Inactivation of mgrB gene regulator and resistance to colistin is becoming endemic in carbapenem-resistant Klebsiella pneumoniae in Greece: A nationwide study from 2014 to 2017 - Aix-Marseille Université Access content directly
Journal Articles International Journal of Antimicrobial Agents Year : 2020

Inactivation of mgrB gene regulator and resistance to colistin is becoming endemic in carbapenem-resistant Klebsiella pneumoniae in Greece: A nationwide study from 2014 to 2017

Sophia Papagianni
  • Function : Author
Nikoletta Charalampaki
  • Function : Author
Sophia Tsiplakou
  • Function : Author
Vassiliki Papaioannou
  • Function : Author
Nikoletta Skarmoutsou
  • Function : Author
Iris Spiliopoulou
  • Function : Author
Myrto Christofidou
  • Function : Author

Abstract

Introduction: In Greece, the spread of carbapenem-resistant Enterobacteriaceae in humans has led to the reintroduction of colistin as a therapeutic agent. Unfortunately, colistin resistance with different mechanisms has emerged. The present work aims to determine the prevalence of carbapenem and colistin resistance and the corresponding mechanisms in Klebsiella pneumoniae clinical isolates from Greece. Methods: From 2014 to 2017, 288 carbapenem-resistant K. pneumoniae clinical strains were gathered from a collection of 973 isolates from eight different hospitals in Greece. Antibiotic susceptibility testing was performed using three different methods. Screening of carbapenem and colistin resistance genes was conducted using polymerase chain reaction (PCR) amplification and sequencing. Results: Among the 288 (29.6 %) carbapenem-resistant isolates, 213 (73.9%) were colistin-resistant (minimum inhibitory concentration [MIC] >2 mg/L). The KPC type was the most common carbapenemase gene (116; 40.3%), followed by VIM (41; 14.2%), NDM (33; 11.5%) and OXA-48 (22; 7.6%). Moreover, 44 (15.3%) strains co-produced two types of carbapenemases. No mcr genes were detected for colistin resistance but mutations in chromosomal genes were found. These included inactivation of the mgrB gene for 148 (69.5%) strains, including insertion sequences for 94 (44.1%), nonsense mutations for 4 (1.9%) and missense mutations for 24 (11.3%). Moreover, PCR amplification of mgrB gene was negative for 26 (12.2%) strains. Finally, 65 (30.5%) colistin-resistant strains exhibited a wild-type mgrB, the mechanisms of which remain to be elucidated. Conclusion: This study shows that K. pneumoniae clinical strains in Greece are resistant to both carbapenems and colistin and this is endemic and is likely chromosomally encoded. (C) 2020 Published by Elsevier B.V.
Fichier principal
Vignette du fichier
S0924857920300807.pdf (1.07 Mo) Télécharger le fichier
Origin : Files produced by the author(s)

Dates and versions

hal-03150172 , version 1 (22-08-2022)

Licence

Attribution - NonCommercial

Identifiers

Cite

Mouna Hamel, Stylianos Chatzipanagiotou, Linda Hadjadj, Efthimia Petinaki, Sophia Papagianni, et al.. Inactivation of mgrB gene regulator and resistance to colistin is becoming endemic in carbapenem-resistant Klebsiella pneumoniae in Greece: A nationwide study from 2014 to 2017. International Journal of Antimicrobial Agents, 2020, 55 (4), ⟨10.1016/j.ijantimicag.2020.105930⟩. ⟨hal-03150172⟩

Collections

IRD CNRS UNIV-AMU
37 View
26 Download

Altmetric

Share

Gmail Facebook X LinkedIn More