A Seven-Year Microbiological and Molecular Study of Bacteremias Due to Carbapenemase-Producing Klebsiella Pneumoniae: An Interrupted Time-Series Analysis of Changes in the Carbapenemase Gene's Distribution after Introduction of Ceftazidime/Avibactam.
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License: CC BY 4.0
Serval ID
serval:BIB_6EC881F67687
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A Seven-Year Microbiological and Molecular Study of Bacteremias Due to Carbapenemase-Producing Klebsiella Pneumoniae: An Interrupted Time-Series Analysis of Changes in the Carbapenemase Gene's Distribution after Introduction of Ceftazidime/Avibactam.
Journal
Antibiotics
ISSN
2079-6382 (Print)
ISSN-L
2079-6382
Publication state
Published
Issued date
14/10/2022
Peer-reviewed
Oui
Volume
11
Number
10
Pages
1414
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Ceftazidime/avibactam (CZA) is a new option for the treatment of KPC-producing Klebsiella pneumoniae. The aim of this study was to determine resistance patterns and carbapenemase genes among K. pneumoniae (CP-Kp) bacteremic isolates before and after CZA introduction.
K. pneumoniae from blood cultures of patients being treated in a Greek university hospital during 2015-21 were included. PCR for bla <sub>KPC</sub> , bla <sub>VIM</sub> , bla <sub>NDM</sub> and bla <sub>OXA-48</sub> genes was performed.
Among 912 K. pneumoniae bacteremias: 725 (79.5%) were due to carbapenemase-producing isolates; 488 (67.3%) carried bla <sub>KPC</sub> ; 108 (14.9%) bla <sub>VIM</sub> ; 100 (13.8%) bla <sub>NDM</sub> ; and 29 (4%) carried a combination of bla <sub>KPC</sub> , bla <sub>VIM</sub> or bla <sub>NDM</sub> . The incidence of CP-Kp bacteremias was 59 per 100,000 patient-days. The incidence of CP-Kp changed from a downward pre-CZA trend to an upward trend in the CZA period (p = 0.007). BSIs due to KPC-producing isolates showed a continuous downward trend in the pre-CZA and CZA periods (p = 0.067), while BSIs due to isolates carrying bla <sub>VIM</sub> or bla <sub>NDM</sub> changed from a downward trend in the pre-CZA to an upward trend in the CZA period (p < 0.001).
An abrupt change in the epidemiology of CP-Kp was observed in 2018, due to the re-emergence of VIM-producing isolates after the suppression of KPC-producing ones via the use of CZA.
K. pneumoniae from blood cultures of patients being treated in a Greek university hospital during 2015-21 were included. PCR for bla <sub>KPC</sub> , bla <sub>VIM</sub> , bla <sub>NDM</sub> and bla <sub>OXA-48</sub> genes was performed.
Among 912 K. pneumoniae bacteremias: 725 (79.5%) were due to carbapenemase-producing isolates; 488 (67.3%) carried bla <sub>KPC</sub> ; 108 (14.9%) bla <sub>VIM</sub> ; 100 (13.8%) bla <sub>NDM</sub> ; and 29 (4%) carried a combination of bla <sub>KPC</sub> , bla <sub>VIM</sub> or bla <sub>NDM</sub> . The incidence of CP-Kp bacteremias was 59 per 100,000 patient-days. The incidence of CP-Kp changed from a downward pre-CZA trend to an upward trend in the CZA period (p = 0.007). BSIs due to KPC-producing isolates showed a continuous downward trend in the pre-CZA and CZA periods (p = 0.067), while BSIs due to isolates carrying bla <sub>VIM</sub> or bla <sub>NDM</sub> changed from a downward trend in the pre-CZA to an upward trend in the CZA period (p < 0.001).
An abrupt change in the epidemiology of CP-Kp was observed in 2018, due to the re-emergence of VIM-producing isolates after the suppression of KPC-producing ones via the use of CZA.
Keywords
KPC, NDM, VIM, bloodstream infection, carbapenem-resistance, carbapenemase, ceftazidime/avibactam, colistin, fosfomycin, tigecycline
Pubmed
Web of science
Open Access
Yes
Create date
09/11/2022 9:31
Last modification date
25/12/2022 7:51
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