SUMMARY
Objective: We aimed to investigate the most prevalent resistance mechanisms in selected carbapenem-resistant Enterobacteriaceae (CRE) strains as well to determine drug resistance to actual and novel antimicrobial agents.
Methods: Strains obtained from hospitalized patients were at first isolated and subsequently identified in our laboratory. Evidence of resistance mechanisms was performed by phenotypic as well as genotypic methods. Quantitative colorimetric micro-method and E-tests were used to determine antimicrobial resistance.
Results: Overall 60 Enterobacteriaceae (Klebsiella pneumoniae 59 (98.3%) and Enterobacter cloacae 1 (1.7%)) strains with decreased susceptibility to carbapenems were included in this survey. Out of them, 54 (90.0%) K. pneumoniae were ESBL, and 1 (1.7%) strain had AmpC ß-lactamase. KPC produced 25 (41.7%) and NDM 30 (50.0%) K. pneumoniae strains. Only 1 (1.7%) E. cloacae was VIM positive. The total resistance of the assessed strains was to colistin 0% and tigecycline 5.1%. KPC producers were resistant to meropenem/vaborbactam and plazomicin in both 4.0% (p=0.003 and p<0.001) and in NDM strains eravacycline resistance revealed 3.3% (p>0.05).
Conclusions: The study pointed out distinct carbapenemases production plays a various role in resistance against antimicrobial agents. In our consideration, generally are effective current drugs but novel agents directed to specific producers carbapenemases - CPE seem to be more efficacious.
Key words: ESBL, carbapenem-resistant Enterobacteriaceae (CRE), carbapenemase-producing Enterobacteriaceae (CPE), multidrug-resistance (MDR), extremely-drug resistance (XDR).
Lek Obz, 2020, 69 (11): 404-408
Ján KOREŇ 1, Zuzana HUBENÁKOVÁ 1, Tibor MALIAR 2, Vladimír KRČMÉRY 1, Martin WAWRUCH 3
1 Institute of Microbiology, Faculty of Medicine, Comenius University and University Hospital Bratislava, Slovakia
2 Department of Biotechnologies, Faculty of Natural Sciences University of SS. Cyril and Methodius in Trnava, Slovakia
3 Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University Bratislava, Slovakia
Ján KOREŇ, Zuzana HUBENÁKOVÁ, Tibor MALIAR, Vladimír KRČMÉRY, Martin WAWRUCH: In vitro efficacy of novel and current antimicrobial agents against carbapenem-resistant/carbapenemase-producing enterobacterales/enterobacteriaceae (CRE, CPE) strains isolated from hospitalized patients. Lek Obz, 2020, 69 (11): 404-408
