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complete genome sequence of a multidrug-resistant, blandm-1-expressing klebsiella pneumoniae k66-45 clinical isolate from norway.multidrug-resistant klebsiella pneumoniae is a major cause of hospital-acquired infections. here, we report the complete genome sequence of the multidrug-resistant, blandm-1-positive strain k. pneumoniae k66-45, isolated from a hospitalized norwegian patient.201728684580
pneumonia in the developing world: characteristic features and approach to management.community-acquired pneumonia (cap) is a common cause of morbidity and mortality in adults worldwide, but its epidemiology varies markedly by region. whilst in high-income countries, the predominant burden of cap is in the elderly and those with chronic cardiovascular and pulmonary co-morbidity, cap patients in low-income settings are often of working age and, in sub-saharan africa, frequently hiv-positive. although region-specific aetiological data are limited, they are sufficient to highlight m ...201728681972
double carbapenem as a rescue strategy for the treatment of severe carbapenemase-producing klebsiella pneumoniae infections: a two-center, matched case-control study.recent reports have suggested the efficacy of a double carbapenem (dc) combination, including ertapenem, for the treatment of carbapenem-resistant klebsiella pneumoniae (cr-kp) infections. we aimed to evaluate the clinical impact of such a regimen in critically ill patients.201728679413
effect of the meropenem mic on the killing activity of meropenem and polymyxin b in combination against kpc-producing klebsiella pneumoniae. 201728676713
dissemination of carbapenem-resistant klebsiella pneumoniae clinical isolates with various combinations of carbapenemases (kpc-2, ndm-1, ndm-4, and oxa-48) and 16s rrna methylases (rmtb and rmtc) in vietnam.twenty-seven clinical isolates of carbapenem-resistant klebsiella pneumoniae with mics ≥4 mg/l for imipenem or meropenem were obtained from inpatients in a hospital in vietnam. antimicrobial susceptibility tests and whole genome sequencing were performed. multilocus sequence typing and the presence of drug resistant genes were determined and a maximum-likelihood phylogenetic tree was constructed by snp alignment of whole genome sequencing data.201728676118
emerging trends of nosocomial pneumonia in intensive care unit of a tertiary care public teaching hospital in western india.nosocomial pneumonia poses great challenge to an intensivist. detailed information about hospital-acquired pneumonia (hap) and ventilator-acquired pneumonia (vap) is crucial for prevention and optimal management, thus improving quality intensive care unit (icu) care. hence, we aimed to study the current trend of nosocomial pneumonia in icu.201728671150
carbapenem resistant klebsiella pneumoniae isolated from bloodstream infection: indian experience.increased incidence of multidrug resistant (mdr) gram negative infection has resulted in high rates of morbidity and mortality. klebsiella pneumoniae is one of the commonest mdr pathogens causing bacteraemia with limited therapeutic options such as colistin and tigecycline. present study focused on molecular characterisation of mdr k. pneumoniae from bloodstream infection and their clinical outcome. a total of 115 k. pneumoniae from january 2015 to september 2016 were included in the study which ...201728670975
in vitro pharmacokinetics/pharmacodynamics evaluation of fosfomycin combined with amikacin or colistin against kpc2-producing klebsiella pneumoniae.objectives: the emergence of carbapenem-resistant enterobacteriaceae, especially klebsiella pneumoniae, has become a major concern in clinic settings. combination therapy is gaining momentum to counter the secondary resistance and potential suboptimal efficacy of monotherapy. the aim of this study was to evaluate the bactericidal effect of fosfomycin (fm), amikacin (amk), or colistin (col) alone and combinations against kpc2-producing k. pneumoniae using dynamic model by simulating human pharmac ...201728670570
molecular characterization of klebsiella pneumoniae isolates from stool specimens of outpatients in sentinel hospitals beijing, china, 2010-2015.klebsiella pneumoniae (k. pneumoniae) is an opportunistic pathogen associated with community-acquired infections and nosocomial infections. from 2010 to 2015, k. pneumoniae testing was included into the exiting diarrhea-syndrome surveillance with objective to estimate the prevalence of k. pneumoniae in diarrhea-syndrome patients, test antibiotics susceptibility and investigate molecular characteristics.201728670346
a novel approach for combating klebsiella pneumoniae biofilm using histidine functionalized silver nanoparticles.treating pathogens is becoming challenging because of multidrug resistance and availability of limited alternative therapies which has further confounded this problem. the situation becomes more alarming when multidrug resistant pathogens form a 3d structure known as biofilm. biofilms are formed in most of the infections especially in chronic infections where it is difficult to eradicate them by conventional antibiotic therapy. chemically synthesized nanoparticles are known to have antibiofilm a ...201728670301
quick 96fasp for high throughput quantitative proteome analysis.filter aided sample preparation (fasp) is becoming a central method for proteomic sample cleanup and peptide generation prior to lc-ms analysis. we previously adapted this method to a 96-well filter plate, and applied to prepare protein digests from cell lysate and body fluid samples in a high throughput quantitative manner. while the 96fasp approach is scalable and can handle multiple samples simultaneously, two key advantages compared to single fasp, it is also time-consuming. the centrifugati ...201728669814
in vivo development of tigecycline resistance in klebsiella pneumoniae owing to deletion of the ramr ribosomal binding site.tigecycline resistance is emerging among klebsiella pneumoniae, but knowledge regarding in vivo development of tigecycline resistance is limited. here we report a new mechanism of tigecycline resistance in k. pneumoniae that evolved during tigecycline therapy. klebsiella pneumoniae isolates were consecutively obtained from urine samples of a patient with scrotal abscess and urinary tract infection before and during tigecycline treatment. two tigecycline-resistant k. pneumoniae strains (kp-3r and ...201728668690
