The Predominance of Strain Replacement Among Enterobacteriaceae Pairs With Emerging Carbapenem Resistance During Hospitalization

2020 ◽  
Vol 221 (Supplement_2) ◽  
pp. S215-S219
Author(s):  
Baixing Ding ◽  
Zhen Shen ◽  
Xiaohua Qin ◽  
Yang Yang ◽  
Xiaogang Xu ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Gel Electrophoresis ◽  
Carbapenem Resistance ◽  
Tertiary Hospital ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field ◽  
Carbapenem Resistant ◽  
Sequence Types ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Isolates of Enterobacteriaceae collected from the same patient can lose carbapenem susceptibility during antimicrobial therapy, but little attention has been given to how this conversion takes place. In the current study, we retrospectively analyzed microbiological and clinical data from patients with enterobacterial infections at a tertiary hospital in Shanghai, China. After screening 4795 patients and 7120 Enterobacteriaceae isolates over the 3-year study period, we found the change from carbapenem susceptible to carbapenem resistant in 41 pairs of isolates, of which 35 pairs (85.4%) were K. pneumoniae and 25 (61.0%) were from the same anatomic sites. Thirty-six isolate pairs showed different pulsed-field gel electrophoresis patterns between the carbapenem-susceptible and the corresponding resistant strain, and 5 pairs displayed identical pulsed-field gel electrophoresis patterns. Thirty-three (91.7%) of the 36 pairs of Enterobacteriaceae isolates were carbapenem-resistant K. pneumoniae with blaKPC-2, and 28 pairs (90.3%) of K. pneumoniae isolates had different sequence types (STs), with ST11 the most common ST found in carbapenem-resistant K. pneumoniae isolates. Forty of the 41 patients had received antimicrobial therapy such as carbapenems, cephalosporins, and fluoroquinolones, before the isolation of carbapenem-resistant Enterobacteriaceae. These results demonstrated that strain replacement is the main cause of emerging carbapenem resistance in Enterobacteriaceae during hospitalization. The loss of carbapenem susceptibility was not mainly due to in vivo development of carbapenem resistance.

scholarly journals Detection of the novel IMP-38 among carbapenemase-producing Enterobacteriaceae in a university hospital, China

2014 ◽  
Vol 8 (08) ◽  
pp. 1044-1048 ◽  
Author(s):  
Zijuan Jian ◽  
Yanming Li ◽  
Wenen Liu ◽  
Hongling Li ◽  
Yunli Zhang ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
University Hospital ◽  
The Novel ◽  
Pulsed Field ◽  
Carbapenem Resistant ◽  
Neonatal Ward ◽  
Carbapenem Resistant Enterobacteriaceae

Introduction: This study set out to investigate the molecular epidemiology of carbapenemase-producing Enterobacteriaceae isolates collected from Xiang Ya Hospital, Hunan, China. Methodology: The carbapenemase genes from Enterobacteriaceae isolates were determined by PCR and sequencing. Relatedness of Klebsiella pneumoniae isolates was evaluated by pulsed-field gel electrophoresis. Results: Twenty-four out of 738 non-repetitive Enterobacteriaceae isolates harbored carbapenemase genes including IMP-38, a novel IMP-type metallo-enzyme. Nine IMP-38-producing isolates were shown to originate from the same clone and caused a small outbreak in the neonatal ward. Conclusions: IMP-38, a novel IMP-type metallo-enzyme, was one of the predominant types of carbapenemase in the clinical carbapenem-resistant Enterobacteriaceae isolates in our hospital.

scholarly journals Phenotypic and Molecular Analysis of Penicillin-Nonsusceptible Streptococcus pneumoniae Isolates in Poland

2006 ◽  
Vol 51 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Ewa Sadowy ◽  
Radosław Izdebski ◽  
Anna Skoczyńska ◽  
Paweł Grzesiowski ◽  
Marek Gniadkowski ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Molecular Analysis ◽  
Gel Electrophoresis ◽  
Multilocus Sequence Typing ◽  
Susceptibility Testing ◽  
Bacterial Pathogen ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field ◽  
Related Clone ◽  
Sequence Types

