Antibiotics

Research

9 pages, 1200 KiB

Open AccessArticle

Burden of Healthcare-Associated Infections in Sicily, Italy: Estimates from the Regional Point Prevalence Surveys 2016–2018

by Martina Barchitta, Andrea Maugeri, Maria Clara La Rosa, Claudia La Mastra, Giuseppe Murolo, Giovanni Corrao and Antonella Agodi

Antibiotics 2021, 10(11), 1360; https://doi.org/10.3390/antibiotics10111360 - 8 Nov 2021

Cited by 10 | Viewed by 2377

Abstract

An assessment of the burden of healthcare-associated infections (HAIs) in terms of disability-adjusted life years (DALYs) is useful for comparing and ranking HAIs and to support infection prevention and control strategies. We estimated the burden of healthcare-associated pneumoniae (HAP), bloodstream infection (HA BSI), [...] Read more.

An assessment of the burden of healthcare-associated infections (HAIs) in terms of disability-adjusted life years (DALYs) is useful for comparing and ranking HAIs and to support infection prevention and control strategies. We estimated the burden of healthcare-associated pneumoniae (HAP), bloodstream infection (HA BSI), urinary tract infection (HA UTI), and surgical site infection (SSI) in Sicily, Italy. We used data from 15,642 patients aged 45 years and above, identified during three repeated point prevalence surveys (PPSs) conducted from 2016 to 2018 according to the European Centre for Disease Prevention and Control protocol. The methodology of the Burden of Communicable Diseases in Europe project was employed. The selected HAIs accounted for 8424 DALYs (95% uncertainty interval (UI): 7394–9605) annually in Sicily, corresponding to 344 DALYs per 100,000 inhabitants aged 45 years and above (95% UI: 302–392). Notably, more than 60% of the burden was attributable to HAP, followed by HA BSI, SSI, and HA UTI. The latter had the lowest burden despite a relatively high incidence, whereas HA BSI generated a high burden even through a relatively low incidence. Differences between our estimates and those of European and Italian PPSs encourage the estimation of the burden of HAIs region by region. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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13 pages, 238 KiB

Open AccessArticle

The Impact of Differences in Surveillance Definitions of Hospital Acquired Urinary Tract Infections (HAUTI)

by Yossef Levi, Debby Ben-David, Inna Estrin, Hodaya Saadon, Maya Krocker, Lili Goldstein, Dan Klafter, Shani Zilberman-Itskovich and Dror Marchaim

Antibiotics 2021, 10(10), 1262; https://doi.org/10.3390/antibiotics10101262 - 18 Oct 2021

Cited by 1 | Viewed by 2489

Abstract

Hospital-acquired urinary tract infections (HAUTI) are common and most cases are related to catheters (CAUTI). HAUTI and CAUTI surveillance is mandatory in many countries as a measure to reduce the incidence of infections and appropriately direct the allocation of preventable resources. The surveillance [...] Read more.

Hospital-acquired urinary tract infections (HAUTI) are common and most cases are related to catheters (CAUTI). HAUTI and CAUTI surveillance is mandatory in many countries as a measure to reduce the incidence of infections and appropriately direct the allocation of preventable resources. The surveillance criteria issued by the Israeli Ministry of Health (IMOH), differ somewhat from that of the U.S. Centers for Disease Control and Prevention (CDC). Our study aims were to query and quantify the impact of these differences. In a retrospective cohort study conducted at Shamir Medical Center, for calendar year 2017, the surveillance criteria of both IMOH and CDC were applied on 644 patient-unique adults with “positive” urine cultures (per similar definitions). The incidence of HAUTI per IMOH was significantly higher compared to CDC (1.24/1000 vs. 1.02/1000 patient-days, p = 0.02), with no impact on hospitalization’s outcomes. The agreement rate between methods was high for CAUTI (92%), but much lower for all HAUTI (83%). The major error rate, i.e., patients diagnosed with HAUTI per IMOH but had no UTI per CDC, was 31%. To conclude, in order for surveillance to reflect the relative situation and direct allocation of preventable resources based on scientific literature, the process should be uniform worldwide. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

13 pages, 1699 KiB

Open AccessArticle

An Outbreak of tet(X6)-Carrying Tigecycline-Resistant Acinetobacter baumannii Isolates with a New Capsular Type at a Hospital in Taiwan

by Yu-Chia Hsieh, Jia-Wen Wu, Yi-Yin Chen, Tran Lam Tu Quyen, Wei-Chao Liao, Shiao-Wen Li, Yin-Cheng Chen and Yi-Jiun Pan

Antibiotics 2021, 10(10), 1239; https://doi.org/10.3390/antibiotics10101239 - 12 Oct 2021

Cited by 13 | Viewed by 2934

Abstract

Dissemination of multidrug-resistant, particularly tigecycline-resistant, Acinetobacter baumannii is of critical importance, as tigecycline is considered a last-line antibiotic. Acquisition of tet(X), a tigecycline-inactivating enzyme mostly found in strains of animal origin, imparts tigecycline resistance to A. baumannii. Herein, we investigated the [...] Read more.

Dissemination of multidrug-resistant, particularly tigecycline-resistant, Acinetobacter baumannii is of critical importance, as tigecycline is considered a last-line antibiotic. Acquisition of tet(X), a tigecycline-inactivating enzyme mostly found in strains of animal origin, imparts tigecycline resistance to A. baumannii. Herein, we investigated the presence of tet(X) variants among 228 tigecycline-non-susceptible A. baumannii isolates from patients at a Taiwanese hospital via polymerase chain reaction using a newly designed universal primer pair. Seven strains (3%) carrying tet(X)-like genes were subjected to whole genome sequencing, revealing high DNA identity. Phylogenetic analysis based on the PFGE profile clustered the seven strains in a clade, which were thus considered outbreak strains. These strains, which were found to co-harbor the chromosome-encoded tet(X6) and the plasmid-encoded bla_OXA-72 genes, showed a distinct genotype with an uncommon sequence type (Oxford ST793/Pasteur ST723) and a new capsular type (KL129). In conclusion, we identified an outbreak clone co-carrying tet(X6) and bla_OXA-72 among a group of clinical A. baumannii isolates in Taiwan. To the best of our knowledge, this is the first description of tet(X6) in humans and the first report of a tet(X)-like gene in Taiwan. These findings identify the risk for the spread of tet(X6)-carrying tigecycline- and carbapenem-resistant A. baumannii in human healthcare settings. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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11 pages, 1319 KiB

Open AccessArticle

Impact of Generic Entry on Hospital Antimicrobial Use: A Retrospective Quasi-Experimental Interrupted Time Series Analysis

by Mercè Espona, Daniel Echeverria-Esnal, Sergi Hernandez, Alexander Almendral, Silvia Gómez-Zorrilla, Enric Limon, Olivia Ferrandez and Santiago Grau

Antibiotics 2021, 10(10), 1149; https://doi.org/10.3390/antibiotics10101149 - 24 Sep 2021

Viewed by 2713

Abstract

Background: The impact of antimicrobials generic entry (GE) is controversial. Their introduction could provide an economic benefit yet may also increase their consumption, leading to a higher risk of resistance. Our aim was to analyze the impact of GE on trends of antimicrobial [...] Read more.

