Coproduction of 16S rRNA Methyltransferase RmtD or RmtG with KPC-2 and CTX-M Group Extended-Spectrum β-Lactamases in Klebsiella pneumoniae

Abstract

bEight Klebsiella pneumoniae clinical strains with high-level aminoglycoside resistance were collected from eight hospitals in São Paulo State, Brazil, in 2010 and 2011. Three of them produced an RmtD group 16S rRNA methyltransferase, RmtD1 or RmtD2. Five strains were found to produce a novel 16S rRNA methyltransferase, designated RmtG, which shared 57 to 58% amino acid identity with RmtD1 and RmtD2. Seven strains coproduced KPC-2 with or without various CTX-M group extended-spectrum ␤-lactamases, while the remaining strain coproduced CTX-M-2.

Klebsiella pneumoniae Sequence Type 11 Isolate Producing RmtG 16S rRNA Methyltransferase from a Patient in Miami, Florida

“…This fragment was sequenced in full using custom sequencing primers. The genetic environment of rmtG was identical to that reported to occur in K. pneumoniae isolate 350/10 from Brazil, where a putative tRNA ribosyltransferase gene precedes rmtG, with an overlap of 8 nucleotides (2).…”

“…The 16S-RMTases most commonly encountered in Enterobacteriaceae worldwide include ArmA and RmtB. RmtG was first reported in Klebsiella pneumoniae producing KPC-2 in Brazil (2) and then also in K. pneumoniae producing CTX-M-2 in Chile (3). Here, we report the identification of K. pneumoniae producing RmtG coupled with both CTX-M-2 and CTX-M-15 at a hospital in Miami, FL.…”

Inventory of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in France as Assessed by a Multicenter Study

“…Carbapenemase production was investigated in carbapenem-resistant strains by specific PCR as previously described (10). Genes encoding AAC(6=)-Ib, AAC(6=)-Ib-cr, AAC(3)-II, RmtA to RmtH, ArmA, NpmA, QnrA, QnrB, QnrC, QnrD, QnrS, Oqx (for strains not belonging to the Klebsiella genus), and QepA were identified by specific PCR assay and sequencing as previously reported (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Plasmidmediated colistin resistance mechanism MCR-1 was investigated as previously described (22).…”

Klebsiella pneumoniae co-producing KPC and RmtG, finally targeting Switzerland

“…The emergence of clones coproducing 16S rRNA methyltransferases further complicates the treatment of infections due to these pathogens, with extremely limited therapeutic options left. The occurrence in Switzerland of a K. pneumoniae clone co-producing KPC-2 and RmtG, with the latter enzyme being so far reported in America and India (Bueno et al, 2013;Filgona et al, 2015;Hu et al, 2014;Poirel et al, 2014), underlines how importation of multidrug-resistant clones may occur despite the high standards of antibiotic stewardship programs and hygiene control in effect in the Swiss healthcare institutions.…”