TY  -  JOUR
AU  -  Ferlini, Margherita
AU  -  Serna Ortega, Paula Andrea
AU  -  Amisano, Marco
AU  -  Giraldi, Francesco
AU  -  Andrini, Laura
AU  -  Raglio, Annibale
AU  -  Migliardi, Marco
T1  -  Escherichia coli produttore di Carbapenemasi bla-KPC
in una paziente<BR>in precedenza colonizzata
da Klebsiella pneumoniae KPC
PY  -  2012
Y1  -  2012-07-01
DO  -  10.1716/1230.13633
JO  -  GIMPIOS
JA  -  Gimpios
VL  -  2
IS  -  3
SP  -  108
EP  -  111
PB  -  Il Pensiero Scientifico Editore
SN  -  1122-407X
Y2  -  2026/06/24
UR  -  http://dx.doi.org/10.1716/1230.13633
N2  -  The production of enzymes such as the KPC (Klebsiella pneumoniae carbapenemase) has rapidly spread in K. pneumoniae, but has been rarely reported in Escherichia coli. The objective of this work is to evaluate the presence of blaKPC gene in a strain of E.coli with a reduced susceptibility to carbapenems, isolated from a inter-hepato diaphragmatic collection from a subject colonized by K. pneumoniae KPC producer. The sensitivity tests showed a low level of resistance to carbapenems: therefore were performed confirmatory phenotypic tests (modified Hodge test and synergism with boronic and dipicolinic acid and EDTA) and molecular (home made and Hy-KPC, NeoMed SRL). The strain was Hodge test modified and synergy with boronic acid positive and molecular tests confirmed the presence of the blaKPC gene. The patient was isolated with contact precautions until discharge and all contacts underwent screening tests for KPC. The isolation of E. coli KPC in an individual carrying K. pneumoniae with the same mechanism of resistance confirms the risk of transmission of the gene blaKPC between different species, for the possible transfer through conjugation of the transposon Tn4401 or of the complete plasmid. The colonization screening shows the high diffusibility of the carriers of this resistance mechanism. The spread in E. coli would have dramatic consequences: this microorganism is a common pathogen and the most frequent cause of urinary tract infections in the community setting. Furthermore, the detection of KPC carbapenemase in a strain of E.coli belonging to the uropathogenic clone ST131 is a major concern. A policy of preventive measures and an improved use of antibiotics are essential to prevent acquisition and spread of resistance.
ER  -