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Poren Hsueh - One of the best experts on this subject based on the ideXlab platform.

  • distribution of extended spectrum β lactamases ampc β lactamases and carbapenemases among Enterobacteriaceae isolates causing intra abdominal infections in the asia pacific region results of the study for monitoring antimicrobial resistance trends sm
    Antimicrobial Agents and Chemotherapy, 2013
    Co-Authors: Wanghuei Sheng, R Badal, Poren Hsueh
    Abstract:

    The increasing trend of β-lactam resistance among Enterobacteriaceae is a worldwide threat. Enterobacteriaceae isolates causing intra-abdominal infections (IAI) from the Study for Monitoring Antimicrobial Resistance Trends (SMART) collected in 2008 and 2009 from the Asia-Pacific region were investigated. Detection of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, and carbapenemases was performed by multiplex PCR. A total of 699 Enterobacteriaceae isolates with positive genotypic results, included Escherichia coli (n = 443), Klebsiella pneumoniae (n = 187), Enterobacter cloacae (n = 45), Klebsiella oxytoca (n = 9), Citrobacter freundii (n = 5), Proteus mirabilis (n = 3), Enterobacter aerogenes (n = 2), Morganella morganii (n = 2), and one each of Enterobacter asburiae, Proteus vulgaris, and Providencia rettgeri were analyzed. Nearly 20% of these β-lactamase-producing Enterobacteriaceae isolates were from community-associated IAI. CTX-M (588 isolates, including 428 [72.8%] with CTX-M-15) was the most common ESBL, followed by SHV (n = 59) and TEM (n = 4). CMY (n = 110, including 102 [92.7%] with CMY-2) was the most common AmpC β-lactamase, followed by DHA (n = 46) and ACT/MIR (n = 40). NDM (n = 65, including 62 [95.4%] with NDM-1) was the most common carbapenemase, followed by IMP (n = 7) and OXA (n = 7). Isolates from hospital-associated IAI had more complicated β-lactamase combinations than isolates from the community. Carbapenemases were all exclusively detected in Enterobacteriaceae isolates from India, except that IMP β-lactamases were also detected in Philippines and Australia. CTX-M β-lactamases were the predominant ESBLs produced by Enterobacteriaceae causing IAI in the Asia-Pacific region. Emergence of CTX-M-15-, CMY-2-, and NDM-1-producing Enterobacteriaceae isolates is of major concern and highlights the need for further surveillance in this area.

  • new delhi metallo β lactamase 1 ndm 1 an emerging threat among Enterobacteriaceae
    Journal of the Formosan Medical Association, 2010
    Co-Authors: Poren Hsueh
    Abstract:

    Infections with carbapenem-resistant Enterobacteriaceae, particularly Klebsiella pneumoniae, is emerging as an important challenge in healthcare settings worldwide.1 Enterobacteriaceae isolates can display resistance to carbapenems by overexpression of Amp-C β-lactamases and extended spectrum β-lactamases (ESBLs) associated with loss of outer membrane porins; overexpression of efflux pumps; and the production of various carbapenemases including metallo-β-lactamases (MBLs; blaIMP, blaVIM, and KHM-1) and K. pneumoniae carbapenemases (KPCs).2,3 New Delhi metallo-β-lactamase 1 (NDM-1), a new type of carbapenemase, was first identified in an isolate from a 59-year-old Swedish man of Indian origin, who was admitted in New Delhi due to K. pneumoniae urinary tract infection in 2008.4 As of September 18, 2010, NDM-1 has been identified in India, Pakistan, Bangladesh, the United Kingdom, the United States, the Netherlands, Australia, Kenya, and Canada; and continues to attract great attention worldwide.4–9 This new NDM-1 has been recently identified in several Enterobacteriacae isolates causing communityonset (e.g. urinary tract infection) or healthcareassociated infections (e.g. bacteremia and ventilator-associated pneumonia).4–9 The species of the isolates harboring this enzyme included K. pneumoniae, Escherichia coli, Enterobacter spp., Citrobacter freundii, Morganella morganii, and Providencia spp.4–9 The metallo-β-lactamase gene for NDM-1 (blaNDM-1) is located on plasmids 50–350 kb in Chennai isolates, 50 kb and 118 kb in Haryana isolates, and 80–500 kb in the United Kingdom isolates.6–8 Several isolates in the United Kingdom harbor the blaNDM-1 gene, suggesting an in situ translocation of blaNDM-1. The blaNDM-1 gene, together with other coexisting resistance mechanisms, confers a high rate of resistance (>90%) to carbapenems (imipenem, meropenem, and ertapenem) and other β-lactams, aztreonam, aminoglycosides, and fluoroquinolones.4–9 The susceptibility rates of isolates from three different regions [United Kingdom (n = 37), Chennaisouth India (n = 44) and Haryana-north India

Neil Woodford - One of the best experts on this subject based on the ideXlab platform.

  • nxl104 combinations versus Enterobacteriaceae with ctx m extended spectrum β lactamases and carbapenemases
    Journal of Antimicrobial Chemotherapy, 2008
    Co-Authors: David M Livermore, Shazad Mushtaq, Marina Warner, Christine Miossec, Neil Woodford
    Abstract:

    Background :T heb-lactamase landscape is changing radically, with CTX-M types now the most prevalent extended-spectrum b-lactamases (ESBLs) worldwide, except maybe in the USA. In addition, there are growing numbers of Enterobacteriaceae with KPC and metallo-carbapenemases. We examined whether combinations of oxyimino-cephalosporins with NXL104, a novel non-b-lactam b-lactamase inhibitor, overcame these resistances. Methods: NXL104 was tested at 4 mg/L in combination with cefotaxime and ceftazidime versus: (i) Escherichia coli transconjugants and wild-type Enterobacteriaceae with CTX-M ESBLs; (ii) Enterobacteriaceae with ertapenem resistance contingent on combinations of impermeability and ESBLs or AmpC; and (iii) Enterobacteriaceae with KPC, SME, metallo- or OXA-48 carbapenemases.

Detchvijitr Suwanpakdee - One of the best experts on this subject based on the ideXlab platform.

  • Clinical epidemiology, risk factors and treatment outcomes of extended-spectrum beta-lactamase producing Enterobacteriaceae bacteremia among children in a Tertiary Care Hospital, Bangkok, Thailand
    BMC Research Notes, 2018
    Co-Authors: Thirapa Nivesvivat, Phunlerd Piyaraj, Sudaluck Thunyaharn, Veerachai Watanaveeradej, Detchvijitr Suwanpakdee
    Abstract:

    Objective Extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae infection is an emerging problem in paediatric populations leading to increased mortality. The purpose of this study was to determine the prevalence, risk factors and clinical outcomes of ESBL-producing Enterobacteriaceae in paediatric blood stream infections (BSIs). A retrospective review of paediatric patients diagnosed with Enterobacteriaceae bacteremia was performed at Phramongkutklao Hospital from 2010 to 2017. Results Among 97 non-duplicated blood isolates, the prevalence of ESBL-producing Enterobacteriaceae was 53.6% (28.9% Escherichia coli and 25.8% Klebsiella spp. isolates). The study indicated that the prevalence of ESBL infection was higher among patients with chronic illness, especially hematologic malignancies, than among patients without underlying disease (P = 0.01). No differences were observed in the prior use of any antibiotics, the use of extended-spectrum cephalosporin, neutropaenia or the presence of an indwelling central venous catheter. Mortality in the ESBL group was significantly higher than that in the non-ESBL group, with observed mortalities of 38.9% and 13.3%, respectively (P 

Chi Cheng - One of the best experts on this subject based on the ideXlab platform.

