Article
Genetics & Heredity
Cuidan Li, Xiaoyuan Jiang, Tingting Yang, Yingjiao Ju, Zhe Yin, Liya Yue, Guannan Ma, Xuebing Wang, Ying Jing, Xinhua Luo, Shuangshuang Li, Xue Yang, Fei Chen, Dongsheng Zhou
Summary: The dissemination of carbapenemase-producing Klebsiella pneumoniae (cpKP) is driven by specific combinations of host-blaKPC-carrying plasmids, which are associated with strong population expansion in 2007-2008. This study provides insights into the molecular epidemiology and genetic basis for the spread of ST11/CG258 cpKP in China.
GENOMICS PROTEOMICS & BIOINFORMATICS
(2022)
Article
Microbiology
Otavio Hallal Ferreira Raro, Patrice Nordmann, Manuel Dominguez Pino, Jacqueline Findlay, Laurent Poirel
Summary: There is an increasing occurrence of multidrug-resistant (MDR) and hypervirulent (hv) Klebsiella pneumoniae (MDR-hvKp) convergent clones. These strains can cause difficult-to-treat infections and have a higher mortality rate in healthy adults. This study in Switzerland identified a rate of 9.0% K. pneumoniae with a virulence genotype, producing carbapenemase and recovered from rectal swabs, urine, and blood. The presence of alarming MDR-hvKp and MDR nonhypervirulent K. pneumoniae (MDR-nhv-Kp) isolates highlights the need for surveillance networks to track and monitor their spread.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2023)
Article
Infectious Diseases
Lin Huang, Min Cao, Yanyan Hu, Rong Zhang, Yufei Xiao, Gongxiang Chen
Summary: The trend of fosfomycin resistance among KPC-KP strains is increasing in China, with the two major mechanisms of resistance being plasmid-mediated fosfomycin resistance gene fosA3 and mutation of the target gene glpT.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2021)
Article
Infectious Diseases
Constantinos Tsioutis, Vanessa M. Eichel, Nico T. Mutters
Summary: This critical review aimed to evaluate the effectiveness of measures to control the spread of KPC-KP in healthcare settings, finding that successful control during outbreaks doesn't necessarily indicate the effectiveness of individual infection control measures, due to low-quality evidence and lack of controlled intervention studies. The distribution of studies, reported cases, and high mortality rates highlight that KPC-KP remains a major healthcare problem globally.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2021)
Article
Infectious Diseases
Jee Hong Kim, Yun Young Cho, Ji Young Choi, Yu Mi Wi, Kwan Soo Ko
Summary: This study investigated the characteristics of KPC-2-producing Klebsiella pneumoniae isolates from a hospital in South Korea. It identified two main clones, ST11 and ST307, with different resistance profiles and virulence levels. Continuous monitoring of these clones, which show different characteristics including resistance and virulence, is necessary.
Article
Infectious Diseases
Cecile Emeraud, Aba Mahamat, Agnes B. Jousset, Sandrine Bernabeu, Tania Goncalves, Camille Pommier, Delphine Girlich, Aurelien Birer, Christophe Rodriguez, Jean-Michel Pawlotsky, Thierry Naas, Remy A. Bonnin, Laurent Dorte
Summary: Since 2021, the rapid spread of highly resistant NDM-14 producing Klebsiella pneumoniae has been identified in hospitals in France. This strain, primarily imported from Morocco, is highly resistant to most antimicrobials and belongs to a single clone. However, it remains susceptible to colistin, cefiderocol, and the combination of aztreonam/avibactam.
Article
Infectious Diseases
Carolina Sabenca, Eliana Costa, Sara Sousa, Lillian Barros, Ana Oliveira, Sonia Ramos, Gilberto Igrejas, Carmen Torres, Patricia Poeta
Summary: The emergence of Klebsiella pneumoniae strains producing ESBL and KPC has become a major public health concern. The ability of these strains to form biofilms is worrisome as it can facilitate the spread of antibiotic resistance and prolong infections in healthcare facilities.
