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Infectious complications caused by carbapenemase-producing Enterobacterales in patients with hematological disorders

https://doi.org/10.17650/1818-8346-2019-14-3-77-89

Abstract

Mortality rates approaching 60 % have been reported in hematological patients with infections caused by carbapenemase-producing Enterobacterales. The incidence of these infections is rapidly increasing, whereas the therapeutic options are limited. This review represents characteristics of infections caused by carbapenemase-producing Enterobacterales in patients with hematological disorders, highlights risk factors and management options of these infections.

About the Authors

K. S. Tandilova
National Research Center for Hematology, Ministry of Health of Russia
Russian Federation

4 Novyy Zykovskiy Proezd, Moscow 125167



G. A. Klyasova
National Research Center for Hematology, Ministry of Health of Russia
Russian Federation

4 Novyy Zykovskiy Proezd, Moscow 125167



References

1. Trecarichi E.M., Pagano L., Martino B. et al. Bloodstream infections caused by Klebsiella pneumoniae in oncohematological patients: clinical impact of carbapenem resistance in a multicentre prospective survey. Am J Hematol 2016;91(11):1076–81. DOI: 10.1002/ajh.24489.

2. Ambler R.P. The structure of beta-lactamases. Philos Trans R Soc Lond B Biol Sci 1980;289(1036):321–31.

3. Lee C.R., Lee J.H., Park K.S. et al. Global dissemination of carbapenemase-producing Klebsiella pneumoniae: epidemiology, genetic context, treatment options, and detection methods. Front Microbiol 2016;7:895. DOI: 10.3389/fmicb.2016.00895.

4. Chiu S.K., Ma L., Chan M.C. et al. Carbapenem nonsusceptible Klebsiella pneumoniae in Taiwan: dissemination and increasing resistance of carbapenemase producers during 2012–2015. Sci Rep 2018;8(1):8468. DOI: 10.1038/s41598-018-26691-z.

5. Evans B.A., Amyes S.G. OXA β-lactamases. Clin Microbiol Rev 2014;27(2):241–63. DOI: 10.1128/CMR.00117-13.

6. Nordmann P., Naas T., Poirel L. Global Spread of Carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2011;17(10):1791–8. DOI: 10.3201/eid1710.110655.

7. Nordmann P., Mariotte S., Naas T. et al. Biochemical properties of a carbapenemhydrolyzing beta-lactamase from Enterobacter cloacae and cloning of the gene into Escherichia coli. Antimicrob Agents Chemother 1993;37(5):939–46. DOI: 10.1128/AAC.37.5.939.

8. Naas T., Nordmann P. Analysis of a carbapenemhydrolyzing class A beta-lactamase from Enterobacter cloacae and of its LysR-type regulatory protein. PNAS 1994;91(16):7693–7.

9. Yigit H., Queenan A.M., Anderson G.J. et al. Novel Carbapenem-Hydrolyzing β-Lactamase, KPC-1, from a CarbapenemResistant Strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 2001;45(4):1151–61. DOI: 10.1128/AAC.45.4.1151-1161.2001.

10. Woodford N., Tierno P.M. Jr, Young K. et al. Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center. Antimicrob Agents Chemother 2004;48(12):4793–9. DOI: 10.1128/AAC.48.12.4793-4799.2004.

11. Leavitt A., Navon-Venezia S., Chmelnitsky I. et al. Emergence of KPC-2 and KPC-3 in carbapenem-resistant Klebsiella pneumoniae strains in an Israeli hospital. Antimicrob Agents Chemother 2007;51(8):3026–9. DOI: 10.1128/AAC.00299-07.

12. Maltezou H.C., Giakkoupi P., Maragos A. et al. Outbreak of infections due to KPC2-producing Klebsiella pneumoniae in a hospital in Crete (Greece). J Infect 2009;58(3):213–9. DOI: 10.1016/j.jinf.2009.01.010

13. Mezzatesta M.L., Gona F., Caio C. et al. Outbreak of KPC-3-producing, and colistinresistant, Klebsiella pneumoniae infections in two Sicilian hospitals. Clin Microbiol Infect 2011;17(9):1444–7. DOI: 10.1111/j.1469-0691.2011.03572.x.

14. van Duin D., Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence 2017;8(4):460–9. DOI: 10.1080/21505594.2016.1222343.

