Detection of NDM-1-Producing
            <i>Klebsiella pneumoniae</i>
            in Kenya

Poirel, Laurent; Revathi, Gunturu; Bernabeu, Sandrine; Nordmann, Patrice

doi:10.1128/aac.01247-10

Cited by 182 publications

(84 citation statements)

References 17 publications

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“…Here, the RmtC enzyme was involved and was encoded by a gene located on the same plasmid carrying the bla NDM-1 gene. Such an association between those two genes was previously reported in a single K. pneumoniae isolate from India (19) and in a series of K. pneumoniae isolates from Kenya (26). A 150-kb and untypeable plasmid coharboring the two genes was similarly identified here and in the Indian isolate.…”

supporting

confidence: 54%

Spread of NDM-1-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Istanbul, Turkey

Poirel

Yılmaz

Istanbullu

et al. 2014

Antimicrob Agents Chemother

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Twenty-two consecutive carbapenem-resistant enterobacterial isolates were recovered from patients hospitalized between January and April 2013 in different units at a university hospital in Istanbul, Turkey. These were Klebsiella pneumoniae isolates producing the carbapenemases OXA-48, NDM-1, and KPC-2, Enterobacter cloacae isolates producing NDM-1, and Escherichia coli isolates producing OXA-48. Most of the OXA-48-producing K. pneumoniae and all the NDM-1-producing E. cloacae were clonally related. The NDM-1-producing E. cloacae isolates recovered from a single neonatal intensive care unit corresponded to a single cluster, highlighting the spread of that clone in that setting.

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confidence: 54%

Spread of NDM-1-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Istanbul, Turkey

Poirel

Yılmaz

Istanbullu

et al. 2014

Antimicrob Agents Chemother

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“…[18] The emergence and possible spread of carbapenem-resistant Enterobacteriaceae isolates in the province would represent an additional step in the wrong direction that might be enhanced by misuse of carpabenems, as observed a few years ago in some Asian countries. [32] …”

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance of bacteria isolated from patients with bloodstream infections at a tertiary care hospital in the Democratic Republic of the Congo

et al. 2015

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Corresponding author: L M Irenge (leonid.irenge@uclouvain.be)Background. Bloodstream infection (BSI) is a life-threatening condition that requires rapid antimicrobial treatment. Methods. We determined the prevalence of bacterial isolates associated with BSI at Bukavu General Hospital (BGH), South Kivu Province, Democratic Republic of the Congo, and their patterns of susceptibility to antimicrobial drugs, from February 2013 to January 2014. Results. We cultured 112 clinically relevant isolates from 320 blood cultures. Of these isolates, 104 (92.9%) were Gram-negative bacteria (GNB), with 103 bacilli (92.0%) and one coccus (0.9%). Among GNB, Escherichia coli (51.9%), Klebsiella spp. (20.2%), Enterobacter spp. (6.7%), Shigella spp. (5.8%) and Salmonella spp. (4.8%) were the most frequent agents causing BSIs. Other GNB isolates included Proteus spp., Citrobacter spp. and Pseudomonas aeruginosa (both 2.9%), and Acinetobacter spp. and Neisseria spp. (both 0.9%). High rates of resistance to co-trimoxazole (100%), erythromycin (100%) and ampicillin (66.7 -100%) and moderate to high resistance to ciprofloxacin, ceftazidime, ceftriaxone, cefuroxime and cefepime were observed among GNB. Furthermore, there were high rates of multidrug resistance and of extended-spectrum β-lactamase (ESBL) production phenotype among Enterobacteriaceae. Gram-positive bacteria included three Staphylococcus aureus isolates (2.7%), four oxacillin-resistant coagulase-negative staphylococci (CoNS) isolates (3.6%) and one Streptococcus pneumoniae (0.9%). No oxacillin-resistant S. aureus was isolated. Among clinically relevant staphylococci, susceptibility to co-trimoxazole and ampicillin was low (0 -25%). In addition, 58 contaminant CoNS were isolated from blood cultures, and the calculated ratio of contaminants to pathogens in blood cultures was 1:2. Conclusions. Multidrug-resistant and ESBL-producing GNB are the leading cause of BSI at BGH. Med J 2015;105(9):752-755. S Afr

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“…The differences observed between both studies (we observed that several class A enzymes, including KPCs and MBLs, were the most undetected carbapenemases by the AES) could be due to the different carbapenems used in the cards. The discrepancy in detection of OXA-163 and OXA-48 could also be due to differences in the hydrolytic profiles of these enzymes (24).…”

Section: Vol 49 2011mentioning

confidence: 99%

Can We Use Imipenem and Meropenem Vitek 2 MICs for Detection of Suspected KPC and Other-Carbapenemase Producers among Species of Enterobacteriaceae?

