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Carbapenem-resistant and carbapenem-susceptible isogenic isolates of Klebsiella pneumoniae ST101 causing infection in a tertiary hospital.
BMC Microbiol. 2015 Sep 03; 15:177.BM

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.

Authors+Show Affiliations

Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. mcubero@bellvitgehospital.cat. Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. mcubero@bellvitgehospital.cat.Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. guillermo.cuervos@bellvitgehospital.cat.Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. adominguez@bellvitgehospital.cat. Spanish Network for Research in Infectious Diseases (RD06/0008), Instituto de Salud Carlos III, Madrid, Spain. adominguez@bellvitgehospital.cat.Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. f.tubau@bellvitgehospital.cat. Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. f.tubau@bellvitgehospital.cat.Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. smartinm@bellvitgehospital.cat. Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. smartinm@bellvitgehospital.cat.Department of Immunology, Microbiology, and Parasitology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Bizkaia, Spain. elena.sevillano@ehu.es.Department of Immunology, Microbiology, and Parasitology, Faculty of Medicine and Dentistry, University of the Basque Country (UPV/EHU), Bizkaia, Spain. lucia.gallego@ehu.es.Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. jayats@bellvitgehospital.cat. Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. jayats@bellvitgehospital.cat.Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. cpena@bellvitgehospital.cat. Spanish Network for Research in Infectious Diseases (RD06/0008), Instituto de Salud Carlos III, Madrid, Spain. cpena@bellvitgehospital.cat.Department of Infectious Diseases, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. mpujol@bellvitgehospital.cat. Spanish Network for Research in Infectious Diseases (RD06/0008), Instituto de Salud Carlos III, Madrid, Spain. mpujol@bellvitgehospital.cat.Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. fina.linares@bellvitgehospital.cat. Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. fina.linares@bellvitgehospital.cat.Department of Microbiology, Hospital Universitari de Bellvitge, University of Barcelona-IDIBELL, Barcelona, Spain. c.ardanuy@bellvitgehospital.cat. Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. c.ardanuy@bellvitgehospital.cat.

Pub Type(s)

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

Language

eng

PubMed ID

26335352

Citation

Cubero, Meritxell, et al. "Carbapenem-resistant and Carbapenem-susceptible Isogenic Isolates of Klebsiella Pneumoniae ST101 Causing Infection in a Tertiary Hospital." BMC Microbiology, vol. 15, 2015, p. 177.
Cubero M, Cuervo G, Dominguez MÁ, et al. Carbapenem-resistant and carbapenem-susceptible isogenic isolates of Klebsiella pneumoniae ST101 causing infection in a tertiary hospital. BMC Microbiol. 2015;15:177.
Cubero, M., Cuervo, G., Dominguez, M. Á., Tubau, F., Martí, S., Sevillano, E., Gallego, L., Ayats, J., Peña, C., Pujol, M., Liñares, J., & Ardanuy, C. (2015). Carbapenem-resistant and carbapenem-susceptible isogenic isolates of Klebsiella pneumoniae ST101 causing infection in a tertiary hospital. BMC Microbiology, 15, 177. https://doi.org/10.1186/s12866-015-0510-9
Cubero M, et al. Carbapenem-resistant and Carbapenem-susceptible Isogenic Isolates of Klebsiella Pneumoniae ST101 Causing Infection in a Tertiary Hospital. BMC Microbiol. 2015 Sep 3;15:177. PubMed PMID: 26335352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carbapenem-resistant and carbapenem-susceptible isogenic isolates of Klebsiella pneumoniae ST101 causing infection in a tertiary hospital. AU - Cubero,Meritxell, AU - Cuervo,Guillermo, AU - Dominguez,M Ángeles, AU - Tubau,Fe, AU - Martí,Sara, AU - Sevillano,Elena, AU - Gallego,Lucía, AU - Ayats,Josefina, AU - Peña,Carmen, AU - Pujol,Miquel, AU - Liñares,Josefina, AU - Ardanuy,Carmen, Y1 - 2015/09/03/ PY - 2015/05/13/received PY - 2015/08/17/accepted PY - 2015/9/4/entrez PY - 2015/9/4/pubmed PY - 2016/1/9/medline SP - 177 EP - 177 JF - BMC microbiology JO - BMC Microbiol VL - 15 N2 - 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. SN - 1471-2180 UR - https://www.unboundmedicine.com/medline/citation/26335352/Carbapenem_resistant_and_carbapenem_susceptible_isogenic_isolates_of_Klebsiella_pneumoniae_ST101_causing_infection_in_a_tertiary_hospital_ L2 - https://bmcmicrobiol.biomedcentral.com/articles/10.1186/s12866-015-0510-9 DB - PRIME DP - Unbound Medicine ER -