Epidemiology of carbapenem-resistant Klebsiella pneumoniae colonization: a surveillance study at a Turkish university hospital from 2009 to 2013

Zarakolu, Pınar; Eser, Özgen Köseoğlu; Aladağ, Elifcan; Alzahrani, Ibrahim; Day, Kathryn M.; Atmaca, Özgür; Boral, Barış; Çakır, Banu; Perry, John D.; Akova, Murat

doi:10.1016/j.diagmicrobio.2016.05.012

Cited by 29 publications

(26 citation statements)

References 23 publications

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“…Similarly, Kuzucu et al found 3.6% carbapenem resistance among the K. pneumoniae isolates from the East part of Turkey in the same time period (28). Then, the rate of carbapenem resistance slightly increased to 6.8% in 2013 (29). In agreement with the previous data, the current study showed that 5.8% of K. pneumoniae isolates recovered from a tertiary hospital in the capital city of Turkey were phenotypically resistant to carbapenems.…”

Section: Discussionsupporting

confidence: 90%

“…This enzyme was firstly reported from a K. pneumoniae isolate in Turkey in 2001 (22). Later, it was reported from different hospitals with increased rates (29,32). A multi-central surveillance study performed at a Turkish university hospital from 2009 to 2013 showed that more than 96% of K. pneumoniae isolates harbored blaOXA-48 carbapenamese (21).…”

Section: Discussionmentioning

confidence: 94%

“…In Turkey, the rate of carbepenem resistance was reported in 2.2% of K. pneumoniae isolates recovered in a university hospital from 2004 to 2007 (26). Thereafter, the increased resistance rates varying from 3.7% to 16.6% were reported from different hospitals (27)(28)(29).…”

Section: Discussionmentioning

confidence: 96%

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Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

Çelikbilek¹,

Ünaldı²,

Kırca³

et al. 2017

Jundishapur J Microbiol

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Background: Carbapenem-resistant Klebsiella pneumoniae isolates can spread among the hospitalized patients and result in serious infections and increase mortality. Molecular studies provide useful information about resistance mechanisms and crosstransmission among the resistant isolates. Objectives: The current study aimed at investigating phenotypic and molecular characteristics of the carbapenem resistance and clonal relationship among the K. pneumoniae isolates recovered from infection sites and rectal swabs of the patients hospitalized in a tertiary hospital. Methods: Resistance to carbapenems was investigated by disc-diffusion and E-test methods. Modified Hodge test (MHT) and ethylenediaminetetraacetic acid (EDTA)-combine disc (ECD) methods were performed to determine carbapenemases. Carbapenemase-encoding genes including blaOXA-48, blaNDM-1, blaKPC, blaIMP, and blaVIM were investigated by multiplex polymerase chain reaction (PCR). Clonal relationship among the isolates was determined by the pulsed-field gel electrophoresis (PFGE). Results: Carbapenem resistance was observed in 93 (5.8%) of the 1605 K. pneumoniae isolates. Majority (n = 66, 71%) of the resistant isolates were recovered from the patients in intensive care units (ICUs). Almost all carbapenem-resistant K. pneumoniae isolates (n = 91, 97.8%) were positive with MHT. Only 6 (6.5%) of the resistant isolates were positive with ECD method. The blaOXA-48 and blaNDM-1 were found in 90.3% (n = 84) and 6.5% (n = 6) of the resistant isolates, respectively. The pulsed-field gel electrophoresis yielded

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

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Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

Çelikbilek¹,

Ünaldı²,

Kırca³

et al. 2017

Jundishapur J Microbiol

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“…Recently, carbapenem-resistant gram-negative bacteria have become quite another multiresistant infectious agent with limited treatment options. Carbapenem-resistant Klebsiella pneumonia (CR-KP) hydrolyses carbapenems via β-lactamase enzyme and thus shows resistance to many antimicrobial agents [1,2]. Unfortunately, these organisms also have resistance mechanisms for the second line antibiotics.…”

Section: Introductionmentioning

confidence: 99%

Carbapenem-resistant Klebsiella pneumonia infection in a tertiary urology clinic: analysis of influencing factors with a controlled trial

et al. 2020

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Background/aim: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections encountered in urology patients differentiate from infections caused by other factors, both in respect to prophylaxis and treatment stage, and require a special approach. We aimed to analyse the predisposing factors and the antibiotherapies for CR-KP infection outbreak in a tertiary urology clinic. Materials and methods:There were 75 patients in the CR-KP positive group (Group I) and 146 patients in the CR-KP negative group (Group II). Analysis of the predisposing factors for CR-KP infection and comparison of the reinfection rate and the antibiotherapies in the 2 groups were the endpoints.Results: In the first group, age, comorbidity, previous antibiotic use, and nephrostomy tube rates were higher (P = 0.015, P = 0.001, P = 0.004, and P < 0.001, respectively). In the second group, open urological surgery rate, and the proportion of patients presenting with flank pain, lower urinary tract symptoms, and haematuria were higher (P = 0.029, P < 0.001, P < 0.001, and P = 0.007). In the first group, the proportion of patients treated with transurethral bladder tumour resection was higher, whereas, percutaneous nephrolithotomy was higher in the second group (P = 0.045 for both). While hospitalization and Foley catheterization duration were longer in the first group (P < 0.001 for both), double J stent and nephrostomy duration were longer in the second group (P < 0.001 and P = 0.005). Mean leukocyte count at admission was higher in the first group (P < 0.001). Conclusion:Advanced age, comorbidities, previous antibiotic use, and prolonged Foley catheterization duration are predisposing factors for this infection in the urology department. Two-week administration of combination antibiotic regimens containing carbapenem were effective for the treatment of this infection.

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“…even KPCs (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In addition, temocillin demonstrated efficacy in in vivo infection models as well as in patients (19)(20)(21).…”

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confidence: 99%

Resurrecting Old β-Lactams: Potent Inhibitory Activity of Temocillin against Multidrug-ResistantBurkholderiaSpecies Isolates from the United States

Zeiser

Becka

Barnes

et al. 2019

Antimicrob Agents Chemother

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Burkholderia spp. are opportunistic human pathogens that infect persons with cystic fibrosis and the immunocompromised. Burkholderia spp. express class A and C ␤-lactamases, which are transcriptionally regulated by PenR A through linkage to cell wall metabolism and ␤-lactam exposure. The potency of temocillin, a 6-methoxy-␤-lactam, was tested against a panel of multidrug-resistant (MDR) Burkholderia spp. In addition, the mechanistic basis of temocillin activity was assessed and compared to that of ticarcillin. Susceptibility testing with temocillin and ticarcillin was conducted, as was biochemical analysis of the PenA1 class A ␤-lactamase and AmpC1 class C ␤-lactamase. Molecular dynamics simulations (MDS) were performed using PenA1 with temocillin and ticarcillin. The majority (86.7%) of 150 MDR Burkholderia strains were susceptible to temocillin, while only 4% of the strains were susceptible to ticarcillin. Neither temocillin nor ticarcillin induced bla expression. Ticarcillin was hydrolyzed by PenA1 (k cat /K m ϭ 1.7 Ϯ 0.2 M Ϫ1 s Ϫ1 ), while temocillin was slow to form a favorable complex (apparent K i [K i app ] ϭ ϳ2 mM). Ticarcillin and temocillin were both potent inhibitors of AmpC1, with K i app values of 4.9 Ϯ 1.0 M and 4.3 Ϯ 0.4 M, respectively. MDS of PenA revealed that ticarcillin is in an advantageous position for acylation and deacylation. Conversely, with temocillin, activesite residues K73 and S130 are rotated and the catalytic water molecule is displaced, thereby slowing acylation and allowing the 6-methoxy of temocillin to block deacylation. Temocillin is a ␤-lactam with potent activity against Burkholderia spp., as it does not induce bla expression and is poorly hydrolyzed by endogenous ␤-lactamases.

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Epidemiology of carbapenem-resistant Klebsiella pneumoniae colonization: a surveillance study at a Turkish university hospital from 2009 to 2013

Cited by 29 publications

References 23 publications

Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

Carbapenem-resistant Klebsiella pneumonia infection in a tertiary urology clinic: analysis of influencing factors with a controlled trial

Resurrecting Old β-Lactams: Potent Inhibitory Activity of Temocillin against Multidrug-ResistantBurkholderiaSpecies Isolates from the United States

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