An update of the evolving epidemic of bla(KPC-2)-carrying Klebsiella pneumoniae in Greece (2009-10)

作者：Giakkoupi Panagiota; Papagiannitsis Costas C; Miriagou Vivi; Pappa Olga; Polemis Michalis; Tryfinopoulou Kyriaki; Tzouvelekis Leonidas S; Vatopoulos Alkiviadis C^*

来源：Journal of Antimicrobial Chemotherapy, 2011, 66(7): 1510-1513.

DOI：10.1093/jac/dkr166

• carbapenemases
• KPC
• sequence types

Objectives: To follow the epidemic of KPC-2-producing Klebsiella pneumoniae in Greece.
Methods: KPC-2-producing isolates (n=378) were collected during January 2009-April 2010 in 40 Greek hospitals. bla(KPC) and bla(VIM) were detected by PCR. Carbapenemase production was confirmed by spectrophotometry. Sequences flanking bla(KPC-2) and their plasmid carriers were studied. Isolates were typed by PFGE and multilocus sequence typing (MLST).
Results: All 378 isolates were bla(KPC-2) positive; 18 also carried bla(VIM-1/VIM-4). Higher isolation frequencies were observed in Athens and Crete. Isolates were classified into 13 PFGE types and 11 sequence types (STs). ST258 was predominant (n=322), followed by ST147 (n=20), ST383 (n=9), ST133 (n=6), ST274 (n=4) and ST323 (n=3). Of the remaining isolates, seven were distributed into five STs (11, 17, 340 and the novel 494 and 495) and seven were not typed. blaKPC-2 could not be transferred from ST258 isolates, in contrast to isolates of ST17, ST133, ST147, ST274, ST494 and ST495. All bla(KPC-2)-encoding plasmids were of similar size (similar to 100 kb) and showed indistinguishable restriction fragment length polymorphism (RFLP) patterns except those from the ST340 isolates. Sequences flanking bla(KPC-2) revealed that the Tn4401a isoform was present in plasmids from all STs except ST340 containing Tn4401b. Co-production of VIM enzymes was observed in isolates of ST147, ST323 and ST383.
Conclusions: Apart from the epidemic of KPC-2-producing K. pneumoniae belonging to ST258 in Greece, diffusion of bla(KPC-2) to at least 10 additional STs has taken place. Notably, strains from three of the latter STs (147, 323 and 383) were found to carry both bla(KPC-2) and bla(VIM).

• 出版日期2011-7