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Characterization of Isolates Associated with Emergence of OXA-48-Producing Klebsiella pneumoniae in Croatia.
Microb Drug Resist 2018; 24(7):973-979MD

Abstract

Here, we report a retrospective study conducted to elucidate emergence, epidemiology, and molecular mechanisms of resistance underlying the early spread of OXA-48 carbapenemase-producing Enterobacteriaceae in Croatia. Retrospective screening for OXA-48 producers was performed on a collection of 296 nonrepetitive, carbapenem-nonsusceptible enterobacterial isolates collected from January 2011 to December 2012 from 40 participating centers in Croatia. Antimicrobial susceptibility profiles and production of carbapenemases were assessed phenotypically. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing were used for epidemiological analysis. Resistance genes were characterized by polymerase chain reaction (PCR) and sequencing. Plasmid localization of blaOXA-48 in isolates and transconjugants was investigated by S1-PFGE and Southern hybridization. PCR mapping was used for identification of genetic platform surrounding blaOXA-48. Out of 296 carbapenem-nonsusceptible isolates, blaOXA-48 gene was detected in 12 Klebsiella pneumoniae isolates. All OXA-48-producing isolates showed varying resistance to carbapenems and 11 were multidrug resistant. All coproduced additional beta-lactamases, including CTX-M-15, which was detected in eight isolates. Isolates were delineated in five clonal types by PFGE corresponding to five sequence types (STs) assigned ST15, ST16, ST37, ST528, and ST1418. All OXA-48 isolates conjugated successfully and other resistance determinants were not cotransferred. blaOXA-48 was carried on a ∼60 kb IncL/M plasmid and was detected within Tn1999.2 composite transposon. OXA-48, a class D carbapenemase, is emerging as a potentially significant contributor among carbapenem-resistant Enterobacteriaceae in Croatia, alongside class A and B carbapenemases. Polyclonal genetic background of K. pneumoniae isolates carrying ∼60 kb incL/M plasmid indicates that dissemination of the blaOXA48 gene is not driven exclusively by the spread of a single clone.

Authors+Show Affiliations

1 Department of Clinical Microbiology, University Hospital for Infectious Diseases , Zagreb, Croatia .2 Department of Clinical Microbiology and Hospital Infections, Dubrava University Hospital , Zagreb, Croatia .3 Department of Clinical Microbiology and Hospital Infections, Clinical Hospital "Sveti Duh ," Zagreb, Croatia .4 Department of Medical Microbiology, Public Health Institute of County Varaždin , Varaždin, Croatia .1 Department of Clinical Microbiology, University Hospital for Infectious Diseases , Zagreb, Croatia .1 Department of Clinical Microbiology, University Hospital for Infectious Diseases , Zagreb, Croatia .1 Department of Clinical Microbiology, University Hospital for Infectious Diseases , Zagreb, Croatia .

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29267137

Citation

Jelić, Marko, et al. "Characterization of Isolates Associated With Emergence of OXA-48-Producing Klebsiella Pneumoniae in Croatia." Microbial Drug Resistance (Larchmont, N.Y.), vol. 24, no. 7, 2018, pp. 973-979.
Jelić M, Škrlin J, Bejuk D, et al. Characterization of Isolates Associated with Emergence of OXA-48-Producing Klebsiella pneumoniae in Croatia. Microb Drug Resist. 2018;24(7):973-979.
Jelić, M., Škrlin, J., Bejuk, D., Košćak, I., Butić, I., Gužvinec, M., & Tambić-Andrašević, A. (2018). Characterization of Isolates Associated with Emergence of OXA-48-Producing Klebsiella pneumoniae in Croatia. Microbial Drug Resistance (Larchmont, N.Y.), 24(7), pp. 973-979. doi:10.1089/mdr.2017.0168.
Jelić M, et al. Characterization of Isolates Associated With Emergence of OXA-48-Producing Klebsiella Pneumoniae in Croatia. Microb Drug Resist. 2018;24(7):973-979. PubMed PMID: 29267137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of Isolates Associated with Emergence of OXA-48-Producing Klebsiella pneumoniae in Croatia. AU - Jelić,Marko, AU - Škrlin,Jasenka, AU - Bejuk,Danijela, AU - Košćak,Iva, AU - Butić,Iva, AU - Gužvinec,Marija, AU - Tambić-Andrašević,Arjana, Y1 - 2017/12/21/ PY - 2017/12/22/pubmed PY - 2018/12/15/medline PY - 2017/12/22/entrez KW - Croatia KW - IncL/M KW - Klebsiella pneumoniae KW - OXA-48 KW - Tn1999.2 SP - 973 EP - 979 JF - Microbial drug resistance (Larchmont, N.Y.) JO - Microb. Drug Resist. VL - 24 IS - 7 N2 - Here, we report a retrospective study conducted to elucidate emergence, epidemiology, and molecular mechanisms of resistance underlying the early spread of OXA-48 carbapenemase-producing Enterobacteriaceae in Croatia. Retrospective screening for OXA-48 producers was performed on a collection of 296 nonrepetitive, carbapenem-nonsusceptible enterobacterial isolates collected from January 2011 to December 2012 from 40 participating centers in Croatia. Antimicrobial susceptibility profiles and production of carbapenemases were assessed phenotypically. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing were used for epidemiological analysis. Resistance genes were characterized by polymerase chain reaction (PCR) and sequencing. Plasmid localization of blaOXA-48 in isolates and transconjugants was investigated by S1-PFGE and Southern hybridization. PCR mapping was used for identification of genetic platform surrounding blaOXA-48. Out of 296 carbapenem-nonsusceptible isolates, blaOXA-48 gene was detected in 12 Klebsiella pneumoniae isolates. All OXA-48-producing isolates showed varying resistance to carbapenems and 11 were multidrug resistant. All coproduced additional beta-lactamases, including CTX-M-15, which was detected in eight isolates. Isolates were delineated in five clonal types by PFGE corresponding to five sequence types (STs) assigned ST15, ST16, ST37, ST528, and ST1418. All OXA-48 isolates conjugated successfully and other resistance determinants were not cotransferred. blaOXA-48 was carried on a ∼60 kb IncL/M plasmid and was detected within Tn1999.2 composite transposon. OXA-48, a class D carbapenemase, is emerging as a potentially significant contributor among carbapenem-resistant Enterobacteriaceae in Croatia, alongside class A and B carbapenemases. Polyclonal genetic background of K. pneumoniae isolates carrying ∼60 kb incL/M plasmid indicates that dissemination of the blaOXA48 gene is not driven exclusively by the spread of a single clone. SN - 1931-8448 UR - https://www.unboundmedicine.com/medline/citation/29267137/Characterization_of_Isolates_Associated_with_Emergence_of_OXA_48_Producing_Klebsiella_pneumoniae_in_Croatia_ L2 - https://www.liebertpub.com/doi/full/10.1089/mdr.2017.0168?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -