Colistin resistance in KPC-producing Klebsiella pneumoniae strains from a high specialization rehabilitation facility

  • Roberta Migliavacca | r.miglia@unipv.it
  • Viola Repetto
  • Aurora Piazza
  • Elisabetta Nucleo
  • Elisabetta Abbaneo
  • Silvana Telecco
  • Antonella Navarra
  • Laura Pagani

Abstract

The worldwide rapid spread of KPC carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) represents an increasing problem in clinical settings. Reports on KPC-Kp epidemic spread in Italian hospitals began to appear since 2010; colistin (COL) represents one of the few remaining therapeutic options available for the treatment of such multi drug-resistant (MDR) pathogens. Here we report the presence and diffusion of COL resistant KPC-Kp isolates from a High Specialization Rehabilitation Facility located in Northern Italy. Species identification and antimicrobial susceptibilities were obtained by NBC46/NM40 Microscan panels (Siemens); imipenem, meropenem and ertapenem MICs were also evaluated by Etest and broth microdilution method; blaKPC-like genes PCR were performed. PFGE (XbaI) was used to investigate clonal relatedness; epidemiological data were collected from the hospital database. Seventy-five carbapenem-resistant K. pneumoniae isolates were collected from the Fondazione S. Maugeri hospital during the period January-June 2011. Seven out of 75 MDR KPC-Kp isolates by Microscan System showed COL resistance (MIC >2 mg/L). Among them, 5/7 were collected from coma and 2/7 from cardiology and rehabilitation cardiology wards. Most of these strains were from urine (5/7); the remaining 2/7 were from blood and bronco-alveolar lavage. The 85.7% of the strains showed susceptibility to tigecycline and fosfomycin; 71.4% only to gentamicina, 28.5% to trimethoprim/sulfamethoxazole and 14.2% to amikacin. The PFGE profiles obtained analyzing 5/7 isolates from patients hospitalized from almost 10 days, showed clonal relatedness between 4/5 isolates, thus confirming the high epidemic potential of almost one KPC-Kp clinical strain collected from 4 different wards.The emergence of COL resistance in KPC-Kp, dramatically reduces the available therapeutic options. These results underline the ability of a COL resistant KPC-producing clone to rapidly spread within this Rehabilitation Facility.

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Published
2012-03-31
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Short Communications
Keywords:
Colistin resistance, Carbapenemases, Rehabilitation Facility
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How to Cite
Migliavacca, R., Repetto, V., Piazza, A., Nucleo, E., Abbaneo, E., Telecco, S., Navarra, A., & Pagani, L. (2012). Colistin resistance in KPC-producing Klebsiella pneumoniae strains from a high specialization rehabilitation facility. Microbiologia Medica, 27(1). https://doi.org/10.4081/mm.2012.2334

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