Carbapenem-Resistant, Gram-Negative Bacilli

Halat, Dalal Hammoudi; Sarkis, Dolla Karam; Moubareck, Carole Ayoub

doi:10.1016/b978-0-12-803642-6.00005-8

Cited by 9 publications

(7 citation statements)

References 110 publications

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“…One hundred and fifty-one CRE strains (12.7%) did not produce any carbapenemase (Table 2). Although not investigated in detail, their carbapenem non-susceptibility was likely due to the production of extended-spectrum or AmpC type beta-lactamases combined with decreased intracellular concentration of the drug caused by porin loss and/or increased efflux mechanisms (Halat et al, 2016). Of them, 93.4% (in contrast to 27.8% of carbapenemase producers, Table 3) exhibited MER MIC < 16 mg/L.…”

Section: Discussionmentioning

confidence: 99%

In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula

Sonnevend

Ghazawi

Darwish

et al. 2020

International Journal of Infectious Diseases

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Our aim was to assess the susceptibility of carbapenem-resistant Enterobacterales (CRE) from the Arabian Peninsula to a broad spectrum of antibiotics, including fosfomycin, ceftazidime-avibactam, and aztreonam-avibactam. Methods: 1192 non-repeat CRE isolated in 2009-2017 from 33 hospitals in five countries of the Arabian Peninsula were tested. The minimum inhibitory concentration of 14 antibiotics was determined. Carbapenemase and 16S methylase genes were detected by PCR. Clonality was assessed by PFGE. Results: The highest rate of susceptibility was detected to aztreonam-avibactam (95.5%) followed by colistin (79.8%), fosfomycin (71.8%) and tigecycline (59.9%). Isolates co-producing two carbapenemases (12.4%) were the least susceptible. Aminoglycoside susceptibility was affected by the frequent production of a 16S methylase. Susceptibility to ceftazidime-avibactam was impacted by the high rate of metallobeta-lactamase producers (46.3%), while aztreonam-avibactam resistance occurred mostly in clonally unrelated, carbapenemase non-producing Escherichia coli. Conclusion: Of the currently available drugs: colistin, tigecycline, and ceftazidime-avibactam coadministered with aztreonam appear to be the most effective to treat CRE infections. However, the presence of non-clonal CRE isolates, in which avibactam does not lower the aztreonam MIC below the clinical breakpoint, is of notable concern. Based on the relatively high rate of fosfomycin susceptibility, it would be desirable to license parenteral fosfomycin in the region.

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Section: Discussionmentioning

confidence: 99%

In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula

Sonnevend

Ghazawi

Darwish

et al. 2020

International Journal of Infectious Diseases

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“…Chromosomal AmpC produces low levels of β-lactamases but can be hyperproduced by β-lactam induction ( Tamma et al., 2019 ). These enzymes are commonly found on Enterobacterales, P. aeruginosa , and A baumannii ( Halat et al., 2016 ). Class C β-lactamases includes AMPC active on cephamycins [CMY-2], ApmC discovered at Dhahran [DHA], AmpC type [ACT], AmpC active on cefoxitin [FOX], Amber class C [ACC], AmpC active on moxalactam [MOX], AmpC from Citrobacter freundii [CFE], and Acinetobacter -derived cephalosporinase [ADC] ( Jacoby, 2006 ).…”

Section: Drug Resistance and Genes Encoding Carbapenemasesmentioning

confidence: 99%

Efficacy and In Vitro Activity of Novel Antibiotics for Infections With Carbapenem-Resistant Gram-Negative Pathogens

Cruz-López

Martínez-Meléndez

Morfín‐Otero

et al. 2022

Front. Cell. Infect. Microbiol.

