Carbapenems: A group of beta-lactam antibiotics in which the sulfur atom in the thiazolidine ring of the penicillin molecule is replaced by a carbon atom. THIENAMYCINS are a subgroup of carbapenems which have a sulfur atom as the first constituent of the side chain.Thienamycins: Beta-lactam antibiotics that differ from PENICILLINS in having the thiazolidine sulfur atom replaced by carbon, the sulfur then becoming the first atom in the side chain. They are unstable chemically, but have a very broad antibacterial spectrum. Thienamycin and its more stable derivatives are proposed for use in combinations with enzyme inhibitors.beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins.Imipenem: Semisynthetic thienamycin that has a wide spectrum of antibacterial activity against gram-negative and gram-positive aerobic and anaerobic bacteria, including many multiresistant strains. It is stable to beta-lactamases. Clinical studies have demonstrated high efficacy in the treatment of infections of various body systems. Its effectiveness is enhanced when it is administered in combination with CILASTATIN, a renal dipeptidase inhibitor.beta-Lactam Resistance: Nonsusceptibility of bacteria to the action of the beta-lactam antibiotics. Mechanisms responsible for beta-lactam resistance may be degradation of antibiotics by BETA-LACTAMASES, failure of antibiotics to penetrate, or low-affinity binding of antibiotics to targets.Anti-Bacterial Agents: Substances that reduce the growth or reproduction of BACTERIA.beta-Lactams: Four-membered cyclic AMIDES, best known for the PENICILLINS based on a bicyclo-thiazolidine, as well as the CEPHALOSPORINS based on a bicyclo-thiazine, and including monocyclic MONOBACTAMS. The BETA-LACTAMASES hydrolyze the beta lactam ring, accounting for BETA-LACTAM RESISTANCE of infective bacteria.Acinetobacter baumannii: A species of gram-negative, aerobic bacteria, commonly found in the clinical laboratory, and frequently resistant to common antibiotics.Microbial Sensitivity Tests: Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses).Enterobacteriaceae Infections: Infections with bacteria of the family ENTEROBACTERIACEAE.Klebsiella pneumoniae: Gram-negative, non-motile, capsulated, gas-producing rods found widely in nature and associated with urinary and respiratory infections in humans.Acinetobacter Infections: Infections with bacteria of the genus ACINETOBACTER.Drug Resistance, Multiple, Bacterial: The ability of bacteria to resist or to become tolerant to several structurally and functionally distinct drugs simultaneously. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS).Pseudomonas aeruginosa: A species of gram-negative, aerobic, rod-shaped bacteria commonly isolated from clinical specimens (wound, burn, and urinary tract infections). It is also found widely distributed in soil and water. P. aeruginosa is a major agent of nosocomial infection.Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method.Enterobacteriaceae: A family of gram-negative, facultatively anaerobic, rod-shaped bacteria that do not form endospores. Its organisms are distributed worldwide with some being saprophytes and others being plant and animal parasites. Many species are of considerable economic importance due to their pathogenic effects on agriculture and livestock.Gram-Negative Bacterial Infections: Infections caused by bacteria that show up as pink (negative) when treated by the gram-staining method.Drug Resistance, Bacterial: The ability of bacteria to resist or to become tolerant to chemotherapeutic agents, antimicrobial agents, or antibiotics. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS).Klebsiella Infections: Infections with bacteria of the genus KLEBSIELLA.Cilastatin: A renal dehydropeptidase-I and leukotriene D4 dipeptidase inhibitor. Since the antibiotic, IMIPENEM, is hydrolyzed by dehydropeptidase-I, which resides in the brush border of the renal tubule, cilastatin is administered with imipenem to increase its effectiveness. The drug also inhibits the metabolism of leukotriene D4 to leukotriene E4.Pseudomonas Infections: Infections with bacteria of the genus PSEUDOMONAS.Dipeptidases: EXOPEPTIDASES that specifically act on dipeptides. EC 3.4.13.Acinetobacter: A genus of gram-negative bacteria of the family MORAXELLACEAE, found in soil and water and of uncertain pathogenicity.Cross Infection: Any infection which a patient contracts in a health-care institution.Enterobacter cloacae: A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that occurs in water, sewage, soil, meat, hospital environments, and on the skin and in the intestinal tract of man and animals as a commensal.Cephalosporins: A group of broad-spectrum antibiotics first isolated from the Mediterranean fungus ACREMONIUM. They contain the beta-lactam moiety thia-azabicyclo-octenecarboxylic acid also called 7-aminocephalosporanic acid.Lactams: Cyclic AMIDES formed from aminocarboxylic acids by the elimination of water. Lactims are the enol forms of lactams.Glycosuria, Renal: An autosomal inherited disorder due to defective reabsorption of GLUCOSE by the PROXIMAL RENAL TUBULES. The urinary loss of glucose can reach beyond 50 g/day. It is attributed to the mutations in the SODIUM-GLUCOSE TRANSPORTER 2 encoded by the SLC5A2 gene.Clavulanic Acid: Clavulanic acid and its salts and esters. The acid is a suicide inhibitor of bacterial beta-lactamase enzymes from Streptomyces clavuligerus. Administered alone, it has only weak antibacterial activity against most organisms, but given in combination with other beta-lactam antibiotics it prevents antibiotic inactivation by microbial lactamase.Penicillanic Acid: A building block of penicillin, devoid of significant antibacterial activity. (From Merck Index, 11th ed)Bacterial Proteins: Proteins found in any species of bacterium.Porins: Porins are protein molecules that were originally found in the outer membrane of GRAM-NEGATIVE BACTERIA and that form multi-meric channels for the passive DIFFUSION of WATER; IONS; or other small molecules. Porins are present in bacterial CELL WALLS, as well as in plant, fungal, mammalian and other vertebrate CELL MEMBRANES and MITOCHONDRIAL MEMBRANES.Gram-Positive Bacteria: Bacteria which retain the crystal violet stain when treated by Gram's method.Serratia Infections: Infections with bacteria of the genus SERRATIA.Ceftazidime: Semisynthetic, broad-spectrum antibacterial derived from CEPHALORIDINE and used especially for Pseudomonas and other gram-negative infections in debilitated patients.Hospitals: Institutions with an organized medical staff which provide medical care to patients.Klebsiella oxytoca: A species of gram-negative bacteria causing URINARY TRACT INFECTIONS and SEPTICEMIA.Formularies, Hospital: Formularies concerned with pharmaceuticals prescribed in hospitals.Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion.Aeromonas hydrophila: A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that may be pathogenic for frogs, fish, and mammals, including man. In humans, cellulitis and diarrhea can result from infection with this organism.Peptidyl Transferases: Acyltransferases that use AMINO ACYL TRNA as the amino acid donor in formation of a peptide bond. There are ribosomal and non-ribosomal peptidyltransferases.Integrons: DNA elements that include the component genes and insertion site for a site-specific recombination system that enables them to capture mobile gene cassettes.Electrophoresis, Gel, Pulsed-Field: Gel electrophoresis in which the direction of the electric field is changed periodically. This technique is similar to other electrophoretic methods normally used to separate double-stranded DNA molecules ranging in size up to tens of thousands of base-pairs. However, by alternating the electric field direction one is able to separate DNA molecules up to several million base-pairs in length.Conjugation, Genetic: A parasexual process in BACTERIA; ALGAE; FUNGI; and ciliate EUKARYOTA for achieving exchange of chromosome material during fusion of two cells. In bacteria, this is a uni-directional transfer of genetic material; in protozoa it is a bi-directional exchange. In algae and fungi, it is a form of sexual reproduction, with the union of male and female gametes.Serratia marcescens: A species of gram-negative, facultatively anaerobic, rod-shaped bacteria found in soil, water, food, and clinical specimens. It is a prominent opportunistic pathogen for hospitalized patients.Colistin: Cyclic polypeptide antibiotic from Bacillus colistinus. It is composed of Polymyxins E1 and E2 (or Colistins A, B, and C) which act as detergents on cell membranes. Colistin is less toxic than Polymyxin B, but otherwise similar; the methanesulfonate is used orally.Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.Bacteroides fragilis: Gram-negative bacteria occurring in the lower intestinal tracts of man and other animals. It is the most common species of anaerobic bacteria isolated from human soft tissue infections.Drug Resistance, Microbial: The ability of microorganisms, especially bacteria, to resist or to become tolerant to chemotherapeutic agents, antimicrobial agents, or antibiotics. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS).Piperacillin: Semisynthetic, broad-spectrum, AMPICILLIN derived ureidopenicillin antibiotic proposed for PSEUDOMONAS infections. It is also used in combination with other antibiotics.Bacteroides Infections: Infections with bacteria of the genus BACTEROIDES.Monobactams: Monocyclic, bacterially produced or semisynthetic beta-lactam antibiotics. They lack the double ring construction of the traditional beta-lactam antibiotics and can be easily synthesized.Plasmids: Extrachromosomal, usually CIRCULAR DNA molecules that are self-replicating and transferable from one organism to another. They are found in a variety of bacterial, archaeal, fungal, algal, and plant species. They are used in GENETIC ENGINEERING as CLONING VECTORS.Molecular Typing: Using MOLECULAR BIOLOGY techniques, such as DNA SEQUENCE ANALYSIS; PULSED-FIELD GEL ELECTROPHORESIS; and DNA FINGERPRINTING, to identify, classify, and compare organisms and their subtypes.DNA, Bacterial: Deoxyribonucleic acid that makes up the genetic material of bacteria.Aztreonam: A monocyclic beta-lactam antibiotic originally isolated from Chromobacterium violaceum. It is resistant to beta-lactamases and is used in gram-negative infections, especially of the meninges, bladder, and kidneys. It may cause a superinfection with gram-positive organisms.Minocycline: A TETRACYCLINE analog, having a 7-dimethylamino and lacking the 5 methyl and hydroxyl groups, which is effective against tetracycline-resistant STAPHYLOCOCCUS infections.Escherichia coli: A species of gram-negative, facultatively anaerobic, rod-shaped bacteria (GRAM-NEGATIVE FACULTATIVELY ANAEROBIC RODS) commonly found in the lower part of the intestine of warm-blooded animals. It is usually nonpathogenic, but some strains are known to produce DIARRHEA and pyogenic infections. Pathogenic strains (virotypes) are classified by their specific pathogenic mechanisms such as toxins (ENTEROTOXIGENIC ESCHERICHIA COLI), etc.Pneumonia, Bacterial: Inflammation of the lung parenchyma that is caused by bacterial infections.beta-Alanine: An amino acid formed in vivo by the degradation of dihydrouracil and carnosine. Since neuronal uptake and neuronal receptor sensitivity to beta-alanine have been demonstrated, the compound may be a false transmitter replacing GAMMA-AMINOBUTYRIC ACID. A rare genetic disorder, hyper-beta-alaninemia, has been reported.Klebsiella: A genus of gram-negative, facultatively anaerobic, rod-shaped bacteria whose organisms arrange singly, in pairs, or short chains. This genus is commonly found in the intestinal tract and is an opportunistic pathogen that can give rise to bacteremia, pneumonia, urinary tract and several other types of human infection.Citrobacter freundii: A species of gram-negative, facultatively anaerobic, rod-shaped bacteria found in humans and other animals including MAMMALS; BIRDS; REPTILES; and AMPHIBIANS. It has also been isolated from SOIL and WATER as well as from clinical specimens such as URINE; THROAT; SPUTUM; BLOOD; and wound swabs as an opportunistic pathogen.Muramoylpentapeptide Carboxypeptidase: Enzyme which catalyzes the peptide cross-linking of nascent CELL WALL; PEPTIDOGLYCAN.Fluoroquinolones: A group of QUINOLONES with at least one fluorine atom and a piperazinyl group.Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.Penicillin-Binding Proteins: Bacterial proteins that share the property of binding irreversibly to PENICILLINS and other ANTIBACTERIAL AGENTS derived from LACTAMS. The penicillin-binding proteins are primarily enzymes involved in CELL WALL biosynthesis including MURAMOYLPENTAPEPTIDE CARBOXYPEPTIDASE; PEPTIDE SYNTHASES; TRANSPEPTIDASES; and HEXOSYLTRANSFERASES.Enterobacter aerogenes: Gram-negative, capsulated, gas-producing rods found widely in nature. Both motile and non-motile strains exist. The species is closely related to KLEBSIELLA PNEUMONIAE and is frequently associated with nosocomial infectionsBacterial Outer Membrane Proteins: Proteins isolated from the outer membrane of Gram-negative bacteria.Multilocus Sequence Typing: Direct nucleotide sequencing of gene fragments from multiple housekeeping genes for the purpose of phylogenetic analysis, organism identification, and typing of species, strain, serovar, or other distinguishable phylogenetic level.Drug Utilization: The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.Bacteria, AnaerobicSulbactam: A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone.Penicillins: A group of antibiotics that contain 6-aminopenicillanic acid with a side chain attached to the 6-amino group. The penicillin nucleus is the chief structural requirement for biological activity. The side-chain structure determines many of the antibacterial and pharmacological characteristics. (Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed, p1065)Aminoglycosides: Glycosylated compounds in which there is an amino substituent on the glycoside. Some of them are clinically important ANTIBIOTICS.Drug Resistance, Multiple: Simultaneous resistance to several structurally and functionally distinct drugs.Stenotrophomonas maltophilia: A species of STENOTROPHOMONAS, formerly called Xanthomonas maltophilia, which reduces nitrate. It is a cause of hospital-acquired ocular and lung infections, especially in those patients with cystic fibrosis and those who are immunosuppressed.Hexosyltransferases: Enzymes that catalyze the transfer of hexose groups. EC 2.4.1.-.Disk Diffusion Antimicrobial Tests: A method where a culturing surface inoculated with microbe is exposed to small disks containing known amounts of a chemical agent resulting in a zone of inhibition (usually in millimeters) of growth of the microbe corresponding to the susceptibility of the strain to the agent.Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water.Bacterial Infections: Infections by bacteria, general or unspecified.Genes, Bacterial: The functional hereditary units of BACTERIA.Isoelectric Focusing: Electrophoresis in which a pH gradient is established in a gel medium and proteins migrate until they reach the site (or focus) at which the pH is equal to their isoelectric point.Quinolones: A group of derivatives of naphthyridine carboxylic acid, quinoline carboxylic acid, or NALIDIXIC ACID.GreeceMolecular Sequence Data: Descriptions of specific amino acid, carbohydrate, or nucleotide sequences which have appeared in the published literature and/or are deposited in and maintained by databanks such as GENBANK, European Molecular Biology Laboratory (EMBL), National Biomedical Research Foundation (NBRF), or other sequence repositories.Bacterial Load: Measurable quantity of bacteria in an object, organism, or organism compartment.Sequence Analysis, DNA: A multistage process that includes cloning, physical mapping, subcloning, determination of the DNA SEQUENCE, and information analysis.Cefoxitin: A semisynthetic cephamycin antibiotic resistant to beta-lactamase.Escherichia coli Infections: Infections with bacteria of the species ESCHERICHIA COLI.Bacteria, AerobicFlavobacterium: A genus of gram-negative, aerobic, rod-shaped bacteria widely distributed in SOIL and WATER. Its organisms are also found in raw meats, MILK and other FOOD, hospital environments, and human clinical specimens. Some species are pathogenic in humans.Bacteria: One of the three domains of life (the others being Eukarya and ARCHAEA), also called Eubacteria. They are unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. Bacteria can be classified by their response to OXYGEN: aerobic, anaerobic, or facultatively anaerobic; by the mode by which they obtain their energy: chemotrophy (via chemical reaction) or PHOTOTROPHY (via light reaction); for chemotrophs by their source of chemical energy: CHEMOLITHOTROPHY (from inorganic compounds) or chemoorganotrophy (from organic compounds); and by their source for CARBON; NITROGEN; etc.; HETEROTROPHY (from organic sources) or AUTOTROPHY (from CARBON DIOXIDE). They can also be classified by whether or not they stain (based on the structure of their CELL WALLS) with CRYSTAL VIOLET dye: gram-negative or gram-positive.Cephalosporin Resistance: Non-susceptibility of an organism to the action of the cephalosporins.Pneumonia, Ventilator-Associated: Serious INFLAMMATION of the LUNG in patients who required the use of PULMONARY VENTILATOR. It is usually caused by cross bacterial infections in hospitals (NOSOCOMIAL INFECTIONS).Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships.Hospitals, Teaching: Hospitals engaged in educational and research programs, as well as providing medical care to the patients.Structure-Activity Relationship: The relationship between the chemical structure of a compound and its biological or pharmacological activity. Compounds are often classed together because they have structural characteristics in common including shape, size, stereochemical arrangement, and distribution of functional groups.

