First Description of KPC-2-Producing Klebsiella oxytoca in Brazil

Almeida, Anna; Cavalcanti, Felipe L. S.; Martins, Willames M. B. S.; Vilela, Marinalda Anselmo; Gales, Ana Cristina; Morais, Marcos Antônio de; Morais, Márcia Maria Camargo de

doi:10.1128/aac.02376-12

Cited by 16 publications

(9 citation statements)

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“…In July 2012, Nobari et al [17] identified a strain of K. pneumoniae bla KPC gene that was isolated from the urine of a female patient hospitalized in an Intensive Care Unit ward; they reported it as the first case of K. pneumoniae bla KPC gene in Iran. Some cases of K. oxytoca have also been identified and reported in Brazil [20] and Venezuela [21]. A study in Austria reported the identification of 31 strains of KPC-producing K. oxytoca isolated from five patients hospitalized in Intensive Care Unit wards [1].…”

Section: Discussionmentioning

confidence: 98%

“…K. oxytoca is an opportunistic pathogen and is now identified and introduced as an important clinical pathogen that is associated with nosocomial infections in hospitalized patients, including children, newborns, and individuals with immune deficiency [19]. A few studies have reported the identification of the KPC gene in K. oxytoca strains in some countries such as Austria [18], Brazil [20], and Venezuela [21]. Identification of this gene plays an important role in the study of K. oxytoca antibiotic resistance.…”

Section: Introductionmentioning

confidence: 99%

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Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Validi

Dallal

Douraghi

et al. 2016

Osong Public Health and Research Perspectives

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ObjectivesProduction of carbapenemase, especially Klebsiella pneumoniae carbapenemases (KPC), is one of the antibiotic resistance mechanisms of Enterobacteriaceae such as Klebsiella oxytoca. This study aimed to investigate and identify KPC-producing K. oxytoca isolates using molecular and phenotypic methods.MethodsA total of 75 isolates of K. oxytoca were isolated from various clinical samples, and were verified as K. oxytoca after performing standard microbiological tests and using a polymerase chain reaction (PCR) method. An antibiotic susceptibility test was performed using a disc diffusion method according to the Clinical and Laboratory Standards Institute guidelines. CHROMagar KPC chromogenic culture media was used to examine and confirm the production of the carbapenemase enzyme in K. oxytoca isolates; in addition, PCR was used to evaluate the presence of blaKPC gene in K. oxytoca strains.ResultsOf a total of 75 K. oxytoca isolates, one multidrug resistant strain was isolated from the urine of a hospitalized woman. This strain was examined to assess its ability to produce carbapenemase enzyme; it produced a colony with a blue metallic color on the CHROMagar KPC chromogenic culture media. In addition, the blaKPC gene was confirmed by PCR. After sequencing, it was confirmed and deposited in GenBank.ConclusionTo date, many cases of KPC-producing Enterobacteriaceae, in particular K. pneumoniae, have been reported in different countries; there are also some reports on the identification of KPC-producing K. oxytoca. Therefore, to prevent the outbreak of nosocomial infections, the early detection, control, and prevention of the spread of these strains are of great importance.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Validi

Dallal

Douraghi

et al. 2016

Osong Public Health and Research Perspectives

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“…However, different platforms also support bla KPC worldwide (34,38,39), including in Brazil (19,27). Tn4401 variants "a" and "c" were related (19,40), and the "b" variant has been described as predominant in K. pneumoniae (41) and in other genera and species (19,42) from Brazil. The Tn4401 variant "a" has been detected since 2007 (19) in hospitals and seems to be the single genetic environment/variant that supports bla KPC-2 in this health care center.…”

Section: Discussionmentioning

confidence: 99%

Expansion and Evolution of a Virulent, Extensively Drug-Resistant (Polymyxin B-Resistant), QnrS1-, CTX-M-2-, and KPC-2-Producing Klebsiella pneumoniae ST11 International High-Risk Clone

et al. 2014

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bIn this study, we report the early expansion, evolution, and characterization of a multiresistant Klebsiella pneumoniae clone that was isolated with increasing frequency from inpatients in a tertiary-care university hospital in Brazil. Seven carbapenem-and quinolone-resistant and polymyxin B-susceptible or -resistant K. pneumoniae isolates isolated between December 2012 and February 2013 were investigated. Beta-lactamase-and plasmid-mediated quinolone resistance (PMQR)-encoding genes and the genetic environment were investigated using PCR, sequencing, and restriction fragment length polymorphism (RFLP). Clonal relatedness was established using XbaI-pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and phylogenetic group characterization. Plasmid analyses included PCR-based replicon typing (PBRT) and hybridization of the S1-PFGE product, plasmid MLST, and conjugation experiments. Virulence potential was assessed by PCR by searching for 10 virulence factor-encoding genes (ureA, fimH, kfuBC, uge, wabG, magA, mrkD, allS, rmpA, and cf29a) and by phenotypic tests to analyze the hypermucoviscous phenotype. The genetic context of a multidrug-resistant and extensively drug-resistant K. pneumoniae ST11-KpI clone harboring IncFIIk-Tn4401a-bla KPC-2 , qnrS1, and bla CTX-M-2 was found. Moreover, three isolates displayed high resistance to polymyxin B (MICs ‫؍‬ 32, 32, and 128 mg/liter) as well as mucous and hypermucoviscous phenotypes. These bacteria also harbored ureA, fimH, uge, wabG, and mrkD, which code for virulence factors associated with binding, biofilm formation, and the ability to colonize and escape from phagocytosis. Our study describes the association of important coresistance and virulence factors in the K. pneumoniae ST11 international high-risk clone, which makes this pathogen successful at infections and points to the quick expansion and evolution of this multiresistant and virulent clone, leading to a pandrug-resistant phenotype and persistent bacteria in a Brazilian hospital.

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“…lebsiella oxytoca is considered an opportunistic pathogen and is recognized as a clinically significant bacterium associated with nosocomial infections (1,2). The relevance of Klebsiella species is marked by their ability to acquire resistance determinants, especially to carbapenems.…”

mentioning

confidence: 99%

First Report of Klebsiella oxytoca Strain Simultaneously Producing NDM-1, IMP-4, and KPC-2 Carbapenemases

Wang

Yuan

Chen

et al. 2017

Antimicrob Agents Chemother

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The nucleotide sequences of five plasmids from one Klebsiella oxytoca isolate were determined using the PacBio RS II system. Plasmid analysis revealed that bla NDM-1 was carried on an IncX3 plasmid. The bla IMP-4 and bla KPC-2 genes were located on IncN and IncP-6 plasmids, respectively. Comparative sequence analysis highlighted the successful spread of carbapenemase-harboring plasmids among different enterobacterial species. We report for the first time, to our knowledge, coproducing NDM-1, KPC-2, and IMP-4 carbapenemases on a K. oxytoca isolate.

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First Description of KPC-2-Producing Klebsiella oxytoca in Brazil

Cited by 16 publications

References 5 publications

Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Expansion and Evolution of a Virulent, Extensively Drug-Resistant (Polymyxin B-Resistant), QnrS1-, CTX-M-2-, and KPC-2-Producing Klebsiella pneumoniae ST11 International High-Risk Clone

First Report of Klebsiella oxytoca Strain Simultaneously Producing NDM-1, IMP-4, and KPC-2 Carbapenemases

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