Epidemiology of carbapenemase-producing Klebsiella pneumoniae in northern Portugal: Predominance of KPC-2 and OXA-48

Lopes, Elizeth; Saavedra, Maria José; Costa, Eliana; Lencastre, Hermı́nia de; Poirel, Laurent; Aires-de-Sousa, Marta

doi:10.1016/j.jgar.2020.04.007

Cited by 32 publications

(27 citation statements)

References 27 publications

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“…Similarly, some international reports showed the presence of bla OXA-48 gene among hospitalized patients [44]. This gene had been reported in human isolates, mainly in Iberian Peninsula [45][46][47][48]. Particularly in Portugal, the OXA-181 carbapenemase was detected among K. pneumoniae isolates of hospitalized patients [8].…”

Section: Discussionmentioning

confidence: 71%

“…Moreover, carbapenemases of the KPC-2, KPC-3 and OXA-48 type have been recently reported among carbapenem resistant K . pneumoniae isolates of different origins from the same hospital analyzed in our study, few of them of blood origin [ 46 , 49 ]. Carbapenems are generally considered the most effective antibacterial agents and the first-choice treatment for infections caused by ESBL-producing Enterobacteriaceae .…”

Section: Discussionmentioning

confidence: 99%

“…The ST11 lineage has been frequently detected worldwide among CTX-M-15- [50] and KPC-producing K. pneumoniae isolates [51]. In addition, isolates of ST348 or ST15 lineages producing CTX-M-15 and/or KPC-2/3 enzymes have been reported either in humans or animals in different studies performed in Portugal [21,32,46]. The ST15 lineage was identified in our study in a SHV-106-producing K. pneumoniae isolate, and similar isolates were previously circulating in a Portuguese hospital [24].…”

Section: Plos Onementioning

confidence: 99%

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Multidrug-resistant Klebsiella pneumoniae harboring extended spectrum β-lactamase encoding genes isolated from human septicemias

et al. 2021

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Klebsiella pneumoniae is a major pathogen implicated in nosocomial infections. Extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae isolates are a public health concern. We aim to characterize the type of β-lactamases and the associated resistance mechanisms in ESBL-producing K. pneumoniae isolates obtained from blood cultures in a Portuguese hospital, as well as to determine the circulating clones. Twenty-two cefotaxime/ceftazidime-resistant (CTX/CAZR) K. pneumoniae isolates were included in the study. Identification was performed by MALDI-TOF MS and the antimicrobial susceptibility testing by disk-diffusion. The screening test for ESBL-production was performed and ESBL-producer isolates were further characterized. The presence of different beta-lactamase genes (blaCTX-M, blaSHV, blaTEM, blaKPC, blaNDM, blaVIM, blaOXA-48, blaCMY-2, blaDHA-1, blaFOX, blaMOX, and blaACC) was analyzed by PCR/sequencing in ESBL-producer isolates, as well as the presence of other resistance genes (aac(6’)-Ib-cr, tetA/B, dfrA, qnrA/B/S, sul1/2/3) or integron-related genes (int1/2/3). Multilocus-sequence-typing (MLST) was performed for selected isolates. ESBL activity was detected in 12 of the 22 CTX/CAZR K. pneumoniae isolates and 11 of them carried the blaCTX-M-15 gene (together with blaTEM), and the remaining isolate carried the blaSHV-106 gene. All the blaCTX-M-15 harboring isolates also contained a blaSHV gene (blaSHV-1, blaSHV-11 or blaSHV-27 variants). Both blaSHV-27 and blaSHV-106 genes correspond to ESBL-variants. Two of the CTX-M-15 producing isolates carried a carbapenemase gene (blaKPC2/3 and blaOXA-48) and showed imipenem resistance. The majority of the ESBL-producing isolates carried the int1 gene, as well as sulphonamide-resistance genes (sul2 and/or sul3); the tetA gene was detected in all eight tetracycline-resistant isolates. Three different genetic lineages were found in selected isolates: ST348 (one CTX-M-15/TEM/SHV-27/KPC-2/3-producer isolate), ST11 (two CTX-M-15/TEM/SHV-1- and CTX-M-15-TEM-SHV-11-OXA-48-producer isolates) and ST15 (one SHV-106/TEM-producer isolate). ESBL enzymes of CTX-M-15 or SHV-type are detected among blood K. pneumoniae isolates, in some cases in association with carbapenemases of KPC or OXA-48 type.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

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Multidrug-resistant Klebsiella pneumoniae harboring extended spectrum β-lactamase encoding genes isolated from human septicemias

et al. 2021

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“…Indeed, all types of ESBLs and carbapenemases identified in this study were also found among human samples in Portugal. The most common acquired carbapenemases identified from clinical samples in the country are KPC (KPC-2 and KPC-3) and OXA-48-type enzymes (OXA-48 and OXA-181) [ 15 , 16 , 17 ]. GES-5 and GES-6 have been found sporadically, with the exception of one hospital in Lisbon where K. pneumoniae isolates co-harboring bla KPC-3 and bla GES-5 represented 17% of the isolates [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…The first clinical carbapenemase-producing K. pneumoniae (KPC-3 producer) isolated in Portugal had been recovered from a patient hospitalized in Lisbon in 2009 [ 14 ]. Contemporary carbapenemase-producing Enterobacteriaceae in the country produced mainly KPC-3, KPC-2, OXA-48, and OXA-181 enzymes [ 15 , 16 , 17 ]. GES-5 was mainly found sporadically with the exception of one hospital in Lisbon, where it represented 17% of the carbapenemase-producing K. pneumoniae isolates [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

High Colonization Rate and Heterogeneity of ESBL- and Carbapenemase-Producing Enterobacteriaceae Isolated from Gull Feces in Lisbon, Portugal

et al. 2020

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In order to evaluate whether seagulls living on the Lisbon coastline, Portugal, might be colonized and consequently represent potential spreaders of multidrug-resistant bacteria, a total of 88 gull fecal samples were screened for detection of extended-spectrum β-lactamase (ESBL)- or carbapenemase-producing Enterobacteriaceae for methicillin-resistant Staphylococcus aureus (MRSA) and for vancomycin-resistant Enterococci (VRE). A large proportion of samples yielded carbapenemase- or ESBL-producing Enterobacteriaceae (16% and 55%, respectively), while only two MRSA and two VRE were detected. Mating-out assays followed by PCR and whole-plasmid sequencing allowed to identify carbapenemase and ESBL encoding genes. Among 24 carbapenemase-producing isolates, there were mainly Klebsiella pneumoniae (50%) and Escherichia coli (33%). OXA-181 was the most common carbapenemase identified (54%), followed by OXA-48 (25%) and KPC-2 (17%). Ten different ESBLs were found among 62 ESBL-producing isolates, mainly being CTX-M-type enzymes (87%). Co-occurrence in single samples of multiple ESBL- and carbapenemase producers belonging to different bacterial species was observed in some cases. Seagulls constitute an important source for spreading multidrug-resistant bacteria in the environment and their gut microbiota a formidable microenvironment for transfer of resistance genes within bacterial species.

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Antibiotic Susceptibility, Biofilm-Forming Ability, and Prevalence of Extended-Spectrum Beta-Lactamase (ESBL)- and Biofilm-Associated Genes Among Klebsiella pneumoniae Isolates from Hospitalized Patients in Northwest of Iran

et al. 2023

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Epidemiology of carbapenemase-producing Klebsiella pneumoniae in northern Portugal: Predominance of KPC-2 and OXA-48

Cited by 32 publications

References 27 publications

Multidrug-resistant Klebsiella pneumoniae harboring extended spectrum β-lactamase encoding genes isolated from human septicemias

Multidrug-resistant Klebsiella pneumoniae harboring extended spectrum β-lactamase encoding genes isolated from human septicemias

High Colonization Rate and Heterogeneity of ESBL- and Carbapenemase-Producing Enterobacteriaceae Isolated from Gull Feces in Lisbon, Portugal

Antibiotic Susceptibility, Biofilm-Forming Ability, and Prevalence of Extended-Spectrum Beta-Lactamase (ESBL)- and Biofilm-Associated Genes Among Klebsiella pneumoniae Isolates from Hospitalized Patients in Northwest of Iran

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