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Volume 25, Number 9—September 2019
Synopsis

Epidemiology of Carbapenemase-Producing Klebsiella pneumoniae in a Hospital, Portugal

Marta Aires-de-Sousa, José Manuel Ortiz de la Rosa, Maria Luísa Gonçalves, Ana Luísa Pereira, Patrice Nordmann, and Laurent PoirelComments to Author 
Author affiliations: Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisbon, Portugal (M. Aires-de-Sousa); Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal (M. Aires-de-Sousa); Université de Fribourg, Fribourg, Switzerland (M. Aires-de-Sousa, J.M. Ortiz de la Rosa, P. Nordmann, L. Poirel); Hospital SAMS, Lisbon (M.L. Gonçalves, A.L. Pereira); Swiss National Reference Center for Emerging Antibiotic Resistance, Fribourg (P. Nordmann, L. Poirel); University of Lausanne, Lausanne, Switzerland (P. Nordmann); University Hospital Centre, Lausanne (P. Nordmann)

Main Article

Table

Characteristics of 46 carbapenemase-producing Klebsiella pneumoniae isolates collected in a hospital in Portugal, 2013–2018*

PFGE type ST Isolation year† No. isolates Resistance determinants‡ Plasmid type§ MIC for ceftazidime/ avibactam, mg/L Nonsusceptible phenotype¶
A
 147
 2016 (6) 7 (15%)
 blaKPC-3, blaGES-5, blaOXA-9, qnrS
 IncFII/ColE1 1.5–3
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP, ETP, MEM, GMI (6), AKN (6), CIP, TIG (1), SXT
2018 (1)
 IncN/ColE1
B
 147
 2016 (2) 6 (13%)
 blaKPC-3, blaOXA-9, qnrS
 IncFII
 1–2
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP, ETP, MEM, GMI, AKN, CIP, TIG, SXT
2017 (2)
2018 (2)
C
 231
 2014 (1) 3
 blaKPC-3, qnrS IncFII
 1.5
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP (2), ETP, MEM, GMI (2), AKN (2), CIP, TIG (1), SXT
2017 (1) blaKPC-3, blaOXA-9, qnrS
2018 (1)
 blaKPC-3, blaOXA-9, qnrS
D
 13
 2017 (2) 7 (15%)
 blaKPC-3, blaOXA-9, qnrS IncFIB
 0.75–2
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP (4), ETP, MEM, GMI (5), AKN (4), CIP (2), TIG (1), FOS (1), SXT
2018 (5)
 blaKPC-3, blaOXA-9 (3), qnrS
E
 147
 2017 (2) 3
 blaKPC-3, blaOXA-9 (1), qnrS IncFIIA
 0.75–1.5
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP, ETP, MEM, GMI (1), AKN (1), CIP, TIG (1), SXT (2)
2018 (1)
 blaKPC-3, blaOXA-9, qnrS
F
 960
 2013
 1
 blaKPC-3, qnrS
 IncN
 2
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP, ETP, MEM, SXT
G
 348
 2017 (1) 7 (15%)
 blaKPC-3, blaOXA-9, qnrS IncFII
 0.5–2
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP (6), ETP, MEM, GMI (6), AKN (5), CIP (6), TIG (2), FOS (1), SXT (6), COL (1)
2018 (6)
 blaKPC-3, blaOXA-9 (5), qnrS
H
 45
 2017
 1
 blaKPC-3, blaOXA-9, qnrS
 IncFII
 0.75
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP, ETP, CIP, SXT
I
 35
 2018
 1
 blaKPC-3, blaOXA-9, qnrS
 IncN
 0.75
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, IMP, ETP, MEM, GMI, AKN, CIP, SXT
J
 17
 2016 (1) 6 (13%)
 blaOXA-181, qnrS
 IncX3
 0.125–0.25
 PPT, TCC, AMC, CZD, CTX, FOX (5), ATM, IMP (3), ETP, GMI (5), AKN (3), CIP, SXT
2017 (1)
2018 (4)
L
 17
 2017
 1
 blaOXA-181, qnrS
 IncX3
 0.25
 PPT, TCC, AMC, CZD, CTX, ATM, ETP, GMI, CIP, SXT
M
 35
 2017 (1) 2
 blaOXA-181, qnrS
 IncX3
 0.25
 PPT, TCC, AMC, CZD, CTX, FOX, ATM, ETP, GMI, CIP, SXT
2018 (1)
 PPT, TCC, AMC, CZD, CTX, ATM, ETP, CIP, SXT
N 29 2018 1 blaGES-5, blaBEL-1, qnrS ColE 0.5 PPT, TCC, AMC, CZD, FOX, FOS

*AKN, amikacin; AMC, amoxicillin/clavulanic acid; ATM, aztreonam; CIP, ciprofloxacin; COL, colistin; CTX, cefotaxime; CZD, ceftazidime; ETP, ertapenem; FOS, fosfomycin; FOX, cefoxitin; GMI, gentamicin; IMP, imipenem; MEM, meropenem; PFGE, pulsed-field gel electrophoresis; PPT, piperacillin/tazobactam; ST, sequence type (determined by multilocus sequence typing); SXT, trimethoprim/sulfamethoxazole; TCC, ticarcillin/clavulanic acid; TIG, tigecycline.
†Periods for which the clonal type is clearly predominant shown in bold. Numbers in parentheses indicate number of isolates recovered for each year listed.
‡Carbapenemase genes are shown in bold. Numbers in parentheses indicate the number of isolates that carry the resistance gene, if not all.
§Type of the plasmid carrying the carbapenemase gene.
¶Numbers in parentheses indicate number of isolates that are nonsusceptible to the antimicrobial agent, if not all.

Main Article

Page created: August 21, 2019
Page updated: August 21, 2019
Page reviewed: August 21, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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