Carbapenemase-Producing Klebsiella pneumoniae in Romania: A Six-Month Survey

PLoS One. 2015 Nov 23;10(11):e0143214. doi: 10.1371/journal.pone.0143214. eCollection 2015.

Abstract

This study presents the first characterization of carbapenem-non-susceptible Klebsiella pneumoniae isolates by means of a structured six-month survey performed in Romania as part of an Europe-wide investigation. Klebsiella pneumoniae clinical isolates from different anatomical sites were tested for antibiotic susceptibility by phenotypic methods and confirmed by PCR for the presence of four carbapenemase genes. Genome macrorestriction fingerprinting with XbaI was used to analyze the relatedness of carbapenemase-producing Klebsiella pneumoniae isolates collected from eight hospitals. Among 75 non-susceptible isolates, 65 were carbapenemase producers. The most frequently identified genotype was OXA-48 (n = 51 isolates), eight isolates were positive for blaNDM-1 gene, four had the blaKPC-2 gene, whereas two were positive for blaVIM-1. The analysis of PFGE profiles of OXA-48 and NDM-1 producing K. pneumoniae suggests inter-hospitals and regional transmission of epidemic clones. This study presents the first description of K. pneumoniae strains harbouring blaKPC-2 and blaVIM-1 genes in Romania. The results of this study highlight the urgent need for the strengthening of hospital infection control measures in Romania in order to curb the further spread of the antibiotic resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacterial Proteins / biosynthesis*
  • Electrophoresis, Gel, Pulsed-Field
  • Hospitals
  • Humans
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification
  • Microbial Sensitivity Tests
  • Phenotype
  • Romania
  • Surveys and Questionnaires*
  • beta-Lactamases / biosynthesis*

Substances

  • Bacterial Proteins
  • beta-Lactamases
  • carbapenemase

Grants and funding

The results presented in this work were supported by the Romanian Ministry of Education and Research, PN 0922 grant "Modernization the diagnosis of infectious diseases and improvement their surveillance through applications based on identifying the molecular mechanisms of resistance to antibiotics and antivirals and of genetic structures involved in the dissemination of resistance phenotype", coordinated by Monica Straut.