Naslov
Klebsiella pneumoniae carbapenemase (KPC) in urinary infection isolates
(Klebsiella pneumoniae carbapenemase (KPC) in urinary infection isolates)

Autori
Bedenić, Branka ; Sardelić, Sanda ; Bogdanić, Maja ; Zarfel, Gernot ; Beader, Nataša ; Šuto, Sandra ; Krilanović, Marija ; Vraneš, Jasmina

Izvornik
Archives of microbiology (0302-8933) 203 (2021), 4; 1825-1831

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Klebsiella pneumoniae ; KPC ; Urinary tract infections ; Resistance

Sažetak
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 beta- lactamases, plasmid-mediated AmpC beta-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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA