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Antibiotics
Special Issues
Microbial Resistance to Carbapenems: Epidemiology, Detection and Treatment Options
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Microbial Resistance to Carbapenems: Epidemiology, Detection and Treatment Options

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Mechanism and Evolution of Antibiotic Resistance".

Deadline for manuscript submissions: 20 November 2024 | Viewed by 7422

Special Issue Editors

Dr. Vasiliki Koumaki

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Guest Editor
Department of Medical Microbiology, Medical School of Athens, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 115 27 Athens, Greece
Interests: antimicrobial resistance; multidrug resistant gram-negatives; resistance mechanisms; PK/PD studies
Special Issues, Collections and Topics in MDPI journals
Dr. Efthymia Protonotariou

E-Mail Website
Guest Editor
Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
Interests: antibiotic resistance mechanisms; phenotypic and molecular methods for antibiotic resistance detection; Klebsiella pneumoniae; Pseudomonas aeruginosa; Acinetobacter baumannii; SARS-CoV-2; clinical microbiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

During the last few years, we have been witnessing the adverse effects of the ‘post-antibiotic era’, characterized by ineffective drugs and the development of superbugs. Antimicrobial resistance represents a major threat to global health, and it has significant impacts regarding morbidity, mortality and healthcare costs. In particular, carbapenem resistance has emerged in Gram-negative pathogens such as Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacterales, which are often implicated in serious, difficult-to-treat health-care-associated infections. The global epidemiology of carbapenem-resistant organisms is of great interest, as acquired carbapenem resistance via carbapenemases is transferrable among Gram-negative microorganisms. Notably, carbapenem-resistant Gram-negative bacteria are under surveillance in many countries. There is also an apparent need for timely detection methods in clinical diagnostics and appropriate therapeutic approaches.  Carbapenem-resistant, Gram-negative bacteria are listed by the WHO as pathogens with critical priority for the development of new drugs. Currently, a few new drugs and combinations, as well as old, revived drugs, have been used for the treatment of infections due to carbapenem-resistant pathogens. Therefore, this Special Issue seeks manuscripts regarding:

  1. The epidemiology of carbapenem-resistant Gram-negative bacteria;
  2. Different laboratory methodologies for prompt detection;
  3. Treatment options for infections attributed to carbapenem-resistant pathogens.

Dr. Vasiliki Koumaki
Dr. Efthymia Protonotariou
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • carbapenems
  • carbapenemases
  • Gram-negatives
  • multidrug resistance (MDR)
  • carpabenem-resistant organisms (CROs)
  • antimicrobial resistance
  • carbapenem resistance detection
  • epidemiology
  • antibiotics
  • carbapenem-resistant Gram-negative bacteria (CRGNB)

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Published Papers (4 papers)

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14 pages, 896 KiB  
Article
Rapid Reversal of Carbapenemase-Producing Pseudomonas aeruginosa Epidemiology from blaVIM- to blaNDM-harbouring Isolates in a Greek Tertiary Care Hospital
by Efthymia Protonotariou, Georgios Meletis, Nikoletta Vlachodimou, Andigoni Malousi, Areti Tychala, Charikleia Katsanou, Aikaterini Daviti, Paraskevi Mantzana and Lemonia Skoura
Antibiotics 2024, 13(8), 762; https://doi.org/10.3390/antibiotics13080762 - 12 Aug 2024
Viewed by 712
Abstract
Carbapenemase-producing Pseudomonas aeruginosa strains present a specific geographical distribution regarding the type of carbapenemase-encoding genes that they harbor. For more than twenty years, VIM-type enzymes were the only major carbapenemases that were detected among P. aeruginosa isolates in Greece until the emergence of [...] Read more.
Carbapenemase-producing Pseudomonas aeruginosa strains present a specific geographical distribution regarding the type of carbapenemase-encoding genes that they harbor. For more than twenty years, VIM-type enzymes were the only major carbapenemases that were detected among P. aeruginosa isolates in Greece until the emergence of NDM-1-encoding P. aeruginosa in early 2023. In the present study, we present the rapid reversal of the carbapenemase-producing P. aeruginosa epidemiology from blaVIM- to blaNDM-harbouring isolates that occurred in our hospital since then. Between January 2023 and February 2024, 139 isolates tested positive for carbapenemase production with the NG-Test CARBA 5 immunochromatographic assay. Eight isolates were processed with the Hybrispot antimicrobial resistance direct flow chip molecular assay, and the first NDM-producing isolate was further analyzed through whole genome sequencing and bioinformatics analysis. Multiple resistance genes were detected by molecular techniques in accordance with the extensively drug-resistant phenotype. The isolate that was subjected to whole-genome sequencing belonged to the P. aeruginosa high-risk clone ST308, and the blaNDM was located in the chromosome in accordance with previously reported data. During the study period, NDM-producing isolates were increasingly detected, and only five months after their emergence, they overcame VIM producers. Our results indicate the potential of this new clone to spread rapidly and predominate within healthcare institutions, further restricting the already limited treatment options. Full article
(This article belongs to the Special Issue Microbial Resistance to Carbapenems: Epidemiology, Detection and Treatment Options)
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12 pages, 285 KiB  
Article
Evolution of Antimicrobial Resistance in Klebsiella pneumoniae over 3 Years (2019–2021) in a Tertiary Hospital in Bucharest, Romania
by Alexandra Cireșă, Daniela Tălăpan, Carmen-Cristina Vasile, Cristina Popescu and Gabriel-Adrian Popescu
Antibiotics 2024, 13(5), 431; https://doi.org/10.3390/antibiotics13050431 - 10 May 2024
Cited by 1 | Viewed by 1760
Abstract
Background: The antimicrobial resistance (AMR) of Klebsiella pneumoniae recorded a steep upward trend over the last two decades, among which carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most concerning strains considering the development and spread of AMR. The aim of this study [...] Read more.
Background: The antimicrobial resistance (AMR) of Klebsiella pneumoniae recorded a steep upward trend over the last two decades, among which carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the most concerning strains considering the development and spread of AMR. The aim of this study was to analyze the evolution of AMR for Klebsiella pneumoniae and to describe the risk factors of AMR for Klebsiella pneumoniae, including the COVID-19 pandemic. Methods: We conducted a retrospective study on Klebsiella pneumoniae non-duplicative isolates collected from patients admitted to a tertiary hospital in Bucharest, Romania, from January 2019 to December 2021. We evaluated AMR changes by comparing resistance between 2019 and the mean of 2020–2021. Results: The rates of AMR increased for third-generation cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and colistin and decreased for trimethoprim/sulfamethoxazole (TMP/SMX), 45.7% in 2019 vs. 28.3% in 2021. A longer length of hospital stay (ꭓ2 = 49.68, p < 0.01); recent antibiotic consumption, RR = 1.38, 95% CI [1.21, 1.57]; and recent contact with hospital settings, RR = 1.54, 95% CI [1.32, 1.8] were risk factors for multidrug-resistant (MDR) Klebsiella pneumoniae. Conclusions: The AMR of Klebsiella pneumoniae increased during 2020–2021 for most of the potential active antibiotics; only TMP/SMX resistance decreased, and it may represent a treatment option for CRKP or MDR Klebsiella pneumoniae infections. Decreasing the excessive use of antibiotics and the implementation of prevention and control measures in healthcare settings are mandatory for avoiding further increases in the AMR rate of Klebsiella pneumoniae. Full article
