The first report of infection with Klebsiella pneumoniae carrying the bla kpc gene in State of Mato Grosso do Sul, Brazil

Chang, Marilene Rodrigues; Biberg, Camila Arguelo; Lopes, Fernando Aguilar; Tetila, Andyane Freitas; Pignatari, Antônio Carlos Campos

doi:10.1590/0037-868215502013

Cited by 7 publications

(8 citation statements)

References 11 publications

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“…These patients had common risk factors, such as prolonged hospitalization, intravenous catheter, previous antimicrobial therapy, and underlying disease. These findings are consistent with previous studies that notified risk factors for acquiring infections with KPC-producing K. pneumoniae 18 . In the present study, all three K. pneumoniae producing KPC were isolated from blood specimens and two of the patients died with septic shock.…”

Section: Resultssupporting

confidence: 93%

Emergence of Klebsiella pneumoniae clinical isolates producing KPC-2 carbapenemase in Cuba

Quiñones

Hart

Espinosa

et al. 2014

New Microbes and New Infections

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The emergence of Klebsiella pneumoniae producing carbapenemase (KPC) has now become a global concern. As a part of a nationwide multicentre surveillance study in Cuba, three K. pneumoniae clinical isolates resistant to carbapenems were detected for a 1-month period (September to October 2011). PCR and sequence analysis revealed that the three strains harboured blaKPC-2. They showed resistance or intermediate susceptibility to expanded-spectrum cephalosporins, other β-lactams, a β-lactam/β-lactamase inhibitor combination, and gentamicin. Two strains were susceptible only to colistin, whereas the other strain showing colistin resistance was susceptible to fluoroquinolones. These blaKPC-2-positive K. pneumoniae strains were classified into ST1271 (CC29), a novel clone harbouring blaKPC-2, and were revealed to be genetically identical by PCR-based DNA fingerprinting. The three patients infected with the KPC-producing K. pneumoniae had common risk factors, and had no overseas travel experience outside Cuba, suggesting local acquisition of the resistant pathogen. This is the first report of a KPC-producing K. pneumoniae in Cuba. Although detection of KPC in Enterobacteriaceae is still rare in Cuba, our finding indicated that KPC-producing bacteria are a global concern and highlighted the need to identify these microorganisms in clinical laboratories.

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Section: Resultssupporting

confidence: 93%

Emergence of Klebsiella pneumoniae clinical isolates producing KPC-2 carbapenemase in Cuba

Quiñones

Hart

Espinosa

et al. 2014

New Microbes and New Infections

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“…In order to identify the occurrence of CR in HM patients and to understand its epidemiology, we reviewed series and selected case reports that report colonization or infection of HM patients with CR bacteria. These studies were undertaken in different areas of the world, including New York, New Delhi, China, Stockholm, Frankfurt, Roma, Brescia, Athens, Ankara, Cairo, and Haifa in the series studies (Tables 1−3; Cattaneo et al, 2012Cattaneo et al, , 2018Kjellander et al, 2012;Schelenz et al, 2013;Satlin et al, 2013aSatlin et al, , 2016El-Mahallawy et al, 2014;Trecarichi et al, 2015Trecarichi et al, , 2016Wang et al, 2015Wang et al, , 2017Micozzi et al, 2017;Ballo et al, 2019), and in United States, Brazil, Spain, Italy, Poland, Turkey, Israel, Japan, China, and Austria in the case reports (Table 4; Muchtar et al, 2012;Carattoli et al, 2013;Chang et al, 2013;Satlin et al, 2013b;Girmenia et al, 2015;Huang et al, 2015;Kara Leitner et al, 2015;Xing et al, 2015;Kantarcioglu et al, 2016;Tofas et al, 2016;Zhang et al, 2016Zhang et al, , 2018Majewski et al, 2017;Piedra-Carrasco et al, 2017;Asai et al, 2018). When we geolocate the regions that have reported the presence of CR bacteria in HM patients in Figure 1, it can be observed that all these studies have been reported in regions that are either endemic or have a significant increase in carbapenemase enzymes (a coincidence with regions with high levels of CR bacteria) (Figure 1).…”

Section: Carbapenem Resistance In Hematological Patients Vs the Worlmentioning

confidence: 99%

Infections Due to Carbapenem-Resistant Bacteria in Patients With Hematologic Malignancies

