Predictors of mortality from extended-spectrum beta-lactamase-producing Enterobacteriaceae bacteremia

Namikawa, Hiroki; Imoto, Waki; Yamada, Koichi; Tochino, Yoshihiro; Kaneko, Yukihiro; Kakeya, Hiroshi; Shuto, Taichi

doi:10.1080/22221751.2023.2217951

Cited by 4 publications

(1 citation statement)

References 55 publications

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“…Therefore, the spread of ESBL/AmpC-producing Gram-negative bacteria poses a growing concern worldwide and is of clinical and epidemiological importance [2]. The case fatality rate for ESBL-producing Enterobacterales infections ranges between 12% and 41% [3], and the in-hospital costs of a single ESBL infection reach up to US$30,093 [4]. Similarly, higher Antibiotics 2023, 12, 1528 2 of 13 mortality and increased hospital costs were observed for patients infected with AmpCproducing bacteria compared with susceptible isolates of the same organisms [5].…”

Section: Introductionmentioning

confidence: 99%

Occurrence, Typing, and Resistance Genes of ESBL/AmpC-Producing Enterobacterales in Fresh Vegetables Purchased in Central Israel

Kon,

Lurie-Weinberger,

Cohen

et al. 2023

Antibiotics

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Beta-lactam resistance can lead to increased mortality, higher healthcare expenses, and limited therapeutic options. The primary mechanism of beta-lactam resistance is the production of extended-spectrum beta-lactamases (ESBL) and AmpC beta-lactamases. The spread of beta-lactamase-producing Enterobacterales via the food chain may create a resistance reservoir. The aims of this study were to determine the prevalence of ESBL/AmpC-producing Enterobacterales in vegetables, to examine the association between EBSL/AmpC-producing bacteria and types of vegetables, packaging, and markets, and to investigate the genetic features of ESBL-producing isolates. The antibiotic susceptibilities were determined using VITEK. Phenotypic ESBL/AmpC production was confirmed using disk diffusion. ESBL-producing isolates were subjected to Fourier-transform infrared (FT-IR) spectroscopy and to whole genome sequencing using Oxford Nanopore sequencing technology. Of the 301 vegetable samples, 20 (6.6%) were positive for ESBL producers (16 Klebsiella pneumoniae and 4 Escherichia coli), and 63 (20.9%) were positive for AmpC producers (56 Enterobacter cloacae complex, 4 Enterobacter aerogenes/cancerogenus, and 3 Pantoea spp., Aeromonas hydrophila, and Citrobacter braakii). The blaCTX-M and blaSHV genes were most common among ESBL-producing isolates. The beta-lactamase genes of the ESBL producers were mainly carried on plasmids. Multilocus sequence typing and FT-IR typing revealed high diversity among the ESBL producers. AmpC producers were significantly more common in leafy greens and ESBL producers were significantly less common in climbing vegetables. The presence of ESBL/AmpC-producing Enterobacterales in raw vegetables may contribute to the dissemination of resistance genes in the community.

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Section: Introductionmentioning

confidence: 99%

Occurrence, Typing, and Resistance Genes of ESBL/AmpC-Producing Enterobacterales in Fresh Vegetables Purchased in Central Israel

Kon,

Lurie-Weinberger,

Cohen

et al. 2023

Antibiotics

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Evaluation of the quickmic system in the rapid diagnosis of Gram-negative bacilli bacteremia

García-Rivera,

Ricart-Silvestre,

Parra Grande

et al. 2024

Microbiol Spectr

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Rapid microbiological diagnosis of the antibiotic susceptibility of Gram-negative bacilli is a priority in clinical microbiology, especially in cases of bacteremia. The rapid advancement of antimicrobial resistance proposes a challenge for empirical antibiotic therapy and shows the need for fast antibiotic susceptibility diagnostics to guide treatments. The QuickMIC System (Gradientech AB, Uppsala, Sweden) is a recently developed rapid diagnostic tool for antibiotic susceptibility testing. Our study evaluates a rapid phenotypic system (QuickMIC) that provides information on the susceptibility of 12 antibiotics against Escherichia coli , Klebsiella spp ., Pseudomonas aeruginosa , Acinetobacter baumannii , Enterobacter cloacae , Proteus spp ., Citrobacter spp., and Serratia marcescens . A total of 816 antibiotic/microorganism combinations were tested, resulting in eight discrepancies. The concordance between the antibiotics offered by QuickMIC and reference methods (MicroScan WalkAway plus system, Beckman Coulter; Etest (BioMerieux microdilution system (Bruker); Real-time PCR (GeneXpert, Cepheid); and immunochromatography (Biotech) was 99.02%. Time elapsed to obtain a valid minimal inhibitory concentration (MIC) was between 2 and 4 h. The QuickMIC system allows for the early adjustment of antibiotic treatment in these infections. Given the existing limitations of currently available rapid methods, its clinical utility is particularly relevant in the management of P. aeruginosa infections and AmpC-producing Enterobacterales. The use of rapid methods can help diversify antibiotic use and reduce carbapenem consumption. IMPORTANCE The rapid diagnosis of antibiotic sensitivity in Gram-negative bacilli is of paramount importance in clinical microbiology, particularly in cases of bacteremia. The escalating challenge of antimicrobial resistance underscores the need for expeditious antibiotic susceptibility diagnostics to guide empirical antibiotic therapy effectively. In light of this, we present our study that evaluates the QuickMIC System, a recently developed rapid diagnostic antibiogram. QuickMIC System, offers a novel approach to phenotypic testing, providing information on the activity of 12 antibiotics against key pathogens, including Escherichia coli , Klebsiella spp ., Pseudomonas aeruginosa , Acinetobacter baumannii , Enterobacter cloacae , Proteus spp ., Citrobacter spp ., and Serratia marcescens . Our investigation involved testing a total of 816 antibiotic/microorganism combinations. The study demonstrated an impressive 99.02% concordance between the QuickMIC System and the reference methods, with only eight discrepancies observed. The time to actionable minimum inhibitory concentration (MIC) ranged between 2 and 4 h, highlighting the system's efficiency in providing rapid results.

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Clinical Outcomes of Hypervirulent Carbapenem-Resistant Klebsiella Pneumoniae Infection: A Cohort Study with Multiplex Analyses in China

Hu,

Fang,

Zhang

et al. 2024

Preprint

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Predictors of mortality from extended-spectrum beta-lactamase-producing Enterobacteriaceae bacteremia

Cited by 4 publications

References 55 publications

Occurrence, Typing, and Resistance Genes of ESBL/AmpC-Producing Enterobacterales in Fresh Vegetables Purchased in Central Israel

Occurrence, Typing, and Resistance Genes of ESBL/AmpC-Producing Enterobacterales in Fresh Vegetables Purchased in Central Israel

Evaluation of the quickmic system in the rapid diagnosis of Gram-negative bacilli bacteremia

Clinical Outcomes of Hypervirulent Carbapenem-Resistant Klebsiella Pneumoniae Infection: A Cohort Study with Multiplex Analyses in China

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