Distribution of beta-Lactamase Genes Among Carbapenem-Resistant Klebsiella pneumoniae Strains Isolated From Patients in Turkey.
10.3343/alm.2015.35.6.595
- Author:
Meryem IRAZ
1
;
Azer OZAD DUZGUN
;
Cemal SANDALLI
;
Mehmet Ziya DOYMAZ
;
Yasemin AKKOYUNLU
;
Aysegul SARAL
;
Anton Y PELEG
;
Osman Birol OZGUMUS
;
Fatih Saban BERIS
;
Hakan KARAOGLU
;
Aysegul COPUR CICEK
Author Information
1. Department of Medical Microbiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
bla(TEM-166);
Colistin;
K. pneumoniae;
NDM-1;
OXA-48
- MeSH:
Anti-Bacterial Agents/*pharmacology;
Bacterial Proteins/*genetics/metabolism;
Carbapenems/*pharmacology;
DNA, Bacterial/chemistry/genetics/metabolism;
Drug Resistance, Bacterial;
Genotype;
Humans;
Klebsiella Infections/diagnosis/microbiology;
Klebsiella pneumoniae/*drug effects/enzymology/isolation & purification;
Microbial Sensitivity Tests;
Polymerase Chain Reaction;
Sequence Analysis, DNA;
Turkey;
beta-Lactamases/*genetics/metabolism
- From:Annals of Laboratory Medicine
2015;35(6):595-601
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The emergence of carbapenem-resistant Klebsiella pneumoniae poses a serious problem to antibiotic management. We investigated the beta-lactamases in a group of carbapenem-resistant K. pneumoniae clinical isolates from Turkey. METHODS: Thirty-seven strains of K. pneumoniae isolated from various clinical specimens were analyzed by antimicrobial susceptibility testing, PCR for the detection of beta-lactamase genes, DNA sequencing, and repetitive extragenic palindronic (REP)-PCR analysis. RESULTS: All 37 isolates were resistant to ampicillin, ampicillin/sulbactam, piperacillin, piperacillin/tazobactam, ceftazidime, cefoperazone/sulbactam, cefepime, imipenem, and meropenem. The lowest resistance rates were observed for colistin (2.7%), tigecycline (11%), and amikacin (19%). According to PCR and sequencing results, 98% (36/37) of strains carried at least one carbapenemase gene, with 32 (86%) carrying OXA-48 and 7 (19%) carrying NDM-1. No other carbapenemase genes were identified. All strains carried a CTX-M-2-like beta-lactamase, and some carried SHV- (97%), TEM- (9%), and CTX-M-1-like (62%) beta-lactamases. Sequence analysis of bla(TEM) genes identified a bla(TEM-166) with an amino acid change at position 53 (Arg53Gly) from bla(TEM-1b), the first report of a mutation in this region. REP-PCR analysis revealed that there were seven different clonal groups, and temporo-spatial links were identified within these groups. CONCLUSIONS: Combinations of beta-lactamases were found in all strains, with the most common being OXA-48, SHV, TEM, and CTX-M-type (76% of strains). We have reported, for the first time, a high prevalence of the NDM-1 (19%) carbapenemase in carbapenem-resistant K. pneumoniae from Turkey. These enzymes often co-exist with other beta-lactamases, such as TEM, SHV, and CTX-M beta-lactamases.
