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Colistin resistant

Ignacio Martin-Loeches, Glenn E Dale, Antoni Torres
With the increase in multi-drug resistant P. aeruginosa, antimicrobials with a novel mechanism of action are needed that can target these infections. Areas covered: Intravenous murepavadin is in Phase 3 development for the treatment of HABP/VABP due to P. aeruginosa. This paper summarizes the available information on the discovery, the in vitro activity, pharmacokinetic and pharmacodynamic properties and the clinical pharmacology of murepavadin to date. Expert commentary: P. aeruginosa has an intrinsic resistance to many antibiotics due to high cellular impermeability and efficient drug efflux mechanisms, and the recent increase in prevalence of multidrug-resistant P...
February 16, 2018: Expert Review of Anti-infective Therapy
F Del Bianco, M Morotti, M F Pedna, P Farabegoli, V Sambri
OBJECTIVES: To start a surveillance program to investigate the possible diffusion of mobilized colistin resistance genes in Enterobacteriaceae strains isolated in the Unit of Microbiology of the Great Romagna Hub Laboratory. METHODS: All the colistin resistant Enterobacteriaceae, isolated from August 1st 2016 to July 31st 2017, were prospectively evaluated for mcr-1 a mcr-2. Backdated survey of mcr-3, mcr-4 and mcr-5 was performed on the same group of isolates. Species identification was achieved by Vitek MS and the antibiotic susceptibility testing was performed both with Vitek-2 and Sensititre systems...
February 12, 2018: International Journal of Infectious Diseases: IJID
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
Wai-Sing Chan, Chun-Hang Au, Dona N Ho, Tsun-Leung Chan, Edmond Shiu-Kwan Ma, Bone Siu-Fai Tang
BACKGROUND: Human fecal carriage of Enterobacteriaceae possessing mobilized colistin resistance genes (mcr-1 and mcr-2) remains obscure in Hong Kong. As part of routine surveillance on emerging antibiotic resistance, we conducted a prospective study on this topic in a regional hospital in Hong Kong. METHODS: From October 31 to November 25, 2016, all fecal specimens submitted for routine analysis were included in this surveillance study. These comprised 672 consecutive routine fecal specimens collected from 616 individuals...
February 13, 2018: BMC Infectious Diseases
Uthaibhorn Singkham-In, Tanittha Chatsuwan
Carbapenem-resistant Acinetobacter baumannii clinical isolates (n=23) were investigated for carbapenem resistance mechanisms and in vitro activities of carbapenems in combination with amikacin, colistin, or fosfomycin. Major carbapenem resistance mechanism was OXA-23 production. The vast majority of these isolates were OXA-23-producing A. baumannii ST195 and ST542, followed by novel STs, ST1417, and ST1423. The interuption of carO by a novel insertion sequence, ISAba40, was found in two isolates. The combinations of imipenem and fosfomycin, meropenem and amikacin, imipenem and amikacin, and imipenem and colistin were synergistic against carbapenem-resistant A...
January 31, 2018: Diagnostic Microbiology and Infectious Disease
Shin-Ichi Yokota, Hiroshi Hakamada, Soh Yamamoto, Toyotaka Sato, Tsukasa Shiraishi, Masaaki Shinagawa, Satoshi Takahashi
Pseudomonas aeruginosa is an important etiological agent of opportunistic infections. Injectable colistin is available as a last-line option of treatment for multidrug-resistant P. aeruginosa infections. When cells were inoculated at a high number, colistin-susceptible P. aeruginosa grew on agar medium containing colistin at a concentration 10-fold higher than the MIC without acquiring colistin resistance. This study examined the responsible mechanism for growth in the presence of a high concentration of colistin...
February 9, 2018: International Journal of Antimicrobial Agents
Noëlle H O'Driscoll, T P Tim Cushnie, Kerr H Matthews, Andrew J Lamb
Whilst colistin (polymyxin E) represents the last mainstream treatment option for multidrug-resistant Gram-negative pathogens, details of its mechanism of action remain to be fully resolved. In this study, the effects of sub-inhibitory, inhibitory-bactericidal, and supra-bactericidal levels of colistin on the membrane integrity and morphology of Escherichia coli and Pseudomonas aeruginosa were investigated using potassium loss, flow cytometry, and scanning electron microscopy (SEM). Supra-bactericidal colistin concentrations induced just 4-12% intracellular potassium loss from bacteria after 24 h...
February 8, 2018: Archives of Microbiology
Yi-Ming Wang, Ling-Cong Kong, Jie Liu, Hong-Xia Ma
Background: Bacterial infections have become more challenging to treat due to the emergence of multidrug-resistant pathogenic bacteria. Combined antibiotics prove to be a relatively effective method to control such resistant strains. This study aim to investigate synergistic activity of eugenol combined with colistin against a collection of clinical isolated Escherichia coli (E.coli) strains, and to evaluate potential interaction. Methods: Antimicrobial susceptibility, minimum inhibitory concentration (MIC) and fractional inhibitory concentration index (FICI) of the bacteria were determined by disk diffusion assay, broth microdilution method and checkerboard assay, respectively...
