Infection with Panresistant<i>Klebsiella pneumoniae:</i>A Report of 2 Cases and a Brief Review of the Literature

Elemam, Azza; Rahimian, Joseph; Mandell, William

doi:10.1086/600042

Cited by 149 publications

(121 citation statements)

References 16 publications

(20 reference statements)

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“…This approach could be dangerous to patients because there are not convincing therapeutic outcome data to justify reporting carbapenemase producers as carbapenem susceptible. Also, the current KPC epidemic demonstrates the widespread adverse consequences that can ensue when labs fail to rapidly detect carbapenemase producers (12). Since susceptibility tests alone will not detect all carbapenemase producers, prevention and control must rely on labs performing detection tests.…”

Section: Carbapenemasesmentioning

confidence: 99%

Extended-Spectrum-β-Lactamase, AmpC, and Carbapenemase Issues

2010

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Section: Carbapenemasesmentioning

confidence: 99%

Extended-Spectrum-β-Lactamase, AmpC, and Carbapenemase Issues

2010

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“…Treatment options for KPC infections are very limited, and colistin has been used either as monotherapy or in combination schemes (1, 6, 13, 14). Indeed, resistance to colistin has been only sporadically reported among KPC producers (1, 2, 3) and has been reported to occur during treatment for KPC-KP infections (5,12). The emergence of CR KPC-KP in our hospital prompted this study to identify possible risk factors that contributed to its development.…”

mentioning

confidence: 95%

Risk Factors and Outcomes Associated with Acquisition of Colistin-Resistant KPC-Producing Klebsiella pneumoniae : a Matched Case-Control Study

Zarkotou¹,

et al. 2010

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A matched 1:3 case-control study investigated factors predicting colistin-resistant versus colistin-susceptible KPC-producing Klebsiella pneumoniae acquisition and its impact on patient outcomes. Case patients were more often admitted from other institutions (P ‫؍‬ 0.019) and had longer therapy with ␤-lactam/␤-lactamase inhibitors (P ‫؍‬ 0.002) and higher overall mortality (P ‫؍‬ 0.05). All 52 study isolates were clonally related, suggesting horizontal dissemination. None of these parameters independently predicted colistin resistance, which probably occurred in a susceptible KPC-KP strain that was subsequently disseminated horizontally.

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“…Infections caused by this pathogen are difficult to eradicate, since K. pneumoniae carries genes for resistance to the majority of antimicrobial drugs, including carbapenems (2,3). The first strain of carbapenem-resistant K. pneumoniae was isolated in 1996; the plasmid-encoded determinant was named K. pneumoniae carbapenemase (KPC) and was indicated as the bla KPC gene (4).…”

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confidence: 99%

Tracking Nosocomial Klebsiella pneumoniae Infections and Outbreaks by Whole-Genome Analysis: Small-Scale Italian Scenario within a Single Hospital

et al. 2015

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f Multidrug-resistant (MDR) Klebsiella pneumoniae is one of the most important causes of nosocomial infections worldwide. After the spread of strains resistant to beta-lactams at the end of the previous century, the diffusion of isolates resistant to carbapenems and colistin is now reducing treatment options and the containment of infections. Carbapenem-resistant K. pneumoniae strains have spread rapidly among Italian hospitals, with four subclades of pandemic clonal group 258 (CG258). Here we show that a single Italian hospital has been invaded by three of these subclades within 27 months, thus replicating on a small scale the "Italian scenario." We identified a single clone responsible for an epidemic outbreak involving seven patients, and we reconstructed its star-like pattern of diffusion within the intensive care unit. This epidemiological picture was obtained through phylogenomic analysis of 16 carbapenem-resistant K. pneumoniae isolates collected in the hospital during a 27-month period, which were added to a database of 319 genomes representing the available global diversity of K. pneumoniae strains. Phenotypic and molecular assays did not reveal virulence or resistance determinants specific for the outbreak isolates. Other factors, rather than selective advantages, might have caused the outbreak. Finally, analyses allowed us to identify a major subclade of CG258 composed of strains bearing the yersiniabactin virulence factor. Our work demonstrates how the use of combined phenotypic, molecular, and whole-genome sequencing techniques can help to identify quickly and to characterize accurately the spread of MDR pathogens.

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Infection with PanresistantKlebsiella pneumoniae:A Report of 2 Cases and a Brief Review of the Literature

Cited by 149 publications

References 16 publications

Extended-Spectrum-β-Lactamase, AmpC, and Carbapenemase Issues

Extended-Spectrum-β-Lactamase, AmpC, and Carbapenemase Issues

Risk Factors and Outcomes Associated with Acquisition of Colistin-Resistant KPC-Producing Klebsiella pneumoniae : a Matched Case-Control Study

Tracking Nosocomial Klebsiella pneumoniae Infections and Outbreaks by Whole-Genome Analysis: Small-Scale Italian Scenario within a Single Hospital

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