title: Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital.
abstract: We investigated the molecular epidemiology of extended spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae isolates derived from the teaching hospitals of University of Pécs, Pécs, Hungary in the time period 2004-2008. Molecular typing, antimicrobial susceptibility testing, detection of common β-lactamase genes (bla(CTX-M), bla(TEM) and bla(SHV)) and virulence associated traits (hypermucoviscosity, magA, k2a, rmpA, siderophores, type 1 and 3 fimbria, biofilm formation, serum resistance) were performed for 102 isolates. The results showed the presence of three major ciprofloxacin resistant CTX-M-15 producing clones (ST15 n = 69, ST101 n = 10, and ST147 n = 9), of which ST15 was predominant and universally widespread. Considering distribution in time and place, ST101 and ST147 were detected at fewer inpatient units and within a narrower time frame, as compared to ST15. Beside major clones, eleven minor clones were identified, and were shown to harbour the following β-lactamase genes: six clones carried bla(CTX-M), four clones harboured bla(SHV-5) and one clone possessed both bla(CTX-M) and ESBL type bla(SHV). Among the SHV-5 producing K. pneumoniae clones a novel sequence type was found, namely ST1193, which harboured a unique infB allele. Different virulence factor content and peculiar antimicrobial susceptibility profile were characteristic for each clone. In contrast to major clone isolates, which showed high level resistance to ciprofloxacin, minor clone isolates displayed significantly lower MIC values for ciprofloxacin suggesting a role for fluoroquinolones in the dissemination of the major K. pneumoniae clones. This is the first description of the CTX-M-15 producing K. pneumoniae clone ST101 in Hungary.
authors.affiliation: Department of Medical Microbiology and Immunology, Clinical Centre, University of Pécs , Pécs , Hungary.
authors.forename: Szilvia
authors.initials: S
authors.lastname: Melegh
authors.affiliation: Department of Medical Microbiology and Immunology, Clinical Centre, University of Pécs , Pécs , Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Schneider
authors.affiliation: Department of Medical Microbiology and Immunology, Clinical Centre, University of Pécs , Pécs , Hungary.
authors.forename: Marianna
authors.initials: M
authors.lastname: Horváth
authors.affiliation: Virological Research Group, Szentágothai Research Centre, University of Pécs , Pécs , Hungary.|Institute of Biology, Faculty of Sciences, University of Pécs , Pécs , Hungary.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Jakab
authors.affiliation: Department of Medical Microbiology and Immunology, Clinical Centre, University of Pécs , Pécs , Hungary.|Institute for Veterinary Medical Research, Centre for Agricultural Research, Hungarian Academy of Sciences , Budapest , Hungary.
authors.forename: Levente
authors.initials: L
authors.lastname: Emődy
authors.affiliation: Department of Medical Microbiology and Immunology, Clinical Centre, University of Pécs , Pécs , Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Tigyi
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D024901:Drug Resistance, Multiple, Bacterial; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D006814:Hungary; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D058889:Molecular Typing; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases
keywords: ESBL; K. pneumoniae; ST101; ST1193; virulence