Abstract
Carbapenemase-producing Klebsiella pneumoniae has recently spread rapidly throughout China. In this study, we characterized a carbapenem-resistant K. pneumoniae isolate that produced both KPC-2 and IMP-4 type carbapenemases. A clinical isolate of K. pneumoniae, resistant to both meropenem and imipenem, was recovered from a urine sample. Antibiotic susceptibility was determined using the broth microdilution method and Etest (bioMérieux, France). Pulsed-field gel electrophoresis and multilocus sequence typing (MLST) were used for gene type analysis. bla KPC and the encoding genes of ESBLs and plasmid-mediated AmpC enzymes were polymerase chain reaction (PCR) amplified and sequenced. Plasmids were analyzed by transformation, enzyme restriction and Southern blot. PCR analysis revealed that the isolate was simultaneously carrying bla KPC-2, bla IMP-4, bla TEM-1, and bla OKP-B genes. MLST assigned the isolate to a novel sequence type, ST476. bla KPC-2-harbouring plasmids of the isolate and comparative strains had similar EcoRI and HindIII restriction maps, while IMP-4-harbouring plasmids had variable HindIII restriction maps. Coexistence of bla KPC-2 and bla IMP-4 was probably due to bla IMP-4-harbouring plasmid transmission into KPC-2-producing K. pneumoniae (ST476). The concomitant presence of these genes is alarming and poses both therapeutic and infection control problems.
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Acknowledgement
We acknowledge the Department of Infectious Diseases, Sir Run Run Shaw Hospital (Zhejiang, China) for assistance with the analysis of PFGE patterns.
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This work was supported by a grant from the Ministry of Health of the People’s Republic of China (No.2009ZX10004-107).
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Wang, Y., Cao, W., Zhu, X. et al. Characterization of a novel Klebsiella pneumoniae sequence type 476 carrying both bla KPC-2 and bla IMP-4 . Eur J Clin Microbiol Infect Dis 31, 1867–1872 (2012). https://doi.org/10.1007/s10096-011-1512-7
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DOI: https://doi.org/10.1007/s10096-011-1512-7