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carbapenemases in children's

Johanna M Vanegas, O Lorena Parra, J Natalia Jiménez
BACKGROUND: Gram-negative bacilli are a cause of serious infections in the pediatric population. Carbapenem are the treatment of choice for infections caused by multidrug-resistant Gram-negative bacilli, but the emergence of carbapenem resistance has substantially reduced access to effective antimicrobial regimens. Children are a population vulnerable to bacterial infections and the emergence of resistance can worsen prognosis. The aim of this study is to describe the clinical and molecular characteristics of infections caused by carbapenem-resistant Gram-negative bacilli in pediatric patients from five tertiary-care hospitals in Medellín, Colombia...
2016: BMC Infectious Diseases
Kassu Desta, Yimtubezinash Woldeamanuel, Aklilu Azazh, Halima Mohammod, Dawit Desalegn, Damte Shimelis, Dereje Gulilat, Biruk Lamisso, Eyasu Makonnen, Alemayehu Worku, Kerstin Mannerqvist, Johan Struwe, Olov Aspevall, Eleni Aklillu
We investigated the gastrointestinal colonization rate and antibiotic resistance patterns of Extended-Spectrum Beta-Lactamase (ESBL)- producing Escherichia coli and Klebsiella pneumoniae in hospitalized patients admitted at Ethiopia's largest tertiary hospital. Fecal samples/swabs from 267 patients were cultured on chrome agar. ESBL. Bacterial species identification, verification of ESBL production and antibiotic susceptibility testing were done using Vitek 2 system (bioMérieux, France). Phenotype characterization of ESBL-E...
2016: PloS One
Nicolas Kieffer, Patrice Nordmann, Marta Aires-de-Sousa, Laurent Poirel
This study aimed to evaluate the prevalence of carbapenemase-producing Enterobacteriaceae in Luanda, Angola. A total of 157 rectal samples were collected from children visiting a pediatric hospital in Luanda in March 2015. Fifty-seven imipenem-nonsusceptible enterobacterial isolates were recovered, most of which were non-clonally related. The blaOXA-181 (50/57) and blaNDM-1 (7/57) carbapenemase genes were identified. Notably, OXA-181-producing Escherichia coli isolates rarely coproduced extended-spectrum β-lactamases and consequently remained susceptible to broad-spectrum cephalosporins...
October 2016: Antimicrobial Agents and Chemotherapy
Radoslaw Jaworski, Ireneusz Haponiuk, Mariusz Steffens, Elzbieta Arlukowicz, Ninela Irga-Jaworska, Maciej Chojnicki, Ewelina Kwasniak, Jacek Zielinski
INTRODUCTION: The incidence of multidrug resistant microorganisms worldwide is increasing. The aim of the study was to present institutional experience with the multidrug resistant microorganism colonization patterns observed in children with congenital heart diseases hospitalized in a hybrid pediatric cardiac surgery center. MATERIAL AND METHODS: Microbiological samples were routinely collected in all children admitted to our department. All microbiological samples were analyzed with regard to multidrug resistant microorganisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Gram-negative rods producing extended-spectrum beta-lactamases (ESBL), multidrug resistant Gram-negative rods (MDR-GNRs), carbapenemase-producing Klebsiella pneumoniae (KPC), carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA)...
June 1, 2016: Archives of Medical Science: AMS
Navaneeth Narayanan, Linda Johnson, Conan MacDougall
Carbapenemases are enzymes that are capable of inactivating all or almost all beta-lactam antimicrobial agents. These enzymes are frequently coexpressed with other resistance mechanisms to non-beta-lactams, leading to extremely drug-resistant pathogens. Once a curiosity, these enzymes have spread into organisms that are among the most common causes of infection, such as Klebsiella pneumoniae and Escherichia coli. Identification of these organisms has proved challenging for clinical microbiology laboratories, leading to revisions in susceptibility standards for carbapenems...
March 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Christopher Alan Moxon, Stéphane Paulus
Multi-drug resistance in Gram negative bacteria, particularly in Enterobacteriaceae, is a major clinical and public health challenge. The main mechanism of resistance in Enterobacteriaceae is linked to the production of beta-lactamase hydrolysing enzymes such as extended spectrum beta-lactamases (ESBL), AmpC beta-lactamases and carbapenemases (Carbapenemase Producing Enterobacteriaceae (CPE)). ESBL and CPE resistance genes are located on plasmids, which can be transmitted between Enterobacteriaceae, facilitating their spread in hospitals and communities...