In vitro activities of aminomethyl-substituted analogs of novel tetrahydrofuranyl carbapenems. (1/947)

CL 188,624, CL 190,294, and CL 191,121 are novel aminomethyl tetrahydrofuranyl (THF)-1 beta-methylcarbapenems. The in vitro antibacterial activities of these THF carbapenems were evaluated and compared with those of biapenem, imipenem, and meropenem against 554 recent clinical isolates obtained from geographically distinct medical centers across North America. The antibacterial activities of the THF carbapenems were equivalent to that of biapenem, and the THF carbapenems were slightly more active than imipenem and less active than meropenem against most of the members of the family Enterobacteriaceae but lacked significant activity against Pseudomonas isolates. In general, CL 191,121 was two- to fourfold more active than CL 188,624 and CL 190,294 against the staphylococcal and enterococcal isolates tested. CL 191,121 was twofold less active than imipenem against methicillin-susceptible staphylococci and was as activity as imipenem against Enterococcus faecalis isolates. Biapenem and meropenem were two- and fourfold less active than CL 191,121, respectively, against the methicillin-susceptible staphylococci and E. faecalis. All the carbapenems displayed equivalent good activities against the streptococci. Biapenem was slightly more active than the other carbapenems against Bacteroides fragilis isolates. Time-kill curve studies demonstrated that the THF carbapenems were bactericidal in 6 h against Escherichia coli and Staphylococcus aureus isolates. The postantibiotic effect exerted by CL 191,121 was comparable to or slightly longer than that of imipenem against isolates of S. aureus, E. coli, and Klebsiella pneumoniae.  (+info)

In vivo activities of peptidic prodrugs of novel aminomethyl tetrahydrofuranyl-1 beta-methylcarbapenems. (2/947)

A series of novel aminomethyl tetrahydrofuranyl (THF)-1 beta-methylcarbapenems which have excellent broad-spectrum antibacterial activities exhibit modest efficacies against acute lethal infections (3.8 mg/kg of body weight against Escherichia coli and 0.9 mg/kg against Staphylococcus aureus) in mice when they are administered orally. In an effort to improve the efficacies of orally administered drugs through enhanced absorption by making use of a peptide-mediated transport system, several different amino acids were added at the aminomethyl THF side chains of the carbapenem molecules. The resulting peptidic prodrugs with L-amino acids demonstrated improved efficacy after oral administration, while the D forms were less active than the parent molecules. After oral administration increased (3 to 10 times) efficacy was exhibited with the alanine-, valine-, isoleucine-, and phenylalanine-substituted prodrugs against acute lethal infections in mice. Median effective doses (ED50s) of < 1 mg/kg against infections caused by S. aureus, E. coli, Enterobacter cloacae, or penicillin-susceptible Streptococcus pneumoniae were obtained after the administration of single oral doses. Several of the peptidic prodrugs were efficacious against Morganella morganii, Serratia marcescens, penicillin-resistant S. pneumoniae, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, and E. coli infections, with ED50s of 1 to 14 mg/kg by oral administration compared with ED50s of 14 to > 32 mg/kg for the parent molecules. In general, the parent molecules demonstrated greater efficacy than the prodrugs against these same infections when the drugs were administered by the subcutaneous route. The parent molecule was detectable in the sera of mice after oral administration of the peptidic prodrugs.  (+info)

In vitro activities of the potent, broad-spectrum carbapenem MK-0826 (L-749,345) against broad-spectrum beta-lactamase-and extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli clinical isolates. (3/947)

An important mechanism of bacterial resistance to beta-lactam antibiotics is inactivation by beta-lactam-hydrolyzing enzymes (beta-lactamases). The evolution of the extended-spectrum beta-lactamases (ESBLs) is associated with extensive use of beta-lactam antibiotics, particularly cephalosporins, and is a serious threat to therapeutic efficacy. ESBLs and broad-spectrum beta-lactamases (BDSBLs) are plasmid-mediated class A enzymes produced by gram-negative pathogens, principally Escherichia coli and Klebsiella pneumoniae. MK-0826 was highly potent against all ESBL- and BDSBL-producing K. pneumoniae and E. coli clinical isolates tested (MIC range, 0.008 to 0.12 microgram/ml). In E. coli, this activity was associated with high-affinity binding to penicillin-binding proteins 2 and 3. When the inoculum level was increased 10-fold, increasing the amount of beta-lactamase present, the MK-0826 MIC range increased to 0.008 to 1 microgram/ml. By comparison, similar observations were made with meropenem while imipenem MICs were usually less affected. Not surprisingly, MIC increases with noncarbapenem beta-lactams were generally substantially greater, resulting in resistance in many cases. E. coli strains that produce chromosomal (Bush group 1) beta-lactamase served as controls. All three carbapenems were subject to an inoculum effect with the majority of the BDSBL- and ESBL-producers but not the Bush group 1 strains, implying some effect of the plasmid-borne enzymes on potency. Importantly, MK-0826 MICs remained at or below 1 microgram/ml under all test conditions.  (+info)

Carbapenem resistance in Escherichia coli associated with plasmid-determined CMY-4 beta-lactamase production and loss of an outer membrane protein. (4/947)

Three cefoxitin-resistant Escherichia coli isolates from stool specimens of a patient with leukemia were either resistant, intermediate, or sensitive to imipenem. Conjugation experiments showed that cefoxitin resistance, but not imipenem resistance, was transferable. All isolates were shown by isoelectric focusing to produce two beta-lactamases with isoelectric points of 5.4 (TEM-1, confirmed by sequencing of a PCR product) and >8.5 (consistent with a class C beta-lactamase). The gene coding for the unknown beta-lactamase was cloned and sequenced and revealed an enzyme which had 99.9% sequence identity with the plasmid-determined class C beta-lactamase CMY-2. The cloned beta-lactamase gene differed from blaCMY-2 at one nucleotide position that resulted in an amino acid change, tryptophan to arginine at position 221. We propose that this enzyme be designated CMY-4. Both the imipenem-resistant and -intermediate isolates lacked a 38-kDa outer membrane protein (OMP) that was present in the imipenem-sensitive isolate. The lack of an OMP alone did not explain the difference in carbapenem susceptibilities observed. However, measurement of beta-lactamase activities (including measurements under conditions where TEM-1 beta-lactamase was inhibited) indicated that the imipenem-intermediate isolate expressed six- to eightfold less beta-lactamase than did the other isolates. This study illustrates that carbapenem resistance in E. coli can arise from high-level expression of plasmid-mediated class C beta-lactamase combined with an OMP deficiency. Furthermore, in the presence of an OMP deficiency, the level of expression of a plasmid-mediated class C beta-lactamase is an important factor in determining whether E. coli isolates are fully resistant to carbapenems.  (+info)

Relationship between morphological changes and endotoxin release induced by carbapenems in Pseudomonas aeruginosa. (5/947)

The relationship between morphological changes and endotoxin release induced in vitro by carbapenems in a clinical isolate of Pseudomonas aeruginosa was examined. The time-course and magnitude of endotoxin release induced varied among imipenem, panipenem, meropenem and biapenem and related to the morphological changes caused by these agents which variously affected cell shape, cell-wall disintegration and cell lysis. The amount of endotoxin released by carbapenem-treated cells correlated with both the cell-wall morphology and bacterial shape immediately before lysis. Meropenem and biapenem caused markedly increased endotoxin release during cell lysis and cell-wall disintegration, whereas imipenem and panipenem caused much less release of endotoxin.  (+info)

Structure-activity relationships of carbapenems to the antagonism of the antipseudomonal activity of other beta-lactam agents and to the beta-lactamase inducibility in Pseudomonas aeruginosa: effects of 1beta-methyl group and C-2 side chain. (6/947)

The antagonism of the antipseudomonal activity of ceftazidime by meropenem (1a) was much less than those by imipenem (2a) and panipenem (2b). To reveal the major structural features of carbapenem compounds responsible for the antagonism, we investigated the structure-activity relationships of carbapenems to their antagonism of the antipseudomonal activity of ceftazidime and to their beta-lactamase-inducibility in P. aeruginosa. The antagonistic effect of 1a was less than that of desmethyl-meropenem (1b). Two other meropenem-analogues (3, 4), with the highly basic C-2 side chain, showed greater antagonistic effects than that of 1a, which has a weakly basic C-2 side chain. The beta-lactamase-inducibility of 1a in P. aeruginosa was lower than those of 2a, 1b and 4. These results indicated that the antagonism of the antipseudomonal activity of ceftazidime by carbapenems was due to the induction of beta-lactamase in P. aeruginosa. As a result of the study on the structure-activity relationships, we clarified that the introduction of a 1beta-methyl group and/or the reduction of the basicity (cationic character) of the C-2 side chain in carbapenem skeleton decreased the antagonistic effect of carbapenems on the antipseudomonal activity of ceftazidime resulted mainly from the decreasing the beta-lactamase inducibility.  (+info)

