Characterisation of the first ongoing outbreak due to KPC-3-producing Klebsiella pneumoniae (ST512) in Spain

López-Cerero, Lorena; Egea, Pilar; Gracia-Ahufinger, Irene; González-Padilla, Marcelino; Rodríguez-López, Fernando; Rodríguez-Baño, Jesús; Pascual, Álvaro

doi:10.1016/j.ijantimicag.2014.08.006

Cited by 43 publications

(19 citation statements)

References 14 publications

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“…Verona integron-encoded MBLs and IMPs are the most common MBLs worldwide especially in Greece, Taiwan, and Japan. Klebsiella pneumoniae carbapenemase was first reported in 1996, and became more widespread and today is the most common carbapenemase (3,7,39). In the present study, KPC, IMP, and VIM were not determined from any of the isolates.…”

Section: Discussioncontrasting

confidence: 52%

Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

Çelikbilek¹,

Ünaldı²,

Kırca³

et al. 2017

Jundishapur J Microbiol

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Background: Carbapenem-resistant Klebsiella pneumoniae isolates can spread among the hospitalized patients and result in serious infections and increase mortality. Molecular studies provide useful information about resistance mechanisms and crosstransmission among the resistant isolates. Objectives: The current study aimed at investigating phenotypic and molecular characteristics of the carbapenem resistance and clonal relationship among the K. pneumoniae isolates recovered from infection sites and rectal swabs of the patients hospitalized in a tertiary hospital. Methods: Resistance to carbapenems was investigated by disc-diffusion and E-test methods. Modified Hodge test (MHT) and ethylenediaminetetraacetic acid (EDTA)-combine disc (ECD) methods were performed to determine carbapenemases. Carbapenemase-encoding genes including blaOXA-48, blaNDM-1, blaKPC, blaIMP, and blaVIM were investigated by multiplex polymerase chain reaction (PCR). Clonal relationship among the isolates was determined by the pulsed-field gel electrophoresis (PFGE). Results: Carbapenem resistance was observed in 93 (5.8%) of the 1605 K. pneumoniae isolates. Majority (n = 66, 71%) of the resistant isolates were recovered from the patients in intensive care units (ICUs). Almost all carbapenem-resistant K. pneumoniae isolates (n = 91, 97.8%) were positive with MHT. Only 6 (6.5%) of the resistant isolates were positive with ECD method. The blaOXA-48 and blaNDM-1 were found in 90.3% (n = 84) and 6.5% (n = 6) of the resistant isolates, respectively. The pulsed-field gel electrophoresis yielded

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Section: Discussioncontrasting

confidence: 52%

Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

Çelikbilek¹,

Ünaldı²,

Kırca³

et al. 2017

Jundishapur J Microbiol

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“…Eight clinical strains of carbapenemase-producing and/or colistin-resistant Enterobacteriaceae were studied: (1) five strains of carbapenemase-producing Klebsiella pneumoniae : Kp07, a VIM-1 ST 1603 clone producer from Spain (Miró et al, 2013 ); Kp21, co-producing VIM-1 and AmpC type beta-lactamase DHA-1 ST 11 clone from Spain (Miró et al, 2013 ); Kp28, co-producing OXA-48 ST11 clone and the extended spectrum beta-lactamase (ESBL) CTX-M-15 from Spain (Oteo et al, 2015 ); a Kp29, co-producing KPC-3 ST512 clone with the extended spectrum beta-lactamases TEM-1 and SHV-11 from Spain (López-Cerero et al, 2014 ); Kp1, a NDM-1 producer from Kenya; (2) Ec271, a Escherichia coli NDM-1 producer from Australia Docobo-Pérez et al, 2012 ; (3) two strains of Enterobacter spp. from Spain, E. cloacae 32 and E. cloacae 297, both resistant to colistin.…”

Section: Methodsmentioning

confidence: 99%

In vitro Activity of Pentamidine Alone and in Combination With Aminoglycosides, Tigecycline, Rifampicin, and Doripenem Against Clinical Strains of Carbapenemase-Producing and/or Colistin-Resistant Enterobacteriaceae

Cebrero-Cangueiro

Álvarez‐Marín

Labrador-Herrera

et al. 2018

Front. Cell. Infect. Microbiol.

