Increasing prevalence and dissemination of NDM-1 metallo- -lactamase in India: data from the SMART study (2009)

Lascols, Christine; Hackel, Meredith; Marshall, Steven H.; Hujer, Andrea M.; Bouchillon, S.; Badal, R.; Hoban, Daryl J.; Bonomo, Robert A.

doi:10.1093/jac/dkr240

Cited by 154 publications

(128 citation statements)

References 25 publications

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“…However, carbapenems are now frontline antibiotics in many more clinical situations than before because of the emergence and spread of ESBL-and plasmid-mediated AmpCproducing Enterobacteriaceae. The emergence of transferable resistance to these antibiotics, which are now disseminating very rapidly, is a public health emergency because of the very limited commercially available antimicrobials showing activity against carbapenemase-producing Gram-negative bacteria [Tortola et al 2005;Hirsch and Tam 2010;Carrer et al 2010;Lascols et al 2011;Nordmann et al 2011;Patel and Bonomo 2011;Glupczynski et al 2012]. This is due to the hydrolytic activity of these enzymes against b-lactams, but also to the fact that these organisms usually harbour resistance mechanisms affecting other classes of antibiotics (e.g.…”

Section: Other Drugsmentioning

confidence: 99%

Clinical management of infections caused by multidrug-resistant Enterobacteriaceae

Delgado-Valverde

Sojo-Dorado

Pascual

2013

Therapeutic Advances in Infection

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Enterobacteriaceae showing resistance to cephalosporins due to extended-spectrum b-lactamases (ESBLs) or plasmid-mediated AmpC enzymes, and those producing carbapenemases have spread worldwide during the last decades. Many of these isolates are also resistant to other first-line agents such as fluoroquinolones or aminoglycosides, leaving few available options for therapy. Thus, older drugs such as colistin and fosfomycin are being increasingly used. Infections caused by these bacteria are associated with increased morbidity and mortality compared with those caused by their susceptible counterparts. Most of the evidence supporting the present recommendations is from in vitro data, animal studies, and observational studies. While carbapenems are considered the drugs of choice for ESBL and AmpC producers, recent data suggest that certain alternatives may be suitable for some types of infections. Combined therapy seems superior to monotherapy in the treatment of invasive infections caused by carbapenemase-producing Enterobacteriaceae. Optimization of dosage according to pharmacokinetics/pharmacodynamics data is important for the treatment of infections caused by isolates with borderline minimum inhibitory concentration due to lowlevel resistance mechanisms. The increasing frequency and the rapid spread of multidrug resistance among the Enterobacteriaceae is a true and complex public health problem. IntroductionThe traditional first-line available options for treating serious infections caused by enterobacteria include penicillins, cephalosporins, monobactams, carbapenems, fluorquinolones, and in certain situations, aminoglycosides. The frequency of resistance to these first-line agents has been rising worldwide during the last decades [Paterson 2006;Rhomberg and Jones 2009;Houghton et al. 2010;Nordmann, et al. 2011] and now reach high proportions in many areas of the world.

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Section: Other Drugsmentioning

confidence: 99%

Clinical management of infections caused by multidrug-resistant Enterobacteriaceae

Delgado-Valverde

Sojo-Dorado

Pascual

2013

Therapeutic Advances in Infection

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“…However, as carbapenemases began to emerge worldwide, the effectiveness of this last-line antibiotic class was challenged. 4 There is insufficient data regarding expression of ESBL, AmpC and metallo-β-lactamases (MBL) by E. coli strains causing extraintestinal infections in India. Hence, the present study was undertaken to find out the prevalence of ESBL, AmpC and MBL production among ExPEC isolates in a tertiary care hospital and to co-relate such infections with treatment and clinical outcome.…”

Section: Introductionmentioning

confidence: 99%

Expression of ESBL, MBL and AmpC β lactamases by extra intestinal Escherichia coli isolates: correlation with treatment and clinical outcome

