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Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016

A multicentre nationwide surveillance study was conducted in Greek hospitals to evaluate epidemiology of carbapenemase-producing Klebsiella pneumoniae clinical isolates, and their susceptibilities to last-line antibiotics. Methods: Minimum inhibitory concentrations (MICs) were evaluated by Etest, co...

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Autores principales: Galani, Irene, Karaiskos, Ilias, Karantani, Irene, Papoutsaki, Vassiliki, Maraki, Sofia, Papaioannou, Vassiliki, Kazila, Polyzo, Tsorlini, Helen, Charalampaki, Nikoletta, Toutouza, Marina, Vagiakou, Helen, Pappas, Konstantinos, Kyratsa, Anna, Kontopoulou, Konstantina, Legga, Olga, Petinaki, Efthymia, Papadogeorgaki, Helen, Chinou, Efrosini, Souli, Maria, Giamarellou, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Centre for Disease Prevention and Control (ECDC) 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167611/
http://dx.doi.org/10.2807/1560-7917.ES.2018.23.31.1700775
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author Galani, Irene
Karaiskos, Ilias
Karantani, Irene
Papoutsaki, Vassiliki
Maraki, Sofia
Papaioannou, Vassiliki
Kazila, Polyzo
Tsorlini, Helen
Charalampaki, Nikoletta
Toutouza, Marina
Vagiakou, Helen
Pappas, Konstantinos
Kyratsa, Anna
Kontopoulou, Konstantina
Legga, Olga
Petinaki, Efthymia
Papadogeorgaki, Helen
Chinou, Efrosini
Souli, Maria
Giamarellou, Helen
author_facet Galani, Irene
Karaiskos, Ilias
Karantani, Irene
Papoutsaki, Vassiliki
Maraki, Sofia
Papaioannou, Vassiliki
Kazila, Polyzo
Tsorlini, Helen
Charalampaki, Nikoletta
Toutouza, Marina
Vagiakou, Helen
Pappas, Konstantinos
Kyratsa, Anna
Kontopoulou, Konstantina
Legga, Olga
Petinaki, Efthymia
Papadogeorgaki, Helen
Chinou, Efrosini
Souli, Maria
Giamarellou, Helen
author_sort Galani, Irene
collection PubMed
description A multicentre nationwide surveillance study was conducted in Greek hospitals to evaluate epidemiology of carbapenemase-producing Klebsiella pneumoniae clinical isolates, and their susceptibilities to last-line antibiotics. Methods: Minimum inhibitory concentrations (MICs) were evaluated by Etest, colistin MICs were also evaluated by broth microdilution SensiTest (now known as ComASP) Colistin. Carbapenemase genes were detected by PCR. Clonal relatedness was assessed by PFGE. Isolates were prospectively collected between November 2014 and April 2016, from 15 hospitals. Results: Among 394 isolates, K. pneumoniae carbepenemase (KPC) remained the most prevalent carbapenemase (66.5%). NDM was the second most prevalent (13.7%), identified in 12 hospitals, followed by VIM (8.6%). OXA-48- and double carbapenemase-producers remained rare (3.6%, 6.3%, respectively). Carbapenemase-producing K. pneumoniae isolates showed high resistance to last-line antibiotics. Gentamicin and colistin were the most active in vitro with 61.9% and 59.6% of the isolates to be inhibited at ≤ 2mg/L, followed by fosfomycin (susceptibility (S): 58.4%) and tigecycline (S: 51.5%). Ceftazidime/avibactam inhibited 99.6% of KPC and 100% of OXA-48-like-producing isolates, while temocillin was active against 58% of KPC isolates at urinary breakpoint of ≤ 32mg/L* and only 2.7% at systemic breakpoint of ≤ 8mg/L. NDM-producing isolates belonged mainly to one clone, whereas KPC, VIM, OXA-48 and double carbapenemase-producers were mainly polyclonal. Conclusions: KPC remains the predominant carbapenemase among K. pneumoniae in Greece, followed by NDM, whereas changing trends of resistance rates to last-line antimicrobials against carbapenemase-producing K. pneumoniae with the exception of ceftazidime/avibactam mandates continuing surveillance to support clinical practice.
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spelling pubmed-61676112018-10-12 Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016 Galani, Irene Karaiskos, Ilias Karantani, Irene Papoutsaki, Vassiliki Maraki, Sofia Papaioannou, Vassiliki Kazila, Polyzo Tsorlini, Helen Charalampaki, Nikoletta Toutouza, Marina Vagiakou, Helen Pappas, Konstantinos Kyratsa, Anna Kontopoulou, Konstantina Legga, Olga Petinaki, Efthymia Papadogeorgaki, Helen Chinou, Efrosini Souli, Maria Giamarellou, Helen Euro Surveill Research Article A multicentre nationwide surveillance study was conducted in Greek hospitals to evaluate epidemiology of carbapenemase-producing Klebsiella pneumoniae clinical isolates, and their susceptibilities to last-line antibiotics. Methods: Minimum inhibitory concentrations (MICs) were evaluated by Etest, colistin MICs were also evaluated by broth microdilution SensiTest (now known as ComASP) Colistin. Carbapenemase genes were detected by PCR. Clonal relatedness was assessed by PFGE. Isolates were prospectively collected between November 2014 and April 2016, from 15 hospitals. Results: Among 394 isolates, K. pneumoniae carbepenemase (KPC) remained the most prevalent carbapenemase (66.5%). NDM was the second most prevalent (13.7%), identified in 12 hospitals, followed by VIM (8.6%). OXA-48- and double carbapenemase-producers remained rare (3.6%, 6.3%, respectively). Carbapenemase-producing K. pneumoniae isolates showed high resistance to last-line antibiotics. Gentamicin and colistin were the most active in vitro with 61.9% and 59.6% of the isolates to be inhibited at ≤ 2mg/L, followed by fosfomycin (susceptibility (S): 58.4%) and tigecycline (S: 51.5%). Ceftazidime/avibactam inhibited 99.6% of KPC and 100% of OXA-48-like-producing isolates, while temocillin was active against 58% of KPC isolates at urinary breakpoint of ≤ 32mg/L* and only 2.7% at systemic breakpoint of ≤ 8mg/L. NDM-producing isolates belonged mainly to one clone, whereas KPC, VIM, OXA-48 and double carbapenemase-producers were mainly polyclonal. Conclusions: KPC remains the predominant carbapenemase among K. pneumoniae in Greece, followed by NDM, whereas changing trends of resistance rates to last-line antimicrobials against carbapenemase-producing K. pneumoniae with the exception of ceftazidime/avibactam mandates continuing surveillance to support clinical practice. European Centre for Disease Prevention and Control (ECDC) 2018-08-02 /pmc/articles/PMC6167611/ http://dx.doi.org/10.2807/1560-7917.ES.2018.23.31.1700775 Text en This article is copyright of The Authors, 2018. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.
spellingShingle Research Article
Galani, Irene
Karaiskos, Ilias
Karantani, Irene
Papoutsaki, Vassiliki
Maraki, Sofia
Papaioannou, Vassiliki
Kazila, Polyzo
Tsorlini, Helen
Charalampaki, Nikoletta
Toutouza, Marina
Vagiakou, Helen
Pappas, Konstantinos
Kyratsa, Anna
Kontopoulou, Konstantina
Legga, Olga
Petinaki, Efthymia
Papadogeorgaki, Helen
Chinou, Efrosini
Souli, Maria
Giamarellou, Helen
Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
title Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
title_full Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
title_fullStr Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
title_full_unstemmed Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
title_short Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
title_sort epidemiology and resistance phenotypes of carbapenemase-producing klebsiella pneumoniae in greece, 2014 to 2016
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167611/
http://dx.doi.org/10.2807/1560-7917.ES.2018.23.31.1700775
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