Geographic patterns of global isolates of carbapenem-resistant Klebsiella pneumoniae and the activity of ceftazidime/avibactam, meropenem/vaborbactam, and comparators against these isolates: Results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program, 2020

Lee, Yu-Lin; Ko, Wen–Chien; Hsueh, Po‐Ren

doi:10.1016/j.ijantimicag.2022.106679

Cited by 17 publications

(6 citation statements)

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“…Furthermore, the inappropriate and excessive use of carbapenems in clinical practice has accelerated the emergence and extensive spread of carbapenem-resistant strains [15]. Various surveillance programs have reported that the resistance rate of carbapenem strains has increased during the last decade, with the predominant pathogens being E. coli and K. pneumonia [1,2,4].…”

Section: Discussionmentioning

confidence: 99%

“…Increasing antimicrobial resistance is a major concern for global public health [1,2]. Various surveillance programs monitoring gram-negative bacteria have reported that the prevalences of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) have increased during the past decade in Asia [3].…”

Section: Introductionmentioning

confidence: 99%

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Trends in antimicrobial resistance of Escherichia coli and Klebsiella pneumoniae from 2016 to 2021 in Shanghai, China

Liao

Liu

Cui

et al. 2023

Preprint

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Objectives We sought to analyze the antimicrobial resistance trends of Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) isolated from patients.Methods Twelve commonly used antibiotics from E. coli and K. pneumoniae isolated every year from 2016 to 2021 were analyzed to identify trends in antimicrobial resistance over time using univariate tests of trend and multivariate regression models to account for the effects of patient demographics.Results The numbers of E. coli and K. pneumoniae strains increased, while the rates of E. coli and K. pneumoniae remained stable. The number and rate of extended-spectrum beta-lactamase (ESBL)-producing E. coli and K. pneumoniae increased. Statistically significant increases in the proportions of E. coli and ESBL-producing E. coli isolates resistant to meropenem, cefepime, cefoperazone-sulbactam, piperacillin-tazobactam, cotrimoxazole, amikacin, ciprofloxacin, and fosfomycin were observed, and increases in the non-ESBL-producing E. coli resistance rates to cefepime, ceftazidime, and piperacillin-tazobactam were observed. Similarly, the proportions of K. pneumoniae and ESBL-producing K. pneumoniae resistant to imipenem, meropenem, cefoxitin, cefepime, ceftazidime, cefoperazone-sulbactam, piperacillin-tazobactam, ciprofloxacin, and fosfomycin increased during the study, while the non-ESBL-producing K. pneumoniae resistance rates to cefazolin and fosfomycin increased.Conclusions Increases in ESBL-producing E. coli and K. pneumoniae resistance to multiple classes of antimicrobials and the marked increase in carbapenem-resistant K. pneumoniae were the most remarkable changes observed from 2016 to 2021. This paper provides important information for governments and clinicians to track antimicrobial resistance and will provide insights into antimicrobial strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trends in antimicrobial resistance of Escherichia coli and Klebsiella pneumoniae from 2016 to 2021 in Shanghai, China

Liao

Liu

Cui

et al. 2023

Preprint

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“…With the use of antibiotics, CRKP has gained extensive attention globally [ 22 ]. While previous studies have seldom focused on the molecular epidemiological data of CRKP infections in Northern China.…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae in a Tertiary Hospital in Northern China

Wang

Dong

Wang

et al. 2022

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. In recent years, carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged rapidly in China with the abuse and overuse of antibiotics, and infections caused by CRKP pose a serious threat to global public health safety. The present study aimed to explore the epidemiological characteristics of CRKP isolates in Northern China and to elucidate their drug resistance mechanisms. Methods. 45 CRKP strains were consecutively collected at a teaching hospital from March 1st, 2018 to June 30th, 2018. Antimicrobial susceptibility was determined by the VITEK2 compact system and microbroth dilution method. Polymerase chain reaction (PCR) and sequencing were used to analyze multilocus sequence typing (MLST), drug resistance determinants, and plasmid types. The transfer of resistance genes was determined by conjugation. All statistical analysis was performed using SPSS 22.0 software. Results. All 45 isolates showed multidrug resistance (MDR). MLST analysis showed ST11 (48.9%, 22/45) was the most frequent type. All of the 45 CRKP isolates contained carbapenemase genes, extended-spectrum β-lactamase (ESBL) genes, and plasmid-mediated quinolone resistance (PMQR) genes. For carbapenemase genes, KPC-2 (93.3%, 42/45) was the main genotype, and followed by GES (37.8%, 17/45) and NDM-1 (11.1%, 5/45). Plasmid typing analysis showed that IncFII and IncFIB were the most prevalent plasmids. The carbapenem resistance rate of K.pneumoniae was 11.4% and ICU was the main CRKP infection source. Conclusions. ST11 is the most frequent sequence type and KPC-2 is the predominant carbapenemase of CRKP strains in Northern China. KPC-2-ST11 are representative clonal lineages.

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“…In a 10-year program involving 76 countries, 20.5% of the 68 897 PA isolates were resistant to carbapenems (CR-PA). Carbapenemase genes were detected in 14.3% of patients infected with CR-PA, and VIM was the most prevalent [35] However, this incidence may vary according to the region [36].…”

Section: Introductionmentioning

confidence: 99%

Management strategies for severe Pseudomonas aeruginosa infections

Do Rego,

Timsit

2023

Current Opinion in Infectious Diseases

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Purpose This review focuses on the management of severe Pseudomonas aeruginosa infections in critically ill patients. Recent findings Pseudomonas aeruginosa is the most common pathogen in intensive care; the main related infections are nosocomial pneumonias, then bloodstream infections. Antimicrobial resistance is common; despite new antibiotics, it is associated with increased mortality, and can lead to a therapeutic deadlock. Summary Carbapenem resistance in difficult-to-treat P. aeruginosa (DTR-PA) strains is primarily mediated by loss or reduction of the OprD porin, overexpression of the cephalosporinase AmpC, and/or overexpression of efflux pumps. However, the role of carbapenemases, particularly metallo-β-lactamases, has become more important. Ceftolozane-tazobactam, ceftazidime-avibactam and imipenem-relebactam are useful against DTR phenotypes (noncarbapenemase producers). Other new agents, such as aztreonam-ceftazidime-avibactam or cefiderocol, or colistin, might be effective for carbapenemase producers. Regarding nonantibiotic agents, only phages might be considered, pending further clinical trials. Combination therapy does not reduce mortality, but may be necessary for empirical treatment. Short-term treatment of severe P. aeruginosa infections should be preferred when it is expected that the clinical situation resolves rapidly.

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Geographic patterns of global isolates of carbapenem-resistant Klebsiella pneumoniae and the activity of ceftazidime/avibactam, meropenem/vaborbactam, and comparators against these isolates: Results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program, 2020

Cited by 17 publications

References 36 publications

Trends in antimicrobial resistance of Escherichia coli and Klebsiella pneumoniae from 2016 to 2021 in Shanghai, China

Trends in antimicrobial resistance of Escherichia coli and Klebsiella pneumoniae from 2016 to 2021 in Shanghai, China

Molecular Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae in a Tertiary Hospital in Northern China

Management strategies for severe Pseudomonas aeruginosa infections

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