African Journal of
Microbiology Research

  • Abbreviation: Afr. J. Microbiol. Res.
  • Language: English
  • ISSN: 1996-0808
  • DOI: 10.5897/AJMR
  • Start Year: 2007
  • Published Articles: 4881

Full Length Research Paper

blaKPC-2 and blaOXA-48 producing Klebsiella pneumoniae found in a Turkish hospital in the Balkans

Sebnem Bukavaz
  • Sebnem Bukavaz
  • Department of Medical Microbiology, Faculty of Medicine, Trakya University, Edirne, Turkey.
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Metin Budak
  • Metin Budak
  • Department of Biophysics, Faculty of Medicine, Trakya University, Edirne, Turkey.
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Aygül Dogan Celik
  • Aygül Dogan Celik
  • VM Medical Park Hospital, Kocaeli, Turkey.
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  •  Received: 12 March 2018
  •  Accepted: 17 April 2018
  •  Published: 28 April 2018

Abstract

Carbapenem-resistant Klebsiella pneumoniae carrying blaKPC-2, blaOxa48, and other metallo--lactamases (MBLs) are difficult to treat. This study was conducted to study the phenotypic and genotypic features of carbapenem resistance in isolates of K. pneumoniae isolated from a tertiary care hospital in the European region of Turkey. Isolates of K. pneumonia (n=100) resistant to at least one carbapenem (imipenem, meropenem, or ertapenem) were collected from 60 patients for 14 months. Carbapenem resistance was determined via the VITEK-2 system and the E-test confirmed this. The Modified Hodge Test (MHT) and Double Disc Synergy Test (DDST) were performed. Genes were analyzed by Sybr-Green real-time, multiplex and convensional polymerase chain reaction (PCR). Phylogenetic relatedness was analyzed by ERIC-PCR. The rate of resistance by E-test against ertapenem, imipenem, and meropenem were 98, 94, and 72%, respectively; 21% of isolates were somewhat susceptible to tygecycline. The MHT positivity was 98% and DDST was negative in all cases. There were 19 and 24% of isolates positive for blaKPC-2 and blaOxa-48, respectively. ERIC-PCR showed that all blaKPC-2-positive isolates were branched into two main clusters with 80.5% similarity. The results indicate that blaKPC-2 mediated carbapenem-resistant Klebsiella pneumoniae (CRKP) infection is spreading in Turkey and blaOXA-48 endemicity continues to be a serious problem. The molecular determination of carbapenemases will be useful for patients with concurrent carbapenem-resistant Enterobacteria¬ceae (CRE) infections. This could prevented outbreaks and complications.

Key words: Klebsiella pneumoniae, carbapenem resistance, blaKPC-2, blaOxa-48.