Calia Carla, Pazzani Carlo, Oliva Marta, Scrascia Maria, Lovreglio Piero, Capolongo Carmen, Dionisi Anna Maria, Chiarelli Adriana, Monno Rosa
Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
Department of Biology, University of Bari "Aldo Moro", Bari, Italy.
APMIS. 2017 May;125(5):491-498. doi: 10.1111/apm.12666. Epub 2017 Mar 15.
Carbapenem-resistant Klebsiella pneumoniae infections are reported with increasing frequency elsewhere in the world, representing a worrying phenomenon for global health. In Italy, there are hotspot data on the diffusion and type of carbapenemase-producing Enterobacteriaceae and K. pneumoniae in particular, with very few data coming from Apulia and Basilicata, two regions of Southern Italy. This study was aimed at characterizing by phenotypic and genotypic methods carbapenem-resistant K. pneumoniae isolated from several Hospitals of Apulia and Basilicata, Southern Italy. Antibiotic susceptibility was also evaluated. The relatedness of carbapenemase-producing K. pneumoniae strains was established by pulsed-field gel electrophoresis (PFGE). Among the 150 K. pneumoniae carbapenemase producers, KPC-3 genotype was the most predominant (95%), followed by VIM-1 (5%). No other genotypes were found and no co-presence of two carbapenemase genes was found. A full concordance between results obtained by both the phenotypic and the genotypic tests was observed. All strains were resistant to β-lactam antibiotics including carbapenems, and among antibiotics tested, only tetracycline and gentamycin showed low percentage of resistance (18% and 15%, respectively). Resistance to colistin was detected in 17.3% of strains studied. The analysis of PFGE profiles of the carbapenemases-positive strains shows that one group (B) of the five (A to E) main groups identified was the most prevalent and detected in almost all the hospitals considered, while the other groups were randomly distributed. Three different sequence types (ST 307, ST 258, and ST 512) were detected with the majority of isolates belonging to the ST 512. Our results demonstrated the wide diffusion of K. pneumoniae KPC-3 in the area considered, the good concordance between phenotypic and genotypic tests. Gentamicin and colistin had a good activity against these strains.
世界各地对碳青霉烯类耐药肺炎克雷伯菌感染的报道越来越频繁，这对全球健康来说是一个令人担忧的现象。在意大利，有关于产碳青霉烯酶肠杆菌科细菌尤其是肺炎克雷伯菌的传播情况和类型的热点数据，而来自意大利南部的阿普利亚和巴西利卡塔这两个地区的数据非常少。本研究旨在通过表型和基因型方法对从意大利南部阿普利亚和巴西利卡塔的几家医院分离出的耐碳青霉烯肺炎克雷伯菌进行特征分析。同时还评估了抗生素敏感性。通过脉冲场凝胶电泳（PFGE）确定产碳青霉烯酶肺炎克雷伯菌菌株之间的相关性。在150株产碳青霉烯酶肺炎克雷伯菌中，KPC-3基因型最为常见（95%），其次是VIM-1（5%）。未发现其他基因型，也未发现两种碳青霉烯酶基因共存的情况。表型和基因型试验结果完全一致。所有菌株对包括碳青霉烯类在内的β-内酰胺类抗生素均耐药，在所测试的抗生素中，只有四环素和庆大霉素显示出较低的耐药率（分别为18%和15%）。在所研究的菌株中，17.3%检测到对黏菌素耐药。对碳青霉烯酶阳性菌株的PFGE图谱分析表明，在鉴定出的五个主要组（A至E）中，一组（B）最为普遍，几乎在所有所考虑的医院中都能检测到，而其他组则随机分布。检测到三种不同的序列类型（ST 307、ST 258和ST 512），大多数分离株属于ST 512。我们的结果表明，KPC-3型肺炎克雷伯菌在该地区广泛传播，表型和基因型试验之间具有良好的一致性。庆大霉素和黏菌素对这些菌株具有良好的活性。
