Антибиотики и Химиотерапия (May 2020)

Antibiotic Resistance and Its Molecular Mechanisms in Carbapenem-Nonsusceptible Klebsiella pneumoniae Isolated in Pediatric ICUs in Moscow

  • O. A. Kryzhanovskaya,
  • A. V. Lazareva,
  • N. M. Alyabieva,
  • R. F. Tepaev,
  • O. V. Karaseva,
  • I. V. Chebotar,
  • N. A. Mayanskiy

Journal volume & issue
Vol. 61, no. 7-8
pp. 22 – 26

Abstract

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Klebsiella pneumoniae Is a significant pathogen associated with hospital infections. Its was isolated in intensive care units (ICU) at two pediatric hospitals in Moscow in 2012-2014 from 41% (387/935) of the patients. The rate of carbapenem-nonsusceptibility (Carba-NS) amounted to 25% for imipenem and 27% for meropenem. For further analyses, 67 isolates were selected, including 57 Carba-NS and 10 Carba-susceptible (Carba-S). Among the isolates, 100% was nonsusceptible to the III-IV generation cephalosporins, 50-84% was resistant to aminoglycosides. The rate of nonsusceptibility to ciprofloxacin and phosphomycin exceeded 90%. All the tested Carba-S K.pneumoniae isolates were susceptible to tigecycline, whereas 25% of the Carba-NS isolates was tigecycline-NS. The prevalence of the colistin-NS isolates was the same in Carba-S (20%) and Carba-NS (26%) bacteria. The blaCTX_M gene was carried by 100% of the Carba-S isolates, combining with the blaTEM gene in 60% of the isolates. In 89% of the Carba-NS isolates the OXA-48 carbapenemase was detected, which was combined with CTX-M and/or TEM in all but 1 isolate. Thus, over the last decade, the rate of Carba-NS among nosocomial K.pneumoniae increased and the OXA-48 carbapenemase was shown to be dominating in the mechanism of Carba-NS in the pediatric ICUs in Moscow.

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