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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
Bulent Kantarcioglu, Huseyin Saffet Bekoz, Fatih Erkam Olgun, Beytullah Cakal, Burak Arkan, Halil Turkoglu, Ali Mert, Deniz Sargin
In chronic myeloid leukemia (CML), the occurrence of blastic transformation is rare. Treatment outcome is generally poor. Allogeneic stem cell transplantation (allo-SCT) is the only potentially curative treatment option for advanced-phase CML. Infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates are associated with high morbidity and mortality rates, particularly in patients with haematological malignancies. Infection and colonization by these multiresistant bacteria may represent a challenge in SCT recipients for the management of post-transplantation complications, as well as for the eligibility to receive a transplant in patients who acquire the pathogen prior to the procedure...
October 2016: Molecular and Clinical Oncology
Santosh Kumar Singh, Minakshi Gupta
Bacteria resistant to colistin, a last resort antibiotic reflect the pre-antibiotic era. In this study, colistin resistance carbapenem-resistant K. pneumoniae (COL(R)- CRKP) strains from neonate's intensive care unit were evaluated. Molecular analysis showed that all the four colistin resistant K. pneumoniae isolates were clonally related with strong biofilm formation ability and harbored blaSHV-34 and blaOXA-48 genes. Our result suggested the need of proper surveillance and adequate infection control to limiting the spread of these organisms...
September 10, 2016: Microbial Pathogenesis
Longhua Hu, Yanling Liu, Linqiang Deng, Qiaoshi Zhong, Yaping Hang, Zengzeng Wang, Lingling Zhan, Liangxing Wang, Fangyou Yu
The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU) and 13 were isolated from ventilators...
2016: Frontiers in Microbiology
Corrado Girmenia, Alessandra Serrao, Martina Canichella
Infections by Carbapenem-Resistant Enterobacteriaceae (CRE), in particular, carbapenem-resistant Klebsiella pneumoniae (CRKp), are a significant public health challenge worldwide. Resistance to carbapenems in enterobacteriaceae is linked to different mechanisms, including the production of the various types of enzymes like KPC, VIM, IMP, NDM, and OXA-48. Despite several attempts to control the spread of these infections at the local and national level, the epidemiological situation for CRKp had worsened in the last years in the Mediterranean area...
2016: Mediterranean Journal of Hematology and Infectious Diseases
Enrico Maria Trecarichi, Livio Pagano, Bruno Martino, Anna Candoni, Roberta Di Blasi, Gianpaolo Nadali, Luana Fianchi, Mario Delia, Simona Sica, Vincenzo Perriello, Alessandro Busca, Franco Aversa, Rosa Fanci, Lorella Melillo, Federica Lessi, Maria Ilaria Del Principe, Chiara Cattaneo, Mario Tumbarello
The aim of the present study was to identify risk factors for mortality in patients suffering from hematological malignancies (HMs) with bloodstream infections (BSIs) caused by Klebsiella pneumoniae (KP). We conducted a prospective cohort study on KP BSI in 13 Italian hematological units participating in the HEMABIS registry-SEIFEM group. The outcome measured was death within 21 days of BSI onset. Survivor and non-survivor subgroups were compared and Cox regression analysis was conducted to identify independent predictors of mortality...
July 18, 2016: American Journal of Hematology
Abdullah Kilic, Eyup Dogan, Sinem Kaya, Sema Oren, Duran Tok, Nurittin Ardic, Mehmet Baysallar
BACKGROUND: The aim of this study was to develop a rapid detection method of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains both MALDI-TOF MS and flow cytometry (FCM). METHODS: A total of 174 K. pneumoniae strains were included in this study. Molecular characterization of carbapenemase gene was performed by PCR. Bacterial identification was performed by MALDI-TOF-MS. Meropenem susceptibility was tested at the concentrations of breakpoints described by the Clinical and Laboratory Standards Institute (CLSI) guide by FCM...
May 30, 2016: Journal of Clinical Laboratory Analysis
Theodoros Karampatakis, Charalampos Antachopoulos, Elias Iosifidis, Athanassios Tsakris, Emmanuel Roilides
Hospital infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) constitute a worldwide problem associated with high rates of treatment failure and mortality. In Greece, CRKP have emerged in 2002 due to VIM carbapenemase production and later due to KPC, NDM and OXA-48-like carbapenemases that have become endemic. The molecular epidemiology of CRKP strains is dynamic, as antibiotic consumption and worldwide traveling are strongly associated with global spread of CRKP isolates. Lately, porin defects, such as disruption of OmpK35 and production of OmpK36 variant, have also contributed to carbapenem resistance...
