1
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Kaneko M, Masuda Y, Sawachika H, Shikata H, Moriyama C, Miura M, Yamamoto H, Nakamura T, Fukumoto K, Utsunomiya Y, Sakai K, Ito Y, Ujike A, Asano Y, Shinomiya H. Isolation of OXA-48-like carbapenemase-producing Escherichia coli susceptible to piperacillin/tazobactam in a Japanese patient without a history of travel abroad. J Infect Chemother 2023; 29:530-533. [PMID: 36746274 DOI: 10.1016/j.jiac.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Oxacillinase (OXA)-48-like β-lactamases are the most common carbapenemases in Enterobacterales in certain regions of the world and are being introduced on a regular basis into regions of non-endemicity. Japan has been characterized by low rates of carbapenemase-producing Enterobacterales, and among them, OXA-48-like carbapenemase-producing isolates are extremely rare. Here we describe a Japanese medical worker, without a history of travel abroad, who was diagnosed as having a community-acquired urinary tract infection, and whose urine sample was found to be positive for OXA-48-like carbapenemase-producing Escherichia coli. None of her close contacts had a history of foreign travel, and the same drug-resistant organism was not observed in other patients who had been hospitalized and undergone environmental culture tests in the same medical institution. This isolate was resistant to penicillins, narrow-spectrum cephalosporins, fluoroquinolones, and cefmetazole, but was susceptible to broad-spectrum cephalosporins, piperacillin/tazobactam, and meropenem and displayed reduced susceptibility to imipenem. The modified carbapenem inactivation test supported carbapenemase production, but inhibitor-based synergistic tests yielded negative results of carbapenemase production. Multiplex polymerase chain reaction revealed the presence of the carbapenemase gene (blaOXA-48) blaTEM and AmpC β-lactamase gene (blaDHA). Singleplex polymerase chain reaction targeting the blaOXA-48 region amplified a product sequencing to nearly the full length (722 bp) and matching 100% with OXA-48. The present case highlights a new concern regarding OXA-48-like carbapenemase-producing Enterobacterales, which remain challenging to detect for clinical laboratories in regions of non-endemicity, and may already be latent in Japan.
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Affiliation(s)
- Masahiko Kaneko
- Department of Hematology, Uwajima City Hospital, Ehime, 798-8510, Japan.
| | - Yuya Masuda
- Department of Hematology, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Hiroshi Sawachika
- Department of Hematology, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Hisaharu Shikata
- Department of Hematology, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Chie Moriyama
- Clinical Laboratory Department, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Minako Miura
- Clinical Laboratory Department, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Hisato Yamamoto
- Department of Hepato-Biliary-Pancreatic Surgery, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Taro Nakamura
- Department of Hepato-Biliary-Pancreatic Surgery, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Komami Fukumoto
- Department of Pharmacy, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Yasushi Utsunomiya
- Department of Infection Control and Prevention, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Kyoko Sakai
- Department of Infection Control and Prevention, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Yuri Ito
- Department of Infection Control and Prevention, Uwajima City Hospital, Ehime, 798-8510, Japan
| | - Ayako Ujike
- Department of Microbiology, Ehime Prefectural Institute of Public Health and Environmental Science, Ehime, 791-0211, Japan
| | - Yukiko Asano
- Department of Microbiology, Ehime Prefectural Institute of Public Health and Environmental Science, Ehime, 791-0211, Japan
| | - Hiroto Shinomiya
- Department of Microbiology, Ehime Prefectural Institute of Public Health and Environmental Science, Ehime, 791-0211, Japan
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2
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Ragheb SM, Govinden U, Osei Sekyere J. Genetic support of carbapenemases: a One Health systematic review and meta-analysis of current trends in Africa. Ann N Y Acad Sci 2021; 1509:50-73. [PMID: 34753206 DOI: 10.1111/nyas.14703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/06/2021] [Accepted: 09/26/2021] [Indexed: 11/28/2022]
Abstract
Antimicrobial resistance (AMR) is a public health threat globally. Carbapenems are β-lactam antibiotics used as last-resort agents for treating antibiotic-resistant infections. Mobile genetic elements (MGEs) play an important role in the dissemination and expression of antimicrobial resistance genes (ARGs), including the mobilization of ARGs within and between species. The presence of MGEs around carbapenem-hydrolyzing enzymes, called carbapenemases, in bacterial isolates in Africa is concerning. The association between MGEs and carbapenemases is described herein. Specific plasmid replicons, integrons, transposons, and insertion sequences were found flanking specific and different carbapenemases across the same and different clones and species isolated from humans, animals, and the environment. Notably, similar genetic contexts have been reported in non-African countries, supporting the importance of MGEs in driving the intra- and interclonal and species transmission of carbapenemases in Africa and globally. Technical and budgetary limitations remain challenges for epidemiological analysis of carbapenemases in Africa, as studies undertaken with whole-genome sequencing remained relatively few. Characterization of MGEs in antibiotic-resistant infections can deepen our understanding of carbapenemase epidemiology and facilitate the control of AMR in Africa. Investment in genomic epidemiology will facilitate faster clinical interventions and containment of outbreaks.