15. French C.E., Coope C., Conway L. et al. Control of carbapenemase-producing Enterobacteriaceae outbreaks in acute settings: an evidence review. J Hosp Infect 2017;95(1):3–45. DOI: 10.1016/j.jhin.2016.10.006

16. Pitout J.D.D., Nordmann P., Poirel L. Сarbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance. Antimicrob Agents Chemother 2015;59(10):5873–84. DOI: 10.1128/AAC.01019-15.

17. Lazareva I.V., Ageevets V.A., Ershova T.A. et al. Prevalence and antibiotic resistance of carbapenemase-producing gram-negative bacteria in Saint Petersburg and some other regions of the Russian Federation. Antibiotiki i khimioterapiya = Antibiotics and Chemotherapy 2016;61;11–12;28–38. (In Russ.).

18. Sukhorukova M.V., Edelstein M.V., Skleenova E.Yu. et al. Antimicrobial resistance of nosocomial Enterobacteriaceae isolates in Russia: results of multicenter epidemiological study «MARATHON» 2013–2014 Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical Microbiology and Antimicrobial Chemotherapy 2017;19;1:49–56. (In Russ.).

19. Edelstein M.V., Zhuravlev V.S., Shek E.A. Prevalence of nosocomial strains Enterobacteriaceae have carbapenemases in Russia. Izvestiya Saratovskogo Universiteta. Njvaya seriya. Seriya: Khemiya. Biologiya. Ekologiya = Izvestiya of Saratov University. New Series. Series: Chemistry. Biology. Ecology 2017;17(1):36–41 (In Russ.). DOI: 10.18500/1816-9775-2017-17-1-36-41.

20. Shevchenko O.V., Mudrak D.Y., Skleenova E.Y. et al. First detection of VIM-4 metallo-β-lactamase-producing Escherichia coli in Russia. Clin Microbiol Infect 2012;18(7):E214–7. DOI: 10.1111/j.1469-0691.2012.03827.x.

21. Sukhorukova M., Savochkina J., Alexandrova I. et al. First outbreak of carbapenemresistant OXA-48-producing Klebsiella pneumoniae in Russia. 22nd European Congress of Clin. Microbiol. Infect. Dis. 2012, March 31–Apr 3. London, United Kingdom. Available at: https://www.escmid.org/escmid_publications/escmid_elibrary/material/?mid=5700.

22. Barantsevich E.P., Churkina I.V., Barantsevich N.E. et al. Emergence of Klebsiella pneumoniae producing NDM-1 carbapenemase in Saint Petersburg, Russia. J Antimicrob Chemother 2013;68(5):1204–6. DOI: 10.1093/jac/dks503.

23. Ageevets V.A., Partina I.V., Lisitsyna E.S. et al. Emergence of carbapenemase-producing Gram-negative bacteria in Saint Petersburg, Russia. Int J Antimicrob Agents 2014;44(2):152–5. DOI: 10.1016/j.ijantimicag.2014.05.004.

24. Edelstein M.V., Sukhorukova M.V., Skleenova E.Y. et al. In vitro activities of avibactam combinations with ceftazidime and aztreonam against clinical Enterobacteriaceae isolates recovered from hospitalized patients in Russia: results of the national surveillance. 27th European Congress of Clin. Microbiol. Infect. Dis. 2017, Apr 22–25. Vienna, Austria. Available at: https://www.escmid.org/escmid_publications/escmid_elibrary/material/?mid=51875.

25. Girmenia C., Rossolini G.M., Piciocchi A. et al. Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy. Bone Marrow Transplant 2015;50(2):282– 8. DOI: 10.1038/bmt.2014.231.

26. Pouch S.M., Satlin M.J. Carbapenem-resistant Enterobacteriaceae in special populations: Solid organ transplant recipients, stem cell transplant recipients, and patients with hematologic malignancies. Virulence 2017;8(4):391–402. DOI: 10.1080/21505594.2016.1213472.

27. Pagano L., Caira M., Trecarichi E.M. et al. Carbapenemase-producing Klebsiella pneumoniae and hematologic malignancies. Emerg Infect Dis 2014;20(7):1235–6. DOI: 10.3201/eid2007.130094.

28. Balkan I.I., Aygün G., Aydın S. et al. Blood stream infections due to OXA-48like carbapenemase-producing Enterobacteriaceae: treatment and survival. Int J Infect Dis 2014;26:51–6. DOI: 10.1016/j.ijid.2014.05.012.

29. Tofas P., Skiada A., Angelopoulou M. et al. Carbapenemase-producing Klebsiella pneumoniae bloodstream infections in neutropenic patients with haematological malignancies or aplastic anaemia: Analysis of 50 cases. Int J Antimicrob Agents 2016;47(4):335–9. DOI: 10.1016/j.ijantimicag.2016.01.011.

30. Satlin M.J., Calfee D.P., Chen L. et al. Emergence of carbapenem-resistant Enterobacteriaceae as causes of bloodstream infections in patients with hematologic malignancies. Leuk Lymphoma 2013;54(4):799–806. DOI: 10.3109/10428194.2012.723210.

31. Averbuch D., Orasch C., Cordonnier C. et al. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia. Haematologica 2013;98(12):1826–35. DOI: 10.3324/haematol.2013.091025.

32. Papanicolas L.E., Gordon D.L., Wesselingh S.L., Rogers G.B. Not just antibiotics: is cancer chemotherapy driving antimicrobial resistance? Trends Microbiol 2018;26(5):393–400. DOI: 10.1016/j.tim.2017.10.009.

33. Tischendorf J., de Avila R.A., Safdar N. Risk of infection following colonization with carbapenem-resistant Enterobacteriaceae: a systematic review. Am J Infect Control 2016;44(5):539–43. DOI: 10.1016/j.ajic.2015.12.005.

34. Micozzi A., Gentile G., Minotti C. et al. Carbapenem-resistant Klebsiella pneumoniae in high-risk haematological patients: factors favouring spread, risk factors and outcome of carbapenem-resistant Klebsiella pneumoniae bacteremias. BMC Infect Dis 2017;17(1):203. DOI: 10.1186/s12879-017-2297-9.

35. Giannella M., Trecarichi E.M., De Rosa F.G. et al. Risk factors for carbapenem-resistant Klebsiella pneumoniae bloodstream infection among rectal carriers: a prospective observational multicentre study. Clin Microbiol Infect 2014;20(12):1357–62. DOI: 10.1111/1469-0691.12747.

36. Girmenia C., Viscoli C., Piciocchi A. et al. Management of carbapenem resistant Klebsiella pneumoniae infections in stem cell transplant recipients: an Italian multidisciplinary consensus statement. Haematologica 2015;100(9):e373–6. DOI: 10.3324/haematol.2015.125484.

37. Forcina A., Baldan R., Marasco V. et al. Control of infectious mortality due to carbapenemaseproducing Klebsiella pneumoniae in hematopoietic stem cell transplantation. Bone Marrow Transplant 2017;52(1):114–9. DOI: 10.1038/bmt.2016.234.

38. Zuckerman T., Benyamini N., Sprecher H. et al. SCT in patients with carbapenem resistant Klebsiella pneumoniae: a single center experience with oral gentamicin for the eradication of carrier state. Bone Marrow Transplant 2011;46(9):1226–30. DOI: 10.1038/bmt.2010.279.

39. Oren I., Sprecher H., Finkelstein R. et al. Eradication of carbapenem-resistant Enterobacteriaceae gastrointestinal colonization with nonabsorbable oral antibiotic treatment: a prospective controlled trial. Am J Infect Control 2013;41(12):1167–72. DOI: 10.1016/j.ajic.2013.04.018.

40. Machuca I., Gutierrez-Gutierrez B., Perez Cortes S. et al. Oral decontamination with aminoglycosides is associated with lower risk of mortality and infections in high-risk patients colonized with colistin-resistant, KPC-producing Klebsiella pneumoniae. J Antimicrob Chemother 2016;71(11):3242– 9. DOI: 10.1093/jac/dkw272.

41. Tascini C., Sbrana F., Flammini S. et al. Oral gentamicin gut decontamination for prevention of KPC-producing Klebsiella pneumoniae infections: relevance of concomitant systemic antibiotic therapy. Antimicrob Agents Chemother 2014;58(4):1972–6. DOI: 10.1128/AAC.02283-13.

42. Tacconelli E., Mazzaferri F., Marie de Smet A. et al. ESCMID-EUCIC clinical guidelines on decolonisation of multidrugresistant Gram-negative bacteria carriers. Clin Microbiol Infect 2019. DOI: 10.1016/j.cmi.2019.01.005.

43. Daikos G.L., Tsaousi S., Tzouvelekis L.S. et al. Carbapenemase-producing Klebsiella pneumoniae bloodstream infections: lowering mortality by antibiotic combination schemes and the role of carbapenems. Antimicrob Agents Chemother 2014;58(4):2322–8. DOI: 10.1128/AAC.02166-13.

