Carbapenem-resistant and carbapenem-susceptible isogenic isolates of Klebsiella pneumoniae ST101 causing infection in a tertiary hospital.

September 15, 2015 at 3:33 pm

BMC Microbiol. 2015 Sep 3;15(1):177.

Cubero M1,2, Cuervo G3, Dominguez MÁ4,5, Tubau F6,7, Martí S8,9, Sevillano E10, Gallego L11, Ayats J12,13, Peña C14,15, Pujol M16,17, Liñares J18,19, Ardanuy C20,21.

1Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. mcubero@bellvitgehospital.cat.

2Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. mcubero@bellvitgehospital.cat.

3Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. guillermo.cuervos@bellvitgehospital.cat.

4Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. adominguez@bellvitgehospital.cat.

5Spanish Network for Research in Infectious Diseases (RD06/0008), Instituto de Salud Carlos III, Madrid, Spain. adominguez@bellvitgehospital.cat.

6Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. f.tubau@bellvitgehospital.cat.

7Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. f.tubau@bellvitgehospital.cat.

8Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. smartinm@bellvitgehospital.cat.

9Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. smartinm@bellvitgehospital.cat.

10Department of Immunology, Microbiology, and Parasitology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Bizkaia, Spain. elena.sevillano@ehu.es.

11Department of Immunology, Microbiology, and Parasitology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Bizkaia, Spain. lucia.gallego@ehu.es.

12Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. jayats@bellvitgehospital.cat.

13Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. jayats@bellvitgehospital.cat.

14Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. cpena@bellvitgehospital.cat.

15Spanish Network for Research in Infectious Diseases (RD06/0008), Instituto de Salud Carlos III, Madrid, Spain. cpena@bellvitgehospital.cat.

16Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. mpujol@bellvitgehospital.cat.

17Spanish Network for Research in Infectious Diseases (RD06/0008), Instituto de Salud Carlos III, Madrid, Spain. mpujol@bellvitgehospital.cat.

18Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. fina.linares@bellvitgehospital.cat.

19Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. fina.linares@bellvitgehospital.cat.

20Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. c.ardanuy@bellvitgehospital.cat.

21Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. c.ardanuy@bellvitgehospital.cat.

Abstract

BACKGROUND:

In this study we describe the clinical and molecular characteristics of an outbreak due to carbapenem-resistant Klebsiella pneumoniae (CR-KP) producing CTX-M-15 and OXA-48 carbapenemase. Isogenic strains, carbapenem-susceptible K. pneumoniae (CS-KP) producing CTX-M-15, were also involved in the outbreak.

RESULTS:

From October 2010 to December 2012 a total of 62 CR-KP and 23 CS-KP were isolated from clinical samples of 42 patients (22 had resistant isolates, 14 had susceptible isolates, and 6 had both CR and CS isolates). All patients had underlying diseases and 17 of them (14 patients with CR-KP and 3 with CS-KP) had received carbapenems previously. The range of carbapenem MICs for total isolates were: imipenem: 2 to >32 μg/ml vs. <2 μg/ml; meropenem: 4 to >32 μg/ml vs. <2 μg/ml; and ertapenem: 8 to >32 μg/ml vs. <2 μg/ml. All the isolates were also resistant to gentamicin, ciprofloxacin, and cotrimoxazole. Both types of isolates shared a common PFGE pattern associated with the multilocus sequence type 101 (ST101). The bla CTX-M-15 gene was detected in all the isolates, whereas the bla OXA-48 gene was only detected in CR-KP isolates on a 70 kb plasmid.

CONCLUSIONS:

The clonal spread of K. pneumoniae ST101 expressing the OXA-48 and CTX-M-15 beta-lactamases was the cause of an outbreak of CR-KP infections. CTX-M-15-producing isolates lacking the bla OXA-48 gene coexisted during the outbreak.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559076/pdf/12866_2015_Article_510.pdf

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Biología Molecular, Epidemiología, Metodos diagnosticos, Resistencia bacteriana, Sepsis, Update. Tags: .

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