title: 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.
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.
authors.affiliation: Department of Clinical Microbiology, Ampath National Laboratory Services, Milpark Hospital, Johannesburg, South Africa. brinka@ampath.co.za
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Brink
authors.forename: Jennifer
authors.initials: J
authors.lastname: Coetzee
authors.forename: Craig
authors.initials: C
authors.lastname: Corcoran
authors.forename: Cornelis G
authors.initials: CG
authors.lastname: Clay
authors.forename: Danusha
authors.initials: D
authors.lastname: Hari-Makkan
authors.forename: Rachael K
authors.initials: RK
authors.lastname: Jacobson
authors.forename: Guy A
authors.initials: GA
authors.lastname: Richards
authors.forename: Charles
authors.initials: C
authors.lastname: Feldman
authors.forename: Louise
authors.initials: L
authors.lastname: Nutt
authors.forename: Johan
authors.initials: J
authors.lastname: van Greune
authors.forename: J D
authors.initials: JD
authors.lastname: Deetlefs
authors.forename: Karin
authors.initials: K
authors.lastname: Swart
authors.forename: Lesley
authors.initials: L
authors.lastname: Devenish
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003091:Colistin / Q000494:pharmacology / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology*; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013019:South Africa / Q000453:epidemiology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases; D003091:Colistin