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Carbapenemase resistant enterobacteriacea

Joseph D Lutgring, Wenming Zhu, Tom J B de Man, Johannetsy J Avillan, Karen F Anderson, David R Lonsway, Lori A Rowe, Dhwani Batra, J Kamile Rasheed, Brandi M Limbago
Oxacillinase (OXA)-48-like carbapenemases remain relatively uncommon in the United States. We performed phenotypic and genotypic characterization of 30 Enterobacteriaceae producing OXA-48-like carbapenemases that were recovered from patients during 2010-2014. Isolates were collected from 12 states and not associated with outbreaks, although we could not exclude limited local transmission. The alleles β-lactamase OXA-181 (blaOXA-181 ) (43%), blaOXA-232 (33%), and blaOXA-48 (23%) were found. All isolates were resistant to ertapenem and showed positive results for the ertapenem and meropenem modified Hodge test and the modified carbapenem inactivation method; 73% showed a positive result for the Carba Nordmann-Poirel test...
April 2018: Emerging Infectious Diseases
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
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
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
Elisabetta Nucleo, Mariasofia Caltagirone, Vittoria Mattioni Marchetti, Roberto D'Angelo, Elena Fogato, Massimo Confalonieri, Camilla Reboli, Albert March, Ferisa Sleghel, Gertrud Soelva, Elisabetta Pagani, Richard Aschbacher, Roberta Migliavacca, Laura Pagani
Background: Rationale and aims of the study were to compare colonization frequencies with MDR bacteria isolated from LTCF residents in three different Northern Italian regions, to investigate risk factors for colonization and the genotypic characteristics of isolates. The screening included Enterobacteriaceae expressing extended-spectrum β-lactamases (ESβLs) and high-level AmpC cephalosporinases, carbapenemase-producing Enterobacteriaceae , Pseudomonas aeruginosa or Acinetobacter baumannii , methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE)...
2018: Antimicrobial Resistance and Infection Control
Zhihai Liu, Jiyun Li, Xiaoming Wang, Dejun Liu, Yuebin Ke, Yang Wang, Jianzhong Shen
The spread of carbapenem-resistant Enterobacteriaceae (CRE) mediated by New Delhi metallo-β-lactamase (NDM) poses a serious challenge to clinicians and has become a major public health concern. NDM has been evolving into variants that possess different hydrolysis activity toward antibiotics, so as to affect treatment strategy. In addition, very few studies on NDM variants have focused on animal-derived bacterial isolates. Our study reports a novel NDM variant, NDM-20, in an isolate of Escherichia coli CCD1 recovered from the food animal swine in China...
2018: Frontiers in Microbiology
Jonathan C Cho, Monika T Zmarlicka, Kristy M Shaeer, Joe Pardo
OBJECTIVE: To review the pharmacology, spectrum of activity, pharmacokinetics, pharmacodynamics, safety, efficacy, administration, and considerations for clinical use of meropenem/vaborbactam (M/V). DATA SOURCES: A literature search using PubMed and (June 2013 to December 2017) was conducted using the search terms meropenem, vaborbactam, RPX7009, biapenem, RPX2003, and carbavance. References from relevant articles and conference abstracts were also reviewed...
March 1, 2018: Annals of Pharmacotherapy
Peter M Hawkey, Roderic E Warren, David M Livermore, Cliodna A M McNulty, David A Enoch, Jonathan A Otter, A Peter R Wilson
The Working Party makes more than 100 tabulated recommendations in antimicrobial prescribing for the treatment of infections caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) and suggest further research, and algorithms for hospital and community antimicrobial usage in urinary infection. The international definition of MDR is complex, unsatisfactory and hinders the setting and monitoring of improvement programmes. We give a new definition of multiresistance. The background information on the mechanisms, global spread and UK prevalence of antibiotic prescribing and resistance has been systematically reviewed...
March 1, 2018: Journal of Antimicrobial Chemotherapy
Victor I Band, Sarah W Satola, Eileen M Burd, Monica M Farley, Jesse T Jacob, David S Weiss
Antibiotic resistance is a growing crisis and a grave threat to human health. It is projected that antibiotic-resistant infections will lead to 10 million annual deaths worldwide by the year 2050. Among the most significant threats are carbapenem-resistant Enterobacteriaceae (CRE), including carbapenem-resistant Klebsiella pneumoniae (CRKP), which lead to mortality rates as high as 40 to 50%. Few treatment options are available to treat CRKP, and the polymyxin antibiotic colistin is often the "last-line" therapy...
