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Sample records for producing kpc carbapenemases

  1. Prevalence, characterization and clinical significance of Klebsiella pneumoniae carbapenemase (KPC producing Klebsiella pneumoniae

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    : Sarita Nayak, Suman Singh, Soeb Jankhwala, Riddhi Pradhan

    2014-11-01

    Full Text Available Klebsiella peumoniae, a capsulated gram negative bacillus is responsible for causing life threatening infections in humans. Carbapenems are the drug of choice for serious infection caused by multidrug resistant Klebsiella pneumoniae. The emergence of carbapenem resistance has made it extremely difficult to treat such infections resulting in significant morbidity and mortality. Aims: To study the prevalence of carbapenem resistance using ertapenem as a marker and to detect Klebsiella pneumoniae Carbapenemase (KPC producing Klebsiella pneumoniae as a mechanism of resistance. Material and Methods: The study included 102 patients from which Klebsiella pneumoniae isolated. Identification and antibiotic susceptibility testing of Klebsiella pneumoniae was performed on miniAPI (Analytical Profile Index, Semiautomated bacterial identification system according to Clinical and Laboratory Standards Institute (CLSI guidelines of 2011. The modified Hodge test was performed for detection of Carbapenemase production. Patient’s clinical and demographic details along with risk factors and co-morbid conditions, type of response to antimicrobial therapy and mortality were collected. Results: The prevalence of carbapenem resistance was found to be 30.41% with 16.6% KPC producing Klebsiella pneumoniae. The co-morbid conditions like immunocompromised state (p =0.042, prior antibiotics therapy (p=0.047, previous hospitalization (p =0.021, intensive care unit stay (p=0.047 and use of indwelling devices (p =0.013 were found to be significantly associated with carbapenem resistance. Adverse clinical outcomes (death or worsening among patients infected with ertapenem resistant patients was found to be statistically significant than ertapenem sensitive strains (p =0.008. Conclusions: A high degree of carbapenem resistance in present study is alarming and poses therapeutic dilemmas for clinicians. Initiating timely and appropriate infection control measures along with a

  2. Emergence and outbreak of carbapenemase-producing KPC-3 Klebsiella pneumoniae in Spain, September 2009 to February 2010: control measures.

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    Robustillo Rodela, A; Díaz-Agero Pérez, C; Sanchez Sagrado, T; Ruiz-Garbajosa, P; Pita López, M J; Monge, V

    2012-02-16

    This report describes the epidemiological features of the first outbreak caused by KPC3 carbapenemase-producing Klebsiella pneumoniae (KPC-3-KP) in Spain and how it was effectively controlled. From 16 September 2009 to the end of February 2010, seven patients infected or colonised with KPC-3-KP were detected. Stool surveillance cultures were recovered from patients, doctors, nurses, nursing assistants, cleaners and hospital porters working in the affected units. Hand swabs were taken from workers and patients’ relatives for culturing. Environmental samples were also taken. Patients infected or colonised with KPC-3-KP were placed in single rooms under contact precautions and 4% chlorhexidine soap was used for their daily hygiene. Staff attended educational seminars and workshops on hand hygiene and isolation of patients. An alcohol-based disinfectant was used for surface cleaning and disinfecting. The floor was cleaned with a disinfectant containing benzalkonium chloride and didecyldimethylammonium. All samples collected were negative for KPC-3-KP. After implementing the control measures, no further cases were reported in the affected units. All cases had comorbidities, long hospital stay and aggressive/intensive antimicrobial treatment. This study emphasises the importance of early intensification of infection control to interrupt the transmission of KPC-producing organisms.

  3. In Vitro Assessment of Combined Polymyxin B and Minocycline Therapy against Klebsiella pneumoniae Carbapenemase (KPC)-Producing K. pneumoniae.

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    Huang, Dennis; Yu, Brenda; Diep, John K; Sharma, Rajnikant; Dudley, Michael; Monteiro, Jussimara; Kaye, Keith S; Pogue, Jason M; Abboud, Cely Saad; Rao, Gauri G

    2017-07-01

    The multidrug resistance profiles of Klebsiella pneumoniae carbapenemase (KPC) producers have led to increased clinical polymyxin use. Combination therapy with polymyxins may improve treatment outcomes, but it is uncertain which combinations are most effective. Clinical successes with intravenous minocycline-based combination treatments have been reported for infections caused by carbapenemase-producing bacteria. The objective of this study was to evaluate the in vitro activity of polymyxin B and minocycline combination therapy against six KPC-2-producing K. pneumoniae isolates (minocycline MIC range, 2 to 32 mg/liter). Polymyxin B monotherapy (0.5, 1, 2, 4, and 16 mg/liter) resulted in a rapid reduction of up to 6 log in bactericidal activity followed by regrowth by 24 h. Minocycline monotherapy (1, 2, 4, 8, and 16 mg/liter) showed no reduction of activity of >1.34 log against all isolates, although concentrations of 8 and 16 mg/liter prolonged the time to regrowth. When the therapies were used in combination, rapid bactericidal activity was followed by slower regrowth, with synergy (60 of 120 combinations at 24 h, 19 of 120 combinations at 48 h) and additivity (43 of 120 combinations at 24 h, 44 of 120 combinations at 48 h) against all isolates. The extent of killing was greatest against the more susceptible polymyxin B isolates (MICs of ≤0.5 mg/liter) regardless of the minocycline MIC. The pharmacodynamic activity of combined polymyxin B-minocycline therapy against KPC-producing K. pneumoniae is dependent on polymyxin B susceptibility. Further in vitro and animal studies must be performed to fully evaluate the efficacy of this drug combination. Copyright © 2017 American Society for Microbiology.

  4. Antimicrobial activity evaluation and comparison of methods of susceptibility for Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter spp. isolates.

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    Rechenchoski, Daniele Zendrini; Dambrozio, Angélica Marim Lopes; Vivan, Ana Carolina Polano; Schuroff, Paulo Alfonso; Burgos, Tatiane das Neves; Pelisson, Marsileni; Perugini, Marcia Regina Eches; Vespero, Eliana Carolina

    The production of KPC (Klebsiella pneumoniae carbapenemase) is the major mechanism of resistance to carbapenem agents in enterobacterias. In this context, forty KPC-producing Enterobacter spp. clinical isolates were studied. It was evaluated the activity of antimicrobial agents: polymyxin B, tigecycline, ertapenem, imipenem and meropenem, and was performed a comparison of the methodologies used to determine the susceptibility: broth microdilution, Etest ® (bioMérieux), Vitek 2 ® automated system (bioMérieux) and disc diffusion. It was calculated the minimum inhibitory concentration (MIC) for each antimicrobial and polymyxin B showed the lowest concentrations for broth microdilution. Errors also were calculated among the techniques, tigecycline and ertapenem were the antibiotics with the largest and the lower number of discrepancies, respectively. Moreover, Vitek 2 ® automated system was the method most similar compared to the broth microdilution. Therefore, is important to evaluate the performance of new methods in comparison to the reference method, broth microdilution. Copyright © 2017 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  5. A multiplex lateral flow immunoassay for the rapid identification of NDM-, KPC-, IMP- and VIM-type and OXA-48-like carbapenemase-producing Enterobacteriaceae

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    Boutal, Hervé; Vogel, Anaïs; Bernabeu, Sandrine; Devilliers, Karine; Creton, Elodie; Cotellon, Garence; Plaisance, Marc; Oueslati, Saoussen; Dortet, Laurent; Jousset, Agnès; Simon, Stéphanie; Naas, Thierry; Volland, Hervé

    2018-01-01

    Abstract Objectives The global spread of carbapenemase-producing Enterobacteriaceae represents a substantial challenge in clinical practice and rapid and reliable detection of these organisms is essential. The aim of this study was to develop and validate a lateral flow immunoassay (Carba5) for the detection of the five main carbapenemases (KPC-, NDM-, VIM- and IMP-type and OXA-48-like). Methods Carba5 was retrospectively and prospectively evaluated using 296 enterobacterial isolates from agar culture. An isolated colony was suspended in extraction buffer and then loaded on the manufactured Carba5. Results All 185 isolates expressing a carbapenemase related to one of the Carba5 targets were correctly and unambiguously detected in Enterobacteriaceae. PMID:29365094

  6. A ten-year surveillance study of carbapenemase-producing Klebsiella pneumoniae in a tertiary care Greek university hospital: predominance of KPC- over VIM- or NDM-producing isolates.

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    Spyropoulou, Aikaterini; Papadimitriou-Olivgeris, Matthaios; Bartzavali, Christina; Vamvakopoulou, Sophia; Marangos, Markos; Spiliopoulou, Iris; Anastassiou, Evangelos D; Christofidou, Myrto

    2016-03-01

    Resistance patterns and carbapenemase gene presence among Klebsiella pneumoniae isolates from the University General Hospital of Patras, Greece during a ten-year period were analysed under a surveillance programme for multi-drug-resistant bacteria. From 2005 to 2014, K. pneumoniae isolates from clinically significant specimens were identified by the Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the agar disc diffusion method and Etest. The strains were tested for the presence of blaVIM, blaIMP, blaKPC, blaNDM and blaOXA-48 genes by PCR. PFGE of chromosomal Xbal DNA digests was performed. A total of 3449 K. pneumoniae isolates were recovered during the last decade. Among them, 1668 (48 %) were carbapenemase-producing: 1333 (80%) K. pneumoniae carbapenemase (KPC)-, 286 (17%) Verona imipenemase (VIM), 45 (3%) KPC- and VIM-, and four New Delhi metallo-beta-lactamase (NDM)-producing. Their resistance rates to gentamicin, colistin and tigecycline were 41%, 23% and 16%, respectively. VIM-producing K. pneumoniae were isolated in 2005 and since 2008 have been endemic. KPC-producing K. pneumoniae (KPC-Kp) isolates were introduced in 2008 and until now represent the predominant carbapenemase-producing K. pneumoniae in our institution. PFGE of 97 KPC-Kp strains identified three types: A, 84 (87%); B, 11 (11%); and E, two (2%). Eleven co-producing KPC and VIM K. pneumoniae isolates belonged to PFGE B. The four NDM-positives were classified to type F. The number of K. pneumoniae bacteraemias increased during the study period, which may be solely attributed to the increase of carbapenemase-producing isolates. The threat of carbapenemase-producing K. pneumoniae emphasizes the urgent need for implementation of infection control measures and budgetary allocations to infection control.

  7. Virulence of Klebsiella pneumoniae isolates harboring bla KPC-2 carbapenemase gene in a Caenorhabditis elegans model.

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    Jean-Philippe Lavigne

    Full Text Available Klebsiella pneumoniae carbapenemase (KPC is a carbapenemase increasingly reported worldwide in Enterobacteriaceae. The aim of this study was to analyze the virulence of several KPC-2-producing K. pneumoniae isolates. The studied strains were (i five KPC-2 clinical strains from different geographical origins, belonging to different ST-types and possessing plasmids of different incompatibility groups; (ii seven transformants obtained after electroporation of either these natural KPC plasmids or a recombinant plasmid harboring only the bla KPC-2 gene into reference strains K. pneumoniae ATCC10031/CIP53153; and (iii five clinical strains cured of plasmids. The virulence of K. pneumoniae isolates was evaluated in the Caenorhabditis elegans model. The clinical KPC producers and transformants were significantly less virulent (LT50: 5.5 days than K. pneumoniae reference strain (LT50: 4.3 days (p<0.01. However, the worldwide spread KPC-2 positive K. pneumoniae ST258 strains and reference strains containing plasmids extracted from K. pneumoniae ST258 strains had a higher virulence than KPC-2 strains belonging to other ST types (LT50: 5 days vs. 6 days, p<0.01. The increased virulence observed in cured strains confirmed this trend. The bla KPC-2 gene itself was not associated to increased virulence.

  8. Spectrophotometry-based detection of carbapenemase producers among Enterobacteriaceae.

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    Bernabeu, Sandrine; Poirel, Laurent; Nordmann, Patrice

    2012-09-01

    Carbapenem-hydrolyzing ß-lactamases are the most powerful ß-lactamases being able to hydrolyse almost all ß-lactams. They are mostly of the KPC, VIM, IMP, NDM, and OXA-48 type. A spectrophotometry technique based on analysis of the imipenem hydrolysis has been developed that differentiated carbapenemase- from noncarbapenemase producers. This inexpensive technique adapted to screening of carbapenemase producers may be implemented in any reference laboratory worldwide. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Occurrence of carbapenemase-producing bacteria in coastal recreational waters.

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    Montezzi, Lara Feital; Campana, Eloiza Helena; Corrêa, Laís Lisboa; Justo, Livia Helena; Paschoal, Raphael Paiva; da Silva, Isabel Lemos Vieira Dias; Souza, Maria do Carmo Maciel; Drolshagen, Marcia; Picão, Renata Cristina

    2015-02-01

    The spread of carbapenemase-producing Gram-negative rods is an emerging global problem. Although most infections due to carbapenemase producers are limited to healthcare institutions, reports of the occurrence of clinically relevant carbapenemase producers in sewage and polluted rivers are increasingly frequent. Polluted rivers flowing to oceans may contaminate coastal waters with multidrug-resistant bacteria, potentially threatening the safety of recreational activities in these locations. Here we assessed the occurrence of carbapenemase producers in water from touristic beaches located in Rio de Janeiro, Brazil, showing distinct pollution patterns. The presence of enterobacteria was noted, including the predominantly environmental genus Kluyvera spp., producing either Klebsiella pneumoniae carbapenemase (KPC) or Guyana extended-spectrum (GES)-type carbapenemases and often associated with quinolone resistance determinants. An Aeromonas sp. harbouring blaKPC and qnrS was also observed. These findings strengthen the role of aquatic matrices as reservoirs and vectors of clinically relevant antimicrobial-resistant bacteria, with potential to favour the spread of these resistance threats throughout the community. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  10. Emergence of KPC-producing Klebsiella pneumoniae in Italy

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    Bossa Maria C

    2010-02-01

    Full Text Available Abstract Background The emergence of KPC-producing K. pneumoniae has now become a global concern. KPC beta-lactamases are plasmid-borne and, like extended spectrum beta lactamases (ESBLs, can accumulate and transfer resistance determinants to other classes of antibiotics. Therefore, infection control guidelines on early identification and control of the spread of organisms carrying these resistant determinants are needed. Findings Klebsiella pneumoniae carbapenemase (KPC was detected in two isolates of carbapenem-resistant K. pneumoniae obtained from patients at an Italian teaching hospital. The first strain was isolated from a culture drawn from a central venous device (CVC in a patient with Crohn's disease who was admitted to a gastroenterology ward. The second was isolated from a urine sample collected from an indwelling urinary catheter in an intensive care unit (ICU patient with a subdural haematoma. The patients had not travelled abroad. Both isolates were resistant to all β-lactams and were susceptible to imipenem and meropenem but resistant to ertapenem. Isolates also showed resistance to other classes of non-β-lactam antibiotics, such as quinolones, aminoglycosides (with the exception for amikacin, trimethoprim-sulfamethoxazole (TMP-SMX and nitrofurantoin. They were determined to contain the plasmid encoding the carbapenemase gene bla-KPC and were also positive in the Hodge test. Conclusions This is the second report of KPC-producing isolates in Italy, but the first concerning KPC type 2 gene, and it may have important implications for controlling the transmission of microorganisms resistant to antibiotics.

  11. The spread of KPC-producing Enterobacteriaceae in Spain: WGS analysis of the emerging high-risk clones of Klebsiella pneumoniae ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3.

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    Oteo, Jesús; Pérez-Vázquez, María; Bautista, Verónica; Ortega, Adriana; Zamarrón, Pilar; Saez, David; Fernández-Romero, Sara; Lara, Noelia; Ramiro, Raquel; Aracil, Belén; Campos, José

    2016-12-01

    We analysed the microbiological traits and population structure of KPC-producing Enterobacteriaceae isolates collected in Spain between 2012 and 2014. We also performed a comparative WGS analysis of the three major KPC-producing Klebsiella pneumoniae clones detected. Carbapenemase and ESBL genes were sequenced. The Institut Pasteur MLST scheme was used. WGS data were used to construct phylogenetic trees, to identify the determinants of resistance and to de novo assemble the genome of one representative isolate of each of the three major K. pneumoniae clones. Of the 2443 carbapenemase-producing Enterobacteriaceae isolates identified during the study period, 111 (4.5%) produced KPC. Of these, 81 (73.0%) were K. pneumoniae and 13 (11.7%) were Enterobacter cloacae. Three major epidemic clones of K. pneumoniae were identified: ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3. ST11/KPC-2 differed from ST101/KPC-2 and ST512/KPC-3 by 27 819 and 6924 SNPs, respectively. ST101/KPC-2 differed from ST512/KPC-3 by 28 345 SNPs. Nine acquired resistance genes were found in ST11/KPC-2, 11 in ST512/KPC-3 and 13 in ST101/KPC-2. ST101/KPC-2 had the highest number of virulence genes (20). An 11 bp deletion at the end of the mgrB sequence was the cause of colistin resistance in ST512/KPC-3. KPC-producing Enterobacteriaceae are increasing in Spain. Most KPC-producing K. pneumoniae isolates belonged to only five clones: ST11 and ST512 caused interregional spread, ST101 caused regional spread and ST1961 and ST678 produced independent hospital outbreaks. ST101/KPC-2 had the highest number of resistance and virulence genes. ST101/KPC-2 and ST512/KPC-3 were recently implicated in the spread of KPC in Italy. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  12. Carbapenemase-Producing Enterobacteriaceae in Yunnan Province, China.

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    Rui, Zheng; Dehua, Liu; Hua, Niu; Yue, Feng; Yunmin, Xu; Jianhua, Li; Xueshan, Xia

    2016-11-22

    Among 144 carbapenem-resistant Enterobacteriaceae strains isolated from 4 hospitals in Yunnan province, 113 were identified as carbapenemase-producing Enterobacteriaceae (CPE). Bla KPC-2 (99/113, 87.6%) was the most common carbapenemase gene and Klebsiella pneumoniae (100/113, 88.5%) was the most common species. Bla NDM-1 (11/113, 9.7%), bla IMP-4 (10/113, 8.8%), and bla IMP-1 (1/113, 0.9%) genes were also detected. Extended-spectrum β-lactamase genes were common in CPE, and the SHV- and CTX-M-types were predominant.

  13. First identification of class A carbapenemase-producing Klebsiella pneumoniae in the Republic of Ireland.

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    Roche, C

    2009-04-02

    The Klebsiella pneumoniae carbapenemase (KPC) was detected in a carbapenem-resistant respiratory isolate of Klebsiella pneumoniae in an Irish hospital. This is the first report of a KPC-producing isolate in the Republic of Ireland. The isolate was resistant to all beta-lactams. Furthermore, it had reduced susceptibility to three other classes of non-beta-lactam antibiotics. The isolate was not associated with travel abroad. Detection of KPC-producing bacteria has important infection control and public health implications.

  14. Management of KPC-producing Klebsiella pneumoniae infections.

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    Bassetti, M; Giacobbe, D R; Giamarellou, H; Viscoli, C; Daikos, G L; Dimopoulos, G; De Rosa, F G; Giamarellos-Bourboulis, E J; Rossolini, G M; Righi, E; Karaiskos, I; Tumbarello, M; Nicolau, D P; Viale, P L; Poulakou, G

    2018-02-01

    Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) has become one of the most important contemporary pathogens, especially in endemic areas. To provide practical suggestion for physicians dealing with the management of KPC-KP infections in critically ill patients, based on expert opinions. PubMed search for relevant publications related to the management of KPC-KP infections. A panel of experts developed a list of 12 questions to be addressed. In view of the current lack of high-level evidence, they were asked to provide answers on the bases of their knowledge and experience in the field. The panel identified several key aspects to be addressed when dealing with KPC-KP in critically ill patients (preventing colonization in the patient, preventing infection in the colonized patient and colonization of his or her contacts, reducing mortality in the infected patient by rapidly diagnosing the causative agent and promptly adopting the best therapeutic strategy) and provided related suggestions that were based on the available observational literature and the experience of panel members. Diagnostic technologies could speed up the diagnosis of KPC-KP infections. Combination treatment should be preferred to monotherapy in cases of severe infections. For non-critically ill patients without severe infections, results from randomized clinical trials are needed for ultimately weighing benefits and costs of using combinations rather than monotherapy. Multifaceted infection control interventions are needed to decrease the rates of colonization and cross-transmission of KPC-KP. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Trends in carbapenemase-producing Enterobacteriaceae, France, 2012 to 2014

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    Dortet, Laurent; Cuzon, Gaëlle; Ponties, Valérie; Nordmann, Patrice

    2017-01-01

    In 2014, a total of 2,976 Enterobacteriaceae isolates with decreased susceptibility to carbapenems were received at the French Associated National Reference Center for Antibiotic Resistance (NRC) and were characterised for their molecular resistance mechanism to carbapenems and compared with results obtained during 2012 and 2013.The overall number of enterobacterial isolates with decreased susceptibility to carbapenems received at the NRC rapidly increased (more than twofold in two years) with a growing proportion of carbapenemase producers (23.1% in 2012 vs 28.6% in 2013 vs 36.2% in 2014). Between 2012 and 2014, the main carbapenemase type was OXA-48, with an increase in OXA-48 variants (mostly OXA-181) and NDM producers, whereas the number KPC producers decreased. We identified a potential spread of OXA-181 producers in the tropical region of Africa. Finally, OXA-48 and OXA-48-related enzymes remained the predominant carbapenemases in France. The number of carbapenemase-producing Escherischia coli isolates was multiplied by fivefold between 2012 and 2014, suggesting a possible dissemination in the community. PMID:28205502

  16. Emergence of KPC-producing Klebsiella pneumoniae ST512 isolated from cerebrospinal fluid of a child in Algeria

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    S. Bakour

    2015-01-01

    Full Text Available We report class A carbapenemase (KPC-3-producing Klebsiella pneumoniae meningitis in a 6-month-old child in Algeria. Multilocus sequence typing showed that the sequence type obtained corresponded to ST512, an allelic single-locus variant of the pandemic ST258 widely distributed in KPC producers from Europe. To our knowledge, this is the first report of KPC-3-producing K. pneumoniae ST512 in a North African country.

  17. Evolving beta-lactamase epidemiology in Enterobacteriaceae from Italian nationwide surveillance, October 2013: KPC-carbapenemase spreading among outpatients.

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    Giani, Tommaso; Antonelli, Alberto; Caltagirone, Mariasofia; Mauri, Carola; Nicchi, Jessica; Arena, Fabio; Nucleo, Elisabetta; Bracco, Silvia; Pantosti, Annalisa; Luzzaro, Francesco; Pagani, Laura; Rossolini, Gian Maria

    2017-08-03

    Extended-spectrum beta-lactamases (ESBLs), AmpC-type beta-lactamases (ACBLs) and carbapenemases are among the most important resistance mechanisms in Enterobacteriaceae. This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates of Escherichia coli (n = 2,352), Klebsiella pneumoniae (n = 697), and Proteus mirabilis (n = 275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCR-carbaS isolates were ESBL-positive (90.5%), and most of them were contributed by E. coli carrying bla CTX-M group 1 genes. Acquired ACBLs were less common and mostly detected in P. mirabilis. ESCR-carbaR isolates were mostly contributed by K. pneumoniae (25.1% and 7.7% among K. pneumoniae isolates from inpatients and outpatients, respectively), with bla KPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients. This article is copyright of The Authors, 2017.

  18. Detection of KPC-2 in a Clinical Isolate of Proteus mirabilis and First Reported Description of Carbapenemase Resistance Caused by a KPC Beta-Lactamase in P. mirabilis

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    An isolate of Proteus mirabilis recovered from bacterial cultures was shown to be resistant to imipenem, meropenem, and ertapenem by disk diffusion susceptibility testing. Amplification of whole cell and/or plasmid DNA recovered from the isolate using primers specific for the blaKPC carbapenemase g...

  19. KPC and VIM producing Enterobacter cloacae strain from a hospital in northeastern Venezuela.

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    Martínez, Dianny; Marcano, Daniel; Rodulfo, Hectorina; Salgado, Nurys; Cuaical, Nirvia; Rodriguez, Lucy; Caña, Luisa; Medina, Belkis; Guzman, Militza; De Donato, Marcos

    2015-06-01

    An 83-year-old male patient is admitted to the central hospital in Cumana, Venezuela with severe urinary infection, history of hospitalizaions and prolonged antimicrobial treatments. A strain of Enterobacter cloacae was isolated showing resistance to multiple types of antibiotics (only sensitive to gentamicin), with phenotype of serine- and metallo-carbapenemases. Both, bla(VIM-2) and bla(KPC) genes were detected in the isolate. This is the first report of an Enterobacteriaceae species producing both KPC carbapenemase and VIM metallo carbapenemase in Venezuela. This finding has a great clinical and epidemiological impact in the region, because of the feasibility of transferring these genes, through mobile elements to other strains of Enterobacter and to other infection-causing species of bacteria.

  20. Phenotypic identification, frequency distribution and antibiogram of carbapenemase producing enterobacteriaceae in clinical isolates

    International Nuclear Information System (INIS)

    Ansari, M.; Saad, N.

    2018-01-01

    Objective:To differentiate between Ambler class A, B and D of carbapenemase-producing Enterobacteriaceae by using simple phenotypic methods that can be carried out in the laboratory without requiring any specialised techniques. Study Design:Cross-sectional study. Place and Duration of Study:Microbiology Department, Army Medical College, NUST, Islamabad, from November 2015 to November 2016. Methodology: Clinical specimens were subjected to identification of Enterobacteriaceae by colony morphology and API 20 E. Carbapenem resistance was detected by applying meropenem disc (10 mu g) by disc diffusion method according to CLSI (Clinical Laboratory Standard Institute) criteria. Carbapenemase production among Enterobacteriaceaewas detected by Modified Hodge test. Phenotypic methods, Phenylboronic acid (for Class A KPC producing Enterobacteriaceae) and EDTA inhibition tests (for Class B MBL producing Entrobacteriaceae) were applied. Presence of OXA 48 was detected by phenotypic method using imipenem 10 mu g, EDTA and PBA discs. Antibiotic susceptibility was determined by Kirby-Bauer disc diffusion method. Results:Forty-three out of 45 (95.45%) were carbapenemase producers. Thirty-eight out of 43 (88.3%) were KPC producers and 4 out of 43 (11.62%) were MBL producers. All KPC producers were Klebsiella pneumoniae. Among five MBL producers, one each (20%) was Enterobacter cloacae and Escherichia coli and 3 (60%) were Klebsiella pneumoniae. All MBL producers were resistant to aztreonam and amoxicillin/clavulanate. Two of the KPC producing Klebsiella pneumoniaewere pan-drug resistant (resistant to colistin and tigecycline). Two were non-carbapenemase producers. Conclusion:Enterobacteriaceaestrains producing KPC-type carbapenemase were the most prevalent (88.3%) in the studied healthcare setup. (author)

  1. Presence of the KPC carbapenemase gene in Enterobacteriaceae causing bacteremia, and the correlation with in vitro carbapenem susceptibility

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    During six months, we obtained Enterobacteriaceae isolates from patients with Gram-negative bacteremia at a 1250-bed teaching hospital in St. Louis, Missouri, and compared carbapenem susceptibility with the presence of blaKPC, a transferable carbapenemase gene. Three (1.2%) out of 243 isolates were ...

  2. Carbapenemase-producing Organism in Food

    Centers for Disease Control (CDC) Podcasts

    2014-08-06

    Dr. Mike Miller reads an abridged version of the article, Carbapenemase-producing Organism in Food.  Created: 8/6/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/13/2014.

  3. Avaliação fenotípica da enzima Klebsiella pneumoniae carbapenemase (KPC em Enterobacteriaceae de ambiente hospitalar Phenotypic research on Klebsiella pneumoniae carbapenemase (KPC enzyme in Enterobacteriaceae from hospitals

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    Rosabel Dienstmann

    2010-02-01

    Full Text Available INTRODUÇÃO E OBJETIVO: A resistência bacteriana é problema frequente e importante no ambiente nosocomial. Nesse contexto, várias bactérias apresentam habilidade de desenvolver mecanismos de resistência enzimáticos, destacando-se as Enterobacteriaceae. Nesta família de microrganismos, a produção de Klebsiella pneumoniae carbapenemase (KPC é um mecanismo emergente, o que justifica sua vigilância constante. MATERIAL E MÉTODO: Este trabalho pesquisou o fenótipo de KPC em 30 isolados clínicos de enterobactérias resistentes a cefalosporinas de terceira geração e sensibilidade diminuída a carbapenem oriundas de dois hospitais (em Porto Alegre e na Grande Porto Alegre, RS. Realizou-se discodifusão com imipenem, meropenem e ertapenem, e 14 cepas com halo INTRODUCTION AND OBJECTIVE: Bacterial resistance is a frequent and important problem in the nosocomial environment. In this context, several bacteria have the ability to develop mechanisms of enzymatic resistance, mainly Enterobacteriaceae. In this family of microorganisms, the production of Klebsiella pneumoniae carbapenemase (KPC is an emerging mechanism, which should be under constant observation. MATERIAL AND METHOD: This study investigated the phenotype of KPC in 30 clinical isolates of Enterobacteriaceae resistant to third generation cephalosporin and carbapenem from two hospitals (Porto Alegre city and Porto Alegre, RS. It was performed disk diffusion method with imipenem, meropenem and ertapenem. Additionally, 14 strains with halo < 22 mm for the last antimicrobial agent underwent modified Hodge test. RESULTS: No sample showed carbapenemase (Hodge negative. DISCUSSION: Despite the fact there was no carbapenemase, resistance to carbapenems is possibly attributed to the presence of beta-lactamases AmpC and/or ESBL associated with changes in the permeability of porin channels. CONCLUSION: Given the emerging nature of KPC, it is important to trace it in Enterobacteriaceae

  4. Improvement of the Xpert Carba-R Kit for the Detection of Carbapenemase-Producing Enterobacteriaceae.

    Science.gov (United States)

    Dortet, Laurent; Fusaro, Mathieu; Naas, Thierry

    2016-06-01

    The Xpert Carba-R kit, version 2 (v2), which has been improved for the efficient detection of blaOXA-181 and blaOXA-232 genes, was tested on a collection of 150 well-characterized enterobacterial isolates that had a reduced susceptibility to carbapenems. The performance of the Xpert Carba-R v2 was high, as it was able to detect the five major carbapenemases (NDM, VIM, IMP, KPC, and OXA-48). Thus, it is now well adapted to the carbapenemase-producing Enterobacteriaceae epidemiology of many countries worldwide. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  5. Combined use of the modified Hodge test and carbapenemase inhibition test for detection of carbapenemase-producing Enterobacteriaceae and metallo-β-lactamase-producing Pseudomonas spp.

    Science.gov (United States)

    Song, Wonkeun; Hong, Seong Geun; Yong, Dongeun; Jeong, Seok Hoon; Kim, Hyun Soo; Kim, Han-Sung; Kim, Jae-Seok; Bae, Il Kwon

    2015-03-01

    We evaluated the combined use of the modified Hodge test (MHT) and carbapenemase inhibition test (CIT) using phenylboronic acid (PBA) and EDTA to detect carbapenemase-producing Enterobacteriaceae (CPE) and metallo-β-lactamase (MBL)-producing Pseudomonas spp. A total of 49 isolates of CPE (15 Klebsiella pneumoniae carbapenemase [KPC], 5 Guiana extended-spectrum β-lactamase [GES]-5, 9 New Delhi metallo-β-lactamase [NDM]-1, 5 Verona integron-encoded metallo-β-lactamase [VIM]-2, 3 imipenem-hydrolyzing β-lactamase [IMP], and 12 oxacillinase [OXA]-48-like), 25 isolates of MBL-producing Pseudomonas spp. (14 VIM-2 and 11 IMP), and 35 carbapenemase-negative controls were included. The MHT was performed for all isolates as recommended by the Clinical and Laboratory Standards Institute. Enhanced growth of the indicator strain was measured in mm with a ruler. The CIT was performed by directly dripping PBA and EDTA solutions onto carbapenem disks that were placed on Mueller-Hinton agar plates seeded with the test strain. Considering the results of the MHT with the ertapenem disk in Enterobacteriaceae and Pseudomonas spp., the CIT with the meropenem disk in Enterobacteriaceae, and the imipenem disk in Pseudomonas spp., three combined disk tests, namely MHT-positive plus PBA-positive, EDTA-positive, and MHT-positive plus PBA-negative plus EDTA-negative, had excellent sensitivity and specificity for the detection of KPC- (100% sensitivity and 100% specificity), MBL- (94% sensitivity and 100% specificity), and OXA-48-like-producing isolates (100% sensitivity and 100% specificity), respectively. Combined use of the MHT and CIT with PBA and EDTA, for the detection of CPE and MBL-producing Pseudomonas spp., is effective in detecting and characterizing carbapenemases in routine laboratories.

  6. Risk factors for KPC-producing Klebsiella pneumoniae: watch out for surgery.

    Science.gov (United States)

    da Silva, Kesia Esther; Maciel, Wirlaine Glauce; Sacchi, Flávia Patussi Correia; Carvalhaes, Cecilia Godoy; Rodrigues-Costa, Fernanda; da Silva, Ana Carolina Ramos; Croda, Mariana Garcia; Negrão, Fábio Juliano; Croda, Julio; Gales, Ana Cristina; Simionatto, Simone

    2016-06-01

    This study describes the molecular characteristics and risk factors associated with carbapenem-resistant Klebsiella pneumoniae strains. Risk factors associated with KPC-producing K. pneumoniae strains were investigated in this case-control study from May 2011 to May 2013. Bacterial identification was performed by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility was determined by broth microdilution. Carbapenemase production was assessed by both modified Hodge test (MHT) and ertapenem hydrolysis using MALDI-TOF MS. The presence of β-lactamase-encoding genes was evaluated by PCR and DNA sequencing. Alterations in genes encoding K. pneumoniae outer membrane proteins were analysed by PCR and DNA sequencing as well as SDS-PAGE. Genetic relatedness among strains was determined by pulsed-field gel electrophoresis. This study included 94 patients. Longer hospitalisation, mechanical ventilation, catheters, and previous surgery were associated with KPC-producing K. pneumoniae. Sixty-eight strains showed resistance to carbapenems. Carbapenemase production was detected by MHT in 67 K. pneumoniae strains and by MALDI-TOF MS in 57. The presence of the blaKPC-2 gene was identified in 57 strains. The blaKPC-2 gene was not found in 11 carbapenem-resistant K. pneumoniae; instead, the blaCTX-M-1-like, blaCTX-M-2-like, blaCTX-M-8 like, blaCTX-M-14-like and blaSHV- like genes associated with OmpK35 and OmpK36 alterations were observed. Thirty-three KPC-producing K. pneumoniae strains were clonally related, and patients infected with these strains had a higher mortality rate (78.78 %). Our results show that KPC-producing K. pneumoniae was associated with several healthcare-related risk factors, including recent surgery.

  7. Genome-based analysis of Carbapenemase-producing Klebsiella pneumoniae isolates from German hospital patients, 2008-2014.

    Science.gov (United States)

    Becker, Laura; Kaase, Martin; Pfeifer, Yvonne; Fuchs, Stephan; Reuss, Annicka; von Laer, Anja; Sin, Muna Abu; Korte-Berwanger, Miriam; Gatermann, Sören; Werner, Guido

    2018-01-01

    By using whole genome sequence data we aimed at describing a population snapshot of carbapenemase-producing K. pneumoniae isolated from hospitalized patients in Germany between 2008 and 2014. We selected a representative subset of 107 carbapenemase-producing K. pneumoniae clinical isolates possessing the four most prevalent carbapenemase types in Germany (KPC-2, KPC-3, OXA-48, NDM-1). Isolates were processed via illumina NGS. Data were analysed using different SNP-based mapping and de-novo assembly approaches. Relevant information was extracted from NGS data (antibiotic resistance determinants, wzi gene/ cps type, virulence genes). NGS data from the present study were also compared with 238 genome data from two previous international studies on K. pneumoniae. NGS-based analyses revealed a preferred prevalence of KPC-2-producing ST258 and KPC-3-producing ST512 isolates. OXA-48, being the most prevalent carbapenemase type in Germany, was associated with various K. pneumoniae strain types; most of them possessing IncL/M plasmid replicons suggesting a preferred dissemination of bla OXA-48 via this well-known plasmid type. Clusters ST15, ST147, ST258, and ST512 demonstrated an intermingled subset structure consisting of German and other European K. pneumoniae isolates. ST23 being the most frequent MLST type in Asia was found only once in Germany. This latter isolate contained an almost complete set of virulence genes and a K1 capsule suggesting occurrence of a hypervirulent ST23 strain producing OXA-48 in Germany. Our study results suggest prevalence of "classical" K. pneumonaie strain types associated with widely distributed carbapenemase genes such as ST258/KPC-2 or ST512/KPC-3 also in Germany. The finding of a supposed hypervirulent and OXA-48-producing ST23 K. pneumoniae isolates outside Asia is highly worrisome and requires intense molecular surveillance.

  8. Prevalence and Molecular Characteristics of Carbapenemase-Producing Enterobacteriaceae From Five Hospitals in Korea.

    Science.gov (United States)

    Jeong, Seok Hoon; Kim, Han Sung; Kim, Jae Seok; Shin, Dong Hoon; Kim, Hyun Soo; Park, Min Jeong; Shin, Saeam; Hong, Jun Sung; Lee, Seung Soon; Song, Wonkeun

    2016-11-01

    The emergence of carbapenemase-producing Enterobacteriaceae (CPE) represents a major clinical problem because these bacteria are resistant to most antibiotics. CPE remain relatively uncommon in Korea. We report the prevalence, clinical characteristics, and molecular epidemiology of CPE isolates collected from five university hospitals in Korea. Between January and December 2015, 393 non-duplicated isolates that were nonsusceptible to ertapenem were analyzed. Production of carbapenemase, extended-spectrum β-lactamase, and AmpC β-lactamase was determined by genotypic tests. Antimicrobial susceptibility profiles were determined by using an Etest. Clonality of Klebsiella pneumoniae carbapenemase (KPC)-2-producing and oxacillinase (OXA)-232-producing Klebsiella pneumoniae isolates was determined by pulsed-field gel electrophoresis (PFGE). Of the 393 isolates tested, 79 (20.1%) were CPE. Of these 79 isolates, 47 (59.5%) harbored the bla(OXA-232) gene while the remaining isolates carried genes bla(KPC-2) (n=27), bla(IMP-1) (n=4), and bla(NDM-1) (n=1). Among the 24 KPC-2 K. pneumoniae isolates from hospital B, 100% were resistant to carbapenems, 8% to colistin, and 0% to tigecycline. Among the 45 OXA-232 K. pneumoniae at hospital C, 95% were resistant to ertapenem, 68% to imipenem, 95% to meropenem, 10% to colistin, and 24% to tigecycline. PFGE analysis revealed a unique pattern for KPC-2 K. pneumoniae and identified 30 isolates belonging to the dominant pulsotypes (PT)1 and PT2 among 41 OXA-232 K. pneumoniae isolates. CPE strains are present in Korea, with the majority of K. pneumoniae isolates producing OXA-232 and KPC-2. The prevalence and predominant genotypes of CPE show hospital-specific differences.

  9. Control of infectious mortality due to carbapenemase-producing Klebsiella pneumoniae in hematopoietic stem cell transplantation.

    Science.gov (United States)

    Forcina, A; Baldan, R; Marasco, V; Cichero, P; Bondanza, A; Noviello, M; Piemontese, S; Soliman, C; Greco, R; Lorentino, F; Giglio, F; Messina, C; Carrabba, M; Bernardi, M; Peccatori, J; Moro, M; Biancardi, A; Nizzero, P; Scarpellini, P; Cirillo, D M; Mancini, N; Corti, C; Clementi, M; Ciceri, F

    2017-01-01

    Carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) infections are an emerging cause of death after hematopoietic stem cell transplantation (HSCT). In allogeneic transplants, mortality rate may rise up to 60%. We retrospectively evaluated 540 patients receiving a transplant from an auto- or an allogeneic source between January 2011 and October 2015. After an Institutional increase in the prevalence of KPC-Kp bloodstream infections (BSI) in June 2012, from July 2012, 366 consecutive patients received the following preventive measures: (i) weekly rectal swabs for surveillance; (ii) contact precautions in carriers (iii) early-targeted therapy in neutropenic febrile carriers. Molecular typing identified KPC-Kp clone ST512 as the main clone responsible for colonization, BSI and outbreaks. After the introduction of these preventive measures, the cumulative incidence of KPC-Kp BSI (P=0.01) and septic shocks (P=0.01) at 1 year after HSCT was significantly reduced. KPC-Kp infection-mortality dropped from 62.5% (pre-intervention) to 16.6% (post-intervention). Day 100 transplant-related mortality and KPC-Kp infection-related mortality after allogeneic HSCT were reduced from 22% to 10% (P=0.001) and from 4% to 1% (P=0.04), respectively. None of the pre-HSCT carriers was excluded from transplant. These results suggest that active surveillance, contact precautions and early-targeted therapies, may efficiently control KPC-Kp spread and related mortality even after allogeneic HSCT.

  10. Prolonged delay for controlling KPC-2-producing Klebsiella pneumoniae outbreak: the role of clinical management.

    Science.gov (United States)

    Delory, T; Seringe, E; Antoniotti, G; Novakova, I; Goulenok, C; Paysant, I; Boyer, S; Carbonne, A; Naas, T; Astagneau, P

    2015-10-01

    Carbapenemase-producing Enterobacteriaceae (CPE) are becoming of immediate concern for infection control policies. Prompt detection of CPE on health care setting admission is crucial to halt the spread of an outbreak. We report a cluster of 13 Klebsiella pneumoniae carbapenemase (KPC)-2-producing K pneumoniae cases in a tertiary care hospital.The objective of this study was to identify contributing factors originating the outbreak. An outbreak investigation was conducted using descriptive epidemiology, observation of health care practices, and interviews of management staff. A root cause analysis was performed to identify patent and latent failures of infection control measures using the association of litigation and risk management method. The main patent failure was the delay in identifying KPC-2-producing K pneumoniae carriers. Contributing factors were work and environmental factors: understaffing, lack of predefined protocols, staff members' characteristics, and underlying patients' characteristics. Latent failures were as follows: no promotion of the national guidelines for prevention of CPE transmission, no clear procedure for the management of patients hospitalized abroad, no clear initiative for promoting a culture of quality in the hospital, biologic activity recently outsourced to a private laboratory, and poor communication among hospital members. Clinical management should be better promoted to control hospital outbreaks and should include team work and safety culture. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  11. NNDSS - Table II. Carbapenemase-producing carbapenem-resistant Enterobacteriaceae

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Carbapenemase-producing carbapenem-resistant Enterobacteriaceae - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000...

  12. Characterization of ST258 Colistin-Resistant, blaKPC-Producing Klebsiella pneumoniae in a Greek Hospital.

    Science.gov (United States)

    Mavroidi, Angeliki; Katsiari, Maria; Likousi, Sofia; Palla, Eleftheria; Roussou, Zoi; Nikolaou, Charikleia; Maguina, Asimina; Platsouka, Evangelia D

    2016-07-01

    The emergence of colistin resistance may further contribute to treatment failure of infection caused by multidrug-resistant (MDR) Klebsiella pneumoniae. The colistin resistance rates were determined and colistin-resistant carbapenemase-producing K. pneumoniae (COL-R CP-Kp) were characterized over an 18-month period in a Greek hospital. Out of 135 carbapenemase producers, 19 isolates (14%) were categorized as resistant to colistin. Phenotypic and molecular characterization of the COL-R CP-Kp isolates revealed that all were MDR blaKPC producers and, excluding one isolate of MLST ST383, belonged to the international clonal lineage ST258. Furthermore, PCR amplification and sequencing of the mgrB locus revealed nucleotide sequences of different sizes and insertions of IS1- and IS5-like mobile elements. The majority (63%) of the COL-R blaKPC producers was recovered from patients in the intensive care unit (ICU) and clinical data indicated that all patients should have acquired these isolates in the ICU. The findings of the present study underscore a concerning evolution of colistin resistance in a setting of high K. pneumoniae carbapenemase (KPC)-Kp endemicity, such as Greece. Thus, continuous surveillance, molecular characterization, prudent use of antibiotics, and implementation of infection control measures for K. pneumoniae are urgent.

  13. Development of selective medium for IMP-type carbapenemase-producing Enterobacteriaceae in stool specimens.

    Science.gov (United States)

    Yamamoto, Norihisa; Kawahara, Ryuji; Akeda, Yukihiro; Shanmugakani, Rathina Kumar; Yoshida, Hisao; Hagiya, Hideharu; Hara, Naohiro; Nishi, Isao; Yukawa, Satomi; Asada, Rumiko; Sasaki, Yumi; Maeda, Kazuhiro; Sakamoto, Noriko; Hamada, Shigeyuki; Tomono, Kazunori

    2017-03-24

    Identification of carbapenemase-producing Enterobacteriaceae (CPE) in faecal specimens is challenging. This fact is particularly critical because low-level carbapenem-resistant organisms such as IMP-producing CPE are most prevalent in Japan. We developed a modified selective medium more suitable for IMP-type CPE. Fifteen reference CPE strains producing different types of β-lactamases were used to evaluate the commercially available CHROMagar KPC and chromID CARBA as well as the newly prepared MC-ECC medium (CHROMagar ECC supplemented with meropenem, cloxacillin, and ZnSO 4 ) and M-ECC medium (CHROMagar ECC supplemented with meropenem and ZnSO 4 ). A total of 1035 clinical samples were then examined to detect CPE using chromID CARBA and M-ECC medium. All tested strains producing NDM-, KPC-, and OXA-48-carbapenemases were successfully cultured in the media employed. Although most of the IMP-positive strains did not grow in CHROMagar KPC, chromID CARBA, or MC-ECC, all tested strains grew on M-ECC. When faecal samples were applied to the media, M-ECC medium allowed the best growth of IMP-type CPE with a significantly higher sensitivity (99.3%) than that of chromID CARBA (13.9%). M-ECC medium was determined as the most favourable selective medium for the detection of IMP-type CPE as well as other types of CPE.

  14. Multifocal diffusion of KPC-3-producing ST512 Klebsiella pneumoniae in Italy

    Directory of Open Access Journals (Sweden)

    Aurora Piazza

    2012-03-01

    Full Text Available Introduction. The dissemination of carbapenemase-producing Klebsiella pneumoniae strains is an increasing problem worldwide. KPC ß-lactamases are Ambler class A enzymes mostly plasmid-encoded; their global spread represents a threat to clinical patients care and public health. Multi locus sequence type (ST258 is currently the most spread K. pneumoniae clone associated with KPC enzymes. Here we report the first identification and multifocal spread of KPC-3 producing K. pneumoniae clinical strains belonging to ST512 in Italy. Materials and Methods. Fifty six carbapenem-resistant K. pneumoniae isolates were collected from 7 Italian hospitals during the period June 2009-May 2011. Isolates were obtained from different wards (spinal unit, medicine, hematology, etc. and biological samples (mostly rectal swabs, urine and blood. Species identification and antimicrobial susceptibilities were obtained by NBC46/NM40 Microscan panels (Siemens. MICs values were interpreted according to EUCAST 2011 breakpoints. Modified Hodge test and combined disk test with phenyl-boronic acid (BOR and EDTA were performed.The presence of blaKPC genes were confirmed by PCR and sequencing. A complete characterization of the produced ß-lactamases (BLs was obtained by IEF followed by PCR experiments using primers specific for the detection of blaCTX-M-, blaTEM- and blaSHV type genes. PFGE and multilocus sequence typing (MLST were both used to investigate clonal isolates relatedness. Results. All 56 isolates resulted positive for the presence of KPC-type carbapenemases by both phenotypical and molecular analysis. Fifteen isolates, chosen as representative, were further investigated. Ten out of 15 isolates harboring the blaKPC-2 gene clustered with the known ST258, while the remaining 5/10 belonged to the newly described ST512 and harbored the blaKPC-3 gene. ST512 isolates, from 3/7 hospitals, were collected from rectal swabs (40%, blood (20%, endotracheal aspirate (20% and

  15. Emergence of Pseudomonas aeruginosa with KPC-type carbapenemase in a teaching hospital: an 8-year study.

    Science.gov (United States)

    García Ramírez, Dolores; Nicola, Federico; Zarate, Soledad; Relloso, Silvia; Smayevsky, Jorgelina; Arduino, Sonia

    2013-10-01

    An outbreak of Klebsiella pneumoniae carbapenamase (KPC)-producing K. pneumoniae occurred at our institution. Multiresistant Pseudomonas aeruginosa could have acquired this transmissible resistance mechanism, going unnoticed because its phenotypic detection in this species is difficult. We compared P. aeruginosa isolates obtained before and after the KPC-producing K. pneumoniae outbreak. No bla(KPC) genes were detected in the isolates obtained before the outbreak, whereas 33/76 (43%) of the isolates obtained after the outbreak harboured the bla(KPC) gene. P. aeruginosa may thus become a reservoir of this transmissible resistance mechanism. It is very important to understand the epidemiology of these multiresistant isolates, in order to achieve early implementation of adequate control measures to contain and reduce their dissemination in the hospital environment.

  16. Molecular characterization of KPC-producing Klebsiella pneumoniae isolated from patients in a Public Hospital in Caracas, Venezuela.

    Science.gov (United States)

    Falco Restrepo, Aura Dayana; Velásquez Nieves, Mariel Alexandra; Takiff, Howard

    Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are amongst the most important causative agents of nosocomial infections worldwide. Isolates of this bacterium have been identified in Venezuela but little is known about their local spread. The aim of this study was to perform the molecular characterization of KPC-producing strains isolated from 2012 to 2013 in a public hospital in Caracas, Venezuela. Twenty-two K. pneumoniae clinical isolates phenotypically classified as KPC producing were subjected to PCR screening for the presence of bla KPC genes and their location within transposon Tn4401. The bla KPC PCR product was sequenced to identify the KPC alleles. Genotypic analysis was performed by means of repetitive extragenic palindromic PCR (rep-PCR) and Multi Locus Sequence Typing (MLST). Finally, conjugation and electroporation assays were used to determine whether the bla KPC genes were found in plasmids. All isolates contained the bla KPC-2 variant, and 21 of the 22 were associated with the Tn4401b isoform. The strains were distributed in 8 sequence types (ST), three of which were new. Conjugation and electroporation assays indicated that 95.5% (n=21/22) of the isolates contained the bla KPC gene in plasmids. This study on circulating bacterial strains and the identification of KPC alleles may help to understand the routes of dissemination and control their spread within this hospital. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  17. A combined disc method with resazurin agar plate assay for early phenotypic screening of KPC, MBL and OXA-48 carbapenemases among Enterobacteriaceae.

    Science.gov (United States)

    Teethaisong, Y; Eumkeb, G; Nakouti, I; Evans, K; Hobbs, G

    2016-08-01

    To validate a combined disc method along with resazurin chromogenic agar for early screening and differentiation of Klebsiella pneumoniae carbapenemase, metallo-β-lactamase and OXA-48 carbapenemase-producing Enterobacteriaceae. The combined disc test comprising of meropenem alone and with EDTA, phenylboronic acid or both EDTA and phenylboronic acid, and temocillin alone were evaluated with the resazurin chromogenic agar plate assay against a total of 86 molecularly confirmed Enterobacteriaceae clinical isolates (11 metallo-β-lactamases, eight Kl. pneumoniae carbapenemases, 11 OXA-48, 32 AmpC and 15 extended-spectrum-β-lactamase producers and nine co-producers of extended-spectrum-β-lactamase and AmpC). The inhibition zone diameters were measured and interpreted at 7 h for the presence of carbapenemase. All carbapenemase producers were phenotypically distinguished by this assay with 100% sensitivity and specificity. This early phenotypic method is very simple, inexpensive, and reliable in the detection and differentiation of carbapenemase-producing Enterobacteriaceae. It could be exploited in any microbiological laboratory for diagnosis of these recalcitrant bacteria. This assay poses excellent performance in discrimination of Kl. pneumoniae carbapenemase, metallo-β-lactamase and OXA-48 carbapenemases within 7 h, which is much faster than conventional disc diffusion methods. The rapid detection could help clinicians screen patients, control infection and provide epidemiological surveillance. © 2016 The Society for Applied Microbiology.

  18. Treatment of infections caused by carbapenemase-producing Enterobacteriaceae.

    Science.gov (United States)

    Rodríguez-Baño, Jesús; Cisneros, José Miguel; Gudiol, Carlota; Martínez, José Antonio

    2014-12-01

    Treatment of infections caused by carbapenemase-producing Enterobacteriaceae (CPE) is currently one of the most important challenges of infectious diseases. The available information is based on in vitro studies, some animal model data and a few case studies and retrospective cohorts; appropriate data are lacking or are very scarce for some old antibiotics that are still occasionally used. Because of the heterogeneity in clinical situations, in specific carbapenemases and in the susceptibility of isolates, individualized treatment decisions must usually be made. Here we review the different antibiotics that might be useful for treating infections caused by CPE. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  19. Development of an algorithm for phenotypic screening of carbapenemase-producing Enterobacteriaceae in the routine laboratory.

    Science.gov (United States)

    Robert, Jérôme; Pantel, Alix; Merens, Audrey; Meiller, Elodie; Lavigne, Jean-Philippe; Nicolas-Chanoine, Marie-Hélène

    2017-01-17

    Carbapenemase-producing Enterobacteriaceae (CPE) are difficult to identify among carbapenem non-susceptible Enterobacteriaceae (NSE). We designed phenotypic strategies giving priority to high sensitivity for screening putative CPE before further testing. Presence of carbapenemase-encoding genes in ertapenem NSE (MIC > 0.5 mg/l) consecutively isolated in 80 French laboratories between November 2011 and April 2012 was determined by the Check-MDR-CT103 array method. Using the Mueller-Hinton (MH) disk diffusion method, clinical diameter breakpoints of carbapenems other than ertapenem, piperazicillin+tazobactam, ticarcillin+clavulanate and cefepime as well as diameter cut-offs for these antibiotics and temocillin were evaluated alone or combined to determine their performances (sensitivity, specificity, positive and negative likelihood ratios) for identifying putative CPE among these ertapenem-NSE isolates. To increase the screening specificity, these antibiotics were also tested on cloxacillin-containing MH when carbapenem NSE isolates belonged to species producing chromosomal cephalosporinase (AmpC) but Escherichia coli. Out of the 349 ertapenem NSE, 52 (14.9%) were CPE, including 39 producing OXA-48 group carbapenemase, eight KPC and five MBL. A screening strategy based on the following diameter cut offs, ticarcillin+clavulanate <15 mm, temocillin <15 mm, meropenem or imipenem <22 mm, and cefepime <26 mm, showed 100% sensitivity and 68.1% specificity with the better likelihood ratios combination. The specificity increased when a diameter cut-off <32 mm for imipenem (76.1%) or meropenem (78.8%) further tested on cloxacillin-containing MH was added to the previous strategy for AmpC-producing isolates. The proposed strategies that allowed for increasing the likelihood of CPE among ertapenem-NSE isolates should be considered as a surrogate for carbapenemase production before further CPE confirmatory testing.

  20. Molecular detection of carbapenemase-producing genes in referral ...

    African Journals Online (AJOL)

    Molecular confirmation of carbapenemase-producing Enterobacteriaceae (CPE) was introduced in South Africa (SA) at the end of 2011. We report on the detection of these resistance genes based on referral isolates. Enterobacteriaceae with non-susceptibility to any of the carbapenems according to defined criteria for ...

  1. Use of Imipenem To Detect KPC, NDM, OXA, IMP, and VIM Carbapenemase Activity from Gram-Negative Rods in 75 Minutes Using Liquid Chromatography-Tandem Mass Spectrometry

    Science.gov (United States)

    Kulkarni, M. V.; Zurita, A. N.; Pyka, J. S.; Murray, T. S.; Hodsdon, M. E.

    2014-01-01

    Resistance to extended-spectrum β-lactam antibiotics has led to a greater reliance upon carbapenems, but the expression of carbapenemases threatens to limit the utility of these drugs. Current methods to detect carbapenemase activity are suboptimal, requiring prolonged incubations during which ineffective therapy may be prescribed. We previously described a sensitive and specific assay for the detection of carbapenemase activity using ertapenem and liquid chromatography-tandem mass spectrometry (LC-MS/MS). In this study, we assessed 402 Gram-negative rods, including both Enterobacteriaceae and non-Enterobacteriaceae expressing IMP, VIM, KPC, NDM, and/or OXA carbapenemases, by using imipenem, meropenem, and ertapenem with LC-MS/MS assays. LC-MS/MS methods for the detection of intact and hydrolyzed carbapenems from an enrichment broth were developed. No ion suppression was observed, and the limits of detection for all three drugs were below 0.04 μg/ml. The sensitivity and specificity of meropenem and ertapenem for carbapenemase activity among non-Enterobacteriaceae were low, but imipenem demonstrated a sensitivity and specificity of 96% and 95%, respectively, among all Gram-negative rods (GNR) tested, including both Enterobacteriaceae and non-Enterobacteriaceae. LC-MS/MS allows for the analysis of more complex matrices, and this LC-MS/MS assay could easily be adapted for use with primary specimens requiring growth enrichment. PMID:24789180

  2. Molecular and epidemiological characterization of carbapenemase-producing Enterobacteriaceae in Norway, 2007 to 2014.

    Science.gov (United States)

    Samuelsen, Ørjan; Overballe-Petersen, Søren; Bjørnholt, Jørgen Vildershøj; Brisse, Sylvain; Doumith, Michel; Woodford, Neil; Hopkins, Katie L; Aasnæs, Bettina; Haldorsen, Bjørg; Sundsfjord, Arnfinn

    2017-01-01

    The prevalence of carbapenemase-producing Enterobacteriaceae (CPE) is increasing worldwide. Here we present associated patient data and molecular, epidemiological and phenotypic characteristics of all CPE isolates in Norway from 2007 to 2014 confirmed at the Norwegian National Advisory Unit on Detection of Antimicrobial Resistance. All confirmed CPE isolates were characterized pheno- and genotypically, including by whole genome sequencing (WGS). Patient data were reviewed retrospectively. In total 59 CPE isolates were identified from 53 patients. Urine was the dominant clinical sample source (37%) and only 15% of the isolates were obtained from faecal screening. The majority of cases (62%) were directly associated with travel or hospitalization abroad, but both intra-hospital transmission and one inter-hospital outbreak were observed. The number of CPE cases/year was low (2-14 cases/year), but an increasing trend was observed. Klebsiella spp. (n = 38) and E. coli (n = 14) were the dominant species and blaKPC (n = 20), blaNDM (n = 19), blaOXA-48-like (n = 12) and blaVIM (n = 7) were the dominant carbapenemase gene families. The CPE isolates were genetically diverse except for K. pneumoniae where clonal group 258 associated with blaKPC dominated. All isolates were multidrug-resistant and a significant proportion (21%) were resistant to colistin. Interestingly, all blaOXA-48-like, and a large proportion of blaNDM-positive Klebsiella spp. (89%) and E. coli (83%) isolates were susceptible in vitro to mecillinam. Thus, mecillinam could have a role in the treatment of uncomplicated urinary tract infections caused by OXA-48- or NDM-producing E. coli or K. pneumoniae. In conclusion, the impact of CPE in Norway is still limited and mainly associated with travel abroad, reflected in the diversity of clones and carbapenemase genes.

  3. Molecular and epidemiological characterization of carbapenemase-producing Enterobacteriaceae in Norway, 2007 to 2014.

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    Ørjan Samuelsen

    Full Text Available The prevalence of carbapenemase-producing Enterobacteriaceae (CPE is increasing worldwide. Here we present associated patient data and molecular, epidemiological and phenotypic characteristics of all CPE isolates in Norway from 2007 to 2014 confirmed at the Norwegian National Advisory Unit on Detection of Antimicrobial Resistance. All confirmed CPE isolates were characterized pheno- and genotypically, including by whole genome sequencing (WGS. Patient data were reviewed retrospectively. In total 59 CPE isolates were identified from 53 patients. Urine was the dominant clinical sample source (37% and only 15% of the isolates were obtained from faecal screening. The majority of cases (62% were directly associated with travel or hospitalization abroad, but both intra-hospital transmission and one inter-hospital outbreak were observed. The number of CPE cases/year was low (2-14 cases/year, but an increasing trend was observed. Klebsiella spp. (n = 38 and E. coli (n = 14 were the dominant species and blaKPC (n = 20, blaNDM (n = 19, blaOXA-48-like (n = 12 and blaVIM (n = 7 were the dominant carbapenemase gene families. The CPE isolates were genetically diverse except for K. pneumoniae where clonal group 258 associated with blaKPC dominated. All isolates were multidrug-resistant and a significant proportion (21% were resistant to colistin. Interestingly, all blaOXA-48-like, and a large proportion of blaNDM-positive Klebsiella spp. (89% and E. coli (83% isolates were susceptible in vitro to mecillinam. Thus, mecillinam could have a role in the treatment of uncomplicated urinary tract infections caused by OXA-48- or NDM-producing E. coli or K. pneumoniae. In conclusion, the impact of CPE in Norway is still limited and mainly associated with travel abroad, reflected in the diversity of clones and carbapenemase genes.

  4. Prevention of colonization and infection by Klebsiella pneumoniae carbapenemase-producing enterobacteriaceae in long-term acute-care hospitals.

    Science.gov (United States)

    Hayden, Mary K; Lin, Michael Y; Lolans, Karen; Weiner, Shayna; Blom, Donald; Moore, Nicholas M; Fogg, Louis; Henry, David; Lyles, Rosie; Thurlow, Caroline; Sikka, Monica; Hines, David; Weinstein, Robert A

    2015-04-15

    Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae (hereafter "KPC") are an increasing threat to healthcare institutions. Long-term acute-care hospitals (LTACHs) have especially high prevalence of KPC. Using a stepped-wedge design, we tested whether a bundled intervention (screening patients for KPC rectal colonization upon admission and every other week; contact isolation and geographic separation of KPC-positive patients in ward cohorts or single rooms; bathing all patients daily with chlorhexidine gluconate; and healthcare-worker education and adherence monitoring) would reduce colonization and infection due to KPC in 4 LTACHs with high endemic KPC prevalence. The study was conducted between 1 February 2010 and 30 June 2013; 3894 patients were enrolled during the preintervention period (lasting from 16 to 29 months), and 2951 patients were enrolled during the intervention period (lasting from 12 to 19 months). KPC colonization prevalence was stable during preintervention (average, 45.8%; 95% confidence interval [CI], 42.1%-49.5%), declined early during intervention, then reached a plateau (34.3%; 95% CI, 32.4%-36.2%; Pinfection, all-cause bacteremia, and blood culture contamination in a high-risk LTACH population. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. Clonality and Resistome analysis of KPC-producing Klebsiella pneumoniae strain isolated in Korea using whole genome sequencing.

    Science.gov (United States)

    Lee, Yangsoon; Kim, Bong-Soo; Chun, Jongsik; Yong, Ji Hyun; Lee, Yeong Seon; Yoo, Jung Sik; Yong, Dongeun; Hong, Seong Geun; D'Souza, Roshan; Thomson, Kenneth S; Lee, Kyungwon; Chong, Yunsop

    2014-01-01

    We analyzed the whole genome sequence and resistome of the outbreak Klebsiella pneumoniae strain MP14 and compared it with those of K. pneumoniae carbapenemase- (KPC-) producing isolates that showed high similarity in the NCBI genome database. A KPC-2-producing multidrug-resistant (MDR) K. pneumoniae clinical isolate was obtained from a patient admitted to a Korean hospital in 2011. The strain MP14 was resistant to all tested β-lactams including monobactam, amikacin, levofloxacin, and cotrimoxazole, but susceptible to tigecycline and colistin. Resistome analysis showed the presence of β-lactamase genes including bla KPC-2, bla SHV-11, bla TEM-169, and bla OXA-9. MP14 also possessed aac(6'-)Ib, aadA2, and aph(3'-)Ia as aminoglycoside resistance-encoding genes, mph(A) for macrolides, oqxA and oqxB for quinolone, catA1 for phenicol, sul1 for sulfonamide, and dfrA12 for trimethoprim. Both SNP tree and cgMLST analysis showed the close relatedness with the KPC producers (KPNIH strains) isolated from an outbreak in the USA and colistin-resistant strains isolated in Italy. The plasmid-scaffold genes in plasmids pKpQil, pKpQil-IT, pKPN3, or pKPN-IT were identified in MP14, KPNIH, and Italian strains. The KPC-2-producing MDR K. pneumoniae ST258 stain isolated in Korea was highly clonally related with MDR K. pneumoniae strains from the USA and Italy. Global spread of KPC-producing K. pneumoniae is a worrying phenomenon.

  6. Clonality and Resistome Analysis of KPC-Producing Klebsiella pneumoniae Strain Isolated in Korea Using Whole Genome Sequencing

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    Yangsoon Lee

    2014-01-01

    Full Text Available We analyzed the whole genome sequence and resistome of the outbreak Klebsiella pneumoniae strain MP14 and compared it with those of K. pneumoniae carbapenemase- (KPC- producing isolates that showed high similarity in the NCBI genome database. A KPC-2-producing multidrug-resistant (MDR K. pneumoniae clinical isolate was obtained from a patient admitted to a Korean hospital in 2011. The strain MP14 was resistant to all tested β-lactams including monobactam, amikacin, levofloxacin, and cotrimoxazole, but susceptible to tigecycline and colistin. Resistome analysis showed the presence of β-lactamase genes including blaKPC-2, blaSHV-11, blaTEM-169, and blaOXA-9. MP14 also possessed aac(6′-Ib, aadA2, and aph(3′-Ia as aminoglycoside resistance-encoding genes, mph(A for macrolides, oqxA and oqxB for quinolone, catA1 for phenicol, sul1 for sulfonamide, and dfrA12 for trimethoprim. Both SNP tree and cgMLST analysis showed the close relatedness with the KPC producers (KPNIH strains isolated from an outbreak in the USA and colistin-resistant strains isolated in Italy. The plasmid-scaffold genes in plasmids pKpQil, pKpQil-IT, pKPN3, or pKPN-IT were identified in MP14, KPNIH, and Italian strains. The KPC-2-producing MDR K. pneumoniae ST258 stain isolated in Korea was highly clonally related with MDR K. pneumoniae strains from the USA and Italy. Global spread of KPC-producing K. pneumoniae is a worrying phenomenon.

  7. Abundance of carbapenemase genes (blaKPC, blaNDM and blaOXA-48) in wastewater effluents from Tunisian hospitals.

    Science.gov (United States)

    Nasri, Emna; Subirats, Jessica; Sànchez-Melsió, Alexandre; Mansour, Hedi Ben; Borrego, Carles M; Balcázar, José Luis

    2017-10-01

    Carbapenems are β-lactam antibiotics with a broad spectrum of activity and are usually considered the last resort for the treatment of severe infections caused by multidrug-resistant pathogens. The clinically most significant carbapenemases are KPC, NDM, and OXA-48-like enzymes, whose genes have been increasingly reported worldwide in members of the family Enterobacteriaceae. In this study, we quantified the abundance of these genes in wastewater effluents from different Tunisian hospitals. The bla NDM and bla OXA-48 -like genes were detected at similar concentrations in all hospital wastewater effluents. In contrast, the bla KPC gene was detected at lower concentration than other genes and it was only detected in three of the seven effluents analyzed. To the best of our knowledge, this study quantified for the first time the abundance of bla KPC , bla NDM , and bla OXA-48 -like genes in wastewater effluents from Tunisian hospitals, highlighting the widespread distribution of these carbapenemase genes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Comprehensive Genome Analysis of Carbapenemase-Producing Enterobacter spp.: New Insights into Phylogeny, Population Structure, and Resistance Mechanisms.

    Science.gov (United States)

    Chavda, Kalyan D; Chen, Liang; Fouts, Derrick E; Sutton, Granger; Brinkac, Lauren; Jenkins, Stephen G; Bonomo, Robert A; Adams, Mark D; Kreiswirth, Barry N

    2016-12-13

    Knowledge regarding the genomic structure of Enterobacter spp., the second most prevalent carbapenemase-producing Enterobacteriaceae, remains limited. Here we sequenced 97 clinical Enterobacter species isolates that were both carbapenem susceptible and resistant from various geographic regions to decipher the molecular origins of carbapenem resistance and to understand the changing phylogeny of these emerging and drug-resistant pathogens. Of the carbapenem-resistant isolates, 30 possessed bla KPC-2 , 40 had bla KPC-3 , 2 had bla KPC-4 , and 2 had bla NDM-1 Twenty-three isolates were carbapenem susceptible. Six genomes were sequenced to completion, and their sizes ranged from 4.6 to 5.1 Mbp. Phylogenomic analysis placed 96 of these genomes, 351 additional Enterobacter genomes downloaded from NCBI GenBank, and six newly sequenced type strains into 19 phylogenomic groups-18 groups (A to R) in the Enterobacter cloacae complex and Enterobacter aerogenes Diverse mechanisms underlying the molecular evolutionary trajectory of these drug-resistant Enterobacter spp. were revealed, including the acquisition of an antibiotic resistance plasmid, followed by clonal spread, horizontal transfer of bla KPC -harboring plasmids between different phylogenomic groups, and repeated transposition of the bla KPC gene among different plasmid backbones. Group A, which comprises multilocus sequence type 171 (ST171), was the most commonly identified (23% of isolates). Genomic analysis showed that ST171 isolates evolved from a common ancestor and formed two different major clusters; each acquiring unique bla KPC -harboring plasmids, followed by clonal expansion. The data presented here represent the first comprehensive study of phylogenomic interrogation and the relationship between antibiotic resistance and plasmid discrimination among carbapenem-resistant Enterobacter spp., demonstrating the genetic diversity and complexity of the molecular mechanisms driving antibiotic resistance in this

  9. Emergence of serine carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States Medical Centers: report from the MYSTIC Program (1999-2005).

    Science.gov (United States)

    Deshpande, Lalitagauri M; Rhomberg, Paul R; Sader, Helio S; Jones, Ronald N

    2006-12-01

    Among 8885 Enterobacteriaceae tested in the 1999 to 2005 period as part of the USA Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, 51 strains with increased imipenem and meropenem MIC values (> or =2 microg/mL) were detected. bla(KPC) was identified from 28 Klebsiella pneumoniae from 3 medical centers in the New York City area (8 ribotypes), 2 Klebsiella oxytoca from Arkansas (same ribotype), 7 Citrobacter freundii (6 from New York [5 ribotypes] and 1 from Delaware), 4 Enterobacter spp. from New York (2 species, different ribotypes), 3 Escherichia coli (2 from New York and 1 from Ohio, same ribotype), and 1 Serratia marcescens (New York). Sequencing confirmed KPC-2 or -3 in all of the strains. S. marcescens strains harboring SME-1 (2 isolates, same ribotype) and SME-2 (1 isolate) were identified from medical centers in Illinois and Washington state, respectively. Our results indicate that bla(KPC-2/3) has emerged widely (New York City area, Arkansas, Delaware, and Ohio) among Enterobacteriaceae isolated in the MYSTIC Program participant sites (2000-2005) and continues to be isolated from multiple species, as a result of clonal expansion and horizontal gene transfer. The escalating occurrence (0.35%) of serine carbapenemases could compromise the role of carbapenems and other beta-lactams in USA clinical practice although observed in only a few locations to date.

  10. Association between the Presence of Aminoglycoside-Modifying Enzymes and In Vitro Activity of Gentamicin, Tobramycin, Amikacin, and Plazomicin against Klebsiella pneumoniae Carbapenemase- and Extended-Spectrum-β-Lactamase-Producing Enterobacter Species.

    Science.gov (United States)

    Haidar, Ghady; Alkroud, Ammar; Cheng, Shaoji; Churilla, Travis M; Churilla, Bryce M; Shields, Ryan K; Doi, Yohei; Clancy, Cornelius J; Nguyen, M Hong

    2016-09-01

    We compared the in vitro activities of gentamicin (GEN), tobramycin (TOB), amikacin (AMK), and plazomicin (PLZ) against 13 Enterobacter isolates possessing both Klebsiella pneumoniae carbapenemase and extended-spectrum β-lactamase (KPC+/ESBL+) with activity against 8 KPC+/ESBL-, 6 KPC-/ESBL+, and 38 KPC-/ESBL- isolates. The rates of resistance to GEN and TOB were higher for KPC+/ESBL+ (100% for both) than for KPC+/ESBL- (25% and 38%, respectively), KPC-/ESBL+ (50% and 17%, respectively), and KPC-/ESBL- (0% and 3%, respectively) isolates. KPC+/ESBL+ isolates were more likely than others to possess an aminoglycoside-modifying enzyme (AME) (100% versus 38%, 67%, and 5%; P = 0.007, 0.06, and 1 AME than with ≤1 AME. The presence of at least 2/3 of KPC, SHV, and TEM predicted the presence of AMEs. PLZ MICs against all isolates were ≤4 μg/ml, regardless of KPC/ESBL pattern or the presence of AMEs. In conclusion, GEN and TOB are limited as treatment options against KPC+ and ESBL+ Enterobacter PLZ may represent a valuable addition to the antimicrobial armamentarium. A full understanding of AMEs and other aminoglycoside resistance mechanisms will allow clinicians to incorporate PLZ rationally into treatment regimens. The development of molecular assays that accurately and rapidly predict antimicrobial responses among KPC- and ESBL-producing Enterobacter spp. should be a top research priority. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  11. Evaluation of the BYG Carba Test, a New Electrochemical Assay for Rapid Laboratory Detection of Carbapenemase-Producing Enterobacteriaceae

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    Yunus, Sami; Massart, Marion; Huang, Te-Din; Glupczynski, Youri

    2015-01-01

    Accurate detection of carbapenemase-producing Enterobacteriaceae (CPE) constitutes a major laboratory diagnostic challenge. We evaluated an electrochemical technique (the BYG Carba test) which allows detection of CPE in less than 35 min. The BYG Carba test was first validated in triplicate against 57 collection isolates with previously characterized β-lactam resistance mechanisms (OXA-48, n = 12; KPC, n = 8; NDM, n = 8; VIM, n = 8; IMP, n = 3; GIM, n = 1; GES-6, n = 1; no carbapenemase, n = 16) and against a panel of 10 isolates obtained from the United Kingdom National External Quality Assessment Service (NEQAS). The test was then evaluated prospectively against 324 isolates referred to the national reference center for suspicion of CPE. The BYG Carba test results were compared with those obtained with the Carba NP test using multiplex PCR sequencing as the gold standard. Of the 57 collection and the 10 NEQAS isolates, all but one GES-6-producing isolate were correctly identified by the Carba BYG test. Among the 324 consecutive Enterobacteriaceae isolates tested prospectively, 146 were confirmed as noncarbapenemase producers by PCR while 178 harbored a carbapenemase gene (OXA-48, n = 117; KPC, n = 25; NDM, n = 23; and VIM, n = 13). Prospectively, in comparison with PCR results, the BYG Carba test displayed 95% sensitivity and 100% specificity versus 89% and 100%, respectively, for the Carba NP test. The BYG Carba test is a novel, rapid, and efficient assay based on an electro-active polymer biosensing technology discriminating between CPE and non-CPE. The precise electrochemical signal (electrochemical impedance variations) allows the establishment of real-time objective measurement and interpretation criteria which should facilitate the accreditation process of this technology. PMID:26637378

  12. Medicinal Plants Used by a Mbyá-Guarani Tribe Against Infections: Activity on KPC-Producing Isolates and Biofilm-Forming Bacteria.

    Science.gov (United States)

    Brandelli, Clara Lia Costa; Ribeiro, Vanessa Bley; Zimmer, Karine Rigon; Barth, Afonso Luís; Tasca, Tiana; Macedo, Alexandre José

    2015-11-01

    The traditional use of medicinal plants for treatment of infectious diseases by an indigenous Mbyá-Guarani tribe from South Brazil was assessed by evaluating the antibiotic and antibiofilm activities against relevant bacterial pathogens. Aqueous extracts from 10 medicinal plants were prepared according to indigenous Mbyá-Guarani traditional uses. To evaluate antibiotic (OD600) and antibiofilm (crystal violet method) activities, Pseudomonas aeruginosa ATCC 27853, Staphylococcus epidermidis ATCC 35984 and seven multi-drug resistant Klebsiella pneumoniae carbapenemase (KPC)-producing bacterial clinical isolates were challenged with the extracts. Furthermore, the susceptibility profile of KPC-producing bacteria and the ability of these isolates to form biofilm were evaluated. The plants Campomanesia xanthocarpa, Maytenus ilicifolia, Bidens pilosa and Verbena sp. showed the best activity against bacterial growth and biofilm formation. The majority of KPC-producing isolates, which showed strong ability to form biofilm and a multidrug resistance profile, was inhibited by more than 50% by some extracts. The Enterobacter cloacae (KPC 05) clinical isolate was the only one resistant to all extracts. This study confirms the importance of indigenous traditional medicinal knowledge and describes for the first time the ability of these plants to inhibit biofilm formation and/or bacterial growth of multi-drug resistant KPC-producing isolates.

  13. Natural Variants of the KPC-2 Carbapenemase have Evolved Increased Catalytic Efficiency for Ceftazidime Hydrolysis at the Cost of Enzyme Stability.

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    Shrenik C Mehta

    2015-06-01

    Full Text Available The spread of β-lactamases that hydrolyze penicillins, cephalosporins and carbapenems among Gram-negative bacteria has limited options for treating bacterial infections. Initially, Klebsiella pneumoniae carbapenemase-2 (KPC-2 emerged as a widespread carbapenem hydrolyzing β-lactamase that also hydrolyzes penicillins and cephalosporins but not cephamycins and ceftazidime. In recent years, single and double amino acid substitution variants of KPC-2 have emerged among clinical isolates that show increased resistance to ceftazidime. Because it confers multi-drug resistance, KPC β-lactamase is a threat to public health. In this study, the evolution of KPC-2 function was determined in nine clinically isolated variants by examining the effects of the substitutions on enzyme kinetic parameters, protein stability and antibiotic resistance profile. The results indicate that the amino acid substitutions associated with KPC-2 natural variants lead to increased catalytic efficiency for ceftazidime hydrolysis and a consequent increase in ceftazidime resistance. Single substitutions lead to modest increases in catalytic activity while the double mutants exhibit significantly increased ceftazidime hydrolysis and resistance levels. The P104R, V240G and H274Y substitutions in single and double mutant combinations lead to the largest increases in ceftazidime hydrolysis and resistance. Molecular modeling suggests that the P104R and H274Y mutations could facilitate ceftazidime hydrolysis through increased hydrogen bonding interactions with the substrate while the V240G substitution may enhance backbone flexibility so that larger substrates might be accommodated in the active site. Additionally, we observed a strong correlation between gain of catalytic function for ceftazidime hydrolysis and loss of enzyme stability, which is in agreement with the 'stability-function tradeoff' phenomenon. The high Tm of KPC-2 (66.5°C provides an evolutionary advantage as

  14. Dominance of IMP-4-Producing Enterobacter cloacae among Carbapenemase-Producing Enterobacteriaceae in Australia

    Science.gov (United States)

    Townell, Nicola; Nimmo, Graeme R.; George, Narelle M.; Robson, Jennifer; Vohra, Renu; Davis, Louise; Heney, Claire; Paterson, David L.

    2015-01-01

    The prevalence of carbapenemase-producing Enterobacteriaceae (CPE) has been increasing worldwide. blaIMP has been reported to be the predominant carbapenemase-encoding gene within Enterobacteriaceae in Australia. However, there are limited data currently available on CPE from Queensland, Australia. A total of 58 CPE isolates were isolated between July 2009 and March 2014 from Queensland hospitals. The clonality of isolates was determined by Diversilab repetitive sequence-based PCR. The isolates were investigated for the resistance mechanisms carbapenemase, extended-spectrum β-lactamase, and AmpC β-lactamase and for aminoglycoside resistance and plasmid-mediated quinolone resistance genes by PCR. The plasmid types associated with carbapenemase-encoding genes were characterized. The majority of the CPE were Enterobacter cloacae (n = 29). The majority of Queensland CPE isolates were IMP producers and comprised 11 species (n = 48). Nine NDM-producing Enterobacteriaceae were identified. One NDM-producing Klebsiella pneumoniae isolate coproduced OXA-48. One K. pneumoniae isolate was an OXA-181 producer. The incidence of IMP producers increased significantly in 2013. blaIMP-4 was found in all IMP-producing isolates. blaTEM, qnrB, and aacA4 were common among IMP-4 producers. The HI2 (67%) and L/M (21%) replicons were associated with blaIMP-4. All HI2 plasmids were of sequence type 1 (ST1). All but one of the NDM producers possessed blaCTX-M-15. The 16S rRNA methylase genes found among NDM producers were armA, rmtB, rmtC, and rmtF. The substantial increase in the prevalence of CPE in Queensland has been associated mainly with the emergence E. cloacae strains possessing HI2 plasmids carrying blaIMP-4 over the past 2 years. The importation of NDM producers and/or OXA-48-like producers in patients also contributed to the increased emergence of CPE. PMID:25918153

  15. Persistence of Klebsiella pneumoniae ST258 as the predominant clone of carbapenemase-producing Enterobacteriaceae in post-acute-care hospitals in Israel, 2008-13.

    Science.gov (United States)

    Adler, Amos; Hussein, Omar; Ben-David, Debby; Masarwa, Samira; Navon-Venezia, Shiri; Schwaber, Mitchell J; Carmeli, Yehuda

    2015-01-01

    To study the molecular characteristics of carbapenemase-producing Enterobacteriaceae (CPE) in post-acute-care hospitals (PACHs) in Israel and to analyse the temporal changes between 2008 and 2013. CPE isolates were obtained during two cross-sectional, point prevalence national surveys of PACHs in Israel performed in 2008 and 2013. Surveillance cultures were collected by streaking rectal swabs onto selective media. Isolates were identified to species level and tested for blaKPC, blaNDM and blaOXA-48 by PCR and by the Carba NP test. Molecular typing was done by PCR for the pilv-l gene, designed for the ST258 KPC-producing Klebsiella pneumoniae (KPC-KP) clone, BOX-PCR and MLST. The prevalence of CPE carriage in the first survey was 184/1147 (16%); all of the isolates were KPC-KP. The prevalence of CPE carriage in the second survey was 127/1287 (9.9%); of these isolates, 113 (89%) were KPC-KP, 9 (7%) were other KPC-producing species and 5 (4%) were NDM- and OXA-48-producing CPE (n = 1 and 4, respectively). The proportion of the KPC-KP population represented by the ST258 clone increased from 120/184 (65%) in 2008 to 91/113 (80%) in 2013. In 58% (71/122) of the KPC-CPE carriers identified in the 2013 survey, the source of acquisition was determined to be the PACH itself. All four OXA-48 CPE were acquired either directly or indirectly from patients arriving from the Palestinian Authority or Syria. Despite the decreased prevalence of CPE in Israeli PACHs, and the emergence of new types of CPE, the KPC-KP ST258 clone remains the predominant clone represented. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. The spread of carbapenemase-producing bacteria in Africa: a systematic review.

    Science.gov (United States)

    Manenzhe, Rendani I; Zar, Heather J; Nicol, Mark P; Kaba, Mamadou

    2015-01-01

    Carbapenems are the last line of defence against ever more prevalent MDR Gram-negative bacteria, but their efficacy is threatened worldwide by bacteria that produce carbapenemase enzymes. The epidemiology of bacteria producing carbapenemases has been described in considerable detail in Europe, North America and Asia; however, little is known about their spread and clinical relevance in Africa. We systematically searched in PubMed, EBSCOhost, Web of Science, Scopus, Elsevier Masson Consulte and African Journals Online, international conference proceedings, published theses and dissertations for studies reporting on carbapenemase-producing bacteria in Africa. We included articles published in English or French up to 28 February 2014. We calculated the prevalence of carbapenemase producers only including studies where the total number of isolates tested was at least 30. Eighty-three studies were included and analysed. Most studies were conducted in North Africa (74%, 61/83), followed by Southern Africa (12%, 10/83), especially South Africa (90%, 9/10), West Africa (8%, 7/83) and East Africa (6%, 6/83). Carbapenemase-producing bacteria were isolated from humans, the hospital environment and community environmental water samples, but not from animals. The prevalence of carbapenemase-producing isolates in hospital settings ranged from 2.3% to 67.7% in North Africa and from 9% to 60% in sub-Saharan Africa. Carbapenemase-producing bacteria have been described in many African countries; however, their prevalence is poorly defined and has not been systematically studied. Antibiotic stewardship and surveillance systems, including molecular detection and genotyping of resistant isolates, should be implemented to monitor and reduce the spread of carbapenemase-producing bacteria. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. Chronological emergence of a class a carbapenemase-producing Enterobacter aerogenes in Taiwan

    Directory of Open Access Journals (Sweden)

    Zheng-Yi Huang

    2014-01-01

    Full Text Available This study reports the case of a 77-year-old, long-term, bedridden patient, with a nosocomial wound infection caused by a multidrug-resistant strain of Enterobacter aerogenes (E. aerogense. The isolate produced an Ambler-class A carbapenemase, which was demonstrated by the Modified Hodge test (MHT and a confirmatory inhibition test. However, no known carbapenemase genes were discovered in this isolate by polymerase chain reactions (PCRs with specific primers. New carbapenemase or other resistant mechanisms could be explored from the isolate of carbapenem-resistant E. aerogense, according to the revised criteria (CLSI, 2012.

  18. An Irish outbreak of New Delhi metallo-β-lactamase (NDM)-1 carbapenemase-producing Enterobacteriaceae: increasing but unrecognized prevalence.

    Science.gov (United States)

    O'Connor, C; Cormican, M; Boo, T W; McGrath, E; Slevin, B; O'Gorman, A; Commane, M; Mahony, S; O'Donovan, E; Powell, J; Monahan, R; Finnegan, C; Kiernan, M G; Coffey, J C; Power, L; O'Connell, N H; Dunne, C P

    2016-12-01

    Carbapenemase-producing Enterobacteriaceae (CPE) may cause healthcare-associated infections with high mortality rates. New Delhi metallo-β-lactamase-1 (NDM-1) is among the most recently discovered carbapenemases. To report the first outbreak of NDM-1 CPE in Ireland, including microbiological and epidemiological characteristics, and assessing the impact of infection prevention and control measures. This was a retrospective microbiological and epidemiological review. Cases were defined as patients with a CPE-positive culture. Contacts were designated as roommates or ward mates. This outbreak involved 10 patients with a median age of 71 years (range: 45-90), located in three separate but affiliated healthcare facilities. One patient was infected (the index case); the nine others were colonized. Nine NDM-1-producing Klebsiella pneumoniae, an NDM-1-producing Escherichia coli and a K. pneumoniae carbapenemase (KPC)-producing Enterobacter cloacae were detected between week 24, 2014 and week 37, 2014. Pulsed-field gel electrophoresis demonstrated similarity. NDM-1-positive isolates were meropenem resistant with minimum inhibitory concentrations (MICs) ranging from 12 to 32 μg/mL. All were tigecycline susceptible (MICs ≤1 μg/mL). One isolate was colistin resistant (MIC 4.0 μg/mL; mcr-1 gene not detected). In 2015, four further NDM-1 isolates were detected. The successful management of this outbreak was achieved via the prompt implementation of enhanced infection prevention and control practices to prevent transmission. These patients did not have a history of travel outside of Ireland, but several had frequent hospitalizations in Ireland, raising concerns regarding the possibility of increasing but unrecognized prevalence of NDM-1 and potential decline in value of travel history as a marker of colonization risk. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  19. Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain.

    Science.gov (United States)

    Palacios-Baena, Zaira R; Oteo, Jesús; Conejo, Carmen; Larrosa, M Nieves; Bou, Germán; Fernández-Martínez, Marta; González-López, Juan José; Pintado, Vicente; Martínez-Martínez, Luis; Merino, María; Pomar, Virginia; Mora-Rillo, Marta; Rivera, María Alba; Oliver, Antonio; Ruiz-Carrascoso, Guillermo; Ruiz-Garbajosa, Patricia; Zamorano, Laura; Bautista, Verónica; Ortega, Adriana; Morales, Isabel; Pascual, Álvaro; Campos, José; Rodríguez-Baño, Jesús

    2016-02-01

    Most available information on carbapenemase-producing Enterobacteriaceae (CPE) is usually associated with specific types of infection or patient or with descriptions of outbreaks. The aim of this study was to comprehensively analyse the clinical epidemiology, clinical features and outcomes of colonisation and infections due to CPE in Spain. A multicentre prospective cohort study was carried out in 34 Spanish hospitals from February to May 2013. All new patients testing positive for CPE in clinical samples were included. Logistic regression was used to identify predictors of mortality. Overall, 245 cases were included. The most frequent organism was Klebsiella pneumoniae (74%) and the carbapenemases belonged to the OXA-48 (74%), metallo-β-lactamase (MBL) (24%) and KPC (2%) groups. Acquisition was nosocomial in 145 cases (60%) and healthcare-associated (HCA) in 91 (37%); 42% of the latter were nursing home residents, in whom OXA-48-producing K. pneumoniae ST405 predominated. MBLs and OXA-48 predominated in ICU and medical patients, respectively. Overall, 67% of patients had infections. The most frequent infections identified in this study were urinary tract (43%) and skin structure (21%) infections, and 10% of infections were bacteraemic. Crude mortality was 20%. Inappropriate antibiotic therapy was independently associated with an increased risk of death (OR = 3.30; 95% CI: 1.34-8.11). We found some differences in the epidemiology of CPE depending on the type of carbapenemase produced. Although a low proportion of CPE infections were bacteraemic, active antibiotic therapy was a protective factor for reducing mortality. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  20. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE) : a prospective, multinational study

    NARCIS (Netherlands)

    Grundmann, Hajo; Glasner, Corinna; Albiger, Barbara; Aanensen, David M.; Tomlinson, Chris T.; Andrasevic, Arjana Tambic; Canton, Rafael; Carmeli, Yehuda; Friedrich, Alexander W.; Giske, Christian G.; Glupczynski, Youri; Gniadkowski, Marek; Livermore, David M.; Nordmann, Patrice; Poirel, Laurent; Rossolini, Gian M.; Seifert, Harald; Vatopoulos, Alkiviadis; Walsh, Timothy; Woodford, Neil; Monnet, Dominique L.

    Background Gaps in the diagnostic capacity and heterogeneity of national surveillance and reporting standards in Europe make it difficult to contain carbapenemase-producing Enterobacteriaceae. We report the development of a consistent sampling framework and the results of the first structured survey

  1. First isolate of KPC-2-producing Klebsiella pneumonaie sequence type 23 from the Americas.

    Science.gov (United States)

    Cejas, Daniela; Fernández Canigia, Liliana; Rincón Cruz, Giovanna; Elena, Alan X; Maldonado, Ivana; Gutkind, Gabriel O; Radice, Marcela A

    2014-09-01

    KPC-2-producing Klebsiella pneumoniae isolates mainly correspond to clonal complex 258 (CC258); however, we describe KPC-2-producing K. pneumoniae isolates belonging to invasive sequence type 23 (ST23). KPC-2 has scarcely been reported to occur in ST23, and this report describes the first isolation of this pathogen in the Americas. Acquisition of resistant markers in virulent clones could mark an evolutionary step toward the establishment of these clones as major nosocomial pathogens. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  2. Understanding staff perceptions about Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae control efforts in Chicago long-term acute care hospitals.

    Science.gov (United States)

    Lyles, Rosie D; Moore, Nicholas M; Weiner, Shayna B; Sikka, Monica; Lin, Michael Y; Weinstein, Robert A; Hayden, Mary K; Sinkowitz-Cochran, Ronda L

    2014-04-01

    To identify differences in organizational culture and better understand motivators to implementation of a bundle intervention to control Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae (KPC). Mixed-methods study. Four long-term acute care hospitals (LTACHs) in Chicago. LTACH staff across 3 strata of employees (administration, midlevel management, and frontline clinical workers). Qualitative interviews or focus groups and completion of a quantitative questionnaire. Eighty employees (frontline, 72.5%; midlevel, 17.5%; administration, 10%) completed surveys and participated in qualitative discussions in August 2012. Although 82.3% of respondents felt that quality improvement was a priority at their LTACH, there were statistically significant differences in organizational culture between staff strata, with administrative-level having higher organizational culture scores (ie, more favorable responses) than midlevel or frontline staff. When asked to rank the success of the KPC control program, mean response was 8.0 (95% confidence interval, 7.6-8.5), indicating a high level of agreement with the perception that the program was a success. Patient safety and personal safety were reported most often as personal motivators for intervention adherence. The most convergent theme related to prevention across groups was that proper hand hygiene is vital to prevention of KPC transmission. Despite differences in organizational culture across 3 strata of LTACH employees, the high degree of convergence in motivation, understanding, and beliefs related to implementation of a KPC control bundle suggests that all levels of staff may be able to align perspectives when faced with a key infection control problem and quality improvement initiative.

  3. Microbiological Features of KPC-Producing Enterobacter Isolates Identified in a U.S. Hospital System

    Science.gov (United States)

    Ahn, Chulsoo; Syed, Alveena; Hu, Fupin; O’Hara, Jessica A.; Rivera, Jesabel I.; Doi, Yohei

    2014-01-01

    Microbiological data regarding KPC-producing Enterobacter spp. are scarce. In this study, 11 unique KPC-producing Enterobacter isolates were identified among 44 ertapenem-non-susceptible Enterobacter isolates collected between 2009 and 2013 at a hospital system in Western Pennsylvania. All cases were healthcare-associated and occurred in medically complex patients. While pulsed-field gel electrophoresis (PFGE) showed diverse restriction patterns overall, multilocus sequence typing (MLST) identified Enterobacter cloacae isolates with sequence types (STs) 93 and 171 from two hospitals each. The levels of carbapenem minimum inhibitory concentrations were highly variable. All isolates remained susceptible to colistin, tigecycline, and the majority to amikacin and doxycycline. A blaKPC-carrying IncN plasmid conferring trimethoprim-sulfamethoxazole resistance was identified in three of the isolates. Spread of blaKPC in Enterobacter spp. appears to be due to a combination of plasmid-mediated and clonal processes. PMID:25053203

  4. KPC-PRODUCING Serratia marcescens IN A HOME-CARE PATIENT FROM RECIFE, BRAZIL.

    Science.gov (United States)

    Margate, Emmily; Magalhães, Vera; Fehlberg, Lorena Cristina Corrêa; Gales, Ana Cristina; Lopes, Ana Catarina Souza

    2015-01-01

    In this brief communication we describe the occurrence of a KPC-producing Serratia marcescens isolate in a home-care patient from Recife, Brazil. The blaKPC, blaSPM, blaIMP, blaVIM, blaOXA, blaCTX-M, blaSHV, blaTEM and blaGES genes were investigated by Polymerase Chain Reaction (PCR) and DNA sequencing. The isolate was positive for blaKPC-2 and blaTEM-1 and was resistant to aztreonam, cefepime, cefotaxime, imipenem, meropenem, gentamicin, ciprofloxacin and cefazidime, and susceptible only to amikacin, tigecycline and gatifloxacin. This is the first report in Brazil of KPC-producing S. marcescens clinical isolate outside of a hospital environment. Caregivers should be alert for the presence of this isolate in the community setting.

  5. Antibiotics Resistance - Carbapenemase-producing germs in livestock populations

    OpenAIRE

    German Federal Institute for Risk Assessment

    2014-01-01

    Carbapenems are antibiotics authorised for the treatment of humans and which were categorised by the World Health Organization as critically important antimicrobials for the treatment of humans. Reserve antibiotics of this kind are only supposed to be used when standard antibiotics no longer show any effects, i.e. for only stricted indications. A mechanism that leads to a resistance of bacteria to carbapenems is the formation of certain enzymes called carbapenemases. What then happens is that...

  6. An outbreak of colistin-resistant Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae in the Netherlands (July to December 2013), with inter-institutional spread.

    Science.gov (United States)

    Weterings, V; Zhou, K; Rossen, J W; van Stenis, D; Thewessen, E; Kluytmans, J; Veenemans, J

    2015-08-01

    We describe an outbreak of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-KP) ST258 that occurred in two institutions (a hospital and a nursing home) in the Netherlands between July and December 2013. In total, six patients were found to be positive for KPC-KP. All isolates were resistant to colistin and exhibited reduced susceptibility to gentamicin and tigecycline. In all settings, extensive environmental contamination was found. Whole genome sequencing revealed the presence of bla KPC-2 and bla SHV-12 genes, as well as the close relatedness of patient and environmental isolates. In the hospital setting, one transmission was detected, despite contact precautions. After upgrading to strict isolation, no further spread was found. After the transfer of the index patient to a nursing home in the same region, four further transmissions occurred. The outbreak in the nursing home was controlled by transferring all KPC-KP-positive residents to a separate location outside the nursing home, where a dedicated nursing team cared for patients. This outbreak illustrates that the spread of pan-resistant Enterobacteriaceae can be controlled, but may be difficult, particularly in long-term care facilities. It, therefore, poses a major threat to patient safety. Clear guidelines to control reservoirs in and outside the hospitals are urgently needed.

  7. ESBL- and Carbapenemase-Producing Enterobacteriaceae in Patients with Bacteremia, Yangon, Myanmar, 2014.

    Science.gov (United States)

    Myat, Tin O; Hannaway, Rachel F; Zin, Khwar N; Htike, Wah W; Win, Kyu K; Crump, John A; Murdoch, David R; Ussher, James E

    2017-05-01

    Among 42 gram-negative bloodstream isolates from inpatients in 3 hospitals in Yangon, Myanmar, admitted during July-December 2014, 16 (38%) were extended-spectrum β-lactamase-producing Enterobacteriaceae and 6 (14%) produced carbapenemase. The high prevalence of multidrug-resistant gram-negative bacteria raises concerns about the empiric treatment of patients with sepsis in Yangon.

  8. Pharmacodynamics of colistin and fosfomycin: a 'treasure trove' combination combats KPC-producing Klebsiella pneumoniae.

    Science.gov (United States)

    Zhao, Miao; Bulman, Zackery P; Lenhard, Justin R; Satlin, Michael J; Kreiswirth, Barry N; Walsh, Thomas J; Marrocco, Amanda; Bergen, Phillip J; Nation, Roger L; Li, Jian; Zhang, Jing; Tsuji, Brian T

    2017-07-01

    KPC-producing Klebsiella pneumoniae are an emerging public health problem around the globe. We defined the combinatorial pharmacodynamics and ability to suppress resistance of two 'old' antibiotics, fosfomycin and colistin, in time-kill experiments and hollow-fibre infection models (HFIM). Two KPC-2-producing K. pneumoniae isolates were used: one susceptible to both colistin and fosfomycin (KPC 9A: MIC colistin 0.25 mg/L and MIC fosfomycin ≤8 mg/L) and the other resistant to colistin and susceptible to fosfomycin (KPC 5A: MIC colistin 64 mg/L and MIC fosfomycin 32 mg/L). Time-kill experiments assessed an array of colistin and fosfomycin concentrations against both isolates. Colistin and fosfomycin pharmacokinetics from critically ill patients were simulated in the HFIM to define the pharmacodynamic activity of humanized regimens over 5 days against KPC 9A. In time-kill experiments, synergy was demonstrated for all colistin/fosfomycin combinations containing >8 mg/L fosfomycin against the double-susceptible KPC strain, 9A. Synergy versus KPC strain 5A was only achieved at the highest concentrations of colistin (4 mg/L) and fosfomycin (512 mg/L) at 48 h. In the HFIM, colistin or fosfomycin monotherapies resulted in rapid proliferation of resistant subpopulations; KPC 9A regrew by 24 h. In contrast to the monotherapies, the colistin/fosfomycin combination resulted in a rapid 6.15 log 10  cfu/mL reduction of KPC 9A by 6 h and complete suppression of resistant subpopulations until 120 h. Colistin and fosfomycin may represent an important treatment option for KPC-producing K. pneumoniae otherwise resistant to traditional antibiotics. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Clinical laboratory detection of carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.

    Science.gov (United States)

    Miller, Shelley; Humphries, Romney M

    2016-08-01

    Carbapenemases, enzymes that hydrolyze carbapenem-class antimicrobials, pose serious clinical and diagnostic challenges, including their recent rapid spread among members of the Enterobacteriaceae, a family with no inherent carbapenem resistance. Currently there is no one-size-fits-all method for detecting carbapenem-resistant Enterobacteriaceae (CRE) in the laboratory, nor how to differentiate carbapenemase-producers (CP) from isolates that are carbapenem-resistant via other or combined mechanisms. This article reviews definitions for CRE and CP-CRE, and discusses current phenotypic and molecular methods available to the clinical laboratory for the detection of both CP and non-CP CRE. Expert commentary: Routine evaluation of carbapenem resistance mechanism by the routine clinical laboratory are not necessary for patient care, as clinical breakpoints best predict response. However, evaluation for carbapenemase is integral to infection control efforts, and laboratories should have the capacity to do such testing, either in house or by submitting isolates to a reference laboratory.

  10. Clonality, outer-membrane proteins profile and efflux pump in KPC- producing Enterobacter sp. in Brazil.

    Science.gov (United States)

    Rosa, Juliana Ferraz; Rizek, Camila; Marchi, Ana Paula; Guimaraes, Thais; Miranda, Lourdes; Carrilho, Claudia; Levin, Anna S; Costa, Silvia F

    2017-03-17

    Carbapenems resistance in Enterobacter spp. has increased in the last decade, few studies, however, described the mechanisms of resistance in this bacterium. This study evaluated clonality and mechanisms of carbapenems resistance in clinical isolates of Enterobacter spp. identified in three hospitals in Brazil (Hospital A, B and C) over 7-year. Antibiotics sensitivity, pulsed-field gel electrophoresis (PFGE), PCR for carbapenemase and efflux pump genes were performed for all carbapenems-resistant isolates. Outer-membrane protein (OMP) was evaluated based on PFGE profile. A total of 130 isolates of Enterobacter spp were analyzed, 44/105 (41, 9%) E. aerogenes and 8/25 (32,0%) E. cloacae were resistant to carbapenems. All isolates were susceptible to fosfomycin, polymyxin B and tigecycline. KPC was present in 88.6% of E. aerogenes and in all E. cloacae resistant to carbapenems. The carbapenems-resistant E. aerogenes identified in hospital A belonged to six clones, however, a predominant clone was identified in this hospital over the study period. There is a predominant clone in Hospital B and Hospital C as well. The mechanisms of resistance to carbapenems differ among subtypes. Most of the isolates co-harbored blaKPC, blaTEM and /or blaCTX associated with decreased or lost of 35-36KDa and or 39 KDa OMP. The efflux pump AcrAB-TolC gene was only identified in carbapenems-resistant E. cloacae. There was a predominant clone in each hospital suggesting that cross-transmission of carbapenems-resistant Enterobacter spp. was frequent. The isolates presented multiple mechanisms of resistance to carbapenems including OMP alteration.

  11. Prevalence of carbapenemase-producing organisms in a tertiary care hospital in Ludhiana

    Directory of Open Access Journals (Sweden)

    Anuniti Mathias

    2016-01-01

    Full Text Available Aim: This study was done to determine the minimum inhibitory concentration (MIC of imipenem for multidrug-resistant (MDR clinical isolates and identify carbapenemase-producing organisms among these MDR isolates. Materials and Methods: The antibiotic susceptibility of clinical isolates was determined by Kirby–Bauer disc diffusion method. MDR isolates showing resistance or reduced susceptibility to carbapenems were further tested for MIC with imipenem and carbapenemase production by Modified Hodge test (MHT. Results: A total of 65 MDR isolates were tested, of which 46 (70.77%, 15 (23%, and 4 (6.15% had MIC in resistant, sensitive, and intermediate range, respectively. MHT was positive for 37 (57% isolates. The most common carbapenemase producers in order of frequency were Acinetobacter baumannii, Klebsiella pneumoniae, Enterobacter aerogenes, Escherichia coli, Pseudomonas spp. Conclusion: Phenotypic tests such as MHT are simple, cost-effective, and easy to perform and hence can be used in any microbiology laboratory to detect carbapenemase production and applied clinically to guide the antimicrobial therapy, especially in severe and life-threatening infections.

  12. Risk factors for fecal carriage of carbapenemase producing Enterobacteriaceae among intensive care unit patients from a tertiary care center in India.

    Science.gov (United States)

    Mittal, Gajanand; Gaind, Rajni; Kumar, Deepak; Kaushik, Gaurav; Gupta, Kunj Bihari; Verma, P K; Deb, Monorama

    2016-07-08

    Resistance amongst the commensal flora is a serious threat because a very highly populated ecosystem like the gut, may at a later stage, be a source of extra intestinal infections, resistant strains may spread to other host or transfer genetic resistance element to other members of micro-biota including pathogens. This study was carried out to assess fecal colonization by carbapenemase producing Enterobacteriaceae (CPE) and associated risk factors among 100 patients admitted to intensive care unit (ICU). The phenotypic and molecular characterizations of CPE were also included. Colonization with CPE was observed in 6.6 % (8/122) controls. Among ICU patients, fecal carriage of CPE was significantly higher on day 4 (D4) (22 %) as compared to day 1 (D1) (11 %) (p value 0.002). The carbapenemase genes detected included OXA- 48, 181, KPC and NDM-1 with NDM-1 being the predominant carbapenemase in both ICU D1 and D4. Among the 50 CPE isolates, 8 (16 %) were susceptible to meropenem and imipenem (Minimum inhibitory concentration; MIC ≤ 1 mg/L) and all were susceptible to colistin (MIC range 0.125 - 1 mg/L) and tigecycline (MIC range 0.06- 1.5 mg/L). The risk factors associated with CPE carriage were duration of ICU stay, use of ventilator and aminoglycosides. Prior colonization with CPE could result in their influx and spread in ICU, challenging infection control measures. Exposure to ICU further increases risk of colonization with diverse carbapenemase-producing Enterobacteriaceae. Gut colonization with these strains may be a source of endogenous infection and horizontal transfer of these genes in future.

  13. Performance of CarbaNP and CIM tests in OXA-48 carbapenemase-producing Enterobacteriaceae.

    Science.gov (United States)

    Yıldız, Serap Süzük; Kaşkatepe, Banu; Avcıküçük, Havva; Öztürk, Şükran

    2017-03-01

    This study applied two phenotypic tests, namely "Carbapenemase Nordmann-Poirel" (CarbaNP) test and "Carbapenem Inactivation Method" (CIM), against the isolates carrying the carbapenem resistance genes. The study included 83 carbapenem-resistant Enterobacteriaceae isolates producing oxacillinase-48 (OXA-48) and 30 carbapenem-sensitive Enterobacteriaceae isolates. Out of the total isolates studied, 77 isolates (92.77%) were identified as Klebsiella pneumoniae and six isolates (7.23%) were identified as Escherichia coli by Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry. Polymerase chain reaction (PCR) method used to detect resistance genes found that 74 isolates (89.16%) produced OXA-48 carbapenemase, whereas nine isolates (10.84%) produced both OXA-48 and New Delhi metallo-beta-lactamase-1 (NDM-1). The isolates producing both OXA-48 and NDM-1 were found to be positive by both phenotypic tests. Among isolates carrying only bla OXA-48 gene alone, nine isolates (13.04%) for CarbaNP test and two isolates for CIM test (2.90%) displayed false negative results, respectively. The sensitivity of CarbaNP and CIM tests was found to be 89.16% and 97.59%, respectively, whereas the specificity was determined to be 100% for both tests. These findings suggest that CarbaNP and CIM tests are useful tools to identify the carbapenemase producers. Molecular methods like PCR are recommended to verify false negative tests predicted to have OXA-48 activity.

  14. The Association Between Colonization With Carbapenemase-Producing Enterobacteriaceae and Overall ICU Mortality : An Observational Cohort Study

    NARCIS (Netherlands)

    Dautzenberg, Mirjam J. D.; Wekesa, Ann N.; Gniadkowski, Marek; Antoniadou, Anastasia; Giamarellou, Helen; Petrikkos, George L.; Skiada, Anna; Brun-Buisson, Christian; Bonten, Marc J. M.; Derde, Lennie P. G.; Willems, RJL

    Objectives: Infections caused by carbapenemase-producing Enterobacteriaceae are increasing worldwide, especially in ICUs, and have been associated with high mortality rates. However, unequivocally demonstrating causality of such infections to death is difficult in critically ill patients because of

  15. High Prevalence of Carbapenemase-Producing Enterobacteriaceae among Hospitalized Children in Luanda, Angola.

    Science.gov (United States)

    Kieffer, Nicolas; Nordmann, Patrice; Aires-de-Sousa, Marta; Poirel, Laurent

    2016-10-01

    This study aimed to evaluate the prevalence of carbapenemase-producing Enterobacteriaceae in Luanda, Angola. A total of 157 rectal samples were collected from children visiting a pediatric hospital in Luanda in March 2015. Fifty-seven imipenem-nonsusceptible enterobacterial isolates were recovered, most of which were non-clonally related. The blaOXA-181 (50/57) and blaNDM-1 (7/57) carbapenemase genes were identified. Notably, OXA-181-producing Escherichia coli isolates rarely coproduced extended-spectrum β-lactamases and consequently remained susceptible to broad-spectrum cephalosporins. The blaOXA-181 gene was always located on an IncX3 plasmid, while the blaNDM-1 gene was located on either IncFIA or IncA/C plasmids. The study identified a high prevalence of OXA-181 among hospitalized children in Angola. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  16. Klebsiella pneumoniae Carbapenemase-2 (KPC-2, Substitutions at Ambler Position Asp179, and Resistance to Ceftazidime-Avibactam: Unique Antibiotic-Resistant Phenotypes Emerge from β-Lactamase Protein Engineering

    Directory of Open Access Journals (Sweden)

    Melissa D. Barnes

    2017-10-01

    Full Text Available The emergence of Klebsiella pneumoniae carbapenemases (KPCs, β-lactamases that inactivate “last-line” antibiotics such as imipenem, represents a major challenge to contemporary antibiotic therapies. The combination of ceftazidime (CAZ and avibactam (AVI, a potent β-lactamase inhibitor, represents an attempt to overcome this formidable threat and to restore the efficacy of the antibiotic against Gram-negative bacteria bearing KPCs. CAZ-AVI-resistant clinical strains expressing KPC variants with substitutions in the Ω-loop are emerging. We engineered 19 KPC-2 variants bearing targeted mutations at amino acid residue Ambler position 179 in Escherichia coli and identified a unique antibiotic resistance phenotype. We focus particularly on the CAZ-AVI resistance of the clinically relevant Asp179Asn variant. Although this variant demonstrated less hydrolytic activity, we demonstrated that there was a prolonged period during which an acyl-enzyme intermediate was present. Using mass spectrometry and transient kinetic analysis, we demonstrated that Asp179Asn “traps” β-lactams, preferentially binding β-lactams longer than AVI owing to a decreased rate of deacylation. Molecular dynamics simulations predict that (i the Asp179Asn variant confers more flexibility to the Ω-loop and expands the active site significantly; (ii the catalytic nucleophile, S70, is shifted more than 1.5 Å and rotated more than 90°, altering the hydrogen bond networks; and (iii E166 is displaced by 2 ÅÅ when complexed with ceftazidime. These analyses explain the increased hydrolytic profile of KPC-2 and suggest that the Asp179Asn substitution results in an alternative complex mechanism leading to CAZ-AVI resistance. The future design of novel β-lactams and β-lactamase inhibitors must consider the mechanistic basis of resistance of this and other threatening carbapenemases.

  17. Erster Bericht über Klebsiella pneumoniae Carbapenemase-bildende Pseudomonas aeruginosa-Stämme, isoliert von Verbrennungspatienten im Iran: phenotypische und genotypische Methoden

    OpenAIRE

    Lari, AR; Azimi, L; Rahbar, M; Alaghehbandan, R; Sattarzadeh-Tabrizi, M

    2014-01-01

    Wound infection associated with carbapenem-resistant Pseudomonas aeruginosa in burn patients is a growing problem. One of the main mechanisms of resistance to carbapenem antibiotics is the ability of P. aeruginosa to produce carbapenemase enzymes. Klebsiella pneumonia carbapemenase (KPC) is an important type of carbapenemase which can hydrolyze carbapenem antibiotics. The Modified Hodge Test (MHT) and boronic acid as a KPC inhibitor are two phenotypic methods used for detection of carbapen...

  18. Klebsiella pneumoniae Carbapenemase-2 (KPC-2), Substitutions at Ambler Position Asp179, and Resistance to Ceftazidime-Avibactam: Unique Antibiotic-Resistant Phenotypes Emerge from β-Lactamase Protein Engineering.

    Science.gov (United States)

    Barnes, Melissa D; Winkler, Marisa L; Taracila, Magdalena A; Page, Malcolm G; Desarbre, Eric; Kreiswirth, Barry N; Shields, Ryan K; Nguyen, Minh-Hong; Clancy, Cornelius; Spellberg, Brad; Papp-Wallace, Krisztina M; Bonomo, Robert A

    2017-10-31

    The emergence of Klebsiella pneumoniae carbapenemases (KPCs), β-lactamases that inactivate "last-line" antibiotics such as imipenem, represents a major challenge to contemporary antibiotic therapies. The combination of ceftazidime (CAZ) and avibactam (AVI), a potent β-lactamase inhibitor, represents an attempt to overcome this formidable threat and to restore the efficacy of the antibiotic against Gram-negative bacteria bearing KPCs. CAZ-AVI-resistant clinical strains expressing KPC variants with substitutions in the Ω-loop are emerging. We engineered 19 KPC-2 variants bearing targeted mutations at amino acid residue Ambler position 179 in Escherichia coli and identified a unique antibiotic resistance phenotype. We focus particularly on the CAZ-AVI resistance of the clinically relevant Asp179Asn variant. Although this variant demonstrated less hydrolytic activity, we demonstrated that there was a prolonged period during which an acyl-enzyme intermediate was present. Using mass spectrometry and transient kinetic analysis, we demonstrated that Asp179Asn "traps" β-lactams, preferentially binding β-lactams longer than AVI owing to a decreased rate of deacylation. Molecular dynamics simulations predict that (i) the Asp179Asn variant confers more flexibility to the Ω-loop and expands the active site significantly; (ii) the catalytic nucleophile, S70, is shifted more than 1.5 Å and rotated more than 90°, altering the hydrogen bond networks; and (iii) E166 is displaced by 2 Å when complexed with ceftazidime. These analyses explain the increased hydrolytic profile of KPC-2 and suggest that the Asp179Asn substitution results in an alternative complex mechanism leading to CAZ-AVI resistance. The future design of novel β-lactams and β-lactamase inhibitors must consider the mechanistic basis of resistance of this and other threatening carbapenemases. IMPORTANCE Antibiotic resistance is emerging at unprecedented rates and threatens to reach crisis levels. One key

  19. MCR-1 and OXA-48 In Vivo Acquisition in KPC-Producing Escherichia coli after Colistin Treatment.

    Science.gov (United States)

    Beyrouthy, Racha; Robin, Frederic; Lessene, Aude; Lacombat, Igor; Dortet, Laurent; Naas, Thierry; Ponties, Valérie; Bonnet, Richard

    2017-08-01

    The spread of mcr-1 -encoding plasmids into carbapenem-resistant Enterobacteriaceae raises concerns about the emergence of untreatable bacteria. We report the acquisition of mcr-1 in a carbapenem-resistant Escherichia coli strain after a 3-week course of colistin in a patient repatriated to France from Portugal. Whole-genome sequencing revealed that the Klebsiella pneumoniae carbapenemase-producing E. coli strain acquired two plasmids, an IncL OXA-48-encoding plasmid and an IncX4 mcr-1 -encoding plasmid. This is the first report of mcr-1 in carbapenemase-encoding bacteria in France. Copyright © 2017 American Society for Microbiology.

  20. Emergence of multidrug-resistant Acinetobacter baumannii producing OXA-23 Carbapenemase in Qatar

    Directory of Open Access Journals (Sweden)

    J.-M. Rolain

    2016-05-01

    Full Text Available The objective of our study was to describe the molecular support of carbapenem resistance from randomly selected clinical isolates of multidrug-resistant (MDR Acinetobacter baumannii as a pilot study from the Hamad Medical Corporation (HMC, Qatar. Results of our report will be used to study carbapenemases using molecular techniques in all isolated MDR A. baumannii. Forty-eight MDR A. baumannii were randomly selected from isolates preserved at HMC. Identification of all isolates was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic resistance was tested phenotypically by Phoenix and confirmed by Etest. The molecular support of carbapenemases (blaOXA-23, blaOXA-24, blaOXA-58, blaNDM was investigated by real-time PCR. The epidemiologic relatedness of the isolates was verified by phylogenetic analysis based on partial sequences of CsuE and blaOXA-51 genes. All 48 isolates were identified as A. baumannii and were confirmed to be resistant to most antibiotics, especially meropenem, imipenems, ciprofloxacin, levofloxacin, amikacin, gentamicin and most of the β-lactams; they were sensitive to colistin. All the isolates were positive for blaOXA-23 and negative for the other tested carbapenemase genes. Clonality analysis demonstrated that different lineages were actually circulating in Qatar; and we suggest that an outbreak occurred in the medical intensive care unit of HMC between 2011 and 2012. Here we report the emergence of MDR A. baumannii producing the carbapenemase OXA-23 in Qatar.

  1. Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae among Ethiopian children

    Science.gov (United States)

    Legese, Melese Hailu; Weldearegay, Gebru Mulugeta; Asrat, Daniel

    2017-01-01

    Background Infections by extended-spectrum beta-lactamase- (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) are an emerging problem in children nowadays. Hence, the aim of this study was to determine the prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae among children suspected of septicemia and urinary tract infections (UTIs). Methods A cross-sectional study was conducted from January to March 2014. A total of 322 study participants suspected of septicemia and UTIs were recruited. All blood and urine samples were cultured on blood and MacConkey agar. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. Antimicrobial susceptibility test was performed on Muller-Hinton agar using disk diffusion. ESBL was detected using combination disk and double-disk synergy methods, and the results were compared. Carbapenemase was detected by modified Hodge method using meropenem. Data were analyzed using SPSS version 20. Results The overall prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae was 78.57% (n=22/28) and 12.12%, respectively. Among the Enterobacteriaceae tested, Klebsiella pneumoniae (84.2%, n=16/19), Escherichia coli (100%, n=5/5), and Klebsiella oxytoca (100%, n=1/1) were positive for ESBL. Double-disk synergy method showed 90.9% sensitivity, 66.7% specificity, 95.2% positive predictive value, and 50% negative predictive value. Carbapenemase-producing Enterobacteriaceae were K. pneumoniae (9.09%, n=3/33) and Morganella morganii (3.03%, n=1/33). Conclusion Screening Enterobacteriaceae for ESBL production is essential for better antibiotics selection and preventing its further emergence and spread. In resource-limited settings, double-disk synergy method can be implemented for screening and confirming ESBL production. Moreover, occurrence of CRE in countries where no carbapenems are sold is worrying microbiologists as well as clinicians. Hence, identifying factors that induce

  2. Detection of bla KPC-2 in Proteus mirabilis in Brazil

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    Adriane Borges Cabral

    2015-02-01

    Full Text Available INTRODUCTION : Infections caused by Klebsiella pneumoniae carbapenemase (KPC-producing isolates pose a major worldwide public health problem today. METHODS : A carbapenem-resistant Proteus mirabilis clinical isolate was investigated for plasmid profiles and the occurrence of β-lactamase genes. RESULTS : The isolate exhibited resistance to ertapenem and imipenem and was susceptible to meropenem, polymyxin, and tigecycline. Five plasmids were identified in this isolate. DNA sequencing analysis revealed the presence of bla KPC-2 and bla TEM-1 genes. An additional PCR using plasmid DNA confirmed that bla KPC-2 was present in one of these plasmids. Conclusions: We report the detection of bla KPC-2 in P. mirabilis in Brazil for the first time. This finding highlights the continuous transfer of bla KPC between bacterial genera, which presents a serious challenge to the prevention of infection by multidrug-resistant bacteria.

  3. Detection systems for carbapenemase gene identification should include the SME serine carbapenemase.

    Science.gov (United States)

    Bush, Karen; Pannell, Megan; Lock, John L; Queenan, Anne Marie; Jorgensen, James H; Lee, Ryan M; Lewis, James S; Jarrett, Deidre

    2013-01-01

    Carbapenemase detection has become a major problem in hospitals that encounter outbreaks of infections caused by carbapenem-resistant Gram-negative bacteria. Rapid detection systems have been reported using multiplex PCR analyses and DNA microarray assays. Major carbapenemases that are detected by these systems include the KPC and OXA serine carbapenemases, and the IMP, VIM and NDM families of metallo-β-lactamases. However, increasing numbers of the SME serine carbapenemase are being reported from Serratia marcescens, especially from North and South America. These organisms differ from many of the other carbapenemase-producing pathogens in that they are generally susceptible to the expanded-spectrum cephalosporins ceftazidime and cefepime while retaining resistance to almost all other β-lactam antibiotics. Thus, multiplex PCR assays or DNA microarray testing of carbapenem-resistant S. marcescens isolates should include analyses for production of the SME carbapenemase. Confirmation of the presence of this enzyme may provide reassurance that oxyimino-cephalosporins can be considered for treatment of infections caused by these carbapenem-resistant pathogens. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  4. A possible alternative to the error prone modified Hodge test to correctly identify the carbapenemase producing Gram-negative bacteria

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    S S Jeremiah

    2014-01-01

    Full Text Available Context: The modified Hodge test (MHT is widely used as a screening test for the detection of carbapenemases in Gram-negative bacteria. This test has several pitfalls in terms of validity and interpretation. Also the test has a very low sensitivity in detecting the New Delhi metallo-β-lactamase (NDM. Considering the degree of dissemination of the NDM and the growing pandemic of carbapenem resistance, a more accurate alternative test is needed at the earliest. Aims: The study intends to compare the performance of the MHT with the commercially available Neo-Sensitabs - Carbapenemases/Metallo-β-Lactamase (MBL Confirmative Identification pack to find out whether the latter could be an efficient alternative to the former. Settings and Design: A total of 105 isolates of Klebsiella pneumoniae resistant to imipenem and meropenem, collected prospectively over a period of 2 years were included in the study. Subjects and Methods: The study isolates were tested with the MHT, the Neo-Sensitabs - Carbapenemases/MBL Confirmative Identification pack and polymerase chain reaction (PCR for detecting the blaNDM-1 gene. Results: Among the 105 isolates, the MHT identified 100 isolates as carbapenemase producers. In the five isolates negative for the MHT, four were found to produce MBLs by the Neo-Sensitabs. The Neo-Sensitabs did not have any false negatives when compared against the PCR. Conclusions: The MHT can give false negative results, which lead to failure in detecting the carbapenemase producers. Also considering the other pitfalls of the MHT, the Neo-Sensitabs - Carbapenemases/MBL Confirmative Identification pack could be a more efficient alternative for detection of carbapenemase production in Gram-negative bacteria.

  5. A possible alternative to the error prone modified Hodge test to correctly identify the carbapenemase producing Gram-negative bacteria.

    Science.gov (United States)

    Jeremiah, S S; Balaji, V; Anandan, S; Sahni, R D

    2014-01-01

    The modified Hodge test (MHT) is widely used as a screening test for the detection of carbapenemases in Gram-negative bacteria. This test has several pitfalls in terms of validity and interpretation. Also the test has a very low sensitivity in detecting the New Delhi metallo-β-lactamase (NDM). Considering the degree of dissemination of the NDM and the growing pandemic of carbapenem resistance, a more accurate alternative test is needed at the earliest. The study intends to compare the performance of the MHT with the commercially available Neo-Sensitabs - Carbapenemases/Metallo-β-Lactamase (MBL) Confirmative Identification pack to find out whether the latter could be an efficient alternative to the former. A total of 105 isolates of Klebsiella pneumoniae resistant to imipenem and meropenem, collected prospectively over a period of 2 years were included in the study. The study isolates were tested with the MHT, the Neo-Sensitabs - Carbapenemases/MBL Confirmative Identification pack and polymerase chain reaction (PCR) for detecting the blaNDM-1 gene. Among the 105 isolates, the MHT identified 100 isolates as carbapenemase producers. In the five isolates negative for the MHT, four were found to produce MBLs by the Neo-Sensitabs. The Neo-Sensitabs did not have any false negatives when compared against the PCR. The MHT can give false negative results, which lead to failure in detecting the carbapenemase producers. Also considering the other pitfalls of the MHT, the Neo-Sensitabs--Carbapenemases/MBL Confirmative Identification pack could be a more efficient alternative for detection of carbapenemase production in Gram-negative bacteria.

  6. Controlling the spread of carbapenemase-producing Gram-negatives: therapeutic approach and infection control.

    Science.gov (United States)

    Carmeli, Y; Akova, M; Cornaglia, G; Daikos, G L; Garau, J; Harbarth, S; Rossolini, G M; Souli, M; Giamarellou, H

    2010-02-01

    Although the rapid spread of carbapenemase-producing Gram-negatives (CPGNs) is providing the scientific community with a great deal of information about the molecular epidemiology of these enzymes and their genetic background, data on how to treat multidrug-resistant or extended drug-resistant carbapenemase-producing Enterobacteriaceae and how to contain their spread are still surprisingly limited, in spite of the rapidly increasing prevalence of these organisms and of their isolation from patients suffering from life-threatening infections. Limited clinical experience and several in vitro synergy studies seem to support the view that antibiotic combinations should be preferred to monotherapies. But, in light of the data available to date, it is currently impossible to quantify the real advantage of drug combinations in the treatment of these infections. Comprehensive clinical studies of the main therapeutic options, broken down by pathogen, enzyme and clinical syndrome, are definitely lacking and, as carbapenemases keep spreading, are urgently needed. This spread is unveiling the substantial unpreparedness of European public health structures to face this worrisome emergency, although experiences from different countries-chiefly Greece and Israel-have shown that CPGN transmission and cross-infection can cause a substantial threat to the healthcare system. This unpreparedness also affects the treatment of individual patients and infection control policies, with dramatic scarcities of both therapeutic options and infection control measures. Although correct implementation of such measures is presumably cumbersome and expensive, the huge clinical and public health problems related to CPGN transmission, alongside the current scarcity of therapeutic options, seem to fully justify this choice.

  7. Klebsiella pneumoniae KPC: first isolations in Italy

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    Carla Fontana

    2009-12-01

    Full Text Available Klebsiella pneumoniae carbapenemase (KPC was detected in two isolates of carbapenem-resistant K. pneumoniae in an italian teaching hospital. This is the first report of a KPC-producing isolates in our country. The first strain was isolated from a urine sample collected from a indwelling urinary catheter in a ICU-patient with subdural haematoma, while the second was from the culture of the central venous catheter (CVC in a patient affected by Crohn’s disease admitted in gastroenterology ward. Both were resistant to all ß-lactams, susceptible to imipenem and meropenem and resistant to ertapenem.They were resistant to other classes of non-ß-lactams antibiotics such as quinolones, aminoglycosides (with the exception of amikacin, trimethoprim-sulfamethoxazole (TMP-SMX as well as to nitrofurantoin.The isolates were not associated with travel abroad.They were found to contain the plasmid encoded carbapenemase gene blaKPC and were also positive to the Hodge’s test.The detection of KPC-producing bacteria has important implications in infection control and public health. The K. pneumoniae carbapenemase (KPC belong to class A ß-lactamases of the functional group 2f. Reported for the first time in U.S. in 2001, these agents were subsequently identified in Europe. KPC strains are typically resistant to penicillins, extended-spectrum cephalosporin and aztreonam and present a peculiar behavior against carbapenems in that MIC is close to the susceptibility value or is borderline (except for ertapenem.This pattern is often associated with resistance to quinolones.The information is conveyed by the resistance plasmids, thus explaining their diffusion and implication in outbreaks of KPC. Despite this, to date there are few reports concerning the isolation of this phenotype in Italy.The purpose of this paper is to present two clinical cases related to the isolation of KPC in our hospital. The KPC-producing strains have been respectively isolated: the first

  8. Characterization and Clinical Impact of Bloodstream Infection Caused by Carbapenemase-Producing Enterobacteriaceae in Seven Latin American Countries.

    Science.gov (United States)

    Villegas, Maria Virginia; Pallares, Christian J; Escandón-Vargas, Kevin; Hernández-Gómez, Cristhian; Correa, Adriana; Álvarez, Carlos; Rosso, Fernando; Matta, Lorena; Luna, Carlos; Zurita, Jeannete; Mejía-Villatoro, Carlos; Rodríguez-Noriega, Eduardo; Seas, Carlos; Cortesía, Manuel; Guzmán-Suárez, Alfonso; Guzmán-Blanco, Manuel

    2016-01-01

    Infections caused by carbapenem-resistant Enterobacteriaceae are a public health problem associated with higher mortality rates, longer hospitalization and increased healthcare costs. We carried out a study to describe the characteristics of patients with carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE bloodstream infection (BSI) from Latin American hospitals and to determine the clinical impact in terms of mortality and antibiotic therapy. Between July 2013 and November 2014, we conducted a multicenter observational study in 11 hospitals from 7 Latin American countries (Argentina, Colombia, Ecuador, Guatemala, Mexico, Peru, Venezuela). Patients with BSI caused by Enterobacteriaceae were included and classified either as CPE or non-CPE based on detection of blaKPC, blaVIM, blaIMP, blaNDM and blaOXA-48 by polymerase chain reaction. Enrolled subjects were followed until discharge or death. Demographic, microbiological and clinical characteristics were collected from medical records. Both descriptive and inferential statistics were used to analyze the information. A total of 255 patients with Enterobacteriaceae BSI were included; CPE were identified in 53 of them. In vitro non-susceptibility to all screened antibiotics was higher in the patients with CPE BSI, remaining colistin, tigecycline and amikacin as the most active drugs. Combination therapy was significantly more frequent in the CPE BSI group (p mortality was 37% (94/255). Overall and attributable mortality were significantly higher in patients with CPE BSI (p mortality. After multivariate adjustment, CPE BSI (adjusted odds ratio [aOR] 4; 95% confidence interval [CI] 1.7-9.5; p = 0.002) and critical illness (aOR 6.5; 95% CI 3.1-13.7; p mortality. This study provides valuable data on the clinical characteristics and mortality risk factors in patients with CPE BSI. We determined that CPE infection is an independent mortality predictor and thus Latin American hospitals should perform campaigns on

  9. Interventional strategies and current clinical experience with carbapenemase-producing Gram-negative bacteria.

    Science.gov (United States)

    Akova, M; Daikos, G L; Tzouvelekis, L; Carmeli, Y

    2012-05-01

    The wide dissemination of carbapenemase-producing Gram-negatives (CPGNs), including enterobacterial species and non-fermenters, has caused a public health crisis of global dimensions. These organisms cause serious infections in hospitalized patients, and are associated with increased mortality. Cross-transmission is common, and outbreaks may occur in healthcare facilities where the infection control practices are inadequate. CPGNs exhibit extensive drug-resistant phenotypes, complicate therapy, and limit treatment options. Systematic data on therapy are limited. However, regimens combining two or more active agents seem to be more efficacious than monotherapy in carbapenemase-producing Klebsiella pneumoniae infections. Strict infection control measures, including active surveillance for timely detection of colonized patients, separation of carriers from non-carriers, and contact precautions, are of utmost importance, and may be the only effective way of preventing the introduction and transmission of these bacteria in healthcare settings. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  10. Control of simultaneous outbreaks of carbapenemase-producing enterobacteriaceae and extensively drug-resistant Acinetobacter baumannii infection in an intensive care unit using interventions promoted in the Centers for Disease Control and Prevention 2012 carbapenemase-resistant Enterobacteriaceae Toolkit.

    Science.gov (United States)

    Enfield, Kyle B; Huq, Nujhat N; Gosseling, Megan F; Low, Darla J; Hazen, Kevin C; Toney, Denise M; Slitt, Gavin; Zapata, Heidi J; Cox, Heather L; Lewis, Jessica D; Kundzins, John R; Mathers, Amy J; Sifri, Costi D

    2014-07-01

    We describe the efficacy of enhanced infection control measures, including those recommended in the Centers for Disease Control and Prevention's 2012 carbapenem-resistant Enterobacteriaceae (CRE) toolkit, to control concurrent outbreaks of carbapenemase-producing Enterobacteriaceae (CPE) and extensively drug-resistant Acinetobacter baumannii (XDR-AB). Before-after intervention study. Fifteen-bed surgical trauma intensive care unit (ICU). We investigated the impact of enhanced infection control measures in response to clusters of CPE and XDR-AB infections in an ICU from April 2009 to March 2010. Polymerase chain reaction was used to detect the presence of blaKPC and resistance plasmids in CRE. Pulsed-field gel electrophoresis was performed to assess XDR-AB clonality. Enhanced infection-control measures were implemented in response to ongoing transmission of CPE and a new outbreak of XDR-AB. Efficacy was evaluated by comparing the incidence rate (IR) of CPE and XDR-AB before and after the implementation of these measures. The IR of CPE for the 12 months before the implementation of enhanced measures was 7.77 cases per 1,000 patient-days, whereas the IR of XDR-AB for the 3 months before implementation was 6.79 cases per 1,000 patient-days. All examined CPE shared endemic blaKPC resistance plasmids, and 6 of the 7 XDR-AB isolates were clonal. Following institution of enhanced infection control measures, the CPE IR decreased to 1.22 cases per 1,000 patient-days (P = .001), and no more cases of XDR-AB were identified. Use of infection control measures described in the Centers for Disease Control and Prevention's 2012 CRE toolkit was associated with a reduction in the IR of CPE and an interruption in XDR-AB transmission.

  11. Comparison of Two Phenotypic Algorithms To Detect Carbapenemase-Producing Enterobacteriaceae

    Science.gov (United States)

    Dortet, Laurent; Bernabeu, Sandrine; Gonzalez, Camille

    2017-01-01

    ABSTRACT A novel algorithm designed for the screening of carbapenemase-producing Enterobacteriaceae (CPE), based on faropenem and temocillin disks, was compared to that of the Committee of the Antibiogram of the French Society of Microbiology (CA-SFM), which is based on ticarcillin-clavulanate, imipenem, and temocillin disks. The two algorithms presented comparable negative predictive values (98.6% versus 97.5%) for CPE screening among carbapenem-nonsusceptible Enterobacteriaceae. However, since 46.2% (n = 49) of the CPE were correctly identified as OXA-48-like producers by the faropenem/temocillin-based algorithm, it significantly decreased the number of complementary tests needed (42.2% versus 62.6% with the CA-SFM algorithm). PMID:28607010

  12. Extensive colonization with carbapenemase-producing microorganisms in Romanian burn patients : infectious consequences from the Colectiv fire disaster

    NARCIS (Netherlands)

    Pirii, L E; Friedrich, A W; Rossen, J W A; Vogels, W; Beerthuizen, G I J M; Nieuwenhuis, M K; Kooistra-Smid, A M D; Bathoorn, E

    Health care of severe burn patients is highly specialized and may require international patient transfer. Burn patients have an increased risk of developing infections. Patients that have been hospitalized in countries where carbapenemase-producing microorganisms (CPMO) are endemic may develop

  13. Prolonged carriage and potential onward transmission of carbapenemase-producing Enterobacteriaceae in Dutch travelers.

    Science.gov (United States)

    van Hattem, Jarne M; Arcilla, Maris S; Bootsma, Martin Cj; van Genderen, Perry J; Goorhuis, Abraham; Grobusch, Martin P; Molhoek, Nicky; Oude Lashof, Astrid Ml; Schultsz, Constance; Stobberingh, Ellen E; Verbrugh, Henri A; de Jong, Menno D; Melles, Damian C; Penders, John

    2016-07-01

    The aim was to study acquisition and persistence of carbapenemase-producing Enterobacteriaceae (CPE) among travelers. Stools from 2001 travelers and 215 nontraveling household members, collected before and immediately post-travel as well as 1, 3, 6 and 12 months upon return, were screened for CPE. Five travelers, all visiting Asia outside the Indian subcontinent, acquired CPE. One traveler persistently carried the same OXA-244 CPE up to 6 months post-travel. Three months after travel, her co-traveling spouse also became positive for this OXA-244 CPE strain, suggesting clonal transmission within this household. Acquisition of CPE is not restricted to travelers to the Indian subcontinent and/or to travelers seeking healthcare during travel and can persist up to at least 6 months post-travel.

  14. Extended-spectrum β-lactamase/AmpC- and carbapenemase-producing Enterobacteriaceae in animals: a threat for humans?

    Science.gov (United States)

    Madec, J-Y; Haenni, M; Nordmann, P; Poirel, L

    2017-11-01

    There has been a great and long-term concern that extended-spectrum β-lactamase (ESBL)/AmpC- and carbapenemase-producing Enterobacteriaceae occurring in animals may constitute a public-health issue. A large number of factors with complex interrelations contribute to the spread of those bacteria among animals and humans. ESBL/AmpC- or carbapenemase-encoding genes are most often located on mobile genetic elements favouring their dissemination. Some shared reservoirs of ESBL/AmpC or carbapenemase genes, plasmids or clones have been identified and suggest cross-transmissions. Even though exposure to animals is regarded as a risk factor, evidence for a direct transfer of ESBL/AmpC-producing bacteria from animals to humans through close contacts is limited. Nonetheless, the size of the commensal ESBL/AmpC reservoir in non-human sources is dramatically rising. This may constitute an indirect risk to public health by increasing the gene pool from which pathogenic bacteria can pick up ESBL/AmpC/carbapenemase genes. The extent to which food contributes to potential transmission of ESBL/AmpC producers to humans is also not well established. Overall, events leading to the occurrence of ESBL/AmpC- and carbapenemase-encoding genes in animals seem very much multifactorial. The impact of animal reservoirs on human health still remains debatable and unclear; nonetheless, there are some examples of direct links that have been identified. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Risk Factors for Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) Acquisition Among Contacts of Newly Diagnosed CP-CRE Patients.

    Science.gov (United States)

    Schwartz-Neiderman, Anat; Braun, Tali; Fallach, Noga; Schwartz, David; Carmeli, Yehuda; Schechner, Vered

    2016-10-01

    OBJECTIVE Carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are extremely drug-resistant pathogens. Screening of contacts of newly identified CP-CRE patients is an important step to limit further transmission. We aimed to determine the risk factors for CP-CRE acquisition among patients exposed to a CP-CRE index patient. METHODS A matched case-control study was performed in a tertiary care hospital in Israel. The study population was comprised of patients who underwent rectal screening for CP-CRE following close contact with a newly identified CP-CRE index patient. Cases were defined as positive tests for CP-CRE. For each case patient, 2 matched controls were randomly selected from the pool of contacts who tested negative for CP-CRE following exposure to the same index case. Bivariate and multivariate analyses were conducted using conditional logistic regression. RESULTS In total, 53 positive contacts were identified in 40 unique investigations (896 tests performed on 735 contacts) between October 6, 2008, and June 7, 2012. bla KPC was the only carbapenemase identified. In multivariate analysis, risk factors for CP-CRE acquisition among contacts were (1) contact with an index patient for ≥3 days (odds ratio [OR], 9.8; 95% confidence interval [CI], 2.0-48.9), (2) mechanical ventilation (OR, 4.1; 95% CI, 1.4-11.9), and (3) carriage or infection with another multidrug-resistant organism (MDRO; OR, 2.6; 95% CI, 1.0-7.1). Among patients who received antibiotics, cephalosporins were associated with a lower risk of acquisition. CONCLUSIONS Patient characteristics (ventilation and carriage of another MDRO) as well as duration of contact are risk factors for CP-CRE acquisition among contacts. The role of cephalosporins requires further study. Infect Control Hosp Epidemiol 2016;1-7.

  16. Carbapenem inactivation: a very affordable and highly specific method for phenotypic detection of carbapenemase-producing Pseudomonas aeruginosa isolates compared with other methods.

    Science.gov (United States)

    Akhi, Mohammad Taghi; Khalili, Younes; Ghotaslou, Reza; Kafil, Hossein Samadi; Yousefi, Saber; Nagili, Behroz; Goli, Hamid Reza

    2017-06-01

    This investigation was undertaken to compare phenotypic and molecular methods for detection of carbapenemase-producing Pseudomonas aeruginosa. A total of 245 non-duplicated isolates of P. aeruginosa were collected from hospitalized patients. Disc diffusion method was used to identify carbapenem-resistant bacteria. Three phenotypic methods, including Modified Hodge Test (MHT), Modified Carba NP (MCNP) test and Carbapenem Inactivation Method (CIM) were used for investigation of carbapenemase production. In addition, polymerase chain reaction (PCR) was used to detect carbapenemase encoding genes. Of 245 P. aeruginosa isolates investigated, 121 isolates were carbapenem-resistant. Among carbapenem-resistant isolates, 40, 39 and 35 isolates exhibited positive results using MHT, MCNP test and CIM, respectively. PCR indicated the presence of carbapenemase genes in 35 of carbapenem-resistant isolates. MHT showed low sensitivity and specificity for carbapenemase detection among P. aeruginosa isolates in comparison to PCR. CIM was most affordable and highly specific than MCNP test compared with the molecular method.

  17. KPC-mediated resistance in Klebsiella pneumoniae in two hospitals in Padua, Italy, June 2009-December 2011: massive spreading of a KPC-3-encoding plasmid and involvement of non-intensive care units

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    Richter Sara N

    2012-07-01

    Full Text Available Abstract Background Klebsiella pneumoniae carbapenemases (KPCs producing bacteria have emerged as a cause of multidrug-resistant nosocomial infections worldwide. KPCs are plasmid-encoded enzymes capable of hydrolysing a broad spectrum of beta-lactams, including carbapenems and monobactams, therefore worryingly limiting antimicrobial treatment options. Analysis of circulating bacterial strains and KPC alleles may help understanding the route of KPC dissemination and therefore help containing the infection. Methods KPC-producing Klebsiella pneumoniae dissemination in two 1580- and 300- bed hospitals in Padua, Italy, from initial outbreak in 2009 to late 2011 was analysed. Molecular and clinical epidemiology, including bacterial strains, KPC-encoding plasmid sequences and associated resistance genes, involved hospital wards and relocation of patients were described. Routine antimicrobial susceptibility testing and MIC of carbapenems on clinical isolates were performed. Detection of resistance genes was obtained by PCR and sequencing. MLST, PFGE and ERIC were used for molecular genotyping. Plasmid analysis was obtained by digestion with restriction enzymes and deep sequencing. Results KPC-positive clinical samples were isolated from nearly 200 patients. In the initial outbreak intensive care units were almost exclusively involved, while medical, surgical and long-term wards were successively massively concerned. Analysis of KPC alleles, plasmids and bacterial sequence types (STs indicated that during the initial outbreak KPC-3 in ST258 and KPC-2 in ST147 were each confined in one of the two surveilled hospitals. While KPC-2 dissemination was effectively contained, KPC-3 in ST258 cross-spreading was observed. The simultaneous presence of two carbapenemases, VIM-1 and KPC-2, in the same isolate was also observed in three patients. Total sequencing of plasmid content of two KPC-3 strains showed novel association of resistance plasmids. Conclusions The

  18. Contribution of horizontal gene transfer to the emergence of VIM-4 carbapenemase producer Enterobacteriaceae in Kuwait

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    Sonnevend Á

    2017-12-01

    Full Text Available Ágnes Sonnevend,1 Nour Yahfoufi,1,2 Akela Ghazawi,1 Wafaa Jamal,3 Vincent Rotimi,3 Tibor Pál1 1Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE; 2Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; 3Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait Abstract: Carbapenem-resistant Enterobacteriaceae encountered in countries of the Arabian Peninsula usually produce OXA-48-like and New Delhi metallo-beta-lactamases (NDM carbapenemases. However, a temporary increase in VIM-4-producing, clonally unrelated Enterobacteriaceae strains was described earlier in a Kuwaiti hospital. We investigated the genetic support of blaVIM-4 in six Klebsiella pneumoniae strains, one Escherichia coli, and one Enterobacter cloacae strain and compared it to that of VIM-4-producing isolates from other countries of the region. Five K. pneumoniae strains and the E. coli strain from Kuwait carried an ~165 kb IncA/C-type plasmid indistinguishable by restriction fragment length polymorphism. The complete sequence of one of them (pKKp4-VIM was established. pKKp4-VIM exhibited extensive similarities to episomes pKP-Gr642 carrying blaVIM-19 encountered in Greece and to the partially sequenced pCC416 harboring blaVIM-4 detected in Italy. In other countries of the region, the only similar plasmid was the one detected in the isolate from the UAE. In all Kuwaiti strains, irrespective of the species and their VIM plasmids, the blaVIM-4 gene was located within the same integron structure (In416, different from those of other countries of the region. Our data show that the spread of this IncA/C plasmid and particularly that of the In416 integron caused a considerable, albeit temporary, increase in the rate of mostly clonally unrelated VIM-producing Enterobacteriaceae strains of multiple species

  19. Characterization and Clinical Impact of Bloodstream Infection Caused by Carbapenemase-Producing Enterobacteriaceae in Seven Latin American Countries.

    Directory of Open Access Journals (Sweden)

    Maria Virginia Villegas

    Full Text Available Infections caused by carbapenem-resistant Enterobacteriaceae are a public health problem associated with higher mortality rates, longer hospitalization and increased healthcare costs. We carried out a study to describe the characteristics of patients with carbapenemase-producing Enterobacteriaceae (CPE and non-CPE bloodstream infection (BSI from Latin American hospitals and to determine the clinical impact in terms of mortality and antibiotic therapy.Between July 2013 and November 2014, we conducted a multicenter observational study in 11 hospitals from 7 Latin American countries (Argentina, Colombia, Ecuador, Guatemala, Mexico, Peru, Venezuela. Patients with BSI caused by Enterobacteriaceae were included and classified either as CPE or non-CPE based on detection of blaKPC, blaVIM, blaIMP, blaNDM and blaOXA-48 by polymerase chain reaction. Enrolled subjects were followed until discharge or death. Demographic, microbiological and clinical characteristics were collected from medical records. Both descriptive and inferential statistics were used to analyze the information.A total of 255 patients with Enterobacteriaceae BSI were included; CPE were identified in 53 of them. In vitro non-susceptibility to all screened antibiotics was higher in the patients with CPE BSI, remaining colistin, tigecycline and amikacin as the most active drugs. Combination therapy was significantly more frequent in the CPE BSI group (p < 0.001. The most common regimen was carbapenem + colistin or polymyxin B. The overall mortality was 37% (94/255. Overall and attributable mortality were significantly higher in patients with CPE BSI (p < 0.001; however, we found that patients with CPE BSI who received combination therapy and those who received monotherapy had similar mortality. After multivariate adjustment, CPE BSI (adjusted odds ratio [aOR] 4; 95% confidence interval [CI] 1.7-9.5; p = 0.002 and critical illness (aOR 6.5; 95% CI 3.1-13.7; p < 0.001 were independently

  20. Characterization and Clinical Impact of Bloodstream Infection Caused by Carbapenemase-Producing Enterobacteriaceae in Seven Latin American Countries

    Science.gov (United States)

    Villegas, Maria Virginia; Pallares, Christian J.; Hernández-Gómez, Cristhian; Correa, Adriana; Álvarez, Carlos; Rosso, Fernando; Matta, Lorena; Luna, Carlos; Zurita, Jeannete; Mejía-Villatoro, Carlos; Rodríguez-Noriega, Eduardo; Seas, Carlos; Cortesía, Manuel; Guzmán-Suárez, Alfonso; Guzmán-Blanco, Manuel

    2016-01-01

    Introduction Infections caused by carbapenem-resistant Enterobacteriaceae are a public health problem associated with higher mortality rates, longer hospitalization and increased healthcare costs. We carried out a study to describe the characteristics of patients with carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE bloodstream infection (BSI) from Latin American hospitals and to determine the clinical impact in terms of mortality and antibiotic therapy. Methods Between July 2013 and November 2014, we conducted a multicenter observational study in 11 hospitals from 7 Latin American countries (Argentina, Colombia, Ecuador, Guatemala, Mexico, Peru, Venezuela). Patients with BSI caused by Enterobacteriaceae were included and classified either as CPE or non-CPE based on detection of blaKPC, blaVIM, blaIMP, blaNDM and blaOXA-48 by polymerase chain reaction. Enrolled subjects were followed until discharge or death. Demographic, microbiological and clinical characteristics were collected from medical records. Both descriptive and inferential statistics were used to analyze the information. Results A total of 255 patients with Enterobacteriaceae BSI were included; CPE were identified in 53 of them. In vitro non-susceptibility to all screened antibiotics was higher in the patients with CPE BSI, remaining colistin, tigecycline and amikacin as the most active drugs. Combination therapy was significantly more frequent in the CPE BSI group (p < 0.001). The most common regimen was carbapenem + colistin or polymyxin B. The overall mortality was 37% (94/255). Overall and attributable mortality were significantly higher in patients with CPE BSI (p < 0.001); however, we found that patients with CPE BSI who received combination therapy and those who received monotherapy had similar mortality. After multivariate adjustment, CPE BSI (adjusted odds ratio [aOR] 4; 95% confidence interval [CI] 1.7–9.5; p = 0.002) and critical illness (aOR 6.5; 95% CI 3.1–13.7; p < 0

  1. Carbapenemase-producing Enterobacteriaceae: a 2-year surveillance in a hospital in Iaşi, Romania.

    Science.gov (United States)

    Braun, Sascha D; Dorneanu, Olivia S; Vremeră, Teodora; Reißig, Annett; Monecke, Stefan; Ehricht, Ralf

    2016-01-01

    Limited information is currently available about the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) in Romania. Routine tests of 1,993 clinical isolates at a hospital in Iaşi yielded 46 isolates that were resistant to carbapenems. All 46 isolates were phenotypically and genotypically analyzed using VITEK-2 and DNA microarray-based assays. Isolates were assigned to Klebsiella pneumoniae and Enterobacter cloacae. For 39 isolates, carbapenem resistance was confirmed and 37 harbored at least one carbapenem resistance gene. Two isolates were probably resistant due to AmpC β-lactamases in combination with a porin loss. The overall concordance between detected phenotype and genotype was 95%. Our data show that carbapenemase-producing isolates with different underlying resistance mechanisms are still rare in Iaşi, but the global rise of CPE warrants intensified surveillance.

  2. Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe.

    Science.gov (United States)

    Cantón, R; Akóva, M; Carmeli, Y; Giske, C G; Glupczynski, Y; Gniadkowski, M; Livermore, D M; Miriagou, V; Naas, T; Rossolini, G M; Samuelsen, Ø; Seifert, H; Woodford, N; Nordmann, P

    2012-05-01

    Plasmid-acquired carbapenemases in Enterobacteriaceae, which were first discovered in Europe in the 1990s, are now increasingly being identified at an alarming rate. Although their hydrolysis spectrum may vary, they hydrolyse most β-lactams, including carbapenems. They are mostly of the KPC, VIM, NDM and OXA-48 types. Their prevalence in Europe as reported in 2011 varies significantly from high (Greece and Italy) to low (Nordic countries). The types of carbapenemase vary among countries, partially depending on the cultural/population exchange relationship between the European countries and the possible reservoirs of each carbapenemase. Carbapenemase producers are mainly identified among Klebsiella pneumoniae and Escherichia coli, and still mostly in hospital settings and rarely in the community. Although important nosocomial outbreaks with carbapenemase-producing Enterobacteriaceae have been extensively reported, many new cases are still related to importation from a foreign country. Rapid identification of colonized or infected patients and screening of carriers is possible, and will probably be effective for prevention of a scenario of endemicity, as now reported for extended-spectrum β-lactamase (mainly CTX-M) producers in all European countries. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  3. Imipenem-resistance in Serratia marcescens is mediated by plasmid expression of KPC-2.

    Science.gov (United States)

    Su, W-Q; Zhu, Y-Q; Deng, N-M; Li, L

    2017-04-01

    Imipenem is a broad-spectrum carbapenem antibiotic with applications against severe bacterial infections. Here, we describe the identification of imipenem-resistant Serratia marcescens in our hospital and the role of plasmid-mediated KPC-2 expression in imipenem resistance. We used the modified Hodge test to detect carbapenemase produced in imipenem-resistant strains. His resistance can be transferred to E. coli in co-culture tests, which implicates the plasmid in imipenem resistance. PCR amplification from the plasmid identified two products consistent with KPC-2 of 583 and 1050 bp that were also present in E. coli after co-culture. The restriction pattern for both plasmids was identical, supporting the transfer from the S. marcescens isolate to E. coli. Finally, gene sequencing confirmed KPC-2 in the plasmid. Due to the presence of KPC-2 in the imipenem-resistant S. marcescens, we propose that KPC-2 mediates antibiotic resistance in the S. marcescens isolate.

  4. Occurrence of Extended Spectrum β-Lactamases, KPC-Type, and MCR-1.2-Producing Enterobacteriaceae from Wells, River Water, and Wastewater Treatment Plants in Oltrepò Pavese Area, Northern Italy

    Directory of Open Access Journals (Sweden)

    Mariasofia Caltagirone

    2017-11-01

    Full Text Available To evaluate the water compartment antibiotic-resistance contamination rates, 11 wells, five streams, and four treatment plants located in the Oltrepò Pavese area were screened for the presence of third generation cephalosporins resistant Gram-negative bacteria. Enterobacteriaceae were also characterized for the Extended-Spectrum-β-Lactamases (ESBLs, carbapenemases, and mcr-1 genes presence. From December 2014 to November 2015, 246 water samples were filtered, plated on Plate Count Agar, MacConkey Agar, and MacConkey Agar with cefotaxime. Isolates were species identified using AutoSCAN-4-System and ESBLs, carbapenemases, and colistin resistance determinants were characterized by PCR, sequencing, and microarray. Plasmid conjugative transfer experiments, PCR-based Replicon typing, Pulsed-Field Gel Electrophoresis, Multi-Locus-Sequence-Typing, and in-silico plasmid characterization were performed. A total of 132 enterobacteria isolates grew on MacConkey agar with cefotaxime: 82 (62.1% were obtained from streams, 41 (31.1% from treatment plants, and 9 (6.8% from wells. Thirty out of 132 (22.7% isolates, mainly belonging to Escherichia coli (n = 15 species, showed a synergic effect with piperacillin-tazobactam. A single ESBL gene of blaCTX−M-type was identified in 19/30 isolates. In further two E. coli strains, a blaCTX−M−1 gene co-existed with a blaSHV-type ESBL determinant. A blaSHV−12 gene was detected in two isolates of E. coli (n = 1 and Klebsiella oxytoca (n = 1, while any ESBL determinant was ascertained in seven Yersinia enterocolitica strains. A blaDHA-type gene was detected in a cefoxitin resistant Y. enterocolitica from a stream. Interestingly, two Klebsiella pneumoniae strains of ST307 and ST258, collected from a well and a wastewater treatment plant, resulted KPC-2, and KPC-3 producers, respectively. Moreover, we report the first detection of mcr-1.2 ST10 E. coli on a conjugative IncX4 plasmid (33.303 bp in size from a stream of

  5. Occurrence of Extended Spectrum β-Lactamases, KPC-Type, and MCR-1.2-Producing Enterobacteriaceae from Wells, River Water, and Wastewater Treatment Plants in Oltrepò Pavese Area, Northern Italy.

    Science.gov (United States)

    Caltagirone, Mariasofia; Nucleo, Elisabetta; Spalla, Melissa; Zara, Francesca; Novazzi, Federica; Marchetti, Vittoria M; Piazza, Aurora; Bitar, Ibrahim; De Cicco, Marica; Paolucci, Stefania; Pilla, Giorgio; Migliavacca, Roberta; Pagani, Laura

    2017-01-01

    To evaluate the water compartment antibiotic-resistance contamination rates, 11 wells, five streams, and four treatment plants located in the Oltrepò Pavese area were screened for the presence of third generation cephalosporins resistant Gram-negative bacteria. Enterobacteriaceae were also characterized for the Extended-Spectrum-β-Lactamases (ESBLs), carbapenemases, and mcr-1 genes presence. From December 2014 to November 2015, 246 water samples were filtered, plated on Plate Count Agar, MacConkey Agar, and MacConkey Agar with cefotaxime. Isolates were species identified using AutoSCAN-4-System and ESBLs, carbapenemases, and colistin resistance determinants were characterized by PCR, sequencing, and microarray. Plasmid conjugative transfer experiments, PCR-based Replicon typing, Pulsed-Field Gel Electrophoresis, Multi-Locus-Sequence-Typing, and in-silico plasmid characterization were performed. A total of 132 enterobacteria isolates grew on MacConkey agar with cefotaxime: 82 (62.1%) were obtained from streams, 41 (31.1%) from treatment plants, and 9 (6.8%) from wells. Thirty out of 132 (22.7%) isolates, mainly belonging to Escherichia coli ( n = 15) species, showed a synergic effect with piperacillin-tazobactam. A single ESBL gene of bla CTX-M -type was identified in 19/30 isolates. In further two E. coli strains, a bla CTX-M-1 gene co-existed with a bla SHV -type ESBL determinant. A bla SHV-12 gene was detected in two isolates of E. coli ( n = 1) and Klebsiella oxytoca ( n = 1), while any ESBL determinant was ascertained in seven Yersinia enterocolitica strains. A bla DHA -type gene was detected in a cefoxitin resistant Y. enterocolitica from a stream. Interestingly, two Klebsiella pneumoniae strains of ST307 and ST258, collected from a well and a wastewater treatment plant, resulted KPC-2, and KPC-3 producers, respectively. Moreover, we report the first detection of mcr-1.2 ST10 E. coli on a conjugative IncX4 plasmid (33.303 bp in size) from a stream of Oltrep

  6. High Gastrointestinal Colonization Rate with Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Emergence of Carbapenemase-Producing K. pneumoniae in Ethiopia

    Science.gov (United States)

    Desta, Kassu; Woldeamanuel, Yimtubezinash; Azazh, Aklilu; Mohammod, Halima; Desalegn, Dawit; Shimelis, Damte; Gulilat, Dereje; Lamisso, Biruk; Makonnen, Eyasu; Worku, Alemayehu; Mannerqvist, Kerstin; Struwe, Johan; Aspevall, Olov; Aklillu, Eleni

    2016-01-01

    We investigated the gastrointestinal colonization rate and antibiotic resistance patterns of Extended-Spectrum Beta-Lactamase (ESBL)- producing Escherichia coli and Klebsiella pneumoniae in hospitalized patients admitted at Ethiopia’s largest tertiary hospital. Fecal samples/swabs from 267 patients were cultured on chrome agar. ESBL. Bacterial species identification, verification of ESBL production and antibiotic susceptibility testing were done using Vitek 2 system (bioMérieux, France). Phenotype characterization of ESBL-E.coli and ESBL- K.pneumoniae was done using Neo-Sensitabs™. ESBL positivity rate was much higher in K. pneumoniae (76%) than E. coli (45%). The overall gastrointestinal colonization rate of ESBL producing Enterobacteriaceae (ESBL-E) in hospitalized patients was 52% (95%CI; 46%–58%) of which, ESBL-E. coli and K.pneumoniae accounted for 68% and 32% respectively. Fecal ESBL-E carriage rate in neonates, children and adults was 74%, 59% and 46% respectively. Gastrointestinal colonization rate of ESBL-E.coli in neonates, children and adults was 11%, 42% and 42% respectively. Of all E. coli strains isolated from adults, children and neonates, 44%, 49% and 22% were ESBL positive (p = 0.28). The prevalence of ESBL-K.pneumoniae carriage in neonates, children and adults was 68%, 22% and 7% respectively. All K. pneumoniae isolated from neonates (100%) and 88% of K. pneumoniae isolated from children were ESBL positive, but only 50% of K.pneumoniae isolated from adults were ESBL positive (p = 0.001). Thirteen patients (5%) were carriers of both ESBL-E.coli and ESBL-KP. The overall carrier rate of ESBL producing isolates resistant to carbapenem was 2% (5/267), all detected in children; three with E.coli HL cephalosporinase (AmpC), resistant to ertapenem and two with K. pneumoniae Carbapenemase (KPC) resistant to meropenem, ertapenem and impenem. We report a high gastrointestinal colonization rate with ESBL-E and the emergence of carbapenems-resistant K

  7. Chromobacterium spp. harbour Ambler class A β-lactamases showing high identity with KPC.

    Science.gov (United States)

    Gudeta, Dereje Dadi; Bortolaia, Valeria; Jayol, Aurélie; Poirel, Laurent; Nordmann, Patrice; Guardabassi, Luca

    2016-06-01

    The origin of KPC is unknown. The aim of this study was to detect progenitors of KPC in silico and to functionally verify their β-lactam hydrolysis activity. The sequence of KPC-2 was used to mine the NCBI protein sequence database. The best non-KPC hits were analysed by amino acid (aa) alignment and phylogenetic tree construction. Genes encoding KPC-2 homologues were expressed in Escherichia coli. The carbapenemase activities of the recombinant strains were characterized by the CarbaNP test and UV spectrophotometry and MICs of selected β-lactams were determined. Genes encoding the closest KPC-2 homologues were identified on the chromosome of Chromobacterium piscinae strain ND17 (CRP-1, 76% aa identity), Chromobacterium sp. C-61 (CRS-1, 70% aa identity) and Chromobacterium haemolyticum DSM19808 (CRH-1, 69% aa identity). All three Chromobacterium β-lactamases were phylogenetically more related to KPC than to other Ambler class A β-lactamases. The 27 bp region preceding the start codon of blaCRP-1 displayed high nucleotide identity to the corresponding region upstream from blaKPC (74%). Heterologous expression of blaCRP-1 and to a lesser extent of blaCRH-1 in E. coli significantly increased the MICs of meropenem and most cephalosporins. The CarbaNP test was positive for both recombinant strains, but spectrophotometric analysis confirmed higher carbapenemase activity for CRP-1-producing clones. The recovery of three class A β-lactamases with up to 76% aa identity to KPC from distinct Chromobacterium species is highly indicative of the role played by this genus in the evolution of KPC. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. Environmental pollution with antimicrobial agents from bulk drug manufacturing industries in Hyderabad, South India, is associated with dissemination of extended-spectrum beta-lactamase and carbapenemase-producing pathogens.

    Science.gov (United States)

    Lübbert, Christoph; Baars, Christian; Dayakar, Anil; Lippmann, Norman; Rodloff, Arne C; Kinzig, Martina; Sörgel, Fritz

    2017-08-01

    High antibiotic and antifungal concentrations in wastewater from anti-infective drug production may exert selection pressure for multidrug-resistant (MDR) pathogens. We investigated the environmental presence of active pharmaceutical ingredients and their association with MDR Gram-negative bacteria in Hyderabad, South India, a major production area for the global bulk drug market. From Nov 19 to 28, 2016, water samples were collected from the direct environment of bulk drug manufacturing facilities, the vicinity of two sewage treatment plants, the Musi River, and habitats in Hyderabad and nearby villages. Samples were analyzed for 25 anti-infective pharmaceuticals with liquid chromatography-tandem mass spectrometry and for MDR Gram-negative bacteria using chromogenic culture media. In addition, specimens were screened with PCR for bla VIM , bla KPC , bla NDM , bla IMP-1 , and bla OXA-48 resistance genes. All environmental specimens from 28 different sampling sites were contaminated with antimicrobials. High concentrations of moxifloxacin, voriconazole, and fluconazole (up to 694.1, 2500, and 236,950 µg/L, respectively) as well as increased concentrations of eight other antibiotics were found in sewers in the Patancheru-Bollaram industrial area. Corresponding microbiological analyses revealed an extensive presence of extended-spectrum beta-lactamase and carbapenemase-producing Enterobacteriaceae and non-fermenters (carrying mainly bla OXA-48 , bla NDM , and bla KPC ) in more than 95% of the samples. Insufficient wastewater management by bulk drug manufacturing facilities leads to unprecedented contamination of water resources with antimicrobial pharmaceuticals, which seems to be associated with the selection and dissemination of carbapenemase-producing pathogens. The development and global spread of antimicrobial resistance present a major challenge for pharmaceutical producers and regulatory agencies.

  9. Carbapenemase VCC-1-Producing Vibrio cholerae in Coastal Waters of Germany

    DEFF Research Database (Denmark)

    Hammerl, Jens A.; Jaeckel, Claudia; Bortolaia, Valeria

    2017-01-01

    During antimicrobial drug resistance testing for Vibrio spp. from coastal waters of Germany, we identified 4 nontoxigenic, carbapenem-resistant V. cholerae isolates. We used whole-genome sequencing to identify the carbapenemase gene bla(VCC-1). In addition, a molecular survey showed that more bla...

  10. Triple combination antibiotic therapy for carbapenemase-producing Klebsiella pneumoniae: a systematic review.

    Science.gov (United States)

    Jacobs, David M; Safir, M Courtney; Huang, Dennis; Minhaj, Faisal; Parker, Adam; Rao, Gauri G

    2017-11-25

    The spread of carbapenemase-producing K. pneumoniae (CPKP) has become a significant problem worldwide. Combination therapy for CPKP is encouraging, but polymyxin resistance to many antibiotics is hampering effective treatment. Combination therapy with three or more antibiotics is being increasingly reported, therefore we performed a systematic review of triple combination cases in an effort to evaluate their clinical effectiveness for CPKP infections. The PubMed database was searched to identify all published clinical outcomes of CPKP infections treated with triple combination therapy. Articles were stratified into two tiers depending on the level of clinical detail provided. A tier 1 study included: antibiotic regimen, regimen-specific outcome, patient status at onset of infection, and source of infection. Articles not reaching these criteria were considered tier 2. Thirty-three studies were eligible, 23 tier 1 and ten tier 2. Among tier 1 studies, 53 cases were included in this analysis. The most common infection was pneumonia (31%) followed by primary or catheter-related bacteremia (21%) and urinary tract infection (17%). Different combinations of antibiotic classes were utilized in triple combinations, the most common being a polymyxin (colistin or polymyxin B, 86.8%), tigecycline (73.6%), aminoglycoside (43.4%), or carbapenem (43.4%). Clinical and microbiological failure occurred in 14/39 patients (35.9%) and 22/42 patients (52.4%), respectively. Overall mortality for patients treated with triple combination therapy was 35.8% (19/53 patients). Triple combination therapy is being considered as a treatment option for CPKP. Polymyxin-based therapy is the backbone antibiotic in these regimens, but its effectiveness needs establishing in prospective clinical trials.

  11. Control of carbapenemase-producing Enterobacteriaceae outbreaks in acute settings: an evidence review.

    Science.gov (United States)

    French, C E; Coope, C; Conway, L; Higgins, J P T; McCulloch, J; Okoli, G; Patel, B C; Oliver, I

    2017-01-01

    In recent years, infections with carbapenemase-producing Enterobacteriaceae (CPE) have been increasing globally and present a major public health challenge. To review the international literature: (i) to describe CPE outbreaks in acute hospital settings globally; and (ii) to identify the control measures used during these outbreaks and report on their effectiveness. A systematic search of MEDLINE and EMBASE databases, abstract lists for key conferences and reference lists of key reviews was undertaken, and information on unpublished outbreaks was sought for 2000-2015. Where relevant, risk of bias was assessed using the Newcastle-Ottawa scale. A narrative synthesis of the evidence was conducted. Ninety-eight outbreaks were eligible. These occurred worldwide, with 53 reports from Europe. The number of cases (CPE infection or colonization) involved in outbreaks varied widely, from two to 803. In the vast majority of outbreaks, multi-component infection control measures were used, commonly including: patient screening; contact precautions (e.g. gowns, gloves); handwashing interventions; staff education or monitoring; enhanced environmental cleaning/decontamination; cohorting of patients and/or staff; and patient isolation. Seven studies were identified as providing the best-available evidence on the effectiveness of control measures. These demonstrated that CPE outbreaks can be controlled successfully using a range of appropriate, commonly used, infection control measures. However, risk of bias was considered relatively high for these studies. The findings indicate that CPE outbreaks can be controlled using combinations of existing measures. However, the quality of the evidence base is weak and further high-quality research is needed, particularly on the effectiveness of individual infection control measures. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  12. Carbapenemase-producing Enterobacteriaceae in Irish critical care units: results of a pilot prevalence survey, June 2011.

    LENUS (Irish Health Repository)

    Burns, K

    2012-11-10

    The epidemiology of carbapenemase-producing Enterobacteriaceae (CPE) in Ireland is changing, with an increase in the number of reported cases in late 2010 and early 2011. Reported cases were predominantly linked to critical care units. In June 2011, a four-week national pilot survey took place in 40 Irish critical care units (37 adult and three paediatric) to examine the prevalence of rectal carriage of CPE and inform national CPE screening guidelines. A total of 760 screening swabs were taken over the study period, and CPE were not detected in any of the participating critical care units.

  13. Prevalence of carbapenemase producing Enterobacteriaceae isolated from German pig-fattening farms during the years 2011-2013.

    Science.gov (United States)

    Roschanski, Nicole; Friese, Anika; von Salviati-Claudius, Christina; Hering, Johanna; Kaesbohrer, Annemarie; Kreienbrock, Lothar; Roesler, Uwe

    2017-02-01

    Since recently Enterobacteriaceae carrying bla VIM-1 genes have been isolated in German animal husbandries, the monitoring of carbapenemase producing Enterobacteriaceae (CPE) in livestock became a major topic within the European Union. Nevertheless, due to missing surveillance studies the worldwide situation in livestock and livestock associated surroundings might still be underestimated. The here described study provides an overview of the CPE-prevalence in German pig-fattening farms during the years 2011-2013 (period when previously described bla VIM-1 findings occurred on pig-fattening farms (Efsa, 2011; Fischer et al., 2012, 2013a)). Therefore, a collection of 238 bacterial anacultures derived from pooled faeces and boot swab samples, collected in a cross-sectional study including 58 pig-fattening farms throughout Germany, were investigated. The bacteria were selected on MacConkey agar plates containing 0.125μg/ml meropenem. Enterobacteriaceae which were able to grow on these plates were further investigated for the presence of carbapenemase genes. Out of eight CPE-suspicious strains, two Escherichia (E.) coli strains-deriving from the same farm-contained the carbapenemase gene bla VIM-1 . For the remaining six Enterobacteriaceae it seems to be likely that they possess other resistance mechanisms, leading to reduced carbapenem susceptibility. Based on the obtained results, the overall CPE prevalence for German pig-fattening farms, sampled during the years 2011-2013 was 1.7%; 95% CI: 0-10. However, as it is of great importance to prevent a further spread of these bacteria between farms and livestock populations as well as their introduction into the food chain, an understanding of their routes of introduction and spread in combination with intensified monitoring programs are considered necessary. Copyright © 2015 Elsevier B.V. All rights reserved.

  14. Analysis of OXA-204 carbapenemase-producing Enterobacteriaceae reveals possible endoscopy-associated transmission, France, 2012 to 2014.

    Science.gov (United States)

    Potron, Anaïs; Bernabeu, Sandrine; Cuzon, Gaëlle; Pontiès, Valérie; Blanchard, Hervé; Seringe, Elise; Naas, Thierry; Nordmann, Patrice; Dortet, Laurent

    2017-12-01

    OXA-48-like beta-lactamase producing bacteria are now endemic in several European and Mediterranean countries. Among this carbapenemase family, the OXA-48 and OXA-181 variants predominate, whereas other variants such as OXA-204 are rarely reported. Here, we report the molecular epidemiology of a collection of OXA-204-positive enterobacterial isolates (n = 29) recovered in France between October 2012 and May 2014. This study describes the first outbreak of OXA-204-producing Enterobacteriaceae in Europe, involving 12 isolates of an ST90 Escherichia coli clone and nine isolates of an ST147 Klebsiella pneumoniae clone. All isolates co-produced the cephalosporinase CMY-4, and 60% of them co-produced the extended-spectrum beta-lactamase CTX-M-15. The bla OXA-204 gene was located on a 150-kb IncA/C plasmid, isolated from various enterobacterial species in the same patient, indicating a high conjugative ability of this genetic vehicle.

  15. Evaluation of the β-CARBA™ test, a colorimetric test for the rapid detection of carbapenemase activity in Gram-negative bacilli.

    Science.gov (United States)

    Bernabeu, Sandrine; Dortet, Laurent; Naas, Thierry

    2017-06-01

    There is an urgent need for accurate and fast diagnostic tests to identify carbapenemase-producing bacteria. Here, we have evaluated a novel colorimetric test (the β-CARBA™ test; Bio-Rad) to detect carbapenemase-producing Gram-negative bacilli from cultured colonies. The performance of the β-CARBA™ test was compared with that of the Carba NP test (or the CarbAcineto NP test) and RAPIDEC ® CARBA NP (bioMérieux) using a collection of 290 isolates with characterized β-lactamase content. This collection included 199 carbapenemase producers (121 Enterobacteriaceae, 36 Pseudomonas and 42 Acinetobacter baumannii ) and 91 non-carbapenemase producers (55 Enterobacteriaceae, 20 Pseudomonas and 16 A. baumannii ). The β-CARBA™ test correctly detected 84.9% of the carbapenemase producers, including all KPC and IMP, 96.4% of VIM, 85.3% of NDM, 80.5% of OXA-48-like and 91.2% of A. baumannii -related OXA carbapenemases (OXA-23, OXA-40, OXA-58, OXA-143 and overexpressed OXA-51). All rare metallo-β-lactamases (SPM, AIM, GIM, DIM and SIM) were detected. Importantly, all non-KPC Ambler class A carbapenemases were not detected, including GES variants with carbapenemase activity ( n  = 6), IMI ( n  = 3), NMC-A ( n  = 1), SME ( n  = 2), FRI-1 ( n  = 1) and BIC-1 ( n  = 1). All non-carbapenemase producers gave a negative result except with OXA-163-, OXA-405- and one TEM-3-producing Citrobacter freundii . The overall sensitivity and specificity of the β-CARBA™ test were 84.9% and 95.6%, respectively. This test is easy to perform and to interpret by non-specialized staff members. Despite lack of specificity towards non-KPC Ambler class A and OXA-48-like carbapenemases, the β-CARBA™ test could complete the existing panel of tests available for the confirmation of carbapenemases in Gram-negatives. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For

  16. Phenotypic method for differentiation of carbapenemases in Enterobacteriaceae: Study from north India

    Directory of Open Access Journals (Sweden)

    Priya Datta

    2012-01-01

    Full Text Available Aims: Carbapenems are usually the choice of antimicrobials in infections caused by Enterobacteriaceae bacteria-producing ESBL (extended spectrum β-lactamases and Amp C. Resistance to carbapenems is mostly due to production of enzymes - Carbapenemases, which are divided into Ambler Classes A, B and D. Phenotypic detection and differentiation of types of Carbapenemases in carbapenem-resistant Enterobacteriaceae (CRE is important for proper infection control and appropriate patient management. Materials and Methods: The present study done in a tertiary care hospital from North India differentiates Class A (KPC type and B (MBL type carbapenemases among Enterobacteriaceae isolates by simple phenotypic method that uses both the inhibitors EDTA and phenylboronic acid. Results: Total of 330 strains of Enterobacteriaceae were included in the study. Out of these 330 strains, 26 strains were resistant to carbapenems. The prevalence of CRE in our Institute is 7.87% (26/330. Conclusions: The prevalence of Enterobacteriaceae strains producing MBL type carbapenemase in our health care setup is 5.75% (19/330. None of the strains among the carbapenem-resistant bacterial isolates showed production of KPC enzyme. The need of the hour is simple, rapid and cost effective tests which will be able to identify and distinguish resistant pathogens for improved patient outcome, facilitating efficient infection control and reducing the escalation of resistance.

  17. A gold nanostar-based SERS platform for point-of-care diagnostics of carbapenemase-producing enterobacteriacae

    Science.gov (United States)

    Kang, Wei Cherng Malvin; Wong, Yen Lynn; Piotrowski, Marek; Teo, Woon Pei J.; He, Shuai; Kah, James C.

    2017-04-01

    The ever-increasing spread and emergence of antibiotic resistance poses a serious threat to global public health. With the existence of Carbapenem-resistant Enterobacteriaceae (CRE) produced by the Klebsiella Pneumoniae bacteria, it renders the use of carbapenems, the last-resort class of β-lactam antibiotics, useless against combating against bacterial infections. Such infections reduce the ability to treat complex infections due to the lack of antibiotic options for treatment, leading to CRE-associated mortalities. Current methods of detection, like CarbaNP test and Modified Hodge's Test, have significant limitations in that the time taken for detection of carbapenemase activity ranges between hours to days, and are non-specific in detecting the specific phenotype, making it challenging to isolate patients rapidly and to devise appropriate treatment for infected patients. We propose a methodology by utilising Surface Enhanced Raman Spectroscopy (SERS) to study bacterial β-lactamase activity. This is done via the use of gold nanostars (AuNS), which have reported excellent SERS properties, conjugated with a β-lactam antibiotic ceftriaxole, as a proof-of-concept study to analyse the changes in the SERS spectra associated with cleavage of the β-lactam ring upon interaction with the New Delhi Metalloproteinase (NDM)- producing Escherichia coli (Class B β-lactamase). We are able to obtain detection of carbapenemase activity within 25 minutes, with the associated changes in SERS spectra being diminishing of SERS peaks at 1358cm-1 and 1495cm-1. This project can be further extended to study the activity of other classes of β-lactamases and other β-lactam antibiotics to improve this state of technology for potential adoption by healthcare institutions.

  18. Epidemiology of extended spectrum β-lactamase, AmpC and class A carbapenemases-producing organisms isolated at San Camillo Hospital of Treviso (Italy between April 2012 and March 2014

    Directory of Open Access Journals (Sweden)

    Margherita Scapaticci

    2016-03-01

    Full Text Available The indiscriminate use of broad-spectrum cephalosporins of the last years has favoured the selection of extended spectrum β-lactamases (ESBLs, AmpC and class A carbapenemases (KPC-producing Enterobacteriaceae strains, representing a real health emergency. At San Camillo Hospital of Treviso, Italy, between April 2012 and March 2014, we isolated 263 suspected ESBL-producing strains from various specimens, including urine (76.4%, wound swabs (9.9%, blood cultures (4.6%, vaginal swabs (2.7%, fragments of bone (1.5% and other materials (4.9%. The majority of the isolated bacteria were represented by Escherichia coli (43.3%, followed by Klebsiella pneumoniae (34.2%, Proteus mirabilis (15.2%, Enterobacter spp. (3.8%, Morganella morganii (1.1%, Serratia spp. (0.8%, Proteus vulgaris (0.4%, Citrobacter freudii (0.4%, Providencia spp. (0.4% and Pseudomonas aeruginosa (0.4%. Using confirmatory phenotypic tests, 89.4% of the isolated resulted ESBL producer, 15.3% of which were also AmpC-producers, 1.5% were ESBL negative and AmpC positive, 4.2% were ESBL negative and AmpC negative, and 4.9%, consisting solely of K.pneumoniae, were confirmed as KPC positive. ESBL-mediated resistance to cephalosporin is not always clearly evident using susceptibility testing performed by agar diffusion-disc or dilution methods, for this reason it is strictly recommended to use specific tests able to reveal important mechanisms of resistance. The optimal use of diagnostic tools in microbiology is necessary to fight the spreading of pathogens with multiple antibiotic resistance mechanisms and in order to avoid giving useless antibiotic therapies to the patients.

  19. Retrospective and prospective evaluation of the Carbapenem inactivation method for the detection of carbapenemase-producing Enterobacteriaceae

    Science.gov (United States)

    Gauthier, Lauraine; Dortet, Laurent; Naas, Thierry

    2017-01-01

    Background There is an urgent need for accurate and rapid diagnostic tests to identify carbapenemase producing enterobacteria (CPE). Here, we have evaluated the Carbapenem Inactivation Method (CIM) test to detect CPEs from cultured colonies. Methods A total of 256 enterobacterial isolates were used to evaluate the performance of the CIM in comparison to Carba NP test and molecular detection used a reference method. Ninety three well-characterized isolates (including 29 non-CPE and 63 CPEs of worldwide origin) with decreased susceptibility to at least one carbapenem were used to (i) evaluate the efficacy of CIM test and (ii) to compare it to the Carba NP test. We also tested different carbapenems to determine the best substrate for this test. Finally, the CIM test was then evaluated prospectively against 164 isolates referred to the French National Reference Center (NRC) for Antimicrobial Resistance from may 2016 to july 2016. Results Based on the results of this retrospective study, sensitivity and specificity of the CIM and the Carba NP test were 92.1% and 100%, respectively. We demonstrated that the meropenem was the best substrate to perform the CIM test since sensitivity and specificity were 81.1% and 100% using ertapenem disk, and 100% and 65,6% using imipenem disk, and respectively. Taking in account the results of retrospective and prospective studies, CIM and Carba NP tests have similar sensitivity, specificity, positive predictive value and negative predictive values being 96.3%, 98.9%, 99.0% and 98.4% for the CIM test versus 96.9%, 100%, 100% and 100% for the Carba NP test. Conclusions Our results confirm that the CIM test may be a useful tool for the reliable confirmation of carbapenemase-activity in enterobacterial isolates, especially in clinical microbiological laboratories with limited resources, no trained personnel, and no specialized equipment. PMID:28158310

  20. Guideline for phenotypic screening and confirmation of carbapenemases in Enterobacteriaceae.

    NARCIS (Netherlands)

    Cohen Stuart, J.; Leverstein-van Hall, M.A.; Voss, A.; et al.,

    2010-01-01

    Adequate detection of carbapenemase-producing Enterobacteriaceae is crucial for infection control measures and appropriate choice of antimicrobial therapy. This guideline aims to improve the detection of carbapenemase-producing Enterobacteriaceae in the routine setting of clinical microbiology

  1. Occurrence of Carbapenemase-Producing Enterobacteriaceae Isolates in the Wildlife: First Report of OXA-48 in Wild Boars in Algeria.

    Science.gov (United States)

    Bachiri, Taous; Bakour, Sofiane; Lalaoui, Rym; Belkebla, Nadia; Allouache, Meriem; Rolain, Jean Marc; Touati, Abdelaziz

    2018-04-01

    The aim of the present study was to screen for the presence of carbapenemase-producing Enterobacteriaceae (CPE) isolates from wild boars and Barbary macaques in Algeria. Fecal samples were collected from wild boars (n = 168) and Barbary macaques (n = 212), in Bejaia, Algeria, between September 2014 and April 2016. The isolates were identified and antimicrobial susceptibility was determined. Carbapenem resistance determinants were studied using PCR and sequencing, while clonal relatedness was performed using multilocus sequence typing (MLST). PCR was used to investigate certain virulence genes. Three CPE isolates from three different samples (1.8%) recovered from wild boars were identified as Escherichia coli (two isolates) and Klebsiella pneumoniae (one isolate). These isolates were resistant to amoxicillin, amoxicillin-clavulanate, tobramycin, ertapenem, and meropenem. The results of PCR and sequencing analysis showed that all three isolates produced the OXA-48 enzyme. The MLST showed that the two E. coli isolates were assigned to the same sequence type, ST635, and belonged to phylogroup A, whereas K. pneumoniae strain belonged to ST13. The K. pneumoniae strain was positive for multiple virulence factors, whereas no virulence determinants were found in E. coli isolates. This is the first report of OXA-48-producing Enterobacteriaceae in wild animals from Algeria and Africa.

  2. Multiple drug resistant carbapenemases producing Acinetobacter baumannii isolates harbours multiple R-plasmids

    Directory of Open Access Journals (Sweden)

    Rajagopalan Saranathan

    2014-01-01

    Full Text Available Background & objectives: The nosocomial human pathogen Acinetobacter baumannii has high propensity to develop resistance to antimicrobials and to become multidrug resistant (MDR, consequently complicating the treatment. This study was carried out to investigate the presence of resistant plasmids (R-plasmids among the clinical isolates of A. baumannii. In addition, the study was performed to check the presence of common β-lactamases encoding genes on these plasmids. Methods: A total of 55 clinical isolates of A. baumannii were included in the study and all were subjected to plasmid DNA isolation, followed by PCR to check the presence of resistance gene determinants such as blaOXA-23 , blaOXA-51, blaOXA-58 and blaIMP-1 on these plasmids that encode for oxacillinase (OXA and metallo-β-lactamase (MBL type of carbapenemases. Plasmid curing experiments were carried out on selected isolates using ethidium bromide and acridine orange as curing agents and the antibiotic resistance profiles were evaluated before and after curing. Results: All the isolates were identified as A. baumannii by 16SrDNA amplification and sequencing. Plasmid DNA isolated from these isolates showed the occurrence of multiple plasmids with size ranging from 500bp to ≥ 25 kb. The percentage of blaOXA-51 and blaOXA-23 on plasmids were found to be 78 and 42 per cent, respectively and 20 isolates (36% carried blaIMP-1 gene on plasmids. Significant difference was observed in the antibiograms of plasmid cured isolates when compared to their parental ones. The clinical isolates became susceptible to more than two antibiotic classes after curing of plasmids indicating plasmid borne resistance. Interpretation & conclusions: Our study determined the plasmid mediated resistance mechanisms and occurrence of different resistance genes on various plasmids isolated from MDR A. baumannii. The present findings showed the evidence for antibiotic resistance mediated through multiple plasmids in

  3. Audit of the management of patients at high risk of carbapenemase-producing enterobacteriaceae (CPE): Are we ready?

    Science.gov (United States)

    Ratnayake, Lasantha; Harris, Amy; Ko, Doreen; Hawtin, Linda

    2017-11-01

    Incidence of carbapenemase-producing enterobacteriaceae (CPE) in the UK is increasing. In 2013, Public Health England (PHE) published a toolkit to control spread of CPE within healthcare settings. To assess compliance to hospital CPE policy (adapted from PHE) in the identification, isolation and screening of suspected CPE patients. Admission booklets of 150 patients were evaluated to see whether the relevant section had been completed to identify high-risk CPE patients. Where necessary, patients were interviewed or their GPs were contacted to assess their CPE risk. Additionally, 28 patients screened for CPE were audited to assess compliance to screening and isolation. Only 23 patients out of 147 (15.6%) were risk assessed on admission. Risk status of 27 (18.4%) patients could not be assessed due to lack of data. Fifteen patients out of 28 (54%) screened for CPE were identified and isolated on admission. Ten out of 19 patients (53%) had three screens 48 h apart. This audit highlights difficulties in screening based on individual risk factors as the majority of patients were not screened on admission and documentation on isolation and screening was poor. More needs to be done to raise awareness of the requirements for routine assessment, isolation and screening.

  4. Prevalence of Acquired Carbapenemase Genes in Klebsiella Pneumoniae by Multiplex PCR in Isfahan

    Directory of Open Access Journals (Sweden)

    Farzin Khorvash

    2017-01-01

    Full Text Available Background: Multi-drug resistant Klebsiella pneumoniae has been considered as a serious global threat. This study was done to investigate carbapenemase producing genomes among K. pneumoniae isolates in Isfahan, Central Iran. Materials and Methods: In a cross-sectional study from 2011 to 2012, 29 carbapenem resistant (according to disc diffusion method carbapenemase producing (according to modified Hodge test K. pneumoniae strains were collected from Intensive Care Unit (ICUs of Al-Zahra referral Hospital. In the strains with the lack of sensitivity to one or several carbapenems, beta-lactams, or beta-lactamases, there has been performed modified Hodge test to investigate carbapenmase and then only strains producing carbapenmases were selected for molecular methods. Results: In this study, there have been 29 cases of K. pneumoniae isolated from hospitalized patients in the (ICU. Three cases (10.3% contained blaVIM, 1 case (3.4% contained blaIMP, and 1 case (3.4% contained blaOXA. The genes blaNDM and blaKPC were not detected. Then, 16 cases (55.2% from positive cases of K. pneumoniae were related to the chip, 4 cases (13.8% to catheter, 6 cases (20.7% to urine, and 3 cases (10.3% to wound. Conclusion: It is necessary to monitor the epidemiologic changes of these carbapenemase genes in K. pneumoniae in our Hospital. More attention should be paid to nosocomial infection control measures. Other carbapenemase producing genes should be investigated.

  5. Emergence and Evolution of Multidrug-Resistant Klebsiella pneumoniae with both blaKPC and blaCTX-M Integrated in the Chromosome

    OpenAIRE

    Huang, Weihua; Wang, Guiqing; Sebra, Robert; Zhuge, Jian; Yin, Changhong; Aguero-Rosenfeld, Maria E.; Schuetz, Audrey N.; Dimitrova, Nevenka; Fallon, John T.

    2017-01-01

    The extended-spectrum-β-lactamase (ESBL)- and Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae represent serious and urgent threats to public health. In a retrospective study of multidrug-resistant K. pneumoniae, we identified three clinical isolates, CN1, CR14, and NY9, carrying both blaCTX-M and blaKPC genes. The complete genomes of these three K. pneumoniae isolates were de novo assembled by using both short- and long-read whole-genome sequencing. In CR14 and NY9, bla...

  6. Carbapenemase-Producing Enterobacteriaceae Recovered from the Environment of a Swine Farrow-to-Finish Operation in the United States.

    Science.gov (United States)

    Mollenkopf, Dixie F; Stull, Jason W; Mathys, Dimitria A; Bowman, Andrew S; Feicht, Sydnee M; Grooters, Susan V; Daniels, Joshua B; Wittum, Thomas E

    2017-02-01

    Carbapenem-resistant Enterobacteriaceae (CRE) present an urgent threat to public health. While use of carbapenem antimicrobials is restricted for food-producing animals, other β-lactams, such as ceftiofur, are used in livestock. This use may provide selection pressure favoring the amplification of carbapenem resistance, but this relationship has not been established. Previously unreported among U.S. livestock, plasmid-mediated CRE have been reported from livestock in Europe and Asia. In this study, environmental and fecal samples were collected from a 1,500-sow, U.S. farrow-to-finish operation during 4 visits over a 5-month period in 2015. Samples were screened using selective media for the presence of CRE, and the resulting carbapenemase-producing isolates were further characterized. Of 30 environmental samples collected from a nursery room on our initial visit, 2 (7%) samples yielded 3 isolates, 2 sequence type 218 (ST 218) Escherichia coli and 1 Proteus mirabilis, carrying the metallo-β-lactamase gene bla IMP-27 on IncQ1 plasmids. We recovered on our third visit 15 IMP-27-bearing isolates of multiple Enterobacteriaceae species from 11 of 24 (46%) environmental samples from 2 farrowing rooms. These isolates each also carried bla IMP-27 on IncQ1 plasmids. No CRE isolates were recovered from fecal swabs or samples in this study. As is common in U.S. swine production, piglets on this farm receive ceftiofur at birth, with males receiving a second dose at castration (≈day 6). This selection pressure may favor the dissemination of bla IMP-27 -bearing Enterobacteriaceae in this farrowing barn. The absence of this selection pressure in the nursery and finisher barns likely resulted in the loss of the ecological niche needed for maintenance of this carbapenem resistance gene. Copyright © 2017 American Society for Microbiology.

  7. Double Copies of bla(KPC-3)::Tn4401a on an IncX3 Plasmid in Klebsiella pneumoniae Successful Clone ST512 from Italy.

    Science.gov (United States)

    Fortini, Daniela; Villa, Laura; Feudi, Claudia; Pires, João; Bonura, Celestino; Mammina, Caterina; Endimiani, Andrea; Carattoli, Alessandra

    2016-01-01

    A carbapenem-resistant sequence type 512 (ST512) Klebsiella pneumoniae carbapenemase 3 (KPC-3)-producing K. pneumoniae strain showing a novel variant plasmid content was isolated in Palermo, Italy, in 2014. ST512 is a worldwide successful clone associated with the spread of bla(KPC) genes located on the IncFIIk pKpQIL plasmid. In our ST512 strain, the bla(KPC-3) gene was unusually located on an IncX3 plasmid, whose complete sequence was determined. Two copies of bla(KPC-3)::Tn4401a caused by intramolecular transposition events were detected in the plasmid. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  8. Molecular identification of tigecycline- and colistin-resistant carbapenemase-producing Acinetobacter baumannii from a Greek hospital from 2011 to 2013.

    Science.gov (United States)

    Mavroidi, Angeliki; Likousi, Sofia; Palla, Eleftheria; Katsiari, Maria; Roussou, Zoi; Maguina, Asimina; Platsouka, Evangelia D

    2015-09-01

    An alarming increase in the resistance rates of tigecycline and colistin among carbapenemase-producing Acinetobacter baumannii recovered from a Greek hospital over a 3-year period (2011-2013) was investigated. The antimicrobial resistance profiles and carbapenemase gene content were determined for a collection of colistin- and/or tigecycline-resistant carbapenemase-producing A. baumannii isolates (n = 42), which were recovered consecutively during the study period. A gradual increase in the incidence of blaOXA-23 producers was observed from 2011 to 2013. A cluster of 21 isolates comprised tigecycline-resistant blaOXA-23 producers displayed a single antimicrobial resistance pattern. The emergence of two blaOXA-23 producers resistant to both tigecycline and colistin was documented. Furthermore, determination of the mechanisms of colistin and tigecycline resistance and molecular typing by the tri-locus sequence typing (3LST) scheme for nine isolates recovered from bloodstream infections were performed. Out of nine isolates, five tigecycline- and two colistin-resistant isolates were blaOXA-23 producers of 3LST ST101 corresponding to the international clone II recovered during 2012-2013. All nine isolates were positive for the presence of the adeB gene of the AdeABC efflux pump. Three colistin-resistant isolates possessed novel substitutions in PmrB, which may be implicated in colistin resistance. To the best of our knowledge, this is the first report of the acquisition of tigecycline and colistin resistance among blaOXA-23-producing A. baumannii of 3LST ST101 in Greece; thus, continuous surveillance and molecular characterization, prudent use of antibiotics and implementation of infection control measures for A. baumannii are urgent.

  9. Active case finding for carbapenemase-producing Enterobacteriaceae in a teaching hospital: prevalence and risk factors for colonization.

    Science.gov (United States)

    Poole, K; George, R; Decraene, V; Shankar, K; Cawthorne, J; Savage, N; Welfare, W; Dodgson, A

    2016-10-01

    Over the past decade, the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) has increased. Whilst basic infection prevention and control practices reduce the risk of transmission, cases of unrecognized carriage pose a potential risk of transmission. To estimate the prevalence of CPE and explore risk factors associated with colonization within a large teaching hospital with an established CPE outbreak. All inpatients that had not previously tested positive for CPE were offered testing. Demographic and hospital episode data were also collected, together with antibiotic and proton pump inhibitor (PPI) use in the preceding 24h. This study identified 70 CPE-positive cases (26 newly identified and 44 previously known) and 592 CPE-negative cases, giving a combined prevalence of 11% [95% confidence interval (CI) 8-13]. Medication (antibiotic and PPI use), previous admission, ethnicity and length of stay were assessed as risk factors for colonization, and none were found to be independently associated with CPE colonization. Using logistic regression, age [odds ratio (OR) 1.03, 95% CI 1.01-1.07] and antibiotic use (OR 2.55, 95% CI 1.08-6.03) were the only risk factors significantly associated with CPE colonization. This study has added to the evidence base by estimating the prevalence of CPE among inpatients in an acute hospital with an established CPE outbreak. A case-finding exercise was feasible and identified a number of new cases. Despite a small sample size, increasing age and prescription of an antibiotic on the day of testing were significantly associated with CPE colonization. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  10. Transmission dynamics of carbapenemase-producing Klebsiella pneumoniae and anticipated impact of infection control strategies in a surgical unit.

    Directory of Open Access Journals (Sweden)

    Vana Sypsa

    Full Text Available BACKGROUND: Carbapenemase-producing Klebsiella pneumoniae (CPKP has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. METHODOLOGY/PRINCIPAL FINDINGS: Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R(0 (average number of secondary cases per primary case in the absence of infection control and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R(0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%. The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8-12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. CONCLUSIONS/SIGNIFICANCE: Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings.

  11. Transmission Dynamics of Carbapenemase-Producing Klebsiella Pneumoniae and Anticipated Impact of Infection Control Strategies in a Surgical Unit

    Science.gov (United States)

    Sypsa, Vana; Psichogiou, Mina; Bouzala, Georgia-Aikaterina; Hadjihannas, Linos; Hatzakis, Angelos; Daikos, Georgios L.

    2012-01-01

    Background Carbapenemase-producing Klebsiella pneumoniae (CPKP) has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. Methodology/Principal Findings Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R0 (average number of secondary cases per primary case in the absence of infection control) and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%). The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8–12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. Conclusions/Significance Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings. PMID:22859965

  12. Imipenem-avibactam: a novel combination for the rapid detection of carbapenemase activity in Enterobacteriaceae and Acinetobacter baumannii by matrix-assisted laser desorption ionization-time of flight mass spectrometry.

    Science.gov (United States)

    Oviaño, Marina; Bou, Germán

    2017-02-01

    In the present study, we propose a novel matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based method for detecting carbapenemase-producing Enterobacteriaceae and Acinetobacter baumannii. For this, we analyzed a series of 131 isolates. Among them, a total of 115 Enterobacteriaceae: 79 of them carrying a carbapenemase enzyme (15bla KPC , 7bla NDM , 11bla IMP , 12bla VIM , and 34bla OXA-48 ) and 16 A. baumannii isolates: 15 of them carrying carbapenemases (10bla OXA-23, 2bla OXA-58, 2bla OXA-24 , and 1bla OXA-237 ). The rest of the isolates were noncarbapenemase producers and used as negative controls. The isolates were submitted to susceptibility testing using a combination of imipenem-avibactam and analysis by the MALDI-TOF Biotyper Compass software (Bruker Daltonik, Germany). The assay showed an overall sensitivity and specificity for carbapenemase detection of 98% and 100%, respectively. The combination of imipenem and avibactam displayed activity against KPC and OXA-48-producing Enterobacteriaceae and thus represents a new strategy for identifying and confirming these carbapenemases. However, the combination did not provide any benefit over A. baumannii. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Development and Validation of a Lateral Flow Immunoassay for Rapid Detection of NDM-Producing Enterobacteriaceae

    Science.gov (United States)

    Boutal, Hervé; Naas, Thierry; Devilliers, Karine; Oueslati, Saoussen; Bernabeu, Sandrine; Simon, Stéphanie

    2017-01-01

    ABSTRACT The global spread of carbapenemase-producing Enterobacteriaceae (CPE) that are often resistant to most, if not all, classes of antibiotics is a major public health concern. The NDM-1 carbapenemase is among the most worrisome carbapenemases given its rapid worldwide spread. We have developed and evaluated a lateral flow immunoassay (LFIA) (called the NDM LFIA) for the rapid and reliable detection of NDM-like carbapenemase-producing Enterobacteriaceae from culture colonies. We evaluated the NDM LFIA using 175 reference enterobacterial isolates with characterized β-lactamase gene content and 74 nonduplicate consecutive carbapenem-resistant clinical isolates referred for expertise to the French National Reference Center (NRC) for Antibiotic Resistance during a 1-week period (in June 2016). The reference collection included 55 non-carbapenemase producers and 120 carbapenemase producers, including 27 NDM producers. All 27 NDM-like carbapenemase producers of the reference collection were correctly detected in less than 15 min by the NDM LFIA, including 22 strains producing NDM-1, 2 producing NDM-4, 1 producing NDM-5, 1 producing NDM-7, and 1 producing NDM-9. All non-NDM-1 producers gave a negative result with the NDM LFIA. No cross-reaction was observed with carbapenemases (VIM, IMP, NDM, KPC, and OXA-48-like), extended-spectrum β-lactamases (ESBLs) (TEM, SHV, and CTX-M), AmpCs (CMY-2, DHA-2, and ACC-1), and oxacillinases (OXA-1, -2, -9, and -10). Similarly, among the 74 referred nonduplicate consecutive clinical isolates, all 7 NDM-like producers were identified. Overall, the sensitivity and specificity of the assay were 100% for NDM-like carbapenemase detection with strains cultured on agar. The NDM LFIA was efficient, rapid, and easy to implement in the routine workflow of a clinical microbiology laboratory for the confirmation of NDM-like carbapenemase-producing Enterobacteriaceae. PMID:28404680

  14. The Challenges of Implementing Next Generation Sequencing Across a Large Healthcare System, and the Molecular Epidemiology and Antibiotic Susceptibilities of Carbapenemase-Producing Bacteria in the Healthcare System of the U.S. Department of Defense.

    Directory of Open Access Journals (Sweden)

    Emil Lesho

    Full Text Available We sought to: 1 provide an overview of the genomic epidemiology of an extensive collection of carbapenemase-producing bacteria (CPB collected in the U.S. Department of Defense health system; 2 increase awareness of the public availability of the sequences, isolates, and customized antimicrobial resistance database of that system; and 3 illustrate challenges and offer mitigations for implementing next generation sequencing (NGS across large health systems.Prospective surveillance and system-wide implementation of NGS.288-hospital healthcare network.All phenotypically carbapenem resistant bacteria underwent CarbaNP® testing and PCR, followed by NGS. Commercial (Newbler and Geneious, on-line (ResFinder, and open-source software (Btrim, FLASh, Bowtie2, an Samtools were used for assembly, SNP detection and clustering. Laboratory capacity, throughput, and response time were assessed.From 2009 through 2015, 27,000 multidrug-resistant Gram-negative isolates were submitted. 225 contained carbapenemase-encoding genes (most commonly blaKPC, blaNDM, and blaOXA23. These were found in 15 species from 146 inpatients in 19 facilities. Genetically related CPB were found in more than one hospital. Other clusters or outbreaks were not clonal and involved genetically related plasmids, while some involved several unrelated plasmids. Relatedness depended on the clustering algorithm used. Transmission patterns of plasmids and other mobile genetic elements could not be determined without ultra-long read, single-molecule real-time sequencing. 80% of carbapenem-resistant phenotypes retained susceptibility to aminoglycosides, and 70% retained susceptibility to fluoroquinolones. However, among the CPB-confirmed genotypes, fewer than 25% retained susceptibility to aminoglycosides or fluoroquinolones.Although NGS is increasingly acclaimed to revolutionize clinical practice, resource-constrained environments, large or geographically dispersed healthcare networks, and

  15. The Challenges of Implementing Next Generation Sequencing Across a Large Healthcare System, and the Molecular Epidemiology and Antibiotic Susceptibilities of Carbapenemase-Producing Bacteria in the Healthcare System of the U.S. Department of Defense.

    Science.gov (United States)

    Lesho, Emil; Clifford, Robert; Onmus-Leone, Fatma; Appalla, Lakshmi; Snesrud, Erik; Kwak, Yoon; Ong, Ana; Maybank, Rosslyn; Waterman, Paige; Rohrbeck, Patricia; Julius, Michael; Roth, Amanda; Martinez, Joshua; Nielsen, Lindsey; Steele, Eric; McGann, Patrick; Hinkle, Mary

    2016-01-01

    We sought to: 1) provide an overview of the genomic epidemiology of an extensive collection of carbapenemase-producing bacteria (CPB) collected in the U.S. Department of Defense health system; 2) increase awareness of the public availability of the sequences, isolates, and customized antimicrobial resistance database of that system; and 3) illustrate challenges and offer mitigations for implementing next generation sequencing (NGS) across large health systems. Prospective surveillance and system-wide implementation of NGS. 288-hospital healthcare network. All phenotypically carbapenem resistant bacteria underwent CarbaNP® testing and PCR, followed by NGS. Commercial (Newbler and Geneious), on-line (ResFinder), and open-source software (Btrim, FLASh, Bowtie2, an Samtools) were used for assembly, SNP detection and clustering. Laboratory capacity, throughput, and response time were assessed. From 2009 through 2015, 27,000 multidrug-resistant Gram-negative isolates were submitted. 225 contained carbapenemase-encoding genes (most commonly blaKPC, blaNDM, and blaOXA23). These were found in 15 species from 146 inpatients in 19 facilities. Genetically related CPB were found in more than one hospital. Other clusters or outbreaks were not clonal and involved genetically related plasmids, while some involved several unrelated plasmids. Relatedness depended on the clustering algorithm used. Transmission patterns of plasmids and other mobile genetic elements could not be determined without ultra-long read, single-molecule real-time sequencing. 80% of carbapenem-resistant phenotypes retained susceptibility to aminoglycosides, and 70% retained susceptibility to fluoroquinolones. However, among the CPB-confirmed genotypes, fewer than 25% retained susceptibility to aminoglycosides or fluoroquinolones. Although NGS is increasingly acclaimed to revolutionize clinical practice, resource-constrained environments, large or geographically dispersed healthcare networks, and military or

  16. Emergence of Serratia marcescens isolates possessing carbapenem-hydrolysing β-lactamase KPC-2 from China.

    Science.gov (United States)

    Lin, X; Hu, Q; Zhang, R; Hu, Y; Xu, X; Lv, H

    2016-09-01

    Eighty-three carbapenem-resistant Serratia marcescens isolates were recovered from Zhejiang Provincial People's Hospital, China. The minimum inhibitory concentrations of imipenem, meropenem, and ertapenem for all isolates were 2 to >128 μg/mL. Polymerase chain reaction indicated that 63 S. marcescens isolates produced Klebsiella pneumoniae carbapenemase (KPC)-2. Clone A (15 isolates) and clone B (41 isolates) were the two dominant clones and clone A strains were gradually replaced by clone B strains between 2011 and 2014. The results indicate that blaKPC-2-positive S. marcescens emerged in our hospital as the major mechanism of carbapenem resistance. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. Clonal emergence of Klebsiella pneumoniae ST14 co-producing OXA-48-type and NDM carbapenemases with high rate of colistin resistance in Dubai, United Arab Emirates.

    Science.gov (United States)

    Moubareck, Carole Ayoub; Mouftah, Shaimaa F; Pál, Tibor; Ghazawi, Akela; Halat, Dalal H; Nabi, Anju; AlSharhan, Mouza A; AlDeesi, Zulfa O; Peters, Christabel C; Celiloglu, Handan; Sannegowda, Manjunath; Sarkis, Dolla K; Sonnevend, Ágnes

    2018-03-09

    Few studies have addressed the molecular epidemiology of carbapenem resistant Enterobacteriaceae (CRE) isolates in the Arabian Peninsula, and such investigations have been missing from Dubai, a major economical, tourism and medical centre of the region. The antibiotic susceptibility, the carbapenemase type produced, and the clonality of 89 CRE strains isolated in five major Dubai hospitals in June 2015 - June 2016 were determined. Thirty three percent of the collection of 70 K. pneumoniae, 13 E. coli and 6 other Enterobacteriaceae were extremely drug resistant, 27% were resistant to colistin, and 4.5% (four K. pneumoniae isolates) were resistant to all antibiotics tested. The colistin resistance rate in K. pneumoniae was 31.4%. None of the isolates carried mobile colistin resistance genes. Seventy-seven isolates produced carbapenemase: 53.3% OXA-48-like, 24.7% NDM, and 22.1% both OXA-48-like and NDM, respectively. PFGE clustered 50% of K. pneumoniae into a 35-membered group, which showed significant association with double carbapenemase production, with extreme drug resistance, and with being isolated from Emirati patients. Members of the cluster belonged to sequence type ST14. The rate of colistin resistance in K. pneumoniae ST14 was 37.1% vs. 27.1% of K. pneumoniae isolates outside of the cluster. Two of the panresistant K. pneumoniae isolates also belonged to ST14, whereas the other two were ST15 and ST231, respectively. In conclusion, beyond the overall high colistin resistance rate in CRE, the emergence of a highly resistant clone of K. pneumoniae ST14 in all Dubai hospitals investigated is a serious problem requiring immediate attention. Copyright © 2018. Published by Elsevier B.V.

  18. Enterobacter cloacae Complex Isolates Harboring blaNMC-A or blaIMI-Type Class A Carbapenemase Genes on Novel Chromosomal Integrative Elements and Plasmids.

    Science.gov (United States)

    Boyd, David A; Mataseje, Laura F; Davidson, Ross; Delport, Johannes A; Fuller, Jeff; Hoang, Linda; Lefebvre, Brigitte; Levett, Paul N; Roscoe, Diane L; Willey, Barbara M; Mulvey, Michael R

    2017-05-01

    Carbapenem-resistant Enterobacter cloacae complex isolates submitted to a reference laboratory from 2010 to 2015 were screened by PCR for seven common carbapenemase gene groups, namely, KPC, NDM, OXA-48, VIM, IMP, GES, and NMC-A/IMI. Nineteen of the submitted isolates (1.7%) were found to harbor Ambler class A bla NMC-A or bla IMI -type carbapenemases. All 19 isolates were resistant to at least one carbapenem but susceptible to aminoglycosides, trimethoprim-sulfamethoxazole, tigecycline, and ciprofloxacin. Most isolates (17/19) gave positive results with the Carba-NP test for phenotypic carbapenemase detection. Isolates were genetically diverse by pulsed-field gel electrophoresis macrorestriction analysis, multilocus sequence typing, and hsp60 gene analysis. The genes were found in various Enterobacter cloacae complex species; however, bla NMC-A was highly associated with Enterobacter ludwigii Whole-genome sequencing and bioinformatics analysis revealed that all NMC-A ( n = 10), IMI-1 ( n = 5), and IMI-9 ( n = 2) producers harbored the carbapenemase gene on EludIMEX-1-like integrative mobile elements (EcloIMEXs) located in the identical chromosomal locus. Two novel genes, bla IMI-5 and bla IMI-6 , were harbored on different IncFII-type plasmids. Enterobacter cloacae complex isolates harboring bla NMC-A/IMI -type carbapenemases are relatively rare in Canada. Though mostly found integrated into the chromosome, some variants are located on plasmids that may enhance their mobility potential. © Crown copyright 2017.

  19. Phenotypic and molecular detection of the bla KPC gene in clinical isolates from inpatients at hospitals in São Luis, MA, Brazil.

    Science.gov (United States)

    Ribeiro, Patricia Cristina Saldanha; Monteiro, Andrea Souza; Marques, Sirlei Garcia; Monteiro, Sílvio Gomes; Monteiro-Neto, Valério; Coqueiro, Martina Márcia Melo; Marques, Ana Cláudia Garcia; de Jesus Gomes Turri, Rosimary; Santos, Simone Gonçalves; Bomfim, Maria Rosa Quaresma

    2016-12-07

    Bacteria that produce Klebsiella pneumoniae carbapenemases (KPCs) are resistant to broad-spectrum β-lactam antibiotics. The objective of this study was to phenotypically and genotypically characterize the antibiotic susceptibility to carbapenems of 297 isolates recovered from clinical samples obtained from inpatients at 16 hospitals in São Luis (Maranhão, Brazil). The study was conducted using phenotypic tests and molecular methods, including polymerase chain reaction (PCR), sequencing and enterobacterial repetitive intergenic consensus (ERIC)-PCR. The nonparametric chi-square test of independence was used to evaluate the associations between the bacterial bla KPC gene and the modified Hodge test, and the chi-square adherence test was used to assess the frequency of carbapenemases and their association with the bla KPC gene. The most frequently isolated species were Acinetobacter baumannii (n = 128; 43.0%), K. pneumoniae (n = 75; 25.2%), and Pseudomonas aeruginosa (n = 42; 14.1%). Susceptibility assays showed that polymixin B was active against 89.3% of the bacterial isolates. The Acinetobacter spp. and K. pneumoniae strains were susceptible to amikacin and tigecycline, and Pseudomonas spp. were sensitive to gentamicin and amikacin. Among the 297 isolates, 100 (33.7%) were positive for the bla KPC gene, including non-fermentative bacteria (A. baumannii) and Enterobacteriaceae species. Among the isolates positive for the bla KPC gene, K. pneumoniae isolates had the highest positivity rate of 60.0%. The bla KPC gene variants detected included KPC-2, which was found in all isolates belonging to species of the Enterobacteriaceae family. KPC-2 and KPC-3 were observed in A. baumannii isolates. Importantly, the bla KPC gene was also detected in three Raoultella isolates and one isolate of the Pantoea genus. ERIC-PCR patterns showed a high level of genetic diversity among the bacterial isolates; it was capable of distinguishing 34 clones among 100 strains

  20. Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniae ST258 clone

    Directory of Open Access Journals (Sweden)

    Madonia Simona

    2011-09-01

    Full Text Available Abstract Background Knowledge of the etiology of pyogenic liver and pancreatic abscesses is an important factor in determining the success of combined surgical and antibiotic treatment. Literature shows geographical variations in the prevalence and distribution of causative organisms, and the spread of Klebsiella pneumoniae carbapenemase-producing bacteria is an emerging cause of abdominal infections. Case presentation We herein describe two cases of intra-abdominal abscesses due to monomicrobial infection by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp. In case 1, a 50-year-old HIV-negative Italian woman with chronic pancreatitis showed infection of a pancreatic pseudocystic lesion caused by KPC-Kp. In case 2, a 64-year-old HIV- negative Italian woman with pancreatic neoplasm and liver metastases developed a liver abscess due to KPC after surgery. Both women were admitted to our hospital but to different surgical units. The clonal relationship between the two isolates was investigated by pulsed-field gel electrophoresis (PFGE. In case 2, the patient was already colonized at admission and inter-hospital transmission of the pathogen was presumed. A long-term combination regimen of colistin with tigecycline and percutaneous drainage resulted in full recovery and clearance of the multidrug-resistant (MDR pathogen. Conclusions Timely microbiological diagnosis, the combined use of new and old antibiotics and radiological intervention appeared to be valuable in managing these serious conditions. The emergence and dissemination of MDR organisms is posing an increasing challenge for physicians to develop new therapeutic strategies and control and prevention frameworks.

  1. Increasing proportion of carbapenemase-producing Enterobacteriaceae and emergence of a MCR-1 producer through a multicentric study among hospital-based and private laboratories in Belgium from September to November 2015.

    Science.gov (United States)

    Huang, Te Din; Bogaerts, Pierre; Berhin, Catherine; Hoebeke, Martin; Bauraing, Caroline; Glupczynski, Youri

    2017-05-11

    Carbapenemase-producing Enterobacteriaceae (CPE) strains have been increasingly reported in Belgium. We aimed to determine the proportion of CPE among Enterobacteriaceae isolated from hospitalised patients and community outpatients in Belgium in 2015. For the hospitalised patients, the results were compared to a previous similar survey performed in the same hospitals in 2012. Twenty-four hospital-based and 10 private laboratories collected prospectively 200 non-duplicated Enterobacteriaceae isolates from clinical specimens. All isolates were screened locally by carbapenem disk diffusion using European Committee on Antimicrobial Susceptibility Testing methodology. Putative CPE strains with inhibition zone diameters below the screening breakpoints were referred centrally for confirmation of carbapenemase production. From September to November 2015, we found a proportion of clinical CPE of 0.55% (26/4,705) and of 0.60% (12/1,991) among hospitalised patients and among ambulatory outpatients respectively. Klebsiella pneumoniae (26/38) and OXA-48-like carbapenemase (28/38) were the predominant species and enzyme among CPE. One OXA-48-producing Escherichia coli isolated from a hospital was found carrying plasmid-mediated MCR-1 colistin resistance. Compared with the 2012 survey, we found a significant increased proportion of clinical CPE (0.55% in 2015 vs 0.25% in 2012; p = 0.02) and an increased proportion of hospitals (13/24 in 2015 vs 8/24 in 2012) with at least one CPE detected. The study results confirmed the concerning spread of CPE including a colistin-resistant MCR-1 producer in hospitals and the establishment of CPE in the community in Belgium. This article is copyright of The Authors, 2017.

  2. Detection of carbapenemase activity in Enterobacteriaceae using LC-MS/MS in comparison with the neo-rapid CARB kit using direct visual assessment and colorimetry.

    Science.gov (United States)

    Huber, Charlotte A; Sidjabat, Hanna E; Zowawi, Hosam M; Kvaskoff, David; Reed, Sarah; McNamara, John F; McCarthy, Kate L; Harris, Patrick; Toh, Benjamin; Wailan, Alexander M; Paterson, David L

    2016-12-01

    It has been described that the sensitivity of the Carba NP test may be low in the case of OXA-48-like carbapenamases and mass spectrometry based methods as well as a colorimetry based method have been described as alternatives. We evaluated 84 Enterobacteriaceae isolates including 31 OXA-48-like producing isolates and 13 isolates that produced either an imipenemase (IMP; n=8), New Delhi metallo-β-lactamase (NDM; n=3), or Klebsiella pneumoniae carbapenemase (KPC; n=2), as well as 40 carbapenemase negative Enterobacteriaceae isolates. We used the Neo-Rapid CARB kit, assessing the results with the unaided eye and compared it with a colorimetric approach. Furthermore, we incubated the isolates in growth media with meropenem and measured the remaining meropenem after one and 2h of incubation, respectively, using liquid chromatography tandem mass spectrometry (LC-MS/MS). Whilst all carbapenemase producing isolates with the exception of the OXA-244 producer tested positive for both the Neo-rapid CARB test using the unaided eye or colorimetry, and the 13 isolates producing either IMP, NDM or KPC hydrolysed the meropenem in the media almost completely after 2h of incubation, the 31 OXA-48-like producing isolates exhibited very variable hydrolytic activity when incubated in growth media with meropenem. In our study, the Neo-Rapid CARB test yielded a sensitivity of 98% for both the traditional and the colorimetric approach with a specificity of 95% and 100% respectively. Our results indicate that the Neo-Rapid CARB test may have use for the detection of OXA-48 type carbapenemases and that it may be particularly important to ensure bacterial lysis for the detection of these weaker hydrolysers. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Prevalence of Class D Carbapenemases among Extended-Spectrum β-Lactamases Producing Escherichia coli Isolates from Educational Hospitals in Shahrekord

    Science.gov (United States)

    Damavandi, Mohammad-Sadegh; Latif Pour, Mohammad

    2016-01-01

    Introduction Extended-spectrum β-lactamases (ESBLs) are a set of plasmid-borne, various and quickly evolving enzymes that are a main therapeutic issue now-a-days for inpatient and outpatient treatment. Aim The aim of this study was to determine multi-drug resistance (MDR) and ESBLs producing E. coli strains, prevalence of class D Carbapenemases among ESBLs producing Escherichia coli isolates from educational hospitals in Shahrekord, Iran. Materials and Methods Uropathogenic Escherichia coli strains were isolated from patients with Urinary Tract Infections (UTIs). The agar disc diffusion test was used to characterize the antimicrobial sensitivity of the E. coli isolates. The ESBL positive strains were identified by phenotypic double-disk synergy test, by third-generation cephalosporin in combination with or without clavulanic acid. Multiplex PCR was carried out for detection of the three families of OXA-type carbapenamases including OXA-23, OXA-24, and OXA-48 in E. coli strains. Results All bacterial isolates were susceptible to meropenem. Ninety isolates produced ESBL, 55 E. coli isolates from inpatients, and 35 isolates from outpatients, with a significant association (presistance in E. coli isolates. PMID:27462579

  4. Prevalence of quinolone resistance mechanisms in Enterobacteriaceae producing acquired AmpC β-lactamases and/or carbapenemases in Spain.

    Science.gov (United States)

    Machuca, Jesús; Agüero, Jesús; Miró, Elisenda; Conejo, María Del Carmen; Oteo, Jesús; Bou, Germán; González-López, Juan José; Oliver, Antonio; Navarro, Ferran; Pascual, Álvaro; Martínez-Martínez, Luis

    2017-10-01

    Quinolone resistance in Enterobacteriaceae species has increased over the past few years, and is significantly associated to beta-lactam resistance. The aim of this study was to evaluate the prevalence of chromosomal- and plasmid-mediated quinolone resistance in acquired AmpC β-lactamase and/or carbapenemase-producing Enterobacteriaceae isolates. The presence of chromosomal- and plasmid-mediated quinolone resistance mechanisms [mutations in the quinolone resistance determining region (QRDR) of gyrA and parC and qnr, aac(6')-Ib-cr and qepA genes] was evaluated in 289 isolates of acquired AmpC β-lactamase- and/or carbapenemase-producing Enterobacteriaceae collected between February and July 2009 in 35 Spanish hospitals. Plasmid mediated quinolone resistance (PMQR) genes were detected in 92 isolates (31.8%), qnr genes were detected in 83 isolates (28.7%), and the aac(6')-Ib-cr gene was detected in 20 isolates (7%). qnrB4 gene was the most prevalent qnr gene detected (20%), associated, in most cases, with DHA-1. Only 14.6% of isolates showed no mutations in gyrA or parC with a ciprofloxacin MIC of 0.5mg/L or higher, whereas PMQR genes were detected in 90% of such isolates. qnrB4 gene was the most prevalent PMQR gene detected, and was significantly associated with acquired AmpC β-lactamase DHA-1. PMQR determinants in association with other chromosomal-mediated quinolone resistance mechanisms, different to mutations in gyrA and parC (increased energy-dependent efflux, altered lipopolysaccharide or porin loss), could lead to ciprofloxacin MIC values that exceed breakpoints established by the main international committees to define clinical antimicrobial susceptibility breakpoints. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  5. Genome of the carbapenemase-producing clinical isolate Elizabethkingia miricola EM_CHUV and comparative genomics with Elizabethkingia meningoseptica and Elizabethkingia anophelis: evidence for intrinsic multidrug resistance trait of emerging pathogens.

    OpenAIRE

    Opota, O.; Diene, S.M.; Bertelli, C.; Prod'hom, G.; Eckert, P.; Greub, G.

    2017-01-01

    Elizabethkingia miricola is a Gram-negative non-fermenting rod emerging as a life-threatening human pathogen. The multidrug-resistant (MDR) carbapenemase-producing clinical isolate E. miricola EM_CHUV was recovered in the setting of severe nosocomial pneumonia. In this study, the genome of E. miricola EM_CHUV was sequenced and a functional analysis was performed, including a comparative genomic study with Elizabethkingia meningoseptica and Elizabethkingia anophelis. The resistome of EM_CHUV r...

  6. The Carbapenem Inactivation Method (CIM), a Simple and Low-Cost Alternative for the Carba NP Test to Assess Phenotypic Carbapenemase Activity in Gram-Negative Rods

    NARCIS (Netherlands)

    Zwaluw, K. van der; Haan, A. de; Pluister, G.N.; Bootsma, H.J.; Neeling, A.J. de; Schouls, L.M.

    2015-01-01

    A new phenotypic test, called the Carbapenem Inactivation Method (CIM), was developed to detect carbapenemase activity in Gram-negative rods within eight hours. This method showed high concordance with results obtained by PCR to detect genes coding for the carbapenemases KPC, NDM, OXA-48, VIM, IMP

  7. Emergence and Evolution of Multidrug-Resistant Klebsiella pneumoniae with both blaKPC and blaCTX-M Integrated in the Chromosome.

    Science.gov (United States)

    Huang, Weihua; Wang, Guiqing; Sebra, Robert; Zhuge, Jian; Yin, Changhong; Aguero-Rosenfeld, Maria E; Schuetz, Audrey N; Dimitrova, Nevenka; Fallon, John T

    2017-07-01

    The extended-spectrum-β-lactamase (ESBL)- and Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae represent serious and urgent threats to public health. In a retrospective study of multidrug-resistant K. pneumoniae , we identified three clinical isolates, CN1, CR14, and NY9, carrying both bla CTX-M and bla KPC genes. The complete genomes of these three K. pneumoniae isolates were de novo assembled by using both short- and long-read whole-genome sequencing. In CR14 and NY9, bla CTX-M and bla KPC were carried on two different plasmids. In contrast, CN1 had one copy of bla KPC-2 and three copies of bla CTX-M-15 integrated in the chromosome, for which the bla CTX-M-15 genes were linked to an insertion sequence, IS Ecp1 , whereas the bla KPC-2 gene was in the context of a Tn 4401a transposition unit conjugated with a PsP3-like prophage. Intriguingly, downstream of the Tn 4401a-bla KPC-2 -prophage genomic island, CN1 also carried a clustered regularly interspaced short palindromic repeat (CRISPR)- cas array with four spacers targeting a variety of K. pneumoniae plasmids harboring antimicrobial resistance genes. Comparative genomic analysis revealed that there were two subtypes of type I-E CRISPR- cas in K. pneumoniae strains and suggested that the evolving CRISPR- cas , with its acquired novel spacer, induced the mobilization of antimicrobial resistance genes from plasmids into the chromosome. The integration and dissemination of multiple copies of bla CTX-M and bla KPC from plasmids to chromosome depicts the complex pandemic scenario of multidrug-resistant K. pneumoniae Additionally, the implications from this study also raise concerns for the application of a CRISPR- cas strategy against antimicrobial resistance. Copyright © 2017 American Society for Microbiology.

  8. Emergence of New Delhi metallo-beta-lactamase 1 and other carbapenemase-producing Acinetobacter calcoaceticus-baumannii complex among patients in hospitals in Ha Noi, Viet Nam

    NARCIS (Netherlands)

    Tran, D.N.; Tran, H.H.; Matsui, M.; Suzuki, M.; Suzuki, S.; Shibayama, K.; Pham, T.D.; Phuong, T.T. Van; Dang, D.A.; Trinh, H.S.; Loan, C.T.; Nga, L.T.; Doorn, H.R. van; Wertheim, H.F.L.

    2017-01-01

    Acinetobacter baumannii is an important cause of multidrug-resistant hospital acquired infections in the world. Here, we investigate the presence of NDM-1 and other carbapenemases among carbapenem-resistant A. baumannii isolated between August 2010 and December 2014 from three large hospitals in

  9. An evaluation of a toolkit for the early detection, management, and control of carbapenemase-producing Enterobacteriaceae: a survey of acute hospital trusts in England.

    Science.gov (United States)

    Coope, C M; Verlander, N Q; Schneider, A; Hopkins, S; Welfare, W; Johnson, A P; Patel, B; Oliver, I

    2018-03-09

    Following hospital outbreaks of carbapenemase-producing Enterobacteriaceae (CPE), Public Health England published a toolkit in December 2013 to promote the early detection, management, and control of CPE colonization and infection in acute hospital settings. To examine awareness, uptake, implementation and usefulness of the CPE toolkit and identify potential barriers and facilitators to its adoption in order to inform future guidance. A cross-sectional survey of National Health Service (NHS) acute trusts was conducted in May 2016. Descriptive analysis and multivariable regression models were conducted, and narrative responses were analysed thematically and informed using behaviour change theory. Most (92%) acute trusts had a written CPE plan. Fewer (75%) reported consistent compliance with screening and isolation of CPE risk patients. Lower prioritization and weaker senior management support for CPE prevention were associated with poorer compliance. Awareness of the CPE toolkit was high and all trusts with patients infected or colonized with CPE had used the toolkit either as provided (32%), or to inform (65%) their own local CPE plan. Despite this, many respondents (80%) did not believe that the CPE toolkit guidance offered an effective means to prevent CPE or was practical to follow. CPE prevention and control requires robust IPC measures. Successful implementation can be hindered by a complex set of factors related to their practical execution, insufficient resources and a lack of confidence in the effectiveness of the guidance. Future CPE guidance would benefit from substantive user involvement, processes for ongoing feedback, and regular guidance updates. Copyright © 2018 The Healthcare Infection Society. All rights reserved.

  10. An optimized work-flow to reduce time-to-detection of carbapenemase-producing Enterobacteriaceae (CPE) using direct testing from rectal swabs.

    Science.gov (United States)

    O'Connor, C; Kiernan, M G; Finnegan, C; O'Hara, M; Power, L; O'Connell, N H; Dunne, C P

    2017-05-04

    Rapid detection of patients with carbapenemase-producing Enterobacteriaceae (CPE) is essential for the prevention of nosocomial cross-transmission, allocation of isolation facilities and to protect patient safety. Here, we aimed to design a new laboratory work-flow, utilizing existing laboratory resources, in order to reduce time-to-diagnosis of CPE. A review of the current CPE testing processes and of the literature was performed to identify a real-time commercial polymerase chain reaction (PCR) assay that could facilitate batch testing of CPE clinical specimens, with adequate CPE gene coverage. Stool specimens (210) were collected; CPE-positive inpatients (n = 10) and anonymized community stool specimens (n = 200). Rectal swabs (eSwab™) were inoculated from collected stool specimens and a manual DNA extraction method (QIAamp® DNA Stool Mini Kit) was employed. Extracted DNA was then processed on the Check-Direct CPE® assay. The three step process of making the eSwab™, extracting DNA manually and running the Check-Direct CPE® assay, took method of CPE screening; average time-to-diagnosis of 48/72 h. Utilizing this CPE work-flow would allow a 'same-day' result. Antimicrobial susceptibility testing results, as is current practice, would remain a 'next-day' result. In conclusion, the Check-Direct CPE® assay was easily integrated into a local laboratory work-flow and could facilitate a large volume of CPE screening specimens in a single batch, making it cost-effective and convenient for daily CPE testing.

  11. Comparison of in-house and commercial real time-PCR based carbapenemase gene detection methods in Enterobacteriaceae and non-fermenting gram-negative bacterial isolates.

    Science.gov (United States)

    Smiljanic, M; Kaase, M; Ahmad-Nejad, P; Ghebremedhin, B

    2017-07-10

    Carbapenemase-producing gram-negative bacteria are increasing globally and have been associated with outbreaks in hospital settings. Thus, the accurate detection of these bacteria in infections is mandatory for administering the adequate therapy and infection control measures. This study aimed to establish and evaluate a multiplex real-time PCR assay for the simultaneous detection of carbapenemase gene variants in gram-negative rods and to compare the performance with a commercial RT-PCR assay (Check-Direct CPE). 116 carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii isolates were genotyped for carbapenemase genes by PCR and sequencing. The defined isolates were used for the validation of the in-house RT-PCR by use of designed primer pairs and probes. Among the carbapenem-resistant isolates the genes bla KPC , bla VIM , bla NDM or bla OXA were detected. Both RT-PCR assays detected all bla KPC , bla VIM and bla NDM in the isolates. The in-house RT-PCR detected 53 of 67 (79.0%) whereas the commercial assay detected only 29 (43.3%) of the OXA genes. The in-house sufficiently distinguished the most prevalent OXA types (23-like and 48-like) in the melting curve analysis and direct detection of the genes from positive blood culture vials. The Check-Direct CPE and the in-house RT-PCR assay detected the carbapenem resistance from solid culture isolates. Moreover, the in-house assay enabled the identification of carbapenemase genes directly from positive blood-culture vials. However, we observed insufficient detection of various OXA genes in both assays. Nevertheless, the in-house RT-PCR detected the majority of the OXA type genes in Enterobacteriaceae and A. baumannii.

  12. Occurrence of false positive results for the detection of carbapenemases in carbapenemase-negative Escherichia coli and Klebsiella pneumoniae isolates.

    Directory of Open Access Journals (Sweden)

    Peng Wang

    Full Text Available Adequate detection of the production of carbapenemase in Enterobacteriaceae isolates is crucial for infection control measures and the appropriate choice of antimicrobial therapy. In this study, we investigated the frequency of false positive results for the detection of carbapenemases in carbapenemase-negative Escherichia coli and Klebsiella pneumoniae clinical isolates by the modified Hodge test (MHT. Three hundred and one E. coli and K. pneumoniae clinical isolates were investigated. All produced extended spectrum β-lactamases (ESBLs but were susceptible to carbapenems. Antimicrobial susceptibility testing was performed by the disk diffusion and agar dilution methods. The MHT was performed using the standard inoculum of test organisms recommended by the CLSI. Genes that encoded ESBLs and carbapenemases were identified by PCR and DNA sequencing. Among the 301 clinical isolates, none of the isolates conformed to the criteria for carbapenemase screening recommended by the CLSI. The susceptibility rates for imipenem, meropenem, and ertapenem all were 100.0%, 100.0%, and 100.0%, respectively. Of the 301 E. coli and K. pneumoniae isolates, none produced carbapenemase. The MHT gave a positive result for 3.3% (10/301 of the isolates. False positive results can occur when the MHT is used to detect carbapenemase in ESBL-producing isolates and clinical laboratories must be aware of this fact.

  13. Outbreak by ventilator-associated ST11 K. pneumoniae with co-production of CTX-M-24 and KPC-2 in SICU of a tertiary teaching hospital in central China

    Directory of Open Access Journals (Sweden)

    Longhua Hu

    2016-08-01

    Full Text Available The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU and 13 were isolated from ventilators. Twenty-four of 28 patients infected by CRKP have been submitted to mechanical ventilation using ventilator. More than 95% of the CRKP isolates were resistant to 13 antimicrobials tested.All CRKP isolates were confirmed as carbapenemase producer and were positive for blaKPC-2, with one positive for both blaKPC-2 and blaNDM-1. All carbapenemase-producing isolates harbored at least one of extended spectrum βlactamase genes tested, among which95.1% (39/41 of the tested isolates were found to harbor both blaCTX-M-24 and blaKPC-2, Of note, one isolate harbored simultaneously two carbapenemase genes (blaKPC-2 and blaNDM-1 and two ESBL genes (blaCTX-M-3 and blaTEM-104 . To the best of our knowledge, coexistence of blaKPC-2 and blaCTX-M-24 in one isolate is first reported. MLST results showed that 41 CRKP isolates belonged to 4 sequence types (STs including ST11, novel ST1854, novel ST1855 and ST1224. PFGE results displayed 3 PFGE clusters. Thirty-eight ST11 CRKP isolates (92.7%, 38/41 including all 13 isolates from ventilators and 25 isolates from patients from 7 wards (18 from是ICU belonged to same PFGE cluster, indicating these isolates were clonally related. Fifteen isolates have an identical undistinguished pattern (100% similarity forming a single clonal population. Moreover, this clone was exclusively linked to the cases attended in SICU and linked to the Ventilators. Additionally, the other SICU cases were

  14. Emergence of New Delhi metallo-beta-lactamase 1 and other carbapenemase-producing Acinetobacter calcoaceticus-baumannii complex among patients in hospitals in Ha Noi, Viet Nam.

    Science.gov (United States)

    Tran, D N; Tran, H H; Matsui, M; Suzuki, M; Suzuki, S; Shibayama, K; Pham, T D; Van Phuong, T T; Dang, D A; Trinh, H S; Loan, C T; Nga, L T V; van Doorn, H R; Wertheim, H F L

    2017-02-01

    Acinetobacter baumannii is an important cause of multidrug-resistant hospital acquired infections in the world. Here, we investigate the presence of NDM-1 and other carbapenemases among carbapenem-resistant A. baumannii isolated between August 2010 and December 2014 from three large hospitals in Hanoi, Vietnam. We identified 23/582 isolates (4 %) (11 from hospital A, five from hospital B, and seven from hospital C) that were NDM-1 positive, and among them 18 carried additional carbapenemase genes, including seven isolates carrying NDM-1, IMP-1, and OXA-58 with high MICs for carbapenems. Genotyping indicated that NDM-1 carrying A. baumannii have expanded clonally in these hospitals. Five new STs (ST1135, ST1136, ST1137, ST1138, and ST1139) were identified. One isolate carried NDM-1 on a plasmid belonging to the N-repA replicon type; no NDM-1-positive plasmids were identified in the other isolates. We have shown the extent of the carbapenem resistance and the local clonal spread of A. baumannii carrying NDM-1 in these hospitals; coexistence of NDM-1 and IMP-1 is reported for the first time from Vietnam here, and this will further seriously limit future therapeutic options.

  15. Outcomes of critically ill intensive care unit patients treated with fosfomycin for infections due to pandrug-resistant and extensively drug-resistant carbapenemase-producing Gram-negative bacteria.

    Science.gov (United States)

    Pontikis, Konstantinos; Karaiskos, Ilias; Bastani, Styliani; Dimopoulos, George; Kalogirou, Michalis; Katsiari, Maria; Oikonomou, Angelos; Poulakou, Garyphallia; Roilides, Emmanuel; Giamarellou, Helen

    2014-01-01

    Fosfomycin is active in vitro against extensively drug-resistant (XDR) and pandrug-resistant (PDR) Pseudomonas aeruginosa and Klebsiella pneumoniae carbapenemase-producing strains; however, the in vivo effectiveness against such pathogens is almost unknown. A multicentre, observational, prospective case-series study was performed in 11 ICUs. All consecutive fosfomycin-treated patients suffering from XDR or PDR fosfomycin-susceptible, microbiologically documented infections were recorded. Clinical and microbiological outcomes were assessed. A safety analysis was performed. In total, 68 patients received fosfomycin during the study period, 48 of whom were considered suitable for effectiveness analysis based on predefined criteria. Bacteraemia and ventilator-associated pneumonia were the main infections. Carbapenemase-producing K. pneumoniae and P. aeruginosa were isolated in 41 and 17 cases, respectively. All isolates exhibited an XDR or PDR profile, being fosfomycin-susceptible by definition. Fosfomycin was administered intravenously at a median dose of 24g/day for a median of 14 days, mainly in combination with colistin or tigecycline. Clinical outcome at Day 14 was successful in 54.2% of patients, whilst failure, indeterminate outcome and superinfection were documented in 33.3%, 6.3% and 6.3%, respectively. All-cause mortality at Day 28 was 37.5%. Bacterial eradication was observed in 56.3% of cases. Fosfomycin resistance developed in three cases. The main adverse event was reversible hypokalaemia. In conclusion, fosfomycin could have a place in the armamentarium against XDR and PDR Gram-negative infections in the critically ill. Resistance development during therapy, which has been a matter of concern in previous studies, did not occur frequently. The necessity of combination with other antibiotics requires further investigation. Copyright © 2013 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  16. Retrospective Analysis of Bacterial Cultures Sampled in German Chicken-Fattening Farms During the Years 2011–2012 Revealed Additional VIM-1 Carbapenemase-Producing Escherichia coli and a Serologically Rough Salmonella enterica Serovar Infantis

    Science.gov (United States)

    Roschanski, Nicole; Fischer, Jennie; Falgenhauer, Linda; Pietsch, Michael; Guenther, Sebastian; Kreienbrock, Lothar; Chakraborty, Trinad; Pfeifer, Yvonne; Guerra, Beatriz; Roesler, Uwe H.

    2018-01-01

    Carbapenems are last-resort antibiotics used in human medicine. The increased detection of carbapenem-resistant Enterobacteriaceae (CRE) is therefore worrying. In 2011 we reported the first livestock-associated VIM-1-producing Salmonella (S.) enterica serovar Infantis (R3) isolate from dust, sampled in a German chicken fattening farm. Due to this observation we retrospectively investigated more than 536 stored bacterial cultures, isolated from 45 chicken fattening farms during the years 2011 and 2012. After a non-selective overnight incubation, the bacteria were transferred to selective media. Escherichia (E.) coli and Salmonella growing on these media were further investigated, including antibiotic susceptibility testing, carbapenemase gene screening and whole genome sequencing (WGS). In total, four CRE were found in three out of 45 investigated farms: Besides R3, one additional Salmonella (G-336-1a) as well as two E. coli isolates (G-336-2, G-268-2). All but G-268-2 harbored the blaVIM-1 gene. Salmonella isolates R3 and G-336-1 were closely related although derived from two different farms. All three blaVIM-1-encoding isolates possessed identical plasmids and the blaVIM-1- containing transposon showed mobility at least in vitro. In isolate G-268-2, the AmpC beta-lactamase gene blaCMY-2 but no known carbapenemase gene was identified. However, a transfer of the phenotypic resistance was possible. Furthermore, G-268-2 contained the mcr-1 gene, combining phenotypical carbapenem- as well as colistin resistance in one isolate. Carbapenem-resistant Enterobacteriaceae have been found in three out of 45 investigated chicken flocks. This finding is alarming and emphasizes the importance of intervention strategies to contain the environmental spread of resistant bacteria in animals and humans. PMID:29636734

  17. Retrospective Analysis of Bacterial Cultures Sampled in German Chicken-Fattening Farms During the Years 2011-2012 Revealed Additional VIM-1 Carbapenemase-Producing Escherichia coli and a Serologically Rough Salmonella enterica Serovar Infantis.

    Science.gov (United States)

    Roschanski, Nicole; Fischer, Jennie; Falgenhauer, Linda; Pietsch, Michael; Guenther, Sebastian; Kreienbrock, Lothar; Chakraborty, Trinad; Pfeifer, Yvonne; Guerra, Beatriz; Roesler, Uwe H

    2018-01-01

    Carbapenems are last-resort antibiotics used in human medicine. The increased detection of carbapenem-resistant Enterobacteriaceae (CRE) is therefore worrying. In 2011 we reported the first livestock-associated VIM-1-producing Salmonella ( S .) enterica serovar Infantis (R3) isolate from dust, sampled in a German chicken fattening farm. Due to this observation we retrospectively investigated more than 536 stored bacterial cultures, isolated from 45 chicken fattening farms during the years 2011 and 2012. After a non-selective overnight incubation, the bacteria were transferred to selective media. Escherichia (E.) coli and Salmonella growing on these media were further investigated, including antibiotic susceptibility testing, carbapenemase gene screening and whole genome sequencing (WGS). In total, four CRE were found in three out of 45 investigated farms: Besides R3, one additional Salmonella (G-336-1a) as well as two E. coli isolates (G-336-2, G-268-2). All but G-268-2 harbored the bla VIM-1 gene. Salmonella isolates R3 and G-336-1 were closely related although derived from two different farms. All three bla VIM-1 -encoding isolates possessed identical plasmids and the bla VIM-1- containing transposon showed mobility at least in vitro . In isolate G-268-2, the AmpC beta-lactamase gene bla CMY-2 but no known carbapenemase gene was identified. However, a transfer of the phenotypic resistance was possible. Furthermore, G-268-2 contained the mcr-1 gene, combining phenotypical carbapenem- as well as colistin resistance in one isolate. Carbapenem-resistant Enterobacteriaceae have been found in three out of 45 investigated chicken flocks. This finding is alarming and emphasizes the importance of intervention strategies to contain the environmental spread of resistant bacteria in animals and humans.

  18. Retrospective Analysis of Bacterial Cultures Sampled in German Chicken-Fattening Farms During the Years 2011–2012 Revealed Additional VIM-1 Carbapenemase-Producing Escherichia coli and a Serologically Rough Salmonella enterica Serovar Infantis

    Directory of Open Access Journals (Sweden)

    Nicole Roschanski

    2018-03-01

    Full Text Available Carbapenems are last-resort antibiotics used in human medicine. The increased detection of carbapenem-resistant Enterobacteriaceae (CRE is therefore worrying. In 2011 we reported the first livestock-associated VIM-1-producing Salmonella (S. enterica serovar Infantis (R3 isolate from dust, sampled in a German chicken fattening farm. Due to this observation we retrospectively investigated more than 536 stored bacterial cultures, isolated from 45 chicken fattening farms during the years 2011 and 2012. After a non-selective overnight incubation, the bacteria were transferred to selective media. Escherichia (E. coli and Salmonella growing on these media were further investigated, including antibiotic susceptibility testing, carbapenemase gene screening and whole genome sequencing (WGS. In total, four CRE were found in three out of 45 investigated farms: Besides R3, one additional Salmonella (G-336-1a as well as two E. coli isolates (G-336-2, G-268-2. All but G-268-2 harbored the blaVIM-1 gene. Salmonella isolates R3 and G-336-1 were closely related although derived from two different farms. All three blaVIM-1-encoding isolates possessed identical plasmids and the blaVIM-1- containing transposon showed mobility at least in vitro. In isolate G-268-2, the AmpC beta-lactamase gene blaCMY-2 but no known carbapenemase gene was identified. However, a transfer of the phenotypic resistance was possible. Furthermore, G-268-2 contained the mcr-1 gene, combining phenotypical carbapenem- as well as colistin resistance in one isolate. Carbapenem-resistant Enterobacteriaceae have been found in three out of 45 investigated chicken flocks. This finding is alarming and emphasizes the importance of intervention strategies to contain the environmental spread of resistant bacteria in animals and humans.

