Tags

Type your tag names separated by a space and hit enter

Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden.
J Antimicrob Chemother. 2009 Apr; 63(4):654-8.JA

Abstract

BACKGROUND

The class A carbapenemase KPC has disseminated rapidly worldwide, challenging the treatment of Gram-negative infections. This report describes the first KPC-producing Klebsiella pneumoniae isolates identified in Norway (n=6) and the second isolate from Sweden.

METHODS

Antimicrobial susceptibility profiles were determined using Etest. PCR and sequencing were used to determine the bla(KPC) variant, the surrounding genetic structure and the presence of AmpC and extended-spectrum beta-lactamase genes. PFGE and multilocus sequence typing (MLST) were used for epidemiological comparisons. Localization of bla(KPC) was investigated by S1 nuclease digestion, followed by PFGE and Southern blot hybridization.

RESULTS

All isolates expressed a multidrug-resistant phenotype with some variability in the carbapenem susceptibility profile. The Norwegian isolates carried bla(KPC-2), while the Swedish isolate carried bla(KPC-3). All isolates carried TEM-1, but were negative for bla(CTX-M) and bla(AmpC) genes. SHV-11 and SHV-12 were detected in the Norwegian isolates, while the Swedish isolate carried only SHV-11. Isolates from four patients were associated with import from Greece (n=3) and Israel. The other isolates were probably associated with local transmissions. PFGE and MLST showed that the isolates were clonally related, with three isolates displaying ST258, a single locus variant of ST11 previously associated with the clonal spread of CTX-M-15-producing K. pneumoniae in Hungary. In all isolates, bla(KPC) was located on plasmids as part of isoform a of Tn4401.

CONCLUSIONS

The emergence of KPC-producing isolates of K. pneumoniae in Norway and Sweden is associated with multiple import events and probable local transmission of a successful multiresistant ST258 clone, closely related to the CTX-M-15-producing ST11 clone previously described in Hungary.

Authors+Show Affiliations

Reference Centre for Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway. orjan.samuelsen@unn.noNo 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

19218573

Citation

Samuelsen, Ørjan, et al. "Emergence of Clonally Related Klebsiella Pneumoniae Isolates of Sequence Type 258 Producing Plasmid-mediated KPC Carbapenemase in Norway and Sweden." The Journal of Antimicrobial Chemotherapy, vol. 63, no. 4, 2009, pp. 654-8.
Samuelsen Ø, Naseer U, Tofteland S, et al. Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. J Antimicrob Chemother. 2009;63(4):654-8.
Samuelsen, Ø., Naseer, U., Tofteland, S., Skutlaberg, D. H., Onken, A., Hjetland, R., Sundsfjord, A., & Giske, C. G. (2009). Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. The Journal of Antimicrobial Chemotherapy, 63(4), 654-8. https://doi.org/10.1093/jac/dkp018
Samuelsen Ø, et al. Emergence of Clonally Related Klebsiella Pneumoniae Isolates of Sequence Type 258 Producing Plasmid-mediated KPC Carbapenemase in Norway and Sweden. J Antimicrob Chemother. 2009;63(4):654-8. PubMed PMID: 19218573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. AU - Samuelsen,Ørjan, AU - Naseer,Umaer, AU - Tofteland,Ståle, AU - Skutlaberg,Dag Harald, AU - Onken,Annette, AU - Hjetland,Reidar, AU - Sundsfjord,Arnfinn, AU - Giske,Christian G, Y1 - 2009/02/13/ PY - 2009/2/17/entrez PY - 2009/2/17/pubmed PY - 2009/4/25/medline SP - 654 EP - 8 JF - The Journal of antimicrobial chemotherapy JO - J Antimicrob Chemother VL - 63 IS - 4 N2 - BACKGROUND: The class A carbapenemase KPC has disseminated rapidly worldwide, challenging the treatment of Gram-negative infections. This report describes the first KPC-producing Klebsiella pneumoniae isolates identified in Norway (n=6) and the second isolate from Sweden. METHODS: Antimicrobial susceptibility profiles were determined using Etest. PCR and sequencing were used to determine the bla(KPC) variant, the surrounding genetic structure and the presence of AmpC and extended-spectrum beta-lactamase genes. PFGE and multilocus sequence typing (MLST) were used for epidemiological comparisons. Localization of bla(KPC) was investigated by S1 nuclease digestion, followed by PFGE and Southern blot hybridization. RESULTS: All isolates expressed a multidrug-resistant phenotype with some variability in the carbapenem susceptibility profile. The Norwegian isolates carried bla(KPC-2), while the Swedish isolate carried bla(KPC-3). All isolates carried TEM-1, but were negative for bla(CTX-M) and bla(AmpC) genes. SHV-11 and SHV-12 were detected in the Norwegian isolates, while the Swedish isolate carried only SHV-11. Isolates from four patients were associated with import from Greece (n=3) and Israel. The other isolates were probably associated with local transmissions. PFGE and MLST showed that the isolates were clonally related, with three isolates displaying ST258, a single locus variant of ST11 previously associated with the clonal spread of CTX-M-15-producing K. pneumoniae in Hungary. In all isolates, bla(KPC) was located on plasmids as part of isoform a of Tn4401. CONCLUSIONS: The emergence of KPC-producing isolates of K. pneumoniae in Norway and Sweden is associated with multiple import events and probable local transmission of a successful multiresistant ST258 clone, closely related to the CTX-M-15-producing ST11 clone previously described in Hungary. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/19218573/Emergence_of_clonally_related_Klebsiella_pneumoniae_isolates_of_sequence_type_258_producing_plasmid_mediated_KPC_carbapenemase_in_Norway_and_Sweden_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkp018 DB - PRIME DP - Unbound Medicine ER -