epidemiology, management, and outcome of carbapenem-resistant klebsiella pneumoniae bloodstream infections in hospitals within the same endemic metropolitan area.in the last decade, carbapenem-resistant klebsiella pneumoniae (cr-kp) has become endemic in several countries, including italy. in the present study, we assessed the differences in epidemiology, management, and mortality of cr-kp bloodstream infection (bsi) in the three main adult acute-care hospitals of the metropolitan area of genoa, italy. from january 2013 to december 2014, all patients with cr-kp bsi were identified through the computerized microbiology laboratory databases of the three ho ...201728668656
klebsiella pneumoniae. 201728665914
successful treatment of multidrug resistant klebsiella pneumoniae using dual carbapenem regimen in immunocompromised patient.this report describes a longitudinal case of immunocompromised patient post kidney transplant who was admitted to our institution repeatedly for treatment of various infections caused by multi-drug resistant klebsiella pneumoniae. the patient was successfully treated with a combination of ertapenem/meropenem on multiple occasions despite the elevated mics. our observations corroborate previous preclinical studies and case reports showing the efficacy of double carbapenem regimens against resista ...201728660131
molecular epidemiology and risk factors of carbapenem-resistant klebsiella pneumoniae infections in eastern china.background: the increasing prevalence of carbapenem-resistant klebsiella pneumoniae (crkp) poses an immediate threat to treatment worldwide. this retrospective study assessed the molecular epidemiology and determined the risk factors for and outcomes of crkp infections in a general teaching hospital in shanghai, china. methods: from january 2013 to july 2015, 100 consecutive unique crkp isolates isolated from hospitalized patients were collected. isolates were screened for antibiotic resistance ...201728659886
metastatic endophthalmitis and thyroid abscess complicating klebsiella pneumoniae liver abscess.the thyroid is resistant to infection due to its anatomical and physiological characteristics. we present a rare case of invasive liver abscess with metastatic thyroid abscess and endogenous endophthalmitis in a previously healthy 55-year-old female patient without diabetes or other medical illness. this report raises an important question of the virulence of klebsiella pneumoniae as an increasingly common causative agent of liver abscess.201728656747
stand-alone eal domain proteins form a distinct subclass of eal proteins involved in regulation of cell motility and biofilm formation in enterobacteria.the second messenger cyclic dimeric gmp (c-di-gmp) is almost ubiquitous among bacteria as are the c-di-gmp turnover proteins, which mediate the transition between motility and sessility. eal domain proteins have been characterized as c-di-gmp-specific phosphodiesterases. while most eal domain proteins contain additional, usually n-terminal, domains, there is a distinct family of proteins with stand-alone eal domains, exemplified by salmonella enterica serovar typhimurium proteins stm3611 (yhjh/p ...201728652301
complete dna sequence of an incm1 plasmid bearing the novel qnre1 plasmid-mediated quinolone resistance variant and blactx-m-8 from klebsiella pneumoniae sequence type 147. 201728652231
in vitro antibacterial activity of fosfomycin combined with other antimicrobials against kpc-producing klebsiella pneumoniae.the increasing prevalence of kpc-producing klebsiella pneumoniae (kpc-kp) strains poses a serious threat to patients. therapeutic options are limited to colistin, fosfomycin, tigecycline and selected aminoglycosides. although the combination of fosfomycin with other antimicrobials is recommended, data regarding possible synergistic activity in vitro and in vivo appear inconsistent. here we report that five drug combinations (fosfomycin combined with imipenem, ertapenem, tigecycline, colistin or ...201728648647
higher mortality of severe influenza patients with probable aspergillosis than those with and without other coinfections.aspergillus-associated infection might comprise up to 23-29% of severe influenza patients from the community throughout stay in an intensive care unit (icu). in taiwan, cases of severe influenza with aspergillosis are increasingly reported. therefore, we describe the relative risk of mortality among severe influenza patients with aspergillosis and other coinfections compared to severe influenza patients without aspergillus coinfections.201728647219
multidrug resistance mechanisms of carbapenem resistant klebsiella pneumoniae strains isolated in chongqing, china.carbapenem-resistant klebsiella pneumoniae (crkp) is considered a serious global threat. however, little is known regarding the multidrug resistance (mdr) mechanisms of crkp. this study investigated the phenotypes and mdr mechanisms of crkp and identified their clonal characteristics.201728643488
first description of methyltransferases in extensively drug-resistant klebsiella pneumoniae isolates from saudi arabia.the resistance determinants for carbapenems, fluoroquinolones and aminoglycosides were characterized in 16 extensively drug-resistant klebsiella pneumoniae (xdrkpn) strains collected from saudi hospitals during 2014.201728639934
lipid peroxidation in gram-negative bacteremia modulates the risk for septic shock and infections by resistant klebsiella pneumoniae.controversies in outcomes with the parenteral administration of antioxidants as adjuvant therapies led to the measurement of malondialdehyde (mda), a product of lipid peroxidation, in serum collected from 120 patients with primary gram-negative bacteremia during the first 24 h from sepsis onset. mda was measured by the thiobarbiturate assay, followed by high-performance liquid chromatography (hplc) analysis. after receiver operator characteristic (roc) curve analysis, patients were divided into ...201728639164
molecular identification of aminoglycoside-modifying enzymes and plasmid-mediated quinolone resistance genes among klebsiella pneumoniae clinical isolates recovered from egyptian patients.inappropriate use of antibiotics in clinical settings is thought to have led to the global emergence and spread of multidrug-resistant pathogens. the goal of this study was to investigate the prevalence of genes encoding aminoglycoside resistance and plasmid-mediated quinolone resistance among clinical isolates of klebsiella pneumoniae. all k. pneumoniae isolates were phenotypically identified using api 20e and then confirmed genotypically through amplification of the specific k. pneumoniae phoe ...201728638412
deleting pck improves growth and suppresses by-product formation during 1,3-propanediol fermentation by klebsiella pneumoniae.to investigate the role of phosphoenolpyruvate (pep) carboxylation in cell metabolism in klebsiella pneumoniae.201728637087
emerging antimicrobial resistance in early and late-onset neonatal sepsis.compared to developed countries, the use of antimicrobials in egypt is less regulated and is available over the counter without the need for prescriptions. the impact of such policy on antimicrobial resistance has not been studied. this study aimed to determine the prevalence of early and late onset sepsis, and the frequency of antimicrobial resistance in a major referral neonatal intensive care unit (nicu).201728630687
identifying spectra of activity and therapeutic niches for ceftazidime-avibactam and imipenem-relebactam against carbapenem-resistant enterobacteriaceae.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 no ...201728630202
antibiotic resistance determinants and clonal relationships among multidrug-resistant isolates of klebsiella pneumoniae.in the present study, we performed pcr based screening to determine the presence of antibiotic resistance genes and sequencing to find mutation in qrdr region among fourteen isolates of k. pneumoniae. association analysis was conducted to detect the co-resistance among the isolates. multi-locus sequence analysis was carried out to determine the clonal relationship among them. all the k. pneumoniae isolates showed resistance to multiple antibiotics and exhibited cross-resistance to antibiotics. a ...201728629728
molecular characterization of clinical imp-producing klebsiella pneumoniae isolates from a chinese tertiary hospital.imp-producing klebsiella pneumoniae (impkpn) exhibits sporadic prevalence in china. the mechanisms related to the spread of impkpn remain unclear.201728629366
resistance to colistin in klebsiella pneumoniae: a 4.0 strain?the global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. from the first observation of a carbapenem-resistant gram-negative bacteria a global spread of extended-spectrum beta-lactamases and carbapenemases producing klebsiella pneumoniae has been observed. treatment options for multidrug-resistant k. pneumoniae are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. unfortunately, ...201728626539
acyloxyacyl hydrolase promotes the resolution of lipopolysaccharide-induced acute lung injury.pulmonary infection is the most common risk factor for acute lung injury (ali). innate immune responses induced by microbe-associated molecular pattern (mamp) molecules are essential for lung defense but can lead to tissue injury. little is known about how mamp molecules are degraded in the lung or how mamp degradation/inactivation helps prevent or ameliorate the harmful inflammation that produces ali. acyloxyacyl hydrolase (aoah) is a host lipase that inactivates gram-negative bacterial endotox ...201728622363
clinical features and prognostic factors of klebsiella endophthalmitis-10-year experience in an endemic region.aimsto identify the clinical features and prognostic factors of endogenous endophthalmitis caused by klebsiella pneumoniae.methodsthis is a retrospective case series of all patients with klebsiella endophthalmitis managed from january 2006 to december 2015 by kowloon east ophthalmic service. statistical analysis involved hypothesis testing on the spss 18.0 software (spss). a significance level of p<0.05 was taken.resultsin the 10-year period, k. pneumoniae accounted for 19 out of 39 cases of end ...201728622312
identification of pathogenic factors in klebsiella pneumoniae using impedimetric sensor equipped with biomimetic surfaces.k.pneumoniae is an opportunistic pathogen that causes nosocomial infections, such as, pneumonia, urinary tract infections, septic shock, and gastro intestinal disease. lipopolysaccharide (lps), capsular polysaccharide, and fimbriae are recognized major virulence factors of k.pneumoniae and play key roles during early stages of infections. in this study, we functionalized the surface of gold electrode with mannose and mucin to monitor the adhesion-associated virulence factors of k.pneumoniae. the ...201728617330
demonstration that a klebsiella pneumoniae subsp. pneumoniae isolated from an insect (nezara viridula) harbors a plasmid-borne type iv secretion system.previously, we reported the isolation of klebsiella pneumoniae subspecies pneumoniae strain kp 5-1 from a southern green stink bug (nezara viridula) that is a significant pest of numerous economically important crops. we subsequently sequenced the strains whole genome. here, we report the presence of a functional plasmid-borne type iv secretion (tfss) system that was identified using genomic mining of the annotated genome. comparison of the kp 5-1 resident 186 kb plasmid (pkp 5-1) with nine othe ...201728616744
serum inflammatory biomarkers and clinical outcomes of copd exacerbation caused by different pathogens.copd exacerbation is characterized by worsening of symptoms, warranting change in treatment. systemic and airway inflammation play roles in the pathogenesis of copd exacerbation. we hypothesized whether increased serum inflammatory biomarkers are associated with the clinical outcomes of copd exacerbation caused by different infectious pathogens.201728615935
multi-drug resistant klebsiella pneumoniae strains circulating in hospital setting: whole-genome sequencing and bayesian phylogenetic analysis for outbreak investigations.carbapenems resistant enterobacteriaceae infections are increasing worldwide representing an emerging public health problem. the application of phylogenetic and phylodynamic analyses to bacterial whole genome sequencing (wgs) data have become essential in the epidemiological surveillance of multi-drug resistant nosocomial pathogens. between january 2012 and february 2013, twenty-one multi-drug resistant k. pneumoniae strains, were collected from patients hospitalized among different wards of the ...201728615687
intraventricular administration of tigecycline for the treatment of multidrug-resistant bacterial meningitis after craniotomy: a case report.intracranial infections, especially multidrug-resistant (mdr) bacterial meningitis, are one of the most severe complications after craniotomy and may greatly impact patient outcomes.201728614982
