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Emergence of multidrug-resistant Proteus mirabilis in a long-term care facility in Croatia (CROSBI ID 227308)

Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija

Bedenić, Branka ; Firis, Nataša ; Elveđi- Gašparović, Vesna ; Krilanović, Marija ; Matanović, Krešimir ; Štimac, Iva ; Luxner, Josefa ; Vraneš, Jasmina ; Zarfel, Gernot ; Grisold, Andrea Emergence of multidrug-resistant Proteus mirabilis in a long-term care facility in Croatia // Wiener klinische Wochenschrift, 128 (2016), 11-12; 404-413. doi: 10.1007/s00508-016-1005-x

Podaci o odgovornosti

Bedenić, Branka ; Firis, Nataša ; Elveđi- Gašparović, Vesna ; Krilanović, Marija ; Matanović, Krešimir ; Štimac, Iva ; Luxner, Josefa ; Vraneš, Jasmina ; Zarfel, Gernot ; Grisold, Andrea

engleski

Emergence of multidrug-resistant Proteus mirabilis in a long-term care facility in Croatia

SUMMARY Purpose: An increased frequency of Proteus mirabilis isolates resistant to expanded- spectrum cephalosporins was observed recently in a long-term care facility in Zagreb (Godan). The aim of this study was the molecular characterization of resistance mechanisms to new cephalosporins in P. mirabilis isolates from this nursing home. Methods: Thirty-eight isolates collected from 2013-2015 showing reduced susceptibility to ceftazidime were investigated. Antibiotic susceptibilities were determined by broth microdilution method. Inhibitor-based tests were performed to detect extended-spectrum (ESBLs) and AmpC β-lactamases. AmpC β- lactamases were characterized by PCR followed by sequencing of blaampC genes. Quinolone resistance determinants (qnr genes) were characterized by PCR. Genotyping of the isolates was performed by rep-PCR and PFGE (pulsed-field gel electrophoresis). Results:Presence of an AmpC β-lactamase was confirmed in all isolates by combined-disk test with phenylboronic acid. All isolates were resistant to amoxicillin alone and combined with clavulanate, cefotaxime, ceftriaxone, cefoxitin, and ciprofloxacin, but susceptible to cefepime, imipenem, and meropenem. PCR followed by sequencing using primers targeting blaampc genes revealed CMY-16 β-lactamase in all but one strain. Blacmy-16 was carried by a non-conjugative plasmid which did not belong to any known plasmid PCR-based incompatibility group (PBRT). Rep-PCR identified one large clone consisting of 15 isolates, three pairs or related isolates, one triplet and four singletons. PFGE confirmed the clonality of the isolates. Conclusions: This is the first report of multidrug resistant P. mirabilis in a nursing home in Croatia. Cephalosporin resistance was due to plasmid-mediated AmpC β- lactamase CMY- 16.

CMY-16 ; Proteus mirabilis ; Amp C β-lactamases ; conjugative plasmid ; clonal dissemination

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Podaci o izdanju

128 (11-12)

2016.

404-413

objavljeno

0043-5325

10.1007/s00508-016-1005-x

Povezanost rada

Temeljne medicinske znanosti

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