scholarly journals Ceftazidime/Avibactam-Resistant Klebsiella pneumoniae subsp. pneumoniae Isolates in a Tertiary Italian Hospital: Identification of a New Mutation of the Carbapenemase Type 3 (KPC-3) Gene Conferring Ceftazidime/Avibactam Resistance

2021 ◽  
Vol 9 (11) ◽  
pp. 2356
Author(s):  
Carla Fontana ◽  
Marco Favaro ◽  
Laura Campogiani ◽  
Vincenzo Malagnino ◽  
Silvia Minelli ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Gene Mutations ◽  
University Hospital ◽  
Nucleotide Position ◽  
Chromogenic Medium ◽  
New Mutation ◽  
Different Types ◽  
Resistant Strains ◽  
The University ◽  
Type 3

Several Klebsiella pneumoniae carpabenemase (KPC) gene mutations are associated with ceftazidime/avibactam (CAZ-AVI) resistance. Here, we describe four Klebsiella pneumoniae subsp. pneumoniae CAZ-AVI-resistant clinical isolates, collected at the University Hospital of Tor Vergata, Rome, Italy, from July 2019 to February 2020. These resistant strains were characterized as KPC-3, having the transition from cytosine to thymine (CAC-TAC) at nucleotide position 814, with histidine that replaces tyrosine (H272Y). In addition, two different types of KPC gene mutations were detected. The first one, common to three strains, was the D179Y (G532T), associated with CAZ-AVI resistance. The second mutation, found only in one strain, is a new mutation of the KPC-3 gene: a transversion from thymine to adenine (CTG-CAG) at nucleotide position 553. This mutation causes a KPC variant in which glutamine replaces leucine (Q168L). None of the isolates were detected by a rapid immunochromatographic assay for detection of carbapenemase (NG Biotech, Guipry, France) and were unable to grow on a selective chromogenic medium Carba SMART (bioMerieux, Firenze, Italy). Thus, they escaped common tests used for the prompt detection of Klebsiella pneumoniae KPC-producing.

Klebsiella Pneumoniae Producing Extended-Spectrum Β-Lactamases seen in the Laboratory of the University Hospital of Befelatanana Antananarivo Madagascar

2021 ◽  
Vol 05 (04) ◽  
Author(s):  
Fidiniaina Mamy Randriatsarafara ◽  
Zafindrasoa Domoina Rakotovao-Ravahatra ◽  
Njaramahery Williame Andriamampandry ◽  
Andriamiadana Luc Rakotovao
Keyword(s):  
Klebsiella Pneumoniae ◽  
University Hospital ◽  
Extended Spectrum ◽  
The University

P1362Diagnostic accuracy of R-wave detection by insertable cardiac monitors

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
M De Coster ◽  
A Demolder ◽  
V De Meyer ◽  
F Vandenbulcke ◽  
F Van Heuverswyn ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Diagnostic Performance ◽  
Wave Amplitude ◽  
University Hospital ◽  
Arrhythmia Detection ◽  
Different Types ◽  
False Diagnosis ◽  
The University ◽  
R Wave Amplitude ◽  
Sudden Reduction

Abstract OnBehalf 1.Department of Cardiology, Ghent University Hospital, Ghent, Belgium Introduction Insertable cardiac monitors (ICM) allow automatic arrhythmia detection but the diagnostic performance can be hampered by poor R-wave sensing leading to false positive recordings. Purpose This study assesses the prevalence and predictors of R-wave under- and oversensing among different ICM types.  Methods Patients implanted with an ICM at the University Hospital of Ghent between January 2017 and August 2018 were included. All ICM tracings recorded at ICM interrogation or transmitted by remote monitoring were reviewed for inadequate R-wave sensing leading to false arrhythmia alerts. Inadequate R wave sensing was defined as undersensing due to sudden reduction in R wave amplitude or oversensing due to the occurrence of artefacts. Patient and implant characteristics were retrieved from the medical record and implant reports. Results The study screened 135 patients (age 59 ± 19 years, 44% female) implanted with different ICM types: Reveal XT and LINQ n = 92 (68%), Confirm and Confirm Rx n = 35 (26%),  BioMonitor n = 8 (6%). ICM analysis was conducted in 112 patients (83%). Overall, false arrhythmia alerts due to inadequate R wave sensing occurred in 22 (20%) of the patients. Among these 22 patients, false diagnosis of bradycardia or pauses were documented in 64%, false high ventricular rates in 14% and false atrial fibrillation alerts in 22% of the patients. Of interest, in an additional 7 (6%) patients significant changes in R wave sensing occurred, although not causing false arrhythmic alerts. Occurrence of R-wave changes occurred in 19% of Reveal, 17% of Confirm and 50% of BioMonitor ICMs (p = not significant). Occurrence of R-wave changes among the different types of ICMs were not related to age, sex, BMI, time of the day, heart frequency or implant R-wave sensing. Conclusion Poor R wave sensing, leading to false arrhythmia detection, occurred in a significant number of ICM, and seems to occur independent of ICM type, patient or implant characteristics. Abstract Figure.

scholarly journals Evaluation of biofilm formation of Klebsiella pneumoniae isolated from medical devices at the University Hospital of Tlemcen, Algeria

2013 ◽  
Vol 7 (49) ◽  
pp. 5558-5564 ◽  
Author(s):  
Bellifa Samia ◽  
Hassaine Hafida ◽  
Balestrino Damien ◽  
Charbonnel Nicolas ◽  
Mrsquo hamedi Imane ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Medical Devices ◽  
Biofilm Formation ◽  
University Hospital ◽  
The University

scholarly journals Klebsiella pneumoniae yfiRNB operon affects biofilm formation, polysaccharide production and drug susceptibility

Microbiology ◽  
2014 ◽  
Vol 160 (12) ◽  
pp. 2595-2606 ◽  
Author(s):  
Mónica G. Huertas ◽  
Lina Zárate ◽  
Iván C. Acosta ◽  
Leonardo Posada ◽  
Diana P. Cruz ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Biofilm Formation ◽  
Surface Characteristics ◽  
Opportunistic Pathogen ◽  
Drug Susceptibility ◽  
Cellulose Production ◽  
Resistant Strains ◽  
Drug Resistant Strains ◽  
Type 3 ◽  
Hospital Acquired

Klebsiella pneumoniae is an opportunistic pathogen important in hospital-acquired infections, which are complicated by the rise of drug-resistant strains and the capacity of cells to adhere to surfaces and form biofilms. In this work, we carried out an analysis of the genes in the K. pneumoniae yfiRNB operon, previously implicated in biofilm formation. The results indicated that in addition to the previously reported effect on type 3 fimbriae expression, this operon also affected biofilm formation due to changes in cellulose as part of the extracellular matrix. Deletion of yfiR resulted in enhanced biofilm formation and an altered colony phenotype indicative of cellulose overproduction when grown on solid indicator media. Extraction of polysaccharides and treatment with cellulase were consistent with the presence of cellulose in biofilms. The enhanced cellulose production did not, however, correlate with virulence as assessed using a Caenorhabditis elegans assay. In addition, cells bearing mutations in genes of the yfiRNB operon varied with respect to the WT control in terms of susceptibility to the antibiotics amikacin, ciprofloxacin, imipenem and meropenem. These results indicated that the yfiRNB operon is implicated in the production of exopolysaccharides that alter cell surface characteristics and the capacity to form biofilms – a phenotype that does not necessarily correlate with properties related with survival, such as resistance to antibiotics.

scholarly journals A Novel Complex Mutant β-Lactamase, TEM-68, Identified in a Klebsiella pneumoniae Isolate from an Outbreak of Extended-Spectrum β-Lactamase-Producing Klebsiellae

2000 ◽  
Vol 44 (6) ◽  
pp. 1499-1505 ◽  
Author(s):  
Janusz Fiett ◽  
Andrzej Pałucha ◽  
Beata Mia˛czyńska ◽  
Maria Stankiewicz ◽  
Hanna Przondo-Mordarska ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
University Hospital ◽  
Pediatric Hospitals ◽  
Extended Spectrum ◽  
Novel Complex ◽  
High Level ◽  
Inhibitor Resistance ◽  
The University ◽  
Level Resistance

ABSTRACT Twenty-two Klebsiella pneumoniae and two K. oxytoca extended-spectrum β-lactamase (ESBL)-producing isolates were collected in 1996 from patients in two pediatric wards of the University Hospital in Wrocław, Poland. Molecular typing has revealed that the K. pneumoniae isolates represented four different epidemic strains. Three kinds of enzymes with ESBL activity (pI values of 5.7, 6.0, and 8.2) were identified. The pI 6.0 β-lactamases belonged to the TEM family, and sequencing of thebla TEM genes amplified from representative isolates revealed that these enzymes were TEM-47, previously identified in K. pneumoniae isolates from pediatric hospitals in Łódź and Warsaw. One of the TEM-47-producing strains from Wrocław was very closely related to the isolates from the other cities, and this indicated countrywide spread of the epidemic strain. The pI 5.7 β-lactamase was produced by a single K. pneumoniae isolate for which, apart from oxyimino-β-lactams, the MICs of β-lactam–inhibitor combinations were also remarkably high. Sequencing revealed that this was a novel TEM β-lactamase variant, TEM-68, specified by the following combination of mutations: Gly238Ser, Glu240Lys, Thr265Met, and Arg275Leu. The new enzyme has most probably evolved from TEM-47 by acquiring the single substitution of Arg275, which before was identified only twice in enzymes with inhibitor resistance (IR) activity. TEM-68 was shown to be a novel complex mutant TEM β-lactamase (CMT-2) which combines strong ESBL activity with relatively weak IR activity and, when expressed inK. pneumoniae, is able to confer high-level resistance to a wide variety of β-lactams, including inhibitor combinations. This data confirms the role of the Arg275Leu mutation in determining IR activity and documents the first isolation of K. pneumoniae producing the complex mutant enzyme.

