Klebsiella pneumoniae carbapenemase (KPC) in urinary infection isolates
Recently, emergence of carbapenem-resistance, in particular due to Klebsiella pneumoniae carbapenemase (KPC), was observed among K . pneumoniae causing urinary tract infections in Croatia. The aim of the study was to characterize, antimicrobial susceptibility, carbapenem resistance, virulence traits...
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Published in: | Archives of microbiology Vol. 203; no. 4; pp. 1825 - 1831 |
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Main Authors: | , , , , , , , |
Format: | Journal Article |
Language: | English |
Published: |
Berlin/Heidelberg
Springer Berlin Heidelberg
01-05-2021
Springer Nature B.V |
Subjects: | |
Online Access: | Get full text |
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Summary: | Recently, emergence of carbapenem-resistance, in particular due to
Klebsiella pneumoniae
carbapenemase (KPC), was observed among
K
.
pneumoniae
causing urinary tract infections in Croatia. The aim of the study was to characterize, antimicrobial susceptibility, carbapenem resistance, virulence traits and plasmid types of the urinary KPC positive isolates of
K. pneumoniae
. The antimicrobial susceptibility to a wide range of antibiotics was determined by broth microdilution method. The transferability of meropenem resistance was determined by conjugation (broth mating method) employing
Escherichia coli
J63 strain resistant to sodium azide. Genes encoding broad and extended-spectrum β-lactamases, plasmid-mediated AmpC β-lactamases, group A and B carbapenemases, and carbapenem hydrolyzing oxacillinases (bla
OXA-48like
), respectively, were determined by Polymerase chain reaction (PCR). In total 30 KPC-positive
K
.
pneumoniae
urinary isolates collected from different regions of Croatia were analysed. The isolates were uniformly resistant to all tested antibiotics except for variable susceptibility to gentamicin, sulphamethoxazole/trimethoprim, and colistin, respectively. Four isolates were resistant to colistin with MICs values ranging from 4 to 16 mg/L. All tested isolates were susceptible to ceftazidime/avibactam. Sixteen isolates transferred meropenem resistance to
E. coli
recipient strain by conjugation. Other resistance markers were not co-transferred. PCR was positive for bla
KPC
and bla
SHV
genes in all isolates whereas 13 isolates tested positive also for bla
TEM
genes. PCR based replicon typing (PBRT) revealed the presence of FIIs in 13 and FIA plasmid in two strains. The study showed dissemination of KPC-producing
K. pneumoniae
in urinary isolates, posing a new epidemiological and treatment challenge. Sulphamethoxazole/trimethoprim, colistin, and ceftazidime/avibactam remain so far, as the therapeutic options. |
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ISSN: | 0302-8933 1432-072X |
DOI: | 10.1007/s00203-020-02161-x |