Molecular characterization of a multidrug-resistant/pandrug-resistant nosocomial polymicrobial infection with Klebsiella pneumoniae, Providencia rettgeri, and Acinetobacter baumannii from Rural Maharashtra, India

The emergence of resistance against commonly used antibiotics has become a serious global concern. The rapid development of antibiotic resistance exhibited by Enterobacteriaceae has caused an increasing concern regarding untreatable bacterial infections. Here, we isolated four pathogens from a geriatric female patient who was hospitalized for a month with ventilator-associated pneumonia (VAP) and fever. The organisms isolated from the tracheal aspirates and urine included Klebsiella pneumoniae, pandrug-resistant Providencia rettgeri, and Acinetobacter baumannii. Resistome analysis indicated that the bacterial isolates from the polymicrobial infection were multiple-drug resitnat and pandrug resistant clones. Molecular characterization revealed presence of blaTEM-1 in K. pneumonaie, P. rettgeri and A. baumannii. The blaTEM-1 and blaNDM-1 genes were present in P. rettgeri and A. baumannii, whereas the blaTEM-1, blaNDM-1 and blaOXA-23 traits were present in A. baumannii isolates. The patient has died due to the unavailability of effective antimicrobial treatment for this drug-resistant polymicrobial infection.

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Ventilator-associated Pneumonia: Multidrug Resistant Acinetobacter vs. Extended Spectrum Beta Lactamase-producing Klebsiella

The Journal of Infection in Developing Countries ◽

10.3855/jidc.12889 ◽

2020 ◽

Vol 14 (06) ◽

pp. 660-663

Author(s):

Mohammadreza Salehi ◽

Sirous Jafari ◽

Lida Ghafouri ◽

Hossein Malekafzali Ardakani ◽

Alireza Abdollahi ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Acinetobacter Baumannii ◽

Multidrug Resistant ◽

Antimicrobial Treatment ◽

P Value ◽

Ventilator Associated Pneumonia ◽

Beta Lactamase ◽

Healthcare Associated Infection ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum

Introduction: Ventilator-associated pneumonia (VAP) has been considered as a healthcare-associated infection with high mortality. Acinetobacter baumannii and Klebsiella pneumoniae are the common causes of VAPs around the world. Methodology: This research was a retrospective observational study in the intensive care unit (ICU) in a tertiary referral collegiate hospital in Tehran between March 2016 and May 2018. Patients who fulfilled VAP due to documented Multidrug Resistant Acinetobacter baumannii (MDR-AB) or Extended Spectrum Beta Lactamase-producing Klebsiella pneumoniae (ESBL-KP) criteria were enrolled. General demographic features, duration of hospital stay, antimicrobial treatment regimens, duration of ICU admission, the period of mechanical ventilation (MV) and 30-day mortality were documented and compared. Results: 210 patients were found with clinical, microbiological and radiological evidence of VAP. In total, 76 patients with MDR-AB and 76 patients with ESBL-KP infections were matched in the final analysis. Duration of hospitalization in the patients with MDR-AB was significantly more than that of patients infected with ESBL-KP (p-value: 0.045). Patients diagnosed with MDR-AB VAP had a 65.8% mortality rate compared to 42.1% in the ESBL-KP infection group (p = 0.003). Conclusions: Results of the present study demonstrated that VAPs caused by MDR-AB may be more hazardous than ESBL-KP VAPs because they could be accompanied by a longer hospitalization course and even a higher mortality.

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Efficacy of Lysophosphatidylcholine as Direct Treatment in Combination with Colistin against Acinetobacter baumannii in Murine Severe Infections Models

Antibiotics ◽

10.3390/antibiotics10020194 ◽

2021 ◽

Vol 10 (2) ◽

pp. 194

Author(s):

Andrea Miró-Canturri ◽

Rafael Ayerbe-Algaba ◽

Manuel Enrique Jiménez-Mejías ◽

Jerónimo Pachón ◽

Younes Smani

Keyword(s):

Acinetobacter Baumannii ◽

Multidrug Resistant ◽

Experimental Models ◽

Antimicrobial Treatment ◽

Clinical Settings ◽

Monotherapy Group ◽

Bacterial Concentration ◽

Sepsis Model ◽

Severe Infections ◽

Stimulation Of

The stimulation of the immune response to prevent the progression of an infection may be an adjuvant to antimicrobial treatment. Here, we aimed to evaluate the efficacy of lysophosphatidylcholine (LPC) treatment in combination with colistin in murine experimental models of severe infections by Acinetobacter baumannii. We used the A. baumannii Ab9 strain, susceptible to colistin and most of the antibiotics used in clinical settings, and the A. baumannii Ab186 strain, susceptible to colistin but presenting a multidrug-resistant (MDR) pattern. The therapeutic efficacies of one and two LPC doses (25 mg/kg/d) and colistin (20 mg/kg/8 h), alone or in combination, were assessed against Ab9 and Ab186 in murine peritoneal sepsis and pneumonia models. One and two LPC doses combined with colistin and colistin monotherapy enhanced Ab9 and Ab186 clearance from spleen, lungs and blood and reduced mice mortality compared with those of the non-treated mice group in both experimental models. Moreover, one and two LPC doses reduced the bacterial concentration in tissues and blood in both models and increased mice survival in the peritoneal sepsis model for both strains compared with those of the colistin monotherapy group. LPC used as an adjuvant of colistin treatment may be helpful to reduce the severity and the resolution of the MDR A. baumannii infection.

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Molecular characterization of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from King Abdulaziz Specialist Hospital at Taif City, Saudi Arabia

Journal of Infection and Public Health ◽

10.1016/j.jiph.2020.12.001 ◽

2021 ◽

Vol 14 (1) ◽

pp. 143-151

Author(s):

Rihab Lagha ◽

Fethi Ben Abdallah ◽

Asmaa A.H. ALKhammash ◽

Nabil Amor ◽

Mohamed M. Hassan ◽

...

Keyword(s):

Saudi Arabia ◽

Klebsiella Pneumoniae ◽

Molecular Characterization ◽

Multidrug Resistant ◽

Clinical Isolates

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Molecular characterization of multidrug resistant strains of Acinetobacter baumannii isolated from pediatric intensive care unit in a Chinese tertiary hospital

BMC Infectious Diseases ◽

10.1186/s12879-018-3511-0 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 7

Author(s):

Yili Chen ◽

Lu Ai ◽

Penghao Guo ◽

Han Huang ◽

Zhongwen Wu ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Acinetobacter Baumannii ◽

Molecular Characterization ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Tertiary Hospital ◽

Multidrug Resistant ◽

Resistant Strains

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Isolation and Characterization of Novel Phages Targeting Pathogenic Klebsiella pneumoniae

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.792305 ◽

2021 ◽

Vol 11 ◽

Author(s):

Na Li ◽

Yigang Zeng ◽

Rong Bao ◽

Tongyu Zhu ◽

Demeng Tan ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Bacterial Infections ◽

Antimicrobial Agents ◽

Multidrug Resistant ◽

S1 Nuclease ◽

Isolation And Characterization ◽

Comprehensive Knowledge ◽

Future Challenges ◽

Lactamase Gene

Klebsiella pneumoniae is a dominant cause of community-acquired and nosocomial infections, specifically among immunocompromised individuals. The increasing occurrence of multidrug-resistant (MDR) isolates has significantly impacted the effectiveness of antimicrobial agents. As antibiotic resistance is becoming increasingly prevalent worldwide, the use of bacteriophages to treat pathogenic bacterial infections has recently gained attention. Elucidating the details of phage-bacteria interactions will provide insights into phage biology and the better development of phage therapy. In this study, a total of 22 K. pneumoniae isolates were assessed for their genetic and phenotypic relatedness by multi-locus sequence typing (MLST), endonuclease S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), and in vitro antibiotic susceptibility testing. In addition, the beta-lactamase gene (blaKPC) was characterized to determine the spread and outbreak of K. pneumoniae carbapenemase (KPC)-producing enterobacterial pathogens. Using these ST11 carbapenem-resistant K. pneumoniae isolates, three phages (NL_ZS_1, NL_ZS_2, and NL_ZS_3) from the family of Podoviridae were isolated and characterized to evaluate the application of lytic phages against the MDR K. pneumoniae isolates. In vitro inhibition assays with three phages and K. pneumoniae strain ZS15 demonstrated the strong lytic potential of the phages, however, followed by the rapid growth of phage-resistant and phage-sensitive mutants, suggesting several anti-phage mechanisms had developed in the host populations. Together, this data adds more comprehensive knowledge to known phage biology and further emphasizes their complexity and future challenges to overcome prior to using phages for controlling this important MDR bacterium.

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