Carriage of genes for various extended-spectrum β-lactamases: a novel resistance strategy of Klebsiella pneumoniae in Poland

Abstract

Among 110 randomly sampled strains from a collection of 247 extended-spectrum beta-lactamase (ESBL)-producing clinical isolates of Klebsiella pneumoniae collected from hospitalised children in three paediatric hospitals in Poland, 64 strains (58.2%) with multiple ESBLs were found, including five non-clonal strains (4.5%) harbouring bla genes for ESBLs of three families (CTX-M, SHV and TEM). This is the first report of the emergence of triple ESBL-producing K. pneumoniae in Poland. In addition, K. pneumoniae strains harbouring bla genes for TEM-130 and TEM-132 ESBLs were detected in Poland for the first time. Epidemiological analysis of the multiple ESBL-producing K. pneumoniae isolates by pulsed-field gel electrophoresis (PFGE) revealed a relatively high genetic diversity between isolates producing the same combination of enzymes. Clonally related strains were uncommon.

Predominance of Klebsiella pneumoniaeST14 carrying CTX-M-15 causing neonatal sepsis in Tanzania

“…As in previous studies [25-27] the bla CTX-M-15 allele associated with ISEcp1 was carried on multiple conjugative plasmids of different sizes ranging from 25 kb-485 kb, with one clone having multiple copies of bla CTX-M-15 genes, one copy in the chromosome and two other copies in a 485 kb and a 25 kb plasmid This reflects transmission dynamics of this element, comprising of intra strain mobility on different genetic entities (chromosome, plasmids) within a single isolate, in addition to inter- strain and inter-species transmissibility. Multiple ESBL alleles were observed in which bla CTX-M-15 and bla SHV-11 co-existed in one clone in the neonatal unit; this has recently been described in clinical isolates in Poland as a new strategy of K. pneumoniae to confer resistance to antibiotics [28]. There is an antibiotic selection advantage for the isolates with multiple alleles and multiple copies of genes for an allele as seen in cluster X7 in this study.…”

“…All outbreaks occurred in the neonatal unit and neonatal ICU at different time-points and could be due patient to patient transmission or the acquisition from a common source (contaminated equipments) or from healthcare workers [28-30]. Different clones were involved in all three outbreaks; this further supports the high diversity of these strains in this setting, and represents a huge challenge for the local hospital infection control team.…”

“…ST147 and ST101 were detected in cluster X 2 which is the most diverse cluster. These sequence-types have been reported to occur worldwide and are associated with multi-resistant K. pneumoniae [28,29]. …”

Emergence of Klebsiella pneumoniae Coproducing KPC-2 and 16S rRNA Methylase ArmA in Poland

“…90 kb that was similar to pCTX-M3 (11). Because pCTX-M3 carries a gene encoding CTX-M-3 ESBL, we carried out PCR assay with primers specific for the bla CTX-M gene family (6). All the isolates tested except for DM0267 were found to produce CTX-M-type ESBL (Table 1).…”

Antibiotic-Resistant Klebsiella pneumoniae and Escherichia coli High-Risk Clones and an IncFII k Mosaic Plasmid Hosting Tn 1 ( bla TEM-4 ) in Isolates from 1990 to 2004

“…These results suggest the existence of highly adapted populations of K. pneumoniae and E. coli able to acquire antimicrobial resistance genes since at least the early 1990s. The sudden decrease of TEM-4 producers in all countries where it had been reported for years (17,18,20,21,35,36) parallels the shift in the epidemiology of beta-lactamases that involves the emergence of CTX-M, KPC (class A), and NDM (class B) and the drop in TEM-ESBL producers (22). Comparative genomics studies recently demonstrated the existence of intraclonal variants with enhanced epidemicity that can successfully spread at the global level as H30 ST131 E. coli or ST258/ST11 K. pneumoniae within clonal group (CG) 258 (37)(38)(39).…”