New Delhi metallo- -lactamase-1: local acquisition in Ontario, Canada, and challenges in detection

Kus, Julianne V.; Tadros, Manal; Simor, Andrew E.; Low, Donald E.; McGeer, Allison; Willey, Barbara M.; Larocque, Cindy; Pike, Karen; Edwards, I.; Dedier, Helen; Melano, Roberto G.; Boyd, David A.; Mulvey, Michael R.; Louie, Lisa; Okeahialam, Christopher; Bayley, Mark; Whitehead, Cynthia; Richardson, Denyse; Carr, L G; Jinnah, Fatema; Poutanen, Susan M.

doi:10.1503/cmaj.110477

Cited by 35 publications

(26 citation statements)

References 15 publications

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“…Both of the patients described by Kus and colleagues 7 were asymptomatic, so treatment of their infections was not necessary. However, if the patients had been symptomatic, their urinary tract infections would have been untreatable -Providencia and Morganella species are intrinsically resistant to colistin.…”

Section: Key Pointsmentioning

confidence: 98%

“…It is therefore possible that, owing to poor sanitation, NDM-1-producing organisms could further spread throughout southern Asia, causing an increase in the prevalence of conditions such as cystitis. 4,5 The examples reported by Kus and colleagues 7 are but two of several cases of colonization or infection with NDM-1-producing organisms known to have occurred in Canada; for the foreseeable future, the Canadian medical community can brace itself for many more -whether they are linked to India or not. The spread of NDM-1 is not only due to its high rate of genetic transfer among unrelated bacterial species, but also to human factors such as travel, sanitation and food production and preparation.…”

Section: Key Pointsmentioning

confidence: 99%

“…In their article for the CMAJ, Kus and colleagues 7 present two important but contrasting case studies. The first patient, an 86-year-old man, had no contact with India or southern Asia.…”

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confidence: 99%

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New Delhi metallo- -lactamase-1: detection and prevention

Walsh¹

2011

Canadian Medical Association Journal

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Section: Key Pointsmentioning

confidence: 98%

Section: Key Pointsmentioning

confidence: 99%

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New Delhi metallo- -lactamase-1: detection and prevention

Walsh¹

2011

Canadian Medical Association Journal

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“…The rapid emergence of NDM-1 has been related to transmissible plasmids which can transfer among dif-ferent isolates; subsequently, NDM-1 can spread throughout the world (Kus et al, 2011;Diene et al, 2011;Liang et al, 2011;Ong et al, 2011). So far, in Iranian studies on different bacteria, the emphasis has been on identification of Ambler class A and class D and also three reports on Ambler class B beta-lactamases (Fallah et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Identification of extended-spectrum-beta-lactamases(ESBLs), metallo-beta-lactamases (MBLs), Amp-C and KPC -lactamases among Klebsiella pneumoniae isolated from adults and pediatric patients in Iran

Fallah¹,

Mojdeh²,

Goudarzi³

et al. 2013

Afr. J. Microbiol. Res.

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Klebsiella pneumoniae is one of the major bacteria that cause acute infections. β-lactamases are main defensive mechanisms in bacteria against drugs. The aim of this study was to determine antibiotic resistance patterns and detection of extended-spectrum-beta-lactamase (ESBL), MBL, Amp-C and KPC β-lactamases among K. pneumoniae strains isolated from adults and infants. This descriptive study was done on 83 K. pneumoniae isolated from two hospitals. Antibiotic susceptibility tests were performed by Kirby-Bauer disc diffusion and broth microdilution methods according to Clinical Laboratory Standards Institute (CLSI) guidelines. ESBLs, MBL, Amp-C and KPC producing strains were detected by phenotypic confirmatory test, combination disk diffusion test (CDDT), Amp-C detection kit and Modified Hodge test, respectively. From 83 K. pneumoniae strains, 48 (57.5%), 3 (3.5%), 23 (28%) and 5 (6%) were ESBL, MBL, Amp-C and KPC positive, respectively. In this study, Fosfomycin and Tigecycline were more active than other antibiotics. The results demonstrated that incidence of ESBLs, Amp-C, MBLs and KPC was critical especially in infants. Therefore, detection of drug resistance patterns in K. pneumoniae and β-lactamases producing isolates is important for the prevention and control of these infections.

