Sepsis caused by New Delhi metallo-β-lactamase (blaNDM-1) and qnrD-producing Morganella morganii, treated successfully with fosfomycin and meropenem: case report and literature review

Abstract

This is the first report of qnrD1 in South America. We consider that this report could be helpful to physicians implementing treatments for infections caused by XDR GNB, including colistin-carbapenem-resistant GNB.

Peroxy Pyruvic Acid-Containing Topical Anti-Infective: A Potential Candidate for a Wound Instillation Solution

“…In addition, prior in-vitro studies indicate that the PPA-containing topical anti-infective might break down the existing biofilm and prevent the regrowth of biofilm at relatively low concentrations. 35,36,[40][41][42][43][44][45][46][50][51][52] These ex-vivo findings reinforce the results of in-vitro and in-vivo animal studies that demonstrate the ability of a PPAcontaining topical anti-infective to remove exudate, possibly prevent wound biofilm, and, therefore, prophylactically enhance wound healing.…”

“…42 There have been reports outside the United States that S. marcescens may have a wide spectrum of antibiotic resistance, 43 including to mupirocin, fusidic acid, and amoxicillinclavulanate. M. morganii is mostly associated with urinary tract infections 44 and produces a chromosomally encoded AmpC b-lactamase that is responsible for resistance to aminopenicillins, amoxicillinclavulanate, and first-and second-generation cephalosporins. In addition, M. morganii is resistant to tetracycline, polymyxins, and nitrofurantoin.…”

“…The hydrogen peroxide and peracid work synergistically to destroy the cell wall and then penetrate to the microbial internal structures, where carboxylic acids and low-level hydrogen peroxide are involved in signaling to the immune response during and after inflammation and angiogenesis. 35,36,[40][41][42][43][44][45][46][50][51][52] The resulting mode of action is not metabolic inhibition, but rather a nonspecific nuclear attack on the bacteria. Therefore, microbial evolution to resistance to this PPA-containing topical anti-infective is unexpected.…”

Coexistence of mcr-1 and bla NDM-1 in Escherichia coli from Venezuela

“…The coexistence of mcr-1 with a carbapenemase is especially worrisome, as therapeutic options in such cases are very limited. Currently, the carbapenemase New Delhi metallo-␤-lactamase 1 (NDM-1) is broadly disseminated worldwide (8), although it has been scarcely described in South America (9,10). In this work, we have detected mcr-1-positive isolates from different origins in Venezuela, as well as the coexistence of this resistance gene with bla NDM-1 .…”

Molecular Epidemiology and Genome Dynamics of New Delhi Metallo-β-Lactamase-Producing Extraintestinal Pathogenic Escherichia coli Strains from India

“…NDM-producing bacteria have been implicated in both hospital-and community-acquired infections and have been recovered from several infection sites, including those associated with urinary tract infections, pneumonia, septicemia, and wound infections as well as from device-associated infections and companion animals (10)(11)(12)(13). Although the exact geographical origin and the precise time for the emergence of the bla NDM gene are unknown, the first NDM-1-positive isolate was recovered in 2009 from a Swedish patient who previously (2007) had an episode of hospitalization in New Delhi, India (14).…”