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A coup d'état by NDM-producing Klebsiella pneumoniae overthrows the major bacterial population during KPC-directed therapy.
Diagn Microbiol Infect Dis. 2020 May 15; 98(1):115080.DM

Abstract

The objective of this study was to utilize a co-culture hollow-fiber infection model (HFIM) to characterize the interplay between a small, difficult-to-detect, New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae (NDM-Kp) minor population and a larger K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae population in the presence of KPC-directed antibacterial therapy. Selective plating onto agar with ceftazidime-avibactam was used to track the density of the NDM-Kp population. Susceptibility testing and the Verigene System failed to identify the small initial NDM-Kp population. However, a ceftazidime-avibactam Etest detected resistant colonies that were confirmed to be NDM-Kp. In the HFIM, all of the investigated drug regimens caused regrowth within 24 h and resulted in >109 CFU/mL of NDM-Kp. Our study demonstrates that the HFIM is a powerful tool for studying the population dynamics of multiple pathogens during antimicrobial exposure and also highlights that difficult-to-detect minor populations of drug-resistant bacteria may cause treatment failure without appropriate antibacterial therapy.

Authors+Show Affiliations

California Northstate University College of Pharmacy, Elk Grove, CA, USA.College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA.Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA.College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: bulman@uic.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32619895

Citation

Lenhard, Justin R., et al. "A Coup D'état By NDM-producing Klebsiella Pneumoniae Overthrows the Major Bacterial Population During KPC-directed Therapy." Diagnostic Microbiology and Infectious Disease, vol. 98, no. 1, 2020, p. 115080.
Lenhard JR, Rana AP, Wenzler E, et al. A coup d'état by NDM-producing Klebsiella pneumoniae overthrows the major bacterial population during KPC-directed therapy. Diagn Microbiol Infect Dis. 2020;98(1):115080.
Lenhard, J. R., Rana, A. P., Wenzler, E., Huang, Y., Kreiswirth, B. N., Chen, L., & Bulman, Z. P. (2020). A coup d'état by NDM-producing Klebsiella pneumoniae overthrows the major bacterial population during KPC-directed therapy. Diagnostic Microbiology and Infectious Disease, 98(1), 115080. https://doi.org/10.1016/j.diagmicrobio.2020.115080
Lenhard JR, et al. A Coup D'état By NDM-producing Klebsiella Pneumoniae Overthrows the Major Bacterial Population During KPC-directed Therapy. Diagn Microbiol Infect Dis. 2020 May 15;98(1):115080. PubMed PMID: 32619895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A coup d'état by NDM-producing Klebsiella pneumoniae overthrows the major bacterial population during KPC-directed therapy. AU - Lenhard,Justin R, AU - Rana,Amisha P, AU - Wenzler,Eric, AU - Huang,Yanqin, AU - Kreiswirth,Barry N, AU - Chen,Liang, AU - Bulman,Zackery P, Y1 - 2020/05/15/ PY - 2019/12/30/received PY - 2020/04/17/revised PY - 2020/05/08/accepted PY - 2020/7/4/pubmed PY - 2020/7/4/medline PY - 2020/7/4/entrez KW - Ceftazidime-avibactam KW - Hollow fiber infection model KW - Klebsiella pneumoniae KW - Polymicrobial KW - Rapid diagnostics SP - 115080 EP - 115080 JF - Diagnostic microbiology and infectious disease JO - Diagn. Microbiol. Infect. Dis. VL - 98 IS - 1 N2 - The objective of this study was to utilize a co-culture hollow-fiber infection model (HFIM) to characterize the interplay between a small, difficult-to-detect, New Delhi metallo-β-lactamase-producing Klebsiella pneumoniae (NDM-Kp) minor population and a larger K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae population in the presence of KPC-directed antibacterial therapy. Selective plating onto agar with ceftazidime-avibactam was used to track the density of the NDM-Kp population. Susceptibility testing and the Verigene System failed to identify the small initial NDM-Kp population. However, a ceftazidime-avibactam Etest detected resistant colonies that were confirmed to be NDM-Kp. In the HFIM, all of the investigated drug regimens caused regrowth within 24 h and resulted in >109 CFU/mL of NDM-Kp. Our study demonstrates that the HFIM is a powerful tool for studying the population dynamics of multiple pathogens during antimicrobial exposure and also highlights that difficult-to-detect minor populations of drug-resistant bacteria may cause treatment failure without appropriate antibacterial therapy. SN - 1879-0070 UR - https://www.unboundmedicine.com/medline/citation/32619895/A_coup_d'état_by_NDM-producing_Klebsiella_pneumoniae_overthrows_the_major_bacterial_population_during_KPC-directed_therapy L2 - https://linkinghub.elsevier.com/retrieve/pii/S0732-8893(20)30457-0 DB - PRIME DP - Unbound Medicine ER -
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