Osteomyelitis Due to Multiple Carbapenemase‐Producing Gram‐Negative Bacteria: The First Case Report of a GES‐13‐Producing <i>Pseudomonas aeruginosa</i> Isolate in Canada

Sepehri, Shadi; Poliquin, Guillaume; Alfattoh, Nora; Boyd, David A.; Mulvey, Michael R.; Denisuik, Andrew; Fanella, Sergio; Karlowsky, James A.; Walkty, Andrew

doi:10.1155/2014/657047

Cited by 9 publications

(8 citation statements)

References 16 publications

(31 reference statements)

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“…In fact, the only report of a bla OXA-48 -producing K . pneumoniae linked to Pakistan appears to be from a December 2012 case of osteomyelitis in an infant that had sustained a burn injury in Karachi, Pakistan before returning to Canada, where the bla OXA-48 producing strain was isolated [ 84 ]. This highlights the complex issues and challenges presented by MDR organisms, as clinicians around the world need to be aware of global trends in antimicrobial resistance as focusing only on local patterns might not be sufficient to make prudent clinical decisions.…”

Section: Discussionmentioning

confidence: 99%

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

et al. 2018

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The emergence and dissemination of carbapenemases, bacterial enzymes able to inactivate most β-lactam antibiotics, in Enterobacteriaceae is of increasing concern. The concurrent spread of resistance against colistin, an antibiotic of last resort, further compounds this challenge further. Whole-genome sequencing (WGS) can play a significant role in the rapid and accurate detection/characterization of existing and emergent resistance determinants, an essential aspect of public health surveillance and response activities to combat the spread of antimicrobial resistant bacteria. In the current study, WGS data was used to characterize the genomic content of antimicrobial resistance genes, including those encoding carbapenemases, in 10 multidrug-resistant Klebsiella pneumoniae isolates from Pakistan. These clinical isolates represented five sequence types: ST11 (n = 3 isolates), ST14 (n = 3), ST15 (n = 1), ST101 (n = 2), and ST307 (n = 1). Resistance profiles against 25 clinically-relevant antimicrobials were determined by broth microdilution; resistant phenotypes were observed for at least 15 of the 25 antibiotics tested in all isolates except one. Specifically, 8/10 isolates were carbapenem-resistant and 7/10 isolates were colistin-resistant. The blaNDM-1 and blaOXA-48 carbapenemase genes were present in 7/10 and 5/10 isolates, respectively; including 2 isolates carrying both genes. No plasmid-mediated determinants for colistin resistance (e.g. mcr) were detected, but disruptions and mutations in chromosomal loci (i.e. mgrB and pmrB) previously reported to confer colistin resistance were observed. A blaOXA-48-carrying IncL/M-type plasmid was found in all blaOXA-48-positive isolates. The application of WGS to molecular epidemiology and surveillance studies, as exemplified here, will provide both a more complete understanding of the global distribution of MDR isolates and a robust surveillance tool useful for detecting emerging threats to public health.

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Section: Discussionmentioning

confidence: 99%

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

et al. 2018

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“… Libya [ 52 ] A. baumanii OXA-23 like; NDM-1 Morocco [ 19 ] A.baumanii n.r. Mongolia [ 53 ] A. baumanii OXA-58 P. aeruginosa VIM-2 Pakistan [ 28 , 54 ] K. pneumoniae OXA-48&NDM; OXA-48 [ 28 ] P. stuartii NDM P. aeruginosa VIM K. oxytoca NDM E. coli OXA-48&NDM A. baumanii OXA 23 Poland [ 55 ] A. baumanii OXA-23 like; OXA-40 like Romania a This study, [ 28 , 56 ] A. baumanii OXA-40; OXA-23 [ 28 ] E. coli OXA-48 [ 56 ] P. aeruginosa n.r. This study, [ 56 ] K. pneumoniae OXA-48&NDM-1; OXA-48 This study P. stuartii NDM-1 This study E. cloacae OXA-48 Tunisia [ 57 – 59 ] P. aeruginosa VIM-2 [ 19 ] A.baumanii OXA-23 like Turkey …”

Section: Resultsmentioning

confidence: 99%

Extensive colonization with carbapenemase-producing microorganisms in Romanian burn patients: infectious consequences from the Colectiv fire disaster

Pirii

Friedrich

Rossen

et al. 2017

Eur J Clin Microbiol Infect Dis

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Health care of severe burn patients is highly specialized and may require international patient transfer. Burn patients have an increased risk of developing infections. Patients that have been hospitalized in countries where carbapenemase-producing microorganisms (CPMO) are endemic may develop infections that are difficult to treat. In addition, there is a risk on outbreaks with CPMOs in burn centers. This study underlines that burn patients may extensively be colonized with CPMOs, and it provides best practice recommendations regarding clinical microbiology and infection control. We evaluated CPMO-carriage and wound colonization in a burn patient initially treated in Romania, and transported to the Netherlands. The sequence types and acquired beta-lactamase genes of highly-resistant microorganisms were derived from next generation sequencing data. Next, we searched literature for reports on CPMOs in burn patients. Five different carbapenemase-producing isolates were cultured: two unrelated OXA-48-producing Klebsiella pneumoniae isolates, OXA-23-producing Acinetobacter baumanii, OXA-48-producing Enterobacter cloacae, and NDM-1-producing Providencia stuartii. Also, multi-drug resistant Pseudomonas aeruginosa isolates were detected. Among the sampling sites, there was high variety in CPMOs. We found 46 reports on CPMOs in burn patients. We listed the epidemiology of CPMOs by country of initial treatment, and summarized recommendations for care of these patients based on these reports and our study.

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“…To date, carbapenemase-producing Gram-negative bacilli remain uncommon in Canada. VIM-, NDM-, and OXA-producing isolates have been reported infrequently in case reports, with acquisition often linked to travel (Mataseje et al, 2013;Mulvey et al, 2011;Peirano et al, 2011Peirano et al, , 2014Pitout et al, 2007;Sepehri et al, 2014;Tijet et al, 2013). A nosocomial outbreak of VIM producing P. aeruginosa has been documented in the Canadian province of Alberta (Pitout et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Isolation of multiple carbapenemase-producing Gram-negative bacilli from a patient recently hospitalized in Nigeria

Walkty

Gilmour

Simner

et al. 2015

Diagnostic Microbiology and Infectious Disease

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Osteomyelitis Due to Multiple Carbapenemase‐Producing Gram‐Negative Bacteria: The First Case Report of a GES‐13‐Producing Pseudomonas aeruginosa Isolate in Canada

Cited by 9 publications

References 16 publications

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

Extensive colonization with carbapenemase-producing microorganisms in Romanian burn patients: infectious consequences from the Colectiv fire disaster

Isolation of multiple carbapenemase-producing Gram-negative bacilli from a patient recently hospitalized in Nigeria

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