March 6, 2018: MBio
Michael A Pfaller, Michael D Huband, Rodrigo E Mendes, Robert K Flamm, Mariana Castanheira
We evaluated meropenem-vaborbactam activity against 11,559 Enterobacteriaceae isolates, including 330 carbapenem-resistant phenotypes (CRE) and carbapenemase genotypes collected worldwide during 2015. Meropenem-vaborbactam (inhibitor at 8 mg/L) and comparators were susceptibility tested using reference broth microdilution methods. CRE isolates were screened for the presence of genes encoding carbapenemases and 292 (88.5%) of the CRE isolates carried these resistance genes. A total of 209 (63.3% of the CRE; 1...
March 3, 2018: International Journal of Antimicrobial Agents
Torunn Pedersen, John Osei Sekyere, Usha Govinden, Krishnee Moodley, Audun Sivertsen, Ørjan Samuelsen, Sabiha Yusuf Essack, Arnfinn Sundsfjord
Whole-genome sequence analyses revealed the presence of bla NDM-1 ( n =31), bla GES-5 ( n =8), bla OXA-232 ( n =1), or bla NDM-5 ( n =1) in extensively drug-resistant and pandrug-resistant Enterobacteriaceae isolated from in-patients in 10 private hospitals (2012-2013) in Durban, South Africa. Two novel NDM-1 encoding plasmids from Klebsiella pneumoniae were closed by PacBio sequencing. In p19-10_01 (IncFIB(K), 223.434 bp) bla NDM-1 was part of a Tn 1548 -like structure (16.276 bp) delineated by IS 26 The multireplicon plasmid p18-43_01 (IncR_1/IncFIB(pB171)/IncFII(Yp); 212...
March 5, 2018: Antimicrobial Agents and Chemotherapy
Young Ah Kim, Yoon Soo Park
Antimicrobial resistance is becoming one of the greatest challenges to public health worldwide. Infections by antimicrobial-resistant organisms could result in the failure of treatment, increased medical costs, prolonged hospital stays, and an increased socioeconomic burden. Antimicrobial usage in Korea remains heavy, even after much effort to reduce their use. According to the Korean antimicrobial resistance surveillance system, the resistance rates of many bacteria are increasing. The resistance rate of Acinetobacter baumannii to imipenem in Korea increased to 85% in 2015, representing a major public threat...
March 2018: Korean Journal of Internal Medicine
Maria Giufrè, Giulia Errico, Marisa Accogli, Monica Monaco, Laura Villa, Maria Antonietta Distasi, Tito Del Gaudio, Annalisa Pantosti, Alessandra Carattoli, Marina Cerquetti
The emergence of carbapenemase-producing Enterobacteriaceae (CPE) is a critical concern worldwide. In Italy, CPE isolates are very frequent with the KPC types strongly predominant whereas the New Delhi metallo-β-lactamase (NDM) enzymes are extremely rare. In this study, we report the first detection of NDM-5-producing Escherichia coli sequence type (ST) 167 isolates from two patients with urinary tract infection (Ec001and Ec002 from urines) including one with colonization (Ec003 from faeces) admitted to the same hospital in 2017 two months apart...
February 28, 2018: International Journal of Antimicrobial Agents
Hanna E Sidjabat, Jolene Gien, David Kvaskoff, Keith Ashman, Kanchan Vaswani, Sarah Reed, Ross P McGeary, David L Paterson, Amanda Bordin, Gerhard Schenk
Antibiotic resistance associated with the clinically significant carbapenemases KPC, NDM and OXA-48 in Enterobacteriaceae is emerging as worldwide. In Australia, IMP-producing Enterobacteriaceae are the most prevalent carbapenemase-producing Enterobacteriaceae (CPE). Genomic characteristics of such CPE are well described, but the corresponding proteome is poorly characterised. We have thus developed a method to analyse dynamic changes in the proteome of CPE under antibiotic pressure. Specifically, we have investigated the effect of meropenem at sub-lethal concentrations to develop a better understanding of how antibiotic pressure leads to resistance...