  19. Low Frequency of Ceftazidime-Avibactam Resistance among Enterobacteriaceae Isolates Carrying blaKPC Collected in U.S. Hospitals from 2012 to 2015.

    Science.gov (United States)

    Castanheira, Mariana; Mendes, Rodrigo E; Sader, Helio S

    2017-03-01

    Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae isolates have been increasingly reported worldwide, and therapeutic options to treat infections caused by these organisms are limited. We evaluated the activity of ceftazidime-avibactam and comparators against 456 Enterobacteriaceae isolates carrying bla KPC collected from 79 U.S. hospitals during 2012 to 2015. Overall, ceftazidime-avibactam (MIC 50/90 , 0.5/2 μg/ml; 99.3% susceptible) and tigecycline (MIC 50/90 , 0.5/1 μg/ml; 98.9% susceptible at ≤2 μg/ml) were the most active agents. Only 80.5% and 59.0% of isolates were susceptible to colistin and amikacin, respectively. All three isolates (0.7%) displaying resistance to ceftazidime-avibactam ( K. pneumoniae ; MICs, ≥16 μg/ml) were evaluated using whole-genome sequencing analysis and relative quantification of expression levels of porins and efflux pump. Two isolates carried metallo-β-lactamase genes, bla NDM-1 or bla VIM-4 , among other β-lactam resistance mechanisms, and one displayed a premature stop codon in ompK35 and decreased expression of ompK36 Ceftazidime-avibactam was active against 100.0 and 99.3% of isolates carrying bla KPC-3 ( n = 221) and bla KPC-2 ( n = 145), respectively. Isolates carrying bla KPC were more commonly recovered from pneumonia ( n = 155), urinary tract ( n = 93), and skin/soft tissue ( n = 74) infections. Ceftazidime-avibactam (97.8 to 100.0% susceptible) was consistently active against isolates from all infection sites. K. pneumoniae (83.3% of the collection) susceptibility rates were 99.2% for ceftazidime-avibactam, 98.9% for tigecycline, and 80.1% for colistin. Ceftazidime-avibactam susceptibility did not vary substantially when comparing isolates from intensive care unit (ICU) patients to those from non-ICU patients. Ceftazidime-avibactam was active against this large collection of isolates carrying bla KPC and represents a valuable addition to the armamentarium currently available for the

  20. Prevalência de carbapenemases em enterobactérias resistentes a carbapenêmicos em quatro hospitais terciários de Porto Alegre [Prevalence of carbapenemases in carbapenem-resistant Enterobacteriaceae in four tertiary care hospitals in Porto Alegre

    Directory of Open Access Journals (Sweden)

    Fabio de Moura Pinto

    2014-04-01

    Conclusão: KPC foi a carbapenemase mais frequentemente detectada. A circulação de uma enzima OXA-48-like foi demonstrada, um achado novo e preocupante em nosso meio. A disseminação persistente da carbapenemase NDM foi também outro achado perturbador do estudo. A positividade maior para carbapenemases enalteceu a importância da estratégia de culturas de vigilância. Esses dados e outros estudos poderão contribuir para um entendimento maior da epidemiologia das ERC.

  1. Phytochemistry and Preliminary Assessment of the Antibacterial Activity of Chloroform Extract of Amburana cearensis (Allemão) A.C. Sm. against Klebsiella pneumoniae Carbapenemase-Producing Strains

    Science.gov (United States)

    Sá, Mirivaldo Barros; Ralph, Maria Taciana; Nascimento, Danielle Cristina Oliveira; Ramos, Clécio Souza; Barbosa, Isvânia Maria Serafin; Sá, Fabrício Bezerra; Lima-Filho, J. V.

    2014-01-01

    The chloroform extract of the stem bark of Amburana cearensis was chemically characterized and tested for antibacterial activity.The extract was analyzed by gas chromatography and mass spectrometry. The main compounds identified were 4-methoxy-3-methylphenol (76.7%), triciclene (3.9%), α-pinene (1.0%), β-pinene (2.2%), and 4-hydroxybenzoic acid (3.1%). Preliminary antibacterial tests were carried out against species of distinct morphophysiological characteristics: Escherichia coli, Salmonella enterica Serotype Typhimurium, Pseudomonas aeruginosa, Staphylococcus aureus, Listeria monocytogenes, and Bacillus cereus. The minimum inhibitory concentration (MIC) was determinate in 96-well microplates for the chloroform extract and an analogue of themain compound identified, which was purchased commercially.We have shown that plant's extract was only inhibitory (but not bactericidal) at the maximum concentration of 6900 μg/mL against Pseudomonas aeruginosa and Bacillus cereus. Conversely, the analogue 2-methoxy-4-methylphenol produced MICs ranging from215 to 431 μg/mL against all bacterial species.New antibacterial assays conducted with such chemical compound against Klebsiella pneumoniae carbapenemase-producing strains have shown similarMICresults and minimumbactericidal concentration (MBC) of 431 μg/mL.We conclude that A. cearensis is a good source of methoxy-methylphenol compounds,which could be screened for antibacterial activity againstmultiresistant bacteria fromdifferent species PMID:24772183

  2. Phytochemistry and Preliminary Assessment of the Antibacterial Activity of Chloroform Extract of Amburana cearensis (Allemão A.C. Sm. against Klebsiella pneumoniae Carbapenemase-Producing Strains

    Directory of Open Access Journals (Sweden)

    Mirivaldo Barros Sá

    2014-01-01

    Full Text Available The chloroform extract of the stem bark of Amburana cearensis was chemically characterized and tested for antibacterial activity.The extract was analyzed by gas chromatography and mass spectrometry. The main compounds identified were 4-methoxy-3-methylphenol (76.7%, triciclene (3.9%, α-pinene (1.0%, β-pinene (2.2%, and 4-hydroxybenzoic acid (3.1%. Preliminary antibacterial tests were carried out against species of distinct morphophysiological characteristics: Escherichia coli, Salmonella enterica Serotype Typhimurium, Pseudomonas aeruginosa, Staphylococcus aureus, Listeria monocytogenes, and Bacillus cereus. The minimum inhibitory concentration (MIC was determinate in 96-well microplates for the chloroform extract and an analogue of themain compound identified, which was purchased commercially.We have shown that plant’s extract was only inhibitory (but not bactericidal at the maximum concentration of 6900 μg/mL against Pseudomonas aeruginosa and Bacillus cereus. Conversely, the analogue 2-methoxy-4-methylphenol produced MICs ranging from215 to 431 μg/mL against all bacterial species.New antibacterial assays conducted with such chemical compound against Klebsiella pneumoniae carbapenemase-producing strains have shown similarMICresults and minimumbactericidal concentration (MBC of 431 μg/mL.We conclude that A. cearensis is a good source of methoxy-methylphenol compounds,which could be screened for antibacterial activity againstmultiresistant bacteria fromdifferent species

  3. Multidrug-Resistant CTX-M-(15, 9, 2)- and KPC-2-Producing Enterobacter hormaechei and Enterobacter asburiae Isolates Possessed a Set of Acquired Heavy Metal Tolerance Genes Including a Chromosomal sil Operon (for Acquired Silver Resistance).

    Science.gov (United States)

    Andrade, Leonardo N; Siqueira, Thiago E S; Martinez, Roberto; Darini, Ana Lucia C

    2018-01-01

    Bacterial resistance to antibiotics is concern in healthcare-associated infections. On the other hand, bacterial tolerance to other antimicrobials, like heavy metals, has been neglected and underestimated in hospital pathogens. Silver has long been used as an antimicrobial agent and it seems to be an important indicator of heavy metal tolerance. To explore this perspective, we searched for the presence of acquired silver resistance genes ( sil operon: silE, silS, silR, silC, silF, silB, silA , and silP ) and acquired extended-spectrum cephalosporin and carbapenem resistance genes ( bla CTX-M and bla KPC ) in Enterobacter cloacae Complex (EcC) ( n = 27) and Enterobacter aerogenes ( n = 8) isolated from inpatients at a general hospital. Moreover, the genetic background of the silA (silver-efflux pump) and the presence of other acquired heavy metal tolerance genes, pcoD (copper-efflux pump), arsB (arsenite-efflux pump), terF (tellurite resistance protein), and merA (mercuric reductase) were also investigated. Outstandingly, 21/27 (78%) EcC isolates harbored silA gene located in the chromosome. Complete sil operon was found in 19/21 silA -positive EcC isolates. Interestingly, 8/20 (40%) E. hormaechei and 5/6 (83%) E. asburiae co-harbored silA/pcoD genes and bla CTX-M-(15,2,or9) and/or bla KPC-2 genes. Frequent occurrences of arsB, terF , and merA genes were detected, especially in silA/pcoD -positive, multidrug-resistant (MDR) and/or CTX-M-producing isolates. Our study showed co-presence of antibiotic and heavy metal tolerance genes in MDR EcC isolates. In our viewpoint, there are few studies regarding to bacterial heavy metal tolerance and we call attention for more investigations and discussion about this issue in different hospital pathogens.

  4. Variants of β-lactamase KPC-2 that are resistant to inhibition by avibactam.

    Science.gov (United States)

    Papp-Wallace, Krisztina M; Winkler, Marisa L; Taracila, Magdalena A; Bonomo, Robert A

    2015-07-01

    KPC-2 is the most prevalent class A carbapenemase in the world. Previously, KPC-2 was shown to hydrolyze the β-lactamase inhibitors clavulanic acid, sulbactam, and tazobactam. In addition, substitutions at amino acid position R220 in the KPC-2 β-lactamase increased resistance to clavulanic acid. A novel bridged diazabicyclooctane (DBO) non-β-lactam β-lactamase inhibitor, avibactam, was shown to inactivate the KPC-2 β-lactamase. To better understand the mechanistic basis for inhibition of KPC-2 by avibactam, we tested the potency of ampicillin-avibactam and ceftazidime-avibactam against engineered variants of the KPC-2 β-lactamase that possessed single amino acid substitutions at important sites (i.e., Ambler positions 69, 130, 234, 220, and 276) that were previously shown to confer inhibitor resistance in TEM and SHV β-lactamases. To this end, we performed susceptibility testing, biochemical assays, and molecular modeling. Escherichia coli DH10B carrying KPC-2 β-lactamase variants with the substitutions S130G, K234R, and R220M demonstrated elevated MICs for only the ampicillin-avibactam combinations (e.g., 512, 64, and 32 mg/liter, respectively, versus the MICs for wild-type KPC-2 at 2 to 8 mg/liter). Steady-state kinetics revealed that the S130G variant of KPC-2 resisted inactivation by avibactam; the k2/K ratio was significantly lowered 4 logs for the S130G variant from the ratio for the wild-type enzyme (21,580 M(-1) s(-1) to 1.2 M(-1) s(-1)). Molecular modeling and molecular dynamics simulations suggested that the mobility of K73 and its ability to activate S70 (i.e., function as a general base) may be impaired in the S130G variant of KPC-2, thereby explaining the slowed acylation. Moreover, we also advance the idea that the protonation of the sulfate nitrogen of avibactam may be slowed in the S130G variant, as S130 is the likely proton donor and another residue, possibly K234, must compensate. Our findings show that residues S130 as well as K234 and R

  5. Carbapenemase-producerende enterobacteriën in Nederland : Onopgemerkte versprewiding naar verschillende regio's.

    NARCIS (Netherlands)

    Leenstra, T; Bosch, T; Vlek, A L; Bonten, M J M; van der Lubben, I M; de Greeff, S C

    2017-01-01

    - Carbapenemase producing Enterobacteriaceae (CPE), including Klebsiella pneumoniae and Escherichia coli, are only sporadically seen in the Netherlands and then mainly in patients who have been transferred from foreign hospitals.- CPE are resistant to virtually all beta-lactam antibiotics, including

  6. IDENTIFICATION OF SERINE CARBAPENEMASE AND METALLOCARBAPENEMASE ENZYMES IN PSEUDOMONAS AERUGINOSA IN GEMS MEDICAL COLLEGE, RAGOLU, SRIKAKULAM

    Directory of Open Access Journals (Sweden)

    Radhika

    2016-06-01

    Full Text Available Various carbapenems have been reported in Pseudomonas aeruginosa such as VIM, NDM & OXA-48, etc. In addition, carbapenemase producers are usually associated with many other non–β-lactam resistance determinants which give rise to multidrug and pan drug resistant isolates. Detection of these enzymes in infected patients and in carriers are the two main approaches for prevention of their spread. Potential carbapenemase producers are currently screened first by susceptibility testing, using breakpoint values for carbapenems. However, many carbapenemase producers do not confer obvious resistance levels to carbapenems. So there is need for Laboratories to search for carbapenemase producers. In such instance, phenotypic based test such as Modified Hodge Test (MHT is very much useful in confirming in vitro production of carbapenemase enzymes. But this test does not differentiate serine carbapenemase enzyme (i.e. Ambler class A & C from metallocarbapenemase (i.e. Ambler class B. To differentiate these two enzymes, MHT positive isolates can be subjected to Disc Synergy test. These two tests are highly sensitive and specific and adaptable to any laboratory in the world. Out of 100 ceftazidime resistant Pseudomonas aeruginosa, 75(75% were sensitive, 7(7% were intermediate sensitive and 18(18% were resistant to imipenem. When the 18 imipenem resistant strains were subjected to Modified Hodge test, 15 gave positive results. When the 15 MHT positive strains subjected to disc synergy test, 8 were positive and 7 were negative showing that 8 were producing metallocarbapenemases and 7 were producing serine carbapenemases. Out of 7 intermediately imipenem sensitive isolates, 2 were producing metallocarbapenemase and 3 were producing serine carbapenemase. Hence, total number of imipenem resistant Pseudomonas aeruginosa isolates were 23.

  7. Use of Cepheid Xpert Carba-R® for Rapid Detection of Carbapenemase-Producing Bacteria in Abdominal Septic Patients Admitted to Intensive Care Unit.

    Directory of Open Access Journals (Sweden)

    Andrea Cortegiani

    Full Text Available Early institution of effective antibiotic therapy and source control are pivotal to improve survival of abdominal septic patients. Xpert® Carba-R is a real time polymerase chain reaction assay for rapid detection and differentiation of five genes (blaKPC, blaVIM, blaOXA-48, blaIMP-1, blaNDM responsible for carbapenem resistance. We performed an observational study investigating the clinical usefulness and applicability of Xpert® Carba-R to detect carbapenem resistance in abdominal septic patients admitted to intensive care unit. We compared the results of Xpert® Carba-R with standard microbiological culture. We collected a set of two rectal/stomia swabs and two swabs from abdominal drainage fluid for each patient. We included 20 patients for a total of 45 comparisons between the two methods. In our clinical setting, the overall performance of Xpert® Carba-R for detection of carbapenem resistance in the presence of genes detectable and non-detectable by the method was: sensitivity 50% (95% CI 24.6-75.3; specificity 93.1% (95% CI 77.2-99.1; positive predictive value (PPV 80% (95% CI 44.4-97.5; negative predictive value (NPV 77.1% (95% CI 56.9-89.6. The inter-rater agreement was 0.47 (SE 0.14; 95% CI 0.20-0.74. When considering the only 5 mechanisms of resistance detected by both methods, the overall diagnostic performance was: sensitivity 100% (95% CI 69.1-100, specificity 94.2 (95% CI 80.8-99.3, PPV 83.3 (95% CI 59.6-97.9 and NPV 100% (95% CI 89.4-100. The inter-rater agreement was 0.88 (SE 0.08; 95% CI 0.71-1. Xpert® Carba-R may be considered an additional diagnostic tool for early diagnosis of carbapenem resistance in abdominal septic patients. Clinicians should be aware of their epidemiology before its introduction in the diagnostic protocol of their intensive care units.

  8. Use of Cepheid Xpert Carba-R® for Rapid Detection of Carbapenemase-Producing Bacteria in Abdominal Septic Patients Admitted to Intensive Care Unit.

    Science.gov (United States)

    Cortegiani, Andrea; Russotto, Vincenzo; Graziano, Giorgio; Geraci, Daniela; Saporito, Laura; Cocorullo, Gianfranco; Raineri, Santi Maurizio; Mammina, Caterina; Giarratano, Antonino

    2016-01-01

    Early institution of effective antibiotic therapy and source control are pivotal to improve survival of abdominal septic patients. Xpert® Carba-R is a real time polymerase chain reaction assay for rapid detection and differentiation of five genes (blaKPC, blaVIM, blaOXA-48, blaIMP-1, blaNDM) responsible for carbapenem resistance. We performed an observational study investigating the clinical usefulness and applicability of Xpert® Carba-R to detect carbapenem resistance in abdominal septic patients admitted to intensive care unit. We compared the results of Xpert® Carba-R with standard microbiological culture. We collected a set of two rectal/stomia swabs and two swabs from abdominal drainage fluid for each patient. We included 20 patients for a total of 45 comparisons between the two methods. In our clinical setting, the overall performance of Xpert® Carba-R for detection of carbapenem resistance in the presence of genes detectable and non-detectable by the method was: sensitivity 50% (95% CI 24.6-75.3); specificity 93.1% (95% CI 77.2-99.1); positive predictive value (PPV) 80% (95% CI 44.4-97.5); negative predictive value (NPV) 77.1% (95% CI 56.9-89.6). The inter-rater agreement was 0.47 (SE 0.14; 95% CI 0.20-0.74). When considering the only 5 mechanisms of resistance detected by both methods, the overall diagnostic performance was: sensitivity 100% (95% CI 69.1-100), specificity 94.2 (95% CI 80.8-99.3), PPV 83.3 (95% CI 59.6-97.9) and NPV 100% (95% CI 89.4-100). The inter-rater agreement was 0.88 (SE 0.08; 95% CI 0.71-1). Xpert® Carba-R may be considered an additional diagnostic tool for early diagnosis of carbapenem resistance in abdominal septic patients. Clinicians should be aware of their epidemiology before its introduction in the diagnostic protocol of their intensive care units.

  9. Frequency of Class B Carbapenemases (MbL) in enterobacteriacae

    International Nuclear Information System (INIS)

    Fakhuruddin, A.; Durrani, M. A.; Bakar, I.

    2014-01-01

    Objective: To determine the frequency of Metallo- -lactamase producing Enteriobacteriaceae species. Method: The descriptive cross-sectional study was carried out from January to December 2011 in the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. A total of 500 specimens were initially collected. The culture positive samples were analysed for further identification, and antimicrobial sensitivity was done according to Clinical and Laboratory Standards Institute guidelines 2009. The Carbapenemases Producing Enterobacteriaceae strains were screened by the Modified Hodge Test, and Metallo-b-Lactamase production was confirmed by the EDTA combined disc test. Result: From amongst 402 organisms detected, 200 (49.75%) were Enterobacteriaceae, while Escherichia coli was the leading pathogen (65%). Only 6% were identified as Carbapenemases Producing Enterobacteriaceae and 9 (75%) of them were Metallo-b-Lactamase producing strains, while 3 (25%) contained other enzymes. Conclusion: Metallo-b-Lactamase producing Enterobacteriaceae species are causing problems in tertiary care hospitals. (author)

  10. In vitro cost-effective methods to detect carbapenemases in Enterobacteriaceae

    Directory of Open Access Journals (Sweden)

    Varsha Gupta

    2018-01-01

    Full Text Available The rise in carbapenemases-producing organisms has challenged the scientific community. Infections caused by these bacteria have limited treatment options. There are various types such as Klebsiella pneumoniae carbapenemase (Ambler class A, metallo-beta-lactamases of VIM-type, IMP-type, NDM-type (Ambler class B, and OXA-48-types (Ambler class D. An efficient strategy for detection of carbapenemase producers is important to determine the appropriate therapeutic modalities. In this study, four methods - Carba NP test, modified Carba NP (MCNP test, carbapenem inactivation method (CIM test, and Rapidec Carba NP kit test were evaluated. We evaluated an in-house MCNP test to detect carbapenemase production using a single protocol which gave reliable results. Furthermore, CIM using routine antibiotic discs gives good results. Both these tests were found to be cost-effective.

  11. Multidrug-Resistant CTX-M-(15, 9, 2- and KPC-2-Producing Enterobacter hormaechei and Enterobacter asburiae Isolates Possessed a Set of Acquired Heavy Metal Tolerance Genes Including a Chromosomal sil Operon (for Acquired Silver Resistance

    Directory of Open Access Journals (Sweden)

    Leonardo N. Andrade

    2018-03-01

    Full Text Available Bacterial resistance to antibiotics is concern in healthcare-associated infections. On the other hand, bacterial tolerance to other antimicrobials, like heavy metals, has been neglected and underestimated in hospital pathogens. Silver has long been used as an antimicrobial agent and it seems to be an important indicator of heavy metal tolerance. To explore this perspective, we searched for the presence of acquired silver resistance genes (sil operon: silE, silS, silR, silC, silF, silB, silA, and silP and acquired extended-spectrum cephalosporin and carbapenem resistance genes (blaCTX−M and blaKPC in Enterobacter cloacae Complex (EcC (n = 27 and Enterobacter aerogenes (n = 8 isolated from inpatients at a general hospital. Moreover, the genetic background of the silA (silver-efflux pump and the presence of other acquired heavy metal tolerance genes, pcoD (copper-efflux pump, arsB (arsenite-efflux pump, terF (tellurite resistance protein, and merA (mercuric reductase were also investigated. Outstandingly, 21/27 (78% EcC isolates harbored silA gene located in the chromosome. Complete sil operon was found in 19/21 silA-positive EcC isolates. Interestingly, 8/20 (40% E. hormaechei and 5/6 (83% E. asburiae co-harbored silA/pcoD genes and blaCTX−M−(15,2,or9 and/or blaKPC−2 genes. Frequent occurrences of arsB, terF, and merA genes were detected, especially in silA/pcoD-positive, multidrug-resistant (MDR and/or CTX-M-producing isolates. Our study showed co-presence of antibiotic and heavy metal tolerance genes in MDR EcC isolates. In our viewpoint, there are few studies regarding to bacterial heavy metal tolerance and we call attention for more investigations and discussion about this issue in different hospital pathogens.

  12. Ceftazidime Is the Key Diversification and Selection Driver of VIM-Type Carbapenemases.

    Science.gov (United States)

    Martínez-García, Laura; González-Alba, José M; Baquero, Fernando; Cantón, Rafael; Galán, Juan Carlos

    2018-05-08

    In recent decades, carbapenems have been considered the last line of antibiotic therapy for Gram-negative bacterial infections. Unfortunately, strains carrying a high diversity of β-lactamases able to hydrolyze carbapenems have emerged in the clinical setting. Among them, VIM β-lactamases have diversified in a bloom of variants. The evolutionary reconstructions performed in this work revealed that, at the end of the 1980s, two independent events involving diversification from VIM-2 and VIM-4 produced at least 25 VIM variants. Later, a third event involving diversification from VIM-1 occurred in the mid-1990s. In a second approach to understanding the emergence of VIM carbapenemases, 44 mutants derived from VIM-2 and VIM-4 were obtained by site-directed mutagenesis based on those positions predicted to be under positive selection. These variants were expressed in an isogenic context. The more-evolved variants yielded increased levels of hydrolytic efficiency toward ceftazidime to a higher degree than toward carbapenems. In fact, an antagonist effect was frequently observed. These results led us to develop an experimental-evolution step. When Escherichia coli strains carrying VIM-2 or VIM-4 were submitted to serial passages at increasing concentrations of carbapenems or ceftazidime, more-efficient new variants (such as VIM-11 and VIM-1, with N165S [bearing a change from N to S at position 165] and R228S mutations, respectively) were only obtained when ceftazidime was present. Therefore, the observed effect of ceftazidime in the diversification and selection of VIM variants might help to explain the recent bloom of carbapenemase diversity, and it also represents another example of the potential universal effect exerted by ceftazidime in the selection of more-efficient β-lactamase variants, as in TEM, CTX-M, or KPC enzymes. IMPORTANCE One of the objectives recently proposed by the World Health Organization (WHO) Assembly in the global plan on antimicrobial

  13. Comparison of two commercial carbapenemase gene confirmatory assays in multiresistant Enterobacteriaceae and Acinetobacter baumannii-complex.

    Science.gov (United States)

    Rösner, Stephan; Gehlweiler, Kevin; Küsters, Uta; Kolbert, Mathias; Hübner, Kirsten; Pfennigwerth, Niels; Mack, Dietrich

    2018-01-01

    Multidrug-resistant Gram-negative bacilli (MDR-GNB) producing carbapenemases are increasing at an alarming speed. Rapid confirmation of carbapenemase type will be an important diagnostic step in clinical microbiology laboratories not only to reduce the risk of transmissions but also for optimising antibiotic therapy in the future. We compared diagnostic reliability of two commercially available molecular assays (Check-Direct CPE vs. AID line probe assay) for detection and typing of carbapenemase genes in 80 well-characterized isolates of MDR-GNB. Respective strains were isolated in various clinical specimens at our clinical microbiology laboratory. The reference standard included confirmation of carbapenemase-production at the molecular level at the German National Reference Laboratory for Multidrug-resistant Gram-negative bacteria (Ruhr-University Bochum, Germany). 53 Enterobacteriaceae and 27 members of the A. baumannii-complex were used in this study. The tested assays appeared highly reliable to confirm carbapenemase-producing Enterobacteriaceae (CPE) with respective sensitivities of 97.7%, but are currently unsuitable for analysis of members of the A. baumannii-complex. Both assays are easy to perform and rapid tools for confirmation and typing of the most common carbapenemase genes in Enterobacteriaceae. Implementation should be possible for any clinical microbiology laboratory with Check-Direct CPE being easier to handle and having less technological requirements.

  14. Comparison of two commercial carbapenemase gene confirmatory assays in multiresistant Enterobacteriaceae and Acinetobacter baumannii-complex.

    Directory of Open Access Journals (Sweden)

    Stephan Rösner

    Full Text Available Multidrug-resistant Gram-negative bacilli (MDR-GNB producing carbapenemases are increasing at an alarming speed. Rapid confirmation of carbapenemase type will be an important diagnostic step in clinical microbiology laboratories not only to reduce the risk of transmissions but also for optimising antibiotic therapy in the future. We compared diagnostic reliability of two commercially available molecular assays (Check-Direct CPE vs. AID line probe assay for detection and typing of carbapenemase genes in 80 well-characterized isolates of MDR-GNB. Respective strains were isolated in various clinical specimens at our clinical microbiology laboratory. The reference standard included confirmation of carbapenemase-production at the molecular level at the German National Reference Laboratory for Multidrug-resistant Gram-negative bacteria (Ruhr-University Bochum, Germany. 53 Enterobacteriaceae and 27 members of the A. baumannii-complex were used in this study. The tested assays appeared highly reliable to confirm carbapenemase-producing Enterobacteriaceae (CPE with respective sensitivities of 97.7%, but are currently unsuitable for analysis of members of the A. baumannii-complex. Both assays are easy to perform and rapid tools for confirmation and typing of the most common carbapenemase genes in Enterobacteriaceae. Implementation should be possible for any clinical microbiology laboratory with Check-Direct CPE being easier to handle and having less technological requirements.

  15. Characteristics and management of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in a tertiary hospital.

    Science.gov (United States)

    Pang, Feng; Jia, Xiu-Qin; Song, Zhen-Zhu; Li, Yan-Hua; Wang, Bin; Zhao, Qi-Gang; Wang, Chuan-Xin; Zhang, Yi; Wang, Le-Xin

    2016-03-01

    The emergence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases is rare. We report an occurrence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases in a Chinese tertiary care hospital from November 2010 to December 2012. The clinical characteristics of 30 patients were described. The genetic relationship of isolates was determined by pulsed-field gel electrophoresis (PFGE). Carbapenemases were detected by modified Hodge test (MHT) and polymerase chain reactions (PCRs). Amplicons were sequenced and blasted to determine the genotype. Most infected patients were from intensive care unit and had complex and serious underlying illnesses requiring mechanical ventilation. PFGE revealed that Klebsiella pneumoniae showed two major PFGE types. Two Klebsiella oxytoca had an indistinguishable PFGE pattern, while four Enterobacter cloacae were different strains. The sequencing studies showed Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in the 23 infected patients. The majority of patients had infections with the carbapenemase-producing Enterobacteriaceae (CPE) strain, most were successfully treated with a range of antibiotics and discharged. It is important to maintain a high index of suspicion to screen for carbapenemase-producing Enterobacteriaceae strains. Rapid identification of these strains and implementation of stringent procedures are the key to prevent major outbreaks in a hospital setting.

  16. Use of Faropenem as an Indicator of Carbapenemase Activity in the Enterobacteriaceae

    Science.gov (United States)

    Day, Kathryn M.; Pike, Rachel; Winstanley, Trevor G.; Lanyon, Clare; Cummings, Stephen P.; Raza, Muhammad W.; Woodford, Neil

    2013-01-01

    The aim of this study was to determine the ability of a disc susceptibility test using faropenem (10 μg) to predict carbapenemase activity in Enterobacteriaceae. A collection of 166 isolates of carbapenemase-producing Enterobacteriaceae (CPE) and 82 isolates of Enterobacteriaceae that produced other β-lactamases was compiled from diverse sources. Disc susceptibility testing was performed using the CLSI/EUCAST methodology with discs of faropenem (10 μg), temocillin (30 μg), and four carbapenems (each 10 μg). A further prospective evaluation of the faropenem disc susceptibility test was performed using 205 consecutive isolates referred to a United Kingdom reference laboratory in parallel with molecular methods for carbapenemase detection. Of 166 isolates of CPE, 99% showed growth up to the edge of a 10-μg faropenem disc compared with only 6% of other β-lactamase producers (sensitivity, 99%; specificity, 94%). A “double zone” around 10-μg faropenem discs was frequently associated with OXA-48 producers. Of the carbapenems, the most useful agent was imipenem, where a zone diameter of ≤23 mm as a predictor of carbapenemase activity had a sensitivity of 99% and a specificity of 85%. The presence of no zone of inhibition around a 30-μg temocillin disc was a consistent feature of strains producing OXA-48 carbapenemase. For 205 isolates of Enterobacteriaceae referred to a United Kingdom reference laboratory, growth up to a 10-μg faropenem disc correctly identified 84 of 86 carbapenemase producers (98% sensitivity), with a specificity of 87%. Disc susceptibility testing using faropenem (10 μg) is a simple, convenient, and highly predictive screening test for carbapenemase-producing Enterobacteriaceae. PMID:23576544

  17. Successful control of 2 simultaneous outbreaks of OXA-48 carbapenemase-producing Enterobacteriaceae and multidrug-resistant Acinetobacter baumannii in an intensive care unit.

    Science.gov (United States)

    Robustillo-Rodela, A; Pérez-Blanco, V; Espinel Ruiz, M A; Ruiz Carrascoso, G; Figueira Iglesias, J C; Abad Martín, D

    2017-12-01

    This report describes a double outbreak of OXA-48-producing Enterobacteriaceae (OXA-48-PE) and multidrug-resistant Acinetobacter baumannii (MRAB) in an intensive care unit (ICU) and the effectiveness of measures implemented, including decontamination with vaporized hydrogen peroxide (VHP). Affected patients were isolated in a confined area and cared for by dedicated personnel. Four percent chlorhexidine soap was used for patient daily hygiene. All patients are subjected to contact precautions. An in-depth cleaning of the ICU was performed with a chlorine solution, followed by decontamination with VHP. Environmental samples were taken before and after the decontamination. From July-October 2015, 13 patients were colonized or infected by OXA-48-PE and 18 by MRAB in the ICU. The cumulative incidence of OXA-48-PE and MRAB was 3.48% and 4.81%, respectively. In the period after the intervention, they were 0.8% and 0%, respectively (P control of outbreaks caused by microorganisms of high environmental impact. The rapid effect after the VHP treatment suggests an influence of this measure in eradication. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  18. An Xpert screen to identify carbapenemases

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    Mubin Kazi

    2016-01-01

    Full Text Available To prevent the spread of carbapenemases-producing Enterobacteriaceae (CPE active surveillance, contact isolation and cohorting infected patients should be practiced. Rectal swabs for the Xpert MDRO-assay of 32 patients were included. 71.85% were positive for targets incorporated into the MDRO-assay; whereas 28% were phenotypically not CRE and Xpert negative (9.37% had different mechanism [bla OXA]. The assay identified 59.3%, 9.37% and 3.1% as bla NDM, bla NDM+VIM and bla VIM, respectively. The assay is a screening test that identifies CPE harbouring organism within an hour and can be installed at tertiary-care facilities to screen colonized patients.

  19. Occurrence of Enterobacter hormaechei carrying blaNDM-1 and blaKPC-2 in China.

    Science.gov (United States)

    Yang, Biwei; Feng, Yu; McNally, Alan; Zong, Zhiyong

    2018-02-01

    Three carbapenem-resistant clinical isolates of the Enterobacter cloacae complex (ECC) were recovered from different patients in a hospital. All 3 isolates carried 2 carbapenemase genes bla KPC-2 and bla NDM-1 . A study was performed to characterize their relatedness and to investigate possible links among the patients. Whole genome sequencing revealed that the isolates were Enterobacter hormaechei and belonged to ST177 of the ECC. There were 19-142 single nucleotide polymorphisms (SNPs) between the isolates, suggesting that the isolates were likely from a central reservoir, which might have existed for some time. bla KPC-2 and bla NDM-1 were carried on 2 different IncF-type plasmids in the isolates. The 3 bla NDM-1 -carrying plasmids were almost identical and were self-transmissible, while the bla KPC-2 -carrying plasmids were only transmissible in the presence of the bla NDM-1 -carrying plasmid. The source of and direct links among them were not identified, suggesting a hospital transmission of a common multidrug resistant strain. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Plasmid transferability of KPC into a virulent K2 serotype Klebsiella pneumoniae.

    Science.gov (United States)

    Siu, Leung-Kei Kristopher; Huang, David B; Chiang, Tom

    2014-03-31

    KPC-producing carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with high mortality; however, their virulence determinants are not well defined. We investigated the virulence and plasmid transferability among KPC-containing K. pneumoniae isolates. KPC-2 and -3 were successfully conjugated and retained by a virulent K2 K. pneumoniae recipient isolate. Antimicrobial susceptibility testing showed KPC-2 and -3 donor strains were resistant to more than four classes of antibiotics while the K2 isolate was only initially resistant to ampicillin. After conjugation of KPC-2 and -3, the K2 K. pneumoniae transconjugants became resistant to all beta-lactams. Additionally, the KPC K2 K. pneumoniae transconjugants continued to retain its high serum resistance and murine lethality. Conjugation and retainment of KPC by virulent K2 K. pneumoniae and the ability of the tranconjugants to maintain its high serum resistance and murine lethality after conjugation was demonstrated in this study. These findings are concerning for the potential of KPC-like genes to disseminate among virulent K. pneumoniae isolates.

  1. Rapid molecular characterization of Acinetobacter baumannii clones with rep-PCR and evaluation of carbapenemase genes by new multiplex PCR in Hospital District of Helsinki and Uusimaa.

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    Tanja Pasanen

    Full Text Available Multidrug-resistant Acinetobacter baumannii (MDRAB is an increasing problem worldwide. Prevalence of carbapenem resistance in Acinetobacter spp. due to acquired carbapenemase genes is not known in Finland. The purpose of this study was to examine prevalence and clonal spread of multiresistant A. baumannii group species, and their carbapenemase genes. A total of 55 Acinetobacter isolates were evaluated with repetitive PCR (DiversiLab to analyse clonality of isolates, in conjunction with antimicrobial susceptibility profile for ampicillin/sulbactam, colistin, imipenem, meropenem, rifampicin and tigecycline. In addition, a new real-time PCR assay, detecting most clinically important carbapenemase genes just in two multiplex reactions, was developed. The assay detects genes for KPC, VIM, IMP, GES-1/-10, OXA-48, NDM, GIM-1, SPM-1, IMI/NMC-A, SME, CMY-10, SFC-1, SIM-1, OXA-23-like, OXA-24/40-like, OXA-58 and ISAbaI-OXA-51-like junction, and allows confident detection of isolates harbouring acquired carbapenemase genes. There was a time-dependent, clonal spread of multiresistant A. baumannii strongly correlating with carbapenamase gene profile, at least in this geographically restricted study material. The new carbapenemase screening assay was able to detect all the genes correctly suggesting it might be suitable for epidemiologic screening purposes in clinical laboratories.

  2. Crystal Structures of KPC-2[beta]-Lactamase in Complex with 3-Nitrophenyl Boronic Acid and the Penam Sulfone PSR-3-226

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    Ke, Wei; Bethel, Christopher R.; Papp-Wallace, Krisztina M.; Pagadala, Sundar Ram Reddy; Nottingham, Micheal; Fernandez, Daniel; Buynak, John D.; Bonomo, Robert A.; van den Akker, Focco (Case Western); (Stokes); (SMU)

    2012-08-01

    Class A carbapenemases are a major threat to the potency of carbapenem antibiotics. A widespread carbapenemase, KPC-2, is not easily inhibited by {beta}-lactamase inhibitors (i.e., clavulanic acid, sulbactam, and tazobactam). To explore different mechanisms of inhibition of KPC-2, we determined the crystal structures of KPC-2 with two {beta}-lactamase inhibitors that follow different inactivation pathways and kinetics. The first complex is that of a small boronic acid compound, 3-nitrophenyl boronic acid (3-NPBA), bound to KPC-2 with 1.62-{angstrom} resolution. 3-NPBA demonstrated a Km value of 1.0 {+-} 0.1 {micro}M (mean {+-} standard error) for KPC-2 and blocks the active site by making a reversible covalent interaction with the catalytic S70 residue. The two boron hydroxyl atoms of 3-NPBA are positioned in the oxyanion hole and the deacylation water pocket, respectively. In addition, the aromatic ring of 3-NPBA provides an edge-to-face interaction with W105 in the active site. The structure of KPC-2 with the penam sulfone PSR-3-226 was determined at 1.26-{angstrom} resolution. PSR-3-226 displayed a K{sub m} value of 3.8 {+-} 0.4 {micro}M for KPC-2, and the inactivation rate constant (kinact) was 0.034 {+-} 0.003 s{sup -1}. When covalently bound to S70, PSR-3-226 forms a trans-enamine intermediate in the KPC-2 active site. The predominant active site interactions are generated via the carbonyl oxygen, which resides in the oxyanion hole, and the carboxyl moiety of PSR-3-226, which interacts with N132, N170, and E166. 3-NPBA and PSR-3-226 are the first {beta}-lactamase inhibitors to be trapped as an acyl-enzyme complex with KPC-2. The structural and inhibitory insights gained here could aid in the design of potent KPC-2 inhibitors.

  3. Modified Carbapenem Inactivation Method for Phenotypic Detection of Carbapenemase Production among Enterobacteriaceae.

    Science.gov (United States)

    Pierce, Virginia M; Simner, Patricia J; Lonsway, David R; Roe-Carpenter, Darcie E; Johnson, J Kristie; Brasso, William B; Bobenchik, April M; Lockett, Zabrina C; Charnot-Katsikas, Angella; Ferraro, Mary Jane; Thomson, Richard B; Jenkins, Stephen G; Limbago, Brandi M; Das, Sanchita

    2017-08-01

    The ability of clinical microbiology laboratories to reliably detect carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) is an important element of the effort to prevent and contain the spread of these pathogens and an integral part of antimicrobial stewardship. All existing methods have limitations. A new, straightforward, inexpensive, and specific phenotypic method for the detection of carbapenemase production, the carbapenem inactivation method (CIM), was recently described. Here we describe a two-stage evaluation of a modified carbapenem inactivation method (mCIM), in which tryptic soy broth was substituted for water during the inactivation step and the length of this incubation was extended. A validation study was performed in a single clinical laboratory to determine the accuracy of the mCIM, followed by a nine-laboratory study to verify the reproducibility of these results and define the zone size cutoff that best discriminated between CP-CRE and members of the family Enterobacteriaceae that do not produce carbapenemases. Bacterial isolates previously characterized through whole-genome sequencing or targeted PCR as to the presence or absence of carbapenemase genes were tested for carbapenemase production using the mCIM; isolates with Ambler class A, B, and D carbapenemases, non-CP-CRE isolates, and carbapenem-susceptible isolates were included. The sensitivity of the mCIM observed in the validation study was 99% (95% confidence interval [95% CI], 93% to 100%), and the specificity was 100% (95% CI, 82% to 100%). In the second stage of the study, the range of sensitivities observed across nine laboratories was 93% to 100%, with a mean of 97%; the range of specificities was 97% to 100%, with a mean of 99%. The mCIM was easy to perform and interpret for Enterobacteriaceae , with results in less than 24 h and excellent reproducibility across laboratories. Copyright © 2017 American Society for Microbiology.

  4. Epidemisk stigning i forekomsten af carbapenemase-producerende enterobakterier i Danmark

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    Wang, Mikala; Ellermann-Eriksen, Svend; Hansen, Dennis Schrøder

    2016-01-01

    Carbapenemase-producing Enterobacteriaceae (CPE) are extremely multiresistant bacteria with few or no treatment options. Infections with CPE are associated with a mortality of 40-50%. In Denmark, CPE were first detected in 2008. Prior to 2013 the CPE incidence was low, but since then the incidence...

  5. Molecular characterization of extended-spectrum β-lactamase, plasmid-mediated AmpC cephalosporinase and carbapenemase genes among Enterobacteriaceae isolates in five medical centres of East and West Azerbaijan, Iran.

    Science.gov (United States)

    Sadeghi, Mohammad Reza; Ghotaslou, Reza; Akhi, Mohammad Taghi; Asgharzadeh, Mohammad; Hasani, Alka

    2016-11-01

    Very little is known about the occurrence and various types of extended-spectrum β-lactamase (ESBL), AmpC and carbapenemase in Iran. The aims of this study were to determine the prevalence of ESBLs, AmpCs and carbapenemase genes among Enterobacteriaceae in Azerbaijan and to characterize the genetic composition of the detected genes. A total of 307 Enterobacteriaceae isolates, recovered from five medical centres, were screened for ESBL, AmpC and carbapenemase activities by the disc diffusion method and phenotypic confirmatory tests. The 162 selected strains (third-generation cephalosporins, cefoxitin- or carbapenem-resistant strains with positive or negative phenotypic confirmatory tests) were selected for multiplex PCR screening for β-lactamase genes, and detected genes were confirmed by sequencing. Of 162 isolates, 156 harboured 1 to 6 β-lactamase genes of 41 types. The most prevalent genes were blaTEM-1 (29.9 %), followed by blaCTX-M-15 (25.7 %). Plasmid-mediated AmpC was detected in 66 strains (21.5 %) alone or in combination with other genes. Carbapenemase-encoding genes were detected in 18 strains (5.8 %) of 27 carbapenem-non-susceptible isolates including 11, 7, 3 and 1 cases of blaOXA-48, blaNDM-1, blaKPC-2 and blaKPC-3 genes, respectively. Interestingly, 148 (94.8 %) of 156 strains with any β-lactamase gene were found to have a multidrug-resistant pattern. The rate of resistance to β-lactams and multidrug-resistant Enterobacteriaceae is high in Azerbaijan. All positive strains for carbapenemase genes were resistant to all β-lactams. The present study reveals the high occurrence of CTX-M-type ESBLs followed by TEM and SHV variants among Enterobacteriaceae isolates. East Azerbaijan seems to be an alarming focus for OXA-48, NDM-1 and KPC dissemination.

  6. In Vitro Activity of Imipenem against Carbapenemase-Positive Enterobacteriaceae Isolates Collected by the SMART Global Surveillance Program from 2008 to 2014.

    Science.gov (United States)

    Karlowsky, James A; Lob, Sibylle H; Kazmierczak, Krystyna M; Badal, Robert E; Young, Katherine; Motyl, Mary R; Sahm, Daniel F

    2017-06-01

    The Study for Monitoring Antimicrobial Resistance Trends (SMART) global surveillance program collected 103,960 isolates of Enterobacteriaceae from 2008 to 2014. From this isolate collection, all ertapenem-nonsusceptible isolates (MIC, ≥1 μg/ml; n = 3,428) and 9,371 isolates of Escherichia coli , Klebsiella pneumoniae , Klebsiella oxytoca , and Proteus mirabilis with an ertapenem-susceptible extended-spectrum-β-lactamase (ESBL)-positive phenotype were assessed for the presence of common carbapenemase genes using a Check-MDR CT101 microarray (Check-Points, Wageningen, the Netherlands) and published multiplex PCR assays. Testing identified 1,493 isolates that harbored a carbapenemase gene (1,485 ertapenem-nonsusceptible isolates and 8 ertapenem-susceptible ESBL-positive isolates) and accounted for 1.4% (1,493/103,960) of all isolates of Enterobacteriaceae The most frequently identified carbapenemase genes were the KPC ( n = 794), OXA-48-like ( n = 300), and NDM ( n = 290) genes. Carbapenemase genes were most frequently identified in Klebsiella pneumoniae ( n = 1,127), Escherichia coli ( n = 149), and Enterobacter cloacae ( n = 110). Among the carbapenemase-positive isolates, 66.7% (2/3), 37.0% (111/300), 20.0% (8/40), 3.3% (3/92), 2.3% (18/794), and 0% (0/290) of the isolates with genes for GES, OXA-48-like, IMP, VIM, KPC, and NDM, respectively, were susceptible to imipenem (MIC, ≤1 μg/ml). Isolates that tested as susceptible to imipenem were not uncommon among carbapenemase-positive isolates (9.4%, 141/1,493) and most frequently carried OXA-48-like enzymes (78.7%; 111/141); however, overall, these isolates remained rare (0.1%, 141/103,960). The practice of screening clinical isolates of Enterobacteriaceae that test as susceptible to carbapenems in vitro for the presence of carbapenemase genes remains controversial and requires further study. Copyright © 2017 American Society for Microbiology.

  7. Emergence of extended spectrum beta-lactamases-producing strains belonging to cefotaxime-M-1 class from intensive care units patients and environmental surfaces in Pakistan

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    Aqsa Ashraf Bukhari

    2016-11-01

    Full Text Available Aim: The emergence of multidrug-resistant (MDR bacteria is the most dangerous threat for the treatment of infectious diseases. The aim of this study was to detect and characterize extended spectrum beta-lactamases (ESBLs and carbapenemase-producing Klebsiella pneumoniae and Escherichia coli among patients and environment of intensive care units (ICUs of three tertiary care hospitals in Pakistan. Materials and Methods: A total of 82 samples from ICU’s patients and inanimate environment (injection trays, wash basins, door handles, hand swabs of professionals, and ICU fridges were screened for ESBL by culturing on CHROMagar-ESBL. ESBL and carbapenemases production were confirmed by double disc synergy test and modified Hodge’s test, respectively. Polymerase chain reaction was used to detect ESBL encoding genes bla cefotaxime (CTX-M, blaCTX-M-1, blaCTX-M-2, blaCTX-M-9, blaTEM, blaSHV and carbapenemase genes blaKPC, bla New Delhi metallo-beta-lactamase-1, blaOXA-48 and blaVIM. Results: Overall, ESBL production was found high 30/82 (36.5% among isolates of which 15.8% K. pneumoniae and 20.7% E. coli were identified. All the K. pneumoniae and majority of E. coli isolates were MDR, i.e., resistance to three or more antimicrobial categories. Molecular characterization showed the blaCTX-M-1 as the predominant genotype found in 17/21 (80% of the isolates. None of the strains was found positive for carbapenemase-encoding genes. Conclusion: In conclusion, this study demonstrates the emergence of MDR ESBL producing strains among ICU patients and hospital environment, posing a serious threat for the control of nosocomial infections.

  8. Chromosomal Amplification of the blaOXA-58 Carbapenemase Gene in a Proteus mirabilis Clinical Isolate.

    Science.gov (United States)

    Girlich, Delphine; Bonnin, Rémy A; Bogaerts, Pierre; De Laveleye, Morgane; Huang, Daniel T; Dortet, Laurent; Glaser, Philippe; Glupczynski, Youri; Naas, Thierry

    2017-02-01

    Horizontal gene transfer may occur between distantly related bacteria, thus leading to genetic plasticity and in some cases to acquisition of novel resistance traits. Proteus mirabilis is an enterobacterial species responsible for human infections that may express various acquired β-lactam resistance genes, including different classes of carbapenemase genes. Here we report a Proteus mirabilis clinical isolate (strain 1091) displaying resistance to penicillin, including temocillin, together with reduced susceptibility to carbapenems and susceptibility to expanded-spectrum cephalosporins. Using biochemical tests, significant carbapenem hydrolysis was detected in P. mirabilis 1091. Since PCR failed to detect acquired carbapenemase genes commonly found in Enterobacteriaceae, we used a whole-genome sequencing approach that revealed the presence of bla OXA-58 class D carbapenemase gene, so far identified only in Acinetobacter species. This gene was located on a 3.1-kb element coharboring a bla AmpC -like gene. Remarkably, these two genes were bracketed by putative XerC-XerD binding sites and inserted at a XerC-XerD site located between the terminase-like small- and large-subunit genes of a bacteriophage. Increased expression of the two bla genes resulted from a 6-time tandem amplification of the element as revealed by Southern blotting. This is the first isolation of a clinical P. mirabilis strain producing OXA-58, a class D carbapenemase, and the first description of a XerC-XerD-dependent insertion of antibiotic resistance genes within a bacteriophage. This study revealed a new role for the XerC-XerD recombinase in bacteriophage biology. Copyright © 2017 American Society for Microbiology.

  9. Isolation of Klebsiella pneumoniae strains with altered susceptibility to carbapenems not carbapenemase mediated

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    Franca Cian

    2009-12-01

    Full Text Available The spread of enterobacteria producing extended-spectrum ß-lactamases (ESBLs is sharply increasing in Italy, while the detection of isolates resistant to carbapenems is still sporadic. Isolates of Klebsiella pneumoniae resistant to all cephalosporins, aminoglycosides and fluoroquinolones have been isolated in Trieste since 2008. Because of the altered profile of resistance to carbapenems, these strains were reported as ESBL-negative and possible carbapenemases producer by the expert system, leaving tigecycline as the only therapeutic choice.The purpose of this study is the characterization of the mechanisms involved in resistance to carbapenems in these strains and the evaluation of a reliable and simple test for phenotypic confirmation of ESBL and/or carbapenemase production. 25 isolates of MDR K. pneumoniae were collected between October 2008 and May 2009, mainly from urinary samples of elderly patients hospitalized in medicine wards. Identification and susceptibility testing were performed using the Vitek 2 system.The double-disc (DD test was used to check the production of ESBLs, while imipenem and imipenem-EDTA synergy test was used to detect the production of metallo-ßlactamase (MBL. Carbapenemase activity was tested by an hydrolysis assay and the production of MBLs was also investigated by PCR. The DD synergy test highlighted the possible production of ESBLs in 18 out of 22 strains, considered as negative by Vitek. All ESBLs producers tested positive for the blaCTX-M-15 allele. Only one isolate was resistant to carbapenems and resulted positive for production of MBL by the phenotypic test.The crude extract showed carbapenemase activity inhibited by EDTA; PCR test gave positive result for a blaVIM-type allele. PCR analysis performed on representative isolates, followed by sequencing, showed that coding sequence of ompk35 was not functional. Results of this study confirmed the emergence of ESBL-positive strains of K. pneumoniae that

  10. Rapid identification of carbapenemase genes in gram-negative bacteria with an oligonucleotide microarray-based assay.

    Directory of Open Access Journals (Sweden)

    Sascha D Braun

    Full Text Available Rapid molecular identification of carbapenemase genes in Gram-negative bacteria is crucial for infection control and prevention, surveillance and for epidemiological purposes. Furthermore, it may have a significant impact upon determining the appropriate initial treatment and greatly benefit for critically ill patients. A novel oligonucleotide microarray-based assay was developed to simultaneously detect genes encoding clinically important carbapenemases as well as selected extended (ESBL and narrow spectrum (NSBL beta-lactamases directly from clonal culture material within few hours. Additionally, a panel of species specific markers was included to identify Escherichia coli, Pseudomonas aeruginosa, Citrobacter freundii/braakii, Klebsiella pneumoniae and Acinetobacter baumannii. The assay was tested using a panel of 117 isolates collected from urinary, blood and stool samples. For these isolates, phenotypic identifications and susceptibility tests were available. An independent detection of carbapenemase, ESBL and NSBL genes was carried out by various external reference laboratories using PCR methods. In direct comparison, the microarray correctly identified 98.2% of the covered carbapenemase genes. This included blaVIM (13 out of 13, blaGIM (2/2, blaKPC (27/27, blaNDM (5/5, blaIMP-2/4/7/8/13/14/15/16/31 (10/10, blaOXA-23 (12/13, blaOXA-40-group (7/7, blaOXA-48-group (32/33, blaOXA-51 (1/1 and blaOXA-58 (1/1. Furthermore, the test correctly identified additional beta-lactamases [blaOXA-1 (16/16, blaOXA-2 (4/4, blaOXA-9 (33/33, OXA-10 (3/3, blaOXA-51 (25/25, blaOXA-58 (2/2, CTX-M1/M15 (17/17 and blaVIM (1/1]. In direct comparison to phenotypical identification obtained by VITEK or MALDI-TOF systems, 114 of 117 (97.4% isolates, including Acinetobacter baumannii (28/28, Enterobacter spec. (5/5, Escherichia coli (4/4, Klebsiella pneumoniae (62/63, Klebsiella oxytoca (0/2, Pseudomonas aeruginosa (12/12, Citrobacter freundii (1/1 and Citrobacter

  11. First report of an OXA-58 carbapenemase-producing Acinetobacter ...

    African Journals Online (AJOL)

    S. Natoubi

    2016-11-18

    Nov 18, 2016 ... urinary tract infection, in Morocco. Acinetobacter baumannii are organisms frequently found in the environment. This bacterium causes several types of infections, such as bacteremia, pneumonia and urinary tract infection [1]. Carbapenem resistance in A. baumannii is more often caused by the production of ...

  12. Molecular detection of carbapenemase-producing genes in referral ...

    African Journals Online (AJOL)

    (OXA-48) and their derivatives) and metallo-β-lactamases (MBL). (imipenemases (IMP) ... treatment options rather than the expression of specific virulence characteristics.[6,7] .... Future analysis of surveillance data for CPE should provide a ...

  13. THE MASS PROFILE OF THE GALAXY TO 80 kpc

    International Nuclear Information System (INIS)

    Gnedin, Oleg Y.; Brown, Warren R.; Geller, Margaret J.; Kenyon, Scott J.

    2010-01-01

    The Hypervelocity Star Survey presents the currently largest sample of radial velocity measurements of halo stars out to 80 kpc. We apply spherical Jeans modeling to these data in order to derive the mass profile of the Galaxy. We restrict the analysis to distances larger than 25 kpc from the Galactic center, where the density profile of halo stars is well approximated by a single power law with logarithmic slope between -3.5 and -4.5. With this restriction, we also avoid the complication of modeling a flattened Galactic disk. In the range 25 kpc c (80 kpc) lies between 175 and 231 km s -1 , with the most likely value of 193 km s -1 . Compared with the value at the solar location, the Galactic circular velocity declines by less than 20% over an order of magnitude in radius. Such a flat profile requires a massive and extended dark matter halo. The mass enclosed within 80 kpc is 6.9 +3.0 -1.2 x 10 11 M sun . Our sample of radial velocities is large enough that the biggest uncertainty in the mass is not statistical but systematic, dominated by the density slope and anisotropy of the tracer population. Further progress requires modeling observed data sets within realistic simulations of galaxy formation.

  14. Epidemiology of extended-spectrum β-lactamase, AmpC, and carbapenemase production in Proteus mirabilis.

    Science.gov (United States)

    Datta, Priya; Gupta, Varsha; Arora, Shilpa; Garg, Shivani; Chander, Jagdish

    2014-01-01

    Proteus mirabilis strains that produce extended-spectrum β-lactamase (ESBL), AmpC β-lactamase, and carbapenemase pose potential threats to patient care because most clinical diagnostic laboratories may not attempt to detect these three major groups of enzymes. Therefore, the objective of this study was to ascertain if P. mirabilis isolates collected from our heathcare facility possess various mechanisms of resistance to β-lactams (i.e., ESBL, AmpC, and carbapenemases) and to additionally arrive at conclusions regarding concurrent testing for these three mechanism of drug resistance in order to reduce cost and time in routine diagnostic testing. Between January 2011 and June 2011, 60 consecutive non-repeated strains of P. mirabilis were evaluated for production of ESBLs, AmpC β-lactamases, and carbapenemases. Of these, 36 isolates were found to be ESBL producers, and 7 (12%) were positive for production of AmpC β-lactamases and ESBLs. Therefore, 19.4% of ESBL-producing Proteus strains coproduced AmpC enzymes. The modified Hodge test confirmed carbapenemase production in only 1 isolate (1.7%), which was also ESBL- and AmpC-positive. The clinical impact of additional AmpC expression in ESBL-producing P. mirabilis results in a newly acquired resistance to β-lactamase inhibitors. In addition, to save time and costs, we recommend the use of cefepime/cefepime-clavulanate or boronic acid for the ESBL detection but in only those strains that were positive for ESBL by screening and negative by confirmatory tests.

  15. High mortality of bloodstream infection outbreak caused by carbapenem-resistant P. aeruginosa producing SPM-1 in a bone marrow transplant unit.

    Science.gov (United States)

    Chaves, Lucas; Tomich, Lísia Moura; Salomão, Matias; Leite, Gleice Cristina; Ramos, Jessica; Martins, Roberta Ruedas; Rizek, Camila; Neves, Patricia; Batista, Marjorie Vieira; Amigo, Ulysses; Guimaraes, Thais; Levin, Anna Sara; Costa, Silvia Figueiredo

    2017-12-01

    Carbapenem resistance in P. aeruginosa is increasing worldwide. In Brazil, SPM-1 is the main P. aeruginosa carbapenemase identified. Little is known about the virulence factor in SPM-1 clones.Methodolgy. We describe a carbapenem-resistant P. aeruginosa bloodstream infection (CRPa-BSI) outbreak in a bone marrow transplant Unit (BMT). Twenty-nine CRPa-BSI cases were compared to 58 controls. Microbiological characteristics of isolates, such as sensitivity, carbapenemase gene PCR for P. aeruginosa, and PFGE are described, as well as the whole-genome sequence (WGS) of three strains.Results/Key findings. The cultures from environmental and healthcare workers were negative. Some isolates harboured KPC and SPM. The WGS showed that the 03 strains belonged to ST277, presented the same mutations in outer membrane protein, efflux pump, and virulence genes such as those involved in adhesion, biofilm, quorum-sensing and the type III secretion system, but differ regarding the carbapenemase profile. A predominant clone-producing SPM harbouring Tn 4371 was identified and showed cross-transmission; no common source was found. Overall mortality rate among cases was 79 %. The first multivariate analysis model showed that neutropenia (P=0.018), GVHD prophylaxis (P=0.016) and prior use of carbapenems (P=0.0089) were associated with CRPa-BSI. However, when MASCC>21 points and platelets were added in the final multivariate analysis, only prior use of carbapenems remained as an independent risk factor for CRPa-BSI (P=0.043). The predominant clone belonging to ST277 showed high mortality. Carbapenem use was the only risk factor associated with CRPa-BSI. This finding is a wake-up call for the need to improve management in BMT units.

  16. The identification of carbapenemase types in Enterobacteriaceae by using molecular assay and phenotyping confirmation tests.

    Science.gov (United States)

    Genc, Ozlem; Aksu, Evrim; Gulcan, Aynur

    2016-06-01

    In this study, we aimed to identify the molecular carbapenemase types of the Enterobacteriaceae isolates and to evaluate the performance of manually prepared and commercially available combination disc methods and the modified Hodge test. One hundred and forty carbapenemase producing isolates and 45 isolates as control group were included in our study. The Xpert CARBA-R test was used as the molecular method. Antibiotic susceptibility tests were performed using combined discs, manually prepared with APBA (3-aminophenyl boronic acid), DPA (dipicolinic acid), EDTA (Ethylene diamine tetra acetic acid), cloxacillin supplements and Mastdiscs Combi-D70C that includes four antibiotic discs with specific inhibitors and temocillin discs. The modified Hodge test was performed on all isolates. OXA-48 gene was identified in 129 isolates , the NDM gene was identified in 10 isolates and VIM in one isolate. Thirty inaccurate results (30/185, 16%) were detected by using the manually prepared confirmation test. The sensitivity and specificity of this test were identified respectively 85% and 73%. Also, the sensitivity and specificity of the Mastdiscs Combi-D70C were identified as 100%. Negative results were detected in 3 NDM isolates with the use of a modified Hodge test. Sensitivity and specificity were calculated for the modified Hodge test respectively 97% and 100%. Finally, molecular methods provide results rapidly but they are not always easily accessible. The modified Hodge test can be used only for screening as a first step test and is not one of the tests that can identify the type of the carbapenemase. When carbapenem-resistant Enterobacteriaceae are detected, a commercial kit like Mastdiscs Combi-D70 may be preferred instead of the manually prepared phenotypic verification tests. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Coproduction of KPC-2 and IMP-10 in Carbapenem-Resistant Serratia marcescens Isolates from an Outbreak in a Brazilian Teaching Hospital.

    Science.gov (United States)

    Silva, Kesia Esther; Cayô, Rodrigo; Carvalhaes, Cecilia Godoy; Patussi Correia Sacchi, Flávia; Rodrigues-Costa, Fernanda; Ramos da Silva, Ana Carolina; Croda, Julio; Gales, Ana Cristina; Simionatto, Simone

    2015-07-01

    We describe an outbreak caused by KPC-2- and IMP-10-producing Serratia marcescens isolates in a Brazilian teaching hospital. Tigecycline was the only active antimicrobial agent tested. The blaIMP-10 gene was located in a new class 1 integron, named In990, carried by a nonconjugative plasmid, in contrast to blaKPC-2. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  18. The Molecular Epidemiology and Genetic Environment of Carbapenemases Detected in Africa.

    Science.gov (United States)

    Sekyere, John Osei; Govinden, Usha; Essack, Sabiha

    2016-01-01

    Research articles describing carbapenemases and their genetic environments in Gram-negative bacteria were reviewed to determine the molecular epidemiology of carbapenemases in Africa. The emergence of resistance to the carbapenems, the last resort antibiotic for difficult to treat bacterial infections, affords clinicians few therapeutic options, with a resulting increase in morbidities, mortalities, and healthcare costs. However, the molecular epidemiology of carbapenemases throughout Africa is less described. Research articles and conference proceedings describing the genetic environment and molecular epidemiology of carbapenemases in Africa were retrieved from Google Scholar, Scifinder, Pubmed, Web of Science, and Science Direct databases. Predominant carbapenemase genes so far described in Africa include the blaOXA-48 type, blaIMP, blaVIM, and blaNDM in Acinetobacter baumannii, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter spp., and Escherichia coli carried on various plasmid types and sizes, transposons, and integrons. Class D and class B carbapenemases, mainly prevalent in A. baumannii, K. pneumoniae, E. cloacae, Citrobacter spp., and E. coli were the commonest carbapenemases. Carbapenemases are mainly reported in North and South Africa as under-resourced laboratories, lack of awareness and funding preclude the detection and reporting of carbapenemase-mediated resistance. Consequently, the true molecular epidemiology of carbapenemases and their genetic environment in Africa is still unknown.

  19. Chromobacterium spp. harbour Ambler class A beta-lactamases showing high identity with KPC

    DEFF Research Database (Denmark)

    Gudeta, Dereje Dadi; Bortolaia, Valeria; Jayol, Aurelie

    2016-01-01

    Objectives: The origin of KPC is unknown. The aim of this study was to detect progenitors of KPC in silico and to functionally verify their beta-lactam hydrolysis activity. Methods: The sequence of KPC-2 was used to mine the NCBI protein sequence database. The best non-KPC hits were analysed by a......-lactamases with up to 76% aa identity to KPC from distinct Chromobacterium species is highly indicative of the role played by this genus in the evolution of KPC....

  20. Crystallization and preliminary diffraction studies of SFC-1, a carbapenemase conferring antibiotic resistance

    International Nuclear Information System (INIS)

    Hong, Myoung-Ki; Lee, Jae Jin; Wu, Xing; Kim, Jin-Kwang; Jeong, Byeong Chul; Pham, Tan-Viet; Kim, Seung-Hwan; Lee, Sang Hee; Kang, Lin-Woo

    2012-01-01

    The SFC-1 gene from S. fonticola was cloned and SFC-1 was expressed, purified and crystallized. X-ray diffraction data were collected from an SFC-1 crystal to 1.6 Å resolution. SFC-1, a class A carbapenemase that confers antibiotic resistance, hydrolyzes the β-lactam rings of β-lactam antibiotics (carbapenems, cephalosporins, penicillins and aztreonam). SFC-1 presents an enormous challenge to infection control, particularly in the eradication of Gram-negative pathogens. As SFC-1 exhibits a remarkably broad substrate range, including β-lactams of all classes, the enzyme is a potential target for the development of antimicrobial agents against pathogens producing carbapenemases. In this study, SFC-1 was cloned, overexpressed, purified and crystallized. The SFC-1 crystal diffracted to 1.6 Å resolution and belonged to the orthorhombic space group P2 1 2 1 2 1 , with unit-cell parameters a = 65.8, b = 68.3, c = 88.8 Å. Two molecules are present in the asymmetric unit, with a corresponding V M of 1.99 Å 3 Da −1 and a solvent content of 38.1%

  1. Direct detection of carbapenemase-associated proteins of Acinetobacter baumannii using nanodiamonds coupled with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

    Science.gov (United States)

    Chang, Kai-Chih; Chung, Chin-Yi; Yeh, Chen-Hsing; Hsu, Kuo-Hsiu; Chin, Ya-Ching; Huang, Sin-Siang; Liu, Bo-Rong; Chen, Hsi-An; Hu, Anren; Soo, Po-Chi; Peng, Wen-Ping

    2018-04-01

    The appearance and spread of carbapenem-resistant Acinetobacter baumannii (CRAB) pose a challenge for optimization of antibiotic therapies and outbreak preventions. The carbapenemase production can be detected through culture-based methods (e.g. Modified Hodge Test-MHT) and DNA based methods (e.g. Polymerase Chain Reaction-PCR). The culture-based methods are time-consuming, whereas those of PCR assays need only a few hours but due to its specificity, can only detect known genetic targets encoding carbapenem-resistance genes. Therefore, new approaches to detect carbapenemase-producing A. baumannii are of great importance. Here, we have developed a rapid and novel method using detonation nanodiamonds (DNDs) as a platform for concentration and extraction of A. baumannii carbapenemase-associated proteins prior to matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF-MS) analysis. To concentrate and extract the A. baumannii carbapenemase-associated proteins, we tested several protein precipitation conditions and found a 0.5% trifluoroacetic acid (TFA) solution within the bacterial suspension could result in strong ion signals with DNDs. A total of 66 A. baumannii clinical-isolates including 51 carbapenem-resistant strains and 15 carbapenem-susceptible strains were tested. Our result showed that among the 51 carbapenem-resistant strains 49 strains had a signal at m/z ~40,279 (±87); among the 15 carbapenem-susceptible strains, 4 strains showed a signal at m/z ~40,279. With on-diamond digestion, we confirmed that the captured protein at m/z ~40,279 was related to ADC family extended-spectrum class C beta-lactamase, from A. baumannii. Using this ADC family protein as a biomarker (m/z ~ 40,279) for carbapenem susceptibility testing of A. baumannii, the sensitivity and the specificity could reach 96% and 73% as compared to traditional imipenem susceptibility testing (MIC results). However, the sensitivity and specificity of this method

  2. Multiplex real-time PCR assay for the detection of extended-spectrum β-lactamase and carbapenemase genes using melting curve analysis.

    Science.gov (United States)

    Singh, Prashant; Pfeifer, Yvonne; Mustapha, Azlin

    2016-05-01

    Real-time PCR melt curve assays for the detection of β-lactamase, extended-spectrum β-lactamase and carbapenemase genes in Gram-negative bacteria were developed. Two multiplex real-time PCR melt curve assays were developed for the detection of ten common β-lactamase genes: blaKPC-like, blaOXA-48-like, blaNDM-like, blaVIM-like, blaIMP-like, blaCTX-M-1+2-group, blaCMY-like, blaACC-like, blaSHV-like and blaTEM-like. The assays were evaluated using 25 bacterial strains and 31 DNA samples (total n=56) comprising different Enterobacteriaceae genera and Pseudomonas spp. These strains were previously characterized at five research institutes. Each resistance gene targeted in this study generated a non-overlapping and distinct melt curve peak. The assay worked effectively and detected the presence of additional resistance genes in 23 samples. The assays developed in this study offer a simple, low cost method for the detection of prevalent β-lactamase, ESBL and carbapenemase genes among Gram-negative pathogens. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Isolation of Enterobacter aerogenes carrying blaTEM-1 and blaKPC-3 genes recovered from a hospital Intensive Care Unit.

    Science.gov (United States)

    Pulcrano, Giovanna; Pignanelli, Salvatore; Vollaro, Adriana; Esposito, Matilde; Iula, Vita Dora; Roscetto, Emanuela; Soriano, Amata Amy; Catania, Maria Rosaria

    2016-06-01

    Enterobacter aerogenes has recently emerged as an important hospital pathogen. In this study, we showed the emergence of E. aerogenes isolates carrying the blaKPC gene in patients colonized by carbapenem-resistant Klebsiella pneumoniae strains. Two multiresistant E. aerogenes isolates were recovered from bronchial aspirates of two patients hospitalized in the Intensive Care Unit at the "Santa Maria della Scaletta" Hospital, Imola. The antimicrobial susceptibility test showed the high resistance to carbapenems and double-disk synergy test confirmed the phenotype of KPC and AmpC production. Other investigation revealed that ESBL and blaKPC genes were carried on the conjugative pKpQIL plasmid. This is a relevant report in Italy that describes a nosocomial infection due to the production of KPC beta-lactamases by an E. aerogenes isolate in patients previously colonized by K. pneumoniae carbapenem-resistant. In conclusion, it's necessary a continuous monitoring of multidrug-resistant strains for the detection of any KPC-producing bacteria that could expand the circulation of carbapenem-resistant pathogens. © 2016 APMIS. Published by John Wiley & Sons Ltd.

  4. Epidemiology and risk factors for faecal extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) carriage derived from residents of seven nursing homes in western Shanghai, China.

    Science.gov (United States)

    Zhao, S-Y; Zhang, J; Zhang, Y-L; Wang, Y-C; Xiao, S-Z; Gu, F-F; Guo, X-K; Ni, Y-X; Han, L-Z

    2016-03-01

    Nursing homes (NHs) have been implicated as significant reservoirs of antibiotic-resistant organisms causing severe infectious disease. We investigated the prevalence and molecular epidemiology of, and risk factors for, faecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E). A multicentre cross-sectional study was conducted in seven NHs in Shanghai between March 2014 and May 2014. Antimicrobial susceptibility testing and polymerase chain reaction were used to detect genes coding for ESBLs and carbapenemases. NH records at individual-resident level and facility level were examined for potential risk factors. Four hundred and fifty-seven Enterobacteriaceae isolates were collected of which 183 (46·92%) were colonized by ESBL-E. CTX-M enzymes (198/200, 99%) predominated, with CTX-M-14 (84/200, 42%) the most common types. Two carbapenemase producers harboured blaKPC-2. Resistance rates to carbapenems, TZP, AK, FOS, CL and TGC were low. History of invasive procedures [odds ratio (OR) 2·384, 95% confidence interval (CI) 1·318-4·310, P = 0·004], narrow-spectrum cephalosporins (OR 1·635, 95% CI 1·045-2·558, P = 0·031) and broad-spectrum cephalosporins (OR 3·276, 95% CI 1·278-8·398, P = 0·014) were independently associated with ESBL-E carriage. In conclusion, NH residents have a very high prevalence of faecal carriage of ESBL-E. Continuous and active surveillance is important, as are prudent infection control measures and antibiotic use to prevent and control the spread of these antibiotic-resistant strains.

  5. Identification of carbapenemase-mediated resistance among Enterobacteriaceae bloodstream isolates: A molecular study from India

    Directory of Open Access Journals (Sweden)

    Srujana Mohanty

    2017-01-01

    Full Text Available Acquired resistance in carbapenem-resistant Enterobacteriaceae (CRE conferred by carbapenemases is a major concern worldwide. Consecutive, non-duplicate isolates of Escherichia coli (EC and Klebsiella pneumoniae from clinically diagnosed bloodstream infections were screened for the presence of carbapenem resistance by standard disk-diffusion method and minimum inhibitory concentration breakpoints using the Clinical and Laboratory Standards Institute guidelines. Carbapenemase-encoding genes were amplified by polymerase chain reaction. Of 387 isolates (214 K. pneumoniae, 173 EC tested, 93 (24.03% were found to be CRE. Of these, 71 (76.3% were positive for at least one tested carbapenemase gene. The frequency of carbapenemase genes was New Delhi metallo-β-lactamse-1 (65.6%, oxacillinase (OXA-48 (24.7%, OXA-181 (23.6%, Verona integron-encoded metallo-β-lactamase (6.4% and K. pneumoniae carbapenemase (2.1%. Our study identified presence of carbapenemases in a large proportion of CRE isolates. Delineation of resistance mechanisms is important in view of future therapeutics concerned with the treatment of CRE and for aiding control efforts by surveillance and infection control interventions.

  6. Dissemination of NDM-1-Producing Enterobacteriaceae Mediated by the IncX3-Type Plasmid

    Science.gov (United States)

    Fu, Ying; Du, Xiaoxing; Shen, Yuqin; Yu, Yunsong

    2015-01-01

    The emergence and spread of NDM-1-producing Enterobacteriaceae have resulted in a worldwide public health risk that has affected some provinces of China. China is an exceptionally large country, and there is a crucial need to investigate the epidemic of bla NDM-1-positive Enterobacteriaceae in our province. A total of 186 carbapenem-resistant Enterobacteriaceae isolates (CRE) were collected in a grade-3 hospital in Zhejiang province. Carbapenem-resistant genes, including bla KPC, bla IMP, bla VIM, bla OXA-48 and bla NDM-1 were screened and sequenced. Ninety isolates were identified as harboring the bla KPC-2 genes, and five bla NDM-1-positive isolates were uncovered. XbaI-PFGE revealed that three bla NDM-1-positive K. pneumoniae isolates belonged to two different clones. S1-PFGE and southern blot suggested that the bla NDM-1 genes were located on IncX3-type plasmids with two different sizes ranging from 33.3 to 54.7 kb (n=4) and 104.5 to 138.9 kb (n=1), respectively, all of which could easily transfer to Escherichia coli by conjugation and electrotransformation. The high-throughput sequencing of two plasmids was performed leading to the identification of a smaller 54-kb plasmid, which had high sequence similarity with a previously reported pCFNDM-CN, and a larger plasmid in which only a 7.8-kb sequence of a common gene environment around bla NDM-1 (bla NDM-1-trpF- dsbC-cutA1-groEL-ΔInsE,) was detected. PCR mapping and sequencing demonstrated that four smaller bla NDM-1 plasmids contained a common gene environment around bla NDM-1 (IS5-bla NDM-1-trpF- dsbC-cutA1-groEL). We monitored the CRE epidemic in our hospital and determined that KPC-2 carbapenemase was a major risk to patient health and the IncX3-type plasmid played a vital role in the spread of the bla NDM-1 gene among the CRE. PMID:26047502

  7. Prevalencia de bacterias Gram negativas portadoras del gen blaKPC en hospitales de Colombia

    OpenAIRE

    Robinson Pacheco; Lyda Osorio; Adriana M. Correa; Maria Virginia Villegas

    2014-01-01

    Introducción. Las enzimas carbapenemasas de tipo KPC tienen gran capacidad de diseminación, son causantes de epidemias y se asocian a mayor mortalidad y estancia hospitalaria. En Colombia se han venido reportando cada vez más desde 2007, pero se desconoce la prevalencia hospitalaria. Objetivo. Estimar la prevalencia hospitalaria del gen blaKPC. Materiales y métodos. Se evaluó la presencia del gen blaKPC y su ‘clonalidad’ en aislamientos de enterobacterias y Pseudomonas aeruginosa de p...

  8. Identification of KPC-producing Klebsiella pneumoniae in clinical samples in Iran

    Directory of Open Access Journals (Sweden)

    fereshte sadat Hashemizadeh

    2013-05-01

    Results: In this study of 202 isolates of Klebsiella, 180 isolates (89.1% of K. pneumoniae and 22 isolates (10.9% of Klebsiella oxytoca were isolated from patients. More than 55% of isolates showed multiple-drug resistance and also above 40% resistance to imipeneme and meropeneme was recorded. The MIC of isolates which were resistant to carbapenemes was above 32µg/ml.The PCR results showed that 22 cases (11.9% of isolates had blakpc gene which most of them had been isolated from urine and blood samples of patients who were hospitalized in the ICU and pediatrics. Conclusion: Regarding the existence of blakpc gene in K. pneumoniae and possibility of transformation of these genes to the other bacteria, reconsideration in antibiotics consumption patterns and more attention to nosocomial infections control criteria are inevitable.

  9. Molecular characterization of class b carbapenemases in advanced stage of dissemination and emergence of class d carbapenemases in Enterobacteriaceae from Croatia.

    Science.gov (United States)

    Bedenić, Branka; Sardelić, Sanda; Luxner, Josefa; Bošnjak, Zrinka; Varda-Brkić, Dijana; Lukić-Grlić, Amarela; Mareković, Ivana; Frančula-Zaninović, Sonja; Krilanović, Marija; Šijak, Dorotea; Grisold, Andrea; Zarfel, Gernot

    2016-09-01

    Carbapenemases involved in acquired carbapenem resistance in Enterobacteriaceae belong to Ambler class A serin β-lactamases, class B metallo-β-lactamases (MBL) or class D OXA-48-like β-lactamases. The aim of the present study was to analyse the molecular epidemiology and the mechanisms and routes of spread of class B and class D carbapenemases in Croatia. In total 68 isolates were analyzed. Antibiotic susceptibility was determined by broth microdilution method. PCR was used to detect antibiotic-resistance genes. Genotyping was performed by rep-PCR and MLST. Sixty-five isolates were found to harbour VIM-1 carbapenemase, seven of which were positive also for NDM-1, while two strains harboured only NDM-1. OXA-48 was detected in three isolates, two of which coproduced VIM-1. Thirty-six strains possessed additional CTX-M-15 β-lactamase whereas 64 were positive for TEM-1. CMY was found in 18 Citrobacter freundii isolates and DHA-1 in one Enterobacter cloacae isolate. Four different plasmid-incompatibility groups were found: A/C, L/M, N and FIIAs. Unlike C. freundii and E. cloacae, Klebsiella pneumoniae showed high diversity of rep-PCR patterns. E. cloacae and C. freundii predominantly belonged to one large clone which was allocated to ST105 and ST24, respectively. Three different types of carbapenemases were identified showing the complexity of CRE in Croatia. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. High-Velocity Cloud Complex H and Weaver's "Jet": Two candidate dwarf satellite galaxies for which dark matter halo models indicate distances of ~27 kpc and ~108 kpc

    Science.gov (United States)

    Simonson, S. Christian

    2018-04-01

    Two anomalous-velocity H I features, High-Velocity Cloud Complex H (HVC H) (Blitz et al. 1999), and Weaver's "jet" (Weaver 1974), appear to be good candidates for dwarf satellites. In this work they are modeled as H I disks in dark matter halos that move in 3D orbits in the combined time-dependent gravitational fields of the Milky Way and M31. As they orbit in the Local Group they develop tidal distortions and produce debris. The current l,b,V appearance of the tidal features as they approach the Milky Way indicate distances of 27 ± 9 kpc for HVC H and 108 ± 36 kpc for Weaver's "jet". As these are within the distances to known Milky Way satellites, finding stellar components would be of interest for the star formation history of the Milky Way. This work uses recent Hubble Space Telescope results on M31 (van der Marel et al. 2012) to calculate the center-of-mass (COM) locations and the dark matter mass distributions of the Milky-Way—M31 system since the Big Bang. Time-dependent COM orbits of the satellites have been computed in 3D, along with rings of test particles representing their disks. Tidal effects that develop on these rings have been compared with published 21-cm line data from Lockman (2003) and Simonson (1975). For HVC H at l = 130.5°, b = +1.5°, V = -200 km/s, the dark matter mass (in solar masses) is estimated as 5.2 ± 3.5E8. The previously estimated H I mass is 6.4E6, or 1.2% of the newly derived satellite mass. For Weaver's "jet", which covers 2° by 7° at l = 197.3°, b = +2.1°, V = -30 to -87 km/s, the dark matter mass is estimated as 1.8 ± 0.6E9. The H I mass is 1.8 ± 1.1E8, or 6% to 12% of the satellite mass. In the case of HVC H, owing to its disk angle of 45°, tidal debris is thrown upward. This would presumably contribute to a halo star stream. In the case of Weaver's "jet", the streamer represents accreting material for the disk. I am grateful to Leo Blitz for bringing Lockman's work on HVC H to my attention and for many helpful

  11. Clonal Transmission of Gram-Negative Bacteria with Carbapenemases NDM-1, VIM-1, and OXA-23/72 in a Bulgarian Hospital.

