title: Risk Factors and Outcomes for Carbapenem-Resistant Klebsiella pneumoniae Isolation, Stratified by Its Multilocus Sequence Typing: ST258 Versus Non-ST258.
abstract: A "high risk" clone of carbapenem-resistant Klebsiella pneumoniae (CRKP) identified by multilocus sequence typing (MLST) as sequence type (ST) 258 has disseminated worldwide. As the molecular epidemiology of the CRE pandemic continues to evolve, the clinical impact of non-ST258 strains is less well defined. We conducted an epidemiological investigation of CRKP based on strains MLST. Among 68 CRKP patients, 61 were ST258 and 7 belonged to non-ST258. Klebsiella pneumoniae ST258 strains were significantly associated with bla KPC production and with resistance to an increased number of antimicrobials. Clinical outcomes were not different. Based on this analysis, one cannot rely solely on the presence of bla KPC in order to diagnose CRKP.
authors.affiliation: Department of Medicine, Division of Infectious Diseases , Wayne State University , Detroit, Michigan.
authors.forename: Sorabh
authors.initials: S
authors.lastname: Dhar
authors.affiliation: Department of Epidemiology , University of Michigan School of Public Health , Detroit.
authors.forename: Emily T
authors.initials: ET
authors.lastname: Martin
authors.affiliation: Department of Clinical Microbiology , Detroit Medical Center, Wayne State University , Michigan.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Lephart
authors.affiliation: Department of Epidemiology , University of Michigan School of Public Health , Detroit.
authors.forename: John P
authors.initials: JP
authors.lastname: McRoberts
authors.affiliation: Department of Medicine, Division of Infectious Diseases , Wayne State University , Detroit, Michigan.
authors.forename: Teena
authors.initials: T
authors.lastname: Chopra
authors.affiliation: Department of Clinical Microbiology , Detroit Medical Center, Wayne State University , Michigan.
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Burger
authors.affiliation: Sackler School of Medicine , Tel-Aviv University.
authors.forename: Ruthy
authors.initials: R
authors.lastname: Tal-Jasper
authors.affiliation: Department of Medicine, Division of Infectious Diseases , Wayne State University , Detroit, Michigan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Hayakawa
authors.affiliation: Division of Infectious Diseases , Assaf Harofeh Medical Center.
authors.forename: Hadas
authors.initials: H
authors.lastname: Ofer-Friedman
authors.affiliation: Department of Clinical Microbiology , Assaf Harofeh Medical Center , Zerifin , Israel.
authors.forename: Tsilia
authors.initials: T
authors.lastname: Lazarovitch
authors.affiliation: Division of Infectious Diseases , Assaf Harofeh Medical Center.
authors.forename: Ronit
authors.initials: R
authors.lastname: Zaidenstein
authors.affiliation: Research Service, Case Western Reserve University, Cleveland; VISN 10 Geriatric Research, Education, and Clinical Center (GRECC) at Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Case Western Reserve University.
authors.forename: Federico
authors.initials: F
authors.lastname: Perez
authors.affiliation: Research Service, Case Western Reserve University, Cleveland; VISN 10 Geriatric Research, Education, and Clinical Center (GRECC) at Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Case Western Reserve University; Departments ofMedicine; Pharmacology; Molecular Biology and Microbiology, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bonomo
authors.affiliation: Department of Medicine, Division of Infectious Diseases , Wayne State University , Detroit, Michigan.
authors.forename: Keith S
authors.initials: KS
authors.lastname: Kaye
authors.affiliation: Sackler School of Medicine, Tel-Aviv University; Division of Infectious Diseases, Assaf Harofeh Medical Center.
authors.forename: Dror
authors.initials: D
authors.lastname: Marchaim
keywords: CRE; KPC; MDRO; outcome; risk factors