scholarly journals Dissemination of extensively drug-resistant and KPC-2 producing Klebsiella pneumoniae isolated from bloodstream infections

2015 ◽  
Vol 9 (09) ◽  
pp. 1016-1021 ◽  
Author(s):  
Feng Zhao ◽  
Jun Zhang ◽  
Ying Fu ◽  
Zhi Ruan ◽  
Xinyou Xie
Keyword(s):  
Klebsiella Pneumoniae ◽  
High Mortality ◽  
Antimicrobial Agents ◽  
Bacterial Species ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Drug Resistant ◽  
Extended Spectrum Beta Lactamase ◽  
Resistant Genes ◽  
Extensively Drug Resistant

Introduction: Bloodstream infections (BSIs) are serious diseases associated with high mortality, especially when caused by extensively drug-resistant (XDR) Klebsiella pneumoniae. The prevalence and pandemic strains of extended-spectrum beta-lactamase (ESBL)-producing K. pneumoniae isolated from blood cultures of patients with BSIs were determined at Sir Run Run Shaw Hospital, China. Methodology: A total of 24 XDR K. pneumoniae were isolated from blood cultures, and the clinical data of the patients were analyzed retrospectively. Bacterial species identification and antimicrobial susceptibility testing were performed using VITEK2 and E-test methods, respectively. Common ESBL-resistant genes were amplified and sequenced after the validation of a modified Hodge test. Strain homology was also analyzed by pulsed-field gel electrophoresis (PFGE). Results: All of the isolates were resistant to 10 antimicrobial agents. Several strains showed partial sensitivity to aminoglycosides, but all showed sensitivity to polymyxin and tigecycline. All strains were Klebsiella pneumoniae carbapenemase (KPC-2) producing, and carried two or three ESBL-resistant genes, which belonged to 13 PFGE clones (A–M). The overall mortality rate in patients was as high as 29.2%. Conclusions: KPC-2-producing K. pneumoniae BSIs are associated with high mortality rates. Our observations suggest that KPC-2 and ESBL-producing K. pneumoniae might be responsible for the clonal dissemination of extensively drug-resistant isolates in our hospital.

scholarly journals Multidrug resistant and extensively drug resistant Acinetobacter baumannii hospital infection associated with high mortality: A retrospective study in the Pediatric Intensive Care Unit

2020 ◽  
Author(s):  
Jingyi Shi ◽  
Ting Sun ◽  
Yun Cui ◽  
Chunxia Wang ◽  
Fei Wang ◽  
...  
Keyword(s):  
Serum Level ◽  
Acinetobacter Baumannii ◽  
High Mortality ◽  
Pediatric Intensive Care ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
High Serum ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Overall Mortality

Abstract Background Multidrug resistant (MDR) and extensively drug resistant (XDR) Acinetobacter baumannii presents challenges for clinical treatment and causes high mortality in children. We aimed to assess the risk factors for MDR/XDR Acinetobacter baumannii infection and for overall mortality in this patient population. Methods This retrospective study included 102 pediatric patients who developed MDR/XDR Acinetobacter baumannii infection in the pediatric intensive care unit (PICU) of Shanghai Children’s Hospital in China from December 2014 to May 2018. Clinical presentations and outcome of the patients were analyzed. The primary outcome was overall mortality. Secondary outcomes included the 28-day mortality and the length of hospital stay. Results Of the 102 patients (63 males and 39 females; mean age: 51.79 months), the overall mortality rate was 29.41%. 18(17.64%) had bloodstream infections;4(3.92%) for which cerebrospinal fluid (CSF) cultures were positive; 14(13.73%) of them got positive cultures in aseptic fluid; 10 (9.8%) had central catheter-associated bloodstream infections; lower respiratory isolates (56/102) accounted for 54.9% of all patients. Non-survival patients appeared to have a lower NK cell activity 5.87%(2.43%, 8.93%) vs. 8.45%(4.51%, 14.61%), P =0.011), higher CD4 + T cell ratio (35.32% (29%, 47.81%) vs. 31.97% (20.52%, 38.22%), P = 0.045), and higher serum level of interlukin-6 (IL-6, 235.51(0.1, 4172.77) pg/ml vs. 0.1(0.1, 110.92) pg/ml, P = 0.028), interlukin-8 (IL-8, 22.73(3.14, 540.12) vs. 0.1(0.1, 25.85)pg/ml, P = 0.03) , and interlukin-10(10.82(0.1, 83.29)pg/ml vs. 6.05(0.1,21.81)pg/ml) were observed. Multivariate logistic analysis indicated that high serum level of BUN (RR, 1.216, 95%CI, 1.27-2.616; P = 0.001) and high serum level of Cr (RR, 1.823, 95%CI, 0.902-0.980；P=0.004,) were associated with high risk of overall mortality in MDR/XDR Acinetobacter baumannii infected patients. Conclusion MDR/XDR- Acinetobacter baumannii is an important opportunistic pathogen that causes nosocomial infection in PICU with a rather high mortality. The incidence increased in recent years, ineffective management, immune dysfunction, acute kidney injury contributed to the risk of death.

