Antimicrobial resistant Klebsiella pneumoniae carriage and infection in specialized geriatric care wards linked to acquisition in the referring hospital

Abstract

Summary:Patients' own gut microbiota were the major source of K. pneumoniae, but extended-spectrum beta-lactamase strains were acquired in the referring hospital. This highlights the potential for rectal screening, and the importance of the wider hospital network, for local risk management.. CC-BY 4.0 International license It is made available under a (which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint . http://dx.doi.org/10.1101/218461 doi: bioRxiv preprint first posted online Nov. 13, 2017; 2 Abstract Background. Klebsiella pneumoniae is a leading cause of extendedspectrum beta-lactamase (ESBL) producing hospital-associated infections, for which elderly patients are at increased risk.

Emergence of extended-spectrum β-lactamase (ESBL) and/or carbapenemase producing Enterobacteriaceae (CPE) and their antimicrobial resistance

“…In terms of the hospital setting, the samples were collected from the patients hospitalized particularly at 1st internal clinic (from 47.6 -56.1 %), then on Geriatric clinic (from 12.2 -21.9 %), Surgical clinic (from 4.9 -14.3 %), Dermatovenerological clinic (from 2.0 -9.5 %), Long-term care department (from 4.4 -7.3 %), Aftercare department (from 2.4 -9.5 %). Few samples (5) were taken into consideration from the patients post mortem from the Institute of Pathological anatomy (expressed in table 1. ).…”

“…If aforementioned microorganisms produce AmpC β-lactamase they are resistant to the above β-lactams (except 4th generation of cephalosporins), but include cephamycins and inhibitors of β-lactamase (clavulanic acid, sulbactam and tazobactam) (4). Accordingly, they are multidrug-resistant (MDR; resistance to ≥ 3 classes of antibiotics) (5). Carbapenems are generally considered as the drugs of choice for the treatment of ESBL and/or AmpC pathogens causing infections, while the other β-lactams and non-β-lactams are in vitro effi cacious as well.…”

Gut mucosal colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in sub-Saharan Africa: a systematic review and meta-analysis

“…Gut mucosal colonisation with Enterobacteriaceae is thought to precede invasive infection 3,4 , and so preventing ESBL-E colonisation is an attractive strategy for prevention of invasive disease. Data describing the basic epidemiology of ESBL-E colonisation in sSA, will help inform the design of interventions targeted at reducing colonisation.…”

Organoid Polymer Functionality and Mode ofKlebsiella PneumoniaeMembrane Antigen Presentation Regulates Ex Vivo Germinal Center Epigenetics in Young and Aged B Cells

“…Klebsiella pneumonia, in particular, is one of the most frequent causes of nosocomial infections that causes many severe diseases including pneumonia, bacteremia, and urinary tract infection, and some recent isolates have developed pan-drug resistance. Among those at risk are infants (who have immature immune systems) and the elderly (who have waning immune defenses); both are subject to heightened incidence and severity of infections 43,44 As a classic T cell-independent antigen, K. pneumoniae's glycan antigens fail to induce strong germinal center reactions to generate and select high-affinity antibody variants by affinity maturation.…”