Search for an optimal test algorithm and characteristic of carbapenemases in nosocomial strains

Klin Lab Diagn. 2020 Dec 29;65(12):771-777. doi: 10.18821/0869-2084-2020-65-12-771-777.

Abstract

Resistance of representatives of the order Enterobacterales to ertapenem 12.1%. The highest frequency of insensitivity to this antimicrobial drug was noted among isolates of K. pneumoniae 29.4%. Among all enterobacterial isolates, resistance to imipenem and meropenem was 17.2% and 20%. The proportion of P. aeruginosa strains is 50.9% resistant to meropenem and imipenem, respectively, and 45% to doripenem. In turn, A. baumannii is resistant to meropenem - 66.6%, imipenem - 63.6%, doripenem - 83.3%. The following resistance genes were found in K. pneumoniae: NDM (n=2), KPC (n=10), OXA (n=1); in P. aeruginosa: VIM (n=8), NDM (n=1), OXA (n=1); A. baumannii OXA (n=1). At present, it is optimal to use molecular methods, in particular real-time PCR, to effectively monitor the distribution of carbapenemase producers, which tend to be widely distributed in a hospital setting. Molecular methods allow you to quickly get the result (during the working day) and give an adequate decision on antibiotic therapy.

Keywords: Enterobacterales; carbapenemases; infection; non-fermenting gram-negative bacteria.

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents / pharmacology*
  • Bacterial Proteins / genetics*
  • Cross Infection
  • Drug Resistance, Bacterial / genetics*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / enzymology*
  • Hospitals
  • Humans
  • Microbial Sensitivity Tests
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • beta-Lactamases
  • carbapenemase