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Changing epidemiology of KPC-producing Klebsiella pneumoniae in Argentina: Emergence of hypermucoviscous ST25 and high-risk clone ST307.
J Glob Antimicrob Resist. 2019 09; 18:238-242.JG

Abstract

OBJECTIVES

To assess the epidemiological features of 76 Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp) isolates recovered from three hospitals in Buenos Aires, Argentina, during 2015-2017.

METHODS

Antimicrobial susceptibilities were determined according to CLSI Clinical and Laboratoy Standards guidelines. Molecular typing of KPC-Kp was performed by pulsed-field gel electrophoresis (PFGE)-Xbal and multilocus sequence typing. Plasmid encoded genes involved in carbapenem, fosfomycin and colistin resistance were detected by polymerase chain reaction (PCR) and sequencing. Also, mgrB inactivation was investigated in those colistin-resistant isolates. Genetic platforms involved in horizontal spread of blaKPC were investigated by PCR mapping.

RESULTS

Besides β-lactams, high resistance rates were observed for gentamycin, quinolones and trimethoprim-sulfamethoxazole. KPC-Kp sequence type (ST)258 corresponded to 26% of the isolates, while 42% corresponded to ST25. The other isolates were distributed in a diversity of lineages such as ST11 (10.5%), ST392 (10.5%), ST307, ST13, ST101, ST15 and ST551. blaKPC-2 was detected in 75 of 76 isolates, and one ST307 isolate harboured blaKPC-3. Tn4401 was identified as the genetic platform for blaKPC in epidemic lineages such as ST258 and ST307. However, in ST25 and ST392, which are usually not related to blaKPC, a blaKPC-bearing non-Tn4401 element was identified. Alterations in mgrB were detected in seven of 11 colistin-resistant isolates.

CONCLUSIONS

Despite previous reports in Argentina, ST258 is no longer the absolute clone among KPC-Kp isolates. In the present study, dissemination of more virulent lineages such as the hypermucoviscous ST25 was detected. The emergence of the high-risk clone ST307 and occurrence of blaKPC-3 was noticed for the first time in this region.

Authors+Show Affiliations

Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Laboratorio de Resistencia Bacteriana, Junin 956, Ciudad Autónoma de Buenos Aires, Argentina; CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas), Godoy Cruz 2290, Ciudad Autónoma de Buenos Aires, Argentina.Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Laboratorio de Resistencia Bacteriana, Junin 956, Ciudad Autónoma de Buenos Aires, Argentina; CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas), Godoy Cruz 2290, Ciudad Autónoma de Buenos Aires, Argentina.Universidad de Buenos Aires, Instituto de Investigaciones Médicas Alfredo Lanari, Combatientes de Malvinas 3150, Ciudad Autónoma de Buenos Aires, Argentina.Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Laboratorio de Resistencia Bacteriana, Junin 956, Ciudad Autónoma de Buenos Aires, Argentina; Universidad de El Salvador, Facultad de Química y Farmacia, Final Avenida Mártires Estudiantes del 30 de julio, San Salvador, El Salvador.Universidad de Buenos Aires, Instituto de Investigaciones Médicas Alfredo Lanari, Combatientes de Malvinas 3150, Ciudad Autónoma de Buenos Aires, Argentina.Hospital Donación Francisco Santojanni, Pilar 950, Ciudad Autónoma de Buenos Aires, Argentina.Hospital Donación Francisco Santojanni, Pilar 950, Ciudad Autónoma de Buenos Aires, Argentina.Hospital Alemán, Av. Pueyrredón 1640, Ciudad Autónoma de Buenos Aires, Argentina.Hospital Alemán, Av. Pueyrredón 1640, Ciudad Autónoma de Buenos Aires, Argentina.Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Laboratorio de Resistencia Bacteriana, Junin 956, Ciudad Autónoma de Buenos Aires, Argentina; CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas), Godoy Cruz 2290, Ciudad Autónoma de Buenos Aires, Argentina.Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Laboratorio de Resistencia Bacteriana, Junin 956, Ciudad Autónoma de Buenos Aires, Argentina; CONICET (Consejo Nacional de Investigaciones Científicas y Técnicas), Godoy Cruz 2290, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: mradice@ffyb.uba.ar.

