title: Characterisation of the first ongoing outbreak due to KPC-3-producing Klebsiella pneumoniae (ST512) in Spain.
abstract: The aim of this study was to characterise carbapenem-resistant Klebsiella pneumoniae isolates that caused an outbreak in a hospital in the south of Spain, originating from a patient transferred in 2012 from Italy. Forty-four K. pneumoniae isolates, recovered from 28 patients, were screened by PCR for extended-spectrum β-lactamase (ESBL) and carbapenemase genes and the products were further sequenced. Plasmids were transferred by electroporation and were classified using PCR-based Inc/rep typing and IncF subtyping. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were used to determine the genetic relatedness of the isolates. All isolates yielded positive modified Hodge test results, harboured bla(SHV-11), bla(TEM-1) and bla(KPC-3) genes, showed an identical PFGE pattern, and were assigned to clone sequence type 512 (ST512). The bla(KPC-3) gene was located on a 140-kb K2:A-:B-plasmid. In conclusion, the successful K. pneumoniae ST512 clone caused a major outbreak in Spain from an imported case and is the first description of an outbreak in this country due to the KPC-3-producing K. pneumoniae ST512 clone.
authors.affiliation: Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain. Electronic address: llopez@us.es.
authors.forename: Lorena
authors.initials: L
authors.lastname: López-Cerero
authors.affiliation: Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Egea
authors.affiliation: Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Gracia-Ahufinger
authors.affiliation: Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Marcelino
authors.initials: M
authors.lastname: González-Padilla
authors.affiliation: Hospital Universitario Reina Sofía, Córdoba, Spain; Department of Microbiology, University of Córdoba, Córdoba, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-López
authors.affiliation: Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Rodríguez-Baño
authors.affiliation: Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain; Department of Microbiology, University of Seville, Seville, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000235:genetics*; D015780:Carbapenems / Q000627:therapeutic use*; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006761:Hospitals; D006801:Humans; D007558:Italy; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D010957:Plasmids / Q000235:genetics; D017422:Sequence Analysis, DNA; D013030:Spain / Q000453:epidemiology; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D004269:DNA, Bacterial; D001618:beta-Lactamases; C495220:beta-lactamase KPC-3, Klebsiella pneumoniae
keywords: KPC-3; Outbreak; ST512