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Molecular characterization of extended spectrum β-lactamases, ampccephalosporinases and carbapenemases in klebsiellapneumoniae causing bacteremia at charles nicolle Hospital of Tunisia
Elaa Maamar1, Samia Hammami2, Sana Ferjani1, Zaineb Hamzaoui1, Asma Jlizi3, M Saidani4, A Slim4, I Boutiba-Ben Boubaker4
1 University of Tunis El Manar, Faculty of Medicine of Tunis -LR99ES09 Research Laboratory «Antimicrobial resistance», 1007 Tunis-, Tunisia
2 University of Tunis El Manar, Faculty of Medicine of Tunis -LR99ES09 Research Laboratory «Antimicrobial resistance», 1007 Tunis; Charles Nicolle Hospital, Laboratory of Microbiology,1006-Tunis; University of Gafsa, Faculty of Sciences of Gafsa, Tunisia
3 Rabta University Hospital, Laboratory of Microbiology,1007-Tunis-, Tunisia
4 University of Tunis El Manar, Faculty of Medicine of Tunis -LR99ES09 Research Laboratory «Antimicrobial resistance», 1007 Tunis; Charles Nicolle Hospital, Laboratory of Microbiology, 1006-Tunis, Tunisia
Correspondence Address:
Elaa Maamar
University of Tunis El Manar, Faculty of Medicine of Tunis -LR99ES09 Research Laboratory «Antimicrobial resistance», 1007 Tunis
Tunisia
 Source of Support: None, Conflict of Interest: None
DOI: 10.5530/ami.2016.2.10
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Purpose of the Study: This study was conducted to detect and characterize the genes encoding extended spectrum β-lactamases and associated β-lactamases (carbapenemases and Ambler Class C β-lactamases).
Patients and Methods: In 2011, out of the 65 non-duplicative Klebsiellapneumoniae collected from blood culture at Charles Nicolle hospital of Tunisia, 36 were resistant to 3rd generation cephalosporin.
Results: All strains showed a double disk synergy test positive. They were mainly isolated in intensive care unit (31%). They were frequently resistant to most antibiotics tested, except colistin and tigecyclin. Five isolates (13%) showed reduced susceptibility to carbapenems. blaCTX-M-15 was harbored by 35 strains and blaSHV-12 by one. blaCTX-M-15 were associated with blaTEM-1 (n=21), blaOXA-48 and blaCMY-2 (n=1) and blaOXA-48and blaTEM-1 (n=4). The conjugation wassuccessfulfor4/5 strains (3 harboring blaCTX-M-15 and one blaSHV-12). The plasmids carrying the blaCTX-M-15 were assigned to IncN or IncL/M only for 2 strains. The remaining blaCTX-M-15-carrying plasmid was negative for all of the replicons tested as well as the blaSHV-12-carrying plasmid.
Conclusion: Our results confirm the spread of CTX-M-15 in our institution. To our knowledge, this is the first report of K. pneumoniae coproducing CTX-M-15, CMY-2 and OXA-48. The implementation of preventive measures against the spread of these multiresistant bacteria is needed.
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