a carbon-dot-based fluorescent nanosensor for simple visualization of bacterial nucleic acids.a simple and facile method for sensing of nucleic acids is in great need for disease biomarker detection and diagnosis. herein, a fluorescent nanosensor utilizing carbon dot nanoparticles is introduced that form visible precipitates in the presence of target dna. carbon dot nanoparticles are fabricated by microwave pyrolysis of polyethylenimine, which emits strong photoluminescence and can form precipitates when added to target dna oligonucleotides. the precipitates can be easily visualized by u ...201728614623
the potential of a brown microalga cultivated in high salt medium for the production of high-value compounds.amphora sp. was isolated from the sfax solar saltern and cultivated under hypersaline conditions. it contains moderate rates of proteins, lipids, sugars, and minerals and a prominent content of bioactive compounds: polyphenols, chlorophyll a, carotenoids, and fatty acids. the analysis of fatty acids with gc/ms showed that the c16 series accounted for about 75% of amphora sp. lipids. saturated fatty acids whose palmitic acid was the most important (27.41%) represented 41.31%. amphora sp. was foun ...201728612024
a fragment of the alarmin prothymosin α as a novel biomarker in murine models of bacteria-induced sepsis.sepsis is a life-threatening condition that requires urgent care. thus, the identification of specific and sensitive biomarkers for its early diagnosis and management are of clinical importance. the alarmin prothymosin alpha (protα) and its decapeptide protα(100-109) are immunostimulatory peptides related to cell death. in this study, we generated bacterial models of sepsis in mice using two klebsiella pneumoniae strains (l-78 and atcc 43816) and monitored sepsis progression using protα(100-109) ...201728611290
in vitro-in vivo discordance with humanized piperacillin-tazobactam exposures against piperacillin-tazobactam-resistant/pan-β-lactam-susceptible klebsiella pneumoniae strains.recent findings have identified klebsiella pneumoniae strains that are pan-β-lactam susceptible (pbl-s) but piperacillin-tazobactam resistant (tzp-r) in vitro we assessed the efficacy of a humanized exposure of piperacillin-tazobactam (tzp) against 12 tzp-r/pbl-s k. pneumoniae isolates in an immunocompromised murine lung infection model. discordance between the in vitro resistance profile and the in vivo efficacy of human-simulated tzp exposures against this phenotypic profile was observed. addi ...201728607019
alcohol-associated intestinal dysbiosis impairs pulmonary host defense against klebsiella pneumoniae.chronic alcohol consumption perturbs the normal intestinal microbial communities (dysbiosis). to investigate the relationship between alcohol-mediated dysbiosis and pulmonary host defense we developed a fecal adoptive transfer model, which allows us to investigate the impact of alcohol-induced gut dysbiosis on host immune response to an infectious challenge at a distal organ, independent of prevailing alcohol use. male c57bl/6 mice were treated with a cocktail of antibiotics (ampicillin, gentami ...201728604843
clinical predictors and outcomes of klebsiella pneumoniae bacteraemia in a regional hospital in hong kong.klebsiella pneumoniae (kp) infection is associated with high morbidity and mortality. multidrug resistance, especially extended-spectrum β-lactamase (esbl) production, in kp is endemic worldwide.201728602703
surveillance of carbapenemase-producing enterobacteriaceae in the indian ocean region between january 2010 and december 2015.the aim of this study was to trace the emergence of carbapenemase-producing enterobacteriaceae (cpe) on reunion island, a french overseas territory well suited for the surveillance of cpe emergence in patients from the entire indian ocean region.201728602387
an unusual case of primary hepatic lymphoma with dramatic but unsustained response to bendamustine plus rituximab and literature review.primary hepatic lymphoma is an uncommon cause of hepatic space-occupying lesions.201728596829
cooperative interactions between toll-like receptor 2 and toll-like receptor 4 in murine klebsiella pneumoniae infections.klebsiella pneumoniae is an opportunistic and clinically significant emerging pathogen. we investigated the relative roles of toll-like receptor (tlr) 2 and tlr4 in initiating host defenses against k. pneumoniae. tlr2 knockout (ko), tlr4 ko, tlr2/4 double ko (dko), and wild-type (wt) mice were inoculated with k. pneumoniae. mice in each group were sacrificed after either 12 or 24h, and the lungs, liver, and blood were harvested to enumerate bacterial colony-forming units (cfu). cytokine and chem ...201728595383
epidemiology of carbapenem-resistant klebsiella pneumoniae bloodstream infections in a chinese children's hospital: predominance of new delhi metallo-β-lactamase-1.the spread of carbapenem-resistant klebsiella pneumoniae (crkp) has become a significant problem worldwide; however, relevant data in children are limited. we performed a retrospective study to better understand the epidemiology of crkp bloodstream infections at beijing children's hospital. a total of 164 k. pneumoniae strains were collected from blood cultures between january 2011 and september 2014, of which 52 (31.7%) were crkp strains. all 52 crkp strains were multidrug resistant; 46 (88.5%) ...201728594635
synthesis and evaluation of antimicrobial activity of [r₄w₄k]-levofloxacin and [r₄w₄k]-levofloxacin-q conjugates.the development of a new class of antibiotics to fight bacterial resistance is a time-consuming effort associated with high-cost and commercial risks. thus, modification, conjugation or combination of existing antibiotics to enhance their efficacy is a suitable strategy. we have previously reported that the amphiphilic cyclic peptide [r₄w₄] had antibacterial activity with a minimum inhibitory concentration (mic) of 2.97 µg/ml against methicillin-resistant staphylococcus aureus (mrsa). herein, we ...201728594345
relationship between β-lactamase production and resistance phenotype in klebsiella pneumoniae strains.this study was designed to evaluate the resistance phenotypes of β-lactamases-producing klebsiella pneumoniae strains. the antibiotic susceptibility and β-lactamase activity of k. pneumoniae strains, including antibiotic-sensitive k. pneumoniae (kpwt), ciprofloxacin-induced resistant k. pneumoniae (kpcip) and clinically isolated k. pneumoniae strains (kpci237, kpci263 and kpci272) were determined in the absence and presence of β-lactamase inhibitors (bli 489, sulbactam, clavulanate and tazobacta ...201728591808
activity of ceftazidime-avibactam against clinical isolates of klebsiella pneumoniae, including kpc-carrying isolates, endemic to new york city.in this report, we examined the (1) activity of ceftazidime-avibactam against clinical isolates klebsiella pneumoniae, including those harboring blakpc, (2) potential mechanisms leading to reduced susceptibility, and (3) activity of ceftazidime-avibactam when combined with other agents. of 802 carbapenem-resistant isolates of k. pneumoniae gathered from new york city from 1999 to 2014, all were susceptible to ceftazidime-avibactam. minimum inhibitory concentrations (mics) were higher in isolates ...201728590820
differential th17 response induced by the two clades of the pandemic st258 klebsiella pneumoniae clonal lineages producing kpc-type carbapenemase.the spread of kpc-type carbapenemases is mainly attributed to the global dissemination of klebsiella pneumoniae (kp) strains belonging to the clonal group (cg) 258, including sequence type (st) 258 and other related sts. two distinct clades of cg258-kp have evolved, which differ mainly for the composition of their capsular polysaccharides, and recent studies indicate that clade 1 evolved from an ancestor of clade 2 by recombination of a genomic fragment carrying the capsular polysaccharide (cps) ...201728586386
knowledge and attitude of physicians about antimicrobial resistance and their prescribing practices in services hospital, lahore, pakistan.a cross sectional study was conducted in services hospital, lahore using a self administered questionnaire to test the knowledge, attitude and prescribing practices of residents and attending physicians using non-probability convenience sampling. a total of 116 questionnaires were filled (response rate=77.3%). knowledge was below average (mean score of 3.66±1.1). only 18 physicians (16%) could correctly estimate the rates of resistance of klebsiella pneumoniae and pseudomonas aeruginosa to cepha ...201728585611
a study of 24 patients with colistin-resistant gram-negative isolates in a tertiary care hospital in south india.as the use of colistin to treat carbapenem-resistant gram-negative infections increases, colistin resistance is being increasingly reported in indian hospitals.201728584435
susceptibility of colistin-resistant, gram-negative bacteria to antimicrobial peptides and ceragenins.the susceptibility of colistin-resistant clinical isolates of klebsiella pneumoniae to ceragenins and antimicrobial peptides (amps) suggests that there is little to no cross-resistance between colistin and ceragenins/amps and that lipid a modifications are found in bacteria with modest changes in susceptibility to ceragenins and with high levels of resistance to colistin. these results suggest that there are differences in the resistance mechanisms to colistin and ceragenins/amps.201728584137
risk factors and clinical outcomes for carbapenem-resistant gram-negative late-onset sepsis in a neonatal intensive care unit.carbapenem-resistant (cr), gram-negative (gn), late-onset sepsis (los) is a serious threat in the neonatal intensive care unit (nicu).201728583886
synergistic activities of meropenem double and triple combinations against carbapenemase-producing enterobacteriaceae.the increasing emergence of carbapenemase-producing enterobacteriaceae poses a considerable threat to global health as only limited treatment options are available and has therefore led to efforts to discover antibiotic combination regimens effective. the aim of this study was to evaluate in vitro synergistic activity of 10 meropenem double and triple combinations against the 5 most frequently encountered carbapenemases-producing enterobacteriaceae. broth microdilution assays showed that the mer ...201728583381
genome watch: klebsiella pneumoniae: when a colonizer turns bad. 201728579608
ventilator-associated pneumonia: the role of emerging diagnostic technologies.antibiotic resistance has emerged as a key determinant of outcome in patients with serious infections along with the virulence of the underlying pathogen. within the intensive care unit (icu) setting, ventilator-associated pneumonia (vap) is a common nosocomial infection that is frequently caused by multidrug-resistant bacteria. antimicrobial resistance is a growing challenge in the care of critically ill patients. escalating rates of antibiotic resistance add substantially to the morbidity, mor ...201728578550
draft genome sequence of a ctx-m-15-producing endophytic klebsiella pneumoniae st198 isolate from commercial lettuce.ctx-m-15-producing klebsiella pneumoniae is one of the leading causes of hospital-acquired infections globally. in this study, we present the draft genome sequence of the first ctx-m-15-producing endophytic k. pneumoniae strain, belonging to sequence type 198 (st198) and isolated from commercial lettuce, which can be used as a reference sequence for comparative analysis with clinical and environmental strains of k. pneumoniae.201728576742
antimicrobial resistance of klebsiella pneumoniae stool isolates circulating in kenya.we sought to determine the genetic and phenotypic antimicrobial resistance (amr) profiles of commensal klebsiella spp. circulating in kenya by testing human stool isolates of 87 k. pneumoniae and three k. oxytoca collected at eight locations. over one-third of the isolates were resistant to ≥3 categories of antimicrobials and were considered multidrug-resistant (mdr). we then compared the resistance phenotype to the presence/absence of 238 amr genes determined by a broad-spectrum microarray and ...201728575064
nickel sequestration by the host-defense protein human calprotectin.the human innate immune protein calprotectin (cp, s100a8/s100a9 oligomer, calgranulin a/calgranulin b oligomer, mrp-8/mrp-14 oligomer) chelates a number of first-row transition metals, including mn(ii), fe(ii), and zn(ii), and can withhold these essential nutrients from microbes. here we elucidate the ni(ii) coordination chemistry of human cp. we present a 2.6-å crystal structure of ni(ii)- and ca(ii)-bound cp, which reveals that cp binds ni(ii) ions at both its transition-metal-binding sites: t ...201728573847
therapeutic potentials of ethanolic extract of leaves of holarrhena floribunda (g. don) dur. and schinz (apocynaceae).holarrhena floribunda is a plant of wide usage in the togolese folk medicine. a previous ethnobotanical survey on the latex plants of the maritime region of the country revealed that this plant was included in several recipes curing malaria and microbial infections. therefore, this study aimed to seek for the effectiveness of the ethanolic extract of the plant in the treatment of these diseases.201728573239
