title: Carbapenemase-Producing Klebsiella pneumoniae in Romania: A Six-Month Survey.
abstract: This study presents the first characterization of carbapenem-non-susceptible Klebsiella pneumoniae isolates by means of a structured six-month survey performed in Romania as part of an Europe-wide investigation. Klebsiella pneumoniae clinical isolates from different anatomical sites were tested for antibiotic susceptibility by phenotypic methods and confirmed by PCR for the presence of four carbapenemase genes. Genome macrorestriction fingerprinting with XbaI was used to analyze the relatedness of carbapenemase-producing Klebsiella pneumoniae isolates collected from eight hospitals. Among 75 non-susceptible isolates, 65 were carbapenemase producers. The most frequently identified genotype was OXA-48 (n = 51 isolates), eight isolates were positive for blaNDM-1 gene, four had the blaKPC-2 gene, whereas two were positive for blaVIM-1. The analysis of PFGE profiles of OXA-48 and NDM-1 producing K. pneumoniae suggests inter-hospitals and regional transmission of epidemic clones. This study presents the first description of K. pneumoniae strains harbouring blaKPC-2 and blaVIM-1 genes in Romania. The results of this study highlight the urgent need for the strengthening of hospital infection control measures in Romania in order to curb the further spread of the antibiotic resistance.
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Brandusa Elena
authors.initials: BE
authors.lastname: Lixandru
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.|The European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
authors.forename: Ani Ioana
authors.initials: AI
authors.lastname: Cotar
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Monica
authors.initials: M
authors.lastname: Straut
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Codruta Romanita
authors.initials: CR
authors.lastname: Usein
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Dana
authors.initials: D
authors.lastname: Cristea
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Ciontea
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Dorina
authors.initials: D
authors.lastname: Tatu-Chitoiu
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Irina
authors.initials: I
authors.lastname: Codita
authors.affiliation: Matei Bals National Institute of Infectious Diseases, Dr. Calistrat Grozovici Street 1, Bucharest, Romania.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Rafila
authors.affiliation: Victor Babes Hospital for Infectious and Tropical Diseases, Mihai Bravu Road 281, Bucharest, Romania.
authors.forename: Maria
authors.initials: M
authors.lastname: Nica
authors.affiliation: Elias Emergency University Hospital, Mărăsti Avenue 17, Bucharest, Romania.
authors.forename: Mariana
authors.initials: M
authors.lastname: Buzea
authors.affiliation: Emergency University Hospital Bucharest, Splaiul Independentei 169, Bucharest, Romania.
authors.forename: Anda
authors.initials: A
authors.lastname: Baicus
authors.affiliation: Fundeni Clinical Institute, Fundeni Road 258, Bucharest, Romania.
authors.forename: Mihaela Camelia
authors.initials: MC
authors.lastname: Ghita
authors.affiliation: Grigore Alexandrescu Emergency Children Hospital, Iancu de Hunedoara Avenue 30-32, Bucharest, Romania.
authors.forename: Irina
authors.initials: I
authors.lastname: Nistor
authors.affiliation: St. Spiridon Emergency Clinical Hospital, Piaţa Independenţei 1, Iasi, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tuchiluş
authors.affiliation: Bacau County Emergency Hospital, Spiru Haret Street 2-4, Bacau, Romania.
authors.forename: Marina
authors.initials: M
authors.lastname: Indreas
authors.affiliation: Nicolae Simionescu Institute of Cellular Biology and Pathology, B.P. Hasdeu Street 8, Bucharest, Romania.
authors.forename: Felicia
authors.initials: F
authors.lastname: Antohe
authors.affiliation: Department of Medical Microbiology, University Medical Center Groningen, Rijksuniversiteit Groningen Hanzeplein 1, 9713 GZ Groningen, Netherlands.
authors.forename: Corinna
authors.initials: C
authors.lastname: Glasner
authors.affiliation: Department of Medical Microbiology, University Medical Center Groningen, Rijksuniversiteit Groningen Hanzeplein 1, 9713 GZ Groningen, Netherlands.
authors.forename: Hajo
authors.initials: H
authors.lastname: Grundmann
authors.affiliation: The European Programme for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
authors.forename: Aftab
authors.initials: A
authors.lastname: Jasir
authors.affiliation: Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Splaiul Independentei 103, Bucharest, Romania.
authors.forename: Maria
authors.initials: M
authors.lastname: Damian
mesh_terms: D001426:Bacterial Proteins / Q000096:biosynthesis*; D016521:Electrophoresis, Gel, Pulsed-Field; D006761:Hospitals; D006801:Humans; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010641:Phenotype; D012383:Romania; D011795:Surveys and Questionnaires; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase