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Cross-Sectional Assessment on Carbapenem-Resistant Gram-Negative Bacteria Isolated from Patients in Moldova

Vadim Nirca1, Frieder Fuchs2,3,4, Tessa Burgwinkel4,5

  • 1Molecular Biology Department, Imunotehnomed Ltd., MD-2001 Chisinau, Moldova.

Microorganisms
|February 26, 2025
PubMed

Insights

Carbapenem-resistant Gram-negative bacteria, including Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, are spreading in Moldova. Molecular analysis revealed shared resistance genes and clonal lineages with neighboring Ukraine, suggesting regional transmission.

Area of Science:

  • Medical Microbiology
  • Molecular Epidemiology
  • Antimicrobial Resistance

Background:

  • Limited data exists on the molecular epidemiology and carbapenem resistance mechanisms of Gram-negative bacteria in Moldova.
  • Carbapenem-resistant Gram-negative bacteria (CRGNB) pose a significant global health threat due to limited treatment options.

Purpose of the Study:

  • To investigate the molecular epidemiology and carbapenem resistance mechanisms of Gram-negative bacterial isolates in Moldova.
  • To identify prevalent sequence types and carbapenemase genes in CRGNB isolates.

Main Methods:

  • Collection of CRGNB isolates from a routine diagnostic laboratory in Moldova over 11 months.
  • Phenotypic and genotypic antimicrobial susceptibility testing.
  • Phylogenetic analysis and multi-locus sequence typing (MLST).

Main Results:

  • Identified clusters of carbapenem-resistant Klebsiella pneumoniae (ST101, ST395, ST377), Acinetobacter baumannii (ST2, ST19, ST78), and Pseudomonas aeruginosa (ST357, ST654).
  • Confirmed phylogenetic links to isolates from Ukraine, indicating potential regional spread.
  • Detected carbapenemase genes including blaOXA-23, blaOXA-72, blaGES-11, blaKPC-3, blaNDM-1, blaOXA-48, and blaVIM-2.

Conclusions:

  • The study suggests the spread of CRGNB in Moldova, with shared characteristics and lineages with neighboring Ukraine.
  • Likely spill-over events and regional transmission driven by successful clonal lineages are facilitating the spread of carbapenem resistance.
  • Genomic similarity among isolates supports the hypothesis of regional transmission events.
Keywords:
Gram-negative bacteriacarbapenem-resistanceepidemiologysurveillance

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