2018: Antimicrobial Resistance and Infection Control
Elaa Maamar, Carla Andrea Alonso, Zaineb Hamzaoui, Nouha Dakhli, Mohamed Salah Abbassi, Sana Ferjani, Mabrouka Saidani, Ilhem Boutiba-Ben Boubaker, Carmen Torres
Our study aimed to investigate colistin resistance and the mechanisms involved in a collection of 35 extended-spectrum beta-lactamase (ESBL) and 13 CMY-2-producing E. coli strains which were previously recovered from chicken gut microbiota in Tunisia, as well as to determine the genetic location of mcr genes. Forty-eight ESBL and CMY-2-producing E. coli strains were obtained from 137 fecal samples of healthy chickens during 2013. These strains were tested for colistin resistance by the broth microdilution method, and screened for mcr-1 and mcr-2 genes by PCR...
January 29, 2018: International Journal of Food Microbiology
Liliane Okdah, Stéphanie Le Page, Abiola Olumuyiwa Olaitan, Grégory Dubourg, Linda Hadjadj, Jean-Marc Rolain
BACKGROUND: The recent emergence of colistin resistance, particularly mcr-1 plasmid-mediated colistin resistance in Gram negative bacteria, has led to renewed interest in antibiotic combinations to overcome clinical therapeutic impasses. OBJECTIVE: We aim to evaluate the potential of the synergistic and bactericidal activity of colistin in combination with sulphonamide compounds including sulfadiazine, sulfamethoxazole, and trimethoprim-sulfamethoxazole, against clinical colistin-resistant bacterial strains, including strains with the plasmidic mcr-1encoding gene...
February 5, 2018: International Journal of Antimicrobial Agents
Fusun Can, Sirin Menekse, Pelin Ispir, Nazli Atac, Ozgur Albayrak, Tuana Demir, Doruk Can Karaaslan, Salih Nafiz Karahan, Mahir Kapmaz, Ozlem Kurt Azap, Funda Timurkaynak, Serap Simsek Yavuz, Seniha Basaran, Fugen Yoruk, Alpay Azap, Safiye Koculu, Nur Benzonana, Nathan A Lack, Mehmet Gönen, Onder Ergonul
Objectives: We describe the molecular characteristics of colistin resistance and its impact on patient mortality. Methods: A prospective cohort study was performed in seven different Turkish hospitals. The genotype of each isolate was determined by MLST and repetitive extragenic palindromic PCR (rep-PCR). Alterations in mgrB were detected by sequencing. Upregulation of pmrCAB, phoQ and pmrK was quantified by RT-PCR. mcr-1 and the genes encoding OXA-48, NDM-1 and KPC were amplified by PCR...
February 3, 2018: Journal of Antimicrobial Chemotherapy
Leila Gheitani, Hossein Fazeli, Sharareh Moghim, Bahram Nasr Isfahani
Overuse and misuse of Carbapenems among Klebsiella pneumoniae isolates have caused Carbapenem-Resistant Klebsiella Pneumonia (CRKP) during recent years. Colistin is one of the last available options, and there are increasing concerns about the dosage and resistance to this agent in long-term monotherapies. This study was designed to identification of carbapenemase producing isolates of K. pneumoniae via phenotypic and genotypic methods as well as evaluation of colistin-meropenem combination therapy potential...
January 31, 2018: Cellular and Molecular Biology
S Peter, D Bezdan, P Oberhettinger, W Vogel, D Dörfel, J Dick, M Marschal, J Liese, C Weidenmaier, I Autenrieth, S Ossowski, M Willmann
Citrobacter species harbouring metallo-beta-lactamases (MBLs) have been reported from various countries and different sources, but their isolation from clinical specimens remains a rare event in Europe. MBL-harbouring Enterobacteriaceae are considered a major threat in infection control as therapeutic options are often limited to colistin. In this study, we applied whole genome sequencing to characterize five clinical isolates of multidrug-resistant Citrobacter werkmanii obtained from rectal swabs. Four strains possessed a class I integron with a novel blaVIM-48 MBL-resistance gene and the aminoglycoside acetyltransferase gene aacA4, while one isolate harboured a blaIMP-8 MBL...
