1. Clonal dissemination of carbapenemase-producing Klebsiella pneumoniae: Two distinct sub-lineages of Sequence Type 11 carrying bla KPC-2 and bla OXA-48 .
- Author
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Lu MC, Tang HL, Chiou CS, Wang YC, Chiang MK, and Lai YC
- Subjects
- Adult, Aged, Aged, 80 and over, Bacterial Capsules genetics, Carbapenem-Resistant Enterobacteriaceae genetics, Electrophoresis, Gel, Pulsed-Field, Female, Genotype, Hospitals, University, Humans, Inpatients, Klebsiella Infections microbiology, Klebsiella Infections transmission, Klebsiella pneumoniae genetics, Male, Middle Aged, Molecular Epidemiology, Molecular Typing, Polymerase Chain Reaction, Prospective Studies, Sequence Analysis, DNA, Taiwan epidemiology, Young Adult, Bacterial Proteins genetics, Carbapenem-Resistant Enterobacteriaceae classification, Carbapenem-Resistant Enterobacteriaceae isolation & purification, Klebsiella Infections epidemiology, Klebsiella pneumoniae classification, Klebsiella pneumoniae isolation & purification, beta-Lactamases genetics
- Abstract
Objectives: The global spread of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a massive threat to human health. We investigated the clonal relatedness of CR-Kp strains in central Taiwan., Methods: CR-Kp strains were prospectively collected from inpatients referred to Chung Shan Medical University Hospital (CSMUH) during September 2011 to December 2015. The presence of carbapenemase genes, including bla
KPC-2 , blaVIM-1 , blaNDM-1 , and blaOXA-48 , was analysed with polymerase chain reaction (PCR) and sequence determination. Clonal relatedness was determined by pulse-field gel electrophoresis and multilocus sequence typing. Capsule synthesis loci were typed based on the variation of the wzi gene., Results: A total of 174 CR-Kp strains were collected. KPC-2 and OXA-48 were present in 63 (36.2%) and 22 (12.6%) CR-Kp strains, respectively. Two strains isolated in 2014 coproduced KPC-2 and OXA-48. Nearly all (98%) carbapenemase-producing K. pneumoniae strains belonged to the ST11 clone and could be further grouped into distinct sub-lineages. Intriguingly, the first sub-lineage, designated ST11-Clade I, contained all KPC-2 strains; OXA-48 strains were mostly included in the second sub-lineage, ST11-Clade II. Furthermore, a variation on the capsule synthesis loci was detected between these two sub-lineages: KL-47 was assigned to ST11-Clade I, whereas KL-64 or KL-9 were the main types for the ST11-Clade II strains., Conclusions: Clonal expansion of ST11 was responsible for the dissemination of carbapenemase-producing K. pneumoniae. Although KPC-2 still predominates, OXA-48 has emerged rapidly. Co-existence of KPC-2 and OXA-48 in two ST11-Clade I K. pneumoniae highlights the urgency to unravel mechanisms that contribute to this highly transmissible lineage., (Copyright © 2018 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.)- Published
- 2018
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