Skip to main content
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems
  • Log in
  • My alerts
  • My Cart

Main menu

  • Home
  • Articles
    • Current Issue
    • Accepted Manuscripts
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About AAC
    • Editor in Chief
    • Editorial Board
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • AAC Podcast
    • RSS
    • FAQ
  • Subscribe
    • Members
    • Institutions
  • ASM
    • Antimicrobial Agents and Chemotherapy
    • Applied and Environmental Microbiology
    • Clinical Microbiology Reviews
    • Clinical and Vaccine Immunology
    • EcoSal Plus
    • Eukaryotic Cell
    • Infection and Immunity
    • Journal of Bacteriology
    • Journal of Clinical Microbiology
    • Journal of Microbiology & Biology Education
    • Journal of Virology
    • mBio
    • Microbiology and Molecular Biology Reviews
    • Microbiology Resource Announcements
    • Microbiology Spectrum
    • Molecular and Cellular Biology
    • mSphere
    • mSystems

User menu

  • Log in
  • My alerts
  • My Cart

Search

  • Advanced search
Antimicrobial Agents and Chemotherapy
publisher-logosite-logo

Advanced Search

  • Home
  • Articles
    • Current Issue
    • Accepted Manuscripts
    • COVID-19 Special Collection
    • Archive
    • Minireviews
  • For Authors
    • Submit a Manuscript
    • Scope
    • Editorial Policy
    • Submission, Review, & Publication Processes
    • Organization and Format
    • Errata, Author Corrections, Retractions
    • Illustrations and Tables
    • Nomenclature
    • Abbreviations and Conventions
    • Publication Fees
    • Ethics Resources and Policies
  • About the Journal
    • About AAC
    • Editor in Chief
    • Editorial Board
    • For Reviewers
    • For the Media
    • For Librarians
    • For Advertisers
    • Alerts
    • AAC Podcast
    • RSS
    • FAQ
  • Subscribe
    • Members
    • Institutions
Mechanisms of Resistance

Outbreak of Klebsiella pneumoniae Producing a New Carbapenem-Hydrolyzing Class A β-Lactamase, KPC-3, in a New York Medical Center

Neil Woodford, Philip M. Tierno Jr., Katherine Young, Luke Tysall, Marie-France I. Palepou, Elaina Ward, Ronald E. Painter, Deborah F. Suber, Daniel Shungu, Lynn L. Silver, Kenneth Inglima, John Kornblum, David M. Livermore
Neil Woodford
1Antibiotic Resistance Monitoring and Reference Laboratory, Specialist and Reference Microbiology Division—Colindale, Health Protection Agency, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: neil.woodford@hpa.org.uk
Philip M. Tierno Jr.
2Departments of Microbiology & Pathology, Tisch Hospital, NYU Medical Center
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Katherine Young
3Human and Animal Infectious Disease Research, Merck Research Laboratories, Rahway, New Jersey
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Luke Tysall
1Antibiotic Resistance Monitoring and Reference Laboratory, Specialist and Reference Microbiology Division—Colindale, Health Protection Agency, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marie-France I. Palepou
1Antibiotic Resistance Monitoring and Reference Laboratory, Specialist and Reference Microbiology Division—Colindale, Health Protection Agency, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elaina Ward
1Antibiotic Resistance Monitoring and Reference Laboratory, Specialist and Reference Microbiology Division—Colindale, Health Protection Agency, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ronald E. Painter
3Human and Animal Infectious Disease Research, Merck Research Laboratories, Rahway, New Jersey
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Deborah F. Suber
3Human and Animal Infectious Disease Research, Merck Research Laboratories, Rahway, New Jersey
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Daniel Shungu
3Human and Animal Infectious Disease Research, Merck Research Laboratories, Rahway, New Jersey
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lynn L. Silver
3Human and Animal Infectious Disease Research, Merck Research Laboratories, Rahway, New Jersey
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kenneth Inglima
2Departments of Microbiology & Pathology, Tisch Hospital, NYU Medical Center
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
John Kornblum
4New York City Department of Health, Public Health Laboratory, New York, New York
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David M. Livermore
1Antibiotic Resistance Monitoring and Reference Laboratory, Specialist and Reference Microbiology Division—Colindale, Health Protection Agency, London, United Kingdom
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
DOI: 10.1128/AAC.48.12.4793-4799.2004
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • FIG. 1.
    • Open in new tab
    • Download powerpoint
    FIG. 1.

    PFGE analysis of XbaI-digested genomic DNA from carbapenem-resistant isolates of K. pneumoniae. Lane 1 contains a concatemer of phage λ DNA used as a molecular size marker. Isolates representing the predominant outbreak strain are shown in lanes 3, 4, 7 to 11, 13, and 18. Other lanes show isolates unrelated to the outbreak strain; the types represented in lanes 5 and 6 and in lanes 12 and 14 were related organisms, each isolated from two or more patients.

  • FIG. 2.
    • Open in new tab
    • Download powerpoint
    FIG. 2.

