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Klebsiella pneumoniae carbapenemase (KPC) in urinary infection isolates.
Arch Microbiol. 2021 May; 203(4):1825-1831.AM

Abstract

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 (blaOXA-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 blaKPC and blaSHV genes in all isolates whereas 13 isolates tested positive also for blaTEM 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.

Authors+Show Affiliations

School of Medicine, University of Zagreb, Zagreb, Croatia. branka.bedenic@kbc-zagreb.hr. Clinical Department for Clinical and Molecular Microbiology, University Hospital Center Zagreb, Kišpatić Street 12, Zagreb, Croatia. branka.bedenic@kbc-zagreb.hr.University Hospital Center Split, Split, Croatia.National Public Health Institute, Zagreb, Croatia.Institute for Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria.School of Medicine, University of Zagreb, Zagreb, Croatia. Clinical Department for Clinical and Molecular Microbiology, University Hospital Center Zagreb, Kišpatić Street 12, Zagreb, Croatia.Andrija Štampar Teaching Public Health Institute, Zagreb, Croatia.Public Health Institute of Dubrovnik-Neretva County, Dubrovnik, Croatia.School of Medicine, University of Zagreb, Zagreb, Croatia. Andrija Štampar Teaching Public Health Institute, Zagreb, Croatia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33507339

Citation

Bedenić, Branka, et al. "Klebsiella Pneumoniae Carbapenemase (KPC) in Urinary Infection Isolates." Archives of Microbiology, vol. 203, no. 4, 2021, pp. 1825-1831.
Bedenić B, Sardelić S, Bogdanić M, et al. Klebsiella pneumoniae carbapenemase (KPC) in urinary infection isolates. Arch Microbiol. 2021;203(4):1825-1831.
Bedenić, B., Sardelić, S., Bogdanić, M., Zarfel, G., Beader, N., Šuto, S., Krilanović, M., & Vraneš, J. (2021). Klebsiella pneumoniae carbapenemase (KPC) in urinary infection isolates. Archives of Microbiology, 203(4), 1825-1831. https://doi.org/10.1007/s00203-020-02161-x
Bedenić B, et al. Klebsiella Pneumoniae Carbapenemase (KPC) in Urinary Infection Isolates. Arch Microbiol. 2021;203(4):1825-1831. PubMed PMID: 33507339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Klebsiella pneumoniae carbapenemase (KPC) in urinary infection isolates. AU - Bedenić,Branka, AU - Sardelić,Sanda, AU - Bogdanić,Maja, AU - Zarfel,Gernot, AU - Beader,Nataša, AU - Šuto,Sandra, AU - Krilanović,Marija, AU - Vraneš,Jasmina, Y1 - 2021/01/28/ PY - 2020/04/16/received PY - 2020/12/23/accepted PY - 2020/11/25/revised PY - 2021/1/29/pubmed PY - 2021/5/20/medline PY - 2021/1/28/entrez KW - KPC KW - Klebsiella pneumoniae KW - Resistance KW - Urinary tract infections SP - 1825 EP - 1831 JF - Archives of microbiology JO - Arch Microbiol VL - 203 IS - 4 N2 - 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 (blaOXA-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 blaKPC and blaSHV genes in all isolates whereas 13 isolates tested positive also for blaTEM 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. SN - 1432-072X UR - https://www.unboundmedicine.com/medline/citation/33507339/Klebsiella_pneumoniae_carbapenemase__KPC__in_urinary_infection_isolates_ L2 - https://dx.doi.org/10.1007/s00203-020-02161-x DB - PRIME DP - Unbound Medicine ER -