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Carbapenem resistant

Jane Hawkey, David B Ascher, Louise M Judd, Ryan R Wick, Xenia Kostoulias, Heather Cleland, Denis W Spelman, Alex Padiglione, Anton Y Peleg, Kathryn E Holt
Acinetobacter baumannii is a common causative agent of hospital-acquired infections and a leading cause of infection in burns patients. Carbapenem-resistant A. baumannii is considered a major public-health threat and has been identified by the World Health Organization as the top priority organism requiring new antimicrobials. The most common mechanism for carbapenem resistance in A. baumannii is via horizontal acquisition of carbapenemase genes. In this study, we sampled 20 A. baumannii isolates from a patient with extensive burns, and characterized the evolution of carbapenem resistance over a 45 day period via Illumina and Oxford Nanopore sequencing...
March 16, 2018: Microbial Genomics
I-Ling Chen, Chen-Hsiang Lee, Shih-Wen Ting, Lily Yu-Chin Wang
Objectives: The increasing number of reports on infections due to carbapenem-resistant Gram-negative bacilli (GNB) has raised concerns, because they have complicated empiric or guided antibiotic therapy for critically ill patients. We aimed to develop a scoring system to predict nosocomial imipenem-resistant GNB (IR-GNB) septicemia among the critically ill patients. Materials and methods: The study included critically ill adult patients with nosocomial GNB septicemia at Kaohsiung Chang Gung Memorial Hospital (CGMH) in 2013-2015, and the scoring system for predicting IR-GNB septicemia was developed, followed by prospective validation conducted among patients at Linkou CGMH and Kaohsiung CGMH between January and June, 2016...
2018: Infection and Drug Resistance
Scott D Kobayashi, Adeline R Porter, Brett Freedman, Ruchi Pandey, Liang Chen, Barry N Kreiswirth, Frank R DeLeo
Carbapenem-resistant Klebsiella pneumoniae is a problem worldwide. A carbapenem-resistant K. pneumoniae lineage classified as multilocus sequence type 258 (ST258) is prominent in the health care setting in many regions of the world, including the United States. ST258 strains can be resistant to virtually all clinically useful antibiotics; treatment of infections caused by these organisms is difficult, and mortality is high. As a step toward promoting development of new therapeutics for ST258 infections, we tested the ability of rabbit antibodies specific for ST258 capsule polysaccharide to enhance human serum bactericidal activity and promote phagocytosis and killing of these bacteria by human neutrophils...
March 13, 2018: MBio
Marguerite L Monogue, George Sakoulas, Victor Nizet, David P Nicolau
β-lactam-β-lactamase inhibitors (BLIs) have previously demonstrated antimicrobial activity against Acinetobacter baumannii (AB). Colistin retains the highest susceptibility rate against A. baumannii, and has demonstrated synergy with other antimicrobials, including β-lactam-BLIs. Therefore, we assessed the potential individual activity and synergistic combinations in vivo against carbapenem-susceptible (CS) and multidrug-resistant (MDR) A. baumannii isolates in neutropenic thigh and lung infection models...
March 13, 2018: Pharmacology
Shui Liu, Yonglin Zhou, Xiaodi Niu, Tingting Wang, Jiyun Li, Zhongjie Liu, Jianfeng Wang, Shusheng Tang, Yang Wang, Xuming Deng
The emergence of plasmid-mediated New Delhi metallo-β-lactamase-1 (NDM-1) in carbapenem-resistant Gram-negative pathogens is an increasing clinical threat. Here we report the discovery of an NDM-1 inhibitor, magnolol, through enzyme inhibition screening. We showed that magnolol significantly inhibited NDM enzyme activity (IC50  = 6.47 µg/mL), and it restored the activity of meropenem against Escherichia coli ZC-YN3, an NDM-1-producing E. coli isolate, in in vitro antibacterial activity assays. Magnolol lacked direct antibacterial activity, but compared with meropenem alone, it reduced the MICs of meropenem against E...
December 2018: Cell Death Discovery
Omnia A Shaker, Howayda E Gomaa, Shereen A ElMasry, Rania M Abdel Halim, Amany H Abdelrahman, Jackline S Kamal
AIM: To evaluate the diagnostic performance of MDI and temocillin disk (30 μg) for detection of carbapenem-resistant Enterobacteriaceae in comparison to real-time PCR. MATERIAL AND METHODS: Fifty specimens submitted to the Microbiology Laboratory of Ain Shams University Hospitals and showed resistance to carbapenem drugs through routine culture and susceptibility testing, were assessed by both temocillin disk (30 μg) and MDI set to detect carbapenem-resistant Enterobacteriaceae ...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Richa Aggarwal, Neha Rastogi, Purva Mathur, Kapil Dev Soni, Subodh Kumar, Amit Gupta, Sushma Sagar
Introduction: There have been isolated case reports and reports of outbreak of colistin-resistant Klebsiella from various parts of the world but only two from India and that too from oncology centers. We report cluster of colistin-resistant Klebsiella pneumonia bloodstream infection cases from our surgical trauma Intensive Care Unit. Methodology: The study was carried out in surgical ICU of Level-I trauma center. Retrospective analysis of all the five patients with CRK was done...
February 2018: Indian Journal of Critical Care Medicine
Demosthenes Makris, Efi Petinaki, Vasssiliki Tsolaki, Efstratios Manoulakas, Konstantinos Mantzarlis, Olimpia Apostolopoulou, Dimitrios Sfyras, Epaminondas Zakynthinos
Background: Retrospective studies have reported good clinical success rates using colistin as monotherapy to treat Acinetobacter baumannii ventilator-associated pneumonia (VAP), comparable to that obtained with colistin combined with other antibiotics. However, inadequate penetration into the pulmonary parenchyma for colistin has been shown in animal models. Aim: The aim of the study was to study prospectively the outcome, measured as clinical response and survival, of intravenously administered colistin versus colistin combined with high-dose ampicillin-sulbactam in Intensive Care Unit (ICU) patients with multiresistant A...
February 2018: Indian Journal of Critical Care Medicine
Martin Everett, Nicolas Sprynski, Alicia Coelho, Jérôme Castandet, Maëlle Bayet, Juliette Bougnon, Clarisse Lozano, David T Davies, Simon Leiris, Magdalena Zalacain, Ian Morrissey, Sophie Magnet, Kirsty Holden, Peter Warn, Filomena De Luca, Jean-Denis Docquier, Marc Lemonnier
Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are increasingly prevalent and have become a major worldwide threat to human health. Carbapenem resistance is driven primarily by the acquisition of β-lactamase enzymes which are able to degrade carbapenem antibiotics (hence termed carbapenemases) and can result in high levels of resistance and treatment failure. Clinically relevant carbapenemases include both serine-β-lactamases (SBLs, e.g. KPC-2 and OXA-48) and metallo-β-lactamases (MBLs), such as NDM-1...
March 12, 2018: Antimicrobial Agents and Chemotherapy
M G Vossen, L Ehmann, S Pferschy, A Maier-Salamon, M Haidinger, C Weiser, J M Wenisch, K Saria, C Kajahn, S Jilch, R Lemmerer, M Bécède, M Zeitlinger, C Kloft, W Jäger, F Thalhammer
OBJECTIVES: Doripenem is a broad-spectrum parenteral carbapenem with enhanced activity against Pseudomonas aeruginosa and Enterobacteriaceae. Current dosing regimens recommend the administration of 0.25-0.5 g once daily in patients undergoing intermittent renal replacement therapy. As patients are usually dialyzed thrice weekly, we aimed to investigate a 1-g post-hemodialysis regimen, thus reducing treatment costs and enhancing patient compliance. A second objective of this trial was to describe the pharmacokinetics of intradialytic doripenem...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Aliana Meneses Ferreira, Frederico Moreira, Thais Guimaraes, Fernanda Spadão, Jessica Fernandes Ramos, Marjorie Vieira Batista, Jayr Schmidt Filho, Silvia Figueiredo Costa, Vanderson Rocha
BACKGROUND: Bloodstream infections (BSI) are a major complication in the early phase of a hematopoietic stem cell transplant (HSCT). AIM: To describe the incidence and risk factors for BSI occurring in the pre-engraftment phase of HSCT and its impact on mortality. METHODS: We retrospectively analysed clinical variables of 232 HSCT patients between 2014 and 2015. Univariate Cox regression analyses were performed to test the association between each covariate and the outcome...
