Carbapenem-resistant Klebsiella pneumoniae outbreak with monoclonal spread: Evaluation of resistance genes and ceftazidime-avibactam susceptibility

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dc.authoridArıcı, Neslihan/0000-0003-4788-0044
dc.authoridTanriverdi, Elif Seren/0000-0002-0449-0356
dc.authoridOTLU, BARIS/0000-0002-6220-0521
dc.authoridKANSAK, NILGUN/0000-0002-1117-3906
dc.authoridAdaleti, Riza/0000-0001-9576-6794
dc.authorwosidKANSAK, NİLGÜN/HHN-1154-2022
dc.authorwosidArıcı, Neslihan/HJP-3410-2023
dc.authorwosidAdaleti, Rıza/HKW-6481-2023
dc.authorwosidTanriverdi, Elif Seren/ABE-4472-2021
dc.authorwosidOTLU, BARIS/ABI-5532-2020
dc.contributor.authorArici, Neslihan
dc.contributor.authorTanriverdi, Elif Seren
dc.contributor.authorCalik, Seyma
dc.contributor.authorKansak, Nilgun
dc.contributor.authorAdaleti, Riza
dc.contributor.authorOtlu, Baris
dc.contributor.authorAksaray, Sebahat
dc.date.accessioned2024-08-04T20:54:33Z
dc.date.available2024-08-04T20:54:33Z
dc.date.issued2023
dc.departmentİnönü Üniversitesien_US
dc.description.abstractPurpose: The aim of this study was to investigate ceftazidime-avibactam (CAZ-AVI) susceptibility, carbapenemase genes, and clonal relationship in carbapenem-resistant Klebsiella pneumoniae (CrKp) isolates.Methods: A total of 28 non-repetitive CrKp isolates with positive carbapenemase production determined by the modified carbapenem inactivation method (mCIM), were included in the study. Identification of the isolates was performed with MALDI-TOF MS (VITEK-MS, bioMerieux, France). The automated system (VITEK-2, bioMerieux) and gradient diffusion test (Etest, bioMerieux) were used to determine antibiotic susceptibility. The mCIM was performed according to CLSI (2021) recommendations. CAZ-AVI susceptibility was carried out using the standard disc diffusion method. Results were evaluated according to EUCAST 2022 criteria. The blaOXA-48, blaNDM, blaKPC, blaIMP and blaVIM genes were investigated by multiplex PCR. The clonal relationship between isolates was determined by both AP-PCR and PFGE methods.Results: Of the total 28 isolates, 89.3% were susceptible to CAZ-AVI. blaOXA-48 gene was found in 85.7% of the isolates, blaOXA-48 thorn blaNDM gene in 10.7%, and blaNDM gene in 3.6%. blaKPC, blaIMP and blaVIM genes were not detected. Three clusters with three different genotypes were determined by the PFGE method. The largest cluster was Genotype A (n:24), followed by Genotype B (n:3), and Genotype C (n:1). AP-PCR was highly compatible with PFGE. The isolates of Genotype A, mostly from the intensive care unit (ICU), were evaluated as outbreak strains with monoclonal dissemination. Conclusions: OXA-48 remains the most frequently detected enzyme in CrKp strains in our country. The ceftazidime-avibactam susceptibility rate of 89.3% indicates that this antibiotic is still effective against CrKp isolates. The unnoticed outbreak detected in our study revealed the severity of intra-hospital cross-contamination affecting different wards, including the ICU. Therefore, in order to limit the spread of CrKp isolates, it is of great importance to implement strict infection control measures, and molecular surveillance programs, especially in the ICU.en_US
dc.identifier.doi10.1016/j.ijmmb.2023.100431
dc.identifier.issn0255-0857
dc.identifier.issn1998-3646
dc.identifier.pmid37945124en_US
dc.identifier.scopus2-s2.0-85165918295en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.urihttps://doi.org/10.1016/j.ijmmb.2023.100431
dc.identifier.urihttps://hdl.handle.net/11616/101487
dc.identifier.volume46en_US
dc.identifier.wosWOS:001051398700001en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofIndian Journal of Medical Microbiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectCarbapenem resistant Ken_US
dc.subjectpneumoniaeen_US
dc.subjectCeftazidime-avibactamen_US
dc.subjectCarbapenemase genesen_US
dc.subjectClonal relationshipen_US
dc.titleCarbapenem-resistant Klebsiella pneumoniae outbreak with monoclonal spread: Evaluation of resistance genes and ceftazidime-avibactam susceptibilityen_US
dc.typeArticleen_US

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