scholarly journals Rapid Detection of Imipenem Resistance in Gram-Negative Bacteria Using Tabletop Scanning Electron Microscopy: A Preliminary Evaluation

2021 ◽  
Vol 12 ◽  
Author(s):  
Gabriel Haddad ◽  
Anthony Fontanini ◽  
Sara Bellali ◽  
Tatsuki Takakura ◽  
Yusuke Ominami ◽  
...  
Keyword(s):  
Bacterial Resistance ◽  
Morphological Changes ◽  
Carbapenem Resistance ◽  
Preliminary Evaluation ◽  
Gram Negative Bacteria ◽  
Blind Test ◽  
Gram Negative ◽  
Length Width ◽  
Imipenem Resistance ◽  
Scanning Electron

Background: Enabling faster Antimicrobial Susceptibility Testing (AST) is critical, especially to detect antibiotic resistance, to provide rapid and appropriate therapy and to improve clinical outcomes. Although several standard and automated culture-based methods are available and widely used, these techniques take between 18 and 24 h to provide robust results. Faster techniques are needed to reduce the delay between test and results.Methods: Here we present a high throughput AST method using a new generation of tabletop scanning electron microscope, to evaluate bacterial ultra-structural modifications associated with susceptibilities to imipenem as a proof of concept. A total of 71 reference and clinical strains of Gram-negative bacteria were used to evaluate susceptibility toward imipenem after 30, 60, and 90 min of incubation. The length, width and electron density of bacteria were measured and compared between imipenem susceptible and resistant strains.Results: We correlated the presence of these morphological changes to the bacterial susceptibility and their absence to the bacterial resistance (e.g., Pseudomonas aeruginosa length without [2.24 ± 0.61 μm] and with [2.50 ± 0.68 μm] imipenem after 30 min [p = 3.032E-15]; Escherichia coli width without [0.92 ± 0.07 μm] and with [1.28 ± 0.19 μm] imipenem after 60 min [p = 1.242E-103]). We validated our method by a blind test on a series of 58 clinical isolates where all strains were correctly classified as susceptible or resistant toward imipenem.Conclusion: This method could be a potential tool for rapidly identifying carbapenem-resistance in Enterobacterales in clinical microbiology laboratories in <2 h, allowing the empirical treatment of patients to be rapidly adjusted.

Changes of imipenem resistance in gram-negative bacteria during 2007-2011

2013 ◽  
Vol 32 (12) ◽  
pp. 1391-1392
Author(s):  
Rui-zhen SUN ◽  
Zhu-lin PAN ◽  
Yang YANG ◽  
Ben-hua JIN ◽  
Da-hai TANG
Keyword(s):  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Imipenem Resistance

scholarly journals Utilization of Vector Autoregressive and Linear Transfer Models to Follow Up the Antibiotic Resistance Spiral in Gram-negative Bacteria From Cephalosporin Consumption to Colistin Resistance

2018 ◽  
Vol 69 (8) ◽  
pp. 1410-1421 ◽  
Author(s):  
Hajnalka Tóth ◽  
Adina Fésűs ◽  
Orsolya Kungler-Gorácz ◽  
Bence Balázs ◽  
László Majoros ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Carbapenem Resistance ◽  
Gram Negative Bacteria ◽  
Vicious Cycle ◽  
Var Models ◽  
Gram Negative ◽  
Vector Autoregressive ◽  
E Coli ◽  
Cephalosporin Resistance ◽  
Klebsiella Spp

Abstract Background Increasing antibiotic resistance may reciprocally affect consumption and lead to use of broader-spectrum alternatives; a vicious cycle that may gradually limit therapeutic options. Our aim in this study was to demonstrate this vicious cycle in gram-negative bacteria and show the utility of vector autoregressive (VAR) models for time-series analysis in explanatory and dependent roles simultaneously. Methods Monthly drug consumption data in defined daily doses per 100 bed-days and incidence densities of gram-negative bacteria (Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter baumannii) resistant to cephalosporins or to carbapenems were analyzed using VAR models. These were compared to linear transfer models used earlier. Results In case of all gram-negative bacteria, cephalosporin consumption led to increasing cephalosporin resistance, which provoked carbapenem use and consequent carbapenem resistance and finally increased colistin consumption, exemplifying the vicious cycle. Different species were involved in different ways. For example, cephalosporin-resistant Klebsiella spp. provoked carbapenem use less than E. coli, and the association between carbapenem resistance of P. aeruginosa and colistin use was weaker than that of A. baumannii. Colistin use led to decreased carbapenem use and decreased carbapenem resistance of P. aeruginosa but not of A. baumannii. Conclusions VAR models allow analysis of consumption and resistance series in a bidirectional manner. The reconstructed resistance spiral involved cephalosporin use augmenting cephalosporin resistance primarily in E. coli. This led to increased carbapenem use, provoking spread of carbapenem-resistant A. baumannii and consequent colistin use. Emergence of panresistance is fueled by such antibiotic-resistance spirals.

