Dissemination of Carbapenem-resistant Klebsiella pneumoniae clinical isolates with various combinations of Carbapenemases

• Published in: BMC infectious diseases 2017-07, Vol.17 (1)
• Main Authors: Tada, Tatsuya, Tsuchiya, Mitsuhiro, Shimada, Kayo, Nga, Tran Thi Thanh, Thu, Le Thi Anh, Phu, Truong Thien, Ohmagari, Norio, Kirikae, Teruo
• Format: Article
• Language: English
• Subjects: Genetic aspects; Klebsiella infections; Ribosomal RNA; Risk factors
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-017-2570-y

Twenty-seven clinical isolates of carbapenem-resistant Klebsiella pneumoniae with MICs [greater than or equai to]4 mg/L for imipenem or meropenem were obtained from inpatients in a hospital in Vietnam. Antimicrobial susceptibility tests and whole genome sequencing were performed. Multilocus sequence typing and the presence of drug resistant genes were determined and a maximum-likelihood phylogenetic tree was constructed by SNP alignment of whole genome sequencing data. All the isolates harbored one of genes encoding carbapenemases, including KPC-2, NDM-1, NDM-4 and OXA-48. Of the isolates, 13 were resistant to arbekacin with MICs [greater than or equai to]256 mg/L and to amikacin with MICs [greater than or equai to]512 mg/L. These isolates harbored a gene encoding a 16S rRNA methylase, either RmtB or RmtC. Eighteen and 4 isolates belonged to international clones, ST15 and ST16, respectively. None of the isolates had colistin-resistant factors. Carbapenem-resistant K. pneumoniae isolates belonged to international clones spread in a medical setting in Vietnam, and that these isolates harbored genes encoding various combinations of carbapenemases and 16S rRNA methylases. This is the first report of KPC-2, NDM-4 and OXA-48 producers in a medical setting in Vietnam.