Emergence of Carbapenem-Resistant Klebsiella pneumoniae: Progressive Spread and Four-Year Period of Observation in a Cardiac Surgery Division

被引：16
作者：
Lombardi, Fortunata [1 ]
Gaia, Paola [2 ]
Valaperta, Rea [1 ]
Cornetta, Maria [2 ]
Tejada, Milvana Rosa [2 ]
Di Girolamo, Luca [1 ]
Moroni, Alessandra [2 ]
Ramundo, Federica [2 ]
Colombo, Alessio [3 ]
Valisi, Massimiliano [3 ]
Costa, Elena [1 ,2 ]
机构：
[1] IRCCS Policlin San Donato, Res Labs Mol Biol, I-20097 Milan, Italy
[2] IRCCS Policlin San Donato, Clin Microbiol Lab, I-20097 Milan, Italy
[3] Serv Lab Fleming Res, Milan, Italy
来源：
BIOMED RESEARCH INTERNATIONAL | 2015年 / 2015卷
关键词：
BETA-LACTAMASE; NEW-YORK; MULTIDRUG-RESISTANT; RISK-FACTORS; INFECTIONS; ENTEROBACTERIACEAE; STRAIN; EPIDEMIOLOGY; PATHOGENS; BROOKLYN;
D O I：
10.1155/2015/871947
中图分类号：
Q81 [生物工程学（生物技术）]; Q93 [微生物学];
学科分类号：
071005 ; 0836 ; 090102 ; 100705 ;
摘要：
Frequent use of carbapenems has contributed to the increase to K. pneumoniae strains resistant to this class of antibiotics (CRKP), causing a problem in the clinical treatment of patients. This investigation reports the epidemiology, genetic diversity, and clinical implication of the resistance to drugs mediated by CRKP in our hospital. A total of 280 K. pneumoniae strains were collected; in particular 98/280 (35%) were CRKP. Sequencing analysis of CRKP isolated strains showed that 9/98 of MBL-producing strains carried the bla(VIM-1) gene and 89/98 of the isolates were positive for bla(KPC-2). Antimicrobial susceptibility tests revealed a complete resistance to third-generation cephalosporins and a moderate resistance to tigecycline, gentamicin, and fluoroquinolones with percentages of resistance of 61%, 64%, and 98%, respectively. A resistance of 31% was shown towards trimethoprim-sulfamethoxazole. Colistin was the most active agent against CRKP with 99% of susceptibility. Clonality was evaluated by PFGE and MLST: MLST showed the same clonal type, ST258, while PFGE analysis indicated the presence of a major clone, namely, pulsotype A. This finding indicates that the prevalent resistant isolates were genetically related, suggesting that the spread of these genes could be due to clonal dissemination as well as to genetic exchange between different clones.
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页数：7
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