Klebsiella pneumoniae is the second most prevalent gram-negative rod that causes nosocomial infections in hospitalized or otherwise immunocompromised patients. It can develop multiple drug resistance that results in limited treatment options and increased use of carbapenems. Various mechanisms are related to the development of carbapenem resistance in K. pneumoniae. The aim of this study was to perform phenotypic and molecular characterization of clinical isolates of carbapenemase-producing K. pneumoniae from two outbreaks recorded in 2017 and 2018 in Clinical Center University of Sarajevo, Bosnia and Herzegovina. Identification of K. pneumoniae isolates was carried out on the basis of morphological, cultural, and biochemical characteristics. Interpretation of antimicrobial resistance was performed according to EUCAST breakpoints. There were four different resistotypes of carbapenemase-producing K. pneumoniae in this study and all were confirmed positive for bla_OXA-48 carbapenemase. Rep-PCR fingerprinting of these strains showed the presence of the two different genetic patterns with no similarity between them. The monitoring, surveillance, and molecular typing are essential to control the emergence of multidrug-resistant strains in nosocomial settings, and to reduce the frequency of outbreak occurrence.

中文翻译：

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波斯尼亚和黑塞哥维那萨拉热窝大学临床中心产生碳青霉烯酶的肺炎克雷伯菌的表征。

肺炎克雷伯氏菌是第二种最常见的革兰氏阴性杆菌，可在住院或其他免疫功能低下的患者中引起医院内感染。它可以产生多种耐药性，导致有限的治疗选择和碳青霉烯类药物的使用增加。各种机制与肺炎克雷伯菌对碳青霉烯耐药的发展有关。这项研究的目的是对2017年和2018年在波斯尼亚和黑塞哥维那萨拉热窝大学临床中心记录的两次暴发产生碳青霉烯酶的肺炎克雷伯菌的临床分离株进行表型和分子表征。肺炎克雷伯菌的鉴定分离物是根据形态，文化和生化特征进行的。抗菌素耐药性的解释根据EUCAST断点进行。在这项研究中，产生碳青霉烯酶的肺炎克雷伯菌有四种不同的抵抗型，并且都被证实对bla _OXA-48碳青霉烯酶呈阳性。这些菌株的Rep-PCR指纹图谱显示存在两种不同的遗传模式，它们之间没有相似性。监测，监视和分子分型对于控制医院环境中多药耐药菌株的出现以及减少暴发发生的频率至关重要。