| Autor: |
Car H; Zagreb Health School, 10000 Zagreb, Croatia., Dobrić M; Department of Anesthesiology, Intensive Medicine and Pain Management, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia., Pospišil M; Department of Emergency Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia., Nađ M; University of Zagreb School of Medicine, 10000 Zagreb, Croatia., Luxner J; Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8010 Graz, Austria., Zarfel G; Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8010 Graz, Austria., Grisold A; Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, 8010 Graz, Austria., Nikić-Hecer A; Department of Microbiology and Hospital Infections, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia., Vraneš J; Department of Microbiology and Parasitology, University of Zagreb School of Medicine, Teaching Institute of Public Health 'Dr. Andrija Štampar', 10000 Zagreb, Croatia., Bedenić B; Biomedical Research Center Šalata, University of Zagreb School of Medicine, Department for Clinical Microbiology and Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia. |
| Abstrakt: |
K. pneumoniae harbors various antibiotic resistance determinants like extended-spectrum and plasmid-mediated AmpC β-lactamases and carbapenemases. In the last three years, in the period of intense population aging, migrations and climate changes in Europe and Croatia as well, we observed changes in antibiotic resistance patters of carbapenem-resistant K. pneumoniae (CRKP) isolates obtained routinely in community and inpatient setting. The aim was to compare and subsequently analyze CRKP hospital and community isolates resistance mechanisms, traits and molecular epidemiology, in order to analyze the dynamic of resistance trends, carbapenemase types and plasmid epidemiology. Disk diffusion and broth dilution method were the methods of choice to determine antibiotic susceptibility. β-lactamases were screened by phenotypic methods and confirmed with PCR. In total 113 isolates were analysed. Resistance to amoxicillin-clavulanate and ertapenem was confirmed in all strains. High resistance rates (over 90%) were observed for extended-spectrum cephalosporins, and ciprofloxacin. OKNV (OXA-48, KPC, NDM, VIM) testing and PCR detected OXA-48 in 106, NDM in 7 and KPC in only one isolate. ESBLs accompanied carbapenemases in 103 isolates. IncL, associated with OXA-48, was the dominant plasmid type. No significant differences in the resistance profile and resistance determinants were found between hospital and community isolates plasmid type. The predominance of OXA-48 carbapenemase is in line with the reports from the neigbouring countries. |
