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Anita Cheruvanky, Nicole Stoesser, Anna E Sheppard, Derrick W Crook, Paul S Hoffman, Erin Weddle, Joanne Carroll, Costi D Sifri, Weidong Chai, Katie Barry, Girija Ramakrishnan, Amy J Mathers
The Klebsiella pneumoniae carbapenemase gene (blaKPC) is typically located within the mobile transposon Tn4401 Enhanced KPC expression has been associated with deletions in the putative promoter region upstream of blaKPC Illumina sequences from blaKPC-positive clinical isolates from a single institution were mapped to a Tn4401b reference sequence, which carries no deletions. The novel isoform Tn4401h (188bp deletion [lsqb]between istB and blaKPC[rsqb]) was present in 14% (39/281) clinical isolates. MICs for Escherichia coli strains containing plasmids with Tn4401a and Tn4401h were more resistant to meropenem (≥16, ≥16), ertapenem (≥8, 4) and cefepime (≥64, 4) than E...
April 3, 2017: Antimicrobial Agents and Chemotherapy
Aura Dayana Falco Restrepo, Mariel Alexandra Velásquez Nieves, Howard Takiff
INTRODUCTION: Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are amongst the most important causative agents of nosocomial infections worldwide. Isolates of this bacterium have been identified in Venezuela but little is known about their local spread. The aim of this study was to perform the molecular characterization of KPC-producing strains isolated from 2012 to 2013 in a public hospital in Caracas, Venezuela. METHODS: Twenty-two K. pneumoniae clinical isolates phenotypically classified as KPC producing were subjected to PCR screening for the presence of blaKPC genes and their location within transposon Tn4401...
March 11, 2017: Enfermedades Infecciosas y Microbiología Clínica
Gustavo C Cerqueira, Ashlee M Earl, Christoph M Ernst, Yonatan H Grad, John P Dekker, Michael Feldgarden, Sinéad B Chapman, João L Reis-Cunha, Terrance P Shea, Sarah Young, Qiandong Zeng, Mary L Delaney, Diane Kim, Ellena M Peterson, Thomas F O'Brien, Mary Jane Ferraro, David C Hooper, Susan S Huang, James E Kirby, Andrew B Onderdonk, Bruce W Birren, Deborah T Hung, Lisa A Cosimi, Jennifer R Wortman, Cheryl I Murphy, William P Hanage
Carbapenem-resistant Enterobacteriaceae (CRE) are among the most severe threats to the antibiotic era. Multiple different species can exhibit resistance due to many different mechanisms, and many different mobile elements are capable of transferring resistance between lineages. We prospectively sampled CRE from hospitalized patients from three Boston-area hospitals, together with a collection of CRE from a single California hospital, to define the frequency and characteristics of outbreaks and determine whether there is evidence for transfer of strains within and between hospitals and the frequency with which resistance is transferred between lineages or species...
January 31, 2017: Proceedings of the National Academy of Sciences of the United States of America
Amy J Mathers, Nicole Stoesser, Weidong Chai, Joanne Carroll, Katie Barry, Anita Cherunvanky, Robert Sebra, Andrew Kasarskis, Tim E Peto, A Sarah Walker, Costi D Sifri, Derrick W Crook, Anna E Sheppard
Carbapenemase genes in Enterobacteriaceae are mostly described as being plasmid associated. However, the genetic context of carbapenemase genes is not always confirmed in epidemiological surveys, and the frequency of their chromosomal integration therefore is unknown. A previously sequenced collection of blaKPC-positive Enterobacteriaceae from a single U.S. institution (2007 to 2012; n = 281 isolates from 182 patients) was analyzed to identify chromosomal insertions of Tn4401, the transposon most frequently harboring blaKPC Using a combination of short- and long-read sequencing, we confirmed five independent chromosomal integration events from 6/182 (3%) patients, corresponding to 15/281 (5%) isolates...
March 2017: Antimicrobial Agents and Chemotherapy
Carla Rodrigues, Jan Bavlovič, Elisabete Machado, José Amorim, Luísa Peixe, Ângela Novais
KPC-3-producing bacteria are endemic in many countries but only recently became apparent their wide distribution in different Portuguese hospitals. The aim of this study is to characterize genetic backgrounds associated with bla KPC-3 among Klebsiella pneumoniae isolates recently identified on non-hospitalized patients in Portugal. Twenty KPC-producing K. pneumoniae identified between October 2014 and November 2015 in three different community laboratories were characterized. Isolates were mainly from patients from long-term care facilities (n = 11) or nursing homes (n = 6), most of them (75%) previously hospitalized in different Portuguese hospitals...
2016: Frontiers in Microbiology
Teresa Martinez, Idali Martinez, Guillermo J Vazquez, Edna E Aquino, Iraida E Robledo
Carbapenems are considered the last-resort antibiotics to treat infections caused by multidrug-resistant Gram-negative bacilli. The Klebsiella pneumoniae carbapenemase (KPC) enzyme hydrolyses β-lactam antibiotics including the carbapenems. KPC has been detected worldwide in Enterobacteriaceae and Pseudomonas aeruginosa isolates associated with transposon Tn4401 commonly located in plasmids. Acinetobacter baumannii has become an important multidrug-resistant nosocomial pathogen. KPC-producing A. baumannii has been reported to date only in Puerto Rico...
