Carbapenem-resistant Klebsiella pneumoniae infections in a Greek intensive care unit: Molecular characterisation and treatment challenges.

Abstract:

:Acquisition of carbapenemase-producing Klebsiella pneumoniae (CP-Kp) strains poses a major threat to critically ill patients. The objectives of this study were to describe the epidemiology of CP-Kp isolates as well as the clinical outcome associated with the corresponding infections and to identify risk factors for mortality of intensive care unit (ICU) patients in a Greek hospital. A prospective, observational study was conducted in a nine-bed general ICU over a 2-year period (April 2010-March 2012). Imipenem-resistant K. pneumoniae isolates recovered from clinical samples of ICU patients were prospectively collected and studied for the presence of carbapenemases. Isolates were submitted to molecular typing using pulsed-field gel electrophoresis (PFGE). In total, 61 CP-Kp isolates (48 KPC-producers and 13 VIM-producers) were recovered from 58 ICU patients. The majority of KPC-producers were classified into a single PFGE type, indicating potent clonal dissemination. Among the 32 infected patients, bacteraemia was diagnosed in 16. Tigecycline+colistin was the most common combination antimicrobial regimen. Infection-attributable mortality was 43.8%. Regarding mortality risk factors, non-survivors were older (P=0.080), all of them presented with septic shock (P=0.010) and they had higher Sepsis-related Organ Failure Assessment (SOFA) scores at infection onset (P=0.004) compared with survivors. Appropriate definitive treatment and combination regimens were not associated with patient survival. In conclusion, CP-Kp infections are associated with limited treatment options and high in-hospital mortality. Effective measures for preventing dissemination of respective isolates in the hospital setting are required.

authors

Katsiari M,Panagiota G,Likousi S,Roussou Z,Polemis M,Alkiviadis Vatopoulos C,Evangelia Platsouka D,Maguina A

doi

10.1016/j.jgar.2015.01.006

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

123-127

issue

2

eissn

2213-7165

issn

2213-7173

pii

S2213-7165(15)00008-9

journal_volume

3

pub_type

杂志文章
  • Evaluation of the in vitro antimicrobial activity of selected Saudi scorpion venoms tested against multidrug-resistant micro-organisms.

    abstract:OBJECTIVES:Scorpion venoms are a rich source of bioactive peptides with promising clinical value that may lead to the discovery and development of new drugs. The present study was designed to evaluate the in vitro antimicrobial activities of the venoms extracted from three medically important Saudi scorpions (Androcton...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2017.03.008

    authors: Al-Asmari AK,Alamri MA,Almasoudi AS,Abbasmanthiri R,Mahfoud M

    更新日期:2017-09-01 00:00:00

  • Interaction of carbapenems and β-lactamase inhibitors towards CTX-M-15 and CTX-M-15G238C mutant.

    abstract:OBJECTIVES:The aim of this study was to evaluate the role of residue 238 in CTX-M-15 and CTX-M-15G238C mutant with respect to carbapenems and various β-lactamase inhibitors. METHODS:A CTX-M-15G238C laboratory mutant was generated by site-directed mutagenesis from CTX-M-15 enzyme by replacing glycine 238 with cysteine....

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2017.04.004

    authors: Sabatini A,Brisdelli F,Celenza G,Marcoccia F,Colapietro M,Tavío MM,Piccirilli A,Amicosante G,Perilli M

    更新日期:2017-09-01 00:00:00

  • Extended-spectrum β-lactamase-producing Enterobacteriaceae from animal origin and wastewater in Tunisia: first detection of O25b-B23-CTX-M-27-ST131 Escherichia coli and CTX-M-15/OXA-204-producing Citrobacter freundii from wastewater.

    abstract:OBJECTIVES:This study aimed to isolate and characterise extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) isolates from animals and wastewater in Tunisia. METHODS:ESBL-E from wastewater (n=123 samples), faeces of healthy animals (poultry, sheep, goats and calves) (n=140) and raw milk from healthy cow...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2019.01.002

    authors: Sghaier S,Abbassi MS,Pascual A,Serrano L,Díaz-De-Alba P,Said MB,Hassen B,Ibrahim C,Hassen A,López-Cerero L

    更新日期:2019-06-01 00:00:00

  • Long-range DHPS mutations unexpectedly increase Mycobacterium chimaera susceptibility to sulfonamides.

    abstract::The two closely related mycobacteria, Mycobacterium intracellulare and Mycobacterium chimaera, exhibit a more than two-fold difference in their in vitro susceptibility to sulfonamides. Sulfonamides are antibiotics targeting the 6-hydroxymethyl-7,8-dihydropteroate synthase (DHPS) enzyme involved in the folate synthesis...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2013.05.003

    authors: Gotthard G,Muhammed Ameen S,Drancourt M,Chabriere E

    更新日期:2013-12-01 00:00:00

  • Methicillin-resistant Staphylococcus aureus nasal colonisation amongst healthcare workers in Kurdistan Region, Iraq.

    abstract:OBJECTIVES:The aim of this study was to determine the prevalence of nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) among healthcare workers (HCWs) compared with non-HCWs at Duhok city, Kurdistan Region, northern Iraq. METHODS:A total of 182 HCWs with different occupations and working in different...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2017.01.010

    authors: Hussein NR,Assafi MS,Ijaz T

    更新日期:2017-06-01 00:00:00

  • Draft genome sequences of three multidrug-resistant Cutibacterium (formerly Propionibacterium) acnes strains isolated from acne patients, China.

    abstract:OBJECTIVES:Cutibacterium acnes (formerly Propionibacterium acnes), an anaerobic Gram-positive bacterium, is a skin commensal and is considered to be associated with acne. Here we report the draft genome sequences of three multidrug-resistant (MDR) C. acnes strains (CA17, CA39 and CA51) isolated from skin lesions of acn...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2017.10.008

    authors: Zhang N,Lu Z,Ma Y

    更新日期:2017-12-01 00:00:00

  • Characterisation of a novel integrative and conjugative element ICESsD9 carrying erm(B) and tet(O) resistance determinants in Streptococcus suis, and the distribution of ICESsD9-like elements in clinical isolates.

    abstract::This study identified a novel integrative and conjugative element (ICESsD9) carrying erm(B) and tet(O) resistance determinants in Streptococcus suis D9 and determined its prevalence in clinical isolates. Comparative genome analysis was performed using Mauve and Artemis Comparison Tool visualisation programs. Inverse P...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2016.05.008

    authors: Huang K,Song Y,Zhang Q,Zhang A,Jin M

    更新日期:2016-12-01 00:00:00

  • Comparative study of the impact of the administration of Amoxicillin and Algo-Bio® alternative substance to antibiotics, on the level of selection of resistant Enterobacteriaceae in the digestive flora of piglets.

    abstract:OBJECTIVES:The aim of study was to evaluate by comparative study the level of selection of antibiotic-resistant Enterobacteriaceae in the digestive microbiota of piglets when using amoxicillin and Algo-Bio®. METHODS:Amoxicillin and Algo-Bio® administration was carried out over a period of 5 days (D0-D4) at a dose of 1...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2018.01.008

    authors: Kouadio IK,Guessennd N,Dadié A,Koffi E,Dosso M

    更新日期:2018-06-01 00:00:00

  • Insertion sequences disrupting mgrB in carbapenem-resistant Klebsiella pneumoniae strains in Brazil.

    abstract:OBJECTIVES:This study aimed to characterise insertional mutations disturbing themgrB gene in carbapenem-resistant Klebsiella pneumoniae (CRKp). METHODS:A total of 118 clinical CRKp isolates were surveyed for polymyxin resistance and insertion sequence (IS) elements disruptingmgrB. RESULTS:Of the 118 isolates, 78 (66....

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2020.11.003

    authors: Silva DMD,Faria-Junior C,Nery DR,Oliveira PM,Silva LOR,Alves EG,Lima GRCEC,Pereira AL

    更新日期:2020-11-24 00:00:00

  • Investigation of pre-clinical pharmacokinetic parameters of atovaquone nanosuspension prepared using a pH-based precipitation method and its pharmacodynamic properties in a novel artemisinin combination.

    abstract:OBJECTIVES:Recently, a growing resistance to antimalarial drugs such as chloroquine, sulfadoxine-pyrimethamine, artemisinin derivatives and mefloquine has been observed. The pharmacokinetic limitation of the current therapy and multi-drug resistance has resulted in an urgent need to study the new antimalarial combinati...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2020.02.018

    authors: Kathpalia H,Juvekar S,Mohanraj K,Apsingekar M,Shidhaye S

    更新日期:2020-09-01 00:00:00

  • Impact of ethnic disparities on the treatment outcomes of HIV-negative drug-resistant tuberculosis patients in Kuala Lumpur, Malaysia: A call for a culturally-sensitive community intervention approach.

