Liječnički vjesnik, Vol. 137 No. 1-2, 2015.
Original scientific paper
FIRST REPORT OF CARBAPENEMASES IN OSIJEK-BARANJA COUNTY IN IMPORTED ENTEROBACTER CLOACAE ISOLATE IN VITRO SUSCEPTIBLE TO CARBAPENEMS
Branka Bedenić
Vlasta Zujić Atalić
Maja Bogdan
Nataša Beader
Karmen Godič Torkar
Senka Ižaković
Abstract
Carbapenems are often the only therapeutic option to treat infections caused by multidrug-resistant Gram-negative bacteria. Emergence of carbapenemases in the isolates of Enterobacteriaceae limits therapeutic options. Carbapenem-resistant Enterobacteriaceae have emerged since 2008 throughout Croatia. In Osijek-Baranja County carbapenem-resistant strains of Enterobacteriaceae were not reported until 2013. The first carbapenem-resistant strain (Enterobacter cloacae) was identified in August 2013 in a patient previously hospitalized at University Hospital Center Zagreb for the treatment of acute lymphoblastic leukemia. Molecular analysis revealed the production of VIM-1 metallo-b-lactamase (MBL). In spite of the metallo-b-lactamase production the strain was not resistant to imipenem and meropenem in disk-diffusion and microdilution test. This report shows that routine susceptibility testing carried out in most laboratories does not necessarily detect carbapenemase production in Enterobacteriaceae. Since these enzymes are encoded on mobile genetic elements there is a risk of horizontal spread to other enterobacterial isolates and the development of hospital outbreaks.
Keywords
Enterobacter cloacae – enzymology, drug effects; Beta-lactamases – biosynthesis; Microbial sensitivity tests; Carbapenems – pharmacology, therapeutic use; Anti-bacterial agents – pharmacology, therapeutic use; Drug resistance, bacterial; Cross infection – microbiology
Hrčak ID:
172668
URI
Publication date:
26.2.2015.
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