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Abstract

Background and aim

A multicentre nationwide surveillance study was conducted in Greek hospitals to evaluate epidemiology of carbapenemase-producing clinical isolates, and their susceptibilities to last-line antibiotics. Minimum inhibitory concentrations (MICs) were evaluated by Etest, colistin MICs were also evaluated by broth microdilution SensiTest (now known as ComASP) Colistin. Carbapenemase genes were detected by PCR. Clonal relatedness was assessed by PFGE. Isolates were prospectively collected between November 2014 and April 2016, from 15 hospitals. : Among 394 isolates, carbepenemase (KPC) remained the most prevalent carbapenemase (66.5%). NDM was the second most prevalent (13.7%), identified in 12 hospitals, followed by VIM (8.6%). OXA-48- and double carbapenemase-producers remained rare (3.6%, 6.3%, respectively). Carbapenemase-producing isolates showed high resistance to last-line antibiotics. Gentamicin and colistin were the most active in vitro with 61.9% and 59.6% of the isolates to be inhibited at ≤ 2mg/L, followed by fosfomycin (susceptibility (S): 58.4%) and tigecycline (S: 51.5%). Ceftazidime/avibactam inhibited 99.6% of KPC and 100% of OXA-48-like-producing isolates, while temocillin was active against 58% of KPC isolates at urinary breakpoint of ≤ 32mg/L* and only 2.7% at systemic breakpoint of ≤ 8mg/L. NDM-producing isolates belonged mainly to one clone, whereas KPC, VIM, OXA-48 and double carbapenemase-producers were mainly polyclonal. : KPC remains the predominant carbapenemase among in Greece, followed by NDM, whereas changing trends of resistance rates to last-line antimicrobials against carbapenemase-producing with the exception of ceftazidime/avibactam mandates continuing surveillance to support clinical practice.

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A corrected article has been published for this content:
Erratum for Euro Surveill. 2018;23(31)
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2018-08-02
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.30.1700775
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Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Irene+Galani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Galani Irene</a>, <a href="/search?value1=Ilias+Karaiskos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Karaiskos Ilias</a>, <a href="/search?value1=Irene+Karantani&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Karantani Irene</a>, <a href="/search?value1=Vassiliki+Papoutsaki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papoutsaki Vassiliki</a>, <a href="/search?value1=Sofia+Maraki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maraki Sofia</a>, <a href="/search?value1=Vassiliki+Papaioannou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papaioannou Vassiliki</a>, <a href="/search?value1=Polyzo+Kazila&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kazila Polyzo</a>, <a href="/search?value1=Helen+Tsorlini&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tsorlini Helen</a>, <a href="/search?value1=Nikoletta+Charalampaki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Charalampaki Nikoletta</a>, <a href="/search?value1=Marina+Toutouza&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Toutouza Marina</a>, <a href="/search?value1=Helen+Vagiakou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vagiakou Helen</a>, <a href="/search?value1=Konstantinos+Pappas&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pappas Konstantinos</a>, <a href="/search?value1=Anna+Kyratsa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kyratsa Anna</a>, <a href="/search?value1=Konstantina+Kontopoulou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kontopoulou Konstantina</a>, <a href="/search?value1=Olga+Legga&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Legga Olga</a>, <a href="/search?value1=Efthymia+Petinaki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Petinaki Efthymia</a>, <a href="/search?value1=Helen+Papadogeorgaki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papadogeorgaki Helen</a>, <a href="/search?value1=Efrosini+Chinou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chinou Efrosini</a>, <a href="/search?value1=Maria+Souli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Souli Maria</a>, <a href="/search?value1=Helen+Giamarellou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Giamarellou Helen</a>, <a href="/search?value1=on+behalf+of+the+study+collaborators&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the study collaborators</a></span>. Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(31):pii=1700775. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.30.1700775" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.30.1700775</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 17 Nov 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 29 Mar 2018 </span> </p>
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