First Outbreak of KPC-2-Producing Klebsiella pneumoniae Sequence Type 258 in a Hospital in South Korea

Hong, Suck Joon; Yong, Dongeun; Kim, Kyeongmi; Hong, Sang Sook; Hong, Seong Geun; Khosbayar, Tulgaa; Song, Wonkeun; Roh, Kyoung Ho; Jeong, Seok Hoon; Lee, Kyungwon; Chong, Yunsop

doi:10.1128/jcm.01730-13

Cited by 29 publications

(21 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, the wide spread of the producers is one of the worrisome global issues encountering antimicrobial resistance. In accordance of occasional reports (Rhee et al, 2010 ; Hong et al, 2013 ; Yoo et al, 2013 ) and data from NLSS (unpublished data), only infrequent occurrence of the KPC producers were identified in South Korea until 2013. However, after a sudden expansion of KPC producers in 2014, rapid nation-wide spread supported by single-hospital outbreaks (Kim et al, 2017 ), frequently associated with inter-hospital or inter-regional spread (Jeong et al, 2016 ) led the endemic stage of KPC in 2015.…”

Section: Discussionsupporting

confidence: 77%

Klebsiella pneumoniae Carbapenemase Producers in South Korea between 2013 and 2015

Yoon

Kim

et al. 2018

Front. Microbiol.

Self Cite

View full text Add to dashboard Cite

Between 2014 and 2015, the Klebsiella pneumoniae carbapenemase (KPC) was becoming endemic in South Korea. To assess this period of transition, we analyzed KPC producers in terms of molecular epidemiology. A total of 362 KPC-producing Enterobacteriaceae strains, including one from 2013, 13 from 2014, and 348 from 2015, were actively collected from 60 hospitals throughout the peninsula. Subtypes of KPC were determined by PCR and direct sequencing, and isotypes of Tn4401 (the transposon flanking the bla KPC gene) were specified by PCR using isotype-specific primers and direct sequencing. Sporadic occurrence of KPC-producing Enterobacteriaceae was initially observed around Seoul, which is the most crowded district of the country, and these strains rapidly disseminated in 2014, to the other parts of the country in 2015. The bacterial clones responsible for the extreme epidemiological transition were K. pneumoniae ST307 (46.2%) and ST11 (21.3%). Less frequently, E. coli (4.7%), Enterobacter spp. (1.4%), and other Enterobacteriaceae members (1.7%) producing the enzyme were identified. The bla KPC-2 gene bracketed by Tn4401a (72.1%) was the most prevalent mobile genetic element responsible for the dissemination, and the same gene carried either by Tn4401b (2.2%) or Tn4401c (6.6%) was identified at a lesser frequency. The genes bla (1.6%) and bla KPC-4 (6.4%), both flanked by Tn4401b, were occasionally identified. This study showed endemic dissemination of KPC producers in 2015 due to a clonal spread of two K. pneumoniae strains. Further systemic surveillance is needed to monitor dissemination of KPC-producers.

show abstract

Section: Discussionsupporting

confidence: 77%

Klebsiella pneumoniae Carbapenemase Producers in South Korea between 2013 and 2015

Yoon

Kim

et al. 2018

Front. Microbiol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…The carbapenem resistance of the isolate that we uncovered in this study may not be due to the horizontal transfer of the plasmid and clonal spread because similar plasmids carrying bla KPC-2 have not been reported and because the K. pneumoniae isolate carrying pKPC-DK05 has a novel genotype unknown to produce K. pneumoniae carbapenemase (KPC) (5)(6)(7)(8). Thus, we can speculate that our carbapenemase-producing K. pneumoniae isolate emerged via incorporation of Tn4401 into the prevailing plasmid.…”

mentioning

confidence: 81%

Complete Sequence of bla _KPC-2 -Harboring Plasmid with a Mosaic of IncN1- and IncN3-Type Plasmids in a Klebsiella pneumoniae Isolate from South Korea

