Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
권호 표지
DOI QR코드

DOI QR Code

Isolation of a Klebsiella pneumoniae Isolate of Sequence Type 258 Producing KPC-2 Carbapenemase in Korea

  • Roh, Kyoung-Ho (Department of Laboratory Medicine, Korea University College of Medicine) ;
  • Lee, Chang-Kyu (Department of Laboratory Medicine, Korea University College of Medicine) ;
  • Sohn, Jang-Wook (Department of Internal Medicine, Korea University College of Medicine) ;
  • Song, Won-Keun (Department of Laboratory Medicine, Hallym University College of Medicine) ;
  • Yong, Dong-Eun (Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine) ;
  • Lee, Kyung-Won (Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine)
  • Published : 2011.10.30
⟨ Previous Next ⟩

Abstract

Carbapenem-resistant Klebsiella pneumoniae isolates producing K. pneumoniae carbapenemases (KPC) were first reported in the USA in 2001, and since then, this infection has been reported in Europe, Israel, South America, and China. In Korea, the first KPC-2-producing K. pneumoniae sequence type (ST) 11 strain was detected in 2010. We report the case of a patient with a urinary tract infection caused by KPC-2-producing K. pneumoniae. This is the second report of a KPC-2-producing K. pneumoniae infection in Korea, but the multilocus sequence type was ST258. The KPC-2-producing isolate was resistant to all tested $\beta$-lactams (including imipenem and meropenem), amikacin, tobramycin, ciprofloxacin, levofloxacin, and trimethoprim-sulfamethoxazole, but was susceptible to gentamicin, colistin, polymyxin B, and tigecycline. The KPC-2-producing isolate was negative to phenotypic extended-spectrum $\beta$-lactamase (ESBL) and AmpC detection tests and positive to modified Hodge test and carbapenemase inhibition test with aminophenylboronic acid.

