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Carbapenem resistant

Lauren E Arthur, Russell S Kizor, Adrian G Selim, Mieke L van Driel, Leonardo Seoane
BACKGROUND: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality, complicating the medical course of approximately 10% of mechanically-ventilated patients, with an estimated attributable mortality of 13%. To treat VAP empirically, the American Thoracic Society currently recommends antibiotic therapy based on the patients' risk of colonisation by an organism with multidrug resistance. The selection of initial antibiotic therapy in VAP is important, as inappropriate initial antimicrobial treatment is associated with higher mortality and longer hospital stay in intensive care unit (ICU) patients...
October 20, 2016: Cochrane Database of Systematic Reviews
Sara A Buckman, Tamara Krekel, Anouk E Muller, John E Mazuski
The treatment of complicated intra-abdominal infections (cIAI) is increasingly challenging due to increased resistance of Gram-negative organisms. These multidrug resistant organisms lead to an increase in morbidity and mortality. This has led to renewed interest in use of older β-lactam antibiotics in combination with newer β-lactamase inhibitors. Ceftazidime-avibactam is one of the newest such combination antibiotics, which has been released for treatment of complicated intra-abdominal infections in combination with metronidazole...
October 19, 2016: Expert Opinion on Pharmacotherapy
Tomasz Wołkowicz, Jan Andrzej Patzer, Wanda Kamińska, Rafał Gierczyński, Danuta Dzierżanowska
This study aimed to analyse the distribution of carbapenem resistance mechanisms among Pseudomonas aeruginosa clinical isolates. Fifty-five P. aeruginosa isolates, resistant both to imipenem and meropenem, from children hospitalised in 2009-2010 were studied. All strains were genotyped by pulsed-field gel electrophoresis (PFGE). Mutations in the oprD gene and the occurrence of insertion sequences (ISs) were determined by DNA sequencing. Mex efflux systems were determined by analysis using the efflux pump inhibitor Phe-Arg β-naphthylamide...
October 8, 2016: Journal of Global Antimicrobial Resistance
John Osei Sekyere
A review of the literature was undertaken to delineate the current level and mechanisms of resistance to carbapenems, colistin, and tigecycline in South Africa. Thirty-two English publications and 32 National Institute of Communicable Diseases communiqués identified between early January 2000 and 20 May, 2016 showed substantial reports of NDM (n = 860), OXA-48 (n = 584), VIM (n = 131), and IMP (n = 45) carbapenemases within this period, mainly in Klebsiella pneumoniae (n = 1138), Acinetobacter baumannii (n = 332), Enterobacter cloacae (n = 201), and Serratia marcescens (n = 108)...
2016: Frontiers in Public Health
Kenneth P Smith, James E Kirby
We evaluated activity of apramycin, a non-ototoxic/non-nephrotoxic aminocyclitol against 141 clinical Enterobacteriaceae isolates, 51% of which were non-susceptible to carbapenems (CRE). Among CRE, 70.8% were apramycin susceptible, which compared favorably to aminoglycosides in current clinical use. Our data suggest that apramycin deserves further investigation as a repurposed, anti-CRE therapeutic.
September 8, 2016: Diagnostic Microbiology and Infectious Disease
Sara Tedeschi, Filippo Trapani, Maddalena Giannella, Francesco Cristini, Fabio Tumietto, Michele Bartoletti, Annalisa Liverani, Salvatore Pignanelli, Luisa Toni, Roberto Pederzini, Augusto Cavina, Pierluigi Viale
OBJECTIVE To assess the impact of an antimicrobial stewardship program (ASP) on antibiotic consumption, Clostridium difficile infections (CDI), and antimicrobial resistance patterns in a rehabilitation hospital. DESIGN Quasi-experimental study of the periods before (from January 2011 to June 2012) and after (from July 2012 to December 2014) ASP implementation. SETTING 150-bed rehabilitation hospital dedicated to patients with spinal-cord injuries. INTERVENTION Beginning in July 2012, an ASP was implemented based on systematic bedside infectious disease (ID) consultation and structural interventions (ie, revision of protocols for antibiotic prophylaxis and education focused on the appropriateness of antibiotic prescriptions)...
October 17, 2016: Infection Control and Hospital Epidemiology
Andre Arizpe, Kelly R Reveles, Shrina D Patel, Samuel L Aitken
Resistance to cephalosporins is now common among Gram-negative bacterial infections, including those caused by the Enterobacteriaceae and Pseudomonas aeruginosa, posing a major threat to public health. As resistance to the traditional drugs of choice for these infections, carbapenems, has also become increasingly common, interest in cefepime and piperacillin-tazobactam as carbapenem-sparing alternatives has increased. Additionally, the availability of the novel β-lactam-β-lactamase inhibitor combinations ceftolozane-tazobactam and ceftazidime-avibactam has added to the antimicrobial armamentarium available to treat these multidrug-resistant infections...