February 2, 2018: International Journal of Antimicrobial Agents
James M Kidd, Joseph L Kuti, David P Nicolau
Introduction Hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) are among the most prevalent infections in hospitalized patients, particularly those in the intensive care unit. Importantly, the frequency of multidrug resistant (MDR) Gram-negative (GN) bacteria as the bacteriologic cause of HABP/VABP is increasing. These include MDR Pseudomonas aeruginosa, Acinetobacter baumannii, and carbapenem resistant Enterobactericeae (CRE). Few antibiotics are currently available when such MDR Gram-negatives are encountered and older agents such as polymyxin B, colistin (polymyxin E), and tigecycline have typically performed poorly in HABP/VABP...
February 7, 2018: Expert Opinion on Pharmacotherapy
Saranya Vijayakumar, Baby Abirami S, Kalaiyarasi Kanthan, Balaji Veeraraghavan
BACKGROUND: Acinetobacter baumannii is a nosocomial pathogen responsible for causing various infections like blood stream infections, meningitis and ventilator associated pneumonia. A.baumannii is resistant to all the drugs including colistin and the development of colistin resistant A. baumannii is of serious concern in the hospital setting. OBJECTIVE: Characterisation of whole genome shotgun sequences of seven colistin resistant A. baumannii isolates from blood stream infections...
January 30, 2018: Journal of Global Antimicrobial Resistance
Ruobing Wang, Yuqing Liu, Qing Zhang, Longyang Jin, Qi Wang, Yawei Zhang, Xiaojuan Wang, Ming Hu, Lulu Li, Jing Qi, Yanbo Luo, Hui Wang
Increasing colistin resistance is a global concern as colistin is used as a last resort for the treatment of carbapenem-resistant Enterobacteriaceae infections. The plasmid-mediated colistin resistance gene mcr-1 was found in distinct bacterial species isolated from humans, animals, and the environment. In this study, farms in four different agricultural provinces in China were investigated to determine the occurrence of the antimicrobial resistance and related genes. A total of 373 Escherichia coli and 54 Klebsiella pneumoniae were isolated from 510 non-duplicated samples...
January 30, 2018: International Journal of Antimicrobial Agents
Lipika Singhal, Megha Sharma, Salony Verma, Ramanpreet Kaur, Xavier Basil Britto, Surbhi Malhotra Kumar, Pallab Ray, Vikas Gautam
INTRODUCTION: With the increasing threat of multidrug-resistant organisms, such as Acinetobacter baumannii, the polymyxin class of drugs (colistin and polymyxin B) has become popular in clinical practice. A better understanding of antimicrobial susceptibility testing methods for colistin and polymyxin B is needed for optimal patient management. MATERIALS AND METHODS: Forty-two carbapenem-resistant A. baumannii isolates were subjected to susceptibility testing for colistin and polymyxin B using the following methods: broth microdilution (BMD) (glass-coated plates [BMD-Gs] and polystyrene plates [BMD-Ps]), agar dilution (AD), E-test®, Vitek®, and disk diffusion...
February 6, 2018: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Shakti Laishram, Agila Kumari Pragasam, Yamuna Devi Bakthavatchalam, Balaji Veeraraghavan
Testing for antimicrobial interactions has gained popularity in the last decade due to the increasing prevalence of drug-resistant organisms and limited options for the treatment of these infections. In vitro combination testing provides information, on which two or more antimicrobials can be combined for a good clinical outcome. Amongst the various in vitro methods of drug interactions, time-kill assay (TKA), checkerboard (CB) assay and E-test-based methods are most commonly used. Comparative performance of these methods reveals the TKA as the most promising method to detect synergistic combinations followed by CB assay and E-test...
October 2017: Indian Journal of Medical Microbiology
Weilong Zhou, Lu Liu, Yu Feng, Zhiyong Zong
A Klebsiella pneumoniae clinical strain, named SCKP83, was isolated and found to be resistant to colistin thanks to the presence plasmid-borne colistin resistant gene mcr-1. The strain was subjected to whole genome sequencing and conjugation experiments. The subsequent analysis indicated that the strain belongs to ST15 and the capsular type K41. In SCKP83, mcr-1 was carried by a 97.4-kb non-self-transmissible plasmid, a 90.9-kb region of which was predicted as an intact phage. This phage was 47.79% GC content, encoded 105 proteins and contained three tRNAs...
2018: Frontiers in Microbiology
Youjun Feng
Polymyxins, a group of cationic antimicrobial polypeptides, act as a last-resort defense against lethal infections by carbapenem-resistant Gram-negative pathogens. Recent emergence and fast spread of mobilized colistin resistance determinant mcr-1 argues the renewed interest of colistin in clinical therapies, threatening global public health and agriculture production. This mini-review aims to present an updated overview on mcr-1, covering its global dissemination, the diversity of its hosts/plasmid reservoirs, the complexity in the genetic environment adjacent to mcr-1, the appearance of new mcr-like genes and the molecular mechanisms for MCR-1/2 colistin resistance...
February 3, 2018: ACS Infectious Diseases
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