ABSTRACT β-Lactams are the drugs of choice for the treatment of infections caused by the important bacterial pathogen Streptococcus pneumoniae. The recent growth of resistance of this organism to penicillin observed worldwide is of the highest concern. In this study, using 887 surveillance pneumococcal isolates recovered in Poland from 1998 to 2002, we observed the increase in penicillin nonsusceptibility from 8.7% to 20.3%. All of the 109 penicillin-nonsusceptible S. pneumoniae (PNSP) isolates identified, together with 22 archival PNSP isolates from 1995 to 1997, were subsequently analyzed by susceptibility testing, serotyping, profiling of pbp genes, pulsed-field gel electrophoresis, and multilocus sequence typing (MLST). Four predominant serotypes, serotypes 6B, 9V, 14, and 23F, characterized 85.5% of the isolates. MLST revealed the presence of 34 sequence types, 15 of which were novel types. Representatives of seven multiresistant international clones (Spain23F-1, Spain6B-2, Spain9V-3, Taiwan23F-15, Poland23F-16, Poland6B-20, and Sweden15A-25) or their closely related variants comprised the majority of the study isolates. The spread of Spain9V-3 and its related clone of serotype 14/ST143 has remarkably contributed to the recent increase in penicillin resistance in pneumococci in the country.

scholarly journals Duodenoscope-Associated Outbreak of a Carbapenem Resistant Enterobacteriaceae

2020 ◽  
Vol 41 (S1) ◽  
pp. s197-s197
Author(s):  
Sung Ran Kim ◽  
Joon Young Song ◽  
Min Hee Cho ◽  
Ji Yeon Song
Keyword(s):  
Gel Electrophoresis ◽  
Case Control ◽  
Pulsed Field Gel Electrophoresis ◽  
Control Analysis ◽  
Endoscopic Retrograde ◽  
Carbapenem Resistant ◽  
Case Control Analysis ◽  
Record Review ◽  
Carbapenem Resistant Enterobacteriaceae ◽  
Cleaning Protocol

Background: We describe and evaluate our outbreak of carbapenem-resistant K. pneumoniae transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Methods: An outbreak investigation was performed when Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) were identified from bile specimens of 4 patients. The investigation included medical record review, practice audits, and surveillance cultures of duodenoscopes and environmental sites. If available, clinical specimens were obtained from patients who had undergone ERCP in the previous 3 months. Carbapenem-resistant Enterobacteriaceae (CRE) screening cultures were performed to identify additional patients until no CRE cases were detected during 2 consecutive weeks. Pulsed-field gel electrophoresis (PFGE) of KPC-KP isolates was implemented. Results: In total, 12 cases were identified with exposure to duodenoscope from February 2019 through April 2019, including 6 cases with infections and 6 asymptomatic carriers. Case-control analysis showed that 2 specific duodenoscopes would be associated with the KPC-KP outbreak. Duodenoscope reprocessing procedures did not deviate from manufacturer recommendations for reprocessing. After ethylene oxide (EO) gas sterilization, the outbreak was terminated. Conclusions: Meticulous cleaning protocol and enhanced surveillance are necessary to prevent outbreaks of CRE. Notably, enhanced cleaning measures, such as sterilization for duodenoscopes, would be required after procedures with KPC-KP carriers.Funding: NoneDisclosures: None

scholarly journals Application of Pulsed-Field Gel Electrophoresis and Binary Typing as Tools in Veterinary Clinical Microbiology and Molecular Epidemiologic Analysis of Bovine and HumanStaphylococcus aureus Isolates

2000 ◽  
Vol 38 (5) ◽  
pp. 1931-1939 ◽  
Author(s):  
Ruth Zadoks ◽  
Willem van Leeuwen ◽  
Herman Barkema ◽  
Otlis Sampimon ◽  
Henri Verbrugh ◽  
...  
Keyword(s):  
Host Species ◽  
Gel Electrophoresis ◽  
Genetic Relatedness ◽  
Pulsed Field Gel Electrophoresis ◽  
Simple Method ◽  
Pulsed Field ◽  
Strain Characterization ◽  
Single Host