June 2016: Future Microbiology
A Gomez-Simmonds, B Nelson, D P Eiras, A Loo, S G Jenkins, S Whittier, D P Calfee, M J Satlin, C J Kubin, E Y Furuya
Previous studies reported decreased mortality in patients with carbapenemase-producing Klebsiella pneumoniae bloodstream infections (BSIs) treated with combination therapy but included carbapenem-susceptible and -intermediate isolates, as per revised CLSI breakpoints. Here, we assessed outcomes in patients with BSIs caused by phenotypically carbapenem-resistant K. pneumoniae (CRKP) according to the number of in vitro active agents received and whether an extended-spectrum beta-lactam (BL) antibiotic, including meropenem, or an extended-spectrum cephalosporin was administered...
June 2016: Antimicrobial Agents and Chemotherapy
Yangmin Hu, Yanting Ping, Leiqing Li, Huimin Xu, Xiaofeng Yan, Haibin Dai
INTRODUCTION: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aim to identify risk factors, especially antibiotic use, for CRKP infection among intensive care unit (ICU) patients. METHODOLOGY: This was a matched case-control study of a 67-bed ICU in a tertiary care teaching hospital from 1 January 2011 through 30 June 2013. The control cases were selected among the patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) and were matched with CRKP cases for year of ICU admission and site of infection...
March 2016: Journal of Infection in Developing Countries
Sorabh Dhar, Emily T Martin, Paul R Lephart, John P McRoberts, Teena Chopra, Timothy T Burger, Ruthy Tal-Jasper, Kayoko Hayakawa, Hadas Ofer-Friedman, Tsilia Lazarovitch, Ronit Zaidenstein, Federico Perez, Robert A Bonomo, Keith S Kaye, Dror Marchaim
A "high risk" clone of carbapenem-resistant Klebsiella pneumoniae (CRKP) identified by multilocus sequence typing (MLST) as sequence type (ST) 258 has disseminated worldwide. As the molecular epidemiology of the CRE pandemic continues to evolve, the clinical impact of non-ST258 strains is less well defined. We conducted an epidemiological investigation of CRKP based on strains MLST. Among 68 CRKP patients, 61 were ST258 and 7 belonged to non-ST258. Klebsiella pneumoniae ST258 strains were significantly associated with bla KPC production and with resistance to an increased number of antimicrobials...
January 2016: Open Forum Infectious Diseases
C Hauck, E Cober, S S Richter, F Perez, R A Salata, R C Kalayjian, R R Watkins, N M Scalera, Y Doi, K S Kaye, S Evans, V G Fowler, R A Bonomo, D van Duin
Patients infected or colonized with carbapenem-resistant Klebsiella pneumoniae (CRKp) are often chronically and acutely ill, which results in substantial mortality unrelated to infection. Therefore, estimating excess mortality due to CRKp infections is challenging. The Consortium on Resistance against Carbapenems in K. pneumoniae (CRACKLE) is a prospective multicenter study. Here, patients in CRACKLE were evaluated at the time of their first CRKp bloodstream infection (BSI), pneumonia or urinary tract infection (UTI)...
June 2016: Clinical Microbiology and Infection
A Xu, B Zheng, Y-C Xu, Z-G Huang, N-S Zhong, C Zhuo
Although antimicrobial resistance poses a great challenge to clinicians in China, there are limited antimicrobial resistance data on Gram-negative bacteria nationwide. We investigated the phenotypic characteristics of carbapenem-resistant Escherichia coli (CREC) and Klebsiella pneumoniae (CRKP) as well as extensively drug-resistant strains of Pseudomonas aeruginosa (XDRPA) and Acinetobacter baumannii (XDRAB) isolated from blood cultures in China. Data were collected on 24113 isolates from the China surveillance of antimicrobial resistance program in 2013, which comprised 208 hospitals located in all seven administrative regions of China...
March 2016: Clinical Microbiology and Infection
Claudia Monari, Luca Merlini, Emanuela Nardelli, Maria Cacioni, Antonella Repetto, Antonella Mencacci, Anna Vecchiarelli
In this study we report the analysis of 131 Klebsiella pneumoniae (K. pneumoniae) clinical isolates from patients hospitalized in various wards, of Perugia General Hospital, from August 2014 to January 2015. Forty two isolates (32.1 %), were resistant to at least one carbapenem antibiotic and, among these isolates, 14 (33.3 %) exhibited resistance to colistin. All isolates were carbapenemases producers and 41 (97.6 %) harboured the bla KPC gene. Carbapenem-resistant K. pneumoniae isolates (CRKPs) were, also, typed for the genotypic diversity and the results revealed the circulation of two major clusters...
