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Carbapenemase screening

Lital Meir-Gruber, Yossi Manor, Shiraz Gefen-Halevi, Musa Y Hindiyeh, Fernando Mileguir, Roberto Azar, Gill Smollan, Natasha Belausov, Galia Rahav, Ari Shamiss, Ella Mendelson, Nathan Keller
The presence of pan-resistant bacteria worldwide possesses a threat to global health. It is difficult to evaluate the extent of carriage of resistant bacteria in the population. Sewage sampling is a possible way to monitor populations. We evaluated the presence of pan-resistant bacteria in Israeli sewage collected from all over Israel, by modifying the pour plate method for heterotrophic plate count technique using commercial selective agar plates. This method enables convenient and fast sewage sampling and detection...
2016: PloS One
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
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
Jonathan A Otter, Philip Burgess, Frances Davies, Siddharth Mookerjee, Julie Singleton, Mark Gilchrist, Darren Parsons, Eimear T Brannigan, Julie Robotham, Alison H Holmes
OBJECTIVE: To perform an economic evaluation on the cost associated with an outbreak of carbapenemase-producing Enterobacteriaceae (CPE). METHODS: We performed an observational economic evaluation of an outbreak of CPE (NDM-producing Klebsiella pneumoniae) affecting 40 patients in a group of five hospitals across three sites in West London. Costs were split into actual expenditure (including anti-infective costs, enhanced CPE screening, contact precautions, temporary ward-based monitors of hand and environmental practice, and environmental decontamination), and 'opportunity cost' (staff time, bed closures, and elective surgical missed revenue)...
October 13, 2016: Clinical Microbiology and Infection
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
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
Joao Gatica, Vijay Tripathi, Stefan J Green, Célia M Manaia, Thomas Berendonk, Damiano Cacace, Christophe Merlin, Norbert Kreuzinger, Thomas Schwartz, Despo Fatta-Kassinos, Luigi Rizzo, Carsten U Schwermer, Hemda Garelick, Edouard Jurkevitch, Eddie Cytryn
Integrons are extensively targeted as a proxy for anthropogenic impact in the environment. We developed a novel high-throughput amplicon sequencing pipeline that enables characterization of thousands of integron gene cassette-associated reads, and applied it to acquire a comprehensive overview of gene cassette composition in effluents from wastewater treatment facilities across Europe. Between 38,100 and 172,995 reads per-sample were generated and functionally characterized by screening against nr, SEED, ARDB and β-lactamase databases...
September 30, 2016: Environmental Science & Technology
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
Mona Wassef, Mona Abdelhaleim, Doaa Ghaith, Yasmin El-Mahdy
New Delhi metallo-β-lactamase (NDM) compromises the efficacy of almost all β-lactam antibiotics, including carbapenems. This study aimed to screen for the blaNDM-1-type gene and NDM-1-type carbapenemase production among Gram-negative bacteria in Cairo University Pediatric Hospital (Cairo, Egypt). Among 382 Gram-negative clinical isolates collected over the period October 2013 to May 2014, 100 clinical isolates showing reduced carbapenem (imipenem and meropenem) susceptibility were included in this study. Initial phenotypic screening for NDM enzyme production was performed by Etest for metallo-β-lactamases (EMBL)...
September 19, 2016: Journal of Global Antimicrobial Resistance
Baharak Babouee Flury, Matthew J Ellington, Katie L Hopkins, Jane F Turton, Michel Doumith, Neil Woodford
Mechanisms leading to carbapenem and cephalosporin resistance were sought in Enterobacter aerogenes isolates that were highly resistant to carbapenems but had no known carbapenemase. Results were compared with recent work examining carbapenem-resistant Enterobacter cloacae. Eighteen carbapenem-resistant E. aerogenes were screened for known β-lactamase and carbapenemase genes, and novel carbapenemases were sought in whole-genome sequencing (WGS) data of the three most resistant isolates. For all isolates, ampC, ampR, ampD and the porin genes omp35 and omp36 were investigated by Sanger sequencing or from available WGS data...
September 12, 2016: International Journal of Antimicrobial Agents
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
Jacopo Sgrignani, Filomena De Luca, Hayarpi Torosyan, Jean-Denis Docquier, Da Duan, Beatrice Novati, Fabio Prati, Giorgio Colombo, Giovanni Grazioso
β-Lactamases are bacterial enzymes conferring resistance to β-lactam antibiotics in clinically-relevant pathogens, and represent relevant drug targets. Recently, the identification of new boronic acids (i.e. RPX7009) paved the way to the clinical application of these molecules as potential drugs. Here, we screened in silico a library of ~1400 boronic acids as potential AmpC β-lactamase inhibitors. Six of the most promising candidates were evaluated in biochemical assays leading to the identification of potent inhibitors of clinically-relevant β-lactamases like AmpC, KPC-2 and CTX-M-15...
September 8, 2016: Journal of Computer-aided Molecular Design
Tao He, Yang Wang, Lichang Sun, Maoda Pang, Lili Zhang, Ran Wang
OBJECTIVES: To investigate the epidemiological characteristics and the surrounding genetic structure of the blaNDM-5 gene in Klebsiella pneumoniae derived from dairy cows in Jiangsu Province, China. METHODS: Ten carbapenem-resistant K. pneumoniae were collected from three dairy farms and were screened for the presence of carbapenemase genes using PCR and sequencing. PFGE and MLST were conducted to analyse the genetic relatedness of the blaNDM-5-harbouring K. pneumoniae isolates...