Pasterán

Lucero

Soloaga³

et al. 2011

J Clin Microbiol

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Imipenem and meropenem Vitek 2 MICs were evaluated for a panel of 104 Enterobacteriaceae for identification of carbapenemase producers. The sensitivity and specificity values for the new CLSI interpretative criteria (CLSI document M100-S20-U, 2010) were 98% and 83% for imipenem and 76% and 83% for meropenem, respectively. We propose an algorithm that is highly sensitive (98%) and specific (94%) for carbapenemase screening based on the combined use of imipenem and meropenem MICs.Carbapenems are increasingly utilized as drugs of last resort against a variety of infections due to the emergence of extended-spectrum-␤-lactamase (ESBL)-producing Enterobacteriaceae (23). The emergence of carbapenem-resistant Enterobacteriaceae is therefore worrisome, as the antimicrobial armamentarium is consequently restricted (6, 17). The resistance of Enterobacteriaceae to carbapenems could be related to carbapenemases or to a dual mechanism associating an outer membrane permeability defect with ␤-lactamases such as AmpC cephalosporinase and ESBLs, particularly with the presence of CTX-M variants (9-11, 15, 16, 27, 29). The vast majority of acquired carbapenemases belong to three of the four known classes of ␤-lactamases, namely, Ambler class A (KPC, Sme, NMC-A, IMI, and some allelic variants of the GES/IBC enzymes), Ambler class B (metallo-␤-lactamases [MBLs]), and Ambler class D (oxacillinases [OXAs]) (5). The locations of carbapenemase genes on highly mobile genetic elements have contributed to their rapid spread and the frequent cotransfer of multiple other antibiotic resistance factors (6,18,19). The ability to limit the spread of carbapenemase producers will require effective laboratory screening methods to rapidly identify patients infected with these organisms. Automated antimicrobial susceptibility testing systems, such as Vitek 2 (bioMérieux, Marcy L'Etoile, France), are commonly used in microbiology laboratories to decrease the laboratory turnaround time. However, several reports have questioned the ability of Vitek 2 to identify carbapenemase producers (1,2,17,25,28). Previous reports suggest an ertapenem MIC of Ն4.0 g/ml (formerly, an ertapenem resistance result [7]) as the most accurate way to detect KPC carbapenemase (2, 17). In Argentina, among several other countries in which CTX-M is endemic, a large proportion of nosocomial Enterobacteriaceae display ertapenem resistance (about 5%, 15%, 20%, and 25% of the Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, and Enterobacter species strains, respectively, from WHONET-Argentina Network [n ϭ 55,351]), although most of them did not produce carbapenemases, as determined by molecular methods. The selection of CTX-M-2-producing mutants with porin loss was responsible for this ertapenem resistance. With ertapenem and meropenem as indicators (MICs of Ն4 g/ml and Ն8 g/ml, respectively), Vitek 2 was not able to differentiate true resistance mediated by carbapenemases from that mediated by AmpC cephalosporinases and ESBLs in combination with an outer membrane perme...

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Detection of NDM-1-Producing Klebsiella pneumoniae in Kenya

Cited by 182 publications

References 17 publications

Spread of NDM-1-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Istanbul, Turkey

Spread of NDM-1-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Istanbul, Turkey

Antimicrobial resistance of bacteria isolated from patients with bloodstream infections at a tertiary care hospital in the Democratic Republic of the Congo

Can We Use Imipenem and Meropenem Vitek 2 MICs for Detection of Suspected KPC and Other-Carbapenemase Producers among Species of Enterobacteriaceae?

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