Emergence of bacterial resistance to cefamandole in vivo due to outer membrane protein deficiency

Klundert, J. A. M. Van De; Gestel, M. H. van; Meerdink, Gavin L.; Marie, S. de

doi:10.1007/bf01975046

Cited by 18 publications

(3 citation statements)

References 9 publications

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“…Carbapenem resistance in K. pneumoniae or other bacteria occurs by two main mechanisms: (i) production of carbapenemases (45), and (ii) porin loss (OmpK35 and OmpK36) combined with the presence of AmpC cephalosporinases or ESBLs such as CTX-M-15 and/or overexpression of efflux pumps (21,46,47).…”

Section: The Crkp Menacementioning

confidence: 99%

“…Class B MBLs are inhibited by EDTA, dipicholinic acid, or 1,10o-phenanthroline in vitro. Class D carbapenemases (e.g., OXA-48-like) which hydrolyze oxacillin, cloxacillin, and carbenicillin, are inhibited in vitro by NaCl (46). As different carbapenemases have emerged over time, many have several enzymatic variants (such as KPC-2, KPC-3, NDM-5, NDM-7, OXA-48, OXA-232, IMP-4, IMP-8, etc.)…”

Section: The Crkp Menacementioning

confidence: 99%

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Neonatal Sepsis: The Impact of Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae

et al. 2021

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The convergence of a vulnerable population and a notorious pathogen is devastating, as seen in the case of sepsis occurring during the first 28 days of life (neonatal period). Sepsis leads to mortality, particularly in low-income countries (LICs) and lower-middle-income countries (LMICs). Klebsiella pneumoniae, an opportunistic pathogen is a leading cause of neonatal sepsis. The success of K. pneumoniae as a pathogen can be attributed to its multidrug-resistance and hypervirulent-pathotype. Though the WHO still recommends ampicillin and gentamicin for the treatment of neonatal sepsis, K. pneumoniae is rapidly becoming untreatable in this susceptible population. With escalating rates of cephalosporin use in health-care settings, the increasing dependency on carbapenems, a “last resort antibiotic,” has led to the emergence of carbapenem-resistant K. pneumoniae (CRKP). CRKP is reported from around the world causing outbreaks of neonatal infections. Carbapenem resistance in CRKP is largely mediated by highly transmissible plasmid-encoded carbapenemase enzymes, including KPC, NDM, and OXA-48-like enzymes. Further, the emergence of a more invasive and highly pathogenic hypervirulent K. pneumoniae (hvKP) pathotype in the clinical context poses an additional challenge to the clinicians. The deadly package of resistance and virulence has already limited therapeutic options in neonates with a compromised defense system. Although there are reports of CRKP infections, a review on neonatal sepsis due to CRKP/ hvKP is scarce. Here, we discuss the current understanding of neonatal sepsis with a focus on the global impact of the CRKP, provide a perspective regarding the possible acquisition and transmission of the CRKP and/or hvKP in neonates, and present strategies to effectively identify and combat these organisms.

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Section: The Crkp Menacementioning

confidence: 99%

Section: The Crkp Menacementioning

confidence: 99%

Neonatal Sepsis: The Impact of Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae

et al. 2021

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“…In comparison to Escherichia coli (E. coli) , Kp has acquired double the number (more than 400) of antimicrobial-resistant (AMR) genes (Wyres and Holt, 2018). Interestingly, ESBL-producing Kp exhibits carbapenem resistance as a result of alterations in permeability due to loss of porins (Bradford et al, 1997; Martinez-Martinez, 2008; Leavitt et al, 2009) and overexpression of efflux pumps (Van De Klundert et al, 1988). Klebsiella pneumoniae has also acquired AMR through horizontal gene transfer enabled by plasmids and a mobile genetic environment (Pendleton et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Targeting the Sugary Armor of Klebsiella Species

Patro

Rathinavelan

2019

Front. Cell. Infect. Microbiol.

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The emergence of multidrug-resistant strains of Gram-negative Klebsiella species is an urgent global threat. The World Health Organization has listed Klebsiella pneumoniae as one of the global priority pathogens in critical need of next-generation antibiotics. Compared to other Gram-negative pathogens, K. pneumoniae accumulates a greater diversity of antimicrobial-resistant genes at a higher frequency. The evolution of a hypervirulent phenotype of K. pneumoniae is yet another concern. It has a broad ecological distribution affecting humans, agricultural animals, plants, and aquatic animals. Extracellular polysaccharides of Klebsiella, such as lipopolysaccharides, capsular polysaccharides, and exopolysaccharides, play crucial roles in conferring resistance against the host immune response, as well as in colonization, surface adhesion, and for protection against antibiotics and bacteriophages. These extracellular polysaccharides are major virulent determinants and are highly divergent with respect to their antigenic properties. Wzx/Wzy-, ABC-, and synthase-dependent proteinaceous nano-machineries are involved in the biosynthesis, transport, and cell surface expression of these sugar molecules. Although the proteins involved in the biosynthesis and surface expression of these sugar molecules represent potential drug targets, variation in the amino acid sequences of some of these proteins, in combination with diversity in their sugar composition, poses a major challenge to the design of a universal drug for Klebsiella infections. This review discusses the challenges in universal Klebsiella vaccine and drug development from the perspective of antigen sugar compositions and the proteins involved in extracellular antigen transport.

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Difficult-to-treat infections

Marie

1990

Intensive Care Med

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The most common problems in the management of serious bacterial infections were reviewed. As illustrations, the diagnostic and therapeutic strategies in two types of deep-seated infections--both associated with a poor penetration of antibiotics--were discussed: (1) In suppurative central venous thrombophlebitis, conservative therapy frequently fails; if so, one should promptly switch to a surgical approach; (2) in most patients with a parapharyngeal space infection, a non-surgical approach can be recommended including early diagnosis by computed tomography (CT), CT-guided needle aspiration, prompt administration of benzylpenicillin in high and frequent dosages or continuously, and follow-up by CT. This regimen may prevent radical surgery even in the presence of deep neck or mediastinal abscesses.

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Emergence of bacterial resistance to cefamandole in vivo due to outer membrane protein deficiency

Cited by 18 publications

References 9 publications

Neonatal Sepsis: The Impact of Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae

Neonatal Sepsis: The Impact of Carbapenem-Resistant and Hypervirulent Klebsiella pneumoniae

Targeting the Sugary Armor of Klebsiella Species

Difficult-to-treat infections

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