Article
Microbiology
Alessandra Carattoli, Gabriele Arcari, Giulia Bibbolino, Federica Sacco, Dario Tomolillo, Federica Maria Di Lella, Maria Trancassini, Luigi Faino, Mario Venditti, Guido Antonelli, Giammarco Raponi
Summary: A study conducted in a university hospital in Rome, Italy identified multiple CZA-resistant KPC-3 protein variants, including novel variants that had not been reported before. These variants showed different sensitivities and activities to antibiotics, possibly due to mutations caused by amino acid substitutions, insertions, and deletions.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2021)
Article
Microbiology
Su Min Kyung, Jun Ho Lee, Eun-Seo Lee, Cheol-Yong Hwang, Han Sang Yoo
Summary: The whole-genome analysis of a novel type of CPKP strain revealed the presence of various AMR genes with variated genomic structures. The findings highlight the necessity of developing additional surveillance programs and control measures for this emerging strain.
Article
Infectious Diseases
Efthymia Protonotariou, Georgios Meletis, Dimitrios Pilalas, Paraskevi Mantzana, Areti Tychala, Charalampos Kotzamanidis, Dimitra Papadopoulou, Theofilos Papadopoulos, Michalis Polemis, Simeon Metallidis, Lemonia Skoura
Summary: This study investigated the molecular epidemiology of carbapenemase-producing Klebsiella pneumoniae (CPKP) in the intensive care units of a Greek hospital and found extensive dissemination and sustained transmission of multiple strains, posing a threat to the selection of pathogens resistant to last-resort antimicrobial agents.
Article
Microbiology
Qiwei Chen, Lizhang Liu, Xiaofang Hu, Xu Jia, Xiaowei Gong, Youjun Feng, Man Huang
Summary: The study focuses on the diversity of KPC-2-producing plasmids in highly transmissible ST11 clones of carbapenem-resistant K. pneumoniae (CRKP). The researchers report a clinical case of a rare ST437 CRKP isolate, K186, which produces KPC-2. Whole-genome sequencing revealed three distinct resistance plasmids, one of which, pK186_KPC, is a small IncN-type plasmid of 26,012bp. The study further suggests that the carbapenem-resistant pK186_KPC might have arisen from the integration of ancestral IncN and IncFII plasmids.
MICROBIOLOGY SPECTRUM
(2022)
Article
Infectious Diseases
Min Zhang, Jia Li, Yuemei Lu, Weiyuan Wu, Jinsong Wu, Yanji Xu, Yuxin Zhong, Shiyi Liu, Chuchu Lin, Shuye Xu, Dandan Chen, Xuefeng Gao, Yutian Luo, Huaisheng Chen, Xueyan Liu, Wei Huang
Summary: This study investigated the characteristics of ST11 subclones of clinical Klebsiella pneumoniae in China and found different patterns of prevalence and genetic relationships among the subclones, highlighting the importance of highly discriminatory genotyping techniques such as cgMLST scheme.
INFECTION AND DRUG RESISTANCE
(2021)
Article
Biology
Natalia C. Rosas, Jonathan Wilksch, Jake Barber, Jiahui Li, Yanan Wang, Zhewei Sun, Andrea Rocker, Chaille T. Webb, Laura Perlaza-Jimenez, Christopher J. Stubenrauch, Vijaykrishna Dhanasekaran, Jiangning Song, George Taiaroa, Mark Davies, Richard A. Strugnell, Qiyu Bao, Tieli Zhou, Michael J. McDonald, Trevor Lithgow
Summary: This study reconstructed the genetic and evolutionary mechanisms of carbapenem resistance in a clinical isolate of Klebsiella quasipneumoniae. It found that multiple genetic loci are necessary for acquiring carbapenem resistance, and the selection of one gene by an antibiotic can facilitate the mutation of another gene, further enhancing the evolution of carbapenem resistance.
Article
Medical Laboratory Technology
A-Jin Lee, Hun Suk Suh
Summary: This study isolated 16 carbapenemase-producing Klebsiella pneumoniae strains from a tertiary-care hospital, showing resistance to multiple antibiotics with ST11 being the most common sequence type. Systematic screening tests are needed to identify carbapenemase producers and prevent healthcare-associated transmission.
CLINICAL LABORATORY
(2021)
Article
Infectious Diseases
Maria V. Golikova, Elena N. Strukova, Kamilla N. Alieva, Vladimir A. Ageevets, Alisa A. Avdeeva, Ofeliia S. Sulian, Stephen H. Zinner
Summary: The minimal inhibitory concentration (MIC) is used to determine bacterial susceptibility or resistance to antibiotics and predict clinical efficacy. Other measures of resistance include the MIC determined at high bacterial inocula (MICHI) and the mutant prevention concentration (MPC). This study analyzed the resistance profiles of different K. pneumoniae strains based on meropenem susceptibility, carbapenemase production, and specific carbapenemase types. The analysis showed that MIC and MPC did not correlate, but there was a significant correlation between MICHI and MPC, indicating similar resistance properties. Determining MICHI can help assess the resistance-related risk of a specific K. pneumoniae strain.
Article
Infectious Diseases
Irene Galani, Ilias Karaiskos, Evdokia Angelidis, Vassiliki Papoutsaki, Lamprini Galani, Maria Souli, Anastasia Antoniadou, Helen Giamarellou
Summary: Three ceftazidime-avibactam-resistant KPC-2-producing Klebsiella pneumoniae strains of ST39 were isolated in Greece, with two strains corresponding to KPC-33 and KPC-57, and the third strain corresponding to KPC-44.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Konstantina Nafplioti, Maria Souli, Panagiota Adamou, Eleni Moraitou, Panagiota Giannopoulou, Paraskevi Chra, Maria Damala, Evangelos Vogiatzakis, Eleftheria Trikka-Graphakos, Vasiliki Baka, Eleni Prifti, Anastasia Antoniadou, Irene Galani
Summary: This study aimed to characterize the 16S rRNA methylase (RMT) genes in aminoglycoside-resistant Enterobacterales and Pseudomonas aeruginosa isolates in hospitals in Athens, Greece in 2015-2016. It found highly resistant isolates with confirmed ESBL and carbapenemase production, with predominant rmtB1 gene in Enterobacterales and similar IncC plasmids responsible for gene dissemination, posing a public health threat.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
I Karaiskos, G. L. Daikos, A. Gkoufa, G. Adamis, A. Stefos, S. Symbardi, G. Chrysos, E. Filiou, D. Basoulis, E. Mouloudi, L. Galani, K. Akinosoglou, K. Arvaniti, A. Masgala, M. Petraki, E. Papadimitriou, I Galani, G. Poulakou, C. Routsi, H. Giamarellou
Summary: The study demonstrates that ceftazidime/avibactam is effective in treating infections caused by KPC-Kp, significantly reducing mortality rates. Additionally, ultimately fatal disease, rapidly fatal disease, and Charlson comorbidity index ≥ 2 were identified as independent predictors of death, while treatment with ceftazidime/avibactam-containing regimens was the only independent predictor of survival.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2021)
Editorial Material
Pharmacology & Pharmacy
Daniele Roberto Giacobbe, Ilias Karaiskos, Matteo Bassetti
EXPERT OPINION ON PHARMACOTHERAPY
(2022)
Review
Infectious Diseases
Ilias Karaiskos, Irene Galani, Vassiliki Papoutsaki, Lamprini Galani, Helen Giamarellou
Summary: The emergence of carbapenemase resistant Gram-negative bacteria is a major public health concern. The review highlights new treatments for infections caused by carbapenemase producing Klebsiella pneumoniae, with a focus on novel antibiotics and beta-lactamase inhibitors. Approvals and developments of new antimicrobial agents show promising outcomes in combating CPKP infections, with potential for improved efficacy and safety profiles in future therapeutic strategies against multidrug-resistant K. pneumoniae.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2022)
Article
Infectious Diseases
Aikaterini Gkoufa, Tomas Sou, Ilias Karaiskos, Christina Routsi, Yu-Wei Lin, Mina Psichogiou, Spyros Zakynthinos, Helen Giamarellou, Jian Li, Lena E. Friberg
Summary: This study assessed the pharmacokinetics of nebulised colistin methanesulfonate (CMS) for the treatment of ventilator-associated pneumonia (VAP) and found that nebulised CMS can achieve high concentrations of formed colistin in the epithelial lining fluid (ELF) while maintaining lower concentrations in plasma.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2022)
Review
Infectious Diseases
Helen Giamarellou, Ilias Karaiskos
Summary: Carbapenem resistance in Gram-negative bacteria is a serious global threat, especially with the presence of difficult-to-treat and pandrug-resistant strains. These infections are associated with high mortality and limited treatment options.
