Carbapenemase Of Intestinal Rods – The Beginning Of Post-Antibiotic Era?
et | 05 oct. 2019
À propos de cet article
Article Category: article
Publié en ligne: 05 oct. 2019
Pages: 271 - 289
Reçu: 01 juil. 2018
Accepté: 01 mai 2019
DOI: https://doi.org/10.21307/PM-2019.58.3.271
© 2019 Sylwia Joanna Chmielewska et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Fig. 1.
![The number of strains of Enterobacterales producing the NDM, KPC mechanism in Poland during the period 2008–2017 [25, 78, 79].](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6470923671e4585e08aa02f2/j_PM-2019.58.3.271_fig_001.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20240704T073143Z&X-Amz-SignedHeaders=host&X-Amz-Expires=18000&X-Amz-Credential=AKIA6AP2G7AKP25APDM2%2F20240704%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Signature=a147be06326880a489f85deab25c51a40d5ded2909768de1b0e67b5cbf4b7999)
The effectiveness of combination therapy vs. monotherapy in the treatment of infections caused by carbapenemase-producing K. pneumoniae
| The ordinal number/ The microorganism/ The mechanism of resistance | The type of infection / | Mortality% (n) – the number of patients who did not survive /the number of patients who received the therapy | Source | |
| Combination therapy | Monotherapy | |||
| 1. | Sepsis/2012–2013/Retrospective | TGC+GN: 23.8% (n = 5/21) | TGC: 37.5% (n = 3/8) GN: 12.5% (n = 1/8) | 28 |
| 2. | UTI, Bloodstream infection, Respiratory tract infection, Skin and soft tissue infection, Intra-abdominal infection/ 2010–2011/Prospective | CL+TGC: 25% (n = 4/16) CL+GN: 40% (n = 2/5) CL+FOS: 0% (n = 0/5) TGC+FOS: 33% (n = 2/6) | GN: 6.3% (n = 1/16) CL: 40% (n = 4/10) | 13 |
| 3. | Bloodstream infection/2010–2011/ Retrospective | TGC+CL: 30% (n = 7/23) TGC+GN: 50% (n = 6/12) TGC+CL+MEM: 13% (n = 2/16) TGC+GN+MEM: 17% (n = 1/6) | TGC: 53% (n = 10/19) | 86 |
| 4. | Sepsis/2012–2014/Retrospective | FOS+MEM: 6% (n = 1/16) TGC+MEM: 25% (n = 1/4) GN+MEM: 0% (n = 0/2) OS+MEM+TGC/MIN/AN: 12.5% (n = 1/8) | MEM: 43% (n = 3/7) IPM: 0% (n = 0/1) TGC: 0% (n = 0/1) AMG: 20% (n = 1/5) | 46 |
| 5. | Bloodstream infection, UTI Respiratory tract infection, Intra-abdominal infection/2010–2013/Retrospective | CL-R 42.6% (n = 23/54) | 50% (n = 39/78) 31.9% (n = 29/91) 36.2 % (n = 25/69) | 87 |
The current susceptibility of carbapenem-resistant Enterobacterales
| The ordinal number/ The period of the investigation | The mechanism of resistance | The number of tested strains (n) | The percentage of strains % (n) classified as resistant or intermediate | Source | |||
| Colistin | Tigecycline | Aminoglycosides | Fosfomycin | ||||
| 1. 2013–2014 | 51 | 7.4% (n = 4) | nd | Amikacin – Gentamicin – 74.5% (n = 38) | 90.2% (n = 46) | 15 | |
| 6 | 0% | nd | 0% | 0% | |||
| 2. 2013–2014 | 187 | 43% (n = 76) | 6% (n = 11) | Gentamicin – 29 (n = 16) | nd | 54 | |
| 3. 2010–2013 | CRE | 280 | 26.1% (n = 73) | 11.8% (n = 33) | Amikacin – 78.6% (n=220) | nd | 76 |
| 4. 2015 | CRE – | 224 | 0% | 2.2% (n = 5) | Amikacin – 37.5% (n = 84) | nd | 42 |