Keywords

References

  1. Nordmann P and Poirel L. Emerging carbapenemases in Gram-negative aerobes. Clin Microbiol Infect 2002;8:321-31. https://doi.org/10.1046/j.1469-0691.2002.00401.x
  2. Queenan AM and Bush K. Carbapenemases: the versatile $\beta$-lactamases. Clin Microbiol Rev 2007;20:440-58. https://doi.org/10.1128/CMR.00001-07
  3. Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis 2009; 9:228-36. https://doi.org/10.1016/S1473-3099(09)70054-4
  4. Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD, et al. Novel carbapenem-hydrolyzing $\beta$-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 2001;45:1151-61. https://doi.org/10.1128/AAC.45.4.1151-1161.2001
  5. Giakkoupi P, Pappa O, Polemis M, Vatopoulos AC, Miriagou V, Zioga A, et al. Emerging Klebsiella pneumoniae isolates coproducing KPC-2 and VIM-1 carbapenemases. Antimicrob Agents Chemother 2009;53:4048-50. https://doi.org/10.1128/AAC.00690-09
  6. Navon-Venezia S, Leavitt A, Schwaber MJ, Rasheed JK, Srinivasan A, Patel JB, et al. First report on a hyperepidemic clone of KPC-3-producing Klebsiella pneumoniae in Israel genetically related to a strain causing outbreaks in the United States. Antimicrob Agents Chemother 2009;53:818-20. https://doi.org/10.1128/AAC.00987-08
  7. Samuelsen O, Naseer U, Tofteland S, Skutlaberg DH, Onken A, Hjetland R, et al. Emergence of clonally related Klebsiella pneumoniae isolates of sequence type 258 producing plasmid-mediated KPC carbapenemase in Norway and Sweden. J Antimicrob Chemother 2009;63:654-8. https://doi.org/10.1093/jac/dkp018
  8. Villegas MV, Lolans K, Correa A, Suarez CJ, Lopez JA, Vallejo M, et al. First detection of the plasmid-mediated class A carbapenemase KPC-2 in clinical isolates of Klebsiella pneumoniae from South America. Antimicrob Agents Chemother 2006;50:2880-2. https://doi.org/10.1128/AAC.00186-06
  9. Wei ZQ, Du XX, Yu YS, Shen P, Chen YG, Li LJ. Plasmid-mediated KPC-2 in a Klebsiella pneumoniae isolate from China. Antimicrob Agents Chemother 2007;51:763-5. https://doi.org/10.1128/AAC.01053-06
  10. Rhee JY, Park YK, Shin JY, Choi JY, Lee MY, Peck KR, et al. KPC-producing extreme drug-resistant Klebsiella pneumoniae isolate from a patient with diabetes mellitus and chronic renal failure on hemodialysis in South Korea. Antimicrob Agents Chemother 2010; 54:2278-9. https://doi.org/10.1128/AAC.00011-10
  11. Pournaras S, Poulou A, Voulgari E, Vrioni G, Kristo I, Tsakris A. Detection of the new metallo-$\beta$-lactamase VIM-19 along with KPC-2, CMY-2 and CTX-M-15 in Klebsiella pneumoniae. J Antimicrob Chemother 2010;65:1604-7. https://doi.org/10.1093/jac/dkq190
  12. Marchaim D, Navon-Venezia S, Schwaber MJ, Carmeli Y. Isolation of imipenem-resistant Enterobacter species: emergence of KPC-2 carbapenemase, molecular characterization, epidemiology, and outcomes. Antimicrob Agents Chemother 2008;52:1413-8. https://doi.org/10.1128/AAC.01103-07
  13. Lee K, Kim CK, Yong D, Jeong SH, Yum JH, Seo YH, et al. Improved performance of the modified Hodge test with MacConkey agar for screening carbapenemase-producing Gram-negative bacilli. J Microbiol Methods 2010;83:149-52. https://doi.org/10.1016/j.mimet.2010.08.010
  14. Song W, Jeong SH, Kim JS, Kim HS, Shin DH, Roh KH, et al. Use of boronic acid disk methods to detect the combined expression of plasmid-mediated AmpC $\beta$-lactamases and extended-spectrum $\beta$-lactamases in clinical isolates of Klebsiella spp., Salmonella spp., and Proteus mirabilis. Diagn Microbiol Infect Dis 2007;57:315-8. https://doi.org/10.1016/j.diagmicrobio.2006.08.023
  15. Giske CG, Gezelius L, Samuelsen O, Warner M, Sundsfjord A, Woodford N. A sensitive and specific phenotypic assay for detection of metallo-$\beta$-lactamases and KPC in Klebsiella pneumoniae with the use of meropenem disks supplemented with aminophenylboronic acid, dipicolinic acid and cloxacillin. Clin Microbiol Infect 2011;17:552-6. https://doi.org/10.1111/j.1469-0691.2010.03294.x
  16. Patzer JA, Walsh TR, Weeks J, Dzierzanowska D, Toleman MA. Emergence and persistence of integron structures harbouring VIM genes in the Children's Memorial Health Institute, Warsaw, Poland, 1998-2006. J Antimicrob Chemother 2009;63:269-73.
  17. Smith Moland E, Hanson ND, Herrera VL, Black JA, Lockhart TJ, Hossain A, et al. Plasmid-mediated, carbapenem-hydrolysing $\beta$-lactamase, KPC-2, in Klebsiella pneumoniae isolates. J Antimicrob Chemother 2003;51:711-4. https://doi.org/10.1093/jac/dkg124
  18. Zarfel G, Hoenigl M, Leitner E, Salzer HJ, Feierl G, Masoud L, et al. Emergence of New Delhi metallo-$\beta$-lactamase, Austria. Emerg Infect Dis 2011;17:129-30. https://doi.org/10.3201/eid1701.101331
  19. Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S. Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J Clin Microbiol 2005;43:4178-82. https://doi.org/10.1128/JCM.43.8.4178-4182.2005
  20. Park YJ, Yu JK, Park KG, Park YG, Lee S, Kim SY, et al. Prevalence and contributing factors of nonsusceptibility to imipenem or meropenem in extended-spectrum $\beta$-lactamase-producing Klebsiella pneumoniae and Escherichia coli. Diagn Microbiol Infect Dis 2011; in press.
  21. Kitchel B, Rasheed JK, Patel JB, Srinivasan A, Navon-Venezia S, Carmeli Y, et al. Molecular epidemiology of KPC-producing Klebsiella pneumoniae isolates in the United States: clonal expansion of multilocus sequence type 258. Antimicrob Agents Chemother 2009; 53:3365-70. https://doi.org/10.1128/AAC.00126-09
  22. Cai JC, Zhou HW, Zhang R, Chen GX. Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates possessing the plasmid-mediated carbapenem-hydrolyzing $\beta$-lactamase KPC-2 in intensive care units of a Chinese hospital. Antimicrob Agents Chemother 2008;52:2014-8. https://doi.org/10.1128/AAC.01539-07
  23. Anderson KF, Lonsway DR, Rasheed JK, Biddle J, Jensen B, McDougal LK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J Clin Microbiol 2007;45:2723-5. https://doi.org/10.1128/JCM.00015-07

