Klebsiella pneumoniae: Development of Carbapenem Resistance due to Acquisition of blaNDM-1 During Antimicrobial Therapy in Twin Infants with Pneumonia

Zhu, Jun; Ding, Baixing; Xu, Xiaogang; Zhu, Demei; Yang, Fan; Zhang, Hong; Hu, Fupin

doi:10.3389/fmicb.2015.01399

Cited by 14 publications

(12 citation statements)

References 12 publications

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“…9,21 Previous studies analyzed the use of broad-spectrum antibiotics (such as carbapenems), urinary catheters, and mechanical ventilation as the risk factors for acquiring CRE strains among hospitalized patients. 22 In the current study, the rate of multidrug resistance among K. pneumoniae isolates was 86.6%.…”

Section: Discussionmentioning

confidence: 52%

Dissemination Pattern of Multidrug Resistant Carbapenemase Producing Klebsiella pneumoniae Isolates Using Pulsed-Field Gel Electrophoresis in Southwestern Iran

Hashemizadeh¹,

Hosseinzadeh²,

Azimzadeh³

et al. 2020

IDR

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Background: Klebsiella pneumoniae is an important cause of healthcare-associated infection. Carbapenemases have increasingly been reported in Enterobacteriaceae, especially in K. pneumoniae. Propose: The objective of this study was to determine antibiotic resistance patterns, and the molecular epidemiology of multidrug resistant K. pneumoniae isolates, obtained from hospitalized patients in Shiraz, Iran. Methods: In this study, 60 K. pneumoniaeisolates were collected from Nemazee and Faghihi referral hospitals. Antibiotic susceptibility testing and MIC were performed by disk diffusion test and Epsilometer (E)-test strips, respectively. Carbapenemase genes were identified by polymerase chain reaction and sequencing. Then, clonal relationships were analyzed, using PFGE. Results: Thirty-three out of 60 K. pneumoniae isolates were resistant to carbapenems. Among the isolates, 86.6% were multidrug resistant (MDR). Polymyxin B (18.3%) and tigecycline (23.3%) were shown to be the most active agents against K. pneumoniae isolates. In our study, the high prevalence of bla NDM (45%) and bla OXA-48 (10%) was detected. Conclusion: The results of this study revealed the widespread carbapenemase gene between different wards in hospitals as a risk factor for treatment options. PFGE analysis showed 11 clusters and 3 singletons based on an 80% similarity level. Also, PFGE analysis showed that there were similar genetic patterns among K. pneumoniae isolates and these patterns were responsible for the distribution of infection in hospitals.

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Section: Discussionmentioning

confidence: 52%

Dissemination Pattern of Multidrug Resistant Carbapenemase Producing Klebsiella pneumoniae Isolates Using Pulsed-Field Gel Electrophoresis in Southwestern Iran

Hashemizadeh¹,

Hosseinzadeh²,

Azimzadeh³

et al. 2020

IDR

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“…In 2010, Rodríguez-Avial reported that the mechanism was bla VIM-1 gene acquisition [37]. In 2015, Junying Zhu reported that the mechanism was bla NDM-1 gene acquisition [27]. CMY .…”

Section: Rasmussen Et Al and Andres Opazo Et Almentioning

confidence: 99%

“…It was discovered that ST37 are international clones associated with multidrug-resistant K. pneumoniae such as extended-spectrum β-lactamase, AmpC or carbapenemase producers [26]. Recently, NDM-1-producing K. pneumoniae belonging to ST37 were reported in China [27], which indicated that multidrug-resistant K. pneumoniae ST37 have been identified in our country. The bla OX A-1 -producing K. pneumoniae has been reported in some sequencing types, such as ST48, ST15 and ST23 [28].…”

mentioning

confidence: 94%

ST37 Klebsiella Pneumoniae : Development of Carbapenem Resistance in Vivo During Antimicrobial Therapy in Neonates

Wang

et al. 2017

Future Microbiol.

