Evaluation of carbapenem-resistant Enterobacteriaceae in an Italian setting: Report from the trench.

February 20, 2015 at 8:09 am

Infect Genet Evol. 2015 Mar;30:8-14.

Barbarini D1, Russello G2, Brovarone F2, Capatti C2, Colla R3, Perilli M4, Moro ML5, Carretto E6.

Author information

1Clinical Virology and Microbiology Laboratory – Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

2Clinical Microbiology Laboratory – IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.

3Laboratory of Analysis Area Nord, AUSL Reggio Emilia, Italy.

4Department of Science and Biomedical Technologies, University of L’Aquila, Italy.

5Area di Programma Rischio Infettivo – Agenzia Sanitaria e Sociale Regione Emilia Romagna, Italy.

6Clinical Microbiology Laboratory – IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. Electronic address: edoardo.carretto@asmn.re.it.

Abstract

The spread of carbapenem resistant Enterobacteriaceae (CRE) has recently become a matter of concern in public health, mainly due to the wide distribution of carbapenemase genes.

Italy is a country considered endemic for the spread of blaKPCKlebsiella pneumoniae (KP). The aim of this study was to depict the epidemiological trend of CRE in one Italian hospital over a long period (3years surveillance, from May 2011 to April 2014).

Based on defined MIC cut-off for specific carbapenems, 164 strains isolated from 146 different patients were analyzed both phenotypically and genotypically to establish the resistance genes.

Molecular typing was performed using the RAPD technique. 77 strains were demonstrated to harbor the blaKPC gene (73 KP, 4 Escherichia coli – EC), 51 strains the blaVIM gene (44 KP, 3 EC, 2 Enterobactercloacae and 2 Klebsiellaoxytoca), 8 the blaNDM gene (3 KP, 4 EC and one Providencia stuartii), 3 the blaOXA-48 gene (2 KP, 1 EC), whereas 25 out of the 164 isolates (of different genera and species) had a negative multiplex-PCR amplification for all the targets tested.

39 out of the 164 strains analyzed (23.8%) revealed discrepancies between the MICs obtained with automated instrument and gradient MICs of more than two logs of difference; the broth microdilution provided a better agreement with the results obtained with the gradient MIC.

The use of RAPD allowed to distinguish different clusters, closely related, both for blaKPC and for blaVIM KP.

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Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Biología Molecular, Epidemiología, FIEBRE en el POSTOPERATORIO, Health Care-Associated Infections, Infecciones asociadas a catater IV, Infecciones emergentes, Infecciones nosocomiales, Metodos diagnosticos, REPORTS, Resistencia bacteriana, Sepsis.

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