54 research outputs found
Elaboración de material docente para la asignatura Expresión Gráfica del Grado Ingeniería Agrícola de la Facultad de Ciencias Agrarias y Ambientales
Memoria ID-0057. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2016-2017
Activity of cefiderocol against high-risk clones of multidrug-resistant Enterobacterales, Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia
BACKGROUND:
Cefiderocol is a novel siderophore cephalosporin, developed for activity against MDR Gram-negative bacilli (MDR-GNB).
OBJECTIVES:
To assess the in vitro antibacterial activity of cefiderocol against a collection of MDR-GNB clinical isolates from hospitals in southern Spain.
METHODS:
Two hundred and thirty-one isolates of successful clones were tested: 125 Enterobacterales (121 ESBL- and/or carbapenemase-producing Klebsiella pneumoniae and 4 carbapenemase-producing Enterobacter cloacae), 80 Acinetobacter baumannii, 6 Pseudomonas aeruginosa and 20 Stenotrophomonas maltophilia. Ceftolozane/tazobactam, ceftazidime, ceftazidime/avibactam, cefepime, aztreonam, meropenem, amikacin, ciprofloxacin, colistin and tigecycline were used as comparators against Enterobacterales, P. aeruginosa and A. baumannii. Minocycline, levofloxacin and trimethoprim/sulfamethoxazole were studied against S. maltophilia instead of aztreonam, ciprofloxacin and cefepime. MICs were determined by broth microdilution according to CLSI guidelines. MIC determination was performed in CAMHB for all antimicrobials except cefiderocol, where iron-depleted CAMHB was used.
RESULTS:
Cefiderocol showed potent in vitro activity against the isolates analysed. MIC50 and MIC90 values were in the ranges 0.125-8 mg/L and 0.5-8 mg/L, respectively, and 98% of isolates were inhibited at ≤4 mg/L. Only five isolates showed cefiderocol MICs of >4 mg/L: three ST2/OXA-24/40-producing A. baumannii, one ST114/VIM-1-producing E. cloacae and one ST114/VIM-1 + OXA-48-producing E. cloacae. All KPC-3-producing K. pneumoniae were susceptible to cefiderocol, even those resistant to ceftazidime/avibactam. P. aeruginosa isolates showed cefiderocol MICs of <4 mg/L, including those resistant to ceftolozane/tazobactam. S. maltophilia isolates displayed cefiderocol MICs of <4 mg/L, including those resistant to levofloxacin and/or trimethoprim/sulfamethoxazole.
CONCLUSIONS:
Cefiderocol showed excellent activity against MDR-GNB, including carbapenem-resistant isolates, and was the most active antimicrobial tested against this collection
Mechanisms of Tolerance and Resistance to Chlorhexidine in Clinical Strains of Klebsiella pneumoniae Producers of Carbapenemase: Role of New Type II Toxin-Antitoxin System, PemIK
Although the failure of antibiotic treatment is normally attributed to resistance, tolerance
and persistence display a significant role in the lack of response to antibiotics. Due to the fact that
several nosocomial pathogens show a high level of tolerance and/or resistance to chlorhexidine,
in this study we analyzed the molecular mechanisms associated with chlorhexidine adaptation in two
clinical strains of Klebsiella pneumoniae by phenotypic and transcriptomic studies. These two strains
belong to ST258-KPC3 (high-risk clone carrying β-lactamase KPC3) and ST846-OXA48 (low-risk
clone carrying β-lactamase OXA48). Our results showed that the K. pneumoniae ST258-KPC3CA
and ST846-OXA48CA strains exhibited a different behavior under chlorhexidine (CHLX) pressure,
adapting to this biocide through resistance and tolerance mechanisms, respectively. Furthermore,
the appearance of cross-resistance to colistin was observed in the ST846-OXA48CA strain (tolerant to
CHLX), using the broth microdilution method. Interestingly, this ST846-OXA48CA isolate contained
a plasmid that encodes a novel type II toxin/antitoxin (TA) system, PemI/PemK. We characterized this
PemI/PemK TA system by cloning both genes into the IPTG-inducible pCA24N plasmid, and found
their role in persistence and biofilm formation. Accordingly, the ST846-OXA48CA strain showed
a persistence biphasic curve in the presence of a chlorhexidine-imipenem combination, and these
results were confirmed by the enzymatic assay (WST-1).The State Plan for R+D+I 2013–2016 National Plan for Scientific Research, Technological Development and Innovation 2008–2011 PI16/01163 and PI19/00878ISCIII-Deputy General Directorate for Evaluation and Promotion of Research - European Regional Development Fund “A way of Making Europe” and Instituto de Salud Carlos III FEDER, Spanish Network for the Research in Infectious Diseases REIPI, RD16/0016/0001, RD16/CIII/0004/0002 and RD16/0016/0006The Study Group on Mechanisms of Action and Resistance to Antimicrobials, GEMAR
Aplicación de modelos fotogramétricos 3D a la docencia de las asignaturas de geología y otras disciplinas afines
Memoria ID-0106. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2017-2018
Diagnóstico de necesidades de formación para revitalizar el sector comercial
Producción CientíficaEstudio del comercio minorista en las ciudades de Valladolid (incluyendo análisis pormenorizado del centro y varios barrios) y Medina del Campo, basado en el impuesto de actividades económicas y la realización de encuestas a comerciantes y consumidores.Geografí
Aprendizaje basado en problemas en los grados de ingeniería
Memoria ID-314. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2013-2014
Evaluación de las competencias generales en los grados de ingeniería
Memoria ID12-0044. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013
Proyecto Apego sobre evaluación y promoción de competencias parentales en el sistema sanitario público andaluz. Parte 2
Análisis del grado de adecuación de las guías docentes del Grado en Ingeniería Civil a la memoria del título
Memoria ID-0234. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015
CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3.
CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain. Methods: In total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis. Results: In total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were bla OXA-48 (263/377), bla KPC-3 (62/377), bla VIM-1 (28/377), and bla NDM-1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5). Conclusion: This study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3
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