Emergence of Escherichia coli, Co-Producing NDM-1 and OXA-48 Carbapenemases, in Urinary Isolates, at a Tertiary Care Centre at Central India

Khajuria, Atul; Praharaj, Ashok Kumar; Kumar, Manjit; Grover, Naveen

doi:10.7860/jcdr/2014/7952.4413

Cited by 34 publications

(31 citation statements)

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“…We recently reported a strain of Raoutella ornithinolytica that harbored the blaOXA-48-like gene with no plasmid characterization that was recovered after this strain [59], and to the best of our knowledge, this is the first description of carrying OXA-48-like carbapenemase in an IncL plasmid isolated in Ecuador. Interestingly, our patient came from Croatia were this mechanism of resistance was reported previously [60][61][62], indicating that contagion with this strain most likely happened in Europe. The implications of globalization and free travel are now being revealed with the fast spread of the SARS-CoV-19, but in reality, this is nothing new and it has long been the case with mechanisms of resistance.…”

Section: Discussionsupporting

confidence: 69%

OXA-48 Carbapenemase in Klebsiella pneumoniae Sequence Type 307 in Ecuador

et al. 2020

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Antibiotic resistance is on the rise, leading to an increase in morbidity and mortality due to infectious diseases. Klebsiella pneumoniae is a Gram-negative bacterium that causes bronchopneumonia, abscesses, urinary tract infection, osteomyelitis, and a wide variety of infections. The ubiquity of this microorganism confounds with the great increase in antibiotic resistance and have bred great concern worldwide. K. pneumoniae sequence type (ST) 307 is a widespread emerging clone associated with hospital-acquired infections, although sporadic community infections have also been reported. The aim of our study is to describe the first case of Klebsiella pneumoniae (ST) 307 harboring the blaOXA-48-like gene in Ecuador. We characterized a new plasmid that carry OXA-48 and could be the source of future outbreaks. The strain was recovered from a patient with cancer previously admitted in a Ukrainian hospital, suggesting that this mechanism of resistance could be imported. These findings highlight the importance of programs based on active molecular surveillance for the intercontinental spread of multidrug-resistant microorganisms with emergent carbapenemases.

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Section: Discussionsupporting

confidence: 69%

OXA-48 Carbapenemase in Klebsiella pneumoniae Sequence Type 307 in Ecuador

et al. 2020

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“…These characteristic features are usually coded on transferable genes [5]. β-lactamases genes are usually found on plasmid encoding resistance to aminoglycosides, fluroquinolones, sulfonamides, tetracyclines and other antibiotics [40] thus leading to cross resistance. ESBL, AmpC and carbapenemases like MBL and KPC leaves us with limited treatment options.…”

Section: Discussionmentioning

confidence: 99%

Plasmid Profiling and Occurrence of β-lactamase Enzymes in Multi-drug Resistant Uropathogenic Escherichia coli in Kathmandu, Nepal

