Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
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.

Main Article

References
  1. Walther-Rasmussen  J, Hiby  N. Class A carbapenemases. J Antimicrob Chemother. 2007;60:47082. DOIPubMedGoogle Scholar
  2. 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;39:5560. DOIPubMedGoogle Scholar
  3. 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;48:47939. DOIPubMedGoogle Scholar
  4. 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;52:125763. DOIPubMedGoogle Scholar
  5. 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.
  6. Clinical and Laboratory Standards Institute Performance standards for antimicrobial susceptibility testing; eighteenth informational supplement (document M100-S18). Wayne (PA): The Institute; 2008.
  7. 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.
  8. 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;45:27235. DOIPubMedGoogle Scholar

Main Article

Page created: December 16, 2010
Page updated: December 16, 2010
Page reviewed: December 16, 2010
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.
file_external