Efflux System Overexpression and Decreased OprD Contribute to the Carbapenem Resistance Among Extended-Spectrum Beta-Lactamase-ProducingPseudomonas aeruginosaIsolates from a Chinese University Hospital

2013 ◽  
Vol 19 (6) ◽  
pp. 463-468 ◽  
Author(s):  
Yang Liu ◽  
Xiang-Yang Li ◽  
La-Gen Wan ◽  
Wei-Yan Jiang ◽  
Fang-Qu Li ◽  
...  
Keyword(s):  
Carbapenem Resistance ◽  
University Hospital ◽  
Beta Lactamase ◽  
Efflux System ◽  
Extended Spectrum Beta Lactamase ◽  
Chinese University ◽  
Extended Spectrum

scholarly journals Treatment of Infections Caused by Extended-Spectrum-Beta-Lactamase-, AmpC-, and Carbapenemase-ProducingEnterobacteriaceae

2018 ◽  
Vol 31 (2) ◽  
Author(s):  
Jesús Rodríguez-Baño ◽  
Belén Gutiérrez-Gutiérrez ◽  
Isabel Machuca ◽  
Alvaro Pascual
Keyword(s):  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
New Drugs ◽  
Beta Lactamase ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
Development Of Resistance ◽  
Extended Spectrum ◽  
Invasive Infections ◽  
Risk Patients

SUMMARYTherapy of invasive infections due to multidrug-resistantEnterobacteriaceae(MDR-E) is challenging, and some of the few active drugs are not available in many countries. For extended-spectrum β-lactamase and AmpC producers, carbapenems are the drugs of choice, but alternatives are needed because the rate of carbapenem resistance is rising. Potential active drugs include classic and newer β-lactam–β-lactamase inhibitor combinations, cephamycins, temocillin, aminoglycosides, tigecycline, fosfomycin, and, rarely, fluoroquinolones or trimethoprim-sulfamethoxazole. These drugs might be considered in some specific situations. AmpC producers are resistant to cephamycins, but cefepime is an option. In the case of carbapenemase-producingEnterobacteriaceae(CPE), only some “second-line” drugs, such as polymyxins, tigecycline, aminoglycosides, and fosfomycin, may be active; double carbapenems can also be considered in specific situations. Combination therapy is associated with better outcomes for high-risk patients, such as those in septic shock or with pneumonia. Ceftazidime-avibactam was recently approved and is active against KPC and OXA-48 producers; the available experience is scarce but promising, although development of resistance is a concern. New drugs active against some CPE isolates are in different stages of development, including meropenem-vaborbactam, imipenem-relebactam, plazomicin, cefiderocol, eravacycline, and aztreonam-avibactam. Overall, therapy of MDR-E infection must be individualized according to the susceptibility profile, type, and severity of infection and the features of the patient.

scholarly journals Emergence and rapid global dissemination of CTX-M-15-associated Klebsiella pneumoniae strain ST307

2018 ◽  
Author(s):  
Kelly L. Wyres ◽  
Jane Hawkey ◽  
Marit A.K. Hetland ◽  
Aasmund Fostervold ◽  
Ryan R. Wick ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Beta Lactamase ◽  
First Report ◽  
Extended Spectrum Beta Lactamase ◽  
Esbl Gene ◽  
Resistance Determinants ◽  
Extended Spectrum ◽  
Globally Distributed

AbstractRecent reports indicate the emergence of a new carbapenemase producing Klebsiella pneumoniae clone, ST307. Here we show that ST307 emerged in the mid-1990s (nearly 20 years prior to its first report), is already globally distributed and is intimately associated with a conserved plasmid harbouring the blaCTX-M-15 extended-spectrum beta-lactamase (ESBL) gene plus other antimicrobial resistance determinants. Our findings support the need for enhanced surveillance of this widespread ESBL clone in which carbapenem resistance is now emerging.

scholarly journals Extended - spectrum beta - lactamase E. coli and K. pneumoniae urinary tract infections

2020 ◽  
Author(s):  
Prayong Vachvanichsanong ◽  
Edward B McNeil ◽  
Pornsak Dissaneewate
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Imaging Study ◽  
University Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Recurrent Uti ◽  
Extended Spectrum ◽  
Tract Infections

Abstract Background: The prevalences of extended - spectrum beta - lactamase (ESBL) Escherichia coli ( E . coli ) and Klebsiella pneumoniae ( K . pneumoniae ) urinary tract infections (UTI) in children are increasing worldwide. We aimed to investigate the prevalence, clinical findings, impact and risk factors of ESBL E . coli / K . pneumoniae UTI.Methods: The medical records of children with UTI aged <15 years admitted to Prince of Songkla University Hospital were reviewed. Results: Theirty-seven boys and 46 girls had ESBL in 102 UTI episodes; 85 boys and 103 girls had non-ESBL in all of their 222 UTI episodes. The median age at presentation was 1.5 (0.7 - 4.8) years for the ESBL group and 1.3 (0.6 - 3.9) for the non-ESBL group (p=0.2). Age and gender were not significantly different between the two groups. The prevalence of ESBL rose between 2004 and 2008 before plateauing at around 30-40% per year. The prevalences in first and recurrent UTI were 27.3% and 46.5%, respectively (p=0.003). Fever prior to UTI diagnosis was found in 78.4% of episodes in the non-ESBL group and 61.8% of episodes in the ESBL group (p=0.003). Multivariate analysis, children without fever (OR=2.14, 95% CI: 1.23-3.74) and those with recurrent UTI (OR=2.67, 95% CI: 1.37 – 5.19) were more likely to have ESBL UTI. The presence of CAKUT had no effect on ESBL UTI. Conclusions: ESBL was found in one-third of E . coli / K . pneumoniae UTI episodes. No clinical condition nor imaging study could predict ESBL. Recurrent UTI was the only independent risk factor.

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