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Bacterial resistance to antibiotics is a globally recognized healthcare problem. B-lactam resistance în Gram negative bacteria, mediated through mecanisms like ESBLs (extended spectrum beta-lactamases), cephalosporinases and carbapenemases, is one of the most important. This study aims to identify the most important tests which can be applied in the laboratory in order to correctly identify Gram-negative bacteria (Enterobacterales, Pseudomonas spp., Acidentobacter spp.) which are resistant to this class of antibiotics and their resistance mechanisms, apply them on the microorganisms isolated in a clinical hospital from Bucharest, Romania, describe and report the findings, followed by the proposal of measures that can reduce the burden of these bacteria and their resistance mechanisms. In order to support the national effort in the fight against the antimicrobial resistance phenomenon, a new phenotipic laboratory identification test is proposed, using resources available in Romania. [ABSTRACT FROM AUTHOR]

Objectives: Fast and accurate diagnostic tests to identify carbapenemase-producing Enterobacteriaceae (CPE) are mandatory for proper antimicrobial therapy and implementing infection control measures. Here, we have developed a rapid Carbapenem Inactivation Method (rCIM) for CPE detection.Methods: The rCIM consists of the incubation of a potential carbapenemase producer with meropenem discs and use of the resulting supernatant to challenge a susceptible indicator strain. Growth of the indicator strain is monitored using a nephelometer. The performances of the rCIM were compared with the CIM and Carba NP tests using a collection of 113 well-characterized carbapenem-resistant enterobacterial isolates, including 85 carbapenemase producers and 28 non-carbapenemase producers. In addition, rCIM was compared with the Carba NP test and PCR sequencing in a prospective analysis of 101 carbapenem-resistant enterobacterial isolates addressed to the French National Reference Center for Antimicrobial Resistance in July 2017.Results and discussion: The rCIM correctly identified 84/85 carbapenemase producers and 28/28 non-carbapenemase producers, yielding a sensitivity of 99% and a specificity of 100%, slightly higher than the CIM and Carba NP test. In the prospective validation study, the rCIM showed a sensitivity and specificity of 97% and 95%, respectively. Two cephalosporinase-hyperproducing Enterobacter cloacae gave false-positive results, whereas an IMI-17-producing Enterobacter asburiae gave a false-negative result. The result was, however, positive when the isolate was grown on selective antibiotic-containing media.Conclusions: The rCIM is a rapid (less than 3 h), cheap and accurate test for the detection of CPEs, which can be implemented in low-resource settings, making it a useful tool for microbiology laboratories. [ABSTRACT FROM AUTHOR]

Carbapenems are last resort antibiotics used in infections caused by multidrug-resistant bacteria. Carbapenem-resistant Enterobacteriaceae infections are an increasingly global threat, especially because carbapenemase production is more frequent than other resistance mechanisms and is encoded by genes located on transferable genetic structures. The production of classes A (KPC), B (IMP, VIM, NDM) and D (OXA-48 and its variants) of carbapenemases has important clinical consequences and is a constant pool of resistance. This review tries to show the diversity of carbapenemases and to underline their importance. [ABSTRACT FROM AUTHOR]

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The production of carbapenemases is one of the most important mechanisms that lead to carbapenem resistance. At the same time, the carbapenemases present on extracromosomial genetic material (plasmids) are transmitted between various bacteria. Although the genes Klebsiella, Enterobacter and Escherichia are most commonly involved in infections, the identification of carbapenemases in other genes may be very important for controlling infections. In this article, we will review a recent study published in the Morbidity and Mortality Weekly Report, which evaluated the production of carbapenemases in enterobacteria belonging to genes less commonly involved in clinical practice. All strains of enterobacteria transmitted to the Center for Disease Control (CDC) in Atlanta and the Public Health Laboratory of the Minnesota Health Department (MDH) from 1 January 2014 to 30 September 2017 were screened for the identification of five carbapenemases (KPC, NDM, OXA-48, IMP, and VIM). Among these, the results for the genera Klebsiella, Enterobacter and Escherichia were excluded. CDC received 1039 EPC-RC isolates during the study, of which 63 (6.1%) of the infrequently identified genera. Over the same period, 149 (12%) of the 1241 CREs were producing carbapenemases. Although in small numbers, isolates from more infrequent genera of enterobacteria that produce carbapenemases may be an important reservoir for dissemination to other bacteria. Additionally, we will add suggestions for current, cost-effective methodological solutions that can improve the knowledge of carbapenemase production in our country. [ABSTRACT FROM AUTHOR]

Globally, more than 50% of HIV infected people are women. HIV infection in women has its particularities, especially because of pregnancy and because of the adverse effects of antiretroviral therapy. Heterosexual contact is the most frequent way of HIV transmission in women. Some gynecological infections like vaginal candidiasis seem to be more persistent and more severe as compared to uninfected female patients. Also, HIV infected women have a higher risk for cervical dysplasia and cancer as compared to uninfected women. The risk of mother-to-child transmission of the virus has dropped significantly in the last decades because of the implementation of routine HIV screening testing in pregnancy, counseling regarding prevention and the large access to antiretroviral treatment. Today, because of the diversity of the therapeutic options and using good prophylactic measures, HIV infected women can have a normal life. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) represents a growing public health problem worldwide. Infections with such bacteria lead to longer hospitalization times, higher healthcare costs and greater morbidity and mortality. Thus, there is a greater need for rapid detection methods in order to limit their spread. The ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) are a series of epidemiologically-important microorganisms of great concern due to their high levels of resistance. This review aimed to update the background information on the ESKAPE pathogens as well as to provide a summary of the numerous phenotypic and molecular methods used to detect their AMR mechanisms. While they are usually linked to hospital acquired infections, AMR is also spreading in the veterinary and the environmental sectors. Yet, the epidemiological loop closes with patients which, when infected with such pathogens, often lack therapeutic options. Thus, it was aimed to give the article a One Health perspective. [ABSTRACT FROM AUTHOR]