Epidemiological Investigation of Legionella pneumophila Serogroup 2 to 14 Isolates from Water Samples by Amplified Fragment Length Polymorphism and Sequence-Based Typing and Detection of Virulence Traits.

Unlabelled: The aim of this study is to explore the dispersion, clonality, and virulence of Legionella pneumophila serogroups 2 to 14 in the Greek environment. Eighty L. pneumophila serogroup 2 to 14 strains isolated from water distribution systems of hotels, hospitals, athletic venues, and ferries in Greece were tested by monoclonal antibodies (MAbs) for serogroup discrimination and molecularly by amplified fragment length polymorphism (AFLP) for genetic diversity.

Characterization of KPC-encoding plasmids from two endemic settings, Greece and Italy.

Objectives: Global dissemination of KPC-type carbapenemases is mainly associated with the spread of high-risk clones of Klebsiella pneumoniae and of KPC-encoding plasmids. In this study, we explored the population structure of KPC-encoding plasmids from the recent epidemics of KPC-producing K. pneumoniae (KPC-Kp) in Greece and Italy, the two major European endemic settings.

Characterisation of IncA/C2 plasmids carrying an In416-like integron with the blaVIM-19 gene from Klebsiella pneumoniae ST383 of Greek origin.

The complete nucleotide sequences of three multidrug resistance (MDR) IncA/C-like plasmids from Enterobacteriaceae isolates carrying the VIM-type carbapenemase-encoding integrons In4863 (blaVIM-19-aacA7-dfrA1-ΔaadA1-smr2) or In4873 (blaVIM-1-aacA7-dfrA1-ΔaadA1-smr2) were determined, which are the first In416-like elements identified in Greece. Plasmids pKP-Gr642 and pKP-Gr8143 were from Klebsiella pneumoniae ST383 isolates, whereas plasmid pEcl-Gr4873 was from an Enterobacter cloacae ST88 isolate. Sequencing showed that pKP-Gr642 (162787bp) and pKP-Gr8143 (154395bp) consisted of the type 1 IncA/C2 conserved backbone, the blaCMY-2-like gene-containing region, and the ARI-B (with the sul2 gene) and ARI-A (with a class 1 integron) resistance islands, like the plasmid pUMNK88_161 from the USA.

Burkholderia cenocepacia bacteremia without respiratory colonization in an adult intensive care unit: epidemiological and molecular investigation of an outbreak.

Background: To investigate an outbreak of Burkholderia cenocepacia bacteremia. Observational study and chart review in a multidisciplinary adult Intensive Care Unit (ICU) at a tertiary care hospital.

Methods: Patients' demographic variables, comorbid conditions, ICU admission diagnosis, disease severity and outcome were analyzed.

Characterization of pKP1780, a novel IncR plasmid from the emerging Klebsiella pneumoniae ST147, encoding the VIM-1 metallo-β-lactamase.

Objectives: To determine the complete nucleotide sequence of the VIM-1-encoding plasmid pKP1780 from Klebsiella pneumoniae ST147 representing a distinct group of IncR replicons.

Methods: The plasmid pKP1780 was from a K. pneumoniae clinical strain (KP-1780) isolated in Greece in 2009.

Antimicrobial activity of prulifloxacin in comparison with other fluoroquinolones against community-acquired urinary and respiratory pathogens isolated in Greece.

Prulifloxacin, the prodrug of ulifloxacin, is a broad-spectrum fluoroquinolone rather recently introduced in certain European countries. We compared the antimicrobial potency of ulifloxacin with that of other fluoroquinolones against common urinary and respiratory bacterial pathogens. The microbial isolates were prospectively collected between January 2007 and May 2008 from patients with community-acquired infections in Greece.

Characterization of pKP1433, a novel KPC-2-encoding plasmid from Klebsiella pneumoniae sequence type 340.

The nucleotide sequence of pKP1433 (55,417 bp), a blaKPC-2-carrying plasmid from Klebsiella pneumoniae sequence type 340, was determined. pKP1433 displayed extensive sequence and structural similarities with the IncN plasmids possessing the KPC-2-encoding Tn4401b isoform. However, the replication, partitioning, and stability of pKP1433 were determined by sequences related to diverse non-IncN plasmids.

Dissemination of blaVIM in Greece at the peak of the epidemic of 2005-2006: clonal expansion of Klebsiella pneumoniae clonal complex 147.

VIM-producing Klebsiella pneumoniae (n = 21) isolated from ten Greek hospitals during 2003-2007 were characterized with multilocus sequence typing (MLST), semi-automated repetitive sequence-based PCR (rep-PCR) (Diversilab), plasmid replicon typing, serotyping and screening for multiple resistance determinants. The isolates were selected to represent different strain clusters (defined by >80% similarity) according to pulsed-field gel electrophoresis. MLST identified three major clonal complexes (CCs); CC147 (n = 8), CC18 (n = 5) and CC14 (n = 3).

An update of the evolving epidemic of blaKPC-2-carrying Klebsiella pneumoniae in Greece (2009-10).

Objectives: To follow the epidemic of KPC-2-producing Klebsiella pneumoniae in Greece.

Methods: KPC-2-producing isolates (n = 378) were collected during January 2009-April 2010 in 40 Greek hospitals. bla(KPC) and bla(VIM) were detected by PCR.

Characterization of metallo-beta-lactamase VIM-27, an A57S mutant of VIM-1 associated with Klebsiella pneumoniae ST147.

VIM-27 metallo-β-lactamase, an Ala(57) → Ser variant of VIM-1, was identified in three Klebsiella pneumoniae isolates belonging to sequence type 147. bla(VIM-27) was part of a class 1 integron carried by non-self-transferable plasmids. Kinetic parameters and MIC determinations indicated that VIM-27 hydrolyzed most β-lactams, especially imipenem and cefoxitin, less effectively than VIM-1.

Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus outbreak among healthcare workers in a long-term care facility.

Background: We investigated an outbreak of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections that occurred among healthcare workers (HCWs) but not among residents of a long-term care facility (LTCF).

Methods: Cases of S. aureus infection were sought by reviewing the medical records of residents and HCWs.

Outbreak of infections due to KPC-2-producing Klebsiella pneumoniae in a hospital in Crete (Greece).

Starting in May 2007, an ongoing outbreak of infections due to carbapenem resistant KPC-2-producing Klebsiella pneumoniae occurred in a tertiary care hospital in Crete (Greece). The outbreak involved 22 patients, none of whom had travelled in a country with known high prevalence of such isolates. KPC-producing K.

Antimicrobial resistance of Esherichia coli urinary isolates from primary care patients in Greece.

Background: Most of antimicrobial susceptibility surveillance studies focus on isolates from hospitalized patients. A retrospective analysis of microbiological data of the antimicrobial susceptibility of Escherichia coli urinary isolates from primary care patients in Greece was performed here.

Material/methods: The in vitro susceptibility to ampicillin, amoxicillin/clavulanate, cefaclor, cefprozil, trimethoprim-sulfamethoxazole (cotrimoxazole), amikacin, and norfloxacin of 2460 E.

Trends in antimicrobial resistance of Acinetobacter baumannii clinical isolates from hospitalised patients in Greece and treatment implications.

This study analysed the proportions of Acinetobacter baumannii isolates resistant to various antibiotics that were recovered from patients hospitalised in Greek hospitals between 1996 and 2006. The microbiological data were derived from the ongoing WHONET Greek System for the Surveillance of Antibiotic Resistance. There were increases in the proportions of A.

Correlation between bacterial indicators and bacteriophages in sewage and sludge.

The use of bacteriophages as potential indicators of faecal pollution has recently been studied. The correlation of the number of bacterial indicators and the presence of three groups of bacteriophages, namely somatic coliphages (SOMCPH), F-RNA-specific phages (FRNAPH) and phages of Bacteroides fragilis (BFRPH), in raw and treated wastewater and sludge is presented in this study. Raw and treated wastewater and sewage sludge samples from two wastewater treatment plants in Athens were collected on a monthly basis, over a 2-year period, and analysed for total coliforms, Escherichia coli, intestinal enterococci and the three groups of bacteriophages.

Sources of diversity of carbapenem resistance levels in Klebsiella pneumoniae carrying blaVIM-1.

Objectives: To elucidate the mechanisms responsible for the diversity of beta-lactam resistance phenotypes among isolates of a VIM-1-producing Klebsiella pneumoniae (VPKP) strain that is endemic in Greek hospitals.

Methods: Five VPKP clinical isolates were studied. MICs of beta-lactams were determined by agar dilution.

Emergence of Proteus mirabilis carrying the bla metallo-beta-lactamase gene.

Seven genetically related Proteus mirabilis clinical isolates from a hospital in Thessaloniki, Greece, exhibited decreased susceptibility to imipenem and carried a bla(VIM-1) metallo-beta-lactamase gene. PCR mapping revealed that bla(VIM-1) was part of a class 1 integron that was probably located in the chromosome and also included the aacA7, dhfr and aadA genes. This is the first description of the bla(VIM-1) metallo-beta-lactamase gene in P.

Transferable DHA-1 cephalosporinase in Escherichia coli.

Three Escherichia coli isolates resistant to third-generation cephalosporins but negative for extended-spectrum beta-lactamase production were isolated from hospitalised patients in Zagreb, Croatia, during June 2003 to February 2004. Resistance was due to the inducible production of a DHA-1 cephalosporinase. Each isolate contained an integron-associated bla(DHA-1)-ampR sequence carried by similar-sized plasmids, of which one was self-transferable.