1. Molecular epidemiology of KPC-producing Klebsiella pneumoniae from invasive infections in Italy: Increasing diversity with predominance of the ST512 clade II sublineage
- Author
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Conte, Viola, Monaco, Monica, Giani, Tommaso, D'Ancona, Fortunato, Moro, Maria Luisa, Arena, Fabio, D'Andrea, Marco Maria, Rossolini, Gian Maria, Pantosti, Annalisa, Bianchi, E., Catania, M. R., Cavalcanti, P., De Nittis, R., Dusi, P. A., Grandesso, S., Gualdi, P., Imbriani, A., Pini, B., Vincenzi, C., Meledandri, M., Agrappi, C., Parisi, G., Pollini, S., Restelli, A., Rocchetti, A., Vailati, F., Aschbacher, R., Barbaro, A., Bona, R., Chirillo, M., Corradini, S., Cuccurullo, S., De Bernochi, A., Dodi, C., Giammanco, A., Mencacci, Antonella, Milano, F., Miragliotta, G., Mungiguerra, M., Pedna, M. F., Piana, Francesca, Porcheddu, G. M., Rossi, M. R., Santino, I., Sartor, A., Sartore, P., Conte V., Monaco M., Giani T., D'Ancona F., Moro M.L., Arena F., D'Andrea M.M., Rossolini G.M., Pantosti A., Bianchi E., Catania M.R., Cavalcanti P., De Nittis R., Dusi P.A., Grandesso S., Gualdi P., Imbriani A., Pini B., Vincenzi C., Meledandri M., Agrappi C., Parisi G., Pollini S., Restelli A., Rocchetti A., Vailati F., Aschbacher R., Barbaro A., Bona R., Chirillo M., Corradini S., Cuccurullo S., De Bernochi A., Dodi C., Giammanco A., Mencacci A., Milano F., Miragliotta G., Mungiguerra M., Pedna M.F., Piana F., Porcheddu G.M., Rossi M.R., Santino I., Sartor A., Sartore P., Conte, V, Monaco, M, Giani, T, D'Ancona, F, Moro, Ml, Arena, F, D'Andrea, Mm, Rossolini, Gm, Pantosti, A, AR-ISS Study Group on Carbapenemase-Producing K., pneumoniae: Bianchi E, Catania, Mr, Cavalcanti, P, De Nittis, R, Dusi, Pa, Grandesso, S, Gualdi, P, Imbriani, A, Pini, B, Vincenzi, C, Meledandri, Alessio, Agrappi, C, Parisi, G, Pollini, S, Restelli, Ugo, Rocchetti, Romualdo, Vailati, F, Aschbacher, R, Barbaro, A, Bona, R, Chirillo, M, Corradini, S, Cuccurullo, S, De Bernochi, A, Dodi, C, Giammanco, Anna, Mencacci, A, Milano, F, Miragliotta, Giuseppe, Mungiguerra, M, Pedna, Mf, Piana, Daniela, Porcheddu, Gm, Rossi, Mr, Santino, I, Sartor, A, and Sartore, P.
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0301 basic medicine ,Microbiology (medical) ,gel ,Klebsiella pneumoniae ,genotype ,030106 microbiology ,Population ,cross-sectional studies ,pulsed-field ,multilocus sequence typing ,electrophoresis, gel, pulsed-field ,humans ,italy ,klebsiella infections ,klebsiella pneumoniae ,molecular epidemiology ,serogroup ,beta-lactamases ,genetic variation ,Settore BIO/19 - Microbiologia Generale ,Cross-Sectional Studies ,Electrophoresis, Gel, Pulsed-Field ,Humans ,Italy ,Klebsiella Infections ,Molecular Epidemiology ,Multilocus Sequence Typing ,Serogroup ,beta-Lactamases ,Genetic Variation ,Genotype ,Pharmacology ,Pharmacology (medical) ,Infectious Diseases ,law.invention ,Microbiology ,beta-Lactamase ,03 medical and health sciences ,law ,Pulsed-field gel electrophoresis ,Typing ,education ,Polymerase chain reaction ,Cross-Sectional Studie ,education.field_of_study ,biology ,Molecular epidemiology ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,Settore MED/07 - Microbiologia e Microbiologia Clinica ,bacterial infections and mycoses ,Virology ,electrophoresis ,Multilocus sequence typing ,Human ,Klebsiella Infection - Abstract
Objectives The spread of carbapenem-resistant Enterobacteriaceae (CRE) represents one of the most worrisome problems for clinical medicine worldwide. In Italy, the Antibiotic-Resistance-Istituto Superiore di Sanita surveillance network, in collaboration with the Committee for Antimicrobial Agents of the Italian Society of Clinical Microbiologists, promoted a study to investigate the carbapenem-resistance mechanisms, clonal relatedness and capsular typing of a recent collection of carbapenem-resistant Klebsiella pneumoniae (CR-KP). Methods A total of 17 laboratories distributed across Italy collected all consecutive non-replicate CR-KP isolated from invasive infections during two different study periods (2011-12 and 2013). Carbapenemase genes were searched for by filter hybridization and confirmed by PCR and sequencing. KPC-producing K. pneumoniae (KPC-KP) were typed by PFGE and MLST. Capsular types were identified by wzi gene typing. Results Of the collected K. pneumoniae isolates (n = 461), the overall proportion of CR-KP was 36.2% (n = 167). The majority (97%) of the CR-KP were positive for the blaKPC gene. Among the KPC-KP population, nine different STs were detected with the majority of isolates (94%) belonging to the clonal group (CG) 258. A subpopulation that belonged to ST512 and showed an identical PFGE profile represented the majority (57%) of KPC-KP strains, with a countrywide distribution. Capsular characterization showed the predominance of the wzi154, cps-2 capsular type (88.8% of all CG258 strains). ST258 strains were associated with both cps-1 and cps-2 capsular types, while ST512 was associated with cps-2 only. Conclusions Although a trend to a polyclonal evolution of the Italian KPC-KP was noted, this study showed that the KPC-KP population remained largely oligoclonal with the wide diffusion of an ST512 lineage carrying cps-2 capsular type and producing the KPC-3 enzyme.
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- 2016