scholarly journals Emergence of Enterobacter cloacae Complex Co-Producing IMP-10 and CTX-M, and Klebsiella pneumoniae Producing VIM-1 in Clinical Isolates in Japan

2020 ◽  
Vol 8 (11) ◽  
pp. 1816
Author(s):  
Satoshi Nishida ◽  
Naohisa Matsunaga ◽  
Yuta Kamimura ◽  
Shinobu Ishigaki ◽  
Taiji Furukawa ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bacterial Species ◽  
Klebsiella Oxytoca ◽  
Tertiary Care ◽  
Enterobacter Cloacae ◽  
Clinical Isolates ◽  
University Hospital ◽  
Healthcare Settings ◽  
Carbapenem Resistant ◽  
Enterobacter Cloacae Complex

Background: Carbapenemase-producing Enterobacteriaceae (CPE) are an emerging threat in healthcare settings worldwide. Objectives: We evaluated the presence of carbapenemase genes in CPE in a tertiary care university hospital in Tokyo, Japan. Methods: Carbapenem-resistant clinical isolates were collected in 2018 at Teikyo University Hospital (Tokyo, Japan). Bacterial species were identified using MALDI-TOF MS. Carbapenemase production was evaluated using a carbapenemase inactivation method. The presence of carbapenemase genes was confirmed by multiplex PCR and DNA sequencing. Results: Four CPE isolates were identified: two Enterobacter cloacae complex strains and Klebsiella oxytoca and Klebsiella pneumoniae strains. Three of the isolates (E. cloacae complex and K. oxytoca) were IMP-1-type producers, including IMP-10 in their produced metallo-β-lactamase, and are epidemic in East Japan. The IMP-10-producing E. cloacae complex strain also produced CTX-M ESBL. The other CPE isolate (K. pneumoniae) is a VIM-1 producer. VIM-1-producing K. pneumoniae is epidemic in Europe, especially in Greece. Accordingly, the VIM-1 producer was isolated from a patient with a medical history in Greece. Conclusions: This study revealed the emergence of E. cloacae complex co-producing IMP-1-type carbapenemase and CTX-M ESBL, and K. pneumoniae producing VIM-1 carbapenemase in clinical isolates in Japan. Metallo-β-lactamase was the most prevalent type of carbapenemase at Teikyo University Hospital, especially IMP-1-type carbapenemase. The detection of VIM-1-producing K. pneumoniae suggests that epidemic CPE from overseas can spread to countries with low CPE prevalence, such as Japan, highlighting the need for active surveillance.

scholarly journals A Multispecies Cluster of VIM-1 Carbapenemase-Producing Enterobacterales Linked by a Novel, Highly Conjugative, and Broad-Host-Range IncA Plasmid Forebodes the Reemergence of VIM-1

2020 ◽  
Vol 64 (4) ◽  
Author(s):  
Gabriele Arcari ◽  
Federica Maria Di Lella ◽  
Giulia Bibbolino ◽  
Fabio Mengoni ◽  
Marzia Beccaccioli ◽  
...  
Keyword(s):  
Host Range ◽  
Bacterial Species ◽  
Klebsiella Oxytoca ◽  
Gene Cassette ◽  
University Hospital ◽  
Broad Host Range ◽  
Class 1 Integron ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Class 1

ABSTRACT In this study, we investigated VIM-1-producing Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Citrobacter freundii, and Enterobacter cloacae strains, isolated in 2019 during a period of active surveillance of carbapenem-resistant Enterobacterales in a large university hospital in Italy. VIM-1-producing strains colonized the gut of patients, with up to three different VIM-1-positive bacterial species isolated from a single rectal swab, but also caused bloodstream infection in one colonized patient. In the multispecies cluster, blaVIM-1 was identified in a 5-gene cassette class 1 integron, associated with several genetic determinants, including the blaSHV-12, qnrS1, and mph(A) genes, located on a highly conjugative and broad-host-range IncA plasmid. The characteristics and origin of this IncA plasmid were studied.

scholarly journals 1189. A Comprehensive Characterization of the Emerging Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates From a Public Hospital in Lima, Peru

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S359-S360 ◽  
Author(s):  
Fiorella Krapp ◽  
Catherine Amaro ◽  
Karen Ocampo ◽  
Lizeth Astocondor ◽  
Noemi Hinostroza ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Dna Extraction ◽  
Antibiotic Susceptibility ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Molecular Characteristics ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
String Test

