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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
Yanping Luo, Jiyong Yang, Liyan Ye, Lin Guo, Qiang Zhao, Rong Chen, Yong Chen, Xuelin Han, Jingya Zhao, Shuguang Tian, Li Han
Twelve nonduplicated KPC-2-producing enterobacterial isolates, including three Escherichia coli, two Citrobacter freundii, two Enterobacter cloacae, four Enterobacter aerogenes, and one Klebsiella oxytoca, were collected from various clinical samples within 18 months (March 2011 to September 2012). Two of the 12 patients died from infections caused by KPC-2-producing pathogens, while the rest of the patients with KPC-2-producing pathogens improved or were cured. The majority of the clinical isolates exhibited a high-level of resistance to oxyimino-cephalosporins and carbapenems, and possessed self-transferable bla(KPC-2)-carrying plasmids with sizes ranging from 20 to 120 kb...
August 2014: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Yang Liu, Xiang-Yang Li, La-Gen Wan, Wei-Yan Jiang, Jing-Hong Yang, Fang-Qu Li
A study was designed to characterize three carbapenemase-producing Klebsiella pneumoniae isolated from pediatric patients in China. Molecular characterization was done using polymerase chain reaction and sequencing for blaVIM, blaNDM, blaIMP, blaKPC, blaCTX-Ms, blaOXAs, blaTEMs, and blaSHV; plasmid-mediated quinolone resistance determinants; aminoglycoside resistance determinants; multilocus sequencing typing; plasmid replicon typing; addiction; and virulence factors. Kp32 belonged to the newly described sequence type 1137, were positive for aac(6')-Ib-suzhou, qnrA1, qnrB4, qnrS1, aac(6')-Ib, rmtB, armA, blaSHV-12, blaCTX-M-15, blaKPC-2, and blaIMP-4; contained IncA/C plasmids that tested positive for K1 capsular antigens, the ccdAB (coupled cell division locus) addiction system and the wabG, ureA, rmpA, magA, allS, fimH, and the aerobactin virulence factors...
April 2014: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Vanessa Bley Ribeiro, Leonardo Neves Andrade, Adriano Rostirolla Linhares, Juliana Barin, Ana Lúcia da Costa Darini, Alexandre P Zavascki, Afonso Luis Barth
Carbapenem-resistant Enterobacteriaceae have been frequently reported worldwide. They represent a serious concern because of the limited therapeutic options. The aim of this study was to investigate the molecular epidemiology of 14 Klebsiella pneumoniae carbapenemase (KPC) producers among 345 clinical isolates of Enterobacteriaceae with reduced susceptibility to carbapenems recovered from 11 separate hospitals in southern Brazil. The blaKPC-2 gene was detected in 14 isolates (4 %): six Enterobacter cloacae, five K...
November 2013: Journal of Medical Microbiology
Liang Chen, Kalyan D Chavda, Nahed Al Laham, Roberto G Melano, Michael R Jacobs, Robert A Bonomo, Barry N Kreiswirth
Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae strains have spread worldwide and become a significant public health threat. blaKPC, the plasmid-borne KPC gene, was frequently identified on numerous transferable plasmids in different incompatibility replicon groups. Here we report the complete nucleotide sequence of a novel blaKPC-3-harboring IncI2 plasmid, pBK15692, isolated from a multidrug-resistant K. pneumoniae ST258 strain isolated from a New Jersey hospital in 2005. pBK15692 is 78 kb in length and carries a backbone that is similar to those of other IncI2 plasmids (pR721, pChi7122-3, pHN1122-1, and pSH146-65), including the genes encoding type IV pili and shufflon regions...
October 2013: Antimicrobial Agents and Chemotherapy
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