Pharmacokinetic changes of a new carbapenem, DA-1131, after intravenous administration to spontaneously hypertensive rats and deoxycorticosterone acetate-salt-induced hypertensive rats. (7/947)

The pharmacokinetics of a new carbapenem, DA-1131, were compared after i.v. administration of the drug, 50 mg/kg, to spontaneously hypertensive rats (SHRs) at 16 weeks of age (an animal model for human primary hypertension) and at 6 weeks of age (corresponding to the early phase of the development of hypertension, at which time blood pressure remains within the normotensive range) and their respective age-matched control normotensive Kyoto-Wistar rats (KW rats), and deoxycorticosterone acetate-salt-induced hypertensive rats at 16 weeks of age (an animal model for human secondary hypertension) and their age-matched control Sprague-Dawley rats. The total area under the plasma concentration-time curve from time zero to time infinity (AUC) (4720 versus 7070 microg x min/ml) was significantly smaller, and the nonrenal clearance (CLNR) (5.37 versus 3.57 ml/min/kg) was significantly faster in 16-week-old SHRs than those in their control KW rats. Similar results were also obtained from 6-week-old SHRs in AUC (3800 versus 4680 microg x min/ml) and CLNR (7.73 versus 3.31 ml/min/kg). However, the values were reversed in 16-week-old deoxycorticosterone acetate-salt rats in AUC (5310 versus 3870 microg.min/ml) and CLNR (2.57 versus 4.90 ml/min/kg). The significantly faster CLNR of DA-1131 in both 6- and 16-week-old SHRs could be supported at least partly by the results of the in vitro metabolism with kidney homogenate and considerably greater total renal dehydropeptidase-I activity. The data above indicated that the significantly faster CLNR of DA-1131 in 16-week-old SHRs than that in their age-matched control KW rats was due to any hereditary characteristics of SHRs and was not due to the hypertensive state itself.  (+info)

In-vitro activity of 29 antimicrobial agents against penicillin-resistant and -intermediate isolates of Streptococcus pneumoniae. (8/947)

Antibiotic resistance among isolates of Streptococcus pneumoniae is increasing worldwide. Optimal therapy, though unknown, should be guided by in-vitro susceptibility testing. Currently, vancomycin is the only approved antibiotic that is universally active against multiresistant S. pneumoniae. In-vitro activities were determined for 29 antimicrobial agents against 22 penicillin-intermediate S. pneumoniae (PISP) and 16 penicillin-resistant S. pneumoniae (PRSP) isolates. MICs were determined in cation-adjusted Mueller-Hinton broth with 3% lysed horse blood in microtitre trays. Antimicrobial classes tested included cephalosporins, penicillin, aminopenicillins, macrolides, quinolones, carbapenems and other antimicrobial agents. Among the classes of antimicrobial agents tested, wide differences in susceptibility were demonstrated for both PISP and PRSP. Of the cephalosporins, ceftriaxone and cefotaxime demonstrated the best in-vitro activity for both PISP and PRSP. Of the quinolones, clinafloxacin and trovafloxacin showed the greatest in-vitro activity. Rifampicin and teicoplanin demonstrated excellent in-vitro activity. Promising in-vitro results of newer agents, such as quinupristin/dalfopristin, ramoplanin, teicoplanin and linezolid may justify further evaluation of these agents in clinical trials.  (+info)

