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Epidemiology and Surveillance

Surveillance and Molecular Epidemiology of Klebsiella pneumoniae Isolates That Produce Carbapenemases: First Report of OXA-48-Like Enzymes in North America

Christine Lascols, Gisele Peirano, Meredith Hackel, Kevin B. Laupland, Johann D. D. Pitout
Christine Lascols
aInternational Health Management Associates Inc., Schaumburg, Illinois, USA
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Gisele Peirano
bDivision of Microbiology, Calgary Laboratory Services, University of Calgary, Calgary, Alberta, Canada
cDepartments of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
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Meredith Hackel
aInternational Health Management Associates Inc., Schaumburg, Illinois, USA
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Kevin B. Laupland
bDivision of Microbiology, Calgary Laboratory Services, University of Calgary, Calgary, Alberta, Canada
cDepartments of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
eMedicine, University of Calgary, Calgary, Alberta, Canada
fCritical Care Medicine, University of Calgary, Calgary, Alberta, Canada
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Johann D. D. Pitout
bDivision of Microbiology, Calgary Laboratory Services, University of Calgary, Calgary, Alberta, Canada
cDepartments of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
dMicrobiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
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DOI: 10.1128/AAC.01686-12
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Article Figures & Data

Tables

  • Table 1

    Numbers of K. pneumoniae isolates that produce different carbapenemasesa

    CarbapenemaseCountry of isolation
    KPC types (n = 47)
        KPC-2 (n = 23)Greece (n = 14), USA (n = 7), Israel (n = 1), Puerto Rico (n = 1)
        KPC-3 (n = 18)USA (n = 9), Israel (n = 8), Columbia (n = 1)
        KPC-11 (n = 6)Greece (n = 6)
    NDM-1 (n = 26)India (n = 26)
    OXA-48-like (n = 13)
        OXA-48 (n = 6)Turkey (n = 3), Argentina (n = 1), USA (n = 2)
        OXA-163 (n = 2)Argentina (n = 2)
        OXA-181 (n = 5)India (n = 5)
    VIM types (n = 19)
        VIM-1 (n = 16)Greece (n = 13), Spain (n = 2), Italy (n = 1)
        VIM-5 (n = 1)Greece (n = 1)
        VIM-27 (n = 1)Turkey (n = 1)
        VIM-33 (n = 1)Greece (n = 1)
    IMP-26 (n = 5)Australia (n = 2), Philippines (n = 3)
    • ↵a n, no. of isolates.

  • Table 2

    Sequence types of Klebsiella pneumoniae that produce carbapenemases

    Sequence typeCarbapenemaseESBL or AmpCCountry of isolation
    ST11 (n = 11)
        Pulsotype 11A (n = 3)OXA-48CTX-M-15Turkey, Argentinia
        Pulsotype 11B (n = 3)NDM-1CTX-M-15, DHA-1India
        Pulsotype 11C (n = 2)OXA-163Argentina
        Pulsotype 11D (n = 3)NDM-1CTX-M-15India
    ST147 (n = 23)
        Pulsotype 147A (n = 9)NDM-1CTX-M-15, CMY-2India
        Pulsotype 147B (n = 2)OXA-181CTX-M-15India
        Pulsotype 147C (n = 12)VIM-1, −27, 33SHV-12, -31, DHA-1Greece, Italy
    ST258 (n = 38)
        Pulsotype 258A (n = 7)KPC-3SHV-12, CTX-M-14USA, Israel
        Pulsotype 258B (n = 6)KPC-3USA, Israel
        Pulsotype 258C (n = 20)KPC-2, −11SHV-12Greece, Israel
        Pulsotype 258D (n = 5)KPC-2SHV-12USA, Puerto Rico
    ST1 (n = 2)VIM-1Spain
    ST14 (n = 2)NDM-1CTX-M-15, CMY-2India
    ST15 (n = 2)OXA-48, −181CTX-M-15USA, India
    ST17 (n = 4)KPC-2, VIM-1, OXA-48Greece, Turkey
    ST340 (n = 2)NDM-1SHV-2, CTX-M-15India
    ST418 (n = 2)KPC-2USA
    ST43 (n = 3)OXA-181, VIM-5SHV-2, CTX-M-15, CTX-M-3India, Turkey
    ST478 (n = 2)IMP-26CTX-M-15Australia
    ST512 (n = 4)KPC-3Israel, Columbia
    ST626 (n = 2)IMP-26Phillipines
    Other STs (n = 13)aNDM-1, VIM-1, OXA-48, KPC-2, −3, and IMP-26CTX-M-15, SHV-5, DHA-1, CMY-2,India, Greece, USA, Philippines
    • ↵a Including ST101, ST20, ST231, ST271, ST278, ST29, ST336, ST34, ST391, ST437, ST572, ST676, and ST903; most of them (n = 9) were NDM-1 producers, with CTX-M-15 from India.