scholarly journals Prevalence of Carbapenem Resistance among Gram-Negative Bacteria in a Tertiary Care Hospital in North-East India

2014 ◽  
Vol 13 (12) ◽  
pp. 56-60 ◽  
Author(s):  
Dr. Ph. Henkhoneng Mate ◽  
◽  
Dr. Kh Sulochana Devi ◽  
Dr. Ksh Mamta Devi ◽  
Dr. San Damrolien ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
North East India ◽  
North East

scholarly journals An overview of carbapenem, its resistance and therapeutic options for infections caused by carbapenem resistant bacteria

2020 ◽  
Vol 9 (9) ◽  
pp. 1454
Author(s):  
Hari P. Nepal ◽  
Rama Paudel
Keyword(s):  
Bacterial Infections ◽  
Carbapenem Resistance ◽  
Therapeutic Options ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Beta Lactam ◽  
Gram Negative ◽  
Penicillin Binding Proteins ◽  
Carbapenem Resistant ◽  
The World

Carbapenems are beta-lactam drugs that have broadest spectrum of activity. They are commonly used as the drugs of last resort to treat complicated bacterial infections. They bind to penicillin binding proteins (PBPs) and inhibit cell wall synthesis in bacteria. Important members that are in clinical use include doripenem, ertapenem, imipenem, and meropenem. Unlike other members, imipenem is hydrolyzed significantly by renal dehydropeptidase; therefore, it is administered together with an inhibitor of renal dehydropeptidase, cilastatin. Carbapenems are usually administered intravenously due to their low oral bioavailability. Most common side effects of these drugs include nausea, vomiting, diarrhea, skin rashes, and reactions at the infusion sites. Increasing resistance to these antibiotics is being reported throughout the world and is posing a threat to public health.  Primary mechanisms of carbapenem resistance include expulsion of drug and inactivation of the drug by production of carbapenemases which may not only hydrolyze carbapenem, but also cephalosporin, penicillin, and aztreonam. Resistance especially among Gram negative bacteria is of much concern since there are only limited therapeutic options available for infections caused by carbapenem resistant Gram-negative bacterial pathogens. Commonly used drugs to treat such infections include polymyxins, fosfomycin and tigecycline.

Determination of carbapenemase genes in clinical isolates using Cepheid Xpert Carba-R

2021 ◽  
pp. 16-19
Author(s):  
N. I. Gabrielyan ◽  
V. G. Kormilitsyna ◽  
V. K. Zaletaeva ◽  
A. V. Krotevich ◽  
I. A. Miloserdov ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Infection Control ◽  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Critical Issue ◽  
Sensitivity Study ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Carbapenem Resistant

Detection of carbapenem resistance genes is a critical issue for hospitals due to possible recommendations for infection control and targeted therapy. The Cepheid Xpert instrument, a Carba-R test for the detection and differentiation of five common carbapenemase genes, was tested from September 2020 to February 2021. As part of the approbation, 20 tests were provided. This review presents the results of the approbation of a relatively regular sensitivity study on Siemens WalkAway‑96 plus. Cepheid Xpert Carba-R analysis has been shown to be an accurate and fast tool for detecting colonization by carbapenem-resistant gram-negative bacteria, which can help limit the spread of these organisms in hospitals.

scholarly journals Antimicrobial functional divergence of the cecropin antibacterial peptide gene family in Musca domestica

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Jian Peng ◽  
Zhaoying Wu ◽  
Weiwei Liu ◽  
Huiling Long ◽  
Guiming Zhu ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Musca Domestica ◽  
Morphological Changes ◽  
Functional Divergence ◽  
Membrane Integrity ◽  
Gram Negative Bacteria ◽  
Dependent Manner ◽  
Antibacterial Effects ◽  
Gram Negative ◽  
Absorbing Material