March 9, 2018: Journal of Hospital Infection
Chia-Ying Liu, Chih-Cheng Lai, Hsiu-Tzy Chiang, Min-Chi Lu, Ling-Fang Wang, Tsai-Ling Tsai, Mei-Yu Kang, Yi-Ni Jan, Yi-Ting Lo, Wen-Chien Ko, Shu-Hui Tseng, Chun-Ming Lee, Po-Ren Hsueh
BACKGROUND/PURPOSE: This study investigated the distribution and persistence of multidrug resistant organisms (MDROs) including methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and multidrug-resistant Acinetobacter baumannii (MDRAB) in six long-term care facilities (LTCFs). METHODS: We investigated the distribution of MDROs in residents of six LTCFs and their environments from January to December 2016 (intervention period)...
February 21, 2018: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Carole Ayoub Moubareck, Shaimaa F Mouftah, Tibor Pál, Akela Ghazawi, Dalal H Halat, Anju Nabi, Mouza A AlSharhan, Zulfa O AlDeesi, Christabel C Peters, Handan Celiloglu, Manjunath Sannegowda, Dolla K Sarkis, Ágnes Sonnevend
Few studies have addressed the molecular epidemiology of carbapenem resistant Enterobacteriaceae (CRE) isolates in the Arabian Peninsula, and such investigations have been missing from Dubai, a major economical, tourism and medical centre of the region. The antibiotic susceptibility, the carbapenemase type produced, and the clonality of 89 CRE strains isolated in five major Dubai hospitals in June 2015 - June 2016 were determined. Thirty three percent of the collection of 70 K. pneumoniae, 13 E. coli and 6 other Enterobacteriaceae were extremely drug resistant, 27% were resistant to colistin, and 4...
March 9, 2018: International Journal of Antimicrobial Agents
Ana Kovacic, Martina Seruga Music, Svjetlana Dekic, Marija Tonkic, Anita Novak, Zana Rubic, Jasna Hrenovic, Ivana Goic-Barisic
Acinetobacter baumannii origin and its epidemiology is under a great concern worldwide since this microorganism has become a leading nosocomial pathogen of the 21th century among the "ESKAPE" group of microorganisms. The aim of the study was to monitor and explore the epidemiology of this important hospital pathogen in the second largest clinical university hospital in Croatia. The presence of A. baumannii in hospital wastewater, as a route for possible transmission outside of the hospital setting, as well as its survival in environmental conditions including seawater, was investigated...
December 2017: International Microbiology: the Official Journal of the Spanish Society for Microbiology
Timothy Palzkill
The most common mechanism of resistance to β-lactam antibiotics in Gram-negative bacteria is the production of β-lactamases that hydrolyze the drugs. Class A β-lactamases are serine active-site hydrolases that include the common TEM, CTX-M, and KPC enzymes. The TEM enzymes readily hydrolyze penicillins and older cephalosporins. Oxyimino-cephalosporins, such as cefotaxime and ceftazidime, however, are poor substrates for TEM-1 and were introduced, in part, to circumvent β-lactamase-mediated resistance. Nevertheless, the use of these antibiotics has lead to evolution of numerous variants of TEM with mutations that significantly increase the hydrolysis of the newer cephalosporins...
