Extended-spectrum β-lactamases: an update on their characteristics, epidemiology and detection

JAC-Antimicrobial Resistance, Journal Year: 2021, Volume and Issue: 3(3)

Published: June 8, 2021

Abstract Extended-spectrum β-lactamase (ESBL)-producing Gram-negative pathogens are a major cause of resistance to expanded-spectrum β-lactam antibiotics. Since their discovery in the early 1980s, they have spread worldwide and an now endemic Enterobacterales isolated from both hospital-associated community-acquired infections. As result, global public health concern. In past, TEM- SHV-type ESBLs were predominant families ESBLs. Today CTX-M-type enzymes most commonly found ESBL type with CTX-M-15 variant dominating worldwide, followed prevalence by CTX-M-14, CTX-M-27 is emerging certain parts world. The genes encoding often on plasmids harboured within transposons or insertion sequences, which has enabled spread. addition, population ESBL-producing Escherichia coli dominated globally highly virulent successful clone belonging ST131. Today, there many diagnostic tools available clinical microbiology laboratory include phenotypic genotypic tests detect β-lactamases. Unfortunately, when not identified timely manner, appropriate antimicrobial therapy frequently delayed, resulting poor outcomes. Several analyses trials shown mixed results regards whether carbapenem must be used treat serious infections caused some older β-lactam-β-lactamase combinations such as piperacillin/tazobactam appropriate. Some newer ceftazidime/avibactam demonstrated efficacy patients. will continue contributor worldwide. It essential that we remain vigilant about identifying them patient isolates through surveillance studies.

Language: Английский

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ESKAPE pathogens: antimicrobial resistance, epidemiology, clinical impact and therapeutics

Nature Reviews Microbiology, Journal Year: 2024, Volume and Issue: 22(10), P. 598 - 616

Published: June 3, 2024

Language: Английский

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Klebsiella oxytoca Complex: Update on Taxonomy, Antimicrobial Resistance, and Virulence

Clinical Microbiology Reviews, Journal Year: 2021, Volume and Issue: 35(1)

Published: Dec. 1, 2021

Klebsiella oxytoca is actually a complex of nine species-Klebsiella grimontii, huaxiensis, michiganensis, K. oxytoca, pasteurii, spallanzanii, and three unnamed novel species. Phenotypic tests can assign isolates to the complex, but precise species identification requires genome-based analysis. The human commensal also an opportunistic pathogen causing various infections, such as antibiotic-associated hemorrhagic colitis (AAHC), urinary tract infection, bacteremia, has caused outbreaks. Production cytotoxins tilivalline tilimycin lead AAHC, while many virulence factors seen in pneumoniae, capsular polysaccharides fimbriae, have been found complex; however, their association with pathogenicity remains unclear. Among 5,724 clinical SENTRY surveillance system, rates nonsusceptibility carbapenems, ceftriaxone, ciprofloxacin, colistin, tigecycline were 1.8%, 12.5%, 7.1%, 0.8%, 0.1%, respectively. Resistance carbapenems increasing alarmingly. In addition intrinsic blaOXY, genes encoding β-lactamases varying spectra hydrolysis, including extended-spectrum β-lactamases, few CTX-M variants several TEM SHV variants, found. blaKPC-2 most common carbapenemase gene mainly on IncN or IncF plasmids. Due ability acquire antimicrobial resistance carriage multiple genes, potential become major threat health.

Language: Английский

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Escherichia coli ST1193: Following in the Footsteps of E. coli ST131

Antimicrobial Agents and Chemotherapy, Journal Year: 2022, Volume and Issue: 66(7)

Published: June 6, 2022

Escherichia coli ST1193 is an emerging global multidrug (MDR) high-risk clone and important cause of community-onset urinary bloodstream infections.

Language: Английский

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International and regional spread of carbapenem-resistant Klebsiella pneumoniae in Europe

Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)

Published: June 14, 2024

Abstract Carbapenem-resistant Klebsiella pneumoniae (CRKP) are of particular concern due to the spread antibiotic resistance genes associated with mobile genetic elements. In this study, we collected 687 carbapenem-resistant strains recovered among clinical samples from 41 hospitals in nine Southern European countries (2016-2018). We identified 11 major clonal lineages, most isolates belonging high-risk clones ST258/512, ST101, ST11, and ST307. bla KPC-like was prevalent carbapenemase-encoding gene (46%), OXA-48 present 39% isolates. Through combination comparison EURECA collection previous EuSCAPE (2013-2014), investigated circulating Europe exhibiting regional differences. particularly found ST258/512 Greece, Italy, Spain, ST101 Serbia Romania, NDM ST11 OXA-48-like ST14 Türkiye. Genomic surveillance across thus provides crucial insights for local risk mapping informs necessary adaptions implementation control strategies.

