Journal article
Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USA
Journal of antimicrobial chemotherapy, Vol.63(3), pp.427-437
03/2009
DOI: 10.1093/jac/dkn547
PMCID: PMC2640158
PMID: 19155227
Abstract
The emergence of bla(KPC)-containing Klebsiella pneumoniae (KPC-Kp) isolates is attracting significant attention. Outbreaks in the Eastern USA have created serious treatment and infection control problems. A comparative multi-institutional analysis of these strains has not yet been performed.
We analysed 42 KPC-Kp recovered during 2006-07 from five institutions located in the Eastern USA. Antimicrobial susceptibility tests, analytical isoelectric focusing (aIEF), PCR and sequencing of bla genes, PFGE and rep-PCR were performed. Results By in vitro testing, KPC-Kp isolates were highly resistant to all non-carbapenem beta-lactams (MIC(90)s >or= 128 mg/L). Among carbapenems, MIC(50/90)s were 4/64 mg/L for imipenem and meropenem, 4/32 mg/L for doripenem and 8/128 for ertapenem. Combinations of clavulanate or tazobactam with a carbapenem or cefepime did not significantly lower the MIC values. Genetic analysis revealed that the isolates possessed the following bla genes: bla(KPC-2) (59.5%), bla(KPC-3) (40.5%), bla(TEM-1) (90.5%), bla(SHV-11) (95.2%) and bla(SHV-12) (50.0%). aIEF of crude beta-lactamase extracts from these strains supported our findings, showing beta-lactamases at pIs of 5.4, 7.6 and 8.2. The mean number of beta-lactamases was 3.5 (range 3-5). PFGE demonstrated that 32 (76.2%) isolates were clonally related (type A). Type A KPC-Kp isolates (20 bla(KPC-2) and 12 bla(KPC-3)) were detected in each of the five institutions. rep-PCR showed patterns consistent with PFGE.
We demonstrated the complex beta-lactamase background of KPC-Kp isolates that are emerging in multiple centres in the Eastern USA. The prevalence of a single dominant clone suggests that interstate transmission has occurred.
Details
- Title: Subtitle
- Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USA
- Creators
- Andrea Endimiani - Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Research Service, Cleveland, OH 44106, USAAndrea M HujerFederico PerezChristopher R BethelKristine M HujerJennifer KroegerMargret OethingerDavid L PatersonMark D AdamsMichael R JacobsDaniel J DiekemaGerri S HallStephen G JenkinsLouis B RiceFred C TenoverRobert A Bonomo
- Resource Type
- Journal article
- Publication Details
- Journal of antimicrobial chemotherapy, Vol.63(3), pp.427-437
- Publisher
- England
- DOI
- 10.1093/jac/dkn547
- PMID
- 19155227
- PMCID
- PMC2640158
- ISSN
- 0305-7453
- eISSN
- 1460-2091
- Grant note
- R01-AI045626 / NIAID NIH HHS R01-AI063517 / NIAID NIH HHS
- Language
- English
- Date published
- 03/2009
- Academic Unit
- Infectious Diseases; Pathology; Internal Medicine
- Record Identifier
- 9983986265002771
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