Esbl enzymes cause some antibiotics not to work for treating bacterial infections. Descriptive epidemiology indicated that a continuous transmission from person to person was most likely. Klebsiella pneumonia, extended spectrum beta lactamase, antimicrobial resistance 1. Esblproducing escherichia coli and klebsiella pneumoniae at a tertiary.
Pdf extended spectrum lactamaseproducing klebsiella. High prevalence of esblproducing klebsiella pneumoniae. The disease is usually seen only in patients with underlying medical problems such as alcoholism or chronic pulmonary disease and often arises as a. Klebsiella pneumoniae are normally harmless bacteria that live in your intestines and feces, but they can be dangerous in other parts of your body. A percentage of 14 to 16% esbl producers among clinical klebsiella isolates has. Three species in the genus klebsiella are associated with illness in humans. The antibiotic susceptibility pattern of the nonesbl producing and esbl producing klebsiella pneumoniae are summarized in table 1. Esblproducing k pneumoniae during the hospital stay was the factor most predictive of death. Pyogenic liver abscess caused by klebsiella pneumoniae. Risk of infection and carriage rates of klebsiella spp. 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.
Phenotypic and genotypic characterization of esbl, ampc. It is one of the ways in which bacteria develop resistance. Extended spectrum betalactamases or esbls for short are a type of enzyme or chemical produced by some bacteria. A gramnegative pneumonia that can cause both nosocomial and communityacquired pneumonia. Growing worldwide resistance to a broad array of antibiotics. Klebsiella esbl bacteremiamortality and risk factors. Extendedspectrum betalactamase producing esbl klebsiella pneumoniae is an important cause of nosocomial infections in neonatal intensive.
The aim of this study was to evaluate risk factors and mortality rate in bacteremia caused by esblproducing klebsiella pneumoniae in a brazilian hospital. Results from the cohort study showed that frequent manipulation a proxy for increased exposure to medical procedures was. In europe, the frequency of such strains seems to be even higher. Extended spectrum beta lactamase esbl is a plasmid enzyme that. Klebsiella pneumoniae, klebsiella oxytoca, and klebsiella granulomatis. Klebsiella is a superbug that causes a range of diseases, depending on which part of the body it infects. Klebsiella pneumoniae is a common enterobacterium that causes a disease spectrum that includes severe pneumonia lobular or lobar, enteritis, urinary tract infection, and miscellaneous septic lesions, including sinusitis, meningitis, and otitis. Several clinical and laboratory variables were evaluated. To survive the effects of antibiotics, germs are constantly finding new. Pdf infections caused by extendedspectrum betalactamase esblproducing pathogens, particularly klebsiella pneumoniae, are increasing. The prevalence of esbl producing klebsiella pneumoniae.
This study was done to determine the susceptibility of different antimicrobials to esbl producing escherichia coli and klebsiella pneumoniae isolated from wound. Examples of germs in the enterobacteriaceae family include escherichia coli e. Use of cefepime for the treatment of infections caused by extended spectrum betalactamaseproducing klebsiella pneumoniae and escherichia coli14 labombardi vj, rotjman a, tran k. Klebsiella pneumoniae is an important pathogen that can. Extendedspectrum betalactamaseproducing escherichia coli and klebsiella pneumoniae. Neutrophilic and necrotizing with an exudate and fibrin filling the airspaces. Klebsiella pneumoniae in healthcare settings hai cdc. Extendedspectrum betalactamase esbl production was defined phenotypically. Klebsiella pneumoniae, a common gut bacteria, causes problems when it moves outside the gut and causes infection. Antibiotic susceptibility testing of esblproducing k.
High prevalence of esblproducing klebsiella pneumoniae in clinical. Pdf detection of klebsiella pneumoniae, pseudomonas. Esbls are most commonly detected in klebsiella pneumoniae, which is an opportunistic pathogen associated with severe infections in hospitalized patients, including. Ertapenem resistance in klebsiella pneumoniae is rare. A threeyear retrospective cohort study with 104 cases of k. Klebsiella pneumoniae an overview sciencedirect topics. For example, klebsiella must enter the respiratory breathing tract to cause pneumoniae, or the blood to cause a bloodstream infection. Introduction to klebsiella pneumoniae carbapenemases. Characterization of escherichia coli and klebsiella pneumoniae esblproducing. Impact of extended spectrum betalactamase producing klebsiella. Esblproducing enterobacteriaceae were confirmed in 17 24. We report on an ertapenemnonsusceptible phenotype among 25 out of 663 3.