Cited by

  1. Trend of Bacterial Resistance for the Past 50 Years in Korea and Future Perspectives - Gram-negative Bacteria vol.43, pp.6, 2011, https://doi.org/10.3947/ic.2011.43.6.458
  2. Current Epidemiology and Growing Resistance of Gram-Negative Pathogens vol.27, pp.2, 2011, https://doi.org/10.3904/kjim.2012.27.2.128
  3. Multiplex PCR for Rapid Detection of Genes Encoding Class A Carbapenemases vol.32, pp.5, 2011, https://doi.org/10.3343/alm.2012.32.5.359
  4. Detection of clonal KPC-2-producing Klebsiella pneumoniae ST258 in Korea during nationwide surveillance in 2011 vol.62, pp.9, 2011, https://doi.org/10.1099/jmm.0.059428-0
  5. Strategies for Interpretive Standards of β-Lactams Susceptibility Testing and Identification of Extended-Spectrum β-Lactamases and Carbapenemases inEnterobacteriaceae vol.16, pp.3, 2011, https://doi.org/10.5145/acm.2013.16.3.111
  6. Limiting and controlling carbapenem-resistant Klebsiella pneumoniae vol.7, pp.None, 2011, https://doi.org/10.2147/idr.s44358
  7. First report of Klebsiella pneumonia carbapenemase-producing Pseudomonas aeruginosa isolated from burn patients in Iran: phenotypic and genotypic methods vol.9, pp.1, 2014, https://doi.org/10.3205/dgkh000226
  8. Clonality and Resistome Analysis of KPC-Producing Klebsiella pneumoniae Strain Isolated in Korea Using Whole Genome Sequencing vol.2014, pp.None, 2011, https://doi.org/10.1155/2014/352862
  9. Further Modification of the Modified Hodge Test for Detecting Metallo-β-Lactamase-Producing Carbapenem-Resistant Enterobacteriaceae vol.35, pp.3, 2011, https://doi.org/10.3343/alm.2015.35.3.298
  10. Detection of Carbapenemases in Clinical Enterobacteriaceae Isolates Using the VITEK AST-N202 Card vol.47, pp.3, 2015, https://doi.org/10.3947/ic.2015.47.3.167
  11. Mechanisms of ertapenem resistance in Enterobacteriaceae isolates in a tertiary university hospital vol.64, pp.5, 2011, https://doi.org/10.1136/jim-2016-000117
  12. Antibiotic-resistant clones in Gram-negative pathogens: presence of global clones in Korea vol.57, pp.3, 2011, https://doi.org/10.1007/s12275-019-8491-2
  13. 분자학적 방법을 이용한 Carbapenemase-Producing Klebsiella oxytoca 검출 vol.51, pp.4, 2011, https://doi.org/10.15324/kjcls.2019.51.4.428
  14. Pathogenomics and Evolutionary Epidemiology of Multi-Drug Resistant Clinical Klebsiella pneumoniae Isolated from Pretoria, South Africa vol.10, pp.None, 2020, https://doi.org/10.1038/s41598-020-58012-8