Carbapenemase production in hospital isolates of multidrug-resistant Klebsiella pneumoniae and Escherichia coli in Serbia

Anika Djordje Trudić; Zora Jelesić; Mira Mihajlović-Ukropina; Deana Medić; Branka Zivlak; Vera Gusman; Milan Djilas

doi:10.2298/VSP150917260T

Anika Djordje Trudić Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Zora Jelesić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Mira Mihajlović-Ukropina University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Deana Medić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Branka Zivlak University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Vera Gusman University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia
Milan Djilas Institute for Public Health of Vojvodina, Novi Sad, Serbia

DOI: https://doi.org/10.2298/VSP150917260T

Keywords: enterobacteriaceae, drug resistance, bacterial, carbapenems, cross infection, genome, serbia, beta lactamases,

Abstract

Abstract

Background/Aim. Carbapenem resistance has escalated in medically important enterobacteria such as Klebsiella pneumoniae and Escherichia coli worldwide. Multidrug-resistant strains represent an important source of concern as effective therapeutic options of infections they cause are limited or none. There were no comprehensive studies considering the presence of carbapenemase production in enterobacteria in Serbia so far. The aim of the study was to determine carbapenemase production in hospital isolates of multidrug-resistant K. pneumoniae and E. coli in Serbia. Methods. Strains of K. pneumoniae and E. coli resistant to at least one carbapenem (imipenem, meropenem, ertapenem) were collected from November 2013 to May 2014. Isolates were obtained from clinical samples of patients treated in 14 hospitals in Serbia. Carbapenem resistance was confirmed using phenotypic tests and polymerase chain reaction (PCR) in National Reference Laboratory for Registration and Surveillance of Antimicrobial Resistance of Bacterial Strains in Novi Sad. Results. Of 129 collected strains, 121 (93.8%) were K. pneumoniae and 8 (6.2%) were E. coli. Seventy (54.3%) strains were obtained from urine, 26 (20.2%) from blood, 19 (14.7%) from wound secretions and 14 (10.9%) from lower respiratory tract secretions. Carbapenemase genes were detected in 58 (45%) isolates. The gene bla New Delhi-metallo-beta-lactamases (bla_NDM) was found in 33 (27.3%) K. pneumoniae, bla oxacillinases-48 (bla_OXA-48) in 10 (8.3%), bla K. pneumonia carbapenemase (bla_KPC) in 1 (0.8%), and 7 (5.4%) strains harbored both bla_OXA-48and bla_NDM. Seven E. coli harbored bla_NDMgene. Conclusion. In Serbia, the most common type of carbapenemase in both multidrug-resistant K. pneumoniae and E. coli is NDM. Co-production of OXA-48 and NDM was found in K. pneumoniae. To our knowledge, KPC production was detected for the first time in Serbia.

Author Biographies

Anika Djordje Trudić, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia

Center for Microbiology, Virology and Immunology, asist. dr

Zora Jelesić, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia

Center for Microbiology, prof. dr

Mira Mihajlović-Ukropina, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia

Center for Microbiology, prof. dr

Deana Medić, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia

Center for microbiology, doc. dr

Branka Zivlak, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia; Institute for Public Health of Vojvodina, Novi Sad, Serbia

Center for microbiology, asist. dr

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