    Science.gov (United States)

    Pfeifer, Yvonne; Trifonova, Angelina; Pietsch, Michael; Brunner, Magdalena; Todorova, Iva; Gergova, Ivanka; Wilharm, Gottfried; Werner, Guido; Savov, Encho

    2017-04-01

    We characterized 72 isolates with reduced susceptibility to carbapenems (50 Acinetobacter spp., 13 Proteus mirabilis, five Escherichia coli, one Morganella morganii, one Enterobacter cloacae, one Providencia rettgeri, and one Pseudomonas aeruginosa) from a hospital in Sofia, Bulgaria. Different β-lactamase genes were identified by polymerase chain reaction and sequencing. Bacterial strain typing was performed by enzymatic macrorestriction and pulsed-field gel electrophoresis (PFGE) typing as well as multilocus sequence typing for selected isolates. The majority of Acinetobacter baumannii (46/50) and one Acinetobacter pittii isolate harbored carbapenemase genes bla OXA-23 or bla OXA-72 ; two A. baumannii contained both genes. PFGE typing of all A. baumannii showed the presence of nine different clones belonging to eight sequence types ST350, ST208, ST436, ST437, ST449, ST231, ST502, and ST579. Molecular characterization of the remaining isolates confirmed the presence of one NDM-1-producing E. coli-ST101 clone (five isolates) and one P. mirabilis clone (13 isolates) with VIM-1 and CMY-99. Furthermore, NDM-1 was identified in P. rettgeri and M. morganii and VIM-2 in the P. aeruginosa isolate. The permanent introduction of OXA-23/72 carbapenemase-producing A. baumannii clones into the hospital and the repeated occurrence of one VIM-1-producing P. mirabilis and one NDM-1-producing E. coli-ST101 clone over a period of more than 1 year is of concern and requires intensified investigations.

  12. Spread of imipenem-resistant Acinetobacter baumannii co-expressing OXA-23 and GES-11 carbapenemases in Lebanon.

    Science.gov (United States)

    Hammoudi, D; Moubareck, C Ayoub; Hakime, N; Houmani, M; Barakat, A; Najjar, Z; Suleiman, M; Fayad, N; Sarraf, R; Sarkis, D Karam

    2015-07-01

    The acquisition of carbapenemases by Acinetobacter baumannii is reported increasingly worldwide, but data from Lebanon are limited. The aims of this study were to evaluate the prevalence of imipenem-resistant A. baumannii in Lebanon, identify resistance determinants, and detect clonal relatedness. Imipenem-resistant A. baumannii were collected from nine Lebanese hospitals during 2012. Antimicrobial susceptibility, the cloxacillin effect, and ethylenediaminetetraacetic acid (EDTA) synergy were determined. Genes encoding carbapenemases and insertion sequence ISAba1 were screened via PCR sequencing. ISAba1 position relative to genes encoding Acinetobacter-derived cephalosporinases (ADCs) and OXA-23 was studied by PCR mapping. Clonal linkage was examined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Out of 724 A. baumannii isolated in 2012, 638 (88%) were imipenem-resistant. Of these, 142 were analyzed. Clavulanic acid-imipenem synergy suggested carbapenem-hydrolyzing extended-spectrum β-lactamase. A positive cloxacillin test indicated ADCs, while EDTA detection strips were negative. Genotyping indicated that 90% of isolates co-harbored blaOXA-23 and blaGES-11. The remaining strains had blaOXA-23, blaOXA-24, blaGES-11, or blaOXA-24 with blaGES-11. ISAba1 was located upstream of blaADC and blaOXA-23 in 97% and 100% of isolates, respectively. ERIC-PCR fingerprinting revealed 18 pulsotypes spread via horizontal gene transfer and clonal dissemination. This survey established baseline evidence of OXA-23 and GES-11-producing A. baumannii in Lebanon, indicating the need for further surveillance. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Prevalencia de bacterias Gram negativas portadoras del gen blaKPC en hospitales de Colombia

    Directory of Open Access Journals (Sweden)

    Robinson Pacheco

    2014-04-01

    Full Text Available Introducción. Las enzimas carbapenemasas de tipo KPC tienen gran capacidad de diseminación, son causantes de epidemias y se asocian a mayor mortalidad y estancia hospitalaria. En Colombia se han venido reportando cada vez más desde 2007, pero se desconoce la prevalencia hospitalaria. Objetivo. Estimar la prevalencia hospitalaria del gen blaKPC. Materiales y métodos. Se evaluó la presencia del gen blaKPC y su ‘clonalidad’ en aislamientos de enterobacterias y Pseudomonas aeruginosa de pacientes hospitalizados. Resultados. De los 424 aislamientos evaluados durante el periodo de estudio, 273 cumplieron con criterios de elegibilidad, 31,1 % fue positivo para el gen blaKPC y, al ajustar por ‘clonalidad’, la positividad fue de 12,8 %. El gen blaKPC se encontró con mayor frecuencia en Klebsiella pneumoniae seguido de P. aeruginosa y otras enterobacterias. A pesar de que la unidad de cuidados intensivos aportó el mayor número de aislamientos, no se encontró un patrón más prevalente del gen blaKPC en las ellas que en las otras salas. El aparato respiratorio fue el sitio anatómico de origen con la mayor prevalencia. No se presentó estacionalidad en la frecuencia de los aislamientos portadores del gen blaKPC. Conclusión. Este estudio reveló la alta prevalencia del gen blaKPC en diferentes microorganismos aislados en varias instituciones hospitalarias del país. La extraordinaria capacidad de propagación del gen blaKPC, las dificultades del diagnóstico y la limitada disponibilidad de antibióticos plantean la apremiante necesidad de fortalecer los sistemas de vigilancia epidemiológica y ajustar oportunamente las políticas institucionales de uso racional de antibióticos con el fin de contener su diseminación a otras instituciones de salud del país.

  14. RR Lyrae star distance scale and kinematics from inner bulge to 50 kpc

    Directory of Open Access Journals (Sweden)

    Dambis Andrei

    2017-01-01

    Full Text Available We use the currently most complete sample of ∼ 3500 type ab RR Lyraes in our Galaxy with available radial-velocity and [Fe/H] measurements to perform a statisticalparallax analysis for a subsample of ∼ 600 type ab RR Lyraes located within 5 kpc from the Sun to refine the parameters of optical and WISE W1-band period-metallicityluminosity relations and adjust our preliminary distances. The new zero point implies the rescaled estimates for the solar Galactocentric distance (RG = 7.99 ± 0.37 kpc and the LMC distance modulus (DMLMC = 18.39 ±0.09. We use the kinematic data for the entire sample to explore the dependence of the halo and thick-disk RR Lyrae velocity ellipsoids on Galactocentric distance from the inner bulge out to R ∼ 50 kpc.

  15. Environmental persistence of OXA-48-producing Klebsiella pneumoniae in a French intensive care unit.

    Science.gov (United States)

    Pantel, Alix; Richaud-Morel, Brigitte; Cazaban, Michel; Bouziges, Nicole; Sotto, Albert; Lavigne, Jean-Philippe

    2016-03-01

    The spread of carbapenemase-producing Gram-negative rods is an emerging global problem. This study describes the epidemiologic features of an outbreak caused by an environmental reservoir of OXA-48-producing Klebsiella pneumoniae caused by persistence of the bacteria during 20 months in an intensive care unit in France. This report emphasizes the importance of early environmental screening to interrupt the transmission of carbapenemase-producingEnterobacteriaceae. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. The spread of bla OXA-48 and bla OXA-244 carbapenemase genes among Klebsiella pneumoniae, Proteus mirabilis and Enterobacter spp. isolated in Moscow, Russia.

    Science.gov (United States)

    Fursova, Nadezhda K; Astashkin, Eugeny I; Knyazeva, Anastasia I; Kartsev, Nikolay N; Leonova, Ekaterina S; Ershova, Olga N; Alexandrova, Irina A; Kurdyumova, Natalia V; Sazikina, Svetlana Yu; Volozhantsev, Nikolay V; Svetoch, Edward A; Dyatlov, Ivan A

    2015-11-02

    The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a great problem of healthcare worldwide. Study of the spread for bla OXA-48-like genes coding epidemically significant carbapenemases among hospital pathogens is important for the regional and global epidemiology of antimicrobial resistance. Antibacterial resistant isolates of Klebsiella pneumoniae (n = 95) from 54 patients, P. mirabilis (n = 32) from 20 patients, Enterobacter aerogenes (n = 6) from four patients, and Enterobacter cloacae (n = 4) from four patients were collected from January, 2013 to October, 2014 in neurosurgical intensive care unit (ICU) of the Burdenko Neurosurgery Institute, Moscow. Characteristics of the isolates were done using susceptibility tests, PCR detection of the resistance genes, genotyping, conjugation, DNA sequencing, and bioinformatic analysis. Major strains under study were multi drug resistant (MDR), resistant to three or more functional classes of drugs simultaneously-98.9 % K. pneumoniae, 100 % P. mirabilis, one E. aerogenes isolate, and one E. cloacae isolate. Molecular-genetic mechanism of MDR in K. pneumoniae and P. mirabilis isolates were based on carrying of epidemic extended-spectrum beta-lactamase bla CTX-M-15 gene (87.2 and 90.6 % accordingly), carbapenemase bla OXA-48-like gene (55.3 and 23.3 % accordingly), and class 1 (54.8 and 31.3 % accordingly) and class 2 (90.6 % P. mirabilis) integrons. The bla OXA-48-like-positive K. pneumoniae were collected during whole two-year surveillance period, while P. mirabilis and Enterobacter spp. carrying bla OXA-48-like genes were detected only after four and 18 months after the research start, respectively. The bla OXA-48-like gene acquisition was shown for P. mirabilis isolates collected from five patients and for E. cloacae isolate collected from one patient during their stay in the ICU, presumably from bla OXA-48-like-positive K. pneumoniae. The source of the bla OXA-244 gene acquired by E

  17. Insights on the Horizontal Gene Transfer of Carbapenemase Determinants in the Opportunistic Pathogen Acinetobacter baumannii

    Science.gov (United States)

    Da Silva, Gabriela Jorge; Domingues, Sara

    2016-01-01

    Horizontal gene transfer (HGT) is a driving force to the evolution of bacteria. The fast emergence of antimicrobial resistance reflects the ability of genetic adaptation of pathogens. Acinetobacter baumannii has emerged in the last few decades as an important opportunistic nosocomial pathogen, in part due to its high capacity of acquiring resistance to diverse antibiotic families, including to the so-called last line drugs such as carbapenems. The rampant selective pressure and genetic exchange of resistance genes hinder the effective treatment of resistant infections. A. baumannii uses all the resistance mechanisms to survive against carbapenems but production of carbapenemases are the major mechanism, which may act in synergy with others. A. baumannii appears to use all the mechanisms of gene dissemination. Beyond conjugation, the mostly reported recent studies point to natural transformation, transduction and outer membrane vesicles-mediated transfer as mechanisms that may play a role in carbapenemase determinants spread. Understanding the genetic mobilization of carbapenemase genes is paramount in preventing their dissemination. Here we review the carbapenemases found in A. baumannii and present an overview of the current knowledge of contributions of the various HGT mechanisms to the molecular epidemiology of carbapenem resistance in this relevant opportunistic pathogen. PMID:27681923

  18. Resolving the age bimodality of galaxy stellar populations on kpc scales

    NARCIS (Netherlands)

    Zibetti, Stefano; Gallazzi, Anna R.; Ascasibar, Y.; Charlot, S.; Galbany, L.; García Benito, R.; Kehrig, C.; de Lorenzo-Cáceres, A.; Lyubenova, M.; Marino, R. A.; Márquez, I.; Sánchez, S. F.; van de Ven, G.; Walcher, C. J.; Wisotzki, L.

    2017-01-01

    Galaxies in the local Universe are known to follow bimodal distributions in the global stellar population properties. We analyse the distribution of the local average stellar population ages of 654 053 sub-galactic regions resolved on ˜1 kpc scales in a volume-corrected sample of 394 galaxies, drawn

  19. SURVEILLANCE of CARBAPENEM NON-SUSCEPTIBLE GRAM NEGATIVE STRAINS and CHARACTERIZATION of CARBAPENEMASES of CLASSES A, B and D in a LEBANESE HOSPITAL.

    Science.gov (United States)

    Hammoudi, Dalal; Moubareck, Carole Ayoub; Kanso, Abeer; Nordmann, Patrice; Sarkis, Dolla Karam

    2015-01-01

    The production of carbapenem-hydrolyzing enzymes has been recognized as one of the most currently relevant resistance mechanisms in gram negative bacterial isolates, and is being detected in various countries. In Lebanon, carbapenem resistance was studied among gram negative pathogens collected from a university hospital from January to June of years 2011 and 2012. All isolates were subjected to phenotypic tests including antibiotic susceptibility, cloxacillin effect, modified Hodge test, and Etest for metallo-β-lactamase detection. They were also subjected to genotyping by PCR sequencing to characterize β-lactamases. Between January and June 2011, 48 carbapenem non-susceptible strains were collected. Of these, one Klebsiella pneumoniae harbored OXA-48 and insertion sequence IS 1999; four Acinetobacter baumanni harbored simultaneously OXA-23 and GES-11, and three Pseudomonas harbored VIM-2 carbapenemase. Between January and June 2012, 100 carbapenem non-susceptible strains were collected. Of these, one K. pneumoniae harbored simultaneously OXA-48, IS 1999, and an acquired AmpC of the ACC group; four Serratia marcescens harbored OXA-48, while among eight A. baumannii, one strain co-harbored OXA-23 and GES-11, six harbored OXA-23 and one OXA-24. Fifteen P, aeruginosa and two Pseudomonas species harbored VIM-2; two P. aeruginosa strains produced IMP-1 and two others IMP-2. This epidemiological survey demonstrates the presence of carbapenemases of Ambler classes A, B, and D in a Lebanese hospital and indicates increase in the number and variety of such enzymes.

  20. Probing the Outflowing Multiphase Gas ∼1 kpc below the Galactic Center

    Energy Technology Data Exchange (ETDEWEB)

    Savage, Blair D.; Kim, Tae-Sun; Wakker, Bart P. [Department of astronomy, University of Wisconsin, Madison, 475 North Charter Street, Madison, WI 53706 (United States); Fox, Andrew J. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD, 21218 (United States); Massa, Derck [Space Science Institute, 4750 Walnut Street, Suite 205, Boulder, CO 80301 (United States); Bordoloi, Rongmon [MIT-Kavli Center for Astrophysics and Space Research, 77 Massachusetts Avenue, Cambridge, MA 02139 (United States); Jenkins, Edward B. [Princeton University Observatory, Princeton, NJ 08544 (United States); Lehner, Nicolas [Department of Physics, University of Notre Dame, Notre Dame, IN 46556 (United States); Bland-Hawthorn, Joss [Institute of Astronomy, School of Physics, University of Sydney, NSW 2006 (Australia); Lockman, Felix J. [Green Bank Observatory, P.O. Box 2, Green Bank, WV 24944 (United States); Hernandez, Svea [Department of Astrophysics, Radboud University, Nijmegen, PO Box 9010, 6500 GL Nijmegen (Netherlands)

    2017-10-01

    Comparison of interstellar medium (ISM) absorption in the UV spectrum of LS 4825, a B1 Ib−II star d  = 21 ± 5 kpc from the Sun toward l  = 1.°67 and b  = −6.°63, with ISM absorption toward an aligned foreground star at d  < 7.0 ± 1.7 kpc, allows us to isolate and study gas associated with the Milky Way nuclear wind. Spectra from the Space Telescope Imaging Spectrograph show low-ionization absorption out to d  < 7 kpc (e.g., O i, C ii, Mg ii, Si ii, Fe ii, S ii) only between 0 and 40 km s{sup −1}, while absorption at d  > 7 kpc, ∼1 kpc below the Galactic plane, is complex and spans −290 to +94 km s{sup −1}. The intermediate and high ions Si iii, C iv, Si iv, and N v show extremely strong absorption with multiple components from −283 to 107 km s{sup −1}, implying that the ISM ∼1 kpc below the Galactic center has a substantial reservoir of plasma and more gas containing C iv and N v than in the Carina OB1 association at z  = 0 kpc. Abundances and physical conditions are presented for many absorption components. The high ion absorption traces cooling transition temperature plasma probably driven by the outflowing hot gas, while the extraordinarily large thermal pressure, p / k  ∼ 10{sup 5} cm{sup −3} K{sup −1}, in an absorption component at −114 km s{sup −1} probably arises from the ram pressure of the outflowing hot gas. The observations are consistent with a flow whose ionization structure in the high ions can be understood through a combination of nonequilibrium radiative cooling and turbulent mixing.

  1. Multispecies and Clonal Dissemination of OXA-48 Carbapenemase in Enterobacteriaceae From Companion Animals in Germany, 2009—2016

    Directory of Open Access Journals (Sweden)

    Sandra Pulss

    2018-06-01

    Full Text Available The increasing spread of carbapenemase-producing Enterobacteriaceae (CPE poses a serious threat to public health. Recent studies suggested animals as a putative source of such bacteria. We investigated 19,025 Escherichia coli, 1607 Klebsiella spp. and 570 Enterobacter spp. isolated from livestock, companion animal, horse, and pet samples between 2009 and 2016 in our routine diagnostic laboratory for reduced susceptibility to carbapenems (CP by using meropenem-containing media. Actively screened CP non-susceptible strains as well as 367 archived ESBL/AmpC-β-lactamase-producing Enterobacteriaceae were then tested for the presence of CP genes by PCRs. Among 21,569 isolates, OXA-48 could be identified as the sole carbapenemase type in 137 (0.64% strains. The blaOXA-48 gene was located on an ∼60-kb IncL plasmid and sequence analysis revealed high similarity to reference plasmid pOXA-48a, which has been involved in the global spread of the blaOXA-48 gene in humans for many years. Klebsiella pneumoniae was the predominant OXA-48 producer (n = 86; 6.6% of all K. pneumoniae isolates, followed by E. cloacae (n = 28; 5.0%, Klebsiella oxytoca (n = 1; 0.3%, and E. coli (n = 22, 0.1%. OXA-48 was not found in livestock, but in dogs (120/3182; 3.8%, cats (13/792; 1.6%, guinea pig (1/43; 2.3%, rat (1/23; 4.3%, mouse (1/180; 0.6%, and one rabbit (1/144; 0.7%. Genotyping identified few major clones among the different enterobacteria species, including sequence types ST11 and ST15 for K. pneumoniae, ST1196 for E. coli, and ST506 and ST78 for E. cloacae, most of which were previously involved in the dissemination of multidrug-resistant strains in humans. The majority of OXA-48 isolates (n = 112 originated from a university veterinary clinic (UVC, while animals from further 16 veterinary institutions were positive. Clonal analyses suggested nosocomial events related to different species and STs in two veterinary clinics and horizontal transfer of the pOXA-48-like

  2. Functional blaKPC-2 sequences are present in United States beef cattle feces regardless of antibiotic use

    Science.gov (United States)

    Recently, using quantitative PCR (qPCR) we detected blaKPC-2 in metagenomic DNA (mgDNA) prepared from the feces of 36 lots beef cattle "raised without antibiotics" (RWA) and 36 lots raised "conventionally" (CONV). Since a small internal fragment of the blaKPC-2 gene was targeted we sought to confirm...

  3. First Detection of GES-5 Carbapenemase-Producing Acinetobacter baumannii Isolate.

    Science.gov (United States)

    Al-Agamy, Mohamed H; Jeannot, Katy; El-Mahdy, Taghrid S; Shibl, Atef M; Kattan, Wael; Plésiat, Patrick; Courvalin, Patrice

    2017-07-01

    This study was conducted to investigate the molecular epidemiology of resistance in Acinetobacter baumannii isolates collected at a hospital in Riyadh, Saudi Arabia, from January through December 2010. Twenty-seven A. baumannii were highly resistant (MIC 90 > 256 μg/ml) to ceftazidime, cefepime, and aztreonam. Imipenem resistance was seen in 24 isolates, of which 18 had an minimum inhibitory concentration (MIC) >32 μg/mL. Ciprofloxacin, gentamicin, and amikacin resistance was found in 93%, 52%, and 37% of all the isolates, respectively. Moreover, 8 (30%) isolates showed colistin resistance, and 15 (56%) were found to have MICs ≥4 μg/mL for tigecycline. The frequency of ADC, GES-1, GES-11, and GES-5 were 96.3% (n = 26), 18.5% (n = 5), 11% (n = 3), and 3.7% (n = 1), respectively. OXA-23 was found in 63% (n = 17) of the isolates; ISAba1 was found upstream of OXA-23 in 16. OXA-24/40 was detected in only one strain. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) analysis revealed that the 27 strains were distributed in 8 sequence types (STs) and 16 clonal pulsotypes (A-P). Five singleton STs were identified, including ST15 and ST113-ST116. The emergence of multidrug-resistant A. baumannii is becoming a major concern in Saudi Arabia. Metallo-β-lactamases have no role in carbapenem resistance in this collection. The spread of OXA-23 in our strains occurred across different STs and pulsotypes, unlike what has been observed in many other countries. PFGE typing was more discriminatory than MLST. The high frequency of colistin and tigecycline resistance found in the isolates calls for continuous monitoring. This study describes the first identification of GES-5 conferring carbapenem resistance in A. baumannii.

  4. Carbapenemase producing Klebsiella pneumoniae in Peru: a case report and antimicrobial resistance discussion

    Directory of Open Access Journals (Sweden)

    Jhosef Franck Quispe Pari

    2018-04-01

    Full Text Available Resumen Las carbapenemasas son uno de los mecanismos enzimáticos de resistencia antimicrobiana, que compromete la mayor parte de los antibióticos betalactámicos. Por lo general, su producción se debe al uso indiscriminado de antimicrobianos. A nivel mundial, la expansión de este mecanismo de resistencia es inminente y las medidas de control son limitadas. Con el objeto de discutir los problemas relacionados a este mecanismo emergente de resistencia, reportamos un caso de Klebsiella pneumoniae productora de carbapenemasas en Huancayo, la Región de la Sierra Central de Perú.

  5. Chromogenic culture media or rapid immunochromatographic test: Which is better for detecting Klebsiella pneumoniae that produce OXA-48 and can they be used in blood and urine specimens.

    Science.gov (United States)

    Genc, Ozlem; Aksu, Evrim

    2018-05-01

    Our goal was to compare a rapid test (OXA-48K-SeT) and four different chromogenic media (CHROMagar KPC, CHROMagar mSuperCARBA, ChromID Carba and ChromID OXA-48) for the detection of OXA-48 producing Klebsiella pneumoniae isolates and spiked urine/blood samples with these bacteria. In total 100 K.pneumoniae isolates, including 60 OXA-48 positive, 15 other carbapenemase producing, 15 Extended spectrum betalactamases (ESBL) positive and 10 carbapenem sensitive K.pneumoniae were included in the study. After all samples were inoculated into all chromogenic media, temocillin discs were placed onto the media. OXA-48K-SeT was studied according to the manufacturer's instructions and the lower detection limit was determined. Sensitivities and specificities of all chromogenic media and rapid test were detected as 100%. All of the OXA-48 producers were found resistant to temocillin on all chromogenic media. The lower detection limit of the rapid assay was determined as 10 6 in both direct bacterial samples and in spiked urine/blood samples. As a result, four chromogenic culture media and OXA-48 K-SeT can be used safely for detection of OXA-48 positive K.pneumoniae isolates. Although direct clinical specimens were not used, our study suggests that this media and OXA-48 K-SeT may be used in patient samples like blood and urine. Further studies are needed to assess this suggestion. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Structures of the Class D Carbapenemase OXA-24 from Acinetobacter baumannii in Complex with Doripenem

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Kyle D.; Ortega, Caleb J.; Renck, Nicholas A.; Bonomo, Robert A.; Powers, Rachel A.; Leonard, David A. (Case Western); (Grand Valley)

    2012-02-08

    The emergence of class D {beta}-lactamases with carbapenemase activity presents an enormous challenge to health practitioners, particularly with regard to the treatment of infections caused by Gram-negative pathogens such as Acinetobacter baumannii. Unfortunately, class D {beta}-lactamases with carbapenemase activity are resistant to {beta}-lactamase inhibitors. To better understand the details of the how these enzymes bind and hydrolyze carbapenems, we have determined the structures of two deacylation-deficient variants (K84D and V130D) of the class D carbapenemase OXA-24 with doripenem bound as a covalent acyl-enzyme intermediate. Doripenem adopts essentially the same configuration in both OXA-24 variant structures, but varies significantly when compared to the non-carbapenemase class D member OXA-1/doripenem complex. The alcohol of the 6a hydroxyethyl moiety is directed away from the general base carboxy-K84, with implications for activation of the deacylating water. The tunnel formed by the Y112/M223 bridge in the apo form of OXA-24 is largely unchanged by the binding of doripenem. The presence of this bridge, however, causes the distal pyrrolidine/sulfonamide group to bind in a drastically different conformation compared to doripenem bound to OXA-1. The resulting difference in the position of the side-chain bridge sulfur of doripenem is consistent with the hypothesis that the tautomeric state of the pyrroline ring contributes to the different carbapenem hydrolysis rates of OXA-1 and OXA-24. These findings represent a snapshot of a key step in the catalytic mechanism of an important class D enzyme, and might be useful for the design of novel inhibitors.

  7. NO EVIDENCE FOR A DARK MATTER DISK WITHIN 4 kpc FROM THE GALACTIC PLANE

    International Nuclear Information System (INIS)

    Moni Bidin, C.; Carraro, G.; Mendez, R. A.; Van Altena, W. F.

    2010-01-01

    We estimated the dynamical surface mass density (Σ) at the solar Galactocentric distance between 2 and 4 kpc from the Galactic plane, as inferred from the observed kinematics of the thick disk. We find Σ(z = 2 kpc) = 57.6 ± 5.8 M sun pc -2 , and it shows only a tiny increase in the z range considered by our investigation. We compared our results with the expectations for the visible mass, adopting the most recent estimates in the literature for contributions of the Galactic stellar disk and interstellar medium, and proposed models of the dark matter distribution. Our results match the expectation for the visible mass alone, never differing from it by more than 0.8 M sun pc -2 at any z, and thus we find little evidence for any dark component. We assume that the dark halo could be undetectable with our method, but the dark disk, recently proposed as a natural expectation of the ΛCDM models, should be detected. Given the good agreement with the visible mass alone, models including a dark disk are less likely, but within errors its existence cannot be excluded. In any case, these results put constraints on its properties: thinner models (scale height lower than 4 kpc) reconcile better with our results and, for any scale height, the lower-density models are preferred. We believe that successfully predicting the stellar thick disk properties and a dark disk in agreement with our observations could be a challenging theoretical task.

  8. Distribution of Extended-Spectrum β-Lactamases, AmpC β-Lactamases, and Carbapenemases among Enterobacteriaceae Isolates Causing Intra-Abdominal Infections in the Asia-Pacific Region: Results of the Study for Monitoring Antimicrobial Resistance Trends (SMART)

    Science.gov (United States)

    Sheng, Wang-Huei; Badal, Robert E.

    2013-01-01

    The increasing trend of β-lactam resistance among Enterobacteriaceae is a worldwide threat. Enterobacteriaceae isolates causing intra-abdominal infections (IAI) from the Study for Monitoring Antimicrobial Resistance Trends (SMART) collected in 2008 and 2009 from the Asia-Pacific region were investigated. Detection of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, and carbapenemases was performed by multiplex PCR. A total of 699 Enterobacteriaceae isolates with positive genotypic results, included Escherichia coli (n = 443), Klebsiella pneumoniae (n = 187), Enterobacter cloacae (n = 45), Klebsiella oxytoca (n = 9), Citrobacter freundii (n = 5), Proteus mirabilis (n = 3), Enterobacter aerogenes (n = 2), Morganella morganii (n = 2), and one each of Enterobacter asburiae, Proteus vulgaris, and Providencia rettgeri were analyzed. Nearly 20% of these β-lactamase-producing Enterobacteriaceae isolates were from community-associated IAI. CTX-M (588 isolates, including 428 [72.8%] with CTX-M-15) was the most common ESBL, followed by SHV (n = 59) and TEM (n = 4). CMY (n = 110, including 102 [92.7%] with CMY-2) was the most common AmpC β-lactamase, followed by DHA (n = 46) and ACT/MIR (n = 40). NDM (n = 65, including 62 [95.4%] with NDM-1) was the most common carbapenemase, followed by IMP (n = 7) and OXA (n = 7). Isolates from hospital-associated IAI had more complicated β-lactamase combinations than isolates from the community. Carbapenemases were all exclusively detected in Enterobacteriaceae isolates from India, except that IMP β-lactamases were also detected in Philippines and Australia. CTX-M β-lactamases were the predominant ESBLs produced by Enterobacteriaceae causing IAI in the Asia-Pacific region. Emergence of CTX-M-15-, CMY-2-, and NDM-1-producing Enterobacteriaceae isolates is of major concern and highlights the need for further surveillance in this area. PMID:23587958

  9. Detection of Carbapenemase Production in a Collection of Enterobacteriaceae with Characterized Resistance Mechanisms from Clinical and Environmental Origins by Use of Both Carba NP and Blue-Carba Tests.

    Science.gov (United States)

    García-Fernández, Sergio; Morosini, María-Isabel; Gijón, Desirèe; Beatobe, Lorena; Ruiz-Garbajosa, Patricia; Domínguez, Lucas; Cantón, Rafael; Valverde, Aránzazu

    2016-02-01

    Rapid-screening methods to confirm the presence of resistance mechanisms in multidrug-resistant bacteria are currently recommended. Carba NP and Blue-Carba tests were evaluated in carbapenemase-producing Enterobacteriaceae from hospital (n = 102) and environmental (n = 57) origins for detecting the different molecular classes among them. Both methods showed to be fast and cost-effective, with high sensitivity (98% to 100%) and specificity (100%), and may be easily introduced in the routine laboratory. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  10. Identification of blaOXA-51, blaOXA-58, blaDIM-1 and blaVIM carbapenemase genes in hospital enterobacteriaceae isolates from Sierra Leone

    Science.gov (United States)

    We describe the results of a molecular epidemiological survey of 15 carbapenemase-encoding genes from a recent collection of clinical isolates. The most salient findings revealed that (i) 60% of the isolates harbored multiple carbapenemase genes, (ii) the blaDIM-1 gene that has only been reported in...

  11. Molecular characterization and antimicrobial susceptibility profile of New Delhi metallo-beta-lactamase-1-producing Escherichia coli among hospitalized patients

    Directory of Open Access Journals (Sweden)

    Anjali Agarwal

    2018-01-01

    CONCLUSION: There is an increased prevalence of NDM-1 gene-producing E. coli isolates. These carbapenemase-producing isolates are more resistant to other group of antibiotics (aminoglycosides, fluoroquinolones along with β-lactam group. Early detection of bla NDM-1 gene can help in choosing the effective treatment options for hospitalized patients in time, thereby reducing the risk of mortality.

  12. An OXA-48-producing Escherichia coli isolated from a Danish patient with no hospitalization abroad

    DEFF Research Database (Denmark)

    Gedebjerg, Anne; Hasman, Henrik; Sorensen, Christian Moller

    2015-01-01

    pOXA-48a carrying the bla(OXA-48) gene isolated from a Danish patient without history of hospitalization abroad. The patient reported tourist travel to Egypt and Turkey. The potential acquisition of carbapenemase-producing organisms by ingestion of contaminated food is discussed....

  13. The Proprotein Convertase KPC-1/Furin Controls Branching and Self-avoidance of Sensory Dendrites in Caenorhabditis elegans

    Science.gov (United States)

    Bülow, Hannes E.

    2014-01-01

    Animals sample their environment through sensory neurons with often elaborately branched endings named dendritic arbors. In a genetic screen for genes involved in the development of the highly arborized somatosensory PVD neuron in C. elegans, we have identified mutations in kpc-1, which encodes the homolog of the proprotein convertase furin. We show that kpc-1/furin is necessary to promote the formation of higher order dendritic branches in PVD and to ensure self-avoidance of sister branches, but is likely not required during maintenance of dendritic arbors. A reporter for kpc-1/furin is expressed in neurons (including PVD) and kpc-1/furin can function cell-autonomously in PVD neurons to control patterning of dendritic arbors. Moreover, we show that kpc-1/furin also regulates the development of other neurons in all major neuronal classes in C. elegans, including aspects of branching and extension of neurites as well as cell positioning. Our data suggest that these developmental functions require proteolytic activity of KPC-1/furin. Recently, the skin-derived MNR-1/menorin and the neural cell adhesion molecule SAX-7/L1CAM have been shown to act as a tripartite complex with the leucine rich transmembrane receptor DMA-1 on PVD mechanosensory to orchestrate the patterning of dendritic branches. Genetic analyses show that kpc-1/furin functions in a pathway with MNR-1/menorin, SAX-7/L1CAM and DMA-1 to control dendritic branch formation and extension of PVD neurons. We propose that KPC-1/furin acts in concert with the ‘menorin’ pathway to control branching and growth of somatosensory dendrites in PVD. PMID:25232734

  14. New Delhi metallo-beta-lactamase 1-producing Enterobacteriaceae: emergence and response in Europe.

    Science.gov (United States)

    Struelens, M J; Monnet, D L; Magiorakos, A P; Santos O'Connor, F; Giesecke, J

    2010-11-18

    Acquired carbapenemases confer extensive antibiotic resistance to Enterobacteriaceae and represent a public health threat. A novel acquired carbapenemase, New Delhi metallo-beta-lactamase 1 (NDM-1), has recently been described in the United Kingdom and Sweden, mostly in patients who had received care on the Indian subcontinent. We conducted a survey among 29 European countries (the European Union Member States, Iceland and Norway) to gather information on the spread of NDM-1-producing Enterobacteriaceae in Europe, on public health responses and on available national guidance on detection, surveillance and control. A total of 77 cases were reported from 13 countries from 2008 to 2010. Klebsiella pneumoniae was the most frequently reported species with 54%. Among 55 cases with recorded travel history, 31 had previously travelled or been admitted to a hospital in India or Pakistan and five had been hospitalised in the Balkan region. Possible nosocomial acquisition accounted for 13 of 77 cases. National guidance on NDM-1 detection was available in 14 countries and on NDM-1 control in 11 countries. In conclusion, NDM-1 is spreading across Europe, where it is frequently linked to a history of healthcare abroad, but also to emerging nosocomial transmission. National guidance in response to the threat of carbapenemase-producing Enterobacteriaceae is available in approximately half of the surveyed European countries. Surveillance of carbapenemase- producing Enterobacteriaceae must be enhanced in Europe and effective control measures identified and implemented.

  15. Is This the Carbapenemase Test We've Been Waiting for? A Multicenter Evaluation of the Modified Carbapenem Inactivation Method.

    Science.gov (United States)

    Butler-Wu, Susan M; Abbott, April N

    2017-08-01

    A plethora of phenotypic methods exist for the detection of carbapenemases; however, clinical laboratories have struggled for years with accurate, objective phenotypic detection of carbapenemase activity in Enterobacteriaceae In this issue of the Journal of Clinical Microbiology , V. M. Pierce et al. (J Clin Microbiol 55:2321-2333, 2017, https://doi.org/10.1128/JCM.00193-17) report on a multicenter evaluation of the modified carbapenem inactivation method (mCIM). The high sensitivity, specificity, reproducibility, and ease of interpretation associated with the mCIM for Enterobacteriaceae will likely lead to its adoption by clinical laboratories. Copyright © 2017 American Society for Microbiology.

  16. The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir) province, Saudi Arabia.

    Science.gov (United States)

    Al-Zahrani, Ibrahim A; Alsiri, Bander A

    2018-01-01

    To identify the prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) and the most common types of cabapenemases among CRKP in the Southern (Asir) province hospitals, Saudi Arabia. Methods: The cross-sectional study was conducted between late April and September in 2015. A total of 54 Klebsiella pneumoniae (K. pneumoniae) isolates with reduced sensitivity to carbapenems were obtained from various clinical specimens of the 2 largest hospitals in the Southern province. Minimum inhibitory concentrations (MICs) of carbapenems were confirmed using E-test. Molecular detection of the most common carbapenemase genes (blaIMP, bla-carbapenem-hydrolyzing oxacillinase [OXA-48], blaVIM, bla-New Delhi metallo-ß-lactamas [NDM], and blaKPC) was performed using multiplex-polymerase chain reaction. Results: The current study found that increasing age and intensive care unit admission were associated with CRKP isolation. The major type of carbapenemases was OXA-48 with 81.5% (n=44) and it seems to reach an endemic level. New Delhi metallo-ß-lactamas (NDM) was the second most frequent carbapenemase by 7.4% (n=4) of isolates while Verona integron-encoded metallo-ß-lactamase (VIM) was reported only in one isolate. Conclusion: Saudi Arabia receives large numbers of visitors and migrant workers from OXA-48 and NDM endemic countries such as Turkey, India, and Pakistan every year.

  17. The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir province, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ibrahim A. Al-Zahrani

    2018-01-01

    Full Text Available Objectives: To identify the prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP and the most common types of cabapenemases among CRKP in the Southern (Asir province hospitals, Saudi Arabia. Methods: The cross-sectional study was conducted between late April and September in 2015. A total of 54 Klebsiella pneumoniae (K. pneumoniae isolates with reduced sensitivity to carbapenems were obtained from various clinical specimens of the 2 largest hospitals in the Southern province. Minimum inhibitory concentrations (MICs of carbapenems were confirmed using E-test. Molecular detection of the most common carbapenemase genes (blaIMP, bla-carbapenem-hydrolyzing oxacillinase [OXA-48], blaVIM, bla-New Delhi metallo-ß-lactamas [NDM], and blaKPC was performed using multiplex-polymerase chain reaction. Results: The current study found that increasing age and intensive care unit admission were associated with CRKP isolation. The major type of carbapenemases was OXA-48 with 81.5% (n=44 and it seems to reach an endemic level. New Delhi metallo-ß-lactamas (NDM was the second most frequent carbapenemase by 7.4% (n=4 of isolates while Verona integron-encoded metallo-ß-lactamase (VIM was reported only in one isolate. Conclusion: Saudi Arabia receives large numbers of visitors and migrant workers from OXA-48 and NDM endemic countries such as Turkey, India, and Pakistan every year.

  18. Emergence of blaNDM-7-Producing Enterobacteriaceae in Gabon, 2016.

    Science.gov (United States)

    Moussounda, Mesmin; Diene, Seydina M; Dos Santos, Sandra; Goudeau, Alain; François, Patrice; van der Mee-Marquet, Nathalie

    2017-02-01

    Reports of carbapenemase-producing Enterobacteriaceae in Africa remain rare and assess mostly bla OXA-48 -producing isolates from Mediterranean countries and South Africa. We identified bla NDM-7 -producing Enterobacteriaceae in Gabon in 2016. The isolates contained bla NDM-7 IncX3 plasmids that were unusual and similar to the one described in a colistin-resistant Klebsiella pneumoniae SZ04 isolate from China.

  19. Inventarisatie Screening carbapenemase-producerende bacteriën in dieren en dierlijke producten: is de huidige screening toereikend?

    NARCIS (Netherlands)

    Wit B; Veldman K; Hordijk J; Heuvelink A; Vellema P; Dierikx CM; Backer JA; Takumi K; van Duijkeren E; I&V

    2017-01-01

    In dit onderzoek is gekeken of de huidige monitoring van carbapenemase-producerende bacteriën (CPE) voldoende is om betrouwbare uitspraken te kunnen doen over het vóórkomen van deze bacteriën in dieren en/of dierlijke producten. De conclusie van dit rapport is dat méér en gerichter monsters van

  20. Diversity of carbapenemases in clinical isolates of Enterobacteriaceae in Croatia--the results of a multicentre study.

    Science.gov (United States)

    Zujić Atalić, V; Bedenić, B; Kocsis, E; Mazzariol, A; Sardelić, S; Barišić, M; Plečko, V; Bošnjak, Z; Mijač, M; Jajić, I; Vranić-Ladavac, M; Cornaglia, G

    2014-11-01

    Since the first carbapenem-resistant Klebsiella pneumoniae strain was isolated in 2008, Enterobacteriaceae with reduced susceptibility to one or more carbapenems have emerged sporadically in different geographical regions in Croatia. These observations gave rise to a multicenter study on carbapenem resistance in Enterobacteriaceae from Croatia. Fifty-seven carbapenem-non-susceptible strains of Enterobacteriaceae were collected during 2011-2012 from four large hospital centres in Croatia. Overall, 36 strains produced VIM-1 β-lactamase, three produced NDM-1, and one produced KPC-2. A high degree of clonal relatedness was observed in Enterobacter cloacae and Citrobacter freundii strains, in contrast to K. pneumoniae strains. BlaVIM genes were located within class1 integron which contained genes encoding resistance to aminoglycosides (aacA4 ). The study found strong association between blaVIM and qnrB6 and between blaNDM and qnrA6 genes. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

  1. THE MILKY WAY'S CIRCULAR-VELOCITY CURVE BETWEEN 4 AND 14 kpc FROM APOGEE DATA

    Energy Technology Data Exchange (ETDEWEB)

    Bovy, Jo [Institute for Advanced Study, Einstein Drive, Princeton, NJ 08540 (United States); Allende Prieto, Carlos; Meszaros, Szabolcs [Instituto de Astrofisica de Canarias (IAC), E-38200 La Laguna, Tenerife (Spain); Beers, Timothy C. [National Optical Astronomy Observatory, Tucson, AZ 85719 (United States); Bizyaev, Dmitry; Ebelke, Garrett L.; Malanushenko, Elena; Malanushenko, Viktor [Apache Point Observatory, P.O. Box 59, Sunspot, NM 88349 (United States); Da Costa, Luiz N.; Girardi, Leo; Maia, Marcio A. G. [Laboratorio Interinstitucional de e-Astronomia-LIneA, Rua Gal. Jose Cristino 77, Rio de Janeiro, RJ 20921-400 (Brazil); Cunha, Katia [Observatorio Nacional, Rio de Janeiro, RJ 20921-400 (Brazil); Eisenstein, Daniel J. [Harvard-Smithsonian Center for Astrophysics, 60 Garden St., MS 20, Cambridge, MA 02138 (United States); Frinchaboy, Peter M. [Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX 76129 (United States); Garcia Perez, Ana Elia; Hearty, Fred R.; Majewski, Steven R.; Nidever, David L. [Department of Astronomy, University of Virginia, Charlottesville, VA 22904 (United States); Hogg, David W. [Center for Cosmology and Particle Physics, Department of Physics, New York University, 4 Washington Place, New York, NY 10003 (United States); Holtzman, Jon, E-mail: bovy@ias.edu [Department of Astronomy, New Mexico State University, Las Cruces, NM 88003 (United States); and others

    2012-11-10

    We measure the Milky Way's rotation curve over the Galactocentric range 4 kpc {approx}< R {approx}< 14 kpc from the first year of data from the Apache Point Observatory Galactic Evolution Experiment. We model the line-of-sight velocities of 3365 stars in 14 fields with b = 0 Degree-Sign between 30 Degree-Sign {<=} l {<=} 210 Degree-Sign out to distances of 10 kpc using an axisymmetric kinematical model that includes a correction for the asymmetric drift of the warm tracer population ({sigma} {sub R} Almost-Equal-To 35 km s{sup -1}). We determine the local value of the circular velocity to be V{sub c} (R {sub 0}) = 218 {+-} 6 km s{sup -1} and find that the rotation curve is approximately flat with a local derivative between -3.0 km s{sup -1} kpc{sup -1} and 0.4 km s{sup -1} kpc{sup -1}. We also measure the Sun's position and velocity in the Galactocentric rest frame, finding the distance to the Galactic center to be 8 kpc < R {sub 0} < 9 kpc, radial velocity V {sub R, Sun} = -10 {+-} 1 km s{sup -1}, and rotational velocity V {sub {phi}, Sun} = 242{sup +10} {sub -3} km s{sup -1}, in good agreement with local measurements of the Sun's radial velocity and with the observed proper motion of Sgr A*. We investigate various systematic uncertainties and find that these are limited to offsets at the percent level, {approx}2 km s{sup -1} in V{sub c} . Marginalizing over all the systematics that we consider, we find that V{sub c} (R {sub 0}) < 235 km s{sup -1} at >99 % confidence. We find an offset between the Sun's rotational velocity and the local circular velocity of 26 {+-} 3 km s{sup -1}, which is larger than the locally measured solar motion of 12 km s{sup -1}. This larger offset reconciles our value for V{sub c} with recent claims that V{sub c} {approx}> 240 km s{sup -1}. Combining our results with other data, we find that the Milky Way's dark-halo mass within the virial radius is {approx}8 Multiplication-Sign 10{sup 11} M {sub Sun }.

  2. Mapping Seyfert and LINER Excitation Modes in the Inner kpc of NGC 3393

    Science.gov (United States)

    Maksym, W. Peter; Fabbiano, Giuseppina; Elvis, Martin; Karovska, Margarita; Paggi, Alessandro; Raymond, John; Wang, Junfeng; Storchi-Bergmann, Thaisa

    2016-09-01

    We mapped the extended narrowline region (ENLR) of NGC 3393 on scales of r≲ 4\\prime\\prime (˜ 1 kpc) from the nucleus using emission line images of Hα λ6563, [O III]λ 5007, and [S II]λ λ 6717,6731, taken with the Hubble Space Telescope as part of the CHandra survey of Extended Emission line Regions in nearby Seyfert galaxies (CHEERS). By mapping these lines onto a spatially resolved Baldwin-Phillips-Terlevich diagram, we investigate the impact of feedback from a Compton-thick active galactic nucleus on its circumnuclear ISM. We find that the expected Seyfert-like emission within the ionization bicone (≲ 3\\prime\\prime ; 770 pc). We also find a new, figure-8-shaped low ionization emission line region (LINER) cocoon enveloping the bicone and defining a sharp (≲ 100 pc) transition between higher and lower-ionization zones. These data illustrate the morphological dependence of ionization states of the ENLR relative to bicone and host gas geometries.

  3. THE ORIGIN OF HVS17, AN UNBOUND MAIN SEQUENCE B STAR AT 50 kpc

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Warren R.; Geller, Margaret J.; Kenyon, Scott J. [Smithsonian Astrophysical Observatory, 60 Garden Street, Cambridge, MA 02138 (United States); Cohen, Judith G., E-mail: wbrown@cfa.harvard.edu, E-mail: mgeller@cfa.harvard.edu, E-mail: skenyon@cfa.harvard.edu, E-mail: jlc@astro.caltech.edu [Palomar Observatory, Mail Stop 249-17, California Institute of Technology, Pasadena, CA 91125 (United States)

    2013-09-20

    We analyze Keck Echellette Spectrograph and Imager spectroscopy of HVS17, a B-type star traveling with a Galactic rest frame radial velocity of +445 km s{sup –1} in the outer halo of the Milky Way. HVS17 has the projected rotation of a main sequence B star and is chemically peculiar, with solar iron abundance and sub-solar alpha abundance. Comparing measured T{sub eff} and log g with stellar evolution tracks implies that HVS17 is a 3.91 ± 0.09 M{sub ☉}, 153 ± 9 Myr old star at a Galactocentric distance of r = 48.5 ± 4.6 kpc. The time between its formation and ejection significantly exceeds 10 Myr and thus is difficult to reconcile with any Galactic disk runaway scenario involving massive stars. The observations are consistent, on the other hand, with a hypervelocity star ejection from the Galactic center. We show that Gaia proper motion measurements will easily discriminate between a disk and Galactic center origin, thus allowing us to use HVS17 as a test particle to probe the shape of the Milky Way's dark matter halo.

  4. THE ORIGIN OF HVS17, AN UNBOUND MAIN SEQUENCE B STAR AT 50 kpc

    International Nuclear Information System (INIS)

    Brown, Warren R.; Geller, Margaret J.; Kenyon, Scott J.; Cohen, Judith G.

    2013-01-01

    We analyze Keck Echellette Spectrograph and Imager spectroscopy of HVS17, a B-type star traveling with a Galactic rest frame radial velocity of +445 km s –1 in the outer halo of the Milky Way. HVS17 has the projected rotation of a main sequence B star and is chemically peculiar, with solar iron abundance and sub-solar alpha abundance. Comparing measured T eff and log g with stellar evolution tracks implies that HVS17 is a 3.91 ± 0.09 M ☉ , 153 ± 9 Myr old star at a Galactocentric distance of r = 48.5 ± 4.6 kpc. The time between its formation and ejection significantly exceeds 10 Myr and thus is difficult to reconcile with any Galactic disk runaway scenario involving massive stars. The observations are consistent, on the other hand, with a hypervelocity star ejection from the Galactic center. We show that Gaia proper motion measurements will easily discriminate between a disk and Galactic center origin, thus allowing us to use HVS17 as a test particle to probe the shape of the Milky Way's dark matter halo

  5. Fecal carriage of extended-spectrum and AmpC β-lactamase-producing Enterobacteriaceae in surgical patients before and after antibiotic prophylaxis

    DEFF Research Database (Denmark)

    Jakobsen, Lotte; Kuhn, Katrin G; Hansen, Frank

    2016-01-01

    The impact of antibiotic prophylaxis on fecal carriage of ESBL-/AmpC-/carbapenemase-producing Enterobacteriaceae (CPE) was investigated. Patients admitted for elective surgery or diagnostic procedure in a Department of Surgical Gastroenterology (SG) (n= 450) and Orthopedic Surgery (OS) (n= 300...

  6. Epidemiology of Extended-Spectrum beta-Lactamase-Producing E-coli and Vancomycin-Resistant Enterococci in the Northern Dutch-German Cross-Border Region

    NARCIS (Netherlands)

    Zhou, Xuewei; Garcia-Cobos, Silvia; Ruijs, Gijs J. H. M.; Kampinga, Greetje A.; Arends, Jan P.; Borst, Dirk M.; Moller, Lieke V.; Holman, Nicole D.; Schuurs, Theo A.; van Coppenraet, Lesla E. Bruijnesteijn; Weel, Jan F.; van Zeijl, Jan H.; Koeck, Robin; Rossen, John W. A.; Friedrich, Alexander W.

    2017-01-01

    Objectives: To reveal the prevalence and epidemiology of extended-spectrum β-lactamase (ESBL)- and/or plasmid AmpC (pAmpC)- and carbapenemase (CP) producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE) across the Northern Dutch-German border region. Methods: A point-prevalence study

  7. Retrospective identification of a previously undetected clinical case of OXA-48-producing K-pneumoniae and E-coli : the importance of adequate detection guidelines

    NARCIS (Netherlands)

    Willemsen, Ina; van Esser, Joost; Kluytmans-van den Bergh, Marjolein; Zhou, Kai; Rossen, John W.; Verhulst, Carlo; Verduin, Kees; Kluytmans, Jan

    The laboratory detection of OXA-48-carbapenemase-producing Enterobacteriaceae is difficult, as minimum inhibition concentrations for carbapenems are often below the clinical breakpoint. In 2011, the Dutch national guideline for the detection of highly resistant micro-organisms was issued, which

  8. Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

    OpenAIRE

    Vajihe Karbasizade; Leila Heidari; Reyhaneh Jafari

    2016-01-01

    "> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nos...

  9. The Spiral Arm Segments of the Galaxy within 3 kpc from the Sun: A Statistical Approach

    Energy Technology Data Exchange (ETDEWEB)

    Griv, Evgeny [Department of Physics, Ben-Gurion University of the Negev, Beer-Sheva 84105 (Israel); Jiang, Ing-Guey [Department of Physics, National Tsing-Hua University, Kuang-Fu Road 101, Hsin-Chu 30013, Taiwan (China); Hou, Li-Gang, E-mail: griv@bgu.ac.il [National Astronomical Observatories, Chinese Academy of Sciences, Jia-20, Beijing 100012 (China)

    2017-08-01

    As can be reasonably expected, upcoming large-scale APOGEE, GAIA, GALAH, LAMOST, and WEAVE stellar spectroscopic surveys will yield rather noisy Galactic distributions of stars. In view of the possibility of employing these surveys, our aim is to present a statistical method to extract information about the spiral structure of the Galaxy from currently available data, and to demonstrate the effectiveness of this method. The model differs from previous works studying how objects are distributed in space in its calculation of the statistical significance of the hypothesis that some of the objects are actually concentrated in a spiral. A statistical analysis of the distribution of cold dust clumps within molecular clouds, H ii regions, Cepheid stars, and open clusters in the nearby Galactic disk within 3 kpc from the Sun is carried out. As an application of the method, we obtain distances between the Sun and the centers of the neighboring Sagittarius arm segment, the Orion arm segment in which the Sun is located, and the Perseus arm segment. Pitch angles of the logarithmic spiral segments and their widths are also estimated. The hypothesis that the collected objects accidentally form spirals is refuted with almost 100% statistical confidence. We show that these four independent distributions of young objects lead to essentially the same results. We also demonstrate that our newly deduced values of the mean distances and pitch angles for the segments are not too far from those found recently by Reid et al. using VLBI-based trigonometric parallaxes of massive star-forming regions.

  10. The Spiral Arm Segments of the Galaxy within 3 kpc from the Sun: A Statistical Approach

    International Nuclear Information System (INIS)

    Griv, Evgeny; Jiang, Ing-Guey; Hou, Li-Gang

    2017-01-01

    As can be reasonably expected, upcoming large-scale APOGEE, GAIA, GALAH, LAMOST, and WEAVE stellar spectroscopic surveys will yield rather noisy Galactic distributions of stars. In view of the possibility of employing these surveys, our aim is to present a statistical method to extract information about the spiral structure of the Galaxy from currently available data, and to demonstrate the effectiveness of this method. The model differs from previous works studying how objects are distributed in space in its calculation of the statistical significance of the hypothesis that some of the objects are actually concentrated in a spiral. A statistical analysis of the distribution of cold dust clumps within molecular clouds, H ii regions, Cepheid stars, and open clusters in the nearby Galactic disk within 3 kpc from the Sun is carried out. As an application of the method, we obtain distances between the Sun and the centers of the neighboring Sagittarius arm segment, the Orion arm segment in which the Sun is located, and the Perseus arm segment. Pitch angles of the logarithmic spiral segments and their widths are also estimated. The hypothesis that the collected objects accidentally form spirals is refuted with almost 100% statistical confidence. We show that these four independent distributions of young objects lead to essentially the same results. We also demonstrate that our newly deduced values of the mean distances and pitch angles for the segments are not too far from those found recently by Reid et al. using VLBI-based trigonometric parallaxes of massive star-forming regions.

  11. mcr-1 and blaKPC-3 in Escherichia coli Sequence Type 744 after Meropenem and Colistin Therapy, Portugal.

    Science.gov (United States)

    Tacão, Marta; Tavares, Rafael Dos Santos; Teixeira, Pedro; Roxo, Inês; Ramalheira, Elmano; Ferreira, Sónia; Henriques, Isabel

    2017-08-01

    Escherichia coli Ec36 was recovered from a patient in Portugal after treatment with meropenem and colistin. Besides an IncF plasmid with Tn1441d-bla KPC-3 , already reported in clinical strains in this country, E. coli Ec36 co-harbored an IncX4::mcr-1 gene. Results highlight emerging co-resistance to carbapenems and polymyxins after therapy with drugs from both classes.

  12. The Fornax Cluster VLT Spectroscopic Survey II - Planetary Nebulae kinematics within 200 kpc of the cluster core

    Science.gov (United States)

    Spiniello, C.; Napolitano, N. R.; Arnaboldi, M.; Tortora, C.; Coccato, L.; Capaccioli, M.; Gerhard, O.; Iodice, E.; Spavone, M.; Cantiello, M.; Peletier, R.; Paolillo, M.; Schipani, P.

    2018-06-01

    We present the largest and most spatially extended planetary nebulae (PNe) catalogue ever obtained for the Fornax cluster. We measured velocities of 1452 PNe out to 200 kpc in the cluster core using a counter-dispersed slitless spectroscopic technique with data from FORS2 on the Very Large Telescope (VLT). With such an extended spatial coverage, we can study separately the stellar haloes of some of the cluster main galaxies and the intracluster light. In this second paper of the Fornax Cluster VLT Spectroscopic Survey, we identify and classify the emission-line sources, describe the method to select PNe, and calculate their coordinates and velocities from the dispersed slitless images. From the PN 2D velocity map, we identify stellar streams that are possibly tracing the gravitational interaction of NGC 1399 with NGC 1404 and NGC 1387. We also present the velocity dispersion profile out to ˜200 kpc radii, which shows signatures of a superposition of the bright central galaxy and the cluster potential, with the latter clearly dominating the regions outside R ˜ 1000 arcsec (˜100 kpc).

  13. Emergence of Imipenem-Resistant Pseudomonas aeruginosa Clinical Isolates from Egypt Coharboring VIM and IMP Carbapenemases.

    Science.gov (United States)

    El-Domany, Ramadan Ahmed; Emara, Mohamed; El-Magd, Mohammed A; Moustafa, Walaa H; Abdeltwab, Nesma M

    2017-09-01

    Pseudomonas aeruginosa is an important human pathogen and the leading cause of nosocomial infections. P. aeruginosa is characterized by massive intrinsic resistance to a multiple classes of antibiotics with carbapenems being the most potent inhibitor of P. aeruginosa and considered the first choice for its treatment. Therefore, it is crucial to investigate novel mechanisms of resistance of P. aeruginosa to carbapenems for achieving successful therapy. A total of 114 P. aeruginosa isolates from two university hospitals in Egypt were recruited in this study. Antimicrobial susceptibility testing revealed that 50 isolates (43.8%) exhibited multidrug-resistant (MDR) phenotype, of them 14 isolates (12.2%) were imipenem (IPM)-resistant. Of these 14 isolates, 13 isolates (11.4%) exhibited the metallo-β-lactamase (MBL) phenotype. MBLs encoding genes, VIM and IMP, were identified by PCR. PCR results revealed that four isolates harbored the VIM gene alone, one isolate harbored IMP gene alone, and four isolates harbored both genes. The correct size of PCR products of VIM and IMP genes (390 and 188 bp, respectively) were sequenced to confirm results of PCR and to look for any possible polymorphism among MBL genes of tested isolates. Data analysis of these sequences showed 100% identity of nucleotide sequences of MBL genes among tested Egyptian patients. To our knowledge, this is the first report of IMP carbapenemase-encoding gene in Africa and the first detection of the emergence of P. aeruginosa coproducing VIM and IMP genes in Egypt.

  14. [Molecular characterization of resistance mechanisms: methicillin resistance Staphylococcus aureus, extended spectrum β-lactamases and carbapenemases].

    Science.gov (United States)

    Oteo, Jesús; Belén Aracil, María

    2015-07-01

    Multi-drug resistance in bacterial pathogens increases morbidity and mortality in infected patients and it is a threat to public health concern by their high capacity to spread. For both reasons, the rapid detection of multi-drug resistant bacteria is critical. Standard microbiological procedures require 48-72 h to provide the antimicrobial susceptibility results, thus there is emerging interest in the development of rapid detection techniques. In recent years, the use of selective and differential culture-based methods has widely spread. However, the capacity for detecting antibiotic resistance genes and their low turnaround times has made molecular methods a reference for diagnosis of multidrug resistance. This review focusses on the molecular methods for detecting some mechanisms of antibiotic resistance with a high clinical and epidemiological impact: a) Enzymatic resistance to broad spectrum β-lactam antibiotics in Enterobacteriaceae, mainly extended spectrum β-lactamases (ESBL) and carbapenemases; and b) methicillin resistance in Staphylococcus aureus. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  15. Comparison of phenotypic and PCR methods for detection of carbapenemases production by Enterobacteriaceae

    Directory of Open Access Journals (Sweden)

    Maryam AlTamimi

    2017-01-01

    Full Text Available Dissemination of carbapenem resistance via Enterobacteriaceae, particularly among Klebsiella pneumoniae and Escherichia coli, is a major public health concern. Rapid methods for determining antimicrobial susceptibility are important to ensure adequate and appropriate use of antimicrobial agents and to limit the spread of these bacteria. In the current study, we compared the rapidity, sensitivity and specificity of traditional methods and molecular-based Xpert Carba-R PCR assay to identify sixty isolates, (26 E. coli and 34 K. pneumoniae. The specificity of MicroScan was 100% while sensitivity to ertapenem (ERT, imipenem (IMI, and meropenem (MER was 93%, 68.9%, and 55.17%, respectively. For the modified Hodge test, the specificity was 96.77% and sensitivity was 89.65%. Although some results of phenotypic assays matched with the definite PCR identification, some results were misleading. Out of the 29 positive PCR samples, three samples of K. pneumoniae were negative for the MHT and one E. coli sample was MHT positive but negative for the PCR. Nine samples were positive for the PCR but were determined as carbapenem sensitive by MicroScan. While MicroScan and MHT requires several hours and multi-steps to obtain results, Xpert Carba-R PCR assay takes less than an hour. Therefore, we recommend using Gene xpert Carba-R assay for the optimal carbapenemnase detection with reducing material, manpower and cost. Also it is important to know the type of carbapenemase is present.

  16. Inventarisatie Screening carbapenemase-producerende bacteriën in dieren en dierlijke producten: is de huidige screening toereikend?

    OpenAIRE

    Wit B; Veldman K; Hordijk J; Heuvelink A; Vellema P; Dierikx CM; Backer JA; Takumi K; van Duijkeren E; I&V

    2017-01-01

    In dit onderzoek is gekeken of de huidige monitoring van carbapenemase-producerende bacteriën (CPE) voldoende is om betrouwbare uitspraken te kunnen doen over het vóórkomen van deze bacteriën in dieren en/of dierlijke producten. De conclusie van dit rapport is dat méér en gerichter monsters van dieren en dierlijke producten genomen zouden moeten worden om lage prevalenties (vóórkomen) van CPE te kunnen monitoren. Daarmee wordt tevens de kans verhoogd besmettingen met CPE te ontdekken, voordat...

  17. Global survey of Klebsiella pneumoniae major porins from ertapenem non-susceptible isolates lacking carbapenemases.

    Science.gov (United States)

    Wise, Mark G; Horvath, Elizabeth; Young, Katherine; Sahm, Daniel F; Kazmierczak, Krystyna M

    2018-03-01

    To understand the diversity of porin disruption in Klebsiella pneumoniae, the major outer membrane protein (OMP) porins, OmpK35 and OmpK36, were examined in a set of isolates that did not harbour traditional carbapenem-hydrolysing enzymes, but nevertheless tested non-susceptible to ertapenem. A world-wide collection of Klebsiella pneumoniae isolates that were part of the Study for Monitoring Antimicrobial Resistance Trends (SMART) surveillance project over the years 2008-2014 were characterised with regard to their β-lactamase gene carriage and potential permeability defects. Four hundred and eighty-seven isolates that did not carry carbapenemase genes, but were non-susceptible to ertapenem, were investigated by sequence analysis of the genes encoding OmpK35 and OmpK36. Isolates without obvious genetic lesions in either major porin gene were further examined by outer membrane protein SDS-PAGE. The majority of isolates, 83.0 % (404/487), exhibited clear genetic disruption in either or both of the ompK35 and ompK36 genes. Among the proportion of the collection with the highest ertapenem MIC value (>4 mg l -1 ), 60.5 % (115/190) showed mutation in both porin genes. Isolates without obvious genetic mutations were examined by SDS-PAGE, and 90.4 % (75/83) were found to lack or show altered expression of at least one of the major OMPs when compared to an ertapenem sensitive control strain. This study illustrates that porin deficiency in Klebsiella pneumoniae is a widespread phenomenon, and in combination with ESBLs and/or AmpC enzymes, likely accounts for the elevated ertapenem MICs observed in this study.

  18. Characterization of extended-spectrum β-lactamases (ESBLs)-producing Salmonella in retail raw chicken carcasses.

    Science.gov (United States)

    Qiao, Jing; Zhang, Qiang; Alali, Walid Q; Wang, Jiawei; Meng, Lingyuan; Xiao, Yingping; Yang, Hua; Chen, Sheng; Cui, Shenghui; Yang, Baowei

    2017-05-02

    Extended-spectrum β-lactamases (ESBLs)-producing Salmonella is considered a serious concern to public health worldwide. However, limited information is available on ESBLs-producing Salmonella in retail chicken products in China. The objective of this study was to characterize ESBLs-producing Salmonella isolates from retail chickens in China. A total of 890 Salmonella isolates from retail chicken carcasses collected from 4 provinces were firstly screened for ESBLs-production phenotype via the double-disk synergy test method. A total of 96 (10.8%, n=890) ESBLs-producing Salmonella were identified and subjected to PFGE analysis, characterization for the presence of ESBLs encoding genes, transposons, carbapenemase and virulence genes. A total of 59 PFGE profiles were detected in these 96 isolates, among which 57.3% were found to harbor bla TEM-1 , whereas 30.2%, 24.0%, 18.8% and 7.3% were carrying bla OXA-1 , bla CTX-M-15 , bla CTX-M-3 and bla PSE-1 genes, respectively. Moreover, 42 (43.8%) isolates co-carried 2 ESBLs-producing genes, and two (2.1%) isolates co-carried 3 genes. Furthermore, 24 (25.0%) ESBLs-producing isolates carried VIM and 10 (10.4%) carried KPC encoding genes that closely associated with carbapenems resistance. Eighty-eight isolates harbored transposons ranging from 4.2% for Tn903 to 76.0% for Tn21. Out of the 88 Salmonella that harbored transposons, 25%, 22.7%, 23.9%, 10.2% and 1.1% of isolates were found to carry 2, 3, 4, 5 and 6 transposons, respectively. The minimum inhibitory concentration (MIC) values for cephalosporins (ceftriaxone, cefoperazone and cefoxitin) to ESBLs-producing isolates were from 4 to 1024μg/mL, for nalidixic acid were from 64 to 512μg/mL, for fluoroquinolones (ciprofloxacin, levofloxacin and gatifloxacin) were from 4 to 256μg/mL. Twenty-nine virulence genes were detected in the 96 ESBLs-producing isolates with 2.1% harbored spvR (lowest) and 90.6% harbored marT and steB (highest). All isolates carried at least one

  19. Activity of Imipenem with Relebactam against Gram-Negative Pathogens from New York City.

    Science.gov (United States)

    Lapuebla, Amabel; Abdallah, Marie; Olafisoye, Olawole; Cortes, Christopher; Urban, Carl; Landman, David; Quale, John

    2015-08-01

    Imipenem with relebactam was active against Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp., including K. pneumoniae carbapenemase (KPC)-producing isolates. Loss of OmpK36 in KPC-producing K. pneumoniae isolates affected the susceptibility of this combination. Enhanced activity was evident against Pseudomonas aeruginosa, including isolates with depressed oprD and increased ampC expression. However, the addition of relebactam to imipenem did not provide added benefit against Acinetobacter baumannii. The combination of imipenem with relebactam demonstrated activity against KPC-producing Enterobacteriaceae and multidrug-resistant P. aeruginosa. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  20. Extended spectrum β-lactamases, carbapenemases and mobile genetic elements responsible for antibiotics resistance in Gram-negative bacteria.

    Science.gov (United States)

    El Salabi, Allaaeddin; Walsh, Timothey R; Chouchani, Chedly

    2013-05-01

    Infectious diseases due to Gram-negative bacteria are a leading cause of morbidity and mortality worldwide. Antimicrobial agents represent one major therapeutic tools implicated to treat these infections. The misuse of antimicrobial agents has resulted in the emergence of resistant strains of Gram-negatives in particular Enterobacteriaceae and non-fermenters; they have an effect not only on a human but on the public health when bacteria use the resistance mechanisms to spread in the hospital environment and to the community outside the hospitals by means of mobile genetic elements. Gram-negative bacteria have become increasingly resistant to antimicrobial agents. They have developed several mechanisms by which they can withstand to antimicrobials, these mechanisms include the production of Extended-spectrum β-lactamases (ESBLs) and carbapenemases, furthermore, Gram-negative bacteria are now capable of spreading such resistance between members of the family Enterobacteriaceae and non-fermenters using mobile genetic elements as vehicles for such resistance mechanisms rendering antibiotics useless. Therefore, addressing the issue of mechanisms of antimicrobial resistance is considered one of most urgent priorities. This review will help to illustrate different resistance mechanisms; ESBLs, carbapenemases encoded by genes carried by mobile genetic elements, which are used by Gram-negative bacteria to escape antimicrobial effect.

  1. Resistencia a los antibióticos beta-lactámicos Carbapenems mediada por el gen blaKPC en Klebsiella pneumoniae

    Directory of Open Access Journals (Sweden)

    Aura Dayana del Carmen Falco Restrepo

    2015-12-01

    Full Text Available  Los carbapenems son antibióticos â-lactamicos de amplio espectro que se utilizan como terapia de primera línea para tratar pacientes con infecciones graves. Actualmente, la resistencia a carbapenems se asocia con la presencia de â-lactamasas capaces de hidrolizar estos antibióticos. La carbapenemasa de clase A más común es KPC, la cual es codificada por el gen blaKPC que generalmente, se encuentra ubicado en plásmidos. La selección y la rápida propagación de aislados de Klebsiella pneumoniae portadores de estas carbapenemasas se ha convertido en un problema de salud pública a nivel mundial. Esta mini-revision describe uno de los mecanismos más frecuentes de resistencia a carbapenems como lo son las enzimas carbapenemasas tipo KPC. Además se describen las variantes del gen blaKPC asi como el elemento genético móvil, el transposon Tn4401, el principal responsable de su diseminación entre géneros y especies bacterianas diferentes. Finalmente se hace una pequeña revisión cronológica de los reportes de la enzima KPC a nivel mundial.

  2. Analisa Penerapan Sistem Hybrid Pada Kapal KPC-28 Dengan Kombinasi Diesel Engine dan Motor Listrik Yang Disuplai Dengan Batterai

    Directory of Open Access Journals (Sweden)

    Tangguh Tangguh Bimantoro

    2014-03-01

    Full Text Available Teknologi Hybrid System Vessel akhir-akhir ini sedang menjadi bahasan yang sering dibicarakan di dunia pendidikan dan teknologi permesinan. Teknologi Hybrid System Vessel yang dimaksud adalah kapal yang berjalan dengan dua sumber tenaga, mesin yang bekerja dengan sumber tenaga bahan bakar dan motor listrik yang bekerja dengan sumber tenaga listrik. Oleh karena adanya permasalahan tersebut maka dikembangkanlah konsep system hybrid pada kapal.Hybrid ini mengacu teknologi pada mobil hybrid yang sudah dikembangkan sekarang, tujuan dari hybrid ini adalah sebagai penghematan BBM dan juga sebagai pereduksi emisi di system permesinan kapal.Penelitian ini menggunakan simulasi dengan software Maxsurf, kemudian dilakukan dengan metode perhitungan manual yang nantinya digunakan untuk menentukan jumlah batterai yang dibutuhkan pada penggerak motor induksi. Hasil dari penelitian ini berupa desain  Hybrid System kapal KPC – 28, serta hasil analisa Hybrid System di kapal apakah memberikan effisiensi bahan bakar yang cukup hemat dengan tanpa menggunakan Hybrid System pada mesin kapal tersebut.

  3. Detection of the IncX3 plasmid carrying blaKPC-3 in a Serratia marcescens strain isolated from a kidney-liver transplanted patient.

    Science.gov (United States)

    Gona, Floriana; Caio, Carla; Iannolo, Gioacchin; Monaco, Francesco; Di Mento, Giuseppina; Cuscino, Nicola; Fontana, Ignazio; Panarello, Giovanna; Maugeri, Gaetano; Mezzatesta, Maria Lina; Stefani, Stefania; Conaldi, Pier Giulio

    2017-10-01

    Dissemination of resistance to carbapenems among Enterobacteriaceae through plasmids is an increasingly important concern in health care worldwide. Here we report the first description of an IncX3 plasmid carrying the blaKPC-3 gene in a strain of Serratia marcescens isolated from a kidney-liver transplanted patient at the transplantation centre ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy). To localize the transposable element containing the resistance-associated gene Next-Generation Sequencing of the bacterial DNA was performed. S. marcescens was positive for blaKPC-3 and blaSHV-11 genes. The molecular analysis demonstrated that the blaKPC-3 gene of this bacterial strain was located in one copy of the Tn-3-like element Tn4401-a carried in a plasmid that is 53 392 bp in size and showed the typical IncX3 scaffold. Our data demonstrated the presence of a new blaKPC-3 harbouring the IncX3 plasmid in S. marcescens. The possible dissemination among Enterobacteriaceae of this type of plasmid should be monitored and evaluated in terms of clinical risk.

  4. Analysis on The Roles of Stakeholders in The Management of Integrated Breeding Beef Cattle Farm Program at PT KPC East Kutai

    Directory of Open Access Journals (Sweden)

    J. Ariansyah

    2013-08-01

    Full Text Available An analysis of the roles of stakeholders was conducted as a continuity program of Peternakan Sapi Terpadu (PESAT; integrated beef cattle farm following the coal mining deactivation by PT Kaltim Prima Coal (KPC of East Kutai, East Kalimantan. The purpose of this study was to formulate stakeholders relation in the future program. The stakeholders involved in this program were PT KPC, local breeders, Sekolah Tinggi Ilmu Pertanian (STIPER; Agriculture Academy of East Kutai, and the local government of East Kutai. The stakeholders analysis was based on the variables of the importance and influence from every analyzed stakeholder. The analysis model used here was the model introduced by Reed et al. (2009. According to the result of the stakeholders analysis, PT KPC was in the key-player quadrant, which score is 25 in both of the interest and the influencial level, while the three others, such as, local breeders, STIPER of East Kutai, and the East Kutai Government were in the subject quadrant. Their score were 24 and 7 for Local breeders, 21 and 9 for STIPER of East Kutai, and 16 and 13 for The East Kutai Government. It means, they had high interest but low influence to the program. The conclusion of this analysis shows that PT KPC is still dominating in the PESAT program management, whereas the three other stakeholders are acting merely as program users that have low involvement in the program management.

  5. Factores relacionados con el control exitoso de un brote por Klebsiella pneumoniae productora de KPC-2 en una unidad de cuidado intensivo en Bogotá, Colombia

    Directory of Open Access Journals (Sweden)

    Gisell Bustos-Moya

    Full Text Available La resistencia a carbapenémicos en Klebsiella pneumoniae ha aumentado de manera considerable, incrementando las tasas de morbimortalidad. El objetivo de este trabajo fue describir las características epidemiológicas, microbiológicas y las medidas de intervención que permitieron el control exitoso de un brote de Klebsiella pneumoniae productora de KPC-2. Métodos: El estudio se realizó en 2 periodos: el primero durante el brote, con instauración de un protocolo de medidas de intervención; y el segundo, de seguimiento posbrote. Se realizaron pruebas de identificación y susceptibilidad por sistema automatizado, tamización de carbapenemasas por test de Hodge modificado, PCR para detección de los genes bla KPC , bla KPC-2 , NDM-1 y estudio de clonalidad por electroforesis de campos pulsados. Resultados: Durante el brote, se identificaron 18 aislamientos de Klebsiella pneumoniae productora de KPC en 11 pacientes. Tres casos fueron confirmados como infección intrahospitalaria. La técnica de PCR reveló la presencia del gen bla KPC en 21 de 22 aislamientos (pacientes y medio ambiente y se identificó la presencia de un clon con una similitud superior al 75%. En el periodo posbrote los cultivos ambientales y de búsqueda de colonizados fueron negativos. Discusión: Se evidenció un control exitoso del brote producido por un clon. La implementación de un protocolo de intervención y la monitorización de su cumplimiento, la comunicación efectiva y el trabajo en equipo fueron indispensables para evitar su propagación y evitar un comportamiento endémico posbrote.

  6. Characterization of VCC-1, a Novel Ambler Class A Carbapenemase from Vibrio cholerae Isolated from Imported Retail Shrimp Sold in Canada.

    Science.gov (United States)

    Mangat, Chand S; Boyd, David; Janecko, Nicol; Martz, Sarah-Lynn; Desruisseau, Andrea; Carpenter, Michael; Reid-Smith, Richard J; Mulvey, Michael R

    2016-01-11

    One of the core goals of the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) is to monitor major meat commodities for antimicrobial resistance. Targeted studies with methodologies based on core surveillance protocols are used to examine other foods, e.g., seafood, for antimicrobial resistance to detect resistances of concern to public health. Here we report the discovery of a novel Ambler class A carbapenemase that was identified in a nontoxigenic strain of Vibrio cholerae (N14-02106) isolated from shrimp that was sold for human consumption in Canada. V. cholerae N14-02106 was resistant to penicillins, carbapenems, and monobactam antibiotics; however, PCR did not detect common β-lactamases. Bioinformatic analysis of the whole-genome sequence of V. cholerae N14-02106 revealed on the large chromosome a novel carbapenemase (referred to here as VCC-1, for Vibrio cholerae carbapenemase 1) with sequence similarity to class A enzymes. Two copies of blaVCC-1 separated and flanked by ISVch9 (i.e., 3 copies of ISVch9) were found in an acquired 8.5-kb region inserted into a VrgG family protein gene. Cloned blaVCC-1 conferred a β-lactam resistance profile similar to that in V. cholerae N14-02106 when it was transformed into a susceptible laboratory strain of Escherichia coli. Purified VCC-1 was found to hydrolyze penicillins, 1st-generation cephalosporins, aztreonam, and carbapenems, whereas 2nd- and 3rd-generation cephalosporins were poor substrates. Using nitrocefin as a reporter substrate, VCC-1 was moderately inhibited by clavulanic acid and tazobactam but not EDTA. In this report, we present the discovery of a novel class A carbapenemase from the food supply. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  7. Spatially Resolved Hard X-ray Emission in the Central 5 kpc of the Galaxy Merger NGC 6240

    Science.gov (United States)

    Wang, Junfeng; Nardini, E.; Fabbiano, G.; Karovska, M.; Elvis, M.; Pellegrini, S.; Max, C. E.; Risaliti, G.; U, V.; Zezas, A.

    2013-04-01

    We have obtained a deep, sub-arcsecond resolution X-ray image of the nuclear region of the luminous galaxy merger NGC 6240 with Chandra, which resolves the X-ray emission from the pair of active nuclei and the diffuse hot gas in great detail. We detect extended hard X-ray emission from 70 million K hot gas over a spatial scale of 5 kpc, indicating the presence of fast shocks with velocity of 2200 km/s. For the first time we obtain spatial distribution of this highly ionized gas emitting FeXXV and find that it shows a remarkable correspondence to the large scale morphology of H_2(1-0) S(1) line emission and Hα filaments. Propagation of fast shocks originated in the starburst driven wind into the ambient dense gas can account for this morphological correspondence. Both the energetics and the iron mass in the hot gas are consistent with the expected injection from the supernovae explosion during the starburst that is commensurate with its high star formation rate.

  8. CLUMPING AND THE INTERPRETATION OF kpc-SCALE MAPS OF THE INTERSTELLAR MEDIUM: SMOOTH H I AND CLUMPY, VARIABLE H{sub 2} SURFACE DENSITY

    Energy Technology Data Exchange (ETDEWEB)

    Leroy, Adam K. [National Radio Astronomy Observtory, 520 Edgemont Road, Charlottesville, VA 22903 (United States); Lee, Cheoljong [Department of Astronomy, University of Virginia, 530 McCormick Road, Charlottesville, VA 22904 (United States); Schruba, Andreas [California Institute for Technology, 1200 E California Blvd, Pasadena, CA 91125 (United States); Bolatto, Alberto [Department of Astronomy, University of Maryland, College Park, MD 20742 (United States); Hughes, Annie; Sandstrom, Karin; Schinnerer, Eva; Walter, Fabian [Max Planck Institute fuer Astronomie, Koenigstuhl 17, D-69117 Heidelberg (Germany); Pety, Jerome [Institut de Radioastronomie Millimetrique, 300 Rue de la Piscine, F-38406 Saint Martin d' Heres (France)

    2013-05-20

    Many recent models consider the structure of individual interstellar medium (ISM) clouds as a way to explain observations of large parts of galaxies. To compare such models to observations, one must understand how to translate between surface densities observed averaging over large ({approx}kpc) scales and surface densities on the scale of individual clouds ({approx}pc scale), which are treated by models. We define a ''clumping factor'' that captures this translation as the ratio of the mass-weighted surface density, which is often the quantity of physical interest, to the area-weighted surface density, which is observed. We use high spatial resolution (sub-kpc) maps of CO and H I emission from nearby galaxies to measure the clumping factor of both atomic and molecular gas. The molecular and atomic ISM exhibit dramatically different degrees of clumping. As a result, the ratio H{sub 2}/H I measured at {approx}kpc resolution cannot be trivially interpreted as a cloud-scale ratio of surface densities. H I emission appears very smooth, with a clumping factor of only {approx}1.3. Based on the scarce and heterogeneous high-resolution data available, CO emission is far more clumped with a widely variable clumping factor, median {approx}7 for our heterogeneous data. Our measurements do not provide evidence for a universal mass-weighted surface density of molecular gas, but also cannot conclusively rule out such a scenario. We suggest that a more sophisticated treatment of molecular ISM structure, one informed by high spatial resolution CO maps, is needed to link cloud-scale models to kpc-scale observations of galaxies.

