Diffusion of OXA-48 carbapenemase among urinary isolates of Klebsiella pneumoniae in non-hospitalized elderly patients

Šuto, Sandra; Bedenić, Branka; Likić, Saša; Kibel, Sara; Anušić, Maja; Tičić, Vladimira; Zarfel, Gernot; Grisold, Andrea; Barišić, Ivan; Vraneš, Jasmina

doi:10.1186/s12866-022-02443-y

Cited by 9 publications

(7 citation statements)

References 42 publications

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“…In general, ESBLs and KPC carbapenemase genes were the most detected ( Figure 4 ), confirming their dissemination in MDR K. pneumoniae isolates as verified in several other studies [ 33 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. KPC enzymes were originally identified in K. pneumoniae which justifies its high prevalence in cases of resistance to carbapenems in this species.…”

Section: Discussionsupporting

confidence: 84%

Exploring the Antibiotic Resistance Profile of Clinical Klebsiella pneumoniae Isolates in Portugal

Oliveira

Castro²,

Silva³

et al. 2022

Antibiotics

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While antibiotic resistance is rising to dangerously high levels, resistance mechanisms are spreading globally among diverse bacterial species. The emergence of antibiotic-resistant Klebsiella pneumoniae, mainly due to the production of antibiotic-inactivating enzymes, is currently responsible for most treatment failures, threatening the effectiveness of classes of antibiotics used for decades. This study assessed the presence of genetic determinants of β-lactam resistance in 102 multi-drug resistant (MDR) K. pneumoniae isolates from patients admitted to two central hospitals in northern Portugal from 2010 to 2020. Antimicrobial susceptibility testing revealed a high rate (>90%) of resistance to most β-lactam antibiotics, except for carbapenems and cephamycins, which showed antimicrobial susceptibility rates in the range of 23.5–34.3% and 40.2–68.6%, respectively. A diverse pool of β-lactam resistance genetic determinants, including carbapenemases- (i.e., blaKPC-like and blaOXA-48-like), extended-spectrum β-lactamases (ESBL; i.e., blaTEM-like, blaCTX-M-like and blaSHV-like), and AmpC β-lactamases-coding genes (i.e., blaCMY-2-like and blaDHA-like) were found in most K. pneumoniae isolates. blaKPC-like (72.5%) and ESBL genes (37.3–74.5%) were the most detected, with approximately 80% of K. pneumoniae isolates presenting two or more resistance genes. As the optimal treatment of β-lactamase-producing K. pneumoniae infections remains problematic, the high co-occurrence of multiple β-lactam resistance genes must be seen as a serious warning of the problem of antimicrobial resistance.

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Section: Discussionsupporting

confidence: 84%

Exploring the Antibiotic Resistance Profile of Clinical Klebsiella pneumoniae Isolates in Portugal

Oliveira

Castro²,

Silva³

et al. 2022

Antibiotics

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“…These species are known to be good vectors for plasmids. There are a lot of strains positive for carbapenemases in our ICUs, as described in the previous studies [ 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. It is possible that cross infections occurred between patients in the same hospital ward.…”

Section: Discussionmentioning

confidence: 93%

“…The dominant combination was OXA-48+NDM, which is in concordance with a multicenter study recently carried out in European countries. All combinations contained OXA-48, which is the most widespread type of carbapenemase in Croatia in the last decade, significantly outnumbering the KPC and VIM variants [ 7 , 8 , 9 , 32 ]. KPC was the additional carbapenemase detected in the isolates from Split, whereas those from Zagreb and Osijek contained MBL and OXA-48.…”

Section: Discussionmentioning

confidence: 99%

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Emergence and Spread of Enterobacterales with Multiple Carbapenemases after COVID-19 Pandemic

et al. 2023

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Resistance to carbapenems in Enterobacterales has become a matter of the highest concern in the last decade. Recently, Enterobacterales harboring multiple carbapenemases were detected in three hospital centers in Croatia and in the outpatient setting, posing a serious therapeutic challenge for clinicians. In this study, we analyzed eight Klebsiella pneumoniae and two Enterobacter cloacae complex isolates with multiple carbapenemases, with regard to antibiotic susceptibility, β-lactamase production and plasmid content. The isolates demonstrated uniform resistance to amoxicillin/clavulanate, piperacillin/tazobactam, cefuroxime, ceftazidime, cefotaxime, ceftriaxone and ertapenem. Among novel β-lactam/inhibitor combinations, ceftazidime/avibactam exhibited moderate activity, with 50% of isolates susceptible. All isolates demonstrated resistance to imipenem/cilastatin/relebactam, and all but one to ceftolozane/tazobactam. Four isolates exhibited a multidrug-resistant phenotype (MDR), whereas six were allocated to an extensively drug-resistant phenotype (XDR). OKNV detected three combinations of carbapenemases: OXA-48+NDM (five isolates), OXA-48+VIM (three isolates) and OXA-48+KPC (two isolates). Inter-array testing identified a wide variety of resistance genes for β-lactam antibiotics: blaCTX-M-15, blaTEM, blaSHV, blaOXA-1, blaOXA-2, blaOXA-9, aminoglycosides: aac6, aad, rmt, arm and aph, fluoroquinolones: qnrA, qnrB and qnrS, sulphonamides: sul1 and sul2 and trimethoprim: dfrA9, dfrA14 and dfrA19n. mcr genes were reported for the first time in Croatia. This study demonstrated the ability of K. pneumoniae and E. cloacae to acquire various resistance determinants under the selection pressure of antibiotics widely used during the COVID-19 pandemic. The novel inter-array method showed good correlation with OKNV and PCR, although some discrepancies were found.

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“…Klebsiella pneumoniae is recognized as a conditioned pathogen that colonizes the mucosal surface of patients and do not cause illness, but K. pneumoniae from the mucosa may spread to other tissues, leading to life-threatening infections and a variety of diseases, including pneumonia, urinary tract infections, blood infections, and sepsis [ 1 , 2 ]. These infections are particularly prominent in newborns, the elderly, and individuals with weakened immune functions [ 3 ]. K. pneumoniae also causes a large number of community-acquired infections.…”

Section: Introductionmentioning

confidence: 99%

Anti-Klebsiella pneumoniae activity of secondary metabolism of Achromobacter from the intestine of Periplaneta americana

Ping

Chen

et al. 2023

BMC Microbiol

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Background Klebsiella pneumoniae is one of the main pathogens of clinical isolation and nosocomial infections, as K. pneumoniae show broad-spectrum resistance to β-lactam and carbapenem antibiotics. It is emerging clinical need for a safe and effective drug to anti-K. pneumoniae. At present, Achromobacter mainly focused on its degradation of petroleum hydrocarbons, polycyclic aromatic hydrocarbons, assisting insects to decompose, degrade heavy metals and utilize organic matter, but there were few reports on the antibacterial activity of the secondary metabolites of Achromobacter. Results In this study, a strain WA5-4-31 from the intestinal tract of Periplaneta americana exhibited strong activity against K. Pneumoniae through preliminary screening. The strain was determined to be Achromobacter sp. through the morphological characteristics, genotyping and phylogenetic tree analysis, which is homologous to Achromobacter ruhlandii by 99%, its accession numbe in GenBank at National Center for Biotechnology Information (NCBI) is MN007235, and its deposit number was GDMCC NO.1.2520. Six compounds (Actinomycin D, Actinomycin X2, Collismycin A, Citrinin, Neoechinulin A and Cytochalasin E) were isolated and determined by activity tracking, chemical separation, nuclear magnetic resonance (NMR) and mass spectrometry (MS) analysis. Among them, Actinomycin D, Actinomycin X2, Collismycin A, Citrinin and Cytochalasin E showed a good effect on anti-K. pneumoniae, with MIC values of 16–64 µg/mL. Conclusions The study reported Achromobacter, which was from the intestinal tract of Periplaneta americana with the activity against K. Pneumoniae, can produce antibacterial compounds for the first time. It lays the foundation for development of secondary metabolites of insect intestinal microorganisms.

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Diffusion of OXA-48 carbapenemase among urinary isolates of Klebsiella pneumoniae in non-hospitalized elderly patients

Cited by 9 publications

References 42 publications

Exploring the Antibiotic Resistance Profile of Clinical Klebsiella pneumoniae Isolates in Portugal

Exploring the Antibiotic Resistance Profile of Clinical Klebsiella pneumoniae Isolates in Portugal

Emergence and Spread of Enterobacterales with Multiple Carbapenemases after COVID-19 Pandemic

Anti-Klebsiella pneumoniae activity of secondary metabolism of Achromobacter from the intestine of Periplaneta americana

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