Virulence and resistance determinants of Klebsiella pneumoniae isolated from a Portuguese tertiary university hospital centre over a 31-year period

A high fosfomycin resistance rate was observed inKlebsiella pneumoniaecarbapenemase (KPC)-producingK. pneumoniae(KPC-KP) in our previous study, but little is known about its mechanisms. In this study, we explored the prevalence of plasmid-mediated fosfomycin resistance determinants among fosfomycin-resistant KPC-KP strains from a Chinese university hospital and determined the complete sequence of a novelfosA3-carrying plasmid isolated from an epidemicK. pneumoniaesequence type (ST) 11 strain. A total of 97 KPC-KP strains were studied, of which 57 (58.8%) were resistant to fosfomycin, including 44 (45.4%) harboringfosA3and 1 harboringfosA. AllfosA3-positive strains belonged to the dominant ST11-pulse type (PT) A clone according to multilocus sequence typing and pulsed-field gel electrophoresis, suggesting clonal dissemination. ThefosA-positive isolate belonged to ST11-PTE. ThefosA3-carrying plasmid pKP1034 is 136,848 bp in length and is not self-transmissible. It is a multireplicon plasmid belonging to IncR-F33:A−: B−. BesidesfosA3, a variety of other resistance determinants, includingblaKPC-2,rmtB,blaCTX-M-65, andblaSHV-12, are identified in pKP1034, which would allow for coselection offosA3by most β-lactams and/or aminoglycosides and facilitate its dissemination despite limited use of fosfomycin in China. Detailed comparisons with related plasmids revealed that pKP1034 is highly mosaic and might have evolved from alarming recombination of theblaKPC-2-carrying plasmid pKPC-LK30 from Taiwan and the epidemicfosA3-carrying plasmid pHN7A8 from mainland China.

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Virulence and resistance determinants of Klebsiella pneumoniae isolated from a Portuguese tertiary university hospital centre over a 31-year period

Enfermedades Infecciosas y Microbiología Clínica ◽

10.1016/j.eimc.2018.11.001 ◽

2019 ◽

Vol 37 (6) ◽

pp. 387-393 ◽

Cited By ~ 4

Author(s):

Cátia Caneiras ◽

Luís Lito ◽

Sagrario Mayoralas-Alises ◽

Salvador Díaz-Lobato ◽

José Melo-Cristino ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

University Hospital ◽

Resistance Determinants

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Eradication of the epidemic ESBL-positive strain of Klebsiella pneumoniae from the bacterial flora of the intensive neonatal care unit of the University Hospital No. 2 in Bydgoszcz

10.26226/morressier.56d5ba31d462b80296c96972 ◽

2016 ◽

Author(s):

Arkadiusz Kuziemski

Keyword(s):

Klebsiella Pneumoniae ◽

Bacterial Flora ◽

Neonatal Care ◽

University Hospital ◽

Positive Strain ◽

Neonatal Care Unit ◽

The University

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Antimicrobial susceptibility of urinary Klebsiella pneumoniae and the emergence of carbapenem-resistant strains: A retrospective study from a university hospital in Morocco, North Africa

African Journal of Urology ◽

10.1016/j.afju.2014.10.004 ◽

2015 ◽

Vol 21 (1) ◽

pp. 36-40 ◽

Cited By ~ 17

Author(s):

M.C. El Bouamri ◽

L. Arsalane ◽

Y. El Kamouni ◽

S. Zouhair

Keyword(s):

Retrospective Study ◽

Klebsiella Pneumoniae ◽

North Africa ◽

Antimicrobial Susceptibility ◽

University Hospital ◽

Carbapenem Resistant ◽

Resistant Strains

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First description of NDM-1-, KPC-2-, VIM-2- and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital

Epidemiology and Infection ◽

10.1017/s0950268814000995 ◽

2014 ◽

Vol 143 (2) ◽

pp. 376-384 ◽

Cited By ~ 27

Author(s):

Y. LIU ◽

L.-G. WAN ◽

Q. DENG ◽

X.-W. CAO ◽

Y. YU ◽

...

Keyword(s):

16S Rrna ◽

Klebsiella Pneumoniae ◽

Teaching Hospital ◽

Multidrug Resistant ◽

The Other ◽

Quinolone Resistance ◽

Resistance Determinants ◽

Carbapenem Resistant ◽

Extended Spectrum ◽

Chinese Teaching

SUMMARYA total of 180 non-duplicate carbapenem-resistant Klebsiella pneumoniae isolates were recovered from patients hospitalized between December 2010 and January 2012 at a Chinese hospital. Eight KPC-2, four NDM-1, one VIM-2, and five KPC-2 plus IMP-4 producers were identified and all were multidrug resistant due to the presence of other resistance determinants, including extended-spectrum β-lactamases (CTX-M-15, SHV-12), 16S rRNA methylases (armA, rmtB) and plasmid-mediated quinolone-resistance determinants (qnrA, B, S, aac(6′)-Ib-cr). Nine K. pneumoniae clones (Kpn-A1/ST395, Kpn-A3/ST11, Kpn-A2/ST134, Kpn-B/ST263, Kpn-C/ST37, Kpn-D/ST39, Kpn-E/ST1151, Kpn-F/ST890, Kpn-G/ST1153) were identified. blaKPC-2 was located on transferable ~65 kb IncL/M (ST395, ST11, ST134, ST39) and ~100 kb IncA/C (ST37, ST1153, ST890) plasmids, respectively. On the other hand, blaNDM-1 was associated with a ~70 kb IncA/C plasmid (ST263). However, non-typable plasmids of ~40 kb containing blaVIM-2 were detected in the ST1151 clone. This work reports the first co-occurrence of four diverse types of carbapenemase of K. pneumoniae clones from a single hospital in China. IncA/C, IncL/M, and other successful plasmids may be important for the dissemination of carbapenemases, producing a complex epidemiological picture.

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