Clinical factors predicting persistent carriage of Klebsiella pneumoniae carbapenemase-producing carbapenem-resistant Enterobacteriaceae among patients with known carriage

Yk, Kim; Song, Shasha; Jn, Lee; Oh, Myounghak; Km, Jo; Kim, Hyung Jun; Jh, Lee; Park, J; Hj, Jang; Kiem, Sungmin

doi:10.1016/j.jhin.2017.10.017

Cited by 28 publications

(20 citation statements)

References 27 publications

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“…Factors such as immunosuppression, ICU admission, antibiotics exposure including carbapenems, invasive devices are making patients at risk of infections by CRKP [21]. The 31 patients involved in the outbreak had complex, extended or repeated, and overlapping inpatient stays, which lead to an increased risk of multidrug resistance strains infection [22,23]. Mostly of the patients who received Carbapenem-including treatment in the 90 days before the strains isolated.…”

Section: Discussionmentioning

confidence: 99%

Successful control of the first carbapenem-resistant Klebsiella pneumoniae outbreak in a Chinese hospital 2017–2019

Zhu

et al. 2020

Antimicrob Resist Infect Control

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Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is considered as a serious global threat. CRKPs occurred only sporadically in the Second Hospital of Shanxi Medical University. Our study aimed to investigate and control the first outbreak of CRKP in our hospital occurred between October 2017 and August 2019. Methods: The antimicrobial stewardship (AMS) workers have been implemented control measures properly. Clinical and epidemiological data were retrospectively collected from medical records. Carbapenemase genes were detected by modified carbapenem inactivation method (mCIM) test and the EDTA-modified carbapenem inactivation method (eCIM) test. Resistance genes were identified by polymerase chain reaction (PCR) and sequencing. Genetic relatedness was studied by multilocus sequence typing (MLST). Results: During the outbreak, 31 patients were infected with CRKP isolates. 20 (64.5%) patients were infected with KPC-2 and/or NDM-1 producing K. pneumoniae. Mostly MLST-sequence types belonged to ST11 (21/31). The outbreak was two major K. pneumoniae clusters present in epidemiologically linked patients. Conclusions: Setting up AMS workers is potentially a highly efficient strategy for the successful control of the outbreak. A multimodal and multidisciplinary infection control strategy proved to be crucial. The emergence of CRKP in our hospital emphasizes the importance of continuous monitoring of these isolates, which helps to limit the spread of CRKPs and improve the level of management.

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Section: Discussionmentioning

confidence: 99%

Successful control of the first carbapenem-resistant Klebsiella pneumoniae outbreak in a Chinese hospital 2017–2019

Zhu

et al. 2020

Antimicrob Resist Infect Control

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“…Carbapenem resistance involves one or more of several diverse mechanisms of actions in multi-resistant Gram-negative bacteria. The most frequently encountered β-lactamase enzymes are the acquired carbapenemases in the Ambler class A group of which Klebsiella pneumoniae carbapenemases predominate worldwide [ 116 , 128 , 129 , 130 , 131 ]. An alarm call on the spread of carbapenem-resistance has been in existence since KPC was identified in 1996 in the United States.…”

Section: Epidemiology Of Carbapenemase-producing Organismsmentioning

confidence: 99%

Carbapenem Resistance: A Review

2017

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Carbapenem resistance is a major and an on-going public health problem globally. It occurs mainly among Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, and may be intrinsic or mediated by transferable carbapenemase-encoding genes. This type of resistance genes are already widespread in certain parts of the world, particularly Europe, Asia and South America, while the situation in other places such as sub-Saharan Africa is not well documented. In this paper, we provide an in-depth review of carbapenem resistance providing up-to-date information on the subject.

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“…The most frequently carbapenemases associated with Enterobacteriaceae worldwide are those belonging to the KPC family (Woodford et al , 2011; Rimoldi et al. , 2017; van Duin and Doi, 2017; Kim et al , 2018; Muggeo et al , 2018). In 2017, among the European Union (EU) and European Economic Area (EEA) countries, the highest detection rates for KPC-producing Klebsiella pneumoniae human invasive isolates were reported from Greece (64.7%), Italy (29.7%) and Romania (22.5%), where the resistance situation for carbapenems remains problematic.…”

Section: Epidemiology Of Carbapenemresistance Among Bacteriamentioning

confidence: 99%

Carbapenemase-producing bacteria in food-producing animals, wildlife and environment: A challenge for human health

Bonardi

Pitino

2019

Ital J Food Safety

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Antimicrobial resistance is an increasing global health problem and one of the major concerns for economic impacts worldwide. Recently, resistance against carbapenems (doripenem, ertapenem, imipenem, meropenem), which are critically important antimicrobials for human cares, poses a great risk all over the world. Carbapenemases are β-lactamases belonging to different Ambler classes (A, B, D) and encoded by both chromosomal and plasmidic genes. They hydrolyze a broad variety of β-lactams, including carbapenems, cephalosporins, penicillins and aztreonam. Despite several studies in human patients and hospital settings have been performed in European countries, the role of livestock animals, wild animals and the terrestrial and aquatic environment in the maintenance and transmission of carbapenemase- producing bacteria has been poorly investigated. The present review focuses on the carbapenemase-producing bacteria detected in pigs, cattle, poultry, fish, mollusks, wild birds and wild mammals in Europe as well as in non-European countries, investigating the genetic mechanisms for their transmission among food-producing animals and wildlife. To shed light on the important role of the environment in the maintenance and genetic exchange of resistance determinants between environmental and pathogenic bacteria, studies on aquatic sources (rivers, lakes, as well as wastewater treatment plants) are described.

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Clinical factors predicting persistent carriage of Klebsiella pneumoniae carbapenemase-producing carbapenem-resistant Enterobacteriaceae among patients with known carriage

Cited by 28 publications

References 27 publications

Successful control of the first carbapenem-resistant Klebsiella pneumoniae outbreak in a Chinese hospital 2017–2019

Successful control of the first carbapenem-resistant Klebsiella pneumoniae outbreak in a Chinese hospital 2017–2019

Carbapenem Resistance: A Review

Carbapenemase-producing bacteria in food-producing animals, wildlife and environment: A challenge for human health

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