Genetic analysis of ESBL-producing Klebsiella pneumoniae isolated from UTI patients in Indonesia
| Autor: | Katsumi Shigemura, Aya Ishii, Koichi Kitagawa, Takayuki Miyara, Toshiro Shirakawa, Saya Yamasaki, Kuntaman Kuntaman, Kayo Osawa, Masato Fujisawa |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Cefotaxime Nalidixic acid Tetracycline Klebsiella pneumoniae 030106 microbiology Ceftazidime Microbial Sensitivity Tests Biology beta-Lactamases Microbiology 03 medical and health sciences 0302 clinical medicine Escherichia coli medicine Humans Pharmacology (medical) 030212 general & internal medicine Replicon Typing biochemical phenomena metabolism and nutrition bacterial infections and mycoses biology.organism_classification Anti-Bacterial Agents Klebsiella Infections Ciprofloxacin Infectious Diseases Indonesia Plasmids medicine.drug |
| Zdroj: | Journal of Infection and Chemotherapy. 27:55-61 |
| ISSN: | 1341-321X |
| DOI: | 10.1016/j.jiac.2020.08.007 |
| Popis: | Introduction Extended spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae is a serious concern for nosocomial infection and the emergence rate in Indonesia is higher than that in developed countries. The purpose of this study was to investigate the genetic characteristics of ESBL-producing K. pneumoniae isolated from UTI patients in Indonesia. Materials and methods We collected K. pneumoniae resistant to ceftazidime or cefotaxime isolated from UTI patients in Dr. Soetomo's Academic Hospital in Surabaya, Indonesia in 2015. Ninety-four strains were identified as ESBL-producing bacteria by confirmation tests. The isolates were investigated by antimicrobial susceptibility testing with 20 drugs and ESBL gene detection, plasmid replicon typing and virulence genes as hypermucoviscous (HMV) strains were tested by the string test. Results High rates of resistance to ciprofloxacin (86.2%), tetracycline (80.9%) and nalidixic acid (78.7%) were observed. CTX-M-15 was the most common ESBL gene (89.4%), 33 of which also carried SHV-type ESBL. IncF was the most prevalent plasmid replicon typing (47.6%). Sixteen (17.0%) strains were judged as HMV, all of which had rmpA and more than half of which had fimH, uge, and wab. IncL/M was the most common replicon plasmid in the HMV strains, and the difference in the positive rate was statistically significant (p = 0.0024). Conclusion This study showed the high prevalence of multiple-drug resistant and predominately CTX-M-15-positive ESBL-producing K. pneumoniae in Indonesia. There was a correlation between IncL/M and the HMV phenotype in this study. As such hypervirulent strains continue to emerge, studying their dissemination with resistance determinants is an urgent priority. |
| Databáze: | OpenAIRE |
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