Editorial Material
Medicine, General & Internal
Daniele Roberto Giacobbe, Vincenzo Di Pilato, Ilias Karaiskos, Tommaso Giani, Anna Marchese, Gian Maria Rossolini, Matteo Bassetti
Summary: Antimicrobial resistance, particularly carbapenem resistance in Gram-negative bacteria, poses a significant global health threat. The emergence of carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) has presented clinicians with unique challenges in managing severe infections. This article discusses the evolution of treatment strategies for KPC-Kp infections over the past decade, guided by clinical evidence and advances in diagnostics.
ANNALS OF MEDICINE
(2023)
Article
Infectious Diseases
Irene Galani, Vassiliki Papoutsaki, Ilias Karaiskos, Nikolaos Moustakas, Lamprini Galani, Sofia Maraki, Viktoria Eirini Mavromanolaki, Olga Legga, Kimon Fountoulis, Evangelia D. Platsouka, Panagiota Giannopoulou, Helen Papadogeorgaki, Maria Damala, Efrosini Chinou, Aggeliki Pasxali, Ioannis Deliolanis, Helen Vagiakou, Efthymia Petinaki, Anastasia Chli, Eleni Vagdatli, Polyzo Kazila, Vassiliki Papaioannou, Konstantina Kontopoulou, Atalia Noemi Ferke, Eleni Moraitou, Anastasia Antoniadou, Helen Giamarellou
Summary: Resistance of A. baumannii to multiple antimicrobials in Greece is very high, making most of them obsolete. This study aimed to determine the molecular epidemiology and susceptibilities of A. baumannii isolates from different Greek hospitals. The majority of isolates produced carbapenemase OXA-23 and were assigned to sequence group G1. Apramycin and cefiderocol showed good activity against the isolates, while minocycline, colistin, and ampicillin-sulbactam had limited activity.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2023)
Article
Rheumatology
Konstantinos Thomas, Ioannis Grigoropoulos, Panagiota Alexopoulou, Emmanouil Karofylakis, Irene Galani, Kyriaki Korina Papadopoulou, Anastasia Tsiavou, Aliki Ntourou, Eleftheria Mavrou, Irina Qevani, Pelagia Katsimbri, Christos Koutsianas, Evgenia Mavrea, Dimitrios Vassilopoulos, Spyros Pournaras, Sotirios Tsiodras, Dimitrios Boumpas, Anastasia Antoniadou
Summary: This study examined the immune response to SARS-CoV-2 vaccination in rheumatic patients treated with rituximab. It was found that despite undetectable anti-spike antibodies in the serum, four out of ten patients showed lasting cell-mediated immune response. The cumulative dose of rituximab had an impact on both humoral and cell-mediated responses to the vaccine. Cell-mediated immune responses may serve as an important marker of vaccine efficacy against SARS-CoV-2.
Review
Microbiology
Ilias Karaiskos, Aikaterini Gkoufa, Elena Polyzou, Georgios Schinas, Zoe Athanassa, Karolina Akinosoglou
Summary: Hospital-acquired pneumonia, including ventilator-associated pneumonia (VAP), is a significant cause of morbidity and mortality in ICUs, particularly due to difficult-to-treat-resistant (DTR) Gram-negative bacteria. The COVID-19 pandemic has led to an increase in cases of secondary nosocomial pneumonia and the need for invasive mechanical ventilation, resulting in high mortality rates. High-dose nebulized colistin methanesulfonate (CMS) has gained interest as a treatment option for DTR pathogens. This review provides an overview of the current knowledge on high-dose nebulized CMS, including pharmacokinetics, clinical studies, toxicity issues, and types of nebulizers. While high-dose nebulized CMS has shown promising efficacy, safety, and improved pharmacokinetics in the treatment of VAP, large-scale trials are needed to confirm its clinical benefits.
Review
Infectious Diseases
Helen Giamarellou, Lamprini Galani, Theodoros Karavasilis, Konstantinos Ioannidis, Ilias Karaiskos
Summary: The increasing global threat of antibiotic resistance highlights the need for strategic action. Medical societies have implemented antibiotic stewardship programs within healthcare institutions to combat resistance. Multidisciplinary teams and evidence-based strategies have shown initial success in reducing resistance rates, but further research is needed for novel interventions.