#Synergistic #combinations and repurposed #antibiotics active against the #pandrug #resistant #Klebsiella pneumoniae #Nevada strain (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Synergistic combinations and repurposed antibiotics active against the pandrug-resistant Klebsiella pneumoniae Nevada strain

Thea Brennan-Krohn [MD], James E. Kirby [MD]

DOI: 10.1128/AAC.01374-19

 

ABSTRACT

In early 2017, the Centers for Disease Control and Prevention issued an alarming report describing a woman in Nevada who died in the setting of infection with a pan-resistant Klebsiella pneumoniae isolate that harbored an NDM-1 enzyme (AR-0636) and was colistin resistant as a result of inactivation of the mgrB regulator gene (1, 2).…

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Klebsiella pneumoniae; USA; Nevada.

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#MDR #Klebsiella pneumoniae ST307 in #Traveler Returning from #PuertoRico to #Dominican Republic (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 8—August 2019 / Research Letter

Multidrug-Resistant Klebsiella pneumoniae ST307 in Traveler Returning from Puerto Rico to Dominican Republic

Rita Rojas, Nenad Macesic, Gilda Tolari, Anel Guzman, and Anne-Catrin Uhlemann

Author affiliations: Hospital General Plaza de la Salud, Santo Domingo, Dominican Republic (R. Rojas, G. Tolari, A. Guzman); Monash University, Melbourne, Victoria, Australia (N. Macesic); Columbia University Medical Center, New York, New York, USA (N. Macesic, A.-C. Uhlemann)

 

Abstract

We report blaKPC-2-harboring carbapenem-resistant Klebsiella pneumoniae in an emerging sequence type 307 lineage in a traveler returning from Puerto Rico to the Dominican Republic. Phylogenetic analyses indicate regional dissemination of this highly drug-resistant clone across the Americas, underscoring the need for adequate surveillance and infection control efforts to prevent further spread.

Keywords: Antibiotics; Drugs Resistance; Carbapenem; Klebsiella pneumoniae; Puerto Rico; Dominican Republic.

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Reduced #ceftazidime and #ertapenem susceptibility due to production of #OXA-2 in #Klebsiella pneumoniae ST258 (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Reduced ceftazidime and ertapenem susceptibility due to production of OXA-2 in Klebsiella pneumoniaeST258

Alina Iovleva, Roberta T Mettus, Christi L McElheny, Mustapha M Mustapha, Daria Van Tyne, Ryan K Shields, A William Pasculle, Vaughn S Cooper, Yohei Doi

Journal of Antimicrobial Chemotherapy, dkz183, https://doi.org/10.1093/jac/dkz183

Published: 24 May 2019

 

Abstract

Background

OXA-2 is a class D β-lactamase that confers resistance to penicillins, as well as narrow-spectrum cephalosporins. OXA-2 was recently reported to also possess carbapenem-hydrolysing activity. Here, we describe a KPC-2-encoding Klebsiella pneumoniae isolate that demonstrated reduced susceptibility to ceftazidime and ertapenem due to production of OXA-2.

Objectives

To elucidate the role of OXA-2 production in reduced ceftazidime and ertapenem susceptibility in a K. pneumoniae ST258 clinical isolate.

Methods

MICs were determined by the agar dilution method. WGS was conducted to identify and compare resistance genes between isolates. Expression of KPC-2 was quantified by quantitative RT–PCR and immunoblotting. OXA-2 was expressed in Escherichia coli TOP10, as well as in K. pneumoniae ATCC 13883, to define the relative contribution of OXA-2 in β-lactam resistance. Kinetic studies were conducted using purified OXA-2 enzyme.

Results

K. pneumoniae 1761 belonged to ST258 and carried both blaKPC-2 and blaOXA-2. However, expression of blaKPC-2 was substantially reduced due to an IS1294insertion in the promoter region. K. pneumoniae 1761, K. pneumoniae ATCC 13883 and E. coli TOP10 carrying blaOXA-2-harbouring plasmids showed reduced susceptibility to ertapenem and ceftazidime, but meropenem, imipenem and cefepime were unaffected. blaOXA-2 was carried on a 2910 bp partial class 1 integron containing aacA4-blaOXA-2-qacEΔ1-sul1 on an IncA/C2plasmid, which was not present in the earlier ST258 isolates possessing blaKPC-2 with intact promoters. Hydrolysis of ertapenem by OXA-2 was confirmed using purified enzyme.

Conclusions

Production of OXA-2 was associated with reduced ceftazidime and ertapenem susceptibility in a K. pneumoniae ST258 isolate.

Issue Section: ORIGINAL RESEARCH

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Beta-lactams; Carbapenem; Ceftazidime; Ertapenem; Meropenem; Imipenem; Cefepime.

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Emergence of #mcr-8.2-bearing #Klebsiella quasipneumoniae of #animal origin (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Emergence of mcr-8.2-bearing Klebsiella quasipneumoniae of animal origin

Xiaorong Yang, Li Liu, Zhiqiang Wang, Li Bai, Ruichao Li

Journal of Antimicrobial Chemotherapy, dkz213, https://doi.org/10.1093/jac/dkz213

Published: 16 May 2019

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Sir,

The emergence of plasmid-mediated mcr-1, conferring resistance to colistin, which is considered as a last-resort drug to treat carbapenem-resistant Enterobacteriaceae (CRE) infections, poses a severe public health concern.1 Eight different mcr genes mainly mediated by plasmids were identified within 3 years after the reporting of mcr-1 in late 2015.1,2,Klebsiella pneumoniae is a well-known bacterium causing life-threatening infections, especially in neonates, the elderly and immunocompromised individuals.3 The mcr-1, mcr-3, mcr-7 and mcr-8 genes have been detected in K. pneumoniae recently.2,4,Klebsiella quasipneumoniae, which is found in animals and…

(…)

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© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Colistin; Klebsiella pneumoniae; MCR8.

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Emergence of #ceftazidime – #avibactam- #resistant #Klebsiella pneumoniae during #treatment, #Finland, December 2018 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018

Kati Räisänen 1, Irma Koivula 2, Heikki Ilmavirta 3, Santeri Puranen 4, Teemu Kallonen 1,5, Outi Lyytikäinen 1, Jari Jalava 1

Affiliations: 1 Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland; 2 Kuopio University Hospital, Unit of Infections and Hospital hygiene, Kuopio University Hospital, Kuopio, Finland; 3 Eastern Finland laboratory Centre, Kuopio, Finland; 4 Aalto University, Department of Computer Science, Espoo, Finland; 5 Department of Biostatistics, University of Oslo, Oslo, Norway

Correspondence:  Kati Räisänen

Citation style for this article: Räisänen Kati, Koivula Irma, Ilmavirta Heikki, Puranen Santeri, Kallonen Teemu, Lyytikäinen Outi, Jalava Jari. Emergence of ceftazidime-avibactam-resistant Klebsiella pneumoniae during treatment, Finland, December 2018. Euro Surveill. 2019;24(19):pii=1900256. https://doi.org/10.2807/1560-7917.ES.2019.24.19.1900256

Received: 24 Apr 2019;   Accepted: 07 May 2019

 

Abstract

In December 2018, a ceftazidime-avibactam (CAZ-AVI)-resistant KPC-2-producing Klebsiella pneumoniae strain was isolated in Finland. CAZ-AVI resistance was observed 34 days after CAZ-AVI treatment in a trauma patient transferred from a hospital in Greece who had been colonised with blaKPC-2-producing K. pneumoniae ST39, and later developed a bloodstream infection. The CAZ-AVI-resistant strain contained a novel 15 amino acid insertion in the KPC-2 protein causing structural changes proximal to the KPC-2 active site.

©   This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: Antibiotics; Drugs Resistance; Ceftazidime; Avibactam; Klebsiella pneumoniae; Greece; Finland.

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Emergence of #NDM1-producing #Klebsiella pneumoniae in #Greece: evidence of a #widespread clonal #outbreak (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Emergence of NDM-1-producing Klebsiella pneumoniae in Greece: evidence of a widespread clonal outbreak

Lida Politi, Konstantina Gartzonika, Nicholas Spanakis, Olympia Zarkotou, Aggeliki Poulou, Lemonia Skoura, Georgia Vrioni, Athanasios Tsakris

Journal of Antimicrobial Chemotherapy, dkz176, https://doi.org/10.1093/jac/dkz176

Published: 07 May 2019

 

Abstract

Objectives

NDM-producing Enterobacteriaceae clinical isolates remain uncommon in the European region. We describe the emergence and broad dissemination of one successful NDM-1-producing Klebsiella pneumoniae clone in Greek hospitals.

Methods

During a 4 year survey (January 2013–December 2016), 480 single-patient carbapenem non-susceptible K. pneumoniae isolates, phenotypically MBL positive, were consecutively recovered in eight Greek hospitals from different locations and subjected to further investigation. Antimicrobial susceptibility testing, combined-disc test, identification of resistance genes by PCR and sequencing, molecular fingerprinting by PFGE, plasmid profiling, replicon typing, conjugation experiments and MLST were performed.

Results

Molecular analysis confirmed the presence of the blaNDM-1 gene in 341 (71%) K. pneumoniae isolates. A substantially increasing trend of NDM-1-producing K. pneumoniae was noticed during the survey (R2 = 0.9724). Most blaNDM-1-carrying isolates contained blaCTX-M-15, blaOXA-1, blaOXA-2 and blaTEM-1genes. PFGE analysis clustered NDM-1 producers into five distinct clonal types, with five distinct STs related to each PFGE clone. The predominant ST11 PFGE clonal type was detected in all eight participating hospitals, despite adherence to the national infection control programme; it was identical to that observed in the original NDM-1 outbreak in Greece in 2011, as well as in a less-extensive NDM-1 outbreak in Bulgaria in 2015. The remaining four ST clonal types (ST15, ST70, ST258 and ST1883) were sporadically detected. blaNDM-1 was located in IncFII-type plasmids in all five clonal types.

Conclusions

This study gives evidence of possibly the largest NDM-1-producing K. pneumoniae outbreak in Europe; it may also reinforce the hypothesis of an NDM-1 clone circulating in the Balkans.

Topic: polymerase chain reaction – plasmids – carbapenem – bulgaria – clone cells – disease outbreaks – electrophoresis, gel, pulsed-field – enterobacteriaceae – genes – greece – ichthyosis, x-linked – infectious disease prevention / control – klebsiella pneumoniae  – replicon – sequence tagged sites – sodium thiosulfate – antimicrobial susceptibility test – beta-lactamase ndm-1 – resistance genes – molecular profiling

Issue Section: ORIGINAL RESEARCH

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Antibiotics; Drugs Resistance; Carbapene; NDM1; Klebsiella pneumoniae; Greece; Nosocomial outbreaks.

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Identification of a #Carbapenemase-Producing #Hypervirulent #Klebsiella pneumoniae Isolate, #USA (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Identification of a Carbapenemase-Producing Hypervirulent Klebsiella pneumoniae Isolate, United States

Maria Karlsson, Richard A. Stanton, Uzma Ansari, Gillian McAllister, Monica Y. Chan, Erisa Sula, Julian E. Grass, Nadezhda Duffy, Melissa L. Anacker, Medora L. Witwer, J. Kamile Rasheed,Christopher A. Elkins, Alison Laufer Halpin

DOI: 10.1128/AAC.00519-19

 

ABSTRACT

We report on a carbapenemase-producing hypervirulent Klebsiella pneumoniae (CP-hvKP) collected from a U.S. patient at an outpatient clinic. The isolate was identified as K. pneumoniae serotype K1, sequence type 23 and included both a hypervirulence (with rmpA, rmpA2 iroBCDN, peg-344 and iucABCD-iutA genes) and a carbapenemase-encoding (blaKPC-2) plasmid. The emergence of CP-hvKP underscores the importance of clinical awareness of this pathotype and the need for continued monitoring of CP-hvKP in the United States.

This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply.

Keywords: Antibiotics; Drugs Resistance; Carbapenen; Klebsiella pneumoniae; Plasmids; USA.

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