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Diversity of resistance mechanisms in carbapenem-resistant Enterobacteriaceae at a health care system in Northern California, from 2013 to 2016.


ABSTRACT: The mechanism of resistance in carbapenem-resistant Enterobacteriaceae (CRE) has therapeutic implications. We comprehensively characterized emerging mechanisms of resistance in CRE between 2013 and 2016 at a health system in Northern California. A total of 38.7% (24/62) of CRE isolates were carbapenemase gene-positive, comprising 25.0% (6/24) blaOXA-48 like, 20.8% (5/24) blaKPC, 20.8% (5/24) blaNDM, 20.8% (5/24) blaSME, 8.3% (2/24) blaIMP, and 4.2% (1/24) blaVIM. Between carbapenemases and porin loss, the resistance mechanism was identified in 95.2% (59/62) of CRE isolates. Isolates expressing blaKPC were 100% susceptible to ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam; blaOXA-48 like-positive isolates were 100% susceptible to ceftazidime-avibactam; and metallo ?-lactamase-positive isolates were nearly all nonsusceptible to above antibiotics. Carbapenemase gene-negative CRE were 100% (38/38), 92.1% (35/38), 89.5% (34/38), and 31.6% (12/38) susceptible to ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, and ceftolozane-tazobactam, respectively. None of the CRE strains were identical by whole genome sequencing. At this health system, CRE were mediated by diverse mechanisms with predictable susceptibility to newer ?-lactamase inhibitors.

SUBMITTER: Senchyna F 

PROVIDER: S-EPMC7155946 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Diversity of resistance mechanisms in carbapenem-resistant Enterobacteriaceae at a health care system in Northern California, from 2013 to 2016.

Senchyna Fiona F   Gaur Rajiv L RL   Sandlund Johanna J   Truong Cynthia C   Tremintin Guillaume G   Kültz Dietmar D   Gomez Carlos A CA   Tamburini Fiona B FB   Andermann Tessa T   Bhatt Ami A   Tickler Isabella I   Watz Nancy N   Budvytiene Indre I   Shi Gongyi G   Tenover Fred C FC   Banaei Niaz N  

Diagnostic microbiology and infectious disease 20181013 3


The mechanism of resistance in carbapenem-resistant Enterobacteriaceae (CRE) has therapeutic implications. We comprehensively characterized emerging mechanisms of resistance in CRE between 2013 and 2016 at a health system in Northern California. A total of 38.7% (24/62) of CRE isolates were carbapenemase gene-positive, comprising 25.0% (6/24) bla<sub>OXA-48 like</sub>, 20.8% (5/24) bla<sub>KPC</sub>, 20.8% (5/24) bla<sub>NDM</sub>, 20.8% (5/24) bla<sub>SME</sub>, 8.3% (2/24) bla<sub>IMP</sub>, a  ...[more]

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