Characterization of ST258 Colistin-Resistant, blaKPC-Producing Klebsiella pneumoniae in a Greek Hospital

Autor: Eleftheria Palla, Asimina Maguina, Charikleia Nikolaou, Zoi Roussou, Sofia Likousi, Evangelia D Platsouka, Angeliki Mavroidi, Maria Katsiari
Rok vydání: 2016
Předmět:
0301 basic medicine
Male
Klebsiella pneumoniae
Antibiotics
Gene Expression
Drug resistance
law.invention
law
Drug Resistance
Multiple
Bacterial
Infection control
Polymerase chain reaction
Aged
80 and over
Cross Infection
biology
Greece
Middle Aged
Hospitals
Anti-Bacterial Agents
Intensive Care Units
Epidemiological Monitoring
Female
medicine.drug
Microbiology (medical)
medicine.drug_class
030106 microbiology
Immunology
Microbial Sensitivity Tests
Microbiology
beta-Lactamases
03 medical and health sciences
Bacterial Proteins
medicine
Humans
Aged
Pharmacology
business.industry
Colistin
Membrane Proteins
Sequence Analysis
DNA
biochemical phenomena
metabolism
and nutrition
equipment and supplies
biology.organism_classification
Klebsiella Infections
Mutagenesis
Insertional
DNA Transposable Elements
Multilocus sequence typing
Mobile genetic elements
business
Zdroj: Microbial drug resistance (Larchmont, N.Y.). 22(5)
ISSN: 1931-8448
Popis: The emergence of colistin resistance may further contribute to treatment failure of infection caused by multidrug-resistant (MDR) Klebsiella pneumoniae. The colistin resistance rates were determined and colistin-resistant carbapenemase-producing K. pneumoniae (COL-R CP-Kp) were characterized over an 18-month period in a Greek hospital. Out of 135 carbapenemase producers, 19 isolates (14%) were categorized as resistant to colistin. Phenotypic and molecular characterization of the COL-R CP-Kp isolates revealed that all were MDR blaKPC producers and, excluding one isolate of MLST ST383, belonged to the international clonal lineage ST258. Furthermore, PCR amplification and sequencing of the mgrB locus revealed nucleotide sequences of different sizes and insertions of IS1- and IS5-like mobile elements. The majority (63%) of the COL-R blaKPC producers was recovered from patients in the intensive care unit (ICU) and clinical data indicated that all patients should have acquired these isolates in the ICU. The findings of the present study underscore a concerning evolution of colistin resistance in a setting of high K. pneumoniae carbapenemase (KPC)-Kp endemicity, such as Greece. Thus, continuous surveillance, molecular characterization, prudent use of antibiotics, and implementation of infection control measures for K. pneumoniae are urgent.
Databáze: OpenAIRE
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