Journal of Global Antimicrobial Resistance,
Год журнала:
2023,
Номер
35, С. 35 - 43
Опубликована: Авг. 22, 2023
Post-operative
central
nervous
system
infections
(PCNSIs)
caused
by
carbapenem-resistant
Enterobacteriaceae
(CRE)
frequently
result
in
unfavorable
outcomes.
However,
CRE
PCNSIs
have
not
been
well
described
from
a
clinical
and
microbiological
perspective.
A
total
of
254
cases
were
included
(Jan.2017-Jun.2020),
features
compared
based
on
pathogenic
classification.
Cox
regression
analysis
was
performed
to
assess
risk
factors
for
mortality.
Antibiotic
susceptibility
testing
whole
genome
sequencing
conducted
isolates
preserved.
MLST,
cgMLST,
resistance
genes
virulence
further
analyzed.
Among
PCNSI
cases,
15.4%
including
28
CRE.
The
28-day
mortality
rates
CRE,
CSE
Non-Enterobacteriaceae
50.0%,
27.3%,
7.4%,
respectively.
42.9%
(12/28)
the
patients
achieved
cure,
with
25.0%
clearance.
ST11-KL64
carrying
blaKPC-2
dominant
(17/23,
73.9%),
rate
its
infection
58.5%.
Most
CRKP
carried
rampA/rampA2
73.9%).
dominated
among
PCNSIs.
Targeted
anti-infective
combination
therapy
ceftazidime/avibactam
or
amikacin,
combined
intrathecal
administration
found
be
effective.
These
findings
render
new
insight
into
landscape
Annals of Clinical Microbiology and Antimicrobials,
Год журнала:
2024,
Номер
23(1)
Опубликована: Фев. 12, 2024
Abstract
Background
Recently,
extensively
drug-resistant
Pseudomonas
aeruginosa
(XDR-PA)
isolates
have
been
increasingly
detected
and
posed
great
challenges
to
clinical
anti-infection
treatments.
However,
little
is
known
about
resistant
hypervirulent
P.
(XDR-hvPA).
In
this
study,
we
investigate
its
epidemiological
characteristics
provide
important
basis
for
preventing
dissemination.
Methods
Clinical
XDR-PA
were
collected
from
January
2018
2023
identified
using
matrix-assisted
laser
desorption/ionization–time-of-flight
mass
spectrometry;
antibiotic
susceptibility
testing
was
performed
by
broth
microdilution
method,
minimum
inhibitory
concentrations
(MICs)
evaluated.
Virulence
evaluated
the
Galleria
mellonella
infection
model;
molecular
characteristics,
including
resistance
genes,
virulence
homology,
determined
whole-genome
sequencing.
Results
A
total
of
77
strains
collected;
47/77
XDR-hvPA.
Patients
aged
>
60
years
showed
a
significantly
higher
detection
rate
XDR-hvPA
than
XDR-non-hvPA.
Among
47
strains,
24
carried
carbapenemase
gene,
bla
GES−1
(10/47),
VIM−2
(6/47),
GES−14
(4/47),
IMP−45
(2/47),
KPC−2
(1/47),
NDM−14
(1/47).
ExoU
,
exoT
exoY
exoS
factors
PA,
found
in
31/47,
47/47,
46/47,
29/47
respectively.
Notably,
two
simultaneously
co-carried
exoU
.
Six
serotypes
(O1,
O4–O7,
O11)
detected;
O11
(19/47),
O7
(13/47),
O4
(9/47)
most
prevalent.
2018–2020,
prevalent
serotypes;
2021
onward,
(16/26)
serotype.
Fourteen
types
ST
detected,
mainly
ST235
(14/47),
ST1158
ST1800
(7/47).
Five
global
epidemic
GES
MIC
value
ceftazidime/avibactam
reached
breakpoint
(8/4
mg/L).
Conclusions
The
unexpectedly
high,
particularly
patients
years,
who
are
seemingly
more
susceptible
contracting
infection.
Clonal
transmission
carrying
which
belongs
ST235,
noted.
Therefore,
monitoring
should
be
strengthened,
elderly
hospitalized
patients,
prevent
spread.
Annals of Clinical Microbiology and Antimicrobials,
Год журнала:
2023,
Номер
22(1)
Опубликована: Ноя. 2, 2023
This
study
aimed
to
illustrate
the
status
of
carbapenem-resistant
Enterobacterales
(CRE)
infections
in
a
Chinese
tertiary
hospital
and
investigate
role
outer
membrane
vesicles
(OMVs)
antibiotic
resistance
Klebsiella
pneumoniae
(CRKP).The
data
CRE
was
collected
from
laboratory
records,
isolates
two
distinct
periods
(2015/07
2017/07
2020/04
2021/04)
were
enrolled
detect
carbapenemase
genes
by
polymerase
chain
reaction
(PCR).
Multilocus
sequence
typing
(MLST)
used
analyze
molecular
characterization
CRKP.
The
conjugation
assay
performed
verify
transmission
plasmid.
OMVs
CRKP
isolated
with
method
combining
an
electrophoretic
technique
300
kDa
cut-off
dialysis
bag.
protein
components
analyzed
liquid
chromatography
tandem-mass
spectrometry
(LC-MS/MS),
meropenem-hydrolyzing
bioactivity
KPC
determined
different
treatments
vitro.A
total
178
isolates,
including
100
2015/07
78
2021/04,
for
detection
genes.
We
found
that
gene
blaKPC
most
prevalent,
followed
blaNDM.
By
MLST,
we
type
(ST)
11
(96.1%)
leading
during
ST15
increased
46.2%
late
period
2021/04.
diameters
ranged
200
nm,
proteomics
analysis
proteins
belonged
"enzyme"
group.
enzyme
CRKP,
could
protect
inside
proteinase
K
digestion.
Moreover,
enzymes
within
OMVs,
which
be
released
after
Triton
X-100
treatment,
hydrolyze
meropenem.CRE
has
increasingly
caused
hospitals,
blaKPC-positive
have
constituted
major
proportion
past
decade.
play
critical
Journal of Microbiology Immunology and Infection,
Год журнала:
2023,
Номер
57(1), С. 128 - 137
Опубликована: Ноя. 3, 2023
Hypervirulent
carbapenem-resistant
Klebsiella
pneumoniae
(Hv-CRKP)
triggered
a
significant
public
health
challenge.
This
study
explored
the
prevalence
trends
and
key
genetic
characteristics
of
Hv-CRKP
in
one
Shanghai
suburbs
hospital
during
2014-2018.
During
five
years,
strains
identified
from
2579
CRKP
by
specific
PCR,
were
subjected
to
performed
short-
long-read
sequencing
technology;
epidemiological
characteristics,
antimicrobial-resistance
genes
(ARGs),
virulence
determinants,
detailed
plasmid
profiles
conjugation
efficiency
comprehensively
investigated.
155
31
non-Hv-CRKP
sequenced.
exhibited
resistance
six
common
antibiotic
classes
(>92%).
ST11
steadily
increased
became
most
prevalent
ST
(85.2%),
followed
ST15
(8.5%),
ST65
(2.6%),
ST23
(1.9%),
ST86
(0.6%).
ST11-KL64
(65.2%)
rapidly
0
2014
93.9%
2018.
blaKPC-2
was
primary
carbapenemase
gene
(97.4%).
Other
ARGs
switched
aac(3)-IId
aadA2
aminoglycoside
sul1
sul2
sulfanilamide.
The
time-dated
phylogenetic
tree
divided
into
four
independent
evolutionary
clades.
Clade
1
3
mostly
limited
ICU,
whereas
2
distributed
among
multiple
departments.
Compared
ybt14
ICEKp12
1,
harbored
ybt9
ICEKp3
blaCTX-M-65.
infected
more
wards
than
showed
greater
transmission
capacity.
Three
plasmids
containing
crucial
demonstrated
their
early
across
China.
has
replaced
ST11-KL47
emerged
as
predominant
epidemic
subtype
various
wards,
highlighting
importance
conducting
comprehensive
surveillance
for
Hv-CRKP,
especially
respiratory
infections.
Infection Genetics and Evolution,
Год журнала:
2023,
Номер
113, С. 105471 - 105471
Опубликована: Июнь 21, 2023
Hypervirulent
carbapenem-resistant
Klebsiella
pneumoniae
(hv-CRKP)
has
been
widely
reported
and
poses
a
global
threat.
However,
the
comprehensive
genetic
structure
of
ST11-KL64
hv-CRKP
possible
evolutionary
mechanisms
from
perspective
this
high-risk
clone
remain
unclear.
Here,
blaKPC-2-blaNDM-1-positive
isolate
was
obtained
human
bloodstream
infection
(BSI).
Whole-genome
sequencing
bioinformatics
analyses
revealed
that
it
contained
fusion
plasmid,
pKPTCM2-1.
pKPTCM2-1
is
conjugative
plasmid
composed
an
oriT-positive
pLVPK-like
virulence
type
IV
secretion
system-produced
blaNDM-1-bearing
IncX3
mediated
by
IS26-based
co-integration.
This
progress
generated
8-bp
target
site
duplications
(TGAAAACC)
on
both
sides.
The
possessed
self-transferability
could
be
transferred
to
blaKPC-2-harboring
CRKP
form
clone.
pLVPK-like-positive
strain
exhibited
levels
similar
those
typical
hypervirulent
K.
NTUH-2044.
mutation,
Tet(A)
(A276S),
which
believed
lead
tigecycline
resistance
observed.
Overall,
emerged
as
tremendous
threat
in
fatal
BSIs
thus,
targeted
surveillance
urgent
need
contain
clones.
Journal of Global Antimicrobial Resistance,
Год журнала:
2023,
Номер
35, С. 35 - 43
Опубликована: Авг. 22, 2023
Post-operative
central
nervous
system
infections
(PCNSIs)
caused
by
carbapenem-resistant
Enterobacteriaceae
(CRE)
frequently
result
in
unfavorable
outcomes.
However,
CRE
PCNSIs
have
not
been
well
described
from
a
clinical
and
microbiological
perspective.
A
total
of
254
cases
were
included
(Jan.2017-Jun.2020),
features
compared
based
on
pathogenic
classification.
Cox
regression
analysis
was
performed
to
assess
risk
factors
for
mortality.
Antibiotic
susceptibility
testing
whole
genome
sequencing
conducted
isolates
preserved.
MLST,
cgMLST,
resistance
genes
virulence
further
analyzed.
Among
PCNSI
cases,
15.4%
including
28
CRE.
The
28-day
mortality
rates
CRE,
CSE
Non-Enterobacteriaceae
50.0%,
27.3%,
7.4%,
respectively.
42.9%
(12/28)
the
patients
achieved
cure,
with
25.0%
clearance.
ST11-KL64
carrying
blaKPC-2
dominant
(17/23,
73.9%),
rate
its
infection
58.5%.
Most
CRKP
carried
rampA/rampA2
73.9%).
dominated
among
PCNSIs.
Targeted
anti-infective
combination
therapy
ceftazidime/avibactam
or
amikacin,
combined
intrathecal
administration
found
be
effective.
These
findings
render
new
insight
into
landscape