December 2016: Current Infectious Disease Reports
L V Kroth, F F Barreiro, D Saitovitch, M A Traesel, D O L d'Avila, C E Poli-de-Figueiredo
BACKGROUND: Solid organ transplant recipients are susceptible to antibiotic-resistant infections and carbapenem-resistant Acinetobacter baumannii (CRAB) has recently been recognized as a serious complication in solid organ recipients. High mortality rates have been described. METHODS: We retrospectively analyzed 807 transplantations and detected 10 patients who died 24 hours after the diagnosis of septicemia, all with CRAB-positive blood cultures. Recipients were followed up for at least 1 year and were stratified into the following groups: Group 1, patients alive; Group 2, patients that died due to other causes except Acinetobacter infection; and Group 3, patients who died within 24 hours of CRAB diagnosis...
September 2016: Transplantation Proceedings
Talerngsak Kanjanabuch, Nuttha Lumlertgul, Lachlan J Pearson, Tanittha Chatsuwan, Krit Pongpirul, Asada Leelahavanichkul, Nisa Thongbor, Gunticha Nuntawong, Laksamon Praderm, Pantiwa Wechagama, Surapong Narenpitak, Apinya Wechpradit, Worauma Punya, Guttiga Halue, Phetpailin Naka, Somboon Jeenapongsa, Somchai Eiam-Ong
♦ Background: Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in Southeast Asia and Northern Australia. Although a wide range of clinical manifestations from this organism are known, peritonitis associated with peritoneal dialysis (PD) has rarely been reported. ♦ Patients and Methods: Peritoneal dialysis patients from all regions in Thailand were eligible for the study if they had peritonitis and either peritoneal fluid or effluent culture positive for B.pseudomallei Patient data obtained included baseline characteristics, laboratory investigations, treatments, and clinical outcomes...
October 13, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Gabriel Cabot, Carla López-Causapé, Alain A Ocampo-Sosa, Lea M Sommer, María Ángeles Domínguez, Laura Zamorano, Carlos Juan, Fe Tubau, Cristina Rodríguez, Bartolomé Moyà, Carmen Peña, Luis Martínez-Martínez, Patrick Plesiat, Antonio Oliver
Whole genome sequencing (WGS) was used for the characterization of the, frequently extensively-drug resistant (XDR), P. aeruginosa high-risk clone ST175. A total of eighteen ST175 isolates recovered from 8 different Spanish hospitals were analyzed; four isolates from four different French hospitals were included for comparison. The typical resistance profile of ST175 included penicillins, cephalosporins, monobactams, carbapenems, aminoglycosides, and fluoroquinolones. In the phylogenetic analysis, the four French isolates clustered together with the two isolates from one of the Spanish regions...
October 10, 2016: Antimicrobial Agents and Chemotherapy
Nandini Chatterjee, Chandan Chatterjee, Sinjan Ghosh, Mainak Mukhopadhyay, Ramkrishna Brahmachari, Kartik Patar
BACKGROUND: Indiscriminate use of antibiotics in urinary tract infections have led to emergence of 'superbugs' worldwide. Periodical review of antibiograms is of utmost importance for optimum patient benefit. OBJECTIVE: To identify the spectrum of organisms responsible for urinary tract infection and evaluate the pattern of antibiotic sensitivity of the organisms. METHODS: Urine samples were collected from all consecutive patients getting admitted in the medicine indoor irrespective of symptomatology...
April 2016: Journal of the Association of Physicians of India
Jing Yu, Kun Tan, Zhihui Rong, Yue Wang, Zhongju Chen, Xuhui Zhu, Li Wu, Li Tan, Wei Xiong, Ziyong Sun, Ling Chen
BACKGROUND: The spread of resistance to carbapenems among Enterobacteriaceae has become a major public health problem in recent years. In this study, we describe an outbreak of Klebsiella pneumoniae in the neonatal ward. First, we aimed to study the drug resistance, genetic relatedness, and transmission mechanism of carbapenem-resistant K. pneumoniae; second, we implemented infection control measures to contain the outbreak. METHODS: We investigated 27 non-repetitive strains isolated from neonates and five strains cultured from around the neonatal ward...
October 12, 2016: BMC Infectious Diseases
Angeliki Mavroidi, Maria Katsiari, Eleftheria Palla, Sofia Likousi, Zoi Roussou, Charikleia Nikolaou, Evangelia D Platsouka
A rapid increase was observed in the incidence of extensively drug-resistant Acinetobacter baumannii (XDR Aba) isolates in a Greek hospital during 2014. To investigate the causes of this rise, the antimicrobial resistance profiles of all carbapenem-resistant (CARB-R) Aba isolates recovered during 2014-2015 were determined. Selected XDR Aba isolates (n = 13) were characterized by molecular methods. XDR Aba (48 isolates) represented 21.4% of the 224 CARB-R Aba recovered during the study period. The 13 selected XDR Aba isolates were positive for the blaOXA-23, the intrinsic blaOXA-51, and the adeB gene of the AdeABC efflux pump, and all belonged to the 3LST ST101, corresponding to the international clone II...
