Molecular epidemiological investigation of carbapenem resistant Klebsiella pneumoniae isolated from intensive care unit patients of six geographical regions of Turkey

Şükran Köse; Tuba Dal; Rıza Aytaç Çetinkaya; Oğuz Arı; Ercan Yenilmez; Esra Nurlu Temel; Emel Sesli Çetin; Çiğdem Arabacı; Seyit Ali Büyüktuna; Mürşit Hasbek; Neslihan Külahlıoğlu; Tuba Müderris; Teoman Kaynar; Tuğba Sarı; Ata Nevzat Yalçın; Kenan Ak; Berivan Tunca Yıldırım; Merve Şahin; Rıza Durmaz

doi:10.3855/jidc.17651

Molecular epidemiological investigation of carbapenem resistant Klebsiella pneumoniae isolated from intensive care unit patients of six geographical regions of Turkey

Authors

Şükran Köse Sağlık Bilimleri University Tepecik Training and Research Hospital, Infectious Diseases Clinical Microbiology, İzmir, Turkey
Tuba Dal Ankara Yıldırım Beyazıt University Faculty of Medicine, Medical Microbiology, Ankara, Turkey
Rıza Aytaç Çetinkaya Sağlık Bilimleri University Hamidiye Faculty of Medicine, Infectious Diseases and Clinical Microbiology, İstanbul, Turkey
Oğuz Arı Ankara Yıldırım Beyazıt University, Central Research and Application Center, Ankara, Turkey https://orcid.org/0000-0003-4930-5035
Ercan Yenilmez Sağlık Bilimleri University Hamidiye Faculty of Medicine, Infectious Diseases and Clinical Microbiology, İstanbul, Turkey https://orcid.org/0000-0002-1145-8856
Esra Nurlu Temel Süleyman Demirel University Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Isparta, Turkey https://orcid.org/0000-0003-4618-168X
Emel Sesli Çetin Süleyman Demirel University Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Isparta, Turkey https://orcid.org/0000-0001-5231-3824
Çiğdem Arabacı Sağlık Bilimleri University Okmeydanı Training and Research Hospital, Medical Microbiology, İstanbul, Turkey https://orcid.org/0000-0003-0050-3225
Seyit Ali Büyüktuna Cumhuriyet University Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Sivas, Turkey https://orcid.org/0000-0001-6518-7361
Mürşit Hasbek Cumhuriyet University Faculty of Medicine, Medical Microbiology, Sivas, Turkey
Neslihan Külahlıoğlu Sağlık Bilimleri University Gülhane Faculty of Health Sciences, Ankara, Turkey
Tuba Müderris İzmir Katip Çelebi University Faculty of Medicine, Medical Microbiology, İzmir, Turkey https://orcid.org/0000-0002-8538-5864
Teoman Kaynar Samsun Gazi State Hospital, Infectious Diseases and Clinical Microbiology, Samsun, Turkey
Tuğba Sarı Pamukkale University Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Denizli, Turkey https://orcid.org/0000-0003-3204-2371
Ata Nevzat Yalçın Akdeniz University Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Antalya, Turkey https://orcid.org/0000-0002-7243-7354
Kenan Ak Cumhuriyet University Faculty of Medicine, Infectious Diseases and Clinical Microbiology, Sivas, Turkey https://orcid.org/0009-0000-1106-1122
Berivan Tunca Yıldırım Private Clinic, Muğla, Turkey https://orcid.org/0000-0002-2376-5183
Merve Şahin Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey https://orcid.org/0000-0002-9847-6845
Rıza Durmaz Ankara Yıldırım Beyazıt University Faculty of Medicine, Medical Microbiology, Ankara, Turkey

DOI:

https://doi.org/10.3855/jidc.17651

Keywords:

MLST, carbapenem, colistin

Abstract

Introduction: Klebsiella pneumonia causes serious infections in hospitalized patients. In recent years, carbapenem-resistant infections increased in the world. The molecular epidemiological investigation of carbapenem-resistant K. pneumoniae isolates was aimed in this study.

Methodology: Fifty carbapenem-resistant K. pneumoniae isolates from six geographical regions of Turkey between September 2019-2020 were included in the study. The disk diffusion method was used for the antibiotic susceptibility testing. The microdilution confirmed colistin susceptibility. Genetic diversity was investigated by MLST (Multi-Locus Sequence Typing).

Results: The resistance rates were as follows: 49 (98%) for meropenem, 47 (94%) imipenem, 50 (100%) ertapenem, 30 (60%) colistin and amoxicillin-clavulanate, 49 (98%) ceftriaxone, 48 (96%) cefepime, 50 (100%) piperacillin-tazobactam, 47 (94%) ciprofloxacin, 40 (80%) amikacin, 37 (74%) gentamicin. An isolate resistant to colistin by disk diffusion was found as susceptible to microdilution. ST 2096 was the most common (n:16) sequence type by MLST.

ST 101 (n:7), ST14 (n:6), ST 147 and ST 15 (n:4), ST391 (n:3), ST 377 and ST16 (n:2), ST22, ST 307, ST 985, ST 336, ST 345, and ST 3681 (n:1) were classified in other isolates. In İstanbul and Ankara ST2096 was common. Among Turkey isolates, the most common clonal complexes (CC) were CC14 (n:26) and CC11 (n = 7).

Conclusions: In Turkey, a polyclonal population of CC14 throughout the country and inter-hospital spread were indicated. The use of molecular typing tools will highlight understanding the transmission dynamics.

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Published

2023-10-31

How to Cite

Köse Şükran, Dal T, Çetinkaya RA, Arı O, Yenilmez E, Temel EN, Çetin ES, Arabacı Çiğdem, Büyüktuna SA, Hasbek M, Külahlıoğlu N, Müderris T, Kaynar T, Sarı T, Yalçın AN, Ak K, Yıldırım BT, Şahin M, Durmaz R (2023) Molecular epidemiological investigation of carbapenem resistant Klebsiella pneumoniae isolated from intensive care unit patients of six geographical regions of Turkey. J Infect Dev Ctries 17:1446–1451. doi: 10.3855/jidc.17651

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Issue

Vol. 17 No. 10: October 2023

Section

Original Articles

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Copyright (c) 2023 Şükran Köse, Tuba Dal, Rıza Aytaç Çetinkaya, Oğuz Arı, Ercan Yenilmez, Esra Nurlu Temel, Emel Sesli Çetin, Çiğdem Arabacı, Seyit Ali Büyüktuna, Mürşit Hasbek, Neslihan Genişel, Tuba Müderris, Teoman Kaynar, Tuğba Sarı, Ata Nevzat Yalçın, Kenan Ak, Berivan Tunca Yıldırım, Merve Şahin, Rıza Durmaz

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