First report of KPC-producing Klebsiella pneumoniae in Croatia

In February 2011. a 78 old male patient was admitted to Clinical Hospital Center Zagreb with subdural haematoma. K. pneumoniae with reduced susceptibility to carbapenems was isolated. The aim of the study was to characterize the carbapenem-resistance mechanisms of the strain. The isolate showed resistance or intermediate susceptibility to expanded-spectrum cephalosporins, β-lactam combinations with inhibitors, carbapenems and gentamicin but remained susceptible only to ciprofloxacin and colistin. Modified Hodge test was consistent with the activity of carbapenemases. The MBL test for metallo-β-lactamase was negative indicating the absence of metallo β-lactamase. Imipenem resistance was not transferred to E. coli recipient strain by conjugation. PCR revealed the presence of blaKPC, blaTEM genes and blaSHV genes. Sequencing of blaKPC gene revealed the presence of KPC-2 β-lactamase. belong to ST37 clone by MLST. Infection control efforts limited the spread of KPC-producing clone of K. pneumoniae in our hospital so far. To our knowledge this is the first report of a KPC-producing K. pneumoniae in Croatia. This report demonstrates the need to monitor both hospitalized patients for the further emergence of carbapenem resistance in K. pneumoniae. Continuous surveillance in tracking KPC-producing K. pneumoniae in the hospitals is necessary to prevent their spread to other hospitals and community