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.
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.
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.
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.
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.
Substances that reduce the growth or reproduction of BACTERIA.
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.
A species of gram-negative, aerobic bacteria, commonly found in the clinical laboratory, and frequently resistant to common antibiotics.
Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses).
Infections with bacteria of the family ENTEROBACTERIACEAE.
Gram-negative, non-motile, capsulated, gas-producing rods found widely in nature and associated with urinary and respiratory infections in humans.
Infections with bacteria of the genus ACINETOBACTER.
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).
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.
Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method.
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.
Infections caused by bacteria that show up as pink (negative) when treated by the gram-staining method.
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).
Infections with bacteria of the genus KLEBSIELLA.
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.
Infections with bacteria of the genus PSEUDOMONAS.
EXOPEPTIDASES that specifically act on dipeptides. EC 3.4.13.
A genus of gram-negative bacteria of the family MORAXELLACEAE, found in soil and water and of uncertain pathogenicity.
Any infection which a patient contracts in a health-care institution.
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.
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.
Cyclic AMIDES formed from aminocarboxylic acids by the elimination of water. Lactims are the enol forms of lactams.
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 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.
A building block of penicillin, devoid of significant antibacterial activity. (From Merck Index, 11th ed)
Proteins found in any species of bacterium.
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.
Bacteria which retain the crystal violet stain when treated by Gram's method.
Infections with bacteria of the genus SERRATIA.
Semisynthetic, broad-spectrum antibacterial derived from CEPHALORIDINE and used especially for Pseudomonas and other gram-negative infections in debilitated patients.
Institutions with an organized medical staff which provide medical care to patients.
A species of gram-negative bacteria causing URINARY TRACT INFECTIONS and SEPTICEMIA.
Formularies concerned with pharmaceuticals prescribed in hospitals.
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.
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.
Acyltransferases that use AMINO ACYL TRNA as the amino acid donor in formation of a peptide bond. There are ribosomal and non-ribosomal peptidyltransferases.
DNA elements that include the component genes and insertion site for a site-specific recombination system that enables them to capture mobile gene cassettes.
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.
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.
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.
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.
Hospital units providing continuous surveillance and care to acutely ill patients.
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.
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).
Semisynthetic, broad-spectrum, AMPICILLIN derived ureidopenicillin antibiotic proposed for PSEUDOMONAS infections. It is also used in combination with other antibiotics.
Infections with bacteria of the genus BACTEROIDES.
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.
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.
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.
Deoxyribonucleic acid that makes up the genetic material of bacteria.
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.
A TETRACYCLINE analog, having a 7-dimethylamino and lacking the 5 methyl and hydroxyl groups, which is effective against tetracycline-resistant STAPHYLOCOCCUS infections.
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.
Inflammation of the lung parenchyma that is caused by bacterial infections.
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.
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.
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.
Enzyme which catalyzes the peptide cross-linking of nascent CELL WALL; PEPTIDOGLYCAN.
A group of QUINOLONES with at least one fluorine atom and a piperazinyl group.
Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.
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.
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 infections
Proteins isolated from the outer membrane of Gram-negative bacteria.
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.
The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.
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.
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)
Glycosylated compounds in which there is an amino substituent on the glycoside. Some of them are clinically important ANTIBIOTICS.
Simultaneous resistance to several structurally and functionally distinct drugs.
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.
Enzymes that catalyze the transfer of hexose groups. EC 2.4.1.-.
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.
The process of cleaving a chemical compound by the addition of a molecule of water.
Infections by bacteria, general or unspecified.
The functional hereditary units of BACTERIA.
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.
A group of derivatives of naphthyridine carboxylic acid, quinoline carboxylic acid, or NALIDIXIC ACID.
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.
Measurable quantity of bacteria in an object, organism, or organism compartment.
A multistage process that includes cloning, physical mapping, subcloning, determination of the DNA SEQUENCE, and information analysis.
A semisynthetic cephamycin antibiotic resistant to beta-lactamase.
Infections with bacteria of the species ESCHERICHIA COLI.
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.
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.
Non-susceptibility of an organism to the action of the cephalosporins.
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).
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 engaged in educational and research programs, as well as providing medical care to the patients.
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)

TY - JOUR. T1 - In vitro activity of tebipenem, a new oral carbapenem antibiotic, against penicillin-nonsusceptible Streptococcus pneumoniae. AU - Kobayashi, Reiko. AU - Konomi, Mami. AU - Hasegawa, Keiko. AU - Morozumi, Miyuki. AU - Sunakawa, Keisuke. AU - Ubukata, Kimiko. PY - 2005/3/1. Y1 - 2005/3/1. N2 - The in vitro activity of tebipenem (TBM), a new oral carbapenem antibiotic, against Streptococcus pneumoniae clinical isolates (n = 202) was compared with those of 15 reference agents. The isolates were classified into five genotypic classes after PCR identification of abnormal pbp1a, pbp2x, and pbp2b genes: (i) penicillin-susceptible S. pneumoniae (PSSP) isolates with no abnormal pbp genes (n = 34; 16.8%), (ii) genotypic penicillin-intermediate S. pneumoniae (gPISP) isolates with only an abnormal pbp2x gene [gPISP (2x)] (n = 48; 23.8%), (iii) gPISP isolates with abnormal pbp1a and pbp2x genes (n = 32; 15.8%), (iv) gPISP isolates with abnormal pbp2x and pbp2b genes (n = 16; 7.9%), and (v) ...
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 ...
Background: Carbapenem antibiotics are important therapeutic agents in the health care setting, they are frequently used as an empiric therapy for life-threatening infections as well as infections with multi-drug-resistant gram-negative bacilli. Carbapenemase-producing Carbapenem-Resistant Enterobacteriaceae (CRE) are a significant public health challenge worldwide. The detection of carbapenemases productions in CRE strains is performed by phenotypic and genotypic methods. The phenotypic methods target carbapenemases production but provide no guidance regarding the specific carbapenemases types, while the genotypic diagnosis has the benefit of determining the exact mechanism conferring carbapenems resistance. Aim: Improvement of the antibiotic policy and infection control strategies in Suez Canal University Hospitals in Ismailia; through adequate detection of carbapenem resistance in the hospitals. Methods: All the CRE isolates were tested by the phenotypic methods (mCIM & eCIM) test to detect
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) has been declared among the most immediate drug-resistant threats to america. when utilized as monotherapy in the treating CRE attacks.3,6C8 A far more recent antibiotic, ceftazidimeCavibactam (FDA-approved in 2015), shows improved safety and efficiency outcomes in comparison to traditional agents, but reports of treatment resistance and failure during therapy have already been noted.9C11 MeropenemCvaborbactam was approved by the FDA in August 2017 as the initial carbapenem beta-lactamase inhibitor mixture with activity against broad-spectrum beta-lactamases in CRE infections. Signs12 MeropenemCvaborbactam is certainly indicated for the treating complicated urinary system attacks (cUTI), including pyelonephritis, in adults aged 18 years and old. MECHANISM OF Actions8,12 Meropenem, a carbapenem antibacterial agent, disrupts bacterial cell-wall synthesis by inhibiting penicillin-binding proteins leading to cell loss of life. Vaborbactam is certainly a ...
Many gaps in the burden of resistant pathogens exist in endemic areas of low- and middle-income economies, especially those endemic for carbapenem resistance. The aim of this study is to evaluate risk factors for carbapenem-resistance, to estimate the association between carbapenem-resistance and all-cause 30-day mortality and to examine whether mortality is mediated by inappropriate therapy. A case-control and a cohort study were conducted in one tertiary-care hospital in Medellín, Colombia from 2014 to 2015. Phenotypic and genotypic characterization of isolates was performed. In the case-control study, cases were defined as patients infected with carbapenem-resistant K. pneumoniae (CRKP) and controls as patients infected with carbapenem-susceptible K. pneumoniae (CSKP). A risk factor analysis was conducted using logistic regression models. In the cohort study, the exposed group was defined as patients infected with CRKP and the non-exposed group as patients infected with CSKP. A survival analysis
Provider Role in Transmission of Carbapenem-Resistant Enterobacteriaceae - Volume 38 Issue 11 - Marika E. Grabowski, Hyojung Kang, Kristen M. Wells, Costi D. Sifri, Amy J. Mathers, Jennifer M. Lobo
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.. ...
Would infants be at high risk for carbapenem-resistant Enterobacteriaceae or CRE infection? Find answers now! No. 1 Questions & Answers Place.
Colistin and polymyxin B MICs were determined for 106 carbapenem-resistant Klebsiella pneumoniae (CR-Kp) isolates using Sensititre Research Use Only GNX2F plates (Thermo Fisher) and compared to CLSI broth macrodilution (BMD) as the reference method. For colistin, EUCAST breakpoints were applied and …
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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In August 2017, meropenem/vaborbactam was FDA approved for complicated urinary tract infections (cUTI) caused by carbapenem-resistant Enterobacteriaceae (CRE). The novel carbapenem/beta-lactamase inhi... more
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 ...
In recent years, hospitals have reported dramatic increases in the number of cases of the highly contagious, difficult-to-treat, and often deadly antibiotic-resistant bacteria carbapenem-resistant Enterobacteriaceae (CRE). Now, investigators at Beth Israel Deaconess Medical Center (BIDMC) have developed a promising method of identifying new antimicrobials that target these organisms. The research is published in April issue of the journal ASSAY and Drug Development Technologies.. CRE are Gram-negative bacteria that frequently express a gene that codes for carbapenemase--an enzyme that breaks down carbapenem and other antibiotics--and that is located on mobile genetic elements called plasmids, which can jump from one bacterium to another. The two most common types of CRE are carbapenem-resistant Klebsiella species and carbapenem-resistant Escherichia coli. Patients who become infected with these bacteria have few antibiotic treatment options.. The US Centers for Disease Control and Prevention ...
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
The aim of the study was to evaluate the impact of tigecycline (TGC) versus meropenem (MPM) on the development of Clostridium difficile associated diarrhoea (CDAD) and to establish the rate of new colonization with carbapenem-resistant Klebsiella pneumoniae (CR-KP) in intra-adominal infection (IAI) treatment. It is a retrospective, single-center, cohort study. 168 patients with IAI treated with TGC were compared with 168 patients with MPM. Overall the median age was 60 (46-73). Significant differences among TGC and MPM groups were observed for hospital acquisition of IAI (61% vs 71% p=0.03), previous surgery (65 vs 51, p=0.02) admission in ICU (50 vs 40% p=0.06). All-cause in-hospital mortality was similar among the two groups (9% vs 11%, p=0.59). A microbiological diagnosis was obtained in 176 (51%). In 51/176 (29%) a polimicrobial infection was diagnosed. Gram-negative bacilli were found in 128/176 (72%). Of these drug susceptible, fluoroquinolone-resistant and ESBL-Enterobacteriaceae ...
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 ...
A compound of formula (I): in which R is: wherein R α is hydrogen, optionally substituted (C 1-6 )alkyl or optionally substituted aryl; R β is hydrogen, optionally substituted (C 1-6 )alkyl or optionally substituted aryl; or R α and R β together form an optionally substituted 5 or 6 membered heterocyclic ring with or without additional heteroatoms; R 1 is (C 1-6 )alkyl which is unsubstituted or substituted by fluoro, a hydroxy group which is optionally protected by a removable hydroxy protecting group, or by an amino group which is optionally protected by a removable amino protecting group; R 2 is hydrogen or methyl; and -CO 2 R 3 is carboxy or a carboxylate anion or the group R 3 is a removable carboxy protecting group. This invention also relates to processes for its preparation, intermediates and pharmaceutical compositions comprising compounds of formula (I). Compounds of formula
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 ...
TY - JOUR. T1 - Down the drain: carbapenem-resistant bacteria in intensive care unit patients and handwashing sinks. AU - Kotsanas, Despina. AU - Wijesooriya, W R P L I. AU - Korman, Tony. AU - Gillespie, Elizabeth E. AU - Wright, Louise. AU - Snook, Kylie. AU - Williams, Natalie. AU - Bell, Jan M. AU - Li, Hua Y. AU - Stuart, Rhonda L. PY - 2013. Y1 - 2013. N2 - Clinical utility of carbapenem antibiotics is under threat because of the emergence of acquired metallo-beta-lactamase (MBL) genes. We describe an outbreak in an intensive care unit (ICU) possibly associated with contaminated sinks. DESIGN, SETTING AND PARTICIPANTS: Four clusters of gram-negative bacteria harbouring the MBL gene blaIMP-4 were detected in the ICU at Dandenong Hospital between November 2009 and July 2012. Epidemiological investigations were undertaken in order to identify a common point source. During September 2012, screening using rectal swabs for all ICU patients, and environmental swabs targeting all ICU handwashing ...
There are several mechanisms of carbapenem resistance. One of the most epidemiologically concerning mechanisms is the emergence of enzymes (carbapenemases) capable of degrading carbapenems and beta-lactams more generally. Amongst these, Klebsiella pneumonia carbapenemases or KPCs for short have made the greatest inroads in the United States. First identified retrospectively from a 1996 sample from North Carolina, they have since spread and become endemic in New York City and now many other locations in the United States and around the world. These Class A serine-based hydrolytic enzymes are for the most part encoded on large, low copy number plasmids. Such large plasmids often employ conjugation machinery to promote transfer of the plasmid and plasmid-borne resistance elements into different bacterial populations. At present, KPCs are predominantly associated with Klebsiella pneumonia (hence their name) and Escherichia coli. KPC strains are notoriously difficult to treat, as they often ...
In hospitalized patients with CRKPs, tigecycline nonsusceptibility was more frequently observed in those admitted from skilled nursing facilities and occurred earlier during hospitalization. Skilled nursing facilities are an important target for interventions to decrease antibacterial resistance to …
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 ...
Learn how HABP/VABP is increasingly caused by carbapenem-resistant Gram-negative pathogens. Please see Important Safety Information and Full Prescribing Information on this website.
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.
Carbapenems - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the Merck Manuals - Medical Professional Version.
Deaths caused by carbapenem-resistant K.pneumoniae. Some strains are developing resistance to antibiotics.. The alarming thing is these bacteria are resistant to one of the key last-line antibiotics, Dr Sophia David, from the Sanger Institute, told BBC News.. The infections are associated with a high mortality rate. Its already worrying that were seeing 2,000 deaths in 2015 - but the concern is that if action isnt taken, then this will continue to rise. Deaths from carbapenem-resistant K. pneumoniae have gone up from 341 in Europe in 2007 to 2,094 by 2015.. ...
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.
On the right plate, carbapenem-resistant Enterobacteriaceae is able to grow even in the presence of antibiotics. Photo by CDC A ...
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- ...
AIMS: We hypothesized and confirmed that tannic acid (TA) reverses carbapenem resistance by inhibiting carbapenemases in class A and B carbapenemase‐producing Enterobacteriaceae. METHODS AND RESULTS: Minimum inhibitory concentrations of carbapenems in the presence and absence of TA and other efflux pump inhibitors, TA‐carbapenemases inhibition assays and computational studies showed that TA had th ...
AIMS: We hypothesized and confirmed that tannic acid (TA) reverses carbapenem resistance by inhibiting carbapenemases in class A and B carbapenemase‐producing Enterobacteriaceae. METHODS AND RESULTS: Minimum inhibitory concentrations of carbapenems in the presence and absence of TA and other efflux pump inhibitors, TA‐carbapenemases inhibition assays and computational studies showed that TA had th ...
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 ...
Infections with carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are associated with high mortality rates (1). Carbapenemases encoded on plasmids can move between bacterial strains and have the potential to rapidly increase the proportion of Enterobacteriaceae resistant to carbapenems; as such, CP-CRE have been a particular focus of public health response. Although the Enterobacteriaceae family includes approximately 50 recognized genera, surveillance for CP-CRE has focused on the organisms most associated with clinical infections: Klebsiella spp., Enterobacter spp., and Escherichia coli (2,3). CRE from other, less commonly encountered genera (hereafter referred to as less common genera) have generally not been targeted for carbapenemase testing, in part, because some of these organisms possess intrinsic resistance to the carbapenem imipenem and others express species-specific chromosomal carbapenemases. However, these organisms can also harbor plasmid-mediated ...
The nexus between resistance determinants, plasmid type, and clonality appears to play a crucial role in the dissemination and survival of carbapenem-resistant Klebsiella pneumoniae (CRKP). The incidence of infections involving CRKP in Saudi Arabia is increasing and there is a need for detailed molecular profiling of this pathogen for CRKP surveillance and control. The resistance determinants of 71 non-redundant CRKP isolates were investigated by polymerase chain reaction (PCR) and sequencing. Plasmid typing was performed using PCR-based replicon typing and the clonality of isolates was determined by multilocus sequence typing. Capsular polysaccharide synthesis genes and other virulence factors were examined using multiplex PCR. Diversity was calculated using DIVEIN, clonal relationship was determined using eBURST, and phylogenetic analysis was performed using SplitsTree4. A polyclonal OXA-48 gene alone was the most common carbapenemase detected in 48/71 (67.6%) isolates followed by NDM-1 alone in 9/71
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.
Reduced susceptibility to carbapenems in Gram-negative pathogens is an emerging feature of the antibiotic-resistance phenomenom Reports about strains resistant to this class of antibiotics among Enterobacteriaceae, particularly in Klebsiella pneumoniae, are increasing.The aims of this study were to assess the incidence of Klebsiella pneumoniae with reduced susceptibility to carbapenems in Bologna area and to carry out the characterization of these strains.The study included isolates of K. pneumoniae that showed reduced susceptibility to carbapenems, as detected by an automated system (Vitek2, bioMérieux). Between January and May 2009, 26 strains were collected (mainly isolated from urinary samples).These isolates were tested for susceptibility to carbapenems by E-test, to define MIC values for meropenem and ertapenem. Moreover, to detect the production of metallo-beta lactamases (MBL) and carbapenemases (KPC) were respectively performed the Etest with imipenem and imipenem/EDTA (IPM-IPM/EDTA) ...
Antibiotics (Basel). 2020 Nov 17;9(11):820. doi: 10.3390/antibiotics9110820.. ABSTRACT. Carbapenems are considered to be the last resort antibiotics for the treatment of infections caused by extended-spectrum beta-lactamase (ESBL)-producing strains. The purpose of this study was to assess antimicrobial resistance profile of Carbapenem-resistant Enterobacteriaceae (CRE) isolated from cattle faeces and determine the presence of carbapenemase and ESBL encoding genes. A total of 233 faecal samples were collected from cattle and analysed for the presence of CRE. The CRE isolates revealed resistance phenotypes against imipenem (42%), ertapenem (35%), doripenem (30%), meropenem (28%), cefotaxime, (59.6%) aztreonam (54.3%) and cefuroxime (47.7%). Multidrug resistance phenotypes ranged from 1.4 to 27% while multi antibiotic resistance (MAR) index value ranged from 0.23 to 0.69, with an average of 0.40. Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), Proteus mirabilis (P. mirabilis) and ...
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 ...
Infections caused by carbapenem-resistant Enterobacteriaceae are a growing concern worldwide. Raoultella ornithinolytica is a species in the Enterobacteriaceae family which can cause hospital-acquired infections and is sporadically reported as carbapenem-resistant from human and environmental sources. In this study, we firstly report on an NDM-1-producing R. ornithinolytica, Rao166, isolated from drinking water in an animal cultivation area in China. In addition to carbapenem-resistance, Rao166 was resistant to several other antibiotics including gentamicin, sulfamethoxazole-trimethoprim, tetracycline and fosfomycin. Rao166 carried a novel IncFIC-type megaplasmid, 382,325 bp in length (pRAO166a). A multidrug resistance region, 60,600 bp in length, was identified in the plasmid containing an aac(3)-IId-like gene, aac(6)-Ib-cr, blaDHA-1, blaTEM-1B, blaCTX-M-3, blaOXA-1, blaNDM-1, qnrB4, catB3, arr-3, sul1, and tet(D). Results from virulence assays implied that Rao166 has considerable pathogenic ...
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-
Background: Carbapenem-resistant K. pneumoniae (KPN) has been an increasing concern worldwide, including in the USA. We evaluated trends in KPC+ KPN from 2007-2009 among isolates from SENTRY Antimicrobial Surveillance Program. Methods: KPN clinical isolates were collected from a total of 42 USA medical centers from 2007-2009. Non-duplicate isolates were studied from blood (BSI), respiratory (RTI), skin and skin structure (SSSI), or other sites per protocol. Susceptibility testing was performed by CLSI broth microdilution. Isolates with imipenem and/or meropenem MIC ≥ 2 g/ml were screened by PCR for various carbapenemase genes (blaIMP, blaVIM, blaKPC, blaSME, blaGES, blaIMI, blaNMC-A, blaOXA-48). Geographic regions were defined using USA Census Regions. Results: Of 2049 KPN isolates, 127 (6.2%) showed carbapenem resistance. blaKPC was identified in 112 (5.5%) isolates over the 3 years. No other carbapenemase genes were identified. For USA regions combined, prevalence rates of KPC+ isolates were ...
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 ...
TY - JOUR. T1 - Double-carbapenem regimen, alone or in combination with colistin, in the treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CR-Kp). AU - Oliva, Alessandra. AU - Scorzolini, L. AU - Castaldi, D. AU - Gizzi, F. AU - De Angelis, M. AU - Storto, Marianna. AU - DAbramo, A. AU - Aloj, F. AU - Mascellino, M T. AU - Mastroianni, C M. AU - Vullo, V. PY - 2017/1. Y1 - 2017/1. KW - Letter. U2 - 10.1016/j.jinf.2016.10.002. DO - 10.1016/j.jinf.2016.10.002. M3 - Article. C2 - 27793662. VL - 74. SP - 103. EP - 106. JO - Journal of Infection. JF - Journal of Infection. SN - 0163-4453. IS - 1. ER - ...
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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TY - JOUR. T1 - Susceptibility rates of clinically important bacteria collected from intensive care units against colistin, carbapenems, and other comparative agents. T2 - Results from surveillance of multicenter antimicrobial resistance in Taiwan (SMART). AU - Lai, Chih Cheng. AU - Chen, Ying Sheng. AU - Lee, Nan Yao. AU - Tang, Hung Jen. AU - Lee, Susan Shin Jung. AU - Lin, Chin Fu. AU - Lu, Po Liang. AU - Wu, Jiunn Jong. AU - Ko, Wen Chien. AU - Lee, Wen Sen. AU - Hsueh, Po Ren. PY - 2019/1/1. Y1 - 2019/1/1. N2 - Objectives: This study aimed to determine the in vitro susceptibility of commonly encountered Gram-negative bacilli (GNB) recovered from patients admitted to intensive care units (ICUs) in Taiwan against colistin, carbapenems, and other comparative agents. Methods: In total, 758 nonduplicate GNB isolates were obtained from clinical specimens of ICU patients at seven medical centers in 2016. Minimum inhibitory concentrations (MICs) were determined using the Vitek 2 susceptibility ...
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.. ...
Doripenem, a 1-β-methyl carbapenem being developed for the treatment of serious systemic bacterial infections, is resistant to hydrolysis by dihydropeptidase 1 (7). In aerobes, doripenem appears to have the advantages of both imipenem (in its activity against gram-positive cocci) and meropenem (in its activity against gram-negative organisms) (12). Metalloenzymes that hydrolyze carbapenems have been found in both aerobic bacteria (3, 10, 11) and anaerobic bacteria (2); the gene for the metalloenzyme may be silent or expressed to various degrees, resulting in a wide range of carbapenem resistance levels (13). In Japan, this accounts for the 2 to 4% rate of resistance to imipenem (1, 16), but these isolates are rarely found in the United States. The purpose of this study was to measure the efficacy of doripenem against a wide range of clinical anaerobic isolates and to compare its in vitro activities to those of other antimicrobial agents.. Bacteria were clinical isolates collected from a wide ...
Carbapenem resistance is a major global health problem that seriously compromises the treatment of infections caused by nosocomial pathogens. Resistance to carbapenems mainly occurs via the production of carbapenemases, such as VIM, IMP, NDM, KPC and OXA, among others. Preclinical and clinical trials are currently underway to test a new generation of promising inhibitors, together with the recently approved avibactam, relebactam and vaborbactam. This review summarizes the main, most promising carbapenemase inhibitors synthesized to date, as well as their spectrum of activity and current stage of development. We particularly focus on β-lactam/β-lactamase inhibitor combinations that could potentially be used to treat infections caused by carbapenemase-producer pathogens of critical priority. The emergence of these new combinations represents a step forward in the fight against antimicrobial resistance, especially in regard to metallo-β-lactamases and carbapenem-hydrolysing class D β
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 ...
Deborah Friedman1. 1 Department of Infectious Diseases, Barwon Health, Geelong, VIC, Australia. The years 2015 to 2016 have been busy for infection control publications.. This conference presentation will focus firstly on topics close to home including; contact isolation, enhanced disinfection, the use of chlorhexidine bathing and screening for Carbapenem-resistant Enterobacteriaceae. Infection control topics further afield will also be explored including; outbreaks of Zika virus, and Yellow fever. ...
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.
Like all carbapenem antibiotics, ertapenem has a broader spectrum of activity than other beta-lactams like penicillins and ... ISBN 978-3-8047-2898-1. Wu CC, Pai TY, Hsiao FY, Shen LJ, Wu FL (October 2016). "The Effect of Different Carbapenem Antibiotics ... The effect is described for other carbapenem antibiotics as well, but seems to be most pronounced for ertapenem and meropenem. ... This is likely caused by several mechanisms: carbapenems inhibit transport of valproic acid from the gut into the body; they ...
Related to penems are carbapenems. Where penems have a sulfur, carbapenems have another carbon. An example is faropenem. Penem ... Sasaki A, Goda K, Enomoto M, Sunagawa M (May 1992). "Synthetic studies of carbapenem and penem antibiotics. II. Synthesis of 3- ... Richard Wise (1990). "The carbapenems and Penem Antibiotics-a brief review". Antimicrobic Newsletter. 7 (10): 73-78. doi: ...
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 ...
However, carbapenem-hydrolyzing beta-lactamases are an exception. On average, about 8.1% of plasma proteins attached to ... Doripenem (Doribax, Finibax) is an antibiotic drug in the carbapenem class. It is a beta-lactam antibiotic drug able to kill ... It is the fourth member of the carbapenem class to be approved in the United States. Mazzei T (August 2010). "The ... The greater stability of doripenem in aqueous solution compared to earlier members of the carbapenem class allows it to be ...
Resistance to carbapenems is also being increasingly reported. A. baumannii can survive on the human skin or dry surfaces for ... Hu, Q; Hu, Z; Li, J; Tian, B; Xu, H; Li, J (2011). "Detection of OXA-type carbapenemases and integrons among carbapenem- ... and the carbapenems are recognised as the gold-standard and treatment of last resort. Acinetobacter species are unusual in that ...
... (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". ...
February 2013). "Novel carbapenem antibiotics for parenteral and oral applications: in vitro and in vivo activities of 2-aryl ... Hazra S, Xu H, Blanchard JS (June 2014). "Tebipenem, a new carbapenem antibiotic, is a slow substrate that inhibits the β- ... Tebipenem is the first carbapenem whose prodrug form, the pivalyl ester, is orally available. El-Gamal MI, Oh CH (2010). " ... Tebipenem (brand name Orapenem) is a broad-spectrum orally-administered antibiotic, from the carbapenem subgroup of β-lactam ...
Clifton IJ, Doan LX, Sleeman MC, Topf M, Suzuki H, Wilmouth RC, Schofield CJ (June 2003). "Crystal structure of carbapenem ... Kershaw NJ, Caines ME, Sleeman MC, Schofield CJ (September 2005). "The enzymology of clavam and carbapenem biosynthesis". Chem ...
Subsequently, carbapenems are sometimes not active against those serious infections. That is why clinicians around the world ... We used to use carbapenems as the main option in several countries for those severe infections; however, now there are several ...
Carbapenems are highly resistant to the β-lactamase enzymes produced by many multiple drug-resistant Gram-negative bacteria, ... Cannon JP, Lee TA, Clark NM, Setlak P, Grim SA (August 2014). "The risk of seizures among the carbapenems: a meta-analysis". ... Vardakas KZ, Tansarli GS, Rafailidis PI, Falagas ME (December 2012). "Carbapenems versus alternative antibiotics for the ...
Morrill, H. J., Pogue, J. M., Kaye, K. S., &LaPlante, K. L. (2015, April). Treatment options for carbapenem-resistant ... "Weak biofilm formation among carbapenem-resistant Klebsiella pneumoniae". Diagnostic Microbiology and Infectious Disease. 95 (4 ... ". "Treatment Options for Carbapenem-Resistant Enterobacteriaceae Infections". LaPlante, Kerry L.; Rybak, Michael J. (December ...
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 ...
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 has ...
... , like other carbapenems, is a potent inducer of multidrug resistance in bacteria. Meropenem is bactericidal except ... It is in the carbapenem family of medications. Meropenem usually results in bacterial death through blocking their ability to ... restores carbapenem susceptibility to NDM-1-positive pathogens in vitro and in vivo". Journal of Antimicrobial Chemotherapy. 72 ... an enzyme that many drug-resistant bacteria use to destroy carbapenems. "Meropenem". The American Society of Health-System ...
Clostridia are also susceptible to tetracyclines, carbapenems (imipenem), metronidazole, vancomycin, and chloramphenicol. The ...
... 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 ...
... acts synergistically with many other antibiotics, including cephalosporins, carbapenems, daptomycin and ...
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. Southern Medical Journal. 103 (5), ... NmcA carbapenem-hydrolyzing enzyme in Enterobacter cloacae in North America. Emerging Infectious Diseases. 9, 999-1002 (2003). ... 44, 2247-2253 (2000). Bratu S, Landman D, Alam M, Tolentino E, Quale J. Detection of KPC carbapenem-hydrolyzing enzymes in ... 17, 1791-1798 (2011). Naas T, Nordmann P. Analysis of a carbapenem-hydrolyzing class A beta-lactamase from Enterobacter cloacae ...
... (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, HugA does not affect cephamycins or carbapenems and is inhibited by clavulanic acid. Similar to other Proteus species ... carbapenems, aztreonam, quinolones, sulphamethoxazole, and co-trimoxazole. Isolates of P. penneri have been found to be ...
"Nosocomial bloodstream infection and the emerging carbapenem-resistant pathogen Ralstonia insidiosa". BMC Infectious Diseases. ...
... (INN) is a carbapenem antibiotic used in combination with betamipron. It is not used in the United States. Panipenem/ ...
Orchid's main products are active pharmaceutical ingredients, including cephalosporins (oral and injectable), carbapenems and ...
Carbapenem-resistant Enterobacterales (CRE) are a serious threat to public health. Infections with CRE are difficult to treat ... Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE) pdf icon[PDF - 24 pages] ...
Carbapenems are further broken down into groups with ertapenem being the lone member of group 1. Group 2 carbapenems (imipenem ... Carbapenem antibiotics were originally developed at Merck & Co. from the carbapenem thienamycin, a naturally derived product of ... Effects of Group 1 versus Group 2 carbapenems on the susceptibility of Acinetobacter baumannii to carbapenems: a before and ... such as Klebsiella pneumoniae and other carbapenem-resistant Enterobacteriaceae). The carbapenem ertapenem is one of several ...
Carbapenem-resistant Enterobacteriaceae (CRE) have been defined as carbapenem-nonsusceptible and extended-spectrum ... Using another antibiotic concomitantly with carbapenem can help prevent the development of carbapenem resistance. One specific ... and carbapenems. Different drugs, such as ertapenem, imipenem, meropenem, and doripenem, belong to the class of carbapenem ... were carbapenem-resistant. Gram-negative bacteria can develop and transfer β-lactam resistance (including carbapenem resistance ...
Carbapenems differ from conventional penicillins (penams) in having no sulfur atom in their 5-membered ring and in having a ... This factor is critical to β-lactamase stability in carbapenems.1 Keywords. Antimicrob Agent Serratia Marcescens Carbapenem ... P.J. Petersen, N. V. Jacobus, W.J. Weiss and R.T. Testa, In vitro and in vivo activities of LJC 10,627, a new carbapenem with ... Carbapenems differ from conventional penicillins (penams) in having no sulfur atom in their 5-membered ring and in having a ...
Carbapenems was found in Washington Manual. The Washington Manual of Medical Therapeutics helps you diagnose and treat hundreds ...
Due to inconsistencies between the drug labels on DailyMed and the pill images provided by RxImage, we no longer display the RxImage pill images associated with drug labels. We anticipate reposting the images once we are able identify and filter out images that do not match the information provided in the drug labels. ...
Provided herein are cell-free systems for generating carbapenems, e.g., a compound of the Formula (I): ,p,,chemistry id=CHEM- ... Native carbapenem (R2═H), 6-methyl carbapenem (R2═-CH3), and 6-ethyl carbapenem (R2═CH2CH3) substrates have been prepared from ... In certain embodiments, a carbapenem synthase (e.g., from P. carotovorum, CarC, and/or from Streptomyces cattleya, ThnG), or ... One such carbapenem, imipenem, was developed in 1985 as an intravenous product. See, e.g., U.S. Pat. No. 4,194,047 incorporated ...
Carbapenem resistance among common Enterobacteriaceae has increased over the past decade; most CRE are associated with health- ... Vital signs: carbapenem-resistant Enterobacteriaceae.. Centers for Disease Control and Prevention (CDC). ... Over the past decade, however, carbapenem-resistant Enterobacteriaceae (CRE) have been recognized in health-care settings as a ... Among Enterobacteriaceae, resistance to broad-spectrum carbapenem antimicrobials has been uncommon. ...
carbapenem synonyms, carbapenem pronunciation, carbapenem translation, English dictionary definition of carbapenem. n. Any of ... This happened irrespective of the recent introduction of carbapenem drugs, 11 years ago in Gaza Strip hospitals.. Carbapenem ... Carbapenem - definition of carbapenem by The Free Dictionary https://www.thefreedictionary.com/carbapenem ... carbapenem. Also found in: Medical, Wikipedia. car·ba·pen·em. (kär′bə-pĕn′əm). n.. Any of several semisynthetic or synthetic ...
Infections with bacteria resistant to carbapenems, a group of highly effective antibiotics, pose a significant threat to ... rapid-risk-assessment-carbapenem-resistant-enterobacteriaceae-first-update. Rapid risk assessment: Carbapenem-resistant ... The global rise of carbapenem resistance in a certain family of bacteria called Enterobacteriaceae, or carbapenem-resistant ... Rapid risk assessment: Carbapenem-resistant Enterobacteriaceae - first update https:/. /. www.. ecdc.. europa.. eu/. en/ ...
Treatment Options for Carbapenem-Resistant Enterobacteriaceae Infections.. Morrill HJ1, Pogue JM2, Kaye KS3, LaPlante KL4. ... Carbapenems have been used as the "last-line" treatment for infections caused by resistant Enterobacteriaceae, including those ... Carbapenem-resistant Enterobacteriaceae infections are associated with poor outcomes and high mortality. Continued research is ... However, Enterobacteriaceae that produce carbapenemases, which are enzymes that deactivate carbapenems and most other ß-lactam ...
... wwwn.cdc.gov/nndss/conditions/carbapenemase-producing-carbapenem-resistant-enterobacteriaceae/case-definition/2018/) ... Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) 2018. Current. CP-CRE, Enterobacter spp.(https://wwwn. ... Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) , 2018 Case Definition (https:// ...
Novel Carbapenem-Hydrolyzing Beta-Lactamase, KPC-1, from a Carbapenem-Resistant Strain of Klebsiella pneumoniae. Antimicrobial ... Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) is defined as E. coli, Klebsiella spp., or ... Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies. ... Carbapenems: Past, Present, and Future. Antimicrobial Agents and Chemotherapy, 2011. 55(11): 4943-4960. DOI: 10.1128/AAC.00296- ...
Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which ... However, research is underway to develop an effective oral carbapenem.[2] References. *^ Birnbaum J, Kahan FM, Kropp H, ... Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which ... Carbapenem antibiotics were originally developed from thienamycin, a naturally-derived product of Streptomyces cattleya.[1] ...
Our findings showed that PCR for KPC gene should be performed to evaluate carbapenem resistance in P. aeruginosa and that this ... Conclusion: Our findings showed that PCR for KPC gene should be performed to evaluate carbapenem resistance in P. aeruginosa ...
... including Enterobacterias Resistentes A Carbapenems (erc) (Ambulatory Care) advice en Espanol ... Enterobacterias Resistentes A Carbapenems (erc) (Ambulatory Care) information by Drugs.com, ... Las carbapenems son un grupo de antibióticos para tratar las infecciones bacterianas. Con las infecciones por ERC, las ... Las enterobacterias resistentes a carbapenems (ERC). son un grupo de bacterias muy difíciles de eliminar cuando provocan una ...
... carbapenem Resistant Enterobacteriaceae). Includes: possible causes, signs and symptoms, standard treatment options and means ... What are carbapenem-resistant Enterobacteriaceae (CRE)?. CRE are a group of bacteria that are very difficult to kill when they ... Carbapenems are a group of antibiotics that treat bacterial infections. In CRE infections, the bacteria release chemicals that ... Learn more about Cre (carbapenem Resistant Enterobacteriaceae). IBM Watson Micromedex. *Mrsa (methicillin-resistant ...
The spread of carbapenem-resistant enterobacteriaceae (CRE) has become not only a clinical challenge but also a global public ... The spread of carbapenem-resistant Enterobacteriaceae (CRE) has become not only a clinical challenge but also a global public ... Carbapenem Resistant Enterobacteriaceae A Review for Laboratorians. *Diagnostic Errors Report Puts Labs Patient Safety Back in ... Carbapenem-resistant Enterobacteriaceae containing New Delhi metallo-beta-lactamase in two patients. MMWR Morb Mortal Wkly Rep ...
Carbapenems Cross Infection Disease Outbreaks Drug Resistance, Bacterial Hospitals Klebsiella Infections Klebsiella Pneumoniae ... February 14, 2013, 12:30 ET CDCHAN-00341-02-14-2013 Carbapenem-resistant Enterobacteriaceae (CRE) are untreatable or difficult- ...
Carbapenems. At minimum inhibitory concentration (MIC) just within the realm of resistance, a high-dose carbapenem may still ... Combination of two carbapenems. The findings of non-controlled case series suggest that combinations of two carbapenems ( ... Combination with carbapenem. A retrospective multicenter study on bloodstream infections by carbapenem-resistant K. pneumoniae ... Cprek JB, Gallagher JC: Ertapenem-containing double-Carbapenem therapy for treatment of infections caused by Carbapenem- ...
Carbapenem-resistant E. aerogenes finally leads to uncontrolled sepsis with current antibiotics. We hypothesize that the ... Carbapenem-resistant E. aerogenes was detected in bile and blood after a five-week course of carbapenem therapy. The patient ... Carbapenem-resistant E. aerogenes finally leads to uncontrolled sepsis with current antibiotics. We hypothesize that the ... Sepsis resulting from Enterobacter aerogenes resistant to carbapenems after liver transplantation Hepatobiliary Pancreat Dis ...
... and/or tigecycline in combination with an anti-pseudomonal carbapenem agent, remain the mainstay for treating clinical CRE ... a major resistance concern emerging during the last decade because of significantly compromising the efficacy of carbapenem ... a major resistance concern emerging during the last decade because of significantly compromising the efficacy of carbapenem ... Carbapenem Resistance Mechanisms Among Cr-E. coli Isolates. *Carbapenem Resistance Mechanisms Among Cr-Enterobacter spp. ...
About Carbapenem Resistant Pseudomonas aeruginosa (CRPA). On this page:. About CRPA. History. Transmission. People most at risk ... The carbapenem class of antibiotics includes meropenem, imipenem, ertapenem, and doripenem. These antibiotics are often used as ...
Carbapenem-resistant Acinetobacter baumannii (CRAB)Anti-Tumor,Tumors,Iodine,Lectin-Induced Cancer,Vegetables: All,Thyroid ... Carbapenem-resistant Acinetobacter baumannii (CRAB) Related Articles. Could Turmeric Save Us From The CDCs Nightmare Bacteria ... 1 Abstracts with Carbapenem-resistant Acinetobacter baumannii (CRAB) Research. Filter by Study Type. In Vitro Study. ... Carbapenem-resistant Acinetobacter baumannii (CRAB) is a Sub of the following Topics. *Acinetobacter baumannii infection ...
Background We describe the prevalence of invasive carbapenem-resistant Acinetobacter spp. isolated from 2005 to 2016 in ... Multivariable analyses indicated that the number of carbapenem-resistant isolates (mean 4.8 ± sd 2.12) and carbapenem ... consisting of 707 carbapenem-susceptible and 93 carbapenem-resistant isolates, respectively. After removal of duplicates, 58 ... Carbapenem resistance Acinetobacter baumannii complex Surveillance Epidemiology Temporal trends Regional trends Abbreviations. ...
  • Concern has arisen in recent years over increasing rates of resistance to carbapenems, as there are few therapeutic options for treating infections caused by carbapenem-resistant bacteria (such as Klebsiella pneumoniae and other carbapenem-resistant Enterobacteriaceae). (wikipedia.org)
  • Carbapenem-resistant Enterobacteriaceae (CRE) have been defined as carbapenem-nonsusceptible and extended-spectrum cephalosporin-resistant Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae complex, Klebsiella pneumoniae, or Klebsiella oxytoca. (wikipedia.org)
  • Infections with carbapenem-resistant Klebsiella pneumoniae were associated with organ/stem cell transplantation, mechanical ventilation, exposure to antimicrobials, and overall longer length of stay in hospitals. (wikipedia.org)
  • Klebsiella pneumoniae are resistant to the carbapenem antibiotics that represent the last line of defence in treating infections, and are therefore regarded as extremely drug resistant (XDR). (thefreedictionary.com)
  • Klebsiella pneumoniae are resistant to the carbapenem antibiotics - the last line of defence to treat infections - and are seen as extremely drug resistant. (thefreedictionary.com)
  • In recent years, the proportions of carbapenem resistance in Klebsiella pneumoniae - a type of Enterobacteriaceae - rapidly increased to high levels in Greece, Italy and Romania. (eurekalert.org)
  • Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) for 2016 show large differences in the national percentages of carbapenem resistant bloodstream infections caused by Klebsiella pneumonia , ranging from 0% to as high as 67%, depending on the country. (eurekalert.org)
  • Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) is defined as E. coli , Klebsiella spp. (cdc.gov)
  • Carbapenem-resistant Klebsiella pneumoniae (CRKP) is resistant to almost all antimicrobial agents, is associated with substantial morbidity and mortality, and poses a serious threat to public health. (dovepress.com)
  • Carbapenem-resistant Klebsiella pneumoniae has emerged globally as a multidrug-resistant hospital pathogen for which there are few treatment options. (pnas.org)
  • Carbapenem-resistant Klebsiella pneumoniae , most notably isolates classified as multilocus sequence type (ST) 258, have emerged as an important cause of hospital deaths. (pnas.org)
  • Safety and Efficacy Study of Eradication of Carbapenem Resistant Klebsiella Pneumonia From the Gastrointestinal Tract by Probiotics. (clinicaltrials.gov)
  • A negative stool culture for Carbapenem resistant Klebsiella pneumonia. (clinicaltrials.gov)
  • Polymyxin B is one of the last resort option for carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection in China. (scielo.br)
  • The increasing prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) is a healthcare crisis in China. (scielo.br)
  • In this study, isolates of Klebsiella pneumoniae and Enterobacter cloacae with resistance to carbapenem antibiotics were sequenced. (asm.org)
  • Carbapenem-sparing antibiotic regimens for infections caused by KPC-producing Klebsiella pneumoniae in Intensive Care Unit. (biomedsearch.com)
  • The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKp) and the increased use of polymyxin B to treat infections caused by these microorganisms may have contributed to the spread of polymyxin-resistant K . pneumoniae isolates (PRKP). (scielo.br)
  • This cross-sectional study was designed to detect the carbapenemase producing K. pneumoniae along with biofilm producers from different clinical specimens and to compare antibiotic susceptibility pattern of biofilm producing carbapenem resistant Klebsiella pneumoniae and biofilm non-producing carbapenem resistant Klebsiella pneumoniae . (nepjol.info)
  • One of the more common ways that Enterobacteriaceae become resistant to carbapenems is due to production of Klebsiella pneumoniae carbapenemase (KPC). (hawaii.gov)
  • To characterize OXA-48 carbapenemase-producing Klebsiella pneumoniae strains isolated after an increase in carbapenem resistance in Catalonia. (elsevier.es)
  • Colistin resistance in Carbapenem-resistant Klebsiella pneumoniae strains. (alliedacademies.org)
  • Because the optimal treatment and clinical significance of ESBL-producing Klebsiella pneumoniae (ESBL-Kp) HD access-related bacteremia remain unclear, we conducted this retrospective study to determine the clinical outcomes of patients treated with either flomoxef or a carbapenem. (biomedcentral.com)
  • There is also scarce information about whether colistin resistance influences the prognosis of carbapenem-resistant Klebsiella pneumoniae (CRKp) bacteraemia. (csic.es)
  • Twenty-seven carbapenem-resistant isolates that were found to be non-carbapenemase producers (15 Escherichia coli , 9 Klebsiella pneumoniae and 3 Pseudomonas aeruginosa ) were further studied. (uwi.edu)
  • Microbiological findings were reported in 212 cases (43%) with 276 isolates: 50 Klebsiella pneumoniae, 46 Pseudomonas aeruginosa, and 39 Acinetobacter baumannii, with carbapenem resistance detected in 55%, 71%, and 65%, respectively. (diva-portal.org)
  • Pharmacodynamic Comparison of the Carbapenems Against E. coli and Klebsiella spp. (thescipub.com)
  • This study-part of the OPTAMA (Optimizing Pharmacodynamic Target Attainment using a Microbiologic Antibiogram) Program-used Monte Carlo simulations to compare cumulative fraction of response (CFR) for carbapenems against ESBL producing isolates of Escherichia coli and Klebsiella species collected in North America. (thescipub.com)
  • The infection was identified as a carbapenem-resistant Klebsiella pneumoniae strain bearing the novel gene blaNDM-1. (wikipedia.org)
  • The carbapenems imipenem and meropenem are recommended by the American Thoracic Society and the Infectious Disease Society of America as one of several first-line therapy options for people with late-onset hospital-acquired or ventilator-associated pneumonia, especially when Pseudomonas, Acinetobacter, or extended spectrum beta-lactamase producing Enterobacteriaceae are suspected pathogens. (wikipedia.org)
  • We describe the prevalence of invasive carbapenem-resistant Acinetobacter spp. (springer.com)
  • Using the Swiss Antibiotic Resistance Centre (anresis) database that includes data from 70% of all hospitalized patients and one third of all ambulatory practitioners in Switzerland, we analysed the number of carbapenem-susceptible and resistant Acinetobacter spp. (springer.com)
  • From 2005 to 2016, 58 cases of resistant or intermediate strains to carbapenem were observed among 632 cases of invasive Acinetobacter . (springer.com)
  • Despite a relatively stable number of carbapenem-resistant Acinetobacter isolates in Switzerland, our results suggest the existence of a diverse pool of A. baumannii species in hospital settings, and confirm the implication of carbapenem-resistant Acinetobacter calcoaceticus - Acinetobacter baumannii (ACB) complex in the vast majority of clinical infections and nosocomial outbreaks with notable regional fluctuations. (springer.com)
  • Here we report on the temporal and regional analysis of invasive carbapenem-resistant Acinetobacter isolated in Switzerland from 2005 to 2016. (springer.com)
  • A 4-year surveillance of carbapenem-resistant Acinetobacter spp. (asm.org)
  • The characteristics of carbapenem heteroresistance were studied in 14 apparently carbapenem-susceptible Acinetobacter baumannii isolates. (asm.org)
  • Acinetobacter baumannii is an opportunistic pathogen associated with severe hospital infections ( 1 , 16 ), which often need the use of carbapenems as the treatment of last resort. (asm.org)
  • Diante da escassez de dados sobre o assunto, estudos que avaliem o tratamento de infecções por Acinetobacter spp resistente a carbapenem são necessários. (usp.br)
  • Antimicrobials drugs frequently reported as active against Acinetobacter spp include carbapenems, colistin, ampicillin/sulbactam, amikacin, rifampin and tetracyclines and currently carbapenens are considered the main antimicrobial treatment. (usp.br)
  • Unfortunately, over the past years there has been a worldwide increase in infections caused by carbapenem-resistant Acinetobacter. (usp.br)
  • We performed a retrospective review of the case records of patients from 1996 to 2004 who had nosocomial infections caused by carbapenem-resistant Acinetobacter spp. (usp.br)
  • Complete genome sequence of the siphoviral bacteriophage Βϕ-R3177, which lyses an OXA-66-producing carbapenem-resistant Acinetobacter baumannii isolate. (jcvi.org)
  • Among these threats, the rapid increase in carbapenem-resistant Acinetobacter baumannii (CRAB) is a particularly challenging global issue in the health care setting. (jcvi.org)
  • To determine the occurrence of carbapenem-resistant Acinetobacter baumannii in fish fished in Mediterranean Sea near the Bejaia coast (Algeria), we studied 300 gills and gut samples randomly and prospectively collected during 1 year. (archives-ouvertes.fr)
  • Our best peptide (Ω76) displayed high efficacy against carbapenem and tigecycline-resistant Acinetobacter baumannii in mice. (sciencemag.org)
  • Cikman A, Gulhan B, Aydin M, Ceylan MR, Parlak M, Karakecili F, Karagoz A. In vitro Activity of Colistin in Combination with Tigecycline against Carbapenem-Resistant Acinetobacter baumannii Strains Isolated from Patients with Ventilator-Associated Pneumonia. (medsci.org)
  • This study investigated the minimum inhibitory concentration (MIC) values and in vitro activity of colistin in combination with tigecycline against carbapenem-resistant Acinetobacter baumannii strains isolated from patients with ventilator-associated pneumonia (VAP) using the E-test method. (medsci.org)
  • In 2012, 0.14 cases per 1,000 patient admissions of carbapenem-resistant Enterobacteriaceae and 0.02 cases per 1,000 patient admissions of carbapenem-resistant Acinetobacter were identified among 38 hospitals. (canada.ca)
  • Carbapenemases are a class of enzymes that can confer earchbasic) databases on April 9, 2012, by using the fol- resistance to carbapenems and other -lactam antibiotic lowing search terms: carbapenem-resistant or carbapen- drugs, but not all carbapenemase-producing isolates are emase-producing or KPC and outcome or mortality. (cdc.gov)
  • DeathsAttributabletoCRE Enterobacteriaceae with susceptible isolates) were excluded, as were studies Statistical Analysis that compared patients who had carbapenem-resistant in- We calculated pooled risk ratios (RRs) and 95% CIs fections with patients who were not infected. (cdc.gov)
  • 0.10 was for infected patients from those for colonized patients and defined to indicate the presence of heterogeneity) and studies that reported on isolates resistant to a carbapenem the I 2 index (for assessing the degree of heterogeneity) other than imipenem, meropenem, or doripenem. (cdc.gov)
  • Therefore, in order to effectively decrease case-fatality rates among patients with the infections owing to carbapenemase-producing CRE isolates, combination antibiotic schemes, including colistin (or amikacin) and/or tigecycline in combination with an anti-pseudomonal carbapenem agent, remain the mainstay for treating clinical CRE infections. (frontiersin.org)
  • Multivariable analyses indicated that the number of carbapenem-resistant isolates (mean 4.8 ± sd 2.12) and carbapenem resistance rates per region per annum (8.4% ± 13.9%) were low and stable over the studied period. (springer.com)
  • All the isolates were resistant to all the β -lactam antibiotics including the carbapenems. (hindawi.com)
  • The MICs for carbapenems were determined, and the isolates were genotyped by pulsed-field gel electrophoresis (PFGE) and sequence typing (ST). Population analysis, testing of the stability of the heteroresistant subpopulations, and time-killing assays were performed. (asm.org)
  • However, reduced susceptibility or resistance to carbapenems is increasingly being observed among A. baumannii clinical isolates ( 2 , 5 , 25 ). (asm.org)
  • The present study aimed to evaluate in vitro the incidence of carbapenem heteroresistance, to characterize the traits of the heteroresistant subpopulations, and to assess the efficacies of carbapenems against heteroresistant A. baumannii isolates. (asm.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)
  • To enhance surveillance of CREs, clinical isolates with phenotypic resistance to carbapenem antibiotics underwent whole-genome sequencing. (asm.org)
  • However, only one (2.4%) of the 41 ESBL producing isolates exhibited carbapenem resistance. (scirp.org)
  • Twenty-five of the isolates were positive for the cfiA carbapenem resistance gene. (diva-portal.org)
  • Of the 65 carbapenem-resistant E. coli (CREC) isolates, 62% were positive for more than one and 31% were positive for two or more of carbapenemase and ESBL genes targeted. (iwaponline.com)
  • Two strains isolated from patients in clinics were positive for NDM1 and OX-48, and isolates from patients in intensive care unit were positive for only OXA-48 carbapenem genes. (alliedacademies.org)
  • Xpert Carba- R is the first FDA-cleared test for detection and differentiation of carbapenemase genes in pure bacterial isolates, previously shown to be non-susceptible to carbapenem antibiotics, which may be cultured from a wide range of clinical specimens, including blood cultures, urine, respiratory samples, abscesses and swab surveillance specimens. (cepheid.com)
  • In contrast to their synergistic effect against carbapenem-resistant A. baumannii isolates, colistin and tigecycline were highly antagonistic to carbapenem-resistant A. baumannii strains isolated from patients with VAP when the drugs were administered together. (medsci.org)
  • This was an important mechanism underpinning carbapenem resistance in these clinical isolates of various species. (uwi.edu)
  • Several outbreaks caused by carbapenem-resistant Italian, Spanish, or Greek were not evaluated. (cdc.gov)
  • A few infections caused by carbapenem-resistant Enterobacteriaceae outside the bowel include wound infection, urinary tract infection (UTI) and pneumonia. (express-press-release.net)
  • Infections caused by carbapenem-resistant strains have few treatment options ( 6 , 7 ) and are associated with mortality rates upwards of 50% ( 8 , 9 ). (sciencemag.org)
  • There is limited treatment option for systemic infections caused by carbapenem- resistant Enterobacteriaceae. (academicjournals.org)
  • The emergence of colistin resistant strains is a very important problem due to decrease of treatment options for infections caused by carbapenem-resistant KPC producing K. pneumoniae . (alliedacademies.org)
  • Imipenem, the first commercially-available carbapenem, (Merck Sharp and Dohme) has been used for nearly 10 years and is now being joined by a second agent, meropenem (Zeneca/Sumitomo). (springer.com)
  • Carbapenem resistance meant imipenem and meropenem MIC [greater than or equal to]4mg/L. (thefreedictionary.com)
  • The typical susceptibility profile for carbapenemase-producing enterobacteria is resistance to carbapenems, penicillins, cephalosporins, and aztreonam, as well as resistance or intermediate susceptibility to ertapenem, imipenem, and meropenem using original interpretative criteria. (aacc.org)
  • The aim of this study was to evaluate the anti-bacterial activity on P. aeruginosa and A. baumannii of the combination of two antibiotics: Colistin and a Carbapenem (Meropenem or Imipenem). (scirp.org)
  • Commonly used carbapenem antibiotics include imipenem (Primaxin), meropenem ( Merrem , Meronem), ertapenem ( Invanz ), and doripenem ( Doribax ). (emedicinehealth.com)
  • In this study, we examined the gene expression profile of a CRE Escherichia coli clinical isolate that is sensitive to meropenem but resistant to ertapenem to explore transcriptomic contributions to resistance and to identify gene knockdown targets for carbapenem potentiation. (pnas.org)
  • Our study uses transcriptomics to better understand carbapenem resistance in a clinical isolate of multidrug-resistant (MDR) Escherichia coli (referred to from here as E. coli CUS2B), which is resistant to ertapenem but sensitive to doripenem and meropenem. (pnas.org)
  • Asymchem's Fuxin, P. R. China site produces the carbapenem intermediate Enol Phosphate (ertapenem, meropenem and tebipenem), for which Asymchem holds an active Drug Master File, as well as other carbapenem intermediates. (medindia.net)
  • Synergy between imipenem or meropenem and BRL 42715 was observed for all of the strains, demonstrating the role of cephalosporinase in carbapenem resistance. (nih.gov)
  • In most cases, the drug of choice in the presence of an ESBL producing organism is a carbapenem (e.g. meropenem, imipenem, ertapenem, doripenem) which are mostly injectable drugs and quite expensive. (scirp.org)
  • Ertapenem is a new member of the carbapenem class, and is often grouped with imipenem and meropenem as a recommended treatment for ESBLs. (thescipub.com)
  • these include combinations of colistin with one or two carbapenems. (aerzteblatt.de)
  • Conclusion: The "in vitro" combination Colistin-Carbapenem is associated with an improvement in MIC. (scirp.org)
  • Z. Daoud, N. Mansour and K. Masri, "Synergistic Combination of Carbapenems and Colistin against P. aeruginosa and A. baumannii," Open Journal of Medical Microbiology , Vol. 3 No. 4, 2013, pp. 253-258. (scirp.org)
  • These observations suggest that the use of carbapenems or colistin to treat severe multidrug-resistant A. baumannii infections may lead to the development of resistance. (asm.org)
  • A carbapenem-sparing regimen of tigecycline plus gentamicin or colistin was effective for treating 24/26 (92%) KPC-Kp infectious episodes in 22 polytrauma ICU patients without comorbidities. (biomedsearch.com)
  • ESKAPE pathogens cause most nosocomial infections, and are frequently resistant to carbapenem antibiotics, usually leaving tigecycline and colistin as the last treatment options. (sciencemag.org)
  • In this study, the firstly detected colistin resistance in carbapenem-resistant KPC-producing K. pneumoniae strains were evaluated. (alliedacademies.org)
  • All strains were resistance for carbapenems and colistin Two of four strains were isolated from patients hospitalized in intensive care and two of them were isolated from patients hospitalized in clinics. (alliedacademies.org)
  • The carbapenem resistance of the strains to colistin and tigecycline was assessed using the E-test method (Liofilchem, Roseto Degli Abruzzi, Italy). (medsci.org)
  • Colistin was administered to 96 patients, 93% with HAI and 49% with culture confirmed carbapenem resistance. (diva-portal.org)
  • The high prevalence of HAI with carbapenem resistant gram-negative strains and common treatment with broad-spectrum antibiotics and colistin suggests that interventions are needed to prevent HAI and to optimize antibiotic use. (diva-portal.org)
  • Pseudomonas aeruginosa (18%) showed highest susceptibility to 87% Sensitivity to Cefepime Tazobactam, Cefepime, Carbapenem and Amikacin followed by 70% Sensitivity to Piperacillin Tazobactam and Cefoperazone sulbactam. (thefreedictionary.com)
  • Carbapenems are often the antibiotics of choice to combat life threatening infections caused by the opportunistic human pathogen Pseudomonas aeruginosa . (frontiersin.org)
  • Following implementation of the program, the researchers observed a statistically significant decrease in both the carbapenem resistance rate in Pseudomonas aeruginosa and the length of carbapenem therapy, which dropped by 72.2% and 59.3% respectively. (contagionlive.com)
  • The observed carbapenem resistance correlated with hydrolytic activity. (asm.org)
  • However, Enterobacteriaceae that produce carbapenemases, which are enzymes that deactivate carbapenems and most other ß-lactam antibiotics, have emerged and are increasingly being reported worldwide. (nih.gov)
  • The novel beta-lactamase inhibitors, avibactam, relebactam, and vaborbactam, can inhibit most carbapenemases but are ineffective against metallo-beta-lactamases (a type of carbapenemase that uses reactive zinc to destroy the carbapenem). (merckmanuals.com)
  • However, reports in Australia of carbapenem resistance due to production of a variety of carbapenemases, including metallo- β -lactamases (MBLs), have been increasing alarmingly. (mja.com.au)
  • Resistance to carbapenems may be mediated via a variety of mechanisms, but the development and spread of carbapenemases ( β -lactamase enzymes that hydrolyse carbapenems and many other β -lactam antibiotics) in Enterobacteriaceae has caused global concern. (scielo.org.za)
  • Studies have indicated that Enterobacteriaceae are producing enzymes such as carbapenemases, which inactivate carbapenems. (academicjournals.org)
  • Carbapenem resistance among Enterobacteriaceae can be conferred by several genetic mechanisms, but epidemiologically the most important of them results in the production of beta-lactamases (carbapenemases), which hydrolyse carbapenems and most other beta-lactams. (scielo.org.za)
  • Carbapenemases (β-lactamases able to inactivate carbapenems) have been identified in both serine β-lactamase (SBL) and metallo-β-lactamase (MBL) families. (uio.no)
  • Resistance to carbapenem antibiotics in this sample was not mediated only by carbapenemases but also by production of extended-spectrum β-lactamases (largely CTX-M-15), accompanied by protein loss. (uwi.edu)
  • Carbapenems are less commonly used in the treatment of community-acquired pneumonia, as community-acquired strains of the most common responsible pathogens (Streptococcus pneumoniae, Haemophilus influenazae, atypical bacteria, and Enterobactericeace) are typically susceptible to narrower spectrum and/or orally administered agents such as fluoroquinolones, amoxicillin, or azithromycin. (wikipedia.org)
  • Within each pattern of susceptibility, the mean MICs of beta-lactam agents other than carbapenems were similar, whether the strains were susceptible or resistant to imipenem. (nih.gov)
  • The increase in carbapenem therapy might be associated with the emergence of A. baumannii strains that produce imipenem-hydrolyzing enzymes, which is a serious concern due to the large spectrum of these enzymes. (asm.org)
  • The aims of this study were to investigate the mechanisms of resistance to polymyxin and to evaluate the genetic diversity in carbapenem and polymyxin-resistant K. pneumoniae strains recovered from patients admitted in intensive care units of public hospitals in the Mid-West of Brazil. (scielo.br)
  • In this study, a novel lytic A. baumannii phage, Βϕ-R3177, infecting carbapenem-resistant A. baumannii strains was isolated from sewage samples at a hospital. (jcvi.org)
  • The emergence of strains resistant to carbapenems has left few treatment options, making infection containment critical. (sciencemag.org)
  • In recent years, the threat posed by K. pneumoniae has markedly increased with the emergence of strains resistant to carbapenem antibiotics ( 3 ) and their worldwide dissemination ( 4 , 5 ). (sciencemag.org)
  • However, other strains displayed at least elevated carbapenem MICs or were carbapenem resistant and produced measurable carbapenemase activities but did not harbour IS elements in the region upstream of the cfiA gene. (diva-portal.org)
  • A widespread dispersal of carbapenem-resistant STs and other clinically significant AR STs observed in the present study suggested the plausible release of these strains into the environment. (iwaponline.com)
  • Recently, the emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-HvKP) strains has become a great challenge to public health. (alliedacademies.org)
  • Similar to penicillins and cephalosporins, carbapenems are members of the beta lactam class of antibiotics, which kill bacteria by binding to penicillin-binding proteins, thus inhibiting bacterial cell wall synthesis. (wikipedia.org)
  • In contrast to all useful penicillins and cephalosporins, and to various experimental carbapenems, these three agents carry the substituents to the β-lactam ring in the trans configuration. (springer.com)
  • Serious concur- fromaroundtheworldpublishedbeforeApril9,2012.At- rent conditions ( 3 , 4 , 19 - 22 ) and prior use of fluoroquino- tributabledeathwasdefinedasthedifferenceinall-cause lones ( 20 , 23 , 24 ), carbapenems ( 22 , 25 ), or broad-spectrum deaths between patients with carbapenem-resistant infec- cephalosporins ( 20 , 22 ) have been independently associated tions and those with carbapenem-susceptible infections. (cdc.gov)
  • Beta-lactam antibiotics include Cephalosporins, Penicillins, monobactams and Carbapenems. (express-press-release.net)
  • Carbapenems are cell wall synthesis inhibiting antibiotics just like penicillins and cephalosporins with a different chemical structure. (scirp.org)
  • The MBT STAR-BL software (RUO) monitors mass shifts introduced by enzymatic degradation of betalactam antibiotics, such as penicillins, 3rd- generation cephalosporins and carbapenems. (bruker.com)
  • Carbapenems exhibit broad spectrum activity against gram-negative bacteria and somewhat narrower activity against gram-positive bacteria. (wikipedia.org)
  • The spectrum of activity of the carbapenems against gram-positive bacteria is fairly broad, but not as exceptionally so as in the case of gram-negative bacteria. (wikipedia.org)
  • 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. (wikipedia.org)
  • People most likely to acquire carbapenem-resistant bacteria are those already receiving medical attention. (wikipedia.org)
  • Exposure to antibiotics, especially fluoroquinolones, and previous hospitalization dramatically increased the risk of acquisition carbapenem-resistant bacteria. (wikipedia.org)
  • It was less than a decade after the introduction of carbapenem and or cephalosporin in the clinical practice, in 1980's that Gram negative bacteria have become resistant to these agents (Datta and Wattal, 2010). (thefreedictionary.com)
  • Infections with bacteria resistant to carbapenems, a group of highly effective antibiotics, pose a significant threat to patients and healthcare systems in all EU/EEA countries, warns ECDC in a Rapid Risk Assessment. (eurekalert.org)
  • The global rise of carbapenem resistance in a certain family of bacteria called Enterobacteriaceae, or carbapenem-resistant Enterobactericaeae (CRE), represents a threat to healthcare delivery and patient safety. (eurekalert.org)
  • ESBL-producing bacteria were considered as carbapenem-susceptible. (cdc.gov)
  • Carbapenem antibiotics are often used as the last line of treatment for infections caused by highly resistant bacteria, including those in the Enterobacteriaceae family. (cdc.gov)
  • In CRE infections, the bacteria release chemicals that prevent carbapenems from killing them. (drugs.com)
  • As the carbapenems have been the gold standard to date for the systemic treatment of serious infections with Gram-negative bacteria, carbapenem resistance presents new and difficult challenges in therapeutic decision-making, particularly because of the high frequency of co-resistance. (aerzteblatt.de)
  • In the past fifteen years, Carbapenems were known to be the drugs of choice for these bacteria. (scirp.org)
  • With the increase in the use and misuse of antibiotics, these bacteria became highly resistant, and almost all available antibiotics, including Carbapenems, became inefficient. (scirp.org)
  • Carbapenem-resistant Enterobacteriaceae (CRE) infection is a condition in which the Enterobacteriaceae bacteria produce enzymes that break down carbapenem antibiotics and make them ineffective against the infection. (emedicinehealth.com)
  • If the bacteria are resistant to carbapenem antibiotics, they are CRE. (emedicinehealth.com)
  • Carbapenem-Resistant Enterobacteriaceae (CRE) are untreatable or difficult to treat bacteria that are resistant to carbapenem antibiotics and nearly all available antibiotics. (acphd.org)
  • Many multidrug-resistant hospital-acquired bacteria are sensitive only to carbapenems. (merckmanuals.com)
  • To determine the role of extended-spectrum β-lactamases in carbapenem-resistant Gram-negative bacteria from south-western Nigeria. (uwi.edu)
  • However, new in vitro data question ertapenem's inclusion as a first line treatment for these bacteria, suggesting that ertapenem has a lower likelihood of obtaining appropriate pharmacodynamic exposure than other carbapenems. (thescipub.com)
  • Carbapenems are a class of beta-lactam antibiotics that are capable of killing most bacteria by inhibiting the synthesis of one of their cell wall layers. (wikipedia.org)
  • In March 2010, a study in a hospital in Mumbai found that most carbapenem-resistant bacteria isolated from patients carried the blaNDM-1 gene. (wikipedia.org)
  • The increasing global prevalence of carbapenem-resistant Enterobacteriaceae (CRE) combined with the decline in effective therapies is a public health care crisis. (asm.org)
  • In recent years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has risen substantially, and the study of CRE resistance mechanisms has become increasingly important for antibiotic development. (pnas.org)
  • Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. (cambridge.org)
  • The increasing prevalence of carbapenem-resistant K. pneumoniae (CRKP) poses a serious threat to public health worldwide. (alliedacademies.org)
  • The carbapenem ertapenem is one of several first-line agents recommended by the Infectious Disease Society of America for the empiric treatment of community-acquired intra-abdominal infections of mild-to-moderate severity. (wikipedia.org)
  • This study found that carbapenem-resistant acquisition has a significantly higher mortality rate and poorer clinical response compared to that of the ertapenem-resistance acquisition. (wikipedia.org)
  • Validation and subsequent manufacture of the generic Ertapenem and Imipenem API's as well as other new carbapenems is slated to begin first half of 2019. (medindia.net)
  • The spread of carbapenem-resistant Enterobacteriaceae (CRE) has become not only a clinical challenge but also a global public health problem. (aacc.org)
  • In 2011, the U.S. National Institutes of Health Clinical Center experienced an outbreak of carbapenem-resistant K. pneumoniae that affected 18 patients, 11 of whom died. (sciencemag.org)
  • In addition, many controversies about optimal treatment exist, and few clinical reports comparing the treatment efficacy of cephamycins and carbapenems have been published [ 7 ]. (biomedcentral.com)
  • This case report delineates the first published case of ceftolozane/tazobactam-induced leukocytosis (up to 36.9 × 10 9 cells/L) and clinical failure when utilized in a high-dose regimen for a patient being treated for ventilator-associated pneumonia secondary to carbapenem-resistant P. aeruginosa . (springer.com)
  • Treatment Options for Carbapenem-Resistant Enterobacteriaceae Infections. (nih.gov)
  • Carbapenem-resistant Enterobacteriaceae infections are associated with poor outcomes and high mortality. (nih.gov)
  • This article provides a comprehensive review of currently available treatment options for infections due to carbapenem-resistant Enterobacteriaceae (CRE). (nih.gov)
  • 97 carbapenems non-susceptible K. pneumoniae were studied. (scielo.br)
  • Deleterious mutations in pmrB gene is the main chromosomal target for induction of polymyxin resistance in carbapenem-resistant K. pneumoniae in public hospitals in the Mid-West of Brazil. (scielo.br)
  • Although multiple resistance mechanisms have been identified ( 10 ), carbapenem resistance in the United States is primarily caused by the plasmid-encoded K. pneumoniae carbapenemase (KPC) gene ( 5 ). (sciencemag.org)
  • In this laboratory studies, agar well diffusion and well microplate dilution of the ethanolic extract of the guava leaves was used to determine the effectiveness of Psidium guajava on carbapenem-resistant K. pneumoniae. (academicjournals.org)
  • The minimum inhibition concentration and minimum bactericidal concentration of ethanolic extract of guava leaves was 6.25 mg/ml indicating significant antibacterial activity against the carbapenem-resistant K. pneumoniae. (academicjournals.org)
  • Rates of colonization and infection with carbapenem-resistant Gram-negative pathogens are on the rise, particularly in southeastern European countries, and this is increasingly true in Germany as well. (aerzteblatt.de)
  • The treatment of severe infection with carbapenem-resistant pathogens should be individualized and carried out in an interdisciplinary framework, in consideration of antibiotic pharmacokinetics and pharmacodynamics in each case. (aerzteblatt.de)
  • A 39-year-old man had a biliary fistula and then was found to have multiple liver abscesses through abdominal ultrasound and an abdominal computed tomography scan, and carbapenem-sensitive E. aerogenes infection was confirmed. (nih.gov)
  • Carbapenem-resistant Enterobacteriaceae (CRE), a major resistance concern emerging during the last decade because of significantly compromising the efficacy of carbapenem agents, has currently become an important focus of infection control. (frontiersin.org)
  • Resistance to carbapenems, a subclass of the cell wall-targeting β-lactams that are often termed antibiotics of last resort, has become increasingly common in recent decades ( 2 ⇓ - 4 ), resulting in rising threats of infection mortality ( 5 , 6 ). (pnas.org)
  • People admitted to any healthcare setting for medical care are more prone to infection and to go for Carbapenem-resistant enterobacteriaceae testing than healthy people. (express-press-release.net)
  • Growing awareness about prevention of Carbapenem resistance and increased efforts by governments through the implementation of infection prevention and control measures might hinder the growth of the Carbapenem-resistant enterobacteriaceae testing market during the forecast period. (express-press-release.net)
  • The CDC has now assessed the extent of the problem of carbapenem-resistant Enterobacteriaceae (CRE) in the U.S. Among almost 4000 acute care hospitals that performed surveillance for either catheter-associated urinary tract infections or central line-associated blood stream infections during the first 6 months of 2012, 181 (4.6%) reported at least one CRE infection. (freecme.com)
  • 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)
  • OBJECTIVE: To establish a statewide network to detect, control, and prevent the spread of carbapenem-resistant Enterobacteriaceae (CRE) in a region with a low incidence of CRE infection. (oregonstate.edu)
  • 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)
  • Camellia sinensis Ameliorates the Efficacy of Last Line Antibiotics Against Carbapenem Resistant Escherichia coli. (sigmaaldrich.com)
  • The drug combination analysis of PTRC-31911-A with five third-line antibiotics was carried out against carbapenem-resistant Escherichia coli. (sigmaaldrich.com)
  • 2. Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE)- November 2015 Update CRE Toolkit. (cambridge.org)
  • It contains recommendations for healthcare facilities and is intended to expand upon the March 2009 "Guidance for control of carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute-care facilities. (europa.eu)
  • The CDC guidance for control of carbapenem-resistant Enterobacteriaceae (CRE) is an important milestone and provides a comprehensive approach for strengthening public health preparedness for CRE prevention and control at both hospital/healthcare facility- and regional levels. (europa.eu)
  • Previous studies on carbapenem-resistant ACB complex in Taiwan reported that the risk factors associated with the isolation of carbapenem-resistant ACB complex were carbapenem use, duration of hospital stay, and admission in ICU. (thefreedictionary.com)
  • 1],[6],[13] The current study revealed that previous fluoroquinolone use is the only factor associated with the isolation of carbapenem-resistant ACB complex. (thefreedictionary.com)
  • The frequency of isolation of carbapenem-resistant enterobacteriaceae is increasing in the U.S., with the highest prevalence in the northeastern region. (freecme.com)
  • Death risk ratios (RRs) for patients infected with carbapenem-resistant Enterobacteriaceae (CRE) versus carbapenem-susceptible Enterobacteriaceae (CSE). (cdc.gov)
  • Thus, the continued surveillance of carbapenem resistant and carbapenemase-producing organisms will enable the Agency to continue to monitor the spread and burden of these types of antimicrobial resistance in Canadian acute-care hospitals. (canada.ca)
  • Carbapenem resistance was confirmed by the Modified Hodge Test. (scirp.org)
  • In addition to resistance to almost all β-lactams including carbapenems, CRE tend to show high levels of resistance to other classes of antibiotic agents due to the frequent occurrence of other resistance genes on the same mobile genetic elements (1). (aacc.org)
  • Furthermore, we identify three genes that may point to antibiotic targets and two genes that offer clues about how Enterobacteriaceae acquire carbapenem resistance. (pnas.org)
  • Inhibition of the genes hycA , dsrB , and bolA potentiated carbapenem efficacy in CRE E. coli , whereas inhibition of the genes flhC and ygaC conferred added resistance. (pnas.org)
  • The epidemiology is compounded by the diversity of carbapenem-hydrolysing enzymes and the ability of their genes to spread between different bacterial species. (eurosurveillance.org)
  • The presence of carbapenem resistance genes (OXA23, NDM1, OXA48, KPC, VIM ve IMP ) was investigated by Polymerase Chain Reaction (PCR) method. (alliedacademies.org)
  • False positive results in inhibitor based tests occur because in the presence of EDTA, oxacillinases are converted to a less active state leading to augmentation of the inhibition zone around the carbapenem disk and reduction of carbapenem MICs. (thefreedictionary.com)
  • KPC and NDM are enzymes that break down carbapenems and make them ineffective. (wikipedia.org)
  • In general, the emergence of carbapenem-hydrolyzing enzymes has been limited compared to the prevalence of other β-lactamases ( 1 ). (asm.org)
  • Other enzymes, in addition to KPC, can breakdown carbapenems and lead to the development of CRE, but they are uncommon in the United States. (hawaii.gov)
  • The carbapenems were developed to overcome antibiotic resistance mediated by bacterial beta-lactamase enzymes. (wikipedia.org)
  • Conclusion: Our findings showed that PCR for KPC gene should be performed to evaluate carbapenem resistance in P. aeruginosa and that this agent can harbor more than one carbapenemase gene. (medworm.com)
  • Carbapenems are active synergistically with aminoglycosides against P. aeruginosa . (merckmanuals.com)
  • Carbapenems play a pivotal role in the management of severe multidrug-resistant gram-negative Enterobacteriaceae and P. aeruginosa infections. (mja.com.au)
  • Rather than monotherapy, clinicians are increasingly resorting to combination therapies, such as dual carbapenems, carbapenems combined with polymyxin B or tigecycline. (scielo.br)
  • 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)
  • A 2015 meta analysis concluded that the anti-pseudomonal penicillin-beta lactamase inhibitor combination piperacillin-tazobactam gives results equivalent to treatment with a carbapenem in patients with sepsis. (wikipedia.org)
  • Carbapenem-resistant Enterobacteriaceae (CRE) are a major concern for patients in healthcare facilities. (cdc.gov)
  • We should be very concerned about the rise in carbapenem resistance in the EU/EEA as there are very few options for the treatment of patients with CRE infections" says Dominique Monnet, Head of ECDC's Antimicrobial Resistance and Healthcare-Associated Infections Programme. (eurekalert.org)
