title: Carbapenemases-producing Klebsiella pneumoniae in hospitals of two regions of Southern Italy.
abstract: Carbapenem-resistant Klebsiella pneumoniae infections are reported with increasing frequency elsewhere in the world, representing a worrying phenomenon for global health. In Italy, there are hotspot data on the diffusion and type of carbapenemase-producing Enterobacteriaceae and K. pneumoniae in particular, with very few data coming from Apulia and Basilicata, two regions of Southern Italy. This study was aimed at characterizing by phenotypic and genotypic methods carbapenem-resistant K. pneumoniae isolated from several Hospitals of Apulia and Basilicata, Southern Italy. Antibiotic susceptibility was also evaluated. The relatedness of carbapenemase-producing K. pneumoniae strains was established by pulsed-field gel electrophoresis (PFGE). Among the 150 K. pneumoniae carbapenemase producers, KPC-3 genotype was the most predominant (95%), followed by VIM-1 (5%). No other genotypes were found and no co-presence of two carbapenemase genes was found. A full concordance between results obtained by both the phenotypic and the genotypic tests was observed. All strains were resistant to β-lactam antibiotics including carbapenems, and among antibiotics tested, only tetracycline and gentamycin showed low percentage of resistance (18% and 15%, respectively). Resistance to colistin was detected in 17.3% of strains studied. The analysis of PFGE profiles of the carbapenemases-positive strains shows that one group (B) of the five (A to E) main groups identified was the most prevalent and detected in almost all the hospitals considered, while the other groups were randomly distributed. Three different sequence types (ST 307, ST 258, and ST 512) were detected with the majority of isolates belonging to the ST 512. Our results demonstrated the wide diffusion of K. pneumoniae KPC-3 in the area considered, the good concordance between phenotypic and genotypic tests. Gentamicin and colistin had a good activity against these strains.
authors.affiliation: Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Calia
authors.affiliation: Department of Biology, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Pazzani
authors.affiliation: Department of Biology, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Oliva
authors.affiliation: Department of Biology, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Scrascia
authors.affiliation: Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Lovreglio
authors.affiliation: Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Capolongo
authors.affiliation: Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Dionisi
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Chiarelli
authors.affiliation: Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Monno
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D016000:Cluster Analysis; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006761:Hospitals; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D017720:Molecular Epidemiology; D058889:Molecular Typing; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: 
  Klebsiella pneumoniae
  ; antimicrobial resistance; carbapenemases; pulsed-field gel electrophoresis