Chakraborty¹

2013

Jmid

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Objective:We investigated the expression of Extended Spectrum β-Lactamases (ESBLs), AmpC β lactamases and Carbapenemases in extraintestinal pathogenic Escherichia coli (ExPEC) isolates and correlated with treatment and outcome of the patients. Methods:Three hundred ExPEC infected patients were included in the study. Demographic data, antibiogram, treatment and outcome were collected. Production of ESBLs was detected by combination disk method; AmpC was detected by AmpC disk test. Carbapenemase production was detected by disk diffusion and confirmed by modified Hodge test. Identification of metallo-β-lactamase (MBL) activity was performed by the carbapenem-EDTA combined disk method and MBL E-test.Results: Out of 300 E. coli isolates, 212 (71%) were ESBL producers. AmpC β lactamase production was seen in 95 (32%) isolates; 16 (17%) isolates were pure AmpC producers whereas 79 (83%) were ESBL co-producers. Twenty nine (9.5%) isolates were carbapenemase producers of which 15 (5%) were MBL producers. For treatment, most widely prescribed antibiotics were β-lactam+β-lactamase inhibitor combinations (39%). Sixty seven percent patients improved; relapse/ re-infection was seen in 18% of patients and 11% patients expired. Increased mortality was seen in patients with blood stream infection and more number of relapses was seen in urinary tract infection. Conclusion:ExPEC producing ESBL or AmpC along with carbapenemases are particularly challenging for clinicians and are a major threat worldwide. Early use of appropriate antibiotics like β-lactam+β-lactamase inhibitor combinations will probably reduce complications in these patients. Key words: AmpC, ExPEC, ESBL, MBL, J Microbiol Infect Dis 2013;3(4): 150-156 Ekstra intestinal Escherichia coli izolatlarından GSBL, MBL ve AmpC β laktamazların salınımı: Tedavi ve klinik sonuçlarla uyumuÖZET Amaç: Ekstra intestinal patojenik Escherichia coli (EİPEC) izolatlarından salınan GSBL, AmpC β laktamazlar ve Karbapenemazların salınımını ve bu hastaların tedavisi ve klinik gidişle ilişkisini araştırdık.Yöntemler: Çalışmaya 300 EİPEC ile enfekte hasta alındı. Demografik veriler, antibiyogram, tedavisi ve sonuçları toplandı. GSBL üretimi kombine disk metodu ve AmpC üretimi AmpC-disk testi ile tespit edildi. Karbapenemaz salınımına modifiye Hodge testi ile doğrulanmış disk diffüzyonla bakıldı. Metallo-β-laktamaz (MBL) aktivitesi karbapenem-EDTA kombine disk metodu ve MBL E-test ile çalışıldı. Bulgular:Üç yüz E. coli izolatının 212'si (% 71) GSBL pozitif idi. AmpC β laktamaz üretimi 95 (% 32) görüldü; izolatların 16'sı (% 17) saf AmpC üretirken, 79'u (% 83) GSBL ile beraberdi. Karbapenemaz üreten yirmi dokuz (% 9,5) izolatın 15'i (% 5) MBL üretiyordu. Tedavi için, en yaygın olarak reçete edilen antibiyotikler β-laktam + β-laktamaz inhibitör kombinasyonları (% 39) idi. Hastaların % 67'i iyileşti; nüks/yeni enfeksiyon hastaların % 18'inde görülürken % 11 hasta da öldü. Kan dolaşımı enfeksiyonu olan ve sık nüks eden idrar yolu enfeksiyonlarında mortalite daha yüksekti.Sonuç: Karbepena...

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“…A worldwide study carried out in two hundred and thirty five isolates of Enterobacteriaceae from intraabdominal infection selected on the basis of their reduced susceptibility to ertapanam (breakpoints MICs ≥ 0.5 mg/L) showed that a large proportion of isolates originated from India (68%). Also of this all the thirty-three bla NDM-1-carrying isolates were from patients in India and comprised five different species [12]. A study carried out in India in 464 isolates, 57 (12.3%) showed a reduced susceptibility to imipenem and meropenem and further showed that all the carbapenamaseresistant isolates were bla (NDM-1) positive by PCR and 13 isolates bore variants that differed in sequence from bla (NDM-1) which were NDM-5, NDM-6, and NDM-7 [13].…”

Section: National Statusmentioning

confidence: 99%

Epidemiology of NDM-1 and its Variants in Multidrug Resistant Gram-Negative Bacilli Isolated from Infection in Cancer Patients

Vira¹,

Bhat²

2017

Med chem

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Increasing prevalence and dissemination of NDM-1 metallo- -lactamase in India: data from the SMART study (2009)

Abstract: A range of carbapenemase genes, associated with diverse ESBLs and/or AmpC backgrounds, were found among Enterobacteriaceae isolated during the study. Many of these ertapenem non-susceptible strains were clonally related and carried various combinations of β-lactamases.

Cited by 154 publications

References 25 publications

Clinical management of infections caused by multidrug-resistant Enterobacteriaceae

Clinical management of infections caused by multidrug-resistant Enterobacteriaceae

Expression of ESBL, MBL and AmpC β lactamases by extra intestinal Escherichia coli isolates: correlation with treatment and clinical outcome

Epidemiology of NDM-1 and its Variants in Multidrug Resistant Gram-Negative Bacilli Isolated from Infection in Cancer Patients

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