Emergence of OXA-48 and OXA-181 carbapenemases among Enterobacteriaceae in South Africa and evidence of in vivo selection of colistin resistance as a consequence of selective decontamination of the gastrointestinal tract

J Clin Microbiol. 2013 Jan;51(1):369-72. doi: 10.1128/JCM.02234-12. Epub 2012 Nov 14.

Abstract

This study reports on the emergence of OXA-48-like carbapenemases among isolates of Enterobacteriaceae in South Africa. In addition, the emergence during therapy of a colistin-resistant OXA-181-producing Klebsiella pneumoniae isolate was documented following selective digestive tract decontamination with oral colistin, which is therefore strongly discouraged.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Colistin / pharmacology
  • Colistin / therapeutic use*
  • Drug Resistance, Bacterial*
  • Enterobacteriaceae / enzymology*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / epidemiology*
  • Gastrointestinal Tract / microbiology*
  • Humans
  • Male
  • Middle Aged
  • South Africa / epidemiology
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases
  • Colistin