Induction and nosocomial dissemination of carbapenem and polymyxin-resistant Klebsiella pneumoniae

Abstract

Introduction:Polymyxins are antimicrobial agents capable of controlling carbapenemase-producing Klebsiella pneumoniae infection. Methods: We report a cluster of four patients colonized or infected by polymyxin-resistant and Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae. Results: Three patients were hospitalized in adjacent wards, and two were admitted to the intensive care unit. The index case maintained prolonged intestinal colonization by KPC-producing K. pneumoniae. Three patients received polymyxin B before the isolation of polymyxin-resistant K. pneumoniae. Conclusions: Colonization by KPC-producing K. pneumoniae and previous use of polymyxin B may be causally related to the development of polymyxin-resistant microorganisms.

Epidemiological Characteristics and Clinical Treatment Outcome of Typhoid Fever in Ningbo, China, 2005–2014: Pulsed-Field Gel Electorophoresis Results Revealing Great Proportion of Common Transmission Sources

“…PFGE was performed to investigate the genetic relatedness of isolates, following the PulseNet standardized protocol (8). Image data were imported into BioNumerics 6.6 software (Applied Maths, Kortrijk, Belgium) and analyzed to distinguish outbreaks and sporadic cases.…”

Genetically Similar Isolates of Salmonella enterica Serotype Enteritidis Persistent in China for a Long‐Term Period

“…PFGE was conducted to investigate the genetic relatedness of all strains according to PulseNet standardized protocol using endonuclease XbaI (Gaspar and others ). S .…”

Increased antimicrobial resistance in Klebsiella pneumoniae from a University Hospital in Rio Grande do Sul, Brazil

“…In our study, all colistin-resistant K. pneumoniae isolates showed high resistance to carbapenems and tigecycline ( Table 2), which is alarming, considering that these antimicrobials are used for the treatment of carbapenem-resistant Enterobacteriaceae in combination with amikacin, which has demonstrated good activity against the isolates, with susceptibility greater than 80% 2 . The colonization of carbapenemase-producing microorganisms, prolonged antimicrobial therapy, and previous use of polymyxins contributed to the emergence of heteroresistance 11,12 . Giani et al 13 , had observed an outbreak of colistin-resistant KPC-3-producing K. pneumoniae due to the deletion of mgrB gene.…”