Characterization of clinically relevant strains of. Epidemiology of carbapenemase producing klebsiella. Carbapenems, such as imipenem and meropenem, are often used to treat infections caused by extendedspectrum betalactamase esblproducing. Klebsiella pneumoniae are increasingly common due to betalactamases resistant to penicillin and ampicillin. Organisms previously known as klebsiella ozaenae and klebsiella rhinoscleromatis are considered nonfermenting subspecies of k pneumoniae that have characteristic clinical manifestations. This study aimed to evaluate the presence of esblampcproducing klebsiella spp. High prevalence of esblproducing klebsiella pneumoniae in. Beta lactamases are enzymes produced by many species of bacteria which destroy one or more antibiotics. Objective to determine efficacy of cefepime in treating infections caused by esblproducing strains of k. Antimicrobial resistance patterns in extendedspectrum. Mortality due to nosocomial infection with klebsiella. Effect of piperacillintazobactam vs meropenem on 30day. Blevins, daniel diekema, hsiuyin chiang, rajeshwari nair, eli perencevich.
Extended spectrum betalactamase esbl and carbapenemase production is a growing problem. Risk factors and outcome of klebsiella pneumoniae sepsis. The incidence of esblproducing klebsiella isolates in the united states has been reported to be 5% of the k. In healthcare settings, klebsiella bacteria can be spread through persontoperson contact for example, from patient to patient via the contaminated. This hospital study was conducted retrospectively and covered a 3 months period. Drug resistance among gramnegative bacteria is a worldwide challenge. What caused the outbreak of esblproducing klebsiella. Due to the importance of drugresistant klebsiella pneumoniae and escherichia coli strains in hospitalacquired infections, we aimed to determine the phenotypic and genotypic characteristics of esbl, ampc, and carbapenemaseproducing isolates obtained from hospitalized patients in tehran and ilam iran. In addition, a few studies reported the carbapenemase ges5 a point mutant deriva tive of the extendedspectrum. Klebsiella pneumoniae causes a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses.
Klebsiella pneumoniae atcc700603 was used as control strain. To get a klebsiella infection, a person must be exposed to the bacteria. Feces samples from 212 healthy thoroughbred racehorses were collected from the japan racing. 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. Pdf klebsiella pneumoniae identification of producing. Genomic analysis of diversity, population structure. These isolates originated from six different hospitals and were multiclonal, belonging to 12 different genetic. Esbl resistance genes are located on plasmids which are transferrable to other strains, thus posing considerable infection control issues. Lactamase esblproducing escherichia coli and klebsiella infections in the united states. Results the investigation comprises 37 cases and the 10 cases with esbl extendedspectrum betalactamaseproducing k. 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. Research article prevalence of esblproducing klebsiella. Esbl is increasing day by day in nearly every center of different countries and necessary steps to prevent the spread and emergence of resistance should be taken. Antibiogram of extended spectrum betalactamase esbl.
Furthermore, the bacteria belong to the esblproducing strains esbl extendedspectrum betalactamase and are therefore increasingly common multiresistant to many broadacting antibiotics such as cephalosporins or ceftazidime. The frequency of esbl producing klebsiella pneumoniae bloodstream infections bsi is high in brazilian hospitals, however little is known regarding what role, if any, resistance plays in the expected outcome in hospitals with a high prevalence of these pathogens. The aim of this study was to evaluate nosocomial infections with k. Klebsiella pneumoniae is now recognized as an urgent threat to human health because of the emergence of multidrugresistant strains associated with hospital outbreaks and hypervirulent strains associated with severe communityacquired infections. Nosocomial outbreak of klebsiella infection resistant to lategeneration cephalosporins.
Nosocomial bloodstream infections caused by klebsiella. In humans it is an unusual part of pharyngeal and oral microflora, but is recognized in up to 20%. Klebsiella pneumoniae is a gramnegative, nonmotile, encapsulated, lactosefermenting, facultative anaerobic, rodshaped bacterium. Enterobacteriaceae are a large family of different types of bacteria germs that commonly cause infections both in healthcare settings and in communities. It is important to note that the nccls confirmatory tests are only intended for the detection of esbls found ine. The aim of this work was to investigate the epidemiological and genetic characteristics of esblproducing klebsiella pneumoniae esblkp. Detection of klebsiella pneumoniae, pseudomonas aeruginosa and esbl producing escherichia coli associated with ovarian hydrobursitis syndrome in female camels camelus dromedarus. Extendedspectrum betalactamase genes of klebsiella pneumoniae strains in taiwan.
Introduction certainly, modern medicine is indebted to. Klebsiella pneumoniae is a bacterium that normally lives inside human intestines, where. Question can piperacillintazobactam be used as carbapenemsparing therapy in patients with bloodstream infections caused by ceftriaxoneresistant escherichia coli or klebsiella pneumoniae findings in this noninferiority randomized clinical trial that included 391 patients with e coli or k pneumoniae bloodstream infection and ceftriaxone resistance, the 30day mortality rate for. Therapy should be guided by susceptibility testing. We summarize the wide resistome of this pathogen, which encompasses plentiful chromosomal and plasmidencoded antibiotic resistance genes args. Among 39 resistant isolates of klebsiella pneumoniae, 17 were esbl producers detected by ddst and pcddt. Antibiotic therapy for klebsiella pneumoniae bacteremia. With those exceptions, strains within this genus ferment.