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Aim:To investigate the mechanism leading to in vivo carbapenem resistance development in Klebsiella pneumoniae. Methods: Carbapenemase was detected using the modified carbapenem inactivation method. β-lactamases resistant genes were identified by PCR and sequencing. Clonal relatedness was evaluated by random amplified polymorphic DNA and multiple locus sequence typing. The relationship between sequence typing and resistant genes was analyzed by using the chi-squared test. Results: All ST37 carbapenem-resistant isolates were bla OXA-1 positive and all ST37 carbapenem-sensitive isolates were bla OXA-1 negative at Stage I. A significant relationship between carbapenem resistance and bla OXA-1 was observed. The bla OXA-1 -positive rate was significantly higher in ST37 K. pneumoniae than others. Conclusion: This is the first study about the development of carbapenem resistance in vivo potentially mediated by bla OXA-1 in ST37 K. pneumoniae among neonates.

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“…The increasing burden of CRE infections, the high rate of treatment failure, the emergence of resistance during treatment [5,6] and the dearth of novel antimicrobial agents highlight the urgency to investigate effective approaches for treating these infections. Polymyxins [polymyxin B (PMB) and polymyxin E (colistin)] are rapidly bactericidal against KPC-producing K. pneumoniae [7].…”

Section: Introductionmentioning

confidence: 99%

Polymyxin B in combination with meropenem against carbapenemase-producing Klebsiella pneumoniae: pharmacodynamics and morphological changes

Sharma

Patel

Abboud

et al. 2017

International Journal of Antimicrobial Agents

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Combination therapy provides a useful therapeutic approach to overcome resistance until new antibiotics become available. In this study, the pharmacodynamics, including the morphological effects, of polymyxin B (PMB) and meropenem alone and in combination against KPC-producing Klebsiella pneumoniae clinical isolates was examined. Ten clinical isolates were obtained from patients undergoing treatment for mediastinitis. KPCs were identified and MICs were measured using microbroth dilution. Time–kill studies were conducted over 24 h with PMB (0.5–16 mg/L) and meropenem (20–120 mg/L) alone or in combination against an initial inoculum of ca. 106 CFU/mL. Scanning electron microscopy (SEM) was employed to analyse changes in bacterial morphology after treatment, and the log change method was used to quantify the pharmacodynamic effect. All isolates harboured the blaKPC-2 gene and were resistant to meropenem (MICs ≥8 mg/L). Clinically relevant PMB concentrations (0.5, 1.0 and 2.0 mg/L) in combination with meropenem were synergistic against all isolates except BRKP28 (polymyxin- and meropenem-resistant, both MICs >128 mg/L). All PMB and meropenem concentrations in combination were bactericidal against polymyxin-susceptible isolates with meropenem MICs ≤16 mg/L. SEM revealed extensive morphological changes following treatment with PMB in combination with meropenem compared with the changes observed with each individual agent. Additionally, morphological changes decreased with increasing resistance profiles of the isolate, i.e. increasing meropenem MIC. These antimicrobial effects may not only be a summation of the effects due to each antibiotic but also a result of differential action that likely inhibits protective mechanisms in bacteria.

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Klebsiella pneumoniae: Development of Carbapenem Resistance due to Acquisition of blaNDM-1 During Antimicrobial Therapy in Twin Infants with Pneumonia

Cited by 14 publications

References 12 publications

<p>Dissemination Pattern of Multidrug Resistant Carbapenemase Producing <em>Klebsiella pneumoniae</em> Isolates Using Pulsed-Field Gel Electrophoresis in Southwestern Iran</p>

<p>Dissemination Pattern of Multidrug Resistant Carbapenemase Producing <em>Klebsiella pneumoniae</em> Isolates Using Pulsed-Field Gel Electrophoresis in Southwestern Iran</p>

ST37 Klebsiella Pneumoniae : Development of Carbapenem Resistance in Vivo During Antimicrobial Therapy in Neonates

Polymyxin B in combination with meropenem against carbapenemase-producing Klebsiella pneumoniae: pharmacodynamics and morphological changes

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