Abstract Background It has been reported that there are more than ten antimicrobial peptides (AMPs) belonging to the cecropin family in Musca domestica; however, few of them have been identified, and the functions of the other molecules are poorly understood. Methods Sequences of the M. domestica cecropin family of genes were cloned from cDNA template, which was reverse-transcribed from total mRNA isolated from third-instar larvae of M. domestica that were challenged with pathogens. Sequence analysis was performed using DNAMAN comprehensive analysis software, and a molecular phylogenetic tree of the cecropin family was constructed using the Neighbour-Joining method in MEGA v.5.0 according to the mature peptide sequences. Antibacterial activity of the synthetic M. domestica cecropin protein was detected and the minimum inhibitory concentration (MIC) values were determined using broth microdilution techniques. Time-killing assays were performed on the Gram-negative bacteria, Acinetobacter baumannii, at the logarithmic or stabilizing stages of growth, and its morphological changes when treated with Cec4 were assessed by scanning electron microscopy (SEM) and detection of leakage of 260 nm absorbing material. Results Eleven cecropin family genes, namely Cec01, Cec02 and Cec1-9, show homology to the Cec form in a multigene family on the Scaffold18749 of M. domestica. In comparing the encoded cecropin protein sequences, most of them have the basic characteristics of the cecropin family, containing 19 conservative amino acid residues. To our knowledge, this is the first experimental demonstration that most genes in the Cec family are functional. Cec02, Cec1, Cec2, Cec5 and Cec7 have similar antibacterial spectra and antibacterial effects against Gram-negative bacteria, while Cec4 displays a more broad-spectrum of antimicrobial activity and has a very strong effect on A. baumannii. Cec4 eliminated A. baumannii in a rapid and concentration-dependent manner, with antibacterial effects within 24 h at 1× MIC and 2× MIC. Furthermore, SEM analysis and the leakage of 260 nm absorbing material detection indicated that Cec4 sterilized the bacteria through the disruption of cell membrane integrity. Conclusions Although there are more than ten cecropin genes related to M. domestica, some of them have no preferred antibacterial activity other than Cec4 against A. baumannii.

scholarly journals CONSUMPTION AND BACTERIAL RESISTANCE TO AMINOGLYCOSIDES AT SUDANESE UNIVERSITY HOSPITAL

2018 ◽  
Vol 11 (8) ◽  
pp. 434
Author(s):  
Einas A Bakheit ◽  
Kamal M Elhag ◽  
Abduelmula R Abduelkarem ◽  
Nada A Basheer
Keyword(s):  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Anatomical Therapeutic Chemical ◽  
Statistical Significance ◽  
Linear Regression Analysis ◽  
University Hospital ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Defined Daily Doses ◽  
Hospital Wards

Objectives: The objective of this study was to describe patterns of antimicrobial resistance to gentamicin (Gen) and amikacin (Ak) among Gram-negative aerobic bacteria during 1-year period and to determine the association between antibiotic resistance and the consumption of Gen.Methods: Aminoglycosides consumption at Soba University Hospital wards was measured and susceptibility of Gram-negative bacteria for the same period was evaluated. Consumption data were converted to defined daily doses (DDDs)/100 bed days based on DDD/anatomical therapeutic chemical the WHO system. The association between the frequency of strains resistant to Gen and Ak and their consumption was assessed by linear regression analysis using Spearman’s correlation. The level of statistical significance was set at p<0.05.Results: A total of 973 Gram-negative isolates were identified and tested for antimicrobial susceptibility to Gen and Ak. Resistance to Gen alone was found to be 19.42%; n=189, resistance to Ak alone was found to be 3.08%; n=30, and resistance to Gen plus Ak was found to be 5.24%; n=51. Pseudomonas aeruginosa was the most resistant pathogen to Ak plus Gen (2.26%; n=22). A positive correlation between the increases in the use of Gen and the prevalence of bacterial resistance among hospital wards was found (correlation coefficient r=0.6; p=0.04).Conclusion: Gen and Ak are still highly active antimicrobial agents for the treatment of aerobic Gram-negative bacteria at times of intensified resistance to other antimicrobial agents. Monitoring the use of aminoglycosides is very important too. 

