It appears as a mucoid lactose fermenter on macconkey agar although found in the normal flora of the mouth, skin, and intestines, it can cause destructive changes to human and animal lungs if aspirated, specifically to the alveoli resulting in bloody, brownish. Introduction to klebsiella pneumoniae carbapenemases. A 7year surveillance of the drug resistance in klebsiella. Molecular analysis confirmed the presence of the bla ndm1 gene in 341 71% k. Esblproducing klebsiella pneumoniae kpn pose a major threat to human health globally. However, some epidemiological changes have been observed since the emergence of ctxm enzymes in k. Esblproducing strain of hypervirulent klebsiella pneumoniae. Klebsiella pneumoniae causes a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Klebsiella pneumoniae, also called friedlanders bacillus, was first described in 1882 by german microbiologist and pathologist carl friedlander. We report intestinal carriage of an extendedspectrum.
We carried out a wgs study to understand the genetic background of esbl producing kpn in malawi and place them in the context of other global isolates. It is important to note that the nccls confirmatory tests are only intended for the detection of esbls found ine. Extended spectrum beta lactamase esbl mediated resistance to. The communityassociated klebsiella pneumoniae has gradually increased 1 and caused liver abscesses in diabetic patients 2. It is known as a pathogen that attacks hospitalized patients at a higher frequency and needds good antibiotic treatment. Examples of germs in the enterobacteriaceae family include escherichia coli e.
The incidence of healthcareassociated esblkpn bacteremia was evaluated before and after initiating. Pdf on jan 1, 2012, sadeta had and others published distribution of nosocomial infections caused by klebsiella pneumoniae esbl strain find, read and cite all the research you need on researchgate. Outbreak of extendedspectrum betalactamaseproducing. This study was done to determine the susceptibility of different antimicrobials to esbl producing escherichia coli and klebsiella pneumoniae isolated from wound.
We carried out a wgs study to understand the genetic background of esblproducing kpn in malawi and place them in the context of other global isolates. A comparison of extendedspectrum beta lactamase esblproducing escherichia coli and klebsiella pneumoniae bloodstream infections in alberta using a provincial surveillance system kathryn r. Adequate empirical therapy was administered in 74% of infections caused by non esbl nonkpc strains, versus 33%. To get a klebsiella infection, a person must be exposed to the bacteria. Vim, imp and ndm enzymes and class d carbapenemases e. Klebsiella species is a topic covered in the johns hopkins abx guide to view the entire topic, please sign in or purchase a subscription official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine. We report mcr1 colistin resistance in esblproducing k. Investigation and control of vancomycinresistant staphylococcus aureus vrsa pdf icon pdf 300 kb cdc. All the isolates from the environmental samples were found to be multidrug resistant and amp c positive.
The antimicrobial susceptibility of klebsiella pneumoniae. Insertion sequencedependent ompk36 mutation associated. A gramnegative pneumonia that can cause both nosocomial and communityacquired pneumonia. A total of two hundred and fifteen 215 clinical isolates were examined, of which 60% were e. Lactamaseproducing klebsiella pneumoniae esblkp in an acute care hospital. Pdf extended spectrum lactamaseproducing klebsiella. Seroepidemiology of klebsiella pneumoniae colonizing the intestinal tract of healthy chinese and overseas chinese adults in asian countries. In healthcare settings, klebsiella bacteria can be spread through persontoperson contact for example, from patient to patient via the contaminated hands of healthcare personnel, or other persons or, less. Successful control of an extendedspectrum betalactamase. Drugresistant klebsiella pneumoniae, especially extendedspectrum.
Escherichia coli and klebsiella pneumoniae are common esbl producing enterobacteriaceae found worldwide, 5 and cause various infectious diseases in both hospital and community settings. Emergence of ndm1producing klebsiella pneumoniae in greece. Thirty percent of such infections acquired during hospitalization and 43% of infections acquired in the intensive care unit were esblproducing. Klebsiella pneumoniae identification of producing extended spectrum beta lactamase esbl and resistance. In this study, the prevalence of extended spectrum beta lactamase esbl producing klebsiella pneumoniae and escherichia coli isolates from the university of abuja teaching hospital and the national hospital was determined.
Klebsiella pneumoniae is a gramnegative, nonmotile, lactose fermenting, rodshape organism. We do not use these to store personal information about you. In enterobacteriaceae and particularly in klebsiella pneumoniae, acquired ambler class a e. Detection, surveillance, prevention and control biomerieux.
This study aimed to detect the presence of qnr genes in esblproducing e. Bacteremic pneumonia caused by extendedspectrum beta. Extendedspectrum beta lactamase genes of klebsiella pneumoniae strains in taiwan. Pdf infections caused by extendedspectrum betalactamase esblproducing pathogens, particularly klebsiella pneumoniae, are increasing. They are often found on the same resistance plasmids as extended spectrum. Nosocomial infections, esbl, klebsiella pneumoniae, bacterial resistance. General information about klebsiella pneumoniae klebpn this website uses cookies our website uses cookies to ensure that we give you the best possible online experience. In the collection of clinical hospital samples, we found eight of 15 e. Klebsiella pneumoniae is a gramnegative, nonmotile, encapsulated, lactosefermenting, facultative anaerobic, rodshaped bacterium. Worldwide prevalence of antibiotic resistance in the. We sequenced the available isolates to determine the phylogenetic relatedness of klebsiella pneumoniae isolates on the basis of their genome sequences. In this study we report on the molecular characterization through whole genome sequencing of an esbl. Enterobacteriaceae are a large family of different types of bacteria germs that commonly cause infections both in healthcare settings and in communities.
Qnr genes are known to confer a lowlevel resistance to fluoroquinolone in enterobacteriaceae. Pyogenic liver abscess caused by klebsiella pneumoniae. Klebsiella pneumoniae is an encapsulated gramnegative bacterium that is frequently found in the flora of the mouth, skin and intestines as well as in natural environments 1. Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers hcws, and the environment were performed to detect potential reservoirs. Evaluation of hardychrom esbl as a detection method of esblproducing escherichia coli, klebsiella pneumoniae, and klebsiella oxytoca. Klebsiella pneumoniae has been responsible for a large number of clonal hospital outbreaks. We identified 217 unique patient bsis, including 92 42% kpcpositive, 49 23% esbl positive, and 1 0.
The incidence of healthcareassociated esblkpn bacteremia was evaluated before and after. Esbl production was detected in 8 strains of klebsiella pneumoniae. A comparison of extendedspectrum betalactamase esbl. For example, klebsiella must enter the respiratory breathing tract to cause pneumoniae, or the blood to cause a bloodstream infection. Extended spectrum cephalosporins, such as the third generation cephalosporins, were originally thought to be resistant to hydrolysis by betalactamases. Esbl producing klebsiella pneumoniae kpn pose a major threat to human health globally. Klebsiella pneumoniae an overview sciencedirect topics.
The disease is usually seen only in patients with underlying medical. Carbapenemresistant enterobacteriaceae cre pdf icon pdf 24 pages general information klebsiella kleb. Bloodstream infections by extendedspectrum beta lactamase producing escherichia coli and klebsiella pneumoniae in children. Antibiogram of extended spectrum betalactamase esbl. Resistance that is produced through the actions of betalactamases. Klebseq, a diagnostic tool for surveillance, detection. Descriptive epidemiology indicated that a continuous transmission from person to person was most likely. Klebsiella pneumoniae is an important cause of neonatal sepsis and cross transmission can occur from the hospital environment. Bush, jennifer ellison, kaitlin hearn, ted pfister, geoffrey taylor. Risk of infection and carriage rates of klebsiella spp. Other tests showed that there was persontoperson spread of these antibioticresistant bacteria. Continuing to use this website means you agree to our use of cookies. The increased prevalence of klebsiella pneumoniae infections and resistance rates are a current cause for concern.
Results from the cohort study showed that frequent manipulation a proxy for increased exposure to medical procedures was. Among 39 resistant isolates of klebsiella pneumoniae, 17 were esbl producers detected by ddst. Bloodstream infections by extendedspectrum beta lactamase producing escherichia coli and. A substantially increasing trend of ndm1producing k. Klebsiella associated infection is the emergence of multidrug resistant strains particularly those involved in nosocomial diseases. Colocalization of carbapenemases or extendedspectrum. Frontiers whole genome sequencing of extendedspectrum. Klebsiella pneumoniae is mainly responsible for hospitalacquired urinary tract infections, bacteremia, pneumonia and intraabdominal infections. The strain had the mcr1 plasmid gene and an inactivated mgrb gene, which are associated with colistin resistance. High prevalence of esblproducing klebsiella pneumoniae in. Attributable costs and length of stay of an extendedspectrum beta lactamase producing klebsiella pneumoniae outbreak in a neonatal intensive care unit. Klebsiella pneumoniae strains producing extended spectrum.
Risk factors for infection by extendedspectrum betalactamase. Klebsiella pneumoniae solates from the hospital environment had antibiogram similar to the patient samples. In this study, we evaluated the genetic relatedness of extendedspectrum beta lactamase producing klebsiella pneumoniae esblkpn isolates from an outbreak in a neonatal intensive care unit nicu in august 2017, we implemented an active countermeasure to control this outbreak successfully. Genetic evolution and clinical impact in extendedspectrum beta lactamase producing escherichia coli and klebsiella pneumoniae. High prevalence of esblproducing klebsiella pneumoniae in clinical samples from. The prevalence and molecular profile of the esblproducing escherichia coli is. Klebsiella is a bacteria that can cause different types of infections such as a urinary tract infection or pneumonia, and is considered a not very common pathogen among patients in the community meaning outside the hospital. Klebsiella pneumoniae presents antimicrobial drug resistance for. Emergence of ndm1producing klebsiella pneumoniae in.