et al. 2020

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In developed countries, hematological malignancies (HM) account for 8 to 10% of cancers diagnosed annually and one-third of patients with HM (HMP) are expected to die from their disease. The former wide spectrum "magic bullet," imipenem, has been ousted by the emergence of carbapenem resistant (CR) pathogens. In endemic areas, infections with CR-bacteria occur in vulnerable patients, notably in HMP, who suffer from high mortality related to infectious complications. In this work, we reviewed epidemiologic and clinical factors associated with CR-infections in adult HMP and data on CR-related mortality and antibiotic treatments in this population. We found that resistance profile of strains involved in HMP infections, mainly bacteremia, reflect local epidemiology. Significant risk factors for infections with CR-bacteria include sex male, age around 50 years old, acute leukemia, selvage chemotherapy, neutropenia, and digestive colonization by CR-bacteria. Mortality rate is high in HMP infected with CR-Enterobacteriaceae, more particularly in case of acute myeloid leukemia and unresolved neutropenia, due to inappropriate empiric management and delayed administration of targeted antibiotics, such as tigecycline, colistin, or new associations of active drugs. Thus, we developed an algorithm for clinicians, assessing the incremental risk for CRbacterial infection occurrence and mortality in febrile HMP, to guide decisions related to empirical therapeutic strategies.

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“…After the East coast of the USA, KPC plasmid strains were isolated almost everywhere in the world: in France for the first time in 2005 in a patient coming back from New York where he had undergone bilateral nephrostomy [6]; in Israel [7,8]; in China and Taiwan [9,10]; in South America: in Columbia in a Pseudomonas aeruginosa strain [11], in Brazil [12,13], in Argentina [14]. .…”

Section: Group Of Penicillinases: Kpcmentioning

confidence: 99%

Carbapenemase-producing Enterobacteriaceae: Overview of a major public health challenge

Nordmann

2014

Médecine et Maladies Infectieuses

208

125

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Bacterial resistance to antibiotics has become a major source of concern for public health. Enterobacteriaceae are among the most common human pathogens, causing community-acquired as well as hospital-acquired infections. Carbapenem-resistant Enterobacteriaceae have been increasingly reported worldwide since their first identification more than 20 years ago. Three main classes of carbapenemases have been identified: Ambler class A beta-lactamase (KPC), class B (metallo-enzymes), and class D (OXA-48 type). Klebsiella pneumoniae carbapenemases (KPC) was first reported in the United States in the late 1990s and since then worldwide, with a marked endemicity in the United States, Greece, and now Italy. Carbapenemase NDM-1 (New Delhi metallo-beta-lactamase-1) is one of the most recently reported metallo-enzymes. It has spread widely in the Indian sub-continent and now worldwide. Carbapenemases of the oxacillinase-48 type (OXA-48) have been identified mostly in Mediterranean and southern European countries with a rapid spread. An early and quick identification of carbapenemase-producing infected patients, but also of carriers, is mandatory to prevent the spread of these highly resistant pathogens. The early identification of carriers and implementing of cohorting strategies is the only means to prevent nosocomial outbreaks caused by carbapenemase, with very few, if any, therapeutic options.Keywords: Enterobacteriaceae; Carbapenemase; Metallo-beta-lactamase; Oxacillinase OXA-48; New Delhi metallo-beta-lactamase-1; Klebsiella pneumoniae carbapenemase RésuméLa résistance bactérienne aux antibiotiques est d'incidence croissante notamment parmi les entérobactéries qui sont les bactéries pathogènes les plus fréquentes pour l'Homme et sont la source de nombreuses infections communautaires et nosocomiales. Des entérobactéries résistantes aux carbapénèmes ont été rapportées avec une fréquence croissante dans le monde depuis leur première description il y a plus de 20 ans. Trois principales classes de carbapénémases ont été décrites : classe A (KPC), classe B (métallo-enzymes) et classe D (OXA-48). Depuis leur première description aux États-Unis à la fin des années 1990, les carbapénémases Klebsiella pneumoniae (KPC) ont été observées sur les cinq continents. La plus forte endémicité se situe aux États-Unis, en Grèce, et plus dernièrement en Italie. Parmi les carbapénémases du groupe des métallo-enzymes, New Delhi metallo-beta-lactamase-1 (NDM-1) est de description plus récente. Elle a une prévalence très élevée dans l'ensemble du sous-continent indien. Les carbapénémases de type oxacillinase-48 (OXA-48) ont été rapportées essentiellement dans le pourtour de la Méditerranée et en Europe du Sud où leur diffusion est particulièrement rapide. Pour prévenir l'extension de la diffusion de ces bactéries pathogènes multirésistantes, l'identification précoce et rapide des sujets infectés, mais aussi des patients porteurs, devient une nécessité. Elle permet la mise en oeuvre d'une stratégie d'isolement par cohorting qui représen...

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The first report of infection with Klebsiella pneumoniae carrying the bla kpc gene in State of Mato Grosso do Sul, Brazil

Cited by 7 publications

References 11 publications

Emergence of Klebsiella pneumoniae clinical isolates producing KPC-2 carbapenemase in Cuba

Emergence of Klebsiella pneumoniae clinical isolates producing KPC-2 carbapenemase in Cuba

Infections Due to Carbapenem-Resistant Bacteria in Patients With Hematologic Malignancies

Carbapenemase-producing Enterobacteriaceae: Overview of a major public health challenge

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