1887

Abstract

This study describes the molecular characteristics and risk factors associated with carbapenem-resistant strains. Risk factors associated with KPC-producing strains were investigated in this case-control study from May 2011 to May 2013. Bacterial identification was performed by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS). Antimicrobial susceptibility was determined by broth microdilution. Carbapenemase production was assessed by both modified Hodge test (MHT) and ertapenem hydrolysis using MALDI-TOF MS. The presence of -lactamase-encoding genes was evaluated by PCR and DNA sequencing. Alterations in genes encoding outer membrane proteins were analysed by PCR and DNA sequencing as well as SDS-PAGE. Genetic relatedness among strains was determined by pulsed-field gel electrophoresis. This study included 94 patients. Longer hospitalisation, mechanical ventilation, catheters, and previous surgery were associated with KPC-producing . Sixty-eight strains showed resistance to carbapenems. Carbapenemase production was detected by MHT in 67 strains and by MALDI-TOF MS in 57. The presence of the gene was identified in 57 strains. The gene was not found in 11 carbapenem-resistant ; instead, the , , , and genes associated with OmpK35 and OmpK36 alterations were observed. Thirty-three KPC-producing strains were clonally related, and patients infected with these strains had a higher mortality rate (78.78 %). Our results show that KPC-producing was associated with several healthcare‐related risk factors, including recent surgery.

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2016-06-01
2019-10-22
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