Skip to main content

Advertisement

SpringerLink
Log in

Emergence of a colistin-resistant KPC-2-producing Klebsiella pneumoniae ST258 clone in Hungary

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Walther-Rasmussen J, Høiby N (2007) Class A carbapenemases. J Antimicrob Chemother 60:470–482

    Article  CAS  PubMed  Google Scholar 

  2. Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD, Alberti S, Bush K, Tenover FC (2001) Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 45:1151–1161

    Article  CAS  PubMed  Google Scholar 

  3. Kitchel B, Rasheed JK, Patel JB, Srinivasan A, Navon-Venezia S, Carmeli Y, Brolund A, Giske CG (2009) Molecular epidemiology of KPC-producing Klebsiella pneumoniae isolates in the United States: clonal expansion of multilocus sequence type 258. Antimicrob Agents Chemother 53:3365–3370

    Article  CAS  PubMed  Google Scholar 

  4. Samuelsen Ø, Naseer U, Tofteland S, Skutlaberg DH, Onken A, Hjetland R, Sundsfjord A, Giske CG (2009) Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. J Antimicrob Chemother 63:654–658

    Article  CAS  PubMed  Google Scholar 

  5. Baraniak A, Izdebski R, Herda M, Fiett J, Hryniewicz W, Gniadkowski M, Kern-Zdanowicz I, Filczak K, Łopaciuk U (2009) Emergence of Klebsiella pneumoniae ST258 with KPC-2 in Poland. Antimicrob Agents Chemother 53:4565–4567

    Article  CAS  PubMed  Google Scholar 

  6. Osterblad M, Kirveskari J, Koskela S, Tissari P, Vuorenoja K, Hakanen AJ, Vaara M, Jalava J (2009) First isolations of KPC-2-carrying ST258 Klebsiella pneumoniae strains in Finland, June and August 2009. Euro Surveill 14:19349

    Google Scholar 

  7. Giani T, D’Andrea MM, Pecile P, Borgianni L, Nicoletti P, Tonelli F, Bartoloni A, Rossolini GM (2009) Emergence in Italy of Klebsiella pneumoniae sequence type 258 producing KPC-3 carbapenemase. J Clin Microbiol 47:3793–3794

    Article  PubMed  Google Scholar 

  8. Damjanova I, Tóth A, Pászti J, Hajbel-Vékony G, Jakab M, Berta J, Milch H, Füzi M (2008) Expansion and countrywide dissemination of ST11, ST15 and ST147 ciprofloxacin-resistant CTX-M-15-type beta-lactamase-producing Klebsiella pneumoniae epidemic clones in Hungary in 2005—the new ‘MRSAs’? J Antimicrob Chemother 62:978–985

    Article  CAS  PubMed  Google Scholar 

  9. Anderson KF, Lonsway DR, Rasheed JK, Biddle J, Jensen B, McDougal LK, Carey RB, Thompson A, Stocker S, Limbago B, Patel JB (2007) Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J Clin Microbiol 45:2723–2725

    Article  CAS  PubMed  Google Scholar 

  10. Shin KS, Son BR, Hong SB, Kim J (2008) Dipicolinic acid-based disk methods for detection of metallo-beta-lactamase-producing Pseudomonas spp. and Acinetobacter spp. Diagn Microbiol Infect Dis 62:102–105

    Article  CAS  PubMed  Google Scholar 

  11. Yong D, Lee K, Yum JH, Shin HB, Rossolini GM, Chong Y (2002) Imipenem-EDTA disk method for differentiation of metallo-beta-lactamase-producing clinical isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol 40:3798–3801

    Article  CAS  PubMed  Google Scholar 

  12. Yagi T, Wachino J, Kurokawa H, Suzuki S, Yamane K, Doi Y, Shibata N, Kato H, Shibayama K, Arakawa Y (2005) Practical methods using boronic acid compounds for identification of class C beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli. J Clin Microbiol 43:2551–2558

    Article  CAS  PubMed  Google Scholar 

  13. Leavitt A, Navon-Venezia S, Chmelnitsky I, Schwaber MJ, Carmeli Y (2007) Emergence of KPC-2 and KPC-3 in carbapenem-resistant Klebsiella pneumoniae strains in an Israeli hospital. Antimicrob Agents Chemother 51:3026–3029

    Article  CAS  PubMed  Google Scholar 

  14. Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S (2005) Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J Clin Microbiol 43:4178–4182

    Article  CAS  PubMed  Google Scholar 

  15. Souli M, Galani I, Giamarellou H (2008) Emergence of extensively drug-resistant and pandrug-resistant Gram-negative bacilli in Europe. Euro Surveill 13:19045

    Google Scholar 

  16. Li J, Nation RL, Turnidge JD, Milne RW, Coulthard K, Rayner CR, Paterson DL (2006) Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect Dis 6:589–601

    Article  CAS  PubMed  Google Scholar 

  17. Antoniadou A, Kontopidou F, Poulakou G, Koratzanis E, Galani I, Papadomichelakis E, Kopterides P, Souli M, Armaganidis A, Giamarellou H (2007) Colistin-resistant isolates of Klebsiella pneumoniae emerging in intensive care unit patients: first report of a multiclonal cluster. J Antimicrob Chemother 59:786–790

    Article  CAS  PubMed  Google Scholar 

  18. Haeggman S, Löfdahl S, Paauw A, Verhoef J, Brisse S (2004) Diversity and evolution of the class A chromosomal beta-lactamase gene in Klebsiella pneumoniae. Antimicrob Agents Chemother 48:2400–2408

    Article  CAS  PubMed  Google Scholar 

  19. Nüesch-Inderbinen MT, Kayser FH, Hächler H (1997) Survey and molecular genetics of SHV beta-lactamases in Enterobacteriaceae in Switzerland: two novel enzymes, SHV-11 and SHV-12. Antimicrob Agents Chemother 41:943–949

    PubMed  Google Scholar 

  20. Brisse S, Fevre C, Passet V, Issenhuth-Jeanjean S, Tournebize R, Diancourt L, Grimont P (2009) Virulent clones of Klebsiella pneumoniae: identification and evolutionary scenario based on genomic and phenotypic characterization. PLoS ONE 4:e4982

    Article  PubMed  Google Scholar 

  21. Feil EJ, Li BC, Aanensen DM, Hanage WP, Spratt BG (2004) eBURST: inferring patterns of evolutionary descent among clusters of related bacterial genotypes from multilocus sequence typing data. J Bacteriol 186:1518–1530

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

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.

Author information

Authors and Affiliations

  1. Department of Bacteriology, National Center for Epidemiology, Gyáli út 2-6, 1097, Budapest, Hungary

    Á. Tóth & L. Jánvári

  2. Department of Phage Typing and Molecular Epidemiology, National Center for Epidemiology, Gyáli út 2-6, 1097, Budapest, Hungary

    I. Damjanova & J. Pászti

  3. Laboratory of Microbiology, Northern Regional Institution of Hungarian National Public Health and Medical Officer Service, Meggyesalja u. 12, 3530, Miskolc, Hungary

    E. Puskás

  4. Laboratory of Microbiology, Corden International Ltd., Budapest, Hungary

    M. Farkas & A. Dobák

  5. Department of Hospital Epidemiology and Hygiene, National Center for Epidemiology, Gyáli út 2-6, 1097, Budapest, Hungary

    K. Böröcz

Authors
  1. Á. Tóth
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. I. Damjanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Puskás
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Jánvári
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Farkas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. Dobák
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K. Böröcz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. Pászti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Á. Tóth.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tóth, Á., Damjanova, I., Puskás, E. et al. Emergence of a colistin-resistant KPC-2-producing Klebsiella pneumoniae ST258 clone in Hungary. Eur J Clin Microbiol Infect Dis 29, 765–769 (2010). https://doi.org/10.1007/s10096-010-0921-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-010-0921-3

Keywords

Search

Navigation