Journal
MICROBIAL DRUG RESISTANCE
Volume 25, Issue 4, Pages 528-537Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/mdr.2018.0006
Keywords
Klebsiella pneumoniae; KPC; multiresistance
Funding
- Sao Paulo Research Foundation (FAPESP) [2014/17184-00]
- Coordination for the Improvement of the Higher Education Personnel (PNPD/CAPES 2015)
- FAPESP [2012/21709-5]
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The dissemination of multiresistant Klebsiella pneumoniae carbapenemase (KPC)-2-producing Klebsiella pneumoniae isolates belonging to international high-risk clones poses a major health care threat. In this study, 48 nonduplicated, carbapenem-resistant K. pneumoniae isolated from 2011 to 2014 in a tertiary hospital were investigated. The bla(KPC-2) gene was the only determinant for carbapenem resistance. The bla(CTX-M-15) gene was the main determinant for the production of extended-spectrum beta-lactamase (ESBL), whereas aph(3 ')-Ia and qnrB were the most common genes associated with resistance to aminoglycosides and quinolones, respectively. Nine different sequence types (STs) were identified. The most common was ST340. Molecular typing by enterobacterial repetitive intergenic consensus-PCR placed 48 strains among 10 different clusters. In the studied hospital, the high-risk clone of KPC-2-producing K. pneumoniae ST340, harboring genes that codify aminoglycoside modifying enzymes, QnrB and CTX-M-15 plus CTXM-2-type ESBLs, is disseminated and acts as a major agent of infections in critically ill patients.
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