Assuntos
Proteínas de Bactérias/genética , Carbapenêmicos/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Enterobacter cloacae/genética , Enterobacter cloacae/isolamento & purificação , Infecções por Enterobacteriaceae/tratamento farmacológico , beta-Lactamases/genética , Idoso , Antibacterianos/farmacologia , Carbapenêmicos/uso terapêutico , Colômbia , Enterobacter cloacae/efeitos dos fármacos , Enterobacter cloacae/enzimologia , Feminino , Humanos , Testes de Sensibilidade MicrobianaAssuntos
Proteínas de Bactérias/genética , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Pneumonia Bacteriana/microbiologia , beta-Lactamases/genética , Idoso , Antibacterianos/uso terapêutico , Colômbia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/enzimologia , Klebsiella pneumoniae/isolamento & purificação , Meropeném , Pneumonia Bacteriana/tratamento farmacológico , Acidente Vascular Cerebral , Tienamicinas/uso terapêuticoRESUMO
In 2008, an increase in the prevalence of carbapenem-resistant Klebsiella pneumoniae was noted in a 286-bed tertiary case hospital in Colombia, where 84 patients (32 infected and 52 colonized) had positive cultures. The identified index patient came from Israel for a liver transplantation. High level carbapenem resistance was observed. Polymyxin B and tigecycline were the only two antibiotics that remained active. PCR-restriction fragment length polymorphism analysis and sequencing revealed blaKPC-3 in the major clone, which was indistinguishable from the K. pneumoniae carbapenemase-3-producing clone described previously in Israel. This exemplifies the threat posed by the global spread of K. pneumoniae carbapenemase-producing pathogens.
Assuntos
Proteínas de Bactérias/metabolismo , Infecção Hospitalar/microbiologia , Infecção Hospitalar/transmissão , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/transmissão , beta-Lactamases/metabolismo , Antibacterianos/uso terapêutico , Colômbia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/mortalidade , Humanos , Israel , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/mortalidade , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Tipagem MolecularRESUMO
Antibiotic resistance among Gram-negative pathogens in hospitals is a growing threat to patients and is driving the increased use of carbapenems. Carbapenems are potent members of the beta-lactam family of antibiotics, with a history of safety and efficacy for serious infections that exceeds 20 years. Original and review articles were identified from a Medline search (1979-2008). Reference citations from identified publications, abstracts from the Interscience Conferences on Antimicrobial Agents and Chemotherapy and package inserts were also used. Carbapenems are effective in treating severe infections at diverse sites, with relatively low resistance rates and a favourable safety profile. Carbapenems are the beta-lactams of choice for the treatment of infections caused by multidrug-resistant organisms. Optimized dosing of carbapenems should limit the emergence of resistance and prolong the utility of these agents. The newly approved doripenem should prove to be a valuable addition to the currently available carbapenems: imipenem, meropenem and ertapenem.