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Emergence of Escherichia coli Sequence Type 131 (ST131) and ST3948 with KPC-2, KPC-3 and KPC-8 carbapenemases from a Long-Term Care and Rehabilitation Facility (LTCRF) in Northern Italy.
Piazza, Aurora; Caltagirone, Mariasofia; Bitar, Ibrahim; Nucleo, Elisabetta; Spalla, Melissa; Fogato, Elena; D'Angelo, Roberto; Pagani, Laura; Migliavacca, Roberta.
Afiliação
  • Piazza A; Laboratory of Microbiology and Clinical Microbiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Brambilla 74, 27100, Pavia, Italy.
  • Caltagirone M; Laboratory of Microbiology and Clinical Microbiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Brambilla 74, 27100, Pavia, Italy.
  • Bitar I; Laboratory of Microbiology and Clinical Microbiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Brambilla 74, 27100, Pavia, Italy.
  • Nucleo E; Laboratory of Microbiology and Clinical Microbiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Brambilla 74, 27100, Pavia, Italy.
  • Spalla M; Laboratory of Microbiology and Clinical Microbiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Brambilla 74, 27100, Pavia, Italy.
  • Fogato E; ASP "Golgi-Redaelli", via Bartolomeo d'Alviano 78, 20146, Milan, Italy.
  • D'Angelo R; ASP "Golgi-Redaelli", via Bartolomeo d'Alviano 78, 20146, Milan, Italy.
  • Pagani L; Laboratory of Microbiology and Clinical Microbiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Brambilla 74, 27100, Pavia, Italy.
  • Migliavacca R; Laboratory of Microbiology and Clinical Microbiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Via Brambilla 74, 27100, Pavia, Italy. r.miglia@unipv.it.
Adv Exp Med Biol ; 901: 77-89, 2016.
Article em En | MEDLINE | ID: mdl-26810233
Aim of the study was to characterize KPC-producing Escherichia coli (KPC-Ec) clinical isolates among a Northern Italy Long-Term Care and Rehabilitation Facility (LTCRF) residents. Thirteen consecutive non repeated MDR E. coli isolates showing ertapenem Minimum Inhibitory Concentrations (MICs) >0.5 mg/L, collected during the period March 2011 - May 2013 from ASP "Redaelli" inpatients, were investigated. The bla KPC/CTX-M/SHV/TEM/OXA genes were identified by PCR and sequencing. KPC-Ec isolates underwent phylotyping, Pulsed-Field Gel Electrophoresis (PFGE), multilocus sequence typing (MLST) and repetitive sequence-based PCR (rep-PCR) profiling. Incompatibility groups analysis and conjugation were also performed. Eleven out of 13 isolates, resulted bla KPC-type positive, were consistently resistant to third generation cephalosporins, fluoroquinolones and trimethoprim-sulphametoxazole (84.6 %), retaining susceptibility to colistin (EUCAST guidelines). At least n = 4/11 of KPC-Ec patients received ≥48 h of meropenem therapy. Sequencing identified 9 bla KPC-2, 1 bla KPC-3 and 1 bla KPC-8 determinants. KPC-Ec plasmids belonged to IncF group (FIIk replicon); conjugation confirmed bla KPC/TEM-1/OXA-9 genes transferability for 10 KPC-Ec. Although three pulsotypes (A, B, C) were identified, all KPC-Ec belonged to phylogenetic group B2. Clone B (B-B5) caused an outbreak of infection involving nine inpatients at five wards. Rep-PCR showed relatedness for seven representative KPC-Ec isolates. Here we report a LTCRF outbreak caused by a ST131-B2 E. coli associated with bla KPC-2 and bla KPC-8 genes, and the emergence of the new ST3948. Elderly people with co-morbidities are at risk for ST131 colonization. KPC-Ec clones local monitoring appears essential both to avoid their spreading among healthcare settings, and to improve therapeutic choices for LTCRF residents.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Beta-Lactamases / Doenças Transmissíveis Emergentes / Proteínas de Escherichia coli / Escherichia coli Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Beta-Lactamases / Doenças Transmissíveis Emergentes / Proteínas de Escherichia coli / Escherichia coli Idioma: En Ano de publicação: 2016 Tipo de documento: Article