Emergence of a colistin-resistant KPC-2-producing Klebsiella pneumoniae ST258 clone in Hungary
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Nine Klebsiella pneumoniae isolates showing non-susceptibility to carbapenems were collected from three centres in the north-eastern region of Hungary. The minimum inhibitory concentrations (MICs) of antibiotics were determined by Etest. The putative production of a carbapenemase was tested by the modified Hodge test. The presence of bla KPC genes was verified by polymerase chain reaction (PCR) and sequencing. Furthermore, molecular typing was performed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). All isolates showed extensively drug-resistant (XDR) phenotype, and of these, eight isolates were highly resistant to colistin. The isolates carried bla KPC-2, bla SHV-12, bla TEM-1 and bla SHV-11. PFGE analysis of the nine KPC-2-producing Hungarian ST258 K. pneumoniae isolates, two KPC-2-producing Norwegian ST258 isolates and 33 CTX-M-15-producing ST11 isolates revealed the existence of one genetic cluster at an 88% similarity level. The overall results of the PFGE clustering, MLST and the presence of SHV-11 in both ST11 and ST258 suggest that this is the first hyperepidemic clonal complex of multidrug-resistant K. pneumoniae, probably CC258/CC340, possibly undergoing worldwide spread.
KeywordsColistin Ertapenem Dipicolinic Acid Klebsiella Pneumoniae Carbapenemases Epidemic Clone
We are grateful to Ørjan Samuelsen for providing the K47-25 and K48-58 KPC-2-producing Klebsiella pneumoniae strains, to Christian G. Giske for his critical reading of the manuscript and to Mrs. János Topf for her skilful technical assistance.
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