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- Khan, Faisal Ahmad, 1986-, et al.
(författare)
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Related carbapenemase-producing Klebsiella isolates detected in both a hospital and associated aquatic environment in Sweden
- 2018
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Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - : Springer. - 0934-9723 .- 1435-4373. ; 37:12, s. 2241-2251
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Tidskriftsartikel (refereegranskat)abstract
- Carbapenem antibiotics are one of the last-resort agents against multidrug-resistant (MDR) bacteria. The occurrence of carbapenemase-producing Enterobacteriaceae (CPE) in wastewater and aquatic environments is an indication of MDR bacteria in the community. This study evaluated CPE in aquatic environments and compared them to the local hospital isolates in Sweden. Phenotypic and genotypic analyses of antibiotic resistance of environmental and clinical CPE were performed. The relatedness of the isolates and possible clonal dissemination was evaluated using phylogenetic and phyloproteomic analysis. Klebsiella oxytoca carrying carbapenemase genes (blaVIM-1, blaIMP-29) were isolated from wastewater and the recipient river, while K. oxytoca (blaVIM-1) and Klebsiella pneumoniae (blaVIM-1, blaOXA-48, blaNDM-1, blaKPC-3) were isolated from patients at the local clinics or hospital. The K. oxytoca classified as sequence type 172 (ST172) isolated from the river was genotypically related to two clinical isolates recovered from patients. The similarity between environmental and clinical isolates suggests the dispersion of blaVIM-1 producing K. oxytoca ST172 from hospital to aquatic environment and the likelihood of its presence in the community. This is the first report of CPE in aquatic environments in Sweden; therefore, surveillance of aquatic and hospital environments for CPE in other urban areas is important to determine the major transfer routes in order to formulate strategies to prevent the spread of MDR bacteria.
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| 2. |
- Salih, Lavin, et al.
(författare)
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Staphylococcus epidermidis isolates from nares and prosthetic joint infections are mupirocin susceptible
- 2018
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Ingår i: Journal of bone and joint infection. - : Ivyspring International Publisher. - 2206-3552. ; 3:1, s. 1-4
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the present study was to investigate the antibiotic susceptibility including mupirocin among Staphylococcus. epidermidis isolated from prosthetic joint infections (PJIs) (n=183) and nasal isolates (n=75) from patients intended to undergo prosthetic joint replacements. Susceptibility to mupirocin (used for eradication of nasal carriership of Staphylococcus aureus) was investigated by gradient test, and susceptibility to various other antimicrobial agents was investigated by disc diffusion test. All isolates, except three from PJIs and one from the nares, were fully susceptible to mupirocin. Multi-drug resistance (≥3 antibiotic classes) was found in 154/183 (84.2%) of the PJI isolates but only in 2/75 (2.7%) of the nares isolates, indicating that S. epidermidis causing PJIs do not originate from the nares.
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| 3. |
- Stenmark, Bianca, 1987-, et al.
(författare)
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Increase of S. capitis in neonates with bacteremia in Sweden due to the emergence of a multidrug-resistant clone
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: Staphylococcus capitis has traditionally been considered a commensal due to its low pathogenicity in healthy adults; however, it has been shown to cause 20% of all cases of neonatal sepsis in neonatal intensive care units (NICUs). In addition, S. capitis strains with reduced susceptibility to last line anti-staphylococcal agents such as vancomycin and linezolid are emerging in NICUs. The aim of this study was to characterize S. capitis isolated from blood in a Swedish NICU and to investigate if the multidrug-resistant clone NRCS-A has disseminated in Sweden.Materials/methods: All S. capitis isolates from neonatal blood cultures collected at Örebro University Hospital during 1987 to the 1st of March 2017 (n=42), were included. Several more episodes of neonatal sepsis with growth of coagulase-negative staphylococci were registered during this time period but probably considered as contaminants and therefore not preserved. Antibiotic susceptibility testing was performed using standardized disc diffusion method on cefoxitin, fusidic acid, clindamycin, erythromycin, gentamicin, rifampicin, trimethroprim/sulfamethoxazole and norfloxacin. Isolates resistant to ≥3 antibiotics were defined as multidrug-resistant. The isolates were whole genome sequenced using the Nextera XT kit (Illumina) on a MiSeq (Illumina). Single nucleotide polymorphisms found with the online tool REALPHY 1.12 in the alignments of shared homologous sites with the reference (the S. capitis NRCS-A strain CR01) were used to create phylogenetic trees.Results: Seventeen isolates out of the 42 isolates (40%) were multidrug-resistant (resistant to fusidic acid, cefoxitin and gentamicin) and 33 out of the 42 isolates (79%) clustered with the multi-resistant NRCS-A clone (Figure 1). The earliest isolate within the NRCS-A cluster was from 2001.Conclusions: Although prevalent since 2001, the increase of S. capitis in neonates with bacteremia since 2010 in Örebro county is mainly due to the dissemination of the multidrug-resistant NRCS-A clone and therefore warrants increased surveillance of the epidemiology and etiology of neonatal sepsis to prevent the spread of this clone.
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