Molekulárně-epidemiologická analýza izolátů z čeledi enterobakteriaceae a rodu pseudomonas rezistentní ke karbapenenům

• Main Author: Šrámková, Anna
• Other Authors: Hrabák, Jaroslav
• Format: Doctoral Thesis
• Language: English
• Published: 2018
• Online Access: http://www.nusl.cz/ntk/nusl-389299

Currently, the development of bacterial resistance is one of the major healthcare problems. Especially, the significant continuous increase of carbapenem-resistant Gram-negative bacteria, which most often affected seriously ill hospitalized patients, is a cause for great concern. Worldwide dissemination of carbapenemase-encoding genes is largely associated with mobile genetic elements and the clonal spread of high-risk clones. The dissertation thesis is focused on a molecular-epidemiological mapping of carbapenemase-positive Gram-negative isolates detected in hospital settings throughout the Czech Republic. Since 2015, a significant increase of carbapenemase-producing Enterobacteriaceæ (CPE) was detected in our country, mainly attributed to the dissemination of OXA-48 and NDM enzymes. Studies focusing on the first big outbreaks as well as sporadic cases of OXA-48 and NDM carbapenemases were performed. Results showed that blaOXA-48-carrying plasmids, which are derivatives of the archetypal IncL plasmid pOXA-48 originally described in Turkey, play a major role in the dissemination of OXA-48 enzymes in Czech hospitals. This finding is in agreement with the data from previous studies reported worldwide. The study of NDM-positive isolates revealed that IncX3 plasmids are the main factor contributing to the...