P1683 Abstract (poster session) Carbapenemase-producing Enterobacteriaceae strains in Hungary I. Damjanova, L. Jánvári, K. Kristóf, D. Szabó, É. Kenesei, L. Szikra, M. Szemenyei, M. Konkoly Thege, A. Lázár, J. Szabó, M. Farkas, A. Dobák, M. Vámos, Á. Juhász, J. Pászti, Á. Tóth* (Budapest, Székesfehérvár, Szeged, Miskolc, Nyíregyháza, Debrecen, HU)

Objectives: Carbapenem resistance among Enterobacteriaceae strains due to the production of carbapenemase enzyme is a growing clinical problem all over the world. The aim of our work was the complex characterization of carbapenemase-producing Enterobacteriaceae isolates submitted to the National Center for Epidemiology between January 2009 and August 2011. Methods: The putative production of a carbapenemase was tested by modified Hodge test. The presence of carbapenemase- and extended spectrum beta-lactamase (ESBL) encoding genes was verified using PCR followed by sequencing. The possible clonal relationships were investigated by PFGE analysis and in some cases by MLST. Results: During the study period 122 carbapenemase-producing Enterobacteriaceae isolates were investigated. Of these, 12 Klebsiella pneumoniae (KP) isolates produced KPC- enzyme, and 110 strains (43 Enterobacter cloacae (EbC), 41 KP, 20 Serratia marcescens, 3 Citrobacter freundii, 2 K. oxytoca and 1 Escherichia coli) produced VIM-type MBLs. All the KPC-producers and half of the MBL- producers proved to be ESBL-producers, as well. Ten KPC-2-producers isolated in 2009 and 2011 belonged to the ST258 KP clone. Class-1 integron carrying the blaVIM-4 gene was detected in all MBL-producers. In many isolates, the structure of integron (In238b) was found to be identical with an integron previously characterized in Hungary from Pseudomonas aeruginosa and Aeromonas hydrophila isolates. Thirty-four KP strains isolated from three nosocomial outbreaks in 2011 belonged to the Hungarian epidemic clone designated ST15, and they carried the same integron. Conclusion: Our results highlight the fact that carbapenemase-producing Enterobacteriaceae strains have emerged rapidly in our country. The increasing number of these strains demonstrates the need of a continuous surveillance and forceful activities of infection control in Hungary.