BMC Infectious Diseases | |
Prevalence of Klebsiella pneumoniae strains producing carbapenemases and increase of resistance to colistin in an Italian teaching hospital from January 2012 To December 2014 | |
Research Article | |
Stefania Stefani1  Roberto Ghirardo2  Monica Basso2  Elisa Franchin2  Nicola Menegotto2  Elena Castellani2  Saverio Giuseppe Parisi2  Alessandro Berto2  Giorgio Palù2  Erica Santacatterina2  Andrea Bartolini2  Roberto Rinaldi3  Tiziana Tommasini4  Ettore De Canale4  | |
[1] Department of Biomedical and Biotecnological Sciences, University of Catania, Catania, Italy;Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy;Infectious Diseases Unit, Padova Hospital, Padova, Italy;Microbiology and Virology Unit, Padova Hospital, Padova, Italy; | |
关键词: Klebsiella pneumoniae carbapenemase producing; Active surveillance; Rectal swabs; Colistin resistance; Multilocus sequence typing; | |
DOI : 10.1186/s12879-015-0996-7 | |
received in 2015-02-16, accepted in 2015-06-22, 发布年份 2015 | |
来源: Springer | |
【 摘 要 】
BackgroundThe aim of this study was to characterize the spread of carbapenemase-producing Klebsiella pneumoniae (CPKP) in a tertiary level hospital using ongoing active surveillance with rectal swab cultures. Furthermore, this study analyzed the presence of CPKP in the clinical samples (CS) of a single patient as well as the evolution of Colistin-sensitive strains (CoS) to Colistin-resistant strains (CoR).MethodsThis study was performed from January 1, 2012 to December 31, 2014. In 2012, a survey was conducted in the Intensive Care Department. In autumn 2013, active monitoring was extended to the Surgery Department, and since mid-2014, the surveillance has included the Medical Department as well. Only the first isolated strain from each patient was included. Antimicrobial susceptibility testing was performed on CPKP isolates: Klebsiella pneumoniae carbapenemase, oxacillinase-48, Verona integron-encoded metallo-β-lactamase and New Delhi metallo-β-lactamase were detected using a validated in-house PCR method, and multilocus sequence typing (MLST) was used to investigate the clonal transmission of strains.ResultsA total of 15,104 patients were included in the study, and 496 consecutive non-replicated strains of CPKP were collected: 149 strains were collected in 2012 (39 [26.2 %] from surveillance rectal swabs [SRS]), 133 strains were collected in 2013 (70 [52.6 %] from SRS) and 214 strains were collected in 2014 (164 [76.6 %] from SRS). We observed a significant increase in the percentage of positive SRS cases in 2014 relative to 2013 and 2012 (p = 0.0001 and p = 0.0172, respectively) and in the proportion of CPKP first isolated by SRS relative to those identified by CS (p < 0.0001). Among all available samples, the number of CoR isolated from SRS was higher in 2013 and 2014 compared with 2012 (p = 0.0019 and p = 0.008, respectively). ST-258 and ST-512 were more prevalent in the tested specimens, and a new single locus variant (SLV) of ST-512 (ST-745) was isolated.ConclusionsThe results of this 3-year study of 15,104 patients highlight the clinical relevance of antimicrobial resistance as well as the drug-selection pressure of colistin therapy. The active surveillance in the three different departments increased the level of CPKP cases isolated by SRS.
【 授权许可】
CC BY
© Parisi et al. 2015
【 预 览 】
Files | Size | Format | View |
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RO202311109775007ZK.pdf | 722KB | download |
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