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Wiener klinische Wochenschrift
Erschienen in:

01.06.2016 | original article

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

verfasst von: Branka Bedenić, Nataša Firis, Vesna Elveđi-Gašparović, Marija Krilanović, Krešimir Matanović, Iva Štimac, Josefa Luxner, Jasmina Vraneš, Tomislav Meštrović, Gernot Zarfel, Andrea Grisold

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 11-12/2016

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Summary Background Methods Results Conclusions

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.
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 polymerase chain reaction (PCR) followed by sequencing of bla ampC genes. Quinolone resistance determinants (qnr genes) were characterized by PCR. Genotyping of the isolates was performed by repetitive element sequence (rep)-PCR and pulsed-field gel electrophoresis (PFGE).
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 bla ampc genes revealed CMY-16 β-lactamase in all but one strain. Bla cmy-16 was carried by a non-conjugative plasmid which did not belong to any known plasmid-based replicon typing (PBRT) group. 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.
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.
Vorheriger Artikel Tracheostomy is associated with decreased hospital mortality after moderate or severe isolated traumatic brain injury
Nächster Artikel Treatment intensification with boceprevir in HIV-positive patients with acute HCV-genotype 1 infection at high risk for treatment failure
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Metadaten
Titel
Emergence of multidrug-resistant Proteus mirabilis in a long-term care facility in Croatia
verfasst von
Branka Bedenić
Nataša Firis
Vesna Elveđi-Gašparović
Marija Krilanović
Krešimir Matanović
Iva Štimac
Josefa Luxner
Jasmina Vraneš
Tomislav Meštrović
Gernot Zarfel
Andrea Grisold
Publikationsdatum
01.06.2016
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 11-12/2016
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-016-1005-x

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