Identification of a blaVIM-4 gene in the internationally successful Klebsiella pneumoniae ST11 clone and in a Klebsiella oxytoca strain in Hungary

Kristóf, Katalin; Tóth, Ákos; Damjanova, Ivelina; Jánvári, Laura; Konkoly-Thege, Marianne; Kocsis, Béla; Koncan, Raffaella; Cornaglia, Giuseppe; Szegő, Eszter; Nagy, K.; Szabó, Dóra

doi:10.1093/jac/dkq133

Cited by 33 publications

(24 citation statements)

References 5 publications

(14 reference statements)

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“…This gene was located in the chromosome of this isolate, and the integron carrying bla VIM-35 harbored aacA(6=)-Ib in the first position followed by the metallo-␤-lactamase gene and the 3= CS. A duplication of 155 bp of the bla VIM 3= end was detected between this gene and the integron at the 3= CS, similar to sequences described for bla VIM-4 -carrying integrons among P. aeruginosa isolates from Poland (25) and other bla VIM -carrying integrons from European countries (26)(27)(28). VIM-35, when expressed in a similar background, displayed similar MIC values as VIM-1, its closest ancestor (Table 5).…”

Section: Resultssupporting

confidence: 75%

Evaluation of Clonality and Carbapenem Resistance Mechanisms among Acinetobacter baumannii-Acinetobacter calcoaceticus Complex and Enterobacteriaceae Isolates Collected in European and Mediterranean Countries and Detection of Two Novel β-Lactamases, GES-22 and VIM-35

Castanheira

Costello

Woosley

et al. 2014

Antimicrob Agents Chemother

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We evaluated doripenem-resistant Acinetobacter baumannii-Acinetobacter calcoaceticus complex (ACB; n ‫؍‬ 411) and Enterobacteriaceae (n ‫؍‬ 92) isolates collected from patients from 14 European and Mediterranean countries during 2009 to 2011 for the presence of carbapenemase-encoding genes and clonality. Following susceptibility testing, carbapenem-resistant (doripenem MIC, >2 g/ml) isolates were screened for carbapenemases. New ␤-lactamase genes were expressed in a common background and susceptibility was tested. Class 1 integrons were sequenced. Clonality was evaluated by pulsed-field gel electrophoresis and multilocus sequence typing (Pasteur scheme). Relative expression of ␤-lactam intrinsic resistance mechanisms was determined for carbapenemase-negative Enterobacteriaceae. ACB and Enterobacteriaceae displayed 58.9 and 0.9% doripenem resistance, respectively. bla OXA-23 , bla OXA-58 , and bla OXA-24/OXA-40 were detected among 277, 77, and 29 ACB, respectively (in 8, 6, and 5 countries). Ten Turkish isolates carried bla GES-11 or bla GES-22 . GES-22 (G243A and M169L mutations in GES-1) had an extendedspectrum ␤-lactamase profile. A total of 33 clusters of >2 ACB isolates were observed, and 227 isolates belonged to sequence type 2/international clone II. Other international clones were limited to Turkey and Israel. Doripenem-resistant Enterobacteriaceae increased significantly (0.7 to 1.6%), and 15 bla KPC-2 -and 22 bla KPC-3 -carrying isolates, mostly belonging to clonal complexes 11 and 258, were observed. Enterobacteriaceae isolates producing OXA-48 (n ‫؍‬ 16; in Turkey and Italy), VIM-1 (n ‫؍‬ 10; in Greece, Poland, and Spain), VIM-26 (n ‫؍‬ 1; in Greece), and IMP-19, VIM-4, and the novel VIM-35 (n ‫؍‬ 1 each from Poland) were detected. VIM-35 had one substitution compared to VIM-1 (A235T) and a similar susceptibility profile. One or more resistance mechanisms were identified in 4/6 carbapenemase-negative Enterobacteriaceae. This broad evaluation confirms results from country-specific surveys and shows a highly diverse population of carbapenemase-producing ACB and Enterobacteriaceae in Europe and Mediterranean countries.

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Section: Resultssupporting

confidence: 75%

Evaluation of Clonality and Carbapenem Resistance Mechanisms among Acinetobacter baumannii-Acinetobacter calcoaceticus Complex and Enterobacteriaceae Isolates Collected in European and Mediterranean Countries and Detection of Two Novel β-Lactamases, GES-22 and VIM-35

Castanheira

Costello

Woosley

et al. 2014

Antimicrob Agents Chemother

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“…KPC-producing K. pneumoniae ST11 isolates have been found in China, Singapore, Taiwan and the UK (Balm et al, 2012;Lauderdale et al, 2012;Qi et al, 2011;Virgincar et al, 2011). Many VIM-producing K. pneumoniae in Hungary have also been found to belong to ST11 (Kristó f et al, 2010). ST11 is also a common ST for NDM-1-producing K. pneumoniae isolates (Giske et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

Molecular typing and resistance mechanisms of imipenem-non-susceptible Klebsiella pneumoniae in Taiwan: results from the Taiwan surveillance of antibiotic resistance (TSAR) study, 2002–2009

Siu

et al. 2013

Journal of Medical Microbiology

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We investigated the molecular mechanisms and clonality of imipenem-non-susceptible Klebsiella pneumoniae isolates collected during a Taiwan national surveillance programme, between 2002 and 2009. Genes for carbapenemases, plasmid-borne ampC-type genes and extended-spectrum b-lactamase (ESBL) genes were analysed by PCR. The major porin channels OmpK35 and OmpK36 were studied by SDS-PAGE. Molecular typing was performed with pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). Our study revealed that all 29 of the isolates tested were ESBL producers. Of the K. pneumoniae isolates collected in Taiwan from 2002 to 2009, most (84.6 %, 11/13) imipenem-resistant (MIC .2 mg l "1 ) isolates carried the bla IMP-8 gene. Isolates with an imipenem MIC of 2 mg l "1 produced ESBLs with or without DHA-1 in combination with OmpK35/36 loss. PFGE analysis revealed that six small clusters of isolates were clonally related. The MLST grouping results were in concordance with the PFGE results. The predominant sequence types (ST) were ST11, ST48 and ST101. Two novel STs, ST1033 and ST1034, were found. The dominant clone in Taiwan, ST11, has been reported worldwide to be associated with various resistance mechanisms.

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“…Since then, only one further carbapenemase producer has been recorded, a K. pneumoniae ST11 strain with VIM-4 enzyme. Interestingly, ST11 is a single-locus variant of ST258 and, in Hungary, is commonly seen producing the CTX-M-15 ESBL but normally lacking VIM genes [81].…”

Section: Hungarymentioning

confidence: 99%

Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts

Livermore²,

et al. 2010

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The emergence and global spread of carbapenemase-producing Enterobacteriaceae is of great concern to health services worldwide. These bacteria are often resistant to all beta-lactam antibiotics and frequently co-resistant to most other antibiotics, leaving very few treatment options. The epidemiology is compounded by the diversity of carbapenem-hydrolysing enzymes and the ability of their genes to spread between different bacterial species. Difficulties are also encountered by laboratories when trying to detect carbapenemase production during routine diagnostic procedures due to an often heterogeneous expression of resistance. Some of the resistance genes are associated with successful clonal lineages which have a selective advantage in those hospitals where antimicrobial use is high and opportunities for transmission exist; others are more often associated with transmissible plasmids. A genetically distinct strain of Klebsiella pneumoniae sequence type (ST) 258 harbouring the K. pneumoniae carbapenemases (KPC) has been causing epidemics of national and international proportions. It follows the pathways of patient referrals, causing hospital outbreaks along the way. Simultaneously, diverse strains harbouring New Delhi metallo-beta-lactamase (NDM-1) are repeatedly being imported into Europe, commonly via patients with prior medical exposure in the Indian subcontinent. Since the nature and scale of carbapenem-non-susceptible Entrobacteriaceae as a threat to hospital patients in Europe remains unclear, a consultation of experts from 31 countries set out to identify the gaps in diagnostic and response capacity, to index the magnitude of carbapenem-non-susceptibility across Europe using a novel five-level staging system, and to provide elements of a strategy to combat this public health issue in a concerted manner.

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Identification of a blaVIM-4 gene in the internationally successful Klebsiella pneumoniae ST11 clone and in a Klebsiella oxytoca strain in Hungary

Cited by 33 publications

References 5 publications

Evaluation of Clonality and Carbapenem Resistance Mechanisms among Acinetobacter baumannii-Acinetobacter calcoaceticus Complex and Enterobacteriaceae Isolates Collected in European and Mediterranean Countries and Detection of Two Novel β-Lactamases, GES-22 and VIM-35

Evaluation of Clonality and Carbapenem Resistance Mechanisms among Acinetobacter baumannii-Acinetobacter calcoaceticus Complex and Enterobacteriaceae Isolates Collected in European and Mediterranean Countries and Detection of Two Novel β-Lactamases, GES-22 and VIM-35

Molecular typing and resistance mechanisms of imipenem-non-susceptible Klebsiella pneumoniae in Taiwan: results from the Taiwan surveillance of antibiotic resistance (TSAR) study, 2002–2009

Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts

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