φbo1e, a newly discovered lytic bacteriophage targeting carbapenemase-producing klebsiella pneumoniae of the pandemic clonal group 258 clade ii lineage.the pandemic dissemination of kpc carbapenemase-producing klebsiella pneumoniae (kpc-kp) represents a major public health problem, given their extensive multidrug resistance profiles and primary role in causing healthcare-associated infections. this phenomenon has largely been contributed by strains of clonal group (cg) 258, mostly of clade ii, which in some areas represent the majority of kpc-kp isolates. here we have characterized a newly discovered lytic podoviridae, named φbo1e, targeting kp ...201728572684
a high-throughput screening strategy to identify inhibitors of ssb protein-protein interactions in an academic screening facility.antibiotic-resistant bacterial infections are increasingly prevalent worldwide, and there is an urgent need for novel classes of antibiotics capable of overcoming existing resistance mechanisms. one potential antibiotic target is the bacterial single-stranded dna binding protein (ssb), which serves as a hub for dna repair, recombination, and replication. eight highly conserved residues at the c-terminus of ssb use direct protein-protein interactions (ppis) to recruit more than a dozen important ...201728570838
risk factors for recurrent carbapenem resistant klebsiella pneumoniae bloodstream infection: a prospective cohort study.to assess risk factors for recurrent carbapenem-resistant klebsiella pneumoniae bloodstream-infection (cr-kp bsi), we performed a prospective observational cohort study of all consecutive adult patients cured of a cr-kp bsi at our hospital over a six-year period (june 2010 to june 2016). maximum follow-up per patient was 180 days from the index blood cultures (bcs). recurrent cr-kp bsi was defined as new evidence of positive bcs in patients with documented clinical response after completing a co ...201728567543
experimental sepsis severity score associated to mortality and bacterial spreading is related to bacterial load and inflammatory profile of different tissues.pneumonia-induced sepsis is responsible for about 50% of cases in the world. patients who develop severe sepsis and septic shock present organ dysfunction and elevated plasma cytokine levels, which may lead to death. clinical scores are important to evaluate the framework of septic patients and are used to predict the syndrome progress, prognostics, and mortality. the objective of the present study was to verify the applicability of a murine clinical score system to experimental sepsis (pneumoni ...201728567497
structural insights into the elevator-like mechanism of the sodium/citrate symporter cits.the sodium-dependent citrate transporter of klebsiella pneumoniae (kpcits) belongs to the 2-hydroxycarboxylate transporter (2-hct) family and allows the cell to use citrate as sole carbon and energy source in anaerobic conditions. here we present crystal structures of kpcits in citrate-bound outward-facing, citrate-bound asymmetric, and citrate-free inward-facing state. the structures reveal that the kpcits dimerization domain remains stationary throughout the transport cycle due to a hydrogen b ...201728566738
peptide markers for rapid detection of kpc carbapenemase by lc-ms/ms.carbapenemase producing organisms (cpos) represent an urgent public health threat, and the need for new rapid methods to detect these organisms has been widely recognized. cpos carrying the klebsiella pneumoniae carbapenemase (bla kpc ) gene have caused outbreaks globally with substantial attributable mortality. here we describe the validation of a rapid ms method for the direct detection of unique tryptic peptides of the kpc protein in clinical bacterial isolates with an isolate-to-result time ...201728566732
phenotypic methods for screening carbapenem-resistant enterobacteriaceae and assessment of their antimicrobial susceptibility profile.in this study, we used phenotypic methods to screen carbapenem-resistant enterobacteriaceae (cres) and evaluated their antimicrobial sensitivity profile.201728562752
himatanthus drasticus leaves: chemical characterization and evaluation of their antimicrobial, antibiofilm, antiproliferative activities.plant-derived products have played a fundamental role in the development of new therapeutic agents. this study aimed to analyze antimicrobial, antibiofilm, cytotoxicity and antiproliferative potentials of the extract and fractions from leaves of himatanthusdrasticus, a plant from the apocynaceae family. after harvesting, h. drasticus leaves were macerated and a hydroalcoholic extract (hdhe) and fractions were prepared. antimicrobial tests, such as agar-diffusion, minimum inhibitory concentration ...201728561790
outbreak by hypermucoviscous klebsiella pneumoniae st11 isolates with carbapenem resistance in a tertiary hospital in china.hypervirulent and multidrug resistant klebsiella pneumoniae strains pose a significant threat to the public health. in the present study, 21 carbapenem-resistant k. pneumoniae isolates (crkp) were determined by the string test as hypermucoviscous k. pneumoniae (hmkp), with the prevalence of 15.0% (21/140) among crkp, and 1.1% (21/1838) among all k. pneumoniae isolates. among them, 7 (33.3%), and 1 (4.76%) isolate belonged to capsular serotype k20 and k2 respectively, while 13 (61.9%, 13/21) were ...201728560183
ceftazidime-avibactam is superior to other treatment regimens against carbapenem-resistant klebsiella pneumoniae bacteremia.there are no data comparing outcomes of patients treated with ceftazidime-avibactam versus comparators for carbapenem-resistant enterobacteriaceae infections. at our center, ceftazidime-avibactam treatment of carbapenem-resistant klebsiella pneumoniae bacteremia was associated with higher rates of clinical success (p = 0.006) and survival (p = 0.01) than other regimens. across treatment groups, there were no differences in underlying diseases, severity of illness, source of bacteremia, or strain ...201728559250
mortality associated with bacteremia due to colistin-resistant klebsiella pneumoniae with high-level meropenem resistance: importance of combination therapy without colistin and carbapenems.combination therapy including colistin and a carbapenem has been found to be associated with lower mortality in the treatment of bloodstream infections (bsi) due to kpc-producing klebsiella pneumoniae when the isolates show a meropenem or imipenem mic of <16 mg/liter. however, the optimal treatment of bsi caused by colistin- and high-level carbapenem-resistant kpc-producing k. pneumoniae is unknown. a prospective cohort study including episodes of bacteremia caused by colistin-resistant and high ...201728559247