August 2016: Journal of Medical Microbiology
Terri Stillwell, Michael Green, Karen Barbadora, Juliet G Ferrelli, Terri L Roberts, Scott J Weissman, Andrew Nowalk
BACKGROUND: The increase in carbapenem-resistant Enterobacteriaceae (CRE) infections is a critical public health issue. We recently experienced the largest single-center pediatric outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) at our hospital. The objective of this study was to describe the molecular epidemiology of this outbreak before and after infection-prevention interventions. METHODS: All positive cultures and associated clinical conditions were reviewed to determine whether health care-associated infections (HAIs) exist...
December 2015: Journal of the Pediatric Infectious Diseases Society
Beiwen Zheng, Jing Zhang, Jinru Ji, Yunhui Fang, Ping Shen, Chaoqun Ying, Jifang Lv, Yonghong Xiao, Lanjuan Li
We report here the emergence of seven IMP-4-producing Raoultella ornithinolytica isolates obtained from one patient. All isolates carried the blaIMP-4 carbapenemase gene, five isolates also carried blaSHV-12, four contained blaTEM-1, and one contained blaOXA-1. Notably, the R. ornithinolytica isolate Ro25724 also expressed Klebsiella pneumoniae carbapenemase (KPC)-2. The blaKPC-2 gene was located on a Tn3-Tn4401 integration structure on a plasmid of ∼450 kb. This is the first description of the coexistence of blaKPC-2 and blaIMP-4 from the genus Raoultella...
November 2015: Antimicrobial Agents and Chemotherapy
Nicole D Pecora, Ning Li, Marc Allard, Cong Li, Esperanza Albano, Mary Delaney, Andrea Dubois, Andrew B Onderdonk, Lynn Bry
UNLABELLED: Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent public health concern. Rapid identification of the resistance genes, their mobilization capacity, and strains carrying them is essential to direct hospital resources to prevent spread and improve patient outcomes. Whole-genome sequencing allows refined tracking of both chromosomal traits and associated mobile genetic elements that harbor resistance genes. To enhance surveillance of CREs, clinical isolates with phenotypic resistance to carbapenem antibiotics underwent whole-genome sequencing...
2015: MBio
Marta Piotrowska, Magdalena Popowska
The mobilome is a pool of genes located within mobile genetic elements (MGE), such as plasmids, IS elements, transposons, genomic/pathogenicity islands, and integron-associated gene cassettes. These genes are often referred to as "flexible" and may encode virulence factors, toxic compounds as well as resistance to antibiotics. The phenomenon of MGE transfer between bacteria, known as horizontal gene transfer (HGT), is well documented. The genes present on MGE are subject to continuous processes of evolution and environmental changes, largely induced or significantly accelerated by man...
2015: Frontiers in Microbiology
Susu He, Alison Burgess Hickman, Alessandro M Varani, Patricia Siguier, Michael Chandler, John P Dekker, Fred Dyda
UNLABELLED: Carbapenemase-producing Enterobacteriaceae (CPE), which are resistant to most or all known antibiotics, constitute a global threat to public health. Transposable elements are often associated with antibiotic resistance determinants, suggesting a role in the emergence of resistance. One insertion sequence, IS26, is frequently associated with resistance determinants, but its role remains unclear. We have analyzed the genomic contexts of 70 IS26 copies in several clinical and surveillance CPE isolates from the National Institutes of Health Clinical Center...
2015: MBio
Carolina Padilha Tavares, Polyana Silva Pereira, Elizabeth de Andrade Marques, Celio Faria, Maria da Penha Araújo Herkenhoff de Souza, Robmary de Almeida, Carlene de Fátima Morais Alves, Marise Dutra Asensi, Ana Paula D'Alincourt Carvalho-Assef
In Brazil, since 2009, there has been an ever increasing widespread of the bla(KPC-2) gene, mainly in Klebsiella pneumoniae. This study aims to assess the molecular epidemiology and genetic background of this gene in Enterobacteriaceae (non-K. pneumoniae) species from 9 Brazilian states between 2009 and 2011. Three hundred eighty-seven isolates were analyzed exhibiting nonsusceptibility to carbapenems, in which the bla(KPC-2) gene was detected in 21.4%. By disk diffusion and E-test, these isolates exhibited high rates of resistance to most of the antimicrobials tested, including tigecycline (45...
August 2015: Diagnostic Microbiology and Infectious Disease
Adriana Correa, Rosa Del Campo, Marcela Perenguez, Victor M Blanco, Mercedes Rodríguez-Baños, Federico Perez, Juan J Maya, Laura Rojas, Rafael Cantón, Cesar A Arias, Maria V Villegas
The ability of Pseudomonas aeruginosa to develop resistance to most antimicrobials represents an important clinical threat worldwide. We report the dissemination in several Colombian hospitals of two predominant lineages of extensively drug-resistant (XDR) carbapenemase-producing P. aeruginosa strains. These lineages belong to the high-risk clones sequence type 111 (ST111) and ST235 and harbor blaVIM-2 on a class 1 integron and blaKPC-2 on a Tn4401 transposon, respectively. Additionally, P. aeruginosa ST1492, a novel single-locus variant of ST111, was identified...
