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Infection prevention and control
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Enterobacterales are a large family of gram-negative bacteria which includes Escherichia coli, Klebsiella spp. and Enterobacter spp., which usually live harmlessly in the gastrointestinal tract of humans; however, they are also some of the most common cause of urinary tract, abdominal and blood stream infections.
Cardiac Implantable Device Infections
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Julian Anthony Rycroft, Simon Tiberi
Up to 90% of infections are caused by Gram-positive organisms—two-thirds of which are coagulase-negative staphylococci, with the majority of the remainder being Staphylococcus aureus. The most common Gram-negative organisms are Enterobacterales spp. and P. aeruginosa. Mycobacterial and fungal causes account for less than 1%. Infection is polymicrobial in around 11% of cases.
Good microbes, bad genes? The dissemination of antimicrobial resistance in the human microbiome
Published in Gut Microbes, 2022
Alexander Crits-Christoph, Haley Anne Hallowell, Kalia Koutouvalis, Jotham Suez
Both experimental and clinical evidence have firmly established that ARGs can be horizontally transferred between microbes in vivo. In experimental settings, spreading of ARGs via HGT between members of the Enterobacterales appears particularly frequent. While Enterobacterales are generally a minority in the healthy gut, in an inflamed state they can bloom in abundance and engage in highly frequent HGT.7 HGT of ARG plasmids between Klebsiella pneumoniae and E. coli has been observed in clinical cases.33,34 Another clinical example identified three Enterobacterales (E. coli, K. pneumoniae, and Enterobacter cloacae) co-infecting a patient that all possessed a blaOXA-48-harboring IncL/M-type plasmid, hinting that the plasmid had been acquired by two of the strains while within the patient’s gut microbiome.35 Conjugation of an ARG plasmid between E. coli strains has also been observed in the infant gut36 and in a human challenge experiment.37 Even in the absence of any antibiotic selective pressure, Serratia liquefaciens was observed transferring a plasmid with extensive ARGs to E. coli within the mouse gut.38 Additionally, post-antibiotic persisters of Salmonella enterica were found to easily transfer resistance plasmids to E. coli in the murine gut.39
Activity of ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, cefiderocol and comparators against Gram-negative organisms causing bloodstream infections in Northern Italy (2019–2021): emergence of complex resistance phenotypes
Published in Journal of Chemotherapy, 2022
Gabriele Bianco, Matteo Boattini, Sara Comini, Marco Iannaccone, Roberto Casale, Valeria Allizond, Anna Maria Barbui, Giuliana Banche, Rossana Cavallo, Cristina Costa
Cumulative antimicrobial susceptibility patterns for overall Enterobacterales isolates and for the four more common Enterobacterales species involved in this study were reported in Table 2. Among Enterobacterales isolates, CZA showed potent activity with MIC50/90 of ≤2/≤2 mg/L and achieved 2.6% of resistance. MEM (MIC50/90, ≤0.12/86 mg/L) and AK (MIC50/90, ≤8/≤8 mg/L) achieved resistance rates less than 10% (9.4% and 8.2%, respectively). CTZ (MIC50/90, ≤1/>4 mg/L) showed more activity than TAZ (MIC50/90, ≤8/>16 mg/L) with 14.2% vs. 25.5% of resistance, respectively. Resistance rates higher than 30% were observed for third generation cephalosporins (MIC50/90, ≤1/>32 mg/L), CP (MIC50/90, ≤0.06/>2 mg/L), and SXT (MIC50/90, ≤2/>4 mg/L). Considering the most common Enterobacterales species involved, significant discrepancies were observed in the antimicrobial susceptibility patterns (Table 2). K. pneumoniae achieved the most resistant cumulative antimicrobial susceptibility profile, showing higher percentages for all antimicrobials tested in comparison to E. coli, E. cloacae complex and Serratia marcescens isolates (P < 0.001). All S. marcescens isolates were susceptible to CTZ and CZA as well to all carbapenems.
Update on the epidemiology of carbapenemases in Latin America and the Caribbean
Published in Expert Review of Anti-infective Therapy, 2021
Juan Carlos García-Betancur, Tobias Manuel Appel, German Esparza, Ana C Gales, Gabriel Levy-Hara, Wanda Cornistein, Silvio Vega, Duilio Nuñez, Luis Cuellar, Luis Bavestrello, Paulo F. Castañeda-Méndez, Juan M. Villalobos-Vindas, María Virginia Villegas
All class A carbapenemases share a serine-residue at their active-site which confers the hydrolytic property to the enzyme. These are chromosomal and plasmid-located β-lactamases with a broad spectrum of hydrolytic activity against β-lactam antibiotics, including carbapenems. Class A carbapenemases are inhibited by new β-lactamase inhibitors such as avibactam and relebactam, while vaborbactam inhibits class A β-lactamases including the KPC-enzymes. Their location in mobile elements, allows them to be transferred and disseminated among a wide range of GNB [20]. These enzymes have predominantly been reported in several members of Enterobacterales, causing severe infections and outbreaks.