scholarly journals First Detection of the Plasmid-Mediated Class A Carbapenemase KPC-2 in Clinical Isolates of Klebsiella pneumoniae from South America

2006 ◽  
Vol 50 (8) ◽  
pp. 2880-2882 ◽  
Author(s):  
Maria Virginia Villegas ◽  
Karen Lolans ◽  
Adriana Correa ◽  
Carlos Jose Suarez ◽  
Jaime A. Lopez ◽  
...  
Keyword(s):  
United States ◽  
Klebsiella Pneumoniae ◽  
South America ◽  
The United States ◽  
Clinical Isolates ◽  
Class A ◽  
Geographic Spread

ABSTRACT The plasmid-mediated class A carbapenemase KPC-2 was isolated from unrelated Klebsiella pneumoniae isolates in Medellin, Colombia. These KPC enzymes are the first from South America and the second isolation outside of the United States. The expanding geographic spread of KPC carbapenemases underscores the importance of clinical recognition of these enzymes.

scholarly journals Genome-scale metabolic modeling reveals increased reliance on valine catabolism in clinical isolates of Klebsiella pneumoniae

2021 ◽  
Author(s):  
Matthew L Jenior ◽  
Mary E Dickenson ◽  
Jason A Papin
Keyword(s):  
United States ◽  
Klebsiella Pneumoniae ◽  
Clinical Isolate ◽  
In Silico ◽  
Meta Analysis ◽  
The United States ◽  
Hospitalized Patients ◽  
Clinical Isolates ◽  
Macrophage Phagocytosis ◽  
Context Specific

AbstractInfections due to carbapenem-resistant Enterobacteriaceae have recently emerged as one of the most urgent threats to hospitalized patients within the United States and Europe. By far the most common etiological agent of these infections is Klebsiella pneumoniae, frequently manifesting in hospital-acquired pneumonia with a mortality rate of ∼50% even with antimicrobial intervention. We performed transcriptomic analysis of data collected from in vitro characterization of both laboratory and clinical isolates revealed shifts in expression of multiple master metabolic regulators across isolate types. Metabolism has been previously shown to be an effective target for antibacterial therapy, and GENREs have provided a powerful means to accelerate identification of potential targets in silico. Combining these techniques with the transcriptome meta-analysis, we generated context-specific models of metabolism utilizing a well-curated GENRE of K. pneumoniae (iYL1228) to identify novel therapeutic targets. Functional metabolic analyses revealed that both composition and metabolic activity of clinical isolate-associated context-specific models significantly differs from laboratory isolate-associated models of the bacterium. Additionally, we identified increased consumption of L-valine in clinical isolate-specific growth simulations. Importantly, valine has been shown to augment macrophage phagocytosis, and this result could be indicative of an immunosuppressive strategy Klebsiella pneumoniae evolved for survival during infection. These findings warrant future studies for potential efficacy of valine transaminase inhibition as a target against K. pneumoniae infection.ImportanceIncidences of infection by Klebsiella pneumoniae have grown in frequency to become the leading agents of CRE infection among hospitalized patients in the United States and Europe. Transcriptomic meta-analysis of data collected from both laboratory and clinical isolates indicated significant shifts in expression of key transcription factors related to metabolism. Metabolic network reconstructions have previously proven effective for quickly identifying potential targets in silico, therefore we combined these approaches by integrating the transcriptomic data from each isolate type into a well-curated GENRE of K. pneumoniae to predict emergent metabolic patterns. Leveraging this systems-biology approach we found discordant patterns of active metabolism between clinical and laboratory isolates, with a striking difference in L-valine catabolism. Exogenous valine is known to increase macrophage phagocytosis, and our results may support immunomodulatory activity in K. pneumoniae evolved to avoid host clearance.

scholarly journals Emerging Plasmid-Mediated Quinolone Resistance Associated with the qnr Gene in Klebsiella pneumoniae Clinical Isolates in the United States

