title: Rapid expansion of KPC-2-producing Klebsiella pneumoniae isolates in two Texas hospitals due to clonal spread of ST258 and ST307 lineages.
abstract: During 2007 to 2010, 23 carbapenem-resistant Enterobacteriaceae strains were recovered in two hospitals in Texas among three institutions surveyed. Eighteen (2.0% overall) strains carried bla(KPC-2) and were collected in 2008 (3/150; 2.0%) and 2010 (15/289; 5.1%). Clonality was noted within hospitals and ten isolates belonged to ST258. All strains carried bla(KPC-2) on plasmids and 14 had this gene embedded in Tn4401a. Tn3 transposase was detected upstream of bla(KPC-2) in two isolates and another strain had two adjacent copies of bla(KPC). Surveillance in prior years shows sporadic detection of KPC-producers in Texas, however, a recent increase in carbapenem-resistant Enterobacteriaceae in this state was due to the spread of KPC-producing Klebsiella pneumoniae, including isolates from ST258.
authors.affiliation: JMI Laboratories, North Liberty, Iowa 52317, USA. mariana-castanheira@jmilabs.com
authors.forename: Mariana
authors.initials: M
authors.lastname: Castanheira
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Farrell
authors.forename: Audrey
authors.initials: A
authors.lastname: Wanger
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Rolston
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
authors.forename: Rodrigo E
authors.initials: RE
authors.lastname: Mendes
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010957:Plasmids; D017422:Sequence Analysis, DNA; D013781:Texas / Q000453:epidemiology; D018440:beta-Lactam Resistance / Q000187:drug effects / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases; C547585:beta-lactamase KPC-2, Klebsiella pneumoniae