Diverse Sequence Types of Klebsiella pneumoniae Contribute to the Dissemination of bla _NDM-1 in India, Sweden, and the United Kingdom

Abstract

f Clinical isolates of Klebsiella pneumoniae producing NDM-1 carbapenemase from India (n ‫؍‬ 22), the United Kingdom (n ‫؍‬ 13), and Sweden (n ‫؍‬ 4) were subjected to multilocus sequence typing (MLST), automated repetitive sequence-based PCR (rep-PCR), serotyping, virulence gene screening, and plasmid replicon typing. The most frequently detected MLST sequence types (STs) were ST14 (n ‫؍‬ 13; all serotype K2), ST11, ST149, ST231, and ST147. The correlation between MLST and automated rep-PCR was excellent. IncA/C was the most frequently detected plasmid replicon type (n ‫؍‬ 14). ST14, ST11, and other successful clones may be important for the dissemination of bla NDM-1 .

A Two-Year Surveillance in Five Colombian Tertiary Care Hospitals Reveals High Frequency of Non-CG258 Clones of Carbapenem-Resistant Klebsiella pneumoniae with Distinct Clinical Characteristics

“…ST14 has been reported in Italy (46), the United Kingdom, Sweden (47), Turkey (48), Spain (49), Tanzania (50), Kenya (51), India (47,52), and Oman (53) and has been found harboring KPC in various facilities in the midwestern United States (54). In addition, it has been reported in sporadic cases carrying KPC-2, CTX-M-15, and TEM-1 in several cities of Colombia (55) and carrying KPC-2 and SHV-12 in Medellín (14).…”

Expansion and Evolution of a Virulent, Extensively Drug-Resistant (Polymyxin B-Resistant), QnrS1-, CTX-M-2-, and KPC-2-Producing Klebsiella pneumoniae ST11 International High-Risk Clone

“…K. pneumoniae ST11 is broadly associated with the dissemination of bla KPC , is dominant in China (50), has become endemic in Taiwan (51), and seems to be the prevalent KPC-2-producing K. pneumoniae clone in Brazil (41,52,53). Moreover, K. pneumoniae ST11 has been associated with outbreaks and dissemination of other carbapenemases, such as OXA-48 (54,55) and NDM (56,57). In Brazil, the bla NDM genes were initially related to non-K. pneumoniae species (4, 58), and we believe that the meeting of these genes with ST11 could cause the national dissemination of NDM producers toward the endemicity of this clone in Brazil.…”

Large Oligoclonal Outbreak Due to Klebsiella pneumoniae ST14 and ST26 Producing the FOX-7 AmpC β-Lactamase in a Neonatal Intensive Care Unit

“…In fact, the majority of studied isolates (81 of 92 isolates) belonged to ST14, which is a widespread "high-risk clone" of K. pneumoniae known for its ability to accumulate and to disseminate emerging resistance determinants, including those for extended-spectrum ␤-lactamases such as CTX-M-15 and for carbapenemases such as NDM-1 and KPC (35). Control of the outbreak was apparently related to reinforcement of infection control measures based on increased awareness of the problem, hand hygiene reliance, and encouragement of alcohol-based hand rub use by health care workers.…”