mcr-1-producing klebsiella pneumoniae outbreak in china. 201728555574
total synthesis and pharmacological investigation of cordyheptapeptide a.the present investigation reports the synthesis of a phenylalanine-rich n-methylated cyclopeptide, cordyheptapeptide a (8), previously isolated from the insect pathogenic fungus cordyceps sp. bcc 1788, accomplished through the coupling of n-methylated tetrapeptide and tripeptide fragments followed by cyclization of the linear heptapeptide unit. structure elucidation of the newly synthesized cyclopolypeptide was performed by means of ft-ir, ¹h-nmr, (13)c-nmr, and fast atom bombardment mass spectr ...201728554994
decrease of ceftriaxone susceptibility in klebsiella pneumoniae according to biofilm maturation. 201728552832
antimicrobial activity evaluation and comparison of methods of susceptibility for klebsiella pneumoniae carbapenemase (kpc)-producing enterobacter spp. isolates.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 syst ...201728552659
metabolic engineering of klebsiella pneumoniae j2b for the production of 1,3-propanediol from glucose.the production of 1,3-propanediol (1,3-pdo) from glucose was investigated using klebsiella pneumoniae j2b, which converts glycerol to 1,3-pdo and synthesize an essential coenzyme b12. in order to connect the glycolytic pathway with the pathway of 1,3-pdo synthesis from glycerol, i.e., to directly produce diol from glucose, glycerol-3-phosphate dehydrogenase and glycerol-3-phosphate phosphatase from saccharomyces cerevisiae were overexpressed. additionally, the effect of expression levels and the ...201728549809
carbapenem-resistant klebsiella pneumoniae in barbados: driving change in practice at the national level.carbapenem-resistant klebsiella pneumoniae (crkp) is of growing concern globally. the risk for transmission of antimicrobial resistant organisms across several continents to the caribbean is a real one given its tourism industry. after a cluster of cases of crkp were detected, several studies detailed in this report were initiated to better characterize the problem.201728542162
analysis of risk factors of peripherally inserted central catheter induced catheter-related infection in patients with leukemia.peripherally inserted central catheter (picc) is commonly used in nursing for patients with leukemia. the purpose of this study was to investigate the risk factors of catheter-related infection (cri) in patients with leukemia and to provide some nursing strategies based on the results.201728540264
activity of minocycline against klebsiella pneumoniae carbapenemase (kpc)-producing enterobacteriaceae clinical isolates, with comparison to doxycycline and tigecycline.we examined the in vitro activity of minocycline against 103 klebsiella pneumoniae carbapenemase (kpc)-producing enterobacteriaceae isolates and found approximately half had susceptible (26%) or intermediate (26%) mics. for a subset of 35 isolates, susceptibility was highest to tigecycline (71% fda vs. 20% eucast) followed by minocycline (14%) and then doxycycline (6%).201728535946
clonal replacement of epidemic kpc-producing klebsiella pneumoniae in a hospital in china.klebsiella pneumoniae is a frequent nosocomial pathogen causing difficult-to-treat infections worldwide. the prevalence of klebsiella pneumoniae carbapenemase (kpc)-producing klebsiella pneumoniae (kpc-kp) is increasing in china. the aim of this study was to investigate the molecular epidemiology of kpc-kp in a nosocomial outbreak.201728535790
tail tubular protein a: a dual-function tail protein of klebsiella pneumoniae bacteriophage kp32.tail tubular protein a (ttpa) is a structural tail protein of klebsiella pneumoniae bacteriophage kp32, and is responsible for adhering the bacteriophage to host cells. for the first time, we found that ttpa also exhibits lytic activity towards capsular exopolysaccharide (eps) of the multiresistant clinical strain of klebsiella pneumoniae, pcm2713, and thus should be regarded as a dual-function macromolecule that exhibits both structural and enzymatic actions. here, we present our crystallograph ...201728533535
clonal dissemination of oxa-232 carbapenemase-producing klebsiella pneumoniae in neonates.five oxa-232 carbapenemase-producing klebsiella pneumoniae isolates, belonging to the pandemic clone sequence type 15 (st15), were isolated from neonates and coproduced blactx-m-15 and blashv-1 genes. all isolates were resistant to ertapenem (mics of >32 μg/ml) and meropenem (mics of 4 to 8 μg/ml) and susceptible or intermediate to imipenem (mics of 1 to 2 μg/ml). the blaoxa-232 gene was located on a cole-type transformable plasmid of 6,141 bp. to the best of our knowledge, this is the first rep ...201728533245
roles of ramr and tet(a) mutations in conferring tigecycline resistance in carbapenem-resistant klebsiella pneumoniae clinical isolates.tigecycline is regarded as a last-resort treatment for carbapenem-resistant klebsiella pneumoniae (crkp) infections, but increasing numbers of tigecycline-resistant k. pneumoniae isolates have been reported. the tigecycline resistance mechanisms in crkp are undetermined. this study aimed to elucidate the mechanisms underlying tigecycline resistance in 16 tigecycline- and carbapenem-resistant k. pneumoniae (tcrkp) isolates. mutations in tigecycline resistance determinant genes [ramr, acrr, oqxr, ...201728533243
first report of oxa-181 and ndm-1 from a clinical klebsiella pneumoniae isolate from nigeria. 201728526566
klebsiella pneumoniae: a major worldwide source and shuttle for antibiotic resistance.klebsiella pneumoniae is an important multidrug-resistant (mdr) pathogen affecting humans and a major source for hospital infections associated with high morbidity and mortality due to limited treatment options. we summarize the wide resistome of this pathogen, which encompasses plentiful chromosomal and plasmid-encoded antibiotic resistance genes (args). under antibiotic selective pressure, k. pneumoniae continuously accumulates args, by de novo mutations, and via acquisition of plasmids and tr ...201728521338