scholarly journals Value of Time to Positivity of Blood Culture in Children with Bloodstream Infections

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Fen Pan ◽  
Wantong Zhao ◽  
Hong Zhang
Keyword(s):  
Bacterial Species ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Drug Resistant ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Microbiological Characteristics ◽  
The Mean ◽  
The Relationship

Objective. This study was to investigate the microbiological characteristics and the relationship between the time to positivity (TTP) of blood cultures and different bacterial species and to assess the clinical value of TTP in children with bloodstream infections (BSIs). Methods. The TTP of all the blood cultures from children with suspected BSIs was retrospectively collected in 2016. The microbiological characteristics and the relationship between the TTP of blood cultures and different bacterial species were also analyzed. Results. A total of 808 strains were isolated from 15835 blood cultures collected, and 145 (17.9%) were Gram-negative, 636 (78.7%) were Gram-positive, and 27 (3.3%) were fungi. The bacteria were divided into definite pathogens (174), possible pathogens (592), fungi (27), and contaminants (15). The average TTP of all positive blood cultures was 30.97 and ranged from 3.23 h to 92.73 h. The TTP of Gram-negative strains was significantly shorter than that of Gram-positive strains (P<0.001) and fungi (P = 0.032). The mean TTP for E. coli (15.60 h) was shortest within the group of Gram-negative isolates, and the mean TTP for Streptococcus (17.34 h) within the group of Gram-positive isolates. Significant difference of the TTP was detected in methicillin-resistant vs methicillin-susceptible S. aureus, extended-spectrum beta-lactamases (ESBLs) positive vs negative Enterobacteriaceae, and extensive drug-resistant and non-XDR A. baumannii. The median TTP in patients with BSI was significantly shorter than in those without it (P<0.001). ROC curve analysis indicated that the TTP cutoff value of CoNS, S. aureus, E. coli, and K. pneumoniae was 22.72 h, 19.6 h, 18.58 h, and 16.43 h, respectively, with most sensitive and specific predictor of BSIs. Conclusions. Our data acknowledged that TTP is a valuable index for the early prognosis of BSIs. TTP not only provides additional utility as a general predictor of bacteria with smear result but also provides the implication of drug-resistant organisms.

scholarly journals An Update on Isolation of Extensively Drug Resistant (XDR) Salmonella enterica from Blood Cultures in a Tertiary Care Centre

2019 ◽  
Vol 33 (4) ◽  
pp. 1-5
Author(s):  
Sadia Hameed
Keyword(s):  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Salmonella Enterica ◽  
Antimicrobial Agents ◽  
Salmonella Typhi ◽  
Blood Cultures ◽  
Drug Resistant ◽  
Second Line ◽  
Extensively Drug Resistant

