A ten‐year surveillance study of carbapenemaseproducingKlebsiella pneumoniaein a tertiary care Greek university hospital: predominance of KPC‐ over VIM‐ or NDM‐producing isolates. Issue 3 (March 2016)

• Record Type: Journal Article
• Authors: Spyropoulou, Aikaterini; Papadimitriou‐Olivgeris, Matthaios; Bartzavali, Christina; Vamvakopoulou, Sophia; Marangos, Markos; Spiliopoulou, Iris; Anastassiou, Evangelos D.; Christofidou, Myrto
• Is Part Of: Journal of medical microbiology. Volume 65:Issue 3(2016)
• Publication Date: 2016-03
• Subjects: Medical microbiology -- Periodicals; 616.9041
• DOI: 10.1099/jmm.0.000217
• Languages: English
• ISSNs: 0022-2615

Abstract

Abstract : N/A: Resistance patterns and carbapenemase gene presence among Klebsiella pneumoniae isolates from the University General Hospital of Patras, Greece during a ten‐year period were analysed under a surveillance programme for multi‐drug‐resistant bacteria. From 2005 to 2014, K . pneumoniae isolates from clinically significant specimens were identified by the Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the agar disc diffusion method and Etest. The strains were tested for the presence of bla VIM, bla IMP, bla KPC, bla NDM and bla OXA‐48 genes by PCR. PFGE of chromosomal Xbal DNA digests was performed. A total of 3449 K . pneumoniae isolates were recovered during the last decade. Among them, 1668 (48 %) were carbapenemase‐producing: 1333 (80 %) K . pneumoniae carbapenemase (KPC)‐, 286 (17 %) Verona imipenemase (VIM), 45 (3 %) KPC‐ and VIM‐, and four New Delhi metallo‐beta‐lactamase (NDM)‐producing. Their resistance rates to gentamicin, colistin and tigecycline were 41 %, 23 % and 16 %, respectively. VIM‐producing K . pneumoniae were isolated in 2005 and since 2008 have been endemic. KPC‐producing K . pneumoniae (KPC‐Kp) isolates were introduced in 2008 and until now represent the predominant carbapenemase‐producing K. pneumoniae in our institution. PFGE of 97 KPC‐Kp strains identified three types: A, 84 (87 %); B, 11 (11 %); and E, two (2 %). Eleven co‐producing KPC and VIM K . pneumoniae isolates belonged to PFGE B. The four NDM‐positives were classified to type F. The number of K . pneumoniae bacteraemias increased during the study period, which may be solely attributed to the increase of carbapenemase‐producing isolates. The threat of carbapenemase‐producing K . pneumoniae emphasizes the urgent need for implementation of infection control measures and budgetary allocations to infection control.