Mouna Hamel1, Stylianos Chatzipanagiotou2, Linda Hadjadj1, Efthimia Petinaki3, Sophia Papagianni4, Nikoletta Charalampaki4, Sophia Tsiplakou5, Vassiliki Papaioannou5, Nikoletta Skarmoutsou6, Iris Spiliopoulou7, Myrto Christofidou7, Nikolaos Papamichalopoulos8, Tilemachos Skalidis9, Nicholaos Legakis9, Kimon Fountoulis9, Efstathia Perivolioti10, Heleni Kraniotaki10, Maria Bournia10, Anastasios Ioannidis2, Alexandra Baron Sophie1, Jean-Marc Rolain11. 1. Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France. 2. Department of Medical Biopathology and Clinical Microbiology, Aeginition Hospital, Athens Medical School, National and Kapodistrian University of Athens, Ave Vassilissis Sophias 72, 11528 Athens, Greece. 3. Department of Microbiology, University Hospital of Larissa, Larissa, Greece. 4. Department of Clinical Microbiology, "Thriasio" General Hospital, Magoula, Greece. 5. KAT General Hospital, Athens, Greece. 6. Sismanogleio General Hospital, Athens, Greece. 7. University Hospital, Patras, Greece. 8. Aiginiteion Hospital, Medical School, National and Kapodistrian University of Athens, Greece. 9. Iaso Maternity and Gynecology Hospital, Athens, Greece. 10. Evagelismos General Hospital, Athens, Greece. 11. Aix Marseille Univ, IRD, APHM, MEPHI, IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France; IHU Méditerranée Infection, 19-21 Boulevard Jean Moulin,13385 Marseille Cedex 05, France. Electronic address: jean-marc.rolain@univ-amu.fr.
Abstract
INTRODUCTION: In Greece, the spread of carbapenem-resistant Enterobacteriaceae in humans has led to the reintroduction of colistin as a therapeutic agent. Unfortunately, colistin resistance with different mechanisms has emerged. The present work aims to determine the prevalence of carbapenem and colistin resistance and the corresponding mechanisms in Klebsiella pneumoniae clinical isolates from Greece. METHODS: From 2014 to 2017, 288 carbapenem-resistant K. pneumoniae clinical strains were gathered from a collection of 973 isolates from eight different hospitals in Greece. Antibiotic susceptibility testing was performed using three different methods. Screening of carbapenem and colistin resistance genes was conducted using polymerase chain reaction (PCR) amplification and sequencing. RESULTS: Among the 288 (29.6 %) carbapenem-resistant isolates, 213 (73.9%) were colistin-resistant (minimum inhibitory concentration [MIC] >2 mg/L). The KPC type was the most common carbapenemase gene (116; 40.3%), followed by VIM (41; 14.2%), NDM (33; 11.5%) and OXA-48 (22; 7.6%). Moreover, 44 (15.3%) strains co-produced two types of carbapenemases. No mcr genes were detected for colistin resistance but mutations in chromosomal genes were found. These included inactivation of the mgrB gene for 148 (69.5%) strains, including insertion sequences for 94 (44.1%), nonsense mutations for 4 (1.9%) and missense mutations for 24 (11.3%). Moreover, PCR amplification of mgrB gene was negative for 26 (12.2%) strains. Finally, 65 (30.5%) colistin-resistant strains exhibited a wild-type mgrB, the mechanisms of which remain to be elucidated. CONCLUSION: This study shows that K. pneumoniae clinical strains in Greece are resistant to both carbapenems and colistin and this is endemic and is likely chromosomally encoded.
INTRODUCTION: In Greece, the spread of carbapenem-resistant Enterobacteriaceae in humans has led to the reintroduction of colistin as a therapeutic agent. Unfortunately, colistin resistance with different mechanisms has emerged. The present work aims to determine the prevalence of carbapenem and colistin resistance and the corresponding mechanisms in Klebsiella pneumoniae clinical isolates from Greece. METHODS: From 2014 to 2017, 288 carbapenem-resistant K. pneumoniae clinical strains were gathered from a collection of 973 isolates from eight different hospitals in Greece. Antibiotic susceptibility testing was performed using three different methods. Screening of carbapenem and colistin resistance genes was conducted using polymerase chain reaction (PCR) amplification and sequencing. RESULTS: Among the 288 (29.6 %) carbapenem-resistant isolates, 213 (73.9%) were colistin-resistant (minimum inhibitory concentration [MIC] >2 mg/L). The KPC type was the most common carbapenemase gene (116; 40.3%), followed by VIM (41; 14.2%), NDM (33; 11.5%) and OXA-48 (22; 7.6%). Moreover, 44 (15.3%) strains co-produced two types of carbapenemases. No mcr genes were detected for colistin resistance but mutations in chromosomal genes were found. These included inactivation of the mgrB gene for 148 (69.5%) strains, including insertion sequences for 94 (44.1%), nonsense mutations for 4 (1.9%) and missense mutations for 24 (11.3%). Moreover, PCR amplification of mgrB gene was negative for 26 (12.2%) strains. Finally, 65 (30.5%) colistin-resistant strains exhibited a wild-type mgrB, the mechanisms of which remain to be elucidated. CONCLUSION: This study shows that K. pneumoniae clinical strains in Greece are resistant to both carbapenems and colistin and this is endemic and is likely chromosomally encoded.
Authors: Liyan Cui; Ning Shen; Ping Yang; Chao Liu; Zhenchao Wu; Jiajia Zheng; Juan Yi; Nan Wu; Zhangli Wu; Ming Lu Journal: Infect Drug Resist Date: 2022-10-17 Impact factor: 4.177
Authors: Andrew S Bray; Richard D Smith; Andrew W Hudson; Giovanna E Hernandez; Taylor M Young; Hannah E George; Robert K Ernst; M Ammar Zafar Journal: mBio Date: 2022-03-21 Impact factor: 7.786
Authors: Jessie E Wozniak; Aroon T Chande; Eileen M Burd; Victor I Band; Sarah W Satola; Monica M Farley; Jesse T Jacob; I King Jordan; David S Weiss Journal: Antibiotics (Basel) Date: 2020-11-19