  9. Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

    Directory of Open Access Journals (Sweden)

    Vajihe Karbasizade

    2016-02-01

    Full Text Available "> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nosocomial infections in Isfahan hospitals.Methods: A total number of 456 clinical specimens were collected from nosocomial infections andevaluated in order to isolate A. baumannii strains. After identification of the isolates, the antibioticsensitivity to carbapenems was assessed using disk diffusion method. The resistance genes of blaOXA-23, 24, 51, and 58 were detected by multiplex PCR method.Results: Fifty A. baumannii isolates were isolated from clinical specimens. Fifty two percent ofthe isolates showed phenotypic resistance to the carbapenems (imipenem and meropenem.According to PCR results, 88% of resistant isolates had ≥1 blaOXA gene. The frequency of resistantisolates bearing blaOXA-23, blaOXA-24 and blaOXA-58 were 77%, 38% and 15% respectively.Conclusions: This study showed the high frequency of carbapenem resistance genes among A.baumannii isolates. Therefore, adopting an appropriate strategy to confine the spreading of thesestrains and also implementing new treatment regimens are necessary.

  10. OXA-244-Producing Escherichia coli Isolates, a Challenge for Clinical Microbiology Laboratories.

    Science.gov (United States)

    Hoyos-Mallecot, Yannick; Naas, Thierry; Bonnin, Rémy A; Patino, Rafael; Glaser, Philippe; Fortineau, Nicolas; Dortet, Laurent

    2017-09-01

    OXA-244 is a single-point-mutant derivative of OXA-48 displaying reduced carbapenemase activity. Here, we report the microbiological features of seven OXA-244-producing Escherichia coli isolates. Only one isolate grew on ChromID Carba Smart medium (bioMérieux), but six of the seven isolates grew on ChromID extended-spectrum-β-lactamase (ESBL) medium (bioMérieux), as they coproduced an ESBL and/or a plasmid-encoded cephalosporinase. The production of a carbapenemase was detected in 57.1%, 71.4%, 71.4%, and 100% of the E. coli isolates using the Carba NP test, the Rapidec Carba NP test (bioMérieux), a matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) hydrolysis assay (Bruker), and the OXA-48 K-SeT assay (Coris BioConcept), respectively. Our results indicate that OXA-244-producing E. coli isolates are difficult to detect, which may lead to their silent spread. Copyright © 2017 American Society for Microbiology.

  11. STORM IN A {sup T}EACUP{sup :} A RADIO-QUIET QUASAR WITH ≈10 kpc RADIO-EMITTING BUBBLES AND EXTREME GAS KINEMATICS

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, C. M.; Thomson, A. P.; Alexander, D. M.; Edge, A. C.; Hogan, M. T.; Swinbank, A. M. [Department of Physics, Durham University, South Road, Durham DH1 3LE (United Kingdom); Bauer, F. E. [Instituto de Astrofísica, Facultad de Física, Pontifica Universidad Católica de Chile, 306, Santiago 22 (Chile); Mullaney, J. R., E-mail: c.m.harrison@mail.com [Department of Physics and Astronomy, University of Sheffield, Sheffield S7 3RH (United Kingdom)

    2015-02-10

    We present multi-frequency (1-8 GHz) Very Large Array data, combined with VIsible MultiObject Spectrograph integral field unit data and Hubble Space Telescope imaging, of a z = 0.085 radio-quiet type 2 quasar (with L {sub 1.4} {sub GHz} ≈ 5 × 10{sup 23} W Hz{sup –1} and L {sub AGN} ≈ 2 × 10{sup 45} erg s{sup –1}). Due to the morphology of its emission-line region, the target (J1430+1339) has been referred to as the ''Teacup'' active galactic nucleus (AGN) in the literature. We identify ''bubbles'' of radio emission that are extended ≈10-12 kpc to both the east and west of the nucleus. The edge of the brighter eastern bubble is co-spatial with an arc of luminous ionized gas. We also show that the ''Teacup'' AGN hosts a compact radio structure, located ≈0.8 kpc from the core position, at the base of the eastern bubble. This radio structure is co-spatial with an ionized outflow with an observed velocity of v = –740 km s{sup –1}. This is likely to correspond to a jet, or possibly a quasar wind, interacting with the interstellar medium at this position. The large-scale radio bubbles appear to be inflated by the central AGN, which indicates that the AGN can also interact with the gas on ≳ 10 kpc scales. Our study highlights that even when a quasar is formally ''radio-quiet'' the radio emission can be extremely effective for observing the effects of AGN feedback.

  12. Instant screening and verification of carbapenemase activity in Bacteroides fragilis in positive blood culture, using matrix-assisted laser desorption ionization--time of flight mass spectrometry.

    Science.gov (United States)

    Johansson, Åsa; Nagy, Elisabeth; Sóki, József

    2014-08-01

    Rapid identification of isolates in positive blood cultures are of great importance to secure correct treatment of septicaemic patients. As antimicrobial resistance is increasing, rapid detection of resistance is crucial. Carbapenem resistance in Bacteroides fragilis associated with cfiA-encoded class B metallo-beta-lactamase is emerging. In our study we spiked blood culture bottles with 26 B. fragilis strains with various cfiA-status and ertapenem MICs. By using main spectra specific for cfiA-positive and cfiA-negative B. fragilis strains, isolates could be screened for resistance. To verify strains that were positive in the screening, a carbapenemase assay was performed where the specific peaks of intact and hydrolysed ertapenem were analysed with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). We show here that it is possible to correctly identify B. fragilis and to screen for enzymic carbapenem resistance directly from the pellet of positive blood cultures. The carbapenemase assay to verify the presence of the enzyme was successfully performed on the pellet from the direct identification despite the presence of blood components. The result of the procedure was achieved in 3 h. Also the Bruker mass spectrometric β-lactamase assay (MSBL assay) prototype software was proven not only to be based on an algorithm that correlated with the manual inspection of the spectra, but also to improve the interpretation by showing the variation in the dataset. © 2014 The Authors.

  13. Integration of the blaNDM-1 carbapenemase gene into Proteus genomic island 1 (PGI1-PmPEL) in a Proteus mirabilis clinical isolate.

    Science.gov (United States)

    Girlich, Delphine; Dortet, Laurent; Poirel, Laurent; Nordmann, Patrice

    2015-01-01

    To decipher the mechanisms and their associated genetic determinants responsible for β-lactam resistance in a Proteus mirabilis clinical isolate. The entire genetic structure surrounding the β-lactam resistance genes was characterized by PCR, gene walking and DNA sequencing. Genes encoding the carbapenemase NDM-1 and the ESBL VEB-6 were located in a 38.5 kb MDR structure, which itself was inserted into a new variant of the Proteus genomic island 1 (PGI1). This new PGI1-PmPEL variant of 64.4 kb was chromosomally located, as an external circular form in the P. mirabilis isolate, suggesting potential mobility. This is the first known description of the bla(NDM-1) gene in a genomic island structure, which might further enhance the spread of the bla(NDM-1) carbapenemase gene among enteric pathogens. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Emergence of carbapenem non-susceptible multidrug resistant Acinetobacter baumannii strains of clonal complexes 103(B) and 92(B) harboring OXA-type carbapenemases and metallo-β-lactamases in Southern India.

    Science.gov (United States)

    Saranathan, Rajagopalan; Vasanth, Vaidyanathan; Vasanth, Thamodharan; Shabareesh, Pidathala Raghavendra Venkata; Shashikala, P; Devi, Chandrakesan Sheela; Kalaivani, Ramakrishnan; Asir, Johny; Sudhakar, Pagal; Prashanth, K

    2015-05-01

    The molecular epidemiology and carbapenem resistance mechanisms of clinical isolates of Acinetobacter baumannii obtained from a south Indian tertiary care hospital were investigated by repetitive extragenic palindromic sequence PCR (REP-PCR) and multi-locus sequence typing (MLST). Analysis of resistant determinants was achieved by PCR screening for the presence of genes encoding OXA-carbapenemases, metallo-β-lactamases (MBLs) and efflux pumps. REP-PCR generated around eight clusters of high heterogeneity; of these, two major clusters (I and V) appeared to be clonal in origin. Analysis of representative isolates from different clusters by MLST revealed that most of the isolates belonged to sequence type 103 of CC103(B) . Second most prevalent ST belonged to clonal complex (CC) 92(B) which is also referred to as international clone II. Most of the isolates were multi-drug resistant, being susceptible only to polymyxin-B and newer quinolones. Class D β-lactamases such as blaOXA-51-like (100%), blaOXA-23-like (56.8%) and blaOXA-24-like (14.8%) were found to be predominant, followed by a class B β-lactamase, namely blaIMP-1 (40.7%); none of the isolates had blaOXA-58 like, blaNDM-1 or blaSIM-1 . Genes of efflux-pump adeABC were predominant, most of isolates being biofilm producers that were PCR-positive for autoinducer synthase gene (>94%). Carbapenem non-susceptible isolates were highly diverse and present throughout the hospital irrespective of type of ward or intensive care unit. Although previous reports have documented diverse resistant mechanisms in A. baumannii, production of MBL and OXA-type of carbapenamases were found to be the predominant mechanism(s) of carbapenem resistance identified in strains isolated from Southern India. © 2015 The Societies and Wiley Publishing Asia Pty Ltd.

  15. GAS DEPLETION IN LOCAL GROUP DWARFS ON ∼250 kpc SCALES: RAM PRESSURE STRIPPING ASSISTED BY INTERNAL HEATING AT EARLY TIMES

    International Nuclear Information System (INIS)

    Nichols, Matthew; Bland-Hawthorn, Joss

    2011-01-01

    A recent survey of the Galaxy and M31 reveals that more than 90% of dwarf galaxies within 270 kpc of their host galaxy are deficient in H I gas. At such an extreme radius, the coronal halo gas is an order of magnitude too low to remove H I gas through ram pressure stripping for any reasonable orbit distribution. However, all dwarfs are known to have an ancient stellar population (∼> 10 Gyr) from early epochs of vigorous star formation which, through heating of H I, could allow the hot halo to remove this gas. Our model looks at the evolution of these dwarf galaxies analytically as the host-galaxy dark matter halo and coronal halo gas build up over cosmic time. The dwarf galaxies-treated as spherically symmetric, smooth distributions of dark matter and gas-experience early star formation, which sufficiently heats the gas, allowing it to be removed easily through tidal stripping by the host galaxy, or ram pressure stripping by a tenuous hot halo (n H = 3 x 10 -4 cm -3 at 50 kpc). This model of evolution is able to explain the observed radial distribution of gas-deficient and gas-rich dwarfs around the Galaxy and M31 if the dwarfs fell in at high redshift (z ∼ 3-10).

  16. Carbapenem non-susceptible enterobacteriaceae in Quebec, Canada: results of a laboratory surveillance program (2010-2012.

    Directory of Open Access Journals (Sweden)

    Brigitte Lefebvre

    Full Text Available The emergence and spread of carbapenemase-producing Enterobacteriaceae (CPE represent a major public health concern because these bacteria are usually extensively resistant to most antibiotics. In order to evaluate their dissemination in Quebec, a surveillance program was introduced in 2010. We report the molecular and epidemiological profiles of CPE isolates collected. Between August 2010 and December 2012, a total of 742 non-duplicate isolates non-susceptible to carbapenems were analysed. AmpC β-lactamase and metallo-β-lactamase production were detected by Etest and carbapenemase production by the modified Hodge test (MHT. Antibiotic susceptibility profiles were determined using broth microdilution or Etest. Clonality of Klebsiella pneumoniae carbapenemase (KPC strains was analyzed by pulsed-field gel electrophoresis (PFGE. The presence of genes encoding carbapenemases as well as other β-lactamases was detected using PCR. Of the 742 isolates tested, 169 (22.8% were CPE. Of these 169 isolates, 151 (89.3% harboured a blaKPC gene while the remaining isolates carried blaSME (n = 9, blaOXA-48 (n = 5, blaNDM (n = 3, and blaNMC (n = 1 genes. Among the 93 KPC strains presenting with a unique pattern (unique PFGE pattern and/or unique antibiotics susceptibility profile, 99% were resistant to ertapenem, 95% to imipenem, 87% to meropenem, 97% to aztreonam, 31% to colistin and 2% to tigecycline. In 19 patients, 2 to 5 KPC strains from different species or with a different PFGE pattern were isolated. CPE strains were present in the province of Quebec with the majority of strains harbouring KPC. Alternately, SME, OXA-48 and NMC containing strains were rarely found.

  17. Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States

    Science.gov (United States)

    Chen, Liang; Patel, Gopi; Gomez-Simmonds, Angela; Weston, Gregory; Kim, Angela C.; Seo, Susan K.; Rosenthal, Marnie E.; Sperber, Steven J.; Jenkins, Stephen G.; Hamula, Camille L.; Uhlemann, Anne-Catrin; Levi, Michael H.; Fries, Bettina C.; Juretschko, Stefan; Rojtman, Albert D.; Hong, Tao; Mathema, Barun; Jacobs, Michael R.; Walsh, Thomas J.; Bonomo, Robert A.; Kreiswirth, Barry N.

    2017-01-01

    ABSTRACT Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or had undergone transplantation. The prevalences of carbapenem resistance among Klebsiella pneumoniae, Enterobacter spp., and Escherichia coli bacteremias were 9.7%, 2.2%, and 0.1%, respectively. Ninety percent of CRE were K. pneumoniae and 92% produced K. pneumoniae carbapenemase (KPC-3, 48%; KPC-2, 44%). Two CRE produced NDM-1 and OXA-48 carbapenemases. Sequence type 258 (ST258) predominated among KPC-producing K. pneumoniae (KPC-Kp). The wzi154 allele, corresponding to cps-2, was present in 93% of KPC-3-Kp, whereas KPC-2-Kp had greater cps diversity. Ninety-nine percent of CRE were ceftazidime-avibactam (CAZ-AVI)-susceptible, although 42% of KPC-3-Kp had an CAZ-AVI MIC of ≥4/4 μg/ml. There was a median of 47 h from bacteremia onset until active antimicrobial therapy, 38% of patients had septic shock, and 49% died within 30 days. KPC-3-Kp bacteremia (adjusted odds ratio [aOR], 2.58; P = 0.045), cancer (aOR, 3.61, P = 0.01), and bacteremia onset in the intensive care unit (aOR, 3.79; P = 0.03) were independently associated with mortality. Active empirical therapy and combination therapy were not associated with survival. Despite a decade of experience with CRE, patients with CRE bacteremia have protracted delays in appropriate therapies and high mortality rates, highlighting the need for rapid diagnostics and evaluation of new therapeutics. PMID:28167547

  18. Characterization of Acinetobacter baumannii clinical isolates carrying bla(OXA-23) carbapenemase and 16S rRNA methylase armA genes in Yemen.

    Science.gov (United States)

    Bakour, Sofiane; Alsharapy, Samer Ahmed; Touati, Abdelaziz; Rolain, Jean-Marc

    2014-12-01

    The aim of this study was to investigate the molecular support of resistance to carbapenems, aminoglycosides, and fluoroquinolones in Acinetobacter baumannii clinical isolates collected from Yemen hospital. Three A. baumannii were isolated in February 2013 from three patients hospitalized at Al-Thawra University Hospital in Sana'a, Yemen. Antibiotic susceptibility testing was performed using the disk diffusion and E-test methods. Carbapenemase production was carried out by the modified Hodge test (MHT) and imipenem-ethylenediaminetetraacetic acid (EDTA) methods. Carbapenem, aminoglycoside, and fluoroquinolone resistance determinants were studied by polymerase chain reaction and sequencing. The epidemiological relatedness of the three strains was studied using multilocus sequence typing (MLST). The isolates were resistant to almost all antibiotics tested with very high imipenem, amikacin, and ciprofloxacin minimum inhibitory concentrations (>32, >256, and >32 mg/L, respectively). The microbiological tests showed that the three A. baumannii were MHT positive, besides, the activity of β-lactamases was not inhibited by EDTA. All the three isolates contained the naturally occurring bla(OXA-51)-like gene and the bla(OXA-23)-like carbapenemase-encoding gene. The 16S rRNA methylase armA gene was detected in the three isolates. In addition, screening for genes encoding the aminoglycoside-modifying enzymes (AMEs) demonstrated that one isolate contained the acetyltransferase gene aac(6')-Ib. Fluoroquinolone resistance was associated with a single mutation Ser83Leu in the quinolone resistance determining region of the gyrA gene in all isolates. The MLST showed that the sequence type (ST) obtained corresponds to ST2 for the three strains. Here we report the first identification of multidrug-resistant A. baumannii isolates harboring the bla(OXA-23)-like gene, AMEs [aac(6')-Ib], and the 16S rRNA methylase (armA) in the Yemen hospital.

  19. Enterobacteriaceae Isolated from the River Danube: Antibiotic Resistances, with a Focus on the Presence of ESBL and Carbapenemases.

    Science.gov (United States)

    Kittinger, Clemens; Lipp, Michaela; Folli, Bettina; Kirschner, Alexander; Baumert, Rita; Galler, Herbert; Grisold, Andrea J; Luxner, Josefa; Weissenbacher, Melanie; Farnleitner, Andreas H; Zarfel, Gernot

    2016-01-01

    In a clinical setting it seems to be normal these days that a relevant proportion or even the majority of different bacterial species has already one or more acquired antibiotic resistances. Unfortunately, the overuse of antibiotics for livestock breeding and medicine has also altered the wild-type resistance profiles of many bacterial species in different environmental settings. As a matter of fact, getting in contact with resistant bacteria is no longer restricted to hospitals. Beside food and food production, the aquatic environment might also play an important role as reservoir and carrier. The aim of this study was the assessment of the resistance patterns of Escherichia coli and Klebsiella spp. out of surface water without prior enrichment and under non-selective culture conditions (for antibiotic resistance). In addition, the presence of clinically important extended spectrum beta lactamase (ESBL) and carbapenmase harboring Enterobacteriaceae should be investigated. During Joint Danube Survey 3 (2013), water samples were taken over the total course of the River Danube. Resistance testing was performed for 21 different antibiotics. Samples were additionally screened for ESBL or carbapenmase harboring Enterobacteriaceae. 39% of all isolated Escherichia coli and 15% of all Klebsiella spp. from the river Danube had at least one acquired resistance. Resistance was found against all tested antibiotics except tigecycline. Taking a look on the whole stretch of the River Danube the proportion of multiresistances did not differ significantly. In total, 35 ESBL harboring Enterobacteriaceae, 17 Escherichia coli, 13 Klebsiella pneumoniae and five Enterobacter spp. were isolated. One Klebsiella pneumoniae harboring NMD-1 carbapenmases and two Enterobacteriaceae with KPC-2 could be identified. Human generated antibiotic resistance is very common in E. coli and Klebsiella spp. in the River Danube. Even isolates with resistance patterns normally associated with intensive

  20. Phenotypic detection of the cfiA metallo-β-lactamase in Bacteroides fragilis with the meropenem-EDTA double-ended Etest and the ROSCO KPC/MBL Confirm Kit

    DEFF Research Database (Denmark)

    Ferløv-Schwensen, Simon Andreas; Acar, Ziyap; Sydenham, Thomas V

    2017-01-01

    OBJECTIVES: To investigate the performance of the meropenem and imipenem double-ended Etest ± EDTA and the tablet-based (meropenem and meropenem + dipicolinic acid) KPC/MBL Confirm Kit to detect cfiA metallo-β-lactamase (MBL) in Bacteroides fragilis. METHODS: Well-characterized B. fragilis isolates...

  1. Characterization of OXA-48-like-producing Enterobacteriaceae isolated from river water in Algeria.

    Science.gov (United States)

    Tafoukt, Rima; Touati, Abdelaziz; Leangapichart, Thongpan; Bakour, Sofiane; Rolain, Jean-Marc

    2017-09-01

    The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a significant problem for healthcare worldwide. The prevalence of carbapenem-resistant Enterobacteriaceae (CPE) in water environments in Algeria are unknown. The aim of this study was to screen for the presence of CPE isolates in the Soummam River in Bejaia, Algeria. Isolates of Enterobacteriaceae recovered from twelve samples of river water and showing reduced susceptibility to carbapenems were included in this study. The isolates were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Isolates were subjected to antimicrobial susceptibility testing and the modified Carba NP test. Carbapenemase and extended-spectrum β-lactamase (ESBL) determinants were studied by PCR amplification and sequencing. The clonal relatedness between isolates was studied by Multilocus Sequence Typing (MLST) method. A total of 20 carbapenem-resistant Enterobacteriaceae strains were included in this study, identified as Escherichia coli (n = 12), Klebsiella pneumoniae (n = 3), Raoultella ornithinolytica (n = 3), Citrobacter freundii (n = 1) and Citrobacter braakii (n = 1). Carbapenemase genes identified in this study included bla OXA-48 , observed in 17 isolates (9 E. coli, 3 K. pneumoniae, 3 R. ornithinolytica, 1 C. freundii and 1 C. braakii), and bla OXA-244 , a variant of bla OXA-48 , was found in three E. coli isolates. MLST showed that 12 E. coli strains belonged to six different sequence types (ST559, ST38, ST212, ST3541, 1972 and ST2142), and we identified three different STs in K. pneumoniae isolates, including ST133, ST2055, and a new sequence type: ST2192. This study showed the presence of OXA-48-like-producing Enterobacteriaceae in water environments and highlighted the potential role of aquatic environments as reservoirs of clinically relevant antimicrobial-resistant bacteria, with the potential to spread throughout the community. Copyright

  2. Diseminación de Klebsiella pneumoniae productoras de KPC-3 en hospitales de Bogotá durante un periodo de tres años

    Directory of Open Access Journals (Sweden)

    Edna Catering Rodríguez

    2014-04-01

    Full Text Available Introducción. Uno de los principales problemas de salud pública a nivel mundial son las infecciones producidas por enterobacterias resistentes a los carbapenémicos, entre las cuales Klebsiella pneumoniae es uno de los patógenos que con mayor frecuencia causa infecciones en el ámbito hospitalario. Objetivo. El objetivo del estudio fue describir la diseminación de aislamientos clínicos de K. pneumoniae productores de la enzima KPC-3 recuperados en hospitales de Bogotá. Materiales y métodos. Se analizaron 82 aislamientos de K. pneumoniae resistentes a antibióticos carbapenémicos recuperados entre el 2008 y el 2010 en 10 hospitales, a los cuales se les realizaron pruebas de detección fenotípica de enzimas por difusión de disco y microdilución, y de detección genotípica por PCR. La determinación de perfiles de sensibilidad frente a 13 antimicrobianos se realizó por métodos automatizados y manuales. La relación genética de los aislamientos se obtuvo por la técnica de PFGE. Resultados. Este estudio presenta el panorama del comportamiento de las enterobacterias resistentes a los carbapenémicos diseminadas en el curso de tres años en 10 hospitales de la ciudad, con características de resistencia a múltiples familias de antibióticos y pertenecientes a varios grupos de clones, cada uno con diferentes subtipos. Conclusiones. La diseminación de aislamientos clínicos de K. pneumoniae productores de enzima KPC-3 en Bogotá plantea la necesidad de fortalecer las acciones de vigilancia epidemiológica frente a este tipo de microorganismos y el desarrollo prioritario de actividades específicas de prevención y control de infecciones.

  3. Revealing H I gas in emission and absorption on pc to kpc scales in a galaxy at z ˜ 0.017

    Science.gov (United States)

    Gupta, N.; Srianand, R.; Farnes, J. S.; Pidopryhora, Y.; Vivek, M.; Paragi, Z.; Noterdaeme, P.; Oosterloo, T.; Petitjean, P.

    2018-05-01

    We present a detailed study of the quasar-galaxy pair: J1243+4043-UGC 07904. The sight line of the background quasar ( zq = 1.5266) passes through a region of the galaxy (zg = 0.0169) at an impact parameter of 6.9 kpc with high metallicity (0.5 Z⊙) and negligible dust extinction. We detect H I 21-cm absorption from the foreground galaxy at arcsecond and milliarcsecond scales. For typical cold neutral medium (CNM) temperatures in the Milky Way, this 21-cm absorber can be classified as a damped Lyα absorber (DLA). We infer the harmonic mean spin temperature of the gas to be ˜400 K and for a simple two-phase medium we estimate the CNM fraction to be fCNM = 0.27. This is remarkably consistent with the CNM fraction observed in the Galaxy and less than that of high-redshift DLAs. The quasar exhibits a core-jet morphology on milliarcsecond scales, corresponding to an overall extent of ˜9 pc at zg. We show that the size of CNM absorbing clouds associated with the foreground galaxy is >5 pc and they may be part of cold gas structures that extend beyond ˜35 pc. Interestingly, the rotation measure of quasar J1243+4043 is higher than any other source in samples of quasars with high-z DLAs. However, we do not find any detectable differences in rotation measures and polarization fraction of sight lines with or without high-z (z ≥ 2) DLAs or low-z (z ≤ 0.3) 21-cm absorbers. Finally, the foreground galaxy UGC 07904 is also part of a galaxy group. We serendipitously detect H I 21-cm emission from four members of the group, and an ˜80 kpc long H I bridge connecting two of the other members. The latter, together with the properties of the group members, suggests that the group is a highly interactive environment.

  4. Kinematics and Metallicity of M31 Red Giants: The Giant Southern Stream and Discovery of a Second Cold Component at R=20 kpc

    Science.gov (United States)

    Kalirai, Jasonjot S.; Guhathakurta, Puragra; Gilbert, Karoline M.; Reitzel, David B.; Majewski, Steven R.; Rich, R. Michael; Cooper, Michael C.

    2006-04-01

    We present spectroscopic observations of red giant branch (RGB) stars in the Andromeda spiral galaxy (M31), acquired with the DEIMOS instrument on the Keck II 10 m telescope. The three fields targeted in this study are in the M31 spheroid, outer disk, and giant southern stream. In this paper, we focus on the kinematics and chemical composition of RGB stars in the stream field located at a projected distance of R=20 kpc from M31's center. A mix of stellar populations is found in this field. M31 RGB stars are isolated from Milky Way dwarf star contaminants using a variety of spectral and photometric diagnostics. The radial velocity distribution of RGB stars displays a clear bimodality-a primary peak centered at v¯1=-513 km s-1 and a secondary one at v¯2=-417 km s-1-along with an underlying broad component that is presumably representative of the smooth spheroid of M31. Both peaks are found to be dynamically cold with intrinsic velocity dispersions of σ(v)~16 km s-1. The mean metallicity and metallicity dispersion of stars in the two peaks is also found to be similar: ~-0.45 and σ([Fe/H])=0.2. The observed velocity of the primary peak is consistent with that predicted by dynamical models for the stream, but there is no obvious explanation for the secondary peak. The nature of the secondary cold population is unclear: it may represent (1) tidal debris from a satellite merger event that is superimposed on, but unrelated to, the giant southern stream; (2) a wrapped around component of the giant southern stream; or (3) a warp or overdensity in M31's disk at Rdisk>50 kpc (this component is well above the outward extrapolation of the smooth exponential disk brightness profile). Data presented herein were obtained at the W. M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California, and the National Aeronautics and Space Administration. The Observatory was made possible by the generous

  5. Ionised gas structure of 100 kpc in an over-dense region of the galaxy group COSMOS-Gr30 at z 0.7

    Science.gov (United States)

    Epinat, B.; Contini, T.; Finley, H.; Boogaard, L. A.; Guérou, A.; Brinchmann, J.; Carton, D.; Michel-Dansac, L.; Bacon, R.; Cantalupo, S.; Carollo, M.; Hamer, S.; Kollatschny, W.; Krajnović, D.; Marino, R. A.; Richard, J.; Soucail, G.; Weilbacher, P. M.; Wisotzki, L.

    2018-01-01

    We report the discovery of a 104 kpc2 gaseous structure detected in [O II]λλ3727, 3729 in an over-dense region of the COSMOS-Gr30 galaxy group at z 0.725 with deep MUSE Guaranteed Time Observations. We estimate the total amount of diffuse ionised gas to be of the order of ( 5 ± 3) × 1010 M⊙ and explore its physical properties to understand its origin and the source(s) of the ionisation. The MUSE data allow the identification of a dozen group members that are embedded in this structure through emission and absorption lines. We extracted spectra from small apertures defined for both the diffuse ionised gas and the galaxies. We investigated the kinematics and ionisation properties of the various galaxies and extended gas regions through line diagnostics (R23, O32, and [O III]/Hβ) that are available within the MUSE wavelength range. We compared these diagnostics to photo-ionisation models and shock models. The structure is divided into two kinematically distinct sub-structures. The most extended sub-structure of ionised gas is likely rotating around a massive galaxy and displays filamentary patterns that link some galaxies. The second sub-structure links another massive galaxy that hosts an active galactic nucleus (AGN) to a low-mass galaxy, but it also extends orthogonally to the AGN host disc over 35 kpc. This extent is likely ionised by the AGN itself. The location of small diffuse regions in the R23 vs. O32 diagram is compatible with photo-ionisation. However, the location of three of these regions in this diagram (low O32, high R23) can also be explained by shocks, which is supported by their high velocity dispersions. One edge-on galaxy shares the same properties and may be a source of shocks. Regardless of the hypothesis, the extended gas seems to be non-primordial. We favour a scenario where the gas has been extracted from galaxies by tidal forces and AGN triggered by interactions between at least the two sub-structures. Based on observations made with

  6. Producing cement

    Energy Technology Data Exchange (ETDEWEB)

    Stone, E G

    1923-09-12

    A process and apparatus are described for producing Portland cement in which pulverized shale is successively heated in a series of inclined rotary retorts having internal stirrers and oil gas outlets, which are connected to condensers. The partially treated shale is removed from the lowermost retort by a conveyor, then fed separately or conjointly into pipes and thence into a number of vertically disposed retorts. Each of these retorts may be fitted interiorly with vertical arranged conveyors which elevate the shale and discharge it over a lip, from whence it falls to the bottom of the retorts. The lower end of each casing is furnished with an adjustable discharge door through which the spent shale is fed to a hopper, thence into separate trucks. The oil gases generated in the retorts are exhausted through pipes to condensers. The spent shale is conveyed to a bin and mixed while hot with ground limestone. The admixed materials are then ground and fed to a rotary kiln which is fired by the incondensible gases derived from the oil gases obtained in the previous retorting of the shale. The calcined materials are then delivered from the rotary kiln to rotary coolers. The waste gases from the kiln are utilized for heating the retorts in which the ground shale is heated for the purpose of extracting therefrom the contained hydrocarbon oils and gases.

  7. Global Molecular Epidemiology of IMP-Producing Enterobacteriaceae.

    Science.gov (United States)

    Matsumura, Yasufumi; Peirano, Gisele; Motyl, Mary R; Adams, Mark D; Chen, Liang; Kreiswirth, Barry; DeVinney, Rebekah; Pitout, Johann D D

    2017-04-01

    International data on the molecular epidemiology of Enterobacteriaceae with IMP carbapenemases are lacking. We performed short-read (Illumina) whole-genome sequencing on a global collection of 38 IMP-producing clinical Enterobacteriaceae (2008 to 2014). IMP-producing Enterobacteriaceae (7 varieties within 11 class 1 integrons) were mainly present in the South Pacific and Asia. Specific bla IMP -containing integrons (In809 with bla IMP-4 , In722 with bla IMP-6 , and In687 with bla IMP-14 ) were circulating among different bacteria in countries such as Australia, Japan, and Thailand. In1312 with bla IMP-1 was present in Klebsiella pneumoniae from Japan and Citrobacter freundii from Brazil. Klebsiella pneumoniae ( n = 22) was the most common species; clonal complex 14 (CC14) from Philippines and Japan was the most common clone and contained In1310 with bla IMP-26 and In1321 with bla IMP-6 The Enterobacter cloacae complex ( n = 9) consisted of Enterobacter hormaechei and E. cloacae cluster III. CC78 (from Taiwan) containing In73 with bla IMP-8 was the most common clone among the E. cloacae complex. This study highlights the importance of surveillance programs using the latest molecular techniques for providing insight into the characteristics and global distribution of Enterobacteriaceae with bla IMP genes. Copyright © 2017 American Society for Microbiology.

  8. Genomic epidemiology of global VIM-producing Enterobacteriaceae.

    Science.gov (United States)

    Matsumura, Yasufumi; Peirano, Gisele; Devinney, Rebekah; Bradford, Patricia A; Motyl, Mary R; Adams, Mark D; Chen, Liang; Kreiswirth, Barry; Pitout, Johann D D

    2017-08-01

    International data on the molecular epidemiology of Enterobacteriaceae with VIM carbapenemases are limited. We performed short read (Illumina) WGS on a global collection of 89 VIM-producing clinical Enterobacteriaceae (2008-14). VIM-producing (11 varieties within 21 different integrons) isolates were mostly obtained from Europe. Certain integrons with bla VIM were specific to a country in different species and clonal complexes (CCs) (In 87 , In 624 , In 916 and In 1323 ), while others had spread globally among various Enterobacteriaceae species (In 110 and In 1209 ). Klebsiella pneumoniae was the most common species ( n  = 45); CC147 from Greece was the most prevalent clone and contained In 590 -like integrons with four different bla VIM s. Enterobacter cloacae complex was the second most common species and mainly consisted of Enterobacter hormaechei ( Enterobacter xiangfangensis , subsp. steigerwaltii and Hoffmann cluster III). CC200 (from Croatia and Turkey), CC114 (Croatia, Greece, Italy and the USA) and CC78 (from Greece, Italy and Spain) containing bla VIM-1 were the most common clones among the E. cloacae complex. This study highlights the importance of surveillance programmes using the latest molecular techniques in providing insight into the characteristics and global distribution of Enterobacteriaceae with bla VIM s. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Individual stellar haloes of massive galaxies measured to 100 kpc at 0.3 < z < 0.5 using Hyper Suprime-Cam

    Science.gov (United States)

    Huang, Song; Leauthaud, Alexie; Greene, Jenny E.; Bundy, Kevin; Lin, Yen-Ting; Tanaka, Masayuki; Miyazaki, Satoshi; Komiyama, Yutaka

    2018-04-01

    Massive galaxies display extended light profiles that can reach several hundreds of kiloparsecs. We use data from the Hyper Suprime-Cam (HSC) survey that is simultaneously wide (˜100 deg2) and deep (>28.5 mag arcsec-2 in i band) to study the stellar haloes of a sample of ˜7000 massive galaxies at z ˜ 0.4. The depth of the HSC data enables us to measure surface mass density profiles to 100 kpc for individual galaxies without stacking. As in previous work, we find that more massive galaxies exhibit more extended outer profiles than smaller galaxies. When this extended light is not properly accounted for (because of shallow imaging and/or inadequate profile modelling), the derived stellar mass function can be significantly underestimated at the high-mass end. Across our sample, the ellipticity of outer light profile increases substantially with radius. We show for the first time that these ellipticity gradients steepen dramatically as a function of galaxy mass, but we detect no mass dependence in outer colour gradients. Our results support the two-phase formation scenario for massive galaxies in which outer envelopes are built up at a later time from a series of merging events. We provide surface mass density profiles in a convenient tabulated format to facilitate comparisons with predictions from numerical simulations of galaxy formation.

  10. CHANDRA OBSERVATIONS OF A 1.9 kpc SEPARATION DOUBLE X-RAY SOURCE IN A CANDIDATE DUAL ACTIVE GALACTIC NUCLEUS GALAXY AT z = 0.16

    International Nuclear Information System (INIS)

    Comerford, Julia M.; Pooley, David; Gerke, Brian F.; Madejski, Greg M.

    2011-01-01

    We report Chandra observations of a double X-ray source in the z = 0.1569 galaxy SDSS J171544.05+600835.7. The galaxy was initially identified as a dual active galactic nucleus (AGN) candidate based on the double-peaked [O III] λ5007 emission lines, with a line-of-sight velocity separation of 350 km s -1 , in its Sloan Digital Sky Survey spectrum. We used the Kast Spectrograph at Lick Observatory to obtain two long-slit spectra of the galaxy at two different position angles, which reveal that the two Type 2 AGN emission components have not only a velocity offset, but also a projected spatial offset of 1.9 h -1 70 kpc on the sky. Chandra/ACIS observations of two X-ray sources with the same spatial offset and orientation as the optical emission suggest that the galaxy most likely contains Compton-thick dual AGNs, although the observations could also be explained by AGN jets. Deeper X-ray observations that reveal Fe K lines, if present, would distinguish between the two scenarios. The observations of a double X-ray source in SDSS J171544.05+600835.7 are a proof of concept for a new, systematic detection method that selects promising dual AGN candidates from ground-based spectroscopy that exhibits both velocity and spatial offsets in the AGN emission features.

  11. Evaluation of the HB&L carbapenemase and extended spectrum beta lactamase-AmpC automated screening kits for the rapid detection of resistant Enterobacteriaceae in rectal swabs

    Directory of Open Access Journals (Sweden)

    Sara Marani

    2017-03-01

    Full Text Available Background. In the past two decades, a rapid increase of infections due to multidrug-resistant Enterobacteriaceae was reported worldwide, including in Italy. These bacteria express genes encoding for extended-spectrum β-lactamases (ESBL or bear a plasmid-mediated AmpC that induce phenotypically a resistance to the last-generation cephalosporins; even more worrying is the rapid increase of Enterobacteriaceae carrying genes conferring resistance to carbapenems (CPE. Materials and methods. The gut may serve as reservoir for these antibiotic drug-resistant bacteria: as a consequence, the rapid detection of drug resistant Enterobacteriaceae from rectal swabs is an important tool to identify rectal carriage of resistant bacteria. This procedure is the basic tool to successfully implement the infection control measures in the hospital wards. The study evaluated the capability of the HB&L ESBL/AmpC and CARBAPENEMASE screening kit (Alifax, Padua, Italy to rapidly identify the drug resistant enterobacteriaceae from rectal swabs: the performance was compared with the conventional method. Results and conclusions. The overall agreement was very good (91% for the detection of ESBL-AmpC, and 96.2% for the identification of CPE; this method is thus an efficient tool to quickly report positive multidrug resistant bacteria in rectal swabs.

  12. Fast and Furious: Shock heated gas as the origin of spatially resolved hard X-ray emission in the central 5 kpc of the galaxy merger NGC 6240

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Junfeng; Nardini, Emanuele; Fabbiano, Giuseppina; Karovska, Margarita; Elvis, Martin; Risaliti, Guido; Zezas, Andreas [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Pellegrini, Silvia [Dipartimento di Astronomia, Universitá di Bologna, Via Ranzani 1, I-40127 Bologna (Italy); Max, Claire [Center for Adaptive Optics, University of California, 1156 High Street, Santa Cruz, CA 95064 (United States); U, Vivian, E-mail: jfwang@northwestern.edu [Institute for Astronomy, University of Hawaii, 2680 Woodlawn Drive, Honolulu, HI 96822 (United States)

    2014-01-20

    We have obtained a deep, subarcsecond resolution X-ray image of the nuclear region of the luminous galaxy merger NGC 6240 with Chandra, which resolves the X-ray emission from the pair of active nuclei and the diffuse hot gas in great detail. We detect extended hard X-ray emission from kT ∼ 6 keV (∼70 MK) hot gas over a spatial scale of 5 kpc, indicating the presence of fast shocks with a velocity of ∼2200 km s{sup –1}. For the first time, we obtain the spatial distribution of this highly ionized gas emitting Fe XXV, which shows a remarkable correspondence to the large-scale morphology of H{sub 2}(1-0) S(1) line emission and Hα filaments. Propagation of fast shocks originating in the starburst-driven wind into the ambient dense gas can account for this morphological correspondence. With an observed L {sub 0.5-8} {sub keV} = 5.3 × 10{sup 41} erg s{sup –1}, the diffuse hard X-ray emission is ∼100 times more luminous than that observed in the classic starburst galaxy M82. Assuming a filling factor of 1% for the 70 MK temperature gas, we estimate its total mass (M {sub hot} = 1.8 × 10{sup 8} M {sub ☉}) and thermal energy (E {sub th} = 6.5 × 10{sup 57} erg). The total iron mass in the highly ionized plasma is M {sub Fe} = 4.6 × 10{sup 5} M {sub ☉}. Both the energetics and the iron mass in the hot gas are consistent with the expected injection from the supernovae explosion during the starburst that is commensurate with its high star formation rate. No evidence for fluorescent Fe I emission is found in the CO filament connecting the two nuclei.

  13. Fast and Furious: Shock Heated Gas as the Origin of Spatially Resolved Hard X-Ray Emission in the Central 5 kpc of the Galaxy Merger NGC 6240

    Science.gov (United States)

    Wang, Junfeng; Nardini, Emanuele; Fabbiano, Giuseppina; Karovska, Margarita; Elvis, Martin; Pellegrini, Silvia; Max, Claire; Risaliti, Guido; U, Vivian; Zezas, Andreas

    2014-01-01

    We have obtained a deep, subarcsecond resolution X-ray image of the nuclear region of the luminous galaxy merger NGC 6240 with Chandra, which resolves the X-ray emission from the pair of active nuclei and the diffuse hot gas in great detail. We detect extended hard X-ray emission from kT ~ 6 keV (~70 MK) hot gas over a spatial scale of 5 kpc, indicating the presence of fast shocks with a velocity of ~2200 km s-1. For the first time, we obtain the spatial distribution of this highly ionized gas emitting Fe XXV, which shows a remarkable correspondence to the large-scale morphology of H2(1-0) S(1) line emission and Hα filaments. Propagation of fast shocks originating in the starburst-driven wind into the ambient dense gas can account for this morphological correspondence. With an observed L 0.5-8 keV = 5.3 × 1041 erg s-1, the diffuse hard X-ray emission is ~100 times more luminous than that observed in the classic starburst galaxy M82. Assuming a filling factor of 1% for the 70 MK temperature gas, we estimate its total mass (M hot = 1.8 × 108 M ⊙) and thermal energy (E th = 6.5 × 1057 erg). The total iron mass in the highly ionized plasma is M Fe = 4.6 × 105 M ⊙. Both the energetics and the iron mass in the hot gas are consistent with the expected injection from the supernovae explosion during the starburst that is commensurate with its high star formation rate. No evidence for fluorescent Fe I emission is found in the CO filament connecting the two nuclei.

  14. Fast and Furious: Shock heated gas as the origin of spatially resolved hard X-ray emission in the central 5 kpc of the galaxy merger NGC 6240

    International Nuclear Information System (INIS)

    Wang, Junfeng; Nardini, Emanuele; Fabbiano, Giuseppina; Karovska, Margarita; Elvis, Martin; Risaliti, Guido; Zezas, Andreas; Pellegrini, Silvia; Max, Claire; U, Vivian

    2014-01-01

    We have obtained a deep, subarcsecond resolution X-ray image of the nuclear region of the luminous galaxy merger NGC 6240 with Chandra, which resolves the X-ray emission from the pair of active nuclei and the diffuse hot gas in great detail. We detect extended hard X-ray emission from kT ∼ 6 keV (∼70 MK) hot gas over a spatial scale of 5 kpc, indicating the presence of fast shocks with a velocity of ∼2200 km s –1 . For the first time, we obtain the spatial distribution of this highly ionized gas emitting Fe XXV, which shows a remarkable correspondence to the large-scale morphology of H 2 (1-0) S(1) line emission and Hα filaments. Propagation of fast shocks originating in the starburst-driven wind into the ambient dense gas can account for this morphological correspondence. With an observed L 0.5-8 keV = 5.3 × 10 41 erg s –1 , the diffuse hard X-ray emission is ∼100 times more luminous than that observed in the classic starburst galaxy M82. Assuming a filling factor of 1% for the 70 MK temperature gas, we estimate its total mass (M hot = 1.8 × 10 8 M ☉ ) and thermal energy (E th = 6.5 × 10 57 erg). The total iron mass in the highly ionized plasma is M Fe = 4.6 × 10 5 M ☉ . Both the energetics and the iron mass in the hot gas are consistent with the expected injection from the supernovae explosion during the starburst that is commensurate with its high star formation rate. No evidence for fluorescent Fe I emission is found in the CO filament connecting the two nuclei.

  15. Three distinct clones of carbapenem-resistant Acinetobacter baumannii with high diversity of carbapenemases isolated from patients in two hospitals in Kuwait

    Directory of Open Access Journals (Sweden)

    N.A. Al-Sweih

    2012-02-01

    Full Text Available Summary: Objectives: This study was undertaken to investigate the clonal relatedness of multidrug-resistant (MDR Acinetobacter baumannii isolates collected from patients in two teaching hospitals in Kuwait. Materials and methods: Clinically significant consecutive isolates of A. baumannii obtained from patients in the Mubarak (36 and Adan (58 hospitals over a period of 6 months were studied. These isolates were identified using molecular methods, and their antimicrobial susceptibility was determined by the Etest method. The mechanism of resistance to carbapenem was investigated by PCR, and pulsed-field gel electrophoresis (PFGE was used to determine the clonal relatedness of MDR isolates. Results: Of the 94 isolates investigated, 80 (85.1% were multidrug resistant (MDR. The A. baumannii PFGE clone A and subclone A1 were the most prevalent in patients infected with MDR isolates. Fifty-five (94.8% and 15 (41.7% of the MDR isolates from the Adan and Mubarak hospitals, respectively, belonged to PFGE clone A; isolates in this group showed higher resistance rates to antibiotics than isolates form other groups. Of the 94 isolates, 40 (42.6% were resistant to either imipenem or meropenem or to both (CRAB. Most CRAB isolates (29/40 or 72.5% carried bla genes, which code for MBL (VIM-2 and IMP-1 enzymes. Two isolates harbored blaOXA-23. Conclusion: Three distinct clones of CRAB were isolated, providing evidence of a high diversity of carbapenemases among our geographically related isolates. Keywords: MDR A. baumannii, Genotypes, bla genes, Kuwait hospitals

  16. Evaluation of a real-time PCR assay for rectal screening of OXA-48-producing Enterobacteriaceae in a general intensive care unit of an endemic hospital.

    Science.gov (United States)

    Fernández, J; Cunningham, S A; Fernández-Verdugo, A; Viña-Soria, L; Martín, L; Rodicio, M R; Escudero, D; Vazquez, F; Mandrekar, J N; Patel, R

    2017-07-01

    Carbapenemase-producing Enterobacteriaceae are increasing worldwide. Rectal screening for these bacteria can inform the management of infected and colonized patients, especially those admitted to intensive care units (ICUs). A laboratory developed, qualitative duplex real-time polymerase chain reaction assay for rapid detection of OXA-48-like and VIM producing Enterobacteriaceae, performed on rectal swabs, was designed and evaluated in an intensive care unit with endemic presence of OXA-48. During analytical assay validation, no cross-reactivity was observed and 100% sensitivity and specificity were obtained for both bla OXA-48-like and bla VIM in all spiked clinical samples. During the clinical part of the study, the global sensitivity and specificity of the real-time PCR assay for OXA-48 detection were 95.7% and 100% (P=0.1250), respectively, in comparison with culture; no VIM-producing Enterobacteriaceae were detected. Clinical features of patients in the ICU who were colonized or infected with OXA-48 producing Enterobacteriaceae, including outcome, were analyzed. Most had severe underlying conditions, and had risk factors for colonization with carbapenemase-producing Enterobacteriaceae before or during ICU admission, such as receiving previous antimicrobial therapy, prior healthcare exposure (including long-term care), chronic disease, immunosuppression and/or the presence of an intravascular catheter and/or mechanical ventilation device. The described real-time PCR assay is fast (~2-3hours, if DNA extraction is included), simple to perform and results are easy to interpret, features which make it applicable in the routine of clinical microbiology laboratories. Implementation in endemic hospitals could contribute to early detection of patients colonized by OXA-48 producing Enterobacteriaceae and prevention of their spread. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. High proportion of intestinal colonization with successful epidemic clones of ESBL-producing Enterobacteriaceae in a neonatal intensive care unit in Ecuador.

    Directory of Open Access Journals (Sweden)

    Viveka Nordberg

    Full Text Available BACKGROUND AND AIMS: Neonatal infections caused by Extended-spectrum beta-lactamase (ESBL-producing bacteria are associated with increased morbidity and mortality. No data are available on neonatal colonization with ESBL-producing bacteria in Ecuador. The aim of this study was to determine the proportion of intestinal colonization with ESBL-producing Enterobacteriaceae, their resistance pattern and risk factors of colonization in a neonatal intensive care unit in Ecuador. METHODS: During a three month period, stool specimens were collected every two weeks from hospitalized neonates. Species identification and susceptibility testing were performed with Vitek2, epidemiologic typing with automated repetitive PCR. Associations between groups were analyzed using the Pearson X (2 test and Fisher exact test. A forward step logistic regression model identified significant predictors for colonization. RESULTS: Fifty-six percent of the neonates were colonized with ESBL-producing Enterobacteriaceae. Length of stay longer than 20 days and enteral feeding with a combination of breastfeeding and formula feeding were significantly associated with ESBL-colonization. The strains found were E. coli (EC, 89% and K. pneumoniae (KP, 11% and epidemiological typing divided these isolates in two major clusters. All EC and KP had bla CTX-M group 1 except for a unique EC isolate that had bla CTX-M group 9. Multi-locus sequence typing performed on the K. pneumoniae strains showed that the strains belonged to ST855 and ST897. The two detected STs belong to two different epidemic clonal complexes (CC, CC11 and CC14, which previously have been associated with dissemination of carbapenemases. None of the E. coli strains belonged to the epidemic ST 131 clone. CONCLUSIONS: More than half of the neonates were colonized with ESBL-producing Enterobacteriaceae where the main risk factor for colonization was length of hospital stay. Two of the isolated clones were epidemic and known

  18. Metallo-β-lactamase-producing clinical isolates from patients of a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Durgesh Gopalrao Deshmukh

    2011-01-01

    Results: Of 638 gram negative bacilli isolates and 3.39% showed imipenem resistance, 2.9% showed MBL production, of which 1.7% were non-fermenters and 1.25% were Enterobacteriaceae, 0.3% showing non-MBL KPC carbapenemas. Most isolates were from the intensive care unit and from post-operative patients. Our findings show that there are significant numbers of isolates having MBL production along with multidrug resistance. There is a need for active surveillance to detect MBL producers.

  19. Oxacillinase (OXA-producing Acinetobacter baumannii in Brazil: clinical and environmental impact and therapeutic options

    Directory of Open Access Journals (Sweden)

    Micheli Medeiros

    2013-12-01

    Full Text Available Following a worldwide trend, infections caused by MDR OXA-type (Ambler class D carbapenemase-producing Acinetobacter baumannii are currently regarded as a clinical and epidemiological emergency in Brazil. OXA-producing A. baumannii strains have been identified in the states of Alagoas, Amazonas, Bahia, Distrito Federal, Espírito Santo, Goiás, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Paraná, Pernambuco, Rio de Janeiro, Rio Grande do Norte, Rio Grande do Sul, Santa Catarina and São Paulo. In some settings, the presence of OXA-23- and/or OXA-143 -producing A. baumannii (so far restricted to Brazil has been endemic and A. baumannii strains carrying blaOXA-23 genes have been detected in hospital wastewater effluents, hence a potential risk to the community and the environment. Although molecular typing by multilocus sequence typing (MLST - Bartual scheme, University of Oxford, http://pubmlst.org/abaumannii/ has revealed the international spread of a clonal complex (CC denominated CC92, in Brazil most OXA-23-producing A. baumannii belong to CC113, CC109 or CC104 clonal complexes. Finally, from a clinical point of view, the main problem of A. baumannii infections is the limited use of antibacterial agents with in vitro activity, often restricted to ampicillin/sulbactam, polymyxin B and/or colistin (polymyxin E.

  20. Detection of VIM-2-, IMP-1- and NDM-1-producing multidrug resistant Pseudomonas aeruginosa in Malaysia.

    Science.gov (United States)

    Liew, Siew Mun; Rajasekaram, Ganeswrei; Puthucheary, Savithri D; Chua, Kek Heng

    2018-02-09

    The increasing incidence of carbapenem-resistant Pseudomonas aeruginosa along with the discovery of novel metallo-β-lactamases (MBLs) is of concern. In this study, the isolation of Malaysian MBL-producing P. aeruginosa clinical strains was investigated. Fifty-three P. aeruginosa clinical strains were isolated from different patients in Sultanah Aminah Hospital, Johor Bahru, Malaysia in 2015. Antimicrobial susceptibility test was conducted. Minimum inhibitory concentrations (MICs) of imipenem and meropenem were determined by Etest. The carbapenem-resistant strains were screened for MBL production by IMP-EDTA double disk synergy test (DDST), MBL imipenem/imipenem-inhibitor (IP/IPI) Etest and polymerase chain reaction (PCR). Genotyping was performed by multilocus sequence typing (MLST) analysis. Three (5.7%) clinical strains were identified as MBL producers. Multidrug resistance was observed in the three strains, and two were resistant to all the antimicrobials tested. Sequencing analysis confirmed the three strains to harbour carbapenemase genes: one with bla IMP-1 , one with bla VIM-2 and the other with bla NDM-1 genes. These multidrug resistant strains were identified as sequence type (ST) 235 and ST308. None of the bla IMP-1 and bla NDM-1 genes have been reported in Malaysian P. aeruginosa. The emergence of imipenemase 1 (IMP-1)- and New Delhi metallo-β-lactamase 1 (NDM-1)-producing P. aeruginosa in Malaysia maybe travel-associated. Copyright © 2018. Published by Elsevier Ltd.

  1. ALMA view of RX J1131-1231: Sub-kpc CO (2-1) mapping of a molecular disk in a lensed star-forming quasar host galaxy

    Science.gov (United States)

    Paraficz, D.; Rybak, M.; McKean, J. P.; Vegetti, S.; Sluse, D.; Courbin, F.; Stacey, H. R.; Suyu, S. H.; Dessauges-Zavadsky, M.; Fassnacht, C. D.; Koopmans, L. V. E.

    2018-05-01

    We present ALMA 2-mm continuum and CO (2-1) spectral line imaging of the gravitationally lensed z = 0.654 star-forming/quasar composite RX J1131-1231 at 240-400 mas angular resolution. The continuum emission is found to be compact and coincident with the optical emission, whereas the molecular gas forms a complete Einstein ring, which shows strong differential magnification. The de-lensed source structure is determined on 400-parsec-scales resolution using a Bayesian pixelated visibility-fitting lens modelling technique. The reconstructed molecular gas velocity-field is consistent with a large rotating disk with a major-axis FWHM 9.4 kpc at an inclination angle of i = 54° and with a maximum rotational velocity of 280 km s-1. From dynamical model fitting we find an enclosed mass within 5 kpc of M(r conversion factor of α = 5.5 ± 2.0 M⊙ (K km s-1 pc2)-1. This suggests that the star-formation efficiency is dependent on the host galaxy morphology as opposed to the nature of the AGN. The far-infrared continuum spectral energy distribution shows evidence for heated dust, equivalent to an obscured star-formation rate of SFR = 69-25+41 × (7.3/μIR) M⊙ yr-1, which demonstrates the composite star-forming and AGN nature of this system.

  2. The distribution of cosmic rays in the galaxy and their dynamics as deduced from recent gamma ray observations. [noting maximum in toroidal region between 4 and 5 kpc from galactic center

    Science.gov (United States)

    Puget, J. L.; Stecker, F. W.

    1974-01-01

    Data from SAS-2 on the galactic gamma ray line flux as a function of longitude is examined. It is shown that the gamma ray emissivity varies with galactocentric distance and is about an order of magnitude higher than the local value in a toroidal region between 4 and 5 kpc from the galactic center. This enhancement is accounted for in part by first-order Fermi acceleration, compression, and trapping of cosmic rays consistent with present ideas of galactic dynamics and galactic structure theory. Calculations indicate that cosmic rays in the 4 to 5 kpc region are trapped and accelerated over a mean time of the order of a few million years or about 2 to 4 times the assumed trapping time in the solar region of the galaxy on the assumption that only an increased cosmic ray flux is responsible for the observed emission. Cosmic ray nucleons, cosmic ray electrons, and ionized hydrogen gas were found to have a strikingly similar distribution in the galaxy according to both the observational data and the theoretical model discussed.

  3. Serratia marcescens harbouring SME-type class A carbapenemases in Canada and the presence of blaSME on a novel genomic island, SmarGI1-1.

    Science.gov (United States)

    Mataseje, L F; Boyd, D A; Delport, J; Hoang, L; Imperial, M; Lefebvre, B; Kuhn, M; Van Caeseele, P; Willey, B M; Mulvey, M R

    2014-07-01

    An increasing prevalence since 2010 of Serratia marcescens harbouring the Ambler class A carbapenemase SME prompted us to further characterize these isolates. Isolates harbouring bla(SME) were identified by PCR and sequencing. Phenotypic analysis for carbapenemase activity was carried out by a modified Hodge test and a modified Carba NP test. Antimicrobial susceptibilities were determined by Etest and Vitek 2. Typing was by PFGE of macrorestriction digests. Whole-genome sequencing of three isolates was carried out to characterize the genomic region harbouring the bla(SME)-type genes. All S. marcescens harbouring SME-type enzymes could be detected using a modified Carba NP test. Isolates harbouring bla(SME) were resistant to penicillins and carbapenems, but remained susceptible to third-generation cephalosporins, as well as fluoroquinolones and trimethoprim/sulfamethoxazole. Isolates exhibited diverse genetic backgrounds, though 57% of isolates were found in three clusters. Analysis of whole-genome sequence data from three isolates revealed that the bla(SME) gene occurred in a novel cryptic prophage genomic island, SmarGI1-1. There has been an increasing occurrence of S. marcescens harbouring bla(SME) in Canada since 2010. The bla(SME) gene was found on a genomic island, SmarGI1-1, that can be excised and circularized, which probably contributes to its dissemination amongst S. marcescens. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. A 30 kpc CHAIN OF ''BEADS ON A STRING'' STAR FORMATION BETWEEN TWO MERGING EARLY TYPE GALAXIES IN THE CORE OF A STRONG-LENSING GALAXY CLUSTER

    Energy Technology Data Exchange (ETDEWEB)

    Tremblay, Grant R.; Davis, Timothy A. [European Southern Observatory, Karl-Schwarzschild-Strasse 2, D-85748 Garching bei München (Germany); Gladders, Michael D.; Florian, Michael [Department of Astronomy and Astrophysics and Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, IL 60637 (United States); Baum, Stefi A.; O' Dea, Christopher P.; Cooke, Kevin C. [Chester F. Carlson Center for Imaging Science and School of Physics and Astronomy, Rochester Institute of Technology, 84 Lomb Memorial Drive, Rochester, NY 14623 (United States); Bayliss, Matthew B. [Department of Physics, Harvard University, 17 Oxford Street, Cambridge, MA 02138 (United States); Dahle, Håkon [Institute of Theoretical Astrophysics, University of Oslo, P.O. Box 1029, Blindern, N-0315 Oslo (Norway); Rigby, Jane R. [Observational Cosmology Laboratory, NASA Goddard Space Flight Center, Code 665, Greenbelt, MD 20771 (United States); Sharon, Keren [Department of Astronomy, University of Michigan, 500 Church Street, Ann Arbor, MI 48109 (United States); Soto, Emmaris [Department of Physics, The Catholic University of America, 200 Hannan Hall, Washington, DC 20064 (United States); Wuyts, Eva, E-mail: grant.tremblay@eso.org [Max-Planck-Institut für Extraterrestrische Physik, Postfach 1312, Giessenbachstr., D-85741 Garching bei München (Germany)

    2014-08-01

    New Hubble Space Telescope ultraviolet and optical imaging of the strong-lensing galaxy cluster SDSS J1531+3414 (z = 0.335) reveals two centrally dominant elliptical galaxies participating in an ongoing major merger. The interaction is at least somewhat rich in cool gas, as the merger is associated with a complex network of 19 massive superclusters of young stars (or small tidal dwarf galaxies) separated by ∼1 kpc in projection from one another, combining to an estimated total star formation rate of ∼5 M {sub ☉} yr{sup –1}. The resolved young stellar superclusters are threaded by narrow Hα, [O II], and blue excess filaments arranged in a network spanning ∼27 kpc across the two merging galaxies. This morphology is strongly reminiscent of the well-known ''beads on a string'' mode of star formation observed on kiloparsec scales in the arms of spiral galaxies, resonance rings, and in tidal tails between interacting galaxies. Nevertheless, the arrangement of this star formation relative to the nuclei of the two galaxies is difficult to interpret in a dynamical sense, as no known ''beads on a string'' systems associated with kiloparsec-scale tidal interactions exhibit such lopsided morphology relative to the merger participants. In this Letter, we present the images and follow-up spectroscopy and discuss possible physical interpretations for the unique arrangement of the young stellar clusters. While we suggest that this morphology is likely to be dynamically short-lived, a more quantitative understanding awaits necessary multiwavelength follow-up, including optical integral field spectroscopy, ALMA submillimeter interferometry, and Chandra X-ray imaging.

  5. Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States.

    Science.gov (United States)

    Satlin, Michael J; Chen, Liang; Patel, Gopi; Gomez-Simmonds, Angela; Weston, Gregory; Kim, Angela C; Seo, Susan K; Rosenthal, Marnie E; Sperber, Steven J; Jenkins, Stephen G; Hamula, Camille L; Uhlemann, Anne-Catrin; Levi, Michael H; Fries, Bettina C; Tang, Yi-Wei; Juretschko, Stefan; Rojtman, Albert D; Hong, Tao; Mathema, Barun; Jacobs, Michael R; Walsh, Thomas J; Bonomo, Robert A; Kreiswirth, Barry N

    2017-04-01

    Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types ( cps ), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or had undergone transplantation. The prevalences of carbapenem resistance among Klebsiella pneumoniae , Enterobacter spp., and Escherichia coli bacteremias were 9.7%, 2.2%, and 0.1%, respectively. Ninety percent of CRE were K. pneumoniae and 92% produced K. pneumoniae carbapenemase (KPC-3, 48%; KPC-2, 44%). Two CRE produced NDM-1 and OXA-48 carbapenemases. Sequence type 258 (ST258) predominated among KPC-producing K. pneumoniae (KPC- Kp ). The wzi154 allele, corresponding to cps-2 , was present in 93% of KPC-3- Kp , whereas KPC-2- Kp had greater cps diversity. Ninety-nine percent of CRE were ceftazidime-avibactam (CAZ-AVI)-susceptible, although 42% of KPC-3- Kp had an CAZ-AVI MIC of ≥4/4 μg/ml. There was a median of 47 h from bacteremia onset until active antimicrobial therapy, 38% of patients had septic shock, and 49% died within 30 days. KPC-3- Kp bacteremia (adjusted odds ratio [aOR], 2.58; P = 0.045), cancer (aOR, 3.61, P = 0.01), and bacteremia onset in the intensive care unit (aOR, 3.79; P = 0.03) were independently associated with mortality. Active empirical therapy and combination therapy were not associated with survival. Despite a decade of experience with CRE, patients with CRE bacteremia have protracted delays in appropriate therapies and high mortality rates, highlighting the need for rapid diagnostics and evaluation of new therapeutics. Copyright © 2017 American Society for Microbiology.

  6. Brookhaven Linac Isotope Producer

    Data.gov (United States)

    Federal Laboratory Consortium — The Brookhaven Linac Isoptope Producer (BLIP)—positioned at the forefront of research into radioisotopes used in cancer treatment and diagnosis—produces commercially...

  7. Producing charcoal from wastes

    Energy Technology Data Exchange (ETDEWEB)

    Pogorelov, V.A.

    1983-01-01

    Experimental works to use wood wastes for producing charcoal are examined, which are being conducted in the Sverdlovsk assembly and adjustment administration of Soyuzorglestekhmontazh. A wasteless prototype installation for producing fine charcoal is described, along with its subsequent briqueting, which is made on the basis of units which are series produced by the factories of the country. The installation includes subassemblies for preparing and drying the raw material and for producing the charcoal briquets. In the opinion of specialists, the charcoal produced from the wastes may be effectively used in ferrous and nonferrous metallurgy and in the production of pipes.

  8. Introduction of OXA-48-producing Enterobacteriaceae to Israeli hospitals by medical tourism.

    Science.gov (United States)

    Adler, Amos; Shklyar, Maya; Schwaber, Mitchell J; Navon-Venezia, Shiri; Dhaher, Yacoub; Edgar, Rotem; Solter, Ester; Benenson, Shmuel; Masarwa, Samira; Carmeli, Yehuda

    2011-12-01

    The carbapenemase OXA-48 has been reported from different Mediterranean countries. It is mostly encoded on a single plasmid in various Enterobacteriaceae species. We characterized the epidemiological and molecular features of OXA-48-producing Enterobacteriaceae (OPE) in Israel. Epidemiological investigation was conducted by the National Center for Infection Control. Genotyping was performed using multilocus sequence typing. The bla(OXA-48)-carrying plasmids were investigated using S1 endonuclease and restriction fragment length polymorphism (RFLP). Conjugation efficiency of the bla(OXA-48)-carrying plasmids was studied in a filter mating experiment. Since 2007, four OPE-infected patients were identified, all non-Israeli (two Palestinian, one Jordanian and one Georgian). Three had prior hospitalization; two in Jordan and one in Georgia. The bla(OXA-48) gene was detected in three Escherichia coli strains belonging to different clonal complexes, one Klebsiella oxytoca and one Klebsiella pneumoniae sequence type 101, as previously reported from Tunisia and Spain. In all isolates, the bla(OXA-48) gene was located inside Tn1999.2 and was carried on a 60 kb plasmid with an identical RFLP pattern. The plasmid was able to conjugate from Klebsiella spp. to E. coli, and had a conjugation efficiency up to ~10000 times higher than that of pKpQIL. OPE, introduced mainly by medical tourism, are an emerging threat to patients from affected Mediterranean countries. The bla(OXA-48)-carrying plasmid demonstrated remarkable conjugation efficiency, which is probably important in the success of its dissemination.

  9. Emergence and mechanism of carbapenem-resistant Escherichia coli in Henan, China, 2014

    Directory of Open Access Journals (Sweden)

    Wen-juan Liang

    2018-05-01

    Full Text Available The emergence and dissemination of carbapenem-resistant Escherichia coli (E. coli strains is a main risk for global public health, but little is known of carbapenemase producing E. coli in Henan, China. The study was undertaken to investigate the prevalence and mechanism of carbapenem-resistant E. coli strains in a hospital in Xinxiang, Henan, China, 2014. A total of 5 carbapenemase-producing E. coli strains were screened from 1014 isolates. We found that they were all resistant to meropenem and imipenem. Amikacin showed the best sensitivity, with gentamicin coming up next. The positive rate of blaNDM was 80% (4/5. The sequencing results showed that two isolates belonged to blaNDM-1 whereas other 2 isolates carried the blaNDM-5. Other carbapenemase genes including blaIMP, blaVIM, blaKPC and blaOXA-48 were not detected. The blaCTX-M-15, blaTEM-1, sul2, aad, and aac(6”–Ib–cr were also detected. MLST analysis showed that NDM-producing E. coli were sporadic. Conjugation test indicated blaNDM could be transferred. In conclusion, the blaNDM was the principal resistance mechanism of carbapenem-resistant E. coli in the hospital, Henan, China. Keywords: blaNDM, Carbapenem-resistant, Escherichia coli

  10. Travel to Asia and traveller's diarrhoea with antibiotic treatment are independent risk factors for acquiring ciprofloxacin-resistant and extended spectrum β-lactamase-producing Enterobacteriaceae-a prospective cohort study.

    Science.gov (United States)

    Reuland, E A; Sonder, G J B; Stolte, I; Al Naiemi, N; Koek, A; Linde, G B; van de Laar, T J W; Vandenbroucke-Grauls, C M J E; van Dam, A P

    2016-08-01

    Travel to (sub)tropical countries is a well-known risk factor for acquiring resistant bacterial strains, which is especially of significance for travellers from countries with low resistance rates. In this study we investigated the rate of and risk factors for travel-related acquisition of extended spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E), ciprofloxacin-resistant Enterobacteriaceae (CIPR-E) and carbapenem-resistant Enterobacteriaceae. Data before and after travel were collected from 445 participants. Swabs were cultured with an enrichment broth and sub-cultured on selective agar plates for ESBL detection, and on plates with a ciprofloxacin disc. ESBL production was confirmed with the double-disc synergy test. Species identification and susceptibility testing were performed with the Vitek-2 system. All isolates were subjected to ertapenem Etest. ESBL and carbapenemase genes were characterized by PCR and sequencing. Twenty-seven out of 445 travellers (6.1%) already had ESBL-producing strains and 45 of 445 (10.1%) travellers had strains resistant to ciprofloxacin before travel. Ninety-eight out of 418 (23.4%) travellers acquired ESBL-E and 130 of 400 (32.5%) travellers acquired a ciprofloxacin-resistant strain. Of the 98 ESBL-E, predominantly Escherichia coli and predominantly blaCTX-M-15, 56% (55/98) were resistant to gentamicin, ciprofloxacin and co-trimoxazole. Multivariate analysis showed that Asia was a high-risk area for ESBL-E as well as CIPR-E acquisition. Travellers with diarrhoea combined with antimicrobial use were significantly at higher risk for acquisition of resistant strains. Only one carbapenemase-producing isolate was acquired, isolated from a participant after visiting Egypt. In conclusion, travelling to Asia and diarrhoea combined with antimicrobial use are important risk factors for acquiring ESBL-E and CIPR-E. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All

  11. Biologically produced sulfur

    NARCIS (Netherlands)

    Kleinjan, W.E.; Keizer, de A.; Janssen, A.J.H.

    2003-01-01

    Sulfur compound oxidizing bacteria produce sulfur as an intermediate in the oxidation of hydrogen sulfide to sulfate. Sulfur produced by these microorganisms can be stored in sulfur globules, located either inside or outside the cell. Excreted sulfur globules are colloidal particles which are

  12. Consumers and Producers

    NARCIS (Netherlands)

    E. Maira (Elisa)

    2018-01-01

    markdownabstractIn the last few decades, advances in information and communication technology have dramatically changed the way consumers and producers interact in the marketplace. The Internet and social media have torn down the information barrier between producers and consumers, leading to

  13. Producers and oil markets

    International Nuclear Information System (INIS)

    Greaves, W.

    1993-01-01

    This article attempts an assessment of the potential use of futures by the Middle East oil producers. It focuses on Saudi Arabia since the sheer size of Saudi Arabian sales poses problems, but the basic issues discussed are similar for the other Middle East producers. (Author)

  14. Carbapenem-Nonsusceptible Enterobacteriaceae in Taiwan

    Science.gov (United States)

    Wang, Jann-Tay; Wu, Un-In; Lauderdale, Tsai-Ling Yang; Chen, Mei-Chen; Li, Shu-Ying; Hsu, Le-Yin; Chang, Shan-Chwen

    2015-01-01

    A total of 1135 carbapenem-resistant (nonsusceptible) Enterobacteriaceae (CRE) isolates were recovered between November 2010 and July 2012 (517 from 2010-2011 and 618 from 2012) from 4 hospitals in Taiwan. Carbapenemase-producing Enterobacteriaceae (CPE) comprised 5.0% (57 isolates), including 17 KPC-2 (16 Klebsiella pneumoniae and 1 Escherichia coli), 1 NDM-1 (K. oxytoca), 37 IMP-8 (26 Enterobacter cloacae, 4 Citrobacter freundii, 4 Raoultella planticola, 1 K. pneumoniae, 1 E. coli and 1 K. oxytoca), and 2 VIM-1 (1 E. cloacae, 1 E. coli). The KPC-2-positive K. pneumoniae were highly clonal even in isolates from different hospitals, and all were ST11. IMP-8 positive E. cloacae from the same hospitals showed higher similarity in PFGE pattern than those from different hospitals. A total of 518 CRE isolates (45.6%) were positive for bla ESBL, while 704 (62.0%) isolates were bla AmpC-positive, 382 (33.6% overall) of which carried both bla ESBL and bla AmpC. CTX-M (414, 80.0%) was the most common bla ESBL, while DHA (497, 70.6%) and CMY (157, 22.3%) were the most common bla AmpC. Co-carriage of bla ESBL and bla AmpC was detected in 31 (54.4%) and 15 (26.3%) of the 57 CPE, respectively. KPC-2 was the most common carbapenemase detected in K. pneumoniae (2.8%), while IMP-8 was the most common in E. cloacae (9.7%). All KPC-2-positive CRE were resistant to all three tested carbapenems. However, fourteen of the 37 IMP-8-positive CRE were susceptible to both imipenem and meropenem in vitro. Intra- and inter-hospital spread of KPC-2-producing K. pneumoniae and IMP-8-producing E. cloacae likely occurred. Although the prevalence of CPE is still low, careful monitoring is urgently needed. Non-susceptibility to ertapenem might need to be considered as one criterion of definition for CRE in areas where IMP type carbapenemase is prevalent. PMID:25794144

  15. Producing the Spielberg Brand

    OpenAIRE

    Russell, J.

    2016-01-01

    This chapter looks at the manufacture of Spielberg’s brand, and the limits of its usage. Spielberg’s directorial work is well known, but Spielberg’s identity has also been established in other ways, and I focus particularly on his work as a producer. At the time of writing, Spielberg had produced (or executive produced) 148 movies and television series across a range of genres that takes in high budget blockbusters and low budget documentaries, with many more to come. In these texts, Spielber...

  16. Agricultural Producer Certificates

    Data.gov (United States)

    Montgomery County of Maryland — A Certified Agricultural Producer, or representative thereof, is an individual who wishes to sell regionally-grown products in the public right-of-way. A Certified...

  17. Methods for producing diterpenes

    DEFF Research Database (Denmark)

    2015-01-01

    The present invention discloses that by combining different di TPS enzymes of class I and class II different diterpenes may be produced including diterpenes not identified in nature. Surprisingly it is revealed that a di TPS enzyme of class I of one species may be combined with a di TPS enzyme...... of class II from a different species, resulting in a high diversity of diterpenes, which can be produced....

  18. Polysaccharide-producing microalgae

    Energy Technology Data Exchange (ETDEWEB)

    Braud, J.P.; Chaumont, D.; Gudin, C.; Thepenier, C.; Chassin, P.; Lemaire, C.

    1982-11-01

    The production of extracellular polysaccharides is studied with Nostoc sp (cyanophycus), Porphiridium cruentum, Rhodosorus marinus, Rhodella maculata (rhodophyci) and Chlamydomonas mexicana (chlorophycus). The polysaccharides produced are separated by centrifugation of the culture then precipitation with alcohol. Their chemical structure was studied by infrared spectrometry and acid hydrolysis. By their rheological properties and especially their insensitivity to temperatrure and pH variations the polysaccharides produced by Porphryridium cruentum and Rhodella maculata appear as suitable candidates for industrial applications.

  19. Emergence of carbapenem resistant Escherichia coli isolates producing blaNDM and blaOXA-48-like carried on IncA/C and IncL/M plasmids at two Iranian university hospitals.

    Science.gov (United States)

    Solgi, Hamid; Giske, Christian G; Badmasti, Farzad; Aghamohammad, Shadi; Havaei, Seyed Asghar; Sabeti, Shahram; Mostafavizadeh, Kamyar; Shahcheraghi, Fereshteh

    2017-11-01

    The emergence of carbapenem resistance among Escherichia coli is a serious threat to public health. The objective of this study was to investigate resistance genes and clonality of carbapenem resistant E. coli in Iran. Between February 2015 and July 2016, a total of 32 non-duplicate E. coli isolates that were ertapenem resistant or intermediate (R/I-ETP) were collected from patient clinical or surveillance cultures (rectal swabs) at two university hospitals. Resistance genes were identified by PCR and sequencing. Conjugation experiments, PCR-based replicon typing, PFGE and multilocus sequence typing (MLST) were performed. PCR assays showed, among the 32 isolates, twenty-nine strains produced carbapenemase genes. The predominant carbapenemase was bla OXA-48 (82.8%), followed by bla NDM-1 (31%), bla NDM-7 (6.9%) and bla OXA-181 (3.4%). Seven of the bla NDM positive isolates co-harbored bla OXA-48 carbapenemases. The bla NDM and bla OXA-48 were found in IncA/C and IncL/M conjugative plasmids, respectively. The bla CTX-M-15 , qnrA and intI1 genes were also present in most isolates. The PFGE revealed genetic diversity among the 28 E. coli isolates, which belonged to six minor PFGE clusters and 14 isolates were singletons. The 26 isolates were distributed into 18 STs, of which two were dominant (ST648 and ST167). We identified one bla NDM-1 -positive ST131 E. coli isolates that harbor the bla CTX-M-15 and bla TEM genes. Horizontal transfer of IncA/C and IncL/M plasmids has likely facilitated the spread of the bla OXA-48 and bla NDM genes among E. coli. Their clonal diversity and the presence of faecal carriers in isolates suggest an endemic spread of OXA-48 and NDM. Therefore, it emphasizes the critical importance of monitoring and controlling the spread of carbapenem resistant E. coli. Copyright © 2017. Published by Elsevier B.V.

  20. Producing metallurgic coke

    Energy Technology Data Exchange (ETDEWEB)

    Abe, T.; Isida, K.; Vada, Y.

    1982-11-18

    A mixture of power producing coals with coal briquets of varying composition is proposed for coking in horizontal chamber furnaces. The briquets are produced from petroleum coke, coal fines or semicoke, which make up less than 27 percent of the mixture to be briquetted and coals with a standard coking output of volatile substances and coals with high maximal Gizeler fluidity. The ratio of these coals in the mixture is 0.6 to 2.1 or 18 to 32 percent, respectively. Noncaking or poorly caking coals are used as the power producing coals. The hardness of the obtained coke is DJ15-30 = 90.5 to 92.7 percent.

  1. Standards and producers' liability

    International Nuclear Information System (INIS)

    Kretschmer, F.

    1979-01-01

    The author discusses the liability of producers and the diligence required, which has to come up to technical standards and the latest state of technology. The consequences of this requirement with regard to claims for damages are outlined and proposals for reforms are pointed out. (HSCH) [de

  2. Producing superhydrophobic roof tiles

    International Nuclear Information System (INIS)

    Carrascosa, Luis A M; Facio, Dario S; Mosquera, Maria J

    2016-01-01

    Superhydrophobic materials can find promising applications in the field of building. However, their application has been very limited because the synthesis routes involve tedious processes, preventing large-scale application. A second drawback is related to their short-term life under outdoor conditions. A simple and low-cost synthesis route for producing superhydrophobic surfaces on building materials is developed and their effectiveness and their durability on clay roof tiles are evaluated. Specifically, an organic–inorganic hybrid gel containing silica nanoparticles is produced. The nanoparticles create a densely packed coating on the roof tile surface in which air is trapped. This roughness produces a Cassie–Baxter regime, promoting superhydrophobicity. A surfactant, n-octylamine, was also added to the starting sol to catalyze the sol–gel process and to coarsen the pore structure of the gel network, preventing cracking. The application of ultrasound obviates the need to use volatile organic compounds in the synthesis, thereby making a ‘green’ product. It was also demonstrated that a co-condensation process effective between the organic and inorganic species is crucial to obtain durable and effective coatings. After an aging test, high hydrophobicity was maintained and water absorption was completely prevented for the roof tile samples under study. However, a transition from a Cassie–Baxter to a Wenzel state regime was observed as a consequence of the increase in the distance between the roughness pitches produced by the aging of the coating. (paper)

  3. Outbreak of Imipenemase-1-Producing Carbapenem-Resistant in an Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Jin Young Lee

    2017-02-01

    Full Text Available Background Carbapenem-resistant Enterobacteriaceae (CRE with acquired metallo β-lactamase (MBL resistance have been increasingly reported worldwide and associated with significant mortality and morbidity. Here, an outbreak of genetically related strains of Klebsiella pneumoniae producing the imipenemase (IMP-1 MBL in a medical intensive care unit (MICU in Korea is reported. Methods Since isolating carbapenem-resistant K. pneumoniae (CRKP at the MICU of the hospital on August 10, 2011, surveillance cultures for CRE in 31 hospitalized patients were performed from August to September 2011. Carbapenem resistance was determined based on the disk diffusion method outlined in the Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR was performed for genes coding for β-lactamase. Associations among isolates were assessed via pulsed-field gel electrophoresis (PFGE. In addition, a surveillance study of environmental cultures and health-care workers (HCWs was conducted in the MICU during the same time frame. Results During the study period, non-duplicated CRKP specimens were discovered in four patients in the MICU, suggestive of an outbreak. On August 10, 2011, CRKP was isolated from the sputum of a 79-year-old male patient who was admitted to the MICU. A surveillance study to detect additional CRE carriers by rectal swab revealed an additional three CRKP isolates. PCR and sequencing of the four isolates identified the presence of the IMP-1 gene. In addition, PFGE showed that the four isolated strains were genetically related. CRE was not identified in specimens taken from the hands of HCWs or other environmental sources during surveillance following the outbreak. Transmission of the carbapenemase-producing Enterobacteriaceae strain was controlled by isolation of the patients and strict contact precautions. Conclusions This study shows that rapid and systemic detection of CRE and strict infection controls are important

  4. Antimicrobials Increase Travelers' Risk of Colonization by Extended-Spectrum Betalactamase-Producing Enterobacteriaceae

    Science.gov (United States)

    Kantele, Anu; Lääveri, Tinja; Mero, Sointu; Vilkman, Katri; Pakkanen, Sari H.; Ollgren, Jukka; Antikainen, Jenni; Kirveskari, Juha

    2015-01-01

    Background. More than 300 million travelers visit regions with poor hygiene annually. A significant percentage of them become colonized by resistant intestinal bacteria such as extended-spectrum beta-lactamase–producing Enterobacteriaceae (ESBL-PE) and may transmit the strains to others and to medical care settings when they return home. Despite the threats to global healthcare caused by an upsurge in antimicrobial resistance, no effort has been centered on prevention of colonization while traveling. Methods. Stool samples were collected from 430 Finns before and after traveling outside Scandinavia. All specimens were analyzed for ESBL- and carbapenemase-producing Enterobacteriaceae (CPE). Questionnaires were used to survey volunteers about use of antimicrobials as well as other potential risk factors. The results were subjected to multivariable analysis. Results. Twenty-one percent (90/430) of the travelers became colonized by ESBL-PE and none by CPE. Geographic region, occurrence of travelers' diarrhea (TD), age, and use of antimicrobial (AB) for TD were identified as independent risk factors predisposing to contracting ESBL-PE. Eleven percent of those in subgroup TD−AB−, 21% in TD+AB−, and 37% in TD+AB+ acquired ESBL-PE. The risk proved to be highest in South Asia (46%); 23% became colonized in subgroup TD−AB−, 47% in TD+AB−, and 80% in TD+AB+. In Southeast Asia, the rates were 14%, 37%, and 69%, respectively. Conclusions. TD and antimicrobials for TD proved to be independent risk factors, with up to 80% of TD+AB+ travelers contracting ESBL-PE. In modern pre-travel counseling for those visiting high-risk regions, travelers should be advised against taking antibiotics for mild or moderate TD. PMID:25613287

  5. A DEEP CHANDRA ACIS STUDY OF NGC 4151. I. THE X-RAY MORPHOLOGY OF THE 3 kpc DIAMETER CIRCUM-NUCLEAR REGION AND RELATION TO THE COLD INTERSTELLAR MEDIUM

    International Nuclear Information System (INIS)

    Wang Junfeng; Fabbiano, Giuseppina; Risaliti, Guido; Elvis, Martin; Karovska, Margarita; Zezas, Andreas; Mundell, Carole G.; Dumas, Gaelle; Schinnerer, Eva

    2011-01-01

    We report on the imaging analysis of ∼200 ks sub-arcsecond resolution Chandra Advanced CCD Imaging Spectrometer (ACIS-S) observations of the nearby Seyfert 1 galaxy NGC 4151. Bright, structured soft X-ray emission is observed to extend from 30 pc to 1.3 kpc in the southwest from the nucleus, much farther than seen in earlier X-ray studies. The terminus of the northeastern X-ray emission is spatially coincident with a CO gas lane, where the outflow likely encounters dense gas in the host galactic disk. X-ray emission is also detected outside the boundaries of the ionization cone, which indicates that the gas there is not completely shielded from the nuclear continuum, as would be the case for a molecular torus collimating the bicone. In the central r 2 emission and dusty spirals we find in an Hubble Space Telescope V - H color image. The agreement between the observed H 2 line flux and the value predicted from X-ray-irradiated molecular cloud models supports photo-excitation by X-rays from the active nucleus as the origin of the H 2 line, although contribution from UV fluorescence or collisional excitation cannot be ruled out with current data. The discrepancy between the mass of cold molecular gas inferred from recent CO and near-infrared H 2 observations may be explained by the anomalous CO abundance in this X-ray-dominated region. The total H 2 mass derived from the X-ray observation agrees with the recent measurement by Storchi-Bergmann et al.