(This article belongs to the Special Issue Microbial Resistance to Carbapenems: Epidemiology, Detection and Treatment Options)
8 pages, 1445 KiB  
Communication
Screening of Klebsiella pneumoniae Isolates for Carbapenemase and Hypervirulence-Associated Genes by Combining the Eazyplex® Superbug CRE and hvKp Assays
by Jürgen Rödel, Yvonne Pfeifer, Martin A. Fischer, Birgit Edel, Sylvia Stoll, Wolfgang Pfister and Bettina Löffler
Antibiotics 2023, 12(6), 959; https://doi.org/10.3390/antibiotics12060959 - 25 May 2023
Cited by 2 | Viewed by 2258
Abstract
The acquisition of hypervirulence-associated genes by carbapenemase-producing Klebsiella pneumoniae is being increasingly observed, and easy-to-use diagnostic tests are needed for the surveillance of the hypervirulent K. pneumoniae (hvKp). In this pilot study, 87 K. pneumoniae isolates from invasive infections collected in 2022 and [...] Read more.
The acquisition of hypervirulence-associated genes by carbapenemase-producing Klebsiella pneumoniae is being increasingly observed, and easy-to-use diagnostic tests are needed for the surveillance of the hypervirulent K. pneumoniae (hvKp). In this pilot study, 87 K. pneumoniae isolates from invasive infections collected in 2022 and 2023 were analysed using the LAMP-based eazyplex® Superbug CRE and hvKp assays for the simultaneous identification of carbapenemases and virulence genes (rmpA/A2, iuC, iroC, ybt, clb). Nine isolates showed a Kleborate virulence score of 4 or 5 (10.3%). The time for the results of the eazyplex® assays ranged from 6.5 to 13 min, and the total turnaround time, including sample preparation, was less than 30 min. Five isolates, three of which produced New Delhi metallo-beta lactamase (NDM), were subjected to whole-genome sequencing (WGS) analysis for further characterisation. The eazyplex® test results for beta-lactamase and virulence genes were confirmed. The eazyplex® hvKp, currently only available as a Research Use Only assay, may be a useful tool for the rapid identification of hvKp without significant additional workload when combined with the eazyplex® Superbug CRE assay for the detection of carbapenemases. Full article
(This article belongs to the Special Issue Microbial Resistance to Carbapenems: Epidemiology, Detection and Treatment Options)
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9 pages, 232 KiB  
Brief Report
Epidemiology and Risk Factors of Carbapenemase-Producing Enterobacteriaceae Acquisition and Colonization at a Korean Hospital over 1 Year
by Hye-Jin Kim, Jung-Hee Hyun, Hyo-Seon Jeong and Yeon-Kyeng Lee
Antibiotics 2023, 12(4), 759; https://doi.org/10.3390/antibiotics12040759 - 14 Apr 2023
Cited by 2 | Viewed by 1907
Abstract
Background: Carbapenemase-producing Enterobacteriaceae (CPE) are known to be primarily responsible for the increasing spread of carbapenem-resistant Enterobacteriaceae and have therefore been targeted for preventing transmission and appropriate treatment. This study aimed to describe the clinical and epidemiological characteristics and risk factors of [...] Read more.
Background: Carbapenemase-producing Enterobacteriaceae (CPE) are known to be primarily responsible for the increasing spread of carbapenem-resistant Enterobacteriaceae and have therefore been targeted for preventing transmission and appropriate treatment. This study aimed to describe the clinical and epidemiological characteristics and risk factors of CPE infection in terms of acquisition and colonization. Methods: We examined patients’ hospital data, including active screening on patients’ admission and in intensive care units (ICUs). We identified risk factors for CPE acquisition by comparing the clinical and epidemiological data of CPE-positive patients between colonization and acquisition groups. Results: A total of 77 CPE patients were included (51 colonized and 26 acquired). The most frequent Enterobacteriaceae species was Klebsiella pneumoniae. Among CPE-colonized patients, 80.4% had a hospitalization history within 3 months. CPE acquisition was significantly associated with treatment in an ICU [adjusted odds ratio (aOR): 46.72, 95% confidence interval (CI): 5.08–430.09] and holding a gastrointestinal tube (aOR: 12.70, 95% CI: 2.61–61.84). Conclusions: CPE acquisition was significantly associated with ICU stay, open wounds, holding catheters or tubes, and antibiotic treatment. Active CPE screening should be implemented on admission and periodically for high-risk patients. Full article
(This article belongs to the Special Issue Microbial Resistance to Carbapenems: Epidemiology, Detection and Treatment Options)
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