Antibiotic Resistance and Its Molecular Mechanisms in Carbapenem-Nonsusceptible Klebsiella pneumoniae Isolated in Pediatric ICUs in Moscow
Abstract
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.
About the Authors
O. A. Kryzhanovskaya
Scientific Center of Children's Health, Ministry of Public Heath of the Russian Federation
Russian Federation
Russian Federation
A. V. Lazareva
Scientific Center of Children's Health, Ministry of Public Heath of the Russian Federation
Russian Federation
Russian Federation
N. M. Alyabieva
Scientific Center of Children's Health, Ministry of Public Heath of the Russian Federation
Russian Federation
Russian Federation
R. F. Tepaev
Scientific Center of Children's Health, Ministry of Public Heath of the Russian Federation
Russian Federation
Russian Federation
O. V. Karaseva
Research Institute of Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
I. V. Chebotar
Scientific Center of Children's Health, Ministry of Public Heath of the Russian Federation
Russian Federation
Russian Federation
N. A. Mayanskiy
Scientific Center of Children's Health, Ministry of Public Heath of the Russian Federation; 1. M. Sechenov 1st Moscow State Medical University
Russian Federation
Russian Federation
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Review
For citations:
Kryzhanovskaya O.A., Lazareva A.V., Alyabieva N.M., Tepaev R.F., Karaseva O.V., Chebotar I.V., Mayanskiy N.A. Antibiotic Resistance and Its Molecular Mechanisms in Carbapenem-Nonsusceptible Klebsiella pneumoniae Isolated in Pediatric ICUs in Moscow. Antibiot Khimioter = Antibiotics and Chemotherapy. 2016;61(7-8):22-26. (In Russ.)
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