microbial competition in environmental nosocomial reservoirs and diffusion capacity of oxa48-klebsiella pneumoniae: potential impact on patients and possible control methods.we have found clusters of klebsiella pneumoniae with oxa48-carbepenemase cases in some hospital rooms, and decided to investigate whether bathroom siphons could be a reservoir for oxa48 bacteria, as occurs with k. oxytoca with other types of carbepenemases.201728515629
respiratory multiplex polymerase chain reaction: an important diagnostic tool in immunocompromised patients.viruses and atypical pathogens can cause significant respiratory illness in immunocompromised patients. multiplex polymerase chain reaction (mpcr) has improved the diagnostic yield of pathogens, and it is easier to identify the co-infections also. the present study was done to evaluate the performance of mpcr on bronchoalveolar lavage (bal) samples in immunocompromised patients.201728515602
angiotensin-converting enzyme enhances the oxidative response and bactericidal activity of neutrophils.angiotensin-converting enzyme (ace) inhibitors are widely used to reduce blood pressure. here, we examined if an ace is important for the antibacterial effectiveness of neutrophils. ace knockout mice or mice treated with an ace inhibitor were more susceptible to bacterial infection by methicillin-resistant staphylococcus aureus (mrsa). in contrast, mice overexpressing ace in neutrophils (neu(ace) mice) have increased resistance to mrsa and better in vitro killing of mrsa, pseudomonas aeruginosa, ...201728515091
oral gentamicin therapy for carbapenem-resistant klebsiella pneumoniae gut colonization in hematologic patients: a single center experience.the mortality for carbapenem-resistant klebsiella pneumoniae (kpc-kp) infection ranges from 18 to 48% depending on the type of therapy. mortality rates in hematologic patients are even higher, up to 85%. gut decontamination with oral gentamicin might be an option to avoid a subsequent kpc-kp infection in colonized patients. we treated 14 hematologic patients with oral gentamicin, 80 mg four times daily, for 7 to 25 days in order to eradicate kpc-kp from the gut, starting oral gentamicin therapy ...201728513809
documentation of ethnomedicinal information and antimicrobial validation of thespesia populnea used by yanadi tribe of ganugapenta village, chittoor district, andhra pradesh, india.this study aimed to document the traditional knowledge of medicinal plants and antimicrobial validation of thespesia populnea used by yanadi tribe of chittoor district, andhra pradesh, india.201728512597
population genomic analysis of 1,777 extended-spectrum beta-lactamase-producing klebsiella pneumoniae isolates, houston, texas: unexpected abundance of clonal group 307.klebsiella pneumoniae is a major human pathogen responsible for high morbidity and mortality rates. the emergence and spread of strains resistant to multiple antimicrobial agents and documented large nosocomial outbreaks are especially concerning. to develop new therapeutic strategies for k. pneumoniae, it is imperative to understand the population genomic structure of strains causing human infections. to address this knowledge gap, we sequenced the genomes of 1,777 extended-spectrum beta-lactam ...201728512093
rapid susceptibility profiling of carbapenem-resistant klebsiella pneumoniae.the expanding global distribution of multi-resistant klebsiella pneumoniae demands faster antimicrobial susceptibility testing (ast) to guide antibiotic treatment. current asts rely on time-consuming differentiation of resistance and susceptibility after initial isolation of bacteria from a clinical specimen. here we describe a flow cytometry workflow to determine carbapenem susceptibility from bacterial cell characteristics in an international k. pneumoniae isolate collection (n = 48), with a r ...201728507322
colistin resistance in carbapenem-resistant klebsiella pneumoniae mediated by chromosomal integration of plasmid dna.here we describe the spread of colistin resistance in clinical isolates of carbapenem-resistant klebsiella pneumoniae in medellín, colombia. among 32 isolates collected between 2012 and 2014, 24 showed genetic alterations in mgrb nineteen isolates belonged to sequence type 512 (st512) (or its single locus variant [slv]) and harbored an 8.1-kb hsdmsr insertion corresponding to iskpn25, indicating a clonal expansion of the resistant strain. the insertion region showed 100% identity to several plas ...201728507118
efficacy and pharmacokinetics of the combination of op0595 and cefepime in a mouse model of pneumonia caused by extended-spectrum-beta-lactamase-producing klebsiella pneumoniae.op0595 (rg6080) is a novel diazabicyclooctane that inhibits class a and c serine beta-lactamases. although the combination of op0595 and cefepime (fep) showed good in vitro activity against extended-spectrum-beta-lactamase (esbl)-producing pathogens, the effect of the combination therapy against severe infections, such as pneumonia or bacteremia, remains unknown in vivo in this study, we investigated the efficacy and pharmacokinetics of the combination therapy of op0595 and fep in a mouse model ...201728507106
prevalence of acquired carbapenemase genes in klebsiella pneumoniae by multiplex pcr in isfahan.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.201728503496
liposome loaded phage cocktail: enhanced therapeutic potential in resolving klebsiella pneumoniae mediated burn wound infections.klebsiella pneumoniae is one of the predominant pathogens in burn wound infections, and prevalence of multidrug resistant strains has further complicated the situation. an increased interest in phage therapy as a means of combating infection has been accruing in recent years. in order to overcome the drawbacks associated with phage therapy, the present study was conducted to evaluate the potential of liposomes as a delivery vehicle for phage in the treatment of burn wound infection.201728502784
changing trends in the aetiology, treatment and outcomes of bloodstream infection occurring in the first year after solid organ transplantation: a single-centre prospective cohort study.to analyse trends in the aetiology, treatment and outcomes of bloodstream infection (bsi) within the first year post-transplant over the last 10-year period, we prospectively recorded all episodes of bsi occurring in solid organ transplant (sot) recipients during the first year post-transplant from 2007 to 2016. trends of factors were analysed by 2-year periods. of 475 consecutive episodes of bsi, 218 occurred within a year of sot in 178 sot recipients. gram-positive bsi decreased over time (40. ...201728500792
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