July 5, 2016: Journal of Infection
Muneeza Anwar, Hassan Ejaz, Aizza Zafar, Hamdan Hamid
Multidrug resistant A. baumannii has emerged as an important and problematic human pathogen as it is the causative agent of several types of infections especially in neonates and immunocompromised patients because they have least capacity to fight against infections. Carbapenems are used as last resort antibiotics for treating these infections but currently resistance against carbapenems due to MBL production is on the rise. The objective of this study was to determine the frequency of antibiotic resistance in A...
2016: Journal of Pathogens
Carlotta Montagnani, Manuela Prato, Carlo Scolfaro, Sara Colombo, Susanna Esposito, Claudia Tagliabue, Andrea Lo Vecchio, Eugenia Bruzzese, Anna Loy, Laura Cursi, Marco Vuerich, Maurizio de Martino, Luisa Galli
BACKGROUND: The spread of carbapenem-resistant Enterobacteriaceae (CRE) is a health problem of major concern. CRE-related infections have significant morbidity and mortality, but data on CRE infection in pediatric population are limited. The aim of this study was to analyze epidemiologic and clinical characteristics, risk factors, therapeutic options and outcome of CRE infections in children in Italy. METHODS: We performed a retrospective, multicenter, observational study of children with confirmed CRE infection or colonization admitted between January 1, 2011, and March 1, 2014, to 7 Italian pediatric centers...
August 2016: Pediatric Infectious Disease Journal
Latania K Logan, Andrea M Hujer, Steven H Marshall, T Nicholas Domitrovic, Susan D Rudin, Xiaotian Zheng, Nadia K Qureshi, Mary K Hayden, Felicia A Scaggs, Anand Karadkhele, Robert A Bonomo
Multidrug-resistant (MDR) Enterobacteriaceae infections are increasing in U.S. children; however, there is a paucity of multicentered analyses of antibiotic resistance genes responsible for MDR phenotypes among pediatric Enterobacteriaceae isolates. In this study, 225 isolates phenotypically identified as extended-spectrum β-lactamase (ESBL) or carbapenemase producers, recovered from children ages 0 to 18 years hospitalized between January 2011 and April 2015 at three Chicago area hospitals, were analyzed...
June 2016: Antimicrobial Agents and Chemotherapy
Nuntra Suwantarat, Latania K Logan, Karen C Carroll, Robert A Bonomo, Patricia J Simner, Susan D Rudin, Aaron M Milstone, Tsigereda Tekle, Tracy Ross, Pranita D Tamma
OBJECTIVE: To determine the prevalence and acquisition of extended-spectrum β-lactamases (ESBLs), plasmid-mediated AmpCs (pAmpCs), and carbapenemases ("MDR Enterobacteriaceae") colonizing children admitted to a pediatric intensive care unit (PICU). DESIGN: Prospective study. SETTING: 40-bed PICU. METHODS: Admission and weekly thereafter rectal surveillance swabs were collected on all pediatric patients during a 6-month study period...
May 2016: Infection Control and Hospital Epidemiology
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
Desiree Caselli, Simone Cesaro, Franca Fagioli, Francesca Carraro, Ottavio Ziino, Giulio Zanazzo, Cristina Meazza, Antonella Colombini, Elio Castagnola
Few data are available on the incidence of carbapenemase-producing Enterobacteriaceae (CPE) infection or colonization in children receiving anticancer chemotherapy. We performed a nationwide survey among centers participating in the pediatric hematology-oncology cooperative study group (Associazione Italiana Ematologia Oncologia Pediatrica, AIEOP). During a 2-year observation period, we observed a threefold increase in the colonization rate, and a fourfold increase of bloodstream infection episodes, caused by CPE, with a 90-day mortality of 14%...
February 2016: Infectious Diseases
Supriya Malvi, Suma Appannanavar, Balvinder Mohan, Harsimran Kaur, Neha Gautam, Bhavneet Bharti, Yashwant Kumar, Neelam Taneja
The epidemiology of enteropathogenic Escherichia coli (EPEC) and the significance of isolation of atypical EPEC (aEPEC) in childhood diarrhoea have not been well studied in an Indian context. A comparative study was undertaken to investigate virulence determinants, antibiotic susceptibility patterns and serogrouping of typical EPEC (tEPEC) versus aEPEC causing diarrhoea in children. A total of 400 prospective and 500 retrospective E. coli isolates were included. PCR was performed for eae, bfpA, efa, nleB, nleE, cdt, ehxA and paa genes...
October 2015: Journal of Medical Microbiology
A V Lazareva, L K Katosova, O A Kryzhanovskaya, O A Ponomarenko, O V Karaseva, A L Gorelik, N A Mayanskiy
Nosocomial infections and their rational antibiotic treatment represent a major challenge for the healthcare nowadays. In this context, gramnegative bacteria including Pseudomonas aeruginosa, Acinetobacter baumanii and Enterobacteriaceae spp. are etiologically important and characterized by a significant level of antibiotic resistance. To examine dynamics of the respiratory tract colonization by hospital flora, tracheal aspirates obtained at three time points from 69 children with severe craniocerebral trauma during their stay in ICU were analysed...
