Spread of an OmpK36-modified ST15 Klebsiella pneumoniae variant during an outbreak involving multiple carbapenem-resistant Enterobacteriaceae species and clones

• Type: Article in International Scientific Journal
• Date: 2012

Authors

Novais, A (Author) Other; Rodrigues, C (Author) Other; Branquinho, R (Author) Other; Antunes, P (Author) FCNAUP; Grosso, F (Author) Other; Boaventura, L (Author) Other; Ribeiro, G (Author) Other; Peixe, L (Author) FFUP

Journal

Title: European Journal of Clinical Microbiology and Infectious Diseases

Vol. 31 No. 11

Pages: 3057-3063

ISSN: 0934-9723

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 43 Citations

ISI Web of Science

Scopus - 44 Citations

Scientific classification

FOS: Medical and Health sciences > Health sciences

CORDIS: Health sciences

Other information

Authenticus ID: P-002-3Z4

DOI: 10.1007/s10096-012-1665-z

Abstract (EN): We aim to characterise multiple ertapenem-resistant (ERT-R, n = 15) Enterobacteriaceae isolates identified as presumptive carbapenemase producers in a Portuguese hospital in a short period of time (March-July 2010). Antibiotic susceptibility patterns, beta-lactamases, genetic relatedness [pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST)], plasmid content and major enterobacterial porins were investigated. Ertapenem resistance was associated with deficiencies in major porins and, in some cases, extended-spectrum beta-lactamase (ESBL) or AmpC beta-lactamase production among outbreak and non-outbreak clones. Most isolates (n = 8) corresponded to two ERT-R Klebsiella pneumoniae ST15 PFGE-types: (i) a sporadic variant (Kp-A-ERT, n = 1) presenting a premature stop codon in ompK36 and (ii) an epidemic variant (Kp-B-ERT, n = 7) exhibiting a new OmpK36 porin variant, which differed additionally in plasmid and antibiotic susceptibility profiles. ST14 (n = 1) and ST45 (n = 1) K. pneumoniae, ST131 (n = 1) and ST354 (n = 1) Escherichia coli, Enterobacter asburiae (n = 1), Enterobacter cloacae (n = 1) and Enterobacter aerogenes (n = 1) ERT-R clones were also sporadically detected. Porin changes in these isolates included non-sense mutations [ompK35, ompK36, ompF; minimum inhibitory concentration (MIC) = 4-32 mg/l], IS-mediated porin disruptions (ompK36, ompC; MIC = 12-> 32 mg/l) or alterations in the L3 loop (ompK36; MIC = 4-16 mg/l). We describe, for the first time in Portugal, the simultaneous emergence of multiple ERT-R Enterobacteriaceae species and clones in a short period of time. Moreover, our results support that a CTX-M-15-producing ST15 K. pneumoniae with an OmpK36-modified porin might successfully spread in the nosocomial setting.

Language: English

Type (Professor's evaluation): Scientific

Notes: Epub 2012 Jun 16. <a href="http://gateway.isiknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=Alerting&SrcApp=Alerting&DestApp=WOS&DestLinkType=FullRecord&KeyUT=000310247800026">Indexado na ISI Web of Science</a>

No. of pages: 7