Kim

Rhee

2016

Antimicrob Agents Chemother

View full text Add to dashboard Cite

“…From 1990 to 2015, there were many studies that reported the identification of the first cases of KPC-producing K. pneumoniae isolates in different countries such as USA, Canada, Italy, Poland, France, Spain, UK, Colombia, India, Argentina, China, Ireland, Greece, Brazil, Turkey, Japan, South Korea, and Iran 9, 10, 11, 12, 13, 14, 15, 16, 17. KPC-producing K. oxytoca isolates are rarely reported [18].…”

Section: Introductionmentioning

confidence: 99%

Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Validi

Dallal

Douraghi

et al. 2016

Osong Public Health and Research Perspectives

View full text Add to dashboard Cite

ObjectivesProduction of carbapenemase, especially Klebsiella pneumoniae carbapenemases (KPC), is one of the antibiotic resistance mechanisms of Enterobacteriaceae such as Klebsiella oxytoca. This study aimed to investigate and identify KPC-producing K. oxytoca isolates using molecular and phenotypic methods.MethodsA total of 75 isolates of K. oxytoca were isolated from various clinical samples, and were verified as K. oxytoca after performing standard microbiological tests and using a polymerase chain reaction (PCR) method. An antibiotic susceptibility test was performed using a disc diffusion method according to the Clinical and Laboratory Standards Institute guidelines. CHROMagar KPC chromogenic culture media was used to examine and confirm the production of the carbapenemase enzyme in K. oxytoca isolates; in addition, PCR was used to evaluate the presence of blaKPC gene in K. oxytoca strains.ResultsOf a total of 75 K. oxytoca isolates, one multidrug resistant strain was isolated from the urine of a hospitalized woman. This strain was examined to assess its ability to produce carbapenemase enzyme; it produced a colony with a blue metallic color on the CHROMagar KPC chromogenic culture media. In addition, the blaKPC gene was confirmed by PCR. After sequencing, it was confirmed and deposited in GenBank.ConclusionTo date, many cases of KPC-producing Enterobacteriaceae, in particular K. pneumoniae, have been reported in different countries; there are also some reports on the identification of KPC-producing K. oxytoca. Therefore, to prevent the outbreak of nosocomial infections, the early detection, control, and prevention of the spread of these strains are of great importance.

show abstract

First Outbreak of KPC-2-Producing Klebsiella pneumoniae Sequence Type 258 in a Hospital in South Korea

Cited by 29 publications

References 12 publications

Klebsiella pneumoniae Carbapenemase Producers in South Korea between 2013 and 2015

Klebsiella pneumoniae Carbapenemase Producers in South Korea between 2013 and 2015

Complete Sequence of bla _KPC-2 -Harboring Plasmid with a Mosaic of IncN1- and IncN3-Type Plasmids in a Klebsiella pneumoniae Isolate from South Korea

Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Contact Info

Product

Resources

About

First Outbreak of KPC-2-Producing Klebsiella pneumoniae Sequence Type 258 in a Hospital in South Korea

Cited by 29 publications

References 12 publications

Klebsiella pneumoniae Carbapenemase Producers in South Korea between 2013 and 2015

Klebsiella pneumoniae Carbapenemase Producers in South Korea between 2013 and 2015

Complete Sequence of bla KPC-2 -Harboring Plasmid with a Mosaic of IncN1- and IncN3-Type Plasmids in a Klebsiella pneumoniae Isolate from South Korea

Identification of Klebsiella pneumoniae Carbapenemase-producing Klebsiella oxytoca in Clinical Isolates in Tehran Hospitals, Iran by Chromogenic Medium and Molecular Methods

Contact Info

Product

Resources

About

Complete Sequence of bla _KPC-2 -Harboring Plasmid with a Mosaic of IncN1- and IncN3-Type Plasmids in a Klebsiella pneumoniae Isolate from South Korea