Language: Английский

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Carbapenem-resistant Klebsiella pneumoniae : the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge

Expert Review of Anti-infective Therapy, Journal Year: 2024, Volume and Issue: 22(1-3), P. 25 - 43

Published: Jan. 18, 2024

Introduction Klebsiella pneumoniae is a major agent of healthcare-associated infections and cause some community-acquired infections, including severe bacteremic associated with metastatic abscesses in liver other organs. Clinical relevance compounded by its outstanding propensity to evolve antibiotic resistance. In particular, the emergence dissemination carbapenem resistance K. has posed challenge due few residual treatment options, which have only recently been expanded new agents. The epidemiological success carbapenem-resistant (CR-Kp) mainly linked clonal lineages that produce carbapenem-hydrolyzing enzymes (carbapenemases) encoded plasmids.

Language: Английский

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Occurrence and mechanisms of tigecycline resistance in carbapenem- and colistin-resistant Klebsiella pneumoniae in Thailand

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: March 3, 2024

Abstract Tigecycline has been regarded as one of the most important last-resort antibiotics for treatment infections caused by extensively drug-resistant (XDR) bacteria, particularly carbapenem- and colistin-resistant Klebsiella pneumoniae (C-C-RKP). However, reports on tigecycline resistance have growing. Overall, ~ 4000 K. clinical isolates were collected over a five-year period (2017–2021), in which 240 C-C-RKP investigated. Most these (91.7%) resistant to tigecycline. Notably, high-risk clone ST16 was predominantly identified, associated with co-harboring bla NDM-1 OXA-232 genes. Their major mechanism overexpression efflux pump acrB gene its regulator RamA, mutations RamR (M184V, Y59C, I141T, A28T, C99/C100 insertion), binding site (PI) ramA (C139T), MarR (S82G), and/or AcrR (L154R, R13Q). Interestingly, four ST147 carried mutated tet (A) gene. To our knowledge, this is first report prevalence mechanisms isolated from Thailand. The high incidence observed among study reflects an ongoing evolution XDR bacteria against antibiotics, demands urgent action.

Language: Английский

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Intricate interplay of CRISPR-Cas systems, anti-CRISPR proteins, and antimicrobial resistance genes in a globally successful multi-drug resistant Klebsiella pneumoniae clone

Genome Medicine, Journal Year: 2025, Volume and Issue: 17(1)

Published: Jan. 30, 2025

Language: Английский

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Rapidly spreading Enterobacterales with OXA-48-like carbapenemases

Journal of Clinical Microbiology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 6, 2025

ABSTRACT Enterobacterales (mostly Klebsiella pneumoniae , Escherichia coli ) with OXA-48-like carbapenemases (e.g., OXA-48, -181, -232, -244) are undermining the global efficiency of carbapenem therapy. In Middle East, North Africa, and some European countries, most common types among . Currently, OXA-48 is endemic in Spain, France, Belgium; OXA-181 Sub-Saharan Africa Indian Subcontinent, while OXA-232 has been increasing Subcontinent. countries Germany, Denmark, Switzerland, France) experiencing community outbreaks E. ST38 that produce OXA-244, these strains have introduced into Norwegian, Polish, Czech hospitals. The ascendancy genes due to combination horizontal spread through promiscuous plasmids IncL, IncX3, ColE2) vertical certain high-risk multidrug-resistant clones K. ST14, ST15, ST147, ST307; ST38, ST410). This a powerful “gene survival strategy” assisted different environments including setting. laboratory diagnosis complex; therefore, bacteria “difficult detect” variants OXA-484) likely underreported spreading silently “beneath radar” hospital settings. forces be reckoned with.

Language: Английский

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Unseen Enemy: Mechanisms of Multidrug Antimicrobial Resistance in Gram-Negative ESKAPE Pathogens

Antibiotics, Journal Year: 2025, Volume and Issue: 14(1), P. 63 - 63

Published: Jan. 9, 2025

Multidrug antimicrobial resistance (AMR) represents a formidable challenge in the therapy of infectious diseases, triggered by particularly concerning gram-negative Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE) pathogens. Designated as "priority" 2017, these bacteria continue to pose significant threat 2024, during worldwide SARS-CoV-2 pandemic, where coinfections with ESKAPE members contributed worsened patient outcomes. The declining effectiveness current treatments against pathogens has led an increased disease burden increase mortality rates globally. This review explores sophisticated mechanisms driving AMR bacteria, focusing on Key bacterial contributing include limitations drug uptake, production antibiotic-degrading enzymes, alterations target sites, enhanced efflux systems. Comprehending pathways is vital for formulating innovative therapeutic strategies tackling ongoing posed resistant

Language: Английский

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