Clonal dissemination of Klebsiella pneumoniae ST258 harbouring KPC-2 in Argentina

Abstract

The present work describes the abrupt emergence of Klebsiella pneumoniae carbapenemase (KPC) and characterizes the first 79 KPC-producing enterobacteria from Argentina (isolated from 2006 to 2010). The emergence of bla(KPC-2) was characterized by two patterns of dispersion: the first was the sporadic occurrence in diverse enterobacteria from distant geographical regions, harbouring plasmids of different incompatibility groups and bla(KPC-2) in an unusual genetic environment flanked by ISKpn8-Δbla(TEM-1) and ISKpn6-like. bla(KPC-2) was associated with IncL/M transferable plasmids; the second was the abrupt clonal spread of K. pneumoniae ST258 harbouring bla(KPC-2) in Tn4401a.

First Isolate of KPC-2-Producing Klebsiella pneumonaie Sequence Type 23 from the Americas

“…As expected, bla KPC-2 was located in Tn4401 as previously reported by Naas et al (3). Replicon typing, determined according to the method of Carattoli et al (4), indicated that the bla KPC-2 -containing plasmid corresponded to the FIA incompatibility group, which had previously been reported to occur in Escherichia coli in Argentina by Gomez et al (5). Conjugation assays, using both Escherichia coli HB101 and Escherichia coli CAG 12177 as receptor strains, did not yield transconjugants, according to a previously mentioned study (5).…”

“…The successful dissemination of K. pneumoniae isolates belonging to clonal complex 258 was a critical factor resulting in their pandemic expansion (6). In our country, a substantial increase of KPC-2-producing K. pneumoniae was observed in 2010, due to the huge dissemination of the hyperendemic sequence type 258 (ST258) clone, which displayed a multidrug-resistant phenotype (5,7,8). A multilocus sequence typing (MLST) scheme was conducted on K. pneumoniae 3089 (9).…”

Comparative Evaluation of a Prototype Chromogenic Medium (ChromID CARBA) for Detecting Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

“…These isolates produce different types of ␤-lactamases capable of hydrolyzing carbapenems. Among these carbapenemases, metallo-␤-lactamases (MBLs; Ambler class B) and Klebsiella pneumoniae carbapenemase (KPC; Ambler class A) are prevailing in Enterobacteriaceae from countries or large geographic regions, including the United States, Israel, Italy, Greece, the Far East, and South America (9,12,14,15,17,18,22,26,27). Moreover, oxacillinase-48 (OXA-48; Ambler class D) has recently been isolated in Enterobacteriaceae from Turkey (6), and it has since been reported from other countries in the Mediterranean Basin and Western Europe (13,22).…”

Antimicrobial Treatment and Containment Measures for an Extremely Drug-Resistant Klebsiella pneumoniae ST101 Isolate Carrying pKPN101-IT, a Novel Fully Sequenced bla KPC-2 Plasmid

“…KPC dissemination has also been associated with a highly epidemic international clone of Klebsiella pneumoniae, sequence type (ST) 258. Nowadays, ST258 and derivatives (such as ST512 and ST745) are predominant worldwide among KPC-positive K. pneumoniae isolates, but additional KPC-producing clones (ST147, ST11, ST307, ST437, ST554, and ST745, among others) have been reported (1,5,6,11).…”