title: Emergence of a colistin-resistant KPC-2-producing Klebsiella pneumoniae ST258 clone in Hungary.
abstract: Nine Klebsiella pneumoniae isolates showing non-susceptibility to carbapenems were collected from three centres in the north-eastern region of Hungary. The minimum inhibitory concentrations (MICs) of antibiotics were determined by Etest. The putative production of a carbapenemase was tested by the modified Hodge test. The presence of bla (KPC) genes was verified by polymerase chain reaction (PCR) and sequencing. Furthermore, molecular typing was performed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). All isolates showed extensively drug-resistant (XDR) phenotype, and of these, eight isolates were highly resistant to colistin. The isolates carried bla (KPC-2), bla (SHV-12), bla (TEM-1) and bla (SHV-11). PFGE analysis of the nine KPC-2-producing Hungarian ST258 K. pneumoniae isolates, two KPC-2-producing Norwegian ST258 isolates and 33 CTX-M-15-producing ST11 isolates revealed the existence of one genetic cluster at an 88% similarity level. The overall results of the PFGE clustering, MLST and the presence of SHV-11 in both ST11 and ST258 suggest that this is the first hyperepidemic clonal complex of multidrug-resistant K. pneumoniae, probably CC258/CC340, possibly undergoing worldwide spread.
authors.affiliation: Department of Bacteriology, National Center for Epidemiology, Gyáli út 2-6, 1097 Budapest, Hungary. toth.akos@oek.antsz.hu
authors.forename: A
authors.initials: A
authors.lastname: Tóth
authors.forename: I
authors.initials: I
authors.lastname: Damjanova
authors.forename: E
authors.initials: E
authors.lastname: Puskás
authors.forename: L
authors.initials: L
authors.lastname: Jánvári
authors.forename: M
authors.initials: M
authors.lastname: Farkas
authors.forename: A
authors.initials: A
authors.lastname: Dobák
authors.forename: K
authors.initials: K
authors.lastname: Böröcz
authors.forename: J
authors.initials: J
authors.lastname: Pászti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000096:biosynthesis* / Q000235:genetics; D015373:Bacterial Typing Techniques; D015780:Carbapenems / Q000494:pharmacology; D016000:Cluster Analysis; D003091:Colistin / Q000494:pharmacology*; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D004269:DNA, Bacterial; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases; D003091:Colistin
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