Distribution of ß-lactamase genes among carbapenem-resistant Klebsiella pneumoniae strains isolated from patients in Turkey
Erişim
info:eu-repo/semantics/closedAccessTarih
2015-11Yazar
Iraz, MeryemÖzad Düzgün, Azer
Sandallı, Cemal
Doymaz, Mehmet Ziya
Akkoyunlu, Yasemin
Saral, Ayşegül
Peleg, Anton Y.
Özgümüş, Osman Birol
Beriş, Fatih Şaban
Karaoğlu, Hakan
Çopur Çiçek, Ayşegül
Erişim
info:eu-repo/semantics/closedAccessÜst veri
Tüm öğe kaydını gösterÖzet
Background
The emergence of carbapenem-resistant Klebsiella pneumoniae poses a serious problem to antibiotic management. We investigated the β-lactamases in a group of carbapenem-resistant K. pneumoniae clinical isolates from Turkey.
Methods
Thirty-seven strains of K. pneumoniae isolated from various clinical specimens were analyzed by antimicrobial susceptibility testing, PCR for the detection of β-lactamase genes, DNA sequencing, and repetitive extragenic palindronic (REP)-PCR analysis.
Results
All 37 isolates were resistant to ampicillin, ampicillin/sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefoperazone/sulbactam, cefepime, imipenem, and meropenem. The lowest resistance rates were observed for colistin (2.7%), tigecycline (11%), and amikacin (19%). According to PCR and sequencing results, 98% (36/37) of strains carried at least one carbapenemase gene, with 32 (86%) carrying OXA-48 and 7 (19%) carrying NDM-1. No other carbapenemase genes were identified. All strains carried a CTX-M-2-like β-lactamase, and some carried SHV- (97%), TEM- (9%), and CTX-M-1-like (62%) β-lactamases. Sequence analysis of blaTEM genes identified a blaTEM-166 with an amino acid change at position 53 (Arg53Gly) from blaTEM-1b, the first report of a mutation in this region. REP-PCR analysis revealed that there were seven different clonal groups, and temporo-spatial links were identified within these groups.
Conclusions
Combinations of β-lactamases were found in all strains, with the most common being OXA-48, SHV, TEM, and CTX-M-type (76% of strains). We have reported, for the first time, a high prevalence of the NDM-1 (19%) carbapenemase in carbapenem-resistant K. pneumoniae from Turkey. These enzymes often co-exist with other β-lactamases, such as TEM, SHV, and CTX-M β-lactamases.
Bağlantı
https://hdl.handle.net/20.500.12440/1765https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579103/pdf/alm-35-595.pdf