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 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.

Whole genome sequencing snapshot of multi-drug resistant Klebsiella pneumoniae strains from hospitals and receiving wastewater treatment plants in Southern Romania

“…bla OXA-48, bla KPC-2, bla NDM-1 and bla OXA-162 ) found in the majority of the influent, effluent and clinical isolates are those reported as prevalent both in Romania and in other geographical areas [29]. Previous studies performed in Romania on carbapenem-non-susceptible Klebsiella pneumoniae clinical isolates have shown that bla OXA-48 was by far the most predominant genotype, followed by bla NDM-1 and bla KPC-2 [30,31,32]. The corresponding STs for the carbapenemase-producing isolates are: ST101 and ST258 (the most prevalent, as also reported in other studies including those performed on Romanian clinical strains by the authors of the present paper [11,33], followed by ST11, ST17, ST219, ST307 and ST395).…”

Evaluation of Phenotypic and Genotypic Characteristics of Carbapnemases-producing Enterobacteriaceae and Its Prevalence in a Referral Hospital in Tehran City

“…This study found CPE with OXA-48, NDM and KPC genes together or alone, in a hospital in Tehran. The co-production of OXA-48-and NDM; OXA-48 and KPC with NDM -producing K. pneumoniae has been reported in some Asian and European countries (30)(31)(32)(34)(35)(36). Beyond the dominance of OXA-48-like and NDM producing strains, it was also notable that almost half of the collection co-produced these two enzymes.…”

Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study

“…20 This fi nding might be analogous to the national expansion of K pneumoniae ST258-related clones with KPC-2 or KPC-3 enzymes in Greece, Italy, and Israel, for example, although with a diff erent clonal lineage and carbapenemase type. OXA-48-like carbapenemases were frequent in Malta, Spain, France, and Belgium, where they appear to be repeatedly introduced from northern Africa.…”