Identification of carbapenemase KPC-2 encoding plasmids among environmental Enterobacteriaceae

Pojava rezistentnih sojeva Enterobacteriaceae posljedica je nerijetke uporabe karbapenemskih antibiotika u kliničkoj praksi. Karbapenemaze hidroliziraju karbapenemske antibiotike, a geni koji ih kodiraju su povezani s visokorizičnim klonovima i šire se horizontalnim prijenosom pomoću plazmida. Cilj ovog istraživanja bio je identificirati plazmide koji kodiraju KPC-2 kod Enterobacteriaceae iz okoliša. Od 30 izolata u kojima je sekvencioniranjem utvrđena prisutnost \(bla_{KPC}\) gena u njih 18 utvrđen je njihov položaj na plazmidima. Plazmidi koji kodiraju \(bla_{KPC-2}\) gen veličine su od 33.3 kb do 160 kb, među kojima su neki od njih već prethodno identificirani u bolničkom okruženju te otpadnim vodama u Hrvatskoj što ukazuje na njihovu diseminaciju u prirodni okoliš. Bitno je također istaknuti da KPC-producirajući sojevi nisu do sada izolirani iz morske vode s javne plaže u Hrvatskoj što ukazuje na mogući javnozdravstveni problem olakšanog širenja među ljudskom populacijom i potrebu za daljnjim istraživanjem njihove rasprostranjenosti u okolišu.The emergence of resistant Enterobacteriaceae strains is a consequence of the not so rare use of carbapenems in clinical practice. Carbapenemases hydrolyse carbapenems, while KPC encoding genes are associated with high-risk clones and spread through horizontal transmission. The aim of this study was to identify the plasmids encoding the KPC-2 in environmental Enterobacteriaceae. In 18 out of 30 \(bla_{KPC}\)-positive isolates their position on plasmids was determined. Plasmids encoding the \(bla_{KPC-2}\) gene range from 33.3 kb to 160 kb, among which some of them have already been identified in the hospital environment and wastewaters in Croatia, indicating their dissemination into the natural environment. It is important to note that KPC-producing strains have not yet been isolated from seawater from a public beach in Croatia which may present a public health risk due to easier spreading among the human population, as well as the need for further investigation of their distribution in the environment