Identification and Characterization of OXA-48 Producing, Carbapenem-Resistant Enterobacteriaceae Isolates in Turkey
|
|
- Dwight White
- 5 years ago
- Views:
Transcription
1 Available online at Annals of Clinical & Laboratory Science, vol. 41, no. 2, Identification and Characterization of OXA-48 Producing, Carbapenem-Resistant Enterobacteriaceae Isolates in Turkey Abdullah Kilic 1, Zerin Aktas 2, Orhan Bedir 1, Ramazan Gumral 1, Yasemin Bulut 3, Charles Stratton 4, Yi-Wei Tang 4, and A. Celal Basustaoglu 1 1 Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy and School of Medicine 06018, Etlik, Ankara, Turkey; 2 Departments of Microbiology and Clinical Microbiology Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; 3 Department of Microbiology, College of Medicine, Firat University, Elazig, Turkey; 4 Departments of Pathology and Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA Abstract. Carbapenem resistance in Enterobacteriaceae isolates has been reported from Turkey and is most often mediated by OXA-48 type carbapenemases. We report the identification and characterization of four carbapenem-resistant isolates (three Klebsiella pneumoniae and one Escherichia coli) among 515 clinical Enterobacteriaceae isolates collected during a 7-month study period in Ankara, Turkey. The four isolates were recovered from blood and urine specimens in patients with varied clinical manifestations. They had distinct pulsed-field gel electrophoresis patterns and harbored a variety of β-lactamases including bla TEM-1, bla SHV-12 genes, bla SHV-11, and/or bla CTX-M-15. PCR and sequencing analysis revealed that the bla OXA-48 gene was present in all four isolates. Our data indicated that the OXA-48-type carbapenemase was the only mechanism for carbapenem resistance in our hospital. Keywords: Antibiotic resistance; Carbapenemase; OXA-48; Enterobacteriaceae Introduction Carbapenems have increasingly been used in severe Enterobacteriaceae infections due to a worldwide increase of extended spectrum β-lactamases (ESBL)-producing organisms, which has resulted in the emergence of carbapenem resistances [1]. The aim of this study was to identify and characterize four carbapenem-non-susceptible isolates, three Klebsiella pneumoniae and one Escherichia coli collected from April through October 2008 at Gulhane Military Medical Academy Hospital (GMMAH), Ankara, Turkey. Address correspondence and reprint requests to Abdullah Kilic, M.D., Departments of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy and School of Medicine 06018, Ankara; tel ; fax ; abkilic@gata.edu.tr; or to Yi-Wei Tang, M.D., Ph.D., Molecular Infectious Disease Laboratory, Vanderbilt University Hospital, 4605 TVC, Nashville, TN ; tel (615) ; fax (615) ; yiwei.tang@vanderbilt.edu Case 1 A 3-year-old boy, diagnosed with neuroblastoma 2 years before, was admitted to the emergency department with complaints of a one week history of fever (39 C), cough, and vomiting. His cough had begun 7 days earlier and was productive of purulent sputum. On physical examination, there were rales and rhonchi in the left lower lung field by auscultation. Tracheal intubation was performed on the patient because of the respiratory distress. Laboratory evaluation at that time revealed a leukocyte count of 1000/mm3, a hemoglobin level of 8 g/dl, and erythrocyte sedimentation rate of 23.1 mm/h. Urine and throat cultures were negative. Chest radiography revealed bilateral interstitial lung infiltrates. The child was given meropenem for pneumonia. During hospitalization, imipenem-meropenem resistant Klebsiella pneumoniae was grown in blood cultures. Meropenem was changed to amikacin on the basis of the susceptibility results. The patient s clinical condition deteriorated /11/ by the Association of Clinical Scientists, Inc.
2 162 Annals of Clinical & Laboratory Science, vol. 41, no. 2, 2011 over the first three days despite antibiotic treatment. He developed sudden cardiac arrest and was resuscitated, but the resuscitation was unsuccessful. Case 2 An 85-year-old woman presented with weakness in her legs and arms, sluggishness, and headache. She had been diagnosed in 2003 with Alzheimer disease and bladder cancer and had been followed over the past 8 years because of these two illnesses. She had had several episodes of headache and weakness during this 8-year period. On physical examination, the patient was un-cooperative. Her temperature was 38.7 C (oral); pulse, 92/ minute; respirations, 20/minute; and blood pressure, 133/79 mm Hg. Her neck, cardiac and lung examinations were unremarkable. The blood hemoglobin level was 13.7 g/dl, the platelet count was /mm 3, and the leukocyte count was 23000/mm 3. An abdominal ultrasound examination revealed that both kidneys exhibited grade III hydronephrosis and had solid masses. The liver and spleen ultrasound findings were unremarkable. Tracheal intubation was performed because of the difficulties with respiration. Urine and throat swab cultures for bacteria were negative. She was given meropenem the first day of admission. Blood cultures were performed on the second and third days after admission. Imipenem-meropenem resistant Escherichia coli was isolated from her blood cultures on the third day. Meropenem was changed to tigecycline on the basis of susceptibility results. Seven days after this antibiotic treatment, her blood cultures were negative. Case 3 A 23-year-old man was admitted to the general surgery department with severe abdominal pain and abdominal distension. An abdominal mass was detected by a computerized-assisted tomography scan of his abdomen. The incisional biopsy was diagnosed as Burkitt s lymphoma. Based on these biopsy results, the patient was admitted to the hematology service with a diagnosis of Burkitt s lymphoma. He then received six cycles of chemotherapy for this disease and was discharged. Six months later, he again presented with abdominal pain and weakness. On physical examination, he was noted to have a mass in his right abdomen. His abdominal examination also revealed tenderness by palpation. His temperature was 37.2 C (oral); pulse, 100/ minute; and blood pressure, 140/60 mm Hg. His laboratory investigations showed a white blood cell count of 300/mm 3, hemoglobin of 11.5g/ dl, and an erythrocyte sedimentation rate of 33.5 mm/h. His neck, cardiac, lung examinations were unremarkable. A bone marrow biopsy was performed and revealed marrow fibrosis with a dense infiltration of undifferentiated blast cells. He was started on an aggressive chemotherapy regimen with hyper-cvad chemotherapy for 6 cycles. While receiving this chemotherapy, he developed a fever (38.2 C) and received antibiotic therapy with imipenem and teicoplanin. Blood cultures revealed an imipenem-meropenem resistant K. pneumoniae. The imipenem