Molecular typing methods &amp;amp; resistance mechanisms of MDR &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt;

Background The global emergence of genes responsible for carbapenemases and the production of mcr in Klebsiella pneumoniae isolates pose a serious threat to public health. The study of carbapenem and colistin resistance (CLR) in K. pneumoniae has a high priority for the infection control committee. The purpose of this study was to determine the antimicrobial resistance rate and evaluate the pattern of CLR in carbapenem-resistant K. pneumoniae (CRKP) isolated from four tertiary care hospitals in Iran, as well as to describe the clonal relationship of multidrug-resistant K. pneumoniae strains. Fifty clinical isolates of CRKP were obtained from four hospitals in Iran. The mcr-harboring isolates and carbapenemase-encoding genes were screened by PCR amplification, and molecular typing (PFGE) was used to assess their spread. Among the total isolates, 38% were identified as CLR by colistin disk elution. Results Among positive isolates for carbapenemase genes, the most frequent gene was blaOXA−48. Additionally, the mcr-1 gene was detected in 6% of the obtained isolates; none of the other mcr genes were detected in the studied isolates. All isolates were grouped under four clusters (A-D). The major cluster was related to the C cluster with 23 isolates. Conclusions The prevalence of CLR K. pneumoniae was estimated to be 18% in our ICU. Colistin-resistant CRKP is becoming an emerging threat in ICU settings, limiting further treatment options. Additionally, we observed a common molecular signature among CRKP isolates. Therefore, hospitals need to implement an effective infection control system to prevent the outbreak of diverse carbapenem- and colistin-resistant isolates in the future.

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The Dark Side of Nosocomial Infections in Critically Ill COVID-19 Patients

Biondo,

Ponzo,

Midiri

et al. 2023

Life

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Coronavirus disease 2019 (COVID-19) is a potentially serious acute respiratory infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Since the World Health Organization (WHO) declared COVID-19 a global pandemic, the virus has spread to more than 200 countries with more than 500 million cases and more than 6 million deaths reported globally. It has long been known that viral respiratory tract infections predispose patients to bacterial infections and that these co-infections often have an unfavourable clinical outcome. Moreover, nosocomial infections, also known as healthcare-associated infections (HAIs), are those infections that are absent at the time of admission and acquired after hospitalization. However, the impact of coinfections or secondary infections on the progression of COVID-19 disease and its lethal outcome is still debated. The aim of this review was to assess the literature on the incidence of bacterial co-infections and superinfections in patients with COVID-19. The review also highlights the importance of the rational use of antibiotics in patients with COVID-19 and the need to implement antimicrobial stewardship principles to prevent the transmission of drug-resistant organisms in healthcare settings. Finally, alternative antimicrobial agents to counter the emergence of multidrug-resistant bacteria causing healthcare-associated infections in COVID-19 patients will also be discussed.

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Molecular typing methods & resistance mechanisms of MDR <i>Klebsiella pneumoniae</i>

Cited by 4 publications

References 119 publications

Molecular typing of clinical multidrug-resistant Klebsiella pneumoniae isolates

Molecular typing of clinical multidrug-resistant Klebsiella pneumoniae isolates

Genotypic characterization and detection of resistance mechanisms in carbapenem- resistant Klebsiella pneumoniae isolated from four tertiary care hospitals in Iran

The Dark Side of Nosocomial Infections in Critically Ill COVID-19 Patients

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