2014: Antibiotiki i Khimioterapii︠a︡, Antibiotics and Chemoterapy [sic]
Nicole Stoesser, Sivilay Xayaheuang, Manivanh Vongsouvath, Koukeo Phommasone, Ivo Elliott, Carlos Del Ojo Elias, Derrick W Crook, Paul N Newton, Yves Buisson, Sue J Lee, David A B Dance
OBJECTIVES: Intestinal carriage constitutes an important reservoir of antimicrobial-resistant bacteria, with some of the highest rates reported from Asia. Antibiotic resistance has been little studied in Laos, where some antibiotics are available without restriction, but others such as carbapenems are not available. PATIENTS AND METHODS: We collected stools from 397 healthy children in 12 randomly selected pre-school childcare facilities in and around Vientiane...
2015: Journal of Antimicrobial Chemotherapy
Marta Ciofi Degli Atti, Paola Bernaschi, Michaela Carletti, Ida Luzzi, Aurora García-Fernández, Alice Bertaina, Annamaria Sisto, Franco Locatelli, Massimiliano Raponi
BACKGROUND: Extensively drug-resistant Pseudomonas aeruginosa (XDR-PA) isolates are susceptible to only one or two classes of antibiotics. In 2011-2012, we investigated an outbreak of XDR-PA affecting children with onco-hematological diseases. METHODS: Outbreak investigation included ascertainment of cases, tracing of intestinal carriers and environmental surveillance. Contact precautions were adopted for patients with infection or colonization. Isolates were tested for antimicrobial susceptibility; phenotypic confirmation of carbapenemase production was performed, and carbapenemase genes were tested by multiplex polymerase-chain-reaction (PCR)...
2014: BMC Infectious Diseases
Pia S Pannaraj, Jennifer Dien Bard, Chiara Cerini, Scott J Weissman
BACKGROUND: Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are on the rise worldwide but are not well described in pediatric populations. This study characterizes the clinical, phenotypic and genotypic characteristics of CRE infections at a free-standing US children's hospital. METHODS: CRE were defined as any clinical Enterobacteriaceae isolate non-susceptible to either imipenem or meropenem and resistant to ceftriaxone, cefotaxime and ceftazidime determined by routine antimicrobial susceptibility testing...
January 2015: Pediatric Infectious Disease Journal
Alexandra Badura, Josefa Luxner, Gebhard Feierl, Franz F Reinthaler, Gernot Zarfel, Herbert Galler, Gudrun Pregartner, Regina Riedl, Andrea J Grisold
The aim was to determine the prevalence of E. coli and coliform bacteria in playground sand of all public children's sandpits in Graz (n = 45), Austria, and to assess the frequency of antimicrobial resistance in E. coli. Molecular characterization included the discrimination of O-serotypes and H-antigens and the determination of virulence and resistance genes, using a microarray technology. E. coli isolates were tested for susceptibility to a set of antibiotics by VITEK2 system and disk diffusion method...
November 2014: Environmental Pollution
Xiaoxing Du, Ying Fu, Yunsong Yu
Tigecycline shows great antimicrobial activity against both Gram-positive and Gram-negative bacteria, and has been considered to be an appropriate choice in controlling infection caused by multi-drug resistant (MDR) pathogens, such as carbapenemase-producing Enterobacteriaceae (CPE). Although many clinical trials evaluate the efficacy and safety of tigecycline on adults, rare reports recommend tigecycline to treat pediatric patient. In this study, we presented a clinical case with tigecycline as an anti-infectious agent on a 14-year-old child who was suffering from infection of intraperitoneal abscess caused by Klebsiella pneumoniae carbapenemases (KPC)-producing Escherichia coli with extreme drug resistant profile...
2013: Annals of Clinical Microbiology and Antimicrobials
R J Drew, J F Turton, R L R Hill, D M Livermore, N Woodford, S Paulus, N A Cunliffe
BACKGROUND: Carbapenem-resistant Enterobacteriaceae are an emerging global infection threat. However, there are few data describing their clinical importance in children. AIM: This retrospective study reviewed the prevalence and resistance mechanisms of carbapenem-resistant Enterobacteriaceae grown from clinical and surveillance samples in a large tertiary referral children's hospital in the UK. METHODS: Carbapenem-resistant Enterobacteriaceae were sought in specimens submitted for diagnostic and surveillance purposes at Alder Hey Children's NHS Foundation Trust, Liverpool, between September 2011 and August 2012...
August 2013: Journal of Hospital Infection
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