Clonal dissemination of multilocus sequence type ST15 KPC-2-producing Klebsiella pneumoniae in Bulgaria
Corresponding Author
Rumyana Markovska
Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
Rumyana Markovska, Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, 2, Zdrave str., 1431 Sofia, Bulgaria. e-mail: [email protected]Search for more papers by this authorTemenuga Stoeva
Department of Microbiology, Medical University of Varna, Varna, Bulgaria
Search for more papers by this authorLyudmila Boyanova
Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorDaniela Dacheva
Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorRadka Kaneva
Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorVanyo Mitev
Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorIvan Mitov
Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorCorresponding Author
Rumyana Markovska
Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
Rumyana Markovska, Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, 2, Zdrave str., 1431 Sofia, Bulgaria. e-mail: [email protected]Search for more papers by this authorTemenuga Stoeva
Department of Microbiology, Medical University of Varna, Varna, Bulgaria
Search for more papers by this authorLyudmila Boyanova
Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorDaniela Dacheva
Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorRadka Kaneva
Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorVanyo Mitev
Molecular Medicine Center, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorIvan Mitov
Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria
Search for more papers by this authorAbstract
A total of 36 consecutive clinical and two fecal-screening carbapenem-resistant Klebsiella pneumoniae isolates from two Bulgarian university hospitals (Varna and Pleven) were investigated. Susceptibility testing, conjugation experiments, and plasmid replicon typing were carried out. Beta-lactamases were characterized by isoelectric focusing, PCR, and sequencing. Clonal relatedness was investigated by RAPD and multilocus sequence typing (MLST). Most of the isolates demonstrated multidrug resistance profile. Amikacin and tigecycline retained good activity with susceptibility rates of 95 and 87%, respectively. The resistance rate to colistin was 63%. Six RAPD- and MLST-types were identified: the dominating MLST-type was ST15 (27 isolates), followed by ST76 (six isolates), and ST1350 (two isolates). ST101, ST258, and ST151 were detected once. All except one of the K. pneumoniae produced KPC-2, mostly in combination with CTX-M-15, while for one isolate (ST101) the enzymes OXA-48 and CTX-M-14 were found. All KPC-2-producing transconjugants revealed the presence of IncFII plasmid. The OXA-48- and CTX-M-14-producing isolate showed the presence of L/M replicon type. The dissemination of KPC-2-producing K.pneumoniae in Bulgaria is mainly due to the sustained spread of successful ST15 clone and to a lesser extent of ST76 clone. This is the first report of OXA-48 producing ST101 K. pneumoniae in Bulgaria.
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