Hospital outbreak caused by Klebsiella pneumoniae producing KPC-2 β-lactamase resistant to colistin

Κοντοπούλου, Κωνσταντίνα; Protonotariou, Efthimia; Vasilakos, K.; Kriti, M.; Koteli, Asimoula; Antoniadou, Eleni; Sofianou, Danai

doi:10.1016/j.jhin.2010.03.021

Cited by 136 publications

(107 citation statements)

References 26 publications

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“…Carbapenem-resistant isolates from individual cases and outbreaks may be different from those examined here. For example, most ST258 K. pneumoniae with KPC carbapenemases are susceptible to gentamicin, tigecycline and colistin but, as already noted, some variants are resistant even to colistin [13,14], whereas non-ST258 K. pneumoniae isolates presently circulating in north-west England, and not included in the present study, often are susceptible to multiple aminoglycosides and fluoroquinolones (Health Protection Agency, data on file). Second, the present results M a n u s c r i p t suggest formulary-based interventions, e.g.…”

Section: Accepted Manuscriptmentioning

confidence: 60%

“…Moreover, in some cases, colistin resistance is selected during therapy, and this may apply for the resistant E. cloacae with NDM-1 enzyme in the present study, which was from a child who had already received colistin for Acinetobacter and Pseudomonas infections [12]. Furthermore, colistin-resistant variants of the international KPC + ST258 K. pneumoniae strain are circulating in Greece and Hungary [13,14], with a few cases also seen in the UK. In the case of tigecycline, there are positive case reports of its use in infections due to K. pneumoniae with VIM and KPC carbapenemases in Greece [15], but also of resistance emerging during therapy, albeit in an off-label setting (nosocomial pneumonia) [16].…”

Section: Accepted Manuscriptmentioning

confidence: 84%

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What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecycline

Livermore¹,

Warner²,

Mushtaq³

et al. 2011

International Journal of Antimicrobial Agents

304

181

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Section: Accepted Manuscriptmentioning

confidence: 60%

Section: Accepted Manuscriptmentioning

confidence: 84%

What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecycline

Livermore¹,

Warner²,

Mushtaq³

et al. 2011

International Journal of Antimicrobial Agents

304

181

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“…This is worrying, because this drug class is the chosen one for the treatment of serious infections caused by multidrug-resistant isolates [4]. As reported by Kantopolou et al, polymyxins could be used as an alternative last choice to treat infections due to resistant Gram-negative bacteria [5].…”

Section: Introductionmentioning

confidence: 99%

Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil

Vivan¹,

Rosa²,

Rizek³

et al. 2017

J Infect Dev Ctries

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Introduction: The emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kpn) isolates is attracting significant attention in nosocomial infection settings. K. pneumoniae is the main pathogen that harbours blaKPC genes. Methodology: This study evaluated 54 K. pneumoniae carbapenem-resistant isolates from patients hospitalized at the University Hospital of Londrina, between July 2009 and July 2010. The isolates were phenotypically screened for carbapenemase production and submitted for genotypic confirmation by polymerase chain reaction (PCR) for KPC, metallo-β-lactamases, OXA-48, and extended-spectrum beta-lactamase genes. The absence of outer membrane proteins (OMP) was investigated by SDS-PAGE. The susceptibility profile was determined by broth microdilution, according to Clinical and Laboratory Standards Institute protocol. Results: All isolates were phenotypically positive for class A carbapenemase production, but negative for metallo-β-lactamase activity. PCR analysis demonstrated that all isolates carried blaKPC genes and sequencing showed that all strains belonged to KPC-2 subtype. Four strains did not show porin expression, and all isolates were resistant to ertapenem, meropenem, and imipenem. Susceptibility rates reached 35.2% for gentamicin, 85.2% for polymixyn B, 87% for colistin, and 98.1% for both tigecycline and fosfomycin. Pulsed-field gel electrophoresis showed six clones, and three of them predominated among the isolates. Conclusions: KPC-2-producing K. pneumoniae is becoming predominant among carbapenem-resistant K. pneumoniae isolates at the hospital. The association of the enzyme KPC with other resistance determinants, such as loss of porins, may increase the severity of the situation of nosocomial infections. There is an urgent need to develop strategies for infection control and prevention.

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“…terdiri dari 3 jenis porin yaitu OmpK35, OmpK36, dan OmpK37 (Hernandez-Alles et al, 1999;Kaczmarek et al, 2006). Porin OmpK35 dan OmpK36 berperan penting pada penetrasi antibiotik ke dalam sel, sehingga hilangnya porin OmpK35 dan OmpK36 dapat menyebabkan resistensi bakteri terhadap carbapenem (Doumith et al, 2009;Goldfarb et al, 2009;Kontopoulou et al, 2010).…”

Section: H a S I L D A N P E M B A H A S A Nunclassified

RESISTENSI <em>Klebsiella</em> sp TERHADAP MEROPENEM DI RSUD PROF. DR. MARGONO SOEKARJO PURWOKERTO

2017

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Resistant Gram-negative bacteria, particularly Klebsiella sp., has become a serious problem in hospitals as one of the main causes of nosocomial infections spread through urine catheterization. Infections of Klebsiella sp. producing extended-spectrum beta-lactamase (ESBL) can lead to significant economic and clinical negative outcome. This study was aimed to determine the sensitivity of ESBL Klebsiella sp. against meropenem as a cause of nosocomial infections in Prof. Dr. Margono Soekarjo hospital. This research obtained urine samples from the urinary catheter of patients hospitalized for at least two days in the surgical ward and intensive care unit. ESBL examination conducted by the initial screen test, meanwhile, sensitivity test to meropenem done by using disk diffusion test. Among the 40 patients examined in this study 7.5% isolates were Klebsiella sp-positive. This research identified five percent of the total patients as ESBL positive with the level of sensitivity against meropenem was revealed as resistant.

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Hospital outbreak caused by Klebsiella pneumoniae producing KPC-2 β-lactamase resistant to colistin

Cited by 136 publications

References 26 publications

What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecycline

What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecycline

Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil

RESISTENSI <em>Klebsiella</em> sp TERHADAP MEROPENEM DI RSUD PROF. DR. MARGONO SOEKARJO PURWOKERTO

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