Worldwide Diversity ofKlebsiella pneumoniaeThat Produce β-LactamaseblaKPC-2Gene1

• DOI: 10.3201/eid1609.091389
• Publication Date: 2010-08-23T14:55:28Z
• Authors: Gaëlle Cuzon; Thierry Naas; HaVy Truong; Maria-Virginia Vi...; Karin T. Wisell; Yehuda Carmeli; Ana. C. Gales; Shiri Navon-Venezia; John P. Quinn; Patrice Nordmann
• Keywords: DNA, Bacterial; 0301 basic medicine; class A; Replication Origin; Infectious and parasitic diseases; RC109-216; Global Health; Communicable Diseases, Emerging; beta-Lactamases; carbapenemase; 03 medical and health sciences; Drug Resistance, Multiple, Bacterial; Humans; bacteria; DNA Primers; Base Sequence; Research; R; Genetic Variation; β-lactamase; Bacterial Typing Techniques; Klebsiella Infections; 3. Good health; KPC; Klebsiella pneumoniae; Genes, Bacterial; DNA Transposable Elements; Medicine; Plasmids

Klebsiella pneumoniaeisolates that produce carbapenemases (KPCs) are rapidly disseminating worldwide. To determine their genetic background, we investigated 16 blaKPC-2-harboring K. pneumoniae isolates from 5 countries. The isolates were multidrug resistant, possessed the blaKPC-2 gene, and differed by additional Beta-lactamase content. They harbored a naturally chromosome-encoded bla gene (blaSHV-1 [12.5%], blaSHV-11 [68.7%], or blaOKP-AVB [18.8%]) and several acquired and plasmid-encoded genes (blaTEM-1 [81.3%], blaCTX-M-2 [31.3%], blaCTX-M-12 [12.5%], blaCTX-M-15 [18.7%], and blaOXA-9 [37.5%]). The blaKPC-2 gene was always associated with 1 of the Tn4401 isoforms (a, b, or c). Tn4401 was inserted on different-sized plasmids that belonged to different incompatibility groups. Several blaKPC-containing K. pneumoniae clones were found: 9 different pulsotypes with 1 major (sequence type 258) and 7 minor distinct allelic profiles. Different clones harboring different plasmids but having identical genetic structure, Tn4401, could be at the origin of the worldwide spread of this emerging resistance gene.