September 12, 2016: Journal of Antimicrobial Chemotherapy
Vincent C C Cheng, Jonathan H K Chen, Simon Y C So, Sally C Y Wong, Pui-Hing Chau, Lisa M W Wong, Radley H C Ching, Modissa M L Ng, Wan-Mui Lee, Ivan F N Hung, Pak-Leung Ho, Kwok-Yung Yuen
OBJECTIVE To study the association between gastrointestinal colonization of carbapenemase-producing Enterobacteriaceae (CPE) and proton pump inhibitors (PPIs). METHODS We analyzed 31,526 patients with prospective collection of fecal specimens for CPE screening: upon admission (targeted screening) and during hospitalization (opportunistic screening, safety net screening, and extensive contact tracing), in our healthcare network with 3,200 beds from July 1, 2011, through December 31, 2015. Specimens were collected at least once weekly during hospitalization for CPE carriers and subjected to broth enrichment culture and multiplex polymerase chain reaction...
September 13, 2016: Infection Control and Hospital Epidemiology
Jun Li, Ming-Xiang Zou, Hai-Chen Wang, Qing-Ya Dou, Yong-Mei Hu, Qun Yan, Wen-En Liu
BACKGROUND: Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae bacteria, which cause serious disease outbreaks worldwide, was rarely detected in Xiangya Hospital, prior to an outbreak that occurred from August 4, 2014, to March 17, 2015. The aim of this study was to analyze the epidemiology and molecular characteristics of the K. pneumoniae strains isolated during the outbreak. METHODS: Nonduplicate carbapenem-resistant K. pneumoniae isolates were screened for blaKPC-2and multiple other resistance determinants using polymerase chain reaction...
2016: Chinese Medical Journal
M Vading, M H Kabir, M Kalin, A Iversen, S Wiklund, P Nauclér, C G Giske
OBJECTIVES: International travel is a risk factor for intestinal colonization with ESBL-producing Enterobacteriaceae (EPE). This prospective cohort study focuses on molecular features of and risk factors for travel-acquired EPE. METHODS: Rectal swabs and survey data were collected from 188 Swedes travelling to four regions of high EPE prevalence. Samples were plated onto selective agars. ESBL producers were determined using phenotypic methods. Molecular characterization regarding virulence factors and phylogenetic grouping of ESBL-producing Escherichia coli was done using PCR...
August 26, 2016: Journal of Antimicrobial Chemotherapy
Yi-Fan Hu, Chang-Pan Liu, Nai-Yu Wang, Shou-Chuan Shih
BACKGROUND: Multidrug-resistant Pseudomonas aeruginosa has emerged as one of the most important healthcare-associated pathogens. Colistin is regarded as the last-resort antibiotic for multidrug-resistant Gram-negative bacteria, but is associated with high rates of acute kidney injury. The aim of this in vitro study is to search for an alternative treatment to colistin for multidrug-resistant P. aeruginosa infections. METHODS: Multidrug and carbapenem-resistant P...
2016: BMC Infectious Diseases
Saranya Vijayakumar, Radha Gopi, Priya Gunasekaran, Manjurekar Bharathy, Kamini Walia, Shalini Anandan, Balaji Veeraraghavan
INTRODUCTION: Acinetobacter baumannii is an important opportunistic pathogen responsible for causing nosocomial infections. Carbapenems are considered to be the drug of choice to treat infections caused by multidrug-resistant A. baumannii. The prevalent mechanism of carbapenem resistance in A. baumannii is enzymatic degradation by β-lactamases. Therefore, the aim of the study is to determine the prevalence and distribution of molecular determinants among the clinical isolates of carbapenem-resistant A...
September 2016: Infectious Diseases and Therapy
Ryuichi Nakano
Dissemination of carbapenem-resistant Enterobacteriaceae (CRE) poses a considerable threat to public health. Infections caused by CRE have limited treatment options and have been associated with high mortality rates. This resistance is largely the consequence of acquisition of carbapenemase genes. The genotypes in the geographical areas were initially different, as the Japanese epidemic was related to the IMP type (Class B), whereas the US epidemic was related to the KPC type (Class A). Thus, clinical detection of carbapenemase producers remains difficult based on each genotypes has specific screening method...
April 2016: Japanese Journal of Antibiotics
C O'Connor, M G Kiernan, C Finnegan, M O'Hara, L Power, N H O'Connell, C P Dunne
Rapid detection of patients with carbapenemase-producing Enterobacteriaceae (CPE) is essential for the prevention of nosocomial cross-transmission, allocation of isolation facilities and to protect patient safety. Here, we aimed to design a new laboratory work-flow, utilizing existing laboratory resources, in order to reduce time-to-diagnosis of CPE. A review of the current CPE testing processes and of the literature was performed to identify a real-time commercial polymerase chain reaction (PCR) assay that could facilitate batch testing of CPE clinical specimens, with adequate CPE gene coverage...
August 17, 2016: Bioengineered
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