The spread of KPC-producing Enterobacteriaceae in Spain: WGS analysis of the emerging high-risk clones of Klebsiella pneumoniae ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3. (15th August 2016)

• Record Type: Journal Article
• Authors: Oteo, Jesús; Pérez-Vázquez, María; Bautista, Verónica; Ortega, Adriana; Zamarrón, Pilar; Saez, David; Fernández-Romero, Sara; Lara, Noelia; Ramiro, Raquel; Aracil, Belén; Campos, José
• Other Names: author non-byline.; Rodríguez-Polo José Antonio author non-byline.; Aznar Esteban author non-byline.; Campelo Carolina author non-byline.; Martínez-Ruiz Rocío author non-byline.; Sánchez-Romero Isabel author non-byline.; Jimenez-Álvarez Silvia author non-byline.; García-Picazo Luisa author non-byline.; Delgado-Iribarren Alberto author non-byline.; Álvarez-García Patricia author non-byline.; Gil Yolanda author non-byline.; Almagro María author non-byline.; Cercenado Emilia author non-byline.; Barberá Eva M. González author non-byline.; Almaraz Salvador Giner author non-byline.; Carazo Inmaculada author non-byline.; Cuesta Inocente author non-byline.; Sánchez-Yebra Waldo author non-byline.; Arana David Molina author non-byline.; Alós Juan-Ignacio author non-byline.; Molina Juan Manuel Hernández author non-byline.; Praetorius Alejandro Gonzalez author non-byline.; del Baño Sonia Solís author non-byline.; Hernández José Luis author non-byline.; Baladón Concepción author non-byline.; Carranza Rafael author non-byline.; Wilhelmi Isabel author non-byline.; Garduño Eugenio author non-byline.; Yagüe Genoveva author non-byline.; Frau Cristina author non-byline.; Rodriguez-Escudero Mª José author non-byline.; Somodevilla Ángel author non-byline.;
• Is Part Of: Journal of antimicrobial chemotherapy. Volume 71:Number 12(2016:Dec.)
• Page Start: 3392
• Page End: 3399
• Publication Date: 2016-08-15
• Subjects: Anti-infective agents -- Periodicals; Chemotherapy -- Periodicals; 615.58
• DOI: 10.1093/jac/dkw321
• Languages: English
• ISSNs: 0305-7453

Abstract

Abstract : The authors employed whole-genome sequencing to show that 3 clones of KPC-producing Klebsiella pneumoniae were responsible for the spread of resistance throughout Spain. Abstract : Objectives: We analysed the microbiological traits and population structure of KPC-producing Enterobacteriaceae isolates collected in Spain between 2012 and 2014. We also performed a comparative WGS analysis of the three major KPC-producing Klebsiella pneumoniae clones detected. Methods: Carbapenemase and ESBL genes were sequenced. The Institut Pasteur MLST scheme was used. WGS data were used to construct phylogenetic trees, to identify the determinants of resistance and to de novo assemble the genome of one representative isolate of each of the three major K. pneumoniae clones. Results: Of the 2443 carbapenemase-producing Enterobacteriaceae isolates identified during the study period, 111 (4.5%) produced KPC. Of these, 81 (73.0%) were K. pneumoniae and 13 (11.7%) were Enterobacter cloacae . Three major epidemic clones of K. pneumoniae were identified: ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3. ST11/KPC-2 differed from ST101/KPC-2 and ST512/KPC-3 by 27 819 and 6924 SNPs, respectively. ST101/KPC-2 differed from ST512/KPC-3 by 28 345 SNPs. Nine acquired resistance genes were found in ST11/KPC-2, 11 in ST512/KPC-3 and 13 in ST101/KPC-2. ST101/KPC-2 had the highest number of virulence genes (20). An 11 bp deletion at the end of the mgrB sequence was the cause of colistin resistance in ST512/KPC-3. Conclusions: KPC-producing Enterobacteriaceae are increasing in Spain. Most KPC-producing K. pneumoniae isolates belonged to only five clones: ST11 and ST512 caused interregional spread, ST101 caused regional spread and ST1961 and ST678 produced independent hospital outbreaks. ST101/KPC-2 had the highest number of resistance and virulence genes. ST101/KPC-2 and ST512/KPC-3 were recently implicated in the spread of KPC in Italy.