scholarly journals Emergence of Carbapenemase-producing Enterobacteriaceae, a Public Health Threat: a Romanian Infectious Disease Hospital Based Study / Emergenţa Enterobacteriaceaelor producătoare de carbapenemaze, o ameninţare pentru sănătatea publică: un studiu realizat într-un spital romanesc de boli infectioase

2015 ◽  
Vol 23 (3) ◽  
pp. 295-301 ◽  
Author(s):  
Alexandru Rafila ◽  
Daniela Talapan ◽  
Olga Mihaela Dorobăţ ◽  
Gabriel Adrian Popescu ◽  
Daniela Piţigoi ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Confirmatory Test ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Different Types ◽  
Clinical Breakpoints ◽  
Resistant Strains ◽  
Disease Hospital ◽  
Phenotypic Methods ◽  
Hospital Acquired

Abstract Introduction: Hospital-acquired infections caused by Enterobacteriaceae producing different types of carbapenem- hydrolizing enzymes are now commonly observed and represent a great limitation for antimicrobial therapy. The purpose of the study was to evaluate the emergence of carbapenem-resistant Enterobaceriaceae among the strains isolated from hospitalized patients to the National Institute of Infectious Diseases, Bucharest (NIID) and the identification of different types of carbapenemases, using phenotypic methods. Materials and methods: Between January - June 2014, 587 strains of Klebsiella pneumoniae, Enterobacter species and E.coli were isolated from various clinical specimens. We were included all non-susceptible strains to carbapenems, according to EUCAST 2014 clinical breakpoints, as determined by using microdilution MicroScan Panels (Siemens Healthcare Diagnostics). The modified Hodge test (MHT) was performed as phenotypic confirmatory test for carbapenemase production according to CLSI guidelines and the combination disk test (KPC, MBL , OXA-48 Confirm kit, Rosco Diagnostica) according to EUCAST guidelines. Results: A total of 45 non-repeat Enterobaceriaceae (32 strains Klebsiella pneumoniae, 5 strains E.coli, 8 strains Enterobacter spp) were identified as non-susceptibile to one or more carbapenems (93,33% ertapenem, 53,33% meropenem, 48,88% imipenem). Most strains were isolated from urine (75,55%). MHT was positive in 55,6% (25/45) of carbapenem-resistant strains; in 24 cases the carbapenem-hydrolizing enzyme was identified as: OXA-48-like (n=16), KPC (n=4), MBL (n=1), KPC + MBL (n=2) and MBL + OXA-48-like (n=1). All carbapenemase- positive strains were 100% resistant to 3rd and 4th generation cephalosporins, showing less resistance to tigecycline (12,5% resistant and 25% intermediate), colistin (37,5%) and fosfomycin (41,6%). Conclusion: During 6 months period, there were isolated 7,66% (45/587) carbapenem-resistant Enterobacteriaceae (K. pneumoniae 21,47%, E. coli 1,23%). Twenty four strains were carbapenemase-producers. The most frequent carbapenemase isolated in our study was OXA-48-like.

scholarly journals Extremely drug-resistant NDM-9-producing ST147 Klebsiella pneumoniae causing infections in Italy, May 2020

2020 ◽  
Vol 25 (48) ◽  
Author(s):  
Marco Falcone ◽  
Cesira Giordano ◽  
Simona Barnini ◽  
Giusy Tiseo ◽  
Alessandro Leonildi ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Phylogenetic Analyses ◽  
Sequence Type ◽  
University Hospital ◽  
New Delhi ◽  
Beta Lactamase ◽  
Drug Resistant ◽  
Large Outbreak ◽  
Fosfomycin Resistance ◽  
The University

A large outbreak of New Delhi metallo-beta-lactamase (NDM)-1-producing Klebsiella pneumoniae sequence type (ST) 147 occurred in Tuscany, Italy in 2018–2019. In 2020, ST147 NDM-9-producing K. pneumoniae were detected at the University Hospital of Pisa, Tuscany, in two critically ill patients; one developed bacteraemia. Genomic and phylogenetic analyses suggest relatedness of 2018–2019 and 2020 strains, with a change from NDM-1 to NDM-9 in the latter and evolution by colistin, tigecycline and fosfomycin resistance acquisition.

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