April 2015: Antimicrobial Agents and Chemotherapy
Polyana Silva Pereira, Mirla Borghi, Rodolpho Mattos Albano, Jonathan Christian Oliveira Lopes, Melise Chaves Silveira, Elizabeth Andrade Marques, Jane Cleide Ribeiro Oliveira, Marise Dutra Asensi, Ana Paula D'Alincourt Carvalho-Assef
The most important resistance mechanism against β-lactam drugs is the production of carbapenemases. In this study, we report the first identification of Klebsiella pneumoniae carbapenemase (KPC)-2 and New Delhi metallo-β-lactamase (NDM)-1 in Enterobacter hormaechei subps. oharae from Brazil. The detection of carbapenemases was done by phenotypic assays, PCR, and DNA sequencing, whereas the identification was performed by conventional techniques, sequencing of the 16S rDNA gene, and hsp60-genotyping. Molecular typing was performed using pulsed-field gel electrophoresis, and antimicrobial susceptibility was surrogated by the Etest methodology...
April 2015: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Yan Jiang, Ping Shen, Zeqing Wei, Lilin Liu, Fang He, Keren Shi, Yanfei Wang, Haiping Wang, Yunsong Yu
Fosfomycin has been proposed as an adjunct to other active agents for treating KPC-producing Klebsiella pneumoniae infections. This study aimed to investigate the prevalence of fosfomycin resistance and plasmid-mediated resistance determinants among KPC-producing K. pneumoniae isolates from clinical samples in China. In total, 278 KPC-producing and 80 extended-spectrum β-lactamase (ESBL)-producing (non-KPC-producing) clinical K. pneumoniae isolates were collected in 12 hospitals from 2010 to 2013. Fosfomycin susceptibility testing was carried out using the agar dilution method...
January 2015: International Journal of Antimicrobial Agents
Anna F Lau, Honghui Wang, Rebecca A Weingarten, Steven K Drake, Anthony F Suffredini, Yong Chen, Marjan Gucek, Jung-Ho Youn, Frida Stock, Hanna Tso, Jim DeLeo, James J Cimino, Karen M Frank, John P Dekker
No abstract text is available yet for this article.
December 2014: Journal of Clinical Microbiology
C Marquez, A Ingold, N Echeverría, A Acevedo, R Vignoli, V García-Fulgueiras, J Viroga, O Gonzalez, V Odizzio, K Etulain, E Nuñez, H Albornoz, G Borthagaray, A Galiana
We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study...
May 2014: New Microbes and New Infections
Teresa Martínez, Guillermo J Vázquez, Edna E Aquino, Idalí Martínez, Iraida E Robledo
Carbapenems are the last-resort antibiotics for the treatment of infections caused by multidrug-resistant Gram-negative bacilli. Klebsiella pneumoniae carbapenemase (KPC) hydrolyses β-lactam antibiotics including the carbapenems. KPCs have been detected in Enterobacteriaceae and Pseudomonas aeruginosa isolates worldwide associated with transposon Tn4401 commonly located in plasmids. Acinetobacter baumannii has become an important multidrug-resistant nosocomial pathogen capable of hydrolysing the carbapenem antibiotics...
December 2014: Journal of Medical Microbiology
Anna F Lau, Honghui Wang, Rebecca A Weingarten, Steven K Drake, Anthony F Suffredini, Mark K Garfield, Yong Chen, Marjan Gucek, Jung-Ho Youn, Frida Stock, Hanna Tso, Jim DeLeo, James J Cimino, Karen M Frank, John P Dekker
Carbapenem-resistant Enterobacteriaceae (CRE) have spread globally and represent a serious and growing threat to public health. Rapid methods for tracking plasmids carrying carbapenemase genes could greatly benefit infection control efforts. Here, we demonstrate that real-time, direct tracking of a single plasmid in a bacterial strain responsible for an outbreak is possible using a commercial matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) system. In this case, we retrospectively tracked the bla(KPC) carbapenemase gene-bearing pKpQIL plasmid responsible for a CRE outbreak that occurred at the NIH Clinical Center in 2011...
August 2014: Journal of Clinical Microbiology
Nerea Porres-Osante, Jose Manuel Azcona-Gutiérrez, Beatriz Rojo-Bezares, Esther Undabeitia, Carmen Torres, Yolanda Sáenz
OBJECTIVES: To characterize the mechanisms involved in carbapenem resistance, as well as the genetic elements supporting their mobilization, in a multidrug-resistant Escherichia coli isolate. METHODS: The E. coli isolate was obtained from a patient with fatal urinary sepsis. Antimicrobial susceptibility testing was performed by the disc diffusion and agar dilution methods. The E. coli molecular type and phylogroup were determined using multilocus sequence typing and the triple PCR technique, respectively...
July 2014: Journal of Antimicrobial Chemotherapy
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