  • Table 3

    Characteristics of K. pneumoniae sequence types ST11, ST147, and ST258 and other STs that produce carbapenemases

    CharacteristicNo. (%) with characteristic:P value
    ST11 (n = 11)ST147 (n = 23)ST258 (n = 38)Other STs (n = 38)
    Carbapenemase<0.001
        NDM6 (55)9 (39)011 (29)
        KPC0038 (100)9 (24)
        OXA-48-like5 (45)2 (9)06 (16)
        VIM012 (52)07 (18)
        IMP0005 (13)
    ESBL<0.001
        CTX-M-155 (45)11 (48)016 (42)
        CTX-M-14003 (8)0
        Other CTX-Ms0001 (3)
        SHV-1204 (17)26 (68)2 (5)
        Other SHVs01 (4)05 (13)
    AmpC0.233
        DHA-11 (1)1 (4)01 (3)
        CMY-202 (9)01 (3)
    Country of origin<0.001
        India6 (55)11 (48)014 (37)
        Philippines0003 (8)
        Australia0002 (5)
        USA0013 (34)5 (13)
        Puerto Rico001 (3)0
        Columbia0001 (3)
        Argentina3 (27)000
        Spain0002 (5)
        Greece011 (48)18 (47)6 (16)
        Italy01 (4)00
        Turkey2 (18)002 (5)
        Israel006 (16)3 (8)
    Antimicrobial susceptibility<0.001
        Col NS1 (1)3 (13)20 (53)9 (24)
        Tig NS2 (18)8 (35)2 (5)5 (13)
    PMQR determinants0.016
        aac(6′)-lb-cr5 (45)003 (8)
        aac(6′)-lb-cr with qnrB1 (1)11 (48)011 (29)
        aac(6′)-lb-cr with qnrS0001 (3)
        qnrB2 (18)003 (8)
        qnrA01 (4)03 (8)
        qnrS0001 (3)
    16S RNA methylases0.014
        armA3 (27)7 (30)010 (26)
        armA with rmtB0002 (5)
        rmtC04 (17)01 (3)
        rmtB001 (3)1 (3)
    Virulence factors
        uge9 (82)23 (100)38 (100)37 (97)0.022
        wabG11 (100)23 (100)38 (100)38 (100)
        urea11 (100)23 (100)38 (100)38 (100)
        magA0000
        mrkD11 (100)23 (100)38 (100)36 (95)0.468
        alls02 (9)05 (13)0.084
        kfuBC00011 (29)<0.001
        rpmA0000
        fimH11 (100)23 (100)38 (100)38 (100)
        Aerobactin0000
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Surveillance and Molecular Epidemiology of Klebsiella pneumoniae Isolates That Produce Carbapenemases: First Report of OXA-48-Like Enzymes in North America
Christine Lascols, Gisele Peirano, Meredith Hackel, Kevin B. Laupland, Johann D. D. Pitout
Antimicrobial Agents and Chemotherapy Dec 2012, 57 (1) 130-136; DOI: 10.1128/AAC.01686-12

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Surveillance and Molecular Epidemiology of Klebsiella pneumoniae Isolates That Produce Carbapenemases: First Report of OXA-48-Like Enzymes in North America
Christine Lascols, Gisele Peirano, Meredith Hackel, Kevin B. Laupland, Johann D. D. Pitout
Antimicrobial Agents and Chemotherapy Dec 2012, 57 (1) 130-136; DOI: 10.1128/AAC.01686-12
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