Corrigendum to “Carbapenem susceptibility among Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae isolates obtained from patients in intensive care units in Taiwan in 2005, 2007, and 2009” [Diagn Microbiol Infect Dis 2015;81(4):290–295]

2017 ◽  
Vol 87 (3) ◽  
pp. 298
Author(s):  
Shio-Shin Jean ◽  
Wen-Sen Lee ◽  
Kuan-Jen Bai ◽  
Kwok-Woon Yu ◽  
Chin-Wang Hsu ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Intensive Care Units ◽  
Enterobacter Cloacae ◽  
Diagn Microbiol Infect

Acquisition of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in intensive care units in Thailand

2020 ◽  
Author(s):  
Kanit Assawatheptawee ◽  
Anong Kiddee ◽  
Anamai Na-udom ◽  
Apirath Wangteeraprasert ◽  
Pornpit Treebupachatsakul ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Intensive Care Units ◽  
Extended Spectrum

scholarly journals Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates Possessing the Plasmid-Mediated Carbapenem-Hydrolyzing β-Lactamase KPC-2 in Intensive Care Units of a Chinese Hospital

2008 ◽  
Vol 52 (6) ◽  
pp. 2014-2018 ◽  
Author(s):  
Jia Chang Cai ◽  
Hong Wei Zhou ◽  
Rong Zhang ◽  
Gong-Xiang Chen
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Serratia Marcescens ◽  
Intensive Care Units ◽  
Gel Electrophoresis ◽  
Outer Membrane Proteins ◽  
Carbapenem Resistance ◽  
E Coli ◽  
Insertional Inactivation

ABSTRACT Twenty-one Serratia marcescens, ten Klebsiella pneumoniae, and one Escherichia coli isolate with carbapenem resistance or reduced carbapenem susceptibility were recovered from intensive care units (ICUs) in our hospital. Enterobacterial repetitive intergenic consensus-PCR and pulsed-field gel electrophoresis demonstrated that all the S. marcescens isolates belonged to a clonal strain and the 10 K. pneumoniae isolates were indistinguishable or closely related to each other. The MICs of imipenem, meropenem, and ertapenem for all isolates were 2 to 8 μg/ml, except for K. pneumoniae K10 (MICs of 128, 256, and >256 μg/ml). Isoelectric focusing, PCRs, and DNA sequencing indicated that all S. marcescens isolates produced KPC-2 and a β-lactamase with a pI of 6.5. All K. pneumoniae isolates produced TEM-1, KPC-2, CTX-M-14, and a β-lactamase with a pI of 7.3. The E. coli E1 isolate produced KPC-2, CTX-M-15, and a β-lactamase with a pI of 7.3. Conjugation studies with E. coli (EC600) resulted in the transfer of reduced carbapenem susceptibility compared to that of the original isolates, and only the bla KPC-2 gene was detected in E. coli transconjugants. Plasmid restriction analysis showed identical restriction patterns among all E. coli transconjugants. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and ompK35/36 gene sequence analysis of outer membrane proteins revealed that K. pneumoniae K10 failed to express OmpK36, because of insertional inactivation by an insertion sequence ISEcp1. All these results indicate that KPC-2-producing S. marcescens, K. pneumoniae, and E. coli isolates emerged in ICUs in our hospital. KPC-2 combined with porin deficiency results in high-level carbapenem resistance in K. pneumoniae. The same bla KPC-2-encoding plasmid was spread among the three different genera.

scholarly journals A genomic epidemiology study of multidrug-resistant Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii in two intensive care units in Hanoi, Vietnam

2020 ◽  
Author(s):  
Leah W. Roberts ◽  
Le Thi Hoi ◽  
Fahad A. Khokhar ◽  
Nguyen Thi Hoa ◽  
Tran Van Giang ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
United Kingdom ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Intensive Care Units ◽  
Surveillance Study ◽  
Community Settings ◽  
Prospective Surveillance ◽  
E Coli