  • How frequently are hospitalized patients colonized with carbapenem-resistant Enterobacteriaceae (CRE) already on contact precautions for other indications? (cambridge.org)
  • Carbapenem-resistant Enterobacteriaceae (CRE) or carbapenemase-producing Enterobacteriaceae (CPE) are highly resistant to antibiotics, leaving only a few options for treatment of infected patients, and thus represent a serious threat to public health. (europa.eu)
  • Carbapenems rather than flomoxef should be the therapy of choice in these critically vulnerable patients. (biomedcentral.com)
  • Carbapenem antibiotics were originally developed at Merck & Co. from the carbapenem thienamycin, a naturally derived product of Streptomyces cattleya. (wikipedia.org)
  • The rise of Gram-negative pathogens expressing metallo-β-lactamases (MBLs) is a growing concern, threatening the efficacy of β-lactam antibiotics, in particular, the carbapenems. (asm.org)
  • Recently, the emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a more critical issue due to the limited therapeutic options available for these pathogens and the significant morbidity and mortality associated with CRE infections (Tang et al. (medworm.com)
  • Carbapenem-resistant Gram-negative pathogens are a critical public health threat and there is an urgent need for new treatments. (uio.no)
  • Overall, these results demonstrate the therapeutic potential of a ZN148-carbapenem combination against MBL-producing Gram-negative pathogens and that ZN148 is a highly promising MBL inhibitor that is capable of operating in a functional space not presently filled by any clinically approved compound. (uio.no)
  • Carbapenems are a class of beta-lactam antibiotics with a broad spectrum of antibacterial activity, and have a structure which renders them highly resistant to beta-lactamases. (bionity.com)
  • Carbapenems, a new class of beta-lactam antibiotics. (bionity.com)
  • Carbapenems are parenteral bactericidal beta-lactam antibiotics that have an extremely broad spectrum. (merckmanuals.com)
  • 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)
  • There are a number of therapeutic alternatives to carbapenems that can be applied with the aid of sensitive microbiological and/or molecular genetic testing. (aerzteblatt.de)
  • The antibiotic stewardship program at the hospital included certain limitations on carbapenem prescriptions, pre-authorization for antibiotic prescription, therapeutic drug monitoring service by pharmacy, management manuals for common infectious diseases, and more. (contagionlive.com)
  • This development is concerning because carbapenems are often the last resort for treating multidrug-resistant gram-negative organisms, particularly those that produce AmpC and extended-spectrum beta-lactamases, which destroy most beta-lactams except for carbapenems. (merckmanuals.com)
  • If approved, SPR994 would be the first oral carbapenem antibiotic for use in adults to treat multidrug resistant Gram-negative infections. (empr.com)
  • In recent years, the emergence of carbapenem-resistant Enterobacteriaceae (CRE) has been marked by the World Health Organization as a critical priority for antibiotic development ( 1 ). (pnas.org)
  • Resistance to β -lactam antibiotics in Enterobacteriaceae has steadily increased, with the emergence of carbapenem-resistant Enterobacteriaceae (CRE) seen in the past decade. (scielo.org.za)
  • Furthermore, although prevention of the emergence and subsequent spread of carbapenem-resistant Enterobacteriaceae (CRE) has focused on acute and chronic care facilities and inter alia on antibiotic exposure in these institutions, CRE may soon become an issue within entire communities, highlighting a role for public health authorities in CRE prevention efforts. (scielo.org.za)
  • The emergence of Carbapenem-resistant Enterobacteriaceae (CRE) is one of the most significant and urgent threats to global human health. (uniquest.com.au)
  • Furthermore, carbapenems are typically unaffected by emerging antibiotic resistance, even to other beta-lactams. (wikipedia.org)
  • Biofilm formation is highly prevalent with varying degree of resistance among different antibiotics including carbapenems that further augments antibiotic resistance. (nepjol.info)
  • There are several different mechanisms by which Enterobacteriaceae can develop resistance to carbapenem antibiotics. (thefreedictionary.com)
  • Carbapenem-resistant enterobacteriaceae testing includes disc diffusion or automated systems, selective agar Carbapenem-resistant enterobacteriaceae testing, minimal inhibitory concentration (MIC) for Carbapenem-resistant enterobacteriaceae testing, synergy Carbapenem-resistant enterobacteriaceae testing, modified Hodge tests, whole genome sequencing, spectrometrics and various other molecular methods. (express-press-release.net)
  • For bloodstream infections known to be due to extended spectrum beta-lactamase producing Enterobacteriaceace, carbapenems are superior to alternative treatments. (wikipedia.org)
  • Consequently, there is a market need for effective inhibitors of class B MBLs as adjuvants for carbapenems. (uniquest.com.au)
  • These MBL inhibitors have the potential to prolong the use of carbapenem antibiotics and address the urgent threat of CRE. (uniquest.com.au)
  • These inhibitors have the potential to be used as an adjuvant with carbapenem antibiotics to restore the activity of carbapenems and treat infections caused by CRE. (uniquest.com.au)
  • Unfortunately, there are no approved inhibitors of MBL-mediated carbapenem-resistance and treatment options for infections caused by MBL-producing Gram-negatives are limited. (uio.no)
  • Capabilities include dedicated HPAPI, in-house enzyme evolution and fermentation for biotransformations, end-to-end continuous flow development and application, hydrogenation, cryogenic capabilities, dedicated carbapenem manufacture, and others. (medindia.net)
  • a carbapenem, undergoes hydrolysis by a dihydropeptidase enzyme in the ________________ to a toxic metabolite. (brainscape.com)
  • The NDM-1 enzyme hydrolyses all available penicillin, cephalosporin and carbapenem antibiotics, and is commonly accompanied by additional resistance mechanisms to multiple antibiotic classes. (scielo.org.za)
  • an enzyme that breaks down carbapenem. (canada.ca)
  • However, the blaNDM-1 gene produces NDM-1, which is a carbapenemase beta-lactamase - an enzyme that hydrolyzes and inactivates these carbapenem antibiotics. (wikipedia.org)
  • However, research is underway to develop an effective oral carbapenem. (bionity.com)
  • Over the past decade, however, carbapenem-resistant Enterobacteriaceae (CRE) have been recognized in health-care settings as a cause of difficult-to-treat infections associated with high mortality. (nih.gov)
  • Carbapenems have been used as the "last-line" treatment for infections caused by resistant Enterobacteriaceae, including those producing extended spectrum ß-lactamases. (nih.gov)
  • We evaluated the number of deaths attributable to care facilities around the world ( 6 - 13 ), and in some plac- carbapenem-resistant Enterobacteriaceae by using studies es, CRE have become endemic ( 14 - 18 ). (cdc.gov)
  • February 14, 2013, 12:30 ET CDCHAN-00341-02-14-2013 Carbapenem-resistant Enterobacteriaceae (CRE) are untreatable or difficult-to-treat multidrugresistant organisms that are emerging in the United States. (cdc.gov)
  • Kallen A , Guh A . United States Centers for Disease Control and Prevention issue updated guidance for tackling carbapenem-resistant enterobacteriaceae. (eurosurveillance.org)
  • Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent public health concern. (asm.org)
  • Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent problem since they cause infections with high morbidity and mortality and lengthen hospital stays ( 1 , 2 ). (asm.org)
  • These are called Carbapenem-resistant Enterobacteriaceae. (express-press-release.net)
  • Carbapenem-resistant Enterobacteriaceae Testing Market is considered to be a gram-negative pathogen testing. (express-press-release.net)
  • People prone to Carbapenem-resistant enterobacteriaceae include people admitted to hospitals or other healthcare settings. (express-press-release.net)
  • Increase in the number of people requiring inpatient medical assistance, growing number of healthcare facilities, increased number of complex surgeries, multiple use of several antibiotics and rise in use of medical devices in the body, such as urinary catheters, intravenous catheters and ventilators, are few of the major factors responsible for growth in the Carbapenem-resistant enterobacteriaceae testing market. (express-press-release.net)
  • In Carbapenem-resistant Enterobacteriaceae Testing, Modified Hodge tests are anticipated to be one of the leading test types for Carbapenem-resistant enterobacteriaceae testing because of high accuracy of test results. (express-press-release.net)
  • These tests are easy to perform and can be performed in a routine laboratory, which makes them more feasible and thus, one of the leading test types in Carbapenem-resistant enterobacteriaceae testing market. (express-press-release.net)
  • Healthcare settings, such as nursing homes and acute care centers, where constant medical care is required for a longer duration of time are more prone to CRE and thus, the demand for Carbapenem-resistant enterobacteriaceae testing is higher in these settings. (express-press-release.net)
  • According to The Centers for Disease Control and Prevention (CDC), by 2013 Carbapenem-resistant enterobacteriaceae was found in almost 42 states. (express-press-release.net)
  • However, the breakout of CRE in the northeast spread through the US, thereby boosting the market for Carbapenem-resistant enterobacteriaceae testing in the region. (express-press-release.net)
  • Carbapenem-resistant Enterobacteriaceae (CRE) are among the most severe threats to the antibiotic era. (harvard.edu)
  • Carbapenem-resistant Enterobacteriaceae (CRE) Control Panel (Inactivated Swab) includes 6 positive control swabs and 6 negative control swabs. (microbiologics.com)
  • Appendix B: General Approach to Carbapenem-resistant Enterobacteriaceae (CRE) Control in Facilities that Rarely or Have Not Identified CRE. (freecme.com)
  • Carbapenem-resistant Enterobacteriaceae or CRE, are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics, in particular carbapenems. (hawaii.gov)
  • hence, the determination of the effective treatment options of carbapenem-resistant Enterobacteriaceae is important for quality healthcare delivery. (academicjournals.org)
  • Subsequently, carbapenem-resistant Enterobacteriaceae (CRE) have indeed become our 'worst nightmare', locally and internationally, and pose a major threat to the viability of all currently available antibiotics. (scielo.org.za)
  • Failure to receive effective antibiotics (flomoxef or a carbapenem) within 5 days after onset of bacteremia and treatment with flomoxef both significantly contributed to higher mortality. (biomedcentral.com)
  • Carbapenem-resistant organisms (CRO) are a major global public health threat. (asm.org)
  • What organisms are carbapenems NOT effective against? (brainscape.com)
  • All three carbapenems showed high probabilities of achieving bactericidal target attainment against ESBL producing organisms, though ertapenem's lower CFR suggests that it might be a second choice agent in institutions with high rates of resistance among ESBLs. (thescipub.com)
  • R.C. Moellering, G. M. Eliopoulos and D.E. Sentochnik, The carbapenems: new broad spectrum f3-lactam antibiotics, J. Antimicrob Chemother. (springer.com)
  • Among Enterobacteriaceae, resistance to broad-spectrum carbapenem antimicrobials has been uncommon. (nih.gov)
  • Carbapenem antibiotics are broad-spectrum antibiotics that treat serious infections that are commonly resistant to many other antibiotics. (emedicinehealth.com)