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Carbapenemase resistant enterobacteriacea

A Aguirre-Quiñonero, L Martínez-Martínez
Infections caused by carbapenemase-producing bacteria are becoming a major clinical and public health concern. Detection of carbapenemase producing strains is often challenging, since susceptibility to carbapenems may vary significantly among carbapenemase producers. Some carbapenemases have shown to exhibit weak activity against carbapenems leading to minimum inhibitory concentrations of carbapenems below the breakpoint for defining clinical resistance and even below the proposed screening breakpoint. Thus, reliable and rapid detection of carbapenemase-activity is needed for an appropriate patient management and a rapid implementation of infection prevention and control measures...
October 18, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Sam Abraham, Mark O'Dea, Darren J Trott, Rebecca J Abraham, David Hughes, Stanley Pang, Genevieve McKew, Elaine Y L Cheong, John Merlino, Sugiyono Saputra, Richard Malik, Thomas Gottlieb
Carbapenem-resistant Enterobacteriaceae (CRE) are a pressing public health issue due to limited therapeutic options to treat such infections. CREs have been predominantly isolated from humans and environmental samples and they are rarely reported among companion animals. In this study we report on the isolation and plasmid characterization of carbapenemase (IMP-4) producing Salmonella enterica Typhimurium from a companion animal. Carbapenemase-producing S. enterica Typhimurium carrying blaIMP-4 was identified from a systemically unwell (index) cat and three additional cats at an animal shelter...
October 21, 2016: Scientific Reports
Richard Aschbacher, Elisabetta Pagani, Massimo Confalonieri, Claudio Farina, Paolo Fazii, Francesco Luzzaro, Pier Giorgio Montanera, Aurora Piazza, Laura Pagani
BACKGROUND: Rates of colonization and infection with multidrug-resistant (MDR) bacteria are increasing worldwide, in both acute care hospitals and long-term care facilities (LTCFs). Italy has one of the highest prevalence of MDR bacteria in European countries, especially with regard to methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL) or carbapenemase producing Enterobacteriaceae (CPE). METHOD: Review of studies on colonization by MDR bacteria from Italian LTCFs, risk factors for colonization and molecular characteristics of surveillance and clinical isolates, compared with other European countries...
2016: Antimicrobial Resistance and Infection Control
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
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
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
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
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
Marion J Skalweit, Mei Li
Genetic screening of Pseudomonas aeruginosa (PSDA) and Acinetobacter baumannii (ACB) reveals genes that confer increased susceptibility to β-lactams when disrupted, suggesting novel drug targets. One such target is lytic transglycosylase. Bulgecin A (BlgA) is a natural product of Pseudomonas mesoacidophila and a lytic transglycosolase inhibitor that works synergistically with β-lactams targeting PBP3 for Enterobacteriaceae. BlgA also weakly inhibits di-Zn(2+) metallo-β-lactamases like L1 of Stenotrophomonas maltophilia...
2016: Drug Design, Development and Therapy
Shio-Shin Jean, Po-Ren Hsueh
OBJECTIVES: To investigate the antimicrobial resistance and assess the molecular characteristics of β-lactamases (ESBLs, AmpC β-lactamases and carbapenemases) among Enterobacteriaceae isolates that caused intra-abdominal infections (IAIs) in patients hospitalized in the Asia-Pacific region during 2008-14. METHODS: Multiplex PCR was used to detect the specific types of β-lactamase in 2893 isolates with MICs of ertapenem >0.5 mg/L. In-hospital acquisition times for most isolates were also delineated...
October 4, 2016: Journal of Antimicrobial Chemotherapy
Pascale Trepanier, Kim Mallard, Danièle Meunier, Rachel Pike, Derek Brown, Janet P Ashby, Hugo Donaldson, F Mustafa Awad-El-Kariem, Indran Balakrishnan, Marc Cubbon, Paul R Chadwick, Michael Doughton, Rachael Doughton, Fiona Hardiman, Graham Harvey, Carolyne Horner, John Lee, Jonathan Lewis, Anne Loughrey, Rohini Manuel, Helena Parsons, John D Perry, Gemma Vanstone, Graham White, Nandini Shetty, John Coia, Camilla Wiuff, Katie L Hopkins, Neil Woodford
OBJECTIVES: To estimate UK prevalence and incidence of clinically significant carbapenemase-producing Enterobacteriaceae (CPE), and to determine epidemiological characteristics, laboratory methods and infection prevention and control (IPC) measures in acute care facilities. METHODS: A 6 month survey was undertaken in November 2013-April 2014 in 21 sentinel UK laboratories as part of the European Survey on Carbapenemase-Producing Enterobacteriaceae (EuSCAPE) project...
September 29, 2016: Journal of Antimicrobial Chemotherapy
Aurélie Jayol, Laurent Poirel, Laurent Dortet, Patrice Nordmann
From January 2014 to December 2014, 972 consecutive non-replicate carbapenemase-producing Enterobacteriaceae isolates from colonised or infected patients were collected at the Associated French National Reference Centre as part of the French national survey on antimicrobial resistance. It included 577 Klebsiella spp. (59%), 236 Escherichia coli (24%), 108 Enterobacter spp. (11%), 50 Citrobacter spp. (5%), and a single Salmonella spp. isolate (0.1%). Of 561 K. pneumoniae isolates, 35 were found to be resistant to colistin (6...
September 15, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Fabrice Compain, Salah Gallahd, Catherine Eckert, Guillaume Arlet, Astrid Ramahefasolo, Dominique Decré, Marie Lavollay, Isabelle Podglajen
Carbapenemase-producing Enterobacteriaceae have become a major therapeutic challenge in hospital- and community-acquired infections worldwide (1).….
September 28, 2016: Journal of Clinical Microbiology
Jocelyn Qi Min Teo, Yiying Cai, Tze-Peng Lim, Thuan Tong Tan, Andrea Lay-Hoon Kwa
Singapore is an international travel and medical hub and faces a genuine threat for import and dissemination of bacteria with broad-spectrum resistance. In this review, we described the current landscape and management of carbapenem resistance in Gram-negative bacteria (GNB) in Singapore. Notably, the number of carbapenem-resistant Enterobacteriaceae has exponentially increased in the past two years. Resistance is largely mediated by a variety of mechanisms. Polymyxin resistance has also emerged. Interestingly, two Escherichia coli isolates with plasmid-mediated mcr-1 genes have been detected...
February 16, 2016: Microorganisms
Séverine Bontron, Patrice Nordmann, Laurent Poirel
The blaNDM-1 gene encodes a carbapenemase that confers resistance to almost all β-lactams, including latest resort carbapenems. It is increasingly reported worldwide in nosocomial and community-acquired Gram-negative bacteria. Acinetobacter baumannii is an important opportunistic pathogen considered as an intermediate reservoir for the blaNDM-1 gene. In this species, the blaNDM-1 gene is located within the Tn125 composite transposon. The mechanism driving the mobility of Tn125 has not yet been elucidated. Here we experimentally demonstrated transposition of Tn125 in A...
September 26, 2016: Antimicrobial Agents and Chemotherapy
Hyo Jin Lee, Jae Ki Choi, Sung Yeon Cho, Si Hyun Kim, Sun Hee Park, Su Mi Choi, Dong Gun Lee, Jung Hyun Choi, Jin Hong Yoo
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) are Gram-negative bacteria with increasing prevalence of infection worldwide. In Korea, 25 cases of CPE isolates were reported by the Korea Centers for Disease Control and Prevention in 2011. Most CPE cases were detected mainly at tertiary referral hospitals. We analyzed the prevalence and risk factors for carbapenem-resistant Enterobacteriaceae (CRE) in a mid-sized community-based hospital in Korea. MATERIALS AND METHODS: We retrospectively analyzed all consecutive episodes of Enterobacteriaceae in a mid-sized community-based hospital from January 2013 to February 2014...
September 2016: Infection & Chemotherapy
Jeanette W P Teo, My-Van La, Raymond T P Lin
A multiplex real-time polymerase chain reaction (PCR) assay was developed for the detection of clinically prevalent IMP, VIM, and OXA-23 gene families. The assay was designed to work on the BD MAX open platform which is a fully automated system for all PCR processes including sample extraction to PCR resulting. A total of 107 well-characterized carbapenem resistant Enterobacteriaceae were evaluated and the results were 100% concordant with the reference test isolates. This assay will serve to complement PCR screens that detect the major carbapenemase families of NDM, KPC, and OXA-48-like...
August 26, 2016: Diagnostic Microbiology and Infectious Disease
Agila Kumari Pragasam, Rani Diana Sahni, Shalini Anandan, Archa Sharma, Radha Gopi, Noorjahan Hadibasha, Priya Gunasekaran, Balaji Veeraraghavan
INTRODUCTION: Rapid identification of carbapenemase producing organisms is of great importance for timely detection, treatment and implementation of control measures to prevent the spread. The Modified Hodge Test (MHT) and Carba NP test is recommended by CLSI for the detection of carbapenemases in Enterobacteriaceae. However, MHT may give false positive results or fail to detect metallo β-lactamases (MBLs). In the US, MHT is the most widely used test for detection of carbapenemases and has been found to have a sensitivity and specificity of >90% for bla KPC producers...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Vilhelm Müller, Nahid Karami, Lena K Nyberg, Christoffer Pichler, Paola C Torche Pedreschi, Saair Quaderi, Joachim Fritzsche, Tobias Ambjörnsson, Christina Åhrén, Fredrik Westerlund
Resistance to life-saving antibiotics increases rapidly worldwide, and multiresistant bacteria have become a global threat to human health. Presently, the most serious threat is the increasing spread of Enterobacteriaceae carrying genes coding for extended spectrum β-lactamases (ESBL) and carbapenemases on highly mobile plasmids. We here demonstrate how optical DNA maps of single plasmids can be used as fingerprints to trace plasmids, for example, during resistance outbreaks. We use the assay to demonstrate a potential transmission route of an ESBL-carrying plasmid between bacterial strains/species and between patients, during a polyclonal outbreak at a neonatal ward at Sahlgrenska University Hospital (Gothenburg, Sweden)...
May 13, 2016: ACS Infectious Diseases
C O'Connor, M Cormican, T W Boo, E McGrath, B Slevin, A O'Gorman, M Commane, S Mahony, E O'Donovan, J Powell, R Monahan, C Finnegan, M G Kiernan, J C Coffey, L Power, N H O'Connell, C P Dunne
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) may cause healthcare-associated infections with high mortality rates. New Delhi metallo-β-lactamase-1 (NDM-1) is among the most recently discovered carbapenemases. AIM: To report the first outbreak of NDM-1 CPE in Ireland, including microbiological and epidemiological characteristics, and assessing the impact of infection prevention and control measures. METHODS: This was a retrospective microbiological and epidemiological review...
August 19, 2016: Journal of Hospital Infection
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