2016: Advances in Experimental Medicine and Biology
J Zhu, L Sun, B Ding, Y Yang, X Xu, W Liu, D Zhu, F Yang, H Zhang, F Hu
The purpose of this study was to investigate the epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) in Shanghai Children's Hospital in China. Twenty-two non-duplicate CRKP strains were collected from pediatric patients between March and June in 2014. Antimicrobial susceptibility testing was conducted by the agar dilution method. Beta-lactamases were characterized by polymerase chain reaction (PCR) and DNA sequencing. The transferability of bla NDM-1 was investigated by conjugation experiment...
April 2016: European Journal of Clinical Microbiology & Infectious Diseases
Julia A Messina, Eric Cober, Sandra S Richter, Federico Perez, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Nikole M Scalera, Yohei Doi, Keith S Kaye, Scott Evans, Robert A Bonomo, Vance G Fowler, David van Duin
BACKGROUND: Various transmission routes contribute to spread of carbapenem-resistant Klebsiella pneumoniae (CRKP) in hospitalized patients. Patients with readmissions during which CRKP is again isolated ("CRKP readmission") potentially contribute to transmission of CRKP. OBJECTIVE: To evaluate CRKP readmissions in the Consortium on Resistance against Carbapenems in K. pneumoniae (CRaCKLe). DESIGN: Cohort study from December 24, 2011, through July 1, 2013...
March 2016: Infection Control and Hospital Epidemiology
Terri Stillwell, Michael Green, Karen Barbadora, Juliet G Ferrelli, Terri L Roberts, Scott J Weissman, Andrew Nowalk
BACKGROUND: The increase in carbapenem-resistant Enterobacteriaceae (CRE) infections is a critical public health issue. We recently experienced the largest single-center pediatric outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) at our hospital. The objective of this study was to describe the molecular epidemiology of this outbreak before and after infection-prevention interventions. METHODS: All positive cultures and associated clinical conditions were reviewed to determine whether health care-associated infections (HAIs) exist...
December 2015: Journal of the Pediatric Infectious Diseases Society
Alejandro Díaz, Diana Cristina Ortiz, Mónica Trujillo, Carlos Garcés, Fabian Jaimes, Andrea Victoria Restrepo
BACKGROUND: Multidrug-resistant Gram-negative infections represent a growing problem and a serious global threat. Data in children are scarce. Klebsiella pneumoniae carbapenemases (KPC) are the most common mechanism of resistance this organism has developed. We report the clinical characteristics and outcomes from a cohort of children infected or colonized with carbapenem-resistant K. pneumoniae (CRKp) at a tertiary care center in Medellín, Colombia. METHODS: We performed a retrospective chart review of all pediatric cases from whom CRKp isolates were obtained from 2008 to 2013...
March 2016: Pediatric Infectious Disease Journal
Jessica B Cprek, Jason C Gallagher
We describe outcomes of patients with infections with carbapenem-resistant Klebsiella pneumoniae (CRKP) who received ertapenem-containing double-carbapenem therapy (ECDCT). Clinical success was observed in 7/18 (39%) patients overall: bloodstream infections, 3/7 (43%); pneumonia, 1/5 (20%); intraabdominal infections, 0/2 (0%); urinary tract infections, 2/3 (67%); and a skin and skin structure infection, 1/1 (100%). Microbiologic success was observed in 11/14 (79%) evaluable patients; 5/18 (28%) patients died...
January 2016: Antimicrobial Agents and Chemotherapy
John P Mills, Naasha J Talati, Kevin Alby, Jennifer H Han
OBJECTIVE An improved understanding of carbapenem-resistant Klebsiella pneumoniae (CRKP) in long-term acute care hospitals (LTACHs) is needed. The objective of this study was to assess risk factors for colonization or infection with CRKP in LTACH residents. METHODS A case-control study was performed at a university-affiliated LTACH from 2008 to 2013. Cases were defined as all patients with clinical cultures positive for CRKP and controls were those with clinical cultures positive for carbapenem-susceptible K...
January 2016: Infection Control and Hospital Epidemiology
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