BACKGROUND: Klebsiella pneumoniae isolates harboring the K. pneumoniae carbapenemase gene (bla(KPC)) are creating a significant healthcare threat in both acute and long-term care facilities (LTCFs). As part of a study conducted in 2004 to determine the risk of stool colonization with extended-spectrum cephalosporin-resistant gram-negative bacteria, 12 isolates of K. pneumoniae that exhibited nonsusceptibility to extended-spectrum cephalosporins were detected. All were gastrointestinal carriage isolates that were not associated with infection. METHODS: Reassessment of the carbapenem minimum inhibitory concentrations using revised 2011 Clinical Laboratory Standards Institute breakpoints uncovered carbapenem resistance. To further investigate, a DNA microarray assay, PCR-sequencing of bla genes, immunoblotting, repetitive-sequence-based PCR (rep-PCR) and multilocus sequence typing (MLST) were performed. RESULTS: The DNA microarray detected bla(KPC) in all 12 isolates, and bla(KPC-3) was identified by PCR amplification and sequencing of the amplicon. In addition, a bla(SHV-11) gene was detected in all isolates. Immunoblotting revealed "low-level" production of the K. pneumoniae carbapenemase, and rep-PCR indicated that all bla(KPC-3)-positive K. pneumoniae strains were genetically related (≥98% similar). According to MLST, all isolates belonged to sequence type 36. This sequence type has not been previously linked with bla(KPC) carriage. Plasmids from 3 representative isolates readily transferred the bla(KPC-3) to Escherichia coli J-53 recipients. CONCLUSIONS: Our findings reveal the "silent" dissemination of bla(KPC-3) as part of Tn4401b on a mobile plasmid in Northeast Ohio nearly a decade ago and establish the first report, to our knowledge, of K. pneumoniae containing bla(KPC-3) in an LTCF caring for neurologically impaired children and young adults.
BACKGROUND:Klebsiella pneumoniae isolates harboring the K. pneumoniae carbapenemase gene (bla(KPC)) are creating a significant healthcare threat in both acute and long-term care facilities (LTCFs). As part of a study conducted in 2004 to determine the risk of stool colonization with extended-spectrum cephalosporin-resistant gram-negative bacteria, 12 isolates of K. pneumoniae that exhibited nonsusceptibility to extended-spectrum cephalosporins were detected. All were gastrointestinal carriage isolates that were not associated with infection. METHODS: Reassessment of the carbapenem minimum inhibitory concentrations using revised 2011 Clinical Laboratory Standards Institute breakpoints uncovered carbapenem resistance. To further investigate, a DNA microarray assay, PCR-sequencing of bla genes, immunoblotting, repetitive-sequence-based PCR (rep-PCR) and multilocus sequence typing (MLST) were performed. RESULTS: The DNA microarray detected bla(KPC) in all 12 isolates, and bla(KPC-3) was identified by PCR amplification and sequencing of the amplicon. In addition, a bla(SHV-11) gene was detected in all isolates. Immunoblotting revealed "low-level" production of the K. pneumoniae carbapenemase, and rep-PCR indicated that all bla(KPC-3)-positive K. pneumoniae strains were genetically related (≥98% similar). According to MLST, all isolates belonged to sequence type 36. This sequence type has not been previously linked with bla(KPC) carriage. Plasmids from 3 representative isolates readily transferred the bla(KPC-3) to Escherichia coli J-53 recipients. CONCLUSIONS: Our findings reveal the "silent" dissemination of bla(KPC-3) as part of Tn4401b on a mobile plasmid in Northeast Ohio nearly a decade ago and establish the first report, to our knowledge, of K. pneumoniae containing bla(KPC-3) in an LTCF caring for neurologically impaired children and young adults.
Authors: Lalitagauri M Deshpande; Paul R Rhomberg; Helio S Sader; Ronald N Jones Journal: Diagn Microbiol Infect Dis Date: 2006-10-03 Impact factor: 2.803
Authors: Kristine M Hujer; Andrea M Hujer; Edward A Hulten; Saralee Bajaksouzian; Jennifer M Adams; Curtis J Donskey; David J Ecker; Christian Massire; Mark W Eshoo; Rangarajan Sampath; Jodi M Thomson; Philip N Rather; David W Craft; Joel T Fishbain; Allesa J Ewell; Michael R Jacobs; David L Paterson; Robert A Bonomo Journal: Antimicrob Agents Chemother Date: 2006-09-25 Impact factor: 5.191
Authors: Claudia M Hoyen; Andrea M Hujer; Kristine M Hujer; Steven H Marshall; Lenore Carias; Philip Toltzis; Louis B Rice; Robert A Bonomo Journal: Microb Drug Resist Date: 2002 Impact factor: 3.431
Authors: Robert A Bonomo; Curtis J Donskey; Jeffery L Blumer; Andrea M Hujer; Claudia K Hoyenm; Michael R Jacobs; Christopher C Whalen; Robert A Salata Journal: J Am Geriatr Soc Date: 2003-04 Impact factor: 5.562
Authors: Roberto Viau; Karen M Frank; Michael R Jacobs; Brigid Wilson; Keith Kaye; Curtis J Donskey; Federico Perez; Andrea Endimiani; Robert A Bonomo Journal: Clin Microbiol Rev Date: 2016-01 Impact factor: 26.132
Authors: Federico Perez; Susan D Rudin; Steven H Marshall; Peter Coakley; Liang Chen; Barry N Kreiswirth; Philip N Rather; Andrea M Hujer; Philip Toltzis; David van Duin; David L Paterson; Robert A Bonomo Journal: Antimicrob Agents Chemother Date: 2013-07-01 Impact factor: 5.191
Authors: David van Duin; Eric Cober; Sandra S Richter; Federico Perez; Robert C Kalayjian; Robert A Salata; Scott Evans; Vance G Fowler; Keith S Kaye; Robert A Bonomo Journal: J Antimicrob Chemother Date: 2014-12-09 Impact factor: 5.790
Authors: Laura J Rojas; Madiha Salim; Eric Cober; Sandra S Richter; Federico Perez; Robert A Salata; Robert C Kalayjian; Richard R Watkins; Steve Marshall; Susan D Rudin; T Nicholas Domitrovic; Andrea M Hujer; Kristine M Hujer; Yohei Doi; Keith S Kaye; Scott Evans; Vance G Fowler; Robert A Bonomo; David van Duin Journal: Clin Infect Dis Date: 2017-03-15 Impact factor: 9.079
Authors: Laura J Rojas; Meredith S Wright; Elsa De La Cadena; Gabriel Motoa; Kristine M Hujer; Maria V Villegas; Mark D Adams; Robert A Bonomo Journal: Antimicrob Agents Chemother Date: 2016-06-20 Impact factor: 5.191
Authors: L Silvia Munoz-Price; Laurent Poirel; Robert A Bonomo; Mitchell J Schwaber; George L Daikos; Martin Cormican; Giuseppe Cornaglia; Javier Garau; Marek Gniadkowski; Mary K Hayden; Karthikeyan Kumarasamy; David M Livermore; Juan J Maya; Patrice Nordmann; Jean B Patel; David L Paterson; Johann Pitout; Maria Virginia Villegas; Hui Wang; Neil Woodford; John P Quinn Journal: Lancet Infect Dis Date: 2013-09 Impact factor: 25.071