Emergence of carbapenemase-producing and colistin resistant Klebsiella pneumoniae ST101 high-risk clone in Turkey

Hazırolan, Gülşen­; Karagöz, Alper

doi:10.1556/030.2020.01275

Cited by 10 publications

(4 citation statements)

References 52 publications

(76 reference statements)

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“…mcr-1 was first reported by Kurekci et al in chicken meat in Turkey (36). Subsequently, studies in which mcr-1 was detected in clinical isolates have been reported (37)(38)(39).…”

Section: Discussionmentioning

confidence: 93%

Evaluation of Plasmid Mediated Colistin Resistance in Colistin Resistant Gram-negative Bacilli

Çaycı¹,

Ülker²,

Vural³

et al. 2023

J Kermanshah Univ Med Sci

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Background: Infections caused by carbapenem-resistant gram-negative bacteria are treated with colonistin as a last resort. However, the increased resistance in recent years is significant for treating multiple drug-resistant infections. Objectives: This study aimed to determine the resistance genes mobile colistin resistance (mcr)-1 and mcr-2 in the colistin-resistant isolates, understand the resistance mechanism, and help with treatment. Methods: Isolates were identified in the Vitek MS automated system. The antibiotic susceptibility was tested with the Vitek 2 Compact automated system. Enteric gram-negative bacilli isolates were stored at -20°C until the molecular study. DNA extraction of colistin-resistant isolates was performed by boiling method. Then, polymerase chain reaction (PCR) optimization was performed using the specific primers, and mcr-1 and mcr-2 genes were investigated by the multiplex PCR method. Results: About 170 enteric gram-negative bacilli isolate were mainly sent from internal medicine (44.7%) and neurology (13.5%) services. According to the species identification, 37.6% of the isolates were Klebsiella pneumonia, and 31.7% were Serratia marcescens. Based on PCR results, mcr-1 and mcr-2 genes were not detected in the isolates. Conclusions: Increased colistin resistance and the worrying discovery of mcr genes require urgent precautions, even though the study did not detect mcr-1 and mcr-2. New studies investigating mcr genes in new isolates are needed to understand the mechanism of resistance and identify resistant isolates.

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“…mcr-1 was first reported by Kurekci et al in chicken meat in Turkey (36). Subsequently, studies in which mcr-1 was detected in clinical isolates have been reported (37)(38)(39).…”

Section: Discussionmentioning

confidence: 93%

Evaluation of Plasmid Mediated Colistin Resistance in Colistin Resistant Gram-negative Bacilli

Çaycı¹,

Ülker²,

Vural³

et al. 2023

J Kermanshah Univ Med Sci

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“…Bloodstream infections caused by colistin-resistant (ColR) Klebsiella pneumoniae (Kp) strains are a cause for concern due to the potential for complications, poor clinical outcomes, and limited treatment options [ 8 , 9 ]. The Polymyxins (colistin and polymyxin B) have made a comeback as a treatment option for infections caused by carbapenem-resistant Klebsiella pneumoniae since there are very few new antimicrobials in the pipeline [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Global Prevalence of Colistin Resistance in Klebsiella pneumoniae from Bloodstream Infection: A Systematic Review and Meta-Analysis

et al. 2022

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Among gram-negative bacteria, Klebsiella pneumoniae is one of the most common causes of healthcare-related infection. Bloodstream infections (BSIs) caused by Klebsiella pneumoniae are notorious for being difficult to treat due to resistance to commonly used antimicrobials. Klebsiella pneumoniae isolates from bloodstream infections are becoming increasingly resistant to carbapenems. In the fight against carbapenem-resistant Klebsiella pneumoniae, colistin [polymyxin E] is the antimicrobial of choice and is thus widely used. Objective: This study aimed to determine the global prevalence of colistin resistance amongst Klebsiella pneumoniae isolates from bloodstream infections. Methods: PubMed, Medline, Scopus, and the Cochrane Library were searched for published articles without restricting the search period. Studies meeting the predefined inclusion and exclusion criteria were included, and quality was assessed using Joanna Briggs Institute Checklist. We used a statistical random effect model to analyze data with substantial heterogeneity (I2 > 50%) in the meta-analysis. Results: A total of 10 studies out of 2873 search results that met the inclusion criteria were included in the final synthesis for this study. A pooled prevalence of colistin resistance was 3.1%, 95%CI (1.5%–4.7%). The highest colistin resistance pooled prevalence was recorded in isolates studied in 2020 and beyond 12.90% (4/31), while Klebsiella pneumoniae isolates studied in 2015 and before and in 2016–2019 showed a pooled colistin resistance rate of 2.89% (48/1661) and 2.95% (28/948), respectively. The highest colistin resistance was found in Klebsiella pneumoniae isolates from Thailand (19.2%), while the least pooled resistance was in Klebsiella pneumoniae from South Korea (0.8%). The pooled prevalence of the multidrug-resistant (MDR) of Klebsiella pneumoniae from bloodstream infection ranged from 80.1% 95%CI (65.0%–95.2%), and the resistance prevalence of other antibiotics by Klebsiella pneumoniae from bloodstream infections were as follows; ciprofloxacin (45.3%), ertapenem (44.4%), meropenem (36.1%), imipenem (35.2%), gentamicin (33.3%), amikacin (25.4%) and tigecycline (5.1%). Klebsiella pneumoniae recovered from the intensive care unit (ICU) showed higher colistin resistance, 11.5% (9/781%), while non-ICU patients showed 3.03% (80/2604) pooled colistin resistance. Conclusion: This study showed low colistin resistance in Klebsiella pneumoniae isolates from global bloodstream infections. However, significant colistin resistance was observed in isolates collected from 2020 and beyond. Significant colistin resistance was also observed in Klebsiella pneumoniae isolates in bloodstream infections from the intensive care unit (ICU) compared to those from non-ICUs. As a result, there is a need to institute colistin administration stewardship in the ICU in clinical settings.

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“…Ülkemizde yapılan çalışmalarda, OXA-48 geni endemik olması nedeniyle en sık saptanan karbapenemaz genidir. Ancak, bunun yanında birbirine yakın sıklıkta KPC ve NDM direnç genleri de görülmektedir (3,(6)(7)(8) . (9)(10)(11)(12) .…”

Section: Introductionunclassified

Klebsiella pneumoniae Klinik Suşlarında, 2012-2020 Yılları Arasında Karbapenem Direnç Oranlarındaki Değişimin ve Direnç Genlerinin Araştırılması

Telli¹

2022

Turk Mikrobiyol Cemiy Derg

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Sonuç: Hastanemizde, karbapenem dirençli K. pneumoniae suşları yıllar içinde giderek artan oranda bulunmuştur. OXA-48 direnç geni en sık (%38.8) tekil gen olarak bulunmuştur. NDM direnç geni ise ikinci sıklıkta bulunmuştur. Bunun yanında ise OXA-48+NDM ikili gen varlığı hastanemiz en sık (%42.3) direnç mekanizması olarak bulunmuştur. Bu nedenlerle, KDKp suşlarında düzenli epidemiyolojik taramalarının ve direnç mekanizmalarının bölgesel ve ulusal olarak araştırmalarının yapılmasının bu bakteriye bağlı enfeksiyonların tedavisinde ve direncin kontrolünde çok önemli olduğu görülmektedir.

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Emergence of carbapenemase-producing and colistin resistant Klebsiella pneumoniae ST101 high-risk clone in Turkey

Cited by 10 publications

References 52 publications

Evaluation of Plasmid Mediated Colistin Resistance in Colistin Resistant Gram-negative Bacilli

Evaluation of Plasmid Mediated Colistin Resistance in Colistin Resistant Gram-negative Bacilli

Global Prevalence of Colistin Resistance in Klebsiella pneumoniae from Bloodstream Infection: A Systematic Review and Meta-Analysis

Klebsiella pneumoniae Klinik Suşlarında, 2012-2020 Yılları Arasında Karbapenem Direnç Oranlarındaki Değişimin ve Direnç Genlerinin Araştırılması

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