Carbapenem-Resistant Klebsiella pneumoniae: Results of a Laboratory Surveillance Program in an Italian General Hospital (August 2014–January 2015)

2015 ◽  
pp. 91-101 ◽  
Author(s):  
Claudia Monari ◽  
Luca Merlini ◽  
Emanuela Nardelli ◽  
Maria Cacioni ◽  
Antonella Repetto ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
General Hospital ◽  
Surveillance Program ◽  
Carbapenem Resistant ◽  
Laboratory Surveillance

scholarly journals Carbapenem-Resistant Klebsiella pneumonia Isolated from Patients Admitted in Tertiary Care Hospital in Saudi Arabia

2020 ◽  
pp. 76-85
Author(s):  
Enas Sh. Khater ◽  
AbdAlazim A. AlFaki ◽  
Shehata Said Abd Elmoaty
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Positive Predictive Value ◽  
General Hospital ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Screening Test ◽  
Clinical Isolates ◽  
Invasive Procedures ◽  
Carbapenem Resistant

Background: Carbapenem-resistant klebsiella pneumoniae is an emerging threat worldwide causing high rates of morbidity and mortality Aim: To evaluate the prevalence of carbapenem-resistant K. pneumonia (CRKP), associated risk factors, type of infections caused by CRKP and their antimicrobial susceptibility. To evaluate Carbapenemase Detection Set (D70C) as screening test for CRKP Place and Duration of the Study: A cross sectional study and prospective cohort study was performed from June 2019 to February 2020 in intensive care unit and medical units of Al Quwayiyah General hospital. Methodology: 541 samples were collected from different patient sources. Klebsiella pneumoniae strain was only selected identified to the species level and AST was done using the Vitek-2. Minimum inhibitory concentration (MIC) of meropenem and imipenem was carried out. A Carbapenemase Detection Set (D70C) was used as screening test for CRKP while Modified Hodge test and multiplex PCR as confirmatory tests. Results: A total of 132 isolates were diagnosed as Enterobacteriaceae out of 541 patient samples.78 clinical isolates were klebsiella pneumoniae which were collected. Out of the 78 clinical isolates CRKP were 36 (46.2%) and CSKP were 42 (53.8%).) CRKP cases aged from (18-84 years) with the median patient age 59 year. Seventeen of 36 patients (47.2%) were males. the majority of the nosocomial CRKP infections were pneumonia 12 (33.3%) followed by urinary tract infection 9 (25%). The most common associated disease was diabetes (30%) followed by renal disease (27.8%). For invasive procedures, Urinary catheter was 27(75%) and 29(69%) followed by Mechanical ventilation 25(69.4%) and 22(52.4%) in CRKP and CSKP patients respectively. Reports of PCR for the 41 isolates which sent to regional laboratory for confirmation revealed that 36 isolates had carbapenemase genes; twenty eight (77.8%) K. pneumonia isolates positive for bla OXA-48 and 5 (13.9%) isolates were positive for blaNDM. in 2 (5.6%) bla KPC were detected, one isolate contained blaIMP. 5 isolates contain both blaOXA-48 and blaNDM. The sensitivity of MHT was analysed to be 91.7%. (95%Cl ratio 77.53% - 98.25%) and the specificity was 100% (95%Cl ratio 54.07% to 100%). The positive predictive value was 100% and the Negative predictive value was 66.7% ( 95%Cl ratio 40.36% to 85.53%). The sensitivity of Carbapenemase Detection Set (D70C) was 94.4% (81.34% to 99.32%) and the specificity was 80% (95%Cl ratio 28.36% to 99.49%). The positive predictive value was 97.1% (95%Cl ratio 85.46% to 99.49%).and the Negative predictive value was 66.7% (95%Cl ratio 32.67% to 89.18%). Conclusion: CRKP prevalence was 46.2% among K. pneumoniae isolates in Al Quwayiya General Hospital. Using invasive procedures such as urinary catheters or mechanical ventilator and misuse of antibiotics were risk factors associated with CRKP indicating that infection control guidelines and effective preventive measures should be strictly applied. It is very important to monitor and report changes in antimicrobial-resistant isolates but Carbapenemase Detection Set (D70C) has low specificity makes it less reliable and need PCR confirmation.

scholarly journals A comparative evaluation of two chromogenic media for surveillance of carbapenem-resistant Enterobacterales with non-carbapenemase-producing or carbapenemase-producing strains other than blaKPC: blaGES-5, blaNDM-1 or blaVIM-2