    Comparison of KPC enzyme sequences. The predicted 24-residue cleavable signal peptide is shaded.

  • FIG. 3.
    • Open in new tab
    • Download powerpoint
    FIG. 3.

    Plasmid profiles (A) and a Southern blot hybridized with a blaKPC probe (B) of K. pneumoniae CL 5761 (lanes 2) and a representative blaKPC-3-containing E. coli electrotransformant (lanes 3). Lanes 1 show the 94-kb plasmid R100.1 (22, 31) as a guide to molecular size.

  • FIG. 4.
    • Open in new tab
    • Download powerpoint
    FIG. 4.

    Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of OMPs extracted from carbapenem-resistant K. pneumoniae isolates. Lanes 1 and 12 show protein molecular size markers as indicated in kilodaltons to the right of the gel (Bio-Rad). Other lanes contain control strain CL 15245 (lanes 2 and 3), CL 5761 (lanes 4 and 5), CL 5762A (lanes 6 and 7), CL 5762B (lanes 8 and 9), and CL 5763 (lanes 10 and 11). Extracts in lanes 2, 4, 6, 8, and 10 were prepared from cells grown in Luria-Bertani broth (high osmolarity); those in lanes 3, 5, 7, 9, and 11 were prepared from cells grown in NB (low osmolarity). The arrow indicates the band corresponding to the inducible porin OmpK35.

Tables

  • Figures
  • TABLE 1.

    PCR primers used in this study

    GenePrimer sequences (5′-3′)Product size (bp)Reference
    bla IMP For, CTACCGCAGCAGAGTCTTTG587 32
    Rev, AACCAGTTTTGCCTTACCAT
    bla VIM For, AGTGGTGAGTATCCGACAG261 35
    Rev, ATGAAAGTGCGTGGAGAC
    bla SME For, AACGGCTTCATTTTTGTTTAG830 27
    Rev, GCTTCCGCAATAGTTTTATCA
    bla KPC For, TGTCACTGTATCGCCGTCca. 1,000 38
    Rev, CTCAGTGCTCTACAGAAAACC
    bla IMI/blaNMCFor, CCA TTC ACC CAT CAC AAC440This study (based on GenBank accession no. U50278 )
    Rev, CTA CCG CAT AAT CAT TTG C
    waaE For, CTG TCG CGT CTG CTA CAG TT851This study (based on GenBank accession no. AF146532 )
    Rev, CCG GAT AGA TCG CTT TTG TG
    qnr For, GAT AAA GTT TTT CAG CAA GAG G593 10
    Rev, ATC CAG ATC GGC AAA GGT TA
  • TABLE 2.

    Details of patients from whom carbapenem-resistant K. pneumoniae was isolated

    PatientDate isolated (mo/yr)Site(s)ICU type(s)aStatusOutcome
    14/00SputumCCUInfectionDied
    25/00SputumMICUInfectionDied
    35/00SputumMICUColonizationRecovered
    45/00Sputum and bloodSICUInfectionDied
    55/00Sputum and urineCCUColonizationRecovered
    65/00SputumMICUInfectionRecovered
    76/00Sputum and urineSICUInfectionRecovered
    86/00UrineSICUInfectionRecovered
    97/00WoundSICU and MICUColonizationRecovered
    107/00SputumMICUColonizationRecovered
    117/00Blood and urineMICUInfectionRecovered
    127/00Blood and urineCCU and MICUInfectionDied
    138/00BloodSICUInfectionDied
    148/00BloodSICUInfectionDied
    158/00SputumSICUColonizationRecovered
    169/00SputumCVCUInfectionRecovered
    179/00WoundSICUInfectionDied
    189/00SputumMICUColonizationRecovered
    1910/00SputumMICUInfectionDied
    2012/00WoundSICUColonizationRecovered
    211/01SputumMICUColonizationRecovered
    222/01SputumSICUColonizationRecovered
    233/01WoundSICUColonizationRecovered
    244/01CatheterSICUInfectionRecovered
    • ↵ a CCU, coronary care unit; CVCU, cardiovascular care unit; MICU, medical intensive care unit; SICU, surgical intensive care unit; PICU, pediatric intensive care unit.

  • TABLE 3.

    Antibiotic susceptibilitiesa and carbapenemase activities of clinical isolates of K. pneumoniae

    AntibioticbInhibitorMIC (μg/ml)
    CL 5761CL 5762ACL 5762BCL 5763CL 15245
    Imipenem−1621616≤0.125
    + CLAc80.588≤0.25
    Meropenem−811616≤0.125
    + CLA823216≤0.125
    Ertapenemd−>320.25>32>32NTe
    Aztreonam−>256256>256>256≤0.25
    + CLA25664>256>256≤0.25
    Ceftazidime−256256>256>256≤0.25
    + CLA12832256>256≤0.25
    Ceftriaxone−256>256>256>256≤0.25
    + CLA6432128256≤0.25
    Cefepime−32128128128≤0.25
    + CLA3286464≤0.25
    Cefoxitin−128322562562
    + CLA25632256256<1
    Piperacillind+ Tazo- bactam>256>256>256>256NT
    Amikacin−163232320.5
    Gentamicin−881616≤0.25
    Chloramphenicol−12864641284
    Ciprofloxacin−42416≤0.06
    Polymyxin B−0.250.25640.1250.25
    Tetracycline−41441
    • ↵ a Antibiotic susceptibility determined by broth microdilution method except where noted.

    • ↵ b Specific activities for CL 5761, CL 5762A, CL 5762B, and CL 5763 were 0.22, 0.46, 0.50, and 0.53, nmol of imipenem hydrolyzed/min/mg of protein, respectively. The specific activity for CL 15245 was not tested.

    • ↵ c + CLA, MIC determined in presence of 4 μg of clavulanic acid/ml; −, no inhibitor.

    • ↵ d Antibiotic susceptibility determined by E test.

    • ↵ e NT, not tested.

  • TABLE 4.

    Antibiotic susceptibilities of E. coli transformants with the 75-kb KPC-3-encoding plasmid

    AntibioticMIC (μg/ml) for:
    DH5αDH5α (KPC-3)aCL 5761
    Imipenem0.12 1 8
    Meropenem≤0.03 0.25 16
    Ceftazidime0.12 16 >32
    Ceftriaxone≤0.25 4 128
    Aztreonam≤0.25 16 >256
    Cefoxitin4 8 256
    Amikacin0.5 16 16
    Gentamicin0.25 1 16
    Streptomycin222
    Chloramphenicol88128
    Ciprofloxacin0.060.064
    Polymyxin B0.50.51
    • ↵ a Boldface values indicate significantly increased MICs.

PreviousNext
Back to top
Download PDF
Citation Tools
Outbreak of Klebsiella pneumoniae Producing a New Carbapenem-Hydrolyzing Class A β-Lactamase, KPC-3, in a New York Medical Center
Neil Woodford, Philip M. Tierno Jr., Katherine Young, Luke Tysall, Marie-France I. Palepou, Elaina Ward, Ronald E. Painter, Deborah F. Suber, Daniel Shungu, Lynn L. Silver, Kenneth Inglima, John Kornblum, David M. Livermore
Antimicrobial Agents and Chemotherapy Nov 2004, 48 (12) 4793-4799; DOI: 10.1128/AAC.48.12.4793-4799.2004

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Print

Alerts
Sign In to Email Alerts with your Email Address
Email

Thank you for sharing this Antimicrobial Agents and Chemotherapy article.

NOTE: We request your email address only to inform the recipient that it was you who recommended this article, and that it is not junk mail. We do not retain these email addresses.

Enter multiple addresses on separate lines or separate them with commas.
Outbreak of Klebsiella pneumoniae Producing a New Carbapenem-Hydrolyzing Class A β-Lactamase, KPC-3, in a New York Medical Center
(Your Name) has forwarded a page to you from Antimicrobial Agents and Chemotherapy
(Your Name) thought you would be interested in this article in Antimicrobial Agents and Chemotherapy.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Share
Outbreak of Klebsiella pneumoniae Producing a New Carbapenem-Hydrolyzing Class A β-Lactamase, KPC-3, in a New York Medical Center
Neil Woodford, Philip M. Tierno Jr., Katherine Young, Luke Tysall, Marie-France I. Palepou, Elaina Ward, Ronald E. Painter, Deborah F. Suber, Daniel Shungu, Lynn L. Silver, Kenneth Inglima, John Kornblum, David M. Livermore
Antimicrobial Agents and Chemotherapy Nov 2004, 48 (12) 4793-4799; DOI: 10.1128/AAC.48.12.4793-4799.2004
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Top
  • Article
    • ABSTRACT
    • MATERIALS AND METHODS
    • RESULTS
    • DISCUSSION
    • ACKNOWLEDGMENTS
    • FOOTNOTES
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

KEYWORDS

Cross Infection
Klebsiella Infections
Klebsiella pneumoniae
beta-lactamases

Related Articles

Cited By...

About

  • About AAC
  • Editor in Chief
  • Editorial Board
  • Policies
  • For Reviewers
  • For the Media
  • For Librarians
  • For Advertisers
  • Alerts
  • AAC Podcast
  • RSS
  • FAQ
  • Permissions
  • Journal Announcements

Authors

  • ASM Author Center
  • Submit a Manuscript
  • Article Types
  • Ethics
  • Contact Us

Follow #AACJournal

@ASMicrobiology

       

ASM Journals

ASM journals are the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology.

About ASM | Contact Us | Press Room

 

ASM is a member of

Scientific Society Publisher Alliance

 

American Society for Microbiology
1752 N St. NW
Washington, DC 20036
Phone: (202) 737-3600

Copyright © 2021 American Society for Microbiology | Privacy Policy | Website feedback

Print ISSN: 0066-4804; Online ISSN: 1098-6596