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: Ettore De Canale, Stefania Stefani, Andrea Bartolini, Roberto Ghirardo, Alessandro Berto, Erica Santacatterina, T. Tommasini, Elena Castellani, Elisa Franchin, Roberto Rinaldi, Giorgio Palù, Monica Basso, Saverio Giuseppe Parisi, Nicola Menegotto
Jazyk: angličtina
Rok vydání: 2015
Předmět:
medicine.medical_specialty
INTENSIVE-CARE-UNIT
Klebsiella pneumoniae carbapenemase producing
Klebsiella pneumoniae
Colistin resistance
Multilocus sequence typing
Klebsiella pneumoniae carbapenemase producing
Active surveillance
Rectal swabs
Colistin resistance
Multilocus sequence typing
INTENSIVE-CARE-UNIT
ACINETOBACTER-BAUMANNII
MULTIDRUG-RESISTANT
RISK-FACTORS
ENTEROBACTERIACEAE
INFECTION
EMERGENCE
MGRB
INACTIVATION
ACQUISITION
Microbial Sensitivity Tests
Drug resistance
Active surveillance
MULTIDRUG-RESISTANT
Polymerase Chain Reaction
ACINETOBACTER-BAUMANNII
beta-Lactamases
Microbiology
EMERGENCE
Rectal swabs
Antibiotic resistance
Medical microbiology
Bacterial Proteins
ENTEROBACTERIACEAE
Intensive care
Internal medicine
Drug Resistance
Bacterial
INFECTION
Prevalence
medicine
Humans
Hospitals
Teaching
Molecular Epidemiology
Molecular epidemiology
biology
Colistin
ACQUISITION
MGRB
biology.organism_classification
Biological Evolution
Anti-Bacterial Agents
Klebsiella Infections
Intensive Care Units
Infectious Diseases
Italy
RISK-FACTORS
INACTIVATION
Research Article
medicine.drug
Zdroj: BMC Infectious Diseases
Popis: 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
Databáze: OpenAIRE
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