therapy was changed to tigecycline on the basis of susceptibility results. His fever abated within two days after initiation of the tigecycline therapy. The patient subsequently improved and was discharged. Case 4 A 23-year-old male patient presented to the urology department complaining of occasional dysuria, suprapubic pain, and lower abdominal discomfort. This patient had been previously diagnosed with urinary tuberculosis and had undergone augmentation cystoplasty (sigmoidocystoplasty and bilateral ureterosigmoidostomy). He was admitted as a patient due to his reduced bladder capacity because of bilateral vesicoureteral reflux (VUR). The physical examination was unremarkable except for mild tenderness in the supra-pubic region. On examination, his temperature was 37.3 C; pulse, 85/minute; respirations, 22/minute; and blood pressure, 117/63 mm Hg. Blood test results showed a hematocrit of 28.8%, an hemoglobin of 10.1 g/ dl, an erythrocyte sedimentation rate of 28 mm/h, a platelet count of /mm 3, leukocytes of 6200/mm 3, glucose of 66, a BUN of and a creatinine of Ultrasonography revealed normal kidneys and ureters. The patient then had surgery to correct his colovesical fistula and
3 was given prophylactic therapy with ertapenem. During the hospitalization, he next developed an episode of cystitis and urine cultures grew imipenem-meropenem resistant K. pneumoniae. Based on susceptibility results, the patient was given tigecyclin. Urine cultures were negative after the antibiotic treatment. The patient was then discharged. Materials and Methods Bacterial strains GMMAH is a 1,500-bed teaching hospital in Ankara, Turkey. All Enterobacteriaceae isolates were identified by conventional biochemical tests and confirmed by the Phoenix, an automated bacteriology system that performs bacterial identification (Becton Dickinson Diagnostic Systems, Sparks, MD, USA). Susceptibility testing All isolates were tested against 19 antimicrobials by the Phoenix system (Becton Dickinson Diagnostic Systems). Interpretations of the test results were made using the CLSI criteria [2]. The susceptibility of the carbapenemresistant isolates was also tested against sixteen antimicrobial agents by the CLSI reference broth microdilution using caution-adjusted Mueller- Hinton broth (BD Biosciences, Sparks, Md.) [2,3]. E. coli ATCC and K. pneumoniae ATCC were used during testing for quality assurance. Screening for β-lactamases When strains were found to have reduced susceptibility to imipenem and/or meropenem, carbapenemase screening tests were assessed by the modified Hodge test [4], the imipenem-edta MBL Etest (AB BioDisk, Solna, Sweden), the imipenem-edta double-disk synergy test [5], the imipenem-edta combined disc test [6], broth based EDTA inhibition test (inhouse assay), and Ken Thompson s direct TE disk test at the CDC. ESBL production was tested by the Phoenix system and by the expanded double disc diffusion synergy test (discs of cefotaxime, ceftazidime, cefpodoxime and cefepime placed around amoxicillin/clavulanic acid). The synergic activity of clavulanate with ceftazidime was confirmed by means of the Etest strips containing OXA-48 producing Enterobacteriaceae 163 ceftazidime with or without clavulanate. Isolates were considered ESBL producers when clavulanate caused a 3 twofold-concentration decrease (ratio, 8) in the MIC of ceftazidime, in combination with a ceftazidime MIC 1 μg/ml. Additionally, a strain was considered ESBL positive if a phantom zone or a deformation of the ceftazidime zone could be observed, independent of the ratios or MICs [7]. PCR and sequencing DNA templates were prepared by the boiling method as described previously by Kilic et al. [8]. Carbapenem-resistance isolates were examined by PCR previously reported conditions with primers specific for blakpc, blaimp, blavim, blatem, blashv, blactx-m, and blaoxa-48 [9]. The nucleotide sequences were analyzed and multiple alignments were performed using the DNAMAN 4.1 Software (Lynnon BioSoft, Québec, Canada). ESBL genes, including blatem, blashv and blactx-m, were detected by PCR and sequenced using the Applied Biosystems sequencer (ABI Prism 310 genetic analyzer) as previously described [9]. Pulse field gel electrophoresis PFGE typing of XbaI-digested DNA for K. pneumoniae isolates was performed by a modification of a previously described method [10]. Electrophoresis was performed with a run time of 20 h under 5 to 30 sec linear ramped pulse times by the contourclamped homogeneous electric field method with a Bio-Rad CHEF DR II system (Bio-Rad, Hercule, CA). The gels were stained with ethidium bromide (0.5 μg/ml) for 40 to 60 min and were photographed under UV transillumination and analyzed with the aid of Quantity One software (Bio-Rad). Results During the study period, 215 K. pneumoniae and 300 E. coli isolates were recovered from inpatients and outpatients at the GMMAH. A total of three K. pneumoniae and one E. coli isolates producing carbapenem-hydrolyzing β-lactamase were recovered from four patients. All of the isolates were non-susceptible to ertapenem and meropenem based on MICs of 16 μg/ml
4 164 Annals of Clinical & Laboratory Science, vol. 41, no. 2, 2011 Table 1. Antibiotic susceptibilities of carbapenem resistant three K. pneumoniae and one E. coli isolates by broth microdilution method*. Antibiotics MIC (µg/ml) KP-150 EC-155 KP-163 KP-177 Amikacin 8 (S) 8 (S) 4 (S) 1 (S) Ampicillin >32 (R) >32 (R) >32 (R) >32 (R) Aztreonam >64 (R) >64 (R) 2 (S) 2 (S) Cefazolin >32 (R) >32 (R) >32 (R) >32 (R) Cefepime >32 (R) >32 (R) 4 (S) 4 (S) Cefoxitin >32 (R) >32 (R) 16 (I) 32 (R) Ciprofloxacin >8 (R) >8 (R) 0.5 (S) 1 (S) Levofloxacin >8 (R) >8 (R) 0.25 (S) 2 (S) Colistin** 4 (R) 0.5 (S) 0.5 (S) 0.5 (S) Ertapenem >16 (R) >16 (R) 4 (I) >16 (R) Imipenem >32 (R) >32 (R) 32 (R) >32 (R) Meropenem 16 (R) >16 (R) >16 (R) >16 (R) Polymyxin B** 4 (R) 0.5 (S) 0.5 (S) 0.5 (S) Tetracycline 4 (S) >32 (R) 2 (S) 8 (I) Tigecycline 0.5 (S) 0.25 (S) 1 (S) 2 (S) Trimethoprim- >8/152 (R) 0.25/4.8 (S) 0.25/4.8 (S) 8/152 (R) sulfamethoxazole * Based on CLSI guidelines (CLSI, 2006; CLSI, 2008). S, susceptible; R, resistant; I, intermediate. ** According to reference 20. S, susceptible; R, resistant. Table 2. β-lactamase detection and characterization of the four carbapenem-resistant Enterobacteriaceae isolates. Variable Numbers of isolates KP-150 EC-155 KP-163 KP-177 Identification K. pneumoniae E. coli K. pneumoniae K. pneumoniae Isolation site Blood Blood Blood Urine blatem-1 + blashv-12 + blashv blactx-m-15 + blaoxa KPC IMP VIM MHT Imipenem-EDTA MBL Etest ESBL production tests + + KPC, K. pneumoniae carbapenemase; IMP, integron containing metallo-β-lactamase; VIM, Verona integron-encoded metallo-βlactamase; MHT, Modified Hodge Test; +, detected;, not detected.
