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.