2004 ◽  
Vol 48 (4) ◽  
pp. 1295-1299 ◽  
Author(s):  
Minggui Wang ◽  
Daniel F. Sahm ◽  
George A. Jacoby ◽  
David C. Hooper
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Plasmid Dna ◽  
Southern Hybridization ◽  
The United States ◽  
Quinolone Resistance ◽  
Clinical Isolates ◽  
E Coli ◽  
Agarose Gels

ABSTRACT Although quinolone resistance commonly results from chromosomal mutation, recent studies indicate that such resistance can also be transferred on plasmids carrying the gene responsible, qnr. One hundred ten ciprofloxacin-resistant clinical isolates of Klebsiella pneumoniae and Escherichia coli from the United States were screened for the qnr gene by PCR and Southern hybridization of plasmid DNA. Conjugation experiments were done with azide-resistant E. coli J53 as the recipient and selection with azide and sulfonamide, a resistance frequently linked to qnr. EcoRI and BamHI digests of qnr-hybridizing plasmids were subjected to electrophoresis on agarose gels and probed with qnr by Southern hybridization. qnr was detected in 8 (11.1%) of 72 K. pneumoniae strains. These eight positive strains were from six states in the United States. qnr was not found in any of the 38 E. coli strains tested. Quinolone resistance was transferred from seven of the eight probe-positive strains. Transconjugants with qnr-hybridizing plasmids had 32-fold increases in ciprofloxacin MICs relative to E. coli J53. For all eight strains, the sequence of qnr was identical to that originally reported. By size and restriction digests, four plasmids were related to the first-reported plasmid, pMG252, and three were different. Five new qnr plasmids encoded FOX-5 β-lactamase, as did pMG252, but two others produced SHV-7 extended-spectrum β-lactamase. Transferable plasmid-mediated quinolone resistance associated with qnr is now widely distributed in quinolone-resistant clinical strains of K. pneumoniae in the United States. Plasmid-determined quinolone resistance contributes to the increasing quinolone resistance of K. pneumoniae isolates and to the linkage previously observed between resistance to quinolones and the latest β-lactam antibiotics.

scholarly journals 597. Cross-resistance of Ceftolozane-Tazobactam and Imipenem-Relebactam Against Clinical P. aeruginosa Isolates: SMART United States 2016–2018

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S281-S281
Author(s):  
Sibylle Lob ◽  
Krystyna Kazmierczak ◽  
Daryl DePestel ◽  
Janet Raddatz ◽  
Katherine Young ◽  
...  
Keyword(s):  
United States ◽  
Treatment Options ◽  
Significant Proportion ◽  
The United States ◽  
Clinical Isolates ◽  
Cross Resistance ◽  
Surveillance Program ◽  
Class A ◽  
Smart Surveillance ◽  
Tract Infections

Abstract Background Ceftolozane-tazobactam (C/T) is an antipseudomonal cephalosporin combined with a β-lactamase inhibitor. The combination was cleared by FDA and EMA and is approved in the United States and over 60 countries worldwide. Relebactam (REL) is an inhibitor of class A and C β-lactamases that is in clinical development in combination with imipenem (IMI). Using clinical isolates collected in the United States as part of the global SMART surveillance program, we compared the activity of C/T and IMI/REL against P. aeruginosa (PA) isolates. Methods In 2016–2018, 29 clinical laboratories from the United States collected up to 250 consecutive, aerobic or facultatively anaerobic, gram-negative pathogens (GNP) from blood, intra-abdominal, urinary, and lower respiratory tract infections. A total of 14,606 GNP were collected, of which 2,774 were PA. MICs were determined using CLSI broth microdilution and interpreted with CLSI 2019 breakpoints; IMI breakpoints were used for IMI/REL. Results The activity of C/T and IMI/REL against 2,774 PA is shown (table). Among all PA, 1.8% of isolates were nonsusceptible (NS) to both agents; 4.4% were susceptible (S) to C/T but not to IMI/REL, and 2.9% were susceptible to IMI/REL but not to C/T. Among the subset of isolates collected from patients in ICUs (n = 827), 87.3% were susceptible to both C/T and IMI/REL, 2.7% were nonsusceptible to both agents, 5.8% of isolates were susceptible only to C/T, and 4.2% of isolates were susceptible only to IMI/REL. Among all C/T-NS isolates (all patient locations, n = 132), 61.4% were IMI/REL-S and <30% were susceptible to all other studied β-lactams and fluoroquinolones. Among all IMI/REL-NS isolates (n = 173), 70.5% were C/T-S and <36% were susceptible to all other studied β-lactams and fluoroquinolones. Of the tested agents, only amikacin and colistin exceeded the activity of C/T or IMI/REL against these NS subsets. Conclusion Resistance to C/T or IMI/REL was not common among recent clinical isolates of PA collected in the United States, and both agents promise to be important treatment options. A significant proportion of isolates nonsusceptible to one agent was susceptible to the other, especially among isolates from patients in ICUs. The data suggest that susceptibility to both agents should be tested at hospitals. Disclosures All authors: No reported disclosures.

