title: Microbiological features of KPC-producing Enterobacter isolates identified in a U.S. hospital system.
abstract: Microbiological data regarding Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacter spp. are scarce. In this study, 11 unique KPC-producing Enterobacter isolates were identified among 44 ertapenem-nonsusceptible Enterobacter isolates collected between 2009 and 2013 at a hospital system in Western Pennsylvania. All cases were healthcare-associated and occurred in medically complex patients. While pulsed-field gel electrophoresis showed diverse restriction patterns overall, multilocus sequence typing identified Enterobacter cloacae isolates with sequence types 93 and 171 from 2 hospitals each. The levels of carbapenem minimum inhibitory concentrations were highly variable. All isolates remained susceptible to colistin and tigecycline, and the majority, to amikacin and doxycycline. A blaKPC-carrying IncN plasmid conferring trimethoprim-sulfamethoxazole resistance was identified in 3 of the isolates. Spread of blaKPC in Enterobacter spp. appears to be due to a combination of plasmid-mediated and clonal processes.
authors: Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors: Chulsoo
authors: C
authors: Ahn
authors: Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors: Alveena
authors: A
authors: Syed
authors: Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China; Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, China.
authors: Fupin
authors: F
authors: Hu
authors: Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors: Jessica A
authors: JA
authors: O'Hara
authors: Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors: Jesabel I
authors: JI
authors: Rivera
authors: Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: yod4@pitt.edu.
authors: Yohei
authors: Y
authors: Doi
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000378:metabolism*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D016972:Enterobacter cloacae / Q000145:classification* / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D000077727:Ertapenem; D005260:Female; D005838:Genotype; D006761:Hospitals; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D010414:Pennsylvania / Q000453:epidemiology; D010957:Plasmids / Q000032:analysis; D055815:Young Adult; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D047090:beta-Lactams; D001618:beta-Lactamases; C063912:carbapenemase; D000077727:Ertapenem
keywords: Enterobacter aerogenes; Enterobacter cloacae; Klebsiella pneumoniae carbapenemease