AbstractBackgroundVietnam has high rates of antimicrobial resistance (AMR) but limited genomic surveillance, impeding our ability to assess transmission dynamics. This study aimed to use whole genome ssequencing (WGS) to examine the transmission of key AMR pathogens in two intensive care units in Hanoi, Vietnam.MethodsA prospective surveillance study of all adults admitted to two intensive care units (ICUs) at the National Hospital for Tropical Diseases (NHTD) and Bach Mai Hospital (BMH) was conducted between June 2017 and January 2018. Clinical and environmental samples were cultured on selective media, characterised using MALDI TOF MS, and Illumina sequenced. Phylogenies based on the de novo assemblies (SPAdes) were constructed using Mafft (PARsnp), Gubbins and RAxML. Resistance genes were detected using Abricate against the NCBI database.Findings3,153 Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii isolates from 369 patients were analysed. Phylogenetic analysis revealed predominant lineages within A. baumannii (global clone [GC]2, sequence types [ST]2, ST571) and K. pneumoniae (ST15, ST16, ST656, ST11, ST147) isolates. Colonisation was most common with E. coli (88.9%) followed by K. pneumoniae (62.4%). 91% of E. coli carried a blaCTX-M variant, while 81% of K. pneumoniae isolates carried blaNDM (54%) and/or blaKPC (45%). Transmission analysis using single nucleotide polymorphisms (SNPs) identified 167 clusters involving 251 (68%) patients, in some cases involving patients from both ICUs. There were no significant differences between the lineages or AMR genes recovered between the two ICUs.InterpretationThis study represents the largest prospective surveillance study of key AMR pathogens in Vietnamese ICUs. Clusters of closely related isolates in patients across both ICUs suggests recent transmission prior to ICU admission in other healthcare settings or in the community.FundingThis work was funded by the Medical Research Council Newton Fund, United Kingdom; the Ministry of Science and Technology, Vietnam (HNQT/SPÐP/04.16) and the Wellcome Trust, United Kingdom.Research in contextEvidence before this studyGlobally, antimicrobial resistance (AMR) is projected to cause 10 million deaths annually by 2050. While 90% of these deaths are expected to occur in African and Asian low- and middle-income countries (LMIC), attributing morbidity and mortality is difficult without the availability of comprehensive AMR data in these settings. Whilst efforts have been made to improve AMR surveillance in these settings, this is often hampered by limited infrastructure, training and financial resources.Added value of this studyThis is the largest prospective surveillance study of three key AMR pathogens (E. coli, K. pneumoniae and A. baumannii) conducted in critical care settings in Vietnam. All patients were colonised or infected with one or more extended spectrum beta-lactamase (ESBL) producing and/or carbapenem-resistant organism. Colonisation with more than one organism was very common, with resistant E. coli predominantly isolated from stool. A small number of predominant lineages were identified for K. pneumoniae and A. baumannii, while the E. coli isolates were highly genetically diverse. A large number of genomic clusters were identified within the two ICUs, some of which spanned both ICUs. There were no significant differences between lineages or AMR genes between the two ICUs.Implications of all the available evidenceThis study found high rates of colonisation and infection with three key AMR pathogens in adults admitted to two Vietnamese ICUs. Whilst transmission was common within ICUs the finding of similar lineages and AMR genes in both ICUs suggests that dissemination of AMR occurs prior to ICU admission, from either referral sites or in community settings prior to hospital admission. Strategies to tackle AMR in Vietnam will need to account for this by extending surveillance beyond ICU to hospital and community settings.

scholarly journals A Novel Gene Cassette,aacA43, in a Plasmid-Borne Class 1 Integron

2011 ◽  
Vol 55 (6) ◽  
pp. 2979-2982 ◽  
Author(s):  
Sally R. Partridge ◽  
Lee C. Thomas ◽  
Andrew N. Ginn ◽  
Agnieszka M. Wiklendt ◽  
Pierre Kyme ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Enterobacter Cloacae ◽  
Gene Cassette ◽  
Class 1 Integron ◽  
Content Type ◽  
Novel Gene ◽  
Class 1

ABSTRACTA novel gene cassette,aacA43, was identified in theaadB-aacA43-oxa10-smr2cassette array in a class 1 integron. Like related aminoglycoside-(6′)-acetyltransferases, AacA43 confers clinically relevant resistance to kanamycin, tobramycin, and some less-used aminoglycosides but not to gentamicin. Although transferable on an IncL/M plasmid,aacA43was identified in only two differentKlebsiella pneumoniaestrains (14 isolates), oneEscherichia colistrain (2 isolates), and oneEnterobacter cloacaestrain in a survey of patients in a Sydney intensive care unit in 2004-2005.

