title: Characterization of ST258 Colistin-Resistant, blaKPC-Producing Klebsiella pneumoniae in a Greek Hospital.
abstract: The emergence of colistin resistance may further contribute to treatment failure of infection caused by multidrug-resistant (MDR) Klebsiella pneumoniae. The colistin resistance rates were determined and colistin-resistant carbapenemase-producing K. pneumoniae (COL-R CP-Kp) were characterized over an 18-month period in a Greek hospital. Out of 135 carbapenemase producers, 19 isolates (14%) were categorized as resistant to colistin. Phenotypic and molecular characterization of the COL-R CP-Kp isolates revealed that all were MDR blaKPC producers and, excluding one isolate of MLST ST383, belonged to the international clonal lineage ST258. Furthermore, PCR amplification and sequencing of the mgrB locus revealed nucleotide sequences of different sizes and insertions of IS1- and IS5-like mobile elements. The majority (63%) of the COL-R blaKPC producers was recovered from patients in the intensive care unit (ICU) and clinical data indicated that all patients should have acquired these isolates in the ICU. The findings of the present study underscore a concerning evolution of colistin resistance in a setting of high K. pneumoniae carbapenemase (KPC)-Kp endemicity, such as Greece. Thus, continuous surveillance, molecular characterization, prudent use of antibiotics, and implementation of infection control measures for K. pneumoniae are urgent.
authors: 1 Department of Microbiology, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Angeliki
authors: A
authors: Mavroidi
authors: 2 Intensive Care Unit, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Maria
authors: M
authors: Katsiari
authors: 1 Department of Microbiology, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Sofia
authors: S
authors: Likousi
authors: 1 Department of Microbiology, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Eleftheria
authors: E
authors: Palla
authors: 1 Department of Microbiology, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Zoi
authors: Z
authors: Roussou
authors: 2 Intensive Care Unit, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Charikleia
authors: C
authors: Nikolaou
authors: 2 Intensive Care Unit, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Asimina
authors: A
authors: Maguina
authors: 1 Department of Microbiology, General Hospital of Nea Ionia "Konstantopouleio-Patission," Athens, Greece .
authors: Evangelia D
authors: ED
authors: Platsouka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D003091:Colistin / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004251:DNA Transposable Elements; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D062665:Epidemiological Monitoring; D005260:Female; D015870:Gene Expression; D006115:Greece / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016254:Mutagenesis, Insertional; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004251:DNA Transposable Elements; D008565:Membrane Proteins; D001618:beta-Lactamases; C063912:carbapenemase; D003091:Colistin