Background: The impact of antimicrobials generic entry (GE) is controversial. Their introduction could provide an economic benefit yet may also increase their consumption, leading to a higher risk of resistance. Our aim was to analyze the impact of GE on trends of antimicrobial consumption in an acute-care hospital. Methods: A retrospective quasi-experimental interrupted time series analysis was conducted at a 400-bed tertiary hospital in Barcelona, Spain. All antimicrobials for systemic use for which a generic product entered the hospital from January 2000 to December 2019 were included. Antimicrobial consumption was expressed as DDD/100 bed days. Results: After GE, the consumption of cefotaxime (0.09, p < 0.001), meropenem (0.54, p < 0.001), and piperacillin-tazobactam (0.13, p < 0.001) increased, whereas the use of clindamycin (−0.03, p < 0.001) and itraconazole (−0.02, p = 0.01) was reduced. An alarming rise in cefepime (0.004), daptomycin (1.02), and cloxacillin (0.05) prescriptions was observed, despite not achieving statistical significance. On the contrary, the use of amoxicillin (−0.07), ampicillin (−0.02), cefixime (−0.06), fluconazole (−0.13), imipenem–cilastatin (−0.50) and levofloxacin (−0.35) decreased. These effects were noticed beyond the first year post GE. Conclusions: GE led to an increase in the consumption of broad-spectrum molecules. The potential economic benefit of generic antibiotics could be diluted by an increase in resistance. Antimicrobial stewardship should continue to monitor these molecules despite GE. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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17 pages, 1505 KiB

Open AccessArticle

The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

by Aleksa Despotovic, Branko Milosevic, Andja Cirkovic, Ankica Vujovic, Ksenija Cucanic, Teodora Cucanic and Goran Stevanovic

Antibiotics 2021, 10(10), 1146; https://doi.org/10.3390/antibiotics10101146 - 23 Sep 2021

Cited by 31 | Viewed by 4716

Abstract

Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU [...] Read more.

Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R² = 0.980, p = 0.01) and carbapenems (R² = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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19 pages, 2548 KiB

Open AccessArticle

Antimicrobial Resistance in Nosocomial Isolates of Gram-Negative Bacteria: Public Health Implications in the Latvian Context

by Nityanand Jain, Inese Jansone, Tatjana Obidenova, Raimonds Simanis, Jānis Meisters, Dagnija Straupmane and Aigars Reinis

Antibiotics 2021, 10(7), 791; https://doi.org/10.3390/antibiotics10070791 - 29 Jun 2021

Cited by 16 | Viewed by 4870

Abstract

Antimicrobial resistance (AMR) is one of the most serious threats in modern medicine which requires the constant monitoring of emerging trends amongst clinical isolates. However, very limited surveillance data is available in the Latvian context. In the present study, we conducted a retrospective [...] Read more.

Antimicrobial resistance (AMR) is one of the most serious threats in modern medicine which requires the constant monitoring of emerging trends amongst clinical isolates. However, very limited surveillance data is available in the Latvian context. In the present study, we conducted a retrospective analysis of microbiological data from one of the largest public multispecialty hospitals in Latvia from 2017 to 2020. AMR trends for 19 gram-negative bacterial (GNB) genera were investigated. During the study period, 11,437 isolates were analyzed with Escherichia spp. (34.71%), Klebsiella spp. (19.22%) and Acinetobacter spp. (10.05%) being the most isolated. Carbapenems like Meropenem and Ertapenem were the most effective against GNBs (3% and 5.4% resistance rates, respectively) while high resistance rates (>50%) were noted against both Ampicillin and Amoxicillin/Clavulanic acid. Enterobacter spp. and Klebsiella spp. showed a significant increase in resistance rate against Ertapenem (p = 0.000) and Trimethoprim-Sulfamethoxazole (p = 0.000), respectively. A decrease in the prevalence of Extended-Spectrum Beta-Lactamase positive (ESBL+) Enterobacterales was noted. Despite the lower prescription levels of the penicillin group antimicrobials than the European average (as reported in ESAC-Net Surveillance reports), GNBs showed high average resistant rates, indicating the role of ESBL+ isolates in driving the resistance rates. Constant and careful vigilance along with proper infection control measures are required to track the emerging trends in AMR in GNBs. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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13 pages, 557 KiB

Open AccessFeature PaperArticle

Daptomycin versus Glycopeptides for the Treatment of Enterococcus faecium Bacteraemia: A Cohort Study

by Daniel Echeverría-Esnal, Luisa Sorli, Nuria Prim, Clara Martin-Ontiyuelo, Juan Pablo Horcajada and Santiago Grau

Antibiotics 2021, 10(6), 716; https://doi.org/10.3390/antibiotics10060716 - 14 Jun 2021

Cited by 5 | Viewed by 4434

Abstract

Background: Ampicillin resistant and glycopeptide susceptible Enterococcus faecium bloodstream infection (GSEF-BSI) incidence has risen. However, the treatment of choice remains unknown. Daptomycin use for the treatment of enterococcal infections has increased, despite effectiveness and safety concerns. The objective was to compare the effectiveness [...] Read more.

Background: Ampicillin resistant and glycopeptide susceptible Enterococcus faecium bloodstream infection (GSEF-BSI) incidence has risen. However, the treatment of choice remains unknown. Daptomycin use for the treatment of enterococcal infections has increased, despite effectiveness and safety concerns. The objective was to compare the effectiveness and safety of daptomycin and glycopeptides in the treatment of GSEF-BSI. Methods: This was a single-centre, retrospective observational cohort study performed at Hospital del Mar (Barcelona, Spain), from January 2006–May 2018. The primary outcome was clinical cure at the end of the therapy, and secondary outcomes included 14-day, 30-day, in-hospital mortality, and length of stay. Results: From a total of 192 patients with GSEF-BSI, 54 (28.1%) were treated with glycopeptides and 17 (8.9%) with daptomycin. Patients treated with daptomycin presented a lower clinical cure than patients treated with glycopeptides (58.8% vs. 83.3%, RR 0.416 (95% CI 0.189–0.915)). After controlling for confounding variables by means of multivariate analysis the significative difference was confirmed (aOR 4.313, 95% CI, 1.053–17.660). The need for treatment discontinuation due to adverse events was similar. Conclusions: Patients with GSEF-BSI treated with glycopeptides showed a higher clinical cure than those treated with daptomycin. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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9 pages, 1200 KiB

Open AccessArticle

Impact of a Nosocomial COVID-19 Outbreak on a Non-COVID-19 Nephrology Ward during the First Wave of the Pandemic in Spain

by María Milagro Montero, Carlota Hidalgo López, Inmaculada López Montesinos, Luisa Sorli, Cristina Barrufet Gonzalez, Judith Villar-García, Roberto Güerri-Fernández, Milagros Herranz, Marta Crespo, María Dolores Arenas Jiménez, Julio Pascual, Cristina González Juanes and Juan P. Horcajada

Antibiotics 2021, 10(6), 619; https://doi.org/10.3390/antibiotics10060619 - 22 May 2021

Cited by 5 | Viewed by 2951

Abstract

Introduction: The aim of this study was to analyze a nosocomial coronavirus disease 2019 (COVID-19) outbreak that occurred on a polyvalent non-COVID-19 ward at a tertiary care university hospital in Spain during the first wave of the pandemic and to describe the containment [...] Read more.

Introduction: The aim of this study was to analyze a nosocomial coronavirus disease 2019 (COVID-19) outbreak that occurred on a polyvalent non-COVID-19 ward at a tertiary care university hospital in Spain during the first wave of the pandemic and to describe the containment measures taken. The outbreak affected healthcare workers (HCWs) and kidney disease patients including transplant patients and those requiring maintenance hemodialysis. Methods: The outbreak investigation and report were conducted in accordance with the Orion statement guidelines. Results: In this study, 15 cases of COVID-19 affecting 10 patients and 5 HCWs were identified on a ward with 31 beds and 43 HCWs. The patients had tested negative for severe acute respiratory syndrome coronavirus 2 infection on admission. One of the HCWs was identified as the probable index case. Five patients died (mortality rate, 50%). They were all elderly and had significant comorbidities. The infection control measures taken included the transfer of infected patients to COVID-19 isolation wards, implementation of universal preventive measures, weekly PCR testing of patients and HCWs linked to the ward, training of HCWs on infection control and prevention measures, and enhancement of cleaning and disinfection. The outbreak was contained in 2 weeks, and no new cases occurred. Conclusion: Nosocomial COVID-19 outbreaks can have high attack rates involving both patients and HCWs and carry a high risk of patient mortality. Hospitals need to implement effective infection prevention and control strategies to prevent nosocomial COVID-19 spread. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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13 pages, 1257 KiB