Imipenem Resistance in Aerobic Gram-Negative Bacteria

1998 ◽  
Vol 10 (2) ◽  
pp. 97-101 ◽  
Author(s):  
E.M. Mokaddas ◽  
S.C. Sanyal
Keyword(s):  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Imipenem Resistance

scholarly journals Emergence of Imipenem-Resistant Gram-Negative Bacilli in Intestinal Flora of Intensive Care Patients

2013 ◽  
Vol 57 (3) ◽  
pp. 1488-1495 ◽  
Author(s):  
Laurence Armand-Lefèvre ◽  
Cécile Angebault ◽  
François Barbier ◽  
Emilie Hamelet ◽  
Gilles Defrance ◽  
...  
Keyword(s):  
Risk Factor ◽  
Intensive Care ◽  
Intestinal Flora ◽  
Carbapenem Resistance ◽  
Genomic Comparison ◽  
Icu Patients ◽  
Gram Negative ◽  
Content Type ◽  
Intensive Care Patients ◽  
Imipenem Resistance

ABSTRACTIntestinal flora contains a reservoir of Gram-negative bacilli (GNB) resistant to cephalosporins, which are potentially pathogenic for intensive care unit (ICU) patients; this has led to increasing use of carbapenems. The emergence of carbapenem resistance is a major concern for ICUs. Therefore, in this study, we aimed to assess the intestinal carriage of imipenem-resistant GNB (IR-GNB) in intensive care patients. For 6 months, 523 consecutive ICU patients were screened for rectal IR-GNB colonization upon admission and weekly thereafter. The phenotypes and genotypes of all isolates were determined, and a case control study was performed to identify risk factors for colonization. The IR-GNB colonization rate increased regularly from 5.6% after 1 week to 58.6% after 6 weeks in the ICU. In all, 56 IR-GNB strains were collected from 50 patients: 36Pseudomonas aeruginosastrains, 12Stenotrophomonas maltophiliastrains, 6Enterobacteriaceaestrains, and 2Acinetobacter baumanniistrains. InP. aeruginosa, imipenem resistance was due to chromosomally encoded resistance (32 strains) or carbapenemase production (4 strains). In theEnterobacteriaceaestrains, resistance was due to AmpC cephalosporinase and/or extended-spectrum β-lactamase production with porin loss. Genomic comparison showed that the strains were highly diverse, with 8 exceptions (4 VIM-2 carbapenemase-producingP. aeruginosastrains, 2Klebsiella pneumoniaestrains, and 2S. maltophiliastrains). The main risk factor for IR-GNB colonization was prior imipenem exposure. The odds ratio for colonization was already as high as 5.9 (95% confidence interval [95% CI], 1.5 to 25.7) after 1 to 3 days of exposure and increased to 7.8 (95% CI, 2.4 to 29.8) thereafter. In conclusion, even brief exposure to imipenem is a major risk factor for IR-GNB carriage.

scholarly journals Metallo-β-lactamase-producing Clinical Isolates from Patients of a Tertiary Care Hospital

2011 ◽  
Vol 3 (02) ◽  
pp. 093-097 ◽  
Author(s):  
Durgesh Gopalrao Deshmukh ◽  
Ajit S Damle ◽  
Jyoti K Bajaj ◽  
Jayshree B Bhakre ◽  
Neeta S Patwardhan
Keyword(s):  
Intensive Care Unit ◽  
Ethylenediaminetetraacetic Acid ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Resistance Mechanisms ◽  
Care Hospital ◽  
Gram Negative ◽  
Serious Infections ◽  
Imipenem Resistance

ABSTRACT Background: The growing increase in the rates of antibiotic resistance is a major cause for concern in both non-fermenting bacilli and isolates of the Enterobacteriaceae family. β-lactams have been the mainstay of treatment for serious infections, and the most active of these are the carbapenems. Acquired metallo-β-lactamases (MBL) have recently emerged as one of the most worrisome resistance mechanisms owing to their capacity to hydrolyze all β-lactams, including carbapenems. We have undertaken this investigation to ascertain the prevalence of MBL-producing non-fermenting bacilli and Enterobacteriaceae. Materials and Methods: The study was conducted over a period of 4 months in a 1200-bedded teaching hospital. Isolates included in the study were screened for imipenem resistance both by conventional methods and mini analytical profile index (miniAPI). The isolates that showed imipenem resistance were tested for MBL production by imipenem (IMP)-ethylenediaminetetraacetic acid combined disc test. Imipenem-resistant non-MBL isolates also tested for Modified Hodge test and AmpC β-lactamases production to detect other mechanisms of carbapenem resistance. Results: Of 638 gram negative bacilli isolates and 3.39% showed imipenem resistance, 2.9% showed MBL production, of which 1.7% were non-fermenters and 1.25% were Enterobacteriaceae, 0.3% showing non-MBL KPC carbapenemas. Most isolates were from the intensive care unit and from post-operative patients. Our findings show that there are significant numbers of isolates having MBL production along with multidrug resistance. There is a need for active surveillance to detect MBL producers.

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