Molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit

Bagattini, Maria; Crivaro, Valeria; Popolo, Anna Di; Gentile, Fabrizio; Scarcella, A; Triassi, Maria; Villari, Paolo; Zarrilli, Raffaele

doi:10.1093/jac/dkl077

Cited by 59 publications

(48 citation statements)

References 9 publications

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“…SHV genes have been shown to confer resistance to third-generation cephalosporins. 6,8 Other reported ESBL types include TEM, CTX-M and OXA. Of note, the prevalent genotypes vary in different countries on the basis of the differences in the use of antibacterial agents and prevalence of plasmids that harbour ESBLs genes.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Infections caused by multidrug-resistant Gram-negative bacilli that produce extended-spectrum b-lactamase (ESBL) enzymes have been reported with increasing frequency in NICU settings. [3][4][5][6][7][8] These organisms elaborate enzymes, the plasmid-encoded b-lactamases, which can deactivate certain antibiotics by hydrolyzing the amide bond in the b-lactam ring of these antibiotics. Although a variety of ESBL enzymes have been described, the TEM and SHV enzymes are the most frequently observed.…”

Section: Introductionmentioning

confidence: 99%

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RETRACTED ARTICLE: Extended-spectrum β-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

et al. 2008

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Objectives: Extended-spectrum beta-lactamase producing (ESBL) Klebsiella pneumoniae is an important cause of nosocomial infections in neonatal intensive care units (NICUs). Our objectives were to determine (1) the incidence of ESBL K. pneumoniae in our NICU, (2) the frequency of SHV-1 and SHV-2 gene acquisition among ESBL K. pneumoniae isolates, (3) the risk factors associated with ESBL K. pneumoniae infection and (4) the clinical outcomes of infected infants.Study Design: We conducted a prospective surveillance study in our NICU over a period of 1 year on all neonates admitted without evidence of early sepsis. We collected specimens from blood, urine, cerebrospinal fluid, swabs from wounds and throat and endotracheal tube aspirates of infants whenever sepsis was suspected. Bacterial isolates were identified via clinical morphology, Gram stain and standard biochemical tests. Antimicrobial susceptibility was determined by disc diffusion method, and phenotypic confirmation of ESBL production was done by the double-disc synergy test and Etest. Genetic detection of SHV-1 and SHV-2 genes in ESBL K. pneumoniae isolates was done by polymerase chain reaction (PCR) and restriction fragment length polymorphisms. Risk factors associated with ESBL K. pneumoniae infection were analysed by both univariate and multiple logistic regression methods.Results: A total of 980 cultures were obtained from 380 neonates, and 372 screening cultures were collected from the environment. K. pneumoniae was cultured from 27 (7%) infants (3.8/1000 patient-days); of them, 18 (67%) were ESBL producers. PCR amplicons revealed the presence of SHV-2 in all 18 isolates (100%), and SHV-1 gene in 8 isolates (44%). Independent risk factors for ESBL K. pneumoniae infection were mechanical ventilation (OR: 4.2, confidence interval (CI): 1.6-11.0); birth weight <1500 g (OR: 3.2, CI: 1.2-8.3) ); duration of hospitalization >15 days (OR: 4

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Extended-spectrum β-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

et al. 2008

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“…Antibiotic therapy with a carbapenem could be useful to control the infection. A multicountry study reported that carbapenems are the treatment of choice for infections caused by ESBL-producing K. pneumoniae (26). Coresistance to several antimicrobial agents has often been described for CTX-M-producing isolates (27,28).…”

Section: Discussionmentioning

confidence: 99%

Strain Typing and Molecular Characterization of CTX-M-1 Group ESBL in Clinical Klebsiella pneumoniae Isolated from Children

Peerayeh

Derakhshan

Fallah

et al. 2016

Arch Pediatr Infect Dis

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“…İzolatların hazırlanması [3,4] 1. Biyokimyasal ve/veya moleküler yöntemlerle tür düzeyinde tanımlanmış bakterilerden kanlı triptikaz soy agar besiyerine tek koloni ekimi yapılır.…”

Section: Yöntemlerunclassified

“…Bakteri süspan-siyonu kısa süre (5 dakika) içinde agaroza gömü-lecek ise oda ısısında, gömülmeyecek ise kırık buz içinde bekletilir. [3,4] 1. HST içerisinde %2'lik düşük erime ısılı agaroz (Gibco BRL, Paisley, UK) hazırlanır.…”

Section: Yöntemlerunclassified

Pulsed-Field Gel Electrophoresis (PFGE) standardization protocol for Proteus mirabilis

Karagöz

Ceylan²,

Durmaz³

2013

J Clin Exp Invest

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Objective: For the detection of outbreaks caused by Proteus mirabilis, strains clonal relations are determined methods as "pulsed-field gel electrophoresis (PFGE)". The aim of this study was optimization of a pulsed-field gel electrophoresis for molecular typing of P. mirabilis. Methods:In this study, PFGE' protocol is optimized for use in molecular typing of P. mirabilis. Phylogenetic analyzes of strains were evaluated with Bionumerics software system (version 6.01; Applied Maths, Sint-MartensLatem, Belgium). Results:This protocol compared with Gram-negative bacteria PFGE protocols, NotI enzyme is suitable for this bacterium. Electrophoresis conditions should be revealed as; -block 1: initial pulse duration 1 sec, ending pulse duration 30 sec, striking angle 120°, the current 6 V/cm 2 , temperature 14°C, time 8 hours; -block 2: initial pulse duration 30 sec, ending pulse duration 70 sec, striking angle 120°, the current 6 V/cm 2 , temperature 14°C, time 16 hours; -TBE, pH=8.4. Conclusion:P. mirabilis strains were typed by PFGE and Bionumerics analysis program were determined clonal relationships. The procedure was simple, reproducible and suitable for these bacteria. Also it was evaluated, because of reducing time, the solution volumes and enzymes can be economically. Outbreaks of nosocomial infections due to bacteria studied assessment and the potential to provide useful information about the degree of prevalence. This optimized protocol is allowed different centers' PFGE results to compare with other laboratories results. J Clin Exp Invest 2013; 4 (3): 306-312

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Molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit

Abstract: The selection of ESBL-producing clones and the transfer of the bla(SHV-12) ESBL gene between different clones were responsible for the spread of K. pneumoniae in the neonatal intensive care unit.

Cited by 59 publications

References 9 publications

RETRACTED ARTICLE: Extended-spectrum β-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

RETRACTED ARTICLE: Extended-spectrum β-lactamase producing Klebsiella pneumoniae in neonatal intensive care unit

Strain Typing and Molecular Characterization of CTX-M-1 Group ESBL in Clinical Klebsiella pneumoniae Isolated from Children

Pulsed-Field Gel Electrophoresis (PFGE) standardization protocol for Proteus mirabilis

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