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Clonal Dissemination of KPC-2, VIM-1, OXA-48-Producing Klebsiella pneumoniae ST147 in Katowice, Poland

Authors
  • OCHOŃSKA, DOROTA1
  • KLAMIŃSKA-CEBULA, HANNA2
  • DOBRUT, ANNA1
  • BULANDA, MAŁGORZATA1
  • BRZYCHCZY-WŁOCH, MONIKA1
  • 1 Department of Molecular Medical Microbiology, Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow , (Poland)
  • 2 Department of Bacteriology, Leszek Giec Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, Katowice , (Poland)
Type
Published Article
Journal
Polish Journal of Microbiology
Publisher
Exeley Inc.
Publication Date
Mar 12, 2021
Volume
70
Issue
1
Pages
107–116
Identifiers
DOI: 10.33073/pjm-2021-010
Source
Exeley
Keywords
License
Green

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an important bacterium of nosocomial infections. In this study, CRKP strains, which were mainly isolated from fecal samples of 14 patients in three wards of the hospital in the Silesia Voivodship, rapidly increased from February to August 2018. Therefore, we conducted microbiological and molecular studies of the CRKP isolates analyzed. Colonized patients had critical underlying diseases and comorbidities; one developed bloodstream infection, and five died (33.3%). Antibiotic susceptibilities were determined by the E-test method. A disc synergy test confirmed carbapenemase production. CTX-Mplex PCR evaluated the presence of resistance genes blaCTX-M-type, blaCTX-M-1, blaCTX-M-9, and the genes blaSHV, blaTEM, blaKPC-2, blaNDM-1, blaOXA-48, blaIMP, and blaVIM-1 was detected with the PCR method. Clonality was evaluated by Multi Locus Sequence Typing (MLST) and Pulsed Field Gel Electrophoresis (PFGE). Six (40%) strains were of XDR (Extensively Drug-Resistant) phenotype, and nine (60%) of the isolates exhibited MDR (Multidrug-Resistant) phenotype. The range of carbapenem minimal inhibitory concentrations (MICs, μg/mL) was as follows doripenem (16 to >32), ertapenem (> 32), imipenem (4 to > 32), and meropenem (> 32). PCR and sequencing confirmed the blaCTX-M-15, blaKPC-2, blaOXA-48, and blaVIM-1 genes in all strains. The isolates formed one large PFGE cluster (clone A). MLST assigned them to the emerging high-risk clone of ST147 (CC147) pandemic lineage harboring the blaOXA-48 gene. This study showed that the K. pneumoniae isolates detected in the multi-profile medical centre in Katowice represented a single strain of the microorganism spreading in the hospital environment.

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