Escherichia coli and klebsiella pneumoniae are common esblproducing enterobacteriaceae found worldwide, 5 and cause various infectious diseases in both hospital and community settings. Pdf esblproduction in escherichia coli and klebsiella. Research article prevalence of esblproducing klebsiella. Neutrophilic and necrotizing with an exudate and fibrin filling the airspaces. We identified 217 unique patient bsis, including 92 42% kpcpositive, 49 23% esblpositive, and 1 0. Nicu in august 2017, we implemented an active countermeasure to control this outbreak successfully. Antibiotic therapy for klebsiella pneumoniae bacteremia. Klebsiella pneumoniae is a ubiquitous gramnegative encapsulated bacterium that resides in the mucosal surfaces of mammals and the environment soil, water, etc.
Pfge analysis clustered ndm1 producers into five distinct clonal. These isolates were screened for esbl production by the inhibitor based test recommended by the national committee for clinical laboratory standards nccls using klebsiella pneumoniae atcc 700603. Implications of production of extendedspectrum blactamases david l. Klebsiella pneumoniae antimicrobial drug resistance. Increasing antimicrobial drug resistance, including carbapenemresistant k. Furthermore, almost 30% of escherichia coli in the study were found to be resistant to. Results the investigation comprises 37 cases and the 10 cases with esbl extendedspectrum beta lactamase producing k. Klebsiella pneumoniae, carbapenem, esbl, ampc, outermembrane protein, insertion sequences. Klebsiella pneumoniae definition of klebsiella pneumoniae. This organism is also surrounded by a capsule, which increases its virulence by acting as a physical barrier to evade the hosts immune response. We summarize the wide resistome of this pathogen, which encompasses plentiful chromosomal and plasmidencoded antibiotic resistance genes args. Distribution of quinolone resistance gene qnr in esbl. Esbls are most commonly detected in klebsiella pneumoniae, which is an opportunistic pathogen associated with severe infections in hospitalized patients, including.
Klebsiella pneumoniae in healthcare settings hai cdc. Other articles where klebsiella pneumoniae is discussed. Klebsiella pneumoniae is an important multidrugresistant mdr pathogen affecting humans and a major source for hospital infections associated with high morbidity and mortality due to limited treatment options. Esblproducing strain of hypervirulent klebsiella pneumoniae k2, france. Jun 18, 2019 qnr genes are known to confer a lowlevel resistance to fluoroquinolone in enterobacteriaceae. The esblproducing klebsiella pneumoniae constitutes one of the most common multidrugresistant mdr groups of gramnegative bacteria involved in nosocomial infections worldwide. The esbl activity could be experimentally transferred to recipient li k12 j622. Genomic analysis of klebsiella pneumoniae isolates from. Klebsiella pneumoniae has been a leading health careacquired infection hai agent for decades 1, 2. Pdf klebsiella pneumoniae identification of producing.
Comparisons of microbiological characteristics and antibiotic. Gramnegative bacilli gnb are common agents of nosocomial infections. Klebseq, a diagnostic tool for surveillance, detection, and. These isolates were screened for esbl production by the inhibitor based test recommended by the national committee for clinical laboratory standards nccls using. From april to june 2001, an outbreak of extendedspectrum beta lactamase esblproducing klebsiella pneumoniae infections was investigated in our neonatal intensive care unit. Carbapenems, such as imipenem and meropenem, are often used to treat infections caused by extendedspectrum beta lactamase esblproducing. In healthcare settings, klebsiella bacteria can be spread through persontoperson contact for example, from patient to patient via the contaminated. Multiplex realtime pcr detection of klebsiella pneumoniae carbapenemase kpc and new delhi metallo. Adequate empirical therapy was administered in 74% of infections caused by nonesbl nonkpc strains, versus 33%. To survive the effects of antibiotics, germs are constantly finding new. The genus klebsiella was named after the german microbiologist edwin klebs 183419. Most bla ndm1carrying isolates contained bla ctxm15, bla oxa1, bla oxa2 and bla tem1 genes. The alarming rise in resistance to shv and esbl producing groups of antibiotics result in high morbidity and mortality.
Comparisons of microbiological characteristics and. Tigecycline or colistin must be used for infection by mbl producing k. What caused the outbreak of esblproducing klebsiella. Previous studies describing the isolation of lytic. Tem and shv type esbl producing were klebsiella pneumoniae. To analyse the transmission dynamics of extended spectrum. Pdf distribution of nosocomial infections caused by. Cultures of the gastrointestinal tracts of patients, the hands of healthcare workers hcws, and the environment were performed to detect potential reservoirs for esblproducing k.
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