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BioMed Research International
Volume 2014, Article ID 548960, 7 pages
Research Article

Detection of Carbapenemase-Producing Enterobacteriaceae in the Baltic Countries and St. Petersburg Area

1Department of Microbiology, University of Tartu, Ravila 19, 50411 Tartu, Estonia
2East-Tallinn Central Hospital, Ravi 18, 10138 Tallinn, Estonia
3Rīga Stradiņš University, 16 Dzirciema Street, Rīga, LV-1007, Latvia
4Smittskyddsinstitutet, Folkhälsomyndigheten, 171 82 Solna, Sweden
5Institut Pasteur in Saint Petersburg, Ul Mira 14, Saint Petersburg 197101, Russia
6St. Petersburg Hospital No. 31, Pr. Dinamo 3, Saint Petersburg 197110, Russia
7St. Petersburg Hospital No. 40, Ul Borisova 9, Sestroretsk, Saint Petersburg 197706, Russia
8Vilnius City Clinical Hospital, Antakalnio Street 57, LT-10007 Vilnius, Lithuania
9Quattromed HTI Laboratories, Väike-Paala 1, 11415 Tallinn, Estonia

Received 4 December 2013; Revised 18 January 2014; Accepted 21 January 2014; Published 4 March 2014

Academic Editor: Karmen Torkar

Copyright © 2014 Anastasia Pavelkovich et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The spread of carbapenemase-producing Enterobacteriaceae is a global problem; however, no exact data on the epidemiology of carbapenemase in the Baltic countries and St. Petersburg area is available. We aimed to evaluate the epidemiology of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in the Baltic States and St. Petersburg, Russia, and to compare the different methods for carbapenemase detection. From January to May 2012, all K. pneumoniae   and E. coli   clinical isolates from 20 institutions in Estonia, Latvia, Lithuania, and St. Petersburg, Russia were screened for carbapenem susceptibility. The IMP, VIM, GIM, NDM, KPC, and OXA-48 genes were detected using real-time PCR and the ability to hydrolyze ertapenem was determined using MALDI-TOF MS. Seventy-seven strains were found to be carbapenem nonsusceptible. From these, 15 K. pneumoniae strains hydrolyzed ertapenem and carried the gene. All of these strains carried integron 1 and most carried integron 3 as well as genes of the CTX-M-1 group. No carbapenemase-producing E. coli or K. pneumoniae strains were found in Estonia, Latvia, or Lithuania; however, NDM-positive K. pneumoniae was present in the hospital in St. Petersburg, Russia. A MALDI-TOF MS-based assay is a suitable and cost-effective method for the initial confirmation of carbapenemase production.