title: CTX-M β-lactamase-producing Klebsiella pneumoniae in suburban New York City, New York, USA.
abstract: CTX-M extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae isolates are infrequently reported in the United States. In this study, we analyzed nonduplicate ESBL-producing K. pneumoniae and Escherichia coli clinical isolates collected during 2005-2012 at a tertiary care medical center in suburban New York City, USA, for the presence of blaCTX-M, blaSHV, blaTEM, and blaKPC genes. Despite a high prevalence of blaCTX-M genes in ESBL-producing E. coli since 2005, blaCTX-M genes were not detected in K. pneumoniae until 2009. The prevalence of CTX-M-producing K. pneumoniae increased significantly over time from 1.7% during 2005-2009 to 26.4% during 2010-2012 (p<0.0001). CTX-M-15 was the dominant CTX-M genotype. Pulsed-field gel electrophoresis and multilocus sequence typing revealed high genetic heterogeneities in CTX-M-producing K. pneumoniae isolates. This study demonstrates the recent emergence and polyclonal spread of multidrug resistant CTX-M-producing K. pneumoniae isolates among patients in a hospital setting in the United States.
authors.forename: Guiqing
authors.initials: G
authors.lastname: Wang
authors.forename: Tiangui
authors.initials: T
authors.lastname: Huang
authors.forename: Pavan Kumar Makam
authors.initials: PK
authors.lastname: Surendraiah
authors.forename: Kemeng
authors.initials: K
authors.lastname: Wang
authors.forename: Rashida
authors.initials: R
authors.lastname: Komal
authors.forename: Jian
authors.initials: J
authors.lastname: Zhuge
authors.forename: Chian-Ru
authors.initials: CR
authors.lastname: Chern
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Kryszuk
authors.forename: Cassidy
authors.initials: C
authors.lastname: King
authors.forename: Gary P
authors.initials: GP
authors.lastname: Wormser
mesh_terms: D000328:Adult; D000368:Aged; D004926:Escherichia coli / Q000145:classification / Q000235:genetics / Q000378:metabolism; D005260:Female; D005838:Genotype; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000378:metabolism*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D009519:New York City / Q000453:epidemiology; D010802:Phylogeny; D015995:Prevalence; D013383:Suburban Population; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D001618:beta-Lactamases
keywords: Escherichia coli; Klebsiella pneumoniae; antimicrobial resistance; bacteria; beta-lactamases CTX-M-15; extended-spectrum beta-lactamases; multilocus sequence typing; pulsed-field gel electrophoresis