44. Rodríguez-Baño J., Gutiérrez-Gutiérrez B., Machuca I., Pascual A. Treatment of infections caused by extended-spectrum-betalactamase-, AmpC-, and carbapenemaseproducing Enterobacteriaceae. Clin Microbiol Rev 2018;31(2). DOI: 10.1128/CMR.00079-17.

45. de Maio Carrilho C.M.D., Marques de Oliveira L., Gaudereto J. et al. A prospective study of treatment of carbapenem-resistant Enterobacteriaceae infections and risk factors associated with outcome. BMC Infect Dis 2016;16(1):629. DOI: 10.1186/s12879-016-1979-z.

46. Gutiérrez-Gutiérrez B., Salamanca E., de Cueto M. et al. A predictive model of mortality in patients with bloodstream infections due to carbapenemase-producing Enterobacteriaceae. Mayo Clin Proc 2016;91(10):1362–71. DOI: 10.1016/j.mayocp.2016.06.024.

47. Hilf M., Yu V.L., Sharp J. et al. Antibiotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of 200 patients. Am J Med 1989;87(5):540–6. DOI: 10.1016/S00029343(89)80611-4.

48. Charlson M.E., Szatrowski T.P., Peterson J., Gold J. Validation of a combined comorbidity index. J Clin Epidemiol 1994;47(11):1245–51. DOI: 10.1016/0895-4356(94)90129-5.

49. Cano A., Gutiérrez-Gutiérrez B., Machuca I. et al. Risks of infection and mortality among patients colonized with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: validation of scores and proposal for management. Clin Infect Dis 2018;66(8):1204–10. DOI: 10.1093/cid/cix991.

50. Tumbarello M., Trecarichi E.M., De Rosa F.G. et al. Infections caused by KPC-producing Klebsiella pneumoniae: differences in therapy and mortality in a multicentre study. J Antimicrob Chemother 2015;70(7):2133–43. DOI: 10.1093/jac/dkv086.

51. Pea F., Della Siega P., Cojutti P. et al. Might real-time pharmacokinetic/pharmacodynamic optimisation of high-dose continuous-infusion meropenem improve clinical cure in infections caused by KPCproducing Klebsiella pneumoniae? Int J Antimicrob Agents 2017;49(2):255–8. DOI: 10.1016/j.ijantimicag.2016.10.018.

52. Del Bono V., Giacobbe D.R., Marchese A. et al. Meropenem for treating KPC-producing Klebsiella pneumoniae bloodstream infections: should we get to the PK/PD root of the paradox? Virulence 2017;8(1):66–73. DOI: 10.1080/21505594.2016.1213476.

53. Bulik C.C., Nicolau D.P. Double-carbapenem therapy for carbapenemase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2011;55(6):3002–4. DOI: 10.1128/AAC.01420-10.

54. De Pascale G., Martucci G., Montini L. et al. Double carbapenem as a rescue strategy for the treatment of severe carbapenemaseproducing Klebsiella pneumoniae infections: a two-center, matched case-control study. Crit Care 2017;21(1):173. DOI: 10.1186/s13054-017-1769-z.

55. Klyasova G.A., Okhmat V.A. Antimicrobial therapy. In: Program treatment of blood system disorders. 2nd edn. Ed.: V.G. Savchenko. Moscow: Praktika, 2018. Pp. 1067–1113. (In Russ.).

56. Kozlov R.S., Stetsyuk O.U., Andreeva I.V. Ceftazidime-avibactam: new rules for the game against multidrugresistant gram-negative bacteria. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya = Clinical Microbiology and Antimicrobial Chemotherapy 2018;20(1):24–34. (In Russ.).

57. Castón J.J., Lacort-Peralta I., MartínDávila P. et al. Clinical efficacy of ceftazidime/ avibactam versus other active agents for the treatment of bacteremia due to carbapenemaseproducing Enterobacteriaceae in hematologic patients. Int J Infect Dis 2017;59:118–23. DOI: 10.1016/j.ijid.2017.03.021.

58. Tumbarello M., Trecarichi E.M., Corona A. et al. Efficacy of ceftazidime-avibactam salvage therapy in patients with infections caused by Klebsiella pneumoniae carbapenemaseproducing K. pneumoniae. Clin Infect Dis 2019;68(3):355–64. DOI: 10.1093/cid/ciy492.


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Tandilova K.S., Klyasova G.A. Infectious complications caused by carbapenemase-producing Enterobacterales in patients with hematological disorders. Oncohematology. 2019;14(3):77-89. (In Russ.) https://doi.org/10.17650/1818-8346-2019-14-3-77-89

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