Carbapenemase-producing Enterobacteriaceae: a 2-year surveillance in a hospital in Iaşi, Romania

Future Microbiol. 2016;11(3):391-401. doi: 10.2217/fmb.15.148. Epub 2016 Mar 14.

Abstract

Aim: Limited information is currently available about the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) in Romania.

Materials & methods: Routine tests of 1,993 clinical isolates at a hospital in Iaşi yielded 46 isolates that were resistant to carbapenems. All 46 isolates were phenotypically and genotypically analyzed using VITEK-2 and DNA microarray-based assays.

Results: Isolates were assigned to Klebsiella pneumoniae and Enterobacter cloacae. For 39 isolates, carbapenem resistance was confirmed and 37 harbored at least one carbapenem resistance gene. Two isolates were probably resistant due to AmpC β-lactamases in combination with a porin loss. The overall concordance between detected phenotype and genotype was 95%.

Conclusion: Our data show that carbapenemase-producing isolates with different underlying resistance mechanisms are still rare in Iaşi, but the global rise of CPE warrants intensified surveillance.

Keywords: CPE; DNA microarray; Romania; carbapenem resistance; carbapenemase-producing Enterobacteriaceae; clinical isolates; genotyping; phenotyping.

MeSH terms

  • Aged
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / biosynthesis*
  • Bacterial Proteins / genetics
  • Drug Resistance, Multiple, Bacterial
  • Enterobacter cloacae / drug effects
  • Enterobacter cloacae / genetics
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / enzymology*
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / microbiology*
  • Enterobacteriaceae Infections / mortality
  • Epidemiological Monitoring*
  • Female
  • Genotype
  • Hospitals / statistics & numerical data*
  • Humans
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / genetics
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Phenotype
  • Prevalence
  • Romania / epidemiology
  • beta-Lactamases / biosynthesis*
  • beta-Lactamases / genetics

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • beta-Lactamases
  • carbapenemase