scholarly journals Ventilator-associated Pneumonia: Multidrug Resistant Acinetobacter vs. Extended Spectrum Beta Lactamase-producing Klebsiella

2020 ◽  
Vol 14 (06) ◽  
pp. 660-663
Author(s):  
Mohammadreza Salehi ◽  
Sirous Jafari ◽  
Lida Ghafouri ◽  
Hossein Malekafzali Ardakani ◽  
Alireza Abdollahi ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
P Value ◽  
Ventilator Associated Pneumonia ◽  
Beta Lactamase ◽  
Healthcare Associated Infection ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Introduction: Ventilator-associated pneumonia (VAP) has been considered as a healthcare-associated infection with high mortality. Acinetobacter baumannii and Klebsiella pneumoniae are the common causes of VAPs around the world. Methodology: This research was a retrospective observational study in the intensive care unit (ICU) in a tertiary referral collegiate hospital in Tehran between March 2016 and May 2018. Patients who fulfilled VAP due to documented Multidrug Resistant Acinetobacter baumannii (MDR-AB) or Extended Spectrum Beta Lactamase-producing Klebsiella pneumoniae (ESBL-KP) criteria were enrolled. General demographic features, duration of hospital stay, antimicrobial treatment regimens, duration of ICU admission, the period of mechanical ventilation (MV) and 30-day mortality were documented and compared. Results: 210 patients were found with clinical, microbiological and radiological evidence of VAP. In total, 76 patients with MDR-AB and 76 patients with ESBL-KP infections were matched in the final analysis. Duration of hospitalization in the patients with MDR-AB was significantly more than that of patients infected with ESBL-KP (p-value: 0.045). Patients diagnosed with MDR-AB VAP had a 65.8% mortality rate compared to 42.1% in the ESBL-KP infection group (p = 0.003). Conclusions: Results of the present study demonstrated that VAPs caused by MDR-AB may be more hazardous than ESBL-KP VAPs because they could be accompanied by a longer hospitalization course and even a higher mortality.

scholarly journals Extended Spectrum Beta Lactamase (ESBL) Producing Klebsiella pneumoniae , a therapeutic challenge.

2015 ◽  
Vol 13 (1) ◽  
pp. 22-25
Author(s):  
Raina Chaudhary ◽  
Sabita Bhatt Bhatt ◽  
Eva Piya
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Esbl Producer ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Sensitivity Pattern

Introduction: Klebsiella pneumoniae is one of the most common Gram negative bacteria encountered byclinicians worldwide as a cause of infections in human. Most of the infections are acquired in hospital settingtherefore, it is reported to be the amongst the 10 most common nosocomial pathogen in various studies. Nowadays,Klebsiella pneumoniae infections are complicated by increase in Extended Spectrum Beta Lactamase (ESBL)producing isolates. Therefore, this study is being conducted with the objective to fi nd out the prevalence ofESBL producing Klebsiella pneumoniaein various clinical samples and to fi nd out there sensitivity pattern.Methods: A total of 100 Klebsiella pneumoniae were isolated from various samples during the period of April2013 to November 2013 in Microbiology Unit of Shree Birendra Hospital. All the isolates were identifi ed withtheir sensitivity pattern according to standard methodology. Combination disc diffusion method was followedfor identifi cation of ESBL.Results: Out of total 100 isolates of Klebsiella pneumoniae21% were ESBL producer.ESBL producer isolatesshowed 100% sensitivity to Imepenem followed by Amikacin 57.1% and Chloramphenicol 47.6%. All theESBL isolates were resistant to both Cefotaxime and Ceftazidime.Conclusions: ESBL producer Klebsiella pneumoniae isolates were multidrug resistant. Continuous surveillanceand timely intervention with discouraging the use of cephalosporin group of antibiotics is mandatory.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12996 

scholarly journals Frequency of extended spectrum beta lactamase in E.CoIi and klebsiella pneumoniae in bacterial cultures.

2021 ◽  
Vol 28 (09) ◽  
pp. 1288-1291
Author(s):  
Saeeda Nabat ul Hassan ◽  
Ghulam Asghar Bhutta ◽  
Khushbu Farva
Keyword(s):  
Klebsiella Pneumoniae ◽  
Generation Cephalosporin ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
P Value ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Bacterial Cultures ◽  
Extended Spectrum

Objective: To determine frequency and pattern of extended spectrum beta lactamase in Klebsiella pneumoniae and E. coli in bacterial cultures. Study Design: Cross Sectional study. Setting: Department of Pathology Sahara Medical College Narowal. Period: January to June 2020. Material & Methods: Total 1100 bacterial isolates were studied out of them 655 E.coli and 445 of klebsiella pneumoniae. All samples were subjected to double disc diffusion method using third generation cephalosporin and amoxacillin-clavulanic acid for detection of ESBL. Data was analyzed using SPSS software version 24, and results were calculated in the form of frequency, percentage and standard deviation. P-value ≤0.05 was taken as statistically non-significant. Results: There were 48.9% male and 51.1% female subjects out of 1100 total cases. E.coli was detected in 59.5% and klebsiella in 40.5% samples. Total 44.2% samples were positive for ESBL enzyme. Of 655 E.coli samples 40.8% and of 445 Klebsiella pneumoniae samples 49.2% were positive for ESBL enzyme. Conclusion: It is necessary to detect ESBL positive Klebsiella pneumoniae and E.coli in laboratory workflow to avoid unnecessary use of antibiotics and development of resistance against them.

Phenotypic detection of extended-spectrum beta-lactamase in multidrug-resistant acinetobacter baumannii isolated in Fauji Foundation Hospital Rawalpindi

2021 ◽  
pp. 1-12
Author(s):  
Asim Ali Shah ◽  
Yasir Ali ◽  
Ayesha Maqbool ◽  
Shahid Ahmad Abbasi ◽  
Admin
Keyword(s):  
Acinetobacter Baumannii ◽  
Sampling Technique ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Multiple Drugs

Abstract Objective: To evaluate the phenotypic detection of extended-spectrum beta-lactamase in multidrug-resistant acinetobacter baumannii. Methods: The cross-sectional study was conducted at the Department of Microbiology, Fauji Foundation Hospital, Rawalpindi, Pakistan, from August 2018 to April 2019, after the ethical approval from the Institutional Review Committee. Consecutive Non- probability sampling technique was used, and comprised clinical specimens, including pus, blood, sputum, urine, tracheal tubes and canula double lumen, which were processed using standard protocols. Colonies of acinetobacter baumannii were identified by gram staining and Analytical Profile Index-20E kit. Combination disc method was used for the identification of extended-spectrum beta-lactamse. Clinical and Laboratory Standards Institute guidelines were used for antimicrobial susceptibility. Data was analysed using SPSS 22 and Sample size was calculated by using earlier study with 5 % margin of error and 95 % confidence level. Results: Of the 78 isolates, 58(74.4%) related to females and 20(25.6%) to males. There was no extended-spectrum beta-lactamse producer. Imipenem, meropenem, cefotaxime, ampicillin and ceftazidime showed 100% resistance, while colistin and polymyxin B were sensitive to all strains. The incidence rate was high in samples isolated from tracheal tubes 47(60.3%), followed by pus 21(26.9%). Age was not found to be a significant factor (p>0.05).   Conclusion: Acinetobacter baumannii showed a high resistance to multiple drugs and was not confined to any specific age group. Colistin and polymyxin B were found to be better choices. Continuous...

scholarly journals Phenotypic Characterization of Extended Spectrum Beta-lactamase, Class C Cephalosporinase and Carbapenemase-Producing Klebsiella Species Isolated from Patients Consulted at Four Yaounde-Based Hospitals.

2021 ◽  
Author(s):  
Emilia Enjema Lyonga Mbamyah ◽  
Mangum Patience Kumcho ◽  
Michel Toukam ◽  
Dieudonné Sedena ◽  
Florence Anjabie Enyeji ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Opportunistic Infections ◽  
Acquired Resistance ◽  
Multidrug Resistant ◽  
Phenotypic Characterization ◽  
Beta Lactamase ◽  
Klebsiella Species ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Class C

Abstract Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections. These infections are often difficult to treat because of acquired resistance to one or several families of antimicrobials. The present study aimed at detecting Extended Spectrum Beta-lactamase (ESBL), Class C cephalosporinase (AmpC) and carbapenemase resistant phenotypes of Klebsiella spp. isolated from patients consulted at four Yaounde-based hospitals. Results: The frequency of the species isolated was Klebsiella pneumoniae (69%), K. oxytoca (14%), K. ozaenae (12%) and K. rhinoscleromatis (5%). Isolates were most resistant to penicillins (90%), sulphonamides (84%), cepaholosporins (80%), and least resistant to carbapenems (10.2%). Three isolates namely: two K. oxytoca and one K. pneumoniae were resistant to all twenty-eight (28) antibiotics tested. Klebsiella pneumoniae was the species with the most multidrug resistant isolates (59.4%). Most isolates (83.6%) expressed at least one resistance phenotype, while 63.6% of the isolates expressed all three phenotypes. Many of the isolates were ESBL producers (71.6%), while fewer isolates were carbapenemase (26.7%) and AmpC (6.6%) producers. Three carbapenemases (Klebsiella pneumoniae carbapenemase-KPC, Metallo-Beta Lactamase-MBL and OXA-48) were detected from 26.7% of the isolates and the combination KPC and MBL were the most detected phenotypes (12.9%). Conclusion: These results reveal that resistance of Klebsiella spp. to cephalosporins is high and this may be exacerbated as a result of the co-expression of AmpC and carbapenemases. About a quarter of the isolates had acquired carbapenemases that confer resistance to all beta-lactamases and carbapenems which constitute last line drugs. The resistance burden is further strengthened in isolates that acquired more than one carbapenemase aggravating associated patient morbidity and mortality. Therefore, it is necessary to continue monitoring antimicrobial resistance of local strains for better informed decisions on empirical treatment guide and better patient care.

scholarly journals Bloodstream infections in children caused by extended spectrum beta-lactamase-producing Klebsiella pneumoniae

2012 ◽  
Vol 64 (4) ◽  
pp. 1339-1347
Author(s):  
Deana Medic ◽  
Vera Gusman ◽  
Mira Mihajlovic-Ukropina ◽  
Zora Jelesic ◽  
Biljana Milosavljevic
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Antimicrobial Drugs ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Vojvodina Province

The aim of this study is to determine the prevalence of extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae strains isolated from blood in children and their susceptibility to antimicrobial drugs commonly used in the therapy. The study was conducted at the Institute of Public Health of Vojvodina Province, Serbia, in a two-year period, from January 2009 to December 2010. A total of 424 non-duplicate strains were isolated from the blood of pediatric patients hospitalized in various wards in the Institute of Health Care of Children and Youth of Vojvodina Province. Fifty isolates of Klebsiella pneumoniae were reported. The frequency of isolation of Klebsiella pneumoniae was 27/222 (12.2%) and 23/202 (11.3%) isolates in 2009 and 2010, respectively. There was a high prevalence of ESBL-producing Klebsiella pneumoniae, 76% (38/50), and 17 isolates (44.7%) were multidrug resistant (MDR). Further drug resistance surveillance in hospitals and the molecular characterization of ESBL-positive isolates in our country is necessary.

scholarly journals Orthopedic Implant-Associated Infection by Multidrug Resistant Enterobacteriaceae

2019 ◽  
Vol 8 (2) ◽  
pp. 220 ◽  
Author(s):  
Bernadette G. Pfang ◽  
Joaquín García-Cañete ◽  
Julia García-Lasheras ◽  
Antonio Blanco ◽  
Álvaro Auñón ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Implant Removal ◽  
Beta Lactamase ◽  
Orthopedic Implant ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Implant Retention ◽  
Clinical Records

Introduction: Orthopedic implant-associated infections caused by multidrug-resistant Enterobacteriaceae are a growing challenge for healthcare providers due to their increasing incidence and the difficulties of medical and surgical treatment. Material and Methods: A retrospective observational study of all cases of multidrug resistant Enterobacteriaceae orthopedic implant-associated infection diagnosed in a tertiary European hospital from December 2011 to November 2017 was carried out. Clinical records were reviewed using a previously designed protocol. Data analysis was performed with IBM® SPSS®, version 22. Results: 25 patients met inclusion criteria. The infected implants included 10 prosthetic joints, seven osteosyntheses, six combinations of prosthetic joint and osteosynthesis material, and two spacers. Of the multidrug resistant Enterobacteriaceae obtained on culture, 12 were extended-spectrum beta-lactamase-producing Escherichia coli, three OXA-48-producing Klebsiella pneumoniae, nine extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, and one extended-spectrum beta-lactamase-producing Proteus mirabilis. Combination antimicrobial therapy was employed in all cases but two. Overall, 16 (64%) patients underwent implant removal. The rate of infection control in the overall implant removal group was 100% compared to 33% in the implant retention group. A strong relationship between implant removal and infection control was observed (p = 0.001). Discussion: Implant removal is strongly associated with infection control. However, in some cases, patient age and comorbidity contraindicate hardware extraction. Potential objectives for future studies should be geared towards targeting the population in which debridement, antibiotic therapy, and implant retention can be used as a first-line therapeutic strategy with a reasonable probability of achieving infection control.

Sign in / Sign up

Export Citation Format

Share Document