Outbreak of colistin-resistant carbapenemase-producing Klebsiella pneumoniae in Tunisia
| Autor: | Wejdene Mansour, Estelle Saras, Marisa Haenni, Olfa Bouallegue, Anis Ben Haj Khalifa, Yosra Mani, Raoudha Grami, Souhail el Atrouss, Noureddine Boujâafar, Jean-Yves Madec, Mohamed Kheder, Mohamed Fekih Hassen |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) Tunisia Klebsiella pneumoniae 030106 microbiology Immunology Microbial Sensitivity Tests Microbiology beta-Lactamases Disease Outbreaks Young Adult 03 medical and health sciences Plasmid Bacterial Proteins Enterobacteriaceae Drug Resistance Bacterial Prevalence medicine Pulsed-field gel electrophoresis Humans Immunology and Allergy Typing Aged Aged 80 and over biology Colistin Membrane Proteins Outbreak Middle Aged biochemical phenomena metabolism and nutrition bacterial infections and mycoses biology.organism_classification Anti-Bacterial Agents Electrophoresis Gel Pulsed-Field Klebsiella Infections DNA Transposable Elements bacteria Multilocus sequence typing Female Multilocus Sequence Typing Plasmids medicine.drug |
| Zdroj: | Journal of Global Antimicrobial Resistance. 10:88-94 |
| ISSN: | 2213-7165 |
| Popis: | Objectives Mechanisms of colistin and carbapenem resistance among a collection of Klebsiella pneumoniae isolates recovered in a university hospital in Tunisia were studied. Methods In vitro antimicrobial susceptibility testing, S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), Southern blotting and PCR-based replicon typing (PBRT) were performed. Extended-spectrum β-lactamases (ESBLs), carbapenemases, AmpC-type enzymes and mgrB genes were detected by PCR and sequencing. Clonality of isolates was assessed by PFGE and multilocus sequence typing (MLST). Results Of 940 Enterobacteriaceae isolates recovered from June 2015 to March 2016 in Tahar Sfar Hospital (Mahdia, Tunisia), 220 were identified as K. pneumoniae, among which 29 were carbapenem-resistant. Carbapenem resistance was mostly due to expression of blaOXA-48 or blaOXA-204 in combination with blaCMY-4. Seven isolates carried blaNDM-1, of which two also harboured blaOXA-48, together with blaCMY-16 in one of them. All but two isolates also harboured blaCTX-M-15. All 20 blaOXA-48 genes were part of transposon Tn1999 on an IncL plasmid, whereas blaOXA-204 was found on transposon Tn2016 on an IncA/C plasmid. Finally, all blaNDM-1 genes were located within a Tn125 transposon on an IncFIIk plasmid. Interestingly, 7 (24.1%) of 29 carbapenem-resistant isolates were resistant to colistin, of which 6 were assigned to ST101, had similar PFGE profiles and presented the same 2-kb insertion in the mgrB gene. Conclusions This study reports, for the first time in Tunisia, the full molecular characterisation of colistin resistance in K. pneumoniae. There is an urgent need for control measures and prudent use of colistin in treatment of infections with carbapenemase-producing K. pneumoniae. |
| Databáze: | OpenAIRE |
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