5 except isolates KP-163 (ertapenem MIC of 4 μg/ ml), and more resistant to imipenem (MICs, 32 μg/ml) (Table 1). KP-150 and EC-155 isolates were inferred to produce an ESBL based on the criterion of a 8-fold reduction in the MICs of oxyimino-β-lactams by clavulanate. Four carbapenem resistant isolates tested by the modified Hodge test, the imipenem-edta MBL Etest, the imipenem-edta double-disk synergy test, and the imipenem-edta combined disc test. All of these tests except the modified Hodge test were negative for all strains. All of the isolates were negative for the genes encoding KPC, IMP, and VIM by PCR assay. PCR indicated that three K. pneumoniae and one E. coli isolates harbored the blaoxa-48 gene (Table 2). In addition, PCR with blactx-m, blatem and blashv-specific primers, followed by classic Sanger DNA sequencing, revealed identical blatem-1 and blashv-12 genes in KP-150, the blashv-11 gene in KP-163 and KP-177, while blactx-m-15 was found in EC-155 isolates. The PFGE profile results demonstrated that three K. pneumoniae isolates producing OXA- 48 carbapenemase had distinct PFGE patterns (Figure 1). Fig 1. Pulsed-field gel electrophoresis patterns of XbaI-digested genomic DNA of Klebsiella pneumoniae isolates. Lane 1, KP- 150; lane 2, KP-163; lane 3, KP-177; lane 4, OXA-48 producing K. pneumoniae control strain was kindly provided from Istanbul University, Istanbul Medical Faculty. The molecular size is given in kilobases. OXA-48 producing Enterobacteriaceae 165 Discussion Carbapenem resistance in Enterobacteriaceae occurs due to various mechanisms, including overproduction of Amp-C β-lactamases associated with loss of outer membrane porins and/or overexpression of efflux pumps [1]. OXA-type carbapenemases have been reported mainly in Acinetobacter spp. throughout many regions of the world and are divided into four phylogenetic subgroups: OXA-23 like, OXA- 24 like, OXA-51 like and OXA-58 [11]. OXA- 48 has been characterized from a K. pneumoniae isolate that was resistant to all β-lactams including carbapenems, with a strong activity against imipenem. The blaoxa-48 gene was not associated with a class 1 integron like most oxacillinase genes, but was plasmid located downstream from the insertion sequence element, IS1999 [12]. Enterobacteriaceae isolates that produce OXA- 48 have rarely been reported from Turkey. The first case was reported in a K. pneumoniae isolate from Istanbul and was found to be resistant to all β-lactams, including carbapenems [12]. Subsequently, OXA-48 has been found in a Citrobacter freundii [13] isolate and an E. coli isolate as well as several K. pneumoniae isolates [9,14]. An outbreak of K. pneumoniae isolates producing OXA-48 was reported from Istanbul, having two different clones [15]. We identified four carbapenem-resistant Enterobacteriaceae isolates in blood and urine samples from 515 clinical K. pneumonia/e. coli isolates during a 7-month study period. In addition, we looked for other mechanisms related to carbapenemresistance, including the KPC, IMP, and VIM genes; all were absent in the four isolates. All of our four cases were serious patients with multiple underlying medical comorbidities and treated with carbapenems prior to the development of OXA-48 producing Enterobacteriaceae bloodstream and urinary tract infections. The mortality rate of infections caused by carbapenem resistant Enterobacteriaceae is very high [16]. Our patients mortality rate was 25%, which is even
6 166 Annals of Clinical & Laboratory Science, vol. 41, no. 2, 2011 lower compared with studies with 42.8%, 66%, and 71.9% mortality in especially bacteremic patients [17]. Enterobacteriaceae isolates producing OXA- 48 are known to be highly resistant to carbapenems because of the combined effects of a high production of OXA-48, owing to the association of the blaoxa-48 gene with IS1999, and the lack of a 36 kda porin [18]. Treatment of infections caused by OXAproducing K. pneumoniae is very difficult since most isolates are resistant to all β-lactams and fluoroqinolones. Tigecycline and polymyxins exhibit in vitro activity against many Grampositive and Gram-negative microorganisms, including multiresistant strains [19]. In this study tigecycline and colistin exhibited good in vitro activity against carbapenem resistant Enterobacteriacaeae isolates. However, the KP- 150 isolate was resistant to polymyxin B with an MIC=4 μg/ml. We suggest that tigecycline and colistin may serve as a promising therapeutic option for infection caused by carbapenem resistant Enterobacteriacaeae. Acknowledgements: We thank Jean Patel, J. Kamile Rasheed, and Karen Anderson from the US Centers for Disease Control and Prevention for their excellent discussion and assistance. References 1. Deshpande LM, Jones RN, Fritsche TR, Sader HS. Occurrence and characterization of carbapenemase-producing Enterobacteriaceae: report from the SENTRY Antimicrobial Surveillance Program ( ). Microb Drug Resist 2006;12: Clinical and Laboratory Standards Institute Performance standards for antimicrobial susceptibility testing; 18th informational supplement. CLSI document M100-S18. Clinical and Laboratory Standards Institute, Wayne, PA. 3. Clinical and Laboratory Standards Institute Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard, 7th ed. CLSI document M7-A7. Clinical and Laboratory Standards Institute, Wayne, PA. 4. Anderson KF, Lonsway DR, Rasheed JK, Biddle J, Jensen B, McDougal LK, Carey RB, Thompson A, Stocker S, Limbago B, Patel JB. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J Clin Microbiol 2007;45: Lee K, Lim YS, Yong D, Yum JH, Chong Y. Evaluation of the Hodge test and the imipenem-edta double-disk synergy test for differentiating metallo-beta-lactamase-producing isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol 2003;41: Yong D, Lee K, Yum JH, Shin HB, Rossolini GM, Chong Y. Imipenem-EDTA disk method for differentiation of metallobeta-lactamase-producing clinical isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol 2002;40: Apfalter P, Assadian O, Daxböck F, Hirschl AM, Rotter ML, Makristathis A. Extended double disc synergy testing reveals a low prevalence of extended-spectrum beta-lactamases in Enterobacter spp. in Vienna, Austria. J Antimicrob Chemother 2007;59: Kilic A, Demiray T, Saracli MA, Bahar G, Aydogan H, Baysallar M, Doganci L. Bacteriological characterization of vancomycinresistant enterococci ina pediatric hospital in Turkey. Ann Microbiol 2004;54: Aktas Z, Kayacan CB, Schneider I, Can B, Midilli K, Bauernfeind A. Carbapenem-hydrolyzing oxacillinase, OXA- 48, persists in Klebsiella pneumoniae in Istanbul, Turkey. Chemotherapy 2008;54: Durmaz R, Otlu B, Koksal F, Hosoglu S, Ozturk R, Ersoy Y, Aktas E, Gursoy NC, Caliskan A. The optimization of a rapid pulsed-field gel electrophoresis protocol for the typing of Acinetobacter baumannii, Escherichia coli and Klebsiella spp. Jpn J Infect Dis 2009;62: Nordmann P, Poirel L. Emerging carbapenemases in Gramnegative aerobes. Clin Microbiol Infect. 2002;8: Poirel L, Héritier C, Tolün V, Nordmann P. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae. Antimicrob Agents Chemother 2004;48: Nazic H, Poirel L, Nordmann P. Further identification of plasmid-mediated quinolone resistance determinant in Enterobacteriaceae in Turkey. Antimicrob Agents Chemother 2005;49: Gulmez D, Woodford N, Palepou MF, Mushtaq S, Metan G, Yakupogullari Y, Kocagoz S, Uzun O, Hascelik G, Livermore DM. Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae isolates from Turkey with OXA-48- like carbapenemases and outer membrane protein loss. Int J Antimicrob Agents 2008;31: Carrër A, Poirel L, Eraksoy H, Cagatay AA, Badur S, Nordmann P. Spread of OXA-48-positive carbapenem-resistant Klebsiella pneumoniae isolates in Istanbul, Turkey. Antimicrob Agents Chemother 2008;52: Bratu S, Landman D, Haag R, Recco R, Eramo A, Alam M, Quale J. Rapid spread of carbapenem-resistant Klebsiella pneumoniae in New York City: a new threat to our antibiotic armamentarium. Arch Intern Med 2005;165: Borer A, Saidel-Odes L, Riesenberg K, Eskira S, Peled N, Nativ R, Schlaeffer F, Sherf M. Attributable mortality rate for carbapenem-resistant Klebsiella pneumoniae bacteremia. Infect Control Hosp Epidemiol 2009;30: Walther-Rasmussen J, Høiby N. OXA-type carbapenemases. J Antimicrob Chemother 2006;57: Nadkarni AS, Schliep T, Khan L, Zeana CB. Cluster of bloodstream infections caused by KPC-2 carbapenemaseproducing Klebsiella pneumoniae in Manhattan. Am J Infect Control 2009;37: Gales AC, Reis AO, Jones RN. Contemporary assessment of antimicrobial susceptibility testing methods for polymyxin B and colistin: review of available interpretative criteria and quality control guidelines. J Clin Microbiol 2001;39:
Revised AAC Version 2» New-Data Letter to the Editor ACCEPTED. Plasmid-Mediated Carbapenem-Hydrolyzing β-lactamase KPC-2 in
AAC Accepts, published online ahead of print on 3 December 2007 Antimicrob. Agents Chemother. doi:10.1128/aac.01180-07 Copyright 2007, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationAAC Accepts, published online ahead of print on 13 October 2008 Antimicrob. Agents Chemother. doi: /aac
AAC Accepts, published online ahead of print on 13 October 2008 Antimicrob. Agents Chemother. doi:10.1128/aac.00931-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationST11 KPC-2 Klebsiella pneumoniae detected in Taiwan
AAC Accepts, published online ahead of print on 30 January 2012 Antimicrob. Agents Chemother. doi:10.1128/aac.05576-11 Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 2 3 4 5
More informationScreening and detection of carbapenemases
Screening and detection of carbapenemases For many isolates with carbapenemases the MICs of carbapenems are around the susceptible breakpoint making resistance difficult to detect - particularly with automated
More informationALERT. Clinical microbiology considerations related to the emergence of. New Delhi metallo beta lactamases (NDM 1) and Klebsiella
ALERT Clinical microbiology considerations related to the emergence of New Delhi metallo beta lactamases (NDM 1) and Klebsiella pneumoniae carbapenemases (KPC) amongst hospitalized patients in South Africa
More informationCarbapenem-resistant Escherichia coli and Klebsiella pneumoniae in Taiwan
Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae in Taiwan An Infection Control Emergency Speaker: L Kristopher Siu Principal Investigator Division of Infectious Diseases National Institute
More informationGuidance on screening and confirmation of carbapenem resistant Enterobacteriacae (CRE) December 12, 2011
Guidance on screening and confirmation of carbapenem resistant Enterobacteriacae (CRE) December 12, 2011 Objectives: To discuss the guidelines for detection of CRE in the laboratory setting. To review
More informationEmergence of Klebsiella pneumoniae ST258 with KPC-2 in Hong Kong. Title. Ho, PL; Tse, CWS; Lai, EL; Lo, WU; Chow, KH
Title Emergence of Klebsiella pneumoniae ST258 with KPC-2 in Hong Kong Author(s) Ho, PL; Tse, CWS; Lai, EL; Lo, WU; Chow, KH Citation International Journal Of Antimicrobial Agents, 2011, v. 37 n. 4, p.
More informationNONFERMENTING GRAM NEGATIVE RODS. April Abbott Deaconess Health System Evansville, IN
NONFERMENTING GRAM NEGATIVE RODS April Abbott Deaconess Health System Evansville, IN OBJECTIVES Discuss basic limitations to assessing carbapenem resistance in nonfermenting GNRs Discuss antimicrobial
More informationDetermining the Optimal Carbapenem MIC that Distinguishes Carbapenemase-Producing
AAC Accepted Manuscript Posted Online 8 August 2016 Antimicrob. Agents Chemother. doi:10.1128/aac.00838-16 Copyright 2016, American Society for Microbiology. All Rights Reserved. 1 1 2 Determining the
More informationPhenotypic Detection Methods of Carbapenemase Production in Enterobacteriaceae
ISSN: 2319-7706 Volume 4 Number 6 (2015) pp. 547-552 http://www.ijcmas.com Original Research Article Phenotypic Detection Methods of Carbapenemase Production in Enterobacteriaceae Sathya Pandurangan 1,
More informationOriginal Article Clinical Microbiology
Original Article Clinical Microbiology Ann Lab Med 2015;35:212-219 http://dx.doi.org/10.3343/alm.2015.35.2.212 ISSN 2234-3806 eissn 2234-3814 Combined Use of the Modified Hodge Test and Carbapenemase Inhibition
More informationIn-House Standardization of Carba NP Test for Carbapenemase Detection in Gram Negative Bacteria
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 01 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.701.342
More information#Corresponding author: Pathology Department, Singapore General Hospital, 20 College. Road, Academia, Level 7, Diagnostics Tower, , Singapore
AAC Accepts, published online ahead of print on 21 October 2013 Antimicrob. Agents Chemother. doi:10.1128/aac.01754-13 Copyright 2013, American Society for Microbiology. All Rights Reserved. 1 Title: Escherichia
More informationEmergence of non-kpc carbapenemases: NDM and more
Emergence of non-kpc carbapenemases: NDM and more --- David Livermore Health Protection Agency, UK The first acquired carbapenemase to be recognised in gram-negative bacteria was IMP-1, a metallo-type,
More informationDiscussion points CLSI M100 S19 Update. #1 format of tables has changed. #2 non susceptible category
Discussion points 2009 CLSI M100 S19 Update Nebraska Public Health Laboratory Changes most important to routine antimicrobial susceptibility testing. Documents available Janet Hindler discussion slide
More informationReceived 31 January 2011/Returned for modification 2 March 2011/Accepted 15 March 2011
JOURNAL OF CLINICAL MICROBIOLOGY, May 2011, p. 1965 1969 Vol. 49, No. 5 0095-1137/11/$12.00 doi:10.1128/jcm.00203-11 Copyright 2011, American Society for Microbiology. All Rights Reserved. Comparative
More informationPrevalence of Extended Spectrum -Lactamases In E.coli and Klebsiella spp. in a Tertiary Care Hospital
ISSN: 2319-7706 Volume 3 Number 10 (2014) pp. 474-478 http://www.ijcmas.com Original Research Article Prevalence of Extended Spectrum -Lactamases In E.coli and Klebsiella spp. in a Tertiary Care Hospital
More informationSurveillance of antimicrobial susceptibility of Enterobacteriaceae pathogens isolated from intensive care units and surgical units in Russia
Feb. 2016 THE JAPANESE JOURNAL OF ANTIBIOTICS 69 1 41 41 Surveillance of antimicrobial susceptibility of Enterobacteriaceae pathogens isolated from intensive care units and surgical units in Russia IRINA
More informationEmergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors
Original Article Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors Murat Dizbay, Ozlem Guzel Tunccan, Omer Karasahin, Firdevs
More informationOvercoming the PosESBLities of Enterobacteriaceae Resistance
Overcoming the PosESBLities of Enterobacteriaceae Resistance Review of current treatment options Jamie Reed, PharmD Pharmacy Grand Rounds August 28, 2018 Rochester, MN 2018 MFMER slide-1 Disclosure No
More informationDetecting CRE. what does one need to do?
5 th ICAN Conference, Harare 4 th November 2014 Room 2: 10:30-12:00 Detecting CRE (Carbapenem-resistant Enterobacteriaceae) what does one need to do? Dr Nizam Damani Associate Medical Director Infection
More informationDetection of Carbapenem Resistant Enterobacteriacae from Clinical Isolates
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 5 Number 5 (2016) pp. 864-869 Journal homepage: http://www.ijcmas.com Original Research Article http://dx.doi.org/10.20546/ijcmas.2016.505.089
More informationORIGINAL INVESTIGATION. Rapid Spread of Carbapenem-Resistant Klebsiella pneumoniae in New York City
ORIGINAL INVESTIGATION Rapid Spread of Carbapenem-Resistant Klebsiella pneumoniae in New York City A New Threat to Our Antibiotic Armamentarium Simona Bratu, MD; David Landman, MD; Robin Haag, RN; Rose
More informationCarbapenems and Enterobacteriaceae
Title Carbapenems and Enterobacteriaceae Presenter s details NHLS Dr Khine Swe Swe/Han FC Path ( Micro), SA MMed( micro), SA DTMH(Wits univ),sa PDIC(Stellen univ)sa MB,BS(Yangon),Myanmar Pathologist,Consultant/Lecturer,
More informationDetection of the KPC-2 Carbapenem-Hydrolyzing Enzyme in Clinical Isolates of ACCEPTED
JCM Accepts, published online ahead of print on April 00 J. Clin. Microbiol. doi:./jcm.00-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.
More informationEmergence of KPC-2 and KPC-3 in carbapenem-resistant Klebsiella pneumoniae ACCEPTED
AAC Accepts, published online ahead of print on 11 June 2007 Antimicrob. Agents Chemother. doi:10.1128/aac.00299-07 Copyright 2007, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationDifferentiation of Carbapenemase producing Enterobacteriaceae by Triple disc Test
Original article: Differentiation of Carbapenemase producing Enterobacteriaceae by Triple disc Test Manish Bansal 1, Nitya Vyas 2, Babita Sharma 3, R.K.Maheshwari 4 1PG Resident, 2 Professor, 3 Assistant
More informationDetection of NDM-1-producing Klebsiella pneumoniae in Kenya
AAC Accepts, published online ahead of print on 29 November 2010 Antimicrob. Agents Chemother. doi:10.1128/aac.01247-10 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationSensitive and specific Modified Hodge Test for KPC and metallo-beta-lactamase
JCM Accepts, published online ahead of print on 19 October 2011 J. Clin. Microbiol. doi:10.1128/jcm.05602-11 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions. All
More informationTHE INVASION BY CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE
ANKEM Derg 2012;26(Ek 2):31-35 THE INVASION BY CARBAPENEMASE-PRODUCING ENTEROBACTERIACEAE Patrice NORDMANN Service de Bactériologie-Virologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, South-Paris Medical
More informationβ- Lactamase Gene carrying Klebsiella pneumoniae and its Clinical Implication
Prevalence of Carbapenem-Hydrolyzing β- Lactamase Gene carrying Klebsiella pneumoniae and its Clinical Implication David Alcid M.D Balaji Yegneswaran M.D. Wanpen Numsuwan Introduction Klebsiella pneumoniae
More informationAffinity of Doripenem and Comparators to Penicillin-Binding Proteins in Escherichia coli and ACCEPTED
AAC Accepts, published online ahead of print on February 00 Antimicrob. Agents Chemother. doi:./aac.01-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
More informationAcademic Perspective in. David Livermore Prof of Medical Microbiology, UEA Lead on Antibiotic resistance PHE
Academic Perspective in Emerging No, we can t Issues treat of carbapenemase Resistance and ESBL in Gram-ve producers Bacteria based on MIC David Livermore Prof of Medical Microbiology, UEA Lead on Antibiotic
More informationRecommendations for the Management of Carbapenem- Resistant Enterobacteriaceae (CRE) in Acute and Long-term Acute Care Hospitals
Recommendations for the Management of Carbapenem- Resistant Enterobacteriaceae (CRE) in Acute and Long-term Acute Care Hospitals Minnesota Department of Health 11/2011 Infectious Disease Epidemiology,
More informationLaboratory CLSI M100-S18 update. Paul D. Fey, Ph.D. Associate Professor/Associate Director Josh Rowland, M.T. (ASCP) State Training Coordinator
Nebraska Public Health Laboratory 2008 CLSI M100-S18 update Paul D. Fey, Ph.D. Associate Professor/Associate Director Josh Rowland, M.T. (ASCP) State Training Coordinator Agenda Discuss 2008 M100- S18
More informationResistance to Polymyxins in France
Resistance to Polymyxins in France Paris Prof. Patrice Nordmann NDM producers in Enterobacteriaceae The polymyxins; colistin and polymyxin B Colistin - Synthesis by Bacillus polymyxa spp colistinus -
More informationHelen Heffernan and Rosemary Woodhouse Antibiotic Reference Laboratory, Institute of Environmental Science and Research Limited (ESR); July 2014.