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Infections by Gram-negative multi-drug resistant (MDR) bacterial species are difficult to treat using available antibiotics. Overuse of carbapenems has contributed to widespread resistance to these antibiotics; as a result, carbapenem-resistant Enterobacterales (CRE), A. baumannii (CRAB), and P. aeruginosa (CRPA) have become common causes of healthcare-associated infections. Carbapenems, tigecycline, and colistin are the last resource antibiotics currently used; however, multiple reports of resistance to these antimicrobial agents have been documented worldwide. Recently, new antibiotics have been evaluated against Gram-negatives, including plazomicin (a new aminoglycoside) to treat CRE infection, eravacycline (a novel tetracycline) with in vitro activity against CRAB, and cefiderocol (a synthetic conjugate) for the treatment of nosocomial pneumonia by carbapenem-non-susceptible Gram-negative isolates. Furthermore, combinations of known β-lactams with recently developed β-lactam inhibitors, such as ceftazidime-avibactam, ceftolozane-tazobactam, ceftazidime-tazobactam, and meropenem-vaborbactam, has been suggested for the treatment of infections by extended-spectrum β-lactamases, carbapenemases, and AmpC producer bacteria. Nonetheless, they are not active against all carbapenemases, and there are reports of resistance to these combinations in clinical isolates.This review summarizes and discusses the in vitro and clinical evidence of the recently approved antibiotics, β-lactam inhibitors, and those in advanced phases of development for treating MDR infections caused by Gram-negative multi-drug resistant (MDR) bacterial species.

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“…Results of this study were showed that, MBLs producers of Pseudomonas aeruginosa were resistant to other antibiotics in high rates especially betalactamantibiotics which included cefoxitin , amoxycillin -clavulanic acid , cephalothin , oxacillin , ceftazidime and piperacillin , in construct , isolates showed high sensitivity to monobactam (aztreonam).MBLs can strongly hydrolyze all bata lactam except monobactam (atreonam) (Saderi et al, 2008), this exception is due to MBLs bind to aztreonam with low affinity and location of the antibiotic within the active site of the enzyme in appropriate hydrolysis, MBLS are resistant to β -lactamase inhibitors commercially available , but they are sensitive to metal ion chelators , this due to metallo β -lactamases dependent on zinc ions in active site of these enzymes , thus binding of metal chelators like EDTA by zinc leads to inhibition of enzyme (Halat et al, 2016) .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Pseudomonas aeruginosa producing Metallo-β- lactamases in wounds and burns infections

2019

University of Thi-Qar Journal of Science

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Metallo β-lactamases (MBLs) producing Pseudomonas aeruginosa have been detected from clinical isolates in worldwide with increase in emergence in the last years. The spread of MBLs positive isolates in a localized hospital environment causes not only a therapeutic problem but as well as a serious concern for infection control handling , hence , this study was aimed to determine the prevalence of P. aeruginosa producing MBLs isolated from some skin infections (wounds and burns). A total of 57 P. aeruginosa were isolated from wounds and burns infections (24 wound swabs and 33 burn swabs) in Al-Hussain Teaching Hospital .Primary screening of carbapenems resistant isolates appeared that 63% (36 isolates) were resistant to imipenem and meropenem .Among the 36 carbapenems resistant isolates that were tested for production MBLs by phenotypic test (CDT)with EDTA inhibitor (as chelating factor), 34 (94%) were MBLs positive and 59.6% from 57 isolates were positive to MBLs production. MICs values of MBLs producers were higher in imipenem ((≥16-64) μg/ml)) than that in meropenem ((≥16-32) μg/ml)). Out of 34 MBLs producer , 24 (72.7%) isolates were founded in specimens of burn swabs , while the wound swabs specimens registered 41.6%. MBLs producing isolates were also tested for antibiotics susceptibility , all isolates (100%)were sensitive to aztreonam and 70.5% to ciprofloxacin. 100% of isolates were resistant to cefoxitin and amoxycillinclavulanic acid.

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Carbapenem-Resistant, Gram-Negative Bacilli

Cited by 9 publications

References 110 publications

In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula

In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula

Efficacy and In Vitro Activity of Novel Antibiotics for Infections With Carbapenem-Resistant Gram-Negative Pathogens

Prevalence of Pseudomonas aeruginosa producing Metallo-β- lactamases in wounds and burns infections

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