scholarly journals Infections in patients colonized with carbapenem-resistant Gram-negative bacteria in a medium Spanish city

2021 ◽  
Author(s):  
Carmen Soria-Segarra ◽  
Mercedes Delgado-Valverde ◽  
María Luisa Serrano-García ◽  
Inmaculada López-Hernández ◽  
José María Navarro-Marí ◽  
...  
Keyword(s):  
Predictive Value ◽  
Stenotrophomonas Maltophilia ◽  
Sanger Sequencing ◽  
Clinical Samples ◽  
Clinical Implications ◽  
Gram Negative Bacteria ◽  
Cross Sectional ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Pulsed Field Electrophoresis

Objective. Because there are few studies on the clinical implications of colonization by carbapenem-resistant gram-negative bacteria (CRB) this was analyzed in rectal smears (RS) and pharyngeals (PS) and its ability to predict infection/colonization. Methodology. A cross-sectional, retrospective study from adult inpatients between January 2016 and December 2019 was conducted. The isolates were characterized by MicroScan and spectrometry of masses applying EUCAST 2018 cutoff points. The detection of carbapenemases was performed by PCR and Sanger sequencing; sequencies was assigned by MLST. The genetic relationship between the clinical isolates was made by pulsed field electrophoresis using the enzymes Xbal, Spel or Apal. Results. A total of 308 (86.03%) RS and 50 (13.97%) positive PS were detected, the RS had a 85% sensibility, 100% specificity, 100% positive predictive value and 97% negative predictive value. In RS, the following were isolated: 44% (n=135) Acinetobacter baumannii, 26% (n =80) Enterobacterales (20 KPC, 29 OXA-48, 22 VIM, 2 IMP, 7 NDM), 17% (n=53) Pseudomonas aeruginosa and 13% (n=40) Stenotrophomonas maltophilia. In the PS were isolated 44% (n=22) S. maltophilia, 40% (n = 20) A. baumannii, 8% (n=4) P. aeruginosa and 8% (n=4) Enterobacterales (3 VIM, 1 OXA). From the patients with simultaneous RS and PS, 41 (40.6%) had positivity in both smears, 45 (44.6%) only in RS and 15 (14.9%) only in PS. Colonization preceded infection in 81.3% (n=13) of the isolates; association between infection and colonization was found (p<0.001; χ2); and the episodes where the information was found all the isolates from the clinical samples and from the smears were similar. Conclusions. The probability of predicting infection through the CRB colonized in different clinical samples is feasible. The RS has a major sensibility to detect colonization.

scholarly journals Carbapenem-resistant Gram-negative bacteria isolated from poultry samples: a cross-sectional study

The Lancet ◽  
2019 ◽  
Vol 393 ◽  
pp. S21
Author(s):  
Abdelraouf A Elmanama ◽  
Mariam R Al-Reefi ◽  
Madleen A Shamali ◽  
Haya I Hemaid
Keyword(s):  
Cross Sectional Study ◽  
Gram Negative Bacteria ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gram Negative ◽  
Carbapenem Resistant

scholarly journals Bad Bugs and No Drugs: Activity of Colistin as Waging War against Emerging Metallo-β-Lactamases Producing Pathogens

2018 ◽  
Vol 24 (1) ◽  
pp. 625-631 ◽  
Author(s):  
Sahar Naz ◽  
Farhan Rasheed ◽  
Muhammad Saeed ◽  
Shagufta Iram ◽  
Ambereen Anwar Imran
Keyword(s):  
Cross Sectional Study ◽  
Resistant Isolate ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Klebsiella Species ◽  
Cross Sectional ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Negative Results ◽  
Carbapenem Resistant

Inter-hospital and intra-hospital dissemination of metallo-β-lactamase (MβL) producing strains possess significant therapeutic challenges. Objective: This study was carried out to evaluate the efficacy of Colistin against MβL producers. Material and Methods: This cross-sectional study was conducted in Microbiology Laboratory, Allama Iqbal Medical College, Lahore, Pakistan from 1stJuly 2016 to 25th February 2017. A total of 12126 clinical samples were collected from patients presenting to Jinnah Hospital, Lahore. Every sample was processed for bacterial culture. Bacterial identification was performed according to standard guidelines. Every gram-negative isolate was further processed for antimicrobial susceptibility testing by modified Kirby Baur disc diffusion method. Zone sizes were interpreted according to CLSI 2016 guidelines. Next day every carbapenem-resistant isolate were further processed for MβL detection by EDTA method, zone size of Carbapenem disc only and Carbapenem disc impregnated with EDTA was compared ( >7 mm increase MβL positive, 0-5 mm increase MβL-negative). Results: Out of total 12126 samples, 35.9% (n=4361) were culture positive and only 40.5% (n=1770) were Gram negative rods. Of these 9.6% (n=170) were Carbapenem-resistant isolates with 47% (n=80) MβL producers. Briefly 51.7% (n=30) Acinetobacter species were MβL positive, Pseudomonas species 38.5% (n=22), Escherichia coli 69.5% (n=16), Klebsiella species 37.0% (n=10), Proteus 66.6% (n=2) and 0% Citrobacter sppwere MβL positive. 32.5% MβL positive isolates were from ICU, 21.2% were from OPD, 12.5%were from Surgical Units, 12.5% were from Medical Unit, 17.5% were from Orthopedic Unit, and 3.7% were from Pulmonology ward. Almost 100% resistant was observed in MβL positive isolates for Imipenem,Piperacillin+ Tazobactum, Ceftriaxone, Co-amoxyclav, Cefoperazone+Sulbactam, Ciprofloxacin, and Amikacin, Doxycycline, and Gentamicin showed 91.2%, 94.0%, and 97.5% resistant rate respectively. No resistance was observed against Colistin. Conclusion: MβL producing Gram negative rods are rising in clinical setups. They are becoming a nightmare for clinicians to treat such infections. Colistin remains the only choice of drug for MβL positive and Negative isolates with 0% resistant rate except for Proteus species, to which it is intrinsically resistant.

scholarly journals Detection of NDM-1, VIM-1 and AIM-type metallo-beta-lactamase genes in Gram-negative bacteria isolated from clinical samples in Tamil Nadu

2020 ◽  
Author(s):  
Prasanth Manohar ◽  
Aemy Joseph ◽  
B Karthika ◽  
Pradeep AnuPriya ◽  
Swetha S Mani ◽  
...  
Keyword(s):  
Tamil Nadu ◽  
Health Concern ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Study Region ◽  
Gram Negative ◽  
Phenotypic Resistance ◽  
Carbapenem Resistant ◽  
Synergy Test

AbstractThe distribution of carbapenem-resistant Gram-negative bacteria has become an increasing public health concern in India. The aim of this study was to investigate the prevalence of carbapenem-resistant bacteria isolated from the clinical samples in Tamil Nadu, India. A total of 126 non-repetitive Gram-negative bacteria were taken for this study. The susceptibility to meropenem was determined by Minimum Inhibitory Concentration (MIC) by broth micro-dilution. The phenotypic resistance screening such as MHT (Modified Hodge test), EDTA disk synergy and CIM (carbapenem inactivation method) were performed. A multiplex PCR was used for the detection of carbapenemase-encoding genes. Among the 126 isolates studied, 82 (65.07%) meropenem-resistant isolates were identified by MIC. A total of 18 (21.9%) isolates were found to be positive for Metallo-β-Lactamase production through EDTA synergy test. None of the isolates were carbapenemase producer by MHT and CIM. The isolates identified with resistance genes (8/82) were blaNDM-1 in two Klebsiella sp., two P. aeruginosa and one A. baumannii, blaVIM-1 in one P. aeruginosa and blaAIM-1 in one P. aeruginosa and one A. baumannii. The study showed the distribution and increase of carbapenem-resistant bacteria in the study region. Therefore, constant monitoring and effective elimination should be focused to reduce the spread of carbapenem-resistant isolates.

scholarly journals ARGONAUT-I: Activity of Cefiderocol (S-649266), a Siderophore Cephalosporin, against Gram-Negative Bacteria, Including Carbapenem-Resistant Nonfermenters and Enterobacteriaceae with Defined Extended-Spectrum β-Lactamases and Carbapenemases

2018 ◽  
Vol 63 (1) ◽  
Author(s):  
Michael R. Jacobs ◽  
Ayman M. Abdelhamed ◽  
Caryn E. Good ◽  
Daniel D. Rhoads ◽  
Kristine M. Hujer ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acinetobacter Baumannii ◽  
Stenotrophomonas Maltophilia ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Extended Spectrum ◽  
Mueller Hinton ◽  
Mueller Hinton Broth

ABSTRACT The activity of the siderophore cephalosporin cefiderocol is targeted against carbapenem-resistant Gram-negative bacteria. In this study, the activity of cefiderocol against characterized carbapenem-resistant Acinetobacter baumannii complex, Stenotrophomonas maltophilia, Pseudomonas aeruginosa, and Enterobacteriaceae strains was determined by microdilution in iron-depleted Mueller-Hinton broth. The MIC90s against A. baumannii, S. maltophilia, and P. aeruginosa were 1, 0.25, and 0.5 mg/liter, respectively. Against Enterobacteriaceae, the MIC90 was 1 mg/liter for the group harboring OXA-48-like, 2 mg/liter for the group harboring KPC-3, and 8 mg/liter for the group harboring TEM/SHV ESBL, NDM, and KPC-2.

scholarly journals Activity of β-lactam/taniborbactam (VNRX-5133) combinations against carbapenem-resistant Gram-negative bacteria

2020 ◽  
Vol 76 (1) ◽  
pp. 160-170
Author(s):  
Shazad Mushtaq ◽  
Anna Vickers ◽  
Michel Doumith ◽  
Matthew J Ellington ◽  
Neil Woodford ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Development ◽  
Published Data ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Class A ◽  
Carbapenem Resistant ◽  
Elizabethkingia Meningoseptica

Abstract Background Boronates are of growing interest as β-lactamase inhibitors. The only marketed analogue, vaborbactam, principally targets KPC carbapenemases, but taniborbactam (VNRX-5133, Venatorx) has a broader spectrum. Methods MICs of cefepime and meropenem were determined combined with taniborbactam or avibactam for carbapenem-resistant UK isolates. β-Lactamase genes and porin alterations were sought by PCR or sequencing. Results Taniborbactam potentiated partner β-lactams against: (i) Enterobacterales with KPC, other class A, OXA-48-like, VIM and NDM (not IMP) carbapenemases; and (ii) Enterobacterales inferred to have combinations of ESBL or AmpC activity and impermeability. Potentiation of cefepime (the partner for clinical development) by taniborbactam was slightly weaker than by avibactam for Enterobacterales with KPC or OXA-48-like carbapenemases, but MICs of cefepime/taniborbactam were similar to those of ceftazidime/avibactam, and the spectrum was wider. MICs of cefepime/taniborbactam nonetheless remained &gt;8 + 4 mg/L for 22%–32% of NDM-producing Enterobacterales. Correlates of raised cefepime/taniborbactam MICs among these NDM Enterobacterales were a cefepime MIC &gt;128 mg/L, particular STs and, for Escherichia coli only: (i) the particular blaNDM variant (even though published data suggest all variants are inhibited similarly); (ii) inserts in PBP3; and (iii) raised aztreonam/avibactam MICs. Little or no potentiation of cefepime or meropenem was seen for Pseudomonas aeruginosa and Acinetobacter baumannii with MBLs, probably reflecting slower uptake or stronger efflux. Potentiation of cefepime was seen for Stenotrophomonas maltophilia and Elizabethkingia meningoseptica, which have both chromosomal ESBLs and MBLs. Conclusions Taniborbactam broadly reversed cefepime or meropenem non-susceptibility in Enterobacterales and, less reliably, in non-fermenters.

scholarly journals Prevalence of carbapenem resistant bacterial strains isolated from different clinical samples: study from a tertiary care hospital in Kathmandu, Nepal

2017 ◽  
Vol 3 (1) ◽  
pp. 11-15
Author(s):  
Sitesh Karn ◽  
Narayan Dutt Pant ◽  
Sanjeev Neupane ◽  
Saroj Khatiwada ◽  
Shaila Basnyat ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Bacterial Strains ◽  
Biochemical Tests ◽  
Gram Negative ◽  
Carbapenem Resistant

Background Carbapenems are considered as drugs of choice for the treatment of the infections caused by drug resistant bacteria. However, in the recent years the prevalence of carbapenem resistant gram negative bacteria has increased significantly. The main objective of this study was to determine the prevalence of carbapenemase producing gram negative bacteria among all the clinical isolates.Material and methods A total of 3246 non-repeated, different clinical specimens from patients attending Kathmandu Model Hospital, from July 2013 to January 2014 were cultured and the gram negative bacterial isolates obtained were subjected to identification with the help of colony morphology, Gram’s stain and conventional biochemical tests. Kirby-Bauer disk diffusion technique was used to perform antimicrobial susceptibility testing. Phenotypic confirmation of carbapenemase and AmpC beta-lactamase production was done by combined disc method.Results 890 samples showed the growth of bacterial pathogens. Out of total 769 gram negative bacteria, 57 were found to be carbapenem resistant. Of which, highest number (47) of the isolates were found to be metallo-β lactamase (MBL) producers. Six bacterial isolates produced both (Klebsiella pneumoniae carbapenemase) KPC and MBL, whereas only one isolate was found to be positive for both MBL and AmpC. Three bacterial strains showed carbapenem resistance due to over production of AmpC β-lactamase.Conclusion Among carbapenem resistant gram negative bacteria, MBL was present as the major enzyme responsible for resisting carbapenem antibiotics.

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