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Affiliation(s)
- Suzan Mohammed Ragheb
- Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt
| | - Usha Govinden
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
| | - John Osei Sekyere
- Department of Microbiology & Immunology, Indiana University School of Medicine-Northwest, Gary, Indiana.,Department of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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3
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Bokhary H, Pangesti KNA, Rashid H, Abd El Ghany M, Hill-Cawthorne GA. Travel-Related Antimicrobial Resistance: A Systematic Review. Trop Med Infect Dis 2021; 6:11. [PMID: 33467065 PMCID: PMC7838817 DOI: 10.3390/tropicalmed6010011] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/26/2022] Open
Abstract
There is increasing evidence that human movement facilitates the global spread of resistant bacteria and antimicrobial resistance (AMR) genes. We systematically reviewed the literature on the impact of travel on the dissemination of AMR. We searched the databases Medline, EMBASE and SCOPUS from database inception until the end of June 2019. Of the 3052 titles identified, 2253 articles passed the initial screening, of which 238 met the inclusion criteria. The studies covered 30,060 drug-resistant isolates from 26 identified bacterial species. Most were enteric, accounting for 65% of the identified species and 92% of all documented isolates. High-income countries were more likely to be recipient nations for AMR originating from middle- and low-income countries. The most common origin of travellers with resistant bacteria was Asia, covering 36% of the total isolates. Beta-lactams and quinolones were the most documented drug-resistant organisms, accounting for 35% and 31% of the overall drug resistance, respectively. Medical tourism was twice as likely to be associated with multidrug-resistant organisms than general travel. International travel is a vehicle for the transmission of antimicrobial resistance globally. Health systems should identify recent travellers to ensure that adequate precautions are taken.
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Affiliation(s)
- Hamid Bokhary
- School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (K.N.A.P.); (G.A.H.-C.)
- University Medical Center, Umm Al-Qura University, Al Jamiah, Makkah, Makkah Region 24243, Saudi Arabia
- The Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead, NSW 2145, Australia; (H.R.); or (M.A.E.G.)
- The Westmead Institute for Medical Research, Westmead, NSW 2145, Australia
| | - Krisna N. A. Pangesti
- School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (K.N.A.P.); (G.A.H.-C.)
- The Westmead Institute for Medical Research, Westmead, NSW 2145, Australia
| | - Harunor Rashid
- The Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead, NSW 2145, Australia; (H.R.); or (M.A.E.G.)
- National Centre for Immunisation Research and Surveillance (NCIRS), Kids Research, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Moataz Abd El Ghany
- The Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Westmead, NSW 2145, Australia; (H.R.); or (M.A.E.G.)
- The Westmead Institute for Medical Research, Westmead, NSW 2145, Australia
- The Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Grant A. Hill-Cawthorne
- School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; (K.N.A.P.); (G.A.H.-C.)
