title: Dissemination of the Klebsiella pneumoniae carbapenemase in the health care settings: tracking the trails of an elusive offender.
abstract: Transmission of antibiotic resistance genes may be mediated by a variety of molecular mechanisms, from mobility of small genetic elements to clonal spread. Since 1997, the carbapenem-hydrolyzing enzyme Klebsiella pneumoniae carbapenemase (KPC) has spread in the United States and across the world, mainly via a single K. pneumoniae clone, sequence type 258. By tracking the trail of dissemination of the bla(KPC) gene inside their institution, Mathers et al. (mBio 2:e00204-11, 2011) have shown evidence of the ability of this gene to spread by several modes, including plasmid transfer and clonal spread. The ever-evolving modes of transmission of resistance genes challenge our ability to detect, track, and eventually control the spread of what has become a major threat to hospitalized patients worldwide.
authors.affiliation: Division of Epidemiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. asmosa@tasmc.health.gov.il
authors.forename: Amos
authors.initials: A
authors.lastname: Adler
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D015780:Carbapenems / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae / Q000201:enzymology*; D008297:Male; D010957:Plasmids / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases