ABSTRACT
We report the first confirmed cases of NDM-1-producing Klebsiella pneumoniae infections in two hospitals in Bulgaria. The isolates were diverse in terms of plasmid and co-resistance gene content. K. pneumoniae PR2682, causing sepsis in patient with polytrauma due to traffic accident, harbored blaNDM-1,blaCMY-4, blaCTX-M-15, blaSHV-1, blaTEM-1b, qnrB, and aac(6')-Ib. blaNDM-1 was transferable by conjugation and located on an IncA/C plasmid of 176-kb, which also carried blaCMY-4, blaCTX-M-15, blaTEM-1b, and qnrB. K. pneumoniae PR2830, causing urinary tract infection in prostate cancer patient, harbored blaNDM-1,blaSHV-1, blaTEM-1, and aac(6')-Ib. blaNDM-1 was carried on an 86-kb IncA/C plasmid transferable by conjugation together with blaTEM-1, and aac(6')-Ib. Multilocus sequence typing indicated that the two isolates belonged to sequence type ST11. The emergence of NDM-1-producing K. pneumoniae indicates that blaNDM-1-mediated resistance is already disseminated among Enterobacteriaceae in Bulgaria. Our results further confirm the role of the Balkans as a secondary reservoir where NDM-encoding genes originate.
Subject(s)
Klebsiella Infections/microbiology , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/metabolism , beta-Lactamases/metabolism , Aged, 80 and over , Bacterial Proteins/metabolism , Bulgaria , Hospitals , Humans , Male , Middle AgedABSTRACT
This report describes the first identification of OXA-24 carbapenemase-producing Acinetobacter baumannii isolates from Bulgaria. According to national surveillance data A. baumannii along with Pseudomonas aeruginosa are the most troublesome microorganisms in hospital environment with high rates of acquired carbapenem resistance. In the present study real-time multiplex PCR was performed to identify the most common carbapenemase genes in 15 non-duplicate carbapenem-resistant A. baumannii isolates collected in 2012. The results showed lack of KPC, GES, VIM, IMP-type enzymes. Four A. baumannii isolates tested positive by PCR for the acquired OXA-24 together with the intrinsic OXA-51 carbapenemase. OXA-24 and OXA-23 were determined as co-existent in one isolate. Two isolates were identified with OXA-23 in addition to the OXA-51 carbapenemase.
Subject(s)
Acinetobacter Infections/microbiology , Acinetobacter baumannii/enzymology , Acinetobacter baumannii/isolation & purification , beta-Lactamases/genetics , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/genetics , Bulgaria , Microbial Sensitivity Tests , Multiplex Polymerase Chain Reaction , Real-Time Polymerase Chain Reaction , beta-Lactams/pharmacologyABSTRACT
We report the identification of OXA-48-producing Klebsiella pneumoniae, causing peritonitis in a cancer patient admitted to the Oncology Hospital in Sofia. The isolate had reduced susceptibility to carbapenems but remained susceptible to extended-spectrum cephalosporins. PCR and sequencing confirmed the presence of blaOXA-48 gene flanked by two intact copies of IS1999 on truncated ΔTn1999.1. This transposon was located on unusual non-typeable 29-kb plasmid that could be transferred only by transformation. Multilocus sequence typing (MLST) indicated the presence of the sequence type ST530.This is the first documented infection due to OXA-48-producing Enterobacteriaceae strain in Bulgaria.