Volume 15, Number 5—May 2009
Letter
Klebsiella pneumoniae Carbapenemase, Canada
Table
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.
References
- Walther-Rasmussen J, Hiby N. Class A carbapenemases. J Antimicrob Chemother. 2007;60:470–82. DOIPubMedGoogle Scholar
- Bradford PA, Bratu S, Urban C, Visalli M, Mariano N, Landman D, Emergence of carbapenem-resistant Klebsiella species possessing the class A carbapenem-hydrolyzing KPC-2 and inhibitor-resistant TEM-30 β-lactamases in New York City. Clin Infect Dis. 2004;39:55–60. DOIPubMedGoogle Scholar
- Woodford N, Tierno PM Jr, Young K, Tysall L, Palepou MF, Ward E, Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A β-lactamase, KPC-3, in a New York medical center. Antimicrob Agents Chemother. 2004;48:4793–9. DOIPubMedGoogle Scholar
- Naas T, Cuzon G, Villegas MV, Lartigue MF, Quinn JP, Nordmann P. Genetic structures at the origin of acquisition of the β-lactamase blaKPC gene. Antimicrob Agents Chemother. 2008;52:1257–63. DOIPubMedGoogle Scholar
- Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard (document M7-A7 Edn). Wayne (PA): The Institute; 2006.
- Clinical and Laboratory Standards Institute Performance standards for antimicrobial susceptibility testing; eighteenth informational supplement (document M100-S18). Wayne (PA): The Institute; 2008.
- Quality Management Program. Laboratory Services. Extended spectrum β-lactamase and AmpC in gram-negative bacilli. In: Rutherford C, editor. Broadsheet; May 15, 2006. p. 1–18.
- Anderson KF, Lonsway DR, Rasheed JK, Biddle J, Jensen B, McDougal LK, Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J Clin Microbiol. 2007;45:2723–5. DOIPubMedGoogle Scholar