Spread of NDM-producing Klebsiella pneumoniae in a tertiary Greek hospital

Kontopoulou, Konstantina and Meletis, Georgios and Pappa, Styliani and Zotou, Sofia and Tsioka, Katerina and Dimitriadou, Panagiota and Antoniadou, Eleni and Papa, Anna (2021) Spread of NDM-producing Klebsiella pneumoniae in a tertiary Greek hospital. ACTA MICROBIOLOGICA ET IMMUNOLOGICA HUNGARICA, 68 (3). pp. 162-168. ISSN 1217-8950

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Abstract

Bacterial carbapenem resistance, especially when mediated by transferable carbapenemases, is of important public health concern. An increased number of metallo-beta-lactamase (MBL)-producing Klebsiella pneumoniae strains isolated in a tertiary hospital in Thessaloniki, Greece, called for further genetic investigation. The study included 29 non-repetitive carbapenem resistant K. pneumoniae isolates phenotypically characterized as MBL-producers collected in a tertiary hospital in Greece. The isolates were screened for the detection of carbapenemase genes (K. pneumoniae carbapenemase (bla(KPC)), Verona-integron-encoded MBL-1 (bla(VIM-1)), imipenemase (bla(IMP)), oxacillinase-48 (bla(OXA-48)) and New Delhi MBL (bla(NDM))). The genetic relationship of the isolates was determined by Random Amplified Polymorphic DNA (RAPD) analysis. The whole genome sequences (WGS) from two NDM-positive K. pneumoniae isolates were further characterized. The presence of New Delhi MBL (bla(NDM)) gene was confirmed in all K. pneumoniae isolates, while bla(KPC) and bla(VIM-1) genes were co-detected in one and two isolates, respectively. The RAPD analysis showed that the isolates were clustered into two groups. The whole genome sequence analysis of two K. pneumoniae isolates revealed that they belonged to the sequence type 11, they carried the bla(NDM-1) gene, and exhibited differences in the number and type of the plasmids and the resistant genes. All MBL-producing K. pneumoniae isolates of the study harbored a bla(NDM) gene, while WGS analysis revealed genetic diversity in resistance genes. Continuous surveillance is needed to detect the emergence of new clones in a hospital setting, while application of antimicrobial stewardship is the only way to reduce the spread of multi-resistant bacteria.

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