scholarly journals Molecular Characterization of Carbapenemase Producing Klebsiella Pneumoniae Dominance of OXA-48, KPC, VIM and NDM Producers in Khartoum, Sudan

2017 ◽  
Vol 2 (3) ◽  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Clinical Samples ◽  
Medical Laboratories ◽  
Molecular Microbiology ◽  
Diffusion Technique ◽  
Carbapenemase Gene ◽  
First Time

Background and Objectives: Little is known about carbapenemase producing Klebsiella pneumoniae (CPK) in Sudan. This study aimed to determine the prevalence of CPK in a major hospital in Khartoum, Sudan between may 2015 - January 2017 and to characterize the isolates and detect the types of carbapenemase (s) they produced. Materials and Methods: The study was done in the Department of Molecular Microbiology, Faculty of Medical Laboratories Science, Al-Neleen University. All the isolates were obtained from clinical samples of patients treated inside the hospitals. Strains of K. pneumoniae resistant to at least one carbapenem (imipenem or meropenem) by using disc diffusion technique according to the CLSI guidelines were included in this study. Molecular detection of carbapenemase genes was achieved using Real-Time PCR (Sacace Biotechnologie, Italie). Results: A total 96 strains of K. pneumoniae of different non duplicated isolates were obtained from different hospitals. Seventy-two percent (70/96) isolates were positive for carbapenemase genes; 59.4% (57/96) were positive for blaKPC genes, 57.3% (55/96) were positive for blaNDM genes, 37.5% (36/96) were positive for blaVIM genes and 35.4% (34/96) were positive for blaOXA-48 genes. Nineteen isolates possessed four genes (blaKPC, blaNDM, blaVIM and blaOXA-48), fourteen isolates possessed three genes{( blaNDM, blaVIM and blaOXA-48=6), (blaKPC, blaNDM, and blaOXA-48=3), (blaKPC, blaNDM and blaVIM =3), (blaKPC, blaVIM and blaOXA-48=2)}, 27 isolates possessed two genes{( blaKPC and blaNDM =21), (blaKPC, blaOXA-48=2), (blaNDM and blaVIM =3), (blaNDM and blaOXA-48=1)}, 10 isolates possessed only one gene (blaKPC =8, blaOXA-48=1 and blaVIM =1) and the remaining 26 isolates were free from these genes. Conclusion & Recommendation: In Sudan, the most common type of carbapenemase gene multidrug-resistant K. pneumoniae is KPC. Co-production of KPC, VIM, NDM and OXA-48 genes are found in K. pneumoniae. To our knowledge, this study was done for the first time in Sudan. Therefore, it is necessary to determine carbapenem resistance in K. pneumoniae isolates and take essential infection control precautions to avoid spread of this resistance.

scholarly journals Characterization of Multidrug-resistant and Virulent Klebsiella Pneumoniae Strains Belonging to the High-risk CG258 Isolated from Inpatients in Northeastern Brazil

2021 ◽  
Author(s):  
Rafael Nakamura-Silva ◽  
Mariana Oliveira-Silva ◽  
João Pedro Rueda Furlan ◽  
Eliana Guedes Stehling ◽  
Carlos Eduardo Saraiva Miranda ◽  
...  
Keyword(s):  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Northeastern Brazil ◽  
Hospital Environment ◽  
Global Public Health ◽  
Antimicrobial Resistance Profile ◽  
First Time

Abstract Multidrug-resistant (MDR) and hypervirulent Klebsiella pneumoniae (hvKp) clones have become a major threat to global public health. The CG258 is considered a high-risk CG and the K. pneumoniae strains belonging to it are known to be often multi-resistant and to spread mainly in the hospital environment. This study aimed to characterize the antimicrobial resistance profile, virulence factors, and the clonal relationships among 13 K. pneumoniae strains belonging to CG258 from patients admitted to a tertiary hospital in Teresina, in the state of Piauí, northeastern Brazil. Ten strains were classified as MDR and three as extensively drug-resistant (XDR). Three different β-lactamase-encoding genes ( bla KPC , bla OXA-1- like , and bla CTX-M-Gp1) and six virulence genes ( fimH , ycfM , mrkD , entB , ybtS , and kfu ) were detected. Moreover, two hypermucoviscous K. pneumoniae strains and one capsular K-type 2 were found. Multilocus sequence typing analysis revealed 10 different sequence types (STs) (ST14, ST17, ST20, ST29, ST45, ST101, ST268, ST1800, ST3995, and ST3996) belonging to CG258, being two (ST3995 and ST3996) described for the first time in this study.

scholarly journals Genomic Characterization of Nonclonal mcr-1-Positive Multidrug-Resistant Klebsiella pneumoniae from Clinical Samples in Thailand