Annual survey of extended-spectrum -lactamase (ESBL)-producing Enterobacteriaceae, 2013 Helen Heffernan and Rosemary Woodhouse Antibiotic Reference Laboratory, Institute of Environmental Science and Research
More informationNature and Science 2017;15(10)
Evaluation of Substrate Profile Test for Detection of Metallobetalactamses among Imipenem Resistant Clinical Isolates of Gram Negative Bacteria Tarek El-said El-Banna, Fatma Ibrahim Sonboland Eslam Shaaban
More informationRapid identification of emerging resistance in Gram negatives. Prof. Patrice Nordmann
Rapid identification of emerging resistance in Gram negatives Prof. Patrice Nordmann Emerging Resistance threats, CDC USA-2013 Enterobacteriaceae producing extendedspectrum β-lactamases (ESBL) Multi-resistant
More informationhydrophila strain ACCEPTED *Corresponding author. Department of Bacteriology, National Center for Epidemiology, 1097
JCM Accepts, published online ahead of print on 26 March 2008 J. Clin. Microbiol. doi:10.1128/jcm.00047-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All
More informationNew Mechanisms of Antimicrobial Resistance and Methods for Carbapenemase Detection
New Mechanisms of Antimicrobial Resistance and Methods for Carbapenemase Detection Stephen G. Jenkins, PhD, F(AAM), D(ABMM) Professor of Pathology and Laboratory Medicine Professor of Pathology in Medicine
More informationORIGINAL ARTICLE SUSCEPTIBILITY PATTERNS IN GRAM NEGATIVE URINARY ISOLATES TO CIPROFLOXACIN, CO-TRIMOXAZOLE AND NITROFURANTOIN
SUSCEPTIBILITY PATTERNS IN GRAM NEGATIVE URINARY ISOLATES TO CIPROFLOXACIN, CO-TRIMOXAZOLE AND NITROFURANTOIN Anoop Sinha 1, Benny P V 2 HOW TO CITE THIS ARTICLE: Anoop Sinha, Benny PV. Susceptibility
More informationPublic Health Surveillance for Multi Drug Resistant Organisms in Orange County
Public Health Surveillance for Multi Drug Resistant Organisms in Orange County Matt Zahn, MD Medical Director Epidemiology and Assessment Orange County Public Health Antimicrobial Mechanisms of Action
More informationMultidrug-resistant organisms are a major public health
Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae Nora Chea, Sandra N. Bulens, Thiphasone Kongphet-Tran, Ruth Lynfield, Kristin M.
More information(Plasmid mediated) Carbapenemases. Timothy R. Walsh, Cardiff University, Wales
(Plasmid mediated) Carbapenemases Timothy R. Walsh, Cardiff University, Wales What is a carbapenemase? How much carbapenem do they need to breakdown before they are called a carbapenemase? ESBL-enzymes
More informationInsert for Kit 98006/98010/ KPC/Metallo-B-Lactamase Confirm Kit KPC+MBL detection Kit KPC/MBL and OXA-48 Confirm Kit REVISION: DBV0034J
Insert for Kit 98006/98010/98015 KPC/Metallo-B-Lactamase Confirm Kit KPC+MBL detection Kit KPC/MBL and OXA-48 Confirm Kit REVISION: DBV0034J DATE OF ISSUE: 09.02.2017 LANGUAGE: English FOR IN VITRO DIAGNOSTIC
More informationORIGINAL ARTICLE. Julie Creighton and Clare Tibbs. Canterbury Health Laboratories, Christchurch
ORIGINAL ARTICLE Evaluation of the MAST indirect carbapenemase test and comparison with a modified carbapenem inactivation method for the detection of carbapenemase enzymes in Gram-negative bacteria Julie
More informationEnterobacteriaceae with acquired carbapenemases, 2016
Enterobacteriaceae with acquired carbapenemases, 2016 Background The acquired or transferable (as opposed to chromosomally encoded) carbapenemases found in Enterobacteriaceae belong to three of the four
More informationIn Vitro Activity of Ceftazidime-Avibactam Against Isolates. in a Phase 3 Open-label Clinical Trial for Complicated
AAC Accepted Manuscript Posted Online 21 November 2016 Antimicrob. Agents Chemother. doi:10.1128/aac.01820-16 Copyright 2016, American Society for Microbiology. All Rights Reserved. 1 2 3 4 5 6 7 8 9 10
More informationDetecting carbapenemases in Enterobacteriaceae
Detecting carbapenemases in Enterobacteriaceae David Livermore Health Protection Agency, Colindale, London 12 August 2003 Mechanisms of carbapenem R in Enterobacteria Impermeability + AmpC or ESBL Metallo
More informationJournal of Infectious Diseases and
Journal of Infectious Diseases & Therapy ISSN: 2332-0877 Journal of Infectious Diseases and Therapy Santanirand et al., J Infect Dis Ther 2018, 6:5 DOI: 10.4172/2332-0877.1000378 Research Article Open
More informationActivity of tigecycline alone and in combination with colistin and meropenem against carbapenemase
Activity of tigecycline alone and in combination with colistin and meropenem against carbapenemase (KPC)-producing Enterobacteriaceae strains by time-kill assay Spyros Pournaras, Georgia Vrioni, Evangelia
More informationDevelopment of a phenotypic method for fecal carriage detection of OXA-48-producing
JCM Accepts, published online ahead of print on 11 May 2011 J. Clin. Microbiol. doi:10.1128/jcm.00055-11 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
More informationIn Vitro Susceptibility Pattern of Cephalosporin- Resistant Gram-Negative Bacteria
In Vitro Susceptibility Pattern of Cephalosporin- Resistant Gram-Negative Bacteria Warunee Punpanich MD*, Worraporn Tantichattanon MD**, Siriporn Wongwatcharapaiboon MD**, Vipa Treeratweeraphong BSc, MSc***
More informationFirst Clinical Cases of OXA-48 Producing Carbapenem Resistant Klebsiella pneumoniae in
JCM Accepts, published online ahead of print on 21 November 2012 J. Clin. Microbiol. doi:10.1128/jcm.02580-12 Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 2 3 4 5 6 7 8 9 10
More informationExpert rules. for Gram-negatives
Academic Perspective in Expert rules Emerging Issues of Resistance in Gram-ve Bacteria for Gram-negatives Trevor Winstanley Sheffield Teaching Hospitals Presented on behalf of David Livermore University
More informationjmb Research Article Review Semi Kim 1, Ji Youn Sung 2, Hye Hyun Cho 3, Kye Chul Kwon 1, and Sun Hoe Koo 1 *
J. Microbiol. Biotechnol. (2014), 24(6), 765 770 http://dx.doi.org/10.4014/jmb.1306.06036 Review Research Article jmb Characterization of CTX-M-14- and CTX-M-15-Producing Escherichia coli and Klebsiella
More informationRegional Emergence of VIM producing carbapenem resistant Pseudomonas aeruginosa (VIM CRPA)
National Center for Emerging and Zoonotic Infectious Diseases Regional Emergence of VIM producing carbapenem resistant Pseudomonas aeruginosa (VIM CRPA) Chris Prestel, MD Epidemic Intelligence Service
More informationCarbapenem Disks on MacConkey agar as screening methods for the detection of. Carbapenem-Resistant Gram negative rods in stools.
JCM Accepts, published online ahead of print on 7 November 2012 J. Clin. Microbiol. doi:10.1128/jcm.02878-12 Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 2 Carbapenem Disks
More informationPhenotypic detection of ESBLs and carbapenemases
Phenotypic detection of ESBLs and carbapenemases Standardized susceptibility testing residential workshop 2016 Katie Hopkins PhD Clinical Scientist Antimicrobial Resistance and Healthcare Associated Infections
More informationInternational transfer of NDM-1-producing Klebsiella. pneumoniae from Iraq to France
AAC Accepts, published online ahead of print on 18 January 2011 Antimicrob. Agents Chemother. doi:10.1128/aac.01761-10 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationCarbapenemases in Enterobacteriaceae: Prof P. Nordmann Bicêtre hospital, South-Paris Med School
Carbapenemases in Enterobacteriaceae: 2012 Prof P. Nordmann Bicêtre hospital, South-Paris Med School March 21, 2012 Trends in Molecular Medecine NDM IMP OXA-48 KPC VIM ALERT VI M KPC KPC NDM I MP OXA-
More informationExpert rules in antimicrobial susceptibility testing: State of the art
Expert rules in antimicrobial susceptibility testing: State of the art ESCMID Postgraduate Education Course Antimicrobial Susceptibility Testing and Surveillance: from Laboratory to Clinic Hospital Universitario
More informationCARBAPENEMASE PRODUCING ENTEROBACTERIACEAE
CARBAPENEMASE PRODUCING ENTEROBACTERIACEAE Veroniek Saegeman Veroniek Saegeman UZLeuven Carbapenemase producing Enterobacteriaceae (CPE) Introduction on antibiotic resistance Classification of ß-lactamases
More informationUpdate on CLSI and EUCAST
Update on CLSI and EUCAST 1 Completed work» Cephalosporin breakpoints for Enterobacteriaceae ESBL screens MIC versus resistance mechanism» Carbapenem breakpoints for Enterobacteriaceae Modified Hodge Test»
More informationPROFESSOR PETER M. HAWKEY
Multi-drug resistant Escherichia coli PROFESSOR PETER M. HAWKEY School of Immunity and Infection College of Medical and Dental Sciences University of Birmingham Birmingham B15 2TT Health Protection Agency
More informationMHSAL Guidelines for the Prevention and Control of Antimicrobial Resistant Organisms (AROs) - Response to Questions
MHSAL Guidelines for the Prevention and Control of Antimicrobial Resistant Organisms (AROs) - Response to Questions Dr. Andrew Walkty Medical Microbiologist, Diagnostic Services Manitoba (DSM) June. 17,
More informationEmergence of OXA-48-type carbapenemase-producing Enterobacteriaceae. in German hospitals
AAC Accepts, published online ahead of print on 30 January 2012 Antimicrob. Agents Chemother. doi:10.1128/aac.05315-11 Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 2 Emergence
More informationDetecting Carbapenemase-Producing Enterobacteriaceae: why isn t there a single best method?
Detecting Carbapenemase-Producing Enterobacteriaceae: why isn t there a single best method? Professor Neil Woodford Antimicrobial Resistance & Healthcare Associated Infections (AMRHAI) Reference Unit Crown
More informationK. Lee, Y. S. Lim, D. Yong, J. H. Yum, and Y. Chong*
JOURNAL OF CLINICAL MICROBIOLOGY, Oct. 2003, p. 4623 4629 Vol. 41, No. 10 0095-1137/03/$08.00 0 DOI: 10.1128/JCM.41.10.4623 4629.2003 Copyright 2003, American Society for Microbiology. All Rights Reserved.
More informationTitle: Detection of OXA-48 carbapenemase in the pandemic clone Escherichia coli O25b:H4-
AAC Accepts, published online ahead of print on 7 May 2012 Antimicrob. Agents Chemother. doi:10.1128/aac.00638-12 Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 2 Title: Detection
More informationIncidence of metallo beta lactamase producing Pseudomonas aeruginosa in ICU patients
Indian J Med Res 127, April 2008, pp 398-402 Incidence of metallo beta lactamase producing Pseudomonas aeruginosa in ICU patients Ami Varaiya, Nikhil Kulkarni, Manasi Kulkarni, Pallavi Bhalekar & Jyotsana
More informationTreatment Strategies for Infections due to MDR-GNR
Treatment Strategies for Infections due to MDR-GNR Michael Satlin, MD Instructor in Medicine Division of Infectious Diseases Weill Cornell Medical College, New York, NY October 16, 2012 1 2 Faculty Disclosure
More informationEnterobacteriaceae with acquired carbapenemases, 2015
Enterobacteriaceae with acquired carbapenemases, 2015 Background The acquired or transferable (as opposed to chromosomally encoded) carbapenemases found in Enterobacteriaceae belong to three of the four
More informationTreatment Options for Urinary Tract Infections Caused by Extended-Spectrum Β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae
Treatment Options for Urinary Tract Infections Caused by Extended-Spectrum Β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae medicine.missouri.edu/jahm/treatment-options-urinary-tract-infections-caused-extended-spectrum-β-lactamase-producingescherichia-coli-klebsiella-pneumoniae/
More informationClinical Microbiology Newsletter
Clinical Microbiology Newsletter $88 Vol. 30, No. 10 www.cmnewsletter.com May 15, 2008 Newer β-lactamases: Clinical and Laboratory Implications, Part I * Ellen Smith Moland, B.S.M.T., Soo-Young Kim, M.D.,
More informationDisclosure. Objectives. Evolution of β Lactamases. Extended Spectrum β Lactamases: The New Normal. Prevalence of ESBL Mystic Program
47 th Annual Meeting August 2-4, 2013 Orlando, FL Extended Spectrum β Lactamases: The New Normal Disclosure I do have a vested interest in or affiliation with the following companies or organizations Triax
More informationAntibiotic Treatment of GNR MDR Infections. Stan Deresinski
Antibiotic Treatment of GNR MDR Infections Stan Deresinski Kucers: The Use of Antibiotics 1st Edition 1972 392 pages Kucers: The Use of Antibiotics 7 th Edition 2017 5338 pages Carbapenem Susceptibility
More informationControversial Issues in Susceptibility Testing: Point/Counterpoint. April N. Abbott, PhD D(ABMM) Romney M. Humphries, PhD D(ABMM)
Controversial Issues in Susceptibility Testing: Point/Counterpoint April N. Abbott, PhD D(ABMM) Romney M. Humphries, PhD D(ABMM) Disclosures RMH: Funding from BD, biomerieux, Beckman-Coulter, GenMark,