March 1, 2018: Scientific Reports
Alejandra Vera-Leiva, Carla Barría-Loaiza, Sergio Carrasco-Anabalón, Celia Lima, Alejandro Aguayo-Reyes, Mariana Domínguez, Helia Bello-Toledo, Gerardo González-Rocha
The dissemination of carbapenemase-producing Enterobacteriaceae is currently considered a serious clinical problem due to the failure in the treatment of infections produced by them. Among the carbapenemases, the enzyme KPC has spread worldwide and has been identified in the main enterobacterial species related with healthcareassociated infections, although Klebsiella pneumoniae is the predominant specie. The blaKPC gene is transported, mainly by the transposon Tn4401, detected in various enterobacterial species of different sequence types (ST) and geographical origin...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Sandra Fournier, Laure Desenfant, Catherine Monteil, Michèle Nion-Huang, Christian Richard, Vincent Jarlier, The Ap-Hp Outbreaks Control Group
An infection control programme was implemented in a 21,000-bed multihospital institution for controlling the spread of carbapenemase-producing Enterobacteriaceae (CPE) and glycopeptide-resistant Enterococcus faecium (GRE), classified as 'emergent extensively drug-resistant bacteria' (eXDR) in France. We evaluated factors associated with outbreaks occurrence (n = 103), which followed 901 eXDR introductions (index case followed or not by secondary cases) from 2010 to 2015. In univariate analysis, knowing that patients had been hospitalised abroad, bacterial species (GRE vs CPE, as well as the CPE Klebsiella pneumoniae compared with the other Enterobacteriaceae species) and type of measures implemented within the first 2 days of hospitalisation were associated with outbreaks occurrence, but not the type of wards where carriers were hospitalised, nor the eXDR colonisation or infection status...
February 2018: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Ryota Gomi, Tomonari Matsuda, Masaki Yamamoto, Pei-Hsin Chou, Michio Tanaka, Satoshi Ichiyama, Minoru Yoneda, Yasufumi Matsumura
Wastewater is considered a major source of antibiotic-resistant bacteria released into the environment. Here, we characterized carbapenemase-producing Enterobacteriaceae (CPE) in wastewater by whole-genome analysis. Wastewater samples (n = 40) were collected from municipal wastewater treatment plants and hospital wastewater in Japan and Taiwan. Samples were screened for CPE using selective media, and the obtained isolates were sequenced using an Illumina MiSeq. The isolates (n = 45) included the following microorganisms: Klebsiella quasipneumoniae (n = 12), Escherichia coli (n = 10), Enterobacter cloacae complex (n = 10), Klebsiella pneumoniae (n = 8), Klebsiella variicola (n = 2), Raoultella ornithinolytica (n = 1), Citrobacter freundii (n = 1), and Citrobacter amalonaticus (n = 1)...
February 26, 2018: Antimicrobial Agents and Chemotherapy
Joo-Hee Hwang, Jeong Su Park, Eunyoung Lee, Ji Yun Bae, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Ji Hwan Bang, Eu Suk Kim, Sang Won Park, Nam Joong Kim, Myoung-Don Oh, Hong Bin Kim
A 10-month active surveillance study was conducted to assess carriage of carbapenemase-producing Enterobacteriaceae (CPE), vancomycin-resistant enterococci (VRE) and toxigenic Clostridium difficile colonization among patients transferred to hospital from long-term care facilities (LTCFs). Four (1.4%) carbapenem-resistant Enterobacteriaceae (none CPE), 59 (21%) VRE carriers, and 20 (7.1%) persons colonized with toxigenic C. difficile were identified from 282 rectal specimens. There was no outbreak of VRE infection during the study period...
February 21, 2018: Journal of Hospital Infection
Ahlem Trifi, Sami Abdellatif, Mouna Oueslati, Meriem Zribi, Foued Daly, Rochdi Nasri, Rahma Mannai, Chadlia Fandri, Salah Ben Lakhal
BACKGROUND: The nosocomial infection (NI) is defined as an infection that is not present or incubating on admission in establishment of care. It can be caused by the patient's germs, care personnel or hospital environment. Multidrug resistant (MDR) bacteria are particularly common in intensive care units that lead to a serious infections and increase morbidity, mortality and cost of care. PURPOSE: To identify the epidemiological characteristics of NI, the predisposing factors, the antimicrobial sensitivity pattern of isolated bacteria and the impact on morbidity and mortality...
March 2017: La Tunisie Médicale
Jesús Rodríguez-Baño, Belén Gutiérrez-Gutiérrez, Isabel Machuca, Alvaro Pascual
Therapy of invasive infections due to multidrug-resistant Enterobacteriaceae (MDR-E) is challenging, and some of the few active drugs are not available in many countries. For extended-spectrum β-lactamase and AmpC producers, carbapenems are the drugs of choice, but alternatives are needed because the rate of carbapenem resistance is rising. Potential active drugs include classic and newer β-lactam-β-lactamase inhibitor combinations, cephamycins, temocillin, aminoglycosides, tigecycline, fosfomycin, and, rarely, fluoroquinolones or trimethoprim-sulfamethoxazole...
April 2018: Clinical Microbiology Reviews
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