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4
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Brahmia S, Lalaoui R, Nedjai S, Djahmi N, Chettibi S, Rolain JM, Bakour S. First Clinical Cases of KPC-2-Producing Klebsiella pneumoniae ST258 in Algeria and Outbreak of Klebsiella pneumoniae ST101 Harboring blaOXA-48 Gene in the Urology Department of Annaba Hospital. Microb Drug Resist 2020; 27:652-659. [PMID: 32991248 DOI: 10.1089/mdr.2020.0080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objectives: The aim of this study was to characterize the molecular mechanisms of carbapenem resistance in Klebsiella pneumoniae isolated from the urology department of Annaba hospital, Algeria. Methods: Between January 2015 and September 2017, 14 carbapenem-resistant K. pneumoniae strains were isolated during routine surveillance work at Ibn Roched hospital of Annaba, Algeria, from the urology department. Theses strains were recovered, and carbapenem resistance mechanisms were investigated. The strains were identified by using matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. Antibiotic susceptibility was assessed by using the Kirby-Bauer method, whereas minimum inhibitory concentration of imipenem/ertapenem and colistin was determined by Etest and broth microdilution methods, respectively. Carbapenem resistance determinants were studied by using PCR and sequencing methods and analyzed by BLAST against the Antibiotic Resistance Gene-ANNOTation (ARG-ANNOT) database. Clonal relationship of strains was performed by using multilocus sequence typing (MLST). Transferability of carbapenem resistance genes was assessed by conjugation and transformation experiments. Results: Fourteen carbapenem-resistant K. pneumoniae isolates were found to be resistant to the eight β-lactam antibiotics tested (except to imipenem for two isolates). Carbapenemase production was positive for all isolates. Molecular characterization revealed that blaKPC-2 and blaOXA-48 genes were detected in 3 (21.4%) and 11 isolates (78.6%), respectively. Other β-lactamases genes were identified, including blaCTX-M-15, blaSHV-1-or 12, and blaTEM-1. MLST revealed that the 14 isolates belonged to 2 different sequence types (STs), including ST101 (11 OXA-48-producing K. pneumoniae) and ST258 (3 KPC-2-producing K. pneumoniae). PCR amplifications for blaKPC-2 and blaOXA-48 carbapenemases genes performed on extracted plasmids, showed positive results, suggesting that both carbapenemase genes were probably borne by plasmids. Conclusion: We report here the first identification of KPC-2-producing K. pneumoniae ST258 in Algerian hospitals and an outbreak of OXA-48-producing K. pneumoniae isolates ST101 in the urology department of Ibn Roched hospital located in Annaba, Algeria.
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Affiliation(s)
- Safa Brahmia
- Laboratoire de Biochimie et de Microbiologie Appliquée, Département de Biochimie, Université Badji Mokhtar-Annaba, Annaba, Algérie.,Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Rym Lalaoui
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Sabrina Nedjai
- Laboratoire de Microbiologie Central, CHU Dorban, Faculté de Médecine, Université Badji Mokhtar-Annaba, Annaba, Algérie
| | - Nassima Djahmi
- Laboratoire de Microbiologie Central, CHU Dorban, Faculté de Médecine, Université Badji Mokhtar-Annaba, Annaba, Algérie
| | - Samir Chettibi
- Service de Chirurgie Urologique, Transplantation, CHU d'Annaba, Annaba, Algérie
| | - Jean-Marc Rolain
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Sofiane Bakour
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
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5
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Nakayama T, Kumeda Y, Kawahara R, Yamamoto Y. Quantification and long-term carriage study of human extended-spectrum/AmpC β-lactamase-producing Escherichia coli after international travel to Vietnam. J Glob Antimicrob Resist 2020; 21:229-234. [DOI: 10.1016/j.jgar.2019.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/05/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022] Open
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6
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Ohmagari N. National Action Plan on Antimicrobial Resistance (AMR) 2016-2020 and relevant activities in Japan. Glob Health Med 2019; 1:71-77. [PMID: 33330758 DOI: 10.35772/ghm.2019.01017] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/25/2019] [Accepted: 12/15/2019] [Indexed: 11/08/2022]
Abstract
Antimicrobial-resistant bacteria that are spreading all over the world have caused significant problems. While these problems are becoming bigger, the development of new antimicrobials has remained stagnant, and some essential antimicrobials for treatment may be depleted in the near future. This is a significant problem that may jeopardize the sustainability of healthcare itself. In Japan, the National Action Plan on Antimicrobial Resistance was established in April 2016. Based on the five strategic objectives set out in the World Health Organization's Global Action Plan on Antimicrobial Resistance, and by adding a 6th objective of international cooperation as a Japanese unique goal, the goals, strategies and specific actions of each of these six fields are presented. This Action Plan is significantly characterized by setting numerical targets as a performance index to be achieved by 2020.
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Affiliation(s)
- Norio Ohmagari
- AMR Clinical Reference Center, Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
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7
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Yousfi H, Hadjadj L, Dandachi I, Lalaoui R, Merah A, Amoura K, Dahi A, Dekhil M, Messalhi N, Diene SM, Baron S, Rolain JM. Colistin- and Carbapenem-Resistant Klebsiella pneumoniae Clinical_Isolates: Algeria. Microb Drug Resist 2018; 25:258-263. [PMID: 30256174 DOI: 10.1089/mdr.2018.0147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study investigates the molecular mechanisms of colistin and carbapenem resistance in Klebsiella pneumoniae ST101 strains. The three K. pneumoniae carried blaCTX-M-15, blaTEM-183, and blaSHV-106 genes and two coharbored blaOXA-48. As for colistin resistance, the isolates had amino acid substitutions in PmrA/B and a truncated mgrB gene in one isolate.
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Affiliation(s)
- Hanane Yousfi
- 1 Aix Marseille University , IRD, APHM, MEPHI, IHU-Mediterranean Infection, Marseille, France
| | - Linda Hadjadj
- 1 Aix Marseille University , IRD, APHM, MEPHI, IHU-Mediterranean Infection, Marseille, France
| | - Iman Dandachi
- 1 Aix Marseille University , IRD, APHM, MEPHI, IHU-Mediterranean Infection, Marseille, France
| | - Rym Lalaoui
- 1 Aix Marseille University , IRD, APHM, MEPHI, IHU-Mediterranean Infection, Marseille, France
| | - Adil Merah
- 2 Microbiology Department, Annaba University Hospital , Annaba, Algeria
| | - Kamel Amoura
- 2 Microbiology Department, Annaba University Hospital , Annaba, Algeria .,3 Department of Infectious Diseases, Annaba University Hospital , Annaba, Algeria
| | - Ahlem Dahi
- 2 Microbiology Department, Annaba University Hospital , Annaba, Algeria .,3 Department of Infectious Diseases, Annaba University Hospital , Annaba, Algeria
| | - Mazouz Dekhil
- 2 Microbiology Department, Annaba University Hospital , Annaba, Algeria .,3 Department of Infectious Diseases, Annaba University Hospital , Annaba, Algeria
| | - Naima Messalhi
- 2 Microbiology Department, Annaba University Hospital , Annaba, Algeria .,3 Department of Infectious Diseases, Annaba University Hospital , Annaba, Algeria
| | - Seydina M Diene
- 1 Aix Marseille University , IRD, APHM, MEPHI, IHU-Mediterranean Infection, Marseille, France
| | - Sophie Baron
- 1 Aix Marseille University , IRD, APHM, MEPHI, IHU-Mediterranean Infection, Marseille, France
| | - Jean-Marc Rolain
- 1 Aix Marseille University , IRD, APHM, MEPHI, IHU-Mediterranean Infection, Marseille, France
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8
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Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates. PLoS One 2018; 13:e0198526. [PMID: 29883490 PMCID: PMC5993281 DOI: 10.1371/journal.pone.0198526] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/21/2018] [Indexed: 12/21/2022] Open
Abstract
The emergence and dissemination of carbapenemases, bacterial enzymes able to inactivate most β-lactam antibiotics, in Enterobacteriaceae is of increasing concern. The concurrent spread of resistance against colistin, an antibiotic of last resort, further compounds this challenge further. Whole-genome sequencing (WGS) can play a significant role in the rapid and accurate detection/characterization of existing and emergent resistance determinants, an essential aspect of public health surveillance and response activities to combat the spread of antimicrobial resistant bacteria. In the current study, WGS data was used to characterize the genomic content of antimicrobial resistance genes, including those encoding carbapenemases, in 10 multidrug-resistant Klebsiella pneumoniae isolates from Pakistan. These clinical isolates represented five sequence types: ST11 (n = 3 isolates), ST14 (n = 3), ST15 (n = 1), ST101 (n = 2), and ST307 (n = 1). Resistance profiles against 25 clinically-relevant antimicrobials were determined by broth microdilution; resistant phenotypes were observed for at least 15 of the 25 antibiotics tested in all isolates except one. Specifically, 8/10 isolates were carbapenem-resistant and 7/10 isolates were colistin-resistant. The blaNDM-1 and blaOXA-48 carbapenemase genes were present in 7/10 and 5/10 isolates, respectively; including 2 isolates carrying both genes. No plasmid-mediated determinants for colistin resistance (e.g. mcr) were detected, but disruptions and mutations in chromosomal loci (i.e. mgrB and pmrB) previously reported to confer colistin resistance were observed. A blaOXA-48-carrying IncL/M-type plasmid was found in all blaOXA-48-positive isolates. The application of WGS to molecular epidemiology and surveillance studies, as exemplified here, will provide both a more complete understanding of the global distribution of MDR isolates and a robust surveillance tool useful for detecting emerging threats to public health.
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9
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Hayakawa K, Mezaki K, Sugiki Y, Nagamatsu M, Miyoshi-Akiyama T, Kirikae T, Kutsuna S, Takeshita N, Yamamoto K, Katanami Y, Ohmagari N. High rate of multidrug-resistant organism colonization among patients hospitalized overseas highlights the need for preemptive infection control. Am J Infect Control 2016; 44:e257-e259. [PMID: 27810070 DOI: 10.1016/j.ajic.2016.06.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 06/21/2016] [Accepted: 06/21/2016] [Indexed: 11/17/2022]
Abstract
We performed 4 years of active screening for multidrug resistant organism (MDRO) colonization among patients with a history of overseas hospitalization. Thirteen (56.5%) of 23 cases were positive for MDROs, which highlights the importance of preemptive infection control to prevent the spread of MDROs in this population.
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Affiliation(s)
- Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Kazuhisa Mezaki
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuko Sugiki
- Infection Control and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Nagamatsu
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Miyoshi-Akiyama
- Pathogenic Microbe Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Teruo Kirikae
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuichi Katanami
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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10
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Travel to Asia and traveller's diarrhoea with antibiotic treatment are independent risk factors for acquiring ciprofloxacin-resistant and extended spectrum β-lactamase-producing Enterobacteriaceae —a prospective cohort study. Clin Microbiol Infect 2016; 22:731.e1-7. [DOI: 10.1016/j.cmi.2016.05.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 04/29/2016] [Accepted: 05/03/2016] [Indexed: 01/16/2023]
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11
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Lee CR, Lee JH, Park KS, Kim YB, Jeong BC, Lee SH. Global Dissemination of Carbapenemase-Producing Klebsiella pneumoniae: Epidemiology, Genetic Context, Treatment Options, and Detection Methods. Front Microbiol 2016; 7:895. [PMID: 27379038 PMCID: PMC4904035 DOI: 10.3389/fmicb.2016.00895] [Citation(s) in RCA: 456] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/26/2016] [Indexed: 01/08/2023] Open
Abstract
The emergence of carbapenem-resistant Gram-negative pathogens poses a serious threat to public health worldwide. In particular, the increasing prevalence of carbapenem-resistant Klebsiella pneumoniae is a major source of concern. K. pneumoniae carbapenemases (KPCs) and carbapenemases of the oxacillinase-48 (OXA-48) type have been reported worldwide. New Delhi metallo-β-lactamase (NDM) carbapenemases were originally identified in Sweden in 2008 and have spread worldwide rapidly. In this review, we summarize the epidemiology of K. pneumoniae producing three carbapenemases (KPCs, NDMs, and OXA-48-like). Although the prevalence of each resistant strain varies geographically, K. pneumoniae producing KPCs, NDMs, and OXA-48-like carbapenemases have become rapidly disseminated. In addition, we used recently published molecular and genetic studies to analyze the mechanisms by which these three carbapenemases, and major K. pneumoniae clones, such as ST258 and ST11, have become globally prevalent. Because carbapenemase-producing K. pneumoniae are often resistant to most β-lactam antibiotics and many other non-β-lactam molecules, the therapeutic options available to treat infection with these strains are limited to colistin, polymyxin B, fosfomycin, tigecycline, and selected aminoglycosides. Although, combination therapy has been recommended for the treatment of severe carbapenemase-producing K. pneumoniae infections, the clinical evidence for this strategy is currently limited, and more accurate randomized controlled trials will be required to establish the most effective treatment regimen. Moreover, because rapid and accurate identification of the carbapenemase type found in K. pneumoniae may be difficult to achieve through phenotypic antibiotic susceptibility tests, novel molecular detection techniques are currently being developed.
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Affiliation(s)
- Chang-Ro Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Jung Hun Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Kwang Seung Park
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Young Bae Kim
- Division of STEM, North Shore Community College, Danvers MA, USA
| | - Byeong Chul Jeong
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
| | - Sang Hee Lee
- National Leading Research Laboratory of Drug Resistance Proteomics, Department of Biological Sciences, Myongji University Yongin, South Korea
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12
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Jamal WY, Albert MJ, Khodakhast F, Poirel L, Rotimi VO. Emergence of New Sequence Type OXA-48 Carbapenemase-ProducingEnterobacteriaceaein Kuwait. Microb Drug Resist 2015; 21:329-34. [DOI: 10.1089/mdr.2014.0123] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Wafaa Y. Jamal
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
- Microbiology Unit, Mubarak Al-Kabir Hospital, Jabriya, Kuwait
| | - M. John Albert
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
- Microbiology Unit, Mubarak Al-Kabir Hospital, Jabriya, Kuwait
| | - Fatima Khodakhast
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
- Microbiology Unit, Mubarak Al-Kabir Hospital, Jabriya, Kuwait
| | - Laurent Poirel
- Medical and Molecular Microbiology Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland
- INSERM U914, South-Paris Medical School, K.-Bicêtre, Paris, France
| | - Vincent O. Rotimi
- Department of Microbiology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
- Microbiology Unit, Mubarak Al-Kabir Hospital, Jabriya, Kuwait
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Tojo M, Mawatari M, Hayakawa K, Nagamatsu M, Shimada K, Mezaki K, Sugiki Y, Kuroda E, Takeshita N, Kutsuna S, Fujiya Y, Miyoshi-Akiyama T, Kirikae T, Ohmagari N. Multidrug-resistant Acinetobactor baumannii isolated from a traveler returned from Brunei. J Infect Chemother 2014; 21:212-4. [PMID: 25444675 DOI: 10.1016/j.jiac.2014.08.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/09/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022]
Abstract
We report a case of multidrug-resistant (MDR) Acinetobactor baumannii isolates obtained from a traveler returned from Brunei. Whole-genome sequencing analysis revealed that the isolates harbored blaOxA-23 and armA. The minimum inhibitory concentrations of antibiotics against the strain were as follows: imipenem, 32 μg/ml; meropenem, 32 μg/ml; ciprofloxacin, 16 μg/ml; amikacin, ≧ 1024 μg/ml; arbekacin, ≧ 1024 μg/ml; aztreonam, 64 μg/ml; colistin, 4 μg/ml. A. baumannii harboring both blaOxA-23 and armA is rarely reported in Japan, and, to the best of our knowledge, this is the second report of A. baumannii harboring both resistant genes in Japan.
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Affiliation(s)
- Masayoshi Tojo
- Department of Anatomy and Embryology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Disease Control and Prevention Center, Japan; Department of Infectious Diseases, Research Institute, Japan
| | | | | | - Maki Nagamatsu
- Disease Control and Prevention Center, Japan; Department of Infectious Diseases, Research Institute, Japan
| | - Kayo Shimada
- Department of Infectious Diseases, Research Institute, Japan
| | | | - Yuko Sugiki
- Infection Control and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Emi Kuroda
- Infection Control and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | | | | | - Teruo Kirikae
- Department of Infectious Diseases, Research Institute, Japan.
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