Антимікробна резистентність провідних збудників інфекцій сечових шляхів у Києві (Україна)

2017 ◽  
Vol 1 (2) ◽  
pp. 48-60
Author(s):  
A.G. Salmanov ◽  
A.V. Rudenko
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Staphylococcus Epidermidis ◽  
Klebsiella Oxytoca ◽  
Enterobacter Aerogenes ◽  
Enterobacter Cloacae ◽  
Proteus Vulgaris ◽  
Providencia Rettgeri ◽  
E Coli

Мета роботи — вивчити резистентність до антибіотиків бактеріальних збудників інфекцій сечових шляхів (ІСШ), виділених у пацієнтів урологічного стаціонару в м. Києві. Матеріали і методи. Досліджено 1612 штамів бактерій, виділених із сечі хворих з ІСШ (цистит, уретрит, пієлонефрит), госпіталізованих в урологічне відділення ДУ «Інститут урології НАМН України» у м. Києві протягом 2016 р. Серед пацієнтів переважали жінки — 1201 (74,5 %). Вік хворих становив від 17 до 74 років. Для збору даних використано медичну документацію лікарні. Мікробіологічні дослідження виконано у лабораторії мікробіології ДУ «Інститут урології НАМН України». Аналізували результати культурального дослідження зразків сечі, зібраних за наявності клінічних ознак ІСШ. Дослідження клінічного матеріалу та інтерпретацію отриманих результатів проводили загальноприйнятими методами. Вивчено чутливість уропатогенів до 31 антибіотика дискодифузійним методом відповідно до рекомендацій Інституту клінічних та лабораторних стандартів США (Clinical and Laboratory Standards Institute (CLSI)). Результати та обговорення. Аналіз мікробного спектра сечі виявив домінування серед уропатогенів штамів Escherichia coli (32,0 %), Enterococcus faecalis (19,5 %), Klebsiella pneumoniae (10,9 %), Staphylococcus epidermidis (8,9 %), S. haemolyticus (6,5 %) та Pseudomonas aeruginosa (6,4 %). Частка Enterococcus faecium, Enterobacter aerogenes і Streptococcus viridans становила відповідно 2,5, 2,2 і 1,6 %, Enterobacter cloacae, Klebsiella oxytoca, Acinetobacter baumannii, Proteus vulgaris та Providencia rettgeri — менше 1,0 %. У більшості випадків (69,7 %) мікроорганізми виділено у монокультурі, у решті випадків — у мікробних асоціа- ціях. Високу резистентність до тестованих антибіотиків виявили штами E. aerogenes (45,1 %), E. cloacae (45,7 %), E. faecium (40,9 %), E. faecalis (40,7 %), E. coli (39,9 %), P. aeruginosa (34,0 %), K. pneumoniae (28,6 %). Найбільш активними до уропатогенів були іміпенем (E. coli — 87,6 %, P. aeruginosa — 75,7 %, E. cloacae — 67,3 %, E. aerogenes — 72,6 %, K. pneumoniae — 93,2 %), меропенем (E. coli — 89,1 %, P. aeruginosa — 76,7 %, K. pneumoniae — 82,6 %), лефлоцин (E. coli — 74,5 %, ентерококи — 78,7 %, P. aeruginosa — 76,7 %, E. cloacae — 73,9 %, E. aerogenes — 80,4 %, K. pneumoniae — 83,5 %), амоксицилін/клавуланат (ентерококи — 84,6 %), фурагін (ентерококи — 82,6 %), цефоперазон (K. pneumoniae — 89,2 %, P. aeruginosa — 73,8 %), цефтріаксон (K. pneumoniae — 80,1 %). Висновки. Антибіотикорезистентність збудників ІСШ — важлива терапевтична проблема. Найбільшою активністю до уропатогенів характеризуються іміпенем, меропенем, лефлоцин, амоксицилін/ клавуланат, фурагін, цефоперазон, цефтріаксон, які можна розглядати як препарат вибору для призначення стартової терапії ІСШ. Необхідно здійснювати постійний моніторинг за резистентністю до дії антибіотиків. Політику використання антибіотиків у кожному стаціонарі слід визначати залежно від локальних даних щодо резистентності до протимікробних препаратів.

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