Evolution of Beta-Lactamases in Urinary Klebsiella pneumoniae Isolates from Croatia; from Extended-Spectrum Beta-Lactamases to Carbapenemases and Colistin Resistance

Scientific paper - Original scientific paper

• Author: Branka Bedenić
• Author: Lucija Pešorda
• Author: Marija Krilanović
• Author: Nataša Beader
• Author: Zoran Veir
• Author: Silvia Schoenthaler
• Author: Daniela Bandić-Pavlović
• Author: Sonja Frančula-Zaninović
• Author: Ivan Barišić
• Author's institution: University of Zagreb; School of Medicine; (Department of Medical Microbiology and Parasitology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Medical Microbiology

Abstract (english)

K. pneumoniae isolates often harbor various antibiotic resistance determinants including extended-spectrum β-lactamases (ESBLs), plasmid-mediated AmpC β-lactamases (p-Amp-C) and carbapenemases. In this study we analyzed 65 K. pneumoniae isolates obtained from urinary tract infections in the outpatients setting, with regard to antibiotic susceptibility, β-lactamase production, virulence traits and plasmid content.Antibiotic susceptibility was determined by broth microdilution method. PCR was applied to detect genes encoding ESBLs, p-Amp-C and carbapenemases and plasmid incompatibility groups. Phenotypic methods were applied to characterize virulence determinants. Increasing resistance trend was observed for amoxicillin/clavulanate, imipenem, meropenem and ciprofloxacin. The study showed that ESBLs belonging to the CTX-M family, conferring high level of resistance to expanded-spectrum cephalosporins (ESC) were the dominant resistance trait among early isolates (2013 to 2016) whereas OXA-48 carbapenemase, belonging to class D, emerged in significant numbers after 2017. OXA-48 producing organisms coharbored ESBLs. KPC-2 was dominant among isolates from Dubrovnik in the recent years. Colistin resistance was reported in three isolates. Inc L/M was the dominant plasmid in the later period, encoding OXA-48. Hyperviscosity was linked to KPC positivity and emerged in the later period. This report describes evolution of antibiotic resistance in K. pneumoniae from ESBLs to carbapenemases and colistin resistance. The study demonstrated the ability of K. pneumoniae to acquire various resistance determinants, over time. The striking diversity of the UTI isolates could result from introduction of the isolates from the hospitals, transfer of plasmids and multidirectional evolution.

• Keywords (english): Amoxicillin; Anti-Bacterial Agents / pharmacology; Bacterial Proteins / genetics; Cephalosporins; Ciprofloxacin; Clavulanic Acid; Colistin / pharmacology; Croatia; Humans; Imipenem; Klebsiella Infections; Klebsiella pneumoniae / genetics; Meropenem; Microbial Sensitivity Tests , beta-Lactamases / genetics
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Current Microbiology
• Numbering: vol. 79, no. 12, 355
• p-ISSN: 0343-8651
• e-ISSN: 1432-0991
• DOI: https://doi.org/10.1007/s00284-022-03026-w
• URN:NBN: urn:nbn:hr:105:972031
• Publication: 2022-10-15
• Document URL: https://link.springer.com/10.1007/s00284-022-03026-w
• Type of resource: Text
• Access conditions: Open access; Embargo expiration date: 2023-11-01
• Created on: 2023-04-14 10:48:13