An Outbreak of Klebsiella pneumoniae and Enterobacter aerogenes Bacteremia After Interventional Pain Management Procedures, New York City, 2008

ABSTRACTWe report the nucleotide sequence of a novelblaKPC-2-harboring IncFIIK1plasmid, pBK32179, isolated from a carbapenem-resistantKlebsiella pneumoniaeST258 strain from a New York City patient. pBK32179 is 165 kb long, consists of a large backbone of pKPN3-like plasmid, and carries an 18.5-kbblaKPC-2-containing element that is highly similar to plasmid pKpQIL. pBK32179-like plasmids were identified in 8.3% of strains in a collection of 96K. pneumoniaeisolates from hospitals in the New York City area.

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Activity of a novel aminoglycoside, ACHN-490, against clinical isolates of Escherichia coli and Klebsiella pneumoniae from New York City

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkq278 ◽

2010 ◽

Vol 65 (10) ◽

pp. 2123-2127 ◽

Cited By ~ 34

Author(s):

D. Landman ◽

E. Babu ◽

N. Shah ◽

P. Kelly ◽

M. Backer ◽

...

Keyword(s):

Escherichia Coli ◽

New York ◽

New York City ◽

Klebsiella Pneumoniae ◽

York City ◽

Clinical Isolates

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Detection of multiple hypervirulent Klebsiella pneumoniae strains in a New York City hospital through screening of virulence genes

Clinical Microbiology and Infection ◽

10.1016/j.cmi.2020.05.012 ◽

2020 ◽

Cited By ~ 2

Author(s):

A.M. Parrott ◽

J. Shi ◽

J. Aaron ◽

D.A. Green ◽

S. Whittier ◽

...

Keyword(s):

New York ◽

New York City ◽

Klebsiella Pneumoniae ◽

York City ◽

Virulence Genes ◽

City Hospital

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A Ceftazidime-Avibactam-Resistant and Carbapenem-Susceptible Klebsiella pneumoniae Strain Harboring blaKPC-14 Isolated in New York City

mSphere ◽

10.1128/msphere.00775-20 ◽

2020 ◽

Vol 5 (4) ◽

Author(s):

Siqiang Niu ◽

Kalyan D. Chavda ◽

Jie Wei ◽

Chunhong Zou ◽

Steven H. Marshall ◽

...

Keyword(s):

New York ◽

New York City ◽

Klebsiella Pneumoniae ◽

York City ◽

The United States ◽

Genomic Sequencing ◽

Content Type ◽

Clinical Variants ◽

Genetic Structures ◽

Antibiotic Combination

ABSTRACT Ceftazidime-avibactam is a potent antibiotic combination against Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae. Here, we describe a unique ceftazidime-avibactam-resistant and carbapenem-susceptible K. pneumoniae strain harboring a novel blaKPC-14 variant. This strain was isolated from a New York City patient in 2003, which predates the introduction of avibactam. Despite resistance to ceftazidime-avibactam, the strain was susceptible to imipenem-relebactam and meropenem-vaborbactam. Comprehensive genomic sequencing revealed that blaKPC-14 is harbored on an ST6 IncN plasmid associated with the early spread of blaKPC. IMPORTANCE KPC is currently the most common carbapenemase identified in the United States. More than 40 KPC variants have been described, of which KPC-2 and KPC-3 are the most frequent clinical variants. However, our understanding of the genetic structures and β-lactam resistance profiles of other novel KPC variants remains incomplete. Here, we report a novel blaKPC variant (blaKPC-14) and the complete genome sequence of blaKPC-14-harboring K. pneumoniae strain BK13048, which is susceptible to carbapenems but resistant to ceftazidime-avibactam. To the best of our knowledge, this is one of the earliest KPC-producing K. pneumoniae strains exhibiting resistance to ceftazidime-avibactam.

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Population Structure of Klebsiella pneumoniae Causing Bloodstream Infections at a New York City Tertiary Care Hospital: Diversification of Multidrug-Resistant Isolates

Journal of Clinical Microbiology ◽

10.1128/jcm.03455-14 ◽

2015 ◽

Vol 53 (7) ◽

pp. 2060-2067 ◽

Cited By ~ 40

Author(s):

Angela Gomez-Simmonds ◽

Michelle Greenman ◽

Sean B. Sullivan ◽

Joshua P. Tanner ◽

Madeleine G. Sowash ◽

...

Keyword(s):

New York ◽

New York City ◽

Klebsiella Pneumoniae ◽

York City ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Bloodstream Infections ◽

Mortality Rates ◽

Care Hospital ◽

Content Type

Despite the growing importance of carbapenem-resistantKlebsiella pneumoniae(CRKP), the clonal relationships between CRKP and antibiotic-susceptible isolates remain unclear. We compared the genetic diversity and clinical features of CRKP, third-generation and/or fourth-generation cephalosporin-resistant (Ceph-R)K. pneumoniae, and susceptibleK. pneumoniaeisolates causing bloodstream infections at a tertiary care hospital in New York City between January 2012 and July 2013. Drug susceptibilities were determined with the Vitek 2 system. Isolates underwent multilocus sequence typing and PCR sequencing of thewziandblaKPCgenes. Clinical and microbiological data were extracted from patient records and correlated with molecular data. Among 223 patients, we identified 272 isolates. Of these, 194 were susceptible, 30 Ceph-R, and 48 CRKP, belonging to 144 sequence types (STs). Susceptible (127 STs) and Ceph-R (20 STs) isolates were highly diverse. ST258 dominated CRKP strains (12 STs, with 63% ST258). There was minimal overlap in STs between resistance groups. TheblaKPC-3gene (30%) was restricted to ST258/wzi154, whereasblaKPC-2(70%) was observed for severalwziallele types. CRKP infections occurred more frequently among solid organ transplant (31%) and dialysis (17%) patients. Mortality rates were high overall (28%) and highest among CRKP-infected patients (59%). In multivariable analyses, advanced age, comorbidities, and disease severity were significant predictors of 30-day mortality rates, whereas theK. pneumoniaesusceptibility phenotype was not. Among CRKP infections, we observed a borderline significant association of increased mortality rates with ST258 and thewzi154 allele. Although the clonal spread of ST258 continues to contribute substantially to the dissemination of CRKP, non-ST258 strains appear to be evolving. Further investigations into the mechanisms promoting CRKP diversification and the effects of clonal backgrounds on outcomes are warranted.

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