scholarly journals Extended-Spectrum β-Lactamases in Klebsiella pneumoniae Bloodstream Isolates from Seven Countries: Dominance and Widespread Prevalence of SHV- and CTX-M-Type β-Lactamases

2003 ◽  
Vol 47 (11) ◽  
pp. 3554-3560 ◽  
Author(s):  
David L. Paterson ◽  
Kristine M. Hujer ◽  
Andrea M. Hujer ◽  
Bethany Yeiser ◽  
Michael D. Bonomo ◽  
...  
Keyword(s):  
United States ◽  
South Africa ◽  
Klebsiella Pneumoniae ◽  
South America ◽  
Clinical Microbiology ◽  
The United States ◽  
Esbl Production ◽  
Extended Spectrum ◽  
Huge Variety

ABSTRACT A huge variety of extended-spectrum β-lactamases (ESBLs) have been detected during the last 20 years. The majority of these have been of the TEM or SHV lineage. We have assessed ESBLs occurring among a collection of 455 bloodstream isolates of Klebsiella pneumoniae, collected from 12 hospitals in seven countries. Multiple β-lactamases were produced by isolates with phenotypic evidence of ESBL production (mean of 2.7 β-lactamases per isolate; range, 1 to 5). SHV-type ESBLs were the most common ESBL, occurring in 67.1% (49 of 73) of isolates with phenotypic evidence of ESBL production. In contrast, TEM-type ESBLs (TEM-10 type, -12 type, -26 type, and -63 type) were found in just 16.4% (12 of 73) of isolates. The finding of TEM-10 type and TEM-12 type represents the first detection of a TEM-type ESBL in South America. PER (for Pseudomonas extended resistance)-type β-lactamases were detected in five of the nine isolates from Turkey and were found with SHV-2-type and SHV-5-type ESBLs in two of the isolates. CTX-M-type ESBLs (bla CTX-M-2 type and bla CTX-M-3 type) were found in 23.3% (17 of 73) of isolates and were found in all study countries except for the United States. We also detected CTX-M-type ESBLs in four countries where they have previously not been described—Australia, Belgium, Turkey, and South Africa. The widespread emergence and proliferation of CTX-M-type ESBLs is particularly noteworthy and may have important implications for clinical microbiology laboratories and for physicians treating patients with serious K. pneumoniae infections.

scholarly journals Plasmid-Mediated KPC-2 in a Klebsiella pneumoniae Isolate from China

2006 ◽  
Vol 51 (2) ◽  
pp. 763-765 ◽  
Author(s):  
Ze-Qing Wei ◽  
Xiao-Xing Du ◽  
Yun-Song Yu ◽  
Ping Shen ◽  
Ya-Gang Chen ◽  
...  
Keyword(s):  
United States ◽  
Klebsiella Pneumoniae ◽  
The United States ◽  
Resistant Isolate ◽  
Genetic Environment ◽  
Class A ◽  
Carbapenem Resistant

ABSTRACT A carbapenem-resistant isolate of Klebsiella pneumoniae producing class A carbapenemase KPC-2 was identified in Zhejiang, China. The KPC-2 gene was located on an approximately 60-kb plasmid in a genetic environment partially different from that of bla KPC-2 in the isolates from the United States and Colombia.

