KPC-Producing Klebsiella pneumoniae Isolates in Croatia: A Nationwide Survey

Autor: Vanda Plečko, Ines Jajic, Ivan Cipris, Danijela Bejuk, Sonja Marinković, Iva Butić, Arjana Tambić Andrašević, Marina Payerl Pal, Marko Jelić, Iva Koscak
Jazyk: angličtina
Rok vydání: 2016
Předmět:
0301 basic medicine
Microbiology (medical)
DNA
Bacterial
Klebsiella pneumoniae
Croatia
030106 microbiology
Immunology
Microbiology
Polymerase Chain Reaction
beta-Lactam Resistance
beta-Lactamases
law.invention
03 medical and health sciences
Plasmid
Antibiotic resistance
Bacterial Proteins
law
Disk Diffusion Antimicrobial Tests
Pulsed-field gel electrophoresis
Humans
Polymerase chain reaction
Southern blot
Pharmacology
Molecular Epidemiology
Molecular epidemiology
biology
Incidence
Gene Expression Regulation
Bacterial
Sequence Analysis
DNA
biochemical phenomena
metabolism
and nutrition
biology.organism_classification
bacterial infections and mycoses
Virology
Health Surveys
Anti-Bacterial Agents
Electrophoresis
Gel
Pulsed-Field
Klebsiella Infections
Carbapenems
Multilocus sequence typing
KPC
ST258
Multilocus Sequence Typing
Plasmids
Popis: Background: In the last few years, Klebsiella pneumoniae strains producing K. pneumoniae carbapenemase (KPC) enzymes have emerged as important multidrug-resistant pathogens in hospitalized patients. This report describes KPC-producing isolates collected through the Croatian antimicrobial resistance surveillance program in the early stage of their dissemination in Croatia. Materials and Methods: Forty-eight KPC-producing K. pneumoniae isolates, collected during a period from February 2011 to August 2013, were analyzed in this study. Antimicrobial susceptibility profiles were determined using disk diffusion and E-test. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used for epidemiological analysis. Identification of β-lactamase genes and associated antibiotic resistance mechanisms was performed by polymerase chain reaction and positive products were sequenced. Localization of blaKPC was investigated by S1 PFGE and Southern hybridization. Results: Of 40 participating centers in Croatia, KPC isolates were recorded in 9 of them. They all had multidrug-resistant phenotype, but showed varying levels of resistance to carbapenems. All isolates displayed ST258, and PFGE showed that all but one were closely related. All isolates harbored blaKPC-2. Isolate with a unique PFGE pattern produced TEM-1, while others produced TEM-116. All isolates harbored blaSHV-11, but were negative for blaCTX-M and blaAmpC genes. All isolates contain one KPC-harboring plasmid, ranging in size from ∼60 to ∼210 kb, characterized as FIIs and IncR. Conclusion: This report describes that the early stage of KPC-producing K. pneumoniae dissemination in Croatia is associated with a prolific PFGE type belonging to ST258. So far, the spread of an outbreak strain is limited to the northwest region of the country.
Databáze: OpenAIRE
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