Open AccessArticle

Cost-Effectiveness Analysis of the Prophylactic Use of Ertapenem for the Prevention of Surgical Site Infections after Elective Colorectal Surgery

by Costanza Vicentini, Maria Michela Gianino, Alessio Corradi, Noemi Marengo, Valerio Bordino, Silvia Corcione, Francesco Giuseppe De Rosa, Giovanni Fattore and Carla Maria Zotti

Antibiotics 2021, 10(3), 259; https://doi.org/10.3390/antibiotics10030259 - 4 Mar 2021

Viewed by 2566

Abstract

Standard surgical antimicrobial prophylaxis (SAP) regimens are less effective in preventing surgical site infections (SSIs) due to rising antimicrobial resistance (AMR) rates, particularly for patients undergoing colorectal surgery. This study aimed to evaluate whether ertapenem should be a preferred strategy for the prevention [...] Read more.

Standard surgical antimicrobial prophylaxis (SAP) regimens are less effective in preventing surgical site infections (SSIs) due to rising antimicrobial resistance (AMR) rates, particularly for patients undergoing colorectal surgery. This study aimed to evaluate whether ertapenem should be a preferred strategy for the prevention of SSIs following elective colorectal surgery compared to three standard SAP regimens: amoxicillin-clavulanate, cefoxitin, and cefazolin plus metronidazole. A cost-effectiveness analysis was conducted using decision tree models. Probabilities of SSIs and AMR-SSIs, costs, and effects (in terms of quality-adjusted life-years) were considered in the assessment of the alternative strategies. Input parameters integrated real data from the Italian surveillance system for SSIs with data from the published literature. A sensitivity analysis was conducted to assess the potential impact of the decreasing efficacy of standard SAP regimens in preventing SSIs. According to our models, ertapenem was the most cost-effective strategy only when compared to amoxicillin-clavulanate, but it did not prove to be superior to cefoxitin and cefazolin plus metronidazole. The sensitivity analysis found ertapenem would be the most cost-effective strategy compared to these agents if their failure rate was more than doubled. The findings of this study suggest ertapenem should not be a preferred strategy for SAP in elective colorectal surgery. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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Review

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13 pages, 699 KiB

Open AccessReview

Infection Control in the Era of COVID-19: A Narrative Review

by Nour Shbaklo, Tommaso Lupia, Francesco G. De Rosa and Silvia Corcione

Antibiotics 2021, 10(10), 1244; https://doi.org/10.3390/antibiotics10101244 - 14 Oct 2021

Cited by 18 | Viewed by 6471

Abstract

COVID-19 quickly became a pandemic causing millions of infections and mortalities. It required real-time adjustments to healthcare systems and infection prevention and control (IPC) measures to limit the spread and protect healthcare providers and hospitalized patients. IPC guidelines were adopted and developed based [...] Read more.

COVID-19 quickly became a pandemic causing millions of infections and mortalities. It required real-time adjustments to healthcare systems and infection prevention and control (IPC) measures to limit the spread and protect healthcare providers and hospitalized patients. IPC guidelines were adopted and developed based on experience gained during the MERS-CoV and SARS-CoV outbreaks. The aim of this narrative review is to summarize current evidence on IPC in healthcare settings and patients with COVID-19 to prevent nosocomial infections during the actual pandemic. A search was run on PubMed using the terms (‘COVID-19’ [Mesh]) AND (‘Infection Control’ [Mesh]) between 2019 and 2021. We identified 86 studies that were in accordance with our aim and summarized them under certain themes as they related to COVID-19 infection control measures. All the guidelines recommend early diagnosis and rapid isolation of COVID-19 patients. The necessary precautions should be taken comprising the whole process, starting with an infectious disease plan, administrative and engineering controls, triage, and PPE training. Guidelines should target modes of transmission, droplet, aerosol, and oral–fecal, while recommending control precautions. Healthcare facilities must promptly implement a multidisciplinary defense system to combat the outbreak. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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Other

