scholarly journals Does the presence of Klebsiella pneumoniae carbapenemase and New Delhi metallo-β-lactamase-1 genes in pathogens lead to fatal outcome?

2016 ◽  
Vol 34 (4) ◽  
pp. 495-499 ◽  
Author(s):  
P Mathur ◽  
S Sagar ◽  
S Kumar ◽  
V Sharma ◽  
D Gupta ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Fatal Outcome ◽  
New Delhi ◽  
Klebsiella Pneumoniae Carbapenemase

A multi-institutional outbreak of New Delhi metallo-β-lactamase–producing Escherichia coli with subsequent acquisition of the Klebsiella pneumoniae carbapenemase gene

2020 ◽  
pp. 1-4
Author(s):  
Ester Solter ◽  
Jason C. Kwong ◽  
Aaron Walton ◽  
Norelle Sherry ◽  
Benjamin P. Howden ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Common Ancestor ◽  
Sequence Type ◽  
Second Phase ◽  
New Delhi ◽  
Genetic Sequencing ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Carbapenemase Gene

Abstract We characterized 57 isolates from a 2-phase clonal outbreak of New Delhi metallo-β-lactamase–producing Eschericha coli, involving 9 Israeli hospitals; all but 1 isolate belonged to sequence-type (ST) 410. Most isolates in the second phase harbored blaKPC-2 in addition to blaNDM-5. Genetic sequencing revealed most dual-carbapenemase–producing isolates to be monophyletically derived from a common ancestor.

scholarly journals Emergence of New Delhi Metallo-Beta-Lactamase (NDM-1) and Klebsiella pneumoniae Carbapenemase (KPC-2) in South Africa

2011 ◽  
Vol 50 (2) ◽  
pp. 525-527 ◽  
Author(s):  
A. J. Brink ◽  
J. Coetzee ◽  
C. G. Clay ◽  
S. Sithole ◽  
G. A. Richards ◽  
...  
Keyword(s):  
South Africa ◽  
Klebsiella Pneumoniae ◽  
New Delhi ◽  
Beta Lactamase ◽  
Klebsiella Pneumoniae Carbapenemase

scholarly journals An Emerging Clone, Klebsiellapneumoniae Carbapenemase 2–Producing K. pneumoniae Sequence Type 16, Associated With High Mortality Rates in a CC258-Endemic Setting

2019 ◽  
Vol 71 (7) ◽  
pp. e141-e150 ◽  
Author(s):  
Diego O Andrey ◽  
Priscila Pereira Dantas ◽  
Willames B S Martins ◽  
Fabíola Marques De Carvalho ◽  
Luiz Gonzaga Paula Almeida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
High Mortality ◽  
Fatal Outcome ◽  
Mortality Rates ◽  
Sequence Type ◽  
Virulence Determinants ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Endemic Setting ◽  
Severity Scores

Abstract Background Carbapenemase-producing Klebsiella pneumoniae has become a global priority, not least in low- and middle-income countries. Here, we report the emergence and clinical impact of a novel Klebsiella pneumoniae carbapenemase–producing K. pneumoniae (KPC-KP) sequence type (ST) 16 clone in a clonal complex (CC) 258–endemic setting. Methods In a teaching Brazilian hospital, a retrospective cohort of adult KPC-KP bloodstream infection (BSI) cases (January 2014 to December 2016) was established to study the molecular epidemiology and its impact on outcome (30-day all-cause mortality). KPC-KP isolates underwent multilocus sequence typing. Survival analysis between ST/CC groups and risk factors for fatal outcome (logistic regression) were evaluated. Representative isolates underwent whole-genome sequencing and had their virulence tested in a Galleria larvae model. Results One hundred sixty-five unique KPC-KP BSI cases were identified. CC258 was predominant (66%), followed by ST16 (12%). The overall 30-day mortality rate was 60%; in contrast, 95% of ST16 cases were fatal. Patients’ severity scores were high and baseline clinical variables were not statistically different across STs. In multivariate analysis, ST16 (odds ratio [OR], 21.4; 95% confidence interval [CI], 2.3–202.8; P = .008) and septic shock (OR, 11.9; 95% CI, 4.2–34.1; P < .001) were independent risk factors for fatal outcome. The ST16 clone carried up to 14 resistance genes, including blaKPC-2 in an IncFIBpQIL plasmid, KL51 capsule, and yersiniabactin virulence determinants. The ST16 clone was highly pathogenic in the larvae model. Conclusions Mortality rates were high in this KPC-KP BSI cohort, where CC258 is endemic. An emerging ST16 clone was associated with high mortality. Our results suggest that even in endemic settings, highly virulent clones can rapidly emerge demanding constant monitoring.

scholarly journals Descrição de casos de Enterobactérias Produtoras de Carbapenemases subtipos Oxa-48 e NDM em hospital público de Porto Alegre

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Juliane De Souza Scherer ◽  
Ricardo Andrade Calvetti
Keyword(s):  
Klebsiella Pneumoniae ◽  
Enterobacter Cloacae ◽  
New Delhi ◽  
Porto Alegre ◽  
Klebsiella Pneumoniae Carbapenemase

Justificativa: A multirresistência bacteriana vem preocupando gestores e profissionais de saúde em esfera global. Neste contexto, a resistência aos carbapenêmicos em enterobactérias é particularmente preocupante em função de sua alta mortalidade (de 40 a 50% em 30 dias) e pelas reduzidas opções de tratamento. Entre as carbapenemases, os subtipos KPC (Klebsiella pneumoniae carbapenemase), NDM (New Delhi Metallobetalactamase) e OXA (Oxa-carbapenemase) são encontrados no estado. Objetivo: descrever os casos de enterobatérias produtoras de carbapenemase (EPC) subtipos OXA e NDM em um hospital público de Porto Alegre. Método: Trata-se de pesquisa transversal, utilizando o banco de dados da Comissão de Controle de Infecção Hospitalar do hospital em estudo. A coleta de dados ocorreu após aprovação do Comitê de Ética em Pesquisa no mês de abril de 2015. A amostra englobou os casos confirmados de EPC subtipos OXA e NDM de janeiro a dezembro de 2013. Resultados: Foram identificados 34 casos de EPC, sendo 22 casos confirmados do subtipo OXA-48 e 12 casos do subtipo NDM. Entre os pacientes portadores do subtipo OXA-48, os homens totalizaram 77,3% e a colonização superou em muito a infecção 81,2%; a mortalidade atingiu 54,5% dos casos, sendo que o microrganismo mais prevalente foi a Klebsiella pneumoniae (45,5%). Os homens somaram 58,4% dos casos de NDM, com predominância de colonizações 83,3% em isolados de Enterobacter cloacae, cuja mortalidade contabilizou 58,3%. Conclusões: A elevada mortalidade e a prevalência de colonizações foram relevantes nesta pesquisa. Portanto, a detecção precoce destes mecanismos de resistência pode contribuir para conter sua disseminação. Descritores: Resistência microbiana a medicamentos; Controle de infecções; Enterobacteriaceae

scholarly journals Monitoring Ceftazidime-Avibactam and Aztreonam Concentrations in the Treatment of a Bloodstream Infection Caused by a Multidrug-Resistant Enterobacter sp. Carrying Both Klebsiella pneumoniae Carbapenemase–4 and New Delhi Metallo-β-Lactamase–1

2019 ◽  
Vol 71 (4) ◽  
pp. 1095-1098 ◽  
Author(s):  
Mohamad Yasmin ◽  
Derrick E Fouts ◽  
Michael R Jacobs ◽  
Hanan Haydar ◽  
Steven H Marshall ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
The United States ◽  
Multidrug Resistant ◽  
Therapeutic Drug ◽  
New Delhi ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Antimicrobial Synergy ◽  
Synergy Testing ◽  
Treatment Adequacy

Abstract In an infection with an Enterobacter sp. isolate producing Klebsiella pneumoniae Carbapenemase–4 and New Delhi Metallo-β-Lactamase–1 in the United States, recognition of the molecular basis of carbapenem resistance allowed for successful treatment by combining ceftazidime-avibactam and aztreonam. Antimicrobial synergy testing and therapeutic drug monitoring assessed treatment adequacy.