Thirty-eight bovine mammary Staphylococcus aureusisolates from diverse clinical, temporal, and geographical origins were genotyped by pulsed-field gel electrophoresis (PFGE) afterSmaI digestion of prokaryotic DNA and by means of binary typing using 15 strain-specific DNA probes. Seven pulsed-field types and four subtypes were identified, as were 16 binary types. Concordant delineation of genetic relatedness was documented by both techniques, yet based on practical and epidemiological considerations, binary typing was the preferable method. Genotypes of bovine isolates were compared to 55 previously characterized human S. aureusisolates through cluster analysis of binary types. Genetic clusters containing strains of both human and bovine origin were found, but bacterial genotypes were predominantly associated with a single host species. Binary typing proved an excellent tool for comparison ofS. aureus strains, including methicillin-resistant S. aureus, derived from different host species and from different databases. For 28 bovine S. aureus isolates, detailed clinical observations in vivo were compared to strain typing results in vitro. Associations were found between distinct genotypes and severity of disease, suggesting strain-specific bacterial virulence. Circumstantial evidence furthermore supports strain-specific routes of bacterial dissemination. We conclude that PFGE and binary typing can be successfully applied for genetic analysis of S. aureusisolates from bovine mammary secretions. Binary typing in particular is a robust and simple method and promises to become a powerful tool for strain characterization, for resolution of clonal relationships of bacteria within and between host species, and for identification of sources and transmission routes of bovine S. aureus.

scholarly journals Surveillance of Carbapenem-Resistant Pseudomonas aeruginosa Isolates from Puerto Rican Medical Center Hospitals: Dissemination of KPC and IMP-18 β-Lactamases

2009 ◽  
Vol 53 (4) ◽  
pp. 1660-1664 ◽  
Author(s):  
Daniel J. Wolter ◽  
Noha Khalaf ◽  
Iraida E. Robledo ◽  
Guillermo J. Vázquez ◽  
Maria I. Santé ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Puerto Rican ◽  
Gel Electrophoresis ◽  
Medical Center ◽  
Pulsed Field Gel Electrophoresis ◽  
Pulsed Field ◽  
Carbapenem Resistant ◽  
Clonal Spread

ABSTRACT During a 6-month period, 37/513 (7.2%) Pseudomonas aeruginosa isolates belonging to 13 pulsed-field gel electrophoresis (PFGE) groups from Puerto Rican hospitals were carbapenem nonsusceptible. Seven of 37 isolates from four PFGE groups carried bla IMP-18, and 25/37 isolates from seven PFGE groups carried bla KPC. The results indicated the clonal spread of bla KPC-positive P. aeruginosa isolates into several Puerto Rican hospitals and the dissemination of bla IMP-18 and bla KPC into genetically unrelated isolates.

scholarly journals High Genetic Diversity ofEnterococcus faeciumandEnterococcus faecalisClinical Isolates by Pulsed-Field Gel Electrophoresis and Multilocus Sequence Typing from a Hospital in Malaysia

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Poh Leng Weng ◽  
Ramliza Ramli ◽  
Mariana Nor Shamsudin ◽  
Yoke-Kqueen Cheah ◽  
Rukman Awang Hamat
Keyword(s):  
Genetic Diversity ◽  
Gel Electrophoresis ◽  
Multilocus Sequence Typing ◽  
Genetic Relatedness ◽  
Pulsed Field Gel Electrophoresis ◽  
High Genetic Diversity ◽  
Pulsed Field ◽  
Susceptibility Profiles ◽  
Sequence Types ◽  
Multiple Antibiotics

