Ongoing epidemic of blaVIM-1-positive Klebsiella pneumoniae in Athens, Greece: a prospective survey

Psichogiou, Mina; Tassios, Panayotis T.; Avlamis, Athina; Stefanou, Ioanna; Kosmidis, Chris; Platsouka, E.; Paniara, Olga; Xanthaki, Anna; Toutouza, Marina; Daikos, Georgios; Tzouvelekis, L. S.

doi:10.1093/jac/dkm443

Cited by 103 publications

(79 citation statements)

References 12 publications

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“…In our region, carbapenem resistance among K. pneumoniae clinical isolates is alarming and is attributed mostly to the production of VIM-type MBLs (12,24). Also, plasmid-mediated AmpC-producing K. pneumoniae isolates are frequently detected and in several cases contribute to reduced susceptibility to carbapenems (unpublished data), which was observed among AmpC producers in the present study.…”

Section: Discussionsupporting

confidence: 75%

“…Tests with such characteristics are particularly needed in regions where MBLs or other resistance determinants are frequently detected among K. pneumoniae isolates with reduced susceptibility to carbapenems. In Greek hospitals, MBL-producing K. pneumoniae clinical isolates are endemic (12,24), but recently the first KPC-possessing K. pneumoniae isolate has also been described (28). The latter isolate was phenotypically identified as a KPC producer by using boronic acid disk tests, and this prompted our laboratory to propose a sensitive but also highly specific phenotypic scheme based on the inhibitory effects of boronic acid.…”

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confidence: 99%

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Evaluation of Boronic Acid Disk Tests for Differentiating KPC-Possessing Klebsiella pneumoniae Isolates in the Clinical Laboratory

et al. 2009

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The worldwide increase in the occurrence and dissemination of KPC ␤-lactamases among gram-negative pathogens makes critical the early detection of these enzymes. Boronic acid disk tests using different antibiotic substrates were evaluated for detection of KPC-possessing Klebsiella pneumoniae isolates. A total of 57 genotypically confirmed KPC-possessing K. pneumoniae isolates with varying carbapenem MICs were examined. To measure the specificity of the tests, 106 non-KPC-possessing isolates (89 K. pneumoniae and 17 Escherichia coli isolates) were randomly selected among those exhibiting reduced susceptibility to cefoxitin, expanded-spectrum cephalosporins, or carbapenems. As many as 56, 53, and 40 of the non-KPC-possessing isolates harbored extended-spectrum ␤-lactamases, metallo-␤-lactamases, and plasmidmediated AmpC ␤-lactamases, respectively. By use of CLSI methodology and disks containing imipenem, meropenem, or cefepime, either alone or in combination with 400 g of boronic acid, all 57 KPC producers gave positive results (sensitivity, 100%) whereas all 106 non-KPC producers were negative (specificity, 100%). The meropenem duplicate disk with or without boronic acid demonstrated the largest differences in inhibition zone diameters between KPC producers and non-KPC producers. By use of disks containing ertapenem, all isolates were correctly differentiated except for five AmpC producers that gave falsepositive results (sensitivity, 100%; specificity, 95.3%). These practical and simple boronic acid disk tests promise to be very helpful for the accurate differentiation of KPC-possessing K. pneumoniae isolates, even in regions where different broad-spectrum ␤-lactamases are widespread.

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Section: Discussionsupporting

confidence: 75%

mentioning

confidence: 99%

Evaluation of Boronic Acid Disk Tests for Differentiating KPC-Possessing Klebsiella pneumoniae Isolates in the Clinical Laboratory

et al. 2009

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“…Detection tests are still evolving, hindered by the heterogeneity of both enzymes and hosts, which confers different levels of carbapenem susceptibility. For example, carbapenemase-producing members of the family Enterobacteriaceae may have imipenem MICs as low as 0.125 g/ml (36). Acinetobacter spp.…”

Section: Carbapenemasesmentioning

confidence: 99%

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

2010

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“…Infections caused by carbapenem resistant bacteria have limited treatment options and these have been associated with high mortality rates. The emergence of carbapenem resistant enterobacteriaceae due to acquired metallo-β-lactamases (MBL) is an international health problem (2)(3)(4). IMP and VIM enyzmes are the most prevalent types in acquired MBL and they have appeared globally.…”

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confidence: 99%

Bacteremia due to A VIM-1 producing klebsiella pneumoniae ısolate from an acute lymphoblastic leukemia patient ın Antalya

2014

J Turgut Ozal Med Cent

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A Klebsiella pneumoniae clinical isolate resistant to imipenem was recovered from blood culture of a 4 years old child with the diagnosis of acute precursor B cell lymphoblastic leukemia. PCR assays of Klebsiella pneumoniae isolate were positive with blaCTX-M and blaVIM genes.Sequence analysis of the 160 bp amplicon matched with blaVIM 1. Patient was discharged on the 15th day of ciprofloxacin theraphy with remission. We report here the first VIM-1 positive Klebsiella pneumoniae isolate case from Akdeniz University Hospital. Urgent and rapid precautions must be preferred including antibiotic policy and infection control practices when the first case with different resistance patern is detected.

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Ongoing epidemic of blaVIM-1-positive Klebsiella pneumoniae in Athens, Greece: a prospective survey

Abstract: A multiclonal epidemic of bla(VIM-1)-carrying K. pneumoniae is under way in the majorhospitals in Greece. Microorganisms producing both VIM-1 and SHV-5 constitute the prevalent multidrug-resistant population of K. pneumoniae in this setting.

Cited by 103 publications

References 12 publications

Evaluation of Boronic Acid Disk Tests for Differentiating KPC-Possessing Klebsiella pneumoniae Isolates in the Clinical Laboratory

Evaluation of Boronic Acid Disk Tests for Differentiating KPC-Possessing Klebsiella pneumoniae Isolates in the Clinical Laboratory

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

Bacteremia due to A VIM-1 producing klebsiella pneumoniae ısolate from an acute lymphoblastic leukemia patient ın Antalya

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