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Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center.
Antimicrob Agents Chemother. 2004 Dec; 48(12):4793-9.AA

Abstract

From April 2000 to April 2001, 24 patients in intensive care units at Tisch Hospital, New York, N.Y., were infected or colonized by carbapenem-resistant Klebsiella pneumoniae. Pulsed-field gel electrophoresis identified a predominant outbreak strain, but other resistant strains were also recovered. Three representatives of the outbreak strain from separate patients were studied in detail. All were resistant or had reduced susceptibility to imipenem, meropenem, ceftazidime, piperacillin-tazobactam, and gentamicin but remained fully susceptible to tetracycline. PCR amplified a blaKPC allele encoding a novel variant, KPC-3, with a His(272)-->Tyr substitution not found in KPC-2; other carbapenemase genes were absent. In the outbreak strain, KPC-3 was encoded by a 75-kb plasmid, which was transferred in vitro by electroporation and conjugation. The isolates lacked the OmpK35 porin but expressed OmpK36, implying reduced permeability as a cofactor in resistance. This is the third KPC carbapenem-hydrolyzing beta-lactamase variant to have been reported in members of the Enterobacteriaceae, with others reported from the East Coast of the United States. Although producers of these enzymes remain rare, the progress of this enzyme group merits monitoring.

Authors+Show Affiliations

Antibiotic resistance Monitoring and Reference Laboratory, Specialist and Reference Microbiology Division-Colindale, Health Protection Agency, London, United Kingdom. neil.woodford@hpa.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15561858

Citation

Woodford, Neil, et al. "Outbreak of Klebsiella Pneumoniae Producing a New Carbapenem-hydrolyzing Class a Beta-lactamase, KPC-3, in a New York Medical Center." Antimicrobial Agents and Chemotherapy, vol. 48, no. 12, 2004, pp. 4793-9.
Woodford N, Tierno PM, Young K, et al. Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center. Antimicrob Agents Chemother. 2004;48(12):4793-9.
Woodford, N., Tierno, P. M., Young, K., Tysall, L., Palepou, M. F., Ward, E., Painter, R. E., Suber, D. F., Shungu, D., Silver, L. L., Inglima, K., Kornblum, J., & Livermore, D. M. (2004). Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center. Antimicrobial Agents and Chemotherapy, 48(12), 4793-9.
Woodford N, et al. Outbreak of Klebsiella Pneumoniae Producing a New Carbapenem-hydrolyzing Class a Beta-lactamase, KPC-3, in a New York Medical Center. Antimicrob Agents Chemother. 2004;48(12):4793-9. PubMed PMID: 15561858.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A beta-lactamase, KPC-3, in a New York Medical Center. AU - Woodford,Neil, AU - Tierno,Philip M,Jr AU - Young,Katherine, AU - Tysall,Luke, AU - Palepou,Marie-France I, AU - Ward,Elaina, AU - Painter,Ronald E, AU - Suber,Deborah F, AU - Shungu,Daniel, AU - Silver,Lynn L, AU - Inglima,Kenneth, AU - Kornblum,John, AU - Livermore,David M, PY - 2004/11/25/pubmed PY - 2005/1/19/medline PY - 2004/11/25/entrez SP - 4793 EP - 9 JF - Antimicrobial agents and chemotherapy JO - Antimicrob. Agents Chemother. VL - 48 IS - 12 N2 - From April 2000 to April 2001, 24 patients in intensive care units at Tisch Hospital, New York, N.Y., were infected or colonized by carbapenem-resistant Klebsiella pneumoniae. Pulsed-field gel electrophoresis identified a predominant outbreak strain, but other resistant strains were also recovered. Three representatives of the outbreak strain from separate patients were studied in detail. All were resistant or had reduced susceptibility to imipenem, meropenem, ceftazidime, piperacillin-tazobactam, and gentamicin but remained fully susceptible to tetracycline. PCR amplified a blaKPC allele encoding a novel variant, KPC-3, with a His(272)-->Tyr substitution not found in KPC-2; other carbapenemase genes were absent. In the outbreak strain, KPC-3 was encoded by a 75-kb plasmid, which was transferred in vitro by electroporation and conjugation. The isolates lacked the OmpK35 porin but expressed OmpK36, implying reduced permeability as a cofactor in resistance. This is the third KPC carbapenem-hydrolyzing beta-lactamase variant to have been reported in members of the Enterobacteriaceae, with others reported from the East Coast of the United States. Although producers of these enzymes remain rare, the progress of this enzyme group merits monitoring. SN - 0066-4804 UR - https://www.unboundmedicine.com/medline/citation/15561858/Outbreak_of_Klebsiella_pneumoniae_producing_a_new_carbapenem_hydrolyzing_class_A_beta_lactamase_KPC_3_in_a_New_York_Medical_Center_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&pmid=15561858 DB - PRIME DP - Unbound Medicine ER -