ABSTRACT
Aim: The types of carbapenemases and clonal relatedness among community isolates of carbapenemase-producing Klebsiella pneumoniae in Belgrade, Serbia, were determined. Materials & methods: During the period 2016-2020, K. pneumoniae community isolates were screened for carbapenemases, and carbapenemase production was confirmed by multiplex PCR. Clonality was determined based on genetic profiles obtained by enterobacterial repetitive intergenic consensus PCR. Results: Carbapenemase genes were detected in 114 of 4800 isolates (2.4%). The most frequent gene was blaOXA-48-like. Most isolates (70.5%) were grouped in ten clusters. Cluster 11 contained 16.4% of all blaOXA-48-like-positive isolates, and all blaKPC-positive isolates were grouped in one cluster. Conclusion: Laboratory-based detection and surveillance are highly recommended in order to control the spread of resistance in community settings.
The main threat of antimicrobial resistance is the ability of bacteria to exchange the genetic material on mobile genetic elements. Carbapenemases are a group of proteins that confer resistance to carbapenem antibiotics and their genes are commonly carried on mobile genetic elements. Five of these proteins have the greatest clinical importance: KPC, VIM, IMP, NDM and OXA-48. Serbia has one of the highest levels of carbapenemase-producing Klebsiella pneumoniae among hospital isolates in Europe, but there are no available data for community isolates. Thus, we analyzed K. pneumoniae isolates from community patients in Belgrade, Serbia. There was no difference between the number of isolates with carbapenemases in comparison with other European regions where similar studies have been conducted. The predominant carbapenemase among community isolates of K. pneumoniae in our study was OXA-48. In previous studies in our country, NDM carbapenemase was the most prevalent among both community and hospital isolates. This is in accordance with the endemicity of NDM enzymes in Balkan countries, but our results suggest that there could be changes in the molecular epidemiology of carbapenemases in Serbia, which should be confirmed by future research.
