Nosocomial infections by Klebsiella pneumoniae carbapenemase producing enterobacteria in a teaching hospital

Seibert, G. Burton; Hörner, Rosmari; Meneghetti, Bettina; Righi, Roselene Alves; Forno, Nara Lúcia Frasson Dal; Salla, Adenilde

doi:10.1590/s1679-45082014ao3131

Cited by 41 publications

(45 citation statements)

References 15 publications

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“…w przeprowadzonej analizie zakażeń szpitalnych powodowanych przez pałeczki Enterobacteriaceae produkujące karbapenemazy. Wykazali oni, że bakterie te były izolowane głównie z wydzieliny oskrzelowej (25%), moczu (21%) oraz krwi (11%) [21].…”

Section: Dyskusjaunclassified

Antibiotic resistance profiles of KPC and NDM carbapenemases-producing Klebsiella pneumoniae

Ojdana¹,

Białymstoku²,

Sacha³

et al. 2019

Medicine

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pneumoniae to ważny czynnik etiologiczny zakażeń szpitalnych, a jego znaczenie kliniczne w ostatnim czasie się zwiększa wskutek narastającej zdolności produkcji karbapenemaz. Cel pracy. Celem pracy było określenie profili oporności na antybiotyki pałeczek K. pneumoniae wytwarzających karbapenemazy KPC lub NDM. Materiał i metody. Badania przeprowadzono na stu trzydziestu czterech szczepach K. pneumoniae, w tym trzydziestu dziewięciu szczepach wytwarzających karbapenemazy typu KPC, oraz dziewięćdziesięciu pięciu wytwarzających metalo-β-laktamazy typu NDM. Szczepy wyizolowano z materiałów klinicznych pochodzących od pacjentów hospitalizowanych w Uniwersyteckim Szpitalu Klinicznym w Białymstoku. Wrażliwość na antybiotyki badanych szczepów przeprowadzono w systemie automatycznym VITEK-2. Ocena wytwarzania karbapenemaz przez badane szczepy została potwierdzona metodami zalecanymi przez EUCAST. Wyniki. Wykazano, że wrażliwość szczepów KPC-dodatnich na antybiotyki była najwyższa na gentamycynę (87,2%) oraz kolistynę (61,1%). W przypadku szczepów NDM-dodatnich stwierdzono, że kolistyna, trimetoprim z sulfametoksazolem oraz gentamycyna były antybiotykami, wobec których odnotowano najwyższe odsetki szczepów wrażliwych, odpowiednio: 93,2%, 66,3% oraz 44,7%. Analiza wyników badania lekowrażliwości wykazała, że u szczepów KPC-dodatnich najczęściej występującym profilem oporności (15,4%) była oporność na cyprofloksacynę, meropenem i trimetoprim z sulfametoksazolem, średnia wrażliwość dotyczyła amikacyny, imipenemu, tygecykliny, natomiast wrażliwość-gentamycyny i kolistyny. W przypadku badanych szczepów NDM-dodatnich najczęstszy profil oporności (32,9%) dotyczył ich oporności na cyprofloksacynę, gentamycynę, meropenem, imipenem, średnią wrażliwość szczepy te wykazywały na amikacynę, tygecyklinę, a wrażliwość-na kolistynę i trimetoprim z sulfametoksazolem. Wnioski. Z przeprowadzonych badań wynika, że wszystkie szczepy K. pneumoniae KPC-dodatnie oraz NDM-dodatnie cechowała wielolekooporność oraz znaczne zróżnicowanie profili oporności na antybiotyki.

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Section: Dyskusjaunclassified

Antibiotic resistance profiles of KPC and NDM carbapenemases-producing Klebsiella pneumoniae

Ojdana¹,

Białymstoku²,

Sacha³

et al. 2019

Medicine

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“…In addition, this resistance mechanism has high potential for dissemination due to its plasmid location, which facilitates transfer to the interspecies gene. Therefore, KPC has been identified in several other Enterobacteriaceae and nonfermenting Gram-negative bacilli ( Acinetobacter baumannii and Pseudomonas aeruginosa ) 3, 4…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial activity evaluation and comparison of methods of susceptibility for Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter spp. isolates

Rechenchoski

Dambrozio

Vivan

et al. 2017

Brazilian Journal of Microbiology

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The production of KPC (Klebsiella pneumoniae carbapenemase) is the major mechanism of resistance to carbapenem agents in enterobacterias. In this context, forty KPC-producing Enterobacter spp. clinical isolates were studied. It was evaluated the activity of antimicrobial agents: polymyxin B, tigecycline, ertapenem, imipenem and meropenem, and was performed a comparison of the methodologies used to determine the susceptibility: broth microdilution, Etest® (bioMérieux), Vitek 2® automated system (bioMérieux) and disc diffusion. It was calculated the minimum inhibitory concentration (MIC) for each antimicrobial and polymyxin B showed the lowest concentrations for broth microdilution. Errors also were calculated among the techniques, tigecycline and ertapenem were the antibiotics with the largest and the lower number of discrepancies, respectively. Moreover, Vitek 2® automated system was the method most similar compared to the broth microdilution. Therefore, is important to evaluate the performance of new methods in comparison to the reference method, broth microdilution.

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“…[16] Seibert et al in their study in Brazil found K. pneumoniae was the microorganism that presented with the greatest resistance to carbapenems ( 62.0%). [17] Praveen et al, 2010 studied K. pneumoniae, from 134 clinical isolates about 43.6% percent isolates were resistant to Meropesnem. (Praveen et al, 2010).…”

Section: Discussion:-mentioning

confidence: 99%

Comparison of Phenotypic and Genotypic Methods for Detection of Carbapenem Resistance in an Indian Tertiary Care Hospital.

Bhat¹,

ijar²,

Kakru³

et al. 2018

IJAR

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Carbapenem-resistant Enterobacteriaceae (CRE), an emerging threat to public health, belong to a family of microorganisms that are difficult to treat because they are highly resistant to antibiotics.These bacteria can cause serious hospital-and community-acquired infections, such as bloodstream infections, wound infections, urinary tract infections and pneumonia. [1] Unlike Methicillin Resistant Staphylococcus aureus (MRSA) resistance, which is mediated by a single mechanism in a single bacterial species, the mechanisms of carbapenem resistance are complex because they involve a broad range of organisms and are mediated by different mechanisms, such as the production of β-lactamases,efflux pump and porin mutations. [2] Carbapenemases are β-lactamases with versatile hydrolytic capacities. They hydrolyze penicillins, cephalosporins, monobactams, and carbapenems. Bacteria producing these β-lactamases may cause serious infections in which the carbapenemase activity renders many β-lactams ineffective. Carbapenemases are members of the Ambler class A, B, and D β-lactamases. The class A carbapenemase group includes members of the SME, IMI, NMC, GES, and KPC families. Of these, the KPC carbapenemases are the most prevalent,found mostly on plasmids in Klebsiella pneumoniae. [3] The first member of the KPC family was discovered through the ICARE surveillance project in a K. pneumoniae clinical isolate from North Carolina in 1996. [4] The gene encoding the KPC enzyme is usually flanked by transposon-related sequences and has been identified on conjugative plasmids,therefore,potential for dissemination is significant. [5,6,7] Isolates that acquire this enzyme are usually resistant to several other classes of antimicrobial agents used as treatment options. Laboratory identification of KPC-producing clinical isolates will be critical for limiting the spread of this resistance mechanism. [8] The most commonly used method for detection of CRE is the measurement of minimum inhibitory concentration (MIC). MICs are important in diagnostic laboratories to confirm resistance of microorganisms to an antimicrobial agent. It is a quantitative measurement of antibiotic activity, and it is defined as the minimum concentration of an antibiotic that can inhibit visible microbial growth under normal conditions. [9,10] In 2009, CLSI published a recommendation that carbapenem susceptible Enterobacteriaceae with susceptible, but elevated MIC, be tested for the presence of the carbapenemase enzyme using the Modified Hodge Test (MHT). [11] In 2010, the CLSI changed

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Nosocomial infections by Klebsiella pneumoniae carbapenemase producing enterobacteria in a teaching hospital

Cited by 41 publications

References 15 publications

Antibiotic resistance profiles of KPC and NDM carbapenemases-producing Klebsiella pneumoniae

Antibiotic resistance profiles of KPC and NDM carbapenemases-producing Klebsiella pneumoniae

Antimicrobial activity evaluation and comparison of methods of susceptibility for Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter spp. isolates

Comparison of Phenotypic and Genotypic Methods for Detection of Carbapenem Resistance in an Indian Tertiary Care Hospital.

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