Molecular characterization of Klebsiella pneumoniae carbapenemase- producing K. pneumoniae (KPC-Kp) isolates recovered from a neurovascular surgical center.

MONTAÑA S; PENINI M; RAMIREZ MS; HERNANDEZ M; CENTRON D; FERNANDEZ J S; SUCARI A

Congreso; ASM Microbe 2018; 2018

American society for microbiology

Background: It is well known that Carbapenem resistant Enterobacteriaceae (CRE) is a growing concern worldwide. Klebsiella pneumoniae carbapenemases (KPC) are the most frequent carbapenemases found in K. pneumoniae and in many others members of the family Enterobacteriaceae. Since blaKPC-2 gene is mostly plasmid encoded and is typically in a Tn4401-like transposon, the capacity of disseminating among K. pneumoniae and in Gram-negative genera is a major concern. Here we present the molecular characterization of carbapenemase- producing K. pneumoniae (KPC-Kp) isolates recovered from a neurovascular surgical center. Methods: A total of 22 KPC-Kp isolates were recovered from a variety of samples during 2014-2016. Among them, we randomly selected five isolates to further investigate. The presence of blaKPC gene and the genetic context was studied by PCR reaction and sequence analysis. Clonal relatedness was determined by ERIC and REP-PCR. Conjugation assay was performed to determine if blaKPC-2 was plasmid located. Results: All the studied isolates harbored blaKPC-2. PCR reaction revealed the presence of two different contexts among the isolates. In only one isolate the blaKPC-2 gene was flanked by an incomplete ISKpn6 downstream and an incomplete blaTEM-1 upstream, also upstream of this last gene an ISKpn8 was found. The other four isolates present the blaKPC-2 gene flanked by a complete ISKpn6 downstream and an incomplete blaTEM-1 upstream. Upstream of ∆ blaTEM-1 an ISkpn7 and ISkpn8 were found. The ERIC and REP- PCR exposed the presence of three different cluster. Positive results were obtained in the conjugation assay. Conclusion: In this work we present KPC-Kp isolates harboring blaKPC-2 in a variety of non-described mobile genetic contexts. This work highlights the genetic variability among KPC-Kp isolates. In addition, the early detection and characterization of these resistance elements are extremely important to avoid their dissemination and consequent treatment failures.