Jesús Oteo1,2, María Pérez-Vázquez3,2, Verónica Bautista3,2, Adriana Ortega3,2, Pilar Zamarrón4, David Saez3, Sara Fernández-Romero3,2, Noelia Lara3,2, Raquel Ramiro3, Belén Aracil3,2, José Campos3,2,5. 1. Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Majadahonda, Madrid, Spain jesus.oteo@isciii.es. 2. Red Española de Investigación en Patología Infecciosa (REIPI), Spain. 3. Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Majadahonda, Madrid, Spain. 4. Servicio de Microbiología, Hospital Virgen de la Salud, Toledo, Spain. 5. Consejo Superior de Investigaciones Científicas, Madrid, Spain.
Abstract
OBJECTIVES: We analysed the microbiological traits and population structure of KPC-producing Enterobacteriaceae isolates collected in Spain between 2012 and 2014. We also performed a comparative WGS analysis of the three major KPC-producing Klebsiella pneumoniae clones detected. METHODS: Carbapenemase and ESBL genes were sequenced. The Institut Pasteur MLST scheme was used. WGS data were used to construct phylogenetic trees, to identify the determinants of resistance and to de novo assemble the genome of one representative isolate of each of the three major K. pneumoniae clones. RESULTS: Of the 2443 carbapenemase-producing Enterobacteriaceae isolates identified during the study period, 111 (4.5%) produced KPC. Of these, 81 (73.0%) were K. pneumoniae and 13 (11.7%) were Enterobacter cloacae. Three major epidemic clones of K. pneumoniae were identified: ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3. ST11/KPC-2 differed from ST101/KPC-2 and ST512/KPC-3 by 27 819 and 6924 SNPs, respectively. ST101/KPC-2 differed from ST512/KPC-3 by 28 345 SNPs. Nine acquired resistance genes were found in ST11/KPC-2, 11 in ST512/KPC-3 and 13 in ST101/KPC-2. ST101/KPC-2 had the highest number of virulence genes (20). An 11 bp deletion at the end of the mgrB sequence was the cause of colistin resistance in ST512/KPC-3. CONCLUSIONS: KPC-producing Enterobacteriaceae are increasing in Spain. Most KPC-producing K. pneumoniae isolates belonged to only five clones: ST11 and ST512 caused interregional spread, ST101 caused regional spread and ST1961 and ST678 produced independent hospital outbreaks. ST101/KPC-2 had the highest number of resistance and virulence genes. ST101/KPC-2 and ST512/KPC-3 were recently implicated in the spread of KPC in Italy.
OBJECTIVES: We analysed the microbiological traits and population structure of KPC-producing Enterobacteriaceae isolates collected in Spain between 2012 and 2014. We also performed a comparative WGS analysis of the three major KPC-producing Klebsiella pneumoniae clones detected. METHODS: Carbapenemase and ESBL genes were sequenced. The Institut Pasteur MLST scheme was used. WGS data were used to construct phylogenetic trees, to identify the determinants of resistance and to de novo assemble the genome of one representative isolate of each of the three major K. pneumoniae clones. RESULTS: Of the 2443 carbapenemase-producing Enterobacteriaceae isolates identified during the study period, 111 (4.5%) produced KPC. Of these, 81 (73.0%) were K. pneumoniae and 13 (11.7%) were Enterobacter cloacae. Three major epidemic clones of K. pneumoniae were identified: ST11/KPC-2, ST101/KPC-2 and ST512/KPC-3. ST11/KPC-2 differed from ST101/KPC-2 and ST512/KPC-3 by 27 819 and 6924 SNPs, respectively. ST101/KPC-2 differed from ST512/KPC-3 by 28 345 SNPs. Nine acquired resistance genes were found in ST11/KPC-2, 11 in ST512/KPC-3 and 13 in ST101/KPC-2. ST101/KPC-2 had the highest number of virulence genes (20). An 11 bp deletion at the end of the mgrB sequence was the cause of colistin resistance in ST512/KPC-3. CONCLUSIONS: KPC-producing Enterobacteriaceae are increasing in Spain. Most KPC-producing K. pneumoniae isolates belonged to only five clones: ST11 and ST512 caused interregional spread, ST101 caused regional spread and ST1961 and ST678 produced independent hospital outbreaks. ST101/KPC-2 had the highest number of resistance and virulence genes. ST101/KPC-2 and ST512/KPC-3 were recently implicated in the spread of KPC in Italy.
Authors: Michael A Bachman; Jennifer E Oyler; Samuel H Burns; Mélissa Caza; François Lépine; Charles M Dozois; Jeffrey N Weiser Journal: Infect Immun Date: 2011-05-16 Impact factor: 3.441
Authors: Tânia Curiao; María Isabel Morosini; Patricia Ruiz-Garbajosa; Ana Robustillo; Fernando Baquero; Teresa M Coque; Rafael Cantón Journal: J Antimicrob Chemother Date: 2010-05-30 Impact factor: 5.790
Authors: Stephen E Mshana; Moritz Fritzenwanker; Linda Falgenhauer; Eugen Domann; Torsten Hain; Trinad Chakraborty; Can Imirzalioglu Journal: BMC Microbiol Date: 2015-06-17 Impact factor: 3.605
Authors: O Lima; A Sousa; R Longueira-Suárez; A Filgueira; C Taboada-Martínez; C Portela-Pino; A Nodar; F Vasallo-Vidal; L Martinez-Lamas; A Pérez-Landeiro; M Rubianes; M T Pérez-Rodríguez Journal: Eur J Clin Microbiol Infect Dis Date: 2022-08-08 Impact factor: 5.103
Authors: Eva Gato; Ignacio Pedro Constanso; Bruno Kotska Rodiño-Janeiro; Paula Guijarro-Sánchez; Tyler Alioto; Manuel Jesús Arroyo; Gema Méndez; Luis Mancera; Marta Gut; Ivo Gut; Miguel Álvarez-Tejado; Germán Bou; Marina Oviaño Journal: J Clin Microbiol Date: 2021-07-19 Impact factor: 5.948
Authors: Marta Fernández-Martínez; Claudia González-Rico; Luis Martínez-Martínez; Maria Carmen Fariñas; Mónica Gozalo-Margüello; Francesc Marco; Irene Gracia-Ahufinger; Maitane Aranzamendi; Ana M Sánchez-Díaz; Teresa Vicente-Rangel; Fernando Chaves; Jorge Calvo Montes Journal: Sci Rep Date: 2021-06-04 Impact factor: 4.379
Authors: Sara Lomonaco; Matthew A Crawford; Christine Lascols; Ruth E Timme; Kevin Anderson; David R Hodge; Debra J Fisher; Segaran P Pillai; Stephen A Morse; Erum Khan; Molly A Hughes; Marc W Allard; Shashi K Sharma Journal: PLoS One Date: 2018-06-08 Impact factor: 3.752
Authors: Daniela Loconsole; Marisa Accogli; Anna Lisa De Robertis; Loredana Capozzi; Angelica Bianco; Anna Morea; Rosanna Mallamaci; Michele Quarto; Antonio Parisi; Maria Chironna Journal: Ann Clin Microbiol Antimicrob Date: 2020-06-01 Impact factor: 3.944