Carbapenems, such as imipenem and meropenem, are antibacterial agents with activity against many gram-negative, gram-positive, and anaerobic microorganisms. Carbapenems are often used to treat multidrug-resistant isolates, especially strains producing extended-spectrum β-lactamases (21, 29, 30, 47, 58). However, the recent appearance of β-lactamases capable of hydrolyzing carbapenems, in addition to other mechanisms of carbapenem resistance, creates an increasing therapeutic dilemma (21, 29, 30, 47,58). Therefore, a better understanding of carbapenem resistance mechanisms is critical to optimizing therapy.. Here we describe the fourth class A β-lactamase with high carbapenem-hydrolyzing activity isolated from a strain ofEnterobacteriaceae. The enzyme KPC-1 shows 45% amino acid identity to Sme-1 (41) from S. marcescens S6. Unlike KPC-1, the other three class A carbapenemases (Nmc-A [42], IMI-1 [57], and Sme-1 [41]) show ,90% similarity to each other at the nucleotide level (41, 47). These ...
Anonymous, 2012: Biochemical and Genetic Characterization of Carbapenem-Hydrolyzing beta-Lactamase OXA-229 from Acinetobacter bereziniae
Trends in carbapenem-resistant Enterobacteriaceae (CRE) collected from hospitals nationwide in Singapore over 3 years are presented. Hospital isolates with imipenem or meropenem minimum inhibitory concentrations (MICs) of ,1 mg/L were sent to the National Public Health Laboratory for further investigation. A total of 400 CRE were submitted, 227 (56.8%) of which carried a carbapenemase gene. blaNDM was the most common (130/400; 32.5%), followed by blaOXA-48-like (blaOXA-48, -181, -232) (55/400; 13.8%). Interestingly, four isolates bearing dual carbapenemase genes were also detected. KPC- and OXA-48-like-producing Klebsiella pneumoniae were fingerprinted by DiversiLab® rep-PCR. Locally, KPC producers do not appear to have clonal dissemination. In contrast, OXA-48-like producers were found to have a greater degree of clustering than KPC producers. © 2013 International Society for Chemotherapy of Infection and Cancer ...
Carbapenem-Resistant Enterobacteriaceae (CRE) are untreatable or difficult to treat bacteria that are resistant to carbapenem antibiotics and nearly all available antibiotics. They can cause serious illness and death; bloodstream infections are fatal in 40% -50% of cases. CRE was designated by the CDC in 2013 as one of the three most urgent drug resistant threats in the United States. An estimated 9,000 CRE infections cause 600 deaths yearly in the U.S.. Risk factors for CRE colonization or infection include open wounds, presence of indwelling devices (such as endotracheal tubes, feeding tubes, and catheters), multiple medical problems, and high antimicrobial use. CRE are easily spread between infected or colonized patients by health care workers and equipment, unless rigorous infection prevention precautions are taken. Cases and outbreaks of CRE have been increasingly recognized in recent years in Northern California, including Alameda County. In June 2017, the Alameda County Public Health ...
Carbapenem-resistant Enterobacteriaceae (CRE) are a serious threat to public health. Infections with CRE are difficult, and in some cases impossible, to treat and have been associated with mortality rates up to 50%(1). Due to the movement of patients throughout the healthcare system, if CRE are a problem in one facility, then typically they are a problem in other facilities in the region as well. To help protect patients and prevent transmission, CDC has updated 2012 CRE toolkit; this document will continue to be updated as new information becomes available.. ...
TY - JOUR. T1 - Synthesis and biological properties of a new series of anti-MRSA β-Lactams; 2-(thiazol-2-ylthio)carbapenems. AU - Shinagawa, Hisatoshi. AU - Yamaga, Hiroshi. AU - Houchigai, Hitoshi. AU - Sumita, Yoshihiro. AU - Sunagawa, Makoto. PY - 1997/3/1. Y1 - 1997/3/1. N2 - A series of 1β-methylcarbapenems containing variously C-2 substituted thiazol-2-ylthio groups were synthesized, and their in vitro anti-MRSA activity was examined. Among them, 1β-methyl-2-(4-arylthiazol-2-ylthio) carbapenems exhibited superior anti-MRSA activity. Introduction of a cationic moiety in the C-2 side chain not only reduced the binding to HSA but also increased the stability against DHP-I, without affecting the anti-MRSA activity. It was also found that the distance between the cationic moiety and the carbapenem skeleton was related to the strength of HSA binding and the stability against DHP-I.. AB - A series of 1β-methylcarbapenems containing variously C-2 substituted thiazol-2-ylthio groups were ...
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Carbapenem-resistant Enterobacteriaceae (CRE) are increasing globally. Particularly, carbapenemase-producing Enterobacteriaceae (CPE) are of concern. Rapid and accurate detection of these strains is critical for appropriate antimicrobial use and hospital infection control. In the present study, criteria for CPE screening were examined using a carbapenem susceptibility disk. Carbapenemase producers showed minimal inhibition zones for faropenem (5 μg): 6-12 mm (mean: 6.9 mm). Some strains with the IMP-6 genotype showed inhibition zones of >30 mm for imipenem (10 μg) and biapenem (10 μg). All strains that formed inhibition zones for FRPM had the IMP-6 genotype. The cut off values of carbapenemase-producers, determined by ROC analysis, were 12 mm for FRPM, 24 mm for meropenem (10 μg), 29 mm for BIPM, 25 mm for doripenem (10 μg), 26 mm for IPM, and 24 mm for panipenem (10 μg). Thus, the sensitivity was the highest (100%) for FRPM. Specificities were 93.44% for MEPM and DRPM and 85.25% for FRPM. ...
The range of antibiotics available to combat bacterial infectious diseases is diminishing due to the development of resistance to all classes of antibiotics. The emergence of Carbapenem-resistant Enterobacteriaceae (CRE) is one of the most significant and urgent threats to global human health. CRE strains that have acquired and expressed genes encoding for extended-spectrum β-lactamases with carbapenemase activity have now been reported across the globe. One strategy for prolonging the use of existing antibiotics has been to develop adjuvants that inhibit the function of β-lactamases and thus restore the bacterias sensitivity to the β-lactam antibiotic (e.g. clavulanic acid and tazobactam). However, for carbapenemase enzymes which are class B β-lactamases (i.e. the metallo-β-lactamases (MBLs)), such inhibition strategies have, so far, been ineffective.. Consequently, there is a market need for effective inhibitors of class B MBLs as adjuvants for carbapenems. These MBL inhibitors have the ...
The emergence of carbapenem-resistant enterobacterial species poses a serious threat to public health worldwide. OXA-48-type carbapenem-hydrolyzing class D β-lactamases are widely distributed among Enterobacteriaceae, with significant geographical differences. To date, 11 OXA-48-like variants have been identified, with classical OXA-48 being the most widespread. These enzymes show high-level hydrolytic activity against penicillins and low-level hydrolysis towards carbapenems. Since the first description of the OXA-48 carbapenemase in Turkey, bacterial strains producing the enzyme have been extensively reported in nosocomial and community outbreaks in many parts of the word, particularly in the Mediterranean area and European countries ...
It was a week into my elderly patients hospital admission when he began to have fever and profuse diarrhea, some 10-12 bowel movement a day. The diagnosis was not hard to make: a stool test showed he had C difficile. Another patient, a thin women in her late 40s who had become paraplegic after a […]. ...
(PRWEB) May 15, 2015 -- GeneWEAVE, Inc.,a clinical diagnostics company addressing multi-drug-resistant organisms (MDRO), announced that initial data presented
As a healthcare-associated infections (HAI) fellow, I get to work closely with highly knowledgeable public health experts from both public and private sectors on emerging public health priorities, such as antimicrobial resistance. This year, I developed a protocol and designed a surveillance system to better understand the burden of carbapenem-resistant Enterobacteriaceae (CRE) in North Carolina. This project requires collaborating with seven major healthcare facilities in our state and the state laboratory of public health. By collecting epidemiologic information from cases and conducting resistance type testing on isolates, surveillance will provide information on the incidence of CRE in North Carolina, identify common mechanisms of carbapenem resistance and identify common healthcare exposures related to CRE. Preliminary results show that of 55 isolates tested, 35 (62%) are positive for Klebsiella pneumoniae carbapenemase (KPC). KPC is a common mechanism of resistance first identified in ...
Physical therapists (PTs) and physical therapist assistants (PTAs), especially those who have patients with wounds, are encouraged to take steps to protect their most vulnerable patients from carbapenem-resistant Enterobacteriaceae (CRE), a family of germs that have become difficult to treat because they have high levels of resistance to antibiotics. In addition to patients at high risks, PTs and PTAs should take all necessary precautions to prevent the spread of CRE to healthy individuals. According to the Centers for Disease Control and Prevention (CDC), CRE are resistant to all, or nearly all, antibiotics-even the most powerful drugs of last-resort. CRE also have high mortality rates, killing 1 in 2 patients who get bloodstream infections from them. Additionally, CRE easily transfer their antibiotic resistance to other bacteria. For example, carbapenem-resistant klebsiella can spread its drug-destroying properties to a normal E. coli bacteria, which makes the E.coli resistant to antibiotics ...
Physical therapists (PTs) and physical therapist assistants (PTAs), especially those who have patients with wounds, are encouraged to take steps to protect their most vulnerable patients from carbapenem-resistant Enterobacteriaceae (CRE), a family of germs that have become difficult to treat because they have high levels of resistance to antibiotics. In addition to patients at high risks, PTs and PTAs should take all necessary precautions to prevent the spread of CRE to healthy individuals. According to the Centers for Disease Control and Prevention (CDC), CRE are resistant to all, or nearly all, antibiotics-even the most powerful drugs of last-resort. CRE also have high mortality rates, killing 1 in 2 patients who get bloodstream infections from them. Additionally, CRE easily transfer their antibiotic resistance to other bacteria. For example, carbapenem-resistant klebsiella can spread its drug-destroying properties to a normal E. coli bacteria, which makes the E.coli resistant to antibiotics ...
The optimal method to screen for gastrointestinal colonization with carbapenem-resistant organisms (CRO) has yet to be established. The direct MacConkey (direct MAC) plate method demonstrates high sensitivity for CRO detection, but established zone diameter (ZD) criteria for ertapenem (≤27 mm) and meropenem (≤32 mm) result in high rates of false positives upon confirmatory testing. To increase specificity, we screened for CRO in two high-risk wards using the direct MAC plate method, recorded ZDs for each sample, and generated receiver operating characteristic (ROC) curves to evaluate the optimal ZD cutoff criteria. Of 6,868 swabs obtained over an 18-month period, 4,766 (69%) had growth on MAC plates, and 2,500 (36%) met criteria for further evaluation based on previously established ZDs around the carbapenem disks. A total of 812 (12%) swabs were confirmed positive for at least one CRO and included 213 (3%) carbapenemase-producing organisms (CPO), resulting in a specificity of 78% for the ...
The term carbapenemase is used to mean any β-lactamase that hydrolyses carbapenems ie any or all of doripenem, ertapenem, imipenem and meropenem. These carbapenems are antimicrobial drugs of last resort and are crucial for preventing and treating life-threatening nosocomial infections. Of clinical concern, many carbapenemases confer resistance or reduced susceptibility to all or nearly all members of the β-lactam class, not just to carbapenems ...
The rate of bacterial infections resistant to even the strongest antibiotics are rising in the U.S. and leading to untreatable and often fatal illnesses. In a recent press conference, officials from the Center for Disease Control and Prevention reported that in 2012 nearly four percent of patients in all U.S. hospitals were infected with the drug-resistant bacteria; the rate in specialty hospitals was nearly 18 percent. The officials called for doctors, hospitals and public health workers to come together to stop the infections from spreading. The last decade has seen an explosion in the rate of hospitalized patients contracting Carbapenem-Resistant Enterobacteriaceae, or CRE s. The name refers to the bacteria s lack of response to carbapenems, a class of drugs currently regarded by experts as last resort antibiotics. CRE s are fatal to over half of patients who get bloodstream infections from them and include over 70 known species that occur naturally in water, soil and the human digestive ...
The rate of bacterial infections resistant to even the strongest antibiotics are rising in the U.S. and leading to untreatable and often fatal illnesses. In a recent press conference, officials from the Center for Disease Control and Prevention reported that in 2012 nearly four percent of patients in all U.S. hospitals were infected with the drug-resistant bacteria; the rate in specialty hospitals was nearly 18 percent. The officials called for doctors, hospitals and public health workers to come together to stop the infections from spreading. The last decade has seen an explosion in the rate of hospitalized patients contracting Carbapenem-Resistant Enterobacteriaceae, or CRE s. The name refers to the bacteria s lack of response to carbapenems, a class of drugs currently regarded by experts as last resort antibiotics. CRE s are fatal to over half of patients who get bloodstream infections from them and include over 70 known species that occur naturally in water, soil and the human digestive ...
387509240 - EP 1003747 A4 2002-11-06 - CARBAPENEMS WITH NAPHTHOSULTAM DERIVATIVE LINKED VIA METHYLENE - [origin: WO9909032A1] The present invention relates to carbapenem antibacterial agents in which the carbapenem nucleus is substituted at the 2-position with a naphthosultam linked through a CH2 group. The napththosultam is further substituted with various substituent groups including at least one cationic group.[origin: WO9909032A1] The present invention relates to carbapenem antibacterial agents in which the carbapenem nucleus is substituted at the 2-position with a naphthosultam linked through a CH2 group. The napththosultam is further substituted with various substituent groups including at least one cationic group.
See more] The spread of extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) is leading to increased carbapenem consumption. Alternatives to carbapenems need to be investigated. We investigated whether β-lactam/β-lactamase inhibitor (BLBLI) combinations are as effective as carbapenems in the treatment of bloodstream infections (BSI) due to ESBL-E. A multinational, retrospective cohort study was performed. Patients with monomicrobial BSI due to ESBL-E were studied; specific criteria were applied for inclusion of patients in the empirical-therapy (ET) cohort (ETC; 365 patients), targeted-therapy (TT) cohort (TTC; 601 patients), and global cohort (GC; 627 patients). The main outcome variables were cure/improvement rate at day 14 and all-cause 30-day mortality. Multivariate analysis, propensity scores (PS), and sensitivity analyses were used to control for confounding. The cure/improvement rates with BLBLIs and carbapenems were 80.0% and 78.9% in the ETC and 90.2% and 85.5% ...
