Prevalence of Klebsiella pneumoniae strains producing carbapenemases and increase of resistance to colistin in an Italian teaching hospital from January 2012 To December 2014.

Autor: Parisi SG; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. saverio.parisi@unipd.it., Bartolini A; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. andbarto@libero.it., Santacatterina E; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. erica.esse@hotmail.it., Castellani E; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. castellanielena2606@gmail.com., Ghirardo R; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. roberto.ghirardo@gmail.com., Berto A; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. alessandro.berto@studenti.unipd.it., Franchin E; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. elisa.franchin@unipd.it., Menegotto N; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. nicola.menegotto@hotmail.it., De Canale E; Microbiology and Virology Unit, Padova Hospital, Padova, Italy. ettore.decanale@sanita.padova.it., Tommasini T; Microbiology and Virology Unit, Padova Hospital, Padova, Italy. tiziana.tommasini@sanita.padova.it., Rinaldi R; Infectious Diseases Unit, Padova Hospital, Padova, Italy. rinaldipd@gmail.com., Basso M; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. monica.basso@unipd.it., Stefani S; Department of Biomedical and Biotecnological Sciences, University of Catania, Catania, Italy. stefanis@unict.it., Palù G; Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy. giorgio.palu@unipd.it.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2015 Jun 27; Vol. 15, pp. 244. Date of Electronic Publication: 2015 Jun 27.
DOI: 10.1186/s12879-015-0996-7
Abstrakt: Background: The aim of this study was to characterize the spread of carbapenemase-producing Klebsiella pneumoniae (CPKP) in a tertiary level hospital using ongoing active surveillance with rectal swab cultures. Furthermore, this study analyzed the presence of CPKP in the clinical samples (CS) of a single patient as well as the evolution of Colistin-sensitive strains (CoS) to Colistin-resistant strains (CoR).
Methods: This study was performed from January 1, 2012 to December 31, 2014. In 2012, a survey was conducted in the Intensive Care Department. In autumn 2013, active monitoring was extended to the Surgery Department, and since mid-2014, the surveillance has included the Medical Department as well. Only the first isolated strain from each patient was included. Antimicrobial susceptibility testing was performed on CPKP isolates: Klebsiella pneumoniae carbapenemase, oxacillinase-48, Verona integron-encoded metallo-β-lactamase and New Delhi metallo-β-lactamase were detected using a validated in-house PCR method, and multilocus sequence typing (MLST) was used to investigate the clonal transmission of strains.
Results: A total of 15,104 patients were included in the study, and 496 consecutive non-replicated strains of CPKP were collected: 149 strains were collected in 2012 (39 [26.2 %] from surveillance rectal swabs [SRS]), 133 strains were collected in 2013 (70 [52.6 %] from SRS) and 214 strains were collected in 2014 (164 [76.6 %] from SRS). We observed a significant increase in the percentage of positive SRS cases in 2014 relative to 2013 and 2012 (p = 0.0001 and p = 0.0172, respectively) and in the proportion of CPKP first isolated by SRS relative to those identified by CS (p < 0.0001). Among all available samples, the number of CoR isolated from SRS was higher in 2013 and 2014 compared with 2012 (p = 0.0019 and p = 0.008, respectively). ST-258 and ST-512 were more prevalent in the tested specimens, and a new single locus variant (SLV) of ST-512 (ST-745) was isolated.
Conclusions: The results of this 3-year study of 15,104 patients highlight the clinical relevance of antimicrobial resistance as well as the drug-selection pressure of colistin therapy. The active surveillance in the three different departments increased the level of CPKP cases isolated by SRS.
Databáze: MEDLINE
Externí odkaz: