A Swordless Knight: Epidemiology and Molecular Characteristics of the bla KPC -Negative Sequence Type 258 Klebsiella pneumoniae Clone
- 1 October 2012
- journal article
- Published by American Society for Microbiology in Journal of Clinical Microbiology
- Vol. 50 (10), 3180-3185
- https://doi.org/10.1128/jcm.00987-12
Abstract
In June 2010, a bla KPC -negative, ertapenem-resistant ST-258 Klebsiella pneumoniae strain was isolated from a patient in the Laniado Medical Center (LMC). Our aims were (i) to describe its molecular characteristics and resistance mechanisms and (ii) to assess whether the bla KPC -negative ST-258 K. pneumoniae clone spreads as efficiently as its KPC-producing isogenic strain. In a prospective study, surveillance of all ertapenem-resistant, carbapenemase-negative K. pneumoniae (ERCNKP) isolates was conducted from June 2010 to May 2011 at LMC (314 beds) and from July 2008 to December 2010 at the Tel Aviv Sourasky Medical Center (TASMC) (1,200 beds). Molecular typing was done by arbitrarily primed PCR, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). A total of 8 of 42 (19%) ERCNKP isolates in LMC and 1 of 32 (3.1%) in TASMC belonged to the ST-258 clone. These strains carried the bla CTX-M-2 or the bla CTX-M-25 extended-spectrum β-lactamase (ESBL) gene. Sequencing of the ompK genes showed a frameshift mutation in the ompK35 gene. The fate of the bla KPC -carrying plasmid, pKpQIL, was determined by S1 analysis and by PCR of the Tn 4401 transposon, repA , and the truncated bla OXA-9 . Plasmid analysis of the ERCNKP ST-258 isolates showed variability in plasmid composition and absence of the Tn 4401 transposon and the pKpQIL plasmid. In addition, the ST-258 clone was identified in 35/35 (100%) of KPC-producing K. pneumoniae isolates but in none of 62 ertapenem-susceptible K. pneumoniae isolates collected in the two centers. Our results suggest that ERCNKP ST-258 evolved by loss of the bla KPC -carrying plasmid pKpQIL. ERCNKP ST-258 appears to have low epidemic potential.Keywords
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