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 bla NDM-1 gene, four had the bla KPC-2 gene, whereas two were positive for bla VIM-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 bla KPC-2 and bla VIM-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.

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The aim of this study was to characterise S. aureus strains from community onset Skin and Soft Tissues Infections (SSTIs) in two locations: Cantacuzino Institute (A strains) and Elias University Emergency Hospital (B strains), in the January 2014-August 2015 interval. All strains from the A location, and three strains from the B location have been isolated from recurrent staphylococcal infections. Materials. Seventy-one S. aureus strains (A-42; B-29) have been collected from different types of SSTIs. Methods: PCR was used to identify virulence factors and AMR genes, disc diffusion and broth microdilution for AST, SCCmec and spa typing. Results and Discussions. MRSA rate of 59.52% and 17.24% among A and B strains, respectively. Twenty of A strains and one of B strains were positive for lukS/F-PV genes; two A strains and four B strains were positive for tst1 gene. Panton-Valentine Leukocidin was present in all t008 and t044 strains. Four strains from A location and seven strains from B location were positive for Staphylococcal Enterotoxins. Three new spa-types were discovered. Conclusions. The most prevalent S. aureus clone in community onset SSTIs was spa type t127, followed by spa types t044, t008. Molecular characterisation of S. aureus strains may predict the tendency to recurrence of stapylococcal SSTIs.

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