title: Emergence of Klebsiella pneumoniae clinical isolates producing KPC-2 carbapenemase in Cuba.
abstract: The emergence of Klebsiella pneumoniae producing carbapenemase (KPC) has now become a global concern. As a part of a nationwide multicentre surveillance study in Cuba, three K. pneumoniae clinical isolates resistant to carbapenems were detected for a 1-month period (September to October 2011). PCR and sequence analysis revealed that the three strains harboured bla KPC-2. They showed resistance or intermediate susceptibility to expanded-spectrum cephalosporins, other β-lactams, a β-lactam/β-lactamase inhibitor combination, and gentamicin. Two strains were susceptible only to colistin, whereas the other strain showing colistin resistance was susceptible to fluoroquinolones. These bla KPC -2-positive K. pneumoniae strains were classified into ST1271 (CC29), a novel clone harbouring bla KPC -2, and were revealed to be genetically identical by PCR-based DNA fingerprinting. The three patients infected with the KPC-producing K. pneumoniae had common risk factors, and had no overseas travel experience outside Cuba, suggesting local acquisition of the resistant pathogen. This is the first report of a KPC-producing K. pneumoniae in Cuba. Although detection of KPC in Enterobacteriaceae is still rare in Cuba, our finding indicated that KPC-producing bacteria are a global concern and highlighted the need to identify these microorganisms in clinical laboratories.
authors.affiliation: Servicio de Bacteriología-Micología, Instituto de Medicina Tropical Pedro Kourí La Habana, Cuba.
authors.forename: D
authors.initials: D
authors.lastname: Quiñones
authors.affiliation: Hospital 'Hermanos Ameijeiras' La Habana, Cuba.
authors.forename: M
authors.initials: M
authors.lastname: Hart
authors.affiliation: Hospital 'Hermanos Ameijeiras' La Habana, Cuba.
authors.forename: F
authors.initials: F
authors.lastname: Espinosa
authors.affiliation: Hospital 'V. I. Lenin' Holguín, Cuba.
authors.forename: S
authors.initials: S
authors.lastname: Garcia
authors.affiliation: Servicio de Bacteriología-Micología, Instituto de Medicina Tropical Pedro Kourí La Habana, Cuba.
authors.forename: Y
authors.initials: Y
authors.lastname: Carmona
authors.affiliation: Department of Hygiene, Sapporo Medical University School of Medicine Sapporo, Japan ; Department of Biomedical Sciences, Ross University School of Veterinary Medicine St. Kitts, West Indies.
authors.forename: S
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Hygiene, Sapporo Medical University School of Medicine Sapporo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Urushibara
authors.affiliation: Department of Hygiene, Sapporo Medical University School of Medicine Sapporo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kawaguchiya
authors.affiliation: Department of Hygiene, Sapporo Medical University School of Medicine Sapporo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kobayashi
keywords: Clinical isolates; Cuba; Klebsiella pneumoniae producing carbapenemase; multilocus sequence typing