Molecular characterisation of carbapenem- and tigecycline-resistant Klebsiella pneumoniae strains isolated from blood and bile samples

2021 ◽  
Author(s):  
Takeaki Wajima ◽  
Takashi Sugawara ◽  
Yutaka Umeda ◽  
Atsuya Hagimoto ◽  
Emi Tanaka ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Characterisation ◽  
Bile Samples

scholarly journals Az antibiotikumrezisztencia változása cholangitisben. Klinikai tapasztalataink

2019 ◽  
Vol 160 (36) ◽  
pp. 1437-1442
Author(s):  
Dóra Illés ◽  
Edit Urbán ◽  
Andrea Lázár ◽  
Kamilla Nagy ◽  
Emese Ivány ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Enterococcus Faecalis ◽  
Fatal Outcome ◽  
Sample Collection ◽  
Endoscopic Retrograde ◽  
Bile Sample ◽  
Inappropriate Use ◽  
First Choice ◽  
Bile Samples

Abstract: Introduction: Due to the inappropriate use of antibiotics (AB), more pathogens become multiresistant. One of the most severe sources of sepsis is cholangitis. To avoid fatal outcome, an effective AB policy plays a key role. Aim: To investigate the AB resistance of bacteria causing cholangitis and the efficacy of AB treatment. Patients and method: Microbiological tests of bile samples collected during cholangitis-indicated endoscopic retrograde cholangiopancreatographies were analysed at the First Department of Medicine, University of Szeged, in 2006 and in 2016. Results: 29 and 111 patients had bile sample collection in 2006 and in 2016, respectively. Of that, 22 (75%) and 106 (95%) were positive. Mean age: 61 ± 14 vs. 71 ± 14 years, no difference between men/women ratio. In 2006, 10 cases empirical AB (ciprofloxacine with metronidazole or imipenem) were used. In 9 cases (90%), the AB was adequate based on the microbiological results. In 2016, in 88 cases empirical AB was applied (ciprofloxacine and metronidazole, ceftriaxone with metronidazole or imipenem with metronidazole). In 29 cases, the empirical AB was ineffective. The efficacy of ciprofloxacine decreased to 64% in 2016. The profile of the most frequent cholangitis-causing pathogens (Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae) was the same, but their resistency against ciprofloxacine increased. The rates of polymicrobal infections were 73% and 63%, respectively. Conclusion: The rates of positive bile samples were significantly higher in 2016. The profile of the most frequent pathogens was the same. The efficacy of the first-choice empirical AB ciprofloxacine decreased in 2016. The types of the most frequent cholangitis-causing bacteria are in line with the ones included in the Tokyo Guideline. Orv Hetil. 2019; 160(36): 1437–1442.

scholarly journals Ceftazidime/avibactam resistance is associated with different mechanisms in KPC-producing Klebsiella pneumoniae strains

2021 ◽  
Author(s):  
Sara Cavallini ◽  
Ilaria Unali ◽  
Anna Bertoncelli ◽  
Riccardo Cecchetto ◽  
Annarita Mazzariol
Keyword(s):  
Amino Acids ◽  
Klebsiella Pneumoniae ◽  
Illumina Sequencing ◽  
Genetic Mutations ◽  
Molecular Characterisation ◽  
Drug Resistant ◽  
Carbapenemase Gene ◽  
Resistant Strains

AbstractThis study focused on Klebsiella pneumoniae isolates that were resistant or had low susceptibility to a combination of ceftazidime/avibactam. We aimed to investigate the mechanisms underlying this resistance. A total of 24 multi-drug resistant isolates of K. pneumoniae were included in the study. The phenotypic determination of carbapenemase presence was based on the CARBA NP test. NG-Test CARBA 5 was also performed, and it showed KPC production in 22 out 24 strains. The molecular characterisation of blaKPC carbapenemase gene, ESBL genes (blaCTX-M, blaTEM, and blaSHV) and porin genes ompK35/36 was performed using the PCR. Finally, ILLUMINA sequencing was performed to determine the presence of genetic mutations.Various types of mutations in the KPC sequence, leading to ceftazidime/avibactam resistance, were detected in the analysed resistant strains. We observed that KPC-31 harboured the D179Y mutation, the deletion of the amino acids 167–168, and the mutation of T243M associated with ceftazidime/avibactam resistance. The isolates that did not present carbapenemase alterations were found to have other mechanisms such as mutations in the porins. The mutations both on the KPC-3 enzyme and in the porins confirmed, that diverse mechanisms confer resistance to ceftazidime/avibactam in K. pneumoniae.

scholarly journals Microbial Profiles and Risk Factors of Preexisting Biliary Infection in Patients with Therapeutic Endoscopy

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Hua-Qiang Ruan ◽  
Guo-Lin Liao ◽  
Peng Peng ◽  
Shi-Quan Liu ◽  
Chang-Liang Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Protective Factor ◽  
Interventional Procedure ◽  
Bacterial Colonization ◽  
Treatment Plan ◽  
Clinical Manifestations ◽  
Therapeutic Endoscopy ◽  
Malignant Diseases ◽  
Bile Samples

Background. The bile infection may already exist before the administration of an interventional procedure, despite no clinical manifestations of cholangitis detected. Blood cultures remained negative even in more than half of the febrile cases with cholangitis. Risk factors associated with bacterial growth in bile before the intervention are not well defined. To establish the bacterial profiles isolated from the bile samples and to identify risk factors for bacterial colonization in the bile system. Methods. Individuals who underwent endoscopic retrograde cholangiopancreatography (ERCP) interventions were enrolled. Bile samples were aspirated and were immediately transferred into a sterile tube for storage. Results. Positive bile cultures were detected in 363 (38.0%) of 956 patients, including 322 benign diseases and 41 malignances. Of 363 positive cases, 351 (96.7%) were monoinfection and 12 (3.3%) multi-infection. Escherichia coli were the most common Gram-negative bacteria (210, 56.0%), followed by Klebsiella pneumoniae (45, 12.0%). Enterococcus faecalis represented the most common Gram-positive microorganism (19, 5.07%), while Candida albicans (11, 2.93%) were the dominant fungi. Klebsiella pneumoniae were more frequently detected in malignant diseases (P=0.046). Age, previous ERCP history or OLT history, and CBD diameter were independent risk factors for positive cultures (P<0.05) while preoperative jaundice drug therapy was the protective factor for bile infection (P<0.05). Conclusion. Monomicrobial infection was dominant among all infections, and Klebsiella pneumoniae strains were more frequently isolated from patients with malignant diseases. To effectively manage patients who are at a high risk for bile infection, a detailed diagnosis and treatment plan for each case should be prepared.

Molecular characterisation of multidrug-resistant Klebsiella pneumoniae belonging to CC258 isolated from outpatients with urinary tract infection in Brazil

2019 ◽  
Vol 18 ◽  
pp. 74-79 ◽  
Author(s):  
Paola Aparecida Alves Azevedo ◽  
João Pedro Rueda Furlan ◽  
Guilherme Bartolomeu Gonçalves ◽  
Carolina Nogueira Gomes ◽  
Rafael da Silva Goulart ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Molecular Characterisation
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