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Adler A, Miller-Roll T, Assous MV, Geffen Y, Paikin S, Schwartz D, Weiner-Well Y, Hussein K, Cohen R, Carmeli Y. A multicenter study of the clonal structure and resistance mechanism of KPC-producing Escherichia coli isolates in Israel. Clin Microbiol Infect 2014; 21:230-5. [PMID: 25658543 DOI: 10.1016/j.cmi.2014.10.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 10/03/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
Abstract
Little is known about the molecular epidemiology of Klebsiella pneumoniae carbapenemase-producing Escherichia coli (KPCEC). We aimed to describe the clonal structure and resistance mechanisms of KPCEC in a multicenter study. The study included 88 isolates from four medical centres in Israel: Tel Aviv Medical Center (n = 17), Laniado Medical Center (n = 12), Sha'are-Zedek Medical Center (n = 38), and Rambam Medical Center (n = 21). Twelve (14%) KPCEC were from clinical sites and 86% from surveillance cultures. The clonal structure was studied by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) and was highly diverse, with 79 and 45 different PFGE types and STs, respectively. The most common clones were ST-131 and ST-410, identified in 21 isolates (23%). Dominant clonal complexes (CCs) were CC131 (n = 16), CC410 (n = 14), CC10 (n = 17), and CC-69 (n = 6). The blaKPC-2 and blaKPC-3 genes were identified in 68 and 20 isolates, respectively. All isolates were non-susceptible to ertapenem; 16 (18%) and 35 (40%) isolates were susceptible (minimal inhibitory concentration ≤1 mg/L) to imipenem and meropenem, respectively. Isolates were susceptible to colistin, amikacin, ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole in 100%, 87%, 28%, 27%, and 21% of the cases, respectively. blaKPC-Harbouring plasmids from Tel Aviv Medical Center as well as from six CC-131 isolates from the other centres were studied by Inc and pMLST typing. Sixteen of the 20 blaKPC2-harbouring plasmids were of identical type, IncN-pMLST ST-15. In conclusion, the clonal structure of KPCEC in Israel is characterized by the predominance of known international extended-spectrum β-lactamase-producing clones and by high intra- and inter-institutional diversity. This suggests that in Israel, clonal spread does not play a major role in the dissemination of KPCEC.
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Affiliation(s)
- A Adler
- National Center for Infection Control, Ministry of Health, Tel Aviv, Israel; Division of Epidemiology, Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - T Miller-Roll
- National Center for Infection Control, Ministry of Health, Tel Aviv, Israel; Division of Epidemiology, Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M V Assous
- Microbiology and Immunology Laboratory, Sha'are-Zedek Medical Center, Jerusalem, Israel
| | - Y Geffen
- Microbiology Laboratory, Rambam Medical Center, Haifa, Israel
| | - S Paikin
- Division of Laboratories, Laniado Medical Center, Netanya, Israel
| | - D Schwartz
- Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Y Weiner-Well
- Section of Infectious Diseases, Shaare-Zedek Medical Center, Jerusalem, Israel
| | - K Hussein
- Section of Infectious Diseases, Rambam Medical Center, Haifa, Israel
| | - R Cohen
- Section of Infectious Diseases, Laniado Medical Center, Netanya, affiliated with the Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Y Carmeli
- National Center for Infection Control, Ministry of Health, Tel Aviv, Israel; Division of Epidemiology, Tel Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Adler A, Assous MV, Paikin S, Shulman A, Miller-Roll T, Hillel S, Aronov R, Carmeli Y, Schwaber MJ. Emergence of VIM-producing Aeromonas caviae in Israeli hospitals. J Antimicrob Chemother 2014; 69:1211-4. [DOI: 10.1093/jac/dkt505] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Geffen Y, Adler A, Paikin S, Khabra E, Gorenshtein S, Aronov R, Carmeli Y. Detection of the plasmid-mediated KPC-2 carbapenem-hydrolysing enzyme in three unusual species of the Enterobacteriaceae family in Israel. J Antimicrob Chemother 2012; 68:719-20. [DOI: 10.1093/jac/dks443] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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