Role of association of OmpK35 and OmpK36 alteration and blaESBL and/or blaAmpC genes in conferring carbapenem resistance among non-carbapenemase-producing Klebsiella pneumoniae
| Autor: | Amine Slim, Mabrouka Saidani, Luis Martínez-Martínez, Marta Fernandez Martinez, Alain A. Ocampo-Sosa, Ilhem Boutiba-Ben Boubaker, Sana Ferjani, Zaineb Hamzaoui, Elaa Maamar, Sarrah Landolsi |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Imipenem Carbapenem Klebsiella pneumoniae 030106 microbiology Meropenem Microbiology 03 medical and health sciences chemistry.chemical_compound polycyclic compounds medicine Pharmacology (medical) Insertion sequence biology General Medicine biochemical phenomena metabolism and nutrition bacterial infections and mycoses biology.organism_classification Enterobacteriaceae Infectious Diseases chemistry Porin bacteria Ertapenem medicine.drug |
| Zdroj: | International Journal of Antimicrobial Agents. 52:898-905 |
| ISSN: | 0924-8579 |
| Popis: | In Klebsiella pneumoniae, loss of the two major outer membrane porins (OMPs) OmpK35 and OmpK36 confers resistance to carbapenems in strains producing extended-spectrum β-lactamases (ESBLs) or plasmid-mediated AmpC-type β-lactamases. This study investigated mechanisms responsible for carbapenem resistance in non-carbapenemase-producing K. pneumoniae (NCPK). All carbapenem-resistant Enterobacteriaceae (CRE) at Charles Nicolle Hospital (Tunis, Tunisia) were collected over a 6-year period (2010–2015). Among the 334 CRE strains collected, 44 (13.2%) were NCPK. MIC ranges for ertapenem, imipenem and meropenem were 1 to >32 mg/L, 0.125–8 mg/L and 0.125–32 mg/L, respectively. All strains showed a multidrug-resistant (MDR) phenotype and were negative for carbapenemase activity. None of the carbapenemase genes searched for were found. ESBL production was confirmed in all isolates except one [CTX-M-15 (n = 39) and SHV-5 (n = 4)]. Three isolates produce DHA-1 (associated with CTX-M-15 in two strains). Molecular fingerprints grouped the 44 NCPK isolates into seven clusters. In seven representative strains of these clusters, SDS-PAGE results showed that four isolates lacked the OmpK35 porin, one isolate lacked OmpK36 and two isolates lacked both OmpK35 and OmpK36. Sequencing of the corresponding porin genes showed amino acid insertions and deletions leading to early termination of translation, point mutations in the promoter region, or insertion sequences disrupting the gene coding sequence. Loss or deficiency of OMPs, coupled with ESBL and/or AmpC production, plays an important role in conferring carbapenem resistance in K. pneumoniae. Dissemination of these MDR bacteria in our hospital may create serious therapeutic problems in the future. |
| Databáze: | OpenAIRE |
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