Investigation of carbapenemase and mcr-1 genes in carbapenem-resistant Klebsiella pneumoniae isolates

  • Çiğdem Arabacı Clinical Microbiology Laboratory, Okmeydani Training and Research Hospital, Republic of Turkey, Ministry of Health, Istanbul, Turkey
  • Tuba Dal Medical Faculty, Ankara Yıldırım Beyazıt University, Ankara, Turkey
  • Tuğcan Başyiğit Medical Faculty, Ankara Yıldırım Beyazıt University, Ankara, Turkey
  • Neslihan Genişel Medical Faculty, Dicle University, Diyarbakır, Turkey
  • Rıza Durmaz Medical Faculty, Ankara Yıldırım Beyazıt University, Ankara, Turkey
Keywords: carbapenem, colistin, resistance

Abstract

Introduction: Carbapenem-resistant Klebsiella pneumoniae are a major problem. We aimed to investigate carbapenemase-encoding genes and transferable mcr-1 genes among 57 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates from hospitalized patients.

Methodology: Antibiotic susceptibility tests were performed by Phoenix (BD). Results for ertapenem and colistin were confirmed by gradient diffusion and microdilution methods. Carbapenemase and mcr-1 genes were investigated by Polymerase Chain Reaction (PCR).

Results: Thirty-two (56.14%) isolates were from intensive care units (ICU). Antibiotic resistance rates by Phoenix: 52.63% for amikacin; 73.69% trimethoprim sulfamethoxazole; 91.23% cefepime; 82.46% tigecycline; 59.65% colistin. Carbapenemases positivity: 82.45% (47) for blaOXA-48, 40.35% (23) blaOXA-55, 3.50% (2) blaOXA-51, 1.75% (1) blaOXA-23, 1.75% (1) blaOXA-24, 1.75% (1) blaIMP. blaOXA-58, blaKPC, blaNDM-1, and blaVIM were not detected. Twenty (35.08%) isolates had both blaOXA-48 and blaOXA-55. Three isolates were mcr-1 (+) and blaOXA-48 (+). One mcr-1 (+) isolates was blaOXA-51 (+). One colistin sensitive isolate determined by Phoenix, was found colistin resistant by microdilution.

Conclusion: OXA-48 and OXA-55 co-harboring isolates and mcr-1 gene (+) isolates were spreading. Automated colistin susceptibility results should be confirmed by microdilution method. Resistance mechanisms in Enterobacteriaceae should be determined and the isolates should be monitored by molecular epidemiological methods. Effective infection control measures will contribute to reduce risk of antibiotic resistant bacterial infections and dissemination of antibiotic resistance.

Published
2019-06-30
How to Cite
1.
Arabacı Çiğdem, Dal T, Başyiğit T, Genişel N, Durmaz R (2019) Investigation of carbapenemase and mcr-1 genes in carbapenem-resistant Klebsiella pneumoniae isolates. J Infect Dev Ctries 13:504-509. doi: 10.3855/jidc.11048
Section
Original Articles