Top Banner
Features of Infections Due to Klebsiella pneumoniae Carbapenemase– Producing Escherichia coli: Emergence of Sequence Type 131 Laura Valentina López Gutiérrez Alejandra Henao Buitrago Medical students
23
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Page 1: kpc e.coli

Features of Infections Due to Klebsiellapneumoniae Carbapenemase–ProducingEscherichia coli: Emergence of Sequence

Type 131

Laura Valentina López Gutiérrez Alejandra Henao Buitrago

Medical students

Page 2: kpc e.coli

Features of Infections Due to Klebsiellapneumoniae Carbapenemase–ProducingEscherichia coli: Emergence of Sequence

Type 131

• Young Ah Kim Zubair A. Qureshi Jennifer M. Adams-Haduch Yoon Soo Park Kathleen A. Shutt Yohei Doi• September 2008 and February 2011• 15 July 2012

Page 3: kpc e.coli

INTRODUCTION

K. pneumoniaeKPC

(Klebsiella pneumoniae carbapenemase)

E. Coli

KPC: endemic in many US hospitals

Page 4: kpc e.coli

GENERALITIES

• Klebsiella• pneumoniae

• Escherichia• coli

Page 5: kpc e.coli

CARBAPENEMS

Carbapenems are a class of B-lactam antibiotics with a broad spectrum of antibacterial activity. They have a structure that renders them highly resistant to most B-lactamases.

Page 6: kpc e.coli

Connection…

• Klebsiella is producing KPC gene, it is introduced to diferents microorganisms, including E. coli; carbapenems are antibiotics to treat respiratory diseases, KPC gives resistance to them

Page 7: kpc e.coli

General Objective

Recognize the problems in hospitals that have klebsiella pneumoniae infection, and the consequences that brings KPC transfer to different species; especially the E.coli bacteria. This raises a concern that the KPC gene may spread to the community with E. coli ST 131, which is now a common culprit causing community- associated, multidrug-resistant infections.

Page 8: kpc e.coli

MATERIALES Y MÉTODOS

Page 9: kpc e.coli

IDENTIFICACIÓN DEL CASO

• La disminución de la susceptibilidad a ertapenem es un indicador importante en la detección de la producción de KPC.

• Prueba de hodge modificado,APB,PCR.

Page 10: kpc e.coli

CONTROL

• Pacientes con E. coli productora de blee pero no de KPC

• El control fue emperejado con los grupos, según edad y sexo del caso

• La información clínica: datos demográficos, tipo de infección, las

condiciones médicas subyacentes, contacto previo con el sistema de salud, previo a los antimicrobianos, y la presencia de catéteres permanentes

Page 11: kpc e.coli

SUSCEPTIBILIDAD

Dilución en caldo

Método dilución en agar

CIM

Page 12: kpc e.coli

PCR

• Kary Mullis en los años 80´s • Amplificación enzimática de un gen o

fragmento específico de DNA

Page 13: kpc e.coli

• APLICACIONES *Clonación *Secuenciación de AN *Rastreo de mutaciones *Diagnóstico de enfermedades genéticas *Detección de microorganismo infecciosos

PCR Amplificación in vitro

Clonación acelular

Page 14: kpc e.coli

MLST- PFGE

• MLST: caracterización de cepas de especies bacterianas, mediante la secuenciación de fragments internos de multiples genes.

• http://mlst.ucc.ie/mlst/dbs/Ecoli• CHEF DR III- DICE.• PFGE: Separación de moleculas de ADN que

varían de tamaño de hasta decenas de PB.

Page 15: kpc e.coli

ANÁLISIS DE PLÁSMIDOS

• El análisis de plásmidos tiene como objetivos detectar su presencia y establecer la relación entre ellos

Page 16: kpc e.coli

RESULTADOS

Page 17: kpc e.coli
Page 18: kpc e.coli
Page 19: kpc e.coli
Page 20: kpc e.coli

DISCUSSION

-Coque TM, Novais A, Carattoli A

- Nicolas-Chanoine MH, Blanco J, Leflon-Guibout

V.

Rogers BA, Sidjabat HE, Paterson DL.

E. coli ST 131 is typically multidrug resistant,

especially including resistance to fluoroquinolones, and most

frequently described as producing plasmid-mediated CTXM-

15 ESBL [23, 24]

Spread of KPC-producing E. coli to the community needs to

be carefully monitored, especially given the propensity of

E. coli ST 131 to cause community-associated infections [8].

YES

YES

Page 21: kpc e.coli

DISCUSSION

*Pitout JD, Nordmann P, Laupland KB, Poirel L.

*Rodriguez-Bano J, Paterson DL.

E. coli ST 131 was recently reported to be the most

significantcause of antimicrobial-

resistant E. coli infection in the

United States as well [34]

The emergence of ST 131 hascoincided with the rise in the number

of community-acquiredESBL-producing E. coli infection in

many parts of theworld [30, 31].

YES

YES

Johnson JR, Johnston B, Clabots C, Kuskowski MA, Castanheira M.

Page 22: kpc e.coli

Conclusions

• KPC transfer between species leads to a serious problem in the community, because bacteria like E.coli, living all the time in the organism.

• infection caused by ESBL-producing E. coli is still susceptible to carbapenems and is more common than KPC-Producing Escherichia coli

Page 23: kpc e.coli

Conclusions

• E. Coli ST 13, showed resistance to different drugs, also represent a big problem in epidemiology of some diseases.

• The studios made at hospitals are very important, because the researchers analyze the probabilities and risk factors to contract a infection