Introduction: Typhoid fever is a public health issue, burdening many regions of the world with poor socioeconomic background. Management of this disease faces the major hurdle of antimicrobial resistance. The present study reveals current pattern of antimicrobial susceptibility among Salmonella enterica (Salmonella typhi & Salmonella paratyphi A) blood culture isolates from typhoid fever cases. Regular data collection about Salmonella infections and their response to antimicrobial agents, coupled with a long term commitment to providing adequate health information systems, is the key to effective planning and policy formation against typhoid fever. Aims & Objectives: To evaluate the prevalence of ceftriaxone resistant Salmonella enterica isolates from blood cultures in Shaikh Zayed Medical Complex for updating nosocomial antimicrobial resistance data. Place and duration of study: This research study was conducted at Shaikh Zayed Medical Complex, Lahore from March 2018 to May 2019. Material & Methods: Blood cultures positive for Salmonella enterica were analyzed, taking into consideration the gender & age of patients with typhoid fever. Antimicrobial susceptibility testing was carried out through disc diffusion method. The recommended antimicrobial agents for S. typhi (Salmonella typhi) & S. paratyphi A (Salmonella Parathyphi A) (as per CLSI, USA 2018/2019 guidelines; described later), were tested and analyzed during this study with the main focus on 3rd generation cephalosporin resistance pattern. Among second line treatment options, meropenem and azithromycin were selected for study. Results: Out of 899 isolates of Salmonella enterica (from 13964 samples for blood culture), 849 (94.4%) were S. typhi and 50 (5.6%) were S. paratyphi A. Of these, 57.1% isolates were from males, 42.9% from females, 81.7% from children (age less than 12 years) and 18.3% were from adults (age more than 12 years). A continuously rising resistance percentage was observed for 3rd generation cephalosporins over the span of fifteen months. It was 43.4% for ceftriaxone (CRO). No case of meropenem and azithromycin resistance was observed during study period. Conclusion: Demographic information was provided by this study regarding high level of resistance among Salmonella enterica isolates particularly S. typhi .The first line antibiotic drugs were a complete failure in ongoing outbreak of typhoid fever. The novel results of this study are the high resistance percentages for 3rd generation cehalosporins, whether oral or parenteral. This result is worrisome as it will leave us with no option but to resort to second line drugs. However, an increasing trend of blood culturing was observed in this research. Extensively drug resistant (XDR) Salmonella infection has definitely highlighted the importance of blood culture and its use as a more preferred diagnostic tool. Key words: Typhoid fever, Extensively drug resistant (XDR) Salmonella enterica, (S. typhi & S. paratyphi A), Antimicrobial Resistance, CRO (Ceftriaxone) resistance.

scholarly journals First Report of an Extensively Drug-Resistant ST23 Klebsiella pneumoniae of Capsular Serotype K1 Co-Producing CTX-M-15, OXA-48 and ArmA in Spain

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 157
Author(s):  
Marta Hernández ◽  
Luis López-Urrutia ◽  
David Abad ◽  
Mónica De Frutos Serna ◽  
Alain Ocampo-Sosa ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Whole Genome ◽  
Drug Resistant ◽  
Genomic Context ◽  
Antibiotic Resistant ◽  
Resistant Genes ◽  
Extensively Drug Resistant ◽  
Oxford Nanopore ◽  
Carbapenemase Gene ◽  
16S Rrna Methylase

An extensively drug-resistant (XDR) Klebsiella pneumoniae isolate MS3802 from a tracheostomy exudate was whole-genome sequenced using MiSeq and Oxford Nanopore MinION platforms in order to identify the antimicrobial resistance and virulence determinates and their genomic context. Isolate MS3802 belonged to the clone ST23 and presented a capsular serotype K1, associated with hypervirulent K. pneumoniae (hvKp) isolates. The isolate harboured a chromosomally encoded blaCTX-M-15 gene and contained a large IncHI1B hybrid virulence/resistance plasmid carrying another copy of the blaCTX-M-15 and the virulence factors iucABCD-iutA, iroBCDN, rmpA and rmpA2. The carbapenemase gene blaOXA-48 was found in a Tn1999-like transposon and the 16S rRNA methylase armA gen located in the vicinity of other antibiotic-resistant genes on an IncM2 plasmid. This study represents, to the best of our knowledge, the first description of a blaCTX-M-15-, blaOXA-48- and armA-harbouring K. pneumoniae of ST23 and capsular serotype K1 in Spain. Our report emphasizes the importance of implementing new surveillance strategies to monitor the risk of emergence and spread of such XDR and hypervirulent K. pneumoniae isolates.

scholarly journals Genomic insights into multi-drug and extensively drug resistant Klebsiella pneumoniae from India

2020 ◽  
Vol 101 ◽  
pp. 12-13
Author(s):  
C. Shankar ◽  
P. Mathur ◽  
J.J. Jacob ◽  
C. Rodrigues ◽  
K. Walia ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Drug Resistant ◽  
Extensively Drug Resistant

scholarly journals Complete Genome Sequences of Four Extensively Drug-Resistant Acinetobacter baumannii Isolates from Thailand

2020 ◽  
Vol 9 (40) ◽  
Author(s):  
Peechanika Chopjitt ◽  
Thidathip Wongsurawat ◽  
Piroon Jenjaroenpun ◽  
Parichart Boueroy ◽  
Rujirat Hatrongjit ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Complete Genome ◽  
Sequence Type ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
Genome Sequences ◽  
Content Type ◽  
Type Isolate ◽  
Resistant Genes ◽  
Extensively Drug Resistant

ABSTRACT Here, we report the complete genome sequences of four clinical isolates of extensively drug-resistant Acinetobacter baumannii (XDRAB), isolated in Thailand. These results revealed multiple antimicrobial-resistant genes, each involving two sequence type 16 (ST16) isolates, ST2, and a novel sequence type isolate, ST1479.

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