Isolation of OXA-48 Carbapenemase-Producing Klebsiella pneumoniae ST101 from an Overseas Traveler Returning to Japan

Hashimoto, Aki; Nagamatsu, Maki; Ohmagari, Norio; Hayakawa, Kayoko; Kato, Yasuyuki; Kirikae, Teruo

doi:10.7883/yoken.67.120

Cited by 14 publications

(7 citation statements)

References 17 publications

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“…ST101 has been described as an emerging pandemic clone found in several countries e.g. Romania, 2012 [ 51 ]; Japan, 2012 [ 52 ]; Spain, 2012–2014 [ 53 ]; Algeria, 2014–2015 [ 54 ]; and others [ 1 ]. The two ST101 strains from the same patient (blood and catheter) were closely related and showed a similar plasmid profile, except for the aac6’-lb gene which was not identified in the assembly for CFSAN044572.…”

Section: Discussionmentioning

confidence: 99%

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

et al. 2018

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The emergence and dissemination of carbapenemases, bacterial enzymes able to inactivate most β-lactam antibiotics, in Enterobacteriaceae is of increasing concern. The concurrent spread of resistance against colistin, an antibiotic of last resort, further compounds this challenge further. Whole-genome sequencing (WGS) can play a significant role in the rapid and accurate detection/characterization of existing and emergent resistance determinants, an essential aspect of public health surveillance and response activities to combat the spread of antimicrobial resistant bacteria. In the current study, WGS data was used to characterize the genomic content of antimicrobial resistance genes, including those encoding carbapenemases, in 10 multidrug-resistant Klebsiella pneumoniae isolates from Pakistan. These clinical isolates represented five sequence types: ST11 (n = 3 isolates), ST14 (n = 3), ST15 (n = 1), ST101 (n = 2), and ST307 (n = 1). Resistance profiles against 25 clinically-relevant antimicrobials were determined by broth microdilution; resistant phenotypes were observed for at least 15 of the 25 antibiotics tested in all isolates except one. Specifically, 8/10 isolates were carbapenem-resistant and 7/10 isolates were colistin-resistant. The blaNDM-1 and blaOXA-48 carbapenemase genes were present in 7/10 and 5/10 isolates, respectively; including 2 isolates carrying both genes. No plasmid-mediated determinants for colistin resistance (e.g. mcr) were detected, but disruptions and mutations in chromosomal loci (i.e. mgrB and pmrB) previously reported to confer colistin resistance were observed. A blaOXA-48-carrying IncL/M-type plasmid was found in all blaOXA-48-positive isolates. The application of WGS to molecular epidemiology and surveillance studies, as exemplified here, will provide both a more complete understanding of the global distribution of MDR isolates and a robust surveillance tool useful for detecting emerging threats to public health.

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Section: Discussionmentioning

confidence: 99%

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

et al. 2018

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“…Since 2003, the endemic spread of these bacteria has been reported in countries such as Turkey, Morocco, Libya, Egypt, Tunisia, and India ( Nordmann and Poirel, 2014 ; Figure 4 ). The sporadic spread has been reported in France ( Liapis et al, 2014 ; Semin-Pelletier et al, 2015 ), Spain ( Oteo et al, 2013b ; Pena et al, 2014 ), Italy ( Giani et al, 2013 , 2014 ), Belgium ( Cuzon et al, 2008 ; Huang et al, 2013 ), the Netherlands ( Kalpoe et al, 2011 ; Dautzenberg et al, 2014 ), the UK ( Dimou et al, 2012 ; Thomas et al, 2013 ), Germany ( Pfeifer et al, 2012 ; Kola et al, 2015 ), Switzerland ( Potron et al, 2012 ; Seiffert et al, 2014 ), Argentina ( Poirel et al, 2011c ; Lascols et al, 2013 ), Lebanon ( Beyrouthy et al, 2014 ), Israel ( Adler et al, 2013 , 2015 ), Kuwait ( Poirel et al, 2012a ; Zowawi et al, 2014 ), Saudi Arabia ( Shibl et al, 2013 ; Liu et al, 2015 ), and Japan ( Nagano et al, 2013 ; Hashimoto et al, 2014 ). The prevalence of OXA-48 carbapenemases among carbapenemase-producing K. pneumoniae in Spain and France was particularly high (74 and 78%, respectively; Robert et al, 2014 ; Palacios-Baena et al, 2016 ).…”

