Features of Infections Due to Klebsiella pneumoniae Carbapenemase–Producing Escherichia coli: Emergence of Sequence Type 131
Open Access
- 4 April 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 55 (2), 224-231
- https://doi.org/10.1093/cid/cis387
Abstract
Background. Klebsiellapneumoniae carbapenemase (KPC)–producing K. pneumoniae has become endemic in many US hospitals. On the other hand, KPC-producing Escherichia coli remains rare. Methods. We studied infection or colonization due to KPC-producing E. coli identified at our hospital between September 2008 and February 2011. A case-control study was conducted to document clinical features associated with this organism. Susceptibility testing, sequencing of β-lactamase genes, pulsed-field gel electrophoresis, multilocus sequence typing, and plasmid analysis were performed for characterization of the isolates. Results. Thirteen patients with KPC-producing E. coli were identified. The patients had multiple comorbid conditions and were in hospital for variable periods of time before KPC-producing E. coli was identified. The presence of liver diseases was independently associated with recovery of KPC-producing E. coli when compared with extended-spectrum β-lactamase–producing E. coli. The isolates showed variable susceptibility to carbapenems. Seven isolates belonged to sequence type (ST) 131, which is the international epidemic, multidrug-resistant clone, but their plasmid profiles were diverse. KPC-producing organisms other than E. coli were isolated within 1 month from 5 of the patients. The KPC-encoding plasmids were highly related in 3 of them, suggesting the occurrence of their interspecies transfer. Conclusions. KPC-producing E. coli infections occur in severely ill patients who are admitted to the hospital. Acquisition of the KPC-encoding plasmids by the ST 131 clone, reported here for the first time to our knowledge in the United States, seems to represent multiple independent events. These plasmids are often shared between E. coli and other species.Keywords
This publication has 37 references indexed in Scilit:
- Intercontinental emergence of Escherichia coli clone O25:H4-ST131 producing CTX-M-15Journal of Antimicrobial Chemotherapy, 2007
- Evaluation of Methods To Identify the Klebsiella pneumoniae Carbapenemase in EnterobacteriaceaeJournal of Clinical Microbiology, 2007
- Detection and Spread of Escherichia coli Possessing the Plasmid-Borne Carbapenemase KPC-2 in Brooklyn, New YorkClinical Infectious Diseases, 2007
- Sex and virulence in Escherichia coli: an evolutionary perspectiveMolecular Microbiology, 2006
- A Change in the Epidemiology of Infections Due to Extended-Spectrum -Lactamase--Producing OrganismsClinical Infectious Diseases, 2006
- Standardization of Pulsed-Field Gel Electrophoresis Protocols for the Subtyping ofEscherichia coliO157:H7,Salmonella, andShigellafor PulseNetFoodborne Pathogens & Disease, 2006
- Emergence of Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) in the communityJournal of Antimicrobial Chemotherapy, 2005
- Epidemiology of urinary tract infections: incidence, morbidity, and economic costsAmerican Journal Of Medicine, 2002
- Rapid and Simple Determination of the Escherichia coli Phylogenetic GroupApplied and Environmental Microbiology, 2000
- Extended Virulence Genotypes ofEscherichia coliStrains from Patients with Urosepsis in Relation to Phylogeny and Host CompromiseThe Journal of Infectious Diseases, 2000