G Sotgiu1, B M Are2, L Pesapane2, A Palmieri3, N Muresu4, A Cossu4, M Dettori4, A Azara3, I I Mura3, C Cocuzza5, S Aliberti6, A Piana3. 1. Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy; Hygiene and Preventive Medicine Unit, AOU Sassari, Sassari, Italy. Electronic address: gsotgiu@uniss.it. 2. Hygiene and Preventive Medicine Unit, AOU Sassari, Sassari, Italy. 3. Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy; Hygiene and Preventive Medicine Unit, AOU Sassari, Sassari, Italy. 4. Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. 5. Department of Surgery and Translational Medicine, University of Milan Bicocca, Milan, Italy. 6. Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
AIM: To describe the phenotypic and genotypic profiles of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains isolated from patients with invasive infections at an Italian university hospital in order to assess the epidemiological trend. METHODS: An observational prospective study was undertaken at the University Hospital of Sassari, Italy to detect KPC-Kp strains in patients with invasive bacteraemia. Isolates were identified phenotypically; carbapenemase production was assessed using phenotypic and genotypic methods. Sequencing of blaKPC genes, pulsed-field gel electrophoresis and multi-locus sequence typing were performed. RESULTS: During the period 2015-2017, 46 cases of invasive infection with K. pneumoniae were recorded. Two-thirds (67.4%) of the patients were male, and the mean age was 69.4 years. Most patients had at least one comorbidity (56.5%) and/or had been hospitalized previously (70.5%), 81.8% had current or recent medical device use, and 85.4% had recent antibiotic exposure. The mortality rate was 52.3%. A multi-drug-resistant pattern (including carbapenems, fluoroquinolones, third-/fourth-generation cephalosporins) was shown for all K. pneumoniae isolates. KPC-3 and -2 were produced by all strains. The most common sequence types were 512 (91.3%) and 101 (8.7%), grouped into three clusters (A, A1 and B). CONCLUSIONS: A high incidence of KPC-Kp in patients with invasive infections was recorded at an Italian university hospital compared with the incidence measured before 2015. This study confirmed the importance of the KPC-3 carbapenemase variant, as reported by other Italian studies. High mortality and comorbidity rates appear to be associated with KPC-Kp infection.
AIM: To describe the phenotypic and genotypic profiles of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) strains isolated from patients with invasive infections at an Italian university hospital in order to assess the epidemiological trend. METHODS: An observational prospective study was undertaken at the University Hospital of Sassari, Italy to detect KPC-Kp strains in patients with invasive bacteraemia. Isolates were identified phenotypically; carbapenemase production was assessed using phenotypic and genotypic methods. Sequencing of blaKPC genes, pulsed-field gel electrophoresis and multi-locus sequence typing were performed. RESULTS: During the period 2015-2017, 46 cases of invasive infection with K. pneumoniae were recorded. Two-thirds (67.4%) of the patients were male, and the mean age was 69.4 years. Most patients had at least one comorbidity (56.5%) and/or had been hospitalized previously (70.5%), 81.8% had current or recent medical device use, and 85.4% had recent antibiotic exposure. The mortality rate was 52.3%. A multi-drug-resistant pattern (including carbapenems, fluoroquinolones, third-/fourth-generation cephalosporins) was shown for all K. pneumoniae isolates. KPC-3 and -2 were produced by all strains. The most common sequence types were 512 (91.3%) and 101 (8.7%), grouped into three clusters (A, A1 and B). CONCLUSIONS: A high incidence of KPC-Kp in patients with invasive infections was recorded at an Italian university hospital compared with the incidence measured before 2015. This study confirmed the importance of the KPC-3 carbapenemase variant, as reported by other Italian studies. High mortality and comorbidity rates appear to be associated with KPC-Kp infection.
Authors: Martina Barchitta; Annalisa Quattrocchi; Andrea Maugeri; Maria Clara La Rosa; Claudia La Mastra; Guido Basile; Giovanni Giuffrida; Francesco Mazzeo Rinaldi; Giuseppe Murolo; Antonella Agodi Journal: Int J Environ Res Public Health Date: 2020-04-28 Impact factor: 3.390
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Authors: Daniela Loconsole; Marisa Accogli; Anna Lisa De Robertis; Loredana Capozzi; Angelica Bianco; Anna Morea; Rosanna Mallamaci; Michele Quarto; Antonio Parisi; Maria Chironna Journal: Ann Clin Microbiol Antimicrob Date: 2020-06-01 Impact factor: 3.944