  • Bacteriophage therapy against Enterobacteriaceae
    Virologica Sinica, 2015
    Co-Authors: Youqiang Xu, Jiangsen Pei, Su Yao, Yong Liu, Chi Cheng
    Abstract:

    The Enterobacteriaceae are a class of gram-negative facultative anaerobic rods, which can cause a variety of diseases, such as bacteremia, septic arthritis, endocarditis, osteomyelitis, lower respiratory tract infections, skin and soft-tissue infections, urinary tract infections, intra-abdominal infections and ophthalmic infections, in humans, poultry, animals and fish. Disease caused by Enterobacteriaceae cause the deaths of millions of people every year, resulting in enormous economic loss. Drug treatment is a useful and efficient way to control Enterobacteriaceae infections. However, with the abuse of antibiotics, drug resistance has been found in growing number of Enterobacteriaceae infections and, as such, there is an urgent need to find new methods of control. Bacteriophage therapy is an efficient alternative to antibiotics as it employs a different antibacterial mechanism. This paper summarizes the history of bacteriophage therapy, its bacterial lytic mechanisms, and the studies that have focused on Enterobacteriaceae and bacteriophage therapy.

Johann D. D. Pitout - One of the best experts on this subject based on the ideXlab platform.

  • Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Update on Molecular Epidemiology and Treatment Options
    Drugs, 2019
    Co-Authors: Gisele Peirano, Johann D. D. Pitout
    Abstract:

    Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are a major global public health concern. Presently, Escherichia coli with CTX-Ms are the most common species associated with global ESBLs; CTX-M-15 is the most frequent CTX-M worldwide and is followed by CTX-M-14, which is often found in South-East Asia. Recent surveillance studies showed that CTX-M-27 is emerging in certain parts of the world especially in Japan and Europe. The population structure of ESBL-producing E. coli is dominated globally by an high-risk clone named ST131. Escherichia coli ST131 belongs to three clades (A, B, and C) and three different subclades (C1, C1-M27, and C2). Clade C1-M27 is associated with bla _CTX-M-27, and C2 with bla _CTX-M-15. Recent whole genome sequencing studies have shown that clade C has evolved from clade B in a stepwise fashion, resulting in one of the most influential global antimicrobial resistance clones that has emerged during the 2000’s. Other important E. coli clones that have been detected among ESBL producers include ST405, ST38, ST648, ST410, and ST1193. The INCREMENT project has shown that ertapenem is as effective as other carbapenems for treating serious infections due to ESBL-producing Enterobacteriaceae. The results of the MERINO open-label randomized controlled study has provided clear evidence that piperacillin-tazobactam should be avoided for targeted therapy of blood-stream infections due to ESBL-producing E. coli and K. pneumoniae, regardless of the patient population, source of infection, bacterial species, and susceptibility result of piperacillin-tazobactam. Research is still warranted to define the optimal therapy of less severe infections due to ESBL-producing Enterobactericeae.

  • the role of international travel in the worldwide spread of multiresistant Enterobacteriaceae
    Journal of Antimicrobial Chemotherapy, 2012
    Co-Authors: Johann D. D. Pitout
    Abstract:

    : From international tourists to war-displaced refugees, more people are on the move than ever before. This provides the opportunity for a variety of antimicrobial-resistant bacteria to be carried from one geographic location to another. The Enterobacteriaceae are among the most important causes of serious hospital-acquired and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these bacteria has become an increasingly relevant problem. International travel and tourism are important modes for the acquisition and spread of antimicrobial-resistant Enterobacteriaceae, especially CTX-M-producing Escherichia coli. Infections with KPC-, VIM-, OXA-48- and NDM-producing Enterobacteriaceae in developed countries have been associated with visiting and being hospitalized in endemic areas such as the USA, Greece and Israel for KPCs, Greece for VIMs, Turkey for OXA-48, and the Indian subcontinent for NDMs. To combat the spread of antimicrobial-resistant Enterobacteriaceae, the French Healthcare Safety Advisory Committee recently issued national recommendations for screening and contact isolation precautions for patients transferred from, or hospitalized outside, France. For effective public and patient health interventions, it is important to understand the role of international travel in the spread of antimicrobial-resistant Enterobacteriaceae. We urgently need well-designed studies to evaluate the transmission potential and risks for colonization and infections due to multiresistant Enterobacteriaceae in travellers who have recently visited or have been hospitalized in endemic areas. The emergence of CTX-M-, KPC- and NDM-producing bacteria is a good example of the role that globalization plays in the rapid dissemination of new antibiotic resistance mechanisms.