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“…However, dependence on carbapenems will increase the selective pressure for carbapenem resistance. Resistance was rare in Toronto in 2009, but several recent case reports suggest that CRE incidence may be increasing (10,24).…”

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confidence: 99%

Decreased Susceptibility to Noncarbapenem Antimicrobials in Extended-Spectrum-β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates in Toronto, Canada

Lowe

McGeer

Muller

et al. 2012

Antimicrob Agents Chemother

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Retrospective review from 11 Canadian hospitals showed increasing incidence of extended-spectrum ␤-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae from 0.12 per 1,000 inpatient days during 2005 to 0.47 per 1,000 inpatient days during 2009. By 2009, susceptibility rates of ESBL-positive E. coli/K. pneumoniae were as follows: ciprofloxacin, 12.8%/ 9.0%; TMP/SMX, 32.9%/12.2%; and nitrofurantoin, 83.8%/10.3%. Nosocomial and nonnosocomial ESBL-producing E. coli isolates had similar susceptibility profiles, while nonnosocomial ESBL-producing K. pneumoniae was associated with decreased ciprofloxacin (P ‫؍‬ 0.03) and nitrofurantoin (P < 0.001) susceptibilities. Multidrug-resistant Enterobacteriaceae strains have become a global concern. Increasing incidence of extended-spectrum ␤-lactamase-producing Enterobacteriaceae (ESBL-E) may be attributable, in part, to the successful clonal dissemination of the CTX-M-15 plasmid worldwide (2, 22). Carbapenem-resistant Enterobacteriaceae (CRE) are also emerging across the globe (3, 9, 15). Low prevalence rates (4.1%) of ESBL-producing E. coli have been described in Canada, predominantly due to CTX-M ␤-lactamases (23), and only sporadic cases of imported CRE have been reported (13,23).Infections due to ESBL-E are associated with increased morbidity, mortality, length of hospital stay, and cost (11). Therapeutic alternatives for ESBL-E are limited with increasing resistance to non-␤-lactam antibiotics (6), resulting in a high likelihood of inappropriate initial empirical therapy (8). Carbapenems continue to be the treatment choice for severe infections due to ESBL-E (16), but resistance to these agents is also emerging (9, 15).In light of these concerns regarding ESBL-E, a retrospective review of incidence rates and susceptibility profiles for ESBL-E was conducted in 11 large hospitals (five academic and six community) in Toronto, Canada, from 2005 to 2009. Participating hospital characteristics have been previously described (12). All ESBL-producing Ambler class A Escherichia coli and Klebsiella pneumoniae clinical isolates were included. Susceptibility testing was performed utilizing VITEK2 (bioMérieux, St. Laurent, Quebec, Canada) in 10 hospitals and Phoenix2 (Becton Dickenson, Mississauga, Ontario, Canada) in the remaining hospital. Isolates intermediate or resistant to an extended-spectrum cephalosporin (cefpodoxime, ceftriaxone, or ceftazidime) were confirmed as ESBL-E with double disk diffusion testing as per the 2009 CLSI standards (1). Mean incidence rates were calculated after each site was adjusted per 1,000 inpatient days. Only the first clinical isolate from any one patient was included. Isolates were defined as nosocomial if they were identified from cultures obtained 3 or more days after admission to the hospital in patients without a prior specimen yielding ESBL-E. Statistical analysis was performed utilizing the chi-squared test or the chi-squared test for trend, as well as a multivariate analysis (SAS 9.2; Cary, NC). Fig. 1. There were 1,994 E...

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New Delhi metallo- -lactamase-1: local acquisition in Ontario, Canada, and challenges in detection

Cited by 35 publications

References 15 publications

New Delhi metallo- -lactamase-1: detection and prevention

New Delhi metallo- -lactamase-1: detection and prevention

Identification of extended-spectrum-beta-lactamases(ESBLs), metallo-beta-lactamases (MBLs), Amp-C and KPC -lactamases among Klebsiella pneumoniae isolated from adults and pediatric patients in Iran

Decreased Susceptibility to Noncarbapenem Antimicrobials in Extended-Spectrum-β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates in Toronto, Canada

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