  6. A molecular line survey toward the nearby galaxies NGC 1068, NGC 253, and IC 342 at 3 mm with the Nobeyama 45 m radio telescope: Impact of an AGN on 1 kpc scale molecular abundances

    Science.gov (United States)

    Nakajima, Taku; Takano, Shuro; Kohno, Kotaro; Harada, Nanase; Herbst, Eric

    2018-01-01

    It is important to investigate the relationships between the power sources and the chemical compositions of galaxies in order to understand the scenario of galaxy evolution. We carried out an unbiased molecular line survey towards active galactic nucleus (AGN) host galaxy NGC1068, and prototypical starburst galaxies, NGC 253 and IC 342, with the Nobeyama 45 m telescope in the 3 mm band. The advantage of this line survey is that the obtained spectra have the highest angular resolution ever obtained with single-dish telescopes. In particular, the beam size of this telescope is ˜15″-19″, which is able to separate spatially the nuclear molecular emission from that of the starburst ring (d ˜ 30″) in NGC 1068. We successfully detected approximately 23 molecular species in each galaxy, and calculated rotation temperatures and column densities. We estimate the molecular fractional abundances with respect to 13CO and CS molecules and compare them among three galaxies in order to investigate the chemical signatures of an AGN environment. As a result, we found clear trends in the abundances of molecules surrounding the AGN on a 1-kpc scale. HCN, H13CN, CN, 13CN, and HC3N are more abundant, and CH3CCH is deficient in NGC 1068 compared with the starburst galaxies. High abundances of HCN, H13CN, and HC3N suggest that the circumnuclear disk in NGC 1068 is in a high-temperature environment. The reason for the non-detection of CH3CCH is likely to be dissociation by high-energy radiation or less sublimation of a precursor of CH3CCH from grains.

  7. USA coal producer perspective

    Energy Technology Data Exchange (ETDEWEB)

    Porco, J. [Alpha Natural Resources, Latrobe, PA (US). Alpha Energy Global Marketing

    2004-07-01

    The focus is on the Central Appalachian coal industry. Alpha Natural Resources was formed in 2002 from Pittston Coal's Virginia and Coastal operations. AMCI's U.S. operations and Mears Enterprises in Pennsylvania were acquired later. The company produces 20-21 million tonnes per year and sells 20 million tonnes of steam coal and 10 million tonnes of exports, including some coal that is brokered. Foundry coke is a major product. Capital investment has resulted in increased productivity. Central Appalachia is expected to continue as a significant coal-producing region for supplying metallurgical coke. Production is expected to stabilize, but not increase; so the mines will have a longer life. 31 slides/overheads are included.

  8. Dimuons produced by antineutrinos

    International Nuclear Information System (INIS)

    Benvenuti, A.; Cline, D.; Ford, W.T.; Imlay, R.; Ling, T.Y.; Mann, A.K.; Orr, R.; Reeder, D.D.; Rubbia, C.; Stefanski, R.; Sulak, L.; Wanderer, P.

    1975-01-01

    In a run with a predominantly phi-bar beam we have observed seven dimuon events which show clearly that dimuons are produced by phi-bar as well as by phi. Using the signature of those events we tentatively identify twelve dimuon events from earlier runs as phi-bar-induced. The characteristics of the total sample support the explanation that dimuons arise from new hadron production

  9. First report of blaNDM-1-producing Acinetobacter baumannii isolated in Lebanon from civilians wounded during the Syrian war.

    Science.gov (United States)

    Rafei, Rayane; Dabboussi, Fouad; Hamze, Monzer; Eveillard, Matthieu; Lemarié, Carole; Mallat, Hassan; Rolain, Jean-Marc; Joly-Guillou, Marie-Laure; Kempf, Marie

    2014-04-01

    The emergence of carbapenem-resistant Acinetobacter baumannii has been observed worldwide. We describe the first detection of A. baumannii carrying the blaNDM-1 gene in Lebanon, isolated from Syrian patients wounded during the civil war. Four carbapenem-resistant A. baumannii strains isolated in 2012 in the Tripoli Government Hospital, Lebanon, from civilians wounded during the Syrian war, were analysed. Susceptibility was determined by disk diffusion testing, and resistance to carbapenems was confirmed by Etest. The presence of blaOXA-23-like, blaOXA-24-like, blaOXA-58-like, blaOXA-143-like, and blaNDM was investigated by PCR. Clonal relationships were studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and blaOXA-51 sequence-based typing. All isolates harboured the blaNDM-1 gene and were negative for other tested carbapenemases. They all belonged to the sequence type 85 and formed a single cluster by PFGE. Finally, blaOXA-51-like gene sequencing revealed the presence of the blaOXA-94 variant in all four isolates. These findings show that Syria constitutes a reservoir for NDM-1-producing bacteria. These results also highlight the need for effective measures to stop the threatening spread of such strains. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Producing quality radiographic images

    International Nuclear Information System (INIS)

    Cullinan, A.M.

    1987-01-01

    This book gives an overview of physics, equipment, imaging, and quality assurance in the radiology department. The chapters are laid out with generous use of subheads to allow for quick reference, Points are illustrated with clear, uncluttered line diagrams and well-produced images. The accompanying explanations are miniature lessons by themselves. Inserted at various points throughout the text are important notes that highlight key concepts. The chapter ''Image Evaluation and Application of Radiographic Principles'' present a systematic approach to evaluating radiographs and contains several sample radiographs to illustrate the points made

  11. Producing x-rays

    International Nuclear Information System (INIS)

    Mallozzi, P.J.; Epstein, H.M.; Jung, R.G.; Applebaum, D.C.; Fairand, B.P.; Gallagher, W.J.

    1977-01-01

    A method of producing x-rays by directing radiant energy from a laser onto a target is described. Conversion efficiency of at least about 3 percent is obtained by providing the radiant energy in a low-power precursor pulse of approximately uniform effective intensity focused onto the surface of the target for about 1 to 30 nanoseconds so as to generate an expanding unconfined coronal plasma having less than normal solid density throughout and comprising a low-density (underdense) region wherein the plasma frequency is less than the laser radiation frequency and a higher-density (overdense) region wherein the plasma frequency is greater than the laser radiation frequency and, about 1 to 30 nanoseconds after the precursor pulse strikes the target, a higher-power main pulse focused onto the plasma for about 10 -3 to 30 nanoseconds and having such power density and total energy that the radiant energy is absorbed in the underdense region and conducted into the overdense region to heat it and thus to produce x-rays therefrom with the plasma remaining substantially below normal solid density and thus facilitating the substantial emission of x-rays in the form of spectral lines arising from nonequilibrium ionization states

  12. A Deep Chandra ACIS Study of NGC 4151. I. The X-ray Morphology of the 3 kpc Diameter Circum-nuclear Region and Relation to the Cold Interstellar Medium

    Science.gov (United States)

    Wang, Junfeng; Fabbiano, Giuseppina; Risaliti, Guido; Elvis, Martin; Karovska, Margarita; Zezas, Andreas; Mundell, Carole G.; Dumas, Gaelle; Schinnerer, Eva

    2011-03-01

    We report on the imaging analysis of ~200 ks sub-arcsecond resolution Chandra Advanced CCD Imaging Spectrometer (ACIS-S) observations of the nearby Seyfert 1 galaxy NGC 4151. Bright, structured soft X-ray emission is observed to extend from 30 pc to 1.3 kpc in the southwest from the nucleus, much farther than seen in earlier X-ray studies. The terminus of the northeastern X-ray emission is spatially coincident with a CO gas lane, where the outflow likely encounters dense gas in the host galactic disk. X-ray emission is also detected outside the boundaries of the ionization cone, which indicates that the gas there is not completely shielded from the nuclear continuum, as would be the case for a molecular torus collimating the bicone. In the central r < 200 pc region, the subpixel processing of the ACIS data recovers the morphological details on scales of <30 pc (<0farcs5) first discovered in Chandra High Resolution Camera images. The X-ray emission is more absorbed toward the boundaries of the ionization cone, as well as perpendicular to the bicone along the direction of a putative torus in NGC 4151. The innermost region where X-ray emission shows the highest hardness ratio is spatially coincident with the near-infrared-resolved H2 emission and dusty spirals we find in an Hubble Space Telescope V - H color image. The agreement between the observed H2 line flux and the value predicted from X-ray-irradiated molecular cloud models supports photo-excitation by X-rays from the active nucleus as the origin of the H2 line, although contribution from UV fluorescence or collisional excitation cannot be ruled out with current data. The discrepancy between the mass of cold molecular gas inferred from recent CO and near-infrared H2 observations may be explained by the anomalous CO abundance in this X-ray-dominated region. The total H2 mass derived from the X-ray observation agrees with the recent measurement by Storchi-Bergmann et al.

  13. Emergence and clonal dissemination of carbapenem-hydrolysing OXA-58-producing Acinetobacter baumannii isolates in Bolivia.

    Science.gov (United States)

    Sevillano, Elena; Fernández, Elena; Bustamante, Zulema; Zabalaga, Silvia; Rosales, Ikerne; Umaran, Adelaida; Gallego, Lucía

    2012-01-01

    Acinetobacter baumannii is an emerging multidrug-resistant pathogen and very little information is available regarding its imipenem resistance in Latin American countries such as Bolivia. This study investigated the antimicrobial resistance profile of 46 clinical strains from different hospitals in Cochabamba, Bolivia, from March 2008 to July 2009, and the presence of carbapenemases as a mechanism of resistance to imipenem. Isolates were obtained from 46 patients (one isolate per patient; 30 males,16 females) with an age range of 1 day to 84 years, and were collected from different sample types, the majority from respiratory tract infections (17) and wounds (13). Resistance to imipenem was detected in 15 isolates collected from different hospitals of the city. These isolates grouped into the same genotype, named A, and were resistant to all antibiotics tested including imipenem, with susceptibility only to colistin. Experiments to detect carbapenemases revealed the presence of the OXA-58 carbapenemase. Further analysis revealed the location of the bla(OXA-58) gene on a 40 kb plasmid. To our knowledge, this is the first report of carbapenem resistance in A. baumannii isolates from Bolivia that is conferred by the OXA-58 carbapenemase. The presence of this gene in a multidrug-resistant clone and its location within a plasmid is of great concern with regard to the spread of carbapenem-resistant A. baumannii in the hospital environment in Bolivia.

  14. Phenotypic Tests for the Detection of β-Lactamase-Producing Enterobacteriaceae Isolated from Different Environments.

    Science.gov (United States)

    de Oliveira, Daniele V; Van Der Sand, Sueli T

    2016-07-01

    Some bacteria from the Enterobacteriaceae family are showing a significant capability to disseminate β-lactams resistance mechanisms among them, and these same mechanisms can be carried out from the hospital environment to superficial water. The aim of this study was to evaluate different phenotypic methods for the detection β-lactamases production by enterobacteria isolated from the anthropogenic environment: hospital wastewater and from a stream that cross the city of Porto Alegre. The applied tests were the modified Hodge test (MHT) and phenotypic tests with the following inhibitors: carbapenemase-phenylboronic acid (APB), metallo-β-lactamase-EDTA, AmpC β-lactamase-cloxacillin, and the confirmatory test for extended-spectrum β-lactamase (ESBL)-clavulanic acid. For this evaluation, 131 isolates were initially subjected to antibiogram using the following antimicrobials: cefotaxime (30 µg), cefpodoxime (10 μg), ceftazidime (30 µg), ertapenem (10 μg), meropenem (10 μg), and aztreonam (30 μg). After this first screening, 62 isolates showed a profile resistance for at least one antimicrobial. These isolates were subjected to all phenotypic tests. Of those, 40 isolates were positive for at least one phenotypic test. In MHT test, one isolate was positive and five were with inconclusive results. The results achieved with the inhibitors are as follows: APB 25/40 positive strains; EDTA 8/40 positive strains; and with CLOXA 2/40 positive strains. ESBL production was observed for 34/40 strains. This assessment shows a high level of bacteria which can produce enzymes that inactivate β-lactams present in the different environment like the stream waters and from the hospital settings.

  15. Protracted Regional Dissemination of GIM-1-Producing Serratia marcescens in Western Germany.

    Science.gov (United States)

    Wendel, Andreas F; Kaase, Martin; Autenrieth, Ingo B; Peter, Silke; Oberhettinger, Philipp; Rieber, Heime; Pfeffer, Klaus; MacKenzie, Colin R; Willmann, Matthias

    2017-03-01

    The metallo-beta-lactamase GIM-1 has been found in various bacterial host species nearly exclusively in western Germany. However, not much is known about the epidemiology of GIM-1-positive Serratia marcescens Here we report on a surprisingly protracted regional dissemination. In-hospital transmission was investigated by using conventional epidemiological tools to identify spatiotemporal links. Strain typing was performed using pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing (WGS). Bayesian phylogeny was used to infer the time axis of the observed occurrence. Thirteen S. marcescens strains from 10 patients from 6 different German hospitals were investigated. Suspected in-hospital transmissions were confirmed by molecular typing at a higher resolution by WGS than by PFGE. A detailed sequence analysis demonstrated the spread of one predominant strain variant but also provided evidence for transfer of the bla GIM-1 gene cassette between different strains. A Bayesian phylogenetic analysis showed that the most recent common ancestor of the identified clonal cluster could be dated back to April 1993 (95% highest posterior density interval, January 1973 to March 2003) and that this strain might have already harbored the bla GIM-1 at that time and, therewith, years before the first detection of this resistance gene in clinical specimens. This study shows a long-standing clonal and plasmid-mediated expansion of GIM-1-producing S. marcescens that might have gone unnoticed in the absence of a standardized and effective molecular screening for carbapenemases. The systematic and early detection of resistance is thus highly advisable, especially for the prevention of potentially long-term dissemination that may progress beyond control. Copyright © 2017 American Society for Microbiology.

  16. Producing Civil Society

    DEFF Research Database (Denmark)

    Feldt, Liv Egholm; Hein Jessen, Mathias

    Since the beginning of the 1990’s, civil society has attracted both scholarly and political interest as the ‘third sphere’ outside the state and the market not only a normatively privileged site of communication and ‘the public sphere’, but also as a resource for democratization processes...... and social cohesion, as well as a provider of welfare services from a welfare state in dire straits. However, such a view upholds a sharp distinction between the three sectors and their distinct logic. This article claims that the separation of spheres is a fundamental part of our ‘social imaginary......’ and as such dominates our way of thinking about civil society. Yet, this view hinders the understanding of how civil society is not a pre-existing or given sphere, but a sphere which is constantly produced both discursively, conceptually and practically. Through two examples; 1,the case of philanthropy in the beginning...

  17. Power Producer Production Valuation

    Directory of Open Access Journals (Sweden)

    M. Kněžek

    2008-01-01

    Full Text Available The ongoing developments in the electricity market, in particular the establishment of the Prague Energy Exchange (PXE and the associated transfer from campaign-driven sale to continuous trading, represent a significant change for power companies.  Power producing companies can now optimize the sale of their production capacities with the objective of maximizing profit from wholesale electricity and supporting services. The Trading Departments measure the success rate of trading activities by the gross margin (GM, calculated by subtracting the realized sales prices from the realized purchase prices and the production cost, and indicate the profit & loss (P&L to be subsequently calculated by the Control Department. The risk management process is set up on the basis of a business strategy defining the volumes of electricity that have to be sold one year and one month before the commencement of delivery. At the same time, this process defines the volume of electricity to remain available for spot trading (trading limits. 

  18. Antibiotics produced by Streptomyces.

    Science.gov (United States)

    Procópio, Rudi Emerson de Lima; Silva, Ingrid Reis da; Martins, Mayra Kassawara; Azevedo, João Lúcio de; Araújo, Janete Magali de

    2012-01-01

    Streptomyces is a genus of Gram-positive bacteria that grows in various environments, and its shape resembles filamentous fungi. The morphological differentiation of Streptomyces involves the formation of a layer of hyphae that can differentiate into a chain of spores. The most interesting property of Streptomyces is the ability to produce bioactive secondary metabolites, such as antifungals, antivirals, antitumorals, anti-hypertensives, immunosuppressants, and especially antibiotics. The production of most antibiotics is species specific, and these secondary metabolites are important for Streptomyces species in order to compete with other microorganisms that come in contact, even within the same genre. Despite the success of the discovery of antibiotics, and advances in the techniques of their production, infectious diseases still remain the second leading cause of death worldwide, and bacterial infections cause approximately 17 million deaths annually, affecting mainly children and the elderly. Self-medication and overuse of antibiotics is another important factor that contributes to resistance, reducing the lifetime of the antibiotic, thus causing the constant need for research and development of new antibiotics. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  19. Cyclotron produced radiopharmaceuticals

    International Nuclear Information System (INIS)

    Kopicka, K.; Fiser, M.; Hradilek, P.; Hanc, P.; Lebeda, O.

    2003-01-01

    Some of the cyclotron-produced radionuclides may serve as important materials for the production of radiopharmaceuticals. This lecture deals with basic information relating to various aspects of these compounds. In comparison with radionuclides /compounds used for non-medical purposes, radiopharmaceuticals are subject to a broader scale of regulations, both from the safety and efficacy point of view; besides that, there are both radioactive and medical aspects that must be taken into account for any radiopharmaceutical. According to the regulations and in compliance with general rules of work with radioactivity, radiopharmaceuticals should only be prepared/manufactured under special conditions, using special areas and special equipment and applying special procedures (e.g. sterilisation, disinfection, aseptic work). Also, there are special procedures for cleaning and maintenance. Sometimes the requirements for the product safety clash with those for the safety of the personnel; several examples of solutions pertaining to these cases are given in the lecture. Also, the specific role of cyclotron radiopharmaceuticals is discussed. (author)

  20. Carbapenem-Resistant E. cloacae in Southwest China: Molecular Analysis of Resistance and Risk Factors for Infections Caused by NDM-1-Producers

    Directory of Open Access Journals (Sweden)

    Xiaojiong Jia

    2018-04-01

    Full Text Available Carbapenem-resistant Enterobacteriaceae (CRE has been considered a serious global threat, but carbapenem resistance remains relatively uncommon in E. cloacae, especially in China. The aim of this study was to characterize carbapenem-resistant E. cloacae (CR-ECL isolates from 2012 to 2016 in Southwest China. Our study revealed that 20 (15.2% of the 132 CR-ECL isolates obtained from patients were identified as NDM-1, with most isolates carrying the IncFIIA plasmids. Notably, we initially observed that the E. cloacae strain co-harbored NDM-1 and IMP-8 carbapenemases simultaneously. Analysis of the genetic environment of these two genes has revealed that the highly conserved regions (blaNDM-1-bleMBL-trpF-tat are associated with the dissemination of NDM-1, while IS26, intI1, and tniC could be involved in the spread of IMP-8. Molecular epidemiology studies showed the nosocomial outbreak caused by NDM-1-producing E. cloacae ST88. Transferring from another hospital and previous carbapenem exposure were identified as independent risk factors for the acquisition of NDM-1-producing E. cloacae. These findings emphasize the need for intensive surveillance and precautions to monitor the further spread of NDM-1 in China.

  1. Presence of quinolone resistance to qnrB1 genes and blaOXA-48 carbapenemase in clinical isolates of Klebsiella pneumoniae in Spain.

    Science.gov (United States)

    Rodríguez Martínez, J M; Díaz-de Alba, P; Lopez-Cerero; Ruiz-Carrascoso, G; Gomez-Gil, R; Pascual, A

    2014-01-01

    A study is presented on the presence of quinolone resistance qnrB1 genes in clinical isolates belonging to the largest series of infections caused by OXA-48-producing Klebsiella pneumoniae in a single-centre outbreak in Spain. Evidence is also provided, according to in vitro results, that there is a possibility of co-transfer of plasmid harbouring blaOXA-48 with an other plasmid harbouring qnrB1 in presence of low antibiotic concentrations of fluoroquinolones, showing the risk of multi-resistance screening. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  2. Rapid increase in resistance to third generation cephalosporins, imipenem and co-resistance in Klebsiella pneumoniae from isolated from 7,140 blood-cultures (2010-2014) using EARS-Net data in Spain.

    Science.gov (United States)

    Aracil-García, Belén; Oteo-Iglesias, Jesús; Cuevas-Lobato, Óscar; Lara-Fuella, Noelia; Pérez-Grajera, Isabel; Fernández-Romero, Sara; Pérez-Vázquez, María; Campos, José

    2017-10-01

    An analysis was made about the evolution of resistance to 3rd generation cephalosporins, imipenem, and other antibiotics in invasive isolates of Klebsiella pneumoniae (K. pneumoniae) according to the Spanish EARS-Net database (2010-2014). Forty-two hospitals from 16 Autonomous Communities with an approximate population coverage of 33% participated. A total 7,140 pneumoniae corresponding to the same number of patients were studied. Overall resistance percentages (I+R) were: cefotaxime 15.8%, ceftazidime 13.7%, imipenem 1.7%, ciprofloxacin 20.1%, tobramycin 14.1%, gentamicin 10.4%, and amikacin 1.9%. Resistance to 3rd generation cephalosporins increased from 9.8% (2010) to 19% (2014); to ciprofloxacin from 15.4% (2010) to 19.6% (2014); to gentamicin from 6.2% (2010) to 10.3% (2014) and to tobramycin from 7.1% (2010) to 14.2% (2014) (presistance to 3rd generation cephalosporins, ciprofloxacin, and aminoglycosides increased from 3.3% (2010) to 9.7% (2014) (pResistance to imipenem also increased from 0.27% (2010) to 3.46% (2014) (presistant to imipenem, of which 104 (86%) produced carbapenemases: 74 OXA-48, 14 VIM, 9 KPC (6 KPC-2 and 3 KPC-3), 6 IMP, and 1 GES. Over the 5 year period (2010-2014), resistance to 3rd generation cephalosporins in invasive K. pneumoniae in Spain has doubled. The combined resistance to 3rd generation cephalosporins, ciprofloxacin, and aminoglycosides has tripled, and imipenem resistance has increased almost 13 times, mostly due to the spread of carbapenemase-producing isolates. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Radiation produced biomaterials

    International Nuclear Information System (INIS)

    Rosiak, J.M.

    1998-01-01

    radiation technique. Immobilization of biologically active species in hydrogel matrices, their use as drug delivery systems and enzyme traps as well as modification of material surfaces to improve their biocompatibility and ability to bond antigens and antibodies have been the main subject of their investigations. The rising interest in the field of application of radiation to bioengineering was also recognized by the International Atoimc Energy Agency, which has initiated the international programs relating to those studies. In these lectures some directions of investigations on the formation of hydrogels and their applications for biomedical purposes have been specified. Also, some examples of commercialized products being produced by means of radiation technique have been presented

  4. Antimicrobial resistance in Enterobacteriaceae in Brazil: focus on β-lactams and polymyxins.

    Science.gov (United States)

    Sampaio, Jorge Luiz Mello; Gales, Ana Cristina

    2016-12-01

    During the last 30 years there has been a dissemination of plasmid-mediated β-lactamases in Enterobacteriaceae in Brazil. Extended spectrum β-lactamases (ESBL) are widely disseminated in the hospital setting and are detected in a lower frequency in the community setting. Cefotaximases are the most frequently detected ESBL type and Klebsiella pneumoniae is the predominant species among ESBL producers. Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae became widely disseminated in Brazil during the last decade and KPC production is currently the most frequent resistance mechanism (96.2%) in carbapenem resistant K. pneumoniae. To date KPC-2 is the only variant reported in Brazil. Polymyxin B resistance in KPC-2-producing K. pneumoniae has come to an alarming rate of 27.1% in 2015 in São Paulo, the largest city in Brazil. New Delhi metallo-β-lactamase was detected in Brazil in 2013, has been reported in different Brazilian states but are not widely disseminated. Antimicrobial resistance in Enterobacteriaceae in Brazil is a very serious problem that needs urgent actions which includes both more strict adherence to infection control measures and more judicious use of antimicrobials. Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  5. Detection of bla-IMP-1 and bla-IMP-2 Genes Among Metallo-β-lactamase-Producing Pseudomonas Aeruginosa Isolated from Burn Patients in Isfahan

    Directory of Open Access Journals (Sweden)

    M. Pourbabaee

    2016-02-01

    Full Text Available Background: Pseudomonas aeruginosa is a nosocomial pathogen which especially causes infections among burn patients. Carbapenems are extensively used for the treatment of infections caused by multidrug-resistant P. aeruginosa isolates. The emergence of carbapenemases producing isolates is an outcome of increased utilization of carbapenems. The aim of this study was to determine the bla-IMP-1 and bla-IMP-2 genes in metallo-β-lactamase (MBL -producing Pseudomonas aeruginosa isolated from burn patients in Isfahan. Material and Methods: A total of 150 P. aeruginosa were isolated from burn patients hospitalized in Imam-Mousakazem hospital in Isfahan. Antimicrobial susceptibility was determined using disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI guidelines. Double Disk Synergy Test (DDST was carried out for screening of MBL production in imipenem-resistant strains. PCR assays were used for detection of bla-IMP-1 and bla-IMP-2 genes among metallo-β-lactamase-producing Pseudomonas aeruginosa isolates. The purified PCR products were sequenced. Results: Of 150 Pseudomonas aeruginosa isolates, %100 identified as multi-drug resistant strains. The most resistance rates were seen against ciprofloxacin, tobromycin, meropenem and imipenem. All of 144 imipenem-resistant Pseudomonas aeruginosa isolates were MBL producing by DDST test. Twenty-nine (19.3% and 8(5.3% MBL producing Pseudomonas aeruginosa isolates harbored bla-IMP-1 and bla-IMP-2 genes respectively. Conclusions: According to results of this study high level resistance to imipenem and MBl genes carriage was seen among Pseudomonas aeruginosa isolated from burn patient infections in our region.

  6. Genomic Analysis of the Emergence and Rapid Global Dissemination of the Clonal Group 258 Klebsiella pneumoniae Pandemic.

    Directory of Open Access Journals (Sweden)

    Jolene R Bowers

    Full Text Available Multidrug-resistant Klebsiella pneumoniae producing the KPC carbapenemase have rapidly spread throughout the world, causing severe healthcare-associated infections with limited antimicrobial treatment options. Dissemination of KPC-producing K. pneumoniae is largely attributed to expansion of a single dominant strain, ST258. In this study, we explore phylogenetic relationships and evolution within ST258 and its clonal group, CG258, using whole genome sequence analysis of 167 isolates from 20 countries collected over 17 years. Our results show a common ST258 ancestor emerged from its diverse parental clonal group around 1995 and likely acquired blaKPC prior to dissemination. Over the past two decades, ST258 has remained highly clonal despite diversity in accessory elements and divergence in the capsule polysaccharide synthesis locus. Apart from the large recombination event that gave rise to ST258, few mutations set it apart from its clonal group. However, one mutation occurs in a global transcription regulator. Characterization of outer membrane protein sequences revealed a profile in ST258 that includes a truncated OmpK35 and modified OmpK37. Our work illuminates potential genomic contributors to the pathogenic success of ST258, helps us better understand the global dissemination of this strain, and identifies genetic markers unique to ST258.

  7. Producers give prices a boost

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    Uranium producers came alive in August, helping spot prices crack the $8.00 barrier for the first time since March. The upper end of NUKEM's price range actually finished the month at $8.20. Scrambling to fulfill their long-term delivery contracts, producers dominate the market. In the span of three weeks, five producers came out for 2 million lbs U3O8, ultimately buying nearly 1.5 million lbs. One producer accounted for over half this volume. The major factor behind rising prices was that producers required specific origins to meet contract obligations. Buyers willing to accept open origins created the lower end of NUKEM's price range

  8. [Distiller Yeasts Producing Antibacterial Peptides].

    Science.gov (United States)

    Klyachko, E V; Morozkina, E V; Zaitchik, B Ts; Benevolensky, S V

    2015-01-01

    A new method of controlling lactic acid bacteria contamination was developed with the use of recombinant Saccharomyces cerevisiae strains producing antibacterial peptides. Genes encoding the antibacterial peptides pediocin and plantaricin with codons preferable for S. cerevisiae were synthesized, and a system was constructed for their secretory expression. Recombinant S. cerevisiae strains producing antibacterial peptides effectively inhibit the growth of Lactobacillus sakei, Pediacoccus pentasaceus, Pediacoccus acidilactici, etc. The application of distiller yeasts producing antibacterial peptides enhances the ethanol yield in cases of bacterial contamination. Recombinant yeasts producing the antibacterial peptides pediocin and plantaricin can successfully substitute the available industrial yeast strains upon ethanol production.

  9. A method of producing hydroxymethyfurfural

    DEFF Research Database (Denmark)

    2011-01-01

    The present invention relates to a method of producing 5-hydroxymethylfurfural by dehydration of fructose and/or glucose and/or mannose.......The present invention relates to a method of producing 5-hydroxymethylfurfural by dehydration of fructose and/or glucose and/or mannose....

  10. Producers' Complex Risk Management Choices

    NARCIS (Netherlands)

    Pennings, J.M.E.; Isengildina, O.; Irwin, S.H.; Garcia, P.; Good, D.L.

    2008-01-01

    Producers have a wide variety of risk management instruments available, making their choice(s) complex. The way producers deal with this complexity can vary and may influence the impact that the determinants, such as risk aversion, have on their choices. A recently developed choice bracketing

  11. Method of producing molybdenum-99

    Science.gov (United States)

    Pitcher, Eric John

    2013-05-28

    Method of producing molybdenum-99, comprising accelerating ions by means of an accelerator; directing the ions onto a metal target so as to generate neutrons having an energy of greater than 10 MeV; directing the neutrons through a converter material comprising techentium-99 to produce a mixture comprising molybdenum-99; and, chemically extracting the molybdenum-99 from the mixture.

  12. Tekna's produced water conference 2005

    International Nuclear Information System (INIS)

    2005-01-01

    The conference has 22 presentations discussing topics on discharge reduction, produced water quality, produced water re-injection, chemicals particularly environmentally friendly ones, separation technology, reservoir souring, total water management systems, pollution, oil in water problems and platform operation. Various field tests and experiences particularly from the offshore petroleum sector are presented (tk)

  13. DOES ELECTRIC CAR PRODUCE EMISSIONS?

    Directory of Open Access Journals (Sweden)

    Vladimír RIEVAJ

    2017-03-01

    Full Text Available This article focuses on the comparison of the amount of emissions produced by vehicles with a combustion engine and electric cars. The comparison, which is based on the LCA factor results, indicates that an electric car produces more emissions than a vehicle with combustion engine. The implementation of electric cars will lead to an increase in the production of greenhouse gases.

  14. Carbapenem-resistant Klebsiella pneumoniae infections in a Greek intensive care unit: Molecular characterisation and treatment challenges.

    Science.gov (United States)

    Katsiari, Maria; Panagiota, Giakkoupi; Likousi, Sophia; Roussou, Zoi; Polemis, Michalis; Alkiviadis Vatopoulos, C; Evangelia Platsouka, D; Maguina, Asimina

    2015-06-01

    Acquisition of carbapenemase-producing Klebsiella pneumoniae (CP-Kp) strains poses a major threat to critically ill patients. The objectives of this study were to describe the epidemiology of CP-Kp isolates as well as the clinical outcome associated with the corresponding infections and to identify risk factors for mortality of intensive care unit (ICU) patients in a Greek hospital. A prospective, observational study was conducted in a nine-bed general ICU over a 2-year period (April 2010-March 2012). Imipenem-resistant K. pneumoniae isolates recovered from clinical samples of ICU patients were prospectively collected and studied for the presence of carbapenemases. Isolates were submitted to molecular typing using pulsed-field gel electrophoresis (PFGE). In total, 61 CP-Kp isolates (48 KPC-producers and 13 VIM-producers) were recovered from 58 ICU patients. The majority of KPC-producers were classified into a single PFGE type, indicating potent clonal dissemination. Among the 32 infected patients, bacteraemia was diagnosed in 16. Tigecycline+colistin was the most common combination antimicrobial regimen. Infection-attributable mortality was 43.8%. Regarding mortality risk factors, non-survivors were older (P=0.080), all of them presented with septic shock (P=0.010) and they had higher Sepsis-related Organ Failure Assessment (SOFA) scores at infection onset (P=0.004) compared with survivors. Appropriate definitive treatment and combination regimens were not associated with patient survival. In conclusion, CP-Kp infections are associated with limited treatment options and high in-hospital mortality. Effective measures for preventing dissemination of respective isolates in the hospital setting are required. Copyright © 2015 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  15. Producing colour pictures from SCAN

    International Nuclear Information System (INIS)

    Robichaud, K.

    1982-01-01

    The computer code SCAN.TSK has been written for use on the Interdata 7/32 minicomputer which will convert the pictures produced by the SCAN program into colour pictures on a colour graphics VDU. These colour pictures are a more powerful aid to detecting errors in the MONK input data than the normal lineprinter pictures. This report is intended as a user manual for using the program on the Interdata 7/32, and describes the method used to produce the pictures and gives examples of JCL, input data and of the pictures that can be produced. (U.K.)

  16. Producing new radionuclides for medicine

    International Nuclear Information System (INIS)

    Michaut, C.

    2009-01-01

    The Arronax cyclotron, a new particle accelerator dedicated to the production of radionuclides for medicine and research has been commissioned in Nantes (France). Because of its unique features: an energy of 70 MeV and an intensity of 750 μA, Arronax will produce radionuclides that can not be produce in present cyclotrons. Among others it will produce Strontium-82 and Germanium-68 that are the precursors for Rubidium-82 and Gallium-68 respectively. 20 per cent of the research works will be dedicated to other domains like radioactive wastes, the radiation biological damage and the radiation damage on electronic devices. (A.C.)

  17. Cellulase producing microorganism ATCC 55702

    Science.gov (United States)

    Dees, H. Craig

    1997-01-01

    Bacteria which produce large amounts of cellulase--containing cell-free fermentate have been identified. The original bacterium (ATCC 55703) was genetically altered using nitrosoguanidine (MNNG) treatment to produce the enhanced cellulase producing bacterium (ATCC 55702), which was identified through replicate plating. ATCC 55702 has improved characteristics and qualifies for the degradation of cellulosic waste materials for fuel production, food processing, textile processing, and other industrial applications. ATCC 55702 is an improved bacterial host for genetic manipulations using recombinant DNA techniques, and is less likely to destroy genetic manipulations using standard mutagenesis techniques.

  18. Methods of producing cesium-131

    Science.gov (United States)

    Meikrantz, David H; Snyder, John R

    2012-09-18

    Methods of producing cesium-131. The method comprises dissolving at least one non-irradiated barium source in water or a nitric acid solution to produce a barium target solution. The barium target solution is irradiated with neutron radiation to produce cesium-131, which is removed from the barium target solution. The cesium-131 is complexed with a calixarene compound to separate the cesium-131 from the barium target solution. A liquid:liquid extraction device or extraction column is used to separate the cesium-131 from the barium target solution.

  19. Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals: Incidence and risk factors.

    Science.gov (United States)

    Cunha, Cheston B; Kassakian, Steven Z; Chan, Ryan; Tenover, Fred C; Ziakas, Panos; Chapin, Kimberle C; Mermel, Leonard A

    2016-02-01

    There are increasing reports of multidrug-resistant gram-negative bacilli in nursing homes and acute care hospitals. We performed a point prevalence survey to detect fecal carriage of gram-negative bacteria carrying carbapenem resistance genes or which were otherwise resistant to carbapenem antibiotics among 500 consecutive admissions from local nursing homes to 2 hospitals in Providence, Rhode Island. We performed a case-control study to identify risk factors associated with carriage of carbapenem-resistant Enterobacteriaceae (CRE). There were 404 patients with 500 hospital admissions during which they had rectal swab samples cultured. Fecal carriage of any carbapenem-resistant or carbapenemase- producing gram-negative bacteria was found in 23 (4.6%) of the 500 hospital admissions, including 7 CRE (1.4%), 2 (0.4%) of which were Klebsiella pneumoniae carbapenemase (ie, blaKPC) producing (CPE) Citrobacter freundii, 1 of which was carbapenem susceptible by standard testing methods. Use of a gastrostomy tube was associated with CRE carriage (P = .04). We demonstrated fecal carriage of carbapenem-resistant or carbapenemase-producing gram-negative bacteria in 4.6% of nursing home patients admitted to 2 acute care hospitals, but only 0.4% of such admissions were patients with fecal carriage of CPE. Use of gastrostomy tubes was associated with fecal carriage of gram-negative bacteria with detectable carbapenem resistance. CRE fecal carriage is uncommon in our hospital admissions from nursing homes. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Methods of producing transportation fuel

    Science.gov (United States)

    Nair, Vijay [Katy, TX; Roes, Augustinus Wilhelmus Maria [Houston, TX; Cherrillo, Ralph Anthony [Houston, TX; Bauldreay, Joanna M [Chester, GB

    2011-12-27

    Systems, methods, and heaters for treating a subsurface formation are described herein. At least one method for producing transportation fuel is described herein. The method for producing transportation fuel may include providing formation fluid having a boiling range distribution between -5.degree. C. and 350.degree. C. from a subsurface in situ heat treatment process to a subsurface treatment facility. A liquid stream may be separated from the formation fluid. The separated liquid stream may be hydrotreated and then distilled to produce a distilled stream having a boiling range distribution between 150.degree. C. and 350.degree. C. The distilled liquid stream may be combined with one or more additives to produce transportation fuel.

  1. Price satisfaction and producer loyalty

    DEFF Research Database (Denmark)

    Mutonyi, Sarah; Beukel, Karin; Gyau, Amos

    2016-01-01

    Purpose The purpose of this paper is to investigate which dimensions of price satisfaction influence producers’ trust in buyers and assess the mediating role of such trust in the relationship between price satisfaction and producer loyalty in fresh fruit supply chains. Design/methodology/approach......Purpose The purpose of this paper is to investigate which dimensions of price satisfaction influence producers’ trust in buyers and assess the mediating role of such trust in the relationship between price satisfaction and producer loyalty in fresh fruit supply chains. Design...... reliability, and relative price are dimensions of price satisfaction that affect producers’ trust in the buyer. Moreover, trust between the producer and the buyer is found to be a strong mediator between price satisfaction and producer loyalty. The findings support recent studies about trust and its mediating...... between the multi-dimensional nature of price satisfaction and producer loyalty with trust as a mediating variable in the business-to-business (B2B) context. Although B2B relationships have been shown to be of great importance for smallholders in enhancing business performance with their buyers, little...

  2. Producing liquid fuels from biomass

    Science.gov (United States)

    Solantausta, Yrjo; Gust, Steven

    The aim of this survey was to compare, on techno-economic criteria, alternatives of producing liquid fuels from indigenous raw materials in Finland. Another aim was to compare methods under development and prepare a proposal for steering research related to this field. Process concepts were prepared for a number of alternatives, as well as analogous balances and production and investment cost assessments for these balances. Carbon dioxide emissions of the alternatives and the price of CO2 reduction were also studied. All the alternatives for producing liquid fuels from indigenous raw materials are utmost unprofitable. There are great differences between the alternatives. While the production cost of ethanol is 6 to 9 times higher than the market value of the product, the equivalent ratio for substitute fuel oil produced from peat by pyrolysis is 3 to 4. However, it should be borne in mind that the technical uncertainties related to the alternatives are of different magnitude. Production of ethanol from barley is of commercial technology, while biomass pyrolysis is still under development. If the aim is to reach smaller carbon dioxide emissions by using liquid biofuels, the most favorable alternative is pyrolysis oil produced from wood. Fuels produced from cultivated biomass are more expensive ways of reducing CO2 emissions. Their potential of reducing CO2 emissions in Finland is insignificant. Integration of liquid fuel production to some other production line is more profitable.

  3. Human body may produce bacteria.

    Science.gov (United States)

    Salerian, Alen J

    2017-06-01

    "Human body may produce bacteria" proposes that human body may produce bacteria and represent an independent source of infections contrary to the current paradigm of infectious disorders proposed by Louis Pasteur in 1880. The following observations are consistent with this hypothesis: A. Bidirectional transformations of both living and nonliving things have been commonly observed in nature. B. Complex multicellular organisms harbor the necessary properties to produce bacteria (water, nitrogen and oxygen). C. Physical laws suggest any previously observed phenomenon or action will occur again (life began on earth; a non living thing). D. Animal muscle cells may generate energy (fermentation). E. Sterilized food products (i.e. boiled eggs), may produce bacteria and fungus under special conditions and without any exposure to foreign living cells. "Human body may produce bacteria" may challenge the current medical paradigm that views human infectious disorders as the exclusive causative byproducts of invading foreign cells. It may also introduce new avenues to treat infectious disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Identifying Spectra of Activity and Therapeutic Niches for Ceftazidime-Avibactam and Imipenem-Relebactam against Carbapenem-Resistant Enterobacteriaceae.

    Science.gov (United States)

    Haidar, Ghady; Clancy, Cornelius J; Chen, Liang; Samanta, Palash; Shields, Ryan K; Kreiswirth, Barry N; Nguyen, M Hong

    2017-09-01

    We determined imipenem, imipenem-relebactam, ceftazidime, and ceftazidime-avibactam MICs against 100 CRE isolates that underwent whole-genome sequencing. Klebsiella pneumoniae carbapenemases (KPCs) were the most common carbapenemases. Forty-six isolates carried extended-spectrum β-lactamases (ESBLs). With the addition of relebactam, imipenem susceptibility increased from 8% to 88%. With the addition of avibactam, ceftazidime susceptibility increased from 0% to 85%. Neither imipenem-relebactam nor ceftazidime-avibactam was active against metallo-β-lactamase (MBL) producers. Ceftazidime-avibactam (but not imipenem-relebactam) was active against OXA-48-like producers, including a strain not harboring any ESBL. Major OmpK36 porin mutations were independently associated with higher imipenem-relebactam MICs ( P imipenem-relebactam and ceftazidime-avibactam had overlapping spectra of activity and niches in which each was superior. Major OmpK36 mutations in KPC- K. pneumoniae may provide a foundation for stepwise emergence of imipenem-relebactam and ceftazidime-avibactam resistance. Copyright © 2017 American Society for Microbiology.

  5. Produced water - composition and analysis

    International Nuclear Information System (INIS)

    Kvernheim, Arne Lund

    1998-01-01

    Produced water can be defined as ''High volume waste-water separated from oil and gas that is produced from subsurface formations''. The water contains aliphatic and aromatic hydrocarbons, particulate matter and soluble salts as well as elements originating from formations and from sea water injections. Residues of chemicals may also be present. The accepted North Sea discharge limit is 40 ppm. In this presentation the focus will be on the chemical composition of produced water and on the challenges involved in developing and implementing analytical methods. The focus will also be on the development of a new oil-in-water analytical method as a replacement for the Freon method. 7 refs., 1 tab

  6. Method of producing grouting mortar

    Energy Technology Data Exchange (ETDEWEB)

    Shelomov, I K; Alchina, S I; Dizer, E I; Gruzdeva, G A; Nikitinskii, V I; Sabirzyanov, A K

    1980-10-07

    A method of producing grouting mortar by mixing the cement with an aqueous salt solution is proposed. So as to increase the quality of the mortar through an acceleration of the time for hardening, the mixture is prepared in two stages, in the first of which 20-30% of the entire cement batch hardens, and in the second of which the remainder of the cement hardens; 1-3-% of an aqueous salt solution is used in quantities of 0.5/1 wt.-% of weight of the cement. The use of this method of producing grouting mortar helps to increase the flexural strength of the cement brick up to 50% after two days ageing by comparison with the strength of cement brick produced from grouting mortar by ordinary methods utilizing identical quantities of the initial components (cement, water, chloride).

  7. Apparatus for producing laser targets

    International Nuclear Information System (INIS)

    Jarboe, T.R.; Baker, W.R.

    1975-01-01

    This patent relates to an apparatus and method for producing deuterium targets or pellets of 25u to 75u diameter. The pellets are sliced from a continuously spun solid deuterium thread at a rate of up to 10 pellets/second. The pellets after being sliced from the continuous thread of deuterium are collimated and directed to a point of use, such as a laser activated combustion or explosion chamber wherein the pellets are imploded by laser energy or laser produced target plasmas for neutral beam injection

  8. Producing deep-water hydrocarbons

    International Nuclear Information System (INIS)

    Pilenko, Thierry

    2011-01-01

    Several studies relate the history and progress made in offshore production from oil and gas fields in relation to reserves and the techniques for producing oil offshore. The intention herein is not to review these studies but rather to argue that the activities of prospecting and producing deep-water oil and gas call for a combination of technology and project management and, above all, of devotion and innovation. Without this sense of commitment motivating men and women in this industry, the human adventure of deep-water production would never have taken place

  9. Method for producing redox shuttles

    Science.gov (United States)

    Pupek, Krzysztof Z.; Dzwiniel, Trevor L.; Krumdick, Gregory K.

    2015-03-03

    A single step method for producing a redox shuttle having the formula 2,5-di-tert-butyl-1,4-phenylene tetraethyl bis(phosphate) is provided, the method comprising phosphorylating tert butyl hydroquinone with a phosphate-containing reagent. Also provided is method for producing 2,5-di-tert-butyl-1,4-phenylene tetraethyl bis(phosphate), the method comprising solubilizing tert-butyl hydroquinone and tetrabutylammonium bromide with methyltetrahydrofuran to create a mixture; heating the mixture while adding base to the mixture in an amount to turn the mixture orange; and adding diethyl chlorophosphate to the orange mixture in an amount to phosphorylate the hydroquinone.

  10. Marketing Hardwoods to Furniture Producers

    Science.gov (United States)

    Steven A. Sinclair; Robert J. Bush; Philip A. Araman

    1989-01-01

    This paper discusses some of the many problems in developing marketing programs for small wood products manufacturers. It examines the problems of using price as a dominant means for getting and attracting customers. The marketing of hardwood lumber to furniture producers is then used as an example. Data from 36 furniture lumber buyers is presented to illustrate...

  11. Importance of producing impactful research

    CSIR Research Space (South Africa)

    Nienaber, S

    2010-11-01

    Full Text Available from the more pragmatic issue of funding. Funding agencies, organisational leadership and policymakers need scientists to prove that the science we produce makes enough of an impact to merit further funding in future. This emphasis and pressure around...

  12. Method of producing vegetable puree

    DEFF Research Database (Denmark)

    2004-01-01

    A process for producing a vegetable puree, comprising the sequential steps of: a)crushing, chopping or slicing the vegetable into pieces of 1 to 30 mm; b) blanching the vegetable pieces at a temperature of 60 to 90°C; c) contacted the blanched vegetable pieces with a macerating enzyme activity; d......) blending the macerated vegetable pieces and obtaining a puree....

  13. Phenotypic and genotypic characterization of Klebsiella pneumoniae strains with reduced susceptibiliy to carbapenems

    Directory of Open Access Journals (Sweden)

    Simone Ambretti

    2009-12-01

    Full Text Available Reduced susceptibility to carbapenems in Gram-negative pathogens is an emerging feature of the antibiotic-resistance phenomenom Reports about strains resistant to this class of antibiotics among Enterobacteriaceae, particularly in Klebsiella pneumoniae, are increasing.The aims of this study were to assess the incidence of Klebsiella pneumoniae with reduced susceptibility to carbapenems in Bologna area and to carry out the characterization of these strains.The study included isolates of K. pneumoniae that showed reduced susceptibility to carbapenems, as detected by an automated system (Vitek2, bioMérieux. Between January and May 2009, 26 strains were collected (mainly isolated from urinary samples.These isolates were tested for susceptibility to carbapenems by E-test, to define MIC values for meropenem and ertapenem. Moreover, to detect the production of metallo-beta lactamases (MBL and carbapenemases (KPC were respectively performed the Etest with imipenem and imipenem/EDTA (IPM-IPM/EDTA and the modified Hodge test. Susceptibility assays performed by E-test showed that 25/26 strains were susceptible to meropenem, while for ertapenem 20/26 strains resulted resistant.The modified Hodge test was positive for 1 strain, while all the isolates were negative to the IPM-IPM/EDTA E-test.These results show that, as recently reported, the majority of strains of K. pneumoniae exhibiting reduced susceptibility to carbapenems, especially to ertapenem, are characterized by the production of ESBLs, which likely is associated with the loss of porins. On the other side, one strain was found to produce KPC and this finding confirms that the diffusion of carbapenemases producing K. pneumoniae has also to be considered in this geographic area.

  14. Distribution of ESBLs, AmpC β-lactamases and carbapenemases among Enterobacteriaceae isolates causing intra-abdominal and urinary tract infections in the Asia-Pacific region during 2008-14: results from the Study for Monitoring Antimicrobial Resistance Trends (SMART).

    Science.gov (United States)

    Jean, Shio-Shin; Hsueh, Po-Ren

    2017-01-01

    To investigate the antimicrobial resistance and assess the molecular characteristics of β-lactamases (ESBLs, AmpC β-lactamases and carbapenemases) among Enterobacteriaceae isolates that caused intra-abdominal infections (IAIs) in patients hospitalized in the Asia-Pacific region during 2008-14. Multiplex PCR was used to detect the specific types of β-lactamase in 2893 isolates with MICs of ertapenem >0.5 mg/L. In-hospital acquisition times for most isolates were also delineated. Among 2728 (94.3%) isolates proven with β-lactamase production, the rates of non-susceptibility to imipenem were low (average = 7.9%) among IAI Enterobacteriaceae isolates from all Asia-Pacific countries except Vietnam (17.7%) and the Philippines (10.2%). A stepwise and significant increase in annual rates of carbapenemase production among these isolates was noted. CTX-M-15 and CTX-M-14 were the dominant ESBL variants in most IAI Enterobacteriaceae species. The most abundant AmpC β-lactamase variants were bla CMY-2 among isolates of Escherichia coli and bla DHA-1 among isolates of Klebsiella pneumoniae. In addition, the IAI Enterobacteriaceae isolates harbouring a bla CMY-2 or bla DHA-1 allele were associated with high community-acquired rates (38.0% and 42.6%, respectively). AmpC ACT and MIR variants were mostly detected in Enterobacter species. The bla NDM-1,4,5,7 -harbouring isolates of E. coli, K. pneumoniae and Enterobacter cloacae were most commonly identified among IAI isolates from Vietnam and the Philippines. Also of note, bla OXA-48 -harbouring IAI Enterobacteriaceae isolates were detected exclusively in Vietnam. The high resistance burden in Vietnam and the Philippines warrants aggressive control policies to combat the worsening trend in antimicrobial resistance among Enterobacteriaceae species causing IAIs. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please

  15. Method for producing carbon nanotubes

    Science.gov (United States)

    Phillips, Jonathan [Santa Fe, NM; Perry, William L [Jemez Springs, NM; Chen, Chun-Ku [Albuquerque, NM

    2006-02-14

    Method for producing carbon nanotubes. Carbon nanotubes were prepared using a low power, atmospheric pressure, microwave-generated plasma torch system. After generating carbon monoxide microwave plasma, a flow of carbon monoxide was directed first through a bed of metal particles/glass beads and then along the outer surface of a ceramic tube located in the plasma. As a flow of argon was introduced into the plasma through the ceramic tube, ropes of entangled carbon nanotubes, attached to the surface of the tube, were produced. Of these, longer ropes formed on the surface portion of the tube located in the center of the plasma. Transmission electron micrographs of individual nanotubes revealed that many were single-walled.

  16. Nonlinear Pricing to Produce Information

    OpenAIRE

    David J. Braden; Shmuel S. Oren

    1994-01-01

    We investigate the firm's dynamic nonlinear pricing problem when facing consumers whose tastes vary according to a scalar index. We relax the standard assumption that the firm knows the distribution of this index. In general the firm should determine its marginal price schedule as if it were myopic, and produce information by lowering the price schedule; “bunching” consumers at positive purchase levels should be avoided. As a special case we also consider a market characterized by homogeneous...

  17. Method for producing metallic nanoparticles

    Science.gov (United States)

    Phillips, Jonathan; Perry, William L.; Kroenke, William J.

    2004-02-10

    Method for producing metallic nanoparticles. The method includes generating an aerosol of solid metallic microparticles, generating non-oxidizing plasma with a plasma hot zone at a temperature sufficiently high to vaporize the microparticles into metal vapor, and directing the aerosol into the hot zone of the plasma. The microparticles vaporize in the hot zone to metal vapor. The metal vapor is directed away from the hot zone and to the plasma afterglow where it cools and condenses to form solid metallic nanoparticles.

  18. Method for producing metallic microparticles

    Science.gov (United States)

    Phillips, Jonathan; Perry, William L.; Kroenke, William J.

    2004-06-29

    Method for producing metallic particles. The method converts metallic nanoparticles into larger, spherical metallic particles. An aerosol of solid metallic nanoparticles and a non-oxidizing plasma having a portion sufficiently hot to melt the nanoparticles are generated. The aerosol is directed into the plasma where the metallic nanoparticles melt, collide, join, and spheroidize. The molten spherical metallic particles are directed away from the plasma and enter the afterglow where they cool and solidify.

  19. Extended producer responsibility in oligopoly

    OpenAIRE

    Hiroaki Ino

    2007-01-01

    I investigate the optimal environmental tax under a policy based on extended producer responsibility (EPR) in oligopoly markets. I introduce the recycling market and explicitly consider how these policies affect the incentive for recycling. I derive the optimal tax rule, which depends on the weighted sum of the markup in the product market and the markdown in the recycling market. In contrast to the existing works that emphasize that the optimal tax rate is lower than the marginal external da...

  20. MARKETING STRATEGIES OF SMARTPHONES PRODUCERS

    OpenAIRE

    Markova V.; Tzinlin M.; Ge C.

    2017-01-01

    Smartphones global market is one of the most dynamically developing markets that can be characterized by high level of competition. The growth of smartphones homogeneity, which is a reduction in difference between technical and functional parameters of smartphones produced by various manufacturers, can be considered the market’s specific feature. The unique situation of high-tech product homogeneity in a fast-growing market is scantily described in specialized literature. The article shows ch...

  1. Method of producing ethyl alcohol

    Energy Technology Data Exchange (ETDEWEB)

    Philliskirk, G; Yates, H J

    1978-09-13

    Ethanol was produced from whey by removing protein from the whey by ultrafiltration, concentrating the deproteinized whey by reverse osmosis to a lactose content of at least 8 g/100 mL, fermenting with Candida pseudotropicalis NCYC 744, and distilling. E.g., milk whey was deproteinized to give a permeate containing 8.3 g lactose/100 mL. After fermentation, the final lactose content was 0.1 g/100 mL and the ethanol concentration was 3.55 g/100 mL, representing a 42% conversion of lactose to ethanol.

  2. Producing biofuels using polyketide synthases

    Science.gov (United States)

    Katz, Leonard; Fortman, Jeffrey L; Keasling, Jay D

    2013-04-16

    The present invention provides for a non-naturally occurring polyketide synthase (PKS) capable of synthesizing a carboxylic acid or a lactone, and a composition such that a carboxylic acid or lactone is included. The carboxylic acid or lactone, or derivative thereof, is useful as a biofuel. The present invention also provides for a recombinant nucleic acid or vector that encodes such a PKS, and host cells which also have such a recombinant nucleic acid or vector. The present invention also provides for a method of producing such carboxylic acids or lactones using such a PKS.

  3. Uranium producers foresee new boom

    International Nuclear Information System (INIS)

    McIntyre, H.

    1979-01-01

    The status of uranium production in Canada is reviewed. Uranium resources in Saskatchewan and Ontario are described and the role of the Cluff Lake inquiry in securing a government decision in favour of further uranium development is mentioned. There have been other uranium strikes near Kelowna, British Columbia and in the Northwest Territories. Increasing uranium demand and favourable prices are making the development of northern resources economically attractive. In fact, all uranium currently produced has been committed to domestic and export contracts so that there is considerable room for expanding the production of uranium in Canada. (T.I.)

  4. Soybean biomass produced in Argentina

    DEFF Research Database (Denmark)

    Semino, Stella Maris; Paul, Helena; Tomei, Julia

    2009-01-01

    Soybean biomass for biodiesel, produced in Argentina amongst other places, is considered by some to reduce greenhouse gas emissions and mitigate climate change when compared with fossil fuel. To ensure that the production of biofuels is ‘sustainable', EU institutions and national governments...... are currently designing certification schemes for the sustainable production of biomass. This paper questions the validity of proposed environmental standards, using the production of Argentine soybean as a case study. The production of soybean production is associated with profound environmental impacts...

  5. Producing deuterium-enriched products

    International Nuclear Information System (INIS)

    1980-01-01

    A method of producing an enriched deuterium product from a gaseous feed stream of mixed hydrogen and deuterium, comprises: (a) combining the feed stream with gaseous bromine to form a mixture of the feed stream and bromine and exposing the mixture to an electrical discharge effective to form deuterium bromide and hydrogen bromide with a ratio of D/H greater than the ratio of D/H in the feed stream; and (b) separating at least a portion of the hydrogen bromide and deuterium bromide from the mixture. (author)

  6. Fatty acid-producing hosts

    Science.gov (United States)

    Pfleger, Brian F; Lennen, Rebecca M

    2013-12-31

    Described are hosts for overproducing a fatty acid product such as a fatty acid. The hosts include an exogenous nucleic acid encoding a thioesterase and, optionally, an exogenous nucleic acid encoding an acetyl-CoA carboxylase, wherein an acyl-CoA synthetase in the hosts are functionally delected. The hosts prefereably include the nucleic acid encoding the thioesterase at an intermediate copy number. The hosts are preferably recominantly stable and growth-competent at 37.degree. C. Methods of producing a fatty acid product comprising culturing such hosts at 37.degree. C. are also described.

  7. Methods of producing luminescent images

    International Nuclear Information System (INIS)

    Broadhead, P.; Newman, G.A.

    1977-01-01

    A method is described for producing a luminescent image in a layer of a binding material in which is dispersed a thermoluminescent material. The layer is heated uniformly to a temperature of 80 to 300 0 C and is exposed to luminescence inducing radiation whilst so heated. The preferred exposing radiation is X-rays and preferably the thermoluminescent material is insensitive to electromagnetic radiation of wavelength longer than 300 mm. Information concerning preparation of the luminescent material is given in BP 1,347,672; this material has the advantage that at elevated temperatures it shows increased sensitivity compared with room temperature. At temperatures in the range 80 to 150 0 C the thermoluminescent material exhibits 'afterglow', allowing the image to persist for several seconds after the X-radiation has ceased, thus allowing the image to be retained for visual inspection in this temperature range. At higher temperatures, however, there is negligible 'afterglow'. The thermoluminescent layers so produced are particularly useful as fluoroscopic screens. The preferred method of heating the thermoluminescent material is described in BP 1,354,149. An example is given of the application of the method. (U.K.)

  8. Concrete produced with recycled aggregates

    Directory of Open Access Journals (Sweden)

    J. J. L. Tenório

    Full Text Available This paper presents the analysis of the mechanical and durable properties of recycled aggregate concrete (RAC for using in concrete. The porosity of recycled coarse aggregates is known to influence the fresh and hardened concrete properties and these properties are related to the specific mass of the recycled coarse aggregates, which directly influences the mechanical properties of the concrete. The recycled aggregates were obtained from construction and demolition wastes (CDW, which were divided into recycled sand (fine and coarse aggregates. Besides this, a recycled coarse aggregate of a specific mass with a greater density was obtained by mixing the recycled aggregates of the CDW with the recycled aggregates of concrete wastes (CW. The concrete was produced in laboratory by combining three water-cement ratios, the ratios were used in agreement with NBR 6118 for structural concretes, with each recycled coarse aggregates and recycled sand or river sand, and the reference concrete was produced with natural aggregates. It was observed that recycled aggregates can be used in concrete with properties for structural concrete. In general, the use of recycled coarse aggregate in combination with recycled sand did not provide good results; but when the less porous was used, or the recycled coarse aggregate of a specific mass with a greater density, the properties of the concrete showed better results. Some RAC reached bigger strengths than the reference concrete.

  9. Synergistic activity of synthetic N-terminal peptide of human lactoferrin in combination with various antibiotics against carbapenem-resistant Klebsiella pneumoniae strains.

    Science.gov (United States)

    Morici, P; Florio, W; Rizzato, C; Ghelardi, E; Tavanti, A; Rossolini, G M; Lupetti, A

    2017-10-01

    The spread of multi-drug resistant (MDR) Klebsiella pneumoniae strains producing carbapenemases points to a pressing need for new antibacterial agents. To this end, the in-vitro antibacterial activity of a synthetic N-terminal peptide of human lactoferrin, further referred to as hLF1-11, was evaluated against K. pneumoniae strains harboring different carbapenemase genes (i.e. OXA-48, KPC-2, KPC-3, VIM-1), with different susceptibility to colistin and other antibiotics, alone or in combination with conventional antibiotics (gentamicin, tigecycline, rifampicin, clindamycin, and clarithromycin). An antimicrobial peptide susceptibility assay was used to assess the bactericidal activity of hLF1-11 against the different K. pneumoniae strains tested. The synergistic activity was evaluated by a checkerboard titration method, and the fractional inhibitory concentration (FIC) index was calculated for the various combinations. hLF1-11 was more efficient in killing a K. pneumoniae strain susceptible to most antimicrobials (including colistin) than a colistin-susceptible strain and a colistin-resistant MDR K. pneumoniae strain. In addition, hLF1-11 exhibited a synergistic effect with the tested antibiotics against MDR K. pneumoniae strains. The results of this study indicate that resistance to hLF1-11 and colistin are not strictly associated, and suggest an hLF1-11-induced sensitizing effect of K. pneumoniae to antibiotics, especially to hydrophobic antibiotics, which are normally not effective on Gram-negative bacteria. Altogether, these data indicate that hLF1-11 in combination with antibiotics is a promising candidate to treat infections caused by MDR-K. pneumoniae strains.

  10. Spatial molecular epidemiology of carbapenem-resistant and New Delhi metallo beta-lactamase (blaNDM)-producing Escherichia coli in the piglets of organized farms in India.

    Science.gov (United States)

    Pruthvishree, B S; Vinodh Kumar, O R; Sinha, D K; Malik, Y P S; Dubal, Z B; Desingu, P A; Shivakumar, M; Krishnaswamy, N; Singh, B R

    2017-06-01

    A cross-sectional study was conducted in 10 government-organized pig farms between 2014 and 2016 representing seven states of India to understand the epidemiology of carbapenem resistance in the Escherichia coli. In this study, fecal sample (n = 673) from non-diarrheic (n = 501) and diarrheic (n = 172) piglets were processed for isolation of carbapenem resistant E. coli. Of 673, E. coli isolate (n = 112) was genotyped for confirming the carbapenem resistance and associated virulence factors. Of the 112 isolates, 23 were phenotypically resistant to carbapenem and 8 were carrying the New Delhi metallo beta-lactamase (blaNDM) gene. The carbapenem-resistant isolates also produced extended spectrum beta-lactamases and were multidrug resistant. The PCR-based pathotyping revealed the presence of stx1, stx2, eae and hlyA genes. The enterobacterial repetitive intergenic consensus PCR dendrogram analysis of the isolates yielded three distinct clusters. The statistical analysis revealed no association between carriages of carbapenem-resistant E. coli in different breed of piglets however, location, sex, health status of piglets and age showed significant difference. The spatial analysis with SaTScan helped in identification of carbapenem-resistant clusters. The presence of carbapenem resistant E. coli isolates with virulence genes in the piglet poses a potential public health risk through possible access and spread via the food chain and environment. Efflux pump may also play an important role in carbapenem resistance in piglet E. coli isolates. Furthermore, identification of risk factors in relation to spatial clusters will help in designing preventive strategies for reducing the risk of spread of carbapenem resistant bacteria. 1. Piglets harbor carbapenem resistant E. coli and have great public health significance. 2. Apart from carbapenemase, efflux pump is also important for carbapenem resistance. 3. This is the first report of blaNDM in the piglets from India. © 2017

  11. Molecular characterization and genetic diversity of ESBL-producing Escherichia coli colonizing the migratory Franklin's gulls (Leucophaeus pipixcan) in Antofagasta, North of Chile.

    Science.gov (United States)

    Báez, John; Hernández-García, Marta; Guamparito, Constanza; Díaz, Sofía; Olave, Abdon; Guerrero, Katherine; Cantón, Rafael; Baquero, Fernando; Gahona, Joselyne; Valenzuela, Nicomedes; Del Campo, Rosa; Silva, Juan

    2015-02-01

    The role of wild animals, particularly migratory birds, in the dissemination of antibiotic-resistant bacteria between geographically distant ecosystems is usually underestimated. The aim of this work was to characterize the Escherichia coli population from Franklin's gull feces, focusing on the extended-spectrum β-lactamase (ESBL)-producing strains. In the summer of 2011, 124 fecal swabs from seagulls (1 of each) migrating from the United States and Canada to the coast of Antofagasta, north of Chile, were collected. Samples were seeded on MacConkey agar supplemented with 2 μg/ml of cefotaxime and a single colony from each plate was tested for ESBL production by the double-disk ESBL synergy test. Antibiotic susceptibility was determined by the disk diffusion method and blaESBL genes were amplified and sequenced. The genetic diversity of isolates was explored by pulsed-field gel electrophoresis (PFGE)-XbaI and multilocus sequence typing. A total of 91 E. coli isolates with high rates of antibiotic resistance were identified. Carbapenemase production was not detected, whereas 67 of the 91 (54%) isolates exhibited an ESBL phenotype due to the presence of CTX-M-15 (61.3%), CTX-M-2 (19.3%), CTX-M-22 (16.1%), and CTX-M-3 (1.6%) coding genes. High genetic diversity was observed, with 30 PFGE patterns and 23 sequence types (STs), including ST131 (18%), ST44 (15%), ST617 (9%), and ST10 (9%). Results presented here are complementary to those previously reported by Hernández et al. in the same gull species, but located in the Central Region of Chile. Differences observed between gulls from both areas lead us to hypothesize that gulls from the northern location retain, as gut carriers, those resistant bacteria acquired in the United States and/or Canada.

  12. Pseudomonas aeruginosa-producing Metallo-β-lactamases (VIM, IMP, SME, and AIM in the Clinical Isolates of Intensive Care Units, a University Hospital in Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Farzin Khorvash

    2017-01-01

    Full Text Available Background: Pseudomonas aeruginosa is a severe challenge for antimicrobial therapy, due to the chromosomal mutations or exhibition of intrinsic resistance to various antimicrobial agents such as most β-lactams. We undertook this study to evaluate the existence of SME, IMP, AIM, and VIM metallo-β-lactamases (MBL encoding genes among P. aeruginosa strains isolated from Intensive Care Unit (ICU patients in Al-Zahra Hospital in Isfahan, Iran. Materials and Methods: In a retrospective cross-sectional study that was conducted between March 2012 and April 2013, a total of 48 strains of P. aeruginosa were collected from clinical specimens of bedridden patients in ICU wards. Susceptibility test was performed by disc diffusion method. All of the meropenem-resistant strains were subjected to modified Hodge test for detection of carbapenemases. Multiplex polymerase chain reaction was performed for detection of blaVIM, blaIMP, blaAIM, and blaSME genes. Results: In disk diffusion method, imipenem and meropenem showed the most and colistin the least resistant antimicrobial agents against P. aeruginosa strains. Of the 48 isolates, 36 (75% were multidrug resistant (MDR. Amplification of β-lactamase genes showed the presence of blaVIM genes in 7 (%14.6 strains and blaIMP genes in 15 (31.3% strains. All of the isolates were negative for blaSME and blaAIM genes. We could not find any statistically significant difference among the presence of this gene and MDR positive, age, or source of the specimen. Conclusion: As patients with infections caused by MBL-producing bacteria are at an intensified risk of treatment failure, fast determination of these organisms is necessary. Our findings may provide useful insights in replace of the appropriate antibiotics and may also prevent MBLs mediated resistance problem.

  13. Detection of Pseudomonas aeruginosa Producing Metallo β Lactamases (VIM, SME, AIM in The Clinical Isolates of Intensive Care Units of Al-Zahra Hospital in Esfahan, Iran

    Directory of Open Access Journals (Sweden)

    Farzin Khorvash

    2015-11-01

    Full Text Available Background:Pseudomonas aeruginosa is a severe challenge for antimicrobial therapy, because of chromosomal mutations or exhibition of intrinsic resistance to various antimicrobial agents such as most β-lactams. We undertook this study to evaluate the existence of SME, AIM and VIM metallo-beta lactamases encoding genes among P. aeruginosa strains isolated from ICU patients in AL- Zahra Hospital in Esfahan-Iran.Methods : In a retrospective cross sectional study that was conducted between March 2012 toApril 2013, in total 48 strains of P. aeruginosa were collected from clinical specimens of bedridden patients in ICU wards. Susceptibility test was performed by disc diffusion method.All of the meropenem resistant strains were subjected to modified Hodge test (MHT for detection of carbapenemases. Multiplex PCR was performed for detection of VIM, blaAIM,blaSME genes.Results : In disk diffusion method imipenem and meropenem showed the most and colistin the least resistant antimicrobial agents against P. aeruginosa strains. Of the 48 isolates 36, (75% were multidrug resistant. Amplification of β –lactamase genes showed the presence of blaVIM genes in 7 (%14.6 strains. All of the isolates were negative for blaSME and blaAIM genes. We ouldn’t find any statistically significance diffe rence among presence of this gene and MDR positive, age or source of the specimen.Conclusion : As patients with infections caused by MBL-producing bacteria are at an intensified risk of treatment failure, fast determination of these organisms is necessary. Our findings may rovide useful insights in replace of the appropriate antibiotics and may also prevent MBLs mediated resistance problem. 

  14. Pseudomonas aeruginosa-producing Metallo-β-lactamases (VIM, IMP, SME, and AIM) in the Clinical Isolates of Intensive Care Units, a University Hospital in Isfahan, Iran.

    Science.gov (United States)

    Khorvash, Farzin; Yazdani, Mohammadreza; Shabani, Shiva; Soudi, Aliasghar

    2017-01-01

    Pseudomonas aeruginosa is a severe challenge for antimicrobial therapy, due to the chromosomal mutations or exhibition of intrinsic resistance to various antimicrobial agents such as most β-lactams. We undertook this study to evaluate the existence of SME, IMP, AIM, and VIM metallo-β-lactamases (MBL) encoding genes among P. aeruginosa strains isolated from Intensive Care Unit (ICU) patients in Al-Zahra Hospital in Isfahan, Iran. In a retrospective cross-sectional study that was conducted between March 2012 and April 2013, a total of 48 strains of P. aeruginosa were collected from clinical specimens of bedridden patients in ICU wards. Susceptibility test was performed by disc diffusion method. All of the meropenem-resistant strains were subjected to modified Hodge test for detection of carbapenemases. Multiplex polymerase chain reaction was performed for detection of blaVIM, blaIMP, blaAIM, and blaSME genes. In disk diffusion method, imipenem and meropenem showed the most and colistin the least resistant antimicrobial agents against P. aeruginosa strains. Of the 48 isolates, 36 (75%) were multidrug resistant (MDR). Amplification of β-lactamase genes showed the presence of blaVIM genes in 7 (%14.6) strains and blaIMP genes in 15 (31.3%) strains. All of the isolates were negative for blaSME and blaAIM genes. We could not find any statistically significant difference among the presence of this gene and MDR positive, age, or source of the specimen. As patients with infections caused by MBL-producing bacteria are at an intensified risk of treatment failure, fast determination of these organisms is necessary. Our findings may provide useful insights in replace of the appropriate antibiotics and may also prevent MBLs mediated resistance problem.

  15. How Mobility Systems Produce Inequality

    DEFF Research Database (Denmark)

    Richardson, Tim; Jensen, Ole B.

    2008-01-01

    This paper explores a crucial aspect of sustainable mobility: the production of social inequality in mobility systems. The approach taken is to focus on how, as new transit infrastructures create alternative ways of traveling in and accessing the city, they create changed conditions for the forma......This paper explores a crucial aspect of sustainable mobility: the production of social inequality in mobility systems. The approach taken is to focus on how, as new transit infrastructures create alternative ways of traveling in and accessing the city, they create changed conditions...... for the formation of subject identities. New types of travellers are realised in the newly engineered spaces of mobility. The paper argues that this focus on these emergent mobile subject types can be useful in investigating the social inequalities that can result from the introduction of new infrastructures...... are constructed and how social inequality is materially produced....

  16. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    members, this thesis investigates a growing political trend and ideological discourse in the Arab world that I have called The New Regressive Left. On the premise that a media outlet can function as a forum for ideology production, the thesis argues that an analysis of this material can help to trace...... the contexture of The New Regressive Left. If the first part of the thesis lays out the theoretical approach and draws the contextual framework, through an exploration of the surrounding Arab media-and ideoscapes, the second part is an analytical investigation of the discourse that permeates the programmes aired...... becomes clear from the analytical chapters is the emergence of the new cross-ideological alliance of The New Regressive Left. This emerging coalition between Shia Muslims, religious minorities, parts of the Arab Left, secular cultural producers, and the remnants of the political,strategic resistance...

  17. Conducting nanofibres produced by electrospinning

    Science.gov (United States)

    Sen, S.; Davis, F. J.; Mitchell, G. R.; Robinson, E.

    2009-08-01

    Electrospun fibres based on polypyrrole have been prepared. The incorporation of preformed polypyrrole into fibres electrospun from a carrier polymer can only be achieved when materials are prepared with particulates smaller than the cross-section of the fibre; even so there are some problems, with the substantial loss of material from the electrode tip. As an alternative approach, soluble polypyrroles can be prepared but these are not of sufficient viscosity to prepare electrospun fibres, once again a carrier polymer must be employed. More effective loadings are gained by the process of coating the outer surface of a pre-spun fibre; in this way electrospun fibres coated with polypyrrole can be prepared. This approach has been adapted to produce silver coated polymer fibres by the use of copolymers of styrene and 3-vinyl benzaldehyde.

  18. Conducting nanofibres produced by electrospinning

    International Nuclear Information System (INIS)

    Sen, S; Mitchell, G R; Robinson, E; Davis, F J

    2009-01-01

    Electrospun fibres based on polypyrrole have been prepared. The incorporation of preformed polypyrrole into fibres electrospun from a carrier polymer can only be achieved when materials are prepared with particulates smaller than the cross-section of the fibre; even so there are some problems, with the substantial loss of material from the electrode tip. As an alternative approach, soluble polypyrroles can be prepared but these are not of sufficient viscosity to prepare electrospun fibres, once again a carrier polymer must be employed. More effective loadings are gained by the process of coating the outer surface of a pre-spun fibre; in this way electrospun fibres coated with polypyrrole can be prepared. This approach has been adapted to produce silver coated polymer fibres by the use of copolymers of styrene and 3-vinyl benzaldehyde.

  19. Producer flexibility answers market forces

    International Nuclear Information System (INIS)

    Von Flatern, R.

    1996-01-01

    The petroleum industry was revolutionized in the 1980s when oil became a commodity and rising prices no longer ensured profits. Alliancing, partnering, integration and operator cooperation became economic responses to the 1990s market reality. The industry has long been a bastion of free-marketeering; competition among producers and service providers continues to control prices. But new, more efficient ways of doing business control costs in an industry buffeted by stagnant prices, a prolonged period of downsizing and increasingly difficult and remote operating environments. How long the new business atmosphere will last depends on industry needs and how well things work out. But based on the successes of the immediate past and the foreseeable future, the new cross-company business practices seem destined only to multiply

  20. Process for producing a polymer

    Energy Technology Data Exchange (ETDEWEB)

    Koshimura, M; Haruta, K; Matsuzaka, J; Terakado, H

    1969-02-13

    A novel polymer is produced by a novel polymerization or copolymerization process in the presence of a free radical-forming catalyst or radical-forming irradiation energy to provide a monomer of the general formula CH/sub 2/=C(R/sub 1/)(COO)-(R/sub 2/OOCR/sub 3/COO)sub(n)-R/sub 2/OH wherein R/sub 1/ is hydrogen, halogen or alkyl radical containing one or two atoms; R/sub 2/ is an epoxy compound residue; R/sub 3/ is a polybasic anhydride residue; and n is an integer. This polymer: (1) enables the cross-linking reaction, (2) improves the adhesiveness of adhesives, pigments, films and coatings; (3) is adjustable for mutual solubility and affinity when blending with other solvents and resins; (4) is resistant to yellowing and mechanically stronger than the benzene nucleus of styrene; (5) improves the textile dyeing affinity, adhesiveness and dispersion of pigments, and the dimensional stability of films and sheets; (6) is suitable as a molding material of synthetic resins, adhesives and coatings because of its three dimensional cross-linking construction; (7) can control the hardness, flexibility and rigidity of the molding materials; and (8) can lower the cost of production. In an example, 10 g of the monomer of the above mentioned formula wherein n=1, R/sub 1/=CH/sub 3/, R/sub 2/=-(CH/sub 2/)/sub 2/ and R/sub 3/ is ortho-substituted benzene, and 0.1 g of benzol peroxide, are added to ampoule, sealed and polymerized at 120/sup 0/C for 2 hours. Next the contents are precipitated in a large amount of benzene to produce a polymer having a molecular weight of 9,500. The products have good dimensional stability as molding materials.

  1. Manual for reactor produced radioisotopes

    International Nuclear Information System (INIS)

    2003-01-01

    numerous new developments that have taken place since then. Hence in this manual it was decided to focus only on reactor produced radioisotopes. This manual contains procedures for 48 important reactor-produced isotopes. These were contributed by major radioisotope producers from different parts of the world and are based on their practical experience. In case of widely used radioisotopes such as 131 I, 32 P and 99 Mo, information from more than one centre is included so that the users can compare the procedures. As in the earlier two versions, a general introductory write-up is included covering basic information on related aspects such as target irradiation, handling facilities, radiation protection and transportation, but in less detail. Relevant IAEA publications on such matters, particularly related to radiation protection and transportation, should be referred to for guidelines. Similarly, the nuclear data contained in the manual are only indicative and the relevant databases should be referred to for more authentic values. It is hoped that the manual will be a useful source of information for those working in radioisotope production laboratories as well as those intending to initiate such activities

  2. MARKETING STRATEGIES OF SMARTPHONES PRODUCERS

    Directory of Open Access Journals (Sweden)

    Markova V.

