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Volume 15, Number 5—May 2009

Letter

Klebsiella pneumoniae Carbapenemase, Canada

Dylan R. PillaiComments to Author , Roberto G. Melano, Prasad Rawte, Stephen Lo, Nathalie Tijet, Milan Fuksa, Nancy Roda, David J. Farrell, and Sigmund Krajden
Author affiliations: Ontario Agency for Health Protection and Promotion, Toronto, Ontario, Canada (D.R. Pillai, R. Melano, P. Rawte, S. Lo, N. Tijet, D.J. Farrell); University of Toronto, Toronto (D.R. Pillai, R. Melano, S. Krajden); University Health Network, Toronto (D.R. Pillai); St. Joseph’s Health Centre, Toronto (M. Fuksa, N. Roda, S. Krajden)

Main Article

Table

Results of initial susceptibility and supplementary testing for Klebsiella pneumoniae carbapenemase in urine and sputum samples from 73-year-old man, Canada*

Isolate MIC, µg/mL†
Disk diffusion results, mm
Initial report‡ Final report§
AMP FOX CIP GEN CTRX MEM FOX CAZ CAC CTX CTC
7184 >16 >16 >2 8 >32 8 16 0 14 13 15 AmpC/ESBL KPC
7315 >16 >16 >2 8 >32 4 0 0 8 13 15 AmpC/ESBL KPC

*AMP, ampicillin; FOX, cefoxitin; CIP, ciprofloxacin; GEN, gentamicin; CTRX, ceftriaxone; MEM, meropenem; CAZ, ceftazidime; CAC, ceftazidime-clavulanic acid; CTX, cefotaxime; CTC, cefotaxime-clavulanic acid; ESBL, extended-spectrum β-lactamase; KPC, Klebsiella pneumoniae carbapenemase.
†MIC values for clinical isolates 7184 (urine) and 7315 (sputum) were obtained by using agar macrodilution.
‡Initial screening for ESBL or AmpC β-lactamase activity, performed by Kirby Bauer disk diffusion according to Clinical Laboratory Standards Institute guidelines (6,7), suggested ESBL or AmpC β-lactamase activity.
§Supplementary modified Hodge test; PCR (specific for blaKPC family), and DNA sequencing confirmed the presence of KPC activity due to blaKPC-2.

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