Nationwide epidemiology of carbapenem resistant Klebsiella pneumoniae isolates from Greek hospitals, with regards to plazomicin and aminoglycoside resistance

被引：71

作者：

Galani, Irene ^{[1
,3
]}

Nafplioti, Konstantina ^{[1
]}

Adamou, Panagiota ^{[1
]}

Karaiskos, Ilias ^{[2
]}

Giamarellou, Helen ^{[2
]}

Souli, Maria ^{[1
]}

Maraki, Sofia ^{[4
]}

Mauromanolaki, Viktoria Eirini ^{[4
]}

Papaioannou, Vassiliki ^{[5
]}

Tsiplakou, Sofia ^{[5
]}

Kazila, Polyzo ^{[6
]}

Diamanti, Ioanna ^{[6
]}

Charalampaki, Nikoletta ^{[7
]}

Trikka-Graphakos, Eleftheria ^{[7
]}

Toutouza, Marina ^{[8
]}

Vagiakou, Helen ^{[9
]}

Pappas, Konstantinos ^{[10
]}

Kyratsa, Anna ^{[11
]}

Paschali, Angeliki ^{[11
]}

Kontopoulou, Konstantina ^{[12
]}

Legga, Olga ^{[13
]}

Petinaki, Efthymia ^{[14
]}

Papadogeorgaki, Helen ^{[15
]}

Chinou, Efrosini ^{[16
]}

机构：

[1] Univ Athens, Infect Dis Lab, Dept Internal Med 4, Fac Med, Athens, Greece

[2] Hygeia Hosp, Dept Internal Med 6, Athens, Greece

[3] Univ Gen Hosp ATTIKON, Rimini 1, Chaidari 12462, Greece

[4] Univ Hosp Heraklion, Dept Clin Bacteriol Parasitol Zoonoses & Geog Med, Iraklion, Greece

[5] KAT Hosp, Dept Microbiol, Athens, Greece

[6] Canc Hosp Thessaloniki THEAGENEIO, Thessaloniki, Greece

[7] THRIASSIO Gen Hosp, Dept Clin Microbiol, Athens, Greece

[8] Hippokrat Athens Gen Hosp, Dept Microbiol, Athens, Greece

[9] Gen Hosp Athens G Gennimatas, Microbiol Lab, Athens, Greece

[10] Athens Naval Hosp, Athens, Greece

[11] Gen Hosp Corfu, Microbiol Lab, Corfu, Greece

[12] Gen Hosp Thessaloniki G Gennimatas, Dept Microbiol, Thessaloniki, Greece

[13] Gen Hosp Lamia, Dept Microbiol, Lamia, Greece

[14] Univ Hosp Larissa, Dept Microbiol, Larisa, Greece

[15] Hygeia Gen Hosp, Microbiol Lab, Athens, Greece

[16] St Savvas Canc Hosp, Dept Microbiol, Athens, Greece

来源：

BMC INFECTIOUS DISEASES | 2019年 / 19卷

关键词：

Plazomicin; K; pneumoniae; Carbapenemase; Greece; MODIFYING ENZYMES; ESCHERICHIA-COLI; ENTEROBACTERIACEAE; EMERGENCE; SPECTRUM; STRAINS;

D O I：

10.1186/s12879-019-3801-1

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

BackgroundTo evaluate the in vitro activities of plazomicin and comparator aminoglycosides and elucidate the underlying aminoglycoside resistance mechanisms among carbapenemase-producing K. pneumoniae isolates collected during a nationwide surveillance study in Greek hospitals.MethodsThree hundred single-patient carbapenemase-producing K. pneumoniae isolates were studied, including 200 KPC-, 50 NDM-, 21 VIM-, 14 KPC & VIM-, 12 OXA-48-, two NDM & OXA- and one KPC & OXA-producing isolates. Susceptibility testing was performed by broth microdilution, and minimum inhibitory concentrations (MICs) interpreted per EUCAST breakpoints. Carbapenemase-, aminoglycoside modifying enzyme- and 16S rRNA methylase- encoding genes were detected by PCR.ResultsOf 300 isolates tested, 5.7% were pandrug resistant and 29.3% extensively drug resistant. Plazomicin inhibited 87.0% of the isolates at 2mg/L, with MIC50/MIC90 of 0.5/4mg/L. Apramycin (a veterinary aminoglycoside) inhibited 86.7% of the isolates at 8mg/L and was the second most active drug after plazomicin, followed by gentamicin (S, 43%; MIC50/MIC90, 4/>256) and amikacin (S, 18.0%; MIC50/MIC90, 32/128). Twenty-three (7.7%) isolates (16 KPC-, 6 VIM- and one KPC & OXA-48-producers) exhibited MICs 64mg/L for plazomicin, and harbored rmtB (n=22) or armA (n=1). AAC(6)-b was the most common aminoglycoside modifying enzyme (84.7%), followed by AAC(3?)-IIa (25.3%), while those two enzymes were co-produced by 21.4% of the isolates.ConclusionsPlazomicin retains activity against most carbapenemase-producing K. pneumoniae isolated from Greek hospitals, with MICs consistently lower than those of the other aminoglycosides, even in the presence of aminoglycoside modifying enzymes. Dissemination of 16S- rRNA methylases in 8% of the isolates is an unwelcome event that needs strict infection control measures and rigorous stewardship interventions.