    2017-12-01

    Full Text Available Smartphones global market is one of the most dynamically developing markets that can be characterized by high level of competition. The growth of smartphones homogeneity, which is a reduction in difference between technical and functional parameters of smartphones produced by various manufacturers, can be considered the market’s specific feature. The unique situation of high-tech product homogeneity in a fast-growing market is scantily described in specialized literature. The article shows changeability of smartphones global market leaders and explains that the key success factor in such a mature market is marketing. Based on secondary information, marketing strategies of long standing market leader in sales Samsung and overtaking Apple companies are determined as well as strategies of contenders for leadership - Chinese companies Huawei and Lenovo. It is shown on Lenovo case that inexplicit positioning leads to a loss of the growing market share due to offensive marketing strategies of other Chinese companies. The research results broaden the knowledge of methodical potential of marketing strategies in companies’ activities in competitive markets of homogeneous high-tech products.

  3. Producing tantalum or columbium powder

    International Nuclear Information System (INIS)

    Rerat, C.F.

    1979-01-01

    A process is described for the production of tantalum or columbium powder with a high yield within a desired range of particle sizes. A molten salt bath of a double salt comprising either an alkali metal tantalum fluoride or an alkali metal columbium fluoride and a relatively large amount of alkali metal halide diluent salt to act as a heat sink is initially maintained at a temperature a little above the liquidus temperature of the salt mixture. A liquid alkali metal at a comparatively low temperature is added to the continuously stirred bath at a high mass flow rate, and reduces the double salt, producing tantalum or columbium. The reaction is exothermic and causes the temperature to rise rapidly to a desired final reaction temperature within the range 760 to 1000 0 . The liquid alkali metal is thereafter fed at a high mass flow rate to complete the reaction quickly at the final reaction temperature. Forced cooling at a heat extraction rate not less than 42 kilojoules/min./kg. of double salt is used during at least a portion of the reaction cycle at a rate sufficient to maintain the final reaction temperature within a desired range. (author)

  4. Sideways Force Produced During Disruptions

    Science.gov (United States)

    Strauss, H. R.; Paccagnella, R.; Breslau, J.; Jardin, S.; Sugiyama, L.

    2012-10-01

    We extend previous studies [1] of vertical displacement events (VDE) which can produce disruptions. The emphasis is on the non axisymmetric ``sideways'' wall force Fx. Simulations are performed using the M3D [2] code. A VDE expels magnetic flux through the resistive wall until the last closed flux surface has q VDE is presented. The wall force depends strongly on γτw, where γ is the mode growth rate and τw is the wall resistive penetration time. The force Fx is largest when γτw is a constant of order unity, which depends on the initial conditions. For large values of γτw, the wall force asymptotes to a relatively smaller value, well below the critical value ITER is designed to withstand. The principle of disruption mitigation by massive gas injection is to cause a disruption with large γτw. [4pt] [1] H. R. Strauss, R. Paccagnella, and J. Breslau,Phys. Plasmas 17, 082505 (2010) [2] W. Park, E.V. Belova, G.Y. Fu, X. Tang, H.R. Strauss, L.E. Sugiyama, Phys. Plasmas 6, 1796 (1999).

  5. Yeast: A new oil producer?

    Directory of Open Access Journals (Sweden)

    Beopoulos Athanasios

    2012-01-01

    Full Text Available The increasing demand of plant oils or animal fat for biodiesel and specific lipid derivatives for the oleochemical field (such as lubricants, adhesives or plastics have created price imbalance in both the alimentary and energy field. Moreover, the lack of non-edible oil feedstock has given rise to concerns on land-use practices and on oil production strategies. Recently, much attention has been paid to the exploitation of microbial oils. Most of them present lipid profiles similar in type and composition to plants and could therefore have many advantages as are no competitive with food, have short process cycles and their cultivation is independent of climate factors. Among microorganisms, yeasts seem to be very promising as they can be easily genetically enhanced, are suitable for large-scale fermentation and are devoid of endotoxins. This review will focus on the recent understanding of yeasts lipid metabolism, the succeeding genetic engineering of the lipid pathways and the recent developments on fermentation techniques that pointed out yeasts as promising alternative producers for oil or plastic.

  6. Collision-produced atomic states

    International Nuclear Information System (INIS)

    Andersen, N.; Copenhagen Univ.

    1988-01-01

    The last 10-15 years have witnessed the development of a new, powerful class of experimental techniques for atomic collision studies, allowing partial or complete determination of the state of the atoms after a collision event, i.e. the full set of quantum-mechanical scattering amplitudes or - more generally - the density matrix describing the system. Evidently, such studies, involving determination of alignment and orientation parameters, provide much more severe tests of state-of-the-art scattering theories than do total or differential cross section measurements which depend on diagonal elements of the density matrix. The off-diagonal elements give us detailed information about the shape and dynamics of the atomic states. Therefore, close studies of collision-produced atomic states are currently leading to deeper insights into the fundamental physical mechanisms governing the dynamics of atomic collision events. The first part of the lectures deals with the language used to describe atomic states, while the second part presents a selection of recent results for model systems which display fundamental aspects of the collision physics in particularly instructive ways. I shall here restrict myself to atom-atom collisions. The discussion will be focused on states decaying by photon emission though most of the ideas can be easily modified to include electron emission as well. (orig./AH)

  7. Engineering microbes to produce biofuels.

    Science.gov (United States)

    Wackett, Lawrence P

    2011-06-01

    The current biofuels landscape is chaotic. It is controlled by the rules imposed by economic forces and driven by the necessity of finding new sources of energy, particularly motor fuels. The need is bringing forth great creativity in uncovering new candidate fuel molecules that can be made via metabolic engineering. These next generation fuels include long-chain alcohols, terpenoid hydrocarbons, and diesel-length alkanes. Renewable fuels contain carbon derived from carbon dioxide. The carbon dioxide is derived directly by a photosynthetic fuel-producing organism(s) or via intermediary biomass polymers that were previously derived from carbon dioxide. To use the latter economically, biomass depolymerization processes must improve and this is a very active area of research. There are competitive approaches with some groups using enzyme based methods and others using chemical catalysts. With the former, feedstock and end-product toxicity loom as major problems. Advances chiefly rest on the ability to manipulate biological systems. Computational and modular construction approaches are key. For example, novel metabolic networks have been constructed to make long-chain alcohols and hydrocarbons that have superior fuel properties over ethanol. A particularly exciting approach is to implement a direct utilization of solar energy to make a usable fuel. A number of approaches use the components of current biological systems, but re-engineer them for more direct, efficient production of fuels. Copyright © 2010 Elsevier Ltd. All rights reserved.

  8. CTX-M ESBL-producing Enterobacteriaceae: estimated prevalence in adults in England in 2014

    Science.gov (United States)

    McNulty, Cliodna A M; Lecky, Donna M; Xu-McCrae, Li; Nakiboneka-Ssenabulya, Deborah; Chung, Keun-Taik; Nichols, Tom; Thomas, Helen Lucy; Thomas, Mike; Alvarez-Buylla, Adela; Turner, Kim; Shabir, Sahida; Manzoor, Susan; Smith, Stephen; Crocker, Linda; Hawkey, Peter M

    2018-01-01

    Abstract Background ESBL-producing Enterobacteriaceae (ESBLPE) are increasing in prevalence worldwide and are more difficult to treat than non-ESBLPE. Their prevalence in the UK general population is unknown, as the only previous UK ESBLPE faecal colonization study involved patients with diarrhoea. Objectives To estimate the prevalence of CTX-M ESBLPE faecal colonization in the general adult population of England in 2014, and investigate risk factors. Methods A stratified random sample of 58 337 registered patients from 16 general practices within four areas of England were invited to participate by returning faeces specimens and self-completed questionnaires. Specimens were tested for ESBLPE and carbapenemase-producing Enterobacteriaceae (CPE). Results 2430 individuals participated (4% of those invited). The estimated prevalence of colonization with CTX-M ESBLPE in England was 7.3% (95% CI 5.6%–9.4%) (Shropshire 774 participants, 4.9% colonization; Southampton City 740 participants, 9.2%; Newham 612 participants, 12.7%; Heart of Birmingham 234 individuals, 16.0%) and was particularly high in: those born in Afghanistan (10 participants, 60.0% colonization, 95% CI 29.7%–84.2%); those born on the Indian subcontinent (India, Pakistan, Bangladesh or Sri Lanka) (259 participants, 25.0% colonization, 95% CI 18.5%–32.9%); travellers to South Asia (India, Pakistan, Bangladesh, Sri Lanka or Nepal) in the last year (140 participants, 38.5% colonization, 95% CI 27.8%–50.5%); and healthcare domestics (8 participants, unweighted 37.5% colonization, 95% CI 8.5%–75.5%). Risk factors identified included: being born in the Indian subcontinent (aOR 5.4, 95% CI 3.0–9.7); travel to South Asia (aOR 2.9, 95% CI 1.8–4.8) or to Africa, China, South or Central America, South East or Pacific Asia or Afghanistan (aOR 2.6, 95% CI 1.7–4.1) in the last year; and working as a healthcare domestic (aOR 6.2, 95% CI 1.3–31). None of the 48 participants who took co-amoxiclav in

  9. Analysis of β-Lactamase Resistance Determinants in Enterobacteriaceae from Chicago Children: a Multicenter Survey

    Science.gov (United States)

    Hujer, Andrea M.; Marshall, Steven H.; Domitrovic, T. Nicholas; Rudin, Susan D.; Zheng, Xiaotian; Qureshi, Nadia K.; Hayden, Mary K.; Scaggs, Felicia A.; Karadkhele, Anand; Bonomo, Robert A.

    2016-01-01

    Multidrug-resistant (MDR) Enterobacteriaceae infections are increasing in U.S. children; however, there is a paucity of multicentered analyses of antibiotic resistance genes responsible for MDR phenotypes among pediatric Enterobacteriaceae isolates. In this study, 225 isolates phenotypically identified as extended-spectrum β-lactamase (ESBL) or carbapenemase producers, recovered from children ages 0 to 18 years hospitalized between January 2011 and April 2015 at three Chicago area hospitals, were analyzed. We used DNA microarray platforms to detect ESBL, plasmid-mediated AmpC (pAmpC), and carbapenemase type β-lactamase (bla) genes. Repetitive-sequence-based PCR and multilocus sequence typing (MLST) were performed to assess isolate similarity. Plasmid replicon typing was conducted to classify plasmids. The median patient age was 4.2 years, 56% were female, and 44% presented in the outpatient setting. The majority (60.9%) of isolates were Escherichia coli and from urinary sources (69.8%). Of 225 isolates exhibiting ESBL- or carbapenemase-producing phenotypes, 90.7% contained a bla gene. The most common genotype was the blaCTX-M-1 group (49.8%); 1.8% were carbapenem-resistant Enterobacteriaceae (three blaKPC and one blaIMP). Overall, pAmpC (blaACT/MIR and blaCMY) were present in 14.2%. The predominant E. coli phylogenetic group was the virulent B2 group (67.6%) associated with ST43/ST131 (Pasteur/Achtman MLST scheme) containing the blaCTX-M-1 group (84%), and plasmid replicon types FIA, FII, and FIB. K. pneumoniae harboring blaKPC were non-ST258 with replicon types I1 and A/C. Enterobacter spp. carrying blaACT/MIR contained plasmid replicon FIIA. We found that β-lactam resistance in children is diverse and that certain resistance mechanisms differ from known circulating genotypes in adults in an endemic area. The potential impact of complex molecular types and the silent dissemination of MDR Enterobacteriaceae in a vulnerable population needs to be studied further

  10. Reactor-produced therapeutic radioisotopes

    International Nuclear Information System (INIS)

    Knapp, F.F. Jr.

    2002-01-01

    The significant worldwide increase in therapeutic radioisotope applications in nuclear medicine, oncology and interventional cardiology requires the dependable production of sufficient levels of radioisotopes for these applications (Reba, 2000; J. Nucl. Med., 1998; Nuclear News, 1999; Adelstein and Manning, 1994). The issues associated with both accelerator- and reactor-production of therapeutic radioisotopes is important. Clinical applications of therapeutic radioisotopes include the use of both sealed sources and unsealed radiopharmaceutical sources. Targeted radiopharmaceutical agents include those for cancer therapy and palliation of bone pain from metastatic disease, ablation of bone marrow prior to stem cell transplantation, treatment modalities for mono and oligo- and polyarthritis, for cancer therapy (including brachytherapy) and for the inhibition of the hyperplastic response following coronary angioplasty and other interventional procedures (For example, see Volkert and Hoffman, 1999). Sealed sources involve the use of radiolabeled devices for cancer therapy (brachytherapy) and also for the inhibition of the hyperplasia which is often encountered after angioplasty, especially with the exponential increase in the use of coronary stents and stents for the peripheral vasculature and other anatomical applications. Since neutron-rich radioisotopes often decay by beta decay or decay to beta-emitting daughter radioisotopes which serve as the basis for radionuclide generator systems, reactors are expected to play an increasingly important role for the production of a large variety of therapeutic radioisotopes required for these and other developing therapeutic applications. Because of the importance of the availability of reactor-produced radioisotopes for these applications, an understanding of the contribution of neutron spectra for radioisotope production and determination of those cross sections which have not yet been established is important. This

  11. 7 CFR 1206.16 - Producer.

    Science.gov (United States)

    2010-01-01

    ... producing, or causing to be produced, mangos beyond the person's own family use and having value at first... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE MANGO PROMOTION, RESEARCH, AND INFORMATION Mango Promotion, Research, and Information Order Definitions § 1206.16 Producer. Producer means...

  12. Mass-producing B mesons

    Energy Technology Data Exchange (ETDEWEB)

    Aleksan, Roy; Ali, Ahmed

    1993-06-15

    Since the discovery of the upsilon resonances in 1977 the physics of the fifth quark - beauty - has played a vital role in establishing and consolidating today's Standard Model of particle physics. In recent years, a wealth of data on B particle (containing the beauty quark) has emerged from the detectors ARGUS (at the DORIS ring, DESY, Hamburg) and CLEO (at the Cornell CESR ring) as well as from CERN's LEP electron-positron collider and the proton-antiproton colliders at CERN and Fermilab. But the most challenging goal of this physics is to explore the mystery of CP violation, so far only seen in neutral kaon decays. This subtle mechanism - a disregard for the combined symmetry of particle antiparticle switching and left-right reflection - possibly moulded the evolution of the Universe after the Big Bang, providing a world dominated by matter, rather than one where matter and antimatter play comparable roles. To fully explore CP violation in the laboratory needs a dedicated machine - a particle 'factory' - to mass produce B mesons. Only when this full picture of CP violation has been revealed will physicists finally be able to solve its mysteries. As well as major proposals in the US and Japan, several ideas have been launched in Europe. Over the years, many working groups have accumulated an impressive amount of data and knowledge on the physics as well as on the machine and detectors. The spearheads of experimental B physics are the ARGUS and CLEO collaborations. Highlights include the determination of the parameters of the (Cabibbo-Kobayashi-Maskawa, CKM) quark mixing matrix, testing the consistency of the Standard Model with six quarks and three leptons, and giving the first indirect hint that the as yet unseen sixth ('top') quark is very heavy, together with initial indications of how it should decay. Valuable complementary information has come from proton-antiproton collider data and particularly from the LEP experiments at the Z resonance. Experiments at

  13. Mass-producing B mesons

    International Nuclear Information System (INIS)

    Aleksan, Roy; Ali, Ahmed

    1993-01-01

    Since the discovery of the upsilon resonances in 1977 the physics of the fifth quark - beauty - has played a vital role in establishing and consolidating today's Standard Model of particle physics. In recent years, a wealth of data on B particle (containing the beauty quark) has emerged from the detectors ARGUS (at the DORIS ring, DESY, Hamburg) and CLEO (at the Cornell CESR ring) as well as from CERN's LEP electron-positron collider and the proton-antiproton colliders at CERN and Fermilab. But the most challenging goal of this physics is to explore the mystery of CP violation, so far only seen in neutral kaon decays. This subtle mechanism - a disregard for the combined symmetry of particle antiparticle switching and left-right reflection - possibly moulded the evolution of the Universe after the Big Bang, providing a world dominated by matter, rather than one where matter and antimatter play comparable roles. To fully explore CP violation in the laboratory needs a dedicated machine - a particle 'factory' - to mass produce B mesons. Only when this full picture of CP violation has been revealed will physicists finally be able to solve its mysteries. As well as major proposals in the US and Japan, several ideas have been launched in Europe. Over the years, many working groups have accumulated an impressive amount of data and knowledge on the physics as well as on the machine and detectors. The spearheads of experimental B physics are the ARGUS and CLEO collaborations. Highlights include the determination of the parameters of the (Cabibbo-Kobayashi-Maskawa, CKM) quark mixing matrix, testing the consistency of the Standard Model with six quarks and three leptons, and giving the first indirect hint that the as yet unseen sixth ('top') quark is very heavy, together with initial indications of how it should decay. Valuable complementary information has come from proton-antiproton collider data and particularly from the LEP experiments at the

  14. Distribution and Antimicrobial Susceptibility Pattern of Gram Negative Bacteria Causing Urinary Tract Infection (UTI and Detection New Delhi Metallo-beta-lactamase-1 (NDM-1 Producing Isolates in Ahwaz

    Directory of Open Access Journals (Sweden)

    Parviz Afrugh

    2016-04-01

    Full Text Available Background: Urinary tract infection (UTI is the commonest bacterial infectious disease in worldwide (especially in developing countries with a high rate of morbidity and financial cost. The management of UTI infections has been jeopardized by increase in immergence of antimicrobial drug resistance. Knowledge of the local bacterial etiology and susceptibility patterns is required to trace any change that might have occurred in time so that updated recommendation for optimal empirical therapy of UTI can be made. The aim of this investigation was distribution and antimicrobial susceptibility pattern of gram negative bacteria causing urinary tract infection (UTI and detection NDM-1 (new-delhi-metallo-beta-lactamase-1 producing isolates in Ahwaz. Materials and Methods: This cross-sectional study was done during a period of one year from April 2013 to March 2014. Clean catch midstream urine samples were collected from suspected patients to UTI. The isolates were identified based on morphological and biochemical testes. Culture was performed on routine microbiological media. Susceptibility testing was performed according CLSI (2013 guidelines. Detection of carbapenemase producing isolates was performed by modified hodge test (MHT. Metallo-beta-lactamase isolates were detected by imipenem-EDTA combined disc test (CDT. Results: In this study 708 gram negative organisms were isolated from urine samples. E.coli was the most common isolated bacteria (67% followed by Klebsiella spp. (26.5% and Enterobacter spp. (2.5%. In antibiotic susceptibility testing more than 90% of isolates were sensitive to tetracycline, ceftazidime, meropenem, amikacin, cefotaxime, imipenem, and cefepime. Isolates were more resistant to cephalothin (32%, co-trimoxazol (30.5%, and nalidixic acid (25%. Conclusion: In our results isolated organisms from outpatients showed very high sensitivity to common antibiotics. Continuous and regular monitoring of susceptibility pattern of

  15. Three Dimensional Checkerboard Synergy Analysis of Colistin, Meropenem, Tigecycline against Multidrug-Resistant Clinical Klebsiella pneumonia Isolates.

    Directory of Open Access Journals (Sweden)

    Claudia Stein

    Full Text Available The spread of carbapenem-non-susceptible Klebsiella pneumoniae strains bearing different resistance determinants is a rising problem worldwide. Especially infections with KPC (Klebsiella pneumoniae carbapenemase - producers are associated with high mortality rates due to limited treatment options. Recent clinical studies of KPC-blood stream infections revealed that colistin-based combination therapy with a carbapenem and/or tigecycline was associated with significantly decreased mortality rates when compared to colistin monotherapy. However, it remains unclear if these observations can be transferred to K. pneumoniae harboring other mechanisms of carbapenem resistance. A three-dimensional synergy analysis was performed to evaluate the benefits of a triple combination with meropenem, tigecycline and colistin against 20 K. pneumoniae isolates harboring different β-lactamases. To examine the mechanism behind the clinically observed synergistic effect, efflux properties and outer membrane porin (Omp genes (ompK35 and ompK36 were also analyzed. Synergism was found for colistin-based double combinations for strains exhibiting high minimal inhibition concentrations against all of the three antibiotics. Adding a third antibiotic did not result in further increased synergistic effect in these strains. Antagonism did not occur. These results support the idea that colistin-based double combinations might be sufficient and the most effective combination partner for colistin should be chosen according to its MIC.

  16. 7 CFR 1212.19 - Producer.

    Science.gov (United States)

    2010-01-01

    ... producing, or causing to be produced, honey beyond personal use and having value at first point of sale. ... person who is engaged in the production and sale of honey in any State and who owns, or shares the...

  17. Genetic engineering of to produce Bacterial Polyhydroxyalkanotes ...

    African Journals Online (AJOL)

    PHAs), in the sense of an environmental precaution appears meaningful and necessary. In order to more economically produce microbial products, this investigation was focused on suitable producers, like the yeast Schizosaccharomyces pombe ...

  18. Characterization of bacteriocin produced by Lactobacillus plantarum ...

    African Journals Online (AJOL)

    Characterization of bacteriocin produced by Lactobacillus plantarum F1 and ... brevis OG1 isolated from Nigerian fermented food products, produced bacteriocins ... interest for food safety and may have future applications as food preservative.

  19. 7 CFR 1131.13 - Producer milk.

    Science.gov (United States)

    2010-01-01

    ... Handling Definitions § 1131.13 Producer milk. Producer milk means the skim milk (or the skim equivalent of components of skim milk) and butterfat in milk of a producer that is: (a) Received by the operator of a pool... percentage in paragraph (d)(2) of this section may be increased or decreased by the market administrator if...

  20. 7 CFR 1033.13 - Producer milk.

    Science.gov (United States)

    2010-01-01

    ... Handling Definitions § 1033.13 Producer milk. Producer milk means the skim milk (or the skim equivalent of components of skim milk), including nonfat components, and butterfat in milk of a producer that is: (a... percentages in paragraph (d)(4) of this section may be increased or decreased by the market administrator if...

  1. 7 CFR 1001.13 - Producer milk.

    Science.gov (United States)

    2010-01-01

    ... Handling Definitions § 1001.13 Producer milk. Producer milk means the skim milk (or the skim equivalent of components of skim milk) and butterfat contained in milk of a producer that is: (a) Received by the operator... be increased or decreased by the Market Administrator if the Market Administrator finds that such...

  2. 7 CFR 1126.13 - Producer milk.

    Science.gov (United States)

    2010-01-01

    ... Handling Definitions § 1126.13 Producer milk. Producer milk means the skim milk (or the skim equivalent of components of skim milk), including nonfat components, and butterfat contained in milk of a producer that is...) of this section may be increased or decreased by the market administrator if there is a finding that...

  3. 7 CFR 1006.13 - Producer milk.

    Science.gov (United States)

    2010-01-01

    ... Handling Definitions § 1006.13 Producer milk. Producer milk means the skim milk (or the skim equivalent of components of skim milk) and butterfat contained in milk of a producer that is: (a) Received by the operator... (d) (1) through (3) of this section may be increased or decreased by the market administrator if the...

  4. 29 CFR 780.213 - Produce business.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Produce business. 780.213 Section 780.213 Labor Regulations... Specific Situations Hatchery Operations § 780.213 Produce business. In some instances, hatcheries also engage in the produce business as such and commingle with the culled eggs and chickens other eggs and...

  5. Comparative analysis of virulence determinants, antibiotic susceptibility patterns and serogrouping of atypical enteropathogenic Escherichia coli versus typical enteropathogenic E. coli in India.

    Science.gov (United States)

    Malvi, Supriya; Appannanavar, Suma; Mohan, Balvinder; Kaur, Harsimran; Gautam, Neha; Bharti, Bhavneet; Kumar, Yashwant; Taneja, Neelam

    2015-10-01

    The epidemiology of enteropathogenic Escherichia coli (EPEC) and the significance of isolation of atypical EPEC (aEPEC) in childhood diarrhoea have not been well studied in an Indian context. A comparative study was undertaken to investigate virulence determinants, antibiotic susceptibility patterns and serogrouping of typical EPEC (tEPEC) versus aEPEC causing diarrhoea in children. A total of 400 prospective and 500 retrospective E. coli isolates were included. PCR was performed for eae, bfpA, efa, nleB, nleE, cdt, ehxA and paa genes. The Clinical and Laboratory Standards Institute's disc diffusion test was used to determine the antimicrobial susceptibility. Phenotypic screening of extended spectrum β-lactamases (ESBLs), AmpC and Klebsiella pneumoniae carbapenemase (KPC) production, and molecular detection of bla(NDM-1), bla(VIM), bla(CTX-M-15), bla(IMP) and bla(KPC) were performed. aEPEC (57.6 %) were more common as compared with tEPEC (42.3 %). The occurrence of virulence genes was observed to be three times higher in aEPEC as compared with tEPEC, efa1 (14.7 % of aEPEC, 4 % of tEPEC) being the most common. Most of the isolates did not belong to the classical EPEC O-serogroups. The highest resistance was observed against amoxicillin (93.22 %) followed by quinolones (83 %), cephalosporins (37.28 %), cotrimoxazole (35.59 %) and carbapenems (30.5 %). Overall equal numbers of aEPEC (41.17 %) and tEPEC (40 %) were observed to be multidrug-resistant. Fifteen EPEC strains demonstrated presence of ESBLs, five produced AmpC and four each produced metallo-β-lactamases and KPC-type carbapenemases; eight, seven and one isolate(s) each were positive for bla(VIM), bla(CTX-M-15) and bla(NDM-1), respectively. Here, to the best of our knowledge, we report for the first time on carbapenem resistance and the presence of bla(NDM-1) and bla(CTX-M-15) in EPEC isolates from India.

  6. Epidemiology of Extended-Spectrum β-Lactamase-Producing E. coli and Vancomycin-Resistant Enterococci in the Northern Dutch-German Cross-Border Region.

    Science.gov (United States)

    Zhou, Xuewei; García-Cobos, Silvia; Ruijs, Gijs J H M; Kampinga, Greetje A; Arends, Jan P; Borst, Dirk M; Möller, Lieke V; Holman, Nicole D; Schuurs, Theo A; Bruijnesteijn van Coppenraet, Lesla E; Weel, Jan F; van Zeijl, Jan H; Köck, Robin; Rossen, John W A; Friedrich, Alexander W

    2017-01-01

    Objectives: To reveal the prevalence and epidemiology of extended-spectrum β-lactamase (ESBL)- and/or plasmid AmpC (pAmpC)- and carbapenemase (CP) producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE) across the Northern Dutch-German border region. Methods: A point-prevalence study on ESBL/pAmpC/CP producing Enterobacteriaceae and VRE was carried out in hospitalized patients in the Northern Netherlands ( n = 445, 2012-2013) and Germany ( n = 242, 2012). Healthy individuals from the Dutch community ( n = 400, 2010-2012) were also screened. In addition, a genome-wide gene-by-gene approach was applied to study the epidemiology of ESBL- Escherichia coli and VRE. Results: A total of 34 isolates from 27 patients (6.1%) admitted to Dutch hospitals were ESBL/pAmpC positive and 29 ESBL- E. coli , three pAmpC- E. coli , one ESBL- Enterobacter cloacae , and one pAmpC- Proteus mirabilis were found. In the German hospital, 18 isolates (16 E. coli and 2 Klebsiella pneumoniae ) from 17 patients (7.7%) were ESBL positive. In isolates from the hospitalized patients CTX-M-15 was the most frequently detected ESBL-gene. In the Dutch community, 11 individuals (2.75%) were ESBL/pAmpC positive: 10 ESBL - E. coli (CTX-M-1 being the most prevalent gene) and one pAmpC E. coli . Six Dutch (1.3%) and four German (3.9%) hospitalized patients were colonized with VRE. Genetic relatedness by core genome multi-locus sequence typing (cgMLST) was found between two ESBL- E. coli isolates from Dutch and German cross-border hospitals and between VRE isolates from different hospitals within the same region. Conclusion: The prevalence of ESBL/pAmpC- Enterobacteriaceae was similar in hospitalized patients across the Dutch-German border region, whereas VRE prevalence was slightly higher on the German side. The overall prevalence of the studied pathogens was lower in the community than in hospitals in the Northern Netherlands. Cross-border transmission of ESBL- E. coli and VRE seems

  7. Epidemiology of Extended-Spectrum β-Lactamase-Producing E. coli and Vancomycin-Resistant Enterococci in the Northern Dutch–German Cross-Border Region

    Directory of Open Access Journals (Sweden)

    Xuewei Zhou

    2017-10-01

    Full Text Available Objectives: To reveal the prevalence and epidemiology of extended-spectrum β-lactamase (ESBL- and/or plasmid AmpC (pAmpC- and carbapenemase (CP producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE across the Northern Dutch–German border region.Methods: A point-prevalence study on ESBL/pAmpC/CP producing Enterobacteriaceae and VRE was carried out in hospitalized patients in the Northern Netherlands (n = 445, 2012–2013 and Germany (n = 242, 2012. Healthy individuals from the Dutch community (n = 400, 2010–2012 were also screened. In addition, a genome-wide gene-by-gene approach was applied to study the epidemiology of ESBL-Escherichia coli and VRE.Results: A total of 34 isolates from 27 patients (6.1% admitted to Dutch hospitals were ESBL/pAmpC positive and 29 ESBL-E. coli, three pAmpC-E. coli, one ESBL-Enterobacter cloacae, and one pAmpC-Proteus mirabilis were found. In the German hospital, 18 isolates (16 E. coli and 2 Klebsiella pneumoniae from 17 patients (7.7% were ESBL positive. In isolates from the hospitalized patients CTX-M-15 was the most frequently detected ESBL-gene. In the Dutch community, 11 individuals (2.75% were ESBL/pAmpC positive: 10 ESBL-E. coli (CTX-M-1 being the most prevalent gene and one pAmpC E. coli. Six Dutch (1.3% and four German (3.9% hospitalized patients were colonized with VRE. Genetic relatedness by core genome multi-locus sequence typing (cgMLST was found between two ESBL-E. coli isolates from Dutch and German cross-border hospitals and between VRE isolates from different hospitals within the same region.Conclusion: The prevalence of ESBL/pAmpC-Enterobacteriaceae was similar in hospitalized patients across the Dutch–German border region, whereas VRE prevalence was slightly higher on the German side. The overall prevalence of the studied pathogens was lower in the community than in hospitals in the Northern Netherlands. Cross-border transmission of ESBL-E. coli and VRE seems unlikely

  8. Inventory transparency for agricultural produce through IOT

    Science.gov (United States)

    Srinivasan, S. P.; Sorna Shanthi, D.; Anand, Aashish V.

    2017-06-01

    Re-structuring the practices of traditional inventory management is becoming more essential to optimize the supply chain transparency and accuracy of agricultural produce. A flexible and transparent inventory management system is becoming the need of any agricultural commodity. It was noticed that the major setback for the farmers who are the suppliers of the farm produce is due to poor supply chain integration. The recent advent technologies and IT explosion can bring up a greater impact in the process of storing, tracking, distributing and monitoring perishable agriculture produce of day to day life. The primary focus of this paper is to integrate IoT into inventory management and other inbound logistics management of agriculture produce. The unique features of agricultural produce like a prediction of supply, demand, the location of warehouses, distribution and tracking of inventory can be integrated through IoT. This paper proposes a conceptual framework for inventory management transparency involved in the supply chain of agriculture produce.

  9. Process for producing ethanol from syngas

    Science.gov (United States)

    Krause, Theodore R; Rathke, Jerome W; Chen, Michael J

    2013-05-14

    The invention provides a method for producing ethanol, the method comprising establishing an atmosphere containing methanol forming catalyst and ethanol forming catalyst; injecting syngas into the atmosphere at a temperature and for a time sufficient to produce methanol; and contacting the produced methanol with additional syngas at a temperature and for a time sufficient to produce ethanol. The invention also provides an integrated system for producing methanol and ethanol from syngas, the system comprising an atmosphere isolated from the ambient environment; a first catalyst to produce methanol from syngas wherein the first catalyst resides in the atmosphere; a second catalyst to product ethanol from methanol and syngas, wherein the second catalyst resides in the atmosphere; a conduit for introducing syngas to the atmosphere; and a device for removing ethanol from the atmosphere. The exothermicity of the method and system obviates the need for input of additional heat from outside the atmosphere.

  10. Bioavailability of isoflavones from soy products in equol producers and non-producers in Japanese women

    Directory of Open Access Journals (Sweden)

    Ayako Miura

    2016-12-01

    Conclusions: The results in this study suggest that bioavailability of isoflavones are different between equol producers and non-producers, because the 24 h urinary excretion of equol in the equol producers were significantly lower than those in the equol non-producers.

  11. Stable, fertile, high polyhydroxyalkanoate producing plants and methods of producing them

    Energy Technology Data Exchange (ETDEWEB)

    Bohmert-Tatarev, Karen; McAvoy, Susan; Peoples, Oliver P.; Snell, Kristi D.

    2015-08-04

    Transgenic plants that produce high levels of polyhydroxybutyrate and methods of producing them are provided. In a preferred embodiment the transgenic plants are produced using plastid transformation technologies and utilize genes which are codon optimized. Stably transformed plants able to produce greater than 10% dwt PHS in tissues are also provided.

  12. Potential biosurfactant producing endophytic and epiphytic fungi ...

    African Journals Online (AJOL)

    Potential biosurfactant producing endophytic and epiphytic fungi, isolated from macrophytes in the Negro River in Manaus, Amazonas, Brazil. ... Solms and Cyperus ligularis L., macrophytes collected from oil-contaminated waters, were studied to assess their potential for producing biosurfactants; the most promising ones ...

  13. Understanding producers' motives for adopting sustainable practices

    NARCIS (Netherlands)

    Trujillo-Barrera, Andres; Pennings, Joost M.E.; Hofenk, Dianne

    2016-01-01

    Understanding the motives and risk attitudes of producers to engage in sustainable practices is important for policy-makers who wish to increase the likelihood of adoption and improve the design of incentives. This article examines the underlying motives of producers to adopt sustainable

  14. Does Bt Corn Really Produce Tougher Residues

    Science.gov (United States)

    Bt corn hybrids produce insecticidal proteins that are derived from a bacterium, Bacillus thuringiensis. There have been concerns that Bt corn hybrids produce residues that are relatively resistant to decomposition. We conducted four experiments that examined the decomposition of corn residues und...

  15. 7 CFR 1124.13 - Producer milk.

    Science.gov (United States)

    2010-01-01

    ... section, Producer milk means the skim milk (or skim milk equivalent of components of skim milk), including... filed a request in writing with the market administrator before the first day of the month the agreement... producer deliveries of each according to a method approved by the market administrator. (4) Diverted milk...

  16. Automatic produce quality monitoring in Reefer containers

    NARCIS (Netherlands)

    Lukasse, L.J.S.; Sanders, M.G.; Kramer, de J.E.

    2003-01-01

    Current day perishable supply chains require intermediate points for manual produce quality inspection. Over the last decade international seatransport of fruit and vegetables in reefer containers has grown tremendously. Reefer containers may completely close the cold chain only if produce quality

  17. 7 CFR 1206.8 - Foreign producer.

    Science.gov (United States)

    2010-01-01

    ... produced, mangos beyond the person's own family use and having value at first point of sale. ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE MANGO PROMOTION, RESEARCH, AND INFORMATION Mango Promotion, Research, and Information Order Definitions § 1206.8 Foreign producer. Foreign...

  18. Technology development for producing nickel metallic filters

    International Nuclear Information System (INIS)

    Hubler, C.H.

    1990-01-01

    A technology to produce metallic filters by Instituto de Engenharia Nuclear (IEN-Brazilian CNEN) providing the Instituto de Pesquisas Energeticas e Nucleares (IPEN-Brazilian CNEN) in obtaining nickel alloy filters used for filtration process of uranium hexafluoride, was developed. The experiences carried out for producing nickel conical trunk filters from powder metallurgy are related. (M.C.K.)

  19. Music Teacher as Writer and Producer

    Science.gov (United States)

    Randles, Clint

    2012-01-01

    In this article I attempt to redefine the role of a music teacher as being more than a director, the more traditional term ascribed to this position. I do this by using descriptions of the role of "writer" and "producer" of student lives borrowed from music education philosophy, screenwriting, and professional music producers. This vision is…

  20. Isolation and molecular characterization of phytase producing ...

    African Journals Online (AJOL)

    Isolation and molecular characterization of phytase producing bacteria from Malaysia hot springs. ... The strains were further analyzed in broth culture using sodium phytate as substrate. Among them, strain L3 was selected as the best producer (0.16 U/ml after 72 h of culture). This phytase showed optimal activity at 37 °C ...

  1. Extended Producer Responsibility in the Aviation Sector

    OpenAIRE

    Brito, Marisa; Laan, Erwin; Irion, B.D.

    2007-01-01

    textabstractIn this paper we investigate recent initiatives with respect to extended producer responsibility in the aviation sector. We compare those with the existing practices in the automobile sector and the emerging regulations in the shipping sector. We describe the challenges and the lessons to be learned from the evolution and state of extended producer responsibility in these two industries.

  2. Exopolysaccharides produced by lactic acid bacteria

    NARCIS (Netherlands)

    Caggianiello, Graziano; Kleerebezem, Michiel; Spano, Giuseppe

    2016-01-01

    A wide range of lactic acid bacteria (LAB) is able to produce capsular or extracellular polysaccharides, with various chemical compositions and properties. Polysaccharides produced by LAB alter the rheological properties of the matrix in which they are dispersed, leading to typically viscous and

  3. Producer services, economic geography, and services tradability

    NARCIS (Netherlands)

    de Vaal, A; van den Berg, M

    We investigate how the incorporation of producer services linkages affects the outcome of an economic geography model. We specify the production of manufactures such that a variety of producer services is needed to transform tradable unfinished goods into final consumption goods. We find that

  4. The Complex Epidemiology of Carbapenem-Resistant Enterobacter Infections: A Multicenter Descriptive Analysis.

    Science.gov (United States)

    Lazarovitch, Tsilia; Amity, Keren; Coyle, Joseph R; Ackerman, Benjamin; Tal-Jasper, Ruthy; Ofer-Friedman, Hadas; Hayakawa, Kayoko; Bogan, Christopher; Lephart, Paul R; Kaplansky, Tamir; Maskit, Moran; Azouri, Tal; Zaidenstein, Ronit; Perez, Federico; Bonomo, Robert A; Kaye, Keith S; Marchaim, Dror

    2015-11-01

    The pandemic of carbapenem-resistant Enterobacteriaceae (CRE) was primarily due to clonal spread of bla KPC producing Klebsiella pneumoniae. Thus, thoroughly studied CRE cohorts have consisted mostly of K. pneumoniae. To conduct an extensive epidemiologic analysis of carbapenem-resistant Enterobacter spp. (CREn) from 2 endemic and geographically distinct centers. CREn were investigated at an Israeli center (Assaf Harofeh Medical Center, January 2007 to July 2012) and at a US center (Detroit Medical Center, September 2008 to September 2009). bla KPC genes were queried by polymerase chain reaction. Repetitive extragenic palindromic polymerase chain reaction and pulsed-field gel electrophoresis were used to determine genetic relatedness. In this analysis, 68 unique patients with CREn were enrolled. Sixteen isolates (24%) were from wounds, and 33 (48%) represented colonization only. All isolates exhibited a positive Modified Hodge Test, but only 93% (27 of 29) contained bla KPC. Forty-three isolates (63%) were from elderly adults, and 5 (7.4%) were from neonates. Twenty-seven patients died in hospital (40.3% of infected patients). Enterobacter strains consisted of 4 separate clones from Assaf Harofeh Medical Center and of 4 distinct clones from Detroit Medical Center. In this study conducted at 2 distinct CRE endemic regions, there were unique epidemiologic features to CREn: (i) polyclonality, (ii) neonates accounting for more than 7% of cohort, and (iii) high rate of colonization (almost one-half of all cases represented colonization). Since false-positive Modified Hodge Tests in Enterobacter spp. are common, close monitoring of carbapenem resistance mechanisms (particularly carbapenemase production) among Enterobacter spp. is important.

  5. Anti-Restriction Protein, KlcAHS, Promotes Dissemination of Carbapenem Resistance

    Directory of Open Access Journals (Sweden)

    Xiaofei Jiang

    2017-05-01

    Full Text Available Carbapenemase-producing Klebsiella pneumoniae (KPC has emerged and spread throughout the world. A retrospective analysis was performed on carbapenem-resistant K. pneumoniae isolated at our teaching hospital during the period 2009–2010, when the initial outbreak occurred. To determine the mechanism(s that underlies the increased infectivity exhibited by KPC, Multilocus Sequence Typing (MLST was conducted. A series of plasmids was also extracted, sequenced and analyzed. Concurrently, the complete sequences of blaKPC−2-harboring plasmids deposited in GenBank were summarized and aligned. The blaKPC−2 and KlcAHS genes in the carbapenem-resistant K. pneumoniae isolates were examined. E. coli strains, carrying different Type I Restriction and Modification (RM systems, were selected to study the interaction between RM systems, anti-RM systems and horizontal gene transfer (HGT. The ST11 clone predominated among 102 carbapenem-resistant K. pneumoniae isolates, all harbored the blaKPC−2 gene; 98% contained the KlcAHS gene. KlcAHS was one of the core genes in the backbone region of most blaKPC−2 carrying plasmids. Type I RM systems in the host bacteria reduced the rate of pHS10842 plasmid transformation by 30- to 40-fold. Presence of the anti-restriction protein, KlcAHS, on the other hand, increased transformation efficiency by 3- to 6-fold. These results indicate that RM systems can significantly restrict HGT. In contrast, KlcAHS can disrupt the RM systems and promote HGT by transformation. These findings suggest that the anti-restriction protein, KlcAHS, represents a novel mechanism that facilitates the increased transfer of blaKPC-2 and KlcAHS-carrying plasmids among K. pneumoniae strains.

  6. Act Fast as Time Is Less: High Faecal Carriage of Carbapenem-Resistant Enterobacteriaceae in Critical Care Patients.

    Science.gov (United States)

    Saseedharan, Sanjith; Sahu, Manisa; Pathrose, Edwin Joseph; Shivdas, Sarita

    2016-09-01

    Carbapenem-resistant Enterobacteriaceae (CRE) are drug-resistant Gram-negative bacteria that are present in the community as well as in hospitals. Their infection and colonisation puts critically ill patients at high risk due to the drug-resistant nature of the strains and possible spreading of these organisms, even in a hospital environment. To examine the presence and types of Enterobacteriaceae species in patients admitted directly from the community. The present study was a one-month pilot conducted in the ICU of a tertiary care hospital in Mumbai, India in 2015. Faecal samples of patients admitted from the community directly to the ICU were analysed using tests like MHT (Modified Hodge) and EDTA for the presence of IMP (action on Imipenem) and KPC ( Klebsiella Test Pneumoniae Carbapenemase) producing strains of Enterobacteriaceae . Polymerase Chain Reaction (PCR) was performed to look for VIM , IMP , NDM 1, OXA , and KPC genes. Antibiotic Sensitivity Test was carried out as per CLSI guidelines. The results showed an alarming level of faecal carriage rates in adult ICU patients. Klebsiella pneumonia was the most common carbapenem-resistant isolate, closely followed by Escherichia coli . PCR results revealed nine strains were positive for bla (KPC) gene, from which 7 were Klebsiella pneumoniae and one each of Escherichia coli and Klebsiella oxytoca was observed. Antibiotic Sensitivity Test results showed that the isolates had maximum sensitivity to Colistin (100%) and Tigecycline (95%). These levels indicate that in the absence of CRE screenings, proper isolation of carrier patients is not possible, leading to possible spreading of these resistant bacteria strains in ICUs. A longer period of study is required to obtain more substantial data to validate the results of this pilot.

  7. Bacteriocin producers from traditional food products

    Directory of Open Access Journals (Sweden)

    Thonart P.

    2007-01-01

    Full Text Available A total of 220 strains of LAB isolated from 32 samples of traditional fermented food from Senegal were screened for bacteriocin production. Two bacteriocin producers, Lactococcus lactis subsp. lactis and Enterococcus faecium, were identified from 12 bacteriocin-producing isolates on the basis of phenotypic analyses and 16S rDNA sequence. Both bacteriocins produced by new isolates show antimicrobial activity against Listeria monocytogenes and Bacillus coagulans whereas only that produced by Lactococcus lactis has an activity against Bacillus cereus. Bacteriocin-producing Lactococcus lactis strains were found in a variety of traditional foods indicating a high potential of growth of this strain in variable ecological complex environment. Partial 16S rDNA of the two bacteriocin producers obtained in this study has been registered to Genbank databases under the accession number AY971748 for Lactococcus lactis subsp. lactis (named CWBI-B1410 and AY971749 for Enterococcus faecium (named CWBI-B1411. The new bacteriocin-producing Lactococcus lactis subsp. lactis strain has been selected for identification and application of the bacteriocin to food preservation.

  8. US producers in a competitive market

    International Nuclear Information System (INIS)

    Beck, M.

    1987-01-01

    The current (1986) situation in the world-wide uranium market is explained and the competitiveness of United States producers is considered in this context. Historical export contracts by US producers are examined to evaluate how sales quantities by region have changed. The influence of inflation and exchange rates on production costs are considered. The threat of US protectionism is discussed. Despite the contraction of the US uranium industry in recent years a number of US producers have remained competitive. Factors which could increase US competitiveness are listed. (U.K.)

  9. Method for producing uranium atomic beam source

    International Nuclear Information System (INIS)

    Krikorian, O.H.

    1976-01-01

    A method is described for producing a beam of neutral uranium atoms by vaporizing uranium from a compound UM/sub x/ heated to produce U vapor from an M boat or from some other suitable refractory container such as a tungsten boat, where M is a metal whose vapor pressure is negligible compared with that of uranium at the vaporization temperature. The compound, for example, may be the uranium-rhenium compound, URe 2 . An evaporation rate in excess of about 10 times that of conventional uranium beam sources is produced

  10. Methods and systems for producing syngas

    Science.gov (United States)

    Hawkes, Grant L; O& #x27; Brien, James E; Stoots, Carl M; Herring, J. Stephen; McKellar, Michael G; Wood, Richard A; Carrington, Robert A; Boardman, Richard D

    2013-02-05

    Methods and systems are provided for producing syngas utilizing heat from thermochemical conversion of a carbonaceous fuel to support decomposition of at least one of water and carbon dioxide using one or more solid-oxide electrolysis cells. Simultaneous decomposition of carbon dioxide and water or steam by one or more solid-oxide electrolysis cells may be employed to produce hydrogen and carbon monoxide. A portion of oxygen produced from at least one of water and carbon dioxide using one or more solid-oxide electrolysis cells is fed at a controlled flow rate in a gasifier or combustor to oxidize the carbonaceous fuel to control the carbon dioxide to carbon monoxide ratio produced.

  11. Natural rubber producing plants: An overview | Venkatachalam ...

    African Journals Online (AJOL)

    ... Hevea and also other natural rubber producing species for alternative source of latex production in the near future. Keywords: Alternative rubber sources, biotechnology, breeding, Hevea brasiliensis, Parthenium argentatum, Taraxacum koksaghyz, Ficus bengalensis, Lactuca serriola. African Journal of Biotechnology Vol.

  12. Methods of producing compounds from plant materials

    Science.gov (United States)

    Werpy, Todd A [West Richland, WA; Schmidt, Andrew J [Richland, WA; Frye, Jr., John G.; Zacher, Alan H. , Franz; James A. , Alnajjar; Mikhail S. , Neuenschwander; Gary G. , Alderson; Eric V. , Orth; Rick J. , Abbas; Charles A. , Beery; Kyle E. , Rammelsberg; Anne M. , Kim; Catherine, J [Decatur, IL

    2010-01-26

    The invention includes methods of processing plant material by adding water to form a mixture, heating the mixture, and separating a liquid component from a solid-comprising component. At least one of the liquid component and the solid-comprising component undergoes additional processing. Processing of the solid-comprising component produces oils, and processing of the liquid component produces one or more of glycerol, ethylene glycol, lactic acid and propylene glycol. The invention includes a process of forming glycerol, ethylene glycol, lactic acid and propylene glycol from plant matter by adding water, heating and filtering the plant matter. The filtrate containing starch, starch fragments, hemicellulose and fragments of hemicellulose is treated to form linear poly-alcohols which are then cleaved to produce one or more of glycerol, ethylene glycol, lactic acid and propylene glycol. The invention also includes a method of producing free and/or complexed sterols and stanols from plant material.

  13. Methods of producing compounds from plant material

    Energy Technology Data Exchange (ETDEWEB)

    Werpy, Todd A.; Schmidt, Andrew J.; Frye, Jr., John G.; Zacher, Alan H.; Franz, James A.; Alnajjar, Mikhail S.; Neuenschwander, Gary G.; Alderson, Eric V.; Orth, Rick J.; Abbas, Charles A.; Beery, Kyle E.; Rammelsberg, Anne M.; Kim, Catherine J.

    2006-01-03

    The invention includes methods of processing plant material by adding water to form a mixture, heating the mixture, and separating a liquid component from a solid-comprising component. At least one of the liquid component and the solid-comprising component undergoes additional processing. Processing of the solid-comprising component produces oils, and processing of the liquid component produces one or more of glycerol, ethylene glycol, lactic acid and propylene glycol. The invention includes a process of forming glycerol, ethylene glycol, lactic acid and propylene glycol from plant matter by adding water, heating and filtering the plant matter. The filtrate containing starch, starch fragments, hemicellulose and fragments of hemicellulose is treated to form linear poly-alcohols which are then cleaved to produce one or more of glycerol, ethylene glycol, lactic acid and propylene glycol. The invention also includes a method of producing free and/or complexed sterols and stanols from plant material.

  14. (ESBL) producing Escherichia coli and Klebsiella pneumoniae

    African Journals Online (AJOL)

    use

    2011-11-21

    Nov 21, 2011 ... the most common serious bacterial infections in infants ... UTI is a common cause of morbidity .... of ESBL and non-ESBL producing Escherichia coli and Klebsiella pneumonia. ... in hospital and community acquired infections.

  15. Must producers earn a resource rent?

    International Nuclear Information System (INIS)

    Austvik, Ole Gunnar

    2003-01-01

    In petroleum producing countries it has been a prevailing opinion that a resource rent should be earned by petroleum producers due to the commodities' non-renewable nature. An important element in this logic is that the supply of oil and natural gas is limited to relatively few places in the world. As the resources are exploited, the remaining reserves are reduced. What is extracted today cannot be extracted tomorrow. Rationing of the scarce resource takes place through pricing mechanisms. Due to the scarcity the consumers must pay a higher price than the marginal production costs, so that the amounts supplied and demanded become equal. Most producers of oil and gas and not just the ones that produce the cheapest, have therefore until now earned an economic rent

  16. How to: Produce a Good Poster.

    Science.gov (United States)

    Simmonds, D

    1984-01-01

    'Poster sessions' have become a widespread feature of medical meetings. Here, an experienced medical artist gives his guidelines for producing a poster that provides clear information in an attractive and easy-to-assemble format.

  17. Sideways wall force produced during tokamak disruptions

    Science.gov (United States)

    Strauss, H.; Paccagnella, R.; Breslau, J.; Sugiyama, L.; Jardin, S.

    2013-07-01

    A critical issue for ITER is to evaluate the forces produced on the surrounding conducting structures during plasma disruptions. We calculate the non-axisymmetric ‘sideways’ wall force Fx, produced in disruptions. Simulations were carried out of disruptions produced by destabilization of n = 1 modes by a vertical displacement event (VDE). The force depends strongly on γτwall, where γ is the mode growth rate and τwall is the wall penetration time, and is largest for γτwall = constant, which depends on initial conditions. Simulations of disruptions caused by a model of massive gas injection were also performed. It was found that the wall force increases approximately offset linearly with the displacement from the magnetic axis produced by a VDE. These results are also obtained with an analytical model. Disruptions are accompanied by toroidal variation of the plasma current Iφ. This is caused by toroidal variation of the halo current, as verified computationally and analytically.

  18. Do bacteria, not fish, produce 'fish kairomone'?

    NARCIS (Netherlands)

    Ringelberg, J.; Van Gool, E.

    1998-01-01

    Fish-associated chemicals enhance phototactic downward swimming in Daphnia. If perch were treated with the antibiotic ampicillin, this enhancement was significantly decreased. Therefore, not fish, but bacteria associated with fish, seem to produce this kairomone. [KEYWORDS: Diel vertical migration;

  19. 7 CFR 1430.510 - New producers.

    Science.gov (United States)

    2010-01-01

    ... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS DAIRY PRODUCTS Dairy Market Loss Assistance Program § 1430... in 1999 or 2000 and not affiliated with other eligible producers may receive payments from sums made...

  20. Diagnostics of laser-produced plasmas

    Directory of Open Access Journals (Sweden)

    Batani Dimitri

    2016-12-01

    Full Text Available We present the general challenges of plasma diagnostics for laser-produced plasmas and give a few more detailed examples: spherically bent crystals for X-ray imaging, velocity interferometers (VISAR for shock studies, and proton radiography.

  1. An anaerobic mitochondrion that produces hydrogen

    NARCIS (Netherlands)

    Boxma, Brigitte; Graaf, Rob M. de; Staay, Georg W.M. van der; Alen, Theo A. van; Ricard, Guenola; Gabaldón, Toni; Hoek, Angela H.A.M. van; Moon-van der Staay, Seung Yeo; Koopman, Werner J.H.; Hellemond, Jaap J. van; Tielens, Aloysius G.M.; Friedrich, Thorsten; Veenhuis, Marten; Huynen, Martijn A.; Hackstein, Johannes H.P.

    2005-01-01

    Hydrogenosomes are organelles that produce ATP and hydrogen, and are found in various unrelated eukaryotes, such as anaerobic flagellates, chytridiomycete fungi and ciliates. Although all of these organelles generate hydrogen, the hydrogenosomes from these organisms are structurally and

  2. Hospital waste management and other small producers

    International Nuclear Information System (INIS)

    Herbst, H.; Roy, J.C.

    1992-01-01

    This paper describes waste management in hospitals and other waste producers. Low-level radioactive wastes are collected by ANDRA (French Agency for radioactive waste management) and informations on waste processing or regulations on radiation sources are given

  3. How To Produce and Characterize Transgenic Plants.

    Science.gov (United States)

    Savka, Michael A.; Wang, Shu-Yi; Wilson, Mark

    2002-01-01

    Explains the process of establishing transgenic plants which is a very important tool in plant biology and modern agriculture. Produces transgenic plants with the ability to synthesize opines. (Contains 17 references.) (YDS)

  4. Strategies of development of European power producers

    International Nuclear Information System (INIS)

    Heddebaut, D.

    2007-12-01

    This economical study answers the following questions: what is the dynamics of European power markets? What is the relative competitiveness of the different power production means? What are the determining factors of electricity wholesale prices? Who are the operators the most threatened by the rise of wholesale prices? To what extend power producers are impacted by the CO 2 constrain? Who are the most efficient producers? The analysis is based on 18 of the most representative groups of the European electric utilities. The first volume of the study presents the strategic perspectives of European power producers: dynamics and basic characteristics of European power markets, strategic options of European operators, typology and financial results of European power producers, scenarios of market reorganization according to Eurostaf (possible mega-mergers in the future, competition). Volume 2 makes a detailed analysis of the positioning and perspectives of the 18 selected groups: key figures, sourcing strategies, production means management, Eurostaf's diagnosis. (J.S.)

  5. Petroleum term markets and OPEC producers countries

    International Nuclear Information System (INIS)

    Bensarsa, F.

    1994-01-01

    The situation of petroleum producers countries in front of term markets is described. With an economics liberalization, policy configuration changing the energetic balance (increasing of american imports, of asiatic demand and developing countries; decreasing of russian production), a more efficient technology, a right management of energetic resources with energy economy, renewable energies and non polluting energies, it is difficult for producers countries to resist at the pressure of financing tools, more and more modern and efficient as they are term markets

  6. Produced Water Management and Beneficial Use

    International Nuclear Information System (INIS)

    Brown, Terry; Frost, Carol; Hayes, Thomas; Heath, Leo; Johnson, Drew; Lopez, David; Saffer, Demian; Urynowicz, Michael; Wheaton, John; Zoback, Mark

    2007-01-01

    Large quantities of water are associated with the production of coalbed methane (CBM) in the Powder River Basin (PRB) of Wyoming. The chemistry of co-produced water often makes it unsuitable for subsequent uses such as irrigated agriculture. However, co-produced waters have substantial potential for a variety of beneficial uses. Achieving this potential requires the development of appropriate water management strategies. There are several unique characteristics of co-produced water that make development of such management strategies a challenge. The production of CBM water follows an inverse pattern compared to traditional wells. CBM wells need to maintain low reservoir pressures to promote gas production. This need renders the reinjection of co-produced waters counterproductive. The unique water chemistry of co-produced water can reduce soil permeability, making surface disposal difficult. Unlike traditional petroleum operations where co-produced water is an undesirable by-product, co-produced water in the PRB often is potable, making it a highly valued resource in arid western states. This research project developed and evaluated a number of water management options potentially available to CBM operators. These options, which focus on cost-effective and environmentally-sound practices, fall into five topic areas: Minimization of Produced Water, Surface Disposal, Beneficial Use, Disposal by Injection and Water Treatment. The research project was managed by the Colorado Energy Research Institute (CERI) at the Colorado School of Mines (CSM) and involved personnel located at CERI, CSM, Stanford University, Pennsylvania State University, the University of Wyoming, the Argonne National Laboratory, the Gas Technology Institute, the Montana Bureau of Mining and Geology and PVES Inc., a private firm

  7. Produced Water Management and Beneficial Use

    Energy Technology Data Exchange (ETDEWEB)

    Terry Brown; Carol Frost; Thomas Hayes; Leo Heath; Drew Johnson; David Lopez; Demian Saffer; Michael Urynowicz; John Wheaton; Mark Zoback

    2007-10-31

    Large quantities of water are associated with the production of coalbed methane (CBM) in the Powder River Basin (PRB) of Wyoming. The chemistry of co-produced water often makes it unsuitable for subsequent uses such as irrigated agriculture. However, co-produced waters have substantial potential for a variety of beneficial uses. Achieving this potential requires the development of appropriate water management strategies. There are several unique characteristics of co-produced water that make development of such management strategies a challenge. The production of CBM water follows an inverse pattern compared to traditional wells. CBM wells need to maintain low reservoir pressures to promote gas production. This need renders the reinjection of co-produced waters counterproductive. The unique water chemistry of co-produced water can reduce soil permeability, making surface disposal difficult. Unlike traditional petroleum operations where co-produced water is an undesirable by-product, co-produced water in the PRB often is potable, making it a highly valued resource in arid western states. This research project developed and evaluated a number of water management options potentially available to CBM operators. These options, which focus on cost-effective and environmentally-sound practices, fall into five topic areas: Minimization of Produced Water, Surface Disposal, Beneficial Use, Disposal by Injection and Water Treatment. The research project was managed by the Colorado Energy Research Institute (CERI) at the Colorado School of Mines (CSM) and involved personnel located at CERI, CSM, Stanford University, Pennsylvania State University, the University of Wyoming, the Argonne National Laboratory, the Gas Technology Institute, the Montana Bureau of Mining and Geology and PVES Inc., a private firm.

  8. Produced water treatment methods for SAGD

    Energy Technology Data Exchange (ETDEWEB)

    Minnich, K. [Veolia Water Solutions and Technologies, Mississauga, ON (Canada)

    2008-07-01

    Produced water treatment methods for steam assisted gravity drainage (SAGD) processes were presented. Lime softening is used to remove sludge before weak acid cation processes. However, the process is not reliable in cold climates, and disposal of the sludge is now posing environmental problems in Alberta. High pH MVC evaporation processes use sodium hydroxide (NaOH) additions to prevent silica scaling. However the process produces silica wastes that are difficult to dispose of. The sorption slurry process was designed to reduce the use of caustic soda and develop a cost-effective method of disposing evaporator concentrates. The method produces 98 per cent steam quality for SAGD injection. Silica is sorbed onto crystals in order to prevent silica scaling. The evaporator concentrate from the process is suitable for on- and off-site deep well disposal. The ceramic membrane process was designed to reduce the consumption of chemicals and improve the reliability of water treatment processes. The ion exchange desilication process uses 80 per cent less power and produces 80 per cent fewer CO{sub 2} emissions than MVC evaporators. A comparative operating cost evaluation of various electric supply configurations and produced water treatment processes was also included, as well as an analysis of produced water chemistry. tabs., figs.

  9. New Delhi Metallo-Β-Lactamase-Producing Carbapenem-Resistant Enterobacteriacae Isolated From Bronchial Washings.

    LENUS (Irish Health Repository)

    Cullivan, S

    2017-11-01

    The prevalence of Carbapenem resistance among Enterobacteriacae species is increasing and poses a potential major public health risk. In recent years, several new carbapenemases have been identified, including New Delhi metallo-β-lactamase (NDM). A 78-year-old non-smoking female with prior medical history of type 2 diabetes mellitus, gastroesophageal reflux disease (GERD) and prior coronary artery bypass grafting was referred to our respiratory outpatient service for evaluation of a chronic cough and dyspnoea in 2013. Clinical examination revealed bibasal pulmonary crepitations but was otherwise unremarkable. Computed tomography of the chest demonstrated atelectasis of the lingula and right middle lobe. She underwent bronchoscopy, which demonstrated laryngeal mucosa inflammation, consistent with her GERD. There was no growth on bacterial, fungal or mycobacterial bronchial washings cultures.

  10. Wintertime Emissions from Produced Water Ponds

    Science.gov (United States)

    Evans, J.; Lyman, S.; Mansfield, M. L.

    2013-12-01

    Every year oil and gas drilling in the U.S. generates billions of barrels of produced water (water brought to the surface during oil or gas production). Efficiently disposing of produced water presents a constant financial challenge for producers. The most noticeable disposal method in eastern Utah's Uintah Basin is the use of evaporation ponds. There are 427 acres of produced water ponds in the Uintah Basin, and these were used to evaporate more than 5 million barrels of produced water in 2012, 6% of all produced water in the Basin. Ozone concentrations exceeding EPA standards have been observed in the Uintah Basin during winter inversion conditions, with daily maximum 8 hour average concentrations at some research sites exceeding 150 parts per billion. Produced water contains ozone-forming volatile organic compounds (VOC) which escape into the atmosphere as the water is evaporated, potentially contributing to air quality problems. No peer-reviewed study of VOC emissions from produced water ponds has been reported, and filling this gap is essential for the development of accurate emissions inventories for the Uintah Basin and other air sheds with oil and gas production. Methane, carbon dioxide, and VOC emissions were measured at three separate pond facilities in the Uintah Basin in February and March of 2013 using a dynamic flux chamber. Pond emissions vary with meteorological conditions, so measurements of VOC emissions were collected during winter to obtain data relevant to periods of high ozone production. Much of the pond area at evaporation facilities was frozen during the study period, but areas that actively received water from trucks remained unfrozen. These areas accounted for 99.2% of total emissions but only 9.5% of the total pond area on average. Ice and snow on frozen ponds served as a cap, prohibiting VOC from being emitted into the atmosphere. Emissions of benzene, toluene, and other aromatic VOCs averaged over 150 mg m-2 h-1 from unfrozen pond

  11. ANAEROBIC BIOLOGICAL TREATMENT OF PRODUCED WATER; TOPICAL

    International Nuclear Information System (INIS)

    John R. Gallagher

    2001-01-01

    During the production of oil and gas, large amounts of water are brought to the surface and must be disposed of in an environmentally sensitive manner. This is an especially difficult problem in offshore production facilities where space is a major constraint. The chief regulatory criterion for produced water is oil and grease. Most facilities have little trouble meeting this criterion using conventional oil-water separation technologies. However, some operations have significant amounts of naphthenic acids in the water that behave as oil and grease but are not well removed by conventional technologies. Aerobic biological treatment of naphthenic acids in simulated-produced water has been demonstrated by others; however, the system was easily overloaded by the large amounts of low-molecular-weight organic acids often found in produced waters. The objective of this research was to determine the ability of an anaerobic biological system to treat these organic acids in a simulated produced water and to examine the potential for biodegradation of the naphthenic acids in the anaerobic environment. A small fixed-film anaerobic biological reactor was constructed and adapted to treat a simulated produced water. The bioreactor was tubular, with a low-density porous glass packing material. The inocula to the reactor was sediment from a produced-water holding pond from a municipal anaerobic digester and two salt-loving methanogenic bacteria. During start-up, the feed to the reactor contained glucose as well as typical produced-water components. When glucose was used, rapid gas production was observed. However, when glucose was eliminated and the major organic component was acetate, little gas was generated. Methane production from acetate may have been inhibited by the high salt concentrations, by sulfide, or because of the lack, despite seeding, of microbes capable of converting acetate to methane. Toluene, a minor component of the produced water (0.1 g/L) was removed in the

  12. ANAEROBIC BIOLOGICAL TREATMENT OF PRODUCED WATER

    Energy Technology Data Exchange (ETDEWEB)

    John R. Gallagher

    2001-07-31

    During the production of oil and gas, large amounts of water are brought to the surface and must be disposed of in an environmentally sensitive manner. This is an especially difficult problem in offshore production facilities where space is a major constraint. The chief regulatory criterion for produced water is oil and grease. Most facilities have little trouble meeting this criterion using conventional oil-water separation technologies. However, some operations have significant amounts of naphthenic acids in the water that behave as oil and grease but are not well removed by conventional technologies. Aerobic biological treatment of naphthenic acids in simulated-produced water has been demonstrated by others; however, the system was easily overloaded by the large amounts of low-molecular-weight organic acids often found in produced waters. The objective of this research was to determine the ability of an anaerobic biological system to treat these organic acids in a simulated produced water and to examine the potential for biodegradation of the naphthenic acids in the anaerobic environment. A small fixed-film anaerobic biological reactor was constructed and adapted to treat a simulated produced water. The bioreactor was tubular, with a low-density porous glass packing material. The inocula to the reactor was sediment from a produced-water holding pond from a municipal anaerobic digester and two salt-loving methanogenic bacteria. During start-up, the feed to the reactor contained glucose as well as typical produced-water components. When glucose was used, rapid gas production was observed. However, when glucose was eliminated and the major organic component was acetate, little gas was generated. Methane production from acetate may have been inhibited by the high salt concentrations, by sulfide, or because of the lack, despite seeding, of microbes capable of converting acetate to methane. Toluene, a minor component of the produced water (0.1 g/L) was removed in the

  13. Bacteriocin-producing Enterococci from Rabbit Meat

    Directory of Open Access Journals (Sweden)

    Szabóová, R.

    2012-01-01

    Full Text Available Aims: Enterococci are lactic acid bacteria belonging to the division Firmicutes. They occur in different ecosystems, rabbits including. Enterococci can possess probiotic properties and produce antimicrobial substances-bacteriocins. Rabbit meat as nutritionally healthy food offers novel source to study bacteriocin-producing and/or probiotic enterococci. Methodology and results: Enterococci were detected from rabbit meat samples (42. Most of the isolates were allotted to the species Enterococcus faecium by PCR method. The isolates have possessed the structural genes for enterocins A, P, B production. The inhibitory substances produced by the isolated enterococci inhibited the growth of 12 indicators. Of 34 isolates, 15 strains have shown the antimicrobial activity against L. monocytogenes CCM 4699, 12 strains against S. aureus 3A3, 10 strains against S. aureus 5A2 as well as Salmonella enterica serovar Enteritidis PT4. Moreover, enterococci have tolerated 5 % bile, low pH; they have produced lactid acid in the amount from 0.740 ± 0.091 to 1.720 ± 0.095 mmol/l. The isolates were mostly sensitive to antibiotics. Conclusion, significance and impact of study: Bacteriocin-producing strain E. faecium M3a has been selected for more detail characterization of its bacteriocin and probiotic properties with the aim for its further application as an additive.

  14. Management of small producers waste in Slovenia

    International Nuclear Information System (INIS)

    Fabjan, Marija; Rojc, Joze

    2007-01-01

    Available in abstract form only. Full text of publication follows: Radioactive materials are extensively used in Slovenia in various fields and applications in medicine, industry and research. For the managing of radioactive waste raised from these establishments the Agency for radwaste management (ARAO) was authorised as the state public service of managing the radioactive waste in 1999. The public service of the radioactive waste of small producers in Slovenia is performed in line with the Governmental decree on the Mode, Subject and Terms of Performing the Public Service of Radioactive Waste Management (Official Gazette RS No. 32/99). According to the Decree the scope of the public service includes: 'collection of the waste from small producers at the producers' premises and its transportation to the storage facility for treatment, storing and disposal', 'acceptance of radioactive waste in case of emergency situation on the premises, in case of transport accidents or some other accidents', 'acceptance of radioactive waste in cases when the producer is unknown', 'management (collection, transport, pre-treatment, storing, together with QA and radiation protection measures) of radioactive waste', 'treatment and conditioning of radioactive waste for storing and disposal', and 'operating of the Central Interim Storage for LIL waste from small producers'. After taking over the performing of the public service, ARAO first started with the project for refurbishment and modernization of the Central Interim Storage Facility, including improvements of the storage utilization and rearrangement of the stored waste. (authors)

  15. Characterization of Soluble Organics in Produced Water

    Energy Technology Data Exchange (ETDEWEB)

    Bostick, D.T.

    2002-01-16

    Soluble organics in produced water and refinery effluents represent treatment problems for the petroleum industry. Neither the chemistry involved in the production of soluble organics nor the impact of these chemicals on total effluent toxicity is well understood. The U.S. Department of Energy provides funding for Oak Ridge National Laboratory (ORNL) to support a collaborative project with Shell, Chevron, Phillips, and Statoil entitled ''Petroleum and Environmental Research Forum project (PERF 9844: Manage Water-Soluble Organics in Produced Water''). The goal of this project, which involves characterization and evaluation of these water-soluble compounds, is aimed at reducing the future production of such contaminants. To determine the effect that various drilling conditions might have on water-soluble organics (WSO) content in produced water, a simulated brine water containing the principal inorganic components normally found in Gulf of Mexico (GOM) brine sources was prepared. The GOM simulant was then contacted with as-received crude oil from a deep well site to study the effects of water cut, produced-water pH, salinity, pressure, temperature, and crude oil sources on the type and content of the WSO in produced water. The identities of individual semivolatile organic compounds (SVOCs) were determined in all as-received crude and actual produced water samples using standard USEPA Method (8270C) protocol. These analyses were supplemented with the more general measurements of total petroleum hydrocarbon (TPH) content in the gas (C{sub 6}-C{sub 10}), diesel (C{sub 10}-C{sub 20}), and oil (C{sub 20}-C{sub 28}) carbon ranges as determined by both gas chromatographic (GC) and infrared (IR) analyses. An open liquid chromatographic procedure was also used to differentiate the saturated hydrocarbon, aromatic hydrocarbon, and polar components within the extractable TPH. Inorganic constituents in the produced water were analyzed by ion

  16. Recycling of aluminum to produce green energy

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, Susana Silva; Lopez Benites, Wendy; Alvarez Gallegos, Alberto A. [Centro de Investigacion en Ingenieria y Ciencias Aplicadas, Av. Universidad 1001, Col. Chamilpa, Cuernavaca, Morelos C.P. 62210 (Mexico); Sebastian, P.J. [Centro de Investigacion en Energia-UNAM, 62580 Temixco, Morelos (Mexico)

    2005-07-15

    High-purity hydrogen gas was generated from the chemical reaction of aluminum with sodium hydroxide. Several molar relations of sodium hydroxide/aluminum were investigated in this study. The experimental results showed that hydrogen yields are acceptable and its purity was good enough to be used in a proton exchange membrane (PEM) fuel cell to produce electricity. An estimation of the amount of energy produced from the reaction of 100 aluminum cans with caustic soda showed that the hydrogen production is feasible to be scaled up to reach up to 5kWh in a few hours. This study is environmentally friendly and also shows that green energy can be produced from aluminum waste at a low cost.

  17. Salmonella in beef and produce from honduras.

    Science.gov (United States)

    Maradiaga, Martha; Miller, Mark F; Thompson, Leslie; Pond, Ansen; Gragg, Sara E; Echeverry, Alejandro; Garcia, Lyda G; Loneragan, Guy H; Brashears, Mindy M

    2015-03-01

    Salmonella continues to cause a considerable number of foodborne illnesses worldwide. The sources of outbreaks include contaminated meat and produce. The purpose of this study was to establish an initial investigation of the burden of Salmonella in produce and beef from Honduras by sampling retail markets and abattoirs. Retail produce samples (cantaloupes, cilantro, cucumbers, leafy greens, peppers, and tomatoes; n = 573) were purchased in three major cities of Honduras, and retail whole-muscle beef (n = 555) samples were also purchased in four major cities. Additionally, both hide and beef carcass (n = 141) samples were collected from two Honduran abattoirs. Whole-muscle beef samples were obtained using a sponge hydrated with buffered peptone water, and 10 ml of the buffered peptone water rinsate of each produce sample was collected with a dry sponge and placed in a bag to be transported back to the United States. Salmonella was detected using a commercially available, closeplatform PCR system, and positive samples were subjected to culture on selective media to obtain isolates. Overall, the prevalence of Salmonella-positive samples, based on PCR detection in Honduras (n = 555) retail beef was 10.1% (95% confidence interval = 7.8, 12.9), whereas 7.8% (n = 141) of beef carcass and hides samples were positive in both beef plants. The overall Salmonella prevalence for all produce samples (n = 573) collected was 2.1% (95% confidence interval = 1.2, 3.6). The most common serotypes identified in Honduras were Salmonella Typhimurium followed by Derby. These results provide an indication of Salmonella contamination of beef and produce in Honduras. Developing a Salmonella baseline for Latin America through an initial investigation like the one presented here contributes to a broader global understanding of the potential exposure through food, thus providing insight into the needs for control strategies.

  18. Activity of MK-7655 combined with imipenem against Enterobacteriaceae and Pseudomonas aeruginosa.

    Science.gov (United States)

    Livermore, David M; Warner, Marina; Mushtaq, Shazad

    2013-10-01

    MK-7655 is a novel inhibitor of class A and C β-lactamases. We investigated its potential to protect imipenem. Chequerboard MICs were determined by CLSI agar dilution: (i) for Enterobacteriaceae with carbapenemases; (ii) for Enterobacteriaceae with carbapenem resistance contingent on combinations of impermeability together with an extended-spectrum β-lactamase or AmpC enzyme; and (iii) for Pseudomonas aeruginosa and other non-fermenters. At a concentration of 4 mg/L, MK-7655 reduced imipenem MICs for Enterobacteriaceae with KPC carbapenemases from 16-64 mg/L to 0.12-1 mg/L. Synergy also was seen for Enterobacteriaceae with impermeability-mediated carbapenem resistance, with weaker synergy seen for isolates with the OXA-48 enzyme. On the other hand, MK-7655 failed to potentiate imipenem against Enterobacteriaceae with metallo-carbapenemases. In the case of P. aeruginosa, where endogenous AmpC confers slight protection versus imipenem, 4 mg/L MK-7655 reduced the MIC of imipenem for all isolates, except those with metallo-carbapenemases: the MICs of imipenem fell from 1-2 mg/L to 0.25-0.5 mg/L for imipenem-susceptible P. aeruginosa and from 16-64 mg/L to 1-4 mg/L for OprD-deficient strains. No potentiation was seen for chryseobacteria or for Stenotrophomonas maltophilia. MK-7655 potentiated imipenem against Enterobacteriaceae with KPC carbapenemases or combinations of β-lactamase and impermeability, but not those with metallo-carbapenemases. It augmented the activity of imipenem against P. aeruginosa in general and OprD mutants in particular.

  19. WCK 4234, a novel diazabicyclooctane potentiating carbapenems against Enterobacteriaceae, Pseudomonas and Acinetobacter with class A, C and D β-lactamases.

    Science.gov (United States)

    Mushtaq, Shazad; Vickers, Anna; Woodford, Neil; Livermore, David M

    2017-06-01

    Several diazabicyclooctanes (DBOs) are under development as inhibitors of class A and C β-lactamases. Inhibition of OXA (class D) carbapenemases is variable, with those of Acinetobacter spp. remaining notably resistant. We describe a novel DBO, WCK 4234 (Wockhardt), with distinctive activity against OXA carbapenemases. MICs of imipenem and meropenem were determined by CLSI agar dilution with WCK 4234 added at 4 or 8 mg/L. Test organisms were clinical Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa with carbapenemases or carbapenem resistance via porin loss plus AmpC or ESBL activity. AmpC mutants were also tested. WCK 4234, which lacked direct antibacterial activity, strongly potentiated imipenem and meropenem against Enterobacteriaceae with OXA-48/OXA-181 or KPC enzymes, or with combinations of impermeability and AmpC or ESBL activity, with MICs reduced to ≤2 mg/L in almost all cases. Carbapenems likewise were potentiated against P. aeruginosa ( n  =   2) with OXA-181 enzyme, with MICs reduced from 64-128 to 2-8 mg/L and against A. baumannii with OXA carbapenemases, particularly OXA-23 or hyperproduced OXA-51, with MICs reduced to ≤2 mg/L for 9/10 acinetobacters with OXA-23 enzyme. Carbapenems were not potentiated against Enterobacteriaceae or non-fermenters with metallo-β-lactamases. WCK 4234 distinctively overcame resistance mediated by OXA-type carbapenemases, including those of A. baumannii . It behaved similarly to other DBOs against strains with KPC carbapenemases or combinations of impermeability and ESBL or AmpC activity. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Method for producing small hollow spheres

    International Nuclear Information System (INIS)

    Hendricks, C.D.

    1979-01-01

    A method is described for producing small hollow spheres of glass, metal or plastic, wherein the sphere material is mixed with or contains as part of the composition a blowing agent which decomposes at high temperature (T >approx. 600 0 C). As the temperature is quickly raised, the blowing agent decomposes and the resulting gas expands from within, thus forming a hollow sphere of controllable thickness. The thus produced hollow spheres (20 to 10 3 μm) have a variety of application, and are particularly useful in the fabrication of targets for laser implosion such as neutron sources, laser fusion physics studies, and laser initiated fusion power plants

  1. Methods for producing reinforced carbon nanotubes

    Science.gov (United States)

    Ren, Zhifen [Newton, MA; Wen, Jian Guo [Newton, MA; Lao, Jing Y [Chestnut Hill, MA; Li, Wenzhi [Brookline, MA

    2008-10-28

    Methods for producing reinforced carbon nanotubes having a plurality of microparticulate carbide or oxide materials formed substantially on the surface of such reinforced carbon nanotubes composite materials are disclosed. In particular, the present invention provides reinforced carbon nanotubes (CNTs) having a plurality of boron carbide nanolumps formed substantially on a surface of the reinforced CNTs that provide a reinforcing effect on CNTs, enabling their use as effective reinforcing fillers for matrix materials to give high-strength composites. The present invention also provides methods for producing such carbide reinforced CNTs.

  2. Reduction of radioactivity produced by nuclear explosives

    Energy Technology Data Exchange (ETDEWEB)

    Lessler, Richard M [Lawrence Radiation Laboratory, University of California, Livermore, CA (United States)

    1970-05-15

    Four main sources contribute to the radioactivity produced by a nuclear explosive: 1. Fission products from the nuclear explosive, 2. Fusion products from the nuclear explosive, 3. Induced radioactivity in the nuclear explosive, 4. Induced radioactivity in the environment. This paper will summarize some of the work done at the Lawrence Radiation Laboratory at Livermore to reduce the radioactivity from these sources to levels acceptable for peaceful applications. Although it is theoretically possible to have no radioactivity produced by nuclear explosives, this goal has not been achieved.

  3. Producing of multicomponent and composite surface layers

    International Nuclear Information System (INIS)

    Wierzchon, T.; Bielinski, P.; Michalski, A.

    1995-01-01

    The paper presents a new method of producing multicomponent and composite layers on steel substrate. The combination of nickel plating with glow-discharge bordering or impulse-plasma deposition method gives an opportunity to obtain good properties of surface layers. The results of examinations of carbon 45 (0.45%C) steel, nickel plated and then borided under glow discharge conditions or covered with TiN layers are presented. The corrosion and friction wear resistance of such layers are markedly higher than for layer produced on non nickel plated substrates. (author). 19 refs, 5 figs

  4. Article and process for producing an article

    Science.gov (United States)

    Lacy, Benjamin Paul; Jacala, Ariel Caesar Prepena; Kottilingam, Srikanth Chandrudu; Schick, David Edward

    2017-10-24

    An article and a process of producing an article are provided. The article includes a base material, a cooling feature arrangement positioned on the base material, the cooling feature arrangement including an additive-structured material, and a cover material. The cooling feature arrangement is between the base material and the cover material. The process of producing the article includes manufacturing a cooling feature arrangement by an additive manufacturing technique, and then positioning the cooling feature arrangement between a base material and a cover material.

  5. Radiation produced by electrons incident on molecules

    International Nuclear Information System (INIS)

    Moehlman, G.R.

    1977-01-01

    The work described in this thesis deals with light intensity measurements of emission spectra (1850-9000 A) produced by a continuous or pulsed beam of monoenergetic electrons (0 - 2000 eV) incident on a variety of molecular gases like H 2 , D 2 , H 2 O, HCl, NH 3 and several hydrocarbons. The emission spectra are dominated by fluorescence from excited fragments produced via dissociative excitation, besides fluorescence from excited parent molecules themselves. The experimental results thus obtained are expressed in terms of emission cross secti