Little is known on the genetic relatedness and potential dissemination of particular enterococcal clones in Malaysia. We studied the antibiotic susceptibility profiles ofEnterococcus faeciumandEnterococcus faecalisand subjected them to pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).E. faeciumandE. faecalisdisplayed 27 and 30 pulsotypes, respectively, and 10 representativeE. faeciumandE. faecalisisolates (five each) yielded few different sequence types (STs): ST17 (2 isolates), ST78, ST203, and ST601 forE. faecium, and ST6, ST16, ST28, ST179, and ST399 forE. faecalis. Resistance to tazobactam-piperacillin and ampicillin amongstE. faeciumisolates was highly observed as compared toE. faecalisisolates. All of the isolates were sensitive to vancomycin and teicoplanin. The presence of epidemic and nosocomial strains of selectedE. faeciumSTs: 17, 78, and 203 andE. faecalisST6 as well as high rates of resistance to multiple antibiotics amongstE. faeciumisolates is of a particular concern.

scholarly journals In Vitro and In Vivo Invasiveness of Different Pulsed-Field Gel Electrophoresis Types of Listeria monocytogenes

2002 ◽  
Vol 68 (11) ◽  
pp. 5698-5703 ◽  
Author(s):  
Charlotte Nexmann Larsen ◽  
Birgit Nørrung ◽  
Helle Mølgaard Sommer ◽  
Mogens Jakobsen
Keyword(s):  
Listeria Monocytogenes ◽  
Gel Electrophoresis ◽  
Pulsed Field Gel Electrophoresis ◽  
In Vivo Studies ◽  
Pfge Type ◽  
Pulsed Field ◽  
Lower Ability ◽  
Low Prevalence

ABSTRACT The virulence of different pulsed-field gel electrophoresis (PFGE) types of Listeria monocytogenes was examined by monitoring their ability to invade Caco-2 cells. Strains belonging to seven different PFGE types originating from both foods and humans were included. No significant differences in invasiveness were detected between strains isolated from humans and those isolated from food. Strains belonging to PFGE type 1 expressed a significantly lower ability to invade cells compared to strains belonging to other PFGE types. Although strains of PFGE type 2 also seemed to invade at a low level, this was not significant in the present study. PFGE types 1 and 2 as well as type 14 are more frequently found in food than the four other PFGE types examined and moreover have a relatively low prevalence in humans compared to their prevalence in food. Thus, the hypothesis that some PFGE types are less virulent than others is supported by this study showing that certain PFGE types of L. monocytogenes commonly found in food are less invasive than others to Caco-2 cells. In contrast to the differences in invasion, identical intracellular growth rates between the different PFGE types were observed. In vivo studies of the actual ability of the strains to invade the liver and spleen of cimetidine-treated rats following an oral dose of 109 L. monocytogenes cells were performed for isolates of PFGE types 1, 2, 5, and 15. After 2 days, equal amounts of bacteria were observed in the liver and spleen of the rats for any of the PFGE types tested.

scholarly journals Emergence of OXA-48-Type Carbapenemase-Producing Enterobacteriaceae in German Hospitals

2012 ◽  
Vol 56 (4) ◽  
pp. 2125-2128 ◽  
Author(s):  
Yvonne Pfeifer ◽  
Kathrin Schlatterer ◽  
Elisabeth Engelmann ◽  
Reinhold A. Schiller ◽  
Hans Reiner Frangenberg ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Gel Electrophoresis ◽  
Insertion Sequence ◽  
Pulsed Field Gel Electrophoresis ◽  
Mutant Form ◽  
Content Type ◽  
Point Mutant ◽  
Pulsed Field ◽  
Conjugative Plasmids ◽  
Carbapenem Resistant

ABSTRACTNine carbapenem-resistantEnterobacteriaceaeisolates collected from eight patients in five German hospitals were investigated. Six isolates produced the OXA-48 carbapenemase, and three isolates produced OXA-162, which is a point mutant form of OXA-48. Both carbapenemase genes were located on IncL/M-type conjugative plasmids. Insertion sequence IS1999(truncated or not by IS1R) was located upstream of theblaOXA-48andblaOXA-162genes in all of the isolates. Pulsed-field gel electrophoresis typing indicated the clonal transmission of an OXA-48-producingKlebsiella pneumoniaestrain in two hospitals.

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