scholarly journals 1675. Epidemiology of Urinary Tract Infections in the United States, 2009 - 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S823-S823
Author(s):  
Kendra Foster ◽  
Linnea A Polgreen ◽  
Brett Faine ◽  
Philip M Polgreen
Keyword(s):  
United States ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Proteus Mirabilis ◽  
Antibiotic Use ◽  
The United States ◽  
Drug Resistant ◽  
E Coli ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections. There is a lack of large epidemiologic studies evaluating the etiologies of UTIs in the United States. This study aimed to determine the prevalence of different UTI-causing organisms and their antimicrobial susceptibility profiles among patients being treated in a hospital setting. Methods We used the Premier Healthcare Database. Patients with a primary diagnosis code of cystitis, pyelonephritis, or urinary tract infection and had a urine culture from 2009- 2018 were included in the study. Both inpatients and patients who were only treated in the emergency department (ED) were included. We calculated descriptive statistics for uropathogens and their susceptibilities. Multi-drug-resistant pathogens are defined as pathogens resistant to 3 or more antibiotics. Resistance patterns are also described for specific drug classes, like resistance to fluoroquinolones. We also evaluated antibiotic use in this patient population and how antibiotic use varied during the hospitalization. Results There were 640,285 individuals who met the inclusion criteria. Females make up 82% of the study population and 45% were age 65 or older. The most common uropathogen was Escherichia Coli (64.9%) followed by Klebsiella pneumoniae (8.3%), and Proteus mirabilis (5.7%). 22.2% of patients were infected with a multi-drug-resistant pathogen. We found that E. Coli was multi-drug resistant 23.8% of the time; Klebsiella pneumoniae was multi-drug resistant 7.4%; and Proteus mirabilis was multi-drug resistant 2.8%. The most common antibiotics prescribed were ceftriaxone, levofloxacin, and ciprofloxacin. Among patients that were prescribed ceftriaxone, 31.7% of them switched to a different antibiotic during their hospitalization. Patients that were prescribed levofloxacin and ciprofloxacin switched to a different antibiotic 42.8% and 41.5% of the time, respectively. Conclusion E. Coli showed significant multidrug resistance in this population of UTI patients that were hospitalized or treated within the ED, and antibiotic switching is common. Disclosures All Authors: No reported disclosures

Detection of Virulence Plasmid–Encoded Genes in Salmonella Typhimurium and Salmonella Kentucky Isolates Recovered from Commercially Processed Chicken Carcasses

2019 ◽  
Vol 82 (8) ◽  
pp. 1364-1368 ◽  
Author(s):  
RIZWANA TASMIN ◽  
PAUL A. GULIG ◽  
SALINA PARVEEN
Keyword(s):  
United States ◽  
Salmonella Typhimurium ◽  
Virulence Genes ◽  
Salmonella Enterica Serovar Typhimurium ◽  
The United States ◽  
Clinical Isolates ◽  
Virulence Plasmid ◽  
Chicken Carcass ◽  
Serovar Typhimurium ◽  
Salmonella Virulence

ABSTRACT Salmonella enterica serovar Typhimurium is one of the leading causes of nontyphoidal gastroenteritis of humans in the United States. Commercially processed poultry carcasses are frequently contaminated with Salmonella serovar Kentucky in the United States. The aim of the study was to detect the Salmonella virulence plasmid containing the spv genes from Salmonella isolates recovered from commercially processed chicken carcasses. A total of 144 Salmonella isolates (Salmonella Typhimurium, n = 72 and Salmonella Kentucky, n = 72) were used for isolation of plasmids and detection of corresponding virulence genes (spvA, spvB, and spvC). Only four (5.5%) Salmonella Typhimurium isolates tested positive for all three virulence genes and hence were classified as possessing the virulence plasmid. All isolates of Salmonella Kentucky were negative for the virulence plasmid and genes. These results indicate that the virulence plasmid, which is very common among clinical isolates of Typhimurium and other Salmonella serovars (e.g., Enteritidis, Dublin, Choleraesuis, Gallinarum, Pullorum, and Abortusovis), may not be present in a significant portion of commercially processed chicken carcass isolates.

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