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Enferm Infecc Microbiol Clin. 2019 Feb;37(2):82-88. doi: 10.1016/j.eimc.2018.02.003. Epub 2018 Apr 6.

Molecular characterization of OXA-48 carbapenemase-producing Klebsiella pneumoniae strains after a carbapenem resistance increase in Catalonia.

[Article in English, Spanish]

Author information

1
Hospital de la Santa Creu i Sant Pau and Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.
2
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital General de Granollers, Barcelona, Spain.
3
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Consorci hospitalari de Vic, Barcelona, Spain.
4
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital General de l'Hospitalet (Consorci Sanitari Integral and Consorci de Laboratoris Intercomarcal), Currently Fundació Puigvert, Barcelona, Spain.
5
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital Universitari Sant Joan de Reus, Tarragona, Spain.
6
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital Municipal de Badalona, Barcelona, Spain.
7
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Corporació de Salut del Maresme i la Selva, Spain.
8
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital Sant Joan Martorell, Barcelona, Spain.
9
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital Sant Joan de Déu de Manresa, Barcelona, Spain.
10
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital General Universitari de Catalunya-Quionsalud, Barcelona, Spain.
11
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital de Mataró, Barcelona, Spain.
12
Grup de Microbiòlegs dels Hospitals Comarcals de Catalunya i Balears, Spain; Hospital de Barcelona-SCIAS, Barcelona, Spain.
13
Hospital de la Santa Creu i Sant Pau and Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain. Electronic address: fnavarror@santpau.cat.

Abstract

INTRODUCTION:

To characterize OXA-48 carbapenemase-producing Klebsiella pneumoniae strains isolated after an increase in carbapenem resistance in Catalonia.

METHODOLOGY:

K. pneumoniae identification, antimicrobial susceptibility studies, the Modified Hodge Test method, amplification of antimicrobial resistance genes (against β-lactamases, quinolones and aminoglycosides), molecular typing (by PFGE and MLST), conjugation assays, plasmid characterization (PBRT-PCR and Southern blot), a description of mobile genetic elements and statistical analysis were done.

RESULTS:

OXA-48 was the only carbapenemase detected, with a prevalence of 1.9%. The blaOXA-48 gene was located in an IncL conjugative plasmid of 62kb and integrated into the transposons Tn1999.2 (91.7%) or Tn1999.1. Five PFGE profiles (A to E) were found, which exactly matched the MLST: ST101, ST17, ST1233, ST14 and ST405, respectively. ST1233 is described here for the first time. K. pneumoniae OXA-48-producing strains were also CTX-M-15 carriers, some producing OXA-1 and TEM-1 penicillinases. The acquired qnrB66 and qnrB1 and aac(3')-IIa, aac(6')-Ib genes were also identified.

CONCLUSION:

The K. pneumoniae ST405 clone has played an important role in the growing prevalence of OXA-48 in Catalonia. All clones described preserved the blaOXA-48 genetic environment and mobile genetic elements (Tn1999). Notably, the three strains with minor sequence types in this study are not multiresistant strains. These strains are expanding in elderly patients (average age of 76 years) with serious underlying diseases, mainly women (61.2%).

KEYWORDS:

Antibiotic resistance; Carbapenemasa; Carbapenemase; MLST; OXA-48; PFGE; Resistencia a los antibióticos

PMID:
29631930
DOI:
10.1016/j.eimc.2018.02.003

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