1. KPC-Producing Klebsiella pneumoniae Isolates in Croatia: A Nationwide Survey.
- Author
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Jelic M, Butic I, Plecko V, Cipris I, Jajic I, Bejuk D, Koscak I, Marinkovic S, Pal MP, and Andrasevic AT
- Subjects
- Anti-Bacterial Agents pharmacology, Bacterial Proteins metabolism, Carbapenems pharmacology, Croatia epidemiology, DNA, Bacterial genetics, Disk Diffusion Antimicrobial Tests, Electrophoresis, Gel, Pulsed-Field, Health Surveys, Humans, Incidence, Klebsiella Infections drug therapy, Klebsiella Infections microbiology, Klebsiella pneumoniae drug effects, Klebsiella pneumoniae growth & development, Klebsiella pneumoniae isolation & purification, Molecular Epidemiology, Multilocus Sequence Typing, Plasmids chemistry, Plasmids classification, Polymerase Chain Reaction, Sequence Analysis, DNA, beta-Lactamases metabolism, Bacterial Proteins genetics, Gene Expression Regulation, Bacterial, Klebsiella Infections epidemiology, Klebsiella pneumoniae genetics, Plasmids metabolism, beta-Lactam Resistance genetics, beta-Lactamases genetics
- Abstract
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 bla
KPC 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.- Published
- 2016
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