1887

Abstract

An alarming increase in the resistance rates of tigecycline and colistin among carbapenemase-producing recovered from a Greek hospital over a 3-year period (2011–2013) was investigated. The antimicrobial resistance profiles and carbapenemase gene content were determined for a collection of colistin- and/or tigecycline-resistant carbapenemase-producing isolates ( = 42), which were recovered consecutively during the study period. A gradual increase in the incidence of producers was observed from 2011 to 2013. A cluster of 21 isolates comprised tigecycline-resistant producers displayed a single antimicrobial resistance pattern. The emergence of two producers resistant to both tigecycline and colistin was documented. Furthermore, determination of the mechanisms of colistin and tigecycline resistance and molecular typing by the tri-locus sequence typing (3LST) scheme for nine isolates recovered from bloodstream infections were performed. Out of nine isolates, five tigecycline- and two colistin-resistant isolates were producers of 3LST ST101 corresponding to the international clone II recovered during 2012–2013. All nine isolates were positive for the presence of the gene of the AdeABC efflux pump. Three colistin-resistant isolates possessed novel substitutions in PmrB, which may be implicated in colistin resistance. To the best of our knowledge, this is the first report of the acquisition of tigecycline and colistin resistance among -producing of 3LST ST101 in Greece; thus, continuous surveillance and molecular characterization, prudent use of antibiotics and implementation of infection control measures for are urgent.

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2015-09-01
2019-11-15
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