Prevalence and mechanisms of decreased susceptibility to carbapenems in Klebsiella pneumoniae isolates

Soo Young Kim; Yeon Joon Park; Jin Kyung Yu; Han Sik Kim; Yong Sung Park; Jong Bok Yoon; Jin Young Yoo; Kyungwon Lee

doi:10.1016/j.diagmicrobio.2006.05.008

Prevalence and mechanisms of decreased susceptibility to carbapenems in Klebsiella pneumoniae isolates

Soo Young Kim, Yeon Joon Park, Jin Kyung Yu, Han Sik Kim, Yong Sung Park, Jong Bok Yoon, Jin Young Yoo, Kyungwon Lee

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Abstract

In this study, we examined the prevalence of and mechanisms of decreased susceptibility to either imipenem or meropenem in Klebsiella pneumoniae isolates. A total of 230 clinical isolates of K. pneumoniae were collected from 13 clinical laboratories from a nationwide distribution. The MICs of imipenem and meropenem were determined by the agar dilution method. To characterize the isolates with decreased susceptibility to carbapenems (MICs of >2 μg/mL), we performed polymerase chain reaction amplification of a variety of β-lactamase genes, isoelectric focusing, and outer membrane profile analysis using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and mass spectrometry. Three isolates (BD6, BD8, and KN16) exhibited decreased susceptibility to carbapenems with imipenem MICs of 1, 4, and 8 μg/mL and meropenem MICs of 4, 8, and 4, respectively. Isolate BD6 produced bla_TEM-1, bla_SHV-12, and bla_OXA-17; isolate BD8 produced bla_GES-3, bla_SHV-12, and bla_OXA-17; and isolate KN16 produced bla_TEM-11, bla_SHV-12, and bla_DHA-1. In all the 3 isolates, OmpK35 porin was not expressed, and in 1 isolate (KN16), OmpK36 was not expressed either. The prevalence of decreased susceptibility to carbapenems was low (1.3%), and none of them showed overt resistance to carbapenems. Decreased susceptibility to carbapenems can occur in K. pneumoniae when bla_GES-3, bla_TEM-11, bla_SHV-12, bla_OXA-17, and/or bla_DHA-1 are produced in combination with porin loss. In addition, to our knowledge, this is the 1st report of bla_OXA-17 in Enterobacteriaceae.

Original language	English
Pages (from-to)	85-91
Number of pages	7
Journal	Diagnostic Microbiology and Infectious Disease
Volume	57
Issue number	1
DOIs	https://doi.org/10.1016/j.diagmicrobio.2006.05.008
Publication status	Published - 2007 Jan

Bibliographical note

Funding Information:
This study was supported by a Korea Research Foundation grant (2004-007053) and by a research fund of St. Vincent's Hospital, Suwon, South Korea. The authors thank all the contributing laboratories that provided isolates for this study and J.J. Park in our laboratory for excellent technical assistance.

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Microbiology (medical)
Infectious Diseases

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10.1016/j.diagmicrobio.2006.05.008

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title = "Prevalence and mechanisms of decreased susceptibility to carbapenems in Klebsiella pneumoniae isolates",

abstract = "In this study, we examined the prevalence of and mechanisms of decreased susceptibility to either imipenem or meropenem in Klebsiella pneumoniae isolates. A total of 230 clinical isolates of K. pneumoniae were collected from 13 clinical laboratories from a nationwide distribution. The MICs of imipenem and meropenem were determined by the agar dilution method. To characterize the isolates with decreased susceptibility to carbapenems (MICs of >2 μg/mL), we performed polymerase chain reaction amplification of a variety of β-lactamase genes, isoelectric focusing, and outer membrane profile analysis using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and mass spectrometry. Three isolates (BD6, BD8, and KN16) exhibited decreased susceptibility to carbapenems with imipenem MICs of 1, 4, and 8 μg/mL and meropenem MICs of 4, 8, and 4, respectively. Isolate BD6 produced blaTEM-1, blaSHV-12, and blaOXA-17; isolate BD8 produced blaGES-3, blaSHV-12, and blaOXA-17; and isolate KN16 produced blaTEM-11, blaSHV-12, and blaDHA-1. In all the 3 isolates, OmpK35 porin was not expressed, and in 1 isolate (KN16), OmpK36 was not expressed either. The prevalence of decreased susceptibility to carbapenems was low (1.3%), and none of them showed overt resistance to carbapenems. Decreased susceptibility to carbapenems can occur in K. pneumoniae when blaGES-3, blaTEM-11, blaSHV-12, blaOXA-17, and/or blaDHA-1 are produced in combination with porin loss. In addition, to our knowledge, this is the 1st report of blaOXA-17 in Enterobacteriaceae.",

author = "Kim, {Soo Young} and Park, {Yeon Joon} and Yu, {Jin Kyung} and Kim, {Han Sik} and Park, {Yong Sung} and Yoon, {Jong Bok} and Yoo, {Jin Young} and Kyungwon Lee",

note = "Funding Information: This study was supported by a Korea Research Foundation grant (2004-007053) and by a research fund of St. Vincent's Hospital, Suwon, South Korea. The authors thank all the contributing laboratories that provided isolates for this study and J.J. Park in our laboratory for excellent technical assistance.",

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AU - Kim, Soo Young

AU - Park, Yeon Joon

AU - Yu, Jin Kyung

AU - Kim, Han Sik

AU - Park, Yong Sung

AU - Yoon, Jong Bok

AU - Yoo, Jin Young

AU - Lee, Kyungwon

N1 - Funding Information: This study was supported by a Korea Research Foundation grant (2004-007053) and by a research fund of St. Vincent's Hospital, Suwon, South Korea. The authors thank all the contributing laboratories that provided isolates for this study and J.J. Park in our laboratory for excellent technical assistance.

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N2 - In this study, we examined the prevalence of and mechanisms of decreased susceptibility to either imipenem or meropenem in Klebsiella pneumoniae isolates. A total of 230 clinical isolates of K. pneumoniae were collected from 13 clinical laboratories from a nationwide distribution. The MICs of imipenem and meropenem were determined by the agar dilution method. To characterize the isolates with decreased susceptibility to carbapenems (MICs of >2 μg/mL), we performed polymerase chain reaction amplification of a variety of β-lactamase genes, isoelectric focusing, and outer membrane profile analysis using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and mass spectrometry. Three isolates (BD6, BD8, and KN16) exhibited decreased susceptibility to carbapenems with imipenem MICs of 1, 4, and 8 μg/mL and meropenem MICs of 4, 8, and 4, respectively. Isolate BD6 produced blaTEM-1, blaSHV-12, and blaOXA-17; isolate BD8 produced blaGES-3, blaSHV-12, and blaOXA-17; and isolate KN16 produced blaTEM-11, blaSHV-12, and blaDHA-1. In all the 3 isolates, OmpK35 porin was not expressed, and in 1 isolate (KN16), OmpK36 was not expressed either. The prevalence of decreased susceptibility to carbapenems was low (1.3%), and none of them showed overt resistance to carbapenems. Decreased susceptibility to carbapenems can occur in K. pneumoniae when blaGES-3, blaTEM-11, blaSHV-12, blaOXA-17, and/or blaDHA-1 are produced in combination with porin loss. In addition, to our knowledge, this is the 1st report of blaOXA-17 in Enterobacteriaceae.

AB - In this study, we examined the prevalence of and mechanisms of decreased susceptibility to either imipenem or meropenem in Klebsiella pneumoniae isolates. A total of 230 clinical isolates of K. pneumoniae were collected from 13 clinical laboratories from a nationwide distribution. The MICs of imipenem and meropenem were determined by the agar dilution method. To characterize the isolates with decreased susceptibility to carbapenems (MICs of >2 μg/mL), we performed polymerase chain reaction amplification of a variety of β-lactamase genes, isoelectric focusing, and outer membrane profile analysis using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and mass spectrometry. Three isolates (BD6, BD8, and KN16) exhibited decreased susceptibility to carbapenems with imipenem MICs of 1, 4, and 8 μg/mL and meropenem MICs of 4, 8, and 4, respectively. Isolate BD6 produced blaTEM-1, blaSHV-12, and blaOXA-17; isolate BD8 produced blaGES-3, blaSHV-12, and blaOXA-17; and isolate KN16 produced blaTEM-11, blaSHV-12, and blaDHA-1. In all the 3 isolates, OmpK35 porin was not expressed, and in 1 isolate (KN16), OmpK36 was not expressed either. The prevalence of decreased susceptibility to carbapenems was low (1.3%), and none of them showed overt resistance to carbapenems. Decreased susceptibility to carbapenems can occur in K. pneumoniae when blaGES-3, blaTEM-11, blaSHV-12, blaOXA-17, and/or blaDHA-1 are produced in combination with porin loss. In addition, to our knowledge, this is the 1st report of blaOXA-17 in Enterobacteriaceae.

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Prevalence and mechanisms of decreased susceptibility to carbapenems in Klebsiella pneumoniae isolates

Abstract

Bibliographical note

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