Molecular Characteristics of KPC-Producing Enterobacteriaceae at the Early Stage of Their Dissemination in Poland, 2008–2009
- 1 December 2011
- journal article
- research article
- Published by American Society for Microbiology in Antimicrobial Agents and Chemotherapy
- Vol. 55 (12), 5493-5499
- https://doi.org/10.1128/aac.05118-11
Abstract
After the first report in May 2008, the National Reference Center for Susceptibility Testing confirmed 113 cases of infection or colonization by KPC-producing members of the family Enterobacteriaceae in Poland by the end of 2009. The vast majority of patients were found in 18 hospitals; three patients were diagnosed at outpatient clinics. Most of the institutions were in the Warsaw area, including three hospitals with the highest numbers of cases. When available, the data on previous hospitalizations often indicated that these hospitals were the probable acquisition sites; one patient arrived from New York. The group of 119 unique isolates consisted of Klebsiella pneumoniae ( n = 114), followed by Klebsiella oxytoca ( n = 3), and Escherichia coli ( n = 2). The K. pneumoniae isolates were dominated by the clone sequence type 258 (ST258) ( n = 111); others were ST11 and ST23. The ST258 group was heterogeneous, with 28 pulsed-field gel electrophoresis (PFGE) subtypes, ∼25 plasmid profiles, and nine β-lactamase patterns differing by KPC variants (KPC-2 mainly), and SHV-12, CTX-M-3, and TEM-1-like enzymes. Plasmids carrying bla KPC genes varied in size (∼48 to 250 kb), structure, and conjugation potential. Transferable IncFII K plasmids of ∼110 to 160 kb, probably pKpQIL or its derivatives, were observed in all K. pneumoniae clones and in K. oxytoca . Also prevalent were nontypeable pETKp50-like plasmids of ∼50 kb, found in K. pneumoniae ST258 and E. coli isolates (ST93 and ST224). Two K. pneumoniae-E. coli pairs from single patients might represent the in vivo transfer of such plasmids. The striking diversity of KPC producers at the early stage of dissemination could result from several introductions of these bacteria into the country, their multidirectional evolution during clonal spread, and transfer of the plasmids.Keywords
This publication has 44 references indexed in Scilit:
- Genetic Factors Associated with Elevated Carbapenem Resistance in KPC-Producing Klebsiella pneumoniaeAntimicrobial Agents and Chemotherapy, 2010
- Complete Nucleotide Sequence of KPC-3-Encoding Plasmid pKpQIL in the Epidemic Klebsiella pneumoniae Sequence Type 258Antimicrobial Agents and Chemotherapy, 2010
- Complete Nucleotide Sequence of Klebsiella pneumoniae Multidrug Resistance Plasmid pKP048, Carrying bla KPC-2 , bla DHA-1 , qnrB4 , and armAAntimicrobial Agents and Chemotherapy, 2010
- Emergence of Klebsiella pneumoniae ST258 with KPC-2 in PolandAntimicrobial Agents and Chemotherapy, 2009
- Molecular Epidemiology of KPC-Producing Klebsiella pneumoniae Isolates in the United States: Clonal Expansion of Multilocus Sequence Type 258Antimicrobial Agents and Chemotherapy, 2009
- Clonal spread of KPC-2 carbapenemase-producing Klebsiella pneumoniae strains in GreeceJournal of Antimicrobial Chemotherapy, 2009
- Characterization of blaKPC-containing Klebsiella pneumoniae isolates detected in different institutions in the Eastern USAJournal of Antimicrobial Chemotherapy, 2009
- Complete Nucleotide Sequence of the pCTX-M3 Plasmid and Its Involvement in Spread of the Extended-Spectrum β-Lactamase GeneblaCTX-M-3Antimicrobial Agents and Chemotherapy, 2007
- Plasmid-Mediated Imipenem-Hydrolyzing Enzyme KPC-2 among Multiple Carbapenem-Resistant Escherichia coli Clones in IsraelAntimicrobial Agents and Chemotherapy, 2006
- Sex and virulence in Escherichia coli: an evolutionary perspectiveMolecular Microbiology, 2006