The importance of nosocomial infections caused by coagulase-negative staphylococci is constantly growing. The threat primarily affects immunocompromised patients, the elderly and neonates, particularly after invasive surgery. The problem is fundamentally exacerbated by expanding antibacterial drug resistance. A case report is presented of an 86-year-old patient who underwent a ruptured abdominal aortic aneurysm surgery and developed septicaemia upon surgical wound infection. The causal agent was likely a carbapenem-resistant Klebsiella pneumoniae, however, daptomycin-resistant Staphylococcus pettenkoferi was identified in blood cultures in the absence of daptomycin treatment. To the authors' knowledge, the case study presented is the first published episode of daptomycin-resistant S. pettenkoferi strain.
Klebsiella pneumoniae, known as a major threat to public health, is the most common factor of nosocomial and community acquired infections. In this study, 50 K. pneumoniae clinical specimens isolated from bronchial, urea, blood, catheter, rectal, bile, tracheal and wound cultures were collected. These isolates were identified and carbapenem resistance was determined via an automated system, CHROMagar Orientation and CHROMagar KPC. The carbapenemase gene regions (blaIMP, blaVIM, blaOXA, blaNDM and blaKPC) and presence of virulence factors (magA, k2A, rmpA, wabG, uge, allS, entB, ycfM, kpn, wcaG, fimH, mrkD, iutA, iroN, hly ve cnf-1) of these isolates were determined by using Multiplex-PCR. The OXA-48 carbapenemase gene regions were determined in 33 of 50 K. pneumoniae strains. In addition, NDM-1 resistance in one, OXA-48 and NDM-1 resistance in four unusual K. pneumoniae isolates were detected. Virulence gene regions that were encountered among K. pneumoniae isolates were 88% wabG, 86% uge, 80% ycfM and 72% entB, related with capsule, capsule lipoprotein and external membrane protein, responsible for enterobactin production, respectively. Even though there was no significant difference between resistant and sensitive strains due to the virulence gene regions (P≥0.05), virulence factors in carbapenem resistant isolates were found to be more diverse. This study is important for both, to prevent the spread of carbapenem resistant infections and to plan for developing effective treatments. Moreover, this study is the first detailed study of the carbapenem resistance and virulence factors in K. pneumoniae strains.
The antibacterial activity of a PVP-ZrO2 nanocomposite was investigated against pathogenic bacteria S. aureus and K. pneumoniae after antibacterial sensitivity was determined and one isolate was chosen that showed more antibiotic resistance. Herein, the Co-culture technique was used to calculate percent reduction of bacteria. The results that were obtained in this method show that ZrO2 nanoparticles have inhibitory effect against pathogenic bacteria gram negative bacteria and gram positive bacteria - with reduction of growth reaching 100% to both S. aureus and K. pnumoniae at 5, 10, 15, 20 and 25% ZrO2, compared with control. The resistance patterns of S. aureus and K.pnuemonia isolates show the Moxifloxacin (MXF) is the best antibiotic for both bacteria - with sensitivity at 100%, while resistance to Ceftriaxone (CRO) is at 90% S. aureus, and at 80% K. pnumoniae. The polymer-nanocomposite was prepared by weight percentage wt. % of (PVP) being dissolved in (10) ml of distilled water, with weight percentages 5%, 10%, 15%, 20% and 25% of ZrO2 nanoparticles added.
Aim The aim of the study was to characterize symptomatic infections and asymptomatic carrier of class B carbapenemase (MBL/NDM) produced Klebsiella pneumoniae in patients hospitalized and treated in Mazowiecki Memorial Hospital of Radom between 2016-2018. Material and methods The study group included 120 patients aged 80+/ – 17.0 years old. Epidemiologic analysis of the study group was conducted. Results The number of patients positive towards Klebsiella pneumoniae MBL was: 57 (47,5%) in 2016, 32 (26,6%) in 2017 and 31 (25,8%) in 2018. The study group included 44 women (36,67%) and 76 men (63,33%) (p<0,005). In clinically significant material 60 bacterial strains were identified, with similar frequency from lower respiratory tract discharge and from urine. Symptomatic infections in 60 patients (50%) and asyptomatic carrier in 60 patients (50%) were confirmed. Symptomatic infections from lower respiratory tract were more frequent than urinary tract infections (p=0,037), wound infections (p<0,001), generalized infections (p<0,001) and digestive tract infections (p<0,001). During 2016-2018 reduction in sensitivity of Klebsiella pneumoniae MBL strains for colistin (100%; 46,5%; 45,8%) and amikacin (72,8%; 80,8%; 45,8%) was observed. Conclusions 1. In hospitalized patients positive towards Klebsiella pneumoniae MBL asymptomatic carrier and symptomatic infections occured with similar frequency. 2. In hospitalized patients Klebsiella pneumoniae MBL strains were most frequently identified from respiratory tract and from urinary tract. 3. Commonly with elongation of periode, then colistin and amikacin were used, the reduction of bacterial sensitivity for these antibiotics was observed.
PL
Cel pracy Celem pracy była charakterystyka objawowych zakażeń i bezobjawowego nosicielstwa szczepow Klebsiella pneumoniae wytwarzających karbapenemazę klasy B (MBL/NDM) u pacjentow leczonych na oddziałach szpitalnych Mazowieckiego Szpitala Specjalistycznego (MSS) w Radomiu w latach 2016-2018. Materiał i metody Grupę badaną stanowiło 120 pacjentow w wieku 80 lat +/ – 17,0. Dokonano analizy epidemiologicznej tych przypadkow. Wyniki Stwierdzono 57 przypadkow (47,5%) w 2016 r., 32 (26,6%) w 2017 r. i 31 (25,8%) w 2018 r. pacjentow z obecnością Klebsiella pneumoniae MBL. W grupie badanej były 44 kobiety (36,67%) i 76 mężczyzn (63,33%) (p<0,005). Z materiałow istotnych klinicznie wyhodowano łącznie 60 szczepow Klebsiella pneumoniae MBL. Z podobną częstością izolowano je z wydzieliny z dolnych drog oddechowych oraz z moczu (p=0,436). U 60 pacjentow (50%) stwierdzono zakażenie objawowe, a w 60 przypadkach (50%) wystąpiło bezobjawowe nosicielstwo. Zakażenia dolnych drog oddechowych występowały częściej od zakażeń układu moczowego (p=0,037), zakażeń rany (p<0,001), zakażeń uogolnionych (p<0,001) oraz zakażeń układu pokarmowego (p<0,001). W latach 2016, 2017 i 2018 wykazano zmniejszenie się wrażliwości szczepow Klabsiella pneumoniae MBL na kolistynę (100%; 46,5%; 45,8%) i amikacynę (72,8%; 80,8%; 45,8%). Wnioski 1. Bezobjawowa kolonizacja pacjentow szczepami Klebsiella pneumoniae MBL występuje z podobną częstością do objawowych zakażeń spowodowanych przez te bakterie. 2. Szczepy Klebsiella pneumoniae MBL izolowane są najczęściej z drog oddechowych i moczowych hospitalizowanych pacjentow. 3. Wraz z wydłużeniem okresu stosowania kolistyny i amikacyny w grupie badanej zaobserwowano zmniejszenie wrażliwości szczepow Klebsiella pneumoniae MBL na te antybiotyki.
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