2019 ◽  
Vol 43 (3) ◽  
pp. 173-176
Author(s):  
Chang-Hun Park
Keyword(s):  
Rapid Detection ◽  
Comparative Evaluation ◽  
Susceptibility Testing ◽  
Rapid Identification ◽  
Surveillance Program ◽  
Contact Precaution ◽  
Chain Reaction ◽  
Carbapenem Resistant ◽  
Control And Prevention ◽  
Polymerase Chain

Abstract Background Infections caused by carbapenem-resistant Enterobacterales (CREs) are an emerging problem associated with high rates of morbidity and mortality. CREs are divided into two categories (carbapenemase-producing [CP] CRE and non-CP CRE). The most prevalent carbapenemase produced by Enterobacterales is Klebsiella pneumoniae carbapenemase (KPC) in Korea. Rapid identification of CREs is clinically important in infection control precaution. We compared the performance of two chromogenic media (chromID CARBA agar and CHROMagar KPC agar) for non-CP CREs or CP CREs with blaGES-5, blaNDM-1 or blaVIM-2 in a Korean hospital. Methods The study was carried out during a 3-month period from April to June 2017 during the surveillance program for CRE colonization. Antimicrobial susceptibility testing (AST) and polymerase chain reaction (PCR) were performed at the Korean Centers for Disease Control and Prevention. Results A total of 45 rectal swabs from 42 hospitalized patients were examined. Sensitivity of both chromID CARBA and CHROMagar KPC were 100% for CP CREs; and 50% and 100% for non-CP CREs, respectively. Specificity of chromID CARBA and CHROMagar KPC were 89.2% and 70.3% for CP CRE, respectively; and 76.9% and 66.7% for non-CP CRE, respectively. Conclusions The CHROMagar KPC is useful to monitor non-CP and CP CREs. The chromID CARBA is efficient for rapid detection of CP CREs requiring high contact precaution.

scholarly journals Molecular Epidemiology and Characterization of Carbapenem-Resistant Klebsiella pneumoniae Isolated from Urine at a Teaching Hospital in Taiwan

2021 ◽  
Vol 9 (2) ◽  
pp. 271
Author(s):  
Yuarn-Jang Lee ◽  
Chih-Hung Huang ◽  
Noor Andryan Ilsan ◽  
I-Hui Lee ◽  
Tzu-Wen Huang
Keyword(s):  
Klebsiella Pneumoniae ◽  
Teaching Hospital ◽  
Efflux Pump ◽  
Resistance Mechanisms ◽  
Pcr Analysis ◽  
Carbapenem Resistant ◽  
High Prevalence ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests ◽  
Tract Infections

Urinary tract infections (UTIs) are common in clinics and hospitals and are associated with a high economic burden. Enterobacterium Klebsiella pneumoniae is a prevalent agent causing UTIs. A high prevalence of carbapenem-resistant K. pneumoniae (CRKP) has emerged recently and is continuing to increase. Seventeen urinary CRKP isolates collected at a teaching hospital in Taiwan from December 2016 to September 2017 were analyzed to elucidate their drug resistance mechanisms. Two-thirds of the isolates were obtained from outpatients. Antimicrobial susceptibility tests demonstrated multidrug resistance in all the isolates. Multilocus sequence typing analysis showed high diversity among the isolates. PCR analysis demonstrated the presence of carbapenemases in three isolates. All isolates carried at least one other extended-spectrum β-lactamase, including TEM, DHA, and CTX-M. Fifteen isolates contained mutations in one of the outer membrane porins that were assessed. The expression levels of the acrB and/or oqxB efflux pump genes, as determined by qRT-PCR, were upregulated in 11 isolates. Six isolates might have utilized other efflux pumps or antimicrobial resistance mechanisms. These analyses demonstrated a highly diverse population and the presence of complex resistance mechanisms in urinary isolates of K. pneumoniae.

scholarly journals Six-year trends of resistance characteristics in carbapenem-resistant Klebsiella pneumoniae isolated from Malaysia

2020 ◽  
Vol 101 ◽  
pp. 67-68
Author(s):  
C.S.J. Teh ◽  
Z.X. Kong ◽  
M.Y. Lau ◽  
F.E. Teng ◽  
Y.Q. Lee ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Carbapenem Resistant

Difference in biofilm formation between carbapenem-resistant and carbapenem-sensitive Klebsiella pneumoniae based on analysis of mrkH distribution

2021 ◽  
Vol 152 ◽  
pp. 104743
Author(s):  
Renchi Fang ◽  
Haiyang Liu ◽  
Xiucai Zhang ◽  
Guofeng Dong ◽  
Jiahui Li ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Biofilm Formation ◽  
Carbapenem Resistant
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