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Tytuł pozycji:

Molecular epidemiology and drug-resistance mechanisms in carbapenem-resistant Klebsiella pneumoniae isolated in patients from a tertiary hospital in Valencia, Spain.

Tytuł:
Molecular epidemiology and drug-resistance mechanisms in carbapenem-resistant Klebsiella pneumoniae isolated in patients from a tertiary hospital in Valencia, Spain.
Autorzy:
Fuster B; Microbiology Department, Valencia General University Hospital, Valencia, Spain. Electronic address: .
Salvador C; Microbiology Department, Valencia General University Hospital, Valencia, Spain.
Tormo N; Microbiology Department, Valencia General University Hospital, Valencia, Spain.
García-González N; Joint Research Unit (Infection and Public Health), FISABIO, University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain.
Gimeno C; Microbiology Department, Valencia General University Hospital, Valencia, Spain; Faculty of Medicine, University of Valencia, Valencia, Spain.
González-Candelas F; Joint Research Unit (Infection and Public Health), FISABIO, University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain; CIBER Epidemiology and Public Health, Valencia, Spain.
Źródło:
Journal of global antimicrobial resistance [J Glob Antimicrob Resist] 2020 Sep; Vol. 22, pp. 718-725. Date of Electronic Publication: 2020 May 22.
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Original Publication: Amsterdam : Published by Elsevier Ltd. on behalf of International Society of Chemotherapy for Infection and Cancer
MeSH Terms:
Klebsiella Infections*/epidemiology
Klebsiella pneumoniae*/genetics
Pharmaceutical Preparations*
Carbapenems/pharmacology ; Humans ; Molecular Epidemiology ; Spain/epidemiology ; Tertiary Care Centers
Contributed Indexing:
Keywords: Carbapenemases; Klebsiella pneumoniae; Resistance mechanisms
Substance Nomenclature:
0 (Carbapenems)
0 (Pharmaceutical Preparations)
Entry Date(s):
Date Created: 20200525 Date Completed: 20210531 Latest Revision: 20210531
Update Code:
20240105
DOI:
10.1016/j.jgar.2020.05.002
PMID:
32446938
Czasopismo naukowe
Objectives: The aim of this study has been to characterize carbapenem-resistant Klebsiella pneumoniae isolates and to determine the resistance mechanisms involved, the clonal relationship between strains and clinical and demographical data of the infected patients.
Methods: Clinical and demographical data from patients were collected and statistically analysed. Antimicrobial susceptibility testing was performed and resistance genes were detected both phenotypically and genotypically. Conjugation assays were performed to show horizontal transferability of resistance genes. Clonal relationship was also studied. Next-generation sequencing (NGS) was performed to obtain information regarding resistance genes, sequence types, virulence factors and plasmid types.
Results: Statistical significance was shown by the presence of an infection if there had been a previous hospital stay; urinary catheter carriage and chronic renal disease also indicated higher probabilities of being infected. More than 95% of the isolates were non-susceptible to third-generation cephalosporins, and more than 90% were non-susceptible to quinolones. Phenotypic and genotypic methods for resistance detection were concordant and later confirmed by NGS. This is the first detection of OXA-48, NDM-1 and CTX-M-15 co-production in the area. No plasmid-mediated colistin resistance was found. Tetracycline, sulfonamides and aminoglycoside resistance genes were found in almost all the isolates studied. No virulence factors were detected. Multilocus sequence typing showed more than 15 different sequence types, with ST101, ST307 and ST11 being the most prevalent.
Conclusions: This study is the first to report such a large group of OXA-48 carbapenemases with clonal dissemination among carbapenem-resistant K. pneumoniae in Valencia. This is also the first detection of OXA-48, NDM-1 and CTX-M-15 co-production in the area.
(Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

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