Results: This study showed high prevalence of efflux pump genes in our local isolates. The AdeB gene was present in all multidrug resistant isolates (100%) while AdeRS gene was found in 95.2%, AdeC gene in 83.3% and AdeA gene in 77.4%. By comparing the prevalence of these gene in carbapenem-susceptible isolates, it was demonstrated that the gene AdeB was absent in all susceptible isolates, also the regulatory gene AdeRS was not found in most of these isolates, while the other genes (AdeA and AdeC) were detected in most carbapenem- susceptible isolates. Susceptibility of isolates to Amikacin, Gentamicin, Ciprofloxacin, Levofloxacin, Tetracycline and Tigecycline was highly increased in the presence of efflux pump inhibitor, so that, PAβN reduced the minimum inhibitory concentrations (MICs) by 4 to 32 folds. Also, MICs of carbapenems were reduced in the presence of the inhibitor by two to eight folds, while the MICs of colistin were not affected. ...
(BPT) - If you’ve ever felt sick or battled a bug, you may have asked your doctor for an antibiotic. Ever since the advent of these wonder drugs, these medications have one common goal: fight bacteria in the body to help maintain a healthy immune system. As new medical breakthroughs emerge, the role of antibiotics has also evolved and helped patients dealing with anything from ear infections to serious lung infections like pneumonia.However, antibiotics are not foolproof. Bacteria, when exposed to antibiotic drugs, can learn how to resist them. These resistant bacteria are known as superbugs, which are harder for antibiotics to kill.Recently, superbugs have become a greater and far more serious concern. In March 2013, the Centers for Disease Control and Prevention (CDC) issued a warning about a new class of superbugs called Carbapenem-resistant Enterobacteriaceae (CRE), which can cause dangerous infections that can get into the bloodstream – and kill up to 50 percent of people when they do
Besides the constant care of patients, healthcare facilities have one more thing on their hands: the CRE (carbapenem-resistant Enterobacteriaceae) bacteria. This lethal enemy is unfortunately growing to be very common in intensive care settings to the point that there is an alert rising due to this.
Canterbury District Health Board (CDHB) said that three people tested positive as potential carriers of Carbapenem-resistant Enterobacteriaceae (CRE).
Brink, Adrian et al. The spread of carbapenem-resistant Enterobacteriaceae in South Africa: Risk factors for acquisition and prevention. SAMJ, S. Afr. med. j., July 2012, vol.102, no.7, p.599-601. ISSN 0256- ...
Carbapenems are a major last-line class of antibiotics to treat bacterial infections. The spread of carbapenem-resistant infections is a threat to healthcare and patient safety in Europe as it seriously curtails the ability to cure infections.
Public Release: 5-Dec-2016 American Society for Microbiology Washington, DC - Dec. 5, 2016 - Carbapenems are one of the most important classes of antibiotics used in humans, and are an important agent against multi-drug resistant bacteria. Now, for the first time, bacteria that carry a transmissible carbapenem resistance gene have been found in…
The U.S. Food and Drug Administration cleared for marketing the Xpert Carba-R Assay, an infection control aid that tests patient specimens to detect specific genetic markers associated with bacteria that are resistant to Carbapenem antibiotics. Carbapenem antibiotics are widely used in hospitals to treat severe infections. These resistant organisms are commonly referred to as Carbapenem-resistant…
There has been much coverage in the media this week for a new paper in the American Journal of Infection Control from the Cardiff group under the leadership of Prof Jean-Yves Maillard. We blogged on the detail of this paper last week, but in summary the paper demonstrated variability in the ability of a range of detergent wipes to remove bacteria and spores from surfaces. NHS Choices has a more balanced view of this paper than the rather sensationalist reporting elsewhere.. Most headlines have suggested that nurses are spreading superbugs around the ward by using wet wipes. The study shows that detergent wipes do not remove pathogens from surfaces in significant numbers. This is not a new finding and hardly surprising as a detergent wipe aims to be the first step in the cleaning process and is not a disinfection stage on its own. Also, its worth noting that the risk of spreading germs using detergent is not restricted to wipes - this has been reported for "mop and bucket" type application of ...
Fujisawa was developing a broad spectrum parenteral carbapenem FR 21818 in preclinical trials in Japan, however, no recent development has been reported. The
KPC-type carbapenemase can efficiently hydrolyze carbapenems, which are thought to be the last effective agents against severe infections caused by Gram-negative bacteria (1, 18). Previous studies have shown that both blaKPC copy number and deletions in the IVS may affect KPC production (12, 17, 19). Two basic genetic environments surrounding the blaKPC gene, the Tn4401 transposon, which is distributed worldwide, and the Tn3-Tn4401 chimera, which is found in China, have been identified (9, 10, 13). As reported in other studies (13, 14, 16), until now, no typical Tn4401 transposon has been detected in any of the clinical strains isolated in our hospital.. As reported by Naas and colleagues (17), the IPM MIC of the recombined E. coli strain containing the promoter combination of P1, P2, and P3 (Tn4401B) was 8 μg/ml. Consistently, the IPM MIC for Tn4401A (64 μg/ml), which contained promoters P1 and P2, was much higher than that for Tn4401B (9, 12, 17, 19). However, except for TZP and ATM, the ...
The global dissemination of carbapenem-resistant Gram-negative pathogens is a significant source of morbidity and mortality. Carbapenemases, or carbapenem-hydro...
The global dissemination of carbapenem-resistant Gram-negative pathogens is a significant source of morbidity and mortality. Carbapenemases, or carbapenem-hydro...
...   Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them
This prescription event monitoring survey evaluated the usage profile of doripenem and clinical experience with the drug in the management of serious bacterial
Learn about Doribax (Doripenem for Injection) may treat, uses, dosage, side effects, drug interactions, warnings, patient labeling, reviews, and related medications.
In March, the director of the US Centers for Disease Control and Prevention, Thomas Frieden, warned authorities of their "limited window of opportunity" to deal with the "nightmare" presented by the rise of a family of bacteria highly resistant to what are often our last line of antibiotic defense: the suite of drugs known as carbapenems. A few months earlier, the UKs chief medical officer, Sally Davies, used similar language to describe a future "apocalyptic scenario" in 20 years time, when people will be dying from infections that are currently understood to be trivial, "because we have run out of antibiotics.". ...
Carbapenem-resistant Enterobacteriaceae (CRE) or carbapenemase-producing Enterobacteriaceae (CPE) are Gram-negative bacteria that are resistant to the carbapenem class of antibiotics, considered the drugs of last resort for such infections. They are resistant because they produce an enzyme called a carbapenemase that disables the drug molecule. The resistance can vary from moderate to severe. Enterobacteriaceae are common commensals and infectious agents. Experts fear CRE as the new "superbug". The bacteria can kill up to half of patients who get bloodstream infections. Tom Frieden, former head of the Centers for Disease Control and Prevention has referred to CRE as "nightmare bacteria". Types of CRE are sometimes known as KPC (Klebsiella pneumoniae carbapenemase) and NDM (New Delhi Metallo-beta-lactamase). KPC and NDM are enzymes that break down carbapenems and make them ineffective. Both of these enzymes, as well as the enzyme VIM (Verona Integron-Mediated Metallo-β-lactamase) have also been ...
Background. During 2006, Israeli hospitals faced a clonal outbreak of carbapenem-resistant Klebsiella pneumoniae that was not controlled by local measures. A nationwide intervention was launched to contain the outbreak and to introduce a strategy to control future dissemination of antibiotic-resistant bacteria in hospitals.. Methods. In March 2007, the Ministry of Health issued guidelines mandating physical separation of hospitalized carriers of carbapenem-resistant Enterobacteriaceae (CRE) and dedicated staffing and appointed a professional task force charged with containment. The task force paid site visits at acute-care hospitals, evaluated infection-control policies and laboratory methods, supervised adherence to the guidelines via daily census reports on carriers and their conditions of isolation, provided daily feedback on performance to hospital directors, and intervened additionally when necessary. The initial intervention period was 1 April 2007-31 May 2008. The primary outcome measure ...
CRE trends during 2006-2015 in the VHA recapitulate the epidemic of carbapenem-resistant K. pneumoniae in the United States and indicate that a "second epidemic" of carbapenem-resistant E. cloacae complex appears to be unfolding. In the United States, the predominant carbapenem-resistant K. pneumoniae genotype is sequence type (ST) 258, which is associated with Tn4401, a mobile genetic element containing blaKPC (7). In contrast, the genetic background of carbapenem-resistant E. cloacae complex is not well defined. Analysis of carbapenem-resistant E. cloacae from the US Midwest and New York, NY, demonstrated dissemination of E. cloacae complex ST171 harboring the blaKPC-3 gene (2,3,8). Further analysis demonstrated that ST171 was associated with a Tn4401 variant within a pBK30683-like plasmid; however, various other plasmids in Enterobacter spp. also harbor blaKPC-3 (4). Of note, in a northeastern US hospital, one third of carbapenem-resistant E. cloacae contained carbapenemases and the rest ...
Schwaber et al identified risk factors for acquisition of carbapenem-resistant Klebsiella pneumoniae in a hospitalized patient. These can help to identify a patient who should be screened for carriage. The authors are from Tel Aviv Sourasky Medical Center.
U.S. and international efforts to control carabapenem-resistant Enterobacteriaceae (CRE) are critical to protect public health. Clinicians caring for patients infected with such organisms have few, if any, therapeutic options available. CRE containing New Delhi metallo-beta-lactamase (NDM), first reported in a patient who had been hospitalized in New Delhi, India, in 2007 (1), are of particular concern because these enzymes usually are encoded on plasmids that harbor multiple resistance determinants and are transmitted easily to other Enterobacteriaceae and other genera of bacteria (2). A urine specimen collected on March 4, 2012, from a patient who recently had been hospitalized in Viet Nam, but who was receiving care at a hospital in Rhode Island, was found to have a Klebsiella pneumoniae isolate containing NDM. The isolate was susceptible only to tigecycline, colistin, and polymyxin B. Point-prevalence surveys of epidemiologically linked patients revealed transmission to a second patient on ...
MMWR June 22, 2012 V.61 N.24 P.446-448 U.S. and international efforts to control carabapenem-resistant Enterobacteriaceae (CRE) are critical to protect public health. Clinicians caring for patients infected with such organisms have few, if any, therapeutic options available. CRE containing New Delhi metallo-beta-lactamase (NDM), first reported in a patient who had been hospitalized in New Delhi,…
N.C. Communicable Disease Branch page about new carbapenem-resistant Enterobacteriaceae (CRE), untreatable or difficult-to-treat Enterobacteriaceae that have developed high levels of resistance to antibiotics, including last-resort antibiotics called carbapenems. Includes NC DHHS and CDC communications about this emerging public health concern as well as links to infection prevention information tailored for patients and healthcare providers.
What are carbapenem-resistant Enterobacteriaceae (CRE)? Enterobacteriaceae are a group of bacteria normally found in the human gut. Common types include E. coli and Klebsiella species. Carbapenems are a class of antibiotics that were developed to treat bacteria that are resistant to other drugs. Due to the overuse of these antibiotics, some types of Enterobacteriaceae have developed resistance to carbapenems; these bacteria are called carbapenem-resistant Enterobacteriaceae (CRE).. Who gets CRE? Healthy people usually do not get CRE infections. In healthcare settings, CRE infections may occur among patients who are receiving treatment for other conditions. Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections.. How are CRE spread? CRE can be transmitted via direct person-to-person contact with an infected person or ...
To the Editor: The carbapenems (meropenem and imipenem), the ß-lactams with the broadest spectrum, are stable to most ß-lactamases (1). Therefore, they are often used as antibiotics of last resort for treating nosocomial infections due to gram-negative bacteria resistant to other ß-lactams. Resistance to carbapenems and susceptibility to other ß-lactams in Pseudomonas aeruginosa is common as a result of reduced drug accumulation or increased expression of pump efflux (1).. Several extended-spectrum ß-lactamases have been reported in P. aeruginosa, but only two, IMP-1 and VIM-1, possess an extended hydrolysis profile that includes carbapenems (2-5). The chromosome-borne and plasmid-mediated carbapenem-hydrolyzing ß-lactamase, IMP-1, has been described in several gram-negative rods, including P. aeruginosa, P. cepacia, Alcaligenes xylosoxydans, and Enterobacteriaceae isolates in Japan (4,6). Recently, a chromosome-borne carbapenem-hydrolyzing ß-lactamase, VIM-1, was reported from a clinical ...
Introduction: The aim of this study was to investigate the presence of carbapenemase production and carbapenem resistance mechanisms in 47 carbapenem resistant Klebsiella pneumoniae isolates by phenotypic confirmatory tests and molecular assay.. Methodology: Carbapenem resistance genes KPC, OXA-48 and NDM were investigated with the BD MAX CRE assay kit in the BD MAX real time PCR instrument. Modified Hodge test, MBL gradient strip test, D70C Carbapenemase Detection Set, Temocillin gradient strip test methods were used as phenotypic confirmatory tests. Clonal relationship between study isolates was investigated with pulsed-field gel electrophoresis.. Results: Analysis with BD MAX CRE assay revealed OXA-48 positivity in 17 (36%) strains, NDM positivity in 6 (13%) strains and coexistence of OXA-48 + NDM positivity in 8 (17%) strains. In 16 (34%) strains, none of the KPC, OXA-48 and NDM genes were detected. While MHT was the most sensitive phenotypic confirmatory test, D70C disc set had not been ...
Objective: Multidrug-resistant Enterobacteriaceae pose a serious infection control challenge and have emerged as a public health threat. We examined national trends in the proportion of Klebsiella pneumoniae isolates resistant to carbapenems (CRKP) and third-generation cephalosporins (G3CRKP).. Design and Setting: Retrospective analysis of approximately 500,000 K. pneumoniae isolates cultured between January 1999 and July 2010 at 287 clinical laboratories throughout the United States.. Methods: Isolates were defined as CRKP if they were nonsusceptible to 1 or more carbapenems and were defined as G3CRKP if they were nonsusceptible to ceftazidime, ceftriaxone, or related antibiotics. A multivariable analysis examined trends in the proportion of resistant isolates, adjusting for age, sex, isolate source, patient location, and geographic region.. Results: The crude proportion of CRKP increased from less than 0.1% to 4.5% between 2002 and 2010; the frequency of G3CRKP increased from 5.3% to 11.5% ...