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Enterobacteriaceae cause different types of community- and hospital-acquired infections. Moreover, the spread of multidrug-resistant Enterobacteriaceae is a public health problem and the World Health Organization pointed them among the pathogens in which the search of new antibiotics is critical. The objective of this study was to analyze the in vitro activity of pentamidine alone and in combination with gentamicin, tobramycin, amikacin, tigecycline, rifampicin, or doripenem against eight clinical strains of carbapenemase-producing and/or colistin-resistant Enterobacteriaceae: five carbapenemase-producing Klebsiella pneumoniae, one carbapenemase-producing Escherichia coli, and two colistin-resistant Enterobacter cloacae. MIC and MBC were determined following standard protocols. MIC results were interpreted for all the antibiotics according to the EUCAST breakpoints but for rifampicin in which the French FSM breakpoint was used. Bactericidal and synergistic activity of pentamidine alone and in combination with antibiotics at concentrations of 1xMIC was measured by time-kill curves. For one selected strain, K. pneumoniae OXA-48/CTX-M-15 time-kill curves were performed also at 1/2xMIC of pentamidine. All studies were performed in triplicate. Pentamidine MIC range was 200–800 μg/mL. The 50, 12.5, 62.5, 87.5, and 62.5% of the strains were susceptible to gentamicin, tobramycin, amikacin, tigecycline, and doripenem, respectively. Only the two E. cloacae strains were susceptible to rifampicin. Pentamidine alone at 1xMIC showed bactericidal activity against all strains, except for the E. cloacae 32 strain. The bactericidal activity of pentamidine alone was also observed in combination. The combinations of pentamidine were synergistic against E. cloacae 32 with amikacin and tobramycin at 24 h and with tigecycline at 8 h. Pentamidine plus rifampicin was the combination that showed synergistic activity against more strains (five out of eight). Pentamidine plus doripenem did not show synergy against any strain. At 1/2xMIC, pentamidine was synergistic with all the studied combinations against the K. pneumoniae OXA-48/CTX-M-15 strain. In summary, pentamidine alone and in combination shows in vitro activity against carbapenemase-producing and/or colistin-resistant Enterobacteriaceae. Pentamidine appears to be a promising option to treat infections caused by these pathogens.

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“…ST11 with bla OXA-48 has recently been identified in Spain (67). Other STs also belonging to CC258 with bla KPC have been reported in Colombia (ST512), Italy (ST512), Israel (ST512), Spain (ST512), Brazil (ST340), and Greece (ST340) (18,68).…”

Section: Cc258: Other Sequence Typesmentioning

confidence: 99%

Carbapenemase-Producing Klebsiella pneumoniae, a Key Pathogen Set for Global Nosocomial Dominance

Pitout

Nordmann

Poirel

2015

Antimicrob Agents Chemother

685

569

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The management of infections due to Klebsiella pneumoniae has been complicated by the emergence of antimicrobial resistance, especially to carbapenems. Resistance to carbapenems in K. pneumoniae involves multiple mechanisms, including the production of carbapenemases (e.g., KPC, NDM, VIM, OXA-48-like), as well as alterations in outer membrane permeability mediated by the loss of porins and the upregulation of efflux systems. The latter two mechanisms are often combined with high levels of other types of ␤-lactamases (e.g., AmpC). K. pneumoniae sequence type 258 (ST258) emerged during the early to mid-2000s as an important human pathogen and has spread extensively throughout the world. ST258 comprises two distinct lineages, namely, clades I and II, and it seems that ST258 is a hybrid clone that was created by a large recombination event between ST11 and ST442. Incompatibility group F plasmids with bla KPC have contributed significantly to the success of ST258. The optimal treatment of infections due to carbapenemase-producing K. pneumoniae remains unknown. Some newer agents show promise for treating infections due to KPC producers; however, effective options for the treatment of NDM producers remain elusive.

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Characterisation of the first ongoing outbreak due to KPC-3-producing Klebsiella pneumoniae (ST512) in Spain

Cited by 43 publications

References 14 publications

Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

In vitro Activity of Pentamidine Alone and in Combination With Aminoglycosides, Tigecycline, Rifampicin, and Doripenem Against Clinical Strains of Carbapenemase-Producing and/or Colistin-Resistant Enterobacteriaceae

Carbapenemase-Producing Klebsiella pneumoniae, a Key Pathogen Set for Global Nosocomial Dominance

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