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9 pages, 1483 KiB

Open AccessBrief Report

Evaluation of the Performances of the Rapid Test RESIST-5 O.O.K.N.V Used for the Detection of Carbapenemases-Producing Enterobacterales

by Assiya El Kettani, Fakhreddine Maaloum, Nehemie Nzoyikorera, Mohamed Khalis, Khalid Katfy, Houria Belabbes and Khalid Zerouali

Antibiotics 2021, 10(8), 953; https://doi.org/10.3390/antibiotics10080953 - 6 Aug 2021

Cited by 3 | Viewed by 2214

Abstract

Background: The emergence of carbapenemase-producing Enterobacterales (CPE) is a public health problem, requiring rapid and reliable diagnostic methods. The aim is to compare the new rapid immunochromatographic (IC) test: RESIST-5 O.O.K.N.V with PCR and the predictive model of EUCAST algorithm for the detection [...] Read more.

Background: The emergence of carbapenemase-producing Enterobacterales (CPE) is a public health problem, requiring rapid and reliable diagnostic methods. The aim is to compare the new rapid immunochromatographic (IC) test: RESIST-5 O.O.K.N.V with PCR and the predictive model of EUCAST algorithm for the detection of CPE. Methods: A longitudinal cross-sectional study was carried out in the bacteriology-virology laboratory of the Ibn Rochd-Casablanca University Hospital, from 1 February 2019 to 28 February 2020, concerning strains with reduced sensitivity to Ertapenem. The identification of bacterial species was carried out according to the standard criteria of microbiology and antibiogram according to CASFM-EUCAST 2019 recommendations. The sensitivity and specificity of the rapid IC test were calculated. Results: The results of the new IC test showed a sensitivity and specificity of 100% for the detection of OXA-48 and NDM. These carbapenemases were detected simultaneously with a sensitivity and specificity of 100%. OXA-48 was the most common carbapenemas found (36%), followed by NDM (24%) and (13.4%) cases of OXA-48 and NDM coexistence. Conclusion: The rapid IC test could be a rapid and effective diagnostic tool for detecting the most common carbapenemases in our context, and to accelerate the implementation of adequate antibiotic therapy and infection control measures in patients with CPE infections Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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8 pages, 641 KiB

Open AccessBrief Report

Two Distinct Genotypes of KPC-2-Producing Klebsiella pneumoniae Isolates from South Korea

by Jee Hong Kim, Yun Young Cho, Ji Young Choi, Yu Mi Wi and Kwan Soo Ko

Antibiotics 2021, 10(8), 911; https://doi.org/10.3390/antibiotics10080911 - 26 Jul 2021

Cited by 6 | Viewed by 2205

Abstract

In this study, we investigated the characteristics of KPC-2-producing Klebsiella pneumoniae (KP-Kp) isolates from a hospital in South Korea. Among the 37 KP-Kp isolates, two main clones were identified—ST11 and ST307. ST11 isolates showed higher minimum inhibitory concentrations for carbapenems than ST307 isolates. [...] Read more.

In this study, we investigated the characteristics of KPC-2-producing Klebsiella pneumoniae (KP-Kp) isolates from a hospital in South Korea. Among the 37 KP-Kp isolates, two main clones were identified—ST11 and ST307. ST11 isolates showed higher minimum inhibitory concentrations for carbapenems than ST307 isolates. All ST307 isolates were resistant to gentamicin and trimethoprim–sulfamethoxazole, but ST11 isolates were not. However, most tigecycline-resistant or colistin-resistant isolates belonged to ST11. The two KP-Kp clones showed different combinations of wzi and K serotypes. Plasmids from ST11 KP-Kp isolates exhibited diverse incompatibility types. Serum resistance and macrophage infection assays indicated that ST11 may be more virulent than ST307. The changes in the main clones of KP-Kp isolates over time as well as the different characteristics of these clones, including virulence, suggest the need for their continuous monitoring. Full article

(This article belongs to the Special Issue Surveillance for Antimicrobial Resistance and Healthcare-Associated Infections in Hospital)

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