引用

页数：12

共 29 条

[21] Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance
Magiorakos, A. -P.
Srinivasan, A.
Carey, R. B.
Carmeli, Y.
Falagas, M. E.
Giske, C. G.
Harbarth, S.
Hindler, J. F.
Kahlmeter, G.
Olsson-Liljequist, B.
Paterson, D. L.
Rice, L. B.
Stelling, J.
Struelens, M. J.
Vatopoulos, A.
Weber, J. T.
Monnet, D. L.
[J]. CLINICAL MICROBIOLOGY AND INFECTION, 2012, 18 (03) : 268 - 281
[22] Antimicrobial activity of plazomicin against Enterobacteriaceae-producing carbapenemases from 50 Brazilian medical centers
Martins, Andreza Francisco
Bail, Larissa
Sanches Ito, Carmen Antonia
Nogueira, Keite da Silva
Dalmolin, Tanise Vendruscolo
Martins, Amanda Silva
Lopes Rocha, Jaime Luis
Serio, Alisa W.
Tuon, Felipe Francisco
[J]. DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2018, 90 (03) : 228 - 232
[23] Emergence of sequence type 11 Klebsiella pneumoniae coproducing NDM-1 and VIM-1 metallo-β-lactamases in a Greek hospital
Papagiannitsis, C. C.
Malli, E.
Florou, Z.
Sarrou, S.
Hrabak, J.
Mantzarlis, K.
Zakynthinos, E.
Petinaki, E.
[J]. DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2017, 87 (03) : 295 - 297
[24] Rise and dissemination of aminoglycoside resistance: the aac(6′)-lb paradigm
Ramirez, Maria S.
Nikolaidis, Nikolas
Tolmasky, Marcelo E.
[J]. FRONTIERS IN MICROBIOLOGY, 2013, 4
[25] Aminoglycoside modifying enzymes
Ramirez, Maria S.
Tolmasky, Marcelo E.
[J]. DRUG RESISTANCE UPDATES, 2010, 13 (06) : 151 - 171
[26] Evaluation of apramycin activity against carbapenem-resistant and -susceptible strains of Enterobacteriaceae
Smith, Kenneth P.
Kirby, James E.
[J]. DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2016, 86 (04) : 439 - 441
[27] Carbapenemases in Klebsiella pneumoniae and Other Enterobacteriaceae: an Evolving Crisis of Global Dimensions
Tzouvelekis, L. S.
Markogiannakis, A.
Psichogiou, M.
Tassios, P. T.
Daikos, G. L.
[J]. CLINICAL MICROBIOLOGY REVIEWS, 2012, 25 (04) : 682 - +
[28] The Balkan region: NDM-1-producing Klebsiella pneumoniae ST11 clonal strain causing outbreaks in Greece
Voulgari, Evangelia
Gartzonika, Constantina
Vrioni, Georgia
Politi, Lida
Priavali, Efthalia
Levidiotou-Stefanou, Stamatina
Tsakris, Athanassios
[J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2014, 69 (08) : 2091 - 2097
[29] In vitro activity of plazomicin against β-lactamase-producing carbapenem-resistant Enterobacteriaceae (CRE)
Zhang, Yunliang
Kashikar, Ankita
Bush, Karen
[J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2017, 72 (10) : 2792 - 2795

← 1 2 3 →