Shrestha¹,

Adhikari

Rijal

et al. 2019

Preprint

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Background Emergence of Extended Spectrum β-Lactamases (ESBL) among gram-negative bacteria, predominantly Escherichia coli in Nepal has been alarming. The main objectives of this study were to determine the prevalence of ESBL, ABL (AmpC type β-Lactamase), MBL (Metallo β-Lactamase) and KPC (Klebseilla pneumoniae carbapenamase) producing multi-drug resistant uropathogenic E. coli and their correlation with plasmid profiling pattern among the patients suspected of or having urinary tract infection in a tertiary hospital in Kathmandu, Nepal. Methods The mid-stream urine samples were collected from patients suspected of or having urinary tract infections (UTI) and were inoculated in Cystine Lactose electrolyte deficient (CLED) agar. The ESBL E. coli were detected by combined disc diffusion technique using cefotaxime with and without clavulanate. The isolates were screened for ABL by inhibitor-based method using cefoxitin alone and/or with cloxacillin. MBL/KPC were detected using combined-disc tests consisting of meropenem alone and with phenylboronic acid (PBA) or Ethylene diamine tetra acetic acid (EDTA), or both PBA and EDTA. Plasmids were extracted by alkaline lysis method from isolates and profiled on agarose gel electrophoresis. Results Out of total 2,661 urine samples, E. coli were isolated in 64.5% (507/788), among which 170 (33.5%) were MDR isolates. All MDR isolates were resistant to amoxicillin and third generation cephalosporins but were highly sensitive to imipenem (94.12%, 160/170), amikacin (92.94%, 158/170) and nitrofurantoin (86.47%, 147/170). Among 170 MDR isolates, 78.2% (133/170) were ESBL, 46.3% (50/170) were AmpC, 11.2% (19/170) were MBL and 0.6% (1/170) was KPC producers. Coproduction of β-Lactamases was detected in 24.12% (41/170) of isolates. E. coli isolates showed one plasmid (>33.5 Kb) which was unanimously present in all the isolates. Overall, 44 different plasmid profile groups were identified based on the molecular weight and number of plasmids. β-lactamase producers were relatively resistant to higher number of antibiotics (≤10) than non-producer (≤8) and number of plasmids were higher in β-lactamase producers (≤7) than non-producers (≤5).

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“…CRE are resistant to most antibiotics and clinical outcomes after CRE infections are generally poor 63–68 . While less frequent than carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem resistant E. coli (CREC) constitute an important subset of CRE, and are on the rise globally and outbreaks have been reported in the US 69, 70 . To date, most CRE infections in the United States and Europe are health-care associated, with patients from long term care facilities at especially high risk 71 .…”

Section: Carbapenemase-producing Enterobacteriaceaementioning

confidence: 99%

Multidrug-Resistant Bacteria in the Community

Duin

Paterson

2016

Infectious Disease Clinics of North America

452

308

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Multidrug resistant (MDR) bacteria are one of the most important current threats to public health. Typically, MDR bacteria are associated with nosocomial infections. However, some MDR bacteria have become quite prevalent causes of community-acquired infections. The spread of MDR bacteria into the community is a crucial development, and is associated with increased morbidity, mortality, healthcare costs and antibiotic use. Factors associated with community dissemination of MDR bacteria overlap but are distinct from those associated with nosocomial spread. Community-associated (CA) MDR bacteria have an antibiotic resistance phenotype that is stable in the absence of antibiotic pressure of the type normally observed in hospitals or nursing homes. An exception to this rule may be those CA-MDR bacteria, of which the prevalence is driven by the presence of antibiotics in the food chain. Additionally, the colonization of otherwise healthy hosts is a common characteristic of CA-MDR bacteria. However, subtle immune deficiencies may still be present in the subjects colonized with specific CA-MDR bacteria. Methicillin-resistant S. aureus (MRSA) is the most prevalent of CA-MDR bacteria. CA-MRSA also has the greatest impact on morbidity and mortality. The main threat on the horizon is represented by Enterobacteriaceae. The production of extended spectrum β-lactamases in Enterobacteriaceae encountered in the community is becoming increasingly prevalent. Of great concern is the potential for the acquisition of carbapenemase genes in CA-Enterobacteriaceae. Prevention of further community spread of MDR bacteria is of the utmost importance, and will require a multi-disciplinary approach involving all stakeholders.

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Emergence of Escherichia coli, Co-Producing NDM-1 and OXA-48 Carbapenemases, in Urinary Isolates, at a Tertiary Care Centre at Central India

Cited by 34 publications

References 0 publications

OXA-48 Carbapenemase in Klebsiella pneumoniae Sequence Type 307 in Ecuador

OXA-48 Carbapenemase in Klebsiella pneumoniae Sequence Type 307 in Ecuador

Plasmid Profiling and Occurrence of β-lactamase Enzymes in Multi-drug Resistant Uropathogenic Escherichia coli in Kathmandu, Nepal

Multidrug-Resistant Bacteria in the Community

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