Ertapenem

Infection caused by Klebsiella pneumoniae ST11 in a patient after craniectomy.

Folia Microbiol (Praha). 2019 May 22;:

Authors: Ojdana D, Kochanowicz J, Sacha P, Sieńko A, Wieczorek P, Majewski P, Hauschild T, Mariak Z, Tryniszewska E

Abstract
Klebsiella pneumoniae infections have always been an important problem in public health, but today, the increasing resistance of these bacteria to antibiotics due to β-lactamases production has renewed interest in K. pneumoniae infections. The aim of the study was to present a case of a neurosurgical patient with multidrug-resistant K. pneumoniae ST11 infection after craniectomy. Four K. pneumoniae isolates from various clinical materials of the patient undergone identification and susceptibility testing with the Vitek2 system. Tests for β-lactamases production were performed according to EUCAST guidelines. Strains were analyzed for bla genes responsible for β-lactamase production (blaTEM, blaSHV, blaCTX-M, blaVIM, blaIMP, blaNDM, blaKPC, blaOXA-48) using PCR. Moreover, the genetic relatedness of these isolates was determined by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). All tested strain presented multidrug resistance. The highest susceptibility was observed for imipenem, meropenem, and ertapenem. The strain isolated from the nervous system was ESBL-positive with blaSHV-11, blaTEM-1, and blaCTX-M-15 genes. Additionally, the strain from urine was blaKPC-3-positive. Molecular typing revealed that all strains belonged to the same clone and identified two PFGE profiles. The analysis of MLST allelic profile showed that tested K. pneumoniae strains belonged to ST11. Identification of ST11 K. pneumoniae as etiological factor of infection unfavorably impacts on prognosis among neurosurgical patient after craniectomy.

PMID: 31119589 [PubMed - as supplied by publisher]

Susceptibilities of Gram-negative bacilli from hospital- and community-acquired intra-abdominal and urinary tract infections: a 2016-2017 update of the Chinese SMART study.

Infect Drug Resist. 2019;12:905-914

Authors: Zhang H, Johnson A, Zhang G, Yang Y, Zhang J, Li D, Duan S, Yang Q, Xu Y

Abstract
Objectives: To update the epidemiology and susceptibility of hospital-acquired (HA) and community-acquired (CA), as well as intensive care unit (ICU) vs non-ICU-derived intra-abdominal infection (IAI) and urinary tract infection (UTI) pathogens in Chinese hospitals. Methods: A total of 2,546 Gram-negative isolates from IAIs and 1,947 isolates from UTIs collected in 16 hospitals and 7 regions of China from 2016 to 2017 were analyzed. Results: E. coli and K. pneumoniae were the most common pathogens identified in HA (40.7%, 21.9%) and CA (49.2%, 21.3%) IAIs and in HA (59.0%, 17.3%) and CA (64.3%, 12.7%) UTIs, respectively. The overall rates of extended-spectrum β-lactamase (ESBL)-positive strains were 48.2% for E. coli and 26.4% for K. pneumoniae. The rates of ESBL-positive E. coli and K. pneumoniae strains were significantly higher in HA than in CA IAIs (51.7% vs 42.4%, P=0.016 and 22.0% vs 20.6%, P<0.001). IAI E. coli ESBL-producing isolates were most susceptible to IPM (97.2%) and AMK (93.9%), and UTI-associated E. coli ESBL-producers were 94.74% susceptible to amikacin (AMK), 97.02% to imipenem (IPM), and 91.4% to ertapenem (ETP). IAI K. pneumoniae ESBL-producing isolates were most susceptible to AMK (84.43%) and IPM (82.79%), and UTI-associated K. pneumoniae ESBL-producers were 88.39% susceptible to AMK, 87.5% to IPM, and 82.14% to ETP. Overall, percentages of susceptible strains to ETP, IPM, AMK, and Piperacillin-Tazobactam (TZP) were in the range of 82.0% to 96.4%, to 5 cephalosporins in the range of 31.4%-69.6% and to 2 fluoroquinolones in the range of 37.8%-45.5% for E. coli and 65.5%-90.7%, 37.7%-75.3%, and 43.9%-73.2% for K. pneumoniae, respectively. Conclusion: E. coli and K. pneumoniae continued to be the main pathogens in Chinese UTIs and IAIs with high ESBL-positive rates between 2016 and 2017. Carbapenem- or amikacin-based therapies were the most effective to combat IAI and UTI pathogens.

PMID: 31118698 [PubMed]