguese-hospital
#14
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
https://www.readbyqxmd.com/read/27617554/a-new-case-report-of-urinary-tract-infection-due-to-kpc-3-producing-klebsiella-pneumoniae-st258-in-spain
#15
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
https://www.readbyqxmd.com/read/27585968/molecular-epidemiology-of-kpc-producing-klebsiella-pneumoniae-from-invasive-infections-in-italy-increasing-diversity-with-predominance-of-the-st512-clade-ii-sublineage
#16
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
https://www.readbyqxmd.com/read/27585787/high-minimum-inhibitory-concentration-of-imipenem-as-a-predictor-of-fatal-outcome-in-patients-with-carbapenem-non-susceptible-klebsiella-pneumoniae
#17
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
https://www.readbyqxmd.com/read/27530752/the-spread-of-kpc-producing-enterobacteriaceae-in-spain-wgs-analysis-of-the-emerging-high-risk-clones-of-klebsiella-pneumoniae-st11-kpc-2-st101-kpc-2-and-st512-kpc-3
#18
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
https://www.readbyqxmd.com/read/27469416/-rapid-increase-in-resistance-to-third-generation-cephalosporins-imipenem-and-co-resistance-in-klebsiella-pneumoniae-from-isolated-from-7-140-blood-cultures-2010-2014-using-ears-net-data-in-spain
#19
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
https://www.readbyqxmd.com/read/27451855/rapid-and-accurate-detection-of-carbapenemase-genes-in-enterobacteriaceae-with-the-cepheid-xpert-carba-r-assay
#20
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
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