scholarly journals Epidemiologic Patterns and Clinical Implications of Genotypic Resistance Mechanism for Carbapenem-Resistant Enterobacteriaceae (CRE)Surveillance Isolates from Los Angeles County

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S288-S288
Author(s):  
Sandeep Bhaurla ◽  
James A Mckinnell ◽  
Patricia Marquez ◽  
Marcelo Moran ◽  
Audrey Manalo ◽  
...  
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Resistance Mechanism ◽  
Clinical Implications ◽  
Genotypic Resistance ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

scholarly journals THE FIRST INVESTIGATION OF AAC(6’)-Ib ENZYME IN CARBAPENEM-RESISTANT ENTEROBACTERIACEAE ISOLATED FROM INDONESIAN PATIENTS

2019 ◽  
Vol 2 (1) ◽  
pp. 8-14
Author(s):  
Beauty Novianty ◽  
Ella Amalia ◽  
Ziske Maritska ◽  
Yuwono Yuwono ◽  
Lusia Hayati
Keyword(s):  
Resistance Mechanism ◽  
Test Results ◽  
Gram Negative ◽  
Therapy Options ◽  
The Past ◽  
Carbapenem Resistant ◽  
Long Time ◽  
Pcr Method ◽  
Vitek 2 ◽  
Carbapenem Resistant Enterobacteriaceae

Background: Over the past decade, numbers of Carbapenemase Producing-Carbapenem Resistant Enterobacteriaceae (CP-CRE) has been increasing worldwide and it has been becoming a threat because of its resistance against carbapenem which is considered as the “last resort” antibiotic. Therapy options for its infection are still limited. Aminoglycoside serves as one of the most commonly used antibiotics, but the resistance against it has already been presented for a long time. Aminoglycoside Modifying Enzyme (AME) is the most important resistance mechanism against aminoglycoside. AAC(6’)-Ib enzyme is one of the most common AME produced by the gram-negative bacteria.Objectives: This study wished to identify the gene of this enzyme among CRE isolated from infected Indonesian patients in Dr. Mohammad Hoesin Hospital Palembang.Methods: Twenty-eight isolates collected from CRE-infected patients identified by Vitek 2 Compact (bioMerieux, USA) in dr. Mohammad Hoesin Hospital Palembang during September—November 2017. AAC(6’)-Ib gene was identified using PCR method, then visualize by electrophoresis. The result is then analyzed by comparing it with a susceptibility test.  Results: Out of 28 samples, AAC(6’)-Ib is identified in 22 (78.57%) samples. Samples with AAC(6’)-Ib showed to be less resistant to various antibiotics, significantly to amikacin (p=0.023).Conclusion: AAC(6’)-Ib gene is found in most of samples implying its frequent occurrence in Indonesian patients.

scholarly journals NDM Production as a Dominant Feature in Carbapenem-Resistant Enterobacteriaceae Isolates from a Tertiary Care Hospital

Antibiotics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 48
Author(s):  
Fakhur Uddin ◽  
Syed Hadi Imam ◽  
Saeed Khan ◽  
Taseer Ahmed Khan ◽  
Zulfiqar Ahmed ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resistance Mechanism ◽  
Enterobacter Cloacae ◽  
Care Hospital ◽  
Healthcare Settings ◽  
Carbapenem Resistant ◽  
Potential Source ◽  
Dominant Feature ◽  
Carbapenem Resistant Enterobacteriaceae

The worldwide spread and increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is of utmost concern and a problem for public health. This resistance is mainly conferred by carbapenemase production. Such strains are a potential source of outbreaks in healthcare settings and are associated with high rates of morbidity and mortality. In this study, we aimed to determine the dominance of NDM-producing Enterobacteriaceae at a teaching hospital in Karachi. A total of 238 Enterobacteriaceae isolates were collected from patients admitted to Jinnah Postgraduate Medical Centre (Unit 4) in Karachi, Pakistan, a tertiary care hospital. Phenotypic and genotypic methods were used for detection of metallo-β-lactamase. Out of 238 isolates, 52 (21.8%) were CRE and 50 isolates were carbapenemase producers, as determined by the CARBA NP test; two isolates were found negative for carbapenemase production by CARB NP and PCR. Four carbapenemase-producing isolates phenotypically appeared negative for metallo-β-lactamase (MBL). Of the 52 CRE isolates, 46 (88.46%) were blaNDM positive. Most of the NDM producers were Klebsiella pneumoniae, followed by Enterobacter cloacae and Escherichia coli. In all the NDM-positive isolates, the blaNDM gene was found on plasmid. These isolates were found negative for the VIM and IPM MBLs. All the CRE and carbapenem-sensitive isolates were sensitive to colistin. It is concluded that the NDM is the main resistance mechanism against carbapenems and is dominant in this region.

