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Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
- Source :
- Eurosurveillance
- Publication Year :
- 2018
- Publisher :
- European Centre for Disease Prevention and Control (ECDC), 2018.
-
Abstract
- Background and aim A multicentre nationwide surveillance study was conducted in Greek hospitals to evaluate epidemiology of carbapenemase-producing Klebsiella pneumoniae clinical isolates, and their susceptibilities to last-line antibiotics. Methods: Minimum inhibitory concentrations (MICs) were evaluated by Etest, colistin MICs were also evaluated by broth microdilution SensiTest (now known as ComASP) Colistin. Carbapenemase genes were detected by PCR. Clonal relatedness was assessed by PFGE. Isolates were prospectively collected between November 2014 and April 2016, from 15 hospitals. Results: Among 394 isolates, K. pneumoniae carbepenemase (KPC) remained the most prevalent carbapenemase (66.5%). NDM was the second most prevalent (13.7%), identified in 12 hospitals, followed by VIM (8.6%). OXA-48- and double carbapenemase-producers remained rare (3.6%, 6.3%, respectively). Carbapenemase-producing K. pneumoniae isolates showed high resistance to last-line antibiotics. Gentamicin and colistin were the most active in vitro with 61.9% and 59.6% of the isolates to be inhibited at ≤ 2mg/L, followed by fosfomycin (susceptibility (S): 58.4%) and tigecycline (S: 51.5%). Ceftazidime/avibactam inhibited 99.6% of KPC and 100% of OXA-48-like-producing isolates, while temocillin was active against 58% of KPC isolates at urinary breakpoint of ≤ 32mg/L* and only 2.7% at systemic breakpoint of ≤ 8mg/L. NDM-producing isolates belonged mainly to one clone, whereas KPC, VIM, OXA-48 and double carbapenemase-producers were mainly polyclonal. Conclusions: KPC remains the predominant carbapenemase among K. pneumoniae in Greece, followed by NDM, whereas changing trends of resistance rates to last-line antimicrobials against carbapenemase-producing K. pneumoniae with the exception of ceftazidime/avibactam mandates continuing surveillance to support clinical practice.
- Subjects :
- 0301 basic medicine
carbapenemases
Epidemiology
Klebsiella pneumoniae
Avibactam
030106 microbiology
carbapenem resistance
temocillin
Ceftazidime
NDM
Microbiology
03 medical and health sciences
chemistry.chemical_compound
ceftazidime/avibactam
Virology
medicine
polycyclic compounds
Temocillin
colistin
Etest
biology
business.industry
Broth microdilution
Public Health, Environmental and Occupational Health
biochemical phenomena, metabolism, and nutrition
biology.organism_classification
Ceftazidime/avibactam
bacterial infections and mycoses
3. Good health
KPC
chemistry
Colistin
tigecycline
business
medicine.drug
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 15607917 and 1025496X
- Volume :
- 23
- Issue :
- 31
- Database :
- OpenAIRE
- Journal :
- Eurosurveillance
- Accession number :
- edsair.doi.dedup.....b216d6ef70d7dc515adddf0d0145cc7b