Clonal Dissemination of OXA-232 Carbapenemase-Producing Klebsiella pneumoniae in Neonates

Abstract

Five OXA-232 carbapenemase-producing Klebsiella pneumoniae isolates, belonging to the pandemic clone sequence type 15 (ST15), were isolated from neonates and coproduced bla CTX-M-15 and bla SHV-1 genes. All isolates were resistant to ertapenem (MICs of Ͼ32 g/ml) and meropenem (MICs of 4 to 8 g/ml) and susceptible or intermediate to imipenem (MICs of 1 to 2 g/ml). The bla OXA-232 gene was located on a ColE-type transformable plasmid of 6,141 bp. To the best of our knowledge, this is the first report of OXA-232 carbapenemase among clinical isolates in China.

Emergence of OXA-232 Carbapenemase-Producing Klebsiella pneumoniae That Carries a pLVPK-Like Virulence Plasmid among Elderly Patients in China

“…Strain E109-1 harbored a 5,339,953-bp chromosome and 177,872-, 135,859-, 128,536-, and ϳ78-kb plasmids, as well as six small plasmids (Ͼ10 kb). bla OXA-232 was located in a 6,141-bp ColKP3-type plasmid designated pE109-1-OXA, which was recovered from all 10 isolates and was 99% identical to the previously reported 6.1-kb bla OXA-232 -bearing plasmid pkNICU5 isolated from a K. pneumoniae strain in China, with 100% coverage (6). The plasmid comprised nine open reading frames (ORFs), including repA, mobA, mobB, mobD, ΔmobC, ΔISEcp1, bla OXA-232 , ΔlysR, and ΔereA, and was not transferable to Escherichia coli EC600 (rifampin resistant) via conjugation (6,11).…”

“…bla OXA-232 was located in a 6,141-bp ColKP3-type plasmid designated pE109-1-OXA, which was recovered from all 10 isolates and was 99% identical to the previously reported 6.1-kb bla OXA-232 -bearing plasmid pkNICU5 isolated from a K. pneumoniae strain in China, with 100% coverage (6). The plasmid comprised nine open reading frames (ORFs), including repA, mobA, mobB, mobD, ΔmobC, ΔISEcp1, bla OXA-232 , ΔlysR, and ΔereA, and was not transferable to Escherichia coli EC600 (rifampin resistant) via conjugation (6,11). All strains exhibited similar drug resistance profiles, including phenotypic resistance to cefmetazole, ceftazidime, cefotaxime, piperacillin-tazobactam, cefoperazone-sulbactam, cefepime, ciprofloxacin, amikacin, and aztreonam, but remained susceptible to ceftazidime-avibactam, tigecycline, and polymyxin B.…”

Nosocomial spread of OXA-232-producing Klebsiella pneumoniae ST15 in a teaching hospital, Shanghai, China

“…OXA232Kp has been reported in eastern China. All these OXA232Kp isolates belong to ST15 and carry a 6.1-kp ColKP3 plasmid bearing the bla OXA-232 gene [21][22][23]. In this study, we reported a nosocomial outbreak of OXA232Kp in a teaching hospital in Shanghai involved with 61 patients.…”

“…2) and appeared to be clonal. At the same time, several outbreak caused by OXA232Kp have been identified in the same area [21][22][23]. Recently, an outbreak of OXA-48-producing K. pneumoniae involving 34 patients at a respiratory ICU has been reported [7].…”

Results from the China Antimicrobial Surveillance Network (CHINET) in 2017 of the In Vitro Activities of Ceftazidime-Avibactam and Ceftolozane-Tazobactam against Clinical Isolates of Enterobacteriaceae and Pseudomonas aeruginosa

“…Additionally, several CRE strains were negative for both bla KPC and bla NDM , and we speculate that these strains may produce the AmpC ␤-lactamase, combined with the increased expression or a deficiency of outer membrane protein, or may produce other carbapenems besides those of the NDM type and KPC type, another important resistance mechanism of CRE. For example, we have reported the clonal spread of the OXA-232 carbapenemase before, and strains positive for the OXA-232 carbapenemase were also susceptible to ceftazidime-avibactam (15). Porin mutations and the increased expression of KPC-3 have been reported to be one of the mechanisms related to resistance to ceftazidime-avibactam in K. pneumoniae (16).…”