Carbapenemase-producing Enterobacterales infections: recent advances in diagnosis and treatment

Lee, Yu-Lin; Chen, Hsien-Meng; Hii, Ing-Moi; Hsueh, Po‐Ren

doi:10.1016/j.ijantimicag.2022.106528

Cited by 39 publications

(28 citation statements)

References 86 publications

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“…All of them had urological disorders and four had immunosuppression, while six had a high Charlson comorbidity index >3. The duration of treatment was 5.5 weeks/episode ([ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ], +/−15.3 days). In 14/17 UTI episodes, the patients had 1 daily dose for the first 3 weeks followed by 1 dose every 48 h.…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen episodes of chronic prostatitis were treated with an oral FT regimen of 1 dose/24–48 h for a total mean duration of 5.5 weeks [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Clinical and microbiological recovery was achieved in more than 90% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Oral fosfomycin-trometamol (FT) could be an alternative to carbapenems in male ESBL-E UTIs. Regarding the epidemiology of the resistance among ESBL strains, ESBL-E remains susceptible to FT in 90% of cases, and to EBSL E. coli in more than 95% of cases [ 5 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Usually in France, FT is indicated as a single oral dose for the first-line treatment of cystitis [ 1 ] and is used in combination with intravenous (IV) administration for the treatment of systemic infections.…”

Section: Introductionmentioning

confidence: 99%

“…However, it is not currently indicated for the treatment of male UTIs [ 1 ]. Only few studies suggested a possible place in this indication [ 5 , 12 , 13 , 14 ]. Recent clinical data support efficacy for the treatment of male UTIs with a clinical cure rate of 50 to 77% and a microbiological eradication rate of more than 50% in male UTIs with E. coli [ 2 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales

Bouiller

Zayet²,

Lalloz

et al. 2022

Antibiotics

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Background: Antimicrobial drugs to treat male urinary tract infection (UTI) with multidrug-resistant Enterobacterales are limited. We studied oral fosfomycin-trometamol (FT) in this situation. The objective was to assess the clinical cure rate in patients presenting UTIs treated with oral FT. Methods: We conducted a single-center observational retrospective study from January 2017 to August 2018. The primary endpoint was clinical cure; and the secondary endpoints were incidence of recurrences, oral FT safety, and microbiological cure. Results: Sixteen male patients were included, presenting 21 UTI episodes. Fourteen patients (88%) have at least one underlying urologic disorder. We described 4 episodes of acute UTI and 17 episodes of chronic bacterial prostatitis (CBP). Sixteen out of twenty-one Enterobacterales were extended spectrum beta-lactamase (ESBL)-producers and all the patients presented a resistance to fluoroquinolones and trimethoprim/sulfamethoxazole. In acute UTI, the regimen was a daily dose of oral FT for a mean duration of 2.5 weeks (+/−7.0 days). Clinical and microbiological recovery was achieved in all patients, with no recurrence after 5.3 months follow-up on average (+/−10.4 days). In CBP, the regimen was one oral dose of fosfomycin every 24–48 h, for a mean duration of 5.5 weeks/UTI episodes (+/−15.3 days). Clinical and microbiological recovery was found in 16/17 cases. Seven of the twelve patients with CBP had relapsed and 3/12 had had a new episode of infection after an average follow-up of 5.8 months. Only 6/21 of patients presented minor or moderate adverse effects, such as digestive disorders. Conclusions: FT could be an alternative option to carbapenems in the treatment of multidrug-resistant Enterobacterales infections for male UTIs.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales

Bouiller

Zayet²,

Lalloz

et al. 2022

Antibiotics

View full text Add to dashboard Cite

show abstract

“…The rapid and global spread of carbapenemase-producing Enterobacterales has triggered an unprecedented public health crisis due to the lack of novel clinically effective antibiotics (Queenan and Bush, 2007;Nordmann et al, 2011a;Lee et al, 2022). Carbapenems are broad-spectrum β-lactam antibiotics that have been administered as a last-line resort, being generally reserved to treat life-threatening infections caused by multidrug-resistant (MDR) Gram-negative bacterial infections (Papp-Wallace et al, 2011;Lee et al, 2022). The production of carbapenemases by certain Enterobacterales and non-fermentative bacteria, can threaten the efficacy of these antimicrobials making them useless (Queenan and Bush, 2007;Nordmann et al, 2011a;Lee et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Genomic Analysis of a Highly Virulent NDM-1-Producing Escherichia coli ST162 Infecting a Pygmy Sperm Whale (Kogia breviceps) in South America

et al. 2022

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Carbapenemase-producing Enterobacterales are rapidly spreading and adapting to different environments beyond hospital settings. During COVID-19 lockdown, a carbapenem-resistant NDM-1-positive Escherichia coli isolate (BA01 strain) was recovered from a pygmy sperm whale (Kogia breviceps), which was found stranded on the southern coast of Brazil. BA01 strain belonged to the global sequence type (ST) 162 and carried the blaNDM–1, besides other medically important antimicrobial resistance genes. Additionally, genes associated with resistance to heavy metals, biocides, and glyphosate were also detected. Halophilic behavior (tolerance to > 10% NaCl) of BA01 strain was confirmed by tolerance tests of NaCl minimal inhibitory concentration, whereas halotolerance associated genes katE and nhaA, which encodes for catalase and Na+/H+ antiporter cytoplasmic membrane, respectively, were in silico confirmed. Phylogenomics clustered BA01 with poultry- and human-associated ST162 lineages circulating in European and Asian countries. Important virulence genes, including the astA (a gene encoding an enterotoxin associated with human and animal infections) were detected, whereas in vivo experiments using the Galleria mellonella infection model confirmed the virulent behavior of the BA01 strain. WHO critical priority carbapenemase-producing pathogens in coastal water are an emerging threat that deserves the urgent need to assess the role of the aquatic environment in its global epidemiology.

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Modified Carba PBP test for rapid detection and differentiation between different classes of carbapenemases in Enterobacterales

Wang,

Lu,

Dou

et al. 2024

Microchim Acta

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Carbapenemase-producing Enterobacterales infections: recent advances in diagnosis and treatment

Cited by 39 publications

References 86 publications

Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales

Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales

Genomic Analysis of a Highly Virulent NDM-1-Producing Escherichia coli ST162 Infecting a Pygmy Sperm Whale (Kogia breviceps) in South America

Modified Carba PBP test for rapid detection and differentiation between different classes of carbapenemases in Enterobacterales

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