    abstract:OBJECTIVE:Little is known about the treatment outcomes of HIV-negative drug-resistant tuberculosis (TB) patients in Malaysia. With respect to this issue, this study aimed to determine factors associated with unsuccessful treatment outcomes among drug-resistant TB patients at the Institute of Respiratory Medicine, Kuala...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2019.05.009

    authors: Shariff NM,Shah SA,Kamaludin F

    更新日期:2019-12-01 00:00:00

  • First report of the mcr-1 colistin resistance gene identified in two Escherichia coli isolates from clinical samples, Philippines, 2018.

    abstract:OBJECTIVES:The first report of a plasmid-borne colistin resistance gene (mcr-1) detected in an Escherichia coli isolate from China heralded the emergence of pandrug-resistant bacteria. Since then, the mcr-1 gene has been detected worldwide, but to date it has not been reported in the Philippines. METHODS:In this study...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2019.12.018

    authors: Velasco JMS,Valderama MTG,Margulieux KR,Diones PCS,Reyes AMB,Leonardia SG,Liao CP,Chua DA Jr,Navarro FCS,Ruekit S,Fernandez S,Macareo LR,Crawford JM,Swierczewski BE

    更新日期:2020-06-01 00:00:00

  • Whole-genome sequencing reveals misidentification of a multidrug-resistant urine clinical isolate as Corynebacterium urealyticum.

    abstract:OBJECTIVES:Corynebacterium urealyticum is a non-diphtherial urease-producing clinically relevant corynebacterium associated with urinary tract infections. Most clinical C. urealyticum isolates are multidrug-resistant. Whole-genome sequencing (WGS) of C. urealyticum VH4248 isolated from a clinical urine sample at Hospit...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2020.07.020

    authors: Rocha DJP,Azevedo V,Brenig B,Silva A,Blom J,Ramos RT,Aguiar ERG,Chapartegui-González I,Fernández-Martínez M,Martínez-Martínez L,Pacheco LGC,Navas J

    更新日期:2020-12-01 00:00:00

  • Antimicrobial stewardship in hospitals: Does it work and can we do it?

    abstract::Selection of resistant pathogens by antimicrobial use is probably the most important cause of antimicrobial resistance. Antimicrobial stewardship (AMS) refers to a multifaceted approach to optimise prescribing. The benefits of AMS programmes have been widely demonstrated in terms of reductions in antimicrobial use, mo...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章,评审

    doi:10.1016/j.jgar.2013.08.001

    authors: Levy Hara G

    更新日期:2014-03-01 00:00:00

  • Carbapenem-resistant Acinetobacter baumannii isolates carrying blaOXA genes with upstream ISAba1: First report of a novel OXA subclass from Iran.

    abstract:OBJECTIVES:Carbapenem-resistant Acinetobacter baumannii (CRAB) have emerged as a serious threat to public-health worldwide. This study aimed to determine the antimicrobial susceptibility of A. baumannii isolates in Iran and to investigate oxacillinase-encoding determinants and their association with insertion sequence ...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2018.12.011

    authors: Yazdansetad S,Najari E,Ghaemi EA,Javid N,Hashemi A,Ardebili A

    更新日期:2019-09-01 00:00:00

  • Urinary tract infection in Uruguayan children: Aetiology, antimicrobial resistance and uropathogenic Escherichia coli virulotyping.

    abstract::Uropathogenic Escherichia coli (UPEC) is the most frequent cause of urinary tract infection (UTI). Virulence factors (VFs) of UPEC in children are not well known. Circulating antibiotic resistance mechanisms in the community are increasing. In this study, the aetiological agents of UTI and antibiotic resistance mechan...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2014.08.003

    authors: Robino L,García-Fulgueiras V,Araujo L,Algorta G,Pírez MC,Vignoli R

    更新日期:2014-12-01 00:00:00

  • Opening Pandora's box: High-level resistance to antibiotics of last resort in Gram-negative bacteria from Nigeria.

    abstract:OBJECTIVES:The aim of this study was to determine the percentage of antimicrobial-resistant isolates and the associated resistance mechanisms in Gram-negative bacteria from South Western Nigeria. METHODS:A total of 306 non-duplicate unbiased Gram-negative isolates were recovered from patients admitted to three teachin...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2019.10.016

    authors: Ogbolu DO,Piddock LJV,Webber MA

    更新日期:2020-06-01 00:00:00

  • Antibiotic susceptibility and molecular epidemiology of Acinetobacter calcoaceticus-baumannii complex strains isolated from a referral hospital in northern Vietnam.

    abstract::Acinetobacter calcoaceticus-baumannii complex is a common cause of hospital-acquired infections (HAIs) globally, remarkable for its high rate of antibiotic resistance, including to carbapenems. There are few data on the resistance of A. baumannii in Vietnam, which are essential for developing evidence-based treatment ...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2014.05.003

    authors: Van TD,Dinh QD,Vu PD,Nguyen TV,Pham CV,Dao TT,Phung CD,Hoang HT,Tang NT,Do NT,Nguyen KV,Wertheim H

    更新日期:2014-12-01 00:00:00

  • Coexistence of blaKPC-2-IncN and mcr-1-IncX4 plasmids in a ST48 Escherichia coli strain in China.

    abstract:OBJECTIVES:The aim of this study was to explore the genomic content of a blaKPC-2- and mcr-1-harbouring Escherichia coli strain and to clarify the molecular mechanism for the transmission of multidrug resistance. METHODS:Antimicrobial susceptibility testing was conducted by the broth microdilution method to determine ...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2020.08.023

    authors: Wang Y,Liu H,Wang Q,Du X,Yu Y,Jiang Y

    更新日期:2020-12-01 00:00:00

  • Global antibacterial resistance: The never-ending story.

    abstract::Bacterial resistance is undoubtedly recognised as a major medical challenge in most healthcare systems. Resistance-determining genes, mostly in combination, and multidrug-resistant (MDR) pathogens are spreading with unprecedented speed. Well known resistance carriers with high clinical impact include the Gram-positive...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章,评审

    doi:10.1016/j.jgar.2013.03.010

    authors: Theuretzbacher U

    更新日期:2013-06-01 00:00:00

  • Epidemiology of multidrug-resistant Gram-negative pathogens isolated from ventilator-associated pneumonia in ICU patients.

    abstract:OBJECTIVES:Antibiotic resistance among Gram-negative pathogens isolated from ventilator-associated pneumonia (VAP) poses a grave threat in intensive care unit (ICU) patients. The aim of this study was to assess the prevalence of pathogens in ICU patients and their drug resistance profile. The prevalence of extended-spe...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2016.12.016

    authors: Gupta R,Malik A,Rizvi M,Ahmed M,Singh A

    更新日期:2017-06-01 00:00:00

  • Evolutionary rescue of bacteria via horizontal gene transfer under a lethal β-lactam concentration.

    abstract::β-Lactams are a commonly used class of bactericidal antibiotics. The number of β-lactam-resistant pathogens is constantly increasing in hospitals around the world. Interestingly, most of the β-lactam-resistant bacteria carry mobile genetic elements, such as conjugative plasmids, that render the pathogen resistant. The...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2014.02.005

    authors: Ojala V,Mattila S,Hoikkala V,Bamford JK,Jalasvuori M

    更新日期:2014-09-01 00:00:00

  • Analysis of interactions of clinical mutants of catalase-peroxidase (KatG) responsible for isoniazid resistance in Mycobacterium tuberculosis with derivatives of isoniazid.

    abstract:OBJECTIVES:Isoniazid (INH) resistance is a major contributor to the emergence of multidrug resistance in Mycobacterium tuberculosis (MTB), hampering the success of tuberculosis treatment. This study aimed to identify good leads based on INH derivatives against INH-resistant MTB strains. Mutations at codon 315 in the ka...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2017.06.014

    authors: Unissa AN,Doss C GP,Kumar T,Swathi S,Lakshmi AR,Hanna LE

    更新日期:2017-12-01 00:00:00

  • Serotype distribution, antibiotic resistance patterns and molecular characteristics of serogroup 6 Streptococcus pneumoniae isolates collected from Chinese children before the introduction of PCV13.

