The ongoing challenge of acquired carbapenemases: a hospital outbreak of Klebsiella pneumoniae simultaneously producing VIM-1 and KPC-2

Zioga, A.; Miriagou, Vivì; Tzelepi, E.; Douzinas, E.; Tsakiri, M.; Nj, Legakis; Daikos, George L.; Tzouvelekis, L. S.

doi:10.1016/j.ijantimicag.2010.04.002

Cited by 29 publications

(23 citation statements)

References 6 publications

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“…The lack of ESBLs in the present study could be attributable to the masking effect of co-production of ESBLs, AmpCs and carbapenemases. For example, co-production of KPCs and MBLs masked the results of EDTA-or boronic acid-based testing in one study (Zioga et al, 2010). Some carbapenemase-producing members of the Enterobacteriaceae also exhibit low-level resistance or even susceptibility to carbapenems (Espedido et al, 2005;Liu et al, 2009).…”

Section: Resultsmentioning

confidence: 99%

“…Carbapenems or fluoroquinolones are often used for the treatment of clinical infections caused by this organism. However, resistance of K. pneumoniae to carbapenems has been increasing (Espedido et al, 2005;Gupta et al, 2011), and this is often due to the production of carbapenemases, particularly K. pneumoniae carbapenemases (KPCs) and class B metallo-b-lactamases (MBLs) (Gupta et al, 2011;Queenan & Bush, 2007;Robledo et al, 2011;Zioga et al, 2010). KPCs, especially KPC-2, have been found in members of the Enterobacteriaceae worldwide (Gupta et al, 2011;Nordmann et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring bla IMP-4 and bla DHA-1 in a neonatal intensive care unit in China

Ying

Chen

et al. 2012

Journal of Medical Microbiology

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Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring bla and bla DHA-1 in a neonatal intensive care unit in China Outbreaks caused by Klebsiella pneumoniae producing carbapenemases and other blactamases have been reported. Four neonates admitted to a neonatal intensive care unit (NICU) in a Chinese hospital developed respiratory infection while receiving intensive care. In all four cases, multidrug-resistant K. pneumoniae was isolated from multiple respiratory specimens, leading to additional characterization of these organisms and investigation of the local environment in the NICU. Multiple b-lactamase genes, including bla TEM-1 , bla IMP-4 , bla DHA-1 and bla CTX-M-14 , as well as the quinolone resistance gene qnrB4, were harboured by transferable plasmids from all four clinical isolates. Furthermore, PFGE confirmed that three of the four clinical isolates from the patients and three K. pneumoniae isolates collected from the hands of healthcare workers and an incubator in the NICU belonged to the same PFGE cluster, indicating that an outbreak due to multidrug-resistant K. pneumoniae carrying bla IMP-4 and bla DHA-1 occurred in this NICU. As far as is known, this is the first report of the co-existence of bla IMP-4 and bla DHA-1 in the same K. pneumoniae isolate. These data suggest that additional precautions are needed to prevent outbreaks of infection caused by multidrug-resistant K. pneumoniae resulting from environmental exposure in NICUs. INTRODUCTIONKlebsiella pneumoniae frequently exhibits resistance to extended-spectrum cephalosporins due to the production of extended-spectrum b-lactamases (ESBLs) (Falagas & Karageorgopoulos, 2009

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring bla IMP-4 and bla DHA-1 in a neonatal intensive care unit in China

Ying

Chen

et al. 2012

Journal of Medical Microbiology

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“…Since the first identification of KPC-producing (15) and VIM-producing (16) Pseudomonas aeruginosa isolates in Colombia, their interhospital clonal dissemination throughout the country has been followed by our group. To the best of our knowledge, the copresence of VIM and KPC has not been reported in species other than Klebsiella pneumoniae (4,8,10,11,14,17), and the only report of a P. aeruginosa isolate coharboring KPC and a metallo-␤-lactamase (IMP-8) was recently published in Puerto Rico (7). Hence, we report for the first time in the world a P. aeruginosa clinical isolate that coharbors VIM and KPC.…”

mentioning

confidence: 75%

First Report of a Pseudomonas aeruginosa Isolate Coharboring KPC and VIM Carbapenemases

Correa

Montealegre²,

Mojica³

et al. 2012

Antimicrob Agents Chemother

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“…It seems that the cooperative action of several transposon elements contributes to the dissemination of bla IMP gene among different species of Enterobacteriaceae. Moreover, it is worth noting that bla VIM genes, along with the bla KPC-2 gene, have emerged in K. pneumoniae (17,30).…”

Section: Discussionmentioning

confidence: 99%

First Report of Klebsiella oxytoca Strain Coproducing KPC-2 and IMP-8 Carbapenemases

Sun

Han

et al. 2011

Antimicrob Agents Chemother

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The study shows for the first time the presence of the Klebsiella oxytoca strain fp10 coproducing plasmidmediated KPC-2 and IMP-8 carbapenemases. The strain was obtained from the fecal sample of an inpatient and showed high-level resistance to imipenem and ertapenem (MICs > 32 g/ml). Conjugation experiments demonstrated the transferability of the carbapenem-resistant determinants. The results of plasmid analysis and Southern hybridization revealed that the bla KPC-2 gene was located on transferable plasmid pFP10-1 (ϳ54 kb), whereas the bla IMP-8 gene was on transferable plasmid pFP10-2 (ϳ180 kb). Analysis of the genetic environment of these two genes has demonstrated that ISKpn6 and ISKpn8 are involved in the spread of the bla KPC-2 gene, while the transposable elements IS26, intI1, and tniC might contribute to the dissemination of the bla IMP-8 gene. The chimera of several transposon-associated elements indicated a novel genetic environment of IMP-type metallo-␤-lactamase gene in Enterobacteriaceae from China.

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The ongoing challenge of acquired carbapenemases: a hospital outbreak of Klebsiella pneumoniae simultaneously producing VIM-1 and KPC-2

Cited by 29 publications

References 6 publications

Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring bla IMP-4 and bla DHA-1 in a neonatal intensive care unit in China

Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring bla IMP-4 and bla DHA-1 in a neonatal intensive care unit in China

First Report of a Pseudomonas aeruginosa Isolate Coharboring KPC and VIM Carbapenemases

First Report of Klebsiella oxytoca Strain Coproducing KPC-2 and IMP-8 Carbapenemases

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