2018: Frontiers in Molecular Biosciences
Laura Becker, Stephan Fuchs, Yvonne Pfeifer, Torsten Semmler, Tim Eckmanns, Gerit Korr, Dagmar Sissolak, Michael Friedrichs, Edith Zill, Mei-Lin Tung, Christian Dohle, Martin Kaase, Sören Gatermann, Holger Rüssmann, Matthias Steglich, Sebastian Haller, Guido Werner
Extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae pose an important threat of infection with increased morbidity and mortality, especially for immunocompromised patients. Here, we use the rise of multidrug-resistant K. pneumoniae in a German neurorehabilitation center from April 2015 to April 2016 to dissect the benefit of whole genome sequencing (WGS) for outbreak analyses. In total, 53 isolates were obtained from 52 patients and examined using WGS. Two independent analysis strategies (reference-based and -free) revealed the same distinct clusters of two CTX-M-15 producing K...
2018: Frontiers in Microbiology
Inés Bado, Romina Papa Ezdra, Nicolás Cordeiro, Matilde Outeda, Leticia Caiata, Virginia García-Fulgueiras, Verónica Seija, Rafael Vignoli
OBJECTIVES: The objective of the present study was to characterise the mechanisms underlying quinolone and oxyimino-cephalosporin resistance in a Citrobacter freundii clinical isolate obtained from the ICU in Uruguay's University Hospital. METHODS: Citrobacter freundii strain CF638 was isolated from a urine culture. Identification and susceptibility testing were performed using the VITEK® 2 system, and MIC determination and disc diffusion assay, respectively. Resistance genes and mobile genetic elements were identified, by PCR and sequencing...
March 8, 2018: Journal of Global Antimicrobial Resistance
Behnaz Soltani, Hamid Heidari, Hadi Sedigh Ebrahim-Saraie, Nahal Hadi, Jalal Mardaneh, Mohammad Motamedifar
The emergence of multiple drug-resistant (MDR) Acinetobacter baumannii strains has become a global problem. This study aimed to evaluate the occurrence of antibiotic resistance and to investigate the presence of antibiotic resistance determinants among A. baumannii isolates obtained from hospitalized patients in Iran. This cross-sectional study was performed on 92 A. baumannii isolates in the years 2015-2016. Antimicrobial susceptibility testing was carried out by the disk diffusion method. The presence of antibiotic resistance determinants was detected by the PCR method...
March 1, 2018: Le Infezioni in Medicina
Aliakbar Rezaei, Hossein Fazeli, Mehdi Moghadampour, Mehrdad Halaji, Jamshid Faghri
Acinetobacter baumannii is one of the most important bacterial species with the ability to produce OXA-type carbapenemases. We aimed to evaluate the prevalence of OXA-type carbapenemases among clinical isolates of A. baumannii in three major hospitals of Isfahan. In this cross-sectional descriptive study, 153 non-repeated strains of A. baumannii were isolated from various clinical samples of hospitalized patients in Al-Zahra, Imam Mousa Kazem, and Shariati hospitals from October 2015 to October 2016. Antimicrobial susceptibility testing for imipenem, meropenem, ertapenem, cefepime, ceftazidime, ceftriaxone, piperacillin-tazobactam, gentamicin, amikacin, ciprofloxacin, and tetracycline was performed using the disk diffusion method...
March 1, 2018: Le Infezioni in Medicina
Fabio Arena, Tommaso Giani, Alberto Antonelli, Olga Lorenza Colavecchio, Patrizia Pecile, Bruno Viaggi, Riccardo Favilli, Gian Maria Rossolini
We evaluated the performance of an automated, rapid (TAT 4-8 h), liquid-culture method for carbapenem-resistant Enterobacteriaceae (CRE) detection from rectal swabs, in a setting of KPC-producing Klebsiella pneumoniae endemicity. With 600 samples (22 positive for CRE, 3.7%), the system sensitivity and specificity, at 8 h, were 100% and 99.2%, respectively.
March 7, 2018: Journal of Microbiological Methods
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