<abstract xmlns="http://www.w3.org/1999/xhtml">Carbapenemase-producing Enterobacterales (CPE) have emerged and spread in Romania since 2010. According to the reports of the EuSPACE (European survey of carbapenemase-producing Enterobacteriaceae) the epidemio-logical stage of the CPE expansion in Romania has shifted from sporadic occurrence in 2013 directly to inter-regional spread in 2014-2015. In this study we aimed to provide data from the timeframe when the dissemination of the carbapenemase genes in Romania began, by retrospectively analyzing CPE strains in a tertiary care university hospital. During the period of November 2012 – October 2013 we found 107 CPE (8.78%) out of 1219 non-duplicate Enterobacterales strains. 26 isolates of various Enterobacterales species carried blaNDM-1, 83 Klebsiella pneumoniae strains were positive for blaOXA-48-like and 2 of these co-harboured blaNDM-1. The increased incidence of OXA-48 producing K. pneumoniae was linked to a two-peaked hospital outbreak during February and May 2013. The percentage of 24.3% of NDM-1 producers was alarming due to the diversity of involved species and the higher resistance levels to carbapenems compared with blaOXA-48-like gene carriers. Plasmid replicon typing revealed a great diversity of plasmids in NDM-1-positive strains, belonging to incompatibility groups A/C, FII, FIIk, HI2, L and M. The strong connection between certain plasmid groups and host species suggests that the transfer of broad host-range plasmids through conjugation does not play the main role in the successful spread of blaNDM-1 among Enterobacterales species.</abstract>

Carbapenemase-producing Enterobacterales (CPE) have emerged and spread in Romania since 2010. According to the reports of the EuSPACE (European survey of carbapenemase-producing Enterobacteriaceae) the epidemio-logical stage of the CPE expansion in Romania has shifted from sporadic occurrence in 2013 directly to inter-regional spread in 2014-2015. In this study we aimed to provide data from the timeframe when the dissemination of the carbapenemase genes in Romania began, by retrospectively analyzing CPE strains in a tertiary care university hospital. During the period of November 2012 – October 2013 we found 107 CPE (8.78%) out of 1219 non-duplicate Enterobacterales strains. 26 isolates of various Enterobacterales species carried blaNDM-1, 83 Klebsiella pneumoniae strains were positive for blaOXA-48-like and 2 of these co-harboured blaNDM-1. The increased incidence of OXA-48 producing K. pneumoniae was linked to a two-peaked hospital outbreak during February and May 2013. The percentage of 24.3% of NDM-1 producers was alarming due to the diversity of involved species and the higher resistance levels to carbapenems compared with blaOXA-48-like gene carriers. Plasmid replicon typing revealed a great diversity of plasmids in NDM-1-positive strains, belonging to incompatibility groups A/C, FII, FIIk, HI2, L and M. The strong connection between certain plasmid groups and host species suggests that the transfer of broad host-range plasmids through conjugation does not play the main role in the successful spread of blaNDM-1 among Enterobacterales species.

Carbapenemase Producing Enterobacterales in Romania: Investigating the Origins

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures

Central Laboratory, Microbiology Compartment

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures,

Revista Romana de Medicina de Laborator

This work is licensed under the Creative Commons Attribution 4.0 Public License.

{"article-title":"Carbapenemase Producing Enterobacterales in Romania: Investigating the Origins"}

Carbapenemase-producing Enterobacterales (CPE) have emerged and spread in Romania since 2010. According to the reports of the EuSPACE (European survey of...

Carbapenemase Producing Enterobacterales in Romania: Investigating the Origins

Published Online: Jul 27, 2020

Page range: 341 - 348

Received: Apr 25, 2020

Accepted: Jun 25, 2020

DOI: https://doi.org/10.2478/rrlm-2020-0027

Keywords
carbapenem resistance, carbapenemase genes, plasmid, NDM-1, minimum inhibitory concentration

© 2020 Szabolcs Molnár et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 Public License.

Carbapenemase Producing Enterobacterales in Romania: Investigating the Origins

Published Online: Jul 27, 2020

Page range: 341 - 348

Received: Apr 25, 2020

Accepted: Jun 25, 2020

DOI: https://doi.org/10.2478/rrlm-2020-0027

Keywordscarbapenem resistance, carbapenemase genes, plasmid, NDM-1, minimum inhibitory concentration

© 2020 Szabolcs Molnár et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 Public License.

Keywords
carbapenem resistance, carbapenemase genes, plasmid, NDM-1, minimum inhibitory concentration