Genotypes and prevalence of carbapenemase-producing Enterobacteriaceae and Pseudomonas aeruginosa in a hospital in Saudi Arabia

2021 ◽  
Author(s):  
Jaffar A Al-Tawfiq ◽  
Ali A Rabaan ◽  
Justin V Saunar ◽  
Ali M Bazzi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Saudi Arabia ◽  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
New Delhi ◽  
Beta Lactam ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background The molecular epidemiology of resistance of carbapenem-resistant Enterobacteriaceae (CRE) and Pseudomonas aeruginosa are important in the study of multidrug-resistant bacteria. We evaluate the prevalence of the different mechanisms of CRE in a hospital in Saudi Arabia. Methods Carbapenem non-susceptible isolates of Enterobacteriaceae and Pseudomonas aeruginosa were tested by real-time PCR for the detection of genes responsible for beta-lactam resistance. Results There were a total of 200 isolates with carbapenem non-susceptibility and these were Klebsiella pneumoniae (n=96, 48%), Escherichia coli (n=51, 25.5%) and Pseudomonas aeruginosa (n=45, 22.5%). The detected carbapenemases were oxacillinase-48 (OXA-48) (n=83, 41.5%), New Delhi metallo-β-lactamase (NDM) (n=19, 2.5%) and both NDM and OXA-48 (n=5, 2.5%). The other carbapenemases were imipenemase (n=1, 0.5%), Verona integrin encoded metallo-β-lactamase (n=6, 3%) and Klebsiella pneumoniae carbapenemase (n=1, 0.5%), but none were detected in 86 isolates (43%). Conclusion The most common carbapenemases were OXA-48 and a significant percentage had no detectable genes. These data will help in the selection of new antimicrobial therapies.

scholarly journals Carbapenemase among Clinical Bacterial Isolates in Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 159-165
Author(s):  
Surya Prasad Devkota ◽  
Ashmita Paudel ◽  
Dharm Raj Bhatta ◽  
Krishna Gurung
Keyword(s):  
Klebsiella Pneumoniae ◽  
Treatment Options ◽  
Public Health Problem ◽  
New Delhi ◽  
Hospital Hygiene ◽  
Human Pathogens ◽  
Self Medication ◽  
Gram Negative ◽  
Klebsiella Pneumoniae Carbapenemase ◽  
Almost All

Gram-negative isolates producing carbapenemase enzymes is a great public health problem in developing countries and their control is challenging task due to the involvement of multiple factors including the practice of self-medication, use of antibiotics on animal farms, poor hospital hygiene, etc. During this study, we searched various databases for relevant publication on carbapenemase-producing isolates in Nepal. Various classes of carbapenemases had been reported in Nepal. Most frequent was the New Delhi Metallo beta lactamase with many variants where NDM-1 was most prevalent. Similarly, Oxacillinase and Klebsiella pneumoniae carbapenemase producers were also prevalent in Nepal. While other carbapenemases like VIM, IPM, and DIM also detected. The isolates producing carbapenemases were extremely drug-resistant as they also co-produced various other carbapenemases, beta-lactamases, 16S rRNA methylase. Most isolates were resistant to many members of carbapenem, cephalosporin, quinolone, penicillin, aminoglycoside group of antibiotics. Such isolates had very few treatment options as only last line drugs like colistin, fosfomycin, and tigecycline was effective against most of these isolates. Carbapenemase production by almost all major human pathogens including E. coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter. Citrobacter, Proteus, Providencia is a matter of concern because some of these enzymes are located on plasmids and pose rapid dissemination among various gram-negative pathogens. Timely surveillance for carbapenemase producers throughout the nation, their proper treatment, and proper hospital hygiene to prevent nosocomial infections by carbapenemase producers, controlled use of carbapenems, educating health care workers, students and the general public about the adverse effects of antimicrobial resistance is imminent.

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