    abstract:OBJECTIVES:Streptococcus pneumoniae is an important pathogen in infectious diseases worldwide, and serogroup 6 S. pneumoniae strains are very common in China. This study investigated the serotype distribution, antibiotic resistance patterns and molecular characteristics of 215 serogroup 6 S. pneumoniae isolates collect...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2017.12.007

    authors: Shi W,Zhou K,Yuan L,Meng Q,Dong F,Gao W,Chen C,Wen D,Yao K

    更新日期:2018-09-01 00:00:00

  • Predictors of death among drug-resistant tuberculosis patients in Kuala Lumpur, Malaysia: A retrospective cohort study from 2009 to 2013.

    abstract::The emergence of drug-resistant tuberculosis (TB) is a major public health threat. However, little is known about the predictors of death in drug-resistant TB in Malaysia. This study aimed to determine the predictors of death in drug-resistant TB patients, including multidrug-resistant TB (MDR-TB), in Kuala Lumpur, Ma...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2016.04.005

    authors: Mohd Shariff N,Shah SA,Kamaludin F

    更新日期:2016-09-01 00:00:00

  • Forecasting models of infections due to carbapenem-resistant Gram-negative bacteria in an intensive care unit in an endemic area.

    abstract:OBJECTIVES:The aim of this study was to forecast the monthly incidence rates of infections [infections/1000 bed-days (IBD)] due to carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Acinetobacter baumannii (CRAB) and total carbapenem-resistant Gra...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2019.06.019

    authors: Karampatakis T,Tsergouli K,Iosifidis E,Antachopoulos C,Mouloudi E,Karyoti A,Tsakris A,Roilides E

    更新日期:2020-03-01 00:00:00

  • Characteristic antimicrobial resistance of clinically isolated Stenotrophomonas maltophilia CYZ via complete genome sequence.

    abstract:OBJECTIVES:Stenotrophomonas maltophilia is an important multidrug-resistant pathogen that is associated with various serious nosocomial infections. In our study, we investigated the antimicrobial resistance traits of clinical S. maltophilia strain CYZ isolated from the sputum of an immunocompromised patient. METHODS:T...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2020.09.008

    authors: Ma J,Feng J,Shan Y,Zhao Y,Qiao H,Xie L,Lin X,Wang C,Chuai X

    更新日期:2020-12-01 00:00:00

  • Prospective multicentre study on azole resistance in Aspergillus isolates from surveillance cultures in haematological patients in Italy.

    abstract:OBJECTIVES:This study was conducted to assess the prevalence of azole resistance in Aspergillus isolates from patients with haematological malignancies or who were undergoing haematopoietic stem cell transplantation and to identify the molecular mechanism of resistance. METHODS:In this 28-month prospective study invol...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2020.01.016

    authors: Prigitano A,Esposto MC,Grancini A,Passera M,Paolucci M,Stanzani M,Sartor A,Candoni A,Pitzurra L,Innocenti P,Micozzi A,Cascio GL,Delia M,Mosca A,Mikulska M,Ossi C,Fontana C,Pizzolante M,Gelmi M,Cavanna C,Lallitto F

    更新日期:2020-09-01 00:00:00

  • Infections by OXA-48-like-producing Klebsiella pneumoniae non-co-producing extended-spectrum beta-lactamase: Can they be successfully treated with cephalosporins?

    abstract:BACKGROUND:OXA-48 is an Ambler class D β-lactamase that hydrolyses penicillin and imipenem but has poor hydrolytic activity against cephalosporins. However, very few clinical experiences of treating extended-spectrum β-lactamase (ESBL)-negative OXA-48 producers with cephalosporins have been published. OBJECTIVES:The a...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2019.02.016

    authors: Escolà-Vergé L,Larrosa N,Los-Arcos I,Viñado B,González-López JJ,Pigrau C,Almirante B,Len O

    更新日期:2019-12-01 00:00:00

  • Biofilm formation and transfer of a streptomycin resistance gene in enterococci from fermented pork.

    abstract:OBJECTIVES:Multidrug-resistant (MDR) enterococci are found extensively in food samples. This study characterized the phenotypic virulence factors and the ability of horizontal gene transfer of a streptomycin resistance gene among enterococci isolated from fermented pork. METHODS:Thirty-six MDR enterococci were subject...

    journal_title:Journal of global antimicrobial resistance

    pub_type: 杂志文章

    doi:10.1016/j.jgar.2020.04.016

    authors: Chotinantakul K,Chansiw N,Okada S

    更新日期:2020-09-01 00:00:00