scholarly journals 2411. Expanded Susceptibility and Resistance Mechanism Testing Among Carbapenem-Resistant Enterobacteriaceae in Connecticut, 2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S721-S721 ◽  
Author(s):  
Amanda Durante ◽  
Meghan Maloney ◽  
Vivian Leung ◽  
Bobbie Macierowski ◽  
Diane Noel ◽  
...  
Keyword(s):  
Resistance Mechanism ◽  
Carbapenem Resistant ◽  
Susceptibility And Resistance ◽  
Carbapenem Resistant Enterobacteriaceae

scholarly journals Comparing the Outcomes of Patients With Carbapenemase-Producing and Non-Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae Bacteremia

2016 ◽  
Vol 64 (3) ◽  
pp. 257-264 ◽  
Author(s):  
Pranita D Tamma ◽  
Katherine E Goodman ◽  
Anthony D Harris ◽  
Tsigereda Tekle ◽  
Ava Roberts ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Resistance Mechanism ◽  
Severity Of Illness ◽  
Carbapenem Resistance ◽  
Resistance Mechanisms ◽  
P Value ◽  
Carbapenem Resistant ◽  
Type 3 ◽  
Encoding Genes ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) are associated with considerable mortality. As mechanisms of carbapenem resistance are heterogeneous, it is unclear if mortality differs based on resistance mechanisms. We sought to determine whether CRE resistance mechanism determination is prognostically informative. Methods We conducted an observational study comparing 14-day mortality between patients with carbapenemase-producing (CP)-CRE compared with non-CP-CRE bacteremia. Clinical data were collected on all patients. A comprehensive DNA microarray-based assay was performed on all isolates to identify β-lactamase-encoding genes. Results There were 83 unique episodes of monomicrobial CRE bacteremia during the study period: 37 (45%) CP-CRE and 46 (55%) non-CP-CRE. The majority of CP-CRE isolates were blaKPC (92%), followed by blaNDM (5%) and blaOXA-48-type (3%). CP-CRE isolates were more likely to have meropenem minimum inhibitory concentrations (MICs) ≥16 µg/mL, while non-CP-CRE isolates were more likely to have meropenem MICs ≤1 µg/mL (P value < .001). A total of 18 (22%) patients died within 14 days, including 12 (32%) in the CP-CRE group and 6 (13%) in the non-CP-CRE group. Adjusting for severity of illness on day 1 of bacteremia, underlying medical conditions, and differences in antibiotic treatment administered, the odds of dying within 14 days were more than 4 times greater for CP-CRE compared with non-CP-CRE bacteremic patients (adjusted odds ratio, 4.92; 95% confidence interval, 1.01–24.81). Conclusion Our findings suggest that CP-CRE may be more virulent than non-CP-CRE and are associated with poorer outcomes. This underscores the added importance of delineating underlying resistance mechanisms of CRE to direct antibiotic treatment decisions.

Population-Based Incidence of Carbapenem-Resistant Klebsiella pneumoniae along the Continuum of Care, Los Angeles County

2013 ◽  
Vol 34 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Patricia Marquez ◽  
Dawn Terashita ◽  
David Dassey ◽  
Laurene Mascola
Keyword(s):  
Los Angeles ◽  
Klebsiella Pneumoniae ◽  
Los Angeles County ◽  
Case Reports ◽  
Continuum Of Care ◽  
Multidrug Resistant ◽  
Population Based ◽  
Case Definition ◽  
Carbapenem Resistant ◽  
The Continuum

Objective.Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging multidrug-resistant pathogen associated with higher mortality, longer hospital stays, and increased costs. CRKP was thought to be sporadic in Los Angeles County (LAC); however, the actual incidence is unknown. To address this, LAC declared CRKP a laboratory-reportable disease on June 1, 2010.Design.Laboratory-based community-wide surveillance.Patients.Any individual who was identified as CRKP positive. CRKP was defined as a K. pneumoniae isolate resistant to all carbapenems by 2010 Clinical and Laboratory Standards Institute criteria.Methods.Laboratory directors of 102 LAC acute care hospitals (ACHs) and 5 reference laboratories were to submit susceptibility testing results for all CRKP-positive specimens. Positive specimens from the same patient within the same calendar month of previous culture were excluded.Results.A total of 814 reports were received from June 1, 2010, through May 31, 2011, from 69 laboratories; 675 (83%) met the case definition. Cases were reported from ACHs (387 [57%]), long-term ACHs (LTACs; 231 [34%]), and skilled nursing facilities (57 [8%]); an outbreak in 1 LTAC was identified. The pooled mean incidence rate in LAC ACHs and LTACs was 0.46 per 1,000 patient-days; the rate in LTACs (2.54 per 1,000 patient-days) was higher than that in ACHs (0.31 per 1,000 patient-days; P < .001). Sixty-five individuals had multiple incidences, accounting for 147 case reports.Conclusion.CRKP is more present in LAC than suspected. Rates were consistently higher in LTACs than in ACHs. Heightened awareness of this problem is needed in all LAC healthcare facilities, as patients access services along the continuum of care.

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