Section: The Epidemiology Genetic Context Treatment Options and Dementioning

confidence: 99%

“…The ST11 isolates carried various carbapenemases, including NDM-1, VIM-1, OXA-48, KPC-2, and OXA-245 ( Lascols et al, 2013 ; Oteo et al, 2013b , 2015 ). In addition, ST14, ST15, ST101, ST147, and ST405 harboring bla OXA-48-like have often been reported in many countries, such as the USA ( Lascols et al, 2013 ), Spain ( Oteo et al, 2013b , 2015 ; Ruiz-Garbajosa et al, 2013 ; Arana et al, 2015 ; Cubero et al, 2015 ), the Czech Republic ( Hrabak et al, 2015 ), Libya ( Lafeuille et al, 2013 ), India ( Lascols et al, 2013 ), Germany ( Gottig et al, 2015 ), Finland ( Osterblad et al, 2012 ), France ( Liapis et al, 2014 ), and Japan ( Hashimoto et al, 2014 ). Recent results from 83 hospitals in Spain showed that OXA-48 (71.5%) and VIM-1 (25.3%) were the most frequently detected carbapenemases, and the most prevalent sequence types were ST11 and ST405 for K. pneumoniae ( Oteo et al, 2015 ).…”

Section: The Epidemiology Genetic Context Treatment Options and Dementioning

confidence: 99%

Global Dissemination of Carbapenemase-Producing Klebsiella pneumoniae: Epidemiology, Genetic Context, Treatment Options, and Detection Methods

et al. 2016

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The emergence of carbapenem-resistant Gram-negative pathogens poses a serious threat to public health worldwide. In particular, the increasing prevalence of carbapenem-resistant Klebsiella pneumoniae is a major source of concern. K. pneumoniae carbapenemases (KPCs) and carbapenemases of the oxacillinase-48 (OXA-48) type have been reported worldwide. New Delhi metallo-β-lactamase (NDM) carbapenemases were originally identified in Sweden in 2008 and have spread worldwide rapidly. In this review, we summarize the epidemiology of K. pneumoniae producing three carbapenemases (KPCs, NDMs, and OXA-48-like). Although the prevalence of each resistant strain varies geographically, K. pneumoniae producing KPCs, NDMs, and OXA-48-like carbapenemases have become rapidly disseminated. In addition, we used recently published molecular and genetic studies to analyze the mechanisms by which these three carbapenemases, and major K. pneumoniae clones, such as ST258 and ST11, have become globally prevalent. Because carbapenemase-producing K. pneumoniae are often resistant to most β-lactam antibiotics and many other non-β-lactam molecules, the therapeutic options available to treat infection with these strains are limited to colistin, polymyxin B, fosfomycin, tigecycline, and selected aminoglycosides. Although, combination therapy has been recommended for the treatment of severe carbapenemase-producing K. pneumoniae infections, the clinical evidence for this strategy is currently limited, and more accurate randomized controlled trials will be required to establish the most effective treatment regimen. Moreover, because rapid and accurate identification of the carbapenemase type found in K. pneumoniae may be difficult to achieve through phenotypic antibiotic susceptibility tests, novel molecular detection techniques are currently being developed.

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“…Thus, it is likely that this patient acquired MDR A. baumannii during his stay in Brunei. Receiving medical care abroad has been suggested as a potential route of transmission of MDR organisms [16,17]. The sequence type of A. baumannii isolated in this study was ST208, which often carries bla OxA-23 and appears to be an emerging lineage mediating the spread of carbapenem resistance [18].…”

Section: Discussionmentioning

confidence: 77%

Multidrug-resistant Acinetobactor baumannii isolated from a traveler returned from Brunei

Tojo

Mawatari²,

Hayakawa³

et al. 2015

Journal of Infection and Chemotherapy

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Isolation of OXA-48 Carbapenemase-Producing Klebsiella pneumoniae ST101 from an Overseas Traveler Returning to Japan

Cited by 14 publications

References 17 publications

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

Resistome of carbapenem- and colistin-resistant Klebsiella pneumoniae clinical isolates

Global Dissemination of Carbapenemase-Producing Klebsiella pneumoniae: Epidemiology, Genetic Context, Treatment Options, and Detection Methods

Multidrug-resistant Acinetobactor baumannii isolated from a traveler returned from Brunei

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