October 11, 2016: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
O Perovic, E Britz, V Chetty, A Singh-Moodley
Molecular confirmation of carbapenemase-producing Enterobacteriaceae (CPE) was introduced in South Africa (SA) at the end of 2011. We report on the detection of these resistance genes based on referral isolates. Enterobacteriaceae with non-susceptibility to any of the carbapenems according to defined criteria for antimicrobial susceptibility testing results were sent to a reference laboratory. A proportion of isolates had limited demographic, epidemiological and clinical data available. Organism identification was reconfirmed using reference laboratory methods, and the presence of carbapenemases was confirmed with a real-time polymerase chain reaction...
September 6, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Ö Ergönül, M Aydin, A Azap, S Başaran, S Tekin, Ş Kaya, S Gülsün, G Yörük, E Kurşun, A Yeşilkaya, F Şimşek, E Yılmaz, H Bilgin, Ç Hatipoğlu, H Cabadak, Y Tezer, T Togan, I Karaoğlan, A İnan, A Engin, H E Alışkan, S Ş Yavuz, Ş Erdinç, L Mulazimoglu, Ö Azap, F Can, H Akalın, F Timurkaynak
This article describes the prevalence of antibiotic resistance and predictors of mortality for healthcare-associated (HA) Gram-negative bloodstream infections (GN-BSI). In total, 831 cases of HA GN-BSI from 17 intensive care units in different centres in Turkey were included; the all-cause mortality rate was 44%. Carbapenem resistance in Klebsiella pneumoniae was 38%, and the colistin resistance rate was 6%. Multi-variate analysis showed that age >70 years [odds ratio (OR) 2, 95% confidence interval (CI) 1...
August 21, 2016: Journal of Hospital Infection
Francesco Barchiesi, Roberto Montalti, Pamela Castelli, Daniele Nicolini, Silvia Staffolani, Federico Mocchegiani, Alessandro Fiorentini, Esther Manso, Marco Vivarelli
BACKGROUND: Infections remain a leading cause of morbidity and mortality among liver transplant (LT) recipients. The aim of our study was to define the factors associated with outcome of early bacterial and fungal infections in a cohort of patients who underwent LT at the University Hospital of Ancona over a nine year period. METHODS: All consecutive patients who underwent LT in our center were considered. An early infection was defined as occurring in the first month post-transplantation...
October 4, 2016: BMC Infectious Diseases
Ashika Singh-Moodley, Olga Perovic
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) is a concern in South Africa and worldwide. It is therefore important that these organisms be accurately identified for infection prevention control purposes. METHOD: In this study 1193 suspected CREs from 46 laboratories from seven provinces in South Africa were assessed to confirm the prevalence of carbapenemase genes from our referral diagnostic isolates for the period 2012 to 2015. We compared the antimicrobial susceptibility testing method used in the reference laboratory to the polymerase chain reaction (PCR) which is used as the gold standard...
October 4, 2016: BMC Infectious Diseases
D N Tran, H H Tran, M Matsui, M Suzuki, S Suzuki, K Shibayama, T D Pham, T T Van Phuong, D A Dang, H S Trinh, C T Loan, L T V Nga, H R van Doorn, H F L Wertheim
Acinetobacter baumannii is an important cause of multidrug-resistant hospital acquired infections in the world. Here, we investigate the presence of NDM-1 and other carbapenemases among carbapenem-resistant A. baumannii isolated between August 2010 and December 2014 from three large hospitals in Hanoi, Vietnam. We identified 23/582 isolates (4 %) (11 from hospital A, five from hospital B, and seven from hospital C) that were NDM-1 positive, and among them 18 carried additional carbapenemase genes, including seven isolates carrying NDM-1, IMP-1, and OXA-58 with high MICs for carbapenems...
October 6, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Ellie J C Goldstein, Diane M Citron, Kerin L Tyrrell, Elisa Leoncio, C Vreni Merriam
The comparative in vitro activity of tedizolid against 124 Bacteroides group species isolates, including carbapenem, metronidazole and piperacillin-tazobactam resistant strains, had an MIC90 of 2 μg/ml (range, 0.5-4 μg/ml) and was 1-4 times more active than linezolid that had an MIC90 of 8 μg/ml (range, 2-16 μg/ml).
October 3, 2016: Anaerobe
Mazen S Bader, Mark Loeb, Annie A Brooks
Urinary tract infections (UTIs) caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options. Gram-negative bacteria, specifically Enterobacteriaceae, are common causes of both community-acquired and hospital acquired UTIs. These organisms can acquire genes that encode for multiple antibiotic resistance mechanisms, including extended-spectrum-lactamases (ESBLs), AmpC- β -lactamase, and carbapenemases. The assessment of suspected UTI includes identification of characteristic symptoms or signs, urinalysis, dipstick or microscopic tests, and urine culture if indicated...
October 7, 2016: Postgraduate Medicine
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