Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay
Introduction: The aim of this study was to investigate the presence of carbapenemase production and carbapenem resistance mechanisms in 47 carbapenem resistant Klebsiella pneumoniae isolates by phenotypic confirmatory tests and molecular assay. Methodology: Carbapenem resistance genes KPC, OXA-4...
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The Journal of Infection in Developing Countries
2019-11-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/10783 |
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| author | Esra Ciftci Emel Sesli Cetin Ebru Us Hüseyin Haydar Kutlu Buket Cicioglu Arıdogan |
| author_facet | Esra Ciftci Emel Sesli Cetin Ebru Us Hüseyin Haydar Kutlu Buket Cicioglu Arıdogan |
| author_sort | Esra Ciftci |
| collection | DOAJ |
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Introduction: The aim of this study was to investigate the presence of carbapenemase production and carbapenem resistance mechanisms in 47 carbapenem resistant Klebsiella pneumoniae isolates by phenotypic confirmatory tests and molecular assay.
Methodology: Carbapenem resistance genes KPC, OXA-48 and NDM were investigated with the BD MAX CRE assay kit in the BD MAX real time PCR instrument. Modified Hodge test, MBL gradient strip test, D70C Carbapenemase Detection Set, Temocillin gradient strip test methods were used as phenotypic confirmatory tests. Clonal relationship between study isolates was investigated with pulsed-field gel electrophoresis.
Results: Analysis with BD MAX CRE assay revealed OXA-48 positivity in 17 (36%) strains, NDM positivity in 6 (13%) strains and coexistence of OXA-48 + NDM positivity in 8 (17%) strains. In 16 (34%) strains, none of the KPC, OXA-48 and NDM genes were detected. While MHT was the most sensitive phenotypic confirmatory test, D70C disc set had not been considered as a useful tool to assist the search for carbapenemase production. Temocillin gradient test alone could not be considered as sufficient to detect the presence of OXA-48. PFGE analyses revealed that 23 of 31 carbapenemase producing strains were in three major PFGE genotypes (A, B and C).
Conclusions: This study revealed that carbapenem resistance observed in K. pneumoniae isolates was mainly due to OXA-48 and NDM genes and the increase of carbapenem resistance among K. pneumoniae strains in our hospital was due to the interhospital spread of especially 3 epidemic clones.
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| format | Article |
| id | doaj-art-786d4a2dd45e4051ae4e5ec7d11fc434 |
| institution | DOAJ |
| issn | 1972-2680 |
| language | English |
| publishDate | 2019-11-01 |
| publisher | The Journal of Infection in Developing Countries |
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| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-786d4a2dd45e4051ae4e5ec7d11fc4342025-08-20T02:57:01ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802019-11-01131110.3855/jidc.10783Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assayEsra Ciftci0Emel Sesli Cetin1Ebru Us2Hüseyin Haydar Kutlu3Buket Cicioglu Arıdogan4Public Health Laboratory, Antalya, Department of Medical Microbiology, TurkeyDepartment of Medical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, TurkeyDepartment of Medical Microbiology, Faculty of Medicine, Ankara University, Ankara, TurkeyDepartment of Medical Microbiology, Faculty of Medicine, Usak University, Usak, TurkeyDepartment of Medical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey Introduction: The aim of this study was to investigate the presence of carbapenemase production and carbapenem resistance mechanisms in 47 carbapenem resistant Klebsiella pneumoniae isolates by phenotypic confirmatory tests and molecular assay. Methodology: Carbapenem resistance genes KPC, OXA-48 and NDM were investigated with the BD MAX CRE assay kit in the BD MAX real time PCR instrument. Modified Hodge test, MBL gradient strip test, D70C Carbapenemase Detection Set, Temocillin gradient strip test methods were used as phenotypic confirmatory tests. Clonal relationship between study isolates was investigated with pulsed-field gel electrophoresis. Results: Analysis with BD MAX CRE assay revealed OXA-48 positivity in 17 (36%) strains, NDM positivity in 6 (13%) strains and coexistence of OXA-48 + NDM positivity in 8 (17%) strains. In 16 (34%) strains, none of the KPC, OXA-48 and NDM genes were detected. While MHT was the most sensitive phenotypic confirmatory test, D70C disc set had not been considered as a useful tool to assist the search for carbapenemase production. Temocillin gradient test alone could not be considered as sufficient to detect the presence of OXA-48. PFGE analyses revealed that 23 of 31 carbapenemase producing strains were in three major PFGE genotypes (A, B and C). Conclusions: This study revealed that carbapenem resistance observed in K. pneumoniae isolates was mainly due to OXA-48 and NDM genes and the increase of carbapenem resistance among K. pneumoniae strains in our hospital was due to the interhospital spread of especially 3 epidemic clones. https://jidc.org/index.php/journal/article/view/10783CarbapenemaseKlebsiella pneumoniaeKPCNDMOXA-48 |
| spellingShingle | Esra Ciftci Emel Sesli Cetin Ebru Us Hüseyin Haydar Kutlu Buket Cicioglu Arıdogan Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay Journal of Infection in Developing Countries Carbapenemase Klebsiella pneumoniae KPC NDM OXA-48 |
| title | Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay |
| title_full | Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay |
| title_fullStr | Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay |
| title_full_unstemmed | Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay |
| title_short | Investigation of Carbapenem resistance mechanisms in Klebsiella pneumoniae by using phenotypic tests and a molecular assay |
| title_sort | investigation of carbapenem resistance mechanisms in klebsiella pneumoniae by using phenotypic tests and a molecular assay |
| topic | Carbapenemase Klebsiella pneumoniae KPC NDM OXA-48 |
| url | https://jidc.org/index.php/journal/article/view/10783 |
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