2018 ◽  
Vol 24 (4) ◽  
pp. 403-410 ◽  
Author(s):  
Apichai Srijan ◽  
Katie R. Margulieux ◽  
Sirigade Ruekit ◽  
Erik Snesrud ◽  
Rosslyn Maybank ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Clinical Samples ◽  
Genomic Characterization

scholarly journals Characterization of CTX-M-15-Klebsiella pneumoniae from inpatients and outpatients of a teaching hospital

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 444
Author(s):  
Muzaheed Muzaheed ◽  
Naveed Sattar Shaikh ◽  
Saeed Sattar Shaikh ◽  
Sadananda Acharya ◽  
Shajiya Sarwar Moosa ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Hospital Setting ◽  
Multidrug Resistant ◽  
Influential Factor ◽  
Detection Methods ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Drug Resistant Bacteria

Background  The presence of Extended-spectrum β-lactamase (ESBL) positive bacteria in hospital setting is an aggravating influential factor for hospitalized patients, and its consequences may be hazardous. Therefore, there is a need for rapid detection methods for newly emerging drug-resistant bacteria. This study was aimed at the molecular characterization of ESBL-positive Klebsiella pneumoniae isolates recovered from clinical samples.   Methods  A total of 513 K. pneumoniae isolates were obtained from various clinical samples during June 2019 to May 2020. The collected isolates were investigated for antimicrobial susceptibility (antibiogram), and PCR and DNA sequencing were performed to analyse the ESBL genes.   Results  Among the 513 isolates, as many as 359 (69.9%) were ESBL producers and 87.5% were multi-drug resistant, while none had resistance to imipenem. PCR scored 3% blaTEM, 3% blaSHV, and 60% blaCTX-M-15 genes for the tested isolates.   Conclusion  The study showed that CTX-M-15 was the major prevalent ESBL type among the isolates. Additionally, all the isolates were susceptible to carbapenems. Screening and detection of ESBL tests are necessary among all isolates from the enterobacteriaceae family in routine microbiology laboratory to prevent associated nosocomial infections. A larger study is essential to understand molecular epidemiology of ESBL producing organisms to minimize morbidities due to these multidrug resistant organisms.

scholarly journals Carbapenemase production in hospital isolates of multidrug-resistant Klebsiella pneumoniae and Escherichia coli in Serbia

2017 ◽  
Vol 74 (8) ◽  
pp. 715-721 ◽  
Author(s):  
Anika Trudic ◽  
Zora Jelesic ◽  
Mira Mihajlovic-Ukropina ◽  
Deana Medic ◽  
Branka Zivlak ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Clinical Samples ◽  
Reference Laboratory ◽  
Bacterial Strains ◽  
Beta Lactamases ◽  
E Coli ◽  
Novi Sad

Background/Aim. Carbapenem resistance has escalated in medically important enterobacteria such as Klebsiella pneumoniae and Escherichia coli worldwide. Multidrug-resistant strains represent an important source of concern as effective therapeutic options of infections they cause are limited or none. There were no comprehensive studies considering the presence of carbapenemase production in enterobacteria in Serbia so far. The aim of the study was to determine carbapenemase production in hospital isolates of multidrug-resistant K. pneumoniae and E. coli in Serbia. Methods. Strains of K. pneumoniae and E. coli resistant to at least one carbapenem (imipenem, meropenem, ertapenem) were collected from November 2013 to May 2014. Isolates were obtained from clinical samples of patients treated in 14 hospitals in Serbia. Carbapenem resistance was confirmed using phenotypic tests and polymerase chain reaction (PCR) in National Reference Laboratory for Registration and Surveillance of Antimicrobial Resistance of Bacterial Strains in Novi Sad. Results. Of 129 collected strains, 121 (93.8%) were K. pneumoniae and 8 (6.2%) were E. coli. Seventy (54.3%) strains were obtained from urine, 26 (20.2%) from blood, 19 (14.7%) from wound secretions and 14 (10.9%) from lower respiratory tract secretions. Carbapenemase genes were detected in 58 (45%) isolates. The gene bla New Delhimetallo-beta-lactamases (blaNDM) was found in 33 (27.3%) K. pneumoniae, bla oxacillinases-48 (blaOXA-48) in 10 (8.3%), bla K. pneumonia carbapenemase (blaKPC) in 1 (0.8%), and 7 (5.4%) strains harbored both blaOXA-48 and blaNDM. Seven E.coli harbored blaNDM gene. Conclusions. In Serbia, the most common type of carbapenemase in both multidrug-resistant K. pneumoniae and E. coli is NDM. Co-production of OXA-48 and NDM was found in K. pneumoniae. To our knowledge, KPC production was detected for the first time in Serbia.

scholarly journals 1280. In-Vitro Activity of Cefiderocol, Imipenem/Relebactam, & Ceftazidime/Avibactam in Ceftolozane/Tazobactam Resistant Strains of Multidrug Resistant Pseudomonas aeruginosa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S655-S655
Author(s):  
Daniel Navas ◽  
Angela Charles ◽  
Amy Carr ◽  
Jose Alexander
Keyword(s):  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Vitro Activity ◽  
Clinical Isolates ◽  
Resistance Testing ◽  
Clinical Samples ◽  
In Vitro Activity ◽  
Carbapenemase Gene ◽  
Resistant Strains

Abstract Background The activity of imipenem/relebactam (I/R), ceftazidime/avibactam (CZA) and cefiderocol (FDC) were evaluated against clinical isolates of multidrug resistant (MDR) strains of P. aeruginosa which was resistant to ceftolozane/tazobactam (C/T). The recent increase of MDR P. aeruginosa strains isolated from clinical samples has prompted research and development of new antimicrobials that can withstand its multiple resistance mechanisms. C/T is an effective option for treatment of MDR P. aeruginosa in our facility with only 10% of resistance in MDR strains, but the emergence of resistance may occur due to the presence of a carbapenemase gene or an ampC mutation. Methods Antimicrobial susceptibility testing for C/T Etest® (bioMérieux, Inc.) were performed on all MDR strains initially screened by the VITEK2® (bioMérieux, Inc.). 10% (n=20) of all MDR isolates were resistant to C/T by the CLSI 2019 breakpoints. These resistant isolates were tested for presence of a carbapenemase gene using the GeneXpert CARBA-R (Cepheid®) PCR and against CZA Etest® (bioMérieux, Inc.) I/R gradient strips (Liofilchem®) and FDC broth microdilution (Thermo Scientific™ Sensititre™). Results A total of 20 clinical isolates of MDR P. aeruginosa resistant to C/T were tested following standardized CLSI protocols and techniques. All 20 isolates were screened for the presence of a carbapenemase gene (blaVIM, blaNDM, blaKPC, blaOXA-48, blaIMP). A blaVIM gene was detected in 6 (30%) out of 20 isolates. FDC demonstrated the greatest activity with 85% (n=17) of susceptible isolates (CLSI MIC <4µg/dL). CZA (CLSI MIC <8µg/dL) and I/R (FDA MIC <2µg/dL) showed 15% (n=3) and 10% (n=2) of susceptible isolates respectively. FDC was active against all 6 blaVIM isolates, where all 6 strains were resistant to CZA and I/R as expected. 3 isolates tested non-susceptible against FDC; additional characterization was not performed at this time. Conclusion Based on these results, FDC demonstrated the greatest in-vitro activity against C/T resistant strains of MDR P. aeruginosa. FDC also demonstrated activity against all 6 MDR P. aeruginosa carrying blaVIM gene. FDC is a strong option to consider on MDR P. aeruginosa strains based on a resistance testing algorithm and a cost/effective protocol. Disclosures All Authors: No reported disclosures

scholarly journals Phenotypic Detection of Carbapenemase Production in Carbapenem-Resistant Enterobacteriaceae by Modified Hodge Test and Modified Strip Carba NP Test

2021 ◽  
Author(s):  
Nisha Patidar ◽  
Nitya Vyas ◽  
Shanoo Sharma ◽  
Babita Sharma
Keyword(s):  
Carbapenem Resistance ◽  
Nonparametric Test ◽  
Multidrug Resistant ◽  
Clinical Samples ◽  
Chi Square ◽  
Carbapenem Resistant ◽  
The Social ◽  
Significant Difference ◽  
High Degree ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Objective Carbapenems are last resort antibiotics for multidrug-resistant Enterobacteriaceae. However, resistance to carbapenem is increasing at an alarming rate worldwide leading to major therapeutic failures and increased mortality rate. Early and effective detection of carbapenemase producing carbapenem-resistant Enterobacteriaceae (CRE) is therefore key to control dissemination of carbapenem resistance in nosocomial as well as community-acquired infection. The aim of present study was to evaluate efficacy of Modified strip Carba NP (CNP) test against Modified Hodge test (MHT) for early detection of carbapenemase producing Enterobacteriaceae (CPE). Material and Methods Enterobacteriaceae isolated from various clinical samples were screened for carbapenem resistance. A total of 107 CRE were subjected to MHT and Modified strip CNP test for the detection of CPE. Statistical Analysis It was done on Statistical Package for the Social Sciences (SPSS) software, IBM India; version V26. Nonparametric test chi-square and Z-test were used to analyze the results within a 95% level of confidence. Results Out of 107 CRE, 94 (88%) were phenotypically confirmed as carbapenemase producer by Modified strip CNP test and 46 (43%) were confirmed by Modified Hodge Test (MHT). Thirty-eight (36%) isolates showed carbapenemase production by both MHT and CNP test, 56 isolates (52%) were CNP test positive but MHT negative, eight (7%) isolates were MHT positive but CNP test negative and five (5%) isolates were both MHT and CNP test negative. There is statistically significant difference in efficiency of Modified CNP test and MHT (p < 0.05). Conclusion Modified strip CNP test is simple and inexpensive test which is easy to perform and interpret and gives rapid results in less than 5 minutes. It has high degree of sensitivity and specificity. Modified strip CNP test shows significantly higher detection capacity for carbapenemase producers as compared with MHT.

scholarly journals Virulent and multidrug‐resistant Klebsiella pneumoniae from clinical samples in Balochistan

2021 ◽  
Author(s):  
Sareeen Fatima ◽  
Faiza Liaqat ◽  
Ali Akbar ◽  
Muhammad Sahfee ◽  
Abdul Samad ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Clinical Samples

Characterization of multidrug-resistant and virulent Klebsiella pneumoniae strains belonging to the high-risk clonal group 258 (CG258) isolated from inpatients in northeastern Brazil

2021 ◽  
Author(s):  
Rafael Nakamura-Silva ◽  
Mariana Oliveira-Silva ◽  
João Pedro Rueda Furlan ◽  
Eliana Guedes Stehling ◽  
Carlos Eduardo Saraiva Miranda ◽  
...  
Keyword(s):  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Northeastern Brazil ◽  
Clonal Group

scholarly journals 1348. In vitro Activity of Plazomicin, a Next-Generation Aminoglycoside, Against Carbapenemase-Producing Klebsiella pneumoniae

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S412-S413
Author(s):  
Michael R Jacobs ◽  
Caryn E Good ◽  
Ayman M Abdelhamed ◽  
Daniel D Rhoads ◽  
Kristine M Hujer ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Vitro Activity ◽  
In Vitro Activity ◽  
Next Generation ◽  
Aminoglycoside Resistance ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
Research Grant

Abstract Background Plazomicin is a next-generation aminoglycoside with in vitro activity against multidrug-resistant Gram-negative species, including carbapenem-resistant isolates. The Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE) is a federally funded, prospective multicenter consortium of 20 hospitals from nine US healthcare systems to track carbapenem-resistant Enterobacteriaceae. Methods Minimum inhibitory concentrations (MICs) of plazomicin were determined by broth microdilution according to current CLSI guidelines against a collection of 697 carbapenem-resistant Klebsiella pneumoniae with defined carbapenem resistance mechanisms, including KPC and OXA carbapenemases. Isolates were submitted by participating CRACKLE centers. Results Carbapenemases present in study isolates included KPC-2 (n = 323), KPC-3 (n = 364), KPC-4 (n = 2), OXA-48 like (n = 7), and NDM (n = 1). Plazomicin MICs ranged from ≤0.12 to &gt;32 mg/L, with MIC50 and MIC90 values of 0.25 and 1 mg/L, respectively (figure). MICs of 689 (98.8%) isolates were ≤4 mg/L, while MICs of the remaining eight isolates were &gt;32 mg/L. Plazomicin MICs were related to specific carbapenemases present in isolates: of eight isolates with MICs &gt;32 mg/L, seven contained OXA-48 like and one contained KPC-3, suggesting that these isolates possess an aminoglycoside-resistance mechanism on the same plasmid as their carbapenemase gene, such as a 16S ribosomal RNA methyltransferase, against which plazomicin is not active. Conclusion Plazomicin has good in vitro potency against a collection of carbapenemase-producing K. pneumoniae, with MIC90 value of 1 mg/L and MICs of ≤4 mg/L for 98.9% of isolates. Disclosures M. R. Jacobs, Achaogen: Investigator, Research grant. Shionogi: Investigator, Research grant. L. Connolly, Achaogen, Inc.: Consultant, Consulting fee. K. M. Krause, Achaogen: Employee, Salary. S. S. Richter, bioMerieux: Grant Investigator, Research grant. BD Diagnostics: Grant Investigator, Research grant. Roche: Grant Investigator, Research grant. Hologic: Grant Investigator, Research grant. Diasorin: Grant Investigator, Research grant. Accelerate: Grant Investigator, Research grant. Biofire: Grant Investigator, Research grant. D. Van Duin, achaogen: Scientific Advisor, Consulting fee. shionogi: Scientific Advisor, Consulting fee. Allergan: Scientific Advisor, Consulting fee. Astellas: Scientific Advisor, Consulting fee. Neumedicine: Scientific Advisor, Consulting fee. Roche: Scientific Advisor, Consulting fee. T2 Biosystems: Scientific Advisor, Consulting fee.

Sign in / Sign up

Export Citation Format

Share Document