| CRE – | 150 | 2% (n = 3) | 4.7% (n = 7) | Amikacin – 44.7% (n = 67) Gentamicin – 58.3% | nd | ||
| 5. 2008–2013 | 306 | 10% (n = 31) | 40% (n = 122) | Amikacin – 78% (n = 239) Gentamicin – 90% | nd | 37 | |
| 6. 2012–2014 | 72 | 13.9% (n = 10) | 38.9% (n = 28) | Amikacin – 62.5% (n = 45) | nd | 41 | |
| 64 | 29.7% (n = 19) | 39.1% (n = 25) | Amikacin – 40.6% (n = 26) | nd | |||
| 7. 2010–2012 | 106 | 26.4% (n = 28) | 47.2% (n = 50) | Amikacin – 25.5% (n = 27) | 28.3% (n = 30) | 75 | |
| 8. 2012–2014 | 121 | 0% | 0% | Amikacin – 2.5% (n = 3) Gentamicin – 25.6% | 7.4% (n = 9) | 63 | |
| 9. 2015 | 24 | 8% (n = 2) | 0% | Amikacin – 100% (n = 24) | nd | 39 | |
| 45 | 11% (n = 5) | 22% (n = 10) | Amikacin – 84% (n = 38) | nd | |||
| 10. 2006–2011 | 103 | 13.16% (n = 5) | 0.97% (n = 1) | Amikacin – 16.51% (n = 17) | nd | 51 | |
| 85 | 0% | 0% | Amikacin – 69.42% (n = 58) | nd | |||
The global dissemination of K. pneumoniae strains producing carbapenemases
| Endemic spread of bacteria | India, Pakistan, Bangladesh, |
| List of countries where the CR-NDM-1 strains have been isolated | Canada, USA, Mexico, Guatemala, Colombia, Brazil; Spain, France, Great Britain, Italy, Switzerland, Greece, Ireland, Germany, the Netherlands, the Czech Republic, Hungary, Romania, Croatia, Norway, Sweden and Finland; Morocco, Tunisia, Algeria, Libya, Saudi Arabia, Egypt, Kenya, South Africa, Madagascar, Mauritius; Oman, China, South Korea, Japan, Taiwan, Singapore, Russia, Turkey, Yemen, Sri Lanka, Nepal, Thailand; Vietnam, Malaysia, Israel, Iraq, Iran; Australia, New Zealand. |
| Endemic spread of bacteria | USA, Colombia, Argentina, Brazil, Italy, Greece, Poland, Israel, China, Taiwan |
| List of countries in which the CR-KPC strains have been isolated | Canada, Mexico, Cuba, Uruguay, Puerto Rico; Spain, France, Belgium, the Netherlands, Germany, Ireland, Sweden, Finland, Hungary, Portugal, Austria, the Czech Republic, Denmark, Norway and Croatia; Algeria, Egypt, South Africa; Russia, India, South Korea, Turkey, Pakistan, Japan, Iran, United Arab Emirates; Australia. |
| Endemic spread of bacteria | Turkey, Morocco, Tunisia, Libya, Egypt, India |
| List of countries where the CR-OXA-48 strains have been isolated | Canada, USA, Argentina; Spain, France, Germany, Switzerland, Belgium, the Netherlands, Great Britain, Italy, Ireland, Poland, Finland, Hungary, Romania, Bulgaria; Algeria, Senegal, South Africa, Saudi Arabia; Russia, Oman, Japan, Sri Lanka, Thailand, Singapore, Kuwait, Lebanon, South Korea, Israel, Iran, United Arab Emirates; Australia, New Zealand. |
| The name of the country | Mechanisms of resistance detected in |
| Brazil | NDM-1/KPC-2 |
| Malaysia | NDM-1/OXA-232 |
| South Korea | NDM-5/OXA-181 and NDM-1/OXA- 232 |
| China | NDM-1/IMP-4 |
| India | NDM-1/OXA-232 |
| Turkey | NDM- 1/OXA-48 |
| Pakistan | NDM-1/KPC-2 |
| Switzerland | NDM-1/OXA-48 |
| United Arab Emirates | NDM-1/OXA-48 |
| Australia | NDM-1/OXA-48 |
| Morocco | NDM-1/OXA-48 |
| Singapore | NDM-1/OXA-181 and NDM-5/OXA-181 |
| USA | NDM-1/OXA-232 |
| France | NDM-1/OXA-232 |