title: IMP-producing carbapenem-resistant Klebsiella pneumoniae in the United States.
abstract: The emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) producing acquired carbapenemases have created a global public health crisis. In the United States, CRE producing the Klebsiella pneumoniae carbapenemase (KPC) are increasingly common and are endemic in some regions. Metallo-β-lactamase (MBL)-producing CRE have recently been reported in the United States among patients who received medical care in countries where such organisms are common. Here, we describe three carbapenem-resistant K. pneumoniae isolates recovered from pediatric patients at a single U.S. health care facility, none of whom had a history of international travel. The isolates were resistant to carbapenems but susceptible to aztreonam, trimethoprim-sulfamethoxazole, and fluoroquinolones. The three isolates were closely related to each other by pulsed-field gel electrophoresis and contained a common plasmid. PCR and sequence analysis confirmed that these isolates produce IMP-4, an MBL carbapenemase not previously published as present among Enterobacteriaceae in the United States.
authors: Centers for Disease Control and Prevention, 1600 Clifton Rd. N.E., MS C16, Atlanta, GA 30329, USA. blimbago@cdc.gov
authors: Brandi M
authors: BM
authors: Limbago
authors: J Kamile
authors: JK
authors: Rasheed
authors: Karen F
authors: KF
authors: Anderson
authors: Wenming
authors: W
authors: Zhu
authors: Brandon
authors: B
authors: Kitchel
authors: Nancy
authors: N
authors: Watz
authors: Susan
authors: S
authors: Munro
authors: Hayley
authors: H
authors: Gans
authors: Niaz
authors: N
authors: Banaei
authors: Alex J
authors: AJ
authors: Kallen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D015780:Carbapenems / Q000494:pharmacology*; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D008297:Male; D058889:Molecular Typing; D010957:Plasmids / Q000032:analysis; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014481:United States; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D004269:DNA, Bacterial; D001618:beta-Lactamases; C063912:carbapenemase