Investigation of carbapenem resistance and the first identification of Klebsiella pneumoniae carbapenemase (KPC) enzyme among Escherichia coli isolates in Turkey: A prospective study.

BACKGROUND

The aim of this study was to determine the presence of carbapenem resistance and carbapenemase production in Escherichia coli isolates from clinical samples in Turkey.

METHODS

The prospective study included a total of 4.052 Escherichia coli isolates collected from patients admitted to a hospital from March 2011 to May 2012. We used ertapenem disc for screening carbapenemase production, and the confirmation was performed by using Etest. The resistance mechanisms and genetic relatedness of the carbapenem resistant strains were investigated by using PCR (polymerase chain reaction) and pulsed-field gel electrophoresis (PFGE), respectively.

RESULTS

Among the 4.052 E. coli isolates, 24 (0.59%) were found to be carbapenem resistant. Of these, only 5 isolates were positive for OXA-48 and 2 isolates were positive for Klebsiella pneumoniae carbapenemase (KPC)-2. The KPC-2 producing E. coli strains (n = 2) were both isolated from the same patient. The bla genes were confirmed using DNA sequence analysis. The genetic relationship between the 24 E. coli strains studied by PFGE revealed that the strains were genetically unrelated.

CONCLUSIONS

This article confirms, to our knowledge for the first time, the detection of KPC-2-producing E. coli in Turkey, with OXA-48 being the most frequent carbapenemase in the study.