Abstract
Background: Klebsiella pneumoniae is now recognized as an urgent threat to public health because of the emergence of multidrug-resistant strains. However, little is known about the emergence of clinically important clones.
Methods: This retrospective surveillance study included 740 K. pneumoniae clinical isolates collected from 5 different hospitals and 1 community laboratory in Portugal. Antimicrobial susceptibility testing was performed by disk diffusion and the results were interpreted according to EUCAST guidelines. Genes encoding β-lactamases including CTX-M, TEM, SHV, DHA, FOX and CMY were screened by PCR and confirmed by sequencing. Plasmid replicon was used to identify the plasmids incompatibility groups. The clonal relationship was evaluated by M13 fingerprinting and multilocus sequence typing (MLST).
Results: All isolates had resistance to gentamicin, ciprofloxacin, cefepime, ceftazidime, cefotaxime and showed synergic effect among clavulanic acid and cephalosporins. In three isolates were also found the carbapenemase KPC-3 which confer resistant to carbapenems. The isolates CTX-M-15 producers belonged to the IncF, IncN and IncA/C groups. 6 different clones were found: ST-15; ST-76; ST-133; ST-147; ST-276 and ST-307. The ST15 CTX-M-15 accounted for 70% of the isolates and was identified in community and in all five hospitals studied.
Conclusions: Our data indicate a widespread of ST15-CTX-M-15 K. pneumoniae which should be considered as clinical relevant for public health. The dissemination of ESBL CTX-M-15 was due both to carriage of related plasmids and to multiclonal spread of K. pneumoniae.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA3912.
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- Copyright ©the authors 2018