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Carbapenem-resistant Enterobacteriaceae: A Growing Superbug Population

May 05, 2016 at 12:00 PM ET

Abstract

The discovery of antibiotics in the early twentieth century has revolutionized the treatment of infectious diseases, saving millions of lives and easing the suffering of many. However, as the structure and function of antibiotics have evolved through the efforts of biotech and pharma companies, prokaryotic species are evolving in parallel, fashioning novel and effective methods to avoid therapeutic killing. In the last several decades, this concern has become more pronounced with the emergence of multidrug-resistant organisms in both community- and hospital-acquired infections, resulting in increased morbidity, mortality, and health-care expense. In this presentation, we will discuss the emergence of multidrug-resistant infections with a particular emphasis on the emergence and global spread of carbapenem-resistant Enterobacteraeae strains.

Key Points

  • Multidrug-resistant strains are an emerging problem throughout the world
  • ATCC acquires, authenticates, and distributes clinically relevant multidrug-resistant strains that are essential to the scientific community
  • KPC, NDM, and OXA strains are now available at ATCC

Presenter

Cara Wilder, headshot.

Cara Wilder, PhD

Senior Scientific Content Specialist, ATCC

Dr. Wilder is a Senior Scientific Writer at ATCC. She has a Ph.D. in Microbiology with background experience working with several pathogenic bacterial species in both in vitro and in vivo environments. Dr. Wilder is the author of numerous publications on varying topics of scientific relevance, including quality control, microbial contamination, assay development, proficiency testing, and multidrug resistance.

Questions and Answers

Can ATCC provide information on the PCR reaction that was used to verify that the NDM-producing strains are blaNDM positive?

The protocols ATCC used to verify the presence of the blaNDM gene were provided by the CDC. You can find the primer sequences, reaction mixture, and the PCR cycling parameters in the customer support section of our website here.

Does ATCC have controls for the Modified Hodge Test?

Yes, ATCC offers ATCC BAA-1705 as a positive control and ATCC BAA-1706 as a negative control for the Modified Hodge Test. Both are Klebsiella pneumoniae strains.

Have the ATCC CRE strains been analyzed for the mechanisms that resulted in drug resistance?

Our KPC and NDM strains have been examined for the presence of the gene conferring carbapenem resistance (blaKPC and blaNDM, respectively). The mechanism of resistance to other antibiotic classes has not been evaluated, only the overall resistance or susceptibility was tested.

How common are metallo-β-lactamase producing CRE in the United States? Which strains does ATCC offer?

Based on the CDC’s surveillance for these organisms, it appears that NDM- and VIM-producing Enterobacteriaceae are uncommon in the United States. ATCC currently offers strains producing the NDM carbapenemase, we do not currently have VIM-producing strains.

How high is the mortality rate associated with CRE infection?

Some studies suggest that the mortality rate associated with CRE infections is as high as 50% (Borer A, et al. Infect Control Hosp Epidemiol 30(10): 972-976, 2009; Patel G, et al. Infect Control Hosp Epidemiol 29: 1099-1106, 2008).

What methods does ATCC use to evaluate antibiotic resistance and sensitivity of a bacterial strain?

ATCC employs a variety of methods for the detection of susceptibility or resistance to antibiotics. These include Kirby-Bauer disc diffusion and VITEK. Which test(s) are used is dependent on the strain. In some cases, if a strain is found to be resistant to a particular antibiotic ATCC would perform an Etest to determine the minimum inhibitory concentration.

What other drug-resistant strains are available from ATCC?

ATCC has a number of drug-resistant strains available. In addition to our carbapenemresistant (CRE) strains, ATCC offers methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Extended-Spectrum beta-lactamase (ESBL) strains, drug-resistant Acinetobacter baumannii, drug-resistant Pseudomonas aeruginosa; isoniazid-resistant mycobacteria, drug-resistant Candida albicans, and drug-resistant vector-borne parasitic protozoa, including strains of Plasmodium falciparum.