Rapid emergence and spread of OXA-48-producing carbapenem-resistant Enterobacteriaceae isolates in Belgian hospitals

Glupczynski, Youri; Huang, Te-Din; Bouchahrouf, Warda; Castro, Roberta Rezende de; Bauraing, Caroline; Gerard, Michèle; Verbruggen, Anne-Marie; Deplano, Ariane; Denis, Olivier; Bogaerts, Pierre

doi:10.1016/j.ijantimicag.2011.10.005

Cited by 113 publications

(81 citation statements)

References 14 publications

(25 reference statements)

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“…Moreover, unlike chromID ESBL and ESBL-BH, chromID CARBA was able to recover the single OXA-48 reference strain in LOD experiments, but this was achieved only at a high inoculum (10 7 CFU/ml). This is of particular interest, since detection of OXA-48-producing pathogens remains problematic, especially in countries where such isolates may have disseminated (13,22).…”

Section: Discussionmentioning

confidence: 99%

“…Among these carbapenemases, metallo-␤-lactamases (MBLs; Ambler class B) and Klebsiella pneumoniae carbapenemase (KPC; Ambler class A) are prevailing in Enterobacteriaceae from countries or large geographic regions, including the United States, Israel, Italy, Greece, the Far East, and South America (9,12,14,15,17,18,22,26,27). Moreover, oxacillinase-48 (OXA-48; Ambler class D) has recently been isolated in Enterobacteriaceae from Turkey (6), and it has since been reported from other countries in the Mediterranean Basin and Western Europe (13,22). Carbapenemase-producing pathogens have been associated with high rates of morbidity and mortality, particularly among critically ill patients with prolonged hospitalization (4,21,32,37).…”

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confidence: 99%

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Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

et al. 2012

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c Carbapenemase-producing Enterobacteriaceae (CPE) are an increasing problem worldwide, and rectal swab surveillance is recommended as a component of infection control programs. The performance of a prototype chromogenic medium (chromID CARBA) was evaluated and compared with media tested by four other screening methods: (i) overnight selective enrichment in 5 ml tryptic soy broth with a 10-g ertapenem disk followed by plating onto MacConkey agar (CDC-TS), (ii) short selective enrichment in 9 ml brain heart infusion broth with a 10-g ertapenem disk followed by plating onto chromID ESBL medium (ESBL-BH), (iii) direct plating onto chromID ESBL, and (iv) direct plating onto MacConkey agar supplemented with meropenem (1 g/ml) (MCM). The screening methods were applied to detect CPE in 200 rectal swab specimens taken from different hospitalized patients. Identification and antimicrobial susceptibility were performed by the Vitek 2 system. Carbapenem MICs were checked by Etest. Carbapenemase production was confirmed using the modified Hodge test, combined-disk tests, and PCR assays. In total, 133 presumptive CPE strains were detected. Phenotypic and genotypic assays confirmed 92 strains to be CPE (56 KPC-positive Klebsiella pneumoniae, 29 VIM-positive K. pneumoniae, and 7 KPC-positive Enterobacter aerogenes strains) recovered from 73 patients, while the remaining 41 strains were confirmed to be CPE negative (19 ESBL producers and 22 nonfermenters). chromID CARBA, ESBL-BH, and chromID ESBL exhibited the highest sensitivity (92.4%), followed by CDC-TS and MCM (89.1%) (P ‫؍‬ 0.631). The specificity was greater for chromID CARBA (96.9%) and ESBL-BH (93.2%) than for CDC-TS (86.4%), MCM (85.2%), and chromID ESBL (84.7%) (P ‫؍‬ 0.014). In conclusion, chromID CARBA was found to be a rapid and accurate culture screening method for active CPE surveillance.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

et al. 2012

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“…However, carbapenems are now frontline antibiotics in many more clinical situations than before because of the emergence and spread of ESBL-and plasmid-mediated AmpCproducing Enterobacteriaceae. The emergence of transferable resistance to these antibiotics, which are now disseminating very rapidly, is a public health emergency because of the very limited commercially available antimicrobials showing activity against carbapenemase-producing Gram-negative bacteria [Tortola et al 2005;Hirsch and Tam 2010;Carrer et al 2010;Lascols et al 2011;Nordmann et al 2011;Patel and Bonomo 2011;Glupczynski et al 2012]. This is due to the hydrolytic activity of these enzymes against b-lactams, but also to the fact that these organisms usually harbour resistance mechanisms affecting other classes of antibiotics (e.g.…”

Section: Other Drugsmentioning

confidence: 99%

Clinical management of infections caused by multidrug-resistant Enterobacteriaceae

Delgado-Valverde

Sojo-Dorado

Pascual

2013

Therapeutic Advances in Infection

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Enterobacteriaceae showing resistance to cephalosporins due to extended-spectrum b-lactamases (ESBLs) or plasmid-mediated AmpC enzymes, and those producing carbapenemases have spread worldwide during the last decades. Many of these isolates are also resistant to other first-line agents such as fluoroquinolones or aminoglycosides, leaving few available options for therapy. Thus, older drugs such as colistin and fosfomycin are being increasingly used. Infections caused by these bacteria are associated with increased morbidity and mortality compared with those caused by their susceptible counterparts. Most of the evidence supporting the present recommendations is from in vitro data, animal studies, and observational studies. While carbapenems are considered the drugs of choice for ESBL and AmpC producers, recent data suggest that certain alternatives may be suitable for some types of infections. Combined therapy seems superior to monotherapy in the treatment of invasive infections caused by carbapenemase-producing Enterobacteriaceae. Optimization of dosage according to pharmacokinetics/pharmacodynamics data is important for the treatment of infections caused by isolates with borderline minimum inhibitory concentration due to lowlevel resistance mechanisms. The increasing frequency and the rapid spread of multidrug resistance among the Enterobacteriaceae is a true and complex public health problem. IntroductionThe traditional first-line available options for treating serious infections caused by enterobacteria include penicillins, cephalosporins, monobactams, carbapenems, fluorquinolones, and in certain situations, aminoglycosides. The frequency of resistance to these first-line agents has been rising worldwide during the last decades [Paterson 2006;Rhomberg and Jones 2009;Houghton et al. 2010;Nordmann, et al. 2011] and now reach high proportions in many areas of the world.

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“…OXA-48 was fi rst reported in Turkey in 2001 30,34 36,40 . Laboratory detection of OXA-48 ß-lactamase poses a serious problem because of the low level carbapenem resistance and sometimes lack of additional ESBL.…”

Section: Discussionmentioning

confidence: 99%

Klebsiella Pneumoniaeoxa-48 in a Urology Patient: Case Report

Jajić¹,

Benčić

Siroglavić

et al. 2017

acc

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SUMMARY -We present an isolate of Klebsiella pneumoniae OXA-48 isolated in a 68-year-old man who underwent radical prostatectomy due to prostate cancer. Th e antibiotic susceptibility testing to a wide range of antibiotics was performed by disk diff usion method and determination of minimal inhibitory concentrations. Th e isolate was classifi ed as multidrug-resistant. It showed intermediate susceptibility to imipenem and meropenem, resistance to ertapenem, and sensitivity only to colistin, amikacin, and trimethoprim-sulfamethoxazole. Th e isolate was positive for ESBLs, negative for AmpC. Polymerase chain reaction and sequencing revealed bla , bla CTX-M-15 and bla . Th e plasmid encoding OXA-48 ß-lactamase did not belong to any known PCR-based replicon typing. According to genotyping, the isolate belonged to ST37.

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Rapid emergence and spread of OXA-48-producing carbapenem-resistant Enterobacteriaceae isolates in Belgian hospitals

Cited by 113 publications

References 14 publications

Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

Clinical management of infections caused by multidrug-resistant Enterobacteriaceae

Klebsiella Pneumoniaeoxa-48 in a Urology Patient: Case Report

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