6533b833fe1ef96bd129b856
RESEARCH PRODUCT
An Update of the Evolving Epidemic of blaKPC Carrying Klebsiella pneumoniae in Sicily, Italy, 2014: Emergence of Multiple Non-ST258 Clones
Celestino BonuraMario GiuffrèAurora AleoTeresa Maria Assunta FascianaF. Di BernardoT. StamponeAnna GiammancoD. PalmaCaterina MamminaDaniela Maria GeraciGiorgio GrazianoLaura SaporitoM. SaporitoC. SodanoM. VerdeM. BaldiE. DonatoT. AmatoR. ImmordinoS. Distefanosubject
CarbapenemKlebsiella pneumoniaelcsh:MedicineGene ExpressionDrug resistancePlasmidbeta-LactamaseDisease OutbreaksMolecular typingFluoroquinoloneDrug Resistance Multiple Bacterialpolycyclic compoundslcsh:ScienceCarbapenemMembrane ProteinDisease OutbreakMultidisciplinarybiologyMedicine (all)IncidenceHospitalsAnti-Bacterial AgentsElectrophoresis Gel Pulsed-FieldKlebsiella pneumoniaeItalyEpidemiological MonitoringHumanFluoroquinolonesPlasmidsResearch Articlemedicine.drugBacterial ProteinAminoglycosides; Anti-Bacterial Agents; Bacterial Proteins; Carbapenems; Clone Cells; Colistin; Drug Resistance Multiple Bacterial; Electrophoresis Gel Pulsed-Field; Epidemiological Monitoring; Fluoroquinolones; Gene Expression; Hospitals; Humans; Incidence; Italy; Klebsiella Infections; Klebsiella pneumoniae; Membrane Proteins; Multilocus Sequence Typing; Mutation; Plasmids; beta-Lactamases; Disease Outbreaks; Agricultural and Biological Sciences (all); Biochemistry Genetics and Molecular Biology (all); Medicine (all)beta-LactamasesMicrobiologyClone CellHospitalAntibiotic resistanceBacterial ProteinsAnti-Bacterial AgentmedicineHumansBiochemistry Genetics and Molecular Biology (all)AminoglycosideColistinlcsh:RMembrane ProteinsCarbapenemase producingbiochemical phenomena metabolism and nutritionbacterial infections and mycosesbiology.organism_classificationVirologyClone CellsKlebsiella InfectionsAminoglycosidesAgricultural and Biological Sciences (all)CarbapenemsMutationColistinMultilocus sequence typinglcsh:QKlebsiella InfectionMultilocus Sequence Typingdescription
Background: In Italy, Klebsiella pneumoniae carbapenemase producing K. pneumoniae (KPC-Kp) strains are highly endemic and KPC producing CC258 is reported as the widely predominating clone. In Palermo, Italy, previous reports have confirmed this pattern. However, recent preliminary findings suggest that an epidemiological change is likely ongoing towards a polyclonal KPC-Kp spread. Here we present the results of molecular typing of 94 carbapenem non susceptible K. pneumoniae isolates detected during 2014 in the three different hospitals in Palermo, Italy. Methods and Results: Ninety-four consecutive, non replicate carbapenem non susceptible isolates were identified in the three largest acute general hospitals in Palermo, Italy, in the six-month period March-August 2014. They were characterized by PCR for β-lactam, aminoglycoside and plasmid mediated fluoroquinolone resistance genetic determinants. The mgrB gene of the colistin resistant isolates was amplified and sequenced. Clonality was assessed by pulsed field gel electrophoresis and multilocus sequence typing. Eight non-CC258 sequence types (STs) were identified accounting for 60% of isolates. In particular, ST307 and ST273 accounted for 29% and 18% of isolates. CC258 isolates were more frequently susceptible to gentamicin and non-CC258 isolates to amikacin. Colistin non susceptibility was found in 42% of isolates. Modifications of mgrB were found in 32 isolates. Conclusions: Concurrent clonal expansion of some STs and lateral transmission of genetic resistance determinants are likely producing a thorough change of the KPC-Kp epidemiology in Palermo, Italy. In our setting mgrB inactivation proved to substantially contribute to colistin resistance. Our findings suggest the need to continuously monitor the KPC-Kp epidemiology and to assess by a nationwide survey the possible shifting towards a polyclonal epidemic.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-04-13 | PLOS ONE |