More informationPhenotypic Detection of Carbapenem Resistance among Klebsiella pneumoniae in Suez Canal University Hospitals, Ismailiya, Egypt
ISSN: 2319-7706 Volume 4 Number 2 (2015) pp. 10-18 http://www.ijcmas.com Original Research Article Phenotypic Detection of Carbapenem Resistance among Klebsiella pneumoniae in Suez Canal University Hospitals,
More informationNightmare Bacteria. Disclosures. Technician Objectives. Pharmacist Objectives. Carbapenem Resistance in Carbapenem Resistance in 2017
Nightmare Bacteria How to Deal with the Reality of Carbapenem-resistant Organisms Disclosures I have no conflicts of interest relative to the content of this presentation Matthew L. Brown, Pharm.D., BCPS
More informationMolecular characterisation of CTX-M-type extendedspectrum β-lactamases of Escherichia coli isolated from a Portuguese University Hospital
EJHP Science Volume 17 2011 Issue 3 P. 1-5 2011 Pharma Publishing and Media Europe. All rights reserved 1781-7595 25 www.ejhp.eu Molecular characterisation of CTX-M-type extendedspectrum β-lactamases of
More informationMECHANISMS OF RESISTANCE TO CARBAPENEMS IN MEROPENEM- RESISTANT ACINETOBACTER
April-June Indian Journal 2007of Medical Microbiology, (2007) 25 (2):121-5 Original Article 121 MECHANISMS OF RESISTANCE TO CARBAPENEMS IN MEROPENEM- RESISTANT ACINETOBACTER ISOLATES FROM CLINICAL SAMPLES
More informationARTICLE IN PRESS International Journal of Antimicrobial Agents xxx (2010) xxx xxx
International Journal of Antimicrobial Agents xxx (2010) xxx xxx Contents lists available at ScienceDirect International Journal of Antimicrobial Agents journal homepage: http://www.elsevier.com/locate/ijantimicag
More informationReporting blood culture results to clinicians: MIC, resistance mechanisms, both?
Reporting blood culture results to clinicians: MIC, resistance mechanisms, both? Christian G. Giske, MD, PhD Senior Consultant Physician/Associate Professor Department of Clinical Microbiology Karolinska
More information10/4/16. mcr-1. Emerging Resistance Updates. Objectives. National Center for Emerging and Zoonotic Infectious Diseases. Alex Kallen, MD, MPH, FACP
National Center for Emerging and Zoonotic Infectious Diseases Emerging Resistance Updates Alex Kallen, MD, MPH, FACP Lead Antimicrobial Resistance and Emerging Pathogens Team Prevention and Response Branch
More informationβ-lactamase inhibitors
β-lactamase inhibitors Properties, microbiology & enzymology DAVID M LIVERMORE Professor of Medical Microbiology, UEA Lead on Antibiotic Resistance, Public Health England β-lactamase classes A B C D Serine
More information(DHA-1): Microbiologic and Clinical Implications
AAC Accepts, published online ahead of print on 20 September 2010 Antimicrob. Agents Chemother. doi:10.1128/aac.00083-10 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationEducational Workshops 2016
Educational Workshops 2016 Keynote CPE Screening We are grateful to Dr Andrew Dodgson, Consultant Microbiologist, Public Health England and Central Manchester Hospitals NHS Foundation Trust Terminology
More informationShaun Yang, PhD, D(ABMM), MLS(ASCP) CM MB CM Assistant Professor of Pathology UNM Health Sciences Center Associate Director of Infectious Disease
Shaun Yang, PhD, D(ABMM), MLS(ASCP) CM MB CM Assistant Professor of Pathology UNM Health Sciences Center Associate Director of Infectious Disease Director of Molecular Infectious Disease TriCore Reference
More informationCARBAPENEMS ARE THE recommended treatment
Acute Medicine & Surgery 2014; 1: 181 185 doi: 10.1002/ams2.36 Case Report Successful treatment of septic shock due to New Delhi metallo-β-lactamase-1-producing Klebsiella pneumoniae in a patient transferred
More informationDetection of NDM-1, VIM-1, KPC, OXA-48, and OXA-162 carbapenemases by MALDI- TOF mass spectrometry
JCM Accepts, published online ahead of print on 2 May 2012 J. Clin. Microbiol. doi:10.1128/jcm.01002-12 Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 2 3 4 5 6 7 8 9 10 11 12
More informationUrinary Tract Infections: From Simple to Complex. Adriane N Irwin, MS, PharmD, BCACP Clinical Assistant Professor Ambulatory Care October 25, 2014
Urinary Tract Infections: From Simple to Complex Adriane N Irwin, MS, PharmD, BCACP Clinical Assistant Professor Ambulatory Care October 25, 2014 Learning Objectives Develop empiric antimicrobial treatment
More informationNoelisa Montero, MPH. Epidemiologist Consultant. October 19, 2017 Connecticut Department of Public Health Healthcare Associated Infections Program
Carbapenem-resistant Enterobacteriaceae (CRE) in Connecticut: Collaborative Development of a Characterization Panel and Testing of Carbapenemase Genetic Markers, 2017 Noelisa Montero, MPH Epidemiologist
More informationFrequency of Occurrence and Antimicrobial Susceptibility of Bacteria from ICU Patients with Pneumonia
Frequency of Occurrence and Antimicrobial Susceptibility of Bacteria from ICU Patients with Pneumonia Helio S. Sader, M.D.* Mariana Castanheira, Ph.D. Rodrigo E. Mendes, Ph.D. Robert K. Flamm, Ph.D. JMI
More informationCarbapenemase Producing Enterobacteriaceae: Screening
Carbapenemase Producing Enterobacteriaceae: Screening Dr David Harvey Consultant Microbiology and Infection Prevention and Control Nov 2015 Aims Is CPE a problem? Does screening have the potential to help?
More informationMethodological and interpretative problems in antimicrobial susceptiblity tests of P. aeruginosa
Methodological and interpretative problems in antimicrobial susceptiblity tests of P. aeruginosa Y. Glupczynski Laboratoire de bactériologie Cliniques Universitaires UCL de Mont-Godinne Université Catholique
More informationOutcome of carbapenem resistant Klebsiella pneumoniae bloodstream infections
ORIGINAL ARTICLE BACTERIOLOGY Outcome of carbapenem resistant Klebsiella pneumoniae bloodstream infections D. Ben-David, R. Kordevani, N. Keller, I. Tal, A. Marzel, O. Gal-Mor, Y. Maor and G. Rahav Infectious
More information