title: Klebsiella pneumoniae Isolate from a New York City Hospital Belonging to Sequence Type 258 and Carrying blaKPC-2 and blaVIM-4.
abstract: Among 69 of 139 (49.6%) carbapenem-nonsusceptible Enterobacteriaceae carrying blaKPC, 1 Klebsiella pneumoniae was also positive for blaVIM. The isolate belonged to sequence type 258 (ST258) and carried blaKPC-2 on a copy of Tn4401a and blaVIM-4 on a class 1 integron. Genes were located on distinct plasmids belonging to Inc types A/C and FII. Elevated expression of the efflux pump AcrAB-TolC (acrA, 15.3 times) and reduced expression of outer membrane protein genes ompK35 and ompK37 (0.16 and 0.081 times, respectively) associated with various amino acid alterations on OmpK37 were observed. The presence of two carbapenemases in ST258 K. pneumoniae is of great concern due to the ability of this organism to widely disseminate.
authors.affiliation: JMI Laboratories, North Liberty, Iowa, USA mariana-castanheira@jmilabs.com.
authors.forename: Mariana
authors.initials: M
authors.lastname: Castanheira
authors.affiliation: JMI Laboratories, North Liberty, Iowa, USA.
authors.forename: Lalitagauri M
authors.initials: LM
authors.lastname: Deshpande
authors.affiliation: JMI Laboratories, North Liberty, Iowa, USA.
authors.forename: Janet C
authors.initials: JC
authors.lastname: Mills
authors.affiliation: JMI Laboratories, North Liberty, Iowa, USA Tufts University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Jones
authors.affiliation: Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Soave
authors.affiliation: Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Jenkins
authors.affiliation: Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, New York, USA.
authors.forename: Audrey N
authors.initials: AN
authors.lastname: Schuetz
mesh_terms: D000328:Adult; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000235:genetics; D015780:Carbapenems / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D026901:Membrane Transport Proteins / Q000235:genetics; D008826:Microbial Sensitivity Tests; D009519:New York City; D010957:Plasmids / Q000235:genetics; D018272:Porins / Q000096:biosynthesis / Q000235:genetics; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D015780:Carbapenems; D026901:Membrane Transport Proteins; C119261:OmpK35 porin, Klebsiella pneumoniae; C118791:OmpK37 protein, Klebsiella pneumoniae; D018272:Porins; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases; C482458:metallo-beta-lactamase VIM-4, Klebsiella pneumoniae