A nosocomial outbreak of KPC‐2‐producing Klebsiella pneumoniae in a Chinese hospital: dissemination of ST11 and emergence of ST37, ST392 and ST395. (10th July 2013)

• Record Type: Journal Article
• Authors: Yang, J.; Ye, L.; Guo, L.; Zhao, Q.; Chen, R.; Luo, Y.; Chen, Y.; Tian, S.; Zhao, J.; Shen, D.; Han, L.; Cantón, R.
• Is Part Of: Clinical microbiology and infection. Volume 19:Number 11(2013:Nov.)
• Page Start: E509
• Page End: E515
• Publication Date: 2013-07-10
• Subjects: Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1111/1469-0691.12275
• Languages: English
• ISSNs: 1198-743X

Abstract

<abstract abstract-type="main" id="clm12275-abs-0001"> <title>Abstract</title> <p>In China, <italic>Klebsiella pneumoniae</italic> carbapenemase (KPC) ‐producing <italic>K. pneumoniae</italic> isolates have been identified. However, little is known about the spread and outbreak of KPC‐producing enterobacterial pathogens. In this study, 48 non‐duplicated KPC‐producing isolates were analysed for genetic relatedness by pulsed‐field gel electrophoresis (PFGE), antimicrobial susceptibility by E‐test, and sequence type (ST) by multilocus sequence typing. S1‐PFGE and Southern blot were used for plasmid profiling, and PCR and subsequent sequencing were performed to determine the effects of genetic background on the <italic>bla</italic><sub>KPC</sub> gene. From December 2011 to June 2012, an outbreak of the KPC‐2‐producing <italic>K. pneumoniae</italic> was observed. The 48 isolates of <italic>K. pneumoniae</italic> are categorized into eight PFGE types (A1, A2, A3, A4, B, C, D and E). The predominant pathogens of the outbreak were strains with PFGE types A1, A2 and A3, which all belong to ST11. Furthermore, ST37, ST392 and ST395 KPC‐2‐producing <italic>K. pneumoniae</italic> isolates have also been sporadically identified. The <italic>bla</italic><sub>KPC‐2</sub>‐carrying plasmids vary in size from 30 to 220 kb. The genetic environments of the <italic>bla</italic><sub>KPC‐2</sub> gene for most strains were consistent with the genetic structure of <italic>bla</italic><sub>KPC‐2</sub> on the plasmid pKP048. In conclusion, the dissemination and outbreak of KPC‐2‐producing <italic>K. pneumoniae</italic> isolates in this study appeared to be clonal, and ST11 <italic>K. pneumoniae</italic> was the predominant clone attributed to the outbreak. This is the first study to report the emergence and spread of KPC‐producing <italic>K. pneumoniae</italic> ST392 and ST395 worldwide. Our findings suggest that horizontal transfer of Tn<italic>3</italic>‐based transposons might mediate the spread of <italic>bla</italic><sub>KPC‐2</sub> gene between different <italic>K. pneumoniae</italic> clones in China.</p> </abstract>