Pub Type(s)

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

Language

eng

PubMed ID

31202977

Citation

Cejas, Daniela, et al. "Changing Epidemiology of KPC-producing Klebsiella Pneumoniae in Argentina: Emergence of Hypermucoviscous ST25 and High-risk Clone ST307." Journal of Global Antimicrobial Resistance, vol. 18, 2019, pp. 238-242.
Cejas D, Elena A, Guevara Nuñez D, et al. Changing epidemiology of KPC-producing Klebsiella pneumoniae in Argentina: Emergence of hypermucoviscous ST25 and high-risk clone ST307. J Glob Antimicrob Resist. 2019;18:238-242.
Cejas, D., Elena, A., Guevara Nuñez, D., Sevillano Platero, P., De Paulis, A., Magariños, F., Alfonso, C., Berger, M. A., Fernández-Canigia, L., Gutkind, G., & Radice, M. (2019). Changing epidemiology of KPC-producing Klebsiella pneumoniae in Argentina: Emergence of hypermucoviscous ST25 and high-risk clone ST307. Journal of Global Antimicrobial Resistance, 18, 238-242. https://doi.org/10.1016/j.jgar.2019.06.005
Cejas D, et al. Changing Epidemiology of KPC-producing Klebsiella Pneumoniae in Argentina: Emergence of Hypermucoviscous ST25 and High-risk Clone ST307. J Glob Antimicrob Resist. 2019;18:238-242. PubMed PMID: 31202977.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changing epidemiology of KPC-producing Klebsiella pneumoniae in Argentina: Emergence of hypermucoviscous ST25 and high-risk clone ST307. AU - Cejas,Daniela, AU - Elena,Alan, AU - Guevara Nuñez,Daiana, AU - Sevillano Platero,Priscila, AU - De Paulis,Adriana, AU - Magariños,Francisco, AU - Alfonso,Claudia, AU - Berger,María Alejandra, AU - Fernández-Canigia,Liliana, AU - Gutkind,Gabriel, AU - Radice,Marcela, Y1 - 2019/06/13/ PY - 2019/01/02/received PY - 2019/06/05/revised PY - 2019/06/06/accepted PY - 2019/6/17/pubmed PY - 2020/6/23/medline PY - 2019/6/17/entrez KW - KPC-producing Klebsiella pneumoniae KW - Sequence type (ST)307, ST25, ST11 and ST392 KW - bla(KPC-3) KW - mgrB inactivation SP - 238 EP - 242 JF - Journal of global antimicrobial resistance JO - J Glob Antimicrob Resist VL - 18 N2 - OBJECTIVES: To assess the epidemiological features of 76 Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp) isolates recovered from three hospitals in Buenos Aires, Argentina, during 2015-2017. METHODS: Antimicrobial susceptibilities were determined according to CLSI Clinical and Laboratoy Standards guidelines. Molecular typing of KPC-Kp was performed by pulsed-field gel electrophoresis (PFGE)-Xbal and multilocus sequence typing. Plasmid encoded genes involved in carbapenem, fosfomycin and colistin resistance were detected by polymerase chain reaction (PCR) and sequencing. Also, mgrB inactivation was investigated in those colistin-resistant isolates. Genetic platforms involved in horizontal spread of blaKPC were investigated by PCR mapping. RESULTS: Besides β-lactams, high resistance rates were observed for gentamycin, quinolones and trimethoprim-sulfamethoxazole. KPC-Kp sequence type (ST)258 corresponded to 26% of the isolates, while 42% corresponded to ST25. The other isolates were distributed in a diversity of lineages such as ST11 (10.5%), ST392 (10.5%), ST307, ST13, ST101, ST15 and ST551. blaKPC-2 was detected in 75 of 76 isolates, and one ST307 isolate harboured blaKPC-3. Tn4401 was identified as the genetic platform for blaKPC in epidemic lineages such as ST258 and ST307. However, in ST25 and ST392, which are usually not related to blaKPC, a blaKPC-bearing non-Tn4401 element was identified. Alterations in mgrB were detected in seven of 11 colistin-resistant isolates. CONCLUSIONS: Despite previous reports in Argentina, ST258 is no longer the absolute clone among KPC-Kp isolates. In the present study, dissemination of more virulent lineages such as the hypermucoviscous ST25 was detected. The emergence of the high-risk clone ST307 and occurrence of blaKPC-3 was noticed for the first time in this region. SN - 2213-7173 UR - https://www.unboundmedicine.com/medline/citation/31202977/Changing_epidemiology_of_KPC_producing_Klebsiella_pneumoniae_in_Argentina:_Emergence_of_hypermucoviscous_ST25_and_high_risk_clone_ST307_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2213-7165(19)30148-1 DB - PRIME DP - Unbound Medicine ER -