INDEX Riassunto pag. 2 Abstract pag 5 Introduction pag.8 Europe pag. 11 Italy pag. 12
Aim of the study pag. 15
Materials and Methods pag. 16
Phenotypic Methods pag. 16
Isolation and Identification pag. 16
Antimicrobial agents and Minimum Inhibitory
Concentration (MIC) determination pag. 16
Phenotypic test for carbapenemase production pag. 17
Synergy testing by time-kill assays pag. 19
Multiple-Combination Bactericidal Test (MCBT) pag. 20
Molecular Methods pag. 21
PCR detection of resistance genes pag. 21
Molecular typing: PFGE pag. 23
Molecular typing: MLST pag. 25
Plasmid analysis pag. 26
Results and Conclusions pag. 27
Discussion pag. 52