Abstract Background In contrast with other countries in Latin America, Peru had been notoriously spared by the global dissemination of carbapenem-resistant Klebsiella pneumoniae (CR-Kp), until recently. Even though, isolated cases of KPC-producing K. pneumoniae had been reported since 2013, it was not until 2016 that the first outbreak of NDM- producing K. pneumoniae was described in Peru. By 2017, rapid emergence of CR-Kp took place in Hospital Cayetano Heredia (HCH), a tertiary care hospital in Lima. Here, we provide a description of clinical, microbiological and molecular characteristics of CR-Kp isolates recovered at HCH. Methods Retrospective review of all CR-Kp clinical isolates recovered at HCH until December 2017. Antibiotic susceptibility data were obtained during routine care (Vitek or disc diffusion) and was assessed using CLSI breakpoints. DNA extraction was performed by heat shock, and PCR was performed to assess carriage of blaNDM gene. String test was performed to detect hypermucoviscosity. Results The first case of CR-Kp in HCH dated from July 2015. Since then, a total of 69 CR-Kp clinical isolates, from 60 patients have been recovered until December 2017. A significant increase in the number of cases was observed during 2017 (Figure 1). The average age of patients was 55. Urinary, and respiratory sources of infection or colonization were the most common ones (35% and 30%, respectively), followed by blood stream (17%) and intraabdominal (10%) infections. Isolate recovery and DNA extraction was achieved in 40 cases. Of these, 15 (38%) had a positive PCR for blaNDM carbapenemase gene (Figure 2). Antibiotic susceptibility testing revealed that amikacin was the most effective antimicrobial with the rest of antimicrobials having extremely high rates of resistance (Figure 3). String test was positive in two of these isolates, suggesting that hypervirulent CR-KP might be emerging in this region. Conclusion An epidemic of CR-Kp has established in our hospital, representing the first one reported in Peru. The different mechanisms of carbapenem resistance found suggest a polyclonal expansion. Amikacin remains the only active antimicrobial within the routinely tested antibiotics, highlighting the need to add other antimicrobials to the routine panel. Disclosures All authors: No reported disclosures.

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 Outbreak Caused by Enterobacteriaceae Harboring NDM-1 Metallo-β-Lactamase Carried in an IncFII Plasmid in a Tertiary Care Hospital in Mexico City

2015 ◽  
Vol 59 (11) ◽  
pp. 7080-7083 ◽  
Author(s):  
Pedro Torres-González ◽  
Miriam Bobadilla-del Valle ◽  
Estrella Tovar-Calderón ◽  
Francisco Leal-Vega ◽  
Araceli Hernández-Cruz ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mexico City ◽  
Tertiary Care Hospital ◽  
Bacterial Species ◽  
Tertiary Care ◽  
Enterobacter Cloacae ◽  
New Delhi ◽  
Care Hospital ◽  
Content Type ◽  
Carbapenem Resistant

ABSTRACTCarbapenem-resistantEnterobacteriaceaecarrying New Delhi metallo-β-lactamase 1 (NDM-1) have rarely been reported in Latin America. We report of an outbreak caused by ablaNDM-1-harboring plasmid spread through different bacterial species, includingEscherichia coli(ST617) andEnterobacter cloacae(ST182) isolates from the same patient and threeKlebsiella pneumoniaeisolates (ST22) derived from three epidemiologically related patients. IncFII plasmids were found in all strains. Measures to control the outbreak were applied successfully.

scholarly journals Evaluation of Different Methods for Detection of Metallo-beta-Lactamases in Pseudomonas aeruginosa Clinical Isolates

2010 ◽  
Vol 59 (1) ◽  
pp. 45-48 ◽  
Author(s):  
TOMASZ BOGIEL ◽  
ALEKSANDER DEPTUŁA ◽  
EUGENIA GOSPODAREK
Keyword(s):  
Clinical Laboratory ◽  
Bacterial Species ◽  
Inhibition Zone ◽  
Clinical Isolates ◽  
University Hospital ◽  
Pcr Assay ◽  
Beta Lactamases ◽  
Carbapenem Resistant ◽  
Phenotypic Methods ◽  
Positive Results

Metallo-beta-lactamases (MBLs) produced by Pseudomnonas aeruginosa are a serious threat due to their ability to be transmitted between the same as well as different bacterial species. Different methods are applied in the clinical laboratory to detect MBLs. The aim of this study was to compare 4 phenotypic methods and a PCR assay for their ability to detect MBLs in clinical isolates of carbapenem-resistant P. aeruginosa strains. The study embraced a total of 70 carbapenem-resistant P. aeruginosa strains isolated in The Department of Microbiology of Dr. A. Jurasz University Hospital in Bydgoszcz. The highest percentage (42.9%) of the strains were isolated from Intensive Care Unit patients, mainly from urine samples (31.4%). Methods used in this study were: double-disc synergy tests in two combinations: using ceftazidime with 2-mercaptopropionic acid and imipenem with EDTA, differences in inhibition zone diameters between discs with imipenem/EDTA and imipenem, Etest MBL (AB Biodisk) and molecular amplification of bla(IMP) and bla(VIM) genes responsible for producing MBLs, using PCR assay. The lowest percentage (1.4%) of positive results in detection of MBLs was obtained using PCR assay, the highest (72.9%) by double-disc synergy tests with imipenem and EDTA, but the specificity of this method may be low.

scholarly journals The Potential Use of Ceftazidime-Avibactam Against Carbapenem Resistant Klebsiella pneumoniae Clinical Isolates Harboring Different Carbapenemase Types in a Thai University Hospital

2021 ◽  
Vol Volume 15 ◽  
pp. 3095-3104
Author(s):  
Worapong Nasomsong ◽  
Parnrada Nulsopapon ◽  
Dhitiwat Changpradub ◽  
Manat Pongchaidecha ◽  
Supanun Pungcharoenkijkul ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Clinical Isolates ◽  
University Hospital ◽  
Carbapenem Resistant ◽  
Potential Use ◽  
Thai University

scholarly journals 235. Next-Generation Sequencing for Investigation of Hospital Outbreak of Carbapenem--Resistant Klebsiella pneumoniae

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S134-S134
Author(s):  
Amani Kholy ◽  
May Mohamed Sherif Soliman ◽  
Arwa Ramadan ◽  
Jehan El-Kholy
Keyword(s):  
Klebsiella Pneumoniae ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Illumina Miseq ◽  
University Hospital ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Hospital Outbreak ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Carbapenem--resistant Enterobacteriaceae constitute an urgent public health problem worldwide. In 2018, carbapenem--resistant Klebsiella pneumoniae (CR-KP) caused outbreaks of infection in 4 intensive-care units (ICUs)in a tertiary-care hospital in Egypt. We aimed to identify the clonal relatedness of isolates by whole genome (WGS). Methods Identification and antibiotic susceptibility testing was done by VITEK-2. Eleven isolates showed identical resistance pattern (resistant to Amikacin, gentamicin, Imipenem, meropenem, levofloxacin, and Piperacillin/Tazobactam) and were susceptible only to colistin. Caba-NP test was positive for carbapenemase production. The 11 isolates were studied by WGS by Illumina Miseq in a reference lab in Cairo University Hospital. Results In only one ICU, WGS identified 4 outbreak isolates of CR-KP that group together as a tight clonal cluster, suggestive of intra-ward transmission event. The outbreak isolates belonged to MLST 147. All isolates carried blaCTXM-15, blaoxa-48, and blaNDM1 encoding ESBL and carbapenemase activity. Other identified resistance genes were Str, AadA, MsrE, Tet, and DfrA, encoding resistance to aminoglycosides, macrolide–lincosamide–streptogramin, tetracycline and trimethoprim/sulphonamides. Virulence genes included Yersiniabactin, aerobactin, rmpA, rmpA2 and wzi64, which has been associated with pathogenicity and hypervirulent K. pneumoniae lineages. No clonal relationships were identified between the isolates from other ICUs. Conclusion WGS is a powerful tool that goes beyond high-resolution tracking of transmission events into identifying the genetic basis of drug-resistance and virulence. Disclosures All authors: No reported disclosures.

scholarly journals Comparative In Vitro Activities of Ciprofloxacin, Clinafloxacin, Gatifloxacin, Levofloxacin, Moxifloxacin, and Trovafloxacin againstKlebsiella pneumoniae, Klebsiella oxytoca,Enterobacter cloacae, and Enterobacter aerogenes Clinical Isolates with Alterations in GyrA and ParC Proteins

1999 ◽  
Vol 43 (8) ◽  
pp. 2051-2055 ◽  
Author(s):  
Sylvain Brisse ◽  
Dana Milatovic ◽  
Ad C. Fluit ◽  
Jan Verhoef ◽  
Nele Martin ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Klebsiella Oxytoca ◽  
Enterobacter Aerogenes ◽  
Enterobacter Cloacae ◽  
Clinical Isolates

ABSTRACT The in vitro activities of ciprofloxacin, clinafloxacin, gatifloxacin, levofloxacin, moxifloxacin, and trovafloxacin were tested against 72 ciprofloxacin-resistant and 28 ciprofloxacin-susceptible isolates of Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Enterobacter aerogenes. Irrespective of the alterations in GyrA and ParC proteins, clinafloxacin exhibited greater activity than all other fluoroquinolones tested against K. pneumoniae and E. aerogenes.

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