1. Center for Disease control and prevention. National Nosocomial Infections Surveillance 9NNIS0 System report, data summary from January 1992 through June 2003. Am J Infect Control 2003:31:481-98 2. Woodford N, Tierno PM Jr, Young K, Tysall L, Palepou MF, Ward E, Painter RE, Suber DF, Shungu D, Silver LL, Inglima K, Kornblum J, Livermore DM. Antimicrobial Agents Chemother. Outbreak of Klebsiella pneumonia producing a new carbapenem-hydrolyzing class a beta-lactamase, KPC-3, in a New York Medical Center.2004;48(12):4793-9. 3. Bradford PA, Bratu S, Urban C, Visalli M, Mariano N, Landman D, Rahal JJ, Brooks S, Cebular S, Quale J Emergence of carbapenem-resistant Klebsiella species possessing the class A carbapenem-hydrolyzing KPC-2 and inhibitor-resistant TEM-30 beta-lactamases in New York City. Clin Infect Dis. 2004 1;39(1):55-60 ...
Carbapenem-resistant Enterobacteriaceae (CRE) are among the most severe threats to public and clinical health because of their high levels of resistance to various antibiotics. We assessed the efficacy of combination therapy with meropenem (MEM) and cefmetazole (CMZ) against Imipenemase (IMP)-producing CRE, using the checkerboard method and time-killing assay on 13 Enterobacteriaceae isolates harboring blaIMP-1 (4 Enterobacter hormaechei, 5 Escherichia coli, and 4 Klebsiella pneumoniae isolates) and 13 isolates harboring blaIMP-6 (8 E. coli and 5 K. pneumoniae isolates). Minimum inhibitory concentrations (MICs) of MEM and CMZ ranged from 2 to 64 and 64 to 2048 μg/mL, respectively. Checkerboard method demonstrated the synergy of the MEM/CMZ combination in all the tested IMP-producing CRE isolates, and the time-kill assay indicated a bactericidal effect for both blaIMP-1 and blaIMP-6 positive CRE when MEM/CMZ combination was used. In vitro, the MEM/CMZ combination was potentially effective against IMP-1-
Identifying transmission route of antimicrobial-resistant pathogen is essential for appropriate infection control strategy in healthcare facilities. We report the utility of single-nucleotide...
A recent outbreak of the "superbug", carbapenem-resistant Enterobacteriaceae (CRE) bacteria, at the Ronald Reagan UCLA Medical Center has resulted in seven confirmed infections and two deaths [2]. The source of the outbreak was found to be two of the hospitals seven Olympus Corp. duodenoscopes that were used between October 3 and January 28 [2]. A total of 179 patients have been exposed [1,2]. The UCLA Medical Center is providing these individuals with free, at-home screening tests to determine if they are infected with the CRE bacteria as a result of their exposure [2].. What is CRE? Carbapenem-resistant Enterobacteriaceae bacteria are part of a family of bacteria commonly found in the colon. Over time, some of these gut-dwelling pathogens have developed high-resistance against many widely used antibiotics. These bacteria contain an enzyme that breaks down carbapenem antibiotics, rendering them useless, and making it very difficult to treat patients with CRE infections. Antibiotic-resistance ...
CRE isolates were recovered from sterile and non-sterile sites in 10 patients, 6 weeks to 24 years of age, between 2011 and 2013. Comorbidities included hematologic, genetic and urologic abnormalities. Two patients had traveled abroad (India, Lebanon) before CRE recovery. Carbapenemase determinants were detected in 5 cases, including KPC-3 in 2 Klebsiella pneumoniae (ST258 and ST18) and 1 Escherichia coli (ST131), and NDM-1 in 1 K. pneumoniae (ST37) and 1 E. coli (ST101) isolate. Additional resistance determinants were detected, including CTX-M-15, SHV-11, TEM-1, CMY-2, CMY-4 and CMY-42. Four patients died, including 2 of 3 patients with CRE bacteremia. There was no evidence of epidemiologic or molecular relatedness between any 2 cases ...
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Carbapenems are antibiotics of last-resort. These agents are crucial for preventing and treating life-threatening bacterial infections. Carbapenemase enzymes, which degrade carbapenems thereby conferring carbapenem resistance, are harbored on transmissible mobile genetic elements called plasmids that are easily spread from species to species and even among different genera of Gram-negative bacteria. Gram-negative bacteria harboring carbapenemase enzymes, in particular Klebsiella pneumoniae carbapenemases (KPC), have been identified in nearly all States in the U.S. Even more concerning is the increasing reports of the appearance of non-endemic carbapenemase variants in the U.S. such as New Delhi metallo-β-lactamase (NDM)-producing Gram-negative bacilli. Early detection of CPOs in the health care-setting is required as patients with unrecognized colonization with a CPO serve as a reservoir for transmission during health-care associated outbreaks. Therapeutic options for infections caused by a CPO ...
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3. Should I use combination or monotherapy for the treatment of serious infections due to carbapenem-resistant Gram-negative bacilli?. When dealing with carbapenem-resistant Gram-negative bacilli clinicians are left with limited and suboptimal treatment options.. While recent additions of ceftolozane/tazobactam (Zerbaxa) and ceftazidime/avibactam (Avycaz) have given clinicians novel beta-lactam based treatment options for Pseudomonas aeruginosa, and carbapenem-resistant enterobacteriaceae (CRE), experience remains extremely limited with these agents and isolates with resistance to these newer agents have already been identified. The options remaining all come with significant limitations that temper enthusiasm about them.. The mainstays of therapy, the polymyxins, are associated with a dose-limiting nephrotoxicity (occurring around ~30-50% of the time!!), an inability to hit pharmacodynamic targets for deep-seeded infections, and significant heteroresistance, most notably in A. baumannii.. While ...
7.24.14. Selective Micro Technologies demonstrated pure chlorine dioxide successfully kills Carbapenem Resistant Klebsiella pneumoniae at greater than 99.9999%. The test was also conducted according to EPA registration standards using active ingredient at the lowest certified limit (LCL). Test demonstrated successful efficacy at 10 minute contact time. According to CDC, "CRE, which stands for carbapenem-resistant Enterobacteriaceae, are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics. Klebsiella species and Escherichia coli (E. coli) are examples of Enterobacteriaceae, a normal part of the human gut bacteria, that can become carbapenem-resistant." CRE bacteria are highly contagious and marked by severe illness or even death. For more information click here.. ...
Eight patients in a Denver hospital last year harbored Klebsiella pneumoniae carrying New Delhi metallo-beta-lactamase (NDM), an enzyme that confers resistance to many antimicrobials, marking the biggest such outbreak in the United States so far, according to the Centers for Disease Control and Prevention (CDC). The outbreak was first spotted with the detection of carbapenem-resistant K pneumoniae (CRKP) in respiratory samples from two patients in July and August, says an article in todays Morbidity and Mortality Weekly Report (MMWR). Review of records and surveillance cultures identified six more cases. The patients had been hospitalized for a median of 18 days before CRKP was identified. Three of them were treated for CRKP infections, and five were found to be asymptomatically colonized. All of them survived. Tests revealed that the initial isolates were resistant to all antimicrobials except tigecycline. An epidemiologic investigation suggested that multiple transmission events had occurred ...
The increasing prevalence of multiresistant Gram-negative bacteria of the Enterobacteriaceae family in Europe is a worrisome phenomenon. Extended spectrum betalactamase-producing Escherichia coli strains are widespread in the community and are frequently imported into the hospital. Of even more concern is the spread of carbapenem-resistant strains of Klebsiella spp. from regions where they are already endemic. Antibiotic use is a main driver of antibiotic resistance, which again increases broad spectrum antibiotic use, resulting in a vicious circle that is difficult to interrupt. The present commentary highlights important findings of a surveillance study of antimicrobial use and resistance in German ICUs over 8 years with a focus on Gram-negative resistance.
TY - JOUR. T1 - A open clinical trial study of tebipenem pivoxil fine granule for treatment of pediatric patients with otorlaryngological infections. AU - Yamanaka, Noboru. AU - Iwata, Satoshi. AU - Totsuka, Kyoichi. AU - Aizawa, Yoshio. AU - Hori, Seiji. AU - Iwai, Naoichi. AU - Ubukata, Kimiko. AU - Sunakawa, Keisuke. PY - 2009/3/1. Y1 - 2009/3/1. N2 - We conducted a phase II open clinical study in pediatric patients with acute otitis media and acute rhinosinusitis to assess efficacy, safety, and drug compliance with TBPM-PI 4 mg/kg bid and 6 mg/kg bid administration. 1. Clinical effect: Efficacy at the end of administration or at discontinuation was 100% (11/11) in the 4 mg/kg bid group and 100% (10/ 10) in the 6 mg/kg bid group, showing good clinical effect in all subjects. 2. Bacteriological effect: Isolated causal microorganisms were 5 strains of Streptococcus pneumoniae, 4 strains of Haemophilus influenzae, and 2 strains of Moraxella catarrhalis. Eradication at the end of administration ...
NDM-1 stands for New Delhi metallo-beta-lactamase, which is an enzyme produced by certain strains of bacteria that have recently acquired the genetic ability to make this compound. The enzyme is active against other compounds that contain a chemical structure known as a beta-lactam ring. Unfortunately, many antibiotics contain this ring, including the penicillins, cephalosporins, and the carbapenems.. NDM-1 infection was first identified (in 2009) in people who resided in or traveled to the India and Pakistan. Antibiotic use in India is not as restricted as it is in the United States and some researchers feel overuse of carbapenems allowed NDM-1 to develop. Others point to the advent of medical tourism as a cause of NDM-1 spread among countries. Medical tourism refers to patients who travel to a country to get medical care that is not available or is more expensive in their own country. The three first cases of NDM-1 infection in the United States were identified in June 2010 in Americans who ...
Carbapenems was found in Washington Manual. The Washington Manual of Medical Therapeutics helps you diagnose and treat hundreds of medical conditions. Consult clinical recommendations from a resource that has been trusted on the wards for 50+ years.
After reports that a dangerous drug-resistant bacterium, carbapenem-resistant Klebsiella pneumoniae, or CRKP, had spread to at least 356 patients in Southern California last year, Times staff writer
BioAssay record AID 43435 submitted by ChEMBL: Concentration required for its inhibitory activity against Escherichia coli K12(OXA1) class D beta-lactamase; Not tested.
Not long ago serious infections with E.coli and K. pneumoniae were treatable with a wide variety of antibiotics. The evolution of ESBL and AmpC producing strains has changed things. Now it is common in Canada to see infections with strains that are resistant to all of the "workhorse" hospital antibiotics (ceftriaxone, piperacillin-tazobactam and ciprofloxacin) making carbapenems the primary agents. Carbapenem use is rising and carbapenemase producing organisms are appearing on our shores - a very large concern.. Cefepime first became available in 1994 and was marketed as the first "4th generation" cephalosporin with a spectrum of activity similar to ceftazidime but with standard Q12H dosing. It is approved for the treatment of pneumonia, urinary tract infections, skin and soft-tissue infections, intra-abdominal infections and febrile neutropenia. Despite its broad label indications it has never been used widely in Canada. On the current BC provincial hospital formulary it is restricted to ...
FOX NEWS - A long-dreaded superbug that is a strain of E. Coli has made its first appearance in the United States, researchers at the U.S. Military HIV Research Program announced Thursday. After being identified in China, Europe and Canada, researchers identified mcr-1 positive- part of the deadly family of bacteria carbapenem-resistant Enterobacteriaceae, or CRE- last month in a urinary tract sample in Pennsylvania, and found it was resistant to the antibiotic colistin.. Colistin, known as the last line of defense against the most antibiotic-resistant bacteria, now appears to be exchanging genes for its resistance and waning in strength, according to a news release.. "Colistin is one of the last efficacious antibiotics for the treatment of highly resistant bacteria. The emergence of a transferable gene that confers resistance to this vital antibiotic is extremely disturbing," Dr. Patrick McGann, of the Multidrug Resistant Organism Repository and Surveillance Network (MRSN) at the Walter Reed ...
The CDC recently published a report on Antibiotic/Antimicrobial Resistance, which revealed that more than 2.8 million antibiotic-resistant infections occur in the U.S. each year, and more than 35,000 people die as a result. In addition, 223,900 cases of Clostridioides difficile occurred in 2017 and at least 12,800 people died.. Clostridioides difficile (C.diff) is of special concern because it causes a dangerous infection that is linked to antibiotic use. It can cause deadly diarrhea when antibiotics kill beneficial bacteria in the digestive system that normally keep it under control. When the C. diff. illnesses and deaths are added, the annualU.S. toll of all these pathogens is more than 3 million infections and 48,000 deaths.. C. diff., drug-resistant gonorrhea, and carbapenem-resistant enterobacteriaceae (CRE) are known as "nightmare bacteria" because they pose a triple threat. They are resistant to all or nearly all antibiotics, they kill up to half of patients who get bloodstream infections ...
Detection of the mcr-1 colistin resistance gene in carbapenem-resistant Enterobacteriaceae from different hospitals in China. Antimicrobial Agents and Chemotherapy. 2016 ...
Washington, D.C., February 27, 2013 /3BL Media/ - Patients who tested positive for carbapenem-resistant Enterobacteriaceae (CRE) took an average of 387 days following hospital discharge to be clear of the organism, according to a new study published in the March issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).. The study was conducted in the Shaare Zedek Medical Center, a 700-bed university-affiliated general hospital in Jerusalem, Israel. The research team analyzed follow-up cultures from 97 CRE-positive patients who had been discharged from the medical center between January 2009 and December 2010.. The average time until cultures became negative was 387 days. At three months, 78 percent of patients remained culture positive; at six months, 65 percent remained positive; at nine months, 51 percent, and at one year 39 percent of patients remained positive, meaning they could potentially ...
Washington, D.C. and Malvern, PA, July 22, 2019 - The U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) will collaborate with the U.S. Department of Defenses Defense Threat Reduction Agency (DTRA) and Venatorx Pharmaceuticals, Inc. of Malvern, Pennsylvania, to develop a novel antibiotic to treat infections caused by bacteria resistant to currently available agents.. The U.S. Centers for Disease Control and Prevention designated antibiotic-resistant infections, including infections such as carbapenem-resistant Enterobacteriaceae (CRE), as urgent public health threats. CDC estimates that antibiotic-resistant infections affect at least two million people in the United States each year and drive $35 billion in healthcare system costs annually.. Venatorxs clinical-stage candidate includes a novel compound, VNRX-5133, which when combined with cefepime, a currently marketed antibiotic, may overcome certain forms of antibiotic ...
Cases of the highly contagious, drug-resistant bacteria, carbapenem-resistant Enterobacteriaceae, have increased fivefold in community hospitals in the Southeastern United States, according to a new study published in the August issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
News Article written for a test. _______________________________________________________________. More Exposed to Superbug in the Second Largest Hospital in L.A.. The second largest hospital in Los Angeles has reported an outbreak of "superbugs", drug resistant infections, and more patients are expected to be exposed. Almost two years ago, the maker of medical scopes started warning hospitals in Europe that there was a risk of a potential outbreak and they would need to prepare. The Food and Drug Administration has issued a warning to use extra caution when after use of the dirty medical scopes which have been linked to the "superbug" outbreak.. Cedars-Sinai Medical Center has already reported four of these "superbug" infections and has identified the drug resistant bacteria as E. Coli. There are also 67 more patients at risk at Cedsar-Sinai who are at risk. Those infected in the Los Angeles area have had to battle a different germ called carbapenem-Resistant Enterobacteriaceae, or CRE.. The ...
The woman was in her 70s when she arrived at a hospital in August 2016 with signs of sepsis. She had been in India years before and had been treated for a broken leg and bone infection, according to the CDC. After doing tests, her doctors found the bacteria - which belong to a class of drug-resistant bugs called carbapenem-resistant Enterobacteriaceae (CRE) - were resistant to all forms of FDA-approved antibiotics. The patient died in September after going into septic shock, according to the CDC ...
Excerpt from: Infection Control Today (click for full article) As the superbugs known as carbapenem-resistant Enterobacteriaceae (CRE) have continued to spread over the last decade with cases in at least 42 states, the Society for Healthcare Epidemiology of America (SHEA)...
James A. McKinnell, MD, is an associate professor of medicine at the David Geffen School of Medicine at Harbor-UCLA Medical Center. His research focuses on understanding optimal treatment and better classifying disease burden from highly drug resistant bacteria, including Carbapenem-resistant Pseudomonas and Enterobacteriaceae spp.. ...
... is a type of beca-lactam antibiotic which are the last resort for many bacterial infections and super bugs. Carbapenems are a very powerful group of penicillin related antibiotics which are very effective as a last defence against certain diseases.
Drug Name】. Generic name: Meropenem for injection. Product Name: Double Energy. 【Properties】 This product is white to slightly yellow powder.. [Ingredients] The main ingredient of this product is meropenem.. [Pharmacological action]. This product is a synthetic broad-spectrum carbapenem antibiotic that produces an antibacterial effect by inhibiting the synthesis of bacterial cell walls.. [Indications] Applicable to infections caused by single or multiple meropenem-sensitive bacteria in adults and children.. 【Dosage】. The intravenous infusion of meropenem should be greater than 5 minutes and the intravenous infusion time should be greater than 15 to 30 minutes. The dosage and interval of administration for an adult should be based on the type of infection, the severity, and the specific circumstances of the patient.. [Specification] According to C17H25N3O5S (1) 0.25g (2) 0.5g (3) 1.0g. ...
According to a recent CDC report titled, Lethal, Drug-resistant Bacteria Spreading in U.S. Healthcare Facilities, drug-resistant germs called carbapenem-resistant Enterobacteriacea ...
Carbapenam synthetase (CarA) is an ATP/Mg2+-dependent enzyme that catalyzes formation of the β-lactam ring in (5R)-carbapenem-3… Expand ...
Abstract BACKGROUND AND OBJECTIVE: The spread of carbapenem-resistant Klebsiella pneumoniae especially blaNDM-1-carrying isolates is a great concern worldwide. In this study we describe the molecular basis of carbapenem-resistant K. pneumoniae in three teaching hospitals at Bandar Abbas, south of Iran. MATERIALS AND METHODS: A total of 170 nonduplicate clinical isolates of K. pneumoniae were investigated. Antimicrobial susceptibility test was performed by disc diffusion method. PCR was carried out for detection of carbapenemase (blaKPC, blaIMP, blaVIM, blaNDM, blaSPM, blaOXA-48, and blaOXA-181) and extended-spectrum β-lactamase (blaCTX-M, blaSHV, blaTEM, blaVEB, blaGES, and blaPER). Clonal relatedness of blaNDM-1-positive isolates was evaluated by multilocus sequence typing (MLST). RESULTS: Tigecycline was the most effective antimicrobial agent with 96.5% susceptibility. In addition, 6.5% of the isolates were carbapenem resistant. BlaNDM-1 was identified in four isolates (isolate A-D) and all ...
Identifying Risk Factors for Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit
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Acinetobacter baumannii is currently one of the key nosocomial pathogens causing severe infections; of special concern is its resistance to expanded-spectrum cephalosporins (ESCs) and carbapenems, often associated with the few so-called European clones (6, 7, 19). It has two natural -lactamases, an AmpC-like enzyme (Acinetobacter-derived cephalosporinase [ADC]) (10) and a carbapenem-hydrolyzing class D -lactamase (CHDL; the OXA-51 type) (15), which affect susceptibility upon increased expression due to ISAba1 insertion upstream of their genes (9, 18). Moreover, acquired -lactamases, including metallo-lactamases (MBLs) and four CHDL types, the OXA-23, OXA-24/40, OXA-58, and OXA-143 types, are observed (15). Knowledge of A. baumannii in Poland has been limited to single isolates (9, 14, 21); our aim was to analyze a bigger group of A. baumannii strains. (Part of this work was presented at the 22nd European Congress of Clinical Microbiology and Infectious Diseases, London, United Kingdom, 31 March to 3
In recent years, the number of nosocomial infections caused byAcinetobacter baumannii has increased significantly (4). Many outbreaks have been reported, especially among patients confined to hospital intensive care units, where the widespread use of antibiotics may select multidrug-resistant strains. The difficulty of treating A. baumannii nosocomial infection is associated with the high resistance to a wide range of antimicrobial agents frequently observed in this species (8). Often, imipenem remains one of the few therapeutic alternatives. Fortunately, imipenem resistance is relatively rare among Acinetobacter clinical isolates. Carbapenem resistance can arise by a decrease in expression of an outer membrane protein (3) or by alteration in penicillin-binding proteins (5). In general, the emergence of carbapenem-hydrolyzing enzymes has been limited compared to the prevalence of other β-lactamases (1). However, in 1985 in Scotland, anA. baumannii strain that produced a plasmid-mediated ...
The increasing speed and decreasing cost of high-throughput DNA sequencing technologies are enabling its application to the practice of medicine (35). Here, we tested whether genome sequencing could help to unravel a nosocomial outbreak and affect hospital infection control decisions. We sequenced patient and environmental isolates within a clinically relevant turnaround time during a hospital KPC-K. pneumoniae outbreak. Among the key insights provided by sequencing were that (i) the outbreak was monoclonal, despite a 3-week interval between the index case and the identification of subsequent cases, (ii) transmission likely occurred from at least two different sites of the index patient, (iii) at least three independent transmission events from the index patient led to two major clusters of colonized patients, (iv) one patient could be linked to a contaminated ventilator, and (v) a small number of putative resistance mutations could be identified in newly colistin-resistant isolates. Moreover, ...
INTRODUCTION: The incidence of multidrug resistant microorganisms worldwide is increasing. The aim of the study was to present institutional experience with the multidrug resistant microorganism colonization patterns observed in children with congenital heart diseases hospitalized in a hybrid pediatric cardiac surgery center. MATERIAL AND METHODS: Microbiological samples were routinely collected in all children admitted to our department. All microbiological samples were analyzed with regard to multidrug resistant microorganisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Gram-negative rods producing extended-spectrum beta-lactamases (ESBL), multidrug resistant Gram-negative rods (MDR-GNRs), carbapenemase-producing Klebsiella pneumoniae (KPC), carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA ...
The articles reports on the discovery of a carbapenem-resistant Klebsiella pneumoniae strain producing a Verona integron-encoded metallo-beta-lactamase (VIM) carbapenemase. The strain, not common among Enterobacteriaceae in the U.S., was detected from an American tourist who was vacationing in Greece. Initial diagnosis was Clostridium difficile infection but was proven otherwise when the patient was transferred to a U.S. hospital. No other patients in the hospital was found to have the strain ...
Carbapenem resistant Enterobacteriaceae are a class of bacteria that are resistant to multiple antibiotics, including carbapenems, which are considered last-resort drugs when other antibiotics have failed.. CRE, which tend to spread in hospitals and long-term care facilities, cause an estimated 9,300 infections and 600 deaths in the U.S. each year, according to the U.S. Centers for Disease Control and Prevention (CDC).. And incidence is on the rise.. Tom Frieden, director of the CDC, has called these nightmare bacteria because they are resistant to some of the last-ditch treatments available to doctors fighting resistant infections.. The researchers looked at about 250 samples of CRE from hospitalized patients from three Boston-area hospitals and from one California hospital. Their goal was to obtain a snapshot of the genetic diversity of CRE, to define the frequency and characteristics of outbreaks, to find evidence of strains being transmitted within and between hospitals, and to learn how ...
Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are a group of emerging highly drug-resistant Gram-negative bacilli causing infections associated with significant morbidity and mortality. Once confined to outbreaks in the northeastern United States (US), they have spread throughout the US and most of the world. KPCs are an important mechanism of resistance for an increasingly wide range of Gram-negative bacteria and are no longer limited to K pneumoniae. KPC-producing bacteria are often misidentified by routine microbiological susceptibility testing and incorrectly reported as sensitive to carbapenems; however, resistance to the carbapenem antibiotic ertapenem is common and a better indicator of the presence of KPCs. Carbapenem antibiotics are generally not effective against KPC-producing organisms. The best therapeutic approach to KPC-producing organisms has yet to be defined; however, common treatments based on in vitro susceptibility testing are the polymyxins, tigecycline, and ...
The prevalence of carbapenem-resistant Gram-negative bacilli is on the rise worldwide, posing a major public health threat. Previously, this was mostly a problem in Pseudomonas and Acinetobacter, but during the last decade, carbapenem resistance has escalated in medically important species such as K …
Molecular characterization and antimicrobial susceptibility of Acinetobacter baumannii isolates obtained from two hospital outbreaks in Los Angeles County, California, USA
Carbapenem -resistant Enterobacteriaceae (CRE) and the Imperative for Antimicrobial Stewardship. Christopher Trabue, M.D. September 13, 2013. Outline. Background and Epidemiology Clinical significance and public health implications Slideshow 2067038 by kylia
Carbapenem resistance in Enterobacteriaceae such as Klebsiella pneumoniae and Escherichia coli poses a significant threat to patients and healthcare systems in all European Union/European Economic Area (EU/EEA) countries. Carbapenem-resistant Enterobacteriaceae (CRE) infections are associated with high mortality, primarily due to delays in administration of effective treatment and the limited availability of treatment options. ...
The rate of bacterial infections resistant to even the strongest antibiotics are rising in the U.S. and leading to untreatable and often fatal illnesses. In a recent press conference, officials from the Center for Disease Control and Prevention reported that in 2012 nearly four percent of patients in all U.S. hospitals were infected with the drug-resistant bacteria; the rate in specialty hospitals was nearly 18 percent. The officials called for doctors, hospitals and public health workers to come together to stop the infections from spreading. The last decade has seen an explosion in the rate of hospitalized patients contracting Carbapenem-Resistant Enterobacteriaceae, or CRE s. The name refers to the bacteria s lack of response to carbapenems, a class of drugs currently regarded by experts as last resort antibiotics. CRE s are fatal to over half of patients who get bloodstream infections from them and include over 70 known species that occur naturally in water, soil and the human digestive ...
The present study aimed to perform a deep phenotypic and genotypic analysis of 15 clinical carbapenem-resistant Acinetobacter baumannii (CRAb) strains isolated in Madagascar between 2008 and 2016 from diverse sources. CRAb isolates collected from the Clinical Biology Centre of the Institut Pasteur of Madagascar, from the neonatal unit of Antananarivo military hospital, and from intensive care units of Mahajanga Androva and Antananarivo Joseph Ravoahangy Andrianavalona (HJRA) hospitals were subjected to susceptibility testing. Whole-genome sequencing allowed us to assess the presence of antibiotic-resistance determinants, insertion sequences, integrons, genomic islands and potential virulence factors in all strains. The structure of the carO porin gene and deduced protein (CarO) were also assessed in CRAb isolates. All isolates were found to be multidrug-resistant strains. Antibiotic-resistance genes against six classes of antimicrobial agents were described. The four carbapenem-resistance genes: blaOXA
Source: Centre for Health Protection, Hong Kong PRC SAR, full page: (LINK).]. Case of NDM-1 Carbapenemase-producing Enterobacteriaceae under CHP investigation. The Public Health Laboratory Services Branch (PHLSB) of the Centre for Health Protection (CHP) of the Department of Health confirmed today (October 16) a case of New Delhi metallo-β-lactamase-1 (NDM-1) Carbapenemase-producing Enterobacteriaceae in a 25-year-old man.. The patient, with good past health, lived in Hong Kong. He travelled to Guangdong Province on September 21 and sustained a severe head injury in a traffic accident on September 27. He was admitted to a local hospital and subsequently transferred to Prince of Wales Hospital for further management on October 4. The patient passed away on October 7.. The patients rectal swab yielded NDM-1 Carbapenemase-producing Enterobacteriaceae as confirmed by the PHLSB.. His travel collaterals and home contacts are asymptomatic. The case has been referred to the coroner for further ...
This study reports the dissemination of multidrug-resistant (MDR) OXA-23-producing Acinetobacter baumannii clones in hospitals in Antananarivo, Madagascar. A total of 53 carbapenem-resistant A. baumannii isolates were obtained from September 2006 to March 2009 in five hospitals. These resistant strains represent 44% of all A. baumannii isolates. The double disk synergy test was performed to screen for production of metallo-beta-lactamases. Polymerase chain reaction (PCR) and DNA sequencing were performed for the detection of bla(AmpC), bla(OXA-51),bla(OXA-23), bla(OXA-24), bla(IMP), bla(VIM). The presence of the insertion sequence ISAba1 relative to bla OXA-23 and bla OXA-51 was assessed by PCR. Isolates were typed by Rep-PCR. All the isolates were MDR and produced the OXA-23 carbapenemase, which was confirmed by sequencing. PCR analysis for AmpC and OXA-51 gave positive results for all strains studied. No isolates produced metallo-beta-lactamases. In all isolates ISAba1 laid upstream of bla OXA-23. The
TY - JOUR. T1 - Prevention of colonization and infection by klebsiella pneumoniae carbapenemase-producing enterobacteriaceae in long-term acute-care hospitals. AU - Hayden, Mary K.. AU - Lin, Michael Y.. AU - Lolans, Karen. AU - Weiner, Shayna. AU - Blom, Donald. AU - Moore, Nicholas M.. AU - Fogg, Louis. AU - Henry, David. AU - Lyles, Rosie. AU - Thurlow, Caroline. AU - Sikka, Monica. AU - Hines, David. AU - Weinstein, Robert A.. PY - 2015/4/15. Y1 - 2015/4/15. N2 - Background. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae (hereafter "KPC") are an increasing threat to healthcare institutions. Long-term acute-care hospitals (LTACHs) have especially high prevalence of KPC. Methods. Using a stepped-wedge design, we tested whether a bundled intervention (screening patients for KPC rectal colonization upon admission and every other week; contact isolation and geographic separation of KPC-positive patients in ward cohorts or single rooms; bathing all patients daily with ...
TY - JOUR. T1 - Evaluation of temocillin for phenotypic carbapenemase screening of Escherichia coli and Salmonella enterica isolates in relation to the presence of genes encoding ESBLs and carbapenemase production. AU - Cavaco, Lina M. AU - Hansen, Frank. AU - Mushtaq, Shazad. AU - Hill, Robert L R. AU - Woodford, Neil. AU - Le Hello, Simon. AU - Hendriksen, Rene S.. AU - Hammerum, Anette Marie. AU - Hasman, Henrik. PY - 2019. Y1 - 2019. N2 - The expression of enzymes of the OXA-48 carbapenemase group is difficult to detect by phenotypic methods owing to frequent low levels of carbapenem resistance and negative results with some screening methods. Temocillin has been shown to be a good option for phenotypic screening as it is hydrolysed by the OXA-48-group enzymes, whereas ESBLs, AmpC and some other carbapenemases have a lower hydrolytic effect on this antimicrobial. However, no epidemiological cut-off for temocillin is available. To evaluate temocillin MICs in relation to the presence or ...
TY - JOUR. T1 - Integron-associated imipenem resistance in Acinetobacter baumannii isolated from a regional hospital in Taiwan. AU - Liu, S. Y.. AU - Lin, J. Y.. AU - Chu, C.. AU - Su, L. H.. AU - Lin, T. Y.. AU - Chiu, C. H.. PY - 2006/1. Y1 - 2006/1. N2 - We investigated the genetic properties of imipenem-resistant Acinetobacter baumannii collected from a regional hospital in Taiwan. Pulsed-field gel electrophoresis demonstrated that the isolates were genetically diverse. Polymerase chain reaction, DNA sequencing, and DNA-DNA hybridisation showed that the blaIMP-1 gene resided as a cassette in a plasmid-borne class 1 integron in two isolates. The majority of the resistant isolates were plasmid-less and carried no blaIMP, blaVIM or bla CFI genes, indicating that other uncharacterised metallo-β- lactamases or mechanisms other than enzyme production are involved in carbapenem resistance in this group of A. baumannii. We conclude that multidrug resistance of A. baumannii was a combined effect of ...
Prompt detection of metallo-beta-lactamase (MBL) producing isolates is necessary to prevent their dissemination. Frequency of MBLs producing strains among multidrug resistant (MDR) Acinetobacter species and Pseudomonas aeruginosa was evaluated in critical care Patients using imipenem-EDTA disk method. One hundred MDR Acinetobacter spp. and 42 Pseudomonas aeruginosa were checked for MBL production, from January to June 2001. MBL was produced by 96.6 % of imipenem-resistant Acinetobacter isolates, whereas 100% imipenem-resistant Pseudomonas aeroginosa isolates were MBL producers. Carbapenem resistance in MDR Acinetobacter spp. and Pseudomonas aeruginosa isolates in this study was due to MBLs. This calls for strict infection control measures to prevent further dissemination.
... is a carbapenem antibiotic marketed by Merck as Invanz. It is structurally very similar to meropenem in that it ... Organisms that produce a metallo-β-lactamase are innately immune to ertapenem (as well as all carbapenems).[citation needed] ... Other members of the carbapenem group (imipenem, doripenem, and meropenem) are broadly active antibacterials that are used for ... Ertapenem differs from other carbapenems in having a somewhat less broad spectrum of activity (not against Pseudomonas ...
Treatment with an aminoglycoside or carbapenem is usually indicated. Carbapenems are a class of beta-lactam antibiotics with a ... Examples of Carbapenems include meropenem and imipenem. "Feedback for Practical 10: Antimicrobial Agents". Archived from the ...
... s are similar in structure to carbapenems. However, where penems have a sulfur, carbapenems have another carbon. There are ... "Medscape.com". Sasaki A, Goda K, Enomoto M, Sunagawa M (May 1992). "Synthetic studies of carbapenem and penem antibiotics. II. ... Although structurally distinct, the penems are often confused with the carbapenem class of drugs. Five main penem subgroups - ...
For instance, some Klebsiella pneumoniae strains are carbapenem resistant.[9] References[edit]. *^ "List of genera included in ... Main article: Carbapenem resistant enterobacteriaceae. Several Enterobacteriaceae strains have been isolated which are ... most recently to the class of antibiotics known as carbapenems." ... resistant to antibiotics including carbapenems, which are often ...
It is a beta-lactam and belongs to the subgroup of carbapenems. It was launched by Shionogi Co. of Japan under the brand name ... Seizure risk: carbapenems in general have been reported to cause seizure activity in some people. In addition, those who ... It is the fourth member of the carbapenem class to be approved in the United States. The greater stability of doripenem in ... However, carbapenem-hydrolyzing beta-lactamases are an exception. On average, about 8.1% of plasma proteins attached to ...
Resistance to carbapenems is also being increasingly reported. A. baumannii can survive on the human skin or dry surfaces for ... and the carbapenems are recognised as the gold-standard and treatment of last resort. Acinetobacter species are unusual in that ... "Detection of OXA-type carbapenemases and integrons among carbapenem-resistant Acinetobactor baumannii in a Teaching Hospital in ...
Imipenem (carbapenems) is often the antibiotic of choice. Aminoglycosides such as amikacin have been found to be very effective ...
... (INN) is a carbapenem antibiotic. It has in vitro activity against anaerobes. 1-β-methyl-carbapenem antibiotic. ... Aldridge KE, Morice N, Schiro DD (April 1994). "In vitro activity of biapenem (L-627), a new carbapenem, against anaerobes". ...
"Novel Carbapenem Antibiotics for Parenteral and Oral Applications: In Vitro and in Vivo Activities of 2-Aryl Carbapenems and ... Tebipenem is the first carbapenem whose prodrug form, the pivalyl ester, is orally available. El-Gamal, M. I.; Oh, C. H. (2010 ... Hazra, S; Xu, H; Blanchard, J (June 2014). "Tebipenem, a New Carbapenem Antibiotic is a Slow Substrate that Inhibits the β- ... Tebipenem (brand name: Orapenem) is a broad-spectrum orally-administered antibiotic, from the carbapenem subgroup of β-lactam ...
"Crystal structure of carbapenem synthase (CarC)". J. Biol. Chem. 278 (23): 20843-20850. doi:10.1074/jbc.M213054200. PMID ... "The enzymology of clavam and carbapenem biosynthesis". Chem. Commun.: 4251-4263. doi:10.1039/b505964j. PMID 16113715. CS1 maint ...
In clavams, the β-lactam is formed prior to the second ring; in carbapenems, the β-lactam ring is closed second in sequence. ... The biosynthesis of the β-lactam ring of tabtoxin mirrors that of the clavams and carbapenems. The closure of the lactam ring ... β-Lactams containing 2,3-dihydro-1H-pyrrole rings are named carbapenems. β-Lactams fused to unsaturated six-membered rings: β- ... There is perhaps a 5%-10% cross-sensitivity between penicillin-derivatives, cephalosporins, and carbapenems; but this figure ...
... more precisely the carbapenem family of antibiotics. This property is due to the physico-chemical similarities between membrane ...
April 2001). "Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae ... but still within the susceptible range for carbapenems. Because these strains are susceptible to carbapenems, they are not ... One of many CREs is carbapenem-resistant Klebsiella pneumoniae (CRKP). Over the past 10 years, a progressive increase in CRKP ... Infection with carbapenem-resistant Enterobacteriaceae (CRE) or carbapenemase-producing Enterobacteriaceae is emerging as an ...
... and carbapenem antibiotics. The group's biosynthetic work has focused on the clavams and carbapenems, with a particular focus ... "Epimerization and desaturation by carbapenem synthase (CarC). A hybrid DFT study". Journal of Computational Chemistry. 27 (6): ...
Like penicillins, carbapenems contain a β-lactam ring (cyclic amide) fused to a five-membered ring. Carbapenems differ in ... Bradley JS, Garau J, Lode H, Rolston KV, Wilson SE, Quinn JP (1999). "Carbapenems in clinical practice: a guide to their use in ... At some later point, oxidation to the carbapenem and ring inversions must occur. The hydroxyethyl side chain of thienamycin is ... Núñez LE, Méndez C, Braña AF, Blanco G, Salas JA (2003). "The biosynthetic gene cluster for the beta-lactam carbapenem ...
It is in the carbapenem family of medications. Meropenem usually results in bacterial death through blocking their ability to ... "Peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) restores carbapenem susceptibility to NDM-1-positive pathogens ... an enzyme that many drug-resistant bacteria use to destroy carbapenems. "Meropenem". The American Society of Health-System ...
Carbapenem antibiotics: reduces valproate levels, potentially leading to seizures. Cimetidine: inhibits valproate's metabolism ...
... a unique member of the crotonase superfamily catalyzing the first step in carbapenem biosynthesis". J. Biol. Chem. 280 (41): ... which is involved in carbapenem biosynthesis. 6-oxo camphor hydrolase, which catalyses the desymmetrization of bicyclic beta- ...
Several Enterobacteriaceae strains have been isolated which are resistant to antibiotics including carbapenems, which are often ... For instance, some Klebsiella pneumoniae strains are carbapenem resistant. "List of genera included in families - ... most recently to the class of antibiotics known as carbapenems." Enterobacteriaceae genomes and related information at PATRIC, ...
This screen enabled the discovery of fosfomycin, cephamycin C, thienamycin and several carbapenems. Specially prepared giant ...
Carbapenems are the treatment of choice for serious infections due to ESBL-producing organisms, yet carbapenem-resistant ( ... and carbapenems (ertapenem), although carbapenems are relatively resistant to beta-lactamase. Beta-lactamase provides ... OXA carbapenemases hydrolyse carbapenems very slowly in vitro, and the high MICs seen for some Acinetobacter hosts (>64 mg/L) ... Carbapenems are famously stable to AmpC β-lactamases and extended-spectrum-β-lactamases. Carbapenemases are a diverse group of ...
The liver injury due to the carbapenems is usually mild and self-limited. Rarely, the carbapenems can cause a clinically ... Imipenem and other carbapenems have not been linked to cases of acute liver failure. The cause of the mild, transient serum ... The course is usually self-limiting, but at least one case of vanishing bile duct syndrome related to the carbapenems has been ... Imipenem is in the carbapenem family of medications and works by interfering with the bacteria's cell wall. Cilastatin blocks ...
Carbapenem antibiotics (heretofore often the treatment of last resort for resistant infections) are generally not effective ... As of 2013 hard-to-treat or untreatable infections of carbapenem-resistant Enterobacteriaceae (CRE), also known as ... C. difficile colitis is most strongly associated with fluoroquinolones, cephalosporins, carbapenems, and clindamycin. Some ...
Carbapenem resistance via the bla KPC-2 gene in Enterobacter cloacae blood culture isolate. South. Med. J.103(5),453-454 (2010 ... NmcA carbapenem-hydrolyzing enzyme in Enterobacter cloacae in North America. Emerg. Infect. Dis.9,999-1002 (2003). 77.Naas T, ... Dis.17,1791-1798 (2011). 74.Naas T, Nordmann P. Analysis of a carbapenem-hydrolyzing class A beta-lactamase from Enterobacter ... Agents Chemother.44,2247-2253 (2000). 84.Bratu S, Landman D, Alam M, Tolentino E, Quale J. Detection of KPC carbapenem- ...
... (formerly CS-023) is a carbapenem β-lactam antibiotic. Efficacy of human-simulated exposures of tomopenem (formerly ...
Carbapenems are a class of beta-lactam antibiotics that are capable of killing most bacteria by inhibiting the synthesis of one ... The carbapenems were developed to overcome antibiotic resistance mediated by bacterial beta-lactamase enzymes. However, the ... In March 2010, a study in a hospital in Mumbai found that most carbapenem-resistant bacteria isolated from patients carried the ... These include the antibiotics of the carbapenem family, which are a mainstay for the treatment of antibiotic-resistant ...
However, other strains displayed at least elevated carbapenem MICs or were carbapenem resistant and produced measurable ... Twenty-five of the isolates were positive for the cfiA carbapenem resistance gene. The resistance rates were 0.8% and 1.3% for ... The major determinant of carbapenem resistance in Bacteroides fragilis is production of CfiA metallo-beta-lactamase via ... Examination of cfiA-mediated carbapenem resistance in Bacteroides fragilis strains from a European antibiotic susceptibility ...
Carbapenems. Indications and usages, anatomical therapeutic chemical and diseases classification codes:. *J01DH51 - Imipenem ...
  • Carbapenems differ from conventional penicillins (penams) in having no sulfur atom in their 5-membered ring and in having a double bond between carbons 2 and 3 (figure 1). (springer.com)
  • Positive on a phenotypic test for carbapenemase production (e.g., metallo-β-lactamase test, modified Hodge test, Carba NP, Carbapenem Inactivation Method [CIM], or modified CIM). (cdc.gov)
  • Antibiotic Sensitivity Testing (AST), Modified Hodge Test (MHT) and Modified Carbapenem inactivation method (mCIM) were performed for detection of carbapenemase production and Congo red agar method (CRA) along with Microtitre plate method were performed for detecting biofilm production. (nepjol.info)
  • The study, which was recently published in the International Journal of Infectious Diseases , examined carbapenem resistance rates, the length of hospital stays, and infection-related mortality rates during the pre-intervention period from April 2010 to September 2011, and the post-intervention period from October 2011 to March 2017. (contagionlive.com)
  • Conclusions: These data suggest that exposure to carbapenems is an independent risk factor for CRKP infection. (jidc.org)
  • For bloodstream infections known to be due to extended spectrum beta-lactamase producing Enterobacteriaceace, carbapenems are superior to alternative treatments. (wikipedia.org)
  • In a preliminary work, we reported on the growth of distinct colonies within the inhibition halo around carbapenem disks or Etest strips and assessed these colonies as having the phenotypic manifestation of carbapenem heteroresistance ( 17 ). (asm.org)
  • We recommend that institutions develop guidelines for the early phenotypic detection of ESBLs and carbapenem resistance. (scirp.org)
  • Our findings show that although multidrug resistant ESBL producing E. coli are prevalent in both the hospital and the community in this environment, carbapenem resistance is still low. (scirp.org)
  • The study included all isolates that were initially identified as carbapenem susceptible by use of the Vitek 2 system (bioMérieux, Marcy l'Étoile, France) to investigate their putative heteroresistant phenotype. (asm.org)
  